Healthcare facts email

[ACor58]

I just received this email recently. Take it for what it is worth, but if it is true it is down right scary.

 

NOW LISTEN UP…….

 

Is there actually a Tom Johnson that practices law for the law firm of Baird Holm in Omaha, NE……….yes

Is his analysis of the plan accurate………………………….I don’t know

Did I read the subject Congressional Bill……………..no, it is 1018 pages so reader beware.

Should you read it………………………that’s up to you, but ignorance is not an acceptable excuse.

Should you care about this legislation……………….I think so, otherwise I wouldn’t send this to you.

 

AGAIN, please understand the link to the Congressional bill will take you to a 1018 page pdf document…………………if you don’t want to go there, don’t click on the link.

 

 

 

 

 

Tom Johnson is a Heath Care litigator in Mary’s old firm, Baird Holm Attorneys, here in Omaha. This is his assessment.

 

TEJ's review . . .

For those of you who want to know what is in the House bill regarding "health care reform" (this is the only bill that has actually been drafted - there are several draft Senate versions but none are complete and there is no administration draft at all), the entire bill is available online at http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf.

 

After scanning through the actual bill, the level of disinformation accompanying its marketing is stunning.

 

Some highlights:

 

1. It sure doesn't appear to me that you can keep your current coverage and physician if you are satisfied. As I read it, anytime there is any change in your plan (change in coverage, change in premium, change in dependents, etc.) you are forced into the public plan. If CBO estimates are anywhere near accurate, about 80 million people will transition immediately to the public plan. That is going to have actuarial implications for the private insurers but they, in turn, can't respond with any changes because to change a plan is to kill the plan. I cannot see how the private health insurance industry can possibly survive for even a year.

 

2. An overall reading makes one thing patently clear - "senior citizens" are going to be asked to go quietly into the night. For starters, the government panel who is going to assess the cost vs. benefit of all medical interventions is going to be bound by a construct that systematically disfavors seniors in the rationing process. That is, they are required to determine the ratio of cost vs. "quality life years" purchased for that cost. Any intervention to be applied to a person with a relatively limited life expectancy is going to come up on the short end of that analysis. Thus, an expensive but life-saving surgery for a 60 year old may end up costing $1000 per quality life year and be covered whereas the same surgery for a 75 year old may cost $5000 per quality life year and therefore not be covered. It will, of course, make no difference that the 60 year old is an unemployed illegal alien with a criminal record as long as your arm and the 75 year old is still running a family business employing 50 people. Just to ease the pain, the bill requires that, starting at age 65, we all participate in "end of life planning" with a government employed counselor and that we do so at least every five years thereafter. Clearly, this is intended as the vehicle by which the government is going to sell us the idea of our duty to die cheaply.

 

3. There is no provision nor incentive to add physicians. We are apparently going to add 45 million regular patients to the system and the same number of primary care physicians are going to care for them.

 

4. All medicine will become an objective exercise. Much like Medicare, permissible treatments will be defined by objective criteria such as the age of the patient and the diagnostic code applied. So, if you are a 70 year old male with a documented diagnosis of stage II prostate cancer, the government will decide the appropriate intervention. The subjective criteria that traditionally have guided all medicine (is this patient a "young" 70 or an "old" 70; is he still sexually active; is quality of life or length of life most important to him; etc.) will no longer be relevant.

 

5. You will not be permitted to acquire non-covered medical services in a private market. Efforts to purchase non-covered services out-of-pocket are criminal and would subject you to prosecution.

 

6. The government will have real-time, direct access to your bank account and the power to make deposits and withdrawals to effectuate the financial aspects of the plan.

 

7. There will be a mandatory, national health card. I can't find it specifically, but I'm willing to bet a bundle that either the bill provides for real-time government access to your medical records or it will sooner rather than later.

 

8. Congress is still exempt from mandatory participation. All Republican sponsored amendments to require Congressional participation have been defeated.

 

9. Undocumented alien residents are entitled to the same medical care and coverage as are you.

 

I sure hope everyone takes the time to let Congress and the President know their feelings on this one. As some of you are no doubt aware, our President, late last week, implored his supporters to report directly to the White House (flag@whitehouse.gov) any "fishy sounding" negative information they receive or hear about the legislation. If any of you are thinking of turning me in, you can save your time. I already sent an email to flag@whitehouse.gov turning myself in.

