30% of companies may drop Medical Coverage

[skooldem1]

By Russ Britt, MarketWatch

LOS ANGELES [[MarketWatch) — Once provisions of the Affordable Care Act start to kick in during 2014, at least three of every 10 employers will probably stop offering health coverage, a survey released Monday shows.

for more:

http://www.marketwatch.com/story/firms-halting-coverage-as-reform-starts-survey-2011-06-06

[chidrummer]

That's cool by me. Medical coverage, and retirement savings for that matter, should never have been tied to employers to begin with.

It's going to be a rocking path, but health care in this country needs to be moved far away from profit-motivated insurance companies with an incentive to deny care to a not-for-profit system with an incentive to provide [[especially preventive) care.

Retirement savings should be independent from specific employers all together and people should be educated early enough and properly enough to structure their own retirement saving systems. Then employers would have the option to contribute to, but have no say in the investment choices. The accounts would follow the person throughout their working lives and not a specific employer.

[ms_m]

I side with the CBO and other think tank groups whose research seems to be based on empirical data as oppose to a survey. Survey results vary depending on how the questions are phrased.

I've been taking a closer look at Vermont. They just passed single payer health coverage for their state...maybe it's time to learn how to ski.:cool:

[stephanie]

Vermont passed single payer! Yeah good for them.

[theboyfromxtown]

I'm a Brit and interested in this. What do you guys understand from a "single payer health coverage"?

The UK has a state scheme and supplementary private schemes.

[ms_m]

I'm a Brit and interested in this. What do you guys understand from a "single payer health coverage"?

The UK has a state scheme and supplementary private schemes.

The bill that passed in Vermont would not be anywhere close to what you guys are use to in the UK. Basically, it simply sets up the groundwork to put a program in place. Also keep in mind, Vermont only has about 600k residents in the entire state. You have to start somewhere though and it will be interesting to see how it all pans out in VT.

Sunday, May 15, 2011
SINGLE PAYER IN VERMONT? WELL, NOT EXACTLY

In just a few days, Vermont’s Governor Peter Shumlin will sign into law what the media is calling “single payer health care reform.” But is it?

Vermont has certainly demonstrated more enthusiasm for a single payer approach than any other state. The Governor and key Democratic legislators have supported the concept, the state has a well-organized lobbying group in Vermont for Single Payer, and a state-funded study earlier this year estimated that a single payer approach could dramatically reduce health care costs. The major result has been passage in the past month by both of the state’s legislative chambers of the bill that Governor Shumlin indicates that he will sign.

So does this mean that Vermont is ready to upend its existing health care financing system and replace it with a French or British-style system? Not exactly.

The versions of the bill passed by Vermont’s House and Senate are each far, far more tentative than committed single payer advocates would wish, and have already been subject to scathing criticism by national single payer advocates. The bill provides for the creation of the legal framework of a public insurance program, to be called Green Mountain Care, but includes no funding mechanism, defines no benefit standards, is vague on the future roles of private insurers, and is silent on exactly how existing federal programs are to be incorporated.

What the bill does do is to establish the state exchange required by the Accountable Care Act, encourage experimental capitated payment structures, and create a Board for Green Mountain Care with responsibility for examining funding, benefit, and other issues, with recommendations to be submitted to the state legislature in 2013.

Even if the Board’s proposals are very strongly in favor of a single payer system, they will face some considerable obstacles to implementation.

Because the present bill’s approach to creation of a new system is to allow two years for development of recommendations, any implementing legislation will be delayed until 2013 at the earliest, giving opponents considerable time to organize and fund their fight. At the same time, whatever funding structure the Board recommends will inevitably result in some winners and some losers—who will almost certainly oppose the proposal—even if the net result is a gain for Vermont’s citizens.

While small businesses are expected to get coverage through the state’s planned exchange, and thus could be forced to participate in a future state-controlled single payer plan, larger employers present more of a problem. If a single payer plan could be shown to be less costly, such employers would presumably be willing to participate. If they are not persuaded of the merits of single payer, however, they could rely on ERISA law to keep their employees out of the new program.

