"Beagles - The only thing I rah-rahed about was my premium going down by half. I would think ANYONE would be happy for me on that account."

indeed, kelleyeng...

i think the point is there are serious WINNERS and LOSERS under obamacare....obviously there are those (like yourself) who are being subsidized by higher premiums for others (like myself and the group policy i am being forced into DROPPING for our employees because it doesn't meet the mandates of coverage at an affordable rate)

don't even get me started on the waivers for political cronies, unions, gov't employees etc...if obamacare was such a fantastic thing, ask yourself why these groups are being allowed to remain outside of the MANDATES and keep their current coverage.

we provided group health care to our employees for 30 years and counting, full ride....never required 'employee contribution' we did this because as a small business which could not afford some of the other perks granted in large corporations, we felt providing good health insurance was a necessity...

thanks to the nonsensical 'mandated coverage' under obamacare, that has come full stop....

we're giving out pay raises to 'compensate' for the loss of the group plan, but to a PERSON, no one is getting anything CLOSE to the good coverage that they/we were getting under our existing plan...

kudos to beaglesdoitbetter for doing a fantastic job of disabusing readers of this thread to the pure political propaganda that flies in the face of FACTS

oh and CA is a mess....nearly SEVENTY PERCENT of doctors are not participating....looking forward to january 1....one can only surmise what kind of extra-legal convolutions obama will decree in order to make sure those who thought they had purchased insurance have not actually done so due to the unworkable 'insurance exchanges'

Here is a link that might be useful: CA high rate of doctor non-participation

I work for a state organization where our plan is a "grandfathered plan" and it doesn't have to cover any of the mandated preventive screenings other than annual mammogram which has been a federal law for about 15 years. However, it has to allow the coverage of young adults up to age 26 and remove the caps on lifetime coverage. We have choice of PPO, HMO, and high-deductible plans. The HMO has limited coverage areas, so we have the PPO. Our premiums barely went up, but our deductible and max out of pocket costs went up quite a bit.

We have had multiple forums on our campus about the ACA and what it means for college students. Whoever posted that this age group is largely disconnected from these issues I would concur with that. Generally, anything political their eyes roll over unless they are a political science major, but these students are going to graduate soon and will need to make important decisions about their health care. If they are uninsured, they must select a plan even though they are students.

Plus, some of them want to work in health care, and they need to have a clue about how it all works if they want to treat patients or someday own their own practice. They don't even think about this.

It's going to take awhile to really see how the ACA works but it's just regulations. When you go to a restaurant and order food, you don't give much thought to the food safety regulations the kitchen must observe but it's good they do.

When my oldest daughter was born in 1970, there were no regulations about car seats. When my GD was born, the Nurses taught us how to install them correctly in the car.

There will always be the Rebels who refuse to wear seat belts, etc. but when we know better, we should do better. When guns are a right and Healthcare is a privilege, our priorities need to be evaluated. I'm thrilled to see the new regulations. And yes, I buckle up every time I get in the car. I make sure the car seats are properly installed and adjusted.

I see the ACA as another regulation like car insurance, seat belt laws , food safety. Progress is change.

And if adding seatbelts to cars caused cars to increase in cost only for select portions of the population by hundreds of dollars EVERY SINGLE MONTH for the rest of their lives when we were promised that everyone would enjoy lower costs, people would still be fighting to the death to get rid of seatbelts. Especially if the new seat belts didn't work as well as the old ones (like, say, resulting in narrow network and lack of access to doctors and higher premiums and/or higher deductibles)

The analogy is more akin to the government deciding that everyone needs a Prius and the government promising that a Prius would be cheaper and have more features... then removing features from the car and raising the cost of a Prius by thousands of dollars for the middle class to subsidize the costs of a Prius for the poor and for the young to subsidize the cost of a Prius for the old. People who were perfectly happy with a Ford Focus are not going to be happy with a Prius, and they sure aren't going to be happy with being made to pay extra for one to subsidize other people getting one.

Just because something is changed, doesn't make it better...

From the NY Times Today (again, not the most conservative of sources):

Because a working website will give the White House “three full years to create millions, and perhaps tens of millions, of winners who are getting insurance or protection,” The Washington Post’s Ezra Klein wrote last week, Democrats can “lose on the politics in the midterm election even as they win on the policy in the long term.”

The entrenchment hypothesis is plausible. But it elides one crucial problem: the extent to which the successful implementation of Obamacare actually depends on the law’s political standing.

That’s because the law can work only if people who don’t necessarily benefit immediately from its provisions decide to participate anyway. If they respond to higher premiums by either staying out or dropping out, then Obamacare will be permanently unstable: the dollar figures, both for insurers and the government, simply won’t add up.

The participation of the young and healthy is supposed to be required, of course, by the individual mandate. But the mandate’s penalty is relatively modest and its enforcement mechanisms relatively weak, which means its power ultimately depends more on civic duty than on immediate self-interest.

The law’s advocates have explicitly acknowledged this point. Explaining the case for the mandate last month, The Atlantic’s Matt O’Brien allowed that “a rational self-maximizer” might decide to pay the fine instead of buying costly coverage. But “real people,” he argued, “aren’t rational self-maximizers ... We don’t like to feel like we’re doing the wrong thing. We like to follow the rules instead. Feel like we’re a good person.”

The experience of Mitt Romney’s Massachusetts, O’Brien concluded, shows how this works: enrollment in Romneycare spiked when the mandate kicked in, and it spiked for healthy people" presumably because they accepted the “positive responsibility” of the mandate, and bought health insurance because it’s what they were “supposed to do.”

But this example does not necessarily bode well for Obamacare’s unfolding. The Massachusetts law was a bipartisan bill passed in a wealthy, homogeneous state with a pervasive left-liberal ethos. The national health care law aspires to create the same sense of “positive responsibility” in a much more polarized, fragmented, socioeconomically diverse and libertarian-minded society, roughly half of which opposes the law outright.

