Obama Care and Taxes

RosalieM
By RosalieM Latest Reply 2015-01-26 11:37:41 -0600
Started 2015-01-24 07:42:38 -0600

Obama Care and taxes.
The penalty this year is $94.00. Next year it will be higher.
If you signed up with a company for insurance and got a subsidy from the government and paid at least one payment to the insurance company and then were dropped because you didn't continue to pay, you may have the government subsidy taken off you tax refund. If you don't have a tax refund coming, they may take it in future years.

Obama care is so bad!!!!!


26 replies

esjesjesj
esjesjesj 2015-01-24 11:46:21 -0600 Report

Let remind everyone that Obama care came about because of insurance company (i.e. private industry) abuses of the healthcare scene. I've been in the self-employed individual health insurance market for almost 20 years I have paid everywhere from $400-$1200 per person for health coverage. Right now, I'm paying $500 a month for a plan that was equivalent to what I was paying $900 a month for back a couple of years ago..

Obama care has many failings but never forget that tens of millions of people now have coverage that they couldn't have before. Most of these cases were because of insurance company policies, not the government. Other failings in fact most of the failings of Obama care can be traced back to Republican actions trying to sabotage the bills and insurance company lobbying efforts. Healthcare experts around the world have pointed out that Obama care didn't go far enough.

We still spend way too much money from our insurance premiums for the egregious and high executive bonuses of insurance companies. The plans are still way too confusing and there's no acknowledgment that deductibles coinsurance and co-pays are an impediment to many people getting healthcare. If you have to choose between spending 40 bucks on tank of gas to get to work or 40 bucks to go to the doctor because you have that cough that won't go away,which are you going to choose? After all, it's just a cough.

Look at this table from Forbes.
http://www.forbes.com/sites/danmunro/2014/06/...

Other studies confirm the same thing. the US is the most expensive country with the worst patient outcomes of major industrialized countries. If you eliminate us from the rankings, Norway is the most expensive healthcare at $5.6 thousand per year per patient but it scores in seventh place. we are 30% more expensive and score dead last.

The countries with better outcomes and lower costs typically have universal coverage with egalitarian treatment. Some are single-payer, some are a highly regulated collection of insurance companies i.e. Germany, (fifth-place, $4.5k per patient year).

If you look at the information we have from around the world, yes, Obama care is flawed but almost every flaw can be traced back to financial interests from insurance companies, drug companies, and medical device industry.

If you want something better, look at how the rest of the world handles healthcare successfully. Those models will also work here successfully and we can build better healthcare by looking at facts and experience not ideology.

RosalieM
RosalieM 2015-01-24 13:14:41 -0600 Report

Obama care is a coalition between insurance companies and the government
What an awful combination. What good is having insurance if you can't afford the deductible and co insurance. It would be better to use the money you pay in premiums to pay the doctor directly. The insurance companies now have
their hand in your pocket (government subsidies) and many still cannot afford to use the insurance. The Republicans need kick in the rear because they only opposed with out a better plan. I can think of a better plan, why can't they.

esjesjesj
esjesjesj 2015-01-24 13:36:52 -0600 Report

Yes, it is an unholy coalition. Obama did something very very smart, he took the plan that Mitt Romney developed as a result of the Cato Institute advocacy and made it a national plan. It is, by its very definition, a political conservatives plan. The public option would be of been a great feature but in here is a good history of what happened and the rationale for the public option.

http://en.wikipedia.org/wiki/Public_health_in...

For what it's worth, the insurance companies have their hands in the government's pockets, the hospital pockets, your pockets. They are fuxing vampires, pardon my blue language but there's no other way to express the reality of their behavior

Jibber Jabber
Jibber Jabber 2015-01-24 13:41:04 -0600 Report

you can call it a politically conservative plan all you want..but just because it was PARTIALLY based on Romneys plan does NOT make it conservative…Romney is NOT my idea of an ideal conservative by a long shot..but I like how you tried to make this a political idealogy "thing" instead of just discussing what Obama care actually is…may work with some..but will not work with me.

