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This is a discussion that I have been wanting to have because frankly I am personally pretty excited about a change here in US law.

Although I know that some will be capable of making this discussion political I ask that you please don't.  Instead I wanted to relate my own experiences with the health insurance topic, Lutherie, getting into the biz, etc. and not be a shill for the affordable care act aka Obamacare.

When I left the stinkin desk job and wanted passionately to someday hang out my shingle and do repair/restoration work the one single issue that I could not overcome and find a solution for was affordable health insurance.

In the states our insurance tends to be connected to our employment and as such doing anything unconventional or as an individual leaves one subject to the wild, wild west of brokered individual health plans.  These plans often sucked.... did not cover much of anything, and cost a fortune as well.  And you could be cancelled, capped, denied for previous conditions such as being nuts like me.

But no longer and this morning I ventured onto the Health Insurance Exchange and purchased the very best plan offered here in Michigan for less than half it's retail price.  I have pre-existing condition(s) as well and every quote that I received in the past was north of $2,200 monthly....  Now I'm enrolled in a "gold" plan that has to cover most everything, can't be cancelled, can't be capped for just under $395 a month!

There is more too.  Because I can now solve my own health insurance problem we, our business is in a position to provide meaningful work to others as well.  There are five of us in our business.

As such for those who ever fancied going pro, severing the bonds of corporate America, the health insurance issue is no longer impossible to solve.

I'm wondering if others here are seeing this new change in US law AND the availability of quality, affordable health insurance as I see it which is as something that is a pretty good deal for Luthiers?

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I went to US schools and specifically remember being taught in US schools that there was little difference between communism and socialism....  Wrong....

Then in my late teens and early 20's I lived in a socialist country where what I saw with my own eyes was very different than the teachings that I had received in the US.  Everyone had health care, what ever it took and it was free.  If you were in school and able to make the grade to get into any other school (university) you were in - free of charge.  We also elected our leaders, all of them, and we also had the provision to unelect our leaders post haste and before terms are over - something that would be very welcome these days here in the US.

The rich still got rich and there were still poor but the safety net was higher and less porous than it is here.  We also had already had a female chief of state who, by the way, was also a dual national being an American from Chicago.

Gays in the military?  Sure - if you could contribute you were in.  Women in combat, sure as well and often women were leaders and officers as well.

Steve we are basically taught in the US from the earliest age that all we have and do is the best on earth.  Regardless of the fact that this is not true it's something that may be useful in understanding Americans so go easy on us poor bastards will ya.... ;)  We know not what we do....;)

We also have a large percentage of Americans, even to this very day.... who wake up every morning only to be disappointed once again, over and over, day after day, because our president is still black....

And to top it all off although we have no problems eliminating the food stamps that were feeding a very poor kid corporations are people too here and even worthy of being permitted to tank the global economy... at will.... again and again....

As for those weapons of mass destruction we still believe that Sadam must have hid them, probably along side of Obama's birth certificate.... 

Anyway I don't want to get political either and basically wrote this to do what others have done to perhaps demonstrate from the other side of some of these issues that you just can't excrete a bunch of political BS and then say you don't want to get political.  You already did, so did I, this is what it looks like, my apologies to all.

Hesh.  Don't apologize, everything you say is valid and reasoned. Indeed unlike the majority of your country men you have experienced life in a different country which would seem to be at odds with the ethos in the US. There is a huge gulf between the knowledge and understanding of the cultures of the US and those existing in Europe, on both sides. For example, the fact that you feel that millions of your countrymen are disappointed that your president is black. Surely that is a manifestation of the American dream. Any one from any culture, regardless of colour, creed or origin can rise to be the most powerful in the land. Whereas I look at the political parties in the UK and almost all are Eton educated, Oxbridge graduates and carrier politicians. If the UK had an ethnic PM, regardless of party, I would be happier with the democratic process. 

Steve

Contrary to what you might think....even black men have bad ideas and ideology. It is not about the color of the skin...believe me! I would have liked Herman Caine as pres.

The skin color is a 'cop out' excuse and is deplorable to be even considered!

