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 labmouse42 wrote:

Palindrome wrote:
I don't. Obesity is more common in America but not that much more common than the UK yet we still pay nearly half what the US does on health care per patient.

Are you sure about that? The CIA reports that brits are only 15th on the list, and the US is a whopping 6. Sorry UK, you got to make a few more pit stops by McDonalds to overtake the US.
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2228rank.html

That information is 10 years old. You also aren't twice as fat so even though there will be an impact its far from the whole story.

 MeanGreenStompa wrote:
Full timers leaving after many years were already being replaced by part timers positions, usually amounting to less hours combined than the full time hours that had departed.

Businesses have been pulling this gak for over a decade now, it's hardly news.

I have an example of this happening in real life.
Bernie Marcus and Arthur Blank opened up The Home Depot. When they ran the company, people who worked there would be called "Orange Blooded" because they had such loyalty to the company.

This was not without reason. When I worked at their corporate headquarters, a lady in accounting was diagnosed with a brain tumor. Bernie Marcus discovered this and called her into his office. He told her that Piedmont Hospital owed him a favor, so he got her immediate care by the best brain surgeon in Georgia.
Those are the kind of stories that inspire loyalty in a company.

At the stores, retired electricians, plumbers, carpenters, etc were hired. These guys were paid a good wage, and you go walk up to any one of them and ask them questions about what you were doing. You would be speaking with an expert who did the work for 30+ years.

When Nardelli became CEO of The Home Depot, in his first year he fired all of those full time retirees and replaced them with part time employees -- because they were much cheaper. The "Orange Blooded" era of THD is passed.

And now Home Depot is an awful store with terrible customer service.

Until we realize that what is good for profit isn't necessarily good for business, and is usually not what is best for people, we'll never be able to have an actual adult conversation about issues such as the ACA.

Palindrome wrote:
That information is 10 years old. You also aren't twice as fat so even though there will be an impact its far from the whole story.

Edit : Just google "country rates by obesity" and you will see many examples that the US is still at 30% obesity. No matter how you slice it, the US is still the fattest in the land. I am disagreeing with your point that the UK is fatter than the US.

Now I agree with you that there are other reasons that the US cost is so high. I even provided a real world example I've seen. Yet obesity rates also have contribute to the increased cost. They will continue to attribute to the increased cost in the UK.

Simply put, its more expensive to treat fat people due to the increased health risks they have. The US has more fat people egro it has higher costs than other countries. This of course does not rate for the double cost for health care, but does have an impact on the overall cost.


Automatically Appended Next Post:

TheHammer wrote:
And now Home Depot is an awful store with terrible customer service.

Until we realize that what is good for profit isn't necessarily good for business, and is usually not what is best for people, we'll never be able to have an actual adult conversation about issues such as the ACA.

What's crazy is that you can have both. There is a book called "Good to Great" which illustrates how this can happen. You can treat your employees well, and be good to the community and still succeed.

KalashnikovMarine wrote:
Probably the latter, give'em a flat fee of "x" for each class taught, then a commission fee of "y" for every person in the course.

Obviously it's best to speak to an accountant, but I would be very wary of this practice, which is typically independent contracting. It's use has increased in the last decade or so and the IRS is cracking down.


OT:
I'm also looking to "start" a business by incorporating as soon as I can sit down and do the LLC paperwork. Truth be told I'm hoping that Obama in office makes it easier to get an SBA backed startup loan as he "invests" in America. I have my doubts. I'm not sure what the ACA implications will be for the self employed.

 Kanluwen wrote:
Wait, did the guy who owns Papa John's really call himself a "Small Business"?

Wow.

Well if you think about it, he's really a chain of small businesses working together under a brand name and single supplier. Having the single supplier (Papa John himself) allows all the small businesses (franchisees and chains of the same) to benefit from economies of scale without actually being the size a company needs to be to do so.

See, if you squint your eyes and tilt your head just right even Exxon is a small business!

And, labmouse, you're absolutely correct that you can run a business profitably while being ethical and treating your employees really well. Until you get bought out, need investment capital, or are otherwise destroyed so financial capital can turn around and make a quick dollar. I mean, a lot of the businesses Bain destroyed were good businesses giving people good jobs and making steady money, until they needed a bridge loan and pension funds were raided.

TheHammer wrote:
See, if you squint your eyes and tilt your head just right even Exxon is a small business!

Probably the dumbest thing I'll hear or read today unless Donald Trump stops by.

