So this anonymous businessman seems to think the ACA will wipe out his whole business without actually being able to point to the part of the bill that will cause that? Perhaps when you see him again you should recommend that he actually read the bill. As the article states, it has several provisions to help small businesses.

@St. Swithin -

Did Nancy Pelosi ever get a chance to read the bill yet? I mean, we all know she didn't read it before she voted to pass it, I was just kind of hoping that maybe she had skimmed it by now.

Also, if the ACA is so great, then why the need for any waivers at all and why did it appear that most of those waivers went to those that were politically well connected to Democrats? After all, you'd think that voting Democrat business people would be embracing the ACA with open arms instead of seeking a waiver from it's implementation, and yet, that's exactly what happened!

If it looks like an EPIC FAIL and smells like an EPIC FAIL, it's probably an EPIC FAIL!!!

Try again!

Why would you assume he hasn't read the bill, Swithin?

I'll ask him to clarify next time I see him, but since he brought it up I've got no reason to doubt that he knows what he's talking about. It's a family business that'll be celebrating its 100th anniversary (hopefully) in the next couple of years. The article's author...well...his track record speaks for itself.

@Bob McBride -- I'd be interested to know. Does this business owner already provide coverage for his employees and fear the costs will go up? Not that costs don't go up regardless. Or does he not provide it and worry that he will have to now?

We didn't have an involved conversation, Randy. He mentioned this in passing as we were discussing the business climate in general. I got the impression he's providing some level of insurance currently and that, as a result of ACA, it's going to end up costing him more to point where if he's forced to continue to provide insurance, he'd be better off cutting staff or going out of business. He did make mention of concerns about his employees wanting coverage for their older children and how this was going to increase his costs. Again, I can try and get specifics from him next time I see him, but the guy isn't an idiot, he has a vested interest in keeping the family business going and he did express the concern. I assume he'd know his business and the challenges he's facing better than I or anyone here would.

@James - still pushing that old lie about no one having read the ACA bill? I remember that bill being debated for four months. I read several articles in the paper each week discussing the contents of the bill. I personally don't think the ACA is that great. It's just five times better than anything the Republicans have come up with. It would be great if there were some serious discussion about how to improve it. Instead all I hear is REPEAL! As for waivers, which ones? Yes, there was a lot of horse-trading to get the bill passed. That's politics. I believe the worst issues have already been amended or removed.

@Bob - So I just want to confirm that you can't spell out why the ACA hurts your anecdotal friend. So your story is basically useless.

Swithin, the guy is a small business owner, he expressed a concern about ACA as it effects his ability to continue doing business as he has for years. I'm taking his word for hit. Your mileage may vary.

I'm not in a position, based on the conversation we had to say exactly why. Rather than guess, I'm going to take his word for it. Certainly he knows more about his business than you or I do.

Your decision to question it, based on nothing more than your personal desire to see ACA go through, is more worthless by far than my mention of a factual occurrence that relates specifically to Keith's ode to the supposed small business benefits of ACA

ttp://www.theblaze.com/stories/how-many-businesses-are-exempt-the-final-number-of-obamacare-waivers-is-in/

http://nation.foxnews.com/nancy-pelosi/2011/10/29/pelosi-defends-obamacare-waivers-1800-firms-theyre-small-companies

http://dailycaller.com/2011/05/17/nearly-20-percent-of-new-obamacare-waivers-are-gourmet-restaurants-nightclubs-fancy-hotels-in-nancy-pelosi%E2%80%99s-district/

So, where's the waiver for my small business family restaurant? How come others received one, particularly in Pelosi's district, but not a small businessman's family restaurant in Wisconsin? I thought a federal judge just said that the government can't treat special interests differently in ruling against parts of Act 10, didn't he?

So this selective picking and choosing of who gets an Obamacare waiver would appear to be unconstitutional under such a precedent, wouldn't it? After all, if restaurants politically connected to Pelosi get a waiver, then shouldn't all restaurants get a waiver? That would appear to be the crux of the judge's opinion in the recent Act 10 case. So what exactly am I missing here?

You're honestly going to sit there and tell Hoffa that this doesn't stink to high heaven??? COME ON!!! I'm getting SICK of this CRAP!!!

REPEAL AND VOTE THE BUM OUT!!!

