This is topic Regal cuts employee hours to stay out of Obamacare in forum Film-Yak at Film-Tech Forum ARCHIVE.
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Posted by Mitchell Dvoskin (Member # 751) on 04-15-2013, 03:36 PM:
Fox News
quote: Fox News
The nation's largest movie theater chain has cut the hours of thousands of employees, saying in a company memo that ObamaCare requirements are to blame.
Regal Entertainment Group, which operates more than 500 theaters in 38 states, last month rolled back shifts for non-salaried workers to 30 hours per week, putting them under the threshold at which employers are required to provide health insurance. The Nashville-based company said in a letter to managers that the move was a direct result of ObamaCare.
“To comply with the Affordable Care Act, Regal had to increase our health care budget to cover those newly deemed eligible based on the law's definition of a full time employee.”
- Memo sent to managers of Regal theaters
“In addition, some managers have requested guidance on what they should tell those employees negatively impacted and, at your discretion, we suggest the following,” read the memo obtained by FoxNews.com. “To comply with the Affordable Care Act, Regal had to increase our health care budget to cover those newly deemed eligible based on the law's definition of a full-time employee.”
“To manage this budget, all other employees will be scheduled in accord with business needs and in a manner that will not negatively impact our health care budget,” the message continues.
Regal, which had revenue of $2.8 billion in 2011, is the latest company to respond this way to the Affordable Health Care Act's requirement that employees at companies of a certain size who work more than 30 hours per week be provided health coverage. Applebee's and Olive Garden also scaled back the hours of workers. A handful of colleges have cut hours because of the law, including Palm Beach State College in Florida and New Jersey’s Kean University. Critics say the law is boomeranging on working folks.
"If you want to have reduced work, lower wages and economic stagnation, this is a great way to do it, said Ed Haislmaier, senior research fellow at the Heritage Foundation.
One Regal theater manager told FoxNews.com the move has sparked a wave of resignations from full-time managers who have seen their hours cut by 25 percent or more.
“In the last couple weeks, managers have been quitting on a daily basis from various locations to try and find full-time work,” said the manager, who asked not to be named. “Regal up until now has never restricted anyone to anything below 40 hours.”
The manager told FoxNews.com ObamaCare has had the unintended consequence of taking food off his table.
“Mandating businesses to offer health care under threat of debilitating fines does not fix a problem, it creates one," he said. "It fosters a new business culture where 30 hours is now considered the maximum in order to avoid paying the high costs associated with this law.
“In a time where 40 hours is just getting us by, putting these kind of financial pressures on employers is a big step in a direction far beyond the reach of feasibility for not only the businesses, but for the employees who rely on their success," he said.
Regal, which operates cinemas under the names Regal Cinemas, Edwards Theatres and United Artists Theaters and recently purchased Oregon-based Hollywood Theaters for $191 million, did not respond to repeated requests for comment from FoxNews.com. The publicly-traded company's stock has risen nearly 30 percent over the last year.
In addition to the movie theater chain and several restaurants, the state of Virginia also rolled back the hours of all part-time employees back to 29 per week in February, with officials from the state claiming that the new mandate would cost the state tens of millions of dollars a year.
Posted by Jim Cassedy (Member # 4115) on 04-15-2013, 04:33 PM:
A restaurant in my neighborhood just closed after being open for only
about 3 weeks, after spending several million dollars rennovating
the building. It was a big place, and was going to require a
large staff to run.
The owners have been rather obscure about the exact reasons for the
closure, except for some vague allusions to "staffing related issues".
But the 'word on the street' is that they realized they weren't going
to be able to comply with new mandated health-care costs imposed not
only by "Obamacare" but also by additional health-care related fees
requrired by the City Of San Francisco.
I'm sure we can expect more of this in the future.
The previous tenant at that location was a coffee-shop/diner that had
been there for at least 20 years or more but was forced to close
a couple of years ago because it was threatened with tens-of-thousands
of dollars worth of fines by a crooked ADA lawyer over some relatively
minor code violations, and they didn't have the money to fight it in court.
So they closed.
Posted by Rick Raskin (Member # 1561) on 04-15-2013, 04:42 PM:
Ah, the law of unintended consequences. The same thing has happened to my wife's hairdresser. We'll certainly see more of this as time goes on. I'll stop before I get political.
Posted by Martin McCaffery (Member # 37) on 04-15-2013, 05:48 PM:
Unless someone is willing to put some verifiable numbers on the table, I call BS.
Posted by Jonathan Goeldner (Member # 4854) on 04-15-2013, 06:01 PM:
oh, Fox news - nuff said...
Posted by Aaron Garman (Member # 1653) on 04-15-2013, 09:25 PM:
Not surprising at all. Too bad for those employees, who were more than likely pretty loyal.
AJG
Posted by Mike Blakesley (Member # 26) on 04-15-2013, 09:39 PM:
quote: Jonathan Goeldner
oh, Fox news - nuff said...
So you're saying it didn't happen? They just made it up?
I can see you not liking Fox News because of their political leanings, but to dismiss their reporting wholesale for that reason is just closed-minded.
A well rounded news consumer will look at reports from many sources and take the average.
Posted by Michael McGovern (Member # 4807) on 04-15-2013, 10:01 PM:
This story is absolutely 100% correct, Regal no longer allowed part time staff to work more than an average of 30 hours. Seeing as most locations only have at most, 3 or 4 full time managers including the GM, this is a pretty major change. I haven't worked for Regal in years, but when I did, they did offer insurance for part time employees, but it was expensive and had very high copays and deductibles, so it almost wasn't even worth having.
I don't really have much to comment on this story without derailing this thread into political territory which isn't allowed here, but this isn't going to do much to help Regal which was a company that in my opinion at least, was always quite hostile towards their employees.
Posted by Steve Guttag (Member # 268) on 04-16-2013, 12:08 AM:
It would seem that the response from the government should be to adjust the law such that they remove the full-time/part-time designation and that a contribution size be set based each hour worked. Since the goal is 100% health care coverage, the designation of full-time/part-time should not factor in. It would put an end to this problem.
Posted by Leo Enticknap (Member # 534) on 04-16-2013, 02:26 AM:
It looks like the law of unintended consequences has struck again. Something similar happened here a couple of years ago: new regulations were brought in requiring temporary agency workers to be given the same employment benefits (principally paid holiday and maternity leave) as fixed-term and permanent employees. It was a great idea in theory, but the result in practice was a wave of outsourcing of call centre and IT-type jobs to the developing world, and for those that couldn't be outsourced, big employers started to bypass the agencies and hire people on zero-hours contracts.
Posted by Dennis Benjamin (Member # 1137) on 04-16-2013, 09:31 AM:
Whether or not it's a real thing, lots of companies will be using it as an excuse to cut employee hours.
The problem at Regal is that most employees have no hours anyways. You can verify this by going to your local Regal location on any given week day. Typically you buy your tickets at a machine, or an employee behind the concession stand. The same employee sells you your popcorn and tears your ticket. Oh yeah, that employee is usually a manager....
Posted by Mike Blakesley (Member # 26) on 04-16-2013, 09:49 AM:
quote: Steve Guttag
Since the goal is 100% health care coverage, the designation of full-time/part-time should not factor in
This is true -- however the biggest problem with the whole health care thing is this: People want something for nothing. They want health care but they think it should be free, or that their employer should just pay for it and absorb the cost.
Everyone seems to think their employer, especially if it's a big company, has bottomless pockets. Well they are NOT bottomless, and there's no guarantee that even a big company can afford to just up and pay for everybody's health insurance -- unless they raise prices, which competition makes difficult. Even if they cut the executive salaries, it might not save enough money to pay the tab. So they cut the only place they can: Hours and employees, and if that isn't enough, they start cutting locations.
If you're going to start requiring health insurance for part time employees along with the full time, just watch the prices skyrocket.
Posted by Martin McCaffery (Member # 37) on 04-16-2013, 11:49 AM:
quote: Dennis Benjamin
Whether or not it's a real thing, lots of companies will be using it as an excuse to cut employee hours.
Absolutely, which is why any such claim should be treated with extreme skepticism (like seatbelts and airbags will make cars unaffordable). Was it the head of Papa John's who claimed he would have to raise the price of pizza or start firing people? Then when the numbers were crunched it turns out he would have to raise the price of pizza 14˘?
Given the state of health insurance in this country, as the price varies dramatically from state to state, and given the state of the ACA, with several states resisting it, any national corporation that would cite ACA requirements as a reason for firing or cutting back hours, is most likely blowing smoke.
Posted by Bobby Henderson (Member # 840) on 04-16-2013, 01:17 PM:
quote: Mike Blakesley
This is true -- however the biggest problem with the whole health care thing is this: People want something for nothing. They want health care but they think it should be free, or that their employer should just pay for it and absorb the cost.
Most people want affordable health care. Not free. Affordable. The people who want free health care are probably already getting it for free.
The bigger problem is hardly anyone is doing anything whatsoever to stop the runaway health care price inflation that has already been skyrocketing for 2 decades. The price increases are fantastic if you own a lot of health care related stocks or work high up in a health care related company. The price increases suck everywhere else. The price increases are bad for the general public and they're terrible for any business that's not in the health care industry.
15 years ago I had a really good health insurance policy that had only a $500 deductible. Our company didn't have to pay much for it. Today my deductible is $3500 and the policy basically sucks, but it's all we can afford because the premiums have been going up at a double digit rate of inflation every damned year for close to two decades. We've changed insurance providers 4 times in the last five years. Every time we come around for renewal I brace for the announcement that we're just doing away with the insurance altogether.
The new health care law is doing little if anything to stop the price increases. At the same time the opponents of that law have made zero effort to stop the price increases either. After all, health care is an asset class for investors and profit engine for certain business people. The patients who need the vital service can just go get screwed for all anyone cares.
No one can absorb these non-stop price increases. The government can't do it forever. Look at our national debt. Many businesses can't afford the price increases either, not without raising prices on their own products. It's also silly to expect individuals to foot the bill 100%. In that situation a hell of a lot of people would suddenly have zero to spend on things like trips to the movie theater. They're just working, going home, blowing a hell of a lot on an over-priced health insurance policy and trying to survive on whatever is left of their paycheck. It would be cheaper for me to make payments on a $80,000 sports car than pay for an individual health insurance policy.
This situation is not good for anyone in the long term. It doesn't matter if you're a business owner, employee, stock day trader or whatever. The government, businesses, media and the general public at large keep kicking this can down the road instead of doing anything of meaningful substance. I see this as the most dire situation this country faces. The health care system is in such a bubble I fear that when it pops it's going to pull us into a considerably worse economic mess than the one from which we're still trying to recover.
Posted by Leo Enticknap (Member # 534) on 04-16-2013, 01:57 PM:
In relation to Bobby's point, the United States spends 17.9% of its GDP on healthcare (World Health Organisation figures), compared to roughly half that in most other developed countries (9.6% in Britain, for example, but the figure is pretty similar throughout Western Europe, Canada, Japan, Australia and NZ). Yet most of the health indicators (e.g. life expectancy and cases per head of population of serious, chronic diseases) are around the same in the US as they are in other developed countries. So why does America spend around twice the amount of money per capita on healthcare to achieve more or less the same result?
