“Soft despotism is a term coined by Alexis de Tocqueville describing the state into which a country overrun by "a network of small complicated rules" might degrade. Soft despotism is different from despotism (also called 'hard despotism') in the sense that it is not obvious to the people."

Sunday, January 06, 2013

Obamacare will squeeze out private medicine and suck more money out of our pockets and into government coffers. And that's as old-school as it comes, when you remember that physicians, once upon a time, applied leeches to their ailing patients.

An Unhealthy Dose of Obamacare Taxes
We don't know where the Affordable Care Act is taking us, but we do know that it will cost a bundle.
J.D. Tuccille | January 4, 2013 REASON

In what was already an eventful year, Obamacare generated lots of buzz in 2012, first in the lead-up to the Supreme Court's much-anticipated ruling on the constitutionality of the Affordable Care Act, and then in the chatter-heavy aftermath of the surprise decision upholding the law. After that, headlines focused on Medicaid expansion (which states would and which states wouldn't) and health insurance exchanges (which states would take the task on, and which would tell the feds to tackle the mess themselves). But government regulations and new or expanded bureaucracies don't pay for themselves, you know; they require tax-funding. And we heard relatively little about the plague of taxes and tax changes that now sweep over us with the dawn of 2013.
Actually, we may have heard a little. The medical device industry had the resources to make a futile fuss relatively early about the 2.3 percent tax that is being levied on gross sales, without regard to profitability. That's right, in the red, or in the black, the medical device industry will have to give the government a cut. According to the Medical Devices Manufacturers Association, a trade group, "Many companies will owe more in taxes than they generate from their operations." The tax, which has its own IRS FAQ, along with 10 pages of helpful guidance (PDF), has somewhat disheartened crafters of pacemakers and brain implants. A survey conducted by the Massachusetts Medical Devices Journal found that "more than 40% of member company executives anticipate job losses as a result of the 2.3% medtech levy."
Speaking of brain implants, Frank Fischer, chief executive of NeuroPace Inc., a start-up company that manufactures just that, told The Wall Street Journal:
"If we were trying to start the company today, I don't believe we'd be able to fund it," he said. "[With] the length of time the regulatory process has been taking over [the] last several years, and this additional issue of the tax on top of that, I believe many companies—if they weren't in the later stages of approval—wouldn't get the funding to get there."
Critics say that the tax could will stifle innovation, although it's just as likely to drive companies to move operations overseas.
But the medical device industry is an organized business community that can fight its own battles. Relatively unprepared individuals are targeted by the Additional Medicare Tax, which whacks higher-income Americans with a 0.9 percent surcharge on wages, Railroad Retirement Tax Act compensation, and self-employment income. The tax boosts the take on any income currently subject to Medicare tax, above the applicable threshold:
  1. $250,000 for married couples filing jointly
  2. $200,000 for individuals
  3. $125,000 if you're married and filing singly
As it turns out, there is a marriage penalty built into Obamacare. Surprise!
As Grace-Marie Turner of the Galen Institute points out, "This means the current 2.9% Medicare payroll tax will be increased to a total of 3.8% — a big hit especially for the self-employed." Keep in mind that the original 2.9 percent is split between employees and employers (nominally, anyway, though the employer's share is generally believed to be reflected in reduced compensation), while the new tax comes straight out of the taxpayer's pocket.
Oh, and note that, according to the IRS's oh-so-helpful FAQ, if you're married and make over 200 grand, but your spouse's income doesn't push you over the $250K limit, too bad for you. Your employer has to withhold the tax and you get to ask for it back when you file. Don't expect a thank-you note for that loan.
Anybody at that income level probably has some investment income, which also comes in for attention from the revenue-hungry Obamacare machine. That attention arrives in the form of a 3.8 percent hit at the same thresholds as wage income, pointed out above. As short and not-so-sweet as that sounds, the tax on investments is far from simple. There is, of course, a handy-dandy IRS FAQ, or you can take a quick glance through the tax agency's 42 pages (PDF) of explanatory rule-making. However, Amy Feldman, a finance wiz at Reuters, offers a bit of caution to those who have even slightly complicated finances:
Medicare surcharge strategies get more complex for those who have trusts ... most trusts — with the exception of charitable trusts, which are exempt — will be affected. One possible strategy: Trusts may be able to reduce or eliminate the Medicare tax by distributing income to beneficiaries.
Feldman also warns that interest payments on intra-family loans "could be" subject to the Obamacare tax. Don't you love that "could be" element of uncertainty when interpreting elements of a tax code that's enforced by fines and prison sentences?
Of course, most Americans don't make enough money to be affected by the Additional Medicare Tax or the Net Investment Tax, but many of us still enjoy using Flexible Savings Accounts. Tax-free contributions to these were uncapped in the past, potentially giving people a great deal of control over their healthcare. Now, though, FSA contributions are limited to $2,500. Anyway, as the IRS informs us, except for insulin, FSAs were already hobbled in 2011, ever since which "the cost of an over-the-counter medicine or drug cannot be reimbursed from Flexible Spending Arrangements (FSAs) or health reimbursement arrangements unless a prescription is obtained." Health Savings Accounts and Archer Medical Savings Accounts got similar treatment.
In another sneaky rule-shift, medical deductions get pushed a little further out of reach as the feds raise the bar you have to reach on expenses before you can write them off. Says the Medicare Newsgroup:
People can now itemize deductions for medical expenses for amounts in excess of 7.5 percent of their adjusted gross income (AGI). If the AGI is $100,000, people can deduct any expenses in excess of $7,500. The threshold will be increased to 10 percent of adjusted gross income on Jan. 1, 2013, making it harder to itemize medical bills. However, individuals 65 and older can still itemize at 7.5 percent until 2017.

