The Glade 4.0

Still the fact is it is an option. You did not say you could think of no option with out other possible downsides - you said you couldn't think of another option. I gave you one.

Fair enough. To clarify, though, I meant non-governmental options that would preserve or improve the current rate of innovation without significantly increasing the risks to patients. I don't think your suggested approach would do that.

So when a pharma company (a) discovers that a compound with the chemical formula XYZ is effective at treating something and (b) develops a manufacturing process to produce that compound, their patent will usually end up being for the process rather than the compound itself, and some other company could legally produce and sell XYZ as long as they use a different process to produce it?

Why are the cheaper methods not usually done in the US?

Do you mean FDA screening for the original drug or for the copycats? If the former, that's true, but while some meaningful easing of restrictions is probably possible without undue risk, I really doubt that we could significantly lower drug prices without crossing the line into unacceptable risk levels.

Are you telling me that you believe drugs developed in Switzerland or Germany (for example) are somehow less safe than those developed in the US?

I just don't see an alternative to significant government involvement. Developing new drugs involves huge amounts of time, money and risk, so pharma companies need substantial financial rewards on the back-end for their successful drugs in order to fund it all. The only way they can get that in the market is if the government grants and then enforces a monopoly, which results in the moral and PR issues we've been talking about. Alternatively, if we want to preserve pharma's financial incentives but keep the drug prices low, the money has to come from somewhere, and the only entity with deep enough pockets and a public-interest mandate is the government, so we'd be looking at things like subsidized research, prize-based payouts, government contracting, etc. If I'm overlooking an alternative that doesn't involve the government (or involves it to a lesser degree), I would gladly consider it. At this point, though, I just don't see what it might be.

"It makes an untruth out of what the president said, that if you like your insurance, you could keep it," said Joe Hansen, president of the United Food and Commercial Workers International Union. "That is not going to be true for millions of workers now."

In comic strips the person on the left always speaks first. - George Carlin

Facism is not a school of thought, it is a racial slur.

Sandhya Somashekhar
287 words
1 June 2013

The Washington Post
Copyright 2013, The Washington Post Co. All Rights Reserved


The Obama administration confirmed Friday that a piece of the 2010 health-care law aimed at helping small businesses provide insurance to their workers will be delayed by a year.

The office in charge of Medicaid and Medicare announced that it was on track for an Oct. 1 launch of the federal SHOP Exchange, an online marketplace where companies with fewer than 50 employees would be able to buy insurance for their workers and get a tax credit.

But employees will not be able to choose from a variety of plans, as was initially expected. They will be able to choose only one plan. The full range of options will not be available until 2015, the agency said.

The delay, proposed earlier this year, upset some business advocates and raised questions about whether the administration was behind on implementing the health-care law.

John Arensmeyer, head of the Small Business Majority, an advocacy group that supports the health law, said the news would likely discourage some businesses from offering insurance to their workers next year. While large businesses will be required to offer insurance beginning next year under the law, it will be optional for businesses with fewer than 50 employees.

But he said the delay will not be experienced in many states that took a leadership role in setting up their own health insurance exchanges.

"While we're disappointed it's not going to be there from day one, we're pleased that feature will be there in most of the exchanges that are being run by the states, and they will be there for all the states beginning in 2015," he said.

http://www.washingtonpost.com

WP20130601healthshop0601

Washington Post

Obamacare and the Young Invincibles
Peter Suderman|Jun. 4, 2013 12:15 pm


At the end of May, California's regulators announced that premiums in the state's insurance exchange would be lower than expected. But it quickly turned out that individual market premiums would actually be higher, and coverage would be more robust, than in the current individual market.

Since then, there's been a lot of back and forth regarding Obamacare and health premium "rate shock." But at this point, there's little dispute that Obamacare will cause individual market health insurance premiums to rise for younger, healthier individuals, relative to the price of individual market insurance that is sold today. Indeed, some folks are arguing that that's the whole point.

Josh Barro, in his new digs at Business Insider, makes this explicit. "What's happening in California," he says, "is exactly what's supposed to happen: If you're young, healthy, and affluent, your insurance is getting more expensive." And conversely, he says, insurance will become cheaper for the "old, sick, and poor."