I'm not trying to get into a Michael Moore-style worshipping of state-run healthcare systems scenario here (they can and do go badly wrong), and strongly suspect that the answer to that question is a lot more complicated and with a lot more factors involved than any politician or medical professional is willing to admit. But the skyrocketing figures that Bobby gives certainly starts to explain why the mismatch is so big.
Posted by Bobby Henderson (Member # 840) on 04-16-2013, 02:09 PM:
quote:
In relation to Bobby's point, the United States spends 17.9% of its GDP on healthcare (World Health Organisation figures), compared to roughly half that in most other developed countries (9.6% in Britain, for example, but the figure is pretty similar throughout Western Europe, Canada, Japan, Australia and NZ).
The United States will surpass the 20% of G.D.P. mark on health care spending before the end of the decade. Who even knows how much of our total economy the health care industry will be devouring by the year 2020? As polarized as the debate has become on this issue I'm sure we'll find out. Nothing of substance is getting done until then.
Posted by Mark J. Marshall (Member # 1409) on 04-16-2013, 02:19 PM:
The economy will collapse before 2020 anyway, Bobby. So who cares??
![[Razz]](tongue.gif)
quote: Jonathan Goeldner
oh, Fox news - nuff said...
So tired of this BS.
Maybe this will help.
Here is MSN whining about it.
Posted by Martin McCaffery (Member # 37) on 04-16-2013, 02:34 PM:
Health Care and Health Insurance are two different things. Proceed with caution ![[Wink]](wink.gif)
Posted by Bobby Henderson (Member # 840) on 04-16-2013, 02:52 PM:
quote: Mark J. Marshall
The economy will collapse before 2020 anyway, Bobby. So who cares??
Apathy contributes to the problem. As does a general public that refuses to do anything to reduce its increased health care risks.
What I don't get is all the people who defend the status quo of this greedy, immoral industry when that industry is not doing one damned thing for them in any way. BTW, I lump everyone from malpractice trial lawyers to pill manufacturers in that group. They all form a convenient circle of cooperative scapegoats to blame on why they all keep giving themselves fat pay raises at our expense.
I never hear anyone come to the defense of companies like Comcast or DirecTV when they want to increase their pay TV rates. Or what about AT&T and Verizon getting rid of unlimited data plans? I doubt if anyone more than zero customers liked that. There's nothing but greedy bastards running those companies as far as everyone is concerned.
If American Electric Power wants to charge me more for electricity it has to go through the Oklahoma Corporation Commission to do so. And the OCC might block the price hike. There's no such controls, much less any standards at all, on what health care entities can charge. One clinic might charge $1000 for a colonoscopy while another charges $5000 for the same thing (without a kiss or reach-around for that kind of screwing).
People joke about the military wasting money on $500 hammers. The medical industry is chock full of that kind of crap.
Posted by Buck Wilson (Member # 5885) on 04-16-2013, 03:16 PM:
Yay!!! Looks like I fall into this category.....
Posted by Chris Slycord (Member # 4239) on 04-16-2013, 03:41 PM:
quote: Mark J. Marshall
Maybe this will help.
Here is MSN whining about it.
And if you reach the end of the article you'll see that their source is the Fox article. Just pointing that out.
But the statements in the article are definitely true, nonetheless.
Posted by Jonathan Goeldner (Member # 4854) on 04-16-2013, 04:24 PM:
jeesh, the Fox news jab was a joke - lighten up folks...
Posted by Chris Slycord (Member # 4239) on 04-16-2013, 04:33 PM:
It wasn't clear, given that you were following up after a claim that the article is BS.
Posted by Jonathan Goeldner (Member # 4854) on 04-16-2013, 04:38 PM:
next time I'll be sure to add a sarcastic smiley... ![[Big Grin]](biggrin.gif)
![[puke]](graemlins/puke.gif)
Posted by Jim Cassedy (Member # 4115) on 04-16-2013, 05:16 PM:
quote: Mark J. Marshall
Here is MSN whining about it.
MSN...'nuff said.
(Sorry guys, I just HAD to do that!) LoL
Posted by Jonathan Goeldner (Member # 4854) on 04-16-2013, 08:53 PM:
^ at least SOMEONE has a sense of humor around here ...
Posted by Mark J. Marshall (Member # 1409) on 04-16-2013, 09:09 PM:
quote: Chris Slycord
And if you reach the end of the article you'll see that their source is the Fox article.
Hmm. Imagine that.
![[Smile]](smile.gif)
Posted by Martin McCaffery (Member # 37) on 04-16-2013, 09:12 PM:
Of course, the source of the Fox article was most likely a Regal press release.
It is amusing that they went to the Heritage Foundation for a detrimental comment about the ACA inasmuch as the ACA is based on the Heritage Foundations healthcare proposal.
Posted by Randy Stankey (Member # 64) on 04-16-2013, 09:27 PM:
While I do think that there are merits to these companies claims that the new health care laws are too expensive, I also think that they are as much or more of a political statement against the current Administration.
Yes, the new laws will increase health care expense for companies. It will affect their bottom lines but I don't think it will affect them that much. They are just doing it to get back at the President who they don't like. Working people are just getting caught in the crossfire. This sucks, big time!
Personally, I don't like the idea of health insurance at all. The idea is that insurance spreads out the risk of paying for big medical bills. I think this is bad for two reasons.
First, I think it is wrong to make some people pay for medical care of others. The majority of people who have health insurance don't use it very often. They'll get checkups and have minor illnesses or injuries treated but, mostly, they consume little or no health care services. It ends up being like a Ponzi scheme.
Second and more importantly, I think that spreading the risk necessitates concentrating authority over the administration of the health care system. Concentrating authority virtually always concentrates the potential for corruption and abuse.
I think that what we see happening today is the effect of corruption and abuse caused by the government forcing the concentration of authority. I fear that it will only get worse as the new laws go into effect.
Posted by Bobby Henderson (Member # 840) on 04-16-2013, 10:22 PM:
I'd be all for getting rid of health insurance if health care itself wasn't so outrageously expensive.
Insurance is there for a variety of catastrophic events. Drivers are supposed to have car insurance because very few if any can afford the cost of T-boning a Cadillac and seriously injuring its occupants. I have home owners insurance because I don't have $100,000 laying around in the event a tornado levels my home or if it burns to the ground. If I keel over and die tomorrow life insurance will make sure my beneficiaries aren't stuck digging several grand out of their own pockets to bury my mortal remains.
The entire health care industry in the US is effectively a giant Ponzi scheme. The insurance companies are just one of the players in the whole circle of players in that industry.
One of the players raises the price of his product/service and blames another player for the price hike. Insurance companies hike the cost of their premiums then blame it on doctors charging more for treatment. The doctors say they have to increase their treatment costs because malpractice insurance and other things they have to buy in their practice are rising. The attorneys are seeking bigger court judgments because they have to put increasing time and resources into suing quacks and biotech companies that have done wrong. It goes on and on. Every type of company working in the health care industry has someone else to blame on why they were forced to raise prices.
I might go along with the circle of blame if the level of greed in these companies wasn't so visible. Our company had Coventry providing health insurance in 2012. When our policy came up for renewal they hiked the price over 30%! Instead we went to Blue Cross/Blue Shield. Not quite so expensive, but the coverage is watered down a little more and the deductible is a little higher. We'll keep going round and round with this charade until we're paying some "insurance company" for a card that actually has no benefits at all -but it's still "insurance" so we'd be in compliance with the health care law and not get fined.
![[Roll Eyes]](rolleyes.gif)
Posted by Chris Slycord (Member # 4239) on 04-16-2013, 10:46 PM:
quote: Martin McCaffery
Of course, the source of the Fox article was most likely a Regal press release.
The article quotes what they claim to be an internal memo sent to managers, for what it's worth.
Posted by Aaron Garman (Member # 1653) on 04-17-2013, 12:06 AM:
I'll just continue reading the Daily Prophet.
Posted by Randy Stankey (Member # 64) on 04-17-2013, 12:39 AM:
I really think that, if health insurance was eliminated (made illegal) the price of health care would quickly fall to market rates. Companies could only charge what people can afford. The mere existence of insurance guarantees prices will climb via the snowball effect that Bobby describes. Health insurance is a form of a Ponzi scheme which will eventually collapse. The government is trying to prop up that Ponzi scheme which will only prolong the agony but I'm fairly sure it will collapse even if it takes 50 years.
Okay, so we get rid of insurance. What can we do when some people can't pay? I don't know. There will have to be some sort of compromise. I'm only guessing, here...
First off, I don't see things like car accidents to be too much of a problem. If you get hit by somebody else who is insured, their policy ought to pay. I don't see why we can't tweak the rules so that we make sure that people hurt in accidents, through no fault of their own, are absolutely taken care of. That shouldn't be too hard to do. Uninsured and underinsured drivers are a separate problem but I think that reforming the insurance system will solve a lot of these problems by bringing cost down in the first place. We could come up with some solution to fill in the gap. I don't know what. I'll have to think about that one.
Second, one problem I see with current health care plans is that they pay for everything from just a Band-Aid to health club memberships. Insurance pays for too much and, thus, dilutes the quality of the things it pays for. For example, if I had $100, to spend, I could buy food for ten people at McDonald's or two people could eat at Hilltop Steak House. Not a perfect example but it illustrates the point that, if you don't spend money on too much stuff, you have more money to spend on better things. Instead of paying for every Band-Aid, we limit what insurance pays for.
Eliminate co-pays and deductibles. All those do is allow insurance companies to manipulate prices by claiming that they have higher or lower deductibles. Let's throw that all out. Either insurance pays or it doesn't. We could put in a lower limit, above which, insurance MUST pay. This will make insurance cheaper to afford and the other things that I mention will cut costs to insurance companies, taking away some incentive to manipulate the markets the way they do, now.
To be honest, I could spend $50 per month on prescriptions.
Under normal circumstances, I usually only visit the doctor two or three times per year. I could spend $50 or $100 for a routine doctor visit. If my current health insurance has a $20 co-pay, that raises the cost of my policy. I end up paying $1200 or more per year for, maybe, $500 worth of service.
For major illness, we could have hospitalization or major medical insurance that is separate from other insurance. It pays only if you are admitted to the hospital or only if the cost is over a certain amount.
Businesses whose employees get sick or hurt on the job already have to pay for Worker's Compensation insurance. Let's cut the crap out of the Worker's Comp system. No messing around. If your worker gets hurt, your company pays. Period. That would certainly go a long way toward making companies using their balance sheets to justify cutting corners on safety. Wouldn't it? That would, hopefully, take care of the problem of people who get hurt at work.
I don't think these ideas are perfect solutions but they are certainly starting points to get the discussion rolling. Regardless of the method, our entire system of paying for health care has to be completely rethought. I don't think the current system is sustainable and I am virtually certain that government sponsored and paid system will do much to solve the problem at all.
We are going to have to do something different. We should start to try to fix it now, from the ground up.
Posted by Leo Enticknap (Member # 534) on 04-17-2013, 02:20 AM:
quote: Randy Stankey
First, I think it is wrong to make some people pay for medical care of others. The majority of people who have health insurance don't use it very often. They'll get checkups and have minor illnesses or injuries treated but, mostly, they consume little or no health care services. It ends up being like a Ponzi scheme.
