text:
Tell me again how my premiums won't go up?
Last year's medical insurance increase was 9%. This year's increase 28%. Sorry, but you're wrong. This isn't Canada or Europe or wherver else; it's land of the have-middle-class-foot-the-bill. Can't pull the wool over my eyes any more! I said I was waiting. Now I can say it 100% assured I know!!! The other shoe has dropped. No salary increases for years and now this type of deep into my pockets take away? I'm not an I told you so kind of person, but I told you so. Let's see how this plays out everywhere. Some employees around the US won't know their increases until January, but since I'm paid on the federal cycle, so I am in the October group.
My cobra costs well over a thousand a month the current plan I'm signing up for will be half that for the same benefits and a lower deductible! I checked out & called doctors who accept the plan as they were all listed on Zoc doc. Thats a major savings for me of about $7,000
Explain the entire groups' increase another way pidge. This group is 5 digits strong. Not 5 or 50 employees. Health didn't impact it. The premium is the same for every employee, whether 25 years old or 55 years old. This is raise in premium for each and every one of the 15,000+ on the group (I'm leaving off the top eschelon group as they're probably self insured). How is it not legislation? It also changed in that they're required to provide short term disability to everyone (I already had it for years now). Free of charge. Or I can buy up to have better protection. It also changed how our time off is being done. I lose 7 days a year out of my sick/vacation time. So far, I'm less than impressed. You might want to remember, I have an educated view of insurance. I know the inner workings and the aspects of the influences which might propel premiums. Other than health???? what is it that could kick it up triple over last year's increase? And they lost the upper tier healthcare provider. This is the "cheap" provider. Others lost the better benefits. Stripped down and kicked up premiums. MMM, my favorite!
I know you don't want to believe it, but try to be reasonable on that end of it. We'll have to see how it works nationwide, and there will be numbers and data coming in, so let's watch. But for Tennessee much higher premiums.
Become self employed and slip under the radar? I'll take the penalty please! Or do without insurance? It's not cheap anywhere for anyone, but it's really not cheap to NOT have insurance.
Whoopdeedo joe. I told you NY has had screwed insurance for years. Blame your state legislators. Also MI, AL, MA and others. Glad they got a kick in the A, but you'll be in the minority.
This post was edited by rob333 on Thu, Oct 17, 13 at 8:37
Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.
Edited to correct the monthly total; I was looking at a 2 week paycheck stub.
This post was edited by esh_ga on Thu, Oct 17, 13 at 8:46
I just asked an HR person to confirm, YES it is an ACA related increase. Sorry! I hope everyone else fares better.
Hay, you're saying what I've been saying. Skyrocketting costs from the babyboomers won't help this matter. Glad to help you. Just wish I had the help of self employed and/or big businesses who would contribute to the pool.
"I just asked an HR person to confirm, YES it is an ACA related increase."
Seems to me that having to pay for "essential benefits" that are not essential to YOU is guaranteed to drive up costs. Why should non-parents who aren't capable of having children have to pay for maternity care? Even if a couple was going to adopt, why would they need pediatric care prior to adopting? Seems like the system is designed to force people to overpay. And that doesn't seem right to me.
Here is a link that might be useful: essential benefits
Why should non-parents who aren't capable of having children have to pay for maternity care?
Because that's the way insurance works. It's also the way property tax works. You pay for stuff you don't use and others pay for you to use stuff that they don't use.
I am glad to personally get two new benefits available as a result of ACA:
- cannot be denied for a pre-existing condition
- cannot be denied for reaching a "life-time maximum"
There are also 10 essential benefits available to everyone, but my plan already included them:
Ambulatory patient services
Emergency services
Laboratory services
Maternity and newborn care
Mental health services and addiction treatment
Rehabilitative Services and devices
Pediatric Services
Prescription drugs
Preventive and wellness services and chronic disease treatment
Here is a link that might be useful: source
You already couldn't be denied for pre-existing. As long as you went from one carrier to the next. If you dropped coverage, then you were subject to pre-existing. If you married and you applied in time, within a month of the marriage, typically, you were covered without pre-existing. If you had a baby, automatcially waived pre-ex. If you adopt, automatically waived pre-ex. If you divorce, able to apply at your own place of employment and automatically waive pre-ex. And? There are so few instances of not having this.
So what does it matter? The majority of people already went from coverage to coverage. It's meaningless. It sounds good, so they're saying it. They're trying to attract those who have been out of the system. That's all.
Sorry your premium went up so much. However, just because your employer is telling you the 28% increase is due to Obamacare doesn't mean it is.
First, if your company employs more than 15,000, it's most like self insured and the "insurer" you see is just acting as a third party administrator. Therefore 1) they already provided automatic coverage for any family member with a pre-existing condition; 2) they don't participate in the exchanges anyway; and 3) the only difference is they have to pick up the cost of one free physical per year and they're covering an additional 4 years of the country's healthiest demographic (adults between 21 and 26).
There is no way a 28% increase resulted from Obamacare. Just no way.
Posted by esh_ga z7 GA (My Page) on
Thu, Oct 17, 13 at 8:39
Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.
What is the $ amount of federal subsidy you will receive to keep your premium that low?
What is the total out of pocket per calendar year? $12,500? Higher?
I am a former HR Director. Premiums go up by 10% generally every year. This year, my Husband's employer is switching from Aetna (decent) to United Healthcare (horrible). Along the way, I have either been a member or negotiated with every major health and welfare carrier out there.
When you bid out your business, a new carrier will natch offer you a very competitive rate to earn your business. You can guess what happens in subsequent years. After about two or three years the rates go up and you bid it out again.
You already couldn't be denied for pre-existing. As long as you went from one carrier to the next
That sure isn't the way things work here. You're covered as long as you maintain your current policy with the same insurer. You can get a worse policy with the same insurer, but you can't switch companies, they won't let you.
But given that insurance premiums have been going up every year, often double digit increases, for the past 15 years, why, suddenly, is this massive increase due to Obamacare? The only explanation I could think of is that your previous policy didn't cover much.
What is the $ amount of federal subsidy you will receive to keep your premium that low?
What is the total out of pocket per calendar year? $12,500? Higher?
I receive no federal subsidy, this is employer-provided insurance. I don't know what the total out of pocket is.
That's how pre-existing works nationally. With carriers who work nationally. Unless of course you live in an F'ed up state and the legislators ruined it for you. MI, CO, TX, AL, MA, NY, probably others which are escaping my recollection. Sorry the 75% don't know it. Blame their HR departments, they should've been telling them to sign on immediately. Oh, another example: when you sign up for the very first employer after the waiting period is complete, pre-ex waived.
Sorry hayden, but my HR department has no dog in the discussion going on here. HR has no reason to lie. Actually, they probably get in trouble for lying. Nice try!
Rob, then go back and ask them to explain to you exactly how the ACA is responsible for the increase. I don't think they are lying but perhaps they don't really understand the reasons for the increase either.
Its not OK to just say its because of the ACA ......you are entitled to the details of exactly why. Without all the information I don't know how your can just accept that it is.
Seems to me that having to pay for "essential benefits" that are not essential to YOU is guaranteed to drive up costs. Why should non-parents who aren't capable of having children have to pay for maternity care? Even if a couple was going to adopt, why would they need pediatric care prior to adopting?
And how is this in anyway related to the ACA? Or is just that some like to make it sound like that evil Obama is making you pay for coverage you don't need because he's a big meanie?
"There are also 10 essential benefits available to everyone, but my plan already included them."
The 10 essential benefits are not "available" to everyone under obamacare.
They are MANDATED for everyone whether they need them or not...except those with "grandfathered" policies.
Policies without the costly baggage Democrats alone decided to call "essential benefits" are being grandfathered in for now. So much for the nonsense claim that "essential benefits" are "how insurance works."
Even the BS language is part of our Brave New World. For example, there is no way maternity care is an "essential benefit" to men, boys, prepubescent girls, elderly or infertile women. The presence of a uterus, functioning or not, has no bearing on what progressives believe and will repeat all day long. Maternity care is an "essential benefit" for all. Sit back and watch, as they come forward to argue for mandated benefits people must buy, even though they have ZERO RISK of needing it. Ever.