The young and healthy are the key issue here. But it's not only the law's impact on the more affluent members of that group that matters. Indeed, in important ways the law's functionality turns on decisions made by relatively less well-off young people. The Economist's Will Wilkinson lays out the choice for a hypothetical uninsured woman in her mid 20s.


Nicole is a healthy 25-year-old freelance illustrator making $30,000 a year. She is presently uninsured due to cost. How can she be expected to behave under Obamacare? Taking into account Nicole's subsidy, she'll be able to buy the least expensive "Bronze" plan on an exchange for $1,919, according the Kaiser Family Foundation's subsidy calculator.

Look, that's not great. After going uninsured for a spell, about a year ago I signed up for a catastrophic plan (found through the Freelancer's Union) that cost me about $100 a month. I was...older than 25. Anyway, it's not always easy to get by on $30,000 in places with high rents, so one can imagine why Nicole might opt to go uninsured. But what about the non-compliance penalty under the individual mandate? Won't it coax her into enrollment?

Over the next two years, as the penalty scales up, it's pretty clear that Nicole would be smartest to pay the initially meagre fine and not sign up for insurance unless she comes down with something expensive. (No exclusions for pre-existing conditions!) But what about in 2016, when the non-compliance penalty is finally fully unfurled? That will be the greater of $695 per uninsured person, or 2.5% of household income over the filing threshold, which is not yet set, but this year was about $10,000 for individuals. So in Nicole's case, that's 2.5% of $20,000, which is only $500. So she's on the hook for $695. For Nicole in 2016, then, the difference between going uninsured and getting a Bronze plan is $1,224, which is just a touch more than I recently paid for a cheap catastrophic plan. If America's Nicoles are going without insurance due to cost, they're not going to be induced to get it under Obamacare. If the programme is going to bring down the cost of an average policy by goading the likes of Nicole into the risk pool, it needs a bigger carrot, stick or both.

I don't know what part of America's young, healthy and uninsured will find itself in a situation akin to Nicole's, but it would seem there's some reason to worry that the programme will not function as promised—especially when most of those eligible for subsidies don't know it, and surveys show that nearly "two-thirds of Americans who currently lack health insurance don't know yet if they will purchase that coverage by the Jan. 1 deadline set by the ACA". In any case, it is not at all clear that Obamacare's subsidies and mandate penalties are sufficient in size to prevent a situation in which the rules of the law "simply shift costs around", or to prevent a cost spiral that would drive the young and healthy out of the market...

How the nation's Nicoles—a group often referred to as young invincibles—decide to respond to these choices will end up having a big impact on how Obamacare functions. As The Examiner's Philip Klein wrote yesterday, "The success of Obamacare hinges completely on the young and healthy. The reason is that the dream of a system in which sicker individuals can obtain coverage at affordable rates is predicated on the idea that the government can corral a lot more young and healthy individuals into the insurance market to offset costs." That may be somewhat difficult, however, if the law's point is to raise costs for those same individuals it needs to cajole into joining the system

The IRS has been given no enforcement mechanism for non-payment of the fine for not having insurance under the ACA.

**** ignore them *****.

They have the same enforcements that they have for any other unpaid taxes.

COLUMBUS, Ohio (AP) — Insurers who plan to participate in the new health insurance exchange are projecting their costs to cover Ohioans to be significantly higher, according to an analysis released Thursday by the Ohio Department of Insurance.

That means individuals should also brace for potentially higher costs when purchasing coverage through the new insurance marketplace created by President Barack Obama's health care law, state officials said.

The state analysis did not look at insurance premiums — the prices individuals would pay. The review examined the cost to insurers to provide the required benefits in the exchange.

Republican Lt. Gov. Mary Taylor, who is also the director of the state's insurance department, said specific premiums will vary for consumers and could change as the state agency reviews the plans.

But, she told reporters in a conference call, "The premiums will track very closely with the cost."

Consumers can get private health insurance, subsidized by the government, through the exchange. Open enrollment starts Oct. 1, and coverage takes effect Jan. 1, 2014.

