As Obamacare ... evolves

[Gerry Clinchy]

In the post that started this thread, Gerry posted this text from the affordable care act:
Could you please give me a reference/link to any "federal health insurance" program? All the affordable care act does is set up exchanges for private insurance.

You'd have to refer back to the article I quoted from. I might suspect that this clause means that any private insuror that does not wish to provide coverage under the act is free to abstain from doing so.

Of course, if all (or most) private insurors were to do that, we would then have to rely on the Fed to provide such coverage? A back door to single-payer? Some speculate that this was the ultimate plan all along.

If private insuors remain in the market, but their pricing structure is too expensive, that would also be a route toward eliminating the private sector as people sought a "government option" (the state exchanges? or another route to single-payer?).

[Gerry Clinchy]

You do realize that after years of decreasing support for higher education from state and local governments, many schools have turned to using adjunct instructors and professors to save money by not having to offer benefits to part time workers, right? This is NOT a new thing. They had a bunch of part timers, many of whom teach courses at more than one college just to try and eek out a living with two part time jobs. So, along comes Obamacare, and the law mandates that large employers must offer insurance to those working 30 hours or more, and the college cuts their hours by another few so the can CONTINUE to offer nothing in the way of health benefits.

However, it could be reasonable that the Obamacare mandate would accelerate this process?

I was reading that this college now will not let their instructors teach any more than 10 credit hours per semester at a pay rate of $750 per credit hour per semester. So if you teach there year round (which is a big stretch because most kids go 2 semesters/year) you cannot make any more than 3 x 7500 = $22,500 per year. If you carry two jobs and can somehow manage to teach 3 semesters at each school, that'll bring you a whopping $43,000 per year with ZERO benefits. Sounds like the conservative's wet dream to me, given what little respect that they have for the teaching profession.

I can see how community colleges and some 4-yr state colleges might be impacted by the decrease in Fed support. OTOH, there are "state colleges" like Penn State that have HUGE endowments. So huge for PS that not too long ago they built some new buildings ... when they already had perfectly good buildings that were not being used.


One thing the article forgot to mention. Even the guy who is able to pull down 3 semesters a year will qualify to have insurance he buys on an exchange subsidized because if he has a family he is way under 400% of the poverty level. These folks are part of the 47% that Rmoney showed such respect for during the election. Too bad they can't take responsibility for their own lives. In the quote above you state: "low-paying employers, in general, are not the only ones who are cutting hours due to the new mandates of Obamacare." Hopefully now you realize that these community colleges ARE among those "low paying employers," using the exact same tactics as restaurant chains etc to save a buck.

Just based on our local community colleges, they have always used adjunct instructors. The community colleges often offer programs that 4-yr colleges do not. Our local CCs offer: auto technology, dental hygenist, culinary arts, a mortuary programs. The best instructors are often those who have practical experience in those careers. Some of those instructors (my son went to a CC for auto tech) don't want to give up their "day jobs". My son's adjunct instructor on auto computers was making $75/hour in his job of dx'g the cause of a "broken" auto computer (that was 20 years ago!). I pay $100/hr for my dental hygenist. I suspect that the dental practice gets about 1/2 of that.

I'm sure there is also "fat" in the education "industry" budget. I recently read of a small college that opted out of intercollegiate competition to use the funds saved to install an overall health program for ALL students; and offer intramural sports for those inclined toward competition.

I think there are many sides to the issue.

[Gerry Clinchy]

Taking $500 billion out of Medicare ...

A caller to Mark Levin's show last night: A man of 54 who has had at least two heart attacks, is diabetic, and with kidney disease that & may soon need dialysis. He said he's paid into SS since age 15. He is on SS Disability, getting $1770/mo. (that will be about $1894 on 1/1/13; $22.727/year). He was informed that on 1/1/13, his income will be $140/YEAR too large to qualify for Medicare prescription coverage. The option he was told he could use is private insurance that will cost $280/MONTH; $3360/YEAR.

It would appear that this where some of the $500 billion will be "saved" in Medicare. I might suspect that this person might ultimately end up in some Medicaid program. It seems like this means that the Fed will reduce its $500 billion in Medicare by shifting that load to the states? Maybe my reasoning is faulty?