The problem there is in genetic susceptibility to serious (read expensive) diseases. Everybody knows someone who leads a relatively unhealthy lifestyle who, when challenged about it, will reply defensively that a friend of theirs smoked 120 a day and lived to 95, and knew someone else who was vegan, teetotal and ran ten miles a day, but was dead of cancer aged 35. They are of course exceptions that prove the general rule: there is a lot we can do to take care of our own health, but some factors are outside our control. Is it morally OK to say 'Sorry pal, but even though there's a history of serious heart disease on both sides of your family, if you have a heart attack, you're on your own?'.
It's very difficult and probably impossible to come up with a system that is even accurate most of the time in rewarding personal responsibility without also punishing bad luck. An insurance model, whether run commercially or in the form of a state-run healthcare service, does at least help those who have been dealt a bad hand (which might not even be genetic: what if both your parents were heavy smokers and you grew up doing a lot of passive smoking?).
quote: Randy Stankey
Second and more importantly, I think that spreading the risk necessitates concentrating authority over the administration of the health care system. Concentrating authority virtually always concentrates the potential for corruption and abuse.
There I could not agree more, and virtually everything that has gone systemically wrong with the British National Health Service (most recently the Stafford Hospital scandal and the Leeds heart unit row) boils down to this.
quote: Randy Stankey
Eliminate co-pays and deductibles. All those do is allow insurance companies to manipulate prices by claiming that they have higher or lower deductibles. Let's throw that all out. Either insurance pays or it doesn't. We could put in a lower limit, above which, insurance MUST pay. This will make insurance cheaper to afford and the other things that I mention will cut costs to insurance companies, taking away some incentive to manipulate the markets the way they do, now.
Also agreed, and my (admittedly superficial) understanding of the French system (explained to me by a French medical student many years ago) is that this is effectively how it works. You pay a small fee to see a family doctor for routine treatments and minor stuff, and are expected to pay for everyday medicines yourself, but if you have a chronic and/or expensive condition, then the state steps in and picks up the tab.
Posted by Lyle Romer (Member # 1266) on 04-17-2013, 06:23 AM:
To add a little more to Bobby's point, the "Affordable Care Act" set out to solve a problem that didn't exist (access to healthcare) and made the problem that does exist (health care costs) worse.
Anybody in the US could get healthcare before this law was passed by going to a hospital ER and never pay for it. Now that all kinds of required coverage has been added to insurance plans (pre existing conditions, etc) the premiums will only go up.
Back to the original story. Look at it this way. Let's say a worker is getting $9 an hour to work 35 hours per week. So they make $315 a week or roughly $1300 a month (rounding). Now, if Regal has to provide a health plan even a cheap one is going to be $300 a month. Therefore Regal would have an increased cost of 23% per employee. It would be less if they just paid the fine but still significant.
Option 2 is to make sure nobody works over the threshold. I'm not so sure this is an "unintended" consequence of the law. To stay away from politics I'll leave it at that.
Posted by Frank B. McLaughlin (Member # 6683) on 04-17-2013, 07:46 AM:
[Anybody in the US could get healthcare before this law was passed by going to a hospital ER and never pay for it.] [/Lyle Romer]
Which brings us to the real problem. When I go to the ER my insurance company pays the $1200 bill. When the uninsured goes in for the "free" visit that unpaid $1200 bill goes to collection. Now the collection company is willing the settle for $350 (actual cost?). Now if EVERYONE had coverage then my bill would have been $350 also. My insurance company would pay and that insurance company could lower my rates. I resent paying for the free-loader.
Now Regal, being the fine upstanding corporate citizen that they are has opted for the bottom line (after all money is involved here). Now if all the theater companies think the same we are still at square one. This is what universal coverage is trying to get us beyond.
Posted by Mike Frese (Member # 4361) on 04-17-2013, 08:49 AM:
How many of you who are calling this a bullshit reason to cut hours have ever hired people AND looked at the cost of providing health insurance?
Lyle, gave a good example of how this works.
Those who are questioning Fox, would you expect MSNBC to have the same article? Hell no! Just look at the coverage of the Philadelphia Abortion doctor. News outlets are political. Now be shocked!
Posted by Bobby Henderson (Member # 840) on 04-17-2013, 09:43 AM:
There's a big catch to the whole walk into the ER and not pay the bill thing. That's only good for a one time thing.
A disease like cancer is different. That's not solved in one visit to the ER. Insurance companies and hospitals can (and do) decide to send someone home to die instead of treating them particularly if they don't have any medical coverage.
Those who do have insurance may be dropped when their policy comes around for its annual renewal. A battle against cancer often isn't won (or lost) inside of a single calendar year. Someone who did have health insurance and help battling cancer may suddenly be on his own. This is also true of other diseases and disorders that patients just have to live with possibly for the rest of their lives -like MS, HIV, Parkinson's Disease, etc.
It's very easy for working people and even business owners to be financially devastated under our health care system in the United States. The people getting crushed into bankruptcy by health care bills aren't freeloading slobs on welfare. But they're seen that way by those who want this very greedy system to remain unchanged.
Posted by Scott Jentsch (Member # 1681) on 04-17-2013, 10:33 AM:
Reading the article a few times shows that it's clearly intended to be provocative, but let's get to the meat of the matter here without introducing political discourse:
==============
Regal Cinemas has adjusted work schedules for "thousands" of employees, and has cited compliance with new federal employment regulations as the reason.
==============
Regardless of what those new regulations are, they are the new law of the land. Just one of very many that businesses have to comply with, and factor the costs of compliance into their cost of doing business.
In this particular case, a major employer, with $2.8 billion in revenue (that comes to an average of $5.6 million per location), has decided to reduce the work hours of its employees so those employees would be reclassified rather than comply with the new regulation that would have otherwise applied to those employees.
The company has chosen to change its employment policies rather than incur unspecified increased costs, which would have affected net profits and/or the price it charges its customers.
Posted by Sean McKinnon (Member # 612) on 04-17-2013, 12:06 PM:
Strange... When I worked foe LCE ten years ago hourly employees were restricted to 30 hours (at least in mass) and with one or two exceptions all managers were salary. It surprises me that Regal allowed hourly employees to work that many hours before this.
Posted by Chris Slycord (Member # 4239) on 04-17-2013, 12:50 PM:
quote: Frank B. McLaughlin
Which brings us to the real problem. When I go to the ER my insurance company pays the $1200 bill. When the uninsured goes in for the "free" visit that unpaid $1200 bill goes to collection. Now the collection company is willing the settle for $350 (actual cost?). Now if EVERYONE had coverage then my bill would have been $350 also. My insurance company would pay and that insurance company could lower my rates. I resent paying for the free-loader.
IMO, it makes no sense to call a settled amount the actual cost. Often times the settled amount is just obtained so that they can get something out of the client, even if it results in a loss (since it is preferable to obtain money and lose than to obtain none and lose more). In those situations, the difference can be taken as a tax write-off.
Further, if the collection agent is obtaining $350 from the client, that means that the hospital is likely only getting around $230-250 since collection agents usually work on commission.
Though, I'd be surprised if a collection agent would bother going to the trouble of finding the person for such an amount ($350). They could easily blow past the collection amount in costs for trying to collect in a very short time.
Posted by Mike Blakesley (Member # 26) on 04-17-2013, 01:09 PM:
quote: Bobby Henderson
There's a big catch to the whole walk into the ER and not pay the bill thing. That's only good for a one time thing.
That's not true. If you are really sick and walk into an ER they will take care of you. Of course they may give you the bare minimum care to keep you alive, but nobody is turned away due to financial need....at least not in Montana.
The problem is that there are SO many people who just show up at the ER for minor problems like a bad cold, and then don't pay the bill. There are definitely a lot of people in this country who are in financial straits because of health care costs, but there are also DEFINITELY a lot of freeloaders too.
Posted by Bobby Henderson (Member # 840) on 04-17-2013, 01:57 PM:
ER use and abuse is in dire need of reform -the main reform being the task of beating the message into the heads of those who put their brains on auto-pilot and head to the ER in knee-jerk response on any issue no matter how minor.
At the same time, I can find many "family doctors" in my area who are not taking in any new patients -and certainly won't have a damned thing to do with any person lacking health insurance coverage. It's also pretty damned difficult to get seen without an appointment even if you do have insurance. Those two factors put more people into emergency rooms for treatment of minor problems.
"Urgent Care Clinics" are popping up in more places. We have a couple of them here in Lawton. They try to pull non-emergency health issues out of the ER. They're also an alternative for patients who don't have a family doctor. You can be seen without an appointment, although wait times can be kind of high. The downside: AFAIK these places will not treat you without proof of insurance. If you don't have coverage you're probably going to be back a the ER.
I think my point about cancer and other long term diseases and disorders still stands. The Hippocratic Oath is pretty much irrelevant. If you don't have health insurance, but have discovered a malignant melanoma on your leg the ER isn't going to do much for you. There's an outside chance they might cut the cancerous freckle off your leg, but that's it. They're not going to assign you an oncologist or put you on a cancer treatment program. An insurance company sure as hell won't offer coverage if they know you have cancer beforehand.
Posted by Joe Redifer (Member # 3) on 04-17-2013, 04:16 PM:
As much as I'd love to pull down my shorts and diarrhea all over Regal, apparently this is not the entire story. It's not entirely false, either. I guess Fox cherry-picked the news. Unfortunately I don't know what the full story is and you won't find any Regal employees posting about it here.
Posted by Chris Slycord (Member # 4239) on 04-17-2013, 07:25 PM:
quote: Mike Blakesley
That's not true. If you are really sick and walk into an ER they will take care of you. Of course they may give you the bare minimum care to keep you alive, but nobody is turned away due to financial need....at least not in Montana.
Yes, no one can be turned away, though the places really only want people who can will usually send them to a public hospital. Paying for transport to a public hospital can be cheaper than dealing with someone who will never pay.
Posted by Lyle Romer (Member # 1266) on 04-17-2013, 10:01 PM:
quote: Bobby Henderson
There's a big catch to the whole walk into the ER and not pay the bill thing. That's only good for a one time thing.
A disease like cancer is different. That's not solved in one visit to the ER. Insurance companies and hospitals can (and do) decide to send someone home to die instead of treating them particularly if they don't have any medical coverage.
This isn't true. Any healthcare facility or provider that accepts any federal program money (Medicare or Medicaid) must treat anybody who walks through the door regardless of their ability to pay.
Now, to the point about insurance, the problem is that insurance started out as protection against catestrophic events that required surgery, hospitalization or long term treatment. When I was a kid, my parents had insurance to cover that kind of stuff ("major medical" I think it was called) and when I went to the Doctor for a sore throat my mom paid for the office visit.
Somewhere along the line "Health Insurance" became "Health Benefits" and that is what started the ridiculous price increases because now the patient isn't paying market value anymore. Also, people that have low copay plans are much more likely to see a doctor because they "don't feel well" since it only costs $20.
Combine that with the malpractice insurance and unnecessary "defensive medicine" procedures and you get where we are now as far as total healthcare expense.
There is some country in Asia that has universal government "catastrophic" insurance coverage. Then each citizen has a health savings account of some sort. All "normal" health care is paid out of that account. I forget the numbers but their heathcare cost per capita is like an order of magnitude lower than ours in the US. This is because for "normal" health care the market keeps the price down.