If you're getting the feeling that the sum total of these taxes and rule changes is to push people away from individual decision-making and toward a collective healthcare system of as yet amorphous form and arbitrary boundaries, you ain't alone. Michael F. Cannon of the Cato Institute has been warning that the Obama Administration's prodding of reluctant Americans to participate in the untested scheme exists in a quasi-legal realm all of its own. Cannon writes, "the IRS has announced it will impose ObamaCare’s taxes on employers and individuals whom Congress expressly exempted from those taxes, and will send potentially hundreds of billions of taxpayer dollars to private health insurance companies, also contrary to the plain language of the statute." He and Jonathan Adler of Case Western Reserve University School of Law document their argument in an article available from the Social Science Research Network.
All in all, we may not know how Obamacare will work out, whether it will squeeze out private medicine or merely further corporatize an already... ummm... mixed-economy system of healthcare. But we do know that it will take a tight grip and suck more money out of our pockets and into government coffers. And that's as old-school as it comes, when you remember that physicians, once upon a time, applied leeches to their ailing patients.


  1. Nothing as overtly flawed at the outset could possibly have landed us in this situation had it not been for the BS spread by the completely in the tank "Free Press" for Obama.

    A sad day for America.

    John Roberts should burn in Hell.

  2. As Jenny said: “I don’t know who we are.”

  3. D. is still awaiting the results of his brain scan. Meanwhile his Stage 4 lung cancer continues to go untreated. The newest full body bone scan results are 'pending' too. I am making no general comment on the VA system. But in this one case I know about, hell you might as well go ahead and shoot yourself. They gave him three or four months to a year about half a year ago. Personally, I think it is a preview of NoCare. And no, I am not asking for sympathy for D., who is born again, much less myself, as crapper would have it. Just reporting on the state of things medical as I know it in this case. I am guessing with my wife that soon he will be told he is 'untreatable'. What a mess. Trying to negotiate between three sites, Walla Walla, Spokane, Seattle and all the bureaucracy in between.

    When I went in about a vision problem two days ago, I had the results the same day. Not expecting the white cane yet, though the crinkles on my retina are starting to look a little like the Bitteroot Mountains. May need a little corrective operation down the road, if NoCare doesn't get me. :)

    What happened was I was reading some Rufus when all of a sudden everything went double, up and down. It is of course possible this is just the result of many hours of trying to make sense of Rufus, and finally my system broke down.