@Bob McBride -- I'm sure your business owner friend said what he said and he believes it. But does he believe it because he has looked over hard figures of what his costs will be under the new law, or is he just reacting to something he heard on talk radio? Big difference.

@JRH -- What do you provide for your employees now? Do they have an insurance plan, and if not, do you pay them enough to purchase a plan of their own? If neither is the case, you should probably drop insisting how people should be responsible for their own care, because it's simply impossible.

@Randy1949 -

I'll answer your questions once you can adequately explain to me how it's fair that small restaurants in Pelosi's district, and some large-scale franchises such as McDonalds, were able to receive waivers from Obamacare, but not every restaurant or franchise was privy to that same privilege.

According to Pelosi, those waivers were justified because "those businesses are very small." So, could you explain for me what liberals consider a 'large' business as being, cause personally, I always thought that McDonald's was pretty large. It's definitely bigger than my little one store front family restaurant!

Randy,

Based on the limited discussion I had with him, the best conclusion I can draw was that his main concern was going to be the additional cost associated with having to provide insurance for his employee's kids 26 or under. I base that on what he said at the time. He doesn't strike me as the type that makes business decisions based on what he hears on talk radio. In fact, I'd be hard pressed to think of anyone who does.

Let me ask you a question along the same lines. Are you basing this as being beneficial to you based on some figures you have that represent what things will cost, post ACA going into effect? Or are you basing it on something you heard on MSNBC? Big difference.

Putting that nonsense aside, I don't think anyone knows exactly what the costs are going to be. But based on the fact that coverage is still going to be provided by the insurance companies and they aren't going to give away the additional coverage, as in my friend's case, free, I think it's safe to assume that if he thinks it's going to cost him more, he's probably right.

Deep breath there JRH! If your business didn't get a waiver it's probably because you didn't request one. That's what all these other waivers are. From http://tiny.cc/48i5bw :
"Many of the waivers are for limited benefit or so called "mini-med" plans—controversial rock-bottom plans that provide a very limited amount of coverage (sometimes as little as $2,000 a year) to beneficiaries that are used heavily in low-wage industries like the restaurant business. New federal rules require such plans to offer a minimum of $750,000 of coverage annually, and the waivers exempt the mini-med plans from such rules on a case-by-case basis."
Your three links are all basically for the same heavily slanted story that implies without proof that Pelosi is doing favors for someone. The waiver grants are mostly in Democratic districts because Republican areas are not getting the word.
I think it's a shame that a lot of small business people have gotten bad info from right-wing sources and are missing the opportunity to get this waiver.

@JRH -- St. Swithin beat me to the punch with the info about the 'mini-meds' and the yearly and lifetime caps.

@Bob McBride -- No, I am certainly not basing this on something I heard on MSNBC. I'm coming from over twenty years of being without health insurance now (with the exception of one year in 1996) and trying to obtain a private plan. I've been turned down flat once because of a medication I was taking at the time (an anti-depressant which I no longer take) and all the rest was because the premiums were out of sight for our income.

I'm nervous about what will happen in 2014 -- whether I'll be able to find anything affordable even with the subsidies. But it's nerve-racking having no insurance at all.

Randy, other than the fact that I shuttered my sole proprietorship and went back to work for someone who provided insurance, nothing you mention there hasn't happened to me. Which is precisely why I refuse to believe that the insurance companies are going to play along with this scheme by reversing course and not increasing costs to the purchaser to cover those they incur as a result of being forced to cover pre-existing conditions and the like. And if there are no cost controls associated with this, talk of subsidies as a means of making it any more affordable is pointless.

You honestly expect me to buy an analysis of the situation performed by Mother Jones!!! I'm waiting for someone to say April Fool's!

WRONG! I did apply. I was told that no more waivers were being offered. Also, why are the waivers only offered on a 'case by case' basis instead of a blanket covering the entire restaurant industry? And why are labor unions lumped into the groups that were given waivers? Was the IBT really only giving mini-med plans to those on their payroll? Wake up!!!

You guys may not realize this, but my small family restaurant isn't pulling Bentleys, Rolls Royces, and Aston Martins in the parking lot every night like the restaurants that received waivers in Pelosi's district do. And yes, my restaurant currently does offer mini-med plans to full time employees, as something was deemed to be better than nothing. Under the new rules of the ACA, the coverage has to be higher so my cost will go up substantially. I'm seriously considering paying the fine instead of offering any coverage at all. May even have to close up shop. As it stands, the place only cleared 15k in profit last year. If the ACA eats into that profit margin, it won't be worth my effort anymore. Then, all those jobs and the tax revenues disappear. Is that really what you guys want to see happen?