Posted by Jesse Skeen (Member # 586) on 04-17-2013, 11:10 PM:
Oh Regal, how you never cease to amaze me...
(This just in: Moviegoers cut trips to movies to stay out of Regal's pockets!)
Posted by Jason Burroughs (Member # 68) on 04-18-2013, 11:47 AM:
quote: Lyle Romer
This isn't true. Any healthcare facility or provider that accepts any federal program money (Medicare or Medicaid) must treat anybody who walks through the door regardless of their ability to pay.
The "duty to treat" that EMTALA imposes on hospitals with emergency rooms that accept Medicare and Medicaid reimbursement begins when a patient comes to the emergency department seeking help. In addition to the emergency department, EMTALA also applies to other properties owned by a hospital, such as ambulances. To comply with EMTALA, the participating hospitals must provide within its capabilities a nondiscriminatory medical screening examination (MSE) to determine if the patient has an emergency medical condition. An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity, such as severe pain, for which the lack of immediate medical attention could reasonably be expected to result in placing the patient in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part." [Smith, JM, "EMTALA Basics: What Medical Professionals Need to Know," Journal of the National Medical Association 94,6 (2002): 426-429]. In the case of pregnant women in labor, an emergency medical condition exists if there is not sufficient time to deliver the baby at another facility or if the unborn child is at critical risk and needs assistance. If an emergency medical condition exists, the hospital must provide the necessary medical treatment to stabilize the patient. Legally, a patient can be considered stabilized when "no material deterioration of the emergency medical condition is likely, within reasonable medical probability, to result from or occur during the transfer of the individual, or, …that the (pregnant) woman has delivered (including the placenta)." [42 U.S.C. § 1395dd(e)(3)]. If no emergency medical condition exists or the emergency medical condition has been stabilized, then the hospital has no further obligation under EMTALA.
Bottom line - they would be obligated to provide emergency treatment ONLY. The hypothetical cancer patient - screwed. Once an uninsured patient is stable (not cured) the provider is under no further obligation. This is why you often see patient dumping, once their Medicaid, or other insurance runs out.
Posted by Bobby Henderson (Member # 840) on 04-18-2013, 12:56 PM:
Yeah, I was going to follow up with something like that to respond to Lyle's comment.
A person who has discovered what could be a deadly melanoma on his leg would fall well outside the "duty to treat" emergency medical conditions. The guy isn't going to die immediately from the melanoma on his leg. So it isn't technically a medical emergency. But it damned sure is an emergency to the guy with the malignant melanoma.
Also, if hospitals actually followed through 100% on people with little or no ability to pay for care we would never see fund-raising drives for local citizens needing cancer treatment or an organ transplant.
Lots of patients are effectively told, "tough shit, go home and die." That is the health care system in this country.
Posted by Michael Marini (Member # 3490) on 04-22-2013, 04:06 PM:
posted 04-21-2013 01:11 PM Central (GMT -6:00) (2:11 PM Local)
Regal Cinema sees backlash over Obamacare cuts
Moviegoers are vowing to boycott the country's biggest theater chain after it slashes employees' hours to avoid the new law.
By Aimee Picchi Thu 10:58 AM
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Regal Entertainment Group (RGC) is finding itself at the center of a drama worthy of a big-screen blockbuster.
The country's biggest movie theater chain has stirred a hornets' nest of controversy after announcing in a company memo that it's cutting hours for thousands of nonsalaried employees to avoid providing health care insurance under Obamacare, according to Fox News.
But that isn't going over well with some customers, who point to Regal's hefty $334 million in 2012 profits and its chief executive's massive 31% pay hike. The company's shares rose 17% last year.
"SHAME on you for cutting employees' hours to avoid giving them healthcare while your CEO made $4.4 million and other executives were given large bonuses. You lose my business," one person wrote on Regal's Facebook page.
Chief executive Amy Miles earned $4.45 million in 2012, up from $3.4 million in the previous year, according to a regulatory filing.
Many people writing on Regal's Facebook page vowed to stop attending films at its theaters, which operate under the Regal, Edwards and United Artists brands. Another wrote, "It is so sad to see companies work so hard to keep from treating their employees fairly. The greedy people at the top forget who makes them rich. Shame on you. I for one will find other movie houses to attend shows from now on."
Obamacare has become a lightning rod among American business owners, with some fast-food franchisees saying they'll have to delay expansion plans or charge more for their food, for example. Dunkin' Brands (DNKN +1.15%) is lobbying the government to change its definition of "full time" to employees working at least 40 hours a week instead of the law's current 30 hours a week.
But Regal Cinemas might be at the receiving end of one of the worst consumer backlashes yet. It's one of only a handful of companies to announce definitively how it plans to cope with the Affordable Care Act, which goes into effect next year. Other companies planning cutbacks because of Obamacare include Applebee's and Denny's (DENN +0.72%), which both suffered from poor brand perception afterward, according to a December report from Today.com.
Regal is also facing pushback from employees, according to Fox News. After getting their hours cut by 25% or more, some full-time managers have resigned, the story notes.
According to a memo obtained by Fox News, Regal advised managers to tell affected employees that "to comply with the Affordable Care Act, Regal had to increase our health care budget to cover those newly deemed eligible based on the law's definition of a full-time employee. To manage this budget, all other employees will be scheduled in accord with business needs and in a manner that will not negatively impact our health care budget."
Posted by Mike Blakesley (Member # 26) on 04-22-2013, 06:22 PM:
I'm tired of people griping about CEOs making too much money. First of all, they usually make that much because they're worth that much. If you want to get good executives you have to pay for them, period.
Next, even if you DID take away all that "excess" executive pay (and who's going to decide how much is excess?), it probably still wouldn't be enough to pay for all the tens of thousands of employees' health insurance. There are three options: Avoid paying for it, or trim employees to pay for it, or raise prices to pay for it.
Most "uninsured" people in this country seem to think that health care should be free...well NOTHING in life is free, which shouldn't be a surprise to anybody with a brain.
Regal is just doing this move to keep their costs down -- which if they don't do, they'll have to raise their ticket and concession prices to pay the tab (or cut down on staffing, which would be crazy given stories we hear about understaffing).
I can't believe I'm actually defending my second-least favorite big theater chain here but if it makes sense, it makes sense.
Posted by Tony Bandiera Jr (Member # 2365) on 04-22-2013, 06:48 PM:
quote: Mike Blakesley
I'm tired of people griping about CEOs making too much money. First of all, they usually make that much because they're worth that much. If you want to get good executives you have to pay for them, period.
A theatre chain as badly managed as Regal is, does not seem to be one where the CEO is good or "worth that much."
And Regal isn't the only example..how about Ebay/Paypal? ![[Mad]](mad.gif)
quote: Mike Blakesley
Regal is just doing this move to keep their costs down -- which if they don't do, they'll have to raise their ticket and concession prices to pay the tab (or cut down on staffing, which would be crazy given stories we hear about understaffing).
See above comment. A chain consistently shortchanging customer service by understaffing and the other evils they do is not one I would consider to be well-run or one where the CEO ranks as deserving of top dollar.
quote: Mike Blakesley
I can't believe I'm actually defending my second-least favorite big theater chain here but if it makes sense, it makes sense.
I can't believe you posted that either, as your position makes no sense based on what I have read from you in the past. You strike me as someone who genuinely cares about providing outstanding customer service, worthy of the high pay of some of these CEO's. If anyone deserves high pay, it is you, and folks like you, who think of the CUSTOMER and EMPLOYEES first. ![[thumbsup]](graemlins/thumbsup.gif)
Posted by Mike Blakesley (Member # 26) on 04-22-2013, 07:09 PM:
Well thank you for the compliment, and believe me I'm no Amy Miles fan (CEO of Regal), but they ARE the #1 chain and they are a profitable company so they must be doing something right. In big cities it's pretty easy to go to a different chain if you don't like the closest one to your house, so SOMEBODY must like them!
Posted by Monte L Fullmer (Member # 2797) on 04-22-2013, 10:44 PM:
Thing I like is that these patrons are wanting to put the dagger in the back of REG when it's really not REG's fault in the first place.
We have 4 REG locations in our area where they do get the crowds and are pleased with the service and satisfaction. That may change a bit when CinemaWest completes their 15plex in this same area by the end of the year and give decent competition to REG on the topics of quality and service.
Posted by Robert E. Allen (Member # 1351) on 04-22-2013, 10:53 PM:
Do you have a large enough population base in the Nampa area to support that many screens Monte? Or is the just another case of the big boys trying to out-screen one another and drive the other one out of business?
Posted by Terry Lynn-Stevens (Member # 7349) on 04-23-2013, 12:27 PM:
I feel bad for the part time workers who will not have any health paid for them, but this is just a response from those who cannot/or do not want to pay for Obamacare. If I am correct, the United States is supposed to be a country where the top have more and the bottom have less, in this case, Obama trying to impose health care coverage and have a company have to pay for the cost of it goes against the whole idea of what America is about.
This idea of reducing part time workers hours has been predicted for a while now.
Now, if Obama really wanted to do something that would benefit everyone, perhaps the government should of come up with a plan that will eliminate billing the end user for the health care. In Canada and other parts of the world, the government will pay for major health care visits...this would be the only solution that would work if you want to cover everyone.
Can anyone confirm something for me, with Obamacare, is now illegal to not have insurance regardless if you have a company pay for it or if you have to pay for it yourself?
Posted by Tony Bandiera Jr (Member # 2365) on 04-23-2013, 12:44 PM:
quote: Mike Blakesley
...they are a profitable company so they must be doing something right.
Which is exactly WHY their action of screwing over the employees is unacceptable. As for doing something right, I wouldn't necessarily agree with that part of it..unless I was a shareholder.
Now, if Regal was NOT profitable and struggling to stay afloat, then their actions would be understandable (not popular, but at least understandable). But with those kinds of profit numbers....
quote: Monte L Fullmer
Thing I like is that these patrons are wanting to put the dagger in the back of REG when it's really not REG's fault in the first place.
Wrong, it IS their fault (in regards to their chosen course of action) and they deserve the daggers and loss of customers (and employees.) See above.
quote: Monte L Fullmer
We have 4 REG locations in our area where they do get the crowds and are pleased with the service and satisfaction.
From what I have read on here and heard from folks here in So Cal, your 4 locations are major exceptions to the norm of Regal.
Oh, and I'm sure our very own Grand Poo-Bah doesn't treat his employees as Regal does.
Posted by Mike Blakesley (Member # 26) on 04-23-2013, 02:03 PM:
I'm sure he doesn't but I also don't think he has a gigantic corporate "structure" breathing down his neck.
You have to take their actions in the context of big-business strategies. Big businesses hire people to do the menial jobs at a low wage. There are way MORE people looking for work than there are jobs. This translates to their ability to do what they have done. Of course it won't please the employees, but it WILL please the board of directors and the stockholders, who are the ones who hold the reins. As for the general public, probably at least 90% of them don't even know any of this drama is taking place, so public opinion really doesn't matter, especially when the next big blockbuster movie comes along and fills all their seats.
I'm not defending them, mind you...I'm just saying my opinion on why they did it. What they "deserve" is often very different from what actually happens in real life.