    "Let light attend me to the grave."

    1. I commented to my eye doc the lack of men in the place. She said we do have two, out of twenty, and would like 'a couple more'. Heh, two out of twenty, and wouldn't mind 'a couple more'. If that is not tokenism I don't know what is.

      Women Rule!

    2. Had great time with the exams. Got to play pirates (eye patch over one eye then the other) and look into a soft black smooth silky darkness, like Churchill described death, but with one dot of light in the middle, which made me think of all the near death experiences I have read, the beginning of the coming of the light out of that sometimes described initial darkness.

      Then the dealie made little flashes of light around, and I had to press a button when I saw them, it was a little like playing Space Invaders with my nephews long ago. She agreed, she had played Space Invaders too!

      I seemed to pass this all right.

      Came time for the pressure test and I was expecting that little puff of air, you've probably experienced that, but they don't do it that way any more. All done by light somehow. Makes a better pressure read too, she said. Guess I was all right there too, as she said nothing about it.

      This is called medical progress, a phenomenon soon to become a memory.

      Got a look at a computer printout of my retina. Usually it is like two smooth bird wings hooked together, but mine looked like it had the Bitteroot Mountains on top, rather than being smooth.

      She said no indication of stroke, but the crinkles were worse. I am not going to need to trade my cane for a white cane anytime soon, however. I am to go right back into the clinic 'immediately' if it happens again. What do I do? I asked. Just walk in? Get an appointment she said. Course this usually takes a couple of weeks, I mentioned, but they make an exception for stuff like this and get you in that day.

      This is called competent medical service.

    3. I know it is difficult, but you should try to skip by the malignant Rufus posts.

      Retinas are extensions of the brain, and R's unhealthy raw baloney sometimes has an effect on said brain quite similar to bacterial meningitus.

    4. .

      You should have gone into writing, Bobbo, you have the knack for it.

      (Also, what else is a right-brained intuit with an English major good for?)

      Of course, now that you are going blind it could be more difficult. But then remember Homer, Huxley, and Milton.



    5. .

      Just kidding, Bob, not about the writing but about the eyes. Not a laughing matter; although I have never heard a diagnosis of crinkles before.


  4. JihadWatch of the Day

    Egyptian lawyers say Obama gave Muslim Brotherhood $1.5 billion

    Getting sick of it yet?

    1. Chuck Hagel to be nominated S. of Defense. Fits right in, does it not?

  5. Fastest Models Flying; DS Sailplanes Nearing The 400 MPH Mark

    DS, short for Dynamic Soaring, has been in many bird’s bag of tricks for eons, but it was only in the late 1990’s that sailplane legend Joe Wurts discovered it could be done with a model.

    I wrote about Joe a few years back. I used to fly w/him when he was a Computer Science Student in college in San Luis Obispo.

    He's now become a legend in RC Model Soaring.
    Lives in New Zealand, haven't learned what kind of work he does there.
    Travels around the World with their Soaring Team.

  6. This comment has been removed by the author.

  7. South Africa
    ...had the Soaring Championships there for 2012. Joe came in second.

  8. rufus,

    You sure do blow a lot of smoke. Actually bullshit.

    Hard to do more than type a few lines as I am on the road but simply Google Carter Whitehouse solar system and you will learn that it, like most all commercial systems of the day, was a thermal water system. One should treat every one of your 'facts' with suspicion.

    Your moral compass is broken regarding torture. Maybe if you actually think about what Quirk has written on the subject you might get the general direction right.

    1. This comment has been removed by the author.

    2. Better to not get between two Obama supporters when one bullshitter is blowing bullshit at the other bullshitter, and vice versa.

    3. May your trip be a happy one, Ash, the scenery magnificent, the adventures challenging, the return safe, though perhaps delayed.

  9. This comment has been removed by the author.

  10. It's unlikely that the low-information voters will understand any of this. They have the arrogance that ignorance provides them. The media will continue to trumpet how evil and greedy capitalists and republicans are.

    And the low-information voter will believe it all. It will take many years or an entire generation or more to get them to understand and realize the damage they have created. Their goal is 100% socialism and it's unfortunate that the people who vote for them won't realize that the elected socialists consider them useful idiots.

