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December 19, 2014

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Letter to the editor:

Obamacare is a boon to seniors

Regarding the so-called Medicare Advantage cuts due to Obamacare:

I received changes to my 2013 Senior Dimensions plan, the biggest Medicare Advantage plan in the state.

Every co-pay I had in 2012 will drop next year or stay the same. The politicians and Obamacare haters are wrong about what will happen to the Medicare Advantage plans. I wish Obamacare passed years ago; I would have saved thousands of dollars.

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  1. Dardin restaurants which has about 180,000 emeployees and operates Olive Garden and other chain food stores is planning to go to all part time workers. Why? Loop hole in Obamacare for employees who work less than 30 hours. The restaurant management want to avoid the high costs of Obamacare that will set in next year.

    "You have to pass the bill to see what's in it." Nancy Pelosi, then House Speaker talking on Obamacare.

    CarmineD

  2. Two big problems with the ACA. 1) When you mandate that business provide medical coverage, but don't control increasing costs very well, businesses will find ways around a mandate. 2) When you institute a costly new benefit but don't provide enough funding because to do so would be unpopular, the benefit is unworkable in its present form and the 'bad' (higher taxes) news will arrive in due time.

    Michael

  3. Dear letter writer, everything I have heard so far convinces me you will lose your Medicare Advantage . You just have to wait a while. It will be a victim of the $700 billion reduction in Meicare costs under the ACA> Good luck!

  4. Dardin restaurants, is only testing a few restaurants with part time work.According to Huffington Post Dardin will be testing part time workers at a "select number of restaurants".In limiting workers to a 30 hour work week as health care changes appear soon.They (Dardin)claim this is only a test.

  5. Bradley,

    I am glad you realize that the employer mandate has large problems. As many Americans still do, I thought our health care system was fine when I was employed by a large employer who picked up the majority of my health care costs. Once I was out of that bubble, I realized my view was wrong. The ACA is very flawed but Obama was correct to point out that our health care and insurance systems were badly in need of changes. Unfortunately, while it contains some needed provisions, the ACA is poor legislation, doesn't control rising costs and is underfunded.

    Michael

  6. We have an employer-based health insurance system in the United States. If a large employers like Darden don't want to provide health insurance for their employees and small employers don't want to provide it because they say they can't afford it, you have to wonder why the system even exists.

    If Darden employees can't get insurance from the company their only option is to turn to welfare when they get sick. Low-wage employees could never afford to buy it in the individual market place. I buy my own insurance and it's not cheap.

    This is why we currently have close to 100 million people on Medicare and Medicaid.

  7. The entire healthcare system is underfunded. It's the cause of our deficit. The unfunded liabilities are in the tens of trillions of dollars. Over the next 40 years it will cost the country between $150 trillion in $200 trillion. That's a nice chunk of money. Too bad it's all going to go to a few million people in the healthcare sector.

    If Big Bird loses his job I highly recommend they he get into the healthcare space. That's where all the money's going.

    In terms of the Medicare advantage plans who cares. 75% of seniors don't even participate. They carry a straight Medicare card.

  8. As Gerry pointed out, we largely have an employer-based health insurance system. From what I can tell, this has come about mainly due to union demands.

    Be careful what you ask for, you might get it.

  9. Our healthcare system came about as a result of post World War II wage and price controls. Employers couldn't give their workers more money so they decided to give them medical benefits. The entire system came about as a complete fluke.

    Truman tried to bring us socialized medicine and nearly had it through Congress. Who came out against it?? The United Auto Workers union! Truman didn't want to go against the autoworkers so he dropped it. How ironic that healthcare costs since the Truman era have nearly destroyed the entire US automobile industry. As boftx said"be careful what you ask for". They never anticipated medical costs exceeding $20,000 per family which is what will happen next year.

  10. "They (Dardin)claim this is only a test."

    Mr. Pizzo:

    Dardin also received a waiver from the Admin on Obamacare. One of the first, despite supporting it.

    Here's my take, FWIW, and the reason it's called a test: Dardin management forsees a fiscal cliff in January 2013. Surprise, surprise. Regardless of the outcome of the November elections. Dardin is taking steps NOW to reduce full timers to part time just in case [think warn letters]. Talk to any and all economists, EVEN CBO, and they'll say that the outlook for the USA economy for the next 5 years is dismal to doom. Sadly, it's no better for the rest of the globe either.

    Also, look for other chains to do the same: Reduce costs by doing and end-around Obamacare.

    Many have done so already [cut employees' hours]. But, they haven't made it public. Most of the employees who work in the buffets and restaurants in the casinos in Las Vegas have seen their hours cut gradually over the last several years along with their benefits. It's common knowledge.

    CarmineD

  11. Dardin doesn't want to pay for medical...period...Obamacare has nothing to do with it. If businesses won't pay the folks end up on medicaid when illness strikes. Business or government, take your pick. No free lunch!