Posted by Terry Lynn-Stevens (Member # 7349) on 04-23-2013, 02:07 PM:
quote: Tony Bandiera Jr
Which is exactly WHY their action of screwing over the employees is unacceptable. As for doing something right, I wouldn't necessarily agree with that part of it..unless I was a shareholder.
Now, if Regal was NOT profitable and struggling to stay afloat, then their actions would be understandable (not popular, but at least understandable). But with those kinds of profit numbers....
Being profitable should have nothing to do with paying for someone's health care.
If I own a company and it is profitable, why should I have to pay for someone else care for health?
Offering company health care benefits is one of the perks among others in trying to keep top talent (the have's) with your company, meaningless movie theatre jobs can easily be replaced (the have not).
Please don't say that it is the moral thing to do.
Posted by Edward Havens (Member # 4715) on 04-23-2013, 02:39 PM:
Health insurance at a job is not a right. There is a reason it's been called a benefit, long before Barack Obama even decided which college he was going to go to, let alone become President. It has been a perk that goes with working hard enough, being good enough and sticking with a job long enough to warrant your employer to pay for that kind of benefit.
That Starbucks offers benefits for their workers who work at least 20 hours a week is, to me, a good reason why their lousy coffee is so damned expensive. Might also suggest they feel the must offer that kind of generous benefits package to keep talent around.
Posted by Joe Redifer (Member # 3) on 04-23-2013, 07:20 PM:
That's not a tremendously good argument there, Edward. You think Starbucks coffee is somehow expensive directly because of health care they provide to their employees. Their coffee is priced according to what people are willing to pay for that particular product. Also, having health benefits is not an indicator of hard work and being adept. Otherwise everyone who had it would be a great worker. The more people you have on your group plan, the easier it is to afford. It's not based on individual awesomeness. Most full time employees at United Artists movie theaters had great health care back in the 90's. Even people making minimum wage. 401K, too.
Anyway the issue really isn't insurance. It's super-high health care COSTS. I recently had my gallbladder removed. $85,000. Justified price? Oh hell no. There's no way it should cost anything near that. Anyone who thinks prices like that are justified are actually part of the problem.
Posted by Louis Bornwasser (Member # 3063) on 04-23-2013, 07:42 PM:
So, no gall anymore? Posting won't ever be the same! Louis
Posted by Mike Blakesley (Member # 26) on 04-23-2013, 09:49 PM:
quote: Joe Redifer
Anyway the issue really isn't insurance. It's super-high health care COSTS.
Agreed...if there's an area begging for regulation, that's got to be it. How can a hospital justify charging something like 8 or 10 dollars for a bandage when you can go buy the same bandage at a CVS for $4 for a box of 10? And that on top of charging thousands of dollars a day for the room you're being sick in.
There are two hospitals in Billings. Both are CONSTANTLY building new wings, "birth centers," or what-have-you, or adding things like art galleries or spacious luxurious lobbies or such. There has never been a time as far as I can remember that there weren't scaffoldings and cranes around those places, building the latest multi-million dollar expansion. I guess they have to do something with all the money they rake in so they can maintain their non-profit status.
If the costs were brought under control, insurance rates would go down, and more employers could afford to offer insurance.
According to the latest issue of "The Week," starting in 2000 the number of employers offering health insurance has dropped every year, and in 2011 only 52% of employers offered it. And, the cost of said insurance has doubled in that time.
Posted by Joe Redifer (Member # 3) on 04-23-2013, 10:25 PM:
And that makes sense. The less people who have it, the more it's going to cost everyone. Pretty soon the health care industry will price themselves out of existence.
Posted by Monte L Fullmer (Member # 2797) on 04-23-2013, 11:59 PM:
quote: Edward Havens
It has been a perk that goes with working hard enough, being good enough and sticking with a job long enough to warrant your employer to pay for that kind of benefit.
Why hearing that being employed at COSTCO is such a great thing since the company invests in its employees due to the massive profit earnings that this company can come across and the owner only draws a flat six digit salary. COSTCO starts out at $11.00/hr with generous raises after each six months of employment - both part and full time.
And their benefit packages are massive for both classes of employment. Just that the PT employess have a 180 day probation before benefits while the FT employees have 90 day probation before benefits. And employees have the opportunity to grow within the company.
Looks like COSTCO is doing something right that is rare these days, which is practicing "company loyalty": caring for their employees to gain the loyalty in return.
Posted by Chris Slycord (Member # 4239) on 04-23-2013, 11:59 PM:
quote: Mike Blakesley
How can a hospital justify charging something like 8 or 10 dollars for a bandage when you can go buy the same bandage at a CVS for $4 for a box of 10? And that on top of charging thousands of dollars a day for the room you're being sick in.
Using the same reasoning there, how can a theater charge over $8 for a bucket of popcorn when the materials used all come to maybe 50-75 cents? Or how I can get a 6 pack of soda for less than a medium drink? There's more to go into costs of things than just what you can get them for elsewhere. Don't get me wrong, costs are out of control but the price of the bandages is hardly even close to the main culprit.
Posted by Sam D. Chavez (Member # 1841) on 04-24-2013, 12:24 AM:
Oh Chris, Oh no you didn't!
You do know how to draw blood.
Posted by Chris Slycord (Member # 4239) on 04-24-2013, 12:46 AM:
I was just pointing out that it doesn't make sense to use that reasoning when we've all laughed at people saying the same kind of thing with respect to theaters. That's all.
Posted by Mike Blakesley (Member # 26) on 04-24-2013, 01:44 AM:
You're not comparing apples to apples though.
Going to a theater is optional. You know what the cost is going to be up front and you can decide if you want to buy the snacks or not. In a hospital, you're probably there against your will and there is no "price list" posted for what you're going to pay. And in a theater there is no insurance company, Medicare or whatever that will pay for the inflated costs of things.
And if you really don't want to pay theater prices you can take the alternative of watching a movie at home for cheaper ...whereas "home surgery" probably isn't happening anytime soon.
Posted by Leo Enticknap (Member # 534) on 04-24-2013, 01:58 AM:
quote: Joe Redifer
Anyway the issue really isn't insurance. It's super-high health care COSTS.
Anecdote: working at a theatre in 1997, I tripped over on a floor that had just been mopped and whacked my head on the side of a platter deck on the way down. Even though I felt fine a couple of minutes later, the manager insisted that I go to Casualty (ER) and get it looked at. After a three-hour wait, the junior doctor took a 20-second look and told me to go back to work and come back again if I felt light-headed or in any way strange. I left, and that was that.
In 2006 I was one of three passengers in a taxi from Anchorage Airport to the downtown area, which skidded on some black ice, hit the central reservation and was then hit by another car, not very hard. Within five minutes or so, several ambulances had shown up, and despite insisting that I wasn't hurt, I was taken to hospital with all sirens blazing. They took a blood sample, x-rayed me, gave me a pain killing injection for the slight ache in my shoulder that had developed by this point and insisted in keeping me in overnight for observation. The two people I was going to the conference with also got the same treatment. I was later contacted several times by the taxi firm's insurer, insisting every time that I hadn't been injured, wasn't suffering from whiplash and didn't need any more treatment, something they had a hard time believing.
Maybe the British hospital wasn't being cautious enough, but I can't help thinking that my experience in Anchorage was a case of complete overkill.
Posted by Lyle Romer (Member # 1266) on 04-24-2013, 05:28 AM:
quote: Leo Enticknap
They took a blood sample, x-rayed me, gave me a pain killing injection for the slight ache in my shoulder that had developed by this point and insisted in keeping me in overnight for observation. The two people I was going to the conference with also got the same treatment. I was later contacted several times by the taxi firm's insurer, insisting every time that I hadn't been injured, wasn't suffering from whiplash and didn't need any more treatment, something they had a hard time believing.
This illustrates a HUGE issue that causes the cost of healthcare in the U.S. to spiral out of control. It's called the fear of getting sued. The hospital did all that stuff because if you had been released and then had a 1 in a million brain aneurysm you or your estate (if you were the typical U.S. citizen that gets a lawyer) would have sued them for malpractice (and at least gotten a huge settlement if not won outright). Worse, if you had had an unrelated heart attack the same thing would happen.
People don't want to believe how much of health care costs is related to frivilous lawsuits. In addition to the high cost of malpractice insurace, providers in the U.S. perform hundreds of billions of dollars per year in "defensive medicine" for no other reason than protecting themselves from lawsuits. A couple of years ago I saw an AMA (American Medical Association) estimate that this practice cost $610 BILLION which is around 23% of all healthcare spending.
Yes, there are other issues in the cost of healthcare but a huge step would be tort reform. Two things that could lead to a huge improvement are:
1) A "losing party pays" system where the losing party has to pay all Attorneys fees for the defendant and the Plaintiff's Attorney is responsible to pay. That way, a Plaintiff can't get out of paying due to income or assets.
2) Create a special court system for Medical Malpractice where the "Jury" is made up of a committee of Doctors. A Jury does not understand the difference between a mistake and negligence. Sure, a patient should get some compensation for a mistake (to pay to fix it and pay if they can't work because of it). But, mistakes shouldn't lead to ridiculous punitive damage. Now, if a provider is "negligent" then they should pay more and be sanctioned.
Posted by Steve Guttag (Member # 268) on 04-24-2013, 06:03 AM:
quote: Lyle Romer
1) A "losing party pays" system where the losing party has to pay all Attorneys fees for the defendant and the Plaintiff's Attorney is responsible to pay. That way, a Plaintiff can't get out of paying due to income or assets.
2) Create a special court system for Medical Malpractice where the "Jury" is made up of a committee of Doctors. A Jury does not understand the difference between a mistake and negligence. Sure, a patient should get some compensation for a mistake (to pay to fix it and pay if they can't work because of it). But, mistakes shouldn't lead to ridiculous punitive damage. Now, if a provider is "negligent" then they should pay more and be sanctioned.
While I agree on tort reform and that our (US) medical system, from a billing, insuring, abusing, sueing...etc. needs a radical reform...including tort reform in general (we are way too sue happy)...one only need to look slightly down the road as to see why the solutions you present will not work.
Item 1)...a company becomes too big to sue. If I have deep pockets...I'll have the ability to hire a team of REALLY GOOD lawyers such that you don't dare sue me on the chance you might lose and have to pay not only your lawyer but all of mine too.
Item 2) It would be unfair to the patient to only have doctors, who may have their own vested interest in not seeing another doctor being sued over a practice they themselves may use...it puts the jury way too slanted. While it is obvious doctors should be used for the medical position...any jury/board...etc. should have a bit of a balanced make up with parties that don't have a vested interest in a particular outcome.
Posted by Mark Hajducki (Member # 1732) on 04-24-2013, 06:09 AM:
quote: Joe Redifer
You think Starbucks coffee is somehow expensive directly because of health care they provide to their employees. Their coffee is priced according to what people are willing to pay for that particular product.
In the UK Starbucks coffee is overpriced (and still poor quality) even though they don't provide staff with medical insurance. Additionally they pay very little tax in the UK.
Posted by Edward Havens (Member # 4715) on 04-24-2013, 09:24 AM:
quote: Joe Redifer
I recently had my gallbladder removed. $85,000. Justified price? Oh hell no. There's no way it should cost anything near that. Anyone who thinks prices like that are justified are actually part of the problem.