Its simple math....below some excerpts from Dave Ramsey explaining the math behind ACA. For complete article and video: http://eaglerising.com/2254/dave-ramsey-destroys-obamacare/
âÂÂJanuary 1st, 2014 every insurance company is required to take on anyone, no matter how sick they are, and they cannot charge them more than someone who is not illâ¦You're 500 lbs. you have diabetes, youâÂÂve got cancer, youâÂÂve had three heart attacks youâÂÂre going to pay the exact same premium as a perfectly healthy person.âÂÂ
âÂÂI understand the motivation, and the nobility and the moral imperative behind that. I get that. But that doesnâÂÂt change the math, the math is that those people get sick more often and run up more medical bills than someone who is healthy. Duh.âÂÂ
âÂÂIf they now have to be covered by the same company that youâÂÂre covered by and theyâÂÂre required to take them⦠then the math kicks in. Because the amount of money that that company was paying out to the medical community is going to go way up. TheyâÂÂre going to pay out to the medical community per person than they ever have before⦠what they pay out per person is how your premium is determined ��" plus profit.âÂÂ
âÂÂEveryone is going to be charged the same. Translation you are going to pay higher premiums to keep the insurance company open, so they donâÂÂt go broke. Because they are now going to have to cover people that they didnâÂÂt have to cover before⦠sick people.âÂÂ
Read more at http://eaglerising.com/2254/dave-ramsey-destroys-obamacare/#sRP8FgHgj2Qs74FS.99
So what does it matter? The majority of people already went from coverage to coverage. It's meaningless. It sounds good, so they're saying it. They're trying to attract those who have been out of the system.
During the Great Recession, it was not unusual for an unemployed person to be unable to afford COBRA premiums. Coming onto a new policy with a new employer with a gap in coverage -- they've fallen into the trap.
Premiums go up by 10% generally every year.
In my area I would say 10-15%.
When you bid out your business, a new carrier will natch offer you a very competitive rate to earn your business. You can guess what happens in subsequent years. After about two or three years the rates go up and you bid it out again.
Same in my experience with a small company.
Also some carriers will offer new plans that are very attractive only to steeply raise the premiums in subsequent years. While the overall increase for an entire company may be 10-15%, these once attractive plans can increase much more. HMOs typically have had the lowest increases.
Rob, I also suggest that you request clarification on how ACA has increased the premiums. You may find out something that will influence future health care insurance decisions.
chase, I listed the reasons for increases at the top. Changes in overall physical health, group size change, etc. There really are no other changes this go around. Insurance actuaries base the premiums on these things. It really is ACA. I'm sorry it bothers everyone, but it's truth. And like I said, we all can keep watching as the numbers roll in. We'll have more data later. I'll get over it, but it sure is a hard hit at a bad time. I still love you, but this is one thing I understand in great depth.
My DH works for our state. Our premiums increased significantly in July (16%), the deductible more than doubled ($150 to $350) and the costs of non-generic drugs doubled with a $50 deductible now on those too.
My opinion is there were a few things that went into this. One, the current governor felt she could do it. She said that premiums had not increased in oh so long and insinuated state employees had been enjoying the largesse of tax payers for too long. She was partially right, premiums had not increased but the out of pocket costs have been ratched up significantly over the years.
I suspect some of the increase has also been due to changes in the law but, I suspect many are using ACA as an excuse for a portion of the increase as many are quite willing to accept that.
you are going to pay higher premiums to keep the insurance company open, so they donâÂÂt go broke. Because they are now going to have to cover people that they didnâÂÂt have to cover before⦠sick people.âÂÂ
....I remember several threads in the past about how insurance premiums were high because of all the uninsured who used ER's/hospitals. You are wrong, you were already paying for "those" people.
There were no significant changes in the group members' personal health. To differentiate it from the insurance term "health of the insurance"...
which is too much jargon. I'll have to think about how to break that one down. Hm....
When the majority of your a group is fairly young/middle aged, and they are fairly healthy, they are a sound (or healthy) insurance pool. The larger the pool and more concentrated on the "fairly"s the healthier it is. It doesn't have to be only "fairly" people, but the more there are, the better it is on on everyone who is involved in the pool. Utilization is lower so the price stays down. Does that make sense?
I've written and erased so many times! Am I still jargoning?
Ohio, they changed how much medicare and medicaid will pay, I THINK. They've shifted the burden. I THINK. I could be wrong. But it seems like that is one of the changes that came about. Like not being subject to pre-existing. I could be wrong! So we are paying one way or the other, just paying differently? I'd be interested to know. I'll have to dig.
"When the majority of your a group is fairly young/middle aged, and they are fairly healthy, they are a sound (or healthy) insurance pool. The larger the pool and more concentrated on the "fairly"s the healthier it is. It doesn't have to be only "fairly" people, but the more there are, the better it is on on everyone who is involved in the pool. "
Yes it makes sense Rob but what the heck has that got to do with the ACA?
One thing that kinda ticks me off, here in the Land of the Free and Home of Disgustingly Exploitive Health Care, is how my son, 21 years old and a specimen of perfect health, pays the same exact insurance premium as some 60 yr old duffer of a professor wheezing away on a pipe, leather patches on his elbows since the only exercise he gets is eating, since they're in the same university insurance pool. Talk about exploiting the young.
The school policies have been long been paying for that kind of stuff. Its actually pretty good coverage, a $500 deductible for only $347 a month, just for himself.
Extra goodness? Unless you have similar coverage, they won't admit you to the school.
The difference being the old duffer professor can rather easily afford the $500 deductible, while my son can't.
Point being that there are an awful lot of mandatory health insurance policies out there that don't discriminate against pre-conditions and so on. Why everybody is howling about Obamacare now is purely political.
...... giving birth in the U.S. is more expensive than any other country in the world. Total costs average $18,329 for a vaginal delivery and $27,866 for a C-section, with the bulk of the bill going to insurers. However, families with insurance still have to pay about $3400 out of pocket.
Here is a link that might be useful: link
You already couldn't be denied for pre-existing.
That is not the way insurance worked. My daughter was on my insurance because she was in college. She graduated and went on to advanced degree at 21. When she was to old to be on my insurance she could not get insurance.
She had asthma. There were women denied because they could get pregnant. She had two strikes against her. As a reason to not be accepted for insurance. I am not saying we could not afford insurance I am talking about no insurance co would accept her on any of their policies.
I would like to know who I could blame when I was working and my insurance went up every year when I had company insurance. Did we blame out companies for not giving us insurance that did not go up every year?
I do not remember a year when years, and years of working that my insurance did not go up. Did people use to have cheap insurance with no increases every year or was it just in my city?
There was a time when we didn't have to pay anything except co-pays and deductibles for employer-provided health insurance. Both of us worked for AT&T until the year 2000 - never paid a premium. Got outsourced to another big company and the next year, 2001, that company decided to charge employees a premium after many years of also not charging employees. Oh, how we longed for the days at AT&T! Except two years later, AT&T followed suit. Now single person coverage at AT&T is $96 a month (for management employees).
Every year since 2001 our insurance has gone up a few dollars. The managing company has changed several times: Aetna, United Healthcare, Blue Cross Blue Shield. The prescription drug provider has changed twice: Medco, now Caremark (CVS). Each switch is no doubt an effort to control costs but still it goes up.
All in response to rising costs.
And then there are those who are stuck in the middle and don't qualify for ACA....they are either too poor for ACA or make too much for Medicaid.
What about those millions of people?
Here is a link that might be useful: The Gap
I receive no federal subsidy, this is employer-provided insurance. I don't know what the total out of pocket is.
No doubt your employer is paying part of the cost of your insurance. What they take out of your check is your portion. My husband has done some HR stuff, and a few years ago he said that the company pays an average of $6000 per employee.