 AustonT wrote:

Probably the dumbest thing I'll hear or read today unless Donald Trump stops by.

Surely that was the point.

 AustonT wrote:

TheHammer wrote:
See, if you squint your eyes and tilt your head just right even Exxon is a small business!

Probably the dumbest thing I'll hear or read today unless Donald Trump stops by.

Don't worry, cowboy, that's just some of my high-falutin New York humor.

The ACA bill just makes a complicated business environment even more challenging...

That's the issue here... really.

What you'll see some outfits will do is to reduce the # of full-time employees and hire even more part-timers. I think the magic number is 50... any outfit with more than 50 full timers will trigger the more onerous part of the ACA bill.

Businesses will adapt, like they always do...

Things would be a lot simpler and administrative costs and overhead would go way down if we went to a Single Payer nationalized healthcare system. But that would be Super Communism (measuring by the yardstick of what some folks consider to be Socialism).

 Mannahnin wrote:
Things would be a lot simpler and administrative costs and overhead would go way down if we went to a Single Payer nationalized healthcare system. But that would be Super Communism (measuring by the yardstick of what some folks consider to be Socialism).

Yeah... I agree with ya there... we spend so much $$$ on overall healthcare, it can't get that much more expensive than having a Canadian Model...right? (btw, Azazel, they ration healthcare there ya know! )

Wait... does that make me a commie?

OH SNAP!

Most of the small business owners I know have been very concerned about the skyrocketing costs of healthcare for the past couple of decades of government inaction, and very eager for our lawmakers to do SOMETHING to start bringing costs into check. Tort reform was one approach that Republicans backed, which has been enacted in many states but failed at reducing costs.

 azazel the cat wrote:
I think "small business" needs to be redefined. 50 employees is a big-box retailer such as Best Buy, or a chain of at least 4-5 smaller retailers like Tasti D-Lite.

Number of employees in a business is normally counted as how many people are employed by the corporation in total. Not at each individual retail location. Different states usually place that figure at under 50, under 100, or under 200 employees, for tax and other legislative purposes.

Franchising operations blur the lines a bit, because individual stores may be their own businesses/corporate entities. Although a large chain like Papa John's should certainly be able to negotiate group health insurance rates based on the total employment figures including their franchises. John Schnatter's just an ideologue conservative who doesn't want to pay for insurance for his employees. He is the exact kind of business owner who protested minimum wage laws, overtime laws, safety regulations, child labor law restrictions (etc.) as bad things because they cut into his margins.

Mannahnin wrote:Things would be a lot simpler and administrative costs and overhead would go way down if we went to a Single Payer nationalized healthcare system. But that would be Super Communism (measuring by the yardstick of what some folks consider to be Socialism).

What amazes me is that some people who support ACA ardently deny that single payer is vastly superior. My sister in law is an ardent liberal who almost violently rejects a NHS solution in favor of ACA. I can't do anything but shake my head.

For me, ACA is a compromise step forward. It's not as far as we need to go, but it was desperately difficult to get even that much passed.

 AustonT wrote:

Mannahnin wrote:Things would be a lot simpler and administrative costs and overhead would go way down if we went to a Single Payer nationalized healthcare system. But that would be Super Communism (measuring by the yardstick of what some folks consider to be Socialism).

What amazes me is that some people who support ACA ardently deny that single payer is vastly superior. My sister in law is an ardent liberal who almost violently rejects a NHS solution in favor of ACA. I can't do anything but shake my head.

I'm having that same conversations with my local liberals(socialist)...

NHS/Canadia Medicare is more in their wheelhouse than the ACA.... what gives? It's it because it's Obama's signature bill?


Automatically Appended Next Post:

 Mannahnin wrote:
For me, ACA is a compromise step forward. It's not as far as we need to go, but it was desperately difficult to get even that much passed.

It's a mess... it really is. It will not do what it "said" it will do.

If this thread is hopping tonight, I'll post some specifics.

 Mannahnin wrote:
For me, ACA is a compromise step forward. It's not as far as we need to go, but it was desperately difficult to get even that much passed.

I think it makes insurance companies more powerful than consumers who are forced to pay for thier product which they can raise the price on as much as they want. Because it won't be what the consumer is willing to pay, it's what the consumer MUST pay. I would rather have a govt bureaucracy than an unchecked corporation in chars of my healthcare. Mostly because at the end of the day medicine should not be a for-profit endeavor.
Basically this is auto insurance round two.

If the ACA fails to help contain costs, maybe we can have a real conversation about single payer, or at least a public option.