This post was edited by beaglesdoitbetter on Sun, Dec 8, 13 at 12:09

ACA maintains a 7% (+ or -) of your income for your share of Healthcare cost. That is less than the tax many of us are charged for the new set of curtains or the new such and such we couldn't live without.

It is time to end the $15. Aspirins in hospitals. Hospitals are non profits and can not turn anyone away. The people with insurance are currently bearing the cost of the uninsured and the underinsured - not only in the cost of premiums but in the poor choice of coverage.

It's important to look at the bigger picture. Healthcare is in crises in our country. Getting sick should not jeopardize personal security.

Even the car industry has regulations and consumers have options of the level of trim we chose to buy. That said, the crash tests on that car are the same, whether one has cloth, leather, roll up or automatic windows. Similarly, there are options you can chose with the ACA offerings. Now, it's more like the crash tests in the car. Even the least trimmed out health plan has to pass the crash test. That is a good thing.

Most of the country disagrees:
Fifty-two percent favor scaling back (20%) or repealing (32%) the law, similar to the 50% from mid-October.
http://www.gallup.com/poll/166145/majority-americans-major-changes-health-law.aspx

Big difference between paying 7 percent sales tax on an item you choose to buy (and can choose NOT to buy if you don't want) and paying up to 9.5 percent of your income for personal premiums alone (and your family's premiums can cost even more, another flaw in this law) and then still having thousands of dollars in deductibles.

When people buy a car, they pay for safety features that have a direct benefit to saving their own lives, not subsidizing other people. This law is redistribution and it wasn't sold that way. The people who passed this should have been honest and let the country decide if they wanted it. They weren't and I just don't think all the broken promises are going to bode well for the goal of encouraging trust in government in the longterm...

Let's be realistic, arguing about this is not going to change anyone's mind. People are going to make up their minds from personal experience and the law is going to stand or fail on its own merits.

Be interesting to see what happens if more people are uninsured after the 1st than before the law took full effect. Or if people still cannot afford healthcare because of high deductibles, so now they're paying up to 9.6 percent of their income for insurance they cannot even use. Or if they cannot find a doctor that actually accepts their new plan.

And be interesting to see how long the people who were lied to continue to punish those responsible come election time. Because people who have to pay hundreds of dollars extra every single month are not going to forget that any time soon.

This post was edited by beaglesdoitbetter on Sun, Dec 8, 13 at 12:26

"Let's be realistic, arguing about this is not going to change anyone's mind. People are going to make up their minds from personal experience and the law is going to stand or fail on its own merits."

Well put, bdb.

We aren't affected by the changes...yet. My main concern is that my son with severe corneal disease, who now lives in Louisiana, will not be able to continue with his specialists who practice in New York. He wears special contact lenses that are made & fitted in a handful of places in the country, and New Orleans isn't one of those places. Nor is there an ophthalmologist near him with comparable expertise in his disease. Right now, we have medical help and coverage. Next year, who knows. If he gets kicked off of our plan (he's over 26, we're paying for his Cobra extension) and has to go on a plan of his own, we may not be able to afford him going out of a narrow network that doesn't meet his needs. He certainly won't be able to afford it on his own.

Megan McCardle column "Doc Shock On Deck"

This post was edited by awm03 on Sun, Dec 8, 13 at 14:24

Just a couple of anecdotal observations:

DH and I very much appreciated the option of catastrophic plans in our 20's and 30's, as have our children when they were between jobs. Our healthy DD now finds herself laid off, on unemployment and unable to purchase catastrophic insurance which would have saved her at least $100/month at a time when she could really use it.

We have several physician friends, all of whom believe the excellent quality of medical care we've known will become a thing of the past. All have discouraged their children from following in their footsteps.

What is very sad is before Obamacare, 85 percent of Americans were happy with their own insurance and 80 percent of all Americans were happy with the quality of their own medical care and healthcare costs.

We've upended the entire American healthcare system to get coverage for 15 percent, some of whom probably don't even want it. Just wait until the employer mandate hits and the disruption that will cause.

Getting coverage for that 15 percent is a laudable goal, but there should have been an honest discussion about the trade-offs that would entail and about how the cost burdens would be shifted.

I truly don't think anyone could argue that it is feasible to provide universal coverage including for the sick and the old with NO ONE's cost going up and everyone getting a $2,500 premium decrease. But that was how Obamacare was sold to us.

Well, it certainly defies basic economics to think the non-subsidized insurance buyers would have lower premiums at the same time they are required to have more coverage ("obamacare compliance'"). Plus there's the higher state/fed taxes to pay for expanded Medicaid. We are expecting our employer to drop coverage next year...and our taxes to jump again. Which is why we are worried about our son's eyesight getting caught in a redtape/financial squeeze.

If you have spent much time in ER's (at least in the south), you may notice that most people are NOT uninsured, but well insured by Medicaid. They could go to the doctor, but don't.

I don't know how many of this board have had to deal with Medicaid and Medicare, but at least the ACA may keep the Post Office in business.

Someone has to PAY for insurance! Insurance, to my eyes, is not the problem, but the COST of healthcare IS. To follow the ACA line of thinking, Medicaid recipients should be the healthiest, because they have good coverage. Do you think this is true?

Nancy

Re: Medicaid and health outcomes:

"This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain."

"We found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions. Medicaid coverage significantly increased the probability of a diagnosis of diabetes and the use of diabetes medication, but we observed no significant effect on average glycated hemoglobin levels or on the percentage of participants with levels of 6.5% or higher."

http://www.nejm.org/doi/full/10.1056/NEJMsa1212321

Medicaid increased medical spending from $3,300 to $4,400 per person, but produced no discernible improvement in blood pressure, cholesterol, blood sugar levels, or risk of heart attacks after two years. Medicaid should have had an immediate impact on these measures, especially among the poor.
http://www.nytimes.com/roomfordebate/2013/05/06/more-medicaid-more-health/why-expand-health-care-with-no-proven-benefits

But, hey, let's spend trillions to expand Medicaid! Never mind that around 1/3 of doctors won't accept it (or, in some cases like New jersey, 60 percent of doctors won't).