And don't forget, that insurance companies must spend at least 80 percent of premiums on actual medical care, not overhead, advertising or profits. If they do take in more in premiums than that, they have to refund policy holders the excess.
From the article linked below:
That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumersâ premium dollars they collect-"85% for large group insurers-"on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
My daughter received a check last year because of this provision.
It's my feeling that part of the cost of premiums going up is because of the uncertainty of a new system. Better to take in too much money and send out refund checks than not take in enough.
Here is a link that might be useful: Forbes article on cap on insurance company profits
" Because the amount of money that that company was paying out to the medical community is going to go way up. TheyâÂÂre going to pay out to the medical community per person than they ever have beforeâ¦"
Except that they won't. All of a sudden the medical "community" is going to be without its long-time colluder. It takes two to tango.
It's my feeling that part of the cost of premiums going up is because of the uncertainty of a new system. Better to take in too much money and send out refund checks than not take in enough.
Plus they get to keep the extra for a year. Collect interest, invest the money and what they return to the company and customers will be nothing and they get to keep the profits from holding the money.
But it is easy to blame Affordable Health Care, not insurance corporate greed that has been in place for years.
The percentage of uninsured young people (ages 19 to 25) fell accordingly, from 48% in 2010 to 21% in 2012. Thats because they were added to their parents Insurance thats ACA
If your making 400% above the poverty limit it will cost yuou little or nothing!
Again most of the people I have talked to who were self employed were paying through the nose for policies with high deductibles thats if these companies would take you at all.
You know rape is a pre existing condition?
You could be sober for 40 years but your alcoholism is a pre existing condition (if you tell them the truth)
I know decent number of free lancers whose premiums like mine will be laf of what they have now.
It's not perfect & won't be till we have a single payer system!
This opposition is total BS!
If your making 400% above the poverty limit it will cost you little or nothing!
I do not believe this is a true statement. As one's income approaches 400% of the poverty limit the percent of your income you are expected to pay for health care increases and the potential subsidy decreases. For someone with an income between 300% and 400% of the poverty level for their size family, they are expected to pay 9.5% of their income before they receive any subsidy.
I also believe that I heard in a class that everyone on not on Medicaid will have to pay a minimum of 3% for healthcare between their share of insurance premiums and copays.
The myth of free medical care lives on.
I don't believe the 400% figure is accurate, either. The medicaid expansion is 133% of poverty level (if the Governor of your state was kind enough to institute the expansion, ie not a Republican).
My understanding is after that you get subsidies to help with premiums, but you will pay something.
However, just because Labrea may have the wrong % doesn't mean he or anyone else thinks medical care will be free.
My answer about health was to Nancy, sorry Chase!
I'm highly disinteresting in asking my HR a quesiton that will soon be asked by millions of people. And answered by more qualified indivdiuals. I'll wait for the answer.
Marquest, how to solve your daughter's type of uninsurance was something that HIPAA and the Clinton administration claimed would be solved. I knew they wouldn't be since it was guaranteed issue for groups. All it did was kick up premiums (which I've explained in detail before. Insurance carriers didn't want to go out of business). But, in Tennessee, when one is a student, they may stay on their parent's plan. When you're hired, you get your own plan and pre-ex doesn't exist. In theory, she could've been ok? Sorry it didn't work for her. It can now. For the record, I don't hate ACA, but I have wondered from day 1 from where the funds would come. It's here.
Yes, being unemployed causes huge problems! Once you're hired, pre-ex is gone when you're on the plan. But if one is out work, why wouldn't Medicaid kick in? Isn't this exactly what it's for?
I am going back on vacation, so don't think I'm ignoring you! Very unplugged. Enjoy your weekend! I may get to check in some today, but really, I'm trying to get off work as early as possible.
I wouldn't. I know my sister wouldn't. I don't think that's a given jill. And if that is the case, they can do what I did, sell it all. Bankrupt and get cash flow. Work multiple jobs. I've done all of these. Whatever it takes. I'm not talking in theories here.
Jill, the 400% of poverty level is accurate. One may qualify for advanced premium credits aka subsidy if one's total household income is between 138% (not 133%) and 400% of the poverty level.
Medicaid expansion was up to 138% of federal poverty level, not 133%.
Thanks, jlhug for the clarification.
So, is it the case that subsidies end at 400%? After that you don't get a subsidy?
If so, I think that's what I was trying to say. Above the 138% you get subsidies. At 400% subsidies end. I didn't know what the cutoff was, but now know it's 400%. Is that correct?
Thanks for educating me!
Rob - you cannot just sell all your assets and then get Medicaid. If you sell your assets, you have cash and therefore cannot qualify for Medicaid. Honestly, for someone that professes to know so much about the insurance industry, I'm surprised you don't know this.
Yep EDD has to have nothing nada squat in order to get medicaid !
But there is that other part of the ACA that everyone neglects.
While public opinion polls have consistently shown a partisan divide in views of the health reform law, the survey finds that young adults who identified themselves as Republicans enrolled in their parents' policies in greater numbers than young adults who identified themselves as Democrats. In March 2013, 63 percent of Republican young adults had enrolled in a parent's policy in the past 12 months, compared with 45 percent of Democrats.
More young people than folks over 75 go to the emergency room in a year
About 15 percent of young adults have a chronic condition and know pretty well that they need health care.
Most young people donâÂÂt qualify for Medicaid right now even if they have very low incomes because most states just donâÂÂt give childless adults Medicaid. ThatâÂÂs one of the biggest changes under Obamacare. If every state expanded Medicaid, about 8 million would qualify for Medicaid. Another 9 million would qualify for subsidies because they make less than 400 percent of poverty.
"Talk about exploiting the young."
I agree with you, David. One of the assumptions about making obamacare "affordable" was the assumption that young, healthy people would sign up for benefits they do not expect to use. Have you seen any data on how that's going? I think the minimum number needs to be around 7 million. I'm not sure young people are going to be as compliant as the government expected them to be.
I think the point, Nik, is that this sort of thing is going on now, in spades, all over the country, where often mandatory, same-premium insurance with large institutions, state schools, etc. leads to young healthy people paying a huge subsidy for old, fat, sick people they work with.
So why isn't aren't the tpers up in arms about this?
Here is a commercial source that might help you do the math for your own family size and income. Seems like there should be a federal website answering basic questions like that. Anyway, I hope this helps. More info at link, including a "poverty calculator."
From the link:
"I read that starting in 2014 tax credits will be available to help make health insurance affordable families with income between 100 and 400 percent of the poverty line. What does this mean?
First of all, the credits will only apply to only to those who are not eligible for other affordable coverage.
The poverty line joins the ranks of poverty level as yet another casual reference to the federal poverty guidelines. To calculate your percentage of poverty, divide your income by the poverty guideline for your household size. Carry the decimal two places in your result; add a percentage sign, and you have your answer. Again, you can click here for the 2013 poverty guidelines.
Income ÷ poverty guideline for household size = percentage of poverty guideline
Example 1 " You are a single individual with an income of $20,000. The 2013 poverty guideline for a one-person household is $11,490.
You are at 174 percent of the federal poverty guidelines. You would qualify for the tax credit.
Example 2 " You are married with 3 kids, and your householdâÂÂs annual income is $150,000. The 2013 poverty guideline for a five-person family or household is $27,570.
You are at 544 percent of the federal poverty guidelines. You would not qualify for the tax credit.
Example 3 " Yours is a 10-person household with an annual income of $75,000. For the 2013 poverty guidelines, you add $4,020 per additional person after the eight-person guideline of $39,630.
Step 1: Determine the federal poverty guideline for your household size.
Step 2: Determine your percentage of poverty.
Your household is at 157 percent of the federal poverty guidelines. You would qualify for the tax credit.
Remember: Tax credit eligibility in 2014 will be determined by 2014 poverty guidelines."
Here is a link that might be useful: source
I believe the 400% cap on subsidies for a married couple is about $92K .
There are some unforeseen (or previously un-realized) factors here.