 AustonT wrote:
Mostly because at the end of the day medicine should not be a for-profit endeavor.

I could not agree with you anymore on anything.

I work for the VA, and I know the VA gets lots of slack for lots of things, many of which are deserved. And while I can't speak for the clinic side of things, the inpatient hospital side is better than any for-profit and non-profit hospital I have ever worked. Is it perfect, not at all. But it is better than any system that is motivated by greed and profit.

As far as the whole "they will ration healthcare argument goes that usually follows any talk about government healthcare" goes (not directed at you): take a look at the fancy package you get at the beginning of each year from your insurance, the one that talks about what is and isn't covered. That is your rationed healthcare to ensure maximum profits.

 Mannahnin wrote:
If the ACA fails to help contain costs, maybe we can have a real conversation about single payer, or at least a public option.

Not until the 'Socializm is da ultimate EBIL and must be destryoed!!!!!!111!!1!1!' crowd either grows a brain or dies off due to poor medical care...

 AustonT wrote:

 Mannahnin wrote:
For me, ACA is a compromise step forward. It's not as far as we need to go, but it was desperately difficult to get even that much passed.

I think it makes insurance companies more powerful than consumers who are forced to pay for thier product which they can raise the price on as much as they want. Because it won't be what the consumer is willing to pay, it's what the consumer MUST pay. I would rather have a govt bureaucracy than an unchecked corporation in chars of my healthcare. Mostly because at the end of the day medicine should not be a for-profit endeavor.
Basically this is auto insurance round two.

This is how I feel about it. The ACA's a half step and doesn't really /help/ any one or anything in the strictest sense of the term. Either go single payer or go all capitalist. In between just makes for problems.

I've lived in the UK and I gotta say, the NHS is pretty damn good.

Relapse wrote:I think we all know enough people that have gakky jobs that prefer working to being unemployed. There are enough families out there with
members doing full time gigs at a fast food place to make me think you must live in some great town where it's only high school kids working there.
Are you saying you'd like to redefine what a small business is so that even more would go under trying to keep up with the demands of Obamacare and more people would be unemployed?

There's a difference between "I work a gakky job to support my family" and "I work a gakky job that cannot possibly support a family". Anything in entry-level retail or service (such as a Tasti D-Lite or other food court shops) is the latter. And I live in Vancouver, Canada, where there are only two types of people who hold those positions: high school kids, and the otherwise unemployable. The circumstances you are referring to are unnatural in the First World, wherein massive unemployment has allowed businesses to exploit a captive workforce, forcing people to take jobs that are grossly overqualified for (requiring a master's degree in finance in order to be a bank teller, for example) because your country has attempted to erode its social welfare network.

whembly wrote:

 Mannahnin wrote:
Things would be a lot simpler and administrative costs and overhead would go way down if we went to a Single Payer nationalized healthcare system. But that would be Super Communism (measuring by the yardstick of what some folks consider to be Socialism).

Yeah... I agree with ya there... we spend so much $$$ on overall healthcare, it can't get that much more expensive than having a Canadian Model...right? (btw, Azazel, they ration healthcare there ya know! )

Wait... does that make me a commie?

I like to think of you as a convert.
And the Canadian single-payer model actually costs less than the ACA model, or whatever the old model was called. It's partially because the prices charged to the single-payer are regulated/negotiated, and not entirely subject to the gouging whims of for-profit businesses.

Mannahnin wrote:Most of the small business owners I know have been very concerned about the skyrocketing costs of healthcare for the past couple of decades of government inaction, and very eager for our lawmakers to do SOMETHING to start bringing costs into check. Tort reform was one approach that Republicans backed, which has been enacted in many states but failed at reducing costs.

Small business owners shouldn't be concerned about tort reform. Tort reform is entirely a conversation started by lobby groups representing insurance companies and multinational corporations. Tort reform is a discussion entirely seperate from this one, which I feel is representative of the entire cancer of corruption found in the US legal system. (long story short, tort reform is entirely one-sided in favour of abusive corporations seeking to escape punishment for their actions)

Mannahnin wrote:

azazel the cat wrote:I think "small business" needs to be redefined. 50 employees is a big-box retailer such as Best Buy, or a chain of at least 4-5 smaller retailers like Tasti D-Lite.

Number of employees in a business is normally counted as how many people are employed by the corporation in total. Not at each individual retail location. Different states usually place that figure at under 50, under 100, or under 200 employees, for tax and other legislative purposes.