The bigger obstacles, however, are likely to be at the federal level. The Accountable Care Act allows states to opt out of federal reform starting in 2017, but not before. [[Although an earlier date has been proposed, it has limited support). The pooling of federal funds envisioned by Vermont’s single payer advocates would require negotiations with Medicare, Medicaid, TRICARE, and Public Health administrators, all in the face of opposition from lobbyists for insurers, providers, and businesses who fear the impacts of a single payer structure on their revenues and profits. And who would be willing to guess whether or not in 2013 the administration in Washington DC is favorable towards any kind of health care reform?
Posted by Roger Collier . at 11:54 AM



Vermont Passes Single-Payer Health Care Bill
May 27, 2011 12:50 PM | 2 Comments | Email to a friend


Vermont Gov. Peter Shumlin signed a bill yesterday authorizing the state to adopt single payer health care - a move some liberals are cheering, saying the state could be a model for single payer on a much larger scale. In 2017 at the earliest,

Vermonters will be guaranteed health care coverage. .In an interview with the International Business Times, Dr. Deborah Richter, M.D. of Vermont Health Care For All [[VTHCA), a Vermont-based non-profit organization, responded to questions about this bill.

QUESTION: Will it cover everyone?
• Richter: That is the intention, to cover every resident of Vermont.
QUESTION: How does it work?
• Richter: Essentially, you no longer need health insurance because it will pay for everyone. Think of it like public schools.
QUESTION: How will it be financed?
• Richter: Vermont residents will pay into the single-payer fund based on their income.
QUESTION: Can Vermont afford it?
• Richter: Total costs are already going up 7 to 8 percent per year, so the [status quo] isn’t affordable. The single-payer health care system puts a budget around health care, so we’ll be spending less in total. There are also efficiencies. We will do health planning. For example, if it looks like we have too many hospital beds for our population, we’ll reduce that number. We will save on administrative costs of having only a single-payer [that health care providers deal with. We will have uniform rates, which mean all providers will be paid the same rate. This will further save administrative costs.
QUESTION: How do you think Vermont lawmakers arrived at the conclusion that it’s affordable?
• Richter: We have an assessment from a Harvard economist who designed the system in Taiwan. The system has a track record of saving money. We have examples around the industrialized world that show us that we, too, can spend less and get better care.
QUESTION: How do you cut down on frivolous hospital visits and waste?
• Richter: Studies have shown that [frivolous visits] happen mostly because people don’t have a primary care doctor. The bill will expand the primary care workforce, which will cut down frivolous visits. Also, people generally don’t enjoy [spending a lot of time in hospitals.
QUESTION: Any further comments?
• Richter: It’s the most fiscally conservative way to cover everybody. I’m amazed people don’t want to embrace this. It’s going to cost less money and give everybody better care.
QUESTION: Can every state do it?
• Richter: Absolutely

[ms_m]

BTW theboyfromxtown, I'm guessing what you call a supplemental private scheme is what we call Cadillac Insurance here in the US. I don't know many middle class folks that can afford it and off the top of my head can't think of anyone personally that has it.

The ACA [[Affordable Care Act) that was passed in congress for the entire country is mandated insurance where by the money is funneled into an exchange to keep the cost of health care down. There would continue to be private insurance companies and physicians. If a state or individual for that matter meets certain guidelines they can opt out.

Here in the the States if your income is below a certain level you can qualify for Medicaid. Medicare is also available under certain circumstances even if you have not reached the age of 65.

The closest thing we have to what you guys have would be health care programs for Veterans....govt hospitals/clinics and govt physicians. These services there have improved dramatically over the years which was not always the case.

[theboyfromxtown]

Thank you. Mrs_M

I hold the view that health and safety should be free of any profit motive....ie private enterprise. The UK has had serious issues with a mixture.

So what happens when the budget has been spent. Is Richter gonna tell the patient that they can't be treated because there's nothing left.

Be forewarned that there are going to be some very hard decisions to take. Here's one in my community. A recent asylum seeker from Somali claiming full social benefits now receives expensive IVF treatment. A pensioner who has paid into the system for 45 years cannot get the best drugs for cancer because they are deemed too expensive.

I hope you don't believe that frivolous visits will reduce, because they won't! They will increase because folk think they now have an entitlement to it and will take as much advantage as possible.

What do you think might happen to those on the fringes of Vermont who just miss out on this service....of course, they will take steps to be included...and that will get bigger and bigger whilst folk who want to move out of the area will still keep their old address etc.

Good luck.....and be prepared to learn of some very greedy folk.

[ms_m]

theboyfromxtown, the cost of health insurance here in the States is astronomical and getting higher. Tens of million people are without it and ER rooms are over crowded as a result. Many have started closing their doors. Two years ago it was said 45,000 people die a year in part, due to lack of insurance. As far as I know we are the last major nation to offer heath care for it's citizen and although the bill has passed, we're still fighting to make sure it can be implemented.

Growing pains, learning curves and even greed can be a part of any new system but the greed we're dealing with now is unacceptable in my book. Anything new will be challenging but staying the course with nothing will be a disaster.