The I have mine mentality. The fear mongrels. What would Jesus do? Clearly, Beagles, you can afford to take care of whatever you have going on in your life. I wish you compassion for others.

I'm tired of welfare for the rich.

To me the biggest problem is the law was written by the highly paid lobbyists who have much more influence on Congress than do any of us, the users of the system. For example, why didn't they do away with the law that allows insurance companies to legally price collude...they are the only ones allowed to do that. Why didn't they add ability of insurance companies to compete across state lines as that would certainly add competition to the system which would help lower costs. But of course they didn't because this would've been less profitable for insurance companies.

Steven Brill at TIME did a fabulous piece on why health care costs are killing us. It is nothing that the ACA is going to fix. It has everything to do with the industry structure and the rules and regulations supporting it. Until Congress grows a backbone and decides to do its job...protect the interests of the American people over the interests of the lobbyists...we will continue to have the most expensive, least effective health care system among developed nations.

Annie, very good points.
Golddust, I know you to usually be "compassionate" but your comment to Beagles is anything but. In this venue I know beagles to be as kind, caring and helpful as I know you to be. The only difference is her political point of view. She never got nasty in her arguments, however your just made your argument very personal and that usually indicates not enough facts to support one's beliefs. Compassion needs to exist not only for those you agree with and support. Having respect for all people no matter rich, poor, left or right needs to exist in order for a person to truly be compassionate. I believe in this thread Beagles shows those qualities.

This post was edited by roarah on Tue, Dec 10, 13 at 9:16

edited to remove

This post was edited by trailrunner on Tue, Dec 10, 13 at 15:09

. edited to remove

This post was edited by trailrunner on Tue, Dec 10, 13 at 15:08

I agree with a lot of your post Tailrunner. The only thing is that I think we need to raise the middle class taxes as well as the upperclass in order to provide for the have nots. The distance is increasing but the middle class is shrinking because more are entering the upper class not the other way around. the 2012 census showed that the poverty level actually decined a hair to 15% which is about 100,000 people less than it had been. Most families who make 120,000k think themselves middle class. They are actually above the top20% and should not be excused from fixing this mess we have as a nation. It should be everyone's burden to carry otherwise there is not enough money to fix it. A Value added Tax is also something we may wish as a nation to explore.
Just because one does not like the ACA does not mean one does not want things to be better, it might mean that one feels it was not even close to ever being able to work for those who most need help.

Here is a link that might be useful: disparity is due to smaller middle class, but poverty levels actuall shrunk a tad.

This post was edited by roarah on Tue, Dec 10, 13 at 10:09

Having spent 2 years on welfare-I grew up in a solidly middle class family-much like many on this forum, but a bad series of life events took me on a 180 that I could never have imagined EVER-and back on to the middle class, comfortable life, I can attest that what Gold & Trail say are true.

I don't know how it is in other states, but in my state, Medicare is virtually non-existent unless for pregnant women and children of those below the poverty line. So those in the ER for an asthma treatment are completely uninsured. They're going there because they have infected teeth. Theyre not being seen for diabetes or heart disease or cancer.

The horrible two years I was on welfare I experienced more discrimination than I could imagine. The only pediatric dentist in town who accepted medicare screamed at me in the waiting room full of people because my daughter cried in his chair. He humiliated me every single visit. I was the only mother I knew on welfare who actually took her children in for dental care and routine medical checks-because I knew how important it was to have this because I'd grown up in a middle class home. The other low income mothers I knew-most who did not have cars to get to the larger towns where there was greater access to health care-were from a long line of lower income families-where the BASICS ARE NOT TAUGHT OR EVEN KNOWN!

There is a little thing called Environmental Justice. Low income people who don't have access to technology, healthy foods-even grocery stores that are not 'package stores'-much less medical/dental care. And not only that-they don't have access to what is taken for granted by the middle class-education!

My own stepson was 6 years old and had a mouth full of cavities-he had 10 root canals by age 9-because his mother, who had custody till he was 5-because his father did not know he had parental rights (they never married)-had never, not once, taken the boy to the dentist. He didn't even know how to properly brush his teeth. Can you, even for a moment, wrap your minds around the fact that a 6 year old didn't know how to brush his teeth?

Hope that kids like that enjoy their cake.

Rorah, you are correct. Beagle, I owe you a sincere apology. I'm sorry. I get frustrated. The Health Care system is failing people now. It doesn't work for all but the upper middle class and wealthy. I am fortunate to be able to afford my premiums that hold the medical system up but I don't know why I should receive medical care while my next door neighbor or my SIL can't, in spite of having good jobs.

Have you been to an Urban ER lately? They look like homeless shelters. We can allow Walmart to underpay their workers to the point where they use us (tax payers) to provide food stamps and Medicade for their workers while they rake in unimaginable profits. That is welfare. That is the real Welfare.

Our Rite Aid Drug store chain just cut everyone's hours to 30. No more benefits! Most employees can now get Medicade and food stamps while the owners fund expense political campaigns in exchange for favors and freedom from taxes.

We need to wake up and stop swallowing the pill. The ACA is a step in the right direction. Maybe the family who owns Walmart needs to pay their share of taxes and provide a livable wage for their employees instead of funding Lobbyists and buying elections. It isn't their money that I envy. It's that they are buying our Government.

But I should not have taken this out on Beagle and I'm sorry.

Edited for clarity... I hit 'not' instead of 'now' in a sentence and it changed the entire meaning. I also removed a snarky remark.

This post was edited by golddust on Tue, Dec 10, 13 at 10:49

Pesky, I think you are referring to Medicaid not Medicare. Medicare is for retires.

"Why didn't they add ability of insurance companies to compete across state lines ..."

Absolutely agree with you on this, AnnieD..

Demonizing the "haves" as selfish & greedy & shameless is nothing but stereotyping. That's being manipulative, not factual.

Lobbyists represent corporations and specific power blocs, not the citizen population at large. To say they represent "the Haves" is tarnishing a chunk of the citizens with waaaaay too broad a brush. I consider myself a member of "the Haves," yet I had ZERO input in determining the course of my family's health care.