Taylor said the department's analysis didn't take into account the impact that government subsidies may have on what Ohioans could pay, adding that the agency didn't have the information needed to quantify it.

Republican Gov. John Kasich chose to let the federal government operate the exchange, instead of the state setting up its own. However, the state says it has the authority to regulate health plans in and out of the exchange.

Fourteen companies, including Aetna and Medical Mutual of Ohio, have filed proposed rates for a total of 214 different plans. Projected costs to the companies for providing the required health benefits under the law ranged from roughly $283 to $577 for the individual health plans, the state said. The average cost was $420.

Citing data from a March study from the Society of Actuaries, state officials said the average cost of the proposals was 88 percent higher than the state's current average cost to cover an individual health insurance plan.

Taylor, the state's most vocal critic of the federal Affordable Care Act, acknowledged the benefits required by the law are "much richer" than the benefits previously available to Ohio consumers.

The Obama administration has questioned the design of the Society of Actuaries' study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick. The study also doesn't take into account the potential price-cutting effect of competition in new state insurance markets, administration officials have said.

More than 1.5 million Ohio residents are uninsured, or about 14 percent. An estimated 524,000 Ohioans would be enrolled in the exchange designed for individuals by 2017, according to a report prepared for the state's insurance department by consulting firm Milliman Inc.

According to the Milliman report, a healthy young man in the individual market could experience a rate increase of between 90 percent and 130 percent, while a 60-year-old with chronic health conditions may see a significant premium decrease.

In comic strips the person on the left always speaks first. - George Carlin

Mandate of 'Obamacare' could further phase out full-time work ; Employers who hire temps and cut hours avoid costly benefits
Patrice Hill , The Washington Times

17 June 2013
© 2013 Washington Times Library. Provided by ProQuest Information and Learning. All rights reserved.


President Obama's health care reform is prompting employers to hire more part-time and temporary workers to escape paying benefits under a mandate that goes into effect next year, amplifying a trend toward transient employment that took hold during the recession, according to a growing number of economic indicators.

Hardest hit by the move toward cutting work hours and increasing temporary hiring are lower-income workers, millions of whom already lack health insurance and are afflicted with constant turnover in jobs at fast-food restaurants, big-box retailers and other businesses with large numbers of low-paid staff.

Wal-Mart, the nation's largest employer, is leading the trend, having increased the share of its temporary staff to 10 percent this year from between 1 percent and 2 percent last year, according to a Reuters survey of 52 Wal-Mart stores last month. It found that half of the stores were hiring only temporary workers - something Wal- Mart previously did only during the Christmas shopping season.

Wal-Mart Stores Inc. CEO Bill Simon conceded that the company is hiring more "flex-time" workers to hold down costs, though the company denied that it was trying to escape benefit payments under the 2010 Affordable Care Act, often dubbed "Obamacare." But business analysts say most of the temporary workers at Wal-Mart are unlikely to ever get insurance through the company because it could take up to a year to become eligible and the workforce has a high turnover rate.

Monthly reports from the Labor Department show a rising trend of temporary hiring and still-elevated levels of part-time workers, though the recession officially ended four years ago this month. Economists say the looming Jan. 1 deadline for providing health insurance to all full-time workers may be the reason why. The mandate applies to companies employing more than 50 people who work 30 or more hours per week.

"The increased use of temp workers may lead to more permanent hiring, but there is also the possibility that employers are taking on more temp workers to keep payrolls under the threshold of 50 workers and thus to remain free from the requirements of the Affordable Care Act," said Sophia Koropeckyj, managing director at Moody's Analytics.

Temporary jobs have grown far faster than the overall job market, with the total temporary workforce reaching pre-recession levels of more than 26 million this year and surging noticeably in recent months. Meanwhile, the number of people working part time because they couldn't find full-time jobs remains elevated at 7.9 million, nearly twice pre-recession levels.

Ball State University economist Michael Hicks said the trend to reduce hours is hurting the same uneducated and unskilled workers who suffered the most during the recession and have been getting an ever-smaller piece of the income and benefits pie for decades. More educated, higher-income workers already have health care benefits from their employers, by and large, and the law is not expected to have as much effect on them, he said.