Several pharma companies advertise that they have programs for those who cannot afford their meds, but it's hard to know if this person would qualify for one of those programs. However, logic tells me that those pharma companies are able to do that because they have a profit margin on the drugs they sell to those who DO pay for their meds. So, in this case, the burden gets shifted to the individual consumer who pays more for scrips or more for health insurance.

It occurs to me that if 30 million lacked health insurance, out of 300 million, then would it not have just been simpler to institute a "tax" of 1/2% on those working, and pool the $ to provide health insurance for those who are uninsured? It's very possible that some of the 30 million uninsured are actually working, but due to pre-existing conditions simply can't afford the premiums for coverage; so even those people would contribute something to their coverage. Maybe this is just too simple?

[Buzz]

Taking $500 billion out of Medicare ...

A caller to Mark Levin's show last night: A man of 54 who has had at least two heart attacks, is diabetic, and with kidney disease that & may soon need dialysis. He said he's paid into SS since age 15. He is on SS Disability, getting $1770/mo. (that will be about $1894 on 1/1/13; $22.727/year). He was informed that on 1/1/13, his income will be $140/YEAR too large to qualify for Medicare prescription coverage. The option he was told he could use is private insurance that will cost $280/MONTH; $3360/YEAR.

It would appear that this where some of the $500 billion will be "saved" in Medicare. I might suspect that this person might ultimately end up in some Medicaid program. It seems like this means that the Fed will reduce its $500 billion in Medicare by shifting that load to the states? Maybe my reasoning is faulty?

Several pharma companies advertise that they have programs for those who cannot afford their meds, but it's hard to know if this person would qualify for one of those programs. However, logic tells me that those pharma companies are able to do that because they have a profit margin on the drugs they sell to those who DO pay for their meds. So, in this case, the burden gets shifted to the individual consumer who pays more for scrips or more for health insurance.

It occurs to me that if 30 million lacked health insurance, out of 300 million, then would it not have just been simpler to institute a "tax" of 1/2% on those working, and pool the $ to provide health insurance for those who are uninsured? It's very possible that some of the 30 million uninsured are actually working, but due to pre-existing conditions simply can't afford the premiums for coverage; so even those people would contribute something to their coverage. Maybe this is just too simple?

This must have been mis stated. Is there an income cutoff for eligibility for medicare part D? I think they meant to say that he makes too much to get MEDICAID prescription coverage.

[Buzz]

Just based on our local community colleges, they have always used adjunct instructors. The community colleges often offer programs that 4-yr colleges do not. Our local CCs offer: auto technology, dental hygenist, culinary arts, a mortuary programs. The best instructors are often those who have practical experience in those careers. Some of those instructors (my son went to a CC for auto tech) don't want to give up their "day jobs". My son's adjunct instructor on auto computers was making $75/hour in his job of dx'g the cause of a "broken" auto computer (that was 20 years ago!). I pay $100/hr for my dental hygenist. I suspect that the dental practice gets about 1/2 of that.

I'm sure there is also "fat" in the education "industry" budget. I recently read of a small college that opted out of intercollegiate competition to use the funds saved to install an overall health program for ALL students; and offer intramural sports for those inclined toward competition.

I think there are many sides to the issue.

I am very aware of what is going on with community colleges. We will be attending a dinner on Thursday that a technical school in SD is putting on to honor our family for scholarship fund that we recently endowed for students in one of their programs. The fund was set up in honor of my father-in-law who set up and wrote the curriculum for a program at their school. At a lunch I attended there recently I was talking to the tech school president. There is an extremely popular program that they have offered that was canceled this year. The reason? They CANNOT afford to pay for a qualified instructor. They lost the one they had to industry and for what they can afford to offer to a replacement, they are not getting any interested applicants. I'm sure that not only did your son's instructor not WANT to give up his day job, I bet he couldn't afford to give it up. I made the mistake of joking that I could possibly come on a part time basis to teach some electrical courses and they were all over it... At this point, the best they can hope for is to lure in a qualified retiree that wants to keep working for a few more years. Either that or the industry in question may need to consider endowing a "professorship/instructorship" at the school so that they can afford someone.