What welfare for the "rich"? The lower college tuitions we don't qualify for? The healthcare subsidies we won't get? The puny tax breaks that get tossed our way then get legislated out? Certainly sounds odd to hear about welfare for the rich, considering the property taxes we pay so everyone, including those who don't pay property taxes, have good roads to drive on and schools to go to, not to mention state and federal taxes we pay to finance ever-growing government services for the real welfare class.

Whatever you may think, it is not that I don't care about poor people. I just come at this from a different angle- I truly don't believe that the government in our country is equipped to provide this type of help. Have you seen what is going on at the government run VA? The care that patients are getting is abominable:
http://www.cnn.com/2013/11/19/health/veterans-dying-health-care-delays/

http://www.bloomberg.com/news/2013-09-09/malpractice-payouts-to-u-s-veterans-reach-12-year-high.html

To me, THIS is what universal healthcare stands for- an inept government providing substandard care and squashing innovation. There are many documented problems in both the UK and in Canada with universal healthcare systems as well.

And as much as I am against single payer, I think that Obamacare is an even worse solution. It hides costs, forces only small portions of the population to foot the entire bill, was sold on a bill of lies, won't really provide more access to healthcare and likely will provide less (have you seen the pictures of the signs people are posting at provider's offices saying that they won't accept ACA plans and people are responsible for charges... this is because so many providers are excluded) and will do nothing to control costs or encourage healthier lifestyles.

I absolutely 100 percent want to fix things in this country so we don't have disparity of health outcomes the way that we do. However, I don't think that this is the right way to do it.

I think we need to change lifestyle factors because a lot of the reasons people are so unhealthy is because they are making lifestyle choices that lead them to be that way. Not sure how we can do this- maybe tax credits to open healthy stores that sell organic food and produce and fresh veggies in areas that are currently food deserts and then provide food aid at this stores. Find other ways to encourage healthy choices- maybe tax credits for people below a certain income who meet certain health standards or attend nutrition courses? I don't know, but we need to find SOME ways to change the factors that result in bad outcomes.

I also think that we went about Obamacare in the worst possible way and it is not going to do anything to reduce costs. I am in favor of health savings accounts to cover catastrophic coverage for everyone w/ the government subsidizing those accounts for people under a certain income level. Then, everyone pays out of pocket for routine care. Imagine how expensive auto insurance would be if it covered routine maintenance and oil changes- that's what health insurance is right now. Health insurance should cover risks that people cannot afford to bear on their own, it shouldn't cover every single routine thing.

There is a big misconception that conservatives don't care about the poor and I think it is very unfair. I personally want to find ways to actually help people and I don't think that the programs that we have now are doing that- I think we're spending trillions of dollars on programs that don't work, haven't worked for decades and it is unlikely they are going to start working now. That may be different than your opinion, but it also doesn't make me a heartless person who doesn't want to help others. And I find it very hard to believe that anyone thinks that what we are currently doing is working....

Also, "welfare for the rich" is a laughable idea. People and companies getting to keep more of their own money because tax credits somewhat reduce their tax burden is not "welfare" it is people getting to keep more of their own money.

This post was edited by beaglesdoitbetter on Tue, Dec 10, 13 at 10:52

Yes but allowing large businesses to keep more money while their employees teeth rot in their heads and keep wages so low that taxpayers must provide healthcare for their employees while they take in billions is not a responsible way to run a business of any kind. It might be legal but it shouldn't be.

How do the people here feel about subsidizing Walmart and MacDonald's and other such companies whose labor practices depend on Government subsidies ?

For the record, my insurance is going up $200. per month. I fall into the small percentage of people who will be paying more (for a better plan) because I'm not eligible for subsidy. Thank God I don't need a subsidy.

Government Employees have long appreciated the good benefits provided. It's time large business follows suit. How much money does one need?

I am very disappointed in what the ACA has become. I am an Obama supporter and really expected so much when the talk began about changing the health care system. I had watched our premium rates rise consistently over the last 15 years. Some years just a little, but often large increase of premium, deductible, and OOP max. This began long before Obama left Chicago! I had hoped we would begin to reign in costs. Less money to big medicine, heaven forbid smaller profits.
The ACA got more and more watered down until we're just left with basically an expanded Medicare system supported by those unlucky enough to not have good employee provided healthcare and/or the self employed. It is doing nothing to reduce cost and little to provide care.
I would much rather health insurance was sold like car insurance. Add a little competition. Shop around for the best plan that fits you. I had hoped the exchange would be that, but the insurance companies are not allowing that to happen. In some states, there is only one company in the exchange. I was hoping more of a Priceline approach, instead of a monopoly system. Of course, with no regulation of healthcare providers, pharmaceutical or insurance companies, nothing will change.
It is disappointing. It seems like all we've done is add a layer of beauracrcy and hold no one responsible for the out of control costs.

In a better job market, these companies would be forced to pay more or offer more to keep employees, and employees would have more opportunities for advancement into better paying jobs. What we need to do is improve the economy, not have a real unemployment rate of 11.5 percent, and this problem would largely go away. I haven't seen too much economic improvement over the past five years, and I believe that is because of over-regulation and the actions taken by President Obama (war on coal, etc.)

I also believe minimum wage jobs should not be jobs that people try to use to support families. Minimum wage jobs should be stepping stones into better opportunities, so lets make more education and job training available and create work incentives as well as incentives for employers to hire the long-term unemployed or to institute employee training and advancement programs.

I also think that the collapse of the traditional family structure has played a HUGE role in creating a lot of problems we are experiencing today. It's like all the workers saying they need $15/hr to support their kids--- if two minimum wage workers were married, they'd have their $15/hr and be able to support their families. Whether a child is raised by a single mother is one of the single biggest predictors of whether that child will grow up in poverty.

This post was edited by beaglesdoitbetter on Tue, Dec 10, 13 at 12:38

Maybe you are correct Beagles but I have a hard time subsidizing anyone's business as part of their business plan.