"The incentives shift to hire higher-income workers full time and low-income workers part time" because health care costs are largely the same per person but constitute a much smaller share of compensation costs with workers earning higher wages, he said. "Employment opportunities for college graduates will continue to expand, but the share of part-time employment will also grow" among the most hard-pressed workers with less education, he said.

"Right now there's a great deal of anecdotal evidence the ACA is promoting a shift from full- to part-time employment," he said. "At some point in the coming months, we'll have more certainty from the data" as employers who are cutting work hours to escape the mandate will do so in a mass rush before the Jan. 1 deadline, he said.

The Ball State economist has been tracking the share of workers who have part-time jobs, and it has stayed at the same high level of one for every 15 full-time workers since the recession - up from one per 26.4 full-time workers before the recession began in December 2007.

Many workers take part-time jobs only because nothing else is available and may have to find two or more part-time jobs to bring in the income of the one full-time job they seek, he said.

More than a quarter of part-time workers are holding down two or more jobs to make ends meet. Many of those workers bide their time in those temporary positions for months or years, hoping that a full- time position will open up. But those workers are likely to be increasingly disappointed, Mr. Hicks said.

"We are turning into a nation of part-time workers in search of full-time jobs," he said.

Crown Financial Ministries CEO Chuck Bentley argues that less than full-time work is the wave of the future for America. "Given the pressures of Obamacare, many will be forced to combine part- time jobs for a full-time salary," he said.

Although the trend is just starting to emerge in the government's official employment statistics, and businesses are loath to acknowledge that they may be avoiding full-time hires because of the law, many people who hire regularly or work in human resources jobs say the trend is unmistakable.

The pressures are cutting the hours even of those who already work part time. Officials in Floyd County, Ind., announced last week plans to pare back the hours of part-time county workers who now work 34 hours a week to get them under the 30-hour-a-week Obamacare mandate. The Southern Lehigh School District in Pennsylvania voted to cut the hours of 51 part-time secretaries, custodians and cafeteria workers to avoid the health care mandate.

"We are always looking to meet our obligations to students, the community, taxpayers, our employees and our staff, and this vote will have a direct impact on some of our employees," South Lehigh School Board President Jeffrey Dimmig told the Lehigh Valley Morning Call, saying he was "troubled" by having to make the move.

Staffing firms that supply temporary and contingent workers are reporting brisk business this year, with temporary jobs increasing significantly faster than full-time jobs. The American Staffing Association reports a 7.6 percent jump in temporary workers in the past year, while Freelancer.com, the world's largest outsourcing marketplace, reported triple-digit growth and a doubling of revenue in the past year.

A Sage North America survey of small businesses, which do the most hiring in the U.S., found that 82 percent intend to hire full- time staff this year, while nearly 60 percent also are hiring part- time, seasonal, contract and temporary workers.

"Flexible staffing solutions are an important tool" in an environment of moderate economic growth and growing regulatory burdens, said Richard Wahlquist, president of the staffing association. "American businesses continue to be very strategic about when and how to increase the size of their workforces."

Caption: just a chance: Job seekers at a recent Los Angeles career fair were less likely than before the recession to find full-time work. Starting Jan. 1, larger employers must provide health care benefits to those who put in at least 30 hours a week. [Photograph by Associated Press]

Washington Times Library

At least those jobs pay a salary. Much more disturbing is the trend of companies replacing paid employees with unpaid interns, promising them "experience" and a chance at a paid position with the company in the future that doesn't actually exist.

Facism is not a school of thought, it is a racial slur.

At least those jobs pay a salary. Much more disturbing is the trend of companies replacing paid employees with unpaid interns, promising them "experience" and a chance at a paid position with the company in the future that doesn't actually exist.

What "trend" exactly is this? Where's the evidence of it?

A quick search on Google identified several lawsuits that have been filed recently alleging that no education was provided, and work was done that would have otherwise been done by paid employees.

This lends some credence to Xeq's statement that this is occurring, but also indicates there is a check on this.