Yesterday, a physician friend of mine explained to me the economics of doctoring while his medical technician was removing wax from my ears. He says that with Obamacare, Medicare and increasingly tough insurance firms, the office visit is now the loss leader of medicine. From a money-making point of view, the office visit only pays for a doctor if they can get a scan or a procedure out of it. That is where you can still make money if you are an office based doctor.
Recently, hospitals have been buying up practices to get access to referrals, which will bring them big money in procedures and scans. The major arguments between Obamacare and the doctors will be on how procedures and scans are reimbursed. If the prices for reimbursement fall, doctors and hospitals will scream. How the disagreement is resolved will be crucial for Obamacare to survive.
IMTS is coming! IMTS is coming! IMTS is coming! And I wonder, who really gets the payback? It is certainly good for the insiders and the cheerleaders like Gardner Publishing (Modern Machine Shop), but maybe the emperor has no clothes. My sense with each new show is that it is basically an insider’s game. The extravaganza is primarily aimed at attracting dealers who will do the grunt work of selling to the actual end users. This is a valid use of the machinery circus called IMTS, but I wonder if the huge money that exhibitors spend is worth the investment. The company open houses that DMG MORI, Mazak and Okuma put on around the country may well bring a bigger bang for the buck. And they are a lot less exhausting to attend.
I am always surprised how often the consensus is wrong about the economy. For the last few years virtually every “expert” was sure that interest rates were headed up – to where they ought to be, where they’ve always been. Yet they have barely moved. The 10-year Treasury is around 2.6%, historically low, and trending lower.
On the other hand, most people thought there would be a significant rebound in home buying. Did not happen. The economy has improved but houses are still not really moving. Two big reasons. First, financial institutions are looking for big down payments, 10-20%, which is an enormous hurdle for first time homebuyers. Second, initial buyers are often burdened with college debt, which impairs their credit and kills their ability to get the down stroke for the first house.
Almost half of the residences being sold today are going for all cash. Most are being bought to rehab and rent out to those 20- and 30-somethings who can’t or won’t buy their first home. A country of owners is turning into a country of renters. I know this is happening now where I live. A five-bedroom home directly across the street from me was recently rehabbed and is now being rented.
On the other hand, the Dow Jones and S&P 500 stock averages have been setting new records after rising more than 25% last year. Retirement assets and savings are flooding into the stock market because fixed income return is dismal, real estate is tough without leverage, and bank accounts pay nothing.
I thought I would never say this, but my allegiance to the Chicago Cubs is waning. The team they are putting together on the field today is the dullest and probably the worst I have ever endured, and I go back to the days of Hank Sauer and Andy Pafko. The Cubs outfielders have hit three homers all season – AS A GROUP. The bullpen is atrocious. The starting pitching has been good, but you can’t win if you score less than two runs a game. Jeff Samardzija, the Cubs ace, is 0-3 with a 1.45 ERA. He is supposed to be traded for “prospects” by July, and he can’t wait I hear. Can you blame him? The idea that you can’t develop prospects while putting a competitive team on the field is absurd. I am officially on strike against this team. Go Blackhawks. Bring on the Chicago Bears. But please don’t ask me to root for the White Sox.
Question: Now that Obamacare has been implemented, have your views on it changed?
No. Let me ask a simple question, is health care affordable? Also, no. Does everyone get insurance as promised, ah no. Another failure. Seems we don’t hold the measurement tool of what was promised to what actually happens with this administration. Another example, year’s ago there was a president who authorized eaves dropping, he got impeached! You probably all remember President Nixon. Today, we have a president who denied global “eaves dropping”. Not only republicans, democrats, doctors, lawyers, companies and people all over the world. Until someone spilt the beans. He just says it’s necessary and wham, the media act like bobbleheads and say, OK. Not like the media of the Nixon Era, is it? Oh guess that depends on what your definition of it is….
As the owner of a small business I can tell you that we were one of the Millions that had our Group Health Plan Canceled due to ObamaCare. Our renewal for 4 families was $105,000 annually (after deductible, before Insurance covered anything). This outrageous cost forced us out of our Group Coverage and on to the Individual Marketplace where the cost of our Insurance for each of us is now taxable as income. This was the Govt plan from the start and their making a killing in the increased Federal and State Income Tax revenue. Say Good Bye to your Employer Group Health Plan once the delayed Business Mandate kicks in sometime in 2016. Thank You Democrats
I’m a S-Corp and health insurance has always been deductible through our group plans. I’m sorry to hear that your plan was canceled and you had to go into the open exchanges as individuals using taxable dollars to buy coverage. Are you saying that there were no group plans to be found that satisfied your company? Most plans that were canceled were inferior programs, but your overhead indicates you had a good plan. Is this a state problem?