How would you design a college system where everyone could afford to get the education that would make Walmart a stepping stone job?

As far as single Mom's go, it can't be both ways. Can't allow insurance to refuse to pay for peoples birth control, get rid of the Abortion Clinics and expect less children born out of wedlock. Kids are having sex more now than ever. Maybe it's a sad reality but it is reality.

Well, were I given control of the government:
1. Stop subsidizing random degrees with low student loan interest rates. You want a degree in feminist studies, English (and I say this as an English major), or any other field where the job skills don't translate into a career field where there is projected job growth or demand, you work and pay for it. I believe a big part of the reason colleges have inflated costs and tuition has gone up so much is because of Pell Grants, Stafford loans, etc. etc. and I think tuition would come down significantly if the government wasn't involved.
As an alternative, use a system like in Australia where students pay back loans after graduation, but their repayment is tied to their income. Schools would think twice about admitting students who cannot succeed or about offering useless degrees if they know that their repayment was tied to the student actually making a living.

I would also limit welfare benefits to 2 years and require that an able-bodied person receiving such benefits MUST be attending a schooling program (GED or Associates Degree program or vocational training) as a condition of continuing to receive those benefits. I'd subsidize the cost of a GED/ associates program with the money that would be saved from the shorter welfare limits) If the person meets certain academic criteria (grade above a certain level) and wants to pursue further education, the benefits and tuition payments would continue until the program was completed. Exceptions would be made only in rare cases in areas of high unemployment and/or with substantial proof that the person could not find a job. I would also remove all of the incentives in our welfare system that currently exist to discourage marriage and and reduce the barriers to savings that exist in our current welfare system (i.e. it is stupid that if you save $2,000 you get kicked off of means-tested programs.... how are people ever supposed to climb out of poverty?)

I'd stop financing schools with property taxes (creates poor schools in low income areas) and encourage the use of school vouchers and charters to allow all kids access to a better education. I would also give tax credits to companies like Wal-Mart if they promote from within or provide job/career training and advancement opportunities.

I'm not a social conservative. People want abortions, fine although I think that should be discouraged through better education and freer access to birth control. And generic birth control should be handed out like candy to anyone who wants it (don't need insurance to cover this, generic birth control can be had for $4 at Wal-Mart). In fact, I believe that taking birth control (paid for by the government) should be a condition of receiving any type of government welfare benefits.

Edited to add, I would impose huge penalties on fathers who walk away from their children without paying child support. Huge. You pay for the cost of your kids or you lose all access to ANY government support including food stamps, you lose your drivers' license, and eventually after a year or two of nonpayments, you go to jail. It is completely unacceptable to me that this society puts all of the burden on mothers and so many men get away with having random sex, fathering multiple children and taking no responsibility. If fathering a child led to 18 years of payments or jail time, maybe they'd think twice.

This post was edited by beaglesdoitbetter on Tue, Dec 10, 13 at 13:20

I am by no means an advocate for McyD's or Walmart but I am not sure everything we read from "thinktanks"about Walmart’s evil ways is truly true. Walmart claims this is the truth and it must be easily disproved and I have not seen any printed news articles proving otherwise. This was Walmarts response to Aston kutcher's tweet last month about walmart,

@aplusk We think you're missing a few things. The majority of our workforce is full-time and makes more than $25,000/year.
��" Walmart Newsroom (@WalmartNewsroom) November 19, 2013

@aplusk Also about 75% of our store management teams started as hourly associates & they earn between $50,000 and $170,000 a year on avg.
��" Walmart Newsroom (@WalmartNewsroom) November 19, 2013

@aplusk Lastly, every year, we promote about 160,000 people to jobs with more responsibility and higher pay.
��" Walmart Newsroom (@WalmartNewsroom) November 19, 2013

@aplusk We know we can always get better as a company. This year we've made providing more opportunities for our associates a top priority.
��" Walmart Newsroom (@WalmartNewsroom) November 19, 2013

This is also from a fact check article, again not sure how accurate but, it states
"CLAIM: The average Walmart associate earns just $8.81 per hour.
FACT: Despite what OUR Walmart/UFCW claims, the average Walmart associate earns $12.83 per hour, and less than 1/2 of 1% of associates earn minimum wage. "

Kutcher failed to reply to Walmart's claims.

Maybe the villainized big companies are not as evil as some lead us to believe. I think the truth is somewhere between the two claims.

Here is an interesting read reiterating what Beagles has articulated.

Here is a link that might be useful: A differing opinion from what we often see

This post was edited by roarah on Tue, Dec 10, 13 at 13:43

Pell grants and scholarships are as rare as hens teeth for all the young folks I know. BCP-whule it may be a $4 generic at Walmart, requires a RX...so need to see a dr. Good luck with that unless you`re near a Planned Parenthood (again, in some places rare as hens teeth *coffTexascoff*)

Rents rising to the point where most low income workers pay up to 50% of their income just to keep a roof over their head. In my market-2 bd apartments start at $700/mo. Min wage is $8/hr. Be realistic when doing the math. They do need to pay utilities, transportation and eat, too.

I live in a small metropolis with crappy public transportation. No bus service after 10pm or on Sundays. Min wage workers often work those hours.

Social reform IS needed, and i get tired of hearing that all is needed is a good education and a 2 parent family. Far, far too many fall between the cracks. Ots not just the generations on welfare, but the ones who used to be at the lower end of middle class who are being affected the worst. You dont hear about them on the nightly news.

Pell grants and scholarships are as rare as hens teeth for all the young folks I know. BCP-whule it may be a $4 generic at Walmart, requires a RX...so need to see a dr. Good luck with that unless you`re near a Planned Parenthood (again, in some places rare as hens teeth *coffTexascoff*)

Rents rising to the point where most low income workers pay up to 50% of their income just to keep a roof over their head. In my market-2 bd apartments start at $700/mo. Min wage is $8/hr. Be realistic when doing the math. They do need to pay utilities, transportation and eat, too.