There are none now. There were literally thousands. It was THE primary reasons to sign up for an HSA. Most of the cost savings came from those write-offs. It covered every OTC medication I ever needed plus chiropractor visits, therapy massage, acupuncture. I basically cared for myself through diet, exercise, etc. and treated aches and pains in a common sense manner which included utilization of the above mentioned services and products. I contributed to my HSA every month to cover doctor visits when I needed to go, and there was catastrophic coverage with a high deductible. I could see any doctor I wanted to. I didn't need the federal government to interfere with my choice of medical treatment but apparently they know more about what I need than I do. And the president said I could keep my plan, time after time. What happened? I also love the fact that congress and their staff are exempt from this obamanation. I'll stop my rant, as I enjoy and respect this forum too much to wade into things political in nature. However, I'll end with a quote from PJ O'Rourke of a couple of years ago: "If you think health care is expensive now, wait 'till it's free". Amen, brother.

I did a post-doc in economics at the CDC studying health care markets. What I discovered was that medical market participants act like monopolists. They charge higher prices and offer lower service levels - like cable TV companies - than would occur in competitive markets. They raise prices higher, faster, and more often than their own costs rise. 

Consequently, the annual inflation rate for office visits, procedures, drugs, devices, etc. is typically 3-5x higher than the inflation rate for other consumer items. This trend began around 1970 and, because inflation is like compound interest, some people have been priced out of healthcare while everyone else has paid a greater and greater percentage of their budgets for healthcare related items. Our standard-of-living has declined because of it. Project this trend forward 20 years and healthcare will only be generally unaffordable. It is an unsustainable trend.

The solution is require competitive markets but, by the very nature of the products offered, it isn't possible. Consequently, the only solution is to try to legislate and regulate medical markets so prices and service levels are quasi-competitive. The Affordable Care Act is one such solution, though it isn't ideal.  The ACA tries to bring about competition by regulating intermediaries - insurance companies. The hope is that insurers, forced to offer competitive prices, will in turn pressure providers to offer competitive rates.

If the best feature of competitive markets is efficiency, then it's ironic that we chose a fairly inefficient method of regulating medical markets. Direct regulation occurs under a single payer system. Unfortunately, it isn't politically feasible in the USA because of the lobbying wealth of the affected companies.  Medical providers are loath to give up monopolistic pricing (and profits) and are fighting tooth-and-nail to prevent any reform.  Ninety five percent of the terrible things you hear about the the Affordable Care Act began on a lobbyist's computer. 

BTW, those of you whose insurers cancelled your old policies - your policies were grandfathered and insurers didn't have to discontinue them.  Insurers knew they could discontinue your old policy, offer you a higher priced one, blame it on the ACA, and that you'd blame the White House - just business as usual in the medical industry.

Go Robbie!!!!

I have run a business since 1981 that has had between one (me) employee at the start to the current 46 or so, and we have paid for health insurance from the start.  In that time, my wife and I have each had a medical challenge, and I have watched many employees with theirs.  At various times things have been easy or difficult to accomplish, and have cost very little or a whole lot accomplish.

The current system based our premium costs on the size of the group - however, I could never understand why the large local corporations should get lower prices then my small business - aren't we all just one group of 300 million?

We are in northern DE with employees with very short commutes from PA, NJ and MD.  Through the same companies, frequently the premiums vary from state to state by a large margin.  One memorable difference was over a 30% lower premium for an employee who lived about 200 yards into PA from DE and used doctors and facilities in DE.

More years than not, premiums went up in double digit inflation, with the highest we saw at 51%.  This has forced us to change insurers as often as annually, but usually every 3 years.  We have participated in the HSA's and other innovations, and currently offer a large deductible policy where we pay the deductible because it is overall cheaper than the same insurance with a small deductible.

What I am looking forward to is being able to compare 2 competing policies as apples and apples.  In our state(s), we may be lucky, but it looks like premiums will be going down slightly for more thorough and understandable offerings.

And my daughter just opened a vintage instrument repair shop in Brooklyn and she will be able to afford good solid coverage.