Some biggies will be playing out in 2014. One is the number of newly-covered, never previously treated, who will be seeking care. There will also be pent-up demand from people who put off spending for care during the recession. Insurance companies are trying to cover all bases.
Today's Chicago Tribune Business page has a story with graph outlining average local costs to large businesses for health care 2008 - 2014 (predicted). There's also a breakdown of premium costs per employee to the employer and to the employee.
This shows a 6.6% predicted cost increase 2013-2014. Cost per employee goes from $10,753 ($2566 employee portion) to $11,466 ($2782 employee portion). Costs are just for premiums. Add in the copays, and you have a nine percent jump in costs to employees, 2012-2013. Total costs to employees are predicted to rise another nine percent next year.
Businesses have been and are continuing to try to shed some of these zooming costs.. Some are dropping benefits that they used to include because they went beyond what the ACA requires. The businesses can't pass along all increases to employees due to the provision of the law that caps the portion of the premium charged to workers at 9.5% of their salaries.
Employers are pushing employees to take more responsibility for their overall health. Some have gone from offering incentives for participation in wellness programs to imposing penalties on workers who won't participate. (Not entirely new; I remember IBM paid for plans to aid smokers and alcoholics.)
The 'bottom line' is what we all knew, all along. Uncontrolled health care costs in the touted 'free market' have the potential to bankrupt all of us. People will pay attention to their own 'bottom lines' now -- and blame the ACA. (That's a good thing if it leads to single payer and reigns in obscene profit in health 'care'.)
Yep EDD has to have nothing nada squat in order to get medicaid !
Exactly. When my dad was very ill and dying back in May of this year, we started the process of applying for Medicaid to cover in-house hospice. We had him moved to temporary in-house hospice which we were allowed to do under Medicare. But, it would only allow him to stay there for 7 days. My brother (a doctor) started the process of applying for Medicaid, but since they had about $7,000 in the bank, he probably would not have qualified (I was told). We had no idea what we would do at the end of the 7 days. Paying for in house hospice was more than we could afford. We couldn't bring him home again. My mom, who is 90 years old, was not capable of taking care of him. He was there for a little over 24 hours when he passed away, so we never had to decide or follow through with Medicaid application.
That $7,000 was the total sum of their money. That was their entire savings. 94 and 90 years old and have $7,000 to their name, and they couldn't qualify for in-house hospice while dying.
Health care in this country sucks.
There are a lot of single, young people who just graduated from high school or college who have no assets, no jobs, and no insurance. The Medicaid expansion will at least give them some cover.
The alternative? Have a baby. The parents and kiddo are then eligible for Medicaid.
Marquest, how to solve your daughter's type of uninsurance was something that HIPAA and the Clinton administration claimed would be solved. I knew they wouldn't be since it was guaranteed issue for groups. All it did was kick up premiums (which I've explained in detail before. Insurance carriers didn't want to go out of business). But, in Tennessee, when one is a student, they may stay on their parent's plan. When you're hired, you get your own plan and pre-ex doesn't exist. In theory, she could've been ok? Sorry it didn't work for her. It can now. For the record, I don't hate ACA, but I have wondered from day 1 from where the funds would come. It's here.
No Rob it did not happen. Because insurance companies had a hold.
To add to the insurance madness. Her first job was with the State Attorney General Office. They like so many other employers do not insure their employees for 6 months. That was their waiting period.
So you have employment and still do not have insurance for another 6 months. It is sad because people say people seem to think losers are lazy people that do not want anything. You have college educated working people in the position of no health care and a heart beat away from having to be on the welfare rolls if they get sick because they do not have health care.
It is like shooting ourselves in the foot as a country because we have to now care for a person because of not having what other countries have that are progressing.
I think of the Health Care Law as the same process of SS. We worked and paid for the old. When we get old the young will pay for us.
The young will also pay for the people that felt they did not have to work and stay home and raise their children. They also did not contribute financially to the system but they still get an SS check.
When you're hired, you get your own plan and pre-ex doesn't exist.
That has not been my experience in California. Pre-ex was excluded from covered treatment for one year after enrollment with new employer's carrier, and then the period was reduced to six months. Maybe a change in CA law reduced the exclusion period.
Again, this was a problem for the unemployed with high COBRA premiums, especially during the Great Recession.
marquest: "The young will also pay for the people that felt they did not have to work and stay home and raise their children. They also did not contribute financially to the system but they still get an SS check."
Only if they qualify for spousal benefits.
"Which Social Security benefits am I eligible to receive?
To be eligible for a Social Security pension benefit, you must be at least 62 years old and have a minimum of 40 Social Security credits. A credit is equal to a designated amount of earnings that increases from year to year based on national earnings averages. For example, employees receive one credit for every $1,160 of earnings on which they paid Social Security taxes in 2013. Because an employee can earn a maximum of four credits per year, you must have worked in a job in which you paid Social Security taxes for at least 10 years or 40 quarters to meet Social Security eligibility requirements.
However, if your spouse is eligible for a Social Security pension, you might be eligible for a spousal benefit. Typically, spousal benefits are equal to 37-50 percent of the spouse?s Social Security benefit and are paid to the dependent spouse while the other spouse is still living. Widow/er benefits are usually equal to 71-100 percent of the spouse's benefit and are paid to the dependent spouse after the other spouse's death. Eligibility is based on age and the number of years married to a qualified spouse. Contact your local Social Security office for complete information on which benefits you are eligible to receive."
Here is a link that might be useful: SS Spousal Benefit
From the OP:
"This isn't Canada or Europe or wherever else"
This was not addressed. What do you mean by this, rob? I think you have perhaps unknowingly identified our actual problem. How do the Europeans manage to cover everyone, at least somewhat, with bankrupting anyone?
Just mull it over. It deserves a lot of attention.
I think of the Health Care Law as the same process of SS. We worked and paid for the old. When we get old the young will pay for us.
We pay for the young, inexperienced drivers who cause a high percentage of the accidents on the road and that price can often be worse than a raised premium.
In that sense we also pay for the drunks and the careless who are calling or texting while driving or are just bad drivers.
Nothing in life or amongst a pool of insured is entirely fair. At the end of the day the important thing is whether or not there is enough insurance reserves to pay claims and, in our capitalist system, to insure a big profit for insurance companies and their shareholders.
Similarly as others have pointed out, property owners pay real estate taxes which benefit younger people, whether students or young teachers or younger couples with children.
Another way to have mandated health insurance for young people (and the rest of us) would have been to tie health insurance in with auto insurance and driving privileges. You get it or you cannot drive a vehicle.
My current self-paid policy (I've *never* had insurance through an employer) covers only hospitalization. It will cover a doctor appt, lab, or ER if such results in a hospitalization. It does not cover any follow-up appts after release from hospitalization.
I've had the policy with the same carrier for over 25 years.
Had the first claim in 2007, which cost me over $4,000 out-of-pocket.
Had another claim in June 2013, which cost me over $4,800 out-of-pocket. Premium at that point was $486/month. The next renewal period (Sept 2013) went up to $692/month. Just me, no kids or wife. $2,500 deductible.
You already couldn't be denied for pre-existing.I checked with three local insurance outfits about a switching carriers/policies. Upon hearing that I had a claim 3 months earlier ... one never called back; one said he doesn't have any enrollments available; the other flat-out said he can't write a policy on me, check back in a year or so.
I've not yet checked what's available under the ACA but I *have* to switch policies since mine doesn't cover the minimum requirements. My income is below the 400%-poverty level for a single person so I assume I'll qualify for some sort of "subsidy" although I'm not clear on exactly how that works.
" Did you really think they would have allowed this if they thought their profits would not increase?"
Didn't "they" just fight a mad campaign in Congress to stop it? They aren't giving up their predatory monopoly easily, but it is being broken. Some high-ups in the industry must be smart enough to realize that.
The insurance companies fought the ACA tooth and nail....just so happened that they don't own as many Democrats as they do Republicans.
Wonder who owns the Dems...someone does.
Dadoes, good luck on your search for affordable health care. Please report back on your experience. Real life stories are a better barometer of the facts than the hype from the right.