I live in a small metropolis with crappy public transportation. No bus service after 10pm or on Sundays. Min wage workers often work those hours.

Social reform IS needed, and i get tired of hearing that all is needed is a good education and a 2 parent family. Far, far too many fall between the cracks. Ots not just the generations on welfare, but the ones who used to be at the lower end of middle class who are being affected the worst. You dont hear about them on the nightly news.

How would you fund schools to make them better in poor neighborhoods? I worked with families in a poor area of Sacramento. Most were Hmong or Mien. The parents walked their children to and from school and didn't have the financial ability to send their children outside their neighborhood to attend better schools even if they existed. Yet these parents want the same thing the rest of us want for our children. A good education and a safe neighborhood with healthy food choices. Parental participation was outstanding in that school.

Charter Schools must give priority to students who live within the District in CA. The good Charter Schools have waiting lists a mile long. Vouchers can be a good idea but again, the religious schools must be in the poor neighborhoods. Charter Schools are putting private schools out of business here.

Charter Schools can be just as good or bad as any other school. What they are managing to do is get rid of Unions and tenure. It's too hard to get rid of poor teachers but Unions strengthen Middle Class.

We are personally taxed at 35%. If Big business would care to join me at my tax rate, problem solved.

A good economy depends on people spending money. As long as our middle class people continue to lose ground, we won't be seeing a rebound any time soon. Wealthy people keep more of their money. Middle Class people spend more of their income because they must. When the Middle Class are thriving, so is our economy. Trickle down economics doesn't work. Look at tax rates during Reagan's era compared to now.

Pesky hit on a very important point.

At our university, we have a lot of "need-based" financial aid, which means kids are poorer. We have a sizable number of low-income, first-generation, rural, non-traditional, and minority students. Many of these students come from families who cannot provide help and whose parents don't understand what they are going through adjusting to college. They do not have many good role models, especially minority males. These are the ones who get Pell, but there is a limit to how much they get and for how long. There are other state scholarships for students who maintain 3.0 or higher, so we work our tails off to help keep these kids eligible. We have a new President, and she is working to boost our endowment so we can offer more scholarships.

I was asked to look at a list of majors who were close to completion who they want to encourage them to complete. Every student who has not finished their degree is because of finances. Very few of them have GPA issues--often because they are working, but most of them are bright. Some of them are only short two courses or a semester.

The REAL reason for rising college costs is diminished state support as a result of gerrymandered districts. For example, at our campus, ~10 years ago we got nearly 40% of our budget from the state; now we get 9% based on the concept that tuition can be increased. This is not just our state. This has been a nationwide agenda to defund public education in this way. Access to Pell grants has nothing to do with it!

Sorry this has nothing to do with health care other than for those students who may or may not have a safety net of parent insurance. I do work on a community coalition to improve walkability and bikeability, access to healthy foods (food deserts), and tobacco cessation. BTW, we have received about $180K in grants from the Prevention Fund of the ACA for community transformation in these areas. Yes, ACA money that has long-term payoff. I am not getting paid, and there is no overhead with these grants either. Everything goes into policies, systems, and environmental changes in these areas. However, the Prevention Fund is the first thing Congress (well, really the House), wants to raid/defund. They wanted to defund it to offset the student loan increases. At least the Senator in the state where I live is someone who has supported both of these causes. Already sent her a donation yesterday, and more is coming, though I cannot compete with the Koch brothers.

Gsciencechic, thanks for the good work you are doing. We can't continue to believe we are a First Nation when we are cutting Education and making it so only the Elite can afford to go to college. It benefits all of us to have a more Educated Society.

It is interesting that most people in the Country of Jordan are College educated. Even the trash collectors. It cost Max $12. To have a cavity filled and when he was hit by a car, the hospital bill was $500. for an overnight stay, including tests to make sure he was OK. The family whose car hit him stood vigil over him until they knew he was going to be OK. Here, we sue people. I sent the family money to repair their windshield because I was so grateful.

Some levity:

The American Medical Association has weighed in on Obama's new health care package.

The Allergists were in favor of scratching it, but the Dermatologists advised not to make any rash moves.

The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.

Meanwhile, Obstetricians felt certain everyone was laboring under a misconception, while the Ophthalmologists considered the idea shortsighted.

Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, grow up!" The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.

Surgeons decided to wash their hands of the whole thing and the Internists claimed it would indeed be a bitter pill to swallow. The Plastic Surgeons opined that this proposal would "put a whole new face on the matter".

The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea. Anesthesiologists thought the whole idea was a gas, and those lofty Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the a$$holes in Washington.

Also:
Periodontists thought the plan was hopelessly gummed up but Orothodontists felt sure they could straighten things out.

Terriks, that is hysterical.

golddust there is a proposal in PA right now to shift funding for school taxes from property taxes (which are resulting in an estimated 10,000 seniors losing their home each year) to a slightly higher income tax and an increase in sales tax (certain items are exempt, like clothes under $50, but sales tax would for the first time be charged on the services of lawyers and accountants) I don't think it will pass b/c there are powerful interests working against it, but that is what I would do to fund schools.

I also believe if vouchers and charters give parents the choice about where to send kids to school, schools will all need to compete to be better. There needs to be changes to the way we organize public education in this country b/c we're spending a lot and not getting very good outcomes.

golddust, I agree a strong middle class is key. I also think Obamacare is a big tax on the middle class. Plus, as the earlier posted data shows, a lot of people aren't leaving the middle class because they are getting poorer but instead because they are moving up.

Taxing businesses at 35 percent is just going to send more money and jobs overseas and give accountants more cash from businesses exploiting loopholes.