    They voted for the socialists thinking they are "gonna take it to whitey" and "take it to the rich man" and all the other petty grievances that stupidity promulgates. "I'm poor, It ain't MY fault cuz some rich dude be keepin' me down!"

    It goes beyond pathetic There really is no word to describe the mechanism that is willful ignorance. It's a combination of laziness, over-emotionalism and feelings of insecurity all rolled into one. Starts in childhood and many people never grow up enough to realize how to accept their own shortcomings.

    1. You, Sir, or Lady, perhaps, will truly be a misfit in our coming utopia.

    2. "low information voter". There is a person getting their talking points from Rush.

    3. The estimated cost of Obamacare has increased to $1.7 trillion. You can’t hide that.

    4. Truth out: Ash is a Rush Listener :-)

      Why does that amuse me?

    5. Potato Head secret Rush listener.


      That's funny all righty, ya got to be a listener to know the el Rushbo.

      Megadittos, Potato Head

  11. The disputed Keystone XL oil pipeline would pose “minimal” risks to Nebraska’s environment, a state agency said in a report released Friday, removing a major barrier to the project’s receiving final approval.

    The much-anticipated final review of the pipeline found that a new route proposed by operator TransCanada Corp. avoids sensitive regions that have been a source of concern. Nebraska became the center of the debate over Keystone XL after the Obama administration rejected a permit for the pipeline last year, saying a congressional deadline made it difficult to conduct a thorough review of the state’s concerns. …

    The U.S. State Department is conducting a separate review of the pipeline because it would cross the U.S.-Canada border. The State Department is expected to issue a draft of its own environmental analysis in coming days.

    The time for f'ing around is over. Now Barky must choose between the greenies, and everyone else in the United States.

  12. It goes beyond pathetic There really is no word to describe the mechanism that is willful ignorance.

    Actually there is a word: “ignorance.”

    This will be an interesting year.

    All this political theater is damaging the country both domestically and abroad. Vitriol and anger are growing because the national leadership in Washington isn’t in a position to solve the country’s biggest problems: the mountain of debt, endless war, the budget deficit, unemployment, irrational the education crisis, aging infrastructure and the explosion of costs in the health care and pension systems.

    The recognition that things cannot go on without a curtailment in social spending and defense spending has so far been eluded by Obama and the Democrats and many of the Republicans. They all know what to do but will not do until forced.

    However, it will not escape their attention as this theater becomes personal to them, even to the low-information voters.

    1. Who you calling "abroad?"

      EU problems far worse, from almost any angle.

      The so-called BRIC countries are each their own special case, with their own unique futures (esp China.)

      I have maintained for about a decade that 3D printing technology will zap the manufacturing space. There will soon be a new "box" in every home, right next to the microwave or cable, with a vastly expanded options menu. Sure, somebody has to manufacture The Box but it's going to change the face of emerging markets.

      Mexico can't do anything to dent the instability caused by drug trafficking.

      Normally I wouldn't give a rat's ass about outside opinion, particularly EU, but a line was crossed somewhere between 2001 and 2008.

      It is past time to recognize that what used to be alpha male behavior defining business as usual in Washington is now clownish behavior that makes the entire country - and everything we used to represent - look stupid and clownish. We've become caricatures of ourselves.

      I may be overstating things but not by much. I have six years before I turn 65. I don't see how I will be able to pay for health care.

      And I've never been sick a day in my fucking life.

      You all have a wonderful day.

    2. How much would you be willing and able to spend for a guaranteed healthcare plan?

    3. It's not that Deuce - it's the doubling of cost during the last decade, which is an average number. The cost escalation number for seniors is probably double that (I would have to research the exact number.)

      It's the old people and the chronically ill, some not small fraction of which is related to "lifestyle choices." But by all means let's settle this birth control/abortion issue first. And maybe work in some god guilt while we're at it.

      I was getting by until I became unemployed. Now the situation is untenable.

  13. "They all know what to do..."

    Do they really?

    1. "...but will not do until forced."