REPEAL AND VOTE THE BUM OUT!!!

He's had one for awhile. His postings are few and far between. I'll let you decide if that's a positive or a negative.

James, I pledge to my very best not to rub it in.

Absolutely agree Croc.

The uproar over the Catholic refusal to cover contraception backs up your point. If health care was truly portable and not tied to the employer, the Catholic Church would not have a beef other than speaking out against women taking the pill.

I don't disagree with that at all. Particularly since it appears that, in the future, we're going to be seeing a lot more contract style employment that would require portability to be feasible.

The problem is that ACA, as structured, doesn't really guarantee the availability of affordable coverage for those who currently have an employer based program and who may lose it as a result of elements of ACA. It also doesn't guarantee affordable coverage for those who currently can't afford insurance If there was a single payer element to it, at least there would be some sort of verifiable, quantifiable option and people might at least know what the expect.

The comeback from those on the left is that it's the Republican's fault that there's no single payer option. That's not a justification for moving forward with an imperfect program that could potentially make things worse for a lot of people. That's using healthcare as a political football, essentially.

There are ways of covering those who don't currently have coverage without upsetting the entire applecart at this point. If the theory is that by dumping a bunch of folks into the market and essentially putting them in a worse position than they are now, it will force the government, via some sort of healthcare consumer uprising, to provide universal healthcare, that's a pretty brutal and thoughtless strategy. If it's an issue of not having thought it through completely, that's no better.

The problem, as I see it, is that the ACA doesn't guarantee affordable coverage for anyone because it leaves the coverage to the private market, which I'd certainly be patronizing if I could afford it. Sure, there are some tax breaks for a private customer depending on income level. There are supposedly tax breaks for small businesses too.

You can call the strategy brutal and thoughtless, but so is the current system it replaces. People lose their employment all the time, often through no fault of their own, and then there goes your health coverage, never to return if you have some kind of pre-existing illness.

Then if all we're essentially doing is replacing one bad system we know with another bad one that we can anticipate as not addressing the real problem for those w/o affordable health insurance and that also has some potential unintended consequences that could make it worse than what we have now, what's the point of doing so?

The answer I always seem to get is that doing something is better than doing nothing.

That's really not a suitable answer.

@Bob McBride --At least under the new law people with pre-existing conditions are not uninsurable for those illnesses. And a company can't collect your premiums for years while you're healthy and then drop you once you get sick. That is a very big improvement.

The people I see objecting are those who have coverage and are afraid it will reduce in quality or they'll lose it altogether. And I'll say, are you content with a system like this? It can happen to you at any time regardless, and then you might see things differently.

Randy, given whose going to be the "payer" (hint: the same insurance companies everyone hates now) what makes you think you're going to be anymore able to afford insurance adjusted to cover pre-existing conditions than you are now? Again, do you think that the costs associated with covering pre-existing conditions are going to be absorbed by the insurance companies. If there's no cost control in place, you have no assurance they won't. And if this increases the cost of insurance across the board astronomically (not a stretch by any circumstances), odds are even more people will be going w/o coverage. Unless you're into the whole "misery loves company" thing, there's unlikely to be any beneficial payoff for you, either.

Think it through, Randy. That's all we can do at this point. There are no guarantees that what you've been told is going to happen is even remotely close to what will happen, because the one thing that needs to be controlled in order for it to work as described, isn't being controlled.

So what's your solution, then Bob McBride? Undo the whole thing and those who will inevitably left out should just accept it with good grace so people who still have insurance can keep it?

If you'll recall, the ACA originally included a public option that would have covered people without putting the burden on the private insurance companies.

By the way, I have no pre-existing conditions other than my age. I'm computing my chances of getting cancer before age 65, and they are tolerable. If not, under the ACA, there is the high risk pool at least.

...and that option is no longer there. Since it's a key component without which there's no assurance of any cost controls, you don't move ahead with ACA as is.