[X. Benedict]

A guy posted observations without document citation. Why take the time at all?

[ACor58]

A guy posted observations without document citation. Why take the time at all?

 

I noticed that too. I started to read the bill but the reason that these dirtbags in congress make them 1000 pages long is so they can hide things in them. I am going to spend some more time looking for specific examples. I sent it into Snopes for a fact check.

[Kelly the Dog]

The first point he makes is entirely and grossly wrong, so I didn't even bother reading past that. He says that the CBO estimates the public plan would be 80 million. The CBO actually says 9-10 million. It's right here. Click on the pdf file and look at page 6.

http://www.cbo.gov/doc.cfm?index=10430

 

There is also a footnote that says with all the employers that choose the public plan for their employees, the total number on the public plan will be 11-12 million, although they say it's tough to say the real number.

[Kelly the Dog]

Just for kicks I read the second item which is ENTIRE BULLSCHITT and is linked to the Zeke Emmanuel paper that was systematically debunked here last night.

 

It's amazing anyone would fall for this.

 

But this **** alleged doctor (who probably doesnt even exist, just the **** who started this farce wrote) is using the paper of one guy -- who isn't part of the government -- who doesn't at all say anything close to this but close to the opposite -- and isn't at all part of any plan in any form -- would ration care to the elderly.

[ACor58]

The funny thing is that I could see the government rationing care to the elderly. Lowers the would be costs of Medicare AND takes care of Social Security in the process.

[finknottle]

A guy posted observations without document citation. Why take the time at all?

 

1-4 are slanted but believable, 5 started to worry me, and 6 on was clearly crazy talk. So I took a quick skim myself, at the small business section. I have a small consulting company and expect to opt out as we each get their own insurance.

 

 

The first thing I noticed is that in addition to referenced taxes unspecified in the section I was reading, an opt out company gets hit with tax on wages of 8% (p183), reduced for small businesses with a total payroll less than 400k.

 

It appears at first blush that a microcompany such as mine will get a 50% tax credit for that tax. But the credit is phased out as the average wages exceed 20K - *I think* it is reduced by a percentage point for each multiple of 20k, but it is written in taxeese so I can't be sure (p189). The credit is also reduced if you have more than 10 employees (not my situation - the point is they get you coming or going. High averages and few employees? Lower percentage. Low averages but high number of employees? Lower percentage.).

 

More alarmingly, no credit shall be granted for the taxes paid on highly compensated employees which - and I think this is a departure from the normal regulations - they define as only 80k in compensation. (p190)

 

 

So - in my admittedly quick skim, I see that I am going to pay a new 8% wage tax, and get none of it back as a deduction or credit. And rather than have the taxes affect only 'gold plated plans,' it hits all of my employees. They make lavish 80k+ salaries, and typically have Kaiser Permamente individual plans. So if I opt out, I pay a new 8% tax on my payroll. If I opt in, I still pay an 8% tax on payroll.

 

If this is true, I'm pretty concerned. And I've only spent 5 minutes looking at the bill!

[Wacka]

Welcome to the informed.

[Chef Jim]

Welcome to the machine.

[Kelly the Dog]

1-4 are slanted but believable, 5 started to worry me, and 6 on was clearly crazy talk. So I took a quick skim myself, at the small business section. I have a small consulting company and expect to opt out as we each get their own insurance.

 

 

The first thing I noticed is that in addition to referenced taxes unspecified in the section I was reading, an opt out company gets hit with tax on wages of 8% (p183), reduced for small businesses with a total payroll less than 400k.

 

It appears at first blush that a microcompany such as mine will get a 50% tax credit for that tax. But the credit is phased out as the average wages exceed 20K - *I think* it is reduced by a percentage point for each multiple of 20k, but it is written in taxeese so I can't be sure (p189). The credit is also reduced if you have more than 10 employees (not my situation - the point is they get you coming or going. High averages and few employees? Lower percentage. Low averages but high number of employees? Lower percentage.).