JoleneAL
JoleneAL 2015-01-26 11:37:41 -0600 Report

The left has to say it is based on Romney or CATO's plan so they can place the blame on the Republicans. We just have to remember, no Republican voted for ObamaCare. This is all on the Demonrats who shoved it through on Christmas Eve. NOW they are running around like snot-nosed brats demanding the Republicans "FIX" their mistakes.

esjesjesj
esjesjesj 2015-01-24 13:52:52 -0600 Report

Obama care is almost identical to the Cato plan. I've been living under Romney care for it seems like forever and the practical difference between Romney care and ACA is vanishingly small.

Okay, if you want to make it apolitical then I can give you example after example of how private industry decisions screwed consumers over time and time again and took government intervention to rein in the abuses of insurance companies. For example, before ACA insurance company suspending between 40 and 50% of your premium dollar on "overhead meeting executive salaries and bonuses stock options etc. not to mention paying people to deny your claims. Now they are limited to something like 10 or 15% overhead.

If private coverage was so good, why do we have so many millions of people literally unable to buy coverage? Why do private insurance companies get to dictate medical care standards and not the doctor?

Obama care changes that. They set standards so that insurance companies are required to treat patients using techniques based in evidence. More control is returned to the doctor. Just because I have mild heart disease, kidney disease, and diabetes, I cannot be denied care. My premiums are the same as they were in the private insurance market.

Healthcare costs are currently held down to only a few percent per year versus a 20% premium increases I was seeing before Obama care.

So, I'm seeing win after win after win. And for me the biggest when is it was Romney care/Obama care that made it possible for me to survive a 99% clogged in one of my coronary arteries and then get back on my feet and restart a business. I have no fears of being dropped for coverage and I can move on with my life..

I will say again, you look at your complaints and you will find that the vast majority of the time it's the result of a private industry decision, not a governmental decision.

Jibber Jabber
Jibber Jabber 2015-01-24 12:21:24 -0600 Report

Oh and my brother's liked their insurance and their doctors…and wanted to keep them…OOOOOps…sorry couldn't…and they were told their premiums would go down…OOOOooops they went up SUBSTANTIALLY and their copays and deductables went up…sooooo…as I said dirty pool for the government to solve one set of problems that one group has by creating problems for other groups..and people keep talking about how great medical care is in other countries…but my girlfriend who has dual german/American citizenship comes HERE for her medical care because they make her wait so damned long for care in Germany…

esjesjesj
esjesjesj 2015-01-24 13:29:26 -0600 Report

http://www.forbes.com/forbes/2009/0921/health...

In case you don't remember, I have extremely strong bias against mythology. The story of your girlfriend coming to the US because Germany healthcare makes you wait too long is a frequent urban legend although usually it's a slam against the Canadian healthcare system.

Another myth is the whole loss of insurance and loss of doctors. Since you probably haven't read the law in a nutshell what it does is specifies standards of care, financial limits, and barring insurance companies from certain egregious practices such as dropping you when you're sick or denying coverage for pre-existing conditions.

Every single example people have raised about where they have lost coverage is usually because A) the plan did not meet ACA standards and could no longer be sold, B) the insurance company consolidated their plans to improve profitability, C) the employer did not want to contribute as large a percentage of money to the cost of insurance.

Loss of doctors is usually due to insurance company shenanigans. Insurance companies manage costs by limiting the number of expensive doctors they have in the network. So if your doctor is good and charges what they're worth, the insurance company is probably going to exclude them from the plan especially a low-cost one. again, not a government decision but a private industry decision.

Your comments on how the numbers of people signing up are diluted by the number of people that can't afford coverage is more of a Fox News talking point than reality. We won't know for a few more years what the pattern looks like. I know from personal experience that when I had to get subsidized care, they took an account income and expenses. Sadly I think the less compassionate members of Congress have or are trying to push through an income only based counting on subsidies. From what I can tell, conservative members of Congress really don't want not rich people to get ahead.

