Monthly Archives: October 2015

John, I can’t find fault with any of your logic. I can only speak to my circumstances. Over the past year, my rates have decreased by nearly 7% compared to 2014, but I had to move to a new carrier to get them. If I stayed with the old carrier, I was facing an 18% increase for a silver-level HMO-style plan based on wellness/.prevention. I can’t say that the ACA had any impact on moving to a gold-style PPO plan with a top flight carrier here in New England, but my $500/$1000 deductibles are down from last year’s $2,000/$4,000. We’re clearly paying significantly less than 2014. Maybe it’s New England, but competition appears to be a factor. Only 2016 will tell whether our new carrier will emulate the old carrier for exorbitant price increases.

Hello John,
Perhaps a view from outside of the US, up here in “semi-socialist” Canada. This is also likely more of a big picture comment on national governance than anything.
I of course cannot comment specifically on rates for medical insurance in the US, but I do think it is a fact that the US is the only really industrialized country that doesn’t have true universal health care. Now, I am by no means holding up our system as the model – after all we were ranked 30th by the WHO and the US, 37th, so clearly we both have a great deal to do in this 21st century world in this regard. (I realize these rankings a re a bit old and do have their flaws).

What I will say though is that there is plenty of evidence to show that as a country’s healthcare and education systems go, so goes the overall success of the country in the long term. Its a bit like you are only as strong as your weakest link. If you do not provide general access to healthcare and education for all citizens, it is only a matter of time before the social fabric begins to erode – the cost of which is far, far greater than the specific costs of delivering those programs. My observation is that you are seeing some of this in the US – it is likely a key factor that is causing such massive division and polarization in the country politically.
I personally don’t agree with fully private health-care. I have many friends in many countries in the medical system, and none of them agree with “medicine for profit”. I think the best models are private delivery within a publically managed system that provides equal access. I know many people in the US when they hear this rush to the – “well you have long wait lists in Canada – we don’t”. That really is not a complete picture. If you need treatment, you get it. But if its not required and/or elective, yes you will go on a wait list. Most Canadians (and Europeans) are fine with that. I have a friend who got sent for an angiogram, which found 4 major blockages in his heart. He had quadruple by-pass surgery the next morning – by a team rated as one of the best in North America. This would all be covered by Health Canada and paid in his taxes – no co-pay, no deductibles, no having to take a 2nd mortgage to pay his medical costs.

At the end of the day, its how you view things – you have lower tax rates than we do, but we pay for our health care in our taxes. Lastly, I think this is a tough transition for the US – it is not going to be easy. You are likely where the National Health or Canada Health or Germany were 30 years ago. But what I think you cant afford to do is leave this to politicians to use as an election football (There is a difference between “politicians” and “public health care” – the former change frequently – the later should be enshrined in law).

This is not meant to be criticism – like I say – we have much to work on too – but I think objective debate that takes this vital topic out of being called OBAMAcare is needed for long term success.
Malcolm

These characteristics of dealing with large businesses can be wonderful barriers to competitors once you get in, and they are very similar one to the other. They are used to paying considerably more because of the few small businesses who go after them.

There is innovation which comes from smaller sized organizations. Then they get absorbed by ← larger fish in the food chain. Economic set backs create the groundwork for entrepreneurial growth – starting a business in lieu of not getting a job with bigcorp or the government. it is a cycle. the proven successful small businesses get acquired by larger companies with capital and no innovation. mom and pop video stores were acquired to make Blockbuster but even these have a life cycle and big does not always mean an enconomy of scale. red box in your grocery store lobby seems to be doing just fine as a vending machine operation.
none of us lead active business lives in the historic perspective of 100’s of years. We have to make payroll or the rent this week, satisfy the customer with good qualty at a market price which is not increasing and do all of the other things required of us by the community we operate in. Small business people are heroes but because we do such a poor job of economic education in our schools their success is viewed as a lucky lottery instead of hard work.
we will be in trouble when they start saying why bother?!

The longer insterest rates remaiin at zero or below zero levels, the more difficult things will be for SMBs and middle classes. Because real zero rates are just for Big corps, banks, etc. in most of the Western world. This means they can almost print money.
On the other hand, all the rest of us are deeply indepted with them (either through credits or public bonds), and we have no other resources but our working hours to pay them, competing on a global basis to sell them.
Inequality is absolutely inevitable, and it will get much much worse beacuse politicans and central banks are into this strategy of ‘asymmetrical capitalism’.

Growing up, technology was touted as a way to make life easier for the next generation. We have arrived!