You really got fucked there, Joe. I had my gallbladder removed in August, and the total cost even before my insurance kicked in for majority of it wasn't anywhere near that. I think my out of pocket for the entire procedure was less than $2500, after the hospital reimbursed me $700 for overcharging me on some costs.
Posted by Bobby Henderson (Member # 840) on 04-24-2013, 09:43 AM:
quote: Chris Slycord
Using the same reasoning there, how can a theater charge over $8 for a bucket of popcorn when the materials used all come to maybe 50-75 cents? Or how I can get a 6 pack of soda for less than a medium drink?
With tongue in cheek anecdote noted, movie theaters can still explain to a certain degree why snack bar items are priced so high (mainly to offset costs of running the theater). Prices at movie theaters are pretty standard too. There are some differences between a multiplex in the downtown of a giant city like Los Angeles and a rural theater in Kentucky. But the pricing differences aren't all that extreme.
Hospitals, clinics, etc. don't really have any pricing standards. They gouge whatever they think they can get away with gouging. For example I've seen clinics here in Oklahoma charging over $5000 for a colonoscopy or just a stress test examination. One could get those services for under $1000 in Colorado Springs.
A local hospital kind of works as its own vertically integrated monopoly. Various doctors, specialists, clincs, etc. are aligned with it to respect its local pricing model. Hospitals, clinics, etc. don't exactly check around to make sure their prices are competitive with other hospitals and clinics in the next town or next state. That's because patients often don't have the time/luxury to shop around for health care. People often only need health care in some sort of emergency. You're not going to drive to the next town to get a better price if you're having a heart attack.
quote: Mike Blakesley
There are two hospitals in Billings. Both are CONSTANTLY building new wings, "birth centers," or what-have-you, or adding things like art galleries or spacious luxurious lobbies or such. There has never been a time as far as I can remember that there weren't scaffoldings and cranes around those places, building the latest multi-million dollar expansion.
I see the same thing happening here in Lawton. Comanche County Memorial Hospital looks like it has doubled in size during the time I have lived in Lawton. I watched the same kind of thing going on where I lived in Georgia -freaking million dollar marble waterfall style structure in the damned lobby.
The health care industry in this country has such an air of douchebag entitlement to it that it makes me sick. It continues to carve out a larger and larger piece of the United States' GDP for itself -leaving less less and less for all other businesses and industries.
I can't figure out why so many business people jealously defend this broken system when this so-called for profit based system is working as hard at it can to take away from them. It's very simple math: the more this nation spends on health care the LESS it has for everything else.
The health care industrial complex has grown way the hell too big and too greedy for its own good. It's long overdue for that monster to be cut down to size.
Posted by Chris Slycord (Member # 4239) on 04-24-2013, 03:02 PM:
quote: Mike Blakesley
Going to a theater is optional. You know what the cost is going to be up front and you can decide if you want to buy the snacks or not. In a hospital, you're probably there against your will and there is no "price list" posted for what you're going to pay. And in a theater there is no insurance company, Medicare or whatever that will pay for the inflated costs of things.
To an extent, it's actually the insurance co's and medicare that can increase costs for everything. Those companies will often either reimburse for much lower than what the going rate actually is (thus making people increase costs elsewhere to cover) or take a longer period to pay, thus making it so the insurance gets billed for more than the going rate (since a facility's bills don't wait for the insurance co to reimburse, thus making the wait time itself a cost). And as a ridiculous example of insurance co's increasing costs, if you were to pay for a blood panel to look at food allergies (or the antibodies associated with them), you'd pay roughly $200-300 but because of the way insurance co's want this type of test coded, you end up with a bill to them that's close to 3-4x that going rate. I won't bore you all with the details of why; shoot me an email or something if you want to know it though.
But you're right that in emergency situations, the hospitals don't usually give you their fee schedule and there isn't time to shop around. And I'll add that insurance co's do whatever they can, legal or not, to not pay.
quote: Lyle Romer
1) A "losing party pays" system where the losing party has to pay all Attorneys fees for the defendant and the Plaintiff's Attorney is responsible to pay. That way, a Plaintiff can't get out of paying due to income or assets.
2) Create a special court system for Medical Malpractice where the "Jury" is made up of a committee of Doctors. A Jury does not understand the difference between a mistake and negligence. Sure, a patient should get some compensation for a mistake (to pay to fix it and pay if they can't work because of it). But, mistakes shouldn't lead to ridiculous punitive damage. Now, if a provider is "negligent" then they should pay more and be sanctioned.
One problem with a "losing party pays everything" system is that it assumes that because the suing party lost, the case was entirely without merit. Many cases are arguably legitimate but still result in the person losing. And a vengeful person might know their case is a slam-dunk and purposely hire the most expensive expert they could find just so the other party gets stuck with it. Then, as mentioned earlier, it becomes even more of a "the rich win" situation since now the poor guy who lost also has to pay the rich party's bills.
And I'm with Steve that having a panel of doctors could be problematic, since to an extent you have a "good ole boy" situation. Now, one change to that jury could be to have it be Lawyers who are medical doctors; that way, you avoid having that same atmosphere since these guys are more or less separate from the rest of the regular doctors and it's not entirely unfeasible since medically-trained lawyers are actually fairly common. Then again, medical lawyers get paid a lot more than juries normally get so that could be a big problem to say the least. lol
Posted by Randy Stankey (Member # 64) on 04-24-2013, 03:42 PM:
So, everybody, pretty much, agrees that the insurance system is broken.
Why, then, does our government propose an even bigger insurance system in hopes of fixing it?
Wouldn't you say that LESS insurance is more logical? Don't you agree that it would be better to have a system where people who can afford it pay reasonable costs for health care then, people who, for no fault of their own, can't afford it get assistance?
As the old saying goes, insanity is doing the same thing over and over again but expecting different results.
How is the currently proposed solution not considered insanity?
Posted by Mike Blakesley (Member # 26) on 04-24-2013, 04:51 PM:
Well to explain the whys, we would have to venture into political waters I fear.
The problem is that there IS no solution. No matter what solution is proposed is going to cost SOMEbody a bunch of money so that's why no solution is ideal. Just a couple of scenarios such as...
1. Government pays for insurance for everybody.
- Makes taxes go way up. That money isn't going to fall out of the sky. It's the same as when the government decides that corporations should pay more in taxes....that just causes the prices to go up and consumers pay more anyway. An added expense ALWAYS means consumers pay more.
2. Government forces regulation on the industry to control prices.
- Takes money out of the hands of the providers and the hospitals, giving them less ability to hire the best employees and also curtailing all those expansions, which costs jobs in all the related industries
3. Government forces everybody to buy health insurance and/or employers to offer it
- Costs virtually everyone money in one way or another, and causes the results that started this thread, plus you will have people who will pay the "penalty" which is cheaper than the insurance will be, therefore they'll be right back on the public dole when they get super-sick.
You get the idea. There are lots of scenarios but none I've ever heard of that doesn't cost a lot of people money somehow, directly or indirectly.
Posted by Chris Slycord (Member # 4239) on 04-24-2013, 04:56 PM:
The grand scheme behind what they're doing is to make insurance costs become so high that the insurance companies can no longer compete and will go away altogether, thus bringing along single-payer. But I think if I quote the politicians that said that this is their goal, I'll be getting further into violating the "no politics" rule than we already have arguably gone.
Posted by Joe Redifer (Member # 3) on 04-24-2013, 06:13 PM:
quote: Leo Enticknap
I can't help thinking that my experience in Anchorage was a case of complete overkill.
It was. For diagnosing gallbladder issues like mine, usually an ultrasound is all that is needed. But before they gave me an ultrasound, they insisted on giving me an MRI for whatever reason. That revealed nothing. Only then did they decide that they needed to do an ultrasound. Either they are complete idiots or full of greed.
quote: Edward Havens
You really got fucked there, Joe.
Yes, with no lube. In the ass. By John Holmes. If he were black. And very angry. But my gallbladder couldn't be taken out lapcroscopically because everything I do, internally and externally must be EXTR3333ME and with much 'tude. So my gallbladder was ragin' huge and hard with multiple stones the size of Ayers Rock. I only need to pay a bit more than 3K out of pocket. But there still is no reason for the total costs to be that high.
Posted by Chris Slycord (Member # 4239) on 04-24-2013, 07:11 PM:
It's actually often the former. My radiology prof said he regularly gets requests for MRI's from physicians looking for things he knows will show up on an xray, simply because the doctors don't really know which test is the appropriate one and get it in their head that "the most expensive, newest one must be the best" even when it doesn't benefit them financially.
Posted by Jack Ondracek (Member # 1466) on 04-24-2013, 07:51 PM:
This is all very interesting. However, I think the point is being lost.
Regal is being pilloried for having a well-paid CEO, a profitable business and a hard-nosed outlook toward providing health care.
In a previous post, someone pointed out that, given a representative cost of $5,000 per employee, Regal could not offer healthcare to those, now considered full-timers and remain a profitable company.
So, since eveyone here seems to have an opinion on the matter, how much of Regal's $337 million profit should be given over to health care and kept out of the greedy paws of their investors? How many employees could be covered? Who would those employees be? What about the rest of the workforce?
What is an appropriate profit level for a company that grosses just under 3 billion dollars, and exactly what qualifies any of us to pass judgment regarding what those guys should be doing?
The employees who don't like what Regal is offering are doing exactly what they should do... walk. If they can find a better deal somewhere else, then more power to them. If it hurts Regal, then the exodus will motivate them to reconsider their position. If not... then that's business, guys.
Posted by Leo Enticknap (Member # 534) on 04-25-2013, 02:59 AM:
quote: Mike Blakesley
You get the idea. There are lots of scenarios but none I've ever heard of that doesn't cost a lot of people money somehow, directly or indirectly.
There is one, but doing it and being honest about it would be about as popular as hiring Gary Glitter to be the principal of a junior school.
That is to admit, and be honest about the fact that not everyone is going to have access to the newest, most state of the art, most expensive healthcare 'products'.
The way this tends to play out in the European government run healthcare systems is that big pharma will come out with a new drug, piece of hardware or procedure that shows promising results but which is eye-wateringly expensive. It is then evaluated by government medical officers, who conclude that the cost-benefit analysis doesn't add up (for example, that treating 50 people for diabetes for a year delivers better value to society and the economy than spending the same money on a new drug that'll keep one terminal cancer patient alive for an extra year), in response to which patients' lobby groups (many of which are backed by big pharma) make a big fuss about it. But ultimately, most people grudgingly accept that there is a finite amount of money in the system to pay for healthcare and that its use has to be prioritised somehow.
This seems a callous analogy, but the brutal truth is that we can't all afford to drive Ferraris, and most people accept that. But we do expect to be able to afford to drive something like a Ford Focus, and when that starts to get difficult (e.g. the price of gas or insurance shoots up to ridiculous levels) that is bad news for society and the economy in a hundred different ways, and very few would deny that it's a problem.
However, healthcare is such an emotional and personal issue that were a politician to say out loud, 'I'm OK letting the cancer patient not live as long, because those 50 diabetes sufferers will probably pay back the cost of their treatment through the tax system as the result of being maintained in better health, whereas the cancer patient won't', he or she would be looking at a career change pretty quickly.