From your comments, I get a strong feeling that you have a justifiably confused understanding of the economics of insurance and especially employer subsidized insurance works. Insurance is gambling. There is a pool of people that embody risk that the insurance company will have to pay out more money than it takes in. Insurance companies like to create bigger and bigger pools because it lets them distribute that risk across a larger number of premium payers. This creates a degree of stability in premiums's because no one event causes the dramatic loss to the overall pool. Insurance companies like to partition populations into smaller pools so they can isolate high risk individuals and charge them exorbitant rates thereby does making them go away and being able to offer lower rates to those who will be nothing but pure profit.

The other way insurance companies generate pure profit plans is with very high deductibles. If your deductible is $10,000 and you don't have it, then the insurance company doesn't pay out because you haven't covered your deductible but you still keep paying your premiums (i.e. pure profit) because you don't want to lose your coverage.

When you get to employer subsidized healthcare, you get into an interesting situation. If you investigate, you will find that the employer is paying the same as or maybe even more than an ACA plan. Right now, I have an ACA gold (https://www.nhp.org/find-health-insurance/Pag... NHP 1000/2000 30/45 $510/mo). It is comparable to many corporate plans in terms of features and costs. .

I suggest going to your human resources and asking them what the employer contribution for healthcare. You will find that they are buying equivalents to the ACA plans except with a different name for roughly the same amount of money. One of my customers is going through open enrollment now and everyone is now bent out of shape because they went from 100% employer coverage to 60% employer coverage. The per plan cost is the same but now people are paying more. Again, this is a private industry decision, not a government one.

In reality, the money the employer spends on your healthcare is actually your money, pretax spent on a plan that you might not necessarily choose. If your employer chooses the cheapest bronze plan, (again private decision) you can't use your own money to upgrade to a better plan.

I hope you can now see that the $200 or $300 a month you contribute is a small fraction of the actual cost.

There are those that will argue that purchasing insurance is an individual choice. The problem with that is if they suffer a major illness, the cost gets put onto the rest of us if they can't pay. However, if they pay into the pool, everybody gets covered and there's no cheating. Although, in my darkest moments I will confess to having fantasies of being with one of these "personal choice/free market" folks while they are having a heart attack. In this fantasy I won't call for emergency services until I can do a full cost comparison on emergency and cardiac care thereby enabling them to make a fully informed and rational choice.

In reality, I believe we should be one pool of people, all the folks in the United States that pay taxes when it comes to healthcare. Doesn't matter if you're a resident alien, native born citizen, green card, illegal alien. If you pay taxes, you are contributing to the pool and you should get coverage. Any time someone talks about excluding anyone for any reason, is setting up a situation where they themselves can be excluded. The only rational and compassionate approach is an egalitarian one.

Nick1962
Nick1962 2015-01-24 19:13:04 -0600 Report

As the spouse of someone in “big pharma”, as you might imagine, we have a good insurance policy. Because we have taken it upon ourselves to start leading a healthier lifestyle, the incentives they offer reduce our premiums. At our age (52 and 57) we are considered “low risk”. Nearly all our claims are for wellness and prevention, and quite honestly, what we claim each year is generally equal to our yearly premium (which actually less than most ACA premiums).

The ACA hasn’t made CARE any more affordable, what it has done is stagnated the industry and dictated care. I had to have a surgical procedure (lower back) just under two years ago. It wasn’t emergency, but it wasn’t elective either. The protocol was that first therapy be attempted, then medication, then therapy coupled with medication, and only then was surgery an option. I wasn’t aware you could “therapy” or “medicate” yourself new spinal discs, and the MRI’s I took clearly showed mine gone. The “protocol” would have only made the situation worse and more burdensome on the insurance company. I managed to jump through the years’ worth of medical hoops in about 3 months and the procedure was finally scheduled. My surgeon, in an effort to improve the STANDARD of care proposed a newer procedure which would cut my recovery time from 4-6 months to 8 weeks, as well as nearly eliminate after therapy, presented this (at an added cost of $15K) and my procedure was denied. Not because of the extra cost (which I would have financed), but because it wasn’t in line with “affordable” (read that as “minimum”) standards. Thanks ACA – we may all get care, but it will be sub-par for a long time. In the end, he (my surgeon) believed so firmly that he took it to peer review (delaying the procedure 3 weeks) and was pretty much told that he wouldn’t get paid beyond the STANDARD unless the outcome was as stated. Well, he financed the extra, I had the surgery and allowed my activity to be tracked. Not only was I back at work in 8 weeks, but I was able to do away with all outside physical therapy (about $8K worth), and to date have never had to return for any aftercare. In my case at least, the medicine is sound, beneficial, and ultimately “affordable” when you look beyond the up-front cost.