Dadoes, it is my understanding that you should receive a subsidy if your income is less than 400% of the poverty level for your size family AND the cost of your health insurance is more than 9.5% of your total household income.
Of course, my understanding may be revised as I learn more about this law.
I think one of the reasons premiums have increased is the uncertainty due to the requirement to cover people with pre-existing conditions. Remember the insurance/fund that was created to cover people with pre-existing conditions between the passing of ACA and 2014? Remember that it ran out of money due to the high costs each insured person incurred? It takes a whole bunch of healthy young people paying premiums to cover the costs of one person on dialysis or with HIV.
DD has gotten hit hard with an increase in health care insurance. She is a healthy 30something single working person. First her contributions to a HSA were halved. Second her portion of her employer provided health care insurance leaped by 18%. Her coverage other than the HSA is about the same for 2014 that it was for 2013. She is in the age and income group that is getting hit very hard with increases in health insurance costs because she is the one who is paying for the coverage for people with pre-existing conditions. Yes, it is great that that people with preexisting conditions can now buy insurance at a reasonable rate, but that doesn't make it easier for DD to pay her mortgage and other bills when her take home income goes down because of an increase in insurance costs.
I saw a figure this morning that about 476,000 people have applied for insurance through the federally run and some of the state run exchanges. But they won't release any figures for people who have actually been able to purchase insurance. They also won't say which state run exchanges are included. Yeah for transparency!
I suspect the real reason for not releasing the data is that they are unsure of it's validity.
With the PR mess they have on their hands right now it would be foolish to release numbers and then have to go back and correct them.
These systems are huge. It will take at least a month to settle it all down, that's the way it is with huge roll-outs like this. A staggered implementation may have been a better choice but I know for sure they would have looked at that. They likely could not do it legally....but the reason is a guess on my part.
Chase, the systems are huge but many programmers have commented on how poorly they are set up. The information presented if you are able to create an account (why do you have to create an account if you just want to window shop?) is barebones at best. Much of the information necessary to make an informed decision just isn't there.
I've been the "victim" of new online registration programs from the IRS. So I know firsthand how it takes time for the bugs to get worked out.
I agree that a phased in roll out would have been better, but probably would have been illegal.
Does anyone know of someone who has actually purchased a policy? I think David may have gotten through the system but hasn't actually been enrolled as of his last post on the subject.
" many programmers have commented on how poorly they are set up"
Jhug, large system design, integration and implementation was my career for many years.
Unless these "programmers" worked on these systems, and I absolutely guarantee you they did not, they are offering uniformed opinions.
"Does anyone know of someone who has actually purchased a policy"
My niece and her husband both have purchased insurance. They had difficulty logining on but found the help line excellent and the system, once they got in, easy to use.
All that aside their insurance premiums have been significantly reduced for similar coverage. I'm not sure what the differences are but they are happy with the price.
Mind you my niece, a Canadian, is less than impressed with the whole health insurance situation in the States.
Chase, you didn't happen to work for CGI, did you?
Here's one of the articles I found about the problems with the system.
Here is a link that might be useful: IT experts question the architecture
This post was edited by jlhug on Sun, Oct 20, 13 at 10:58
I don't know who managed the implementation of this code for them, but I wish some company like IBM would stand up and say - "let us help you fix this". IBM Global Services (not the equipment side but the consulting arm) has the resources and the expertise to dig in and get some problems solved.
No I didn't but I do know them very well and have done business with their Canadian Telecom group. My career was on the business side of system implementation and design. Defining the business requirements, designing the user interface, testing, implementation and roll out. In this case I would be on the 'Government side " of the project.
CGI Federal used to be AMS , an American SI that was purchased by CGI a few years back. CGI Federal aka AMS has done business with the Federal government for over 30 years. If I recall there was some sort of structural separation from CGI Canada required at the time of purchase in order to allow AMS /CGI to continue receiving federal contracts.
Don't get we wrong I am not saying the design was good, I haven't a clue, I'm saying that troubles with implementing systems this large, especially when the government is the one defining the business requirements, is a complicated bit of business. Much of the system design flows from the business requirements and the governments are notorious for changing the rules right up until implementation...may have done some of that myself if the truth be told!
I can't argue any facts, because I don't know them, I find the comments in that article suspect.
Unless you had privy to the business requirements and the system design you can't comment with any degree of certainty. You notice they use words like "I suspect" and "possibly".
Here is some info on AMS and the subsequent purchase by CGI.
The structural separation I was thinking of was not between CGI and CGI federal but rather between the side of AMS that did systems development work for the Department of Defense vs the rest of the government.
These guys have been doing federal government work for many , many years....my bet is the relationship between the business developers and the system developers is too cozy.
Here is what I posted earlier:
Waiting for open enrollment to see what next year's premium is, but for 2012 it was $204 per month for me and 2 child dependents (spouse has own plan). In 2013 it is $232 per month for same coverage, a 14% increase.
For 2014 it will be $240 per month with increased benefits such as the elimination of any lifetime caps and other wellness improvements. A smaller increase than 2012-2013.
Yes, but what did they do extra for your spouse? Because, here, they made you waive them at least three times if they could apply for coverage under their employer's insurance. They're trying to get everyone situated where they belong. Not a bad thing, just procedural.
Increased benefits beyond elmination of the lifetime cap? What benefits are they? Mandatory Short Term Disability was one we had added, but they just took it away in sick/vacation/personal time here. Six of one, half dozen of another isn't better to me.
Are your changes truly an improvement?
I cannot agree that trading one benefit for an equal one is an improvement. Making sure your spouse gets on their employer's plan (if they can) isn't better. Making sure you are covered with some base sickness payments isn't better. Are you just trading one thing for another? Different isn't better when you end up with the same thing. I admit the cap loss is a good thing, but the rest seems like nothing noteable.
And, more importantly, there will be states where it is lower in cost, so far New York and California because they have crappy legislation states, and there will be some that stay consistent. Yours may be a consistent state. This is an equalization time. Let's wait until all of the numbers are out and there is an overall trend going on, before noting all the NY/CA anecdotal cases as being the "standard" for the nation. Two states a nation does not make.
Yes, but what did they do extra for your spouse?
I said before that my spouse is covered elsewhere, with another employer. I didn't have to do anything about that this year.
Removing the lifetime cap is a huge improvement for those that may need it - and we never know if we are one of the ones that will need it should something catastrophic strike. That's the whole point of most insurance - just in case.
My only point today was to come back and report 2014 cost changes since I didn't know them at the time of the original post.
I am glad you updated us. I'll be glad when everyone does. Why say I received "other wellness improvements" when you specifically listed the one benefit out? Being vague has me believing you don't know or you won't say? I'm glad you had a typical increase! That's good. I'll be glad when most everyone has typical increases or reductions.
I do remember those saying, why would you get increased premiums (I can name names, but why?), but let's see the reality. Still waiting.
You're right, I just listed the one thing. My intention was to refer to the general list of improvements that the ACA has caused all insurance to include and which are now reflected in my plan:
No annual or lifetime limits on healthcare.
Insurance companies can't drop you when you are sick or for making a mistake on your application.
You can't be denied coverage for pre-existing conditions.
Young Adults can stay on their parent's plan until 26. (I have two children between the ages of 19-22 so that is a real benefit to us/them.)
A large improvement to women's health services. (We have two females in the family including one that is eligible for free birth control prescriptions).
New preventative Services at no-out-of pocket costs.
So those things and more are now part of my plan. Some of the things required (e.g., Essential health benefits like emergency care, hospitalization, prescription drugs, and maternity and newborn care must be included on all non-grandfathered plans at no out-of-pocket limit) were already a part of my plan.
Here is a link that might be useful: source
DD, a single woman, has health insurance through her employer. Her share of the cost went up 50% with no additional coverage or benefits. Her employer pays 50% of the cost of her health insurance, so his costs went up as well. Her co-pays went up $5 a visit. The letter from the insurance company did specifically refer to ACA as the reason for the majority of the increase in premiums.
rob, maybe but I do not doubt for a minute that insurance companies have legal departments that know how to guard against libel while still guarding the interests of the insurance companies--which is not whether their clients live or die but whether the bottom line remains in the black.