  12. "Dardin doesn't want to pay for medical...period...Obamacare has nothing to do with it. If businesses won't pay the folks end up on medicaid when illness strikes. Business or government, take your pick. No free lunch!"

    Mr. Hageman et al:

    I'm not going to argue the reasons with you. I don't know what they are. BUT, I know this: Obamacare gives the chain a loop hole with the 30 hour work week. Dardin saw the opening and is taking it for whatever reasons.

    I have often said here and will again: Carmine's law of unforeseen consequences. Federal laws often accomplish just the opposite of their intended purposes. Obamacare with 2700 pages of bureacratise is prima facie proof.

    CarmineD

  13. Dunno if Darden going to all part-timers is going to work out for them. Unhappy employees tend to give bad service to customers. Sit-down restaurants are a service industry and customers tend to drift away from bad service. Over 90% of customers will not complain, they will just go away and stay away.

    The Darden employees may be able to get coverage through the Obamacare health insurance exchanges, and many of them will switch jobs to find similar or better work which is covered by health insurance. For Darden, that means a drain of their better employees to other companies.

    And, I wonder whether the IRS would tweak the regulations on deductibility of executive health insurance premiums so that companies like Darden who reduce most employees to part-time to avoid Obamacare coverage also lose the deductibility of executive health care.

    So I guess we will see how this works out for Darden.

  14. Health care is not "underfunded." Americans pay twice as much for "health care" as anywhere else but we get poorer results. Our life expectancy and quality of life are much lower than Europe and elsewhere. Doctors seem to enjoy astronomical incomes and often own the lab companies and other places they "refer" us to. Doctors hire multitudes of semi-trained subsidized staff and give them little chance for advancement. It is only where they are required to have an RN, LPN, of PA that there is some "job opportunity" of any meaning. Doctors are rewarded for increasing costs and increasing "care." They charge, say $500 for an office visit, listen to you for 5 minutes, check your pulse and tell you to come back in 3 weeks if things are the same. In 3 weeks when you return, they MIGHT do whatever they should have done the first time. Compound this attitude and activity and you've got U.S. "health care." On the other hand, more recent trends when a large employer has consumer-driven health plans, patients are more interested in prompt results when they NEED care. There are far fewer runs to the M.D. for minor things and much more interest during the first visit. Costs are way down. Now would Michael, Carmine, John, Bradley and all figure out a way to get consumer-driven into Medicaid? Medicare already has SOME of this as seniors tend to be more concerned with quality of care and COST of care--copays and RX costs.

  15. Bradley,

    I agree with you. It is a very tough problem and I don't know the solution either. I do recognize however, that whenever we pool risk and then cover it with insurance, as we do with auto insurance and health care insurance, we seem to end up with high costs and not much real competition. I think if you paid the doctor directly for an office visit or a minor medical test, like my parents did when I was young, we'd be a lot better off. Then doctor's and labs simply could not command the prices they get now.

    I would at least like to try a system where health Care insurance only covered catastrophic illnesses and injuries. Everything else would be paid 'out of pocket'.

    What we had before the ACA was a very poor system. What we will have after the ACA will be a very poor system. Those who think otherwise are engaging in wishful thinking.

    Michael

  16. Ah, good to know that business is not getting on board and instead looking for more loopholes.

    Now, I will inquire of businesses as to whether they are supplying healthcare insurance or cutting workers hours before I purchase anything.

    I will boycott those that are, including the Olive Garden, who goes to the top of my list. I will also pass the word to others so they can do the same.

  17. Bradley,

    "research and development will naturally stagnate"

    Where did you get that impression?

    European universal healthcare systems don't have that problem, and in fact the results of their R&D contributes alot to US medicine.

    As I read medical journals it becomes clear how much they contribute to healthcare advancements and knowledge.

    I think that is another of those false impressions used to try to stop a universal plan from becoming a reality in the last hold out industrialized country.

    You must realize how much the healthcare industries have to lose if we go to a universal system. It is like killing the chicken that lays the golden eggs. They will float all kinds of false impressions and information to keep that chicken alive.

  18. Michael,

    "I would at least like to try a system where health Care insurance only covered catastrophic illnesses and injuries. Everything else would be paid 'out of pocket'."

    I know you are self employed, and a lawyer if I have read correctly.

    So, your income is such that it exceeds the average, and substantially compared to those who are in the lower quantiles of the economic ladder, which are considerable.

    Would you and other employers be willing to pay substantially higher wages for employees so their ability to pay the high cost of non-catastrophic healthcare would not cause them financial deprivation? I am referring to one hospitalization setting them significantly behind on mortgage payments, making them subject to foreclosure, or being unable to pay for all their other necessities and meet their obligations responsibly. This doesn't only effect an individual; it effects families.

    I get the impression that you are not aware of all the reasons one can find themselves in the hospital, and especially the very high costs? Or the high cost of treating a chronic condition. There is no distinction made between those who can afford to pay and those who can't as far as charges go.