I’m as benevolent as anyone, and certainly believe in helping those in need. However, when you start telling my wife and I, who have gone to college, earned our degrees, and have spent 35+ years paying into the insurance “pool” that I can’t have a certain level of care, even if I’m willing to pay for it myself, that’s not egalitarian, it’s almost communist. I’ll be more than happy to continue under the ACA, as long as my overweight beer swilling, chip eating neighbor gets the crap taxed out of him on the junk food to help fund it as well, because he’s using it way more than me. Hey, there’s a thought - smokers often pay higher premiums for life and health, speeders get dinged on car insurance. Let’s just put a huge tax on all the overconsumed crap we eat to fund the ACA - we’d make tons of money, junk food would be less affordable, and thus taking it out of the very mouths of those who shouldn’t be eating it. I like that idea a whole lot more than robbing me and supporting the status quo without even trying to solve the problem in the first place.

esjesjesj
esjesjesj 2015-01-24 22:49:02 -0600 Report

I would be interested to know if the premiums you are counting are the premiums you pay out of your paycheck? I'd like to know the actual plan so I can do a little double checking on the price.

The limits for care put on your doctor are not the governments fault. It's the insurance companies limits. There's a great deal of push for "evidence-based care" because in theory, it means you only pay for treatment that works. There's also a lot of pushback against "evidence-based care" because there hasn't been enough research money to prove alternatives are valid.

Case in point is the number of test strips. I argue that even type II diabetic needs at least five a day but the evidence-based care says a type II should measure once day but it's really not important.

If you look at the government specs, it says that at a minimum the insurance company should support evidence-based care but nothing limits them to only evidence-based care.

With regards to your opinion on overweight people, you need to revise it a bit. Yes, unhealthy foods should be taxed such as low-fat products, anything with high carbohydrate count, or soy. Definitely should heavily tax soy…

But here I am at 220 pounds 6 feet tall eating a healthy 1500 cal a day@20 carbs (measured, not eyeballed), cholesterol is highish, triglycerides are high. before my knee injury I was hiking weekly and nobody knows why weight and cholesterol are not budging. My mom's second husband is close to 400 pounds and eats almost nothing. The weight is almost entirely due to beta blockers and other heart medications.

There are lots of other drugs such as atypical antipsychotics, antidepressants, diabetes medications etc. that generate excessive weight gain. Be careful pointing that finger because someday you might find yourself on metoprolol and gaining a pound a week while your doctor says "oh it's normal" as you pack on another hundred pounds. I told the doctor go get stuffed when I gained 15-20.

Nick1962
Nick1962 2015-01-25 14:58:07 -0600 Report

Yes, the premiums come out of our paychecks, and when I was laid up for 8 weeks, my pocket. We had a group plan through BCBS, and now a similar one through Cigna. Again this is a group plan, not an individual one, and our savings comes from the power of the pool as well as the overall health of it…

Yes, care limits are administrated through the insurance company because they are the payer, as it should be. However, in our group, they are also the ones who determine risk and can be negotiated with, which was the case with me, and fortunately his procedure is now evidence-based and not outcome-based. Our government is not qualified to make those decisions, especially in such a sweeping generalization, nor was it formed to. You don’t negotiate with the government, so good luck trying that with the ACA.

I agree testing should be done often. Our group (again, bear in mind we have a major pharmaceutical company in it) is of the same belief and I can pretty much get as many strips as I want within reason.