Whether you're looking at a European-style government run system or an American-style one based on commerical insurance products, it seems to me that the only viable way to keep costs down is to take a cold, dispassionate look at what it's possible to provide for what the average citizen is realistically able to pay (be that through taxes or insurance), and cut the cloth accordingly.
Posted by Lyle Romer (Member # 1266) on 04-25-2013, 05:21 AM:
quote: Randy Stankey
Wouldn't you say that LESS insurance is more logical? Don't you agree that it would be better to have a system where people who can afford it pay reasonable costs for health care then, people who, for no fault of their own, can't afford it get assistance?
This is exactly what should be done. The problem is that there is no market for healthcare. I don't have dental insurance. When I choose a dentist, I weigh the price and the service and pick the one that meets my cost/benefit analysis the best.
When going to a Doctor I don't do this because it costs the same copay wherever I go. Same with prescriptions. The copay is different based on the "tier" of medication but I can't shop around and price cialis vs. viagara.
The best system would be for "normal" healthcare (like sore throats, caughs, high blood pressure) to be paid out of pocket using some sort of tax free health savings account option. People below a certain income level would get money put into this account based upon the average "normal" cost for a person of their age group. To encourage them to also look for economical care allow them to get a percentage of the balance refunded to them as cash at the end of the year.
Now, for situations like Joe's, everybody should have a catestrophic insurance policy paid out of pocket, throuh their employer or subsidized for those that can't afford it. These policies are MUCH cheaper than the "insurance" we have now.
To make this work, companies must be forbidden from providing the health care "benefits" that they do now (or are required to under Obamacare). The problem is that we talk about health insurance but somewhere along the line "insurance" (which is supposed to protect against unplanned, high cost expenses) turned into "benefits" where everything is paid for by the "insurance" company except for copay/deductibles.
Imagine if food worked the same way and no matter what grocery store you went to you just paid a copay. Do you think the cost of food would go down? I think not!
Posted by Lyle Romer (Member # 1266) on 04-25-2013, 07:19 AM:
quote: Bobby Henderson
The health care industrial complex has grown way the hell too big and too greedy for its own good. It's long overdue for that monster to be cut down to size.
While I agree with you on the size and cost of health care, the key is to figure out where the money is going. I can tell you 100% it isn't to the Doctors. Doctors earn significantly less today than they did 2 decades ago. I'm talking about raw dollars, it is even less counting inflation.
There are true issues like malpractice/defensive medicine that increase costs but my guess is that a lot of money goes to insurance company profits (to be middle men) and executives/management of "non-profit" hospitals.
Posted by Randy Stankey (Member # 64) on 04-25-2013, 08:38 AM:
quote: Lyle Romer
The problem is that there is no market for healthcare.
There is no market for healthcare because of insurance.
I agree with you that health insurance should be for catastrophic events or major health problems. What used to be called "hospitalization insurance."
I also agree with your grocery store analogy.
There is a saying: "Men value most those things which come at a cost."
(I believe it was by Goethe??)
Point is, if you can get something for free, you don't value it anymore. Only when you have to pay for something do you value enough to protect it.
If people get health care for free, they don't value it as much.
Bring back the cost to health care. Not a mafia-like extortion system. When people have to pay for what they get, they'll start being a lot more careful.
Posted by Bobby Henderson (Member # 840) on 04-25-2013, 09:19 AM:
quote: Lyle Romer
While I agree with you on the size and cost of health care, the key is to figure out where the money is going.
Wall Street. That's where a bunch of the health care dollars are going. Drug companies, biotech companies, hospital corporations and companies who supply various gadgets and consumables to hospitals all fall in that group. And Insurance companies too. These companies are spread around the world -some of them based in countries with so-called socialized medicine. Many of these outfits are publicly traded companies with stock prices that are angrily expected by investors to improve and yield big fat dividends. These investors are found all over the United States and around the rest of the world. Our bloated, cash gouging health care is propping up investors everywhere. Just like our Ponzi scheme housing industry was doing this past decade.
quote: Chris Slycord
To an extent, it's actually the insurance co's and medicare that can increase costs for everything.
I agree with that. But the hospitals themselves do all the price gouging they can regardless if the patient has insurance or not. Often if a patient has no insurance he'll be charged two, three or more times the cost that would be officially billed to the insurance company. And the insurance company pays only a fraction of that official billed cost.
quote: Chris Slycord
One problem with a "losing party pays everything" system is that it assumes that because the suing party lost, the case was entirely without merit.
The biggest problem with a "losing party pays everything" system is the fact it costs a shit-ton of money to even go to court in the first place. It costs a fuck-ton of money to fight a case. Our legal system is a disgraceful joke -especially on the civil end of things. The person or company with the biggest "war chest" of cash can bleed his opponent dry by way of procedural continuances, delays, etc. There is no "day in court" anymore with these types of matters. You'll have more like a year or ten years in court to see something through to a verdict.
Even in criminal law those with money can get away with murder and innocent people who can't afford a good attorney may get railroaded. Add to this the fact too many positions in our legal system are politically elected and thus politically biased.
We do need tort reform, but we need it in a far more fundamental way than what's being talked about now.
quote: Mike Blakesley
The problem is that there IS no solution.
Oh, there are solutions. But none that are going to be universally liked by anyone. The health care situation in the United States is a giant shit sandwich and we're all going to have to take a bite of it. For the past few decades everybody has been pulling various tricks to put off the eventually eating of the foot long turd hot dog.
Costs absolutely must be brought under control. The current situation, even with "Obamacare" passed into law, is not sustainable. This entire nation, not just the government, will go broke eventually if this situation does not change. The math is very crystal clear on this.
Hard choices will have to be made, perhaps even ones that seem immoral.
End of life care is one of the most costly areas of our health care system. It might be the most controversial area. Still, it needs serious re-thinking and overhaul.
Like it or not, the general public absolutely must make it their job to improve and maintain good health and thus reduce risk. Cost reductions in health care are impossible without the public meeting the health care industry halfway by reducing their risks. This notion of Americans just doing whatever the hell they want to do and eating whatever the hell they want to eat and then expecting affordable health care is insane fantasy.
Posted by Martin McCaffery (Member # 37) on 04-25-2013, 10:31 AM:
I can't remember the name of the book right now, but a reporter went around to the major industrialized nations with different styles of universal care. He got treated for the same chronic problem in Britain, France, Germany, Japan, Canada, maybe a few others. Two things he discovered were universal:
1) Everyone bitched about the healthcare system
2) No One wanted the US system.
Posted by Randy Stankey (Member # 64) on 04-26-2013, 09:06 AM:
So, why do we need a health care "system?"
We don't have an auto repair system.
If your car breaks down, you take it to a mechanic and he charges you to fix it. If you are in an accident you can use insurance. If somebody crashes into your car, the legal system provides for remedies. If you want to paint your car a different color, if you want to put in a car stereo or soup up your engine there is no authority telling you whether you can or can not do that, provided your car meets the standard for being "street legal." (You can still soup up your car any way you want if you only drive it on a race track or other private property.)
We don't have a home repair system.
If you want to fix up your house, we don't have government authorities telling you whether you can put siding on your house or whether you can build an addition. As long as you meet current building codes, you pay a contractor or go to the home improvement store and buy what you need. If you have a catastrophe, there is insurance and, if there is a natural disaster over a wide area, government backed disaster recovery funds are available.
We all take responsibility for our own houses and cars and we don't need the government to do it for us. Why is health care any more important or any less important than homes or autos? Why does the government need to step in and manage one or not the others?
Why doesn't the government have a "housing system" where homes are built and cared for by government authorities? I guess it's because that would be Communism and Communism is bad. Right?
So, why is having the government taking care of one thing bad but taking care of the other is good? Shouldn't it be good or bad in both cases?
Why shouldn't the government provide me with a car, too?
What needs to be done is to dismantle the system. Do away with comprehensive health insurance. Bring health care costs down to market rates. Make people who can afford it pay for their own reasonable health care costs as the need arises. Help people who can not pay or who are victims of crimes or disasters get the care they need, as they need it.
To start, get rid of comprehensive health insurance. At least, the way we have it now. Let's go back to the way it was when we had hospitalization and accident insurance and use that as a starting point. Then, if we need any kind of a "system" we make it so that it just fills in the gaps where people need it.
Posted by Edward Havens (Member # 4715) on 04-26-2013, 03:30 PM:
We don't need an auto repair system, as not everyone owns a car.
We don't need a home repair system, as not everyone owns their own home.
We do need a health care system, as everyone gets unwell from time to time.
Posted by Bobby Henderson (Member # 840) on 04-26-2013, 03:58 PM:
quote: Randy Stankey
If you want to fix up your house, we don't have government authorities telling you whether you can put siding on your house or whether you can build an addition.
That's not the best analogy to use regarding health care. There are various authorities that can/will tell you what to do regarding hour home. Many local governments will have codes and ordinances that regulate additions built onto homes and do require permitting before construction can proceed. There are neighborhood associations in many residential additions that will dictate things like housing color scheme, what kind of plants you can put your yard and even periodic maintenance.
I'm not all that keen on some of these ideas, although I do understand perfectly why the rules are there. If you buy a home in a nice neighorbood you don't want the guy across the street or next door letting his house fall into disrepair. That problem is more than just an eyesore. It drives down the property values of your own home. This is central to why neighborhood associations exist. City governments do need to require building codes and enforce those rules. That's simply because too many home builders are not to be trusted and will be guaranteed to take all kinds of cost cutting, profit improving shortcuts wherever the opportunity may present itself. Here in Lawton, within its city limits, building codes are strict. Outside of city limits, in Comanche County there's hardly any rules at all. If you have a home built out there, you had better know your stuff on home construction and be on the site constantly. Or you'll have an beautiful, overpriced home with the structural integrity of a cardboard hut.
Dishonesty, unfortunately, is a big part of human behavior. If every person had integrity we wouldn't need things like laws, or even government for that matter.
quote: Randy Stankey
What needs to be done is to dismantle the system. Do away with comprehensive health insurance. Bring health care costs down to market rates.
It would be an interesting experiment to see what would happen with all these hospitals, clinics and the giant McMansions adjacent to them if they could only charge what patients could afford to pay out of pocket.
I'm guessing the health care system would be a mere fraction of its current size. The legions of health care industry workers in it mainly for the money and country club status would all be doing something completely different for a living. We would probably have even more attorneys than we have now.
Posted by Randy Stankey (Member # 64) on 04-26-2013, 05:12 PM:
The great majority of people don't live in places where neighborhood organizations have any say. Most people build houses according to building codes without needing an authority to tell them to do so.
About two years ago, I hurt my foot. I stepped on something and cut my toe wide open. Nothing super bad but I needed stitches. I went to an urgent care center. When I got there, the woman asked which insurance I would use. I said, "Cash." She looked at me like I had three heads! Before she could say anything, I took out my wallet and counted a couple of Benjamins down on the counter. "I said, cash money."
The bill came to 180-something dollars and she couldn't even make twenty dollars change. They had to mail me a check in order to give me back what I was owed. It took a month for me to get my money!
Is this a "system" that we want to have?