      What would force a divided Congress representing a divided nation to do what needs to be done?


  14. Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration's health care law was to stem the rapid rise in insurance costs for consumers.

    Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

    It's reaching to point where I can't afford to hold health insurance. I should just go out and kill someone and let the state pay for it.

    1. Obama said that your insurance costs would decrease about $2500 per year. I guess we have to wait until the full program "kicks-in", huh?

      Do you have a high deductible or "hospilization type" policy? I know, even those run into the hundreds of $$ per month.

      Have you thought about (looked at the numbers) for going without insurance?

      I agree, it's the pits.

    2. Insurance costs are going up for everyone, prices are not.


    3. Insurance costs are going up for everyone

      No, they're being selectively raised for target groups, point of the article, of which I am one.

      I carry a $6000 deductible policy,cheapest major medical available in the state, which is killing me slowly. And no I'm not sitting on a quarter mil that I can pay for major treatment. It's the borderline elderly of borderline means that are getting squeezed to death.

    4. I'll "share" some more.

      I have a handicapped relative on Medicaid. He pays monthly by check. (Actually I do as his co-guardian.) This particular corner of the Medicaid system is not set up for electronic bill pay or selecting more convenient pay periods such as quarterly or semi-annually. Nope. Write that check, stamp it and send it in.

      Lately, the local administrative agency has been "late" in submitting his invoices. We call, get voice mail and no answer. That's the routine.

      The first time it happened I went "upstairs" using Yellow Pages, got some useful information, and returned with that to the local Voice-Mail lady who finally responded with some such explanation that it was "our fault". I hadn't been involved with that particular payment so I apologized profusely and let her play Superior Smart Ass.

      Second time it happened I contacted Voice-Mail lady's local supervisor and got very interesting info. Not only was the office transitioning onto a new computer system (everyone's doing that - I am starting to become suspicious - this "new" system will neither allow e-billing nor period selection) ...

      but! it will allow the administrative authority to "drop" clients from its rolls. They were transitioning the seniors and the needy last hoping that those who "got dropped" during the transition wouldn't call back and request reinstatement (my relative is classified as "medically needy" because he is handicapped.)

      My relative has "people" who "call back." We've been going through this every month for the past four months. We got his Jan invoice on time. Waiting to see if they cash his check on time. Then we start over again February.

    5. .

      I can sympathize.

      I have knocked Obamacare for a number of reasons and as with any new bureaucracy some people will end up worse off; however, with the subsidies built in, it should help a lot of people (at least with the costs). Have you checked out how you will be affected next year?


    6. .

      My last post had to do with 'your' health care costs.

      The whole Medicaid fiasco varies by state even though they only pay 40% of the cost. I'm sure we will hear a lot more of this as states try to cut costs.


    7. No Quirk I have not checked into next year. What good would it do? I am already on the cheapest plan. I get my thin envelopes in the mail with the news. If I had saved all the money I spent on health care insurance over the years (just my share, not the employer) it's something well north of quarter of million (for some reason I can't remember - one might think that number would be burned in my brain.) I would have been so far ahead of the game.

    8. If you could swing it maybe you ought to pay ahead a few months. If a bank saw your payment history maybe they could help you with that.

    9. .

      I do sypathize. I have relatives that have been in the same situation. And I am not being a smart ass or trying to intrude when I say it never hurts to check, especially if you are unemployed. I thought Obamacare had subsidies and such to help people in your situation although I'm not familiar with the details. The most it can cost you is some time.

      At the state level it's amazing the amount of programs they have out there (although it varies by state). However, they don't go out of their way publicize them. It's like your Medicaid experiance. They would like those people who got dropped by mistake to just go away and not come back. That is one of the issues with those states who refused to take on the additional Medicaid recipients under Obamacare. Even though the FEDS pay most of the cost for the new people, each state has a certain percentage of Medicaid eligible people in the state who never apply for benefits just because they don't know that they are eligible. The states don't want any changes that might wake that sleeping giant.



    10. I will look into it Quirk.

  15. Top 100 Traits of Personality-Disordered Individuals

    Approximately 1 in 11 people meet the current diagnostic criteria for having a personality disorder.