With regards to my opinion on overweight people, please re-read my post. At no point did I mention weight. I did mention poor eating habits though. I’m 5’-9” tall and weighed 286 lbs. and taking 6 medications (in fact one med was to counteract the weight gain of another). I’m now 170 lbs. and on only one. Yes, I fully understand (and have been caught in) the weight/medication loop. I’m not finger pointing, but I do know there is a way out of the loop, and accepting “that’s normal” to a 20lb. weight gain is unacceptable. Where I will point fingers though – I had been on a minor 15-minute hike with several other tourists which included a (seemingly) affluent and healthy family with two 14 year old boys. I’m 52 and my wife is 57, neither of which would be considered “specimens of good health”, but even we out-climbed them. As did two women in their late 60’s, and pretty much the rest of the tour group. They held us up. We later caught up with them in town at a food stand – there was no question what was causing all the huffing and puffing on the hill.

If the government wants to stick its nose in health, stick it back in the school gym class these kids would have failed miserably. Or stick it back on the health room nurse who notices the short 225 lb. boy who has no medical reason to be obese other than being allowed to mindlessly stuff his face in front of the television. The ACA is treating the result, not the cause, and it will only continue to worsen.

Jibber Jabber
Jibber Jabber 2015-01-24 13:44:47 -0600 Report

I stopped reading after frequent urban legend…I love people that post articles to back up what they want you to believe…I do not post articles…I have friends that live in Germany, Italy and England…and family that lives in Norway, Sweden and England…sorry but the health care system is NOT what you are leading people to believe it is..and any publication that says it is obviously politically motivated…my ex was a research bio-chemist…and he once told me (something I already knew)…stats can be adjusted to say whatever they are needed to say…and research can be as well..

esjesjesj
esjesjesj 2015-01-24 13:56:57 -0600 Report

If you stop reading, no wonder you hold ill-informed opinions. I have friends in most of Europe as well (Ireland, Sweden, Finland, Estonia, Croatia) and every one of them have lived in the states. They went back and even though they bitch about high taxes at home, to a person, they breathe a sigh of relief that they know they can get their medical needs covered at a better price with better patient outcomes.

After stats can be adjusted, your ex should also told you that lying with statistics always gets revealed. Why? Because other people look at the same problem and when subsequent research shows different results, that's a pretty good indicator that somebody lied. With healthcare stats, it doesn't matter where they come from their all basically the same. US healthcare is the most expensive, US healthcare has the worst patient outcomes of any industrialized nation.

RosalieM
RosalieM 2015-01-24 13:40:23 -0600 Report

Esj
I don't disagree with what you say. We needed to have a better plan. Obama care is not a better plan, it is a disaster. People should be educated, encouraged and rewarded for a healthy lifestyle. Health care costs would go down, and those whose health problems are not lifestyle related could be properly cared for.
Our crappy food supply would get better as people wouldn't buy their crap so much. Maybe we should tax crappy food and use the money for health care caused by crappy food. I think I have the makings of a health care plan in my melon (my sons name for brain). He is so funny.

esjesjesj
esjesjesj 2015-01-24 14:01:22 -0600 Report

Oh I'm right with you on the food and lifestyle issue. Again, in darker moments I would love to see a tax on stupidity, that math skills, weight of car/carbon production in addition to processed foods.

But I ask you to consider this, if you have a world where you can create special exclusions to increase somebody's costs, what are you going to do when they use that against you. Don't think it won't because the history of the world shows that it will.

I think the best solution overall would be to find a way to use the tax policy to bring back externalities onto the folks that are using externalities to shed costs onto the general population. For example, a factory that emits tons of pollution and ruins the health of people in the town. That externality of not paying for pollution control plus the cost of health damage should be brought back onto that factory because the other one that caused it.

I think closing the loop on externalities would take care of the bad diet bad practice issues that you are justifiably concerned with.

RosalieM
RosalieM 2015-01-24 14:24:08 -0600 Report

Esj,
It is way past time for personal responsibility to take hold. Trying to level the playing field between the have and have nots by political means is just disaster. If it were up to me, I would require personal responsibility at every level. Even the God f the Universe cannot pull that off. So for me I strive to be personally responsible in all my dealings. Try it, the results are astounding.

