Affordable Care Act and Ramifications Discussion

Parent Cafe
561

<p>Yes, Tom. </p>

<p>Since this thread is full of the anectdotal.</p>

<p>My grandmother was healthy. She smoked and drank and her husband came home alive from wwII. They ate ring bologna, and they joked around. At 83, after a full and fun as heck life, my grandfather died in his sleep. He drank and smoked til the day he died, and he was always thin, as that generation tended to be.</p>

<p>My grandmother gave up alcohol and cigarettes, and within two years she was in a home with althzeimers disease. She lived for ten more years, for the last six she had no idea who anybody was. If you’d have asked her? She would have smoked and drank and ate more butter and pasta and fatty steak.</p>

<p>This is just the latest fountain of youth. It’s not going to work</p>

<p>Yes, everyone deserves health care. But, the obsession is obscene and ruining our lives.</p>

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<p>The bronze plan only lowers premiums by raising out of pocket costs. It has nothing to do with being in a lower risk pool.</p>

563

<p>Yeah, but you are healthy so you should have less need to worry about out of pocket costs. If you are healthy you will come out ahead using the bronze plan.</p>

<p>Look… the healthy are subsidizing the unhealthy. </p>

<p>The young are subsidizing the old. </p>

<p>Those with higher incomes are going to subsidize the lower incomes …</p>

<p>But mathematically, those are the ways to insure the most people…</p>

564

<p>[CDC</a> - Healthy Brain Initiative: Alzheimer’s Disease - Aging](<a href=“http://www.cdc.gov/aging/aginginfo/alzheimers.htm]CDC”>What is Alzheimer's Disease? | CDC)</p>

<p>This is the real zombie movie coming our way.</p>

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<p>In the end, it’s not going to matter. It’s still going to cost more and more.</p>

565

<p>Well, I asked my doc once why so many people I knew of quit smoking and then got lung cancer within a short period. No, he didn’t say, there’s your causation, she quit and she got sick for it. He said, underlying causes, possible the disease was already underway, etc. </p>

<p>We make our choices. We like to blame the system for our woes- maybe there is some blame, but it doesn’t release us from our responsibilities. </p>

<p>So how do we reconcile an idea there are Food Police out to control us, leading us into obesity- and the complaints about the lack of health education, ignorance of wiser choices, which leads some into…obesity?</p>

<p>There simply isn’t enough info out yet about the new plans. I’m convinced that, though our own contacts can’t answer questions, some info is getting out, obviously, to insurers, legislators, advocates. So we end up with this hodgepodge of commentary- and no one place to confirm or pull it together, for ourselves. Some of this requires wait and see.</p>

<p>My grandmother, since we’re doing anecdotes, ate healthy, was active, physically and intellectually, lived to 99 in semi independence, never had bp or cholesterol issues, did develop macular degeneration in the last 3 years, and was only subject to senile dementia in the last maybe 6-12 months, still able to function where she lived, with just an occasional look-in.</p>

566

<p>A lot of this is just going to turn out to be genetic, in the end.</p>

<p>Have you ever gone to a high school reunion? It’s not life choices that makes one guy look like he’s 50 and the other guy look like he’s 30. Part of it’s just that the one guy is 50 and the other guy is 30. </p>

<p>No matter what we do, it’s not going to turn out that we all live a healthy life forever. Regardless of choices.</p>

<p>And then, after we’ve policed each other like we have nothing better to do with our mind, 1 in 2 will not have a mind after 85 years old. After that it just goes up.</p>

<p>So, maybe we need to look at the fact that humans aren’t immortal, while we are at it.</p>

567

<p>Are the end-of-life costs of the elderly (over 65) relavent to the ACA?</p>

568

<p>Genetic advantages on one side and genetic predispositions on the other. Each side potentially affected by lifestyle choices. In my family, the women are long-lived, no major ailments (cancer, Alzheimers, etc.) with two exceptions, both notably sedentary, overweight, poor eaters (lots of sugars and fats.)</p>

<p>ACA addresses hospice and there has been back and forth re “end of life counseling.” google.</p>