    1. Based just on Number 14 alone, I perceive we here all have personality disorders -

      14 -Circular Conversations - Circular Conversations are arguments which go on almost endlessly, repeating the same patterns with no real resolution.

      And that is just the tip of the iceberg, read the whole, you'll see what I mean.

      lalalalalala -la!

    2. Better to call them "personality diss-orders."

  16. Health Insurers Raise Some Rates by Double Digits

    Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

  17. We are 20 years into an era where real wages in the private sector have fallen. Great capital has done well. Corporations have done well. Lawyers have done well and politicians have done very well.

    Labor has not.

    In the US, as a direct result of globalization, outsourcing and illegal immigration, has diminished that which was once common: Healthcare, employer based, a commodity that is disappearing.

    The result is that there is little disposable income available for private healthcare.

    There has to be a political policy and a demand that real wages (not inflation) are increased. This can be done. It has to be done.

    1. Then it seems a start is to get rid of globalization, outsourcing and illegal immigration.

      One can hope.

      And hope.....

      But I can't see much progress to be made. My guy, stanch Republican conservative, for instance, just voted to make it a little easier for some family members of illegals to stay. He's not called Raul for nothing, it seems. Maybe it's about his relatives. Maybe just tribalism. I need to check into his background more than I have done so far.


  18. Moments of Clarity - Moments of Clarity are spontaneous, temporary periods when a person with a personality disorder is able to see beyond their own world view and can, for a brief period, understand, acknowledge, articulate and begin to make amends for their dysfunctional behavior.

    Gaslighting - Gaslighting is the practice of systematically convincing an individual that their understanding of reality is mistaken or false. The term "Gaslighting" is taken from the 1944 MGM movie “Gaslight”.

    Name-Calling - Name-Calling is a form of Verbal Abuse which people sometimes indulge in when their emotional thought processes take control from their rational thought processes.

    That hill billy from Mississhitti, Doofus, once found an acorn, otherwise his whole world would be a fantasy.

    Apply this little exercise to yourself, you will see we are all personality disordered.

    1. Except perhaps Sam. Who seems overall quite sane, compared.

    2. Yeah, but anybody that hangs out with us has to have his own unique set of disorders. :)

    3. Moments of Clarity used to be called epiphanies:

      An epiphany (from the ancient Greek ἐπιφάνεια, epiphaneia, "manifestation, striking appearance") is an experience of sudden and striking realization. Generally the term is used to describe breakthrough scientific, religious or philosophical discoveries, but it can apply in any situation in which an enlightening realization allows a problem or situation to be understood from a new and deeper perspective. Epiphanies are studied by psychologists[1][2] and other scholars, particularly those attempting to study the process of innovation.[3][4][5]

      Epiphanies are relatively rare occurrences and generally following a process of significant thought about a problem. Often they are triggered by a new and key piece of information, but importantly, a depth of prior knowledge is required to allow the leap of understanding.[3][4][6][7] Famous epiphanies include Archimedes's discovery of a method to determine the density of an object and Isaac Newton's realization that a falling apple and the orbiting moon are both pulled by the same force.[8][6][7]

      The word epiphany originally referred to insight through the divine.[9] Today, this concept is used much more often and without such connotations, but a popular implication remains that the epiphany is supernatural, as the discovery seems to come suddenly from the outside.[9]

      Artists call it "channelling."

    4. I call it 'getting rid of the brain'.

      Because as we have all learned all these years listening to bobo, the brain and consciousness aren't the same, and, as Dr. Alexander, neurosurgeon, just found to his surprise, and delight, and against all his expectations, and has reported to us, you actually have a lot better 'view' of things if your brain is flatlined.

    5. Damn the brain. It gives us time, space, categories of understanding, filters out stuff, and the rest, and, as Joe Campbell says, 'renders frustrate the apprehension of the source'.

      And I do think artists, poets, musicians, children, those in deep prayer or meditation and others do seem to get a little beyond the ordinary apprehension of things.