Who would think that increased benefits would increase the premium? Surely you're smart enough to figure that out. Unfortunately,someone in Washington wasn't smart enough to realize it would happen, OR, was smart enough and has done what he promised the insurance companies. More business, more profits.
DD is one of the young healthy adults whose premiums have increased to cover the unhealthy who can no longer be charged a more in premiums because their medical expenses are higher and for the elderly whose premiums can not be more that three times her premiums. She makes too much for a subsidy. Someone has to pick up those costs and she just happens to be in that demographic.
Here's a link to a discussion of why her insurance went up so much.
Here is a link that might be useful: Obamacare costs young people more
This post was edited by jlhug on Fri, Nov 22, 13 at 19:49
Would someone please tell me just how "risk specific" the plans should be (I'm "talking" to those of you who are appalled that the young and healthy will have to subsidize the old and sick).
Maybe a separate risk category for twenty to forty year old males?
Another risk category for twenty to forty year old females? ("at risk" for pregnancy, afterall)
How about a risk category of fifty somethings who are healthy?
And another risk category for fifty somethings who have major illnesses or are at risk of a major illness - cancer, multiple sclerosis, heart trouble, etc.
Now, tell me what you think the premium is going to be for someone who presently has cancer? (If your guess is under triple digits, you're too low.)
And if you can't afford your healthcare insurance when you actually need it, WHAT IS THE POINT OF PAYING FOR IT WHEN YOU DON'T NEED IT?
That's really the bottom line. You pay now so you can access it later. This is how it works in large corporations where the younger employees subsidize the healthcare of the older employees. And it is how the ACA is going to have to work.
Otherwise, what is the point?
I ran across this article this morning, a fairly candid - and far from flattering - assessment of trying to get insurance for employees if you're a small business.
I thought it was interesting - in some cases, its better to drop insurance because your workers are better off if they buy on the exchanges, in other cases, no.
The guy can see the light at the end tunnel, but says its likely better to wait a year.
Here is a link that might be useful: link
Well-stated. The whole idea that I shouldn't have to pay for anything I don't want is ridiculous in a democratic society, particularly with health care. I've been fortunate to have had access to health insurance my whole working life and now in retirement. When I was young, my premiums were huge in comparison to what I needed out of the health care system, but I didn't resent it, or decide that I should put off getting coverage until I was middle-aged so I wouldn't have to subsidize those old folks. I realized that one day I might be putting more demands on the system and it would all work out. Even today I'm still pretty healthy and really haven't gotten my money's worth out of the system by having some expensive, serious condition. But I guess that's ok!
For those who think that we should be able to pick and choose exactly what we want from our government programs, and not pay a cent for things we don't want for ourselves or others, I say fine. I'll start the list. Let's stop the following so I can pay lower taxes: optional foreign wars, the war on drugs, subsidies for the oil industry and corporate farming, tax breaks for banks and hedge fund managers, caps on Social Security at higher income levels, tax breaks for U.S companies that send jobs overseas and use accounting sleight-of-hand to vastly reduce their taxes, etc.
In the future, the Social Security system will in time run out of money. In order to keep it going, more money needs to come into the system, either through raising the percentage of SocSec taxes taken out of wages -- which has been done many times -- or by raising/eliminating the caps on the amount of income subject to SocSec taxes, or both. It wouldn't be an immediate effect, but it would keep my taxes lower than they would be because high wage earners would be putting more in to the SocSec fund.
However, my list wasn't intended to be a comprehensive plan to lower my taxes, nor was it meant to be serious. My point was that people's complaints about having to contribute to a health system that may provide benefits they don't need (or need right now): 1) pales in comparison to all the things that are out of whack in our economy and tax system, and 2) ignores all the things we already accept when we live in this society and pay our taxes.
If we started a thread with lists of all the things people don't want to pay for, or want others to pay for, it would be quite interesting. I'm sure some people would include: welfare, unemployment insurance, food stamps, childhood nutrition, Medicare, Medicaid, and Social Security, to name a few. But the point is, we can't be selective about what we individually are allowed to support, and using this tactic to pick at the ACA is just so much whining as far as I'm concerned. It's sophistry that avoids acknowledging what is practical and how a democratic society functions.
This seems like the best place to report the changes in our employer-based insurance. My employer offers 4 different plans (same carriers, plans, and conditions as this past year). After signing up for benefits renewal:
* PPO and EPO health insurance premiums increased by 40%.
* "Self-directed" plans (with high co-pays and higher deductibles) increased 20%.
The benefits analysts says that roughly half of the increase was due to medical inflation, and half of the increase was due to ACA requirements.
For those of you that got better deals, how do feel about the fact that there are others who worked and planned to provide health insurance for themselves and their families, they liked it and were told they could keep it and it turns out Obama lied and they could not. These people are now faced with paying hundreds and hundreds of dollars more per month which they literally cannot afford--so that you now have insurance?
What do you think is going to happen to the economy when these people can't buy new clothes, can't buy the groceries they were accustomed to buying, can't go on trips because they can't afford the fuel, can't go out to eat, can't save?
We have many more adversely affected than those that benefit it seems to me.
It's be easier for individuals to just suck it up and adopt the people that didn't have health care than initiate this disaster.
Of course I would not be happy that anyone's premium or costs increased even one cent. However, I do see the change as a process towards a better future in terms of healthcare.
Think back to when Social Security was implemented - people had monies withheld from their check, less in their pocket. All with the promise that it would be better for them in the future. Now millions of people could not do without the Social Security payments they receive in retirement and in disability. Same with Medicare taxes and benefits.
Prior to 2001 my employer paid 100% of my healthcare premium; in 2001 we were asked to start paying (I think it was like $91 then, but it could have been less; I remember being shocked as I had changed employers in 2000 and felt like I had made a mistake but up til then my new employer had not required employees to pay anything). In 2002 my spouse's employer also changed from 0% contribution to being asked to pay part of it.
Both are very large companies. Increases have been going on for some time.
There are at least two ways to feel sorry for these people (figures seem to indicate it's 0.6% of the population, present junk policy holders). Feel sorry for those who have to pay more for good coverage, or feel sorry for those who's junk plans get canceled or denied coverage when they need it for serious illnesses. Which do you feel sorry for the most?
The ones I feel sorry for the most are the marginal folks who live in red states that are being royally screwed for purely political reasons.
No. We shifted the sky rocketing costs to the working Middle America, asked to foot the bill, yet again. Finally, you're seeing me being fully my fiscally conservative self. Which is what I've been saying all along. I kept asking where were they going to get this funding from? No one could answer. The reality is, healthcare is sky rocketing because of an large aging population. The reality. So there you have it. It's not Obamacare by itself. Obamacare just pulled the rug out on Medicaid/Medicare relief to the healthcare system and pretended like the new plans would fill the gap. WRONG!
So I'll ask it again, why are premiums tied to employment? If they're tied to employment and nothing else, how exactly will everyone get coverage?
Now that so few have applied for the government plans, who will fill the gap?!!!!
Middle America. The group already crunched in the inflation ridden, stagnant wage earning status that we're stuck in. It's only going to get worse. Unless something changes. What is that change to be? Taxes. There. I said it. They'll call it a fee, or something else, but taxes. And it'll be another Middle American suck it up time.
Added this, or they can require proof from every person that they have coverage. I'd settle for that. Everyone should have to help. Since the new coverage is within reach to everyone. Supposedly.
This post was edited by rob333 on Tue, Nov 26, 13 at 11:48
Actually, y'all are missing the bigger picture. brush is shoving the burden onto you and me. It's not about getting around or sticking it to the government, it's just plain short changing us.
I find that more offensive.