    Even non-catastrophic "out of pocket" costs can cause destitution for many.

    Clearly, I wouldn't try to suggest some reforms for the legal profession to control their costs.

    I think it is difficult for people who haven't had healthcare careers to understand the realities of the industry which generally effects many more people, most without the incomes to afford care.

    I still remain a proponent for a single payer universal healthcare system.

  19. Carmine,

    "EVEN CBO, and they'll say that the outlook for the USA economy for the next 5 years is dismal to doom. Sadly, it's no better for the rest of the globe either."

    Not a very good testimonial for capitalism, due to its inherent cyclical disorders and disasters.
    ~~~~~~~~~~~

    As far as healthcare goes, I would advise all those who will be subjected to Vouchercare, and privatized Social Security to start saving big time for the future when they will be needing more healthcare, and paying more for it.

    For those whose Social Security will depend on the financial markets, add even more savings. The financial markets are bound to crash, and in between add recessions and inflationary periods, predictable or not, with a resulting loss in your security, maybe more than once before you need it.

    Remember, the closer you are to retirement, the less likely you will recover financially.

    You may have to tighten your belts considerably now, in order to meet your needs in the future.

  20. Healthcare benefits are factored into the employee costs, considered as a total package to employees along with wages.

    If businesses don't have to provide health insurance benefits, will they give the employees equivalent pay increases?

  21. "Not a very good testimonial for capitalism, due to its inherent cyclical disorders and disasters."

    Can't blame capitalism alone. Government, with misguided fiscal and monetary policies, plays a huge part in the economic failures both here and abroad.

    CarmineD

  22. ONE of the problems with health care is insurance companies. They have free reign, almost, to limit coverage and then spend endless on administrative costs--low to moderate-level employees who must give pre-approval, post-approval and can still deny payment. Can we get GAO to "audit" and tell us how much all the admin costs versus what the actual denied coverage was?

  23. Bradley, you make good points, and I apologize to Michael for being out of line.

    While I responded to Michael, and used my assumptions about him, I was thinking more of a model, rather than Michael specifically, and erred by not doing so appropriately.

    Believe me, Bradley, there is so much R&D going on in countries with universal coverage that you would be amazed. I read of new and ongoing research on a daily basis. So, lack of R&D is not a viable argument against universal care.

    Why couldn't governments with universal healthcare systems have R&D or science budgets separate from healthcare...perhaps science grants for R&D? It is a matter of seeing the importance and the will to implement such budgets.

    Of course, in the current economic crisis, that might be difficult for some.

    Remember that universities and private industry are also involved in R&D, sometimes jointly. There are many ways to go about it.

    Universal healthcare doesn't appear to me to effect R&D, based on my reading on all the R&D I read of.

    When I started out in healthcare in the 60's, a doctors office visit was $10, a complete history and physical was $25. Today, it would be from $80-125 for an office visit of 10 min., and up to almost $500 for a complete H&P that takes 20 mins.

    Yes, that last one was my personal experience, and that was about 15 years ago!

    Add lab tests and you can reach another $400 avg.

    There is no way that most people could afford such healthcare costs today, without insurance.

    Those costs keep going up annually at the will of the provider. So, there are no constraints outside of insurance and government programs.

    A single payer universal healthcare system would out of necessity, have to bring healthcare cost under control. Providers, the public, and the economy would adjust, without effecting quality.

    There are successful plans all over the industrialized world. It isn't as if we would have to design a system from scratch.

    Right at the moment, we need planning, so such a system would not begin for some time, which might be good given the economic crisis/chaos.

  24. Carmine,

    "Can't blame capitalism alone. Government, with misguided fiscal and monetary policies, plays a huge part in the economic failures both here and abroad."

    I agree to a point. However, governmenrs are also capitalist. Example: Unfunded wars serve the military complex and end up costing taxpayers, eventually.

    Even healthcare costs are part of the capitalist economy.

    Both of those areas are profit oriented.

    It is in the interest of both of those capitalist industries to benefit from wars, in one case, and illness and injuries, etc., in the other case.

    Personally, I would rather have healthcare rather than war.

    Government spending from taxes helps capitalist industries profit, sometimes too much.

    If we didn't have government providing for some social needs, we might find a massive revolution at some point. Everyone has a breaking point. When you have nothing, you have nothing to lose.

    The Great Depression is an example of what can happen. Roosevelt acted as he did to stop such a revolt from proceeding, contrary to all the illusions of altruism to the people.

  25. Additionally, Carmine, I don't think you can disagree that capitalism from the market standpoint has a pattern of going from boom to bust to boom to bust. Aren't those the bull market vs. the bear market cycles?

    That is the cyclic instability that I refer to and is separate from government.

  26. Oh my, I am tired and can't think well enough to make sense.

    Include recessions, depressions, and inflation.

    OK, off to bed... good night.

  27. Thanks kepi!