      And that is why Ruf and I have it so over Quirk, poor thing, totally entangled as he is in a Spock like view things.


    6. The word epiphany originally referred to insight through the divine.

      Which goes again to show the deep wisdom lurking in language, and the roots of words.

  19. Health insurers jacking up rates by double digits in advance of Obamacare
    January 6, 2013
    California and Ohio companies raising rates by over 20%

  20. Doris, I, somewhere, came up with the idea that you live in California. Is that correct? If so, this is good news for your disabled family member -

    Indeed, all 58 counties in California, except Fresno, are offering care to more poor residents, which includes the most conservative counties, like Modoc, Orange, San Diego and Kern.

    Expanding coverage to the 63,000 uninsured county residents couldn't come too soon for Paul Hensler, the administrator in charge of the county's public hospital, Kern Medical Center.

    "Our proposal was to expand coverage to those that don't have coverage and reduce the cost of care and improve outcomes," he said. Because the county is now assigning uninsured, low-income adults — who up until now have been excluded from Medicaid — to primary care clinics, their chronic diseases are managed better, keeping them out of his emergency room.

    Surprisingly though, the roll-out of what conservatives derisively call "Obamacare" has largely gone unnoticed in Bakersfield.

    "This is one of those things that is being implemented under the radar," says Ken Mettler, who helped . . . . . .

    1. In short, Medicaid will reach up to a little over $14,000.00, where Obamacare (and, the subsidies) kick in. IN CALIFORNIA.

      In Mississippi, Ark, Tx, and a bunch of other backward-assed states that have very low ceilings for earnings to qualify for Medicaid (in Ms, as in most of those, it's a touch over $6,000.00/yr) if you make between $6,000.00 ish and $14,000.00 ish you're in No Man's Land. Too much income to qualify for Medicaid, and not enough to qualify for Obamacare.

    2. Now, here's the sad part. In Ms, and these other loon states, the Feds will pay 100% of the cost for the first 3 years, and 90% of the cost, thereafter for these states to up their Medicaid coverage to the $14,000.00 ish figure.

      These crazy fools hate Obama so much that many of them are refusing to take the free money (and, in so doing, guarantee Insurance to 100% of their citizens.)

    3. Not in California any more Rufus although I lived in both northern and Southern CA for some time.

      My relative is fully covered. The biggest headache (recently, his history is very long) is working around the administrative attempts to make billing difficult in order to drop clients from the enrollments. Not to put too fine a point on it, but his public coverage is better and cheaper than my own private policy.

    4. Which makes sense I guess since the private guys don't want to drop you but the public rolls do.

    5. RE These crazy fools

      That works directly into Jenny's point about not recognizing ourselves. Some levels and durations of "stuck on stupid" used to be lethal, which implies a certain self-correction. Now it seems as if they're almost existential enhancements.

  21. I am putting up a post on the global problem of falling wages. It sunny, calm and 50 degrees in Pennsylvania and I am off for a long walk.

  22. Vladimir Putin has learned a few things from the last 20-plus years. In the two invasions of Saddam Hussein’s Iraq, which at the time was a big client of Russia and its arms production, Moscow relied on diplomatic maneuvers to hold off the US/UK-led coalitions — and ended up looking impotent. Putin himself tried to do the same thing with Libya, and had the same record of success. This time, Putin isn’t going to rely on diplomatic niceties; he’s sending a message that Russia will not brook the kind of interventions the West has conducted over the last generation with another one of its client states.

  23. OBAMACARE vs. outsourcing in 2014? The U.S. healthcare reform (“Obama Care” or the “Patient Protection and Affordable Care Act”) is intended to pressure large and small employers through force and taxation. Enacted in July 2010, the end result will show North American companies deciding to send customer support, sales, lead generation and appointment setting jobs offshore to stay competitive or risk going out of business. Many business owners will hire a dedicated bilingual employee nearshore who is 100% qualified for their project. Financially speaking, ESL call center employees in Costa Rica are as effective as transitional in-house staff for half of the cost. This proven strategy will give small to medium sized companies the option to scale up their BPO staff without getting caught in the Obamacare challenge in 2014.