Everyone should have to have some sort of plan. Bare bones or full cover-everything-all-the-time (and you pay for whichever you pick), something! If it's just middle Americans and sick Americans who are paying/using it, we're all going down. All Americans.
Costs MUST be offset somehow. If you have a better plan how that pool of funds can get higher in a fair way, let's hear it.
Posted by kudzu9 Zone 8b (My Page) on
Tue, Nov 26, 13 at 15:29
I'm fine with the government staying out of your health as long as you promise that you won't avail yourself of any form of program such as Medicare and Social Security.
That's fine by me, as long as I get back what was contributed.
You willing to do that?
I'm happy to participate in the society I live in, and I support our social systems. I have never begrudged paying in to Social Security or paying for decent health care. So I would have no interest in seeking a refund of what I've contributed, if that were possible. I believe that a strong social support network is essential to a country that considers itself to be First World, and wish we had more if it...like moving further to single payer health insurance
Getting all your money back and opting out fully from our social systems seems appealing...until you need those services. It's like people who refuse to wear seat belts because it impinges on their freedom...and then go through the windshield. If they live after their expensive trip to the emergency room and followup treatment -- and without decent medical insurance -- they end up bankrupt and a burden to themselves and everyone else due to their need for lifetime care and support funded by other taxpayers. I don't want those people cut loose, but if the fantasy of rugged individualism were a little less rampant in this country, we would all be better off financially.
Even if I became bankrupt--which is highly unlikely, I would not expect my fellow citizens to pay for my health care or for my living expenses in old age.
We should be disciplined enough to live within our means and save for our own retirements and not expect others to supplement us.
I agree with you about being disciplined and prudent and being responsible for one's own well-being. I have similar expectations for myself.
On the other hand, while I don't expect my house to burn down, it's a possibility, and, since the community won't build a new one for me if it does, I choose to have homeowners insurance. I haven't filed a claim in 40 years, so I haven't gotten anything back, but I do it because I appreciate the ability to participate in a risk pool for a reasonable amount of money. I've paid tens of thousands of dollars for this insurance over the years. Likewise, I've put untold amounts into health insurance premiums and needed far less back (thankfully) than I've put in.
I've been lucky, and maybe you have, too. But not everyone is as responsible or fortunate or lucky as we, perhaps, are. Your philosophy is fine for you, but it wouldn't work for a lot of people in this country. I don't want to start a debate about why that is, but the reality is that too many people have been shut out from decent health care and seek help only when their condition is grave and expensive. Others think they are invulnerable or don't want to (or can't) pay for decent health care until they find themselves in desperate circumstances. Whether through irresponsibility or shortsightedness, they become a contributing factor in out-of-control health care costs.
In my opinion, unless society can agree on a social contract that everyone contributes to so that everyone deserves support, we are dooming ourselves to a highly dysfunctional result. I would argue that -- totally apart from any humanitarian or fairness issues -- the economic damage of this situation is enough to cause us to work together to resolve it. That's why I support the Affordable Care Act...as imperfect as it is.
This post was edited by kudzu9 on Tue, Nov 26, 13 at 17:13
Good post, Kudzu.
I do not agree with you about supporting the ACA because I believe it will be the ruin of this country and our way of life.
However I do want everyone to have reasonably priced health care, supplementing those that are truly physically and mentally disabled where they literally cannot work at all.
"Lionheart, would you be willing to share exact amounts - the monthly premium for 2013 vs. the premium for 2014 on the PPO?"
For 2013, the employee contribution for the family plan was $351.08 per month. For individual coverage it was $120.20 per month.
For 2014, the employee cost for family coverage is $490.94 per month. For individual coverage it is now $168.06 per month.
This represents 30% of the premium cost. Employer pays the other 70%.
"Lion, they need to make sure you know how to compute a 40% increase. *wink"
"Thanks. And no that wasn't the reason I wanted to know."
You're welcome. I know that it wasn't the reason you wanted to know. It's an honest question. People like to have information to compare (I know I do).
If I say something increases by 40%, it doesn't have much meaning unless you know the numbers. It's the actual numbers that give impact.
For example, if something costs $10 and increases by 40% to $14, it's not a big deal because very few people are going to be impoverished by a $4 difference (even though it's a significant percentage increase).
If something starts at hundreds or thousands of dollars and increases by 40%, people are going to really feel the effect. Hit folks in the wallet and it becomes personal. No one is very happy about this situation.
Btw, you asked that question just in time, because the enrollment period was ending yesterday and I didn't think that info would be available on our website any longer. So I snuck in last night and saved the numbers. :-)
Brush was being humorous (hence the wink at the end) and I acknowledged the humor and chuckled at it. That doesn't mean that I think you had ulterior motives in asking. I generally don't mind answering questions, unless it gives away too much personal information or can get me in trouble. :-)
"Posted by demifloyd 8 (My Page) on Tue, Nov 26, 13 at 14:48
How bout the government stay out of my business and my health."
Except when it comes to YOUR Social Security and Medicare, right, Demi? You have already made it quite clear that those are 2 entitlements that you'll be happy the government provide. I suggest that there is some real inconsistency in your arguments, particularly as it applies to ruin.
Our deductibles are going from $0 to $500 each next yr so this will become new cash out of pocket. Our premiums are also going up by about 25%....in the range of numbers lion mentioned.
Posted by jmc01 (My Page) on
Wed, Nov 27, 13 at 9:09
"Posted by demifloyd 8 (My Page) on Tue, Nov 26, 13 at 14:48
How bout the government stay out of my business and my health."
Except when it comes to YOUR Social Security and Medicare, right, Demi? You have already made it quite clear that those are 2 entitlements that you'll be happy the government provide. I suggest that there is some real inconsistency in your arguments, particularly as it applies to ruin.
Our deductibles are going from $0 to $500 each next yr so this will become new cash out of pocket. Our premiums are also going up by about 25%....in the range of numbers lion mentioned.
Ummm, I don't think I've ever discussed that topic, specifically, as it relates to myself being "happy" to take two entitlements, MUCH LESS being "quite clear" about it.
I know that I have said on several occasions that I would be content to just take back what was paid in and be left alone, which I said again on this thread.
If you will be so kind as to post where I said that to refresh my
memory and back up your claims it would be appreciated.
Your sarcasm was noted, and I don't know why.
I have no idea what you are talking about inconsistency as to "ruin."
You can explain yourself on that too.
Sorry I have to call boo frickety hoo from going from a $0 to $500 deductible.
Mine is $5,500 and has been for 10 years.


text:
People like Longden who admit to hearing inner voices can generally expect two outcomes: a diagnosis of insanity, and potent medication. But a group of psychiatrists and psychologists believe it's time we reconsidered labels such as schizophrenia and the drugs used as treatment. In fact, they believe we should get people to listen to, and actually engage with, the voices inside their heads.
Longden believes her biggest mistake was in telling a friend she was at university with about her experiences. "I explained that the voices were actually quite positive, but she was horrified and insisted I see a psychiatrist, who ignored my unhappiness and homed in on the voice, assuming it meant I had no sense of normality. For example, I was quite involved with the university television station, and the psychiatrist stated in her notes that I had delusions of being a broadcaster. The second time I saw her, she suggested that I admit myself to hospital for three days for tests."
Three days turned into three months, during which time Longden was told that if she left, she'd be sectioned and forced back. The drugs she was coerced into taking did little except cause weight gain, and the terrifying label of schizophrenia she was given was, Longden believes, directly responsible for the arrival of 12 very hostile inner voices.
Like most multiple-voice hearers, Longden says one voice was dominant. "He was demonic, and had a visual manifestation of a huge grotesque figure swathed in black. His threats were graphic and violent. The other voices, which were less clear, would back him up."
Dr Rufus May, a clinical psychologist, says the aim of getting people to connect with their voices is to enable them to incorporate them into their daily lives so they are not distressing. "Voices themselves are not a problem; it's people's relationship with them that's important. So, rather than voices being something that we should avoid at all costs - the traditional psychiatric view - we should be trying to get people to face them, understand them and work with them."