You create a system that addresses the needs of those who can't afford health insurance w/o messing up the system for those who have it through employers - i.e., a public option. You start there. If the public option is workable, THEN if you want to encourage others to move to it, you do so. You don't start by enlarging the pool and then have them fend for themselves in the marketplace while you try to figure out how to make it "affordable" for them.

You don't have an architect draw up plans for a building and then not build the first two floors due to a disagreement over the design and expect the building to support itself by hovering over the foundation. ACA w/o the public option is that building. Again, "something" isn't always better than nothing.

In that case, your problem is with the GOP members in committee who did away with the public option. Unless the aim of the opposition all along was to amend the bill until it was so odious that the whole thing would be rejected, and then we're back at square one.

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

"There was a long struggle between Obama's advocates and free-market health care advocates over the question of a "public option", which would have created a federal public-benefit corporation subsidized to compete with the private companies in the exchange. Republicans and their allies eventually defeated this "public option" idea by arguing that the public nature of such a company would give an unfair edge over the private organizations in the exchange and would "unfairly out-compete" the private insurers. After a group of Corporate Senate Democrats and Joseph Lieberman joined Republicans in their objections to the public option, the PPACA was passed without a public option included, ensuring the insurance exchange would be inevitably composed purely of the private health insurers.[9]"

Or you could blame the Dems for not being able to get the job done. Either way, it doesn't matter. It's not there and w/o it, it won't work.

I blame the more conservative elements of Congress for protecting the interests of private corporations instead of the health of their constituents. My point is that the bill started out exactly as you had proposed and was blocked. And now you dismiss the entire idea.

Yes, Randy, I do. I reject it because it's not going to work as-is. I should be for it? Why?

Good lord....

I think the first question is why the cost of healthcare skyrocketed. Define cost -- is it health insurance premiums, or is it the cost of prescriptions, doctors and hospital fees after removing the middle man? Why does a day in the hospital cost upwards of two thousand dollars a day now?

Is it greedy insurance companies? Is it greedy hospitals? Is it illegal immigrants? Is it greedy pharma?
Good question. I just think something is clearly out of whack. My best guess is that it is some sort of manipulation by those making better than 100 million a year off health care. In any case, it would be nice if someone could do us a favor in the middle and lower class.

Part of it is medical advances and expensive technology. Almost sixty years ago, three of my siblings developed kidney failure as infants. They died. Today there would be dialysis and transplants and a lifetime of anti-rejection drugs, all very expensive.

I think the hospitals spread out the cost of those very expensive MRI machines into the daily cost of a bed. It's a mixed blessing -- we can cure so much more, but it comes at the price of financial ruin for some of the people cured, or even those who die.

@J.B. Schmidt -- Wait a minute -- Medicaid jacked the price? I will agree that Medicaid encourages a little creative exaggerating of services performed. But you have to be aware that insurance companies negotiate their own rates of return with doctors and hospitals, which does the same thing. Are you actually blaming the high cost of medical care on Medicaid and Medicare?

@Randy
Not soley, as a listed a couple of factors. However, if one group of people is not paying the rate required then the other group must suck of the slack.

As for ins and dr negotiating the rates. Both has a vested interested and I don't think the dr. are going to negotiate a rate below what the service require. If insurance were left with fewer regulations, then consumers would be in a better position to shop around. This competitive shopping would force the insurance companies to be working harder to lower prices.

Yes, JB, but you know that doctors and hospitals do charge the out of pocket patients more than the insured ones. Which means that if you have no insurance and a minimal ability to pay you are doubly out of luck.

Taoist Crocodile
29 seconds ago
Actually, here's another fascinating article by the same author, about how only a small number of super-unhealthy people require a massive amount of healthcare, driving up costs in a geographic area:

http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=1

Now, what's the preferred approach to this problem? In JB's case, it seems to be "f--k those people; let 'em die." Or, you could take the holistic social-service approach indicated in the article, and wind up improving outcomes and decreasing the amount of care consumed by these few people.

I have, in the past several years, actually taken the informed risk of NOT going to the ER after a bad fall because of the cost involved. The last thing I could afford was a $3000 bill for X-rays just to be told, yeah, it's broken, go home and take some aspirin, it'll heal on its own in several months. (The bone in question was one that couldn't be set anyway.) I figured that if the pain got worse I could see my own physician in the next few days.

It makes me angry when people talk about ERs as if they're free healthcare providers. They're not.