 

More alarmingly, no credit shall be granted for the taxes paid on highly compensated employees which - and I think this is a departure from the normal regulations - they define as only 80k in compensation. (p190)

 

 

So - in my admittedly quick skim, I see that I am going to pay a new 8% wage tax, and get none of it back as a deduction or credit. And rather than have the taxes affect only 'gold plated plans,' it hits all of my employees. They make lavish 80k+ salaries, and typically have Kaiser Permamente individual plans. So if I opt out, I pay a new 8% tax on my payroll. If I opt in, I still pay an 8% tax on payroll.

 

If this is true, I'm pretty concerned. And I've only spent 5 minutes looking at the bill!

In the House plan, IIRC, if you have less than 25 employees you are exempt from the obligation and wouldn't have to opt out where the tax penalties come in. I'm not positive about that but I think that's how it works.

[X. Benedict]

In the House plan, IIRC, if you have less than 25 employees you are exempt from the obligation.

 

this bill is pretty much up for grabs....but It is under Title III.

[bills_fan]

I call shenanigans. No way #5 is true. And #6 is absurd.

 

Not buying it. BS scare tactic.

[finknottle]

Welcome to the machine.

 

Suppose my reading is correct, and consider my semi-hypothetical S Corp. We have four engineers doing technical consulting and earning 100k each. And I average 20k corporate profit in addition to being a salaried employee. Happy employees, a small but ok return, a modest American success story, huh?

 

But now I have a new 32k tax. I can't turn around and lower their salaries by 8k - they would quit. But if the company eats it, that means I personally eat it - all 32k of it, every year (remember, it's a pass through, so no profit is no protection). For a company whose profit ranges between -20k and 40k, that is rediculous.

 

So the unintended consequences are as follows: the best bet financially is to let everyone go and simply fold the company. The alternative is to lower payroll by reducing employees - turn it into a low-salary high-dividend one man shop. Is this the dynamic economy we want to encourage?

[finknottle]

In the House plan, IIRC, if you have less than 25 employees you are exempt from the obligation and wouldn't have to opt out where the tax penalties come in. I'm not positive about that but I think that's how it works.

 

Isn't the house plan the link provided? What do you make of page 183 sec 142? It seems to say you pay a tax if you opt out, and the tax is reduced for businesses with a payroll less than 400k.

[X. Benedict]

The summary may be helpful:

 

http://docs.google.com/gview?a=v&q=cac...hl=en&gl=us

[KD in CA]

8. Congress is still exempt from mandatory participation.

 

Without commenting on the rest of it, I'd bet my house that this is true and likely the best indicator that this plan is a complete disaster.

[Kelly the Dog]

Isn't the house plan the link provided? What do you make of page 183 sec 142? It seems to say you pay a tax if you opt out, and the tax is reduced for businesses with a payroll less than 400k.

I'm trying to find out. So say you have 5 employees, and they make 80K+ a year, and they all pay 100% their own insurance, or do you guys pick up part of it? (I know it's a small business, I am not making any judgment whatsoever on whether or not you guys should pay for employee insurance, most 5 person places can't.)

[ThereIsNoDog]

Whether you choose to (naively) "not believe" most of the OP, if anything, #8 should tell you all you need to know.

[Kelly the Dog]

Without commenting on the rest of it, I'd bet my house that this is true and likely the best indicator that this plan is a complete disaster.

 

The Feds apparently have a great policy but the janitors at federal buildings are in the same pool as the congressmen and senators and have the exact same options. They can choose from various plans within the exchange, some of which have higher co-pays or deductibles or coverage. It's up to them.

http://www.politifact.com/truth-o-meter/st...-care-benefits/

If you choose to spend a lot of individual money on extravagant extras and plans, that is up to you.

[finknottle]

Suppose my reading is correct, and consider my semi-hypothetical S Corp. ...

 

While I'm singing the blues, let me raise another health-related pet peeve.

 

As a small company, I offer cash instead of health insurance. My employees are professionals who would rather get a plan of their choosing anyway...

 

But I ought at least to provide some form of HSA - that makes great sense in this scenario. And in theory, I can. But the problem is that the government say's that I can not administer the plan, I have to go to a designated company for that. Fine. They will charge me a few thousand dollars a year to administer it. That exceeds the tax benefits for only 2-4 people.