[Gerry Clinchy]

I am very aware of what is going on with community colleges. We will be attending a dinner on Thursday that a technical school in SD is putting on to honor our family for scholarship fund that we recently endowed for students in one of their programs. The fund was set up in honor of my father-in-law who set up and wrote the curriculum for a program at their school. At a lunch I attended there recently I was talking to the tech school president. There is an extremely popular program that they have offered that was canceled this year. The reason? They CANNOT afford to pay for a qualified instructor. They lost the one they had to industry and for what they can afford to offer to a replacement, they are not getting any interested applicants. I'm sure that not only did your son's instructor not WANT to give up his day job, I bet he couldn't afford to give it up. I made the mistake of joking that I could possibly come on a part time basis to teach some electrical courses and they were all over it... At this point, the best they can hope for is to lure in a qualified retiree that wants to keep working for a few more years. Either that or the industry in question may need to consider endowing a "professorship/instructorship" at the school so that they can afford someone.

Indeed, the cooperation of the private sector to help fund programs for useful skills that fit into the community college model is a good idea; and it has worked well in the past.

Our local CC is working with PP&L electric utility to design a course for linemen. I noted weeks ago that there was some issue with utility companies decreasing their forces of linemen to control costs. Often this was done by attrition of not replacing those who retired. Guess it worked too well ... so now they don't have enough trained linemen. Our two long outages the past two years may have made that especially critical. So, now they are going to work with the CC to solve that problem ... and those are good-paying jobs.

Actually, I think our society has tended to become snobbish, looking down upon blue collar work. In truth, blue collar work can require a high level of skill and we should value it more. Had a friend who became a harrier ... lots of openings for his line of work. Not many young people consider that as a career. He makes good income doing a lot of work on racehorses.

[Gerry Clinchy]

This must have been mis stated. Is there an income cutoff for eligibility for medicare part D? I think they meant to say that he makes too much to get MEDICAID prescription coverage.

You could be correct, Buzz. The caller may have been confusing the two. It may be that with SS disability, there is a coordination of the two programs. Although I did think that SS disability did fall into Medicare coverage, but there may be different rules for those under retirement age.

[Buzz]

Indeed, the cooperation of the private sector to help fund programs for useful skills that fit into the community college model is a good idea; and it has worked well in the past.

Our local CC is working with PP&L electric utility to design a course for linemen. I noted weeks ago that there was some issue with utility companies decreasing their forces of linemen to control costs. Often this was done by attrition of not replacing those who retired. Guess it worked too well ... so now they don't have enough trained linemen. Our two long outages the past two years may have made that especially critical. So, now they are going to work with the CC to solve that problem ... and those are good-paying jobs.

Actually, I think our society has tended to become snobbish, looking down upon blue collar work. In truth, blue collar work can require a high level of skill and we should value it more. Had a friend who became a harrier ... lots of openings for his line of work. Not many young people consider that as a career. He makes good income doing a lot of work on racehorses.

Tried to send you a PM, and it seems that your inbox is overflowing...

[Gerry Clinchy]

Tried to send you a PM, and it seems that your inbox is overflowing...

I don't use the PM function ... too cumbersome. Just use the email address in my signature.

[Henry V]

You'd have to refer back to the article I quoted from. I might suspect that this clause means that any private insuror that does not wish to provide coverage under the act is free to abstain from doing so.

Of course, if all (or most) private insurors were to do that, we would then have to rely on the Fed to provide such coverage? A back door to single-payer? Some speculate that this was the ultimate plan all along.

If private insuors remain in the market, but their pricing structure is too expensive, that would also be a route toward eliminating the private sector as people sought a "government option" (the state exchanges? or another route to single-payer?).

Sorry Gerry your answer is not very defensible from my perspective. The article you posted does not provide any links to a "federal health insurance program", only empty rhetoric. If you have a link, please provide one.

The private insurance exchanges are being set-up for private insurers to compete for customers. A concept first promoted by conservatives. While I agree that insurance companies may decide not to participate it seems doubtful that many would not want to be part of this system that provides ready access to many more customers.

If this is a backdoor way to a single payer system, don't you find it ironic that all the conservative states that have decided to depend on the federal government to establish their exchange may then be most responsible for enabling the single payer system in the long run. Hilarious, if you ask me.