We need a fairer tax code and we need to stop trying to incentivize behavior through our tax code, but I do not think raising rates (for individuals or businesses) is the right solution.

gsciencechick, I've seen a lot about how many people cannot finish their degrees because of finances. That's why I think government aid/benefits should be tied to degree programs. As long as someone is working towards completing a vocational program, associates degree or bachelor's degree, that person should have tuition costs covered and get enough financial support to finish the program. In my opinion, that should be how our welfare system is run. If you have insufficient/low income and aren't working towards a way to improve yourself (and you aren't disabled or otherwise unable to work), benefits are cut off... If you are working towards a degree/ job training, you get enough support and tuition assistance to be successful in that program until completion.

it isn't PC to say it, but a good education and a 2 parent family are the two biggest predictors of whether someone will be in poverty or not. There are always some exceptions, but for the most part, if you have those two things, you are way less likely to fall through the cracks.

golddust, do we actually agree on something?? I'm in favor of extensive tort reform in this country to stop the lawsuits!

LOL, terriks!

I get health headlines through email twice per day. Here is an interesting study on the Mass. plan.

Study links broader health insurance in Massachusetts with better health and care
Posted on December 10, 2013 by Stone Hearth News

ANN ARBOR, Mich. ��" In 2006, Massachusetts was on the same brink that the entire nation is on today: the brink of expanding health insurance to cover far more people than before, through government-driven, market-based reform.

Now, a new study shows the health of residents in that one trailblazing state improved measurably, especially among the poor and near-poor, in just the first five years ��" compared with the health of residents in neighboring states. So did the use of some preventive care, specifically two tests designed to spot colon and cervical cancers early, and cholesterol tests to gauge heart disease risk.

Meanwhile, over those same five years, Massachusetts residents were increasingly likely to say they had health insurance and access to a personal doctor, and less likely to say that costs stood in the way of getting care, than other New Englanders. The changes occurred at similar rates for black, white and Hispanic residents.

Writing in the new issue of The Milbank Quarterly ( a health policy scholarly journal), the study’s authors note that they can’t be certain that all the population-wide differences between Massachusetts and its neighbors came directly from the expansion of insurance coverage. Other reforms likely had an impact, too. But their detailed statistical analysis, supported by the Commonwealth Fund, points firmly to a positive impact, especially among residents with the lowest incomes.

“Everyone has been looking over the past few years at Massachusetts, which was the first state to show the rest of the U.S. that near-universal coverage could be achieved,” says first author Philip Van der Wees, Ph.D., a Dutch researcher who was at Harvard University when the study was conducted. “We found that people have gained in general, mental, and physical health, and that some preventive measures improved. We would hope that this would be a blueprint for the rest of the U.S., though Massachusetts is not the average state, because it began from a higher level of insurance,” among the state’s residents than the current U.S. average.

Van der Wees worked on the study with John Z. Ayanian, M.D., MPP, formerly of Harvard Medical School and now director of the University of Michigan Institute for Healthcare Policy and Innovation, and with Harvard health care statistics expert Alan Zaslavsky, Ph.D. Van der Wees at the time was a Commonwealth Fund Dutch Harkness Fellow in Health Care Policy and Practice; he is now at Radboud University Nijmegen Medical Center in the Netherlands.

“Our results demonstrate the potential benefits of health care reform in Massachusetts that may also be achieved through the implementation of the federal Affordable Care Act,” says Ayanian.

“And, just as with the ACA, the impact of broader health insurance coverage in Massachusetts is intertwined with the effects of numerous efforts in the public and private sector to improve health care quality and contain costs,” he adds.

Statewide surveys reveal changes

The data for the study came from annual random telephone surveys during 2001 through 2011 that asked 345,211 New Englanders questions about their general, physical and mental health, and their use of and access to health care services including cholesterol testing and screening for cancers of the breast, colon and cervix. The data were gathered by state health departments in conjunction with the federal Centers for Disease Control and Prevention.

The researchers used advanced statistical approaches to study the data collected between 2001 and 2011 as part of the CDC’s Behavioral Risk Factor Surveillance System. This allowed them to detect subtle differences in health status and behaviors, and to analyze these differences further by income and race/ethnicity.

While the research didn’t show huge jumps in any particular area of health, care, or access, the overall pattern is consistent with a positive impact from increased health insurance and other reforms, compared with states that didn’t embark on major reform efforts. Even when the researchers excluded data from Vermont and Maine, which launched smaller-scale reform efforts, Massachusetts showed greater improvements.

The authors note that the “rising tide” effect in Massachusetts compared with other states was greater among those whose incomes were within 300 percent of the federal poverty level. These poor and near-poor residents had a faster rise in measures related to health care access and health status. The rate of changes in health status, access and care were similar among white, black and Hispanic residents, which means that deeply entrenched disparities in health likely persisted.

By studying access to care and health outcomes for five years after health reform took effect in Massachusetts, the authors also were able to distinguish how access to care and health outcomes changed over time. Whereas improvements in insurance coverage and reduced cost barriers to care were seen within one year after health reform, access to personal doctors improved after two years and gains in health status became evident after four years.

These statewide findings counter prior anecdotal perceptions that access to primary care worsened in Massachusetts after more residents gained insurance coverage.

The editor of the Milbank Quarterly, U-M Medical School professor Howard Markel, M.D., Ph.D., calls the study an important contribution to understanding of the potential implications of the federal Affordable Care Act.

“In an era of demagoguery and exaggeration posing as “facts” it is essential to collect and analyze solid evidence on our nation’s health care policies,” says Markel, the George E. Wantz Distinguished Professor of the History of Medicine and Director of the Center for the History of Medicine at U-M. “Indeed, it is the only way I know to approach the Sisyphean task of reforming and improving health care access for all Americans. Publishing and disseminating articles like this one is a solid start in that direction.”

At the time of the study, Ayanian was at the Harvard Medical School and School of Public Health, and the Brigham and Women’s Hospital. Now as director of U-M’s IHPI, he leads a group of more than 400 researchers ��" many of them focused on evaluating the impact of the Affordable Care Act and other changes in health care policy and practice.

Here is a link that might be useful: Mass. program and HC

I don't think anyone disputes that everyone having access to healthcare can have some benefit on health outcomes and/or state of mind, although even here, the data says that there weren't necessarily any "huge jumps in any particular area or health, care or access." There is also lots of contradicting data on this study, including data showing it is hard to get access to primary care doctors. (Which is likely to be much worse on the national level since Mass was among the states w/ the highest ratio of physicians to residents)

Where the dispute comes is, how much of an impact does just giving insurance have; how should insurance be provided; what should it cover; and who should bear the cost.