Why do we want to uphold a system that doesn't work, just to save the jobs of a few doctors when a person can't even pay cash on the barrel for a minor medical procedure? Would you rather let companies lay off workers in order to keep themselves from paying into a broken system? Isn't that what Regal is doing?
I say, tear down the "system" and start over with something that works better before the whole thing crashes.
Posted by Bobby Henderson (Member # 840) on 04-26-2013, 08:36 PM:
Paying cash/check upon being treated for a minor medical problem is no big deal. If only the situation with health care was that simple.
The problem is there's too many other medical situations that are a hell of a lot worse and take a lot more than one simple visit to fix (cancer, various diseases, very serious/life threatening injuries, etc.). You gotta have insurance for that. Even there, health insurance isn't going to cover everything -like being unable to work because you're stuck in the hospital or debilitated at home.
No one except for the very well off are going to have the amount of cash just laying around to immediately pay a doctor's bill for getting horribly injured in a car accident or fighting a 2 year battle with cancer. Chronic conditions, such as HIV, that require a patient to take a cocktail of drugs for the rest of his/her life can be financially devastating. You need some sort of "insurance" for those kinds of things. What's the alternative? Euthanizing people like we do with horses when they break a leg?
Posted by Jonathan Goeldner (Member # 4854) on 04-26-2013, 08:45 PM:
I thought the whole point of Obamacare was that the healthy 25-35 year olds paying their health insurance would be providing the funds to those who are sick and in need of medical costs. It's like car insurance, we pay it so those who get into accidents the accumulated amount pays for their costs.
Posted by Mike Blakesley (Member # 26) on 04-26-2013, 10:38 PM:
quote: Bobby Henderson
I'm guessing the health care system would be a mere fraction of its current size.
Well THAT would be a disaster right there. I don't know what it's like where you live but around here, in the cities you already have to wait in a nice line to get into an emergency room, and if you want to get an appointment with any kind of a decent specialist you're usually talking weeks or often months.
In my town of 2000, the care might not be quite as cutting edge, but you can usually get in the same day or maybe the next day. The rates are way cheaper too. But...they don't have any specialists or do major surgery here, so if you need anything huge done, you're right back on the same overcrowded treadmill at Billings or wherever.
Posted by Randy Stankey (Member # 64) on 04-26-2013, 10:43 PM:
The problem wasn't that I could pay cash. The problem was that they didn't want to take it. The woman wouldn't have taken the money if she wasn't obliged to. I even said she could bill me if she didn't want to be paid but I thought her head was going to explode at the mere mention of it.
A system that all but discriminates against those who pay cash, regardless of the cost, is hopelessly screwed up! We need to tear it down and build it back up again or else it will collapse under its own weight.
Posted by Mike Blakesley (Member # 26) on 04-27-2013, 12:30 AM:
I think you are over-reacting to the whole can't-pay-cash thing. The reason they didn't want to take cash is that ALMOST NOBODY PAYS CASH. They probably wouldn't get more than one or two people a year who would want to pay cash, if that. To be set up for cash they would have to install a cash drawer of some kind, provide change, keep it secure, train somebody to handle it (including the banking), and of course the usual bookkeeping crap and theft worries. It's just easier for them not to bother with it.
I would equate it to hearing impaired systems in small theaters -- it's a thing that just isn't used. I can't remember the last time someone asked to use our system. I don't know if it even works anymore. We'd have been money ahead to just save the $ we spent on it and risk one upset patron every 20 years. (If it wasn't for the ADA concerns that is.)
Posted by Monte L Fullmer (Member # 2797) on 04-27-2013, 03:10 AM:
I found this article on the topic of the "29-49" ruling of the "ACA of 2014". Interesting reading to show this action is almost everywhere throughout the country.
Thx-Monte
News Page
quote:
In the minds of many employers, the Affordable Care Act is brought to them by the numbers 29 and 49 — and by the letters N and O.
A shock hit 10,000 part-time workers for the state of Virginia, including large numbers of adjunct college faculty, when the state passed its annual budget this spring. By law, they can now work no more than 29 hours a week.
They are just the tip of the iceberg. The number 29 is on the minds of employers everywhere this spring, from state and local governments to large corporations and mom-and-pop stores.
Some whisper it, others shout it. Few are unaware of it. Twenty-nine is the key threshold that keeps employers free from the new health care mandates. Bump up to 30 hours, and an employee is full time and the employer must help pay for health care.
Small businesses have also been watching the number 49. This is the employee headcount trigger that kicks in health care requirements. Keep headcount below 49 “full-time equivalent employees,” and an employer can avoid health care requirements altogether.
Many businesses attribute the hours pinch (29) and the headcount squeeze (49) to the Affordable Care Act, popularly known as Obamacare.
The squeeze on part-time hours particularly hurts many employees because so many are working part time. In the March jobs report from the Bureau of Labor statistics, involuntary part-time employment stood at 7.6 million, 3 million higher than when the Great Recession began in 2007.
In measuring the new law’s impact on take-home pay, most eyes have been on private businesses, especially franchise owners. With negative publicity keeping heads down in the business world, another indicator is state and local governments — equally sensitive to cost but more insulated from bad publicity.
Heads up
Late last year, controversy swirled around comments by corporate leaders and major franchise owners, as a number of high-profile business leaders gave early and vocal notice they would be slashing full-time hours in the coming year.
Among these were corporate voices, such as Whole Foods and Darden Restaurants, the latter being the parent company of Olive Garden and Red Lobster. Darden announced in October it was experimenting with a “part-time only” model at restaurants in four markets.
Major franchise owners of brands such as Applebee’s and Wendy’s also spoke out.
In November, Zane Tankel, chairman and CEO of Apple-Metro, which owns some 40 Applebee’s restaurants in the New York area, said he would be cutting hours to avoid health care costs.
“So what does that say – that says we won't build more restaurants. We won't hire more people," he told Fox Business Network at the time.
Heads down
The result of the outspokenness in some cases was a brand-damaging backlash, leading to tactical retreat. Wendy’s corporate quickly distanced itself from the franchises that moved to cut hours, announcing that corporate-owned stores would not follow suit. By December, Darden announced it was cancelling its plans to shift to a strict part-time model.
“What happens is the 'Huffington Post' picks it up and you essentially have a boycott going on in front of your door,” said Matt Haller, Vice President for Public Affairs at the International Franchise Association, a lobbying group that represents franchise owners. “That’s why the smart brands have been keeping quiet on it.”
With individual brands laying low, Haller said, trade associations like his have been more vocal about the law’s impact, but at the same time they have become increasingly resigned.
“We’ve been a little more pragmatic since the election,” Haller said. “It’s the reality. It’s the law of the land.” He said IFA’s focus is “tweaking the law around the edges” both in Congress and in regulatory rule making.
49ers and 29ers
With the clock ticking on the “look back” year, many small business owners remain confused about what will be demanded of them, said Kevin Kuhlman, manager of legislative affairs for the National Federation of Independent Businesses.
Last week Kuhlman spoke with a homebuilder in Arizona who thought he would fall below the 50 employee threshold because half of his 65 employees were on a spouse’s health plan. That’s not how the rule works, Kuhlman explained.
The majority of NFIB’s members have fewer than 49 employees, Kuhlman said. These employers can avoid the health care requirement by keeping headcount low. Those above that mark, he said, are already looking at cutting part-time hours to hold them to 29 hours per week.
“People are telling us that this is what they are doing,” Kuhlman said. “It’s not what they want to do. But they say this is probably what’s going to happen.”
The downward pressure on both headcount and hours is particularly problematic for franchise owners. Almost all franchise owners aspire to own multiple locations, Haller said, and the business model really doesn’t make sense otherwise. But multiple franchise locations now become an instant trigger for unsustainable health care costs, according to Haller, because the 49-employee rule encompasses all of a company’s holdings.
Municipal blues
It’s not just private businesses that are squeezing part-time hours. Cedar Falls, Iowa, with a population of just less than 40,000, is not all that much larger than some small businesses. The city had 59 part-time employees on its books, each previously limited to 32 hours a week. Even before the Affordable Care Act, in other words, Cedar Falls was saving health care costs by limiting full-time employment.
In response to the ACA, however, Cedar Falls has imposed a weekly quota of 29 hours on these employees, mostly clerical, janitorial and maintenance workers.
The alternative was to lay off 25-30 employees, said Cedar Falls Administrative Services Director Richard McAlister.
“We thought that would be inhumane,” McAlister said, noting that the cost of providing health care to all 59 would have been $855,000 a year.
The impact on city services is less dramatic than the impact on the individual worker, McAlister said, because the worker's take-home pay suffers a significant hit with the new restrictions.
McAlister has been in close contact with other Iowa cities and notes that, although Cedar Falls was an early mover, “some of them have quietly initiated the same type of thing.” Some cities are in a quandary, he said, because they had previously provided prorated health benefits to temporary workers. Under the new law, that will not be allowed.
McAlister said Cedar Falls has received a little push back after its decision. “We had a little bit of push back, but I would say 80 to 90 percent was positive. You are doing the right thing. This is a business decision. You are trying to keep people employed.”
McAlister said he also got feedback from the private sector, including a lot of restaurants.
“They told us they were doing the same thing,” he said. “I think it takes some of the heat off of them. They can say even the city is doing this.”
“Frankly, I would have preferred that we not be as high profile as we were,” McAlister said. “You like to be able to do these kind of personal things quietly. But in the end, it was probably good that we got the message out. It does allow people to plan what they do into the future.”
Posted by Bobby Henderson (Member # 840) on 04-27-2013, 12:03 PM:
quote: Mike Blakesley
Well THAT would be a disaster right there. I don't know what it's like where you live but around here, in the cities you already have to wait in a nice line to get into an emergency room, and if you want to get an appointment with any kind of a decent specialist you're usually talking weeks or often months.
Agreed. It would be a disaster.
Nevertheless, if our nation's health care industry was built solely on what average people could pay out of their pocket for care there wouldn't be much of any health care industry at all. Average people wouldn't be able to pay doctors, nurses, specialists, etc. what they expect to make for that line of work. Most of those medical professionals would find a more lucrative line of work. I don't think there are very many doctors or nurses in that profession just for the love of the work and would do it for low pay.
Our so-called "free market" health care system would not survive without the enormous amounts of money flowing into it from the taxpayers and insurance companies as well as the patients themselves. If the system was run totally on pocket cash from patients very few clinics would have the kinds of technological devices you see in many hospitals now. We already have "socialized medicine" -a very strange form of it.
Posted by Mitchell Dvoskin (Member # 751) on 04-27-2013, 06:50 PM:
quote: Randy Stankey
So, why do we need a health care "system?"
Take this argument to it's logical conclusion:
· Why do we need police? Everyone could hire there own security guards and private investigators as needed.
· Why do we need fire departments? Everyone could contract for private fire protection.
· Why do we need public education? Everyone could pay for tutors or private schools directly to educate their children.
The list goes on and on. We, as a society, have agreed over the years to collectively pay for certain services for the common good. This is not new, it goes back to the founding of the republic. At some point in our lives, all of us will need major health care. Why shouldn't it be provided for the common good as other services, some of which we may never need, are provided, at least at some basic level.
As Mike Blakesley pointed out, getting there will cost no matter how it is done, but then so does police, fire, education, etc.
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