Even with localized increases, the ACA lowered my company’s Blue Cross health costs by a net 22.1%
The ACA program has it’s roots in plans outlined by the Heritage Foundation and implemented in MA through Romney-care. Everyone recognizes that the past programs were failing, at least by standards in other industrialized nations. Hopefully, we’re on the right track and can put our collective management skills to work to improve the ACA as it evolves.
Wow, that is high, we have family HMO for around $1000 per month. $40 co pay Where are you located? We are in Up State NY, were the taxes are high and the economy flat.
It used to be that if you hurt your arm badly enough, they would have to amputate it. Nowadays, they take and arm AND a leg just to make it worth their time.
Our government has NEVER been able to run ANYTHING successfully. How could this turn out any differently?
The tax code
The monetary system
Department of Veteran Affairs
Education (student loan debacle)
and this is a short list, their batting avg. is zero.
They are pretty good at taking our money.
We’ve just gone through our first round of insurance renewals post Obamacare. After several years of modest increases, we got a 25% increase. This is nothing new. We’ve switched carriers every four or five years because of these patterns. We shopped around and found a comparable program for the same prices as we had been paying. Some minor differences (plus and minus), but basically the same coverage. The big difference in the new plans is the individual premiums based on age. We decided to pass these through rather than use an average rate. About three quarters of our employees saw reductions in monthly premiums. The older people made up the difference in higher premiums. Overall, we were pleased with the change. We are a small manufacturer (26 people) and our monthly premium is about $11,000.
It certainly has. Before it was really bad now it’s disastrous. No one from this failed administration has shown solid numbers of even the slightest success or affordable. OC is just another controlling government agency. The health care system was working just fine except the system was never designed to handle the growth of so many fat and unhealthy people. Encompass that with an in your face government subsidized junk food industry and you got yourself a major problem on your hand. Today’s medical solutions are 5 minutes in the office, a pat on the back and a prescription for another pill. The only thing OC does is pile on the debt allowing people to grow fatter and fatter knowing that the government will come to their rescue. With FAT and unhealthy being the norm, health care will continue to be unaffordable and less reachable in the future.
Let me say I respect all you business owners, you are the guys on the front lines. But, to a great extent, all I hear is negatives, so OK, what will work?
Going back to the beginning, I see that Obama failed to deliver on two important promises – one, separate health care from employment benefits and two introduce market forces.
I think we should be making health insurance true insurance, i.e. a hedge against the risk of an unlikely, but very expensive situation. The care that everyone needs, vaccinations, regular check ups, periodic screening and so on, should be the reponsibility of the patient. These items do not represent risks, they are 100% likely to be needed and are a part of the cost of living. The consumer of these services ought to be able to go where he can get the best price and service whether it be WalMart or his favorite doctor.
Look, Obama could have worked with the Republicans all along and made this a great change but he chose not to do that and must now wear his mistake. We needed the freedom to buy insurance across state lines, keep things competitive, help everyone gain a sensible healthcare insurance plan or at least cover those who were not covered somehow. Actually we WERE covering them through higher per capita costs to those of us who had insurance. I am tired of hearing any form of defense for this mans healthcare nightmare he calls “Affordable”, it’s a freaking nightmare and will get only worse.
We had a Blue Cross Family program before Obama Care that was affordable for most of our employees. Now a lot of our employees just have insurance on their self and have sought more affordable insurance for their children through other programs. Our deductibles went up and coverage went down. We have one individual due to special medications who is going to be out about $8,000.00 more a year just covering his basic medications. I have only heard of one person i know who has benefited from Obama Care as opposed to many who are on the less fortunate end. This person was without insurance before. The others all had had better coverage at a better price.
Not going to get into the nitty-gritty of it, but my health insurance coverage is worse now than it ever has been and I’m paying in more $$$ than I ever have.
The back ground and prior work history should say enough about Obamacare actually doing anything more than bankrupting Americans and a fine system of healthcare we had prior to this “Affordable” care act bring passed. It’s a joke, just like its namesake.
We are now avoiding going yo the doctor to save money because our health care has skyrocketed. Bring back justice. Vote Republican!
Just watch out for the RINO’s they love to spend money too. Remember Bush’s unfunded senior prescription plan.
Just had renewal, rates went up 24% and deductibles doubled. Can’t wait till next year. Go President BO.
Lloyd, I don’t know what happened, but you look awful. Too much time on a Caribbean beach this winter?
Oh, wait, that isn’t a picture of you, its a sea turtle.