Also, Romneycare isn't Obamacare. Massachusetts' population is different than the population of the U.S. as a whole. Romneycare was passed on a bipartisan basis in an educated, liberal state and almost everyone actually signed up. If young people don't sign up for Obamacare (which is happening now), there will be a death spiral. If people lose their insurance (which is happening now and will happen big time next year), then more people could end up uninsured. If the networks are too narrow (which is happening now), then people will lose access to their doctor and/or may not be able to find an appropriate provider. If the list of covered drugs is too narrow on Obamacare plans (which is happening now), people will not have access to medication.

Just because the desired outcome is good, doesn't make an unworkable law forced on a country who didn't want it the right way to achieve it. Think the data so far shows this pretty clearly:

365,000 people enrolled in exchange plans during October and November

More than a million just in California have lost their coverage.

More Americans say the law has hurt (19%) rather than helped (9%) their family

This post was edited by beaglesdoitbetter on Wed, Dec 11, 13 at 9:38

Thanks Sue for your thoughtful post. Yes, we do agree on more than one thing.

Small business drives this Nations Economy, yet successful small business pay a 35% tax rate because we can't buy the Government, have no access to loopholes and basically have no representation whatsoever, outside of Activism. Let the billionaires go over seas! And tax the heck out of them for doing so.

Taxation without representation is happening under the radar but it isn't happening to the big $$ crying about it. It's happening to your Plumber, your Independent Contractor, the successful Mom and Pop store. People too busy running their businesses to pay attention.

If this Nations small business must pay a 35% tax rate and provide insurance, sick days, vacation and retirement (because it's morally the right thing to do) while the billionaires use up my 35% share to subsidize their employee healthcare? I will never be silent about that and will not dust their doors. They are already robbing me.

I think an education used to be an indicator of avoiding poverty. However, an education that has somebody saddled with a mountain of debt and no job prospects (and this is no longer limited to English and philosophy majors) will have a hard time keeping themselves and their children even marginally within the middle class.

While there are also those rising above the middle class, there are still many families like my own struggling to keep from losing ground they worked hard to gain and that struggle has long pre-dated the ACA.

I will say though, whether somebody is trying to improve their lot or not, if they are hungry, they should be fed and I am happy to pay taxes to make sure that happens. My stomach is just not strong enough to see people starve to death or to see children sleeping on the street because their parents housing benefit was cut off after 2 years.

Terriks, that's histerical!! At this point, all we an do is laugh!

I hear the phrase DINO and RINO all of the time.

As a country I think we are EINO. Exceptional In Name Only.

*The US has a higher degree of inequality than almost any other developed country.

*US military expenditures are higher than that of the next 11 countries combined.

*The US ranks close to the bottom compared to other industrialized countries on issues affecting mortality.

*No country incarcerates a higher percentage of its population than the US.

*US students post only average scores on a key skills test administered to kids across the industrialized world.

Not very exceptional.

Access to quality healthcare, healthful food, a powerful education, and worthwhile work. That's what I think an exceptional country can offer. An exceptional country would offer prosperity to all - not just the oiliest and most well connected.

There are numerous replicable examples of healthcare systems with much better outcomes. Had we gotten single payer as many developed countries have, perhaps we could start calling ourselves Exceptional again. Or at least Exceptional Lite.

terriks, the Hematologists thought the package was too rich for their blood...

Tish and Dee....I so agree!

I did read recently that the reason we score so low in education compared to other countries is because we test ALL students (special ed, severely mentally handicapped, etc. ) while other countries test only their best and brightest.

My goodness, at least where I live we have so many social programs both public and private that there is no need for someone to starve to death or sleep on the street for long. I work with a couple of the private programs and they seem to be much more efficient and effective than the federal government - which is to be expected as any large organization is fraught with bureaucracy and waste.

Sometimes I feel like we have become so focused on expecting the government to take care of everything that we are creating a society of people who start to think they are powerless to make a better life for themselves. They expect the government to do it and that's never going to work if people don't believe in themselves.

I grew up in a low income, dysfunctional family with two alcoholic parents, father often unemployed, bankrupt at one point. The one good thing my parents did was to instill in me that you are responsible for your own situation - bad decisions, bad judgment, whatever. If you want to make a better life for yourself, you can but it's up to you to do so. Whatever else they did to make my life a living hell, I am eternally grateful for the above.

As a result I set a few goals for myself in high school that I think were very important in how I ended up.

1. get a college education in a field where you can get a job and support yourself without depending on a man (don't pick a degree that's useless in terms of making a living)

2. don't get pregnant before you're married or even after you're married if you can't afford to support a family and don't have more kids than you can afford (you aren't entitled to have kids especially if can't take care of them)

3. work hard, stay out of debt, don't waste money on booze and smokes

4. don't marry a loser

Hardly a day goes by that I don't think how sad I am for how much my parents struggled in life and how grateful I am that they raised me in a way that inspired me not to go down the same path they did. I think we need more mentors and positive role models to help people see the possibilities in their lives and help them believe in themselves. I think too much government dependence crushes peoples' spirits.

Delete

This post was edited by romy718 on Sat, Dec 14, 13 at 14:46

You might want to take a look at Megan McArdle's other healthcare articles too, which I think have been consistently good and in-depth. I really enjoy her writing and have followed her as she's moved from the Atlantic to the Daily Beast and now to Bloomberg. She's not a kneejerk conservative nor is she a shill for the Democrats. She calls 'em as she sees 'em through her economist's lens. Her followers are of all stripes and of more than average intelligence and expertise, so the ensuing debates in the comments sections provide as much food for thought as Megan does.

Here is a link that might be useful: Megan McArdle

Gibby, I heard someone on the radio the other day say they were worried about cut-backs eliminating pre-K programs that were the ticket to middle class.....I thought, " No, the ticket to middle class is MORALS!!!"

Nancy