Jibber Jabber
Jibber Jabber 2015-01-24 12:08:38 -0600 Report

May all be true…but MOST of the people I know have been screwed over by this…when people cite how "OTHER" people have benefited from Obama care I just usually roll my eyes…why?? Because it is dirty pool to solve some peoples problems by manufacturing more problems for a different set of people…it just is…and as far as tens of millions of people having new insurance…a very very very large percentage of those people now qualify for Medicaid…through Medicaid expansion…and did not have to get screwed over…happy for them really…BUT estimates are that as much as a full half of people that "signed up" for Obama care STILL do not have medical insurance because they just could not afford the premiums… How would YOU like to be the person that was dropped from their medical insurance and had to sign up through the market place for substantially increased premiums..and now cant figure out how the hell you are suppose to pay your mortgage…yeah one of the big "flaws" in Obama care is the penalties and subsidies are income based without any consideration for a persons expenses…I have three kids in college…am I suppose to tell them to drop out so I can buy insurance…I think NOT..

RebDee
RebDee 2015-01-24 10:24:49 -0600 Report

Lucky for me, I didn't get Obama care. I kept my Kaiser Permanente which I have had for many years. My membership is paid through my Medicare. So I never see the money and don't have to pay anything except copay of $5 for doctors, $20 for x-rays, $30 for labs (so I get them all at once instead of one at a time), $50 for emergency, and $100 for inpatient hospitalization. I still have to pay for my medication but after the first prescription, if I order it by mail for 3 months, I pay for 2 and 1 is free which is a big help. Luckily, many of my medications have been stopped as my weight goes down.

Jibber Jabber
Jibber Jabber 2015-01-24 07:53:28 -0600 Report

The Obama care penalty tax is income based…how much you pay is correlated directly from your income…I have several friends that must pay the tax this year and they are all being penalized different amounts…people such as myself that have managed to find a good sliding scale health facility with almost free prescription meds are better off paying the penalty than paying the premiums then the deductibles and copays.. I use to pay $25 dollars for a doctors visit and another $25 if I needed any blood work…all of the meds my husband and I take are 5 bucks a month regardless of what they are…NOW that I have changed to the diabetes clinic I pay NOTHING for my visits…I only pay for test and the same 5 dollars a month for scripts…so WTF would I shell out almost 700 a month in premiums for the "affordable" health care the loser and chief is trying to shove down my throat…and my husband recently had hernia surgery at LSU and because of their income based program for non insured people…received a bill for 320 dollars..yep…320 dollars…just about half of one months premiums…and because the surgery itself costs about 6,000 dollars if we would of bought the "affordable" insurance we would of had to pay the first $5,000 because THAT is the deductible on the mid level plan we qualified for…lmao

RosalieM
RosalieM 2015-01-24 09:37:50 -0600 Report

Jibber,
You might be right and I might be wrong. Something has changed. Unless the minimum was $94. I will have to do more research.
Who pays for the clinic you go to? Is it the state? Is it a non profit? Somebody always has to pay.
We don't have a diabetic clinic like that here. I don't even know of an endo here. This is a metropolitan area, not a farm town.

Jibber Jabber
Jibber Jabber 2015-01-24 11:15:50 -0600 Report

LSU is a teaching hospital…connected to LSU University and LSU school of nursing…as well as LSU Dental school..AND is Affiliated with Tulane Medical School…(My middle son attends LSU school of Nursing)…All of the endos at the clinic have crap loads of experience..but IT IS teaching facility so we have many medical/nursing students hanging around facility, talking to us and reviewing our files…see..free care is good for us…free training is good for them…and trust me these colleges are feeling no pain…especially Tulane who charges their students 50K a year plus expenses to attend..AS far as the almost free meds go…they seem to have a hook up with pharmaceutical companies…LSU and Tulane do a lot of research for them..alot…of research…They tend to not do a lot of government research however..and THAT is how medical schools are basically ranked…according to how much government funding they receive…they also do many studies for new medications…I don't touch the studies..I have no desire to be a paid test subject…The ONLY way I would do that is if someone told me I was going to die but they were testing a drug that might help me..

RosalieM
RosalieM 2015-01-24 13:21:02 -0600 Report

Jibber
Thanks for that information. The University of Wisconsin probably has a similar arrangement, but it is too far away to be practical.

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