 This whole health care mess , will IMHO implode on it/s own  sooner or later irrespective of who is running washington. While we are arguing about playing chess with healtcare varying from state to state , our fearless leaders are creating a   amnesty deal  for perhaps 20-30 million illegal aliens , and for them to bring in their dependents. They alone will bankrupt our already beleagured healthcare system.So while most of us are arguing about healthcare, the wizards in washington dc.  are looking for new ways to break the middle class in the usa. I  kindly suggest we throw them all out.Call 1-800 INDIA, and have congressmen/women who will work for 1/3 the price of  our current legislators do , on the 1 provisio, that they do not fund themselves a private  healthcare as our current  gov/t has which exempts them from O/bummercare. I hope my rant has not offended any indian /american luthiers.

Great post Ed - Thank You!

It's also nice to see that not everyone forgets that the health care system that we have/had is so badly broken that it serves virtually no one well except the insurance companies...

One of the very welcome benefits indeed of the ACA is that one will be able to compare apples to apples in respect to policies going forward.  This in and of itself is huge because insurance in general is so very complicated that for most of us, me included, understanding this stuff is not easy.

It's also true that policy price increases have been happening for years now often double digit percentages and for no justifiable reason....

Regarding subsidies I wonder how many people realize that they are already subsidized for many things and the idea of subsidies is NOT new.  Use natural gas to heat your home or business, the gas compaines are subsidized.  Electricity - same thing.  Purchase gas for your vehicles and there is a subsidy there too.  Eat food grown or produced in the US - it's subsidized as well...  Shop at Wal-Mart* or eat at McDonalds?  A recent study found the average age of a MacDonalds employee to be 28 and nearly one out of two of them are on some form of public assistance because compaines such as Wal-Mart* and MacDonalds have found a way to pay so very little that they are basically taking subsidies from the American taxpayers since we have to provide public assistance to their employees because they are not paid a living wage.  Check-out Costco if you want to see a very well run company that pays well, values people, has very high retention rates.

The ACA is indeed a subsidy too for many including a family of four who can still earn around $90K annually and still receive a subsidy.

The difference this time, in my view, is instead of corporate welfare and subsidizing corporate farms, oil companies, public utility companies, etc. these ACA subsidies go right to value for the people - individual health insurance plans.  And there in likely is the rub for some in that they see that someone is getting something and that this will be difficult to undo in time because folks WILL like it once all is said and done.

I had an argument with someone recently who attempted to call the ACA yet another entitlement and "welfare..."  I didn't respond and it likely never occured to this person that they just offended every one on social security, Medicare, etc. with the loose interpetation of welfare.  And to take the cake it's likely that this person's kid who is in college, likely, is able to stay on thier parents policy until the age of 26 now because of the ACA.

America is now so very bitterly devided along political lines that we are hurting ourselves, unable to reognize that for once something HAS been done that will greatly benefit most, and paralized to deal with other issues because of arrested development steming from the ACA.

I had a small heart attack a couple of months back.  It was ugly, I was down, an ambulance came, pretty scary.  Since I have other pre-existing conditions affordable health insurance was not available to me.  So I visited a world-class ER uninsured.  They were wonderful, fixed me up and I'm back to being the very same jerk that I always was..;)  I also have a $10K ER visit bill that I now have to pay and I will pay it but this won't be easy or fun....

As of Jan. 1 I will be insured, no longer subject to being financially ruined if I get sick.  I'm also going to take advantage of the opportunity that I have to be healthy by doing my part too.  I have big plans to work on my health and hopefully be healthier for it.  This is the least that I can do and I view it as a duty on my part too to see my new health insurance as a partnership of sorts where I have to do my share too.

I'm also now in a position to perhaps hire more people too because I am now protected from liability as to my health that I had no protections from before.

The bugs will get worked out, the web site is NOT the program, just a portal to it..., millions are benefitting already, and like it or not it's the law of the land.  One law I wholeheartly support and it could not have come sooner in my case either.

 Hope your feeling better hesh.Didn/t realize you had so much( tsouris)  trouble with health problems.Get well soon.

Thanks my friend - I'm doing fine now thankfully but I still seem to be my own worst enemy in that I need to learn to be less passionate about things....

Take care

 Hesh , I was levelled with that same criticism over 40 yrs ago. lol.  Passion is what drives creativity, otherwise look around  at all the Dead F*cks once they hit 60. Keep truckin man

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