569

<p>thanks LF, I would think you would guess I don’t need to be directed to google on that one, but really, thanks for that.</p>

<p>Bay, that’s why I said I’d like to see a breakdown of pre and post medicare dollars. The whole thing is presented to us as a “whole” and not broken down by age. I mean the dollar spending.</p>

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<p>The google was for Bay, who asked about EOL. But frankly, even google can’t get past that there is NO universal site for these questions. Whether or not someone is able to sludge through acres of healthspeak. I’m stymied.</p>

571

<p>exactly. We don’t even know how much of what they say is a cost is a cost for those under the medicare age and how much is really a cost for the over medicare set.</p>

<p>It matters, imho. </p>

<p>Mostly, though, I really don’t want any more rules., I’m so sick of rules being added to our lives year after year. Land of the rules and home of more rules.</p>

572

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<p>I was asking whether a discussion of end-of-life care for those covered by Medicare (over 65) was relevant to this discussion of the ACA. The discussion seemed to be veering in that direction. Of course there will be end of life counseling and hospice issues for people of any age who are dying, so those costs for the under 65-set will be relevant to the ACA, but that is not what I was asking.</p>

573

<p>[NHE</a> Fact Sheet - Centers for Medicare & Medicaid Services](<a href=“http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html]NHE”>http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html)</p>

<p><a href=“http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2011PDF.pdf[/url]”>http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/Proj2011PDF.pdf&lt;/a&gt;&lt;/p&gt;

<p>Page 23… Has a good breakdown.</p>

<p>By memory… The average young person 18-30 uses about $1000 in health care services a year. The average expenditure for people with private health insurance is about $4000+ per year. </p>

<p>Medicare spending per person is around $14,000 a year…</p>

574

<p>Meanwhile, per today’s LATimes business section: half of small businesses are going to cut back on workers and hours to avoid the expense of Obamacare according to a survey done by the US Chamber of Commerce.</p>

575

<p>I bet many of those businesses answering the survey are not even impacted by Obamacare</p>

576

<p>[Small&lt;/a&gt; businesses restructuring to avoid Obamacare requirements, U.S. Chamber says (updated) | al.com](<a href=“http://www.al.com/business/index.ssf/2013/07/small_businesses_restructuring.html]Small”>Small businesses restructuring to avoid Obamacare requirements, U.S. Chamber says (updated) - al.com)</p>

<p>I like the paragraph that mentions that businesses dont understand the hours requirement.</p>

<p>Ok…I looked…it is around 12,000 a year of healthcare spending for those on medicare and close to 5,000 a year for those on private healthcare plans.</p>

<p>You dont have to be old to be on medicare.</p>

577

<p>I’m sort of amazed by the amount of ink spilled over understanding the business requirements. I worked in shopping center management and thus dealt with many hundreds of tenants. They all have regulatory requirements and some have tons and tons. These range from labor reporting issues - consider how much money Walmart puts into managing employee hours! - to waste disposal to training to signs to license inspections, etc. In many locations, you have to document what goes down the drain. This is just another set of requirements which you learn and implement. Sure, I’ve had Chinese restaurants where they hack into water lines and destroy sewers with grease but even that should have been caught by local inspection and they were just plain violating the law. And I’ve seen dry cleaners that dumped fluid … with mandatory reporting and even monitoring wells imposed. But every business runs according to rules. You learn them and teach them. You figure out how to cope with them.</p>

578

<p>That was a bit of a disconnect for me as well. I knew that the law adds up the hours of part-time employees for the count. This could result in some interesting gyrations otherwise such as the use of more temporary workers on a contract basis as opposed to an employer basis. The temporary staffing firms, I believe, have geared up for this for the administrative assistant areas. I wonder if they will do the same for something like food service workers.</p>

<p>BTW, this discussion has earned me $1K. I bought UNH on Wednesday because of this discussion and have about a 7% gain on it now.</p>

579

<p>In law firms, we are seeing a major increase in the use of temps and contract workers. As most law firms collude on policies, there are all sorts of meetings about this topic. Of course, it’s always cheaper for employers to have fewer employees.</p>

580

<p>BCEagle91, unh… :).</p>