I suspect we agree on this. My point was that if you own 5 fast food locations, you cannot consider yourself a small business owner anymore, and I think the definition needs to reflect that. When I think "small business", I think a mom & pop hardware store or something, and that's what large business owners want me to think. I just don't want medium-to-large business owners to try and hide behind that mom & pop facade: "Mom & pop" do not own 5 locations.

Mannahnin wrote:For me, ACA is a compromise step forward. It's not as far as we need to go, but it was desperately difficult to get even that much passed.

It'll get much, much easier from here on out. Once everyone gets a taste of what it's like to have healthcare, you'll never be able to take it away without violence. And it'll be much, much easier to reform the ACA into a true universal healthcare system once you've got the hearts & minds behind you. Then, it's only a matter of time until the insurance industry has no choice but to die in a direct assault, so to speak.

AustonT wrote:Basically this is auto insurance round two.

In BC, auto insurance is mandatory for the driver, sort of the same way the ACA is with healthcare. Except the auto insurance is provided by the province (sort of), in the form of the Insurance Corporation of British Columbia. And it's awesome. Everyone on the road has auto insurance, and I think the price is the cheapest in Canada (considering what is covered). So, to nobody's surprise, my answer to you would be to socialize the entire process. Having trouble with the mandate to buy private insurance because it creates a captive consumer? Then feth the insurance company, and have the government provide it. It'll work out better for the consumer, and there won't ever be a consumer-vs-profit conflict of interest.

 azazel the cat wrote:

RelapseI wrote:

AustonT wrote:Basically this is auto insurance round two.

In BC, auto insurance is mandatory for the driver, sort of the same way the ACA is with healthcare. Except the auto insurance is provided by the province (sort of), in the form of the Insurance Corporation of British Columbia. And it's awesome. Everyone on the road has auto insurance, and I think the price is the cheapest in Canada (considering what is covered). So, to nobody's surprise, my answer to you would be to socialize the entire process. Having trouble with the mandate to buy private insurance because it creates a captive consumer? Then feth the insurance company, and have the government provide it. It'll work out better for the consumer, and there won't ever be a consumer-vs-profit conflict of interest.

I think you're agreeing with me but instead of just saying "yeah, I agree" you used a paragraph. They may ration healthcare in Canada but apparently they don't ration words.

So apparently decent healthcare=ZOMG END OF THE WURLD.

That's new.

 azazel the cat wrote:

Yeah... I agree with ya there... we spend so much $$$ on overall healthcare, it can't get that much more expensive than having a Canadian Model...right? (btw, Azazel, they ration healthcare there ya know! )

Wait... does that make me a commie?

I like to think of you as a convert.
And the Canadian single-payer model actually costs less than the ACA model, or whatever the old model was called. It's partially because the prices charged to the single-payer are regulated/negotiated, and not entirely subject to the gouging whims of for-profit businesses.

In theory giving people coverage should reduce costs overall just by itself. Presently we legally require hospitals to provide emergency care to anyone in need. We wind up paying for that emergency care via higher charges from and tax writeoffs for the hospitals. If people get proper preventive care and see the doctor in the office or the clinic before it gets to the emergency room stage, that's a lot cheaper care being provided and paid for.

 Mannahnin wrote:
In theory giving people coverage should reduce costs overall just by itself. Presently we legally require hospitals to provide emergency care to anyone in need. We wind up paying for that emergency care via higher charges from and tax writeoffs for the hospitals. If people get proper preventive care and see the doctor in the office or the clinic before it gets to the emergency room stage, that's a lot cheaper care being provided and paid for.

We'll see... and that'll take time to make that determination. In the meantime, everyone's cost will go up to address current sick population and those who hadn't been going to annual checkups.

Plus, as a nation... we ain't getting any younger.

There's a reason why the US spends more on healthcare per person than anyone else, but also still has the worst levels of care in the developed world (overall). It's simple once you think about - if you're paid for the amount of treatment you provide, then the main incentive is to provide more treatment to the best payers, regardless of whether or not that treatment is effective, needed, or could be better used elsewhere.

I'm still staggered by the idea that in a modern first-world democracy, you can die of an entirely curable disease simply because you can't pay for the treatment. If universal healthcare (even is using a flawed model) is Obama's only legacy for the US, then he's still got to go down as one of the greatest figures in American history - the number of lives that will be saved and the amount of suffering eased will be incredible.

As for myself in the UK, I'm immensely grateful we have the NHS already!