As if this wasn't enough, back at university Longden found herself the victim of a bullying campaign. "People had heard about where I'd been and within a week, my door in the halls of residence had been defaced, and I was spat at. I started to self-harm. The worst instance was in the student bar when a group of people asked me to stub a cigarette out on my forearm. When I did it, they cheered."
Longden became suicidal and was sectioned. After seven weeks back in hospital, she went to stay with her parents in Bradford, where she continued to self-harm and her voices were louder than ever. Her psychiatrist told her it would almost have been better if she'd had cancer because it would be easier to cure.
Finally, the breakthrough came. "Everyone had treated me with this total lack of hope, and as completely passive. But then I was put in touch with a psychiatrist who asked me what I thought would help me. When I said I felt I could deal with the voices better when my mind was clear, he supported me to reduce the medication. Better still, he suggested that I engage with the voices because they probably had a symbolic meaning that might help me recover."
Longden began to recognise her voices as a representation of unconscious feelings of self-loathing. This helped her to fear them less. "If they were metaphorical, it stood to reason they couldn't have any control in the external world," she says.
The psychiatrist encouraged her to talk back to them. "I began to question them, and their replies gave me great insight into my subconscious feelings - enormously helpful in my therapy - and then I started negotiating with them. Sometimes I'd say to the dominant one, 'I'll only talk to you after EastEnders,' and he'd agree!"
Three years on, Longden is off medication. She says she's happy, and is studying for a doctorate in clinical psychology. Although her voices sometimes return, she feels in complete control of them. "I see them as useful - almost like a stress barometer. My mum's clue to feeling stressed is a migraine; mine is the voices."
Dr Rufus May, a clinical psychologist, says the aim of getting people to connect with their voices is to enable them to incorporate them into their daily lives so they are not distressing. "Voices themselves are not a problem; it's people's relationship with them that's important. So, rather than voices being something that we should avoid at all costs - the traditional psychiatric view - we should be trying to get people to face them, understand them and work with them."
May says negative voices can be turned into a positive experience. "If a voice is telling someone to kill themselves, that could be signifying rage. So the voice-hearer could say, 'Thanks for flagging this up. I'm not going to take you literally, but you've shown me there are things I need to change about me.'"
He even talks to his patients' voices himself. "I ask the person to tell me verbatim what each voice is saying. I'll ask questions such as, 'How long have you been in Mary's life?" and 'Why did you come along?' Sometimes, they'll tell me something about the person they themselves are unaware of. After all, we're dealing with the subconscious here."
May recalls one man, Edward, whose voice told him to build a time machine. "I asked this voice - via Edward - why. It transpired that Edward felt responsible for his brother's death and wanted to go back and change it. We were able to address that and Edward began to realise he wasn't responsible."
Such responses may even be life-saving opportunities. May cites the case of John Barrett who, having walked out of a secure hospital unit, stabbed a retired banker in 2004 after hearing voices in his head. "It seems to me that people didn't work meaningfully with his voices. He'd had a violent childhood, so his voice could have represented his father."
May is now involved in training mental health professionals in helping people who hear voices. "Conventional training goes deep, but it helps that I have a high profile," he says. In fact, he doesn't advocate that all voice-hearers take this route. "But if you catch people early, or other approaches haven't worked, it can work very well."
Some professionals - such as Richard Bentall, professor of experimental clinical psychology at Manchester University - go further, stating that medications should be avoided wherever possible. "They have high costs in terms of side-effects, some life-threatening. Antipsychotic drugs, in particular, can produce stiffness, tremors, involuntary movements, massive weight gain and increased risk of heart attacks and diabetes," he says.
What's more, research estimates that about half of patients given drugs don't get an adequate therapeutic response. "Add to this the fact that they are given a label like schizophrenia - which has no scientific meaning, and is deeply stigmatising - and it's little wonder that voice-hearers are given such little hope. The bottom line is that we need to stop trying to cure people, and liberate them instead."
Professor Marius Romme, a psychiatrist, adds that many inner voices can be unthreatening and even positive. "They may try to comfort, congratulate, guide or reassure. It's wrong to turn this into a shameful problem that people either feel they have to deny or to take medication to suppress."
Romme's work was instrumental in the formation of the Hearing Voices Network, an education and self-help registered charity for voice-hearers. Jacqui Dillon, who chairs the network, says:"We call inner voices - or indeed visions - messengers, because they give strong signals into people's mindsets."
The network has a growing professional following, Dillon says. "We get a lot of referrals from psychiatrists nowadays, although there's still a long way to go."
Talking headsStudies have found that between four and 10 per cent of Britons hear voices. Between 70 and 90 cent of people who hear voices do so following traumatic events. Voices can be male, female, without gender, child, adult, human or non-human. People may hear one voice or many. Some people report hearing hundreds, although in almost all reported cases, one dominates above the others. Voices can be experienced in the head, in the ears, outside the head, in some other part of the body, or in the environment. Voices often reflect important aspects of the hearer's emotional state - emotions that are often unexpressed by the hearer. The "hearing voices movement" has spread across the world. There are groups in countries as far afield as Australia, Finland, Japan and Palestine. Well-known voice hearers include Plato, Sigmund Freud, Beethoven, Byron, Charles Dickens, Virginia Woolf, Sylvia Plath, Isaac Newton and Winston Churchill.
Source: How I Tamed the Voices in my Head
See also: Redefining Hearing Voices
Schizophrenia, Psychosis, Recovery, The Recovery Based Model, Hope for Schizophrenia Sufferers, Voice Hearers Network

subset: commoncrawl


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Copenhagen Business School
About the Program
The Copenhagen Business School is Denmark's most internationally oriented institution of higher education, as well as the one university in Denmark offering the most comprehensive range of university level degrees in business, economics and modern languages. It is a richly stimulating international and multicultural environment in which to work and study. Students enroll directly into University courses alongside other Danish students.
Map It!
Course Information
Location |
Copenhagen, Denmark |
Language of Instruction |
English |
Language Proficiency |
Program Type |
Exchange; students select courses offered by partner institution |
Program Dates |
Fall, Spring, Academic Year |
Living Arrangements |
Independent Arrangement |
3.0 |
Other Requirements |
Advisor will provide information to qualified students re: applying directly to the partner university |
Application Deadline |
Deadline extended to March 10th for fall/academic year admission; October 1 spring admission |
Program Cost
Application Fee |
$60 |
Tuition Rate |
$3,085 per semester for NY residents ;$9,795 per semester for non-residents |
Program Fee |
$750 per semester |
Administrative Fee |
$200 (non-refundable) |
International Health Insurance |
$55 per month approximately |
Other Fees |
$10,000-$12,000 (approximately; Students pay room, board, books, transportation and other university fees directly to overseas university) |
Travel Costs |
$1,100-$1,500 (approximately; Students are responsible for their travel arrangements including airfare, visa costs) |
More Information
Grades earned in an exchange program WILL NOT calculate towards the cumulative GPA for SBU students.
Non-SBU students must contact their home university regarding their grade and credit transfer policy.
Links and Resources
View WebsiteView Course InformationView Academic CalendarView Accommodation InformationApply NowContact Information
Stony Brook University
Stony Brook, N.Y.


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Episode #25 – California Zinfandel: Where is it now?
April 4, 2006
Watch as Gary Vaynerchuk explores the ever changing world of California Zinfandel. Zinfandel has gone through it's ups and it's downs and this is a nice update of where it is! Gary tastes the R&B Cellars Zinfandel 2003, Brown Estate Chiles Valley Zinfandel 2003 and the Frogs Leap Zinfandel 2003.


text: I really like the subtle yet deep apple scent of this soap. It's very moisturizing and suds up nicely. My only FYI is that this is a normal sized bar soap, not like the usual oversized ones that 100 Percent Pure sells (or used to sell?). Highly recommend if you like their products and are willing to spend the money! Non irritating for my sensitive skin. :)


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Great sex does more than blow your mind—it's good for your heart, your head and your beauty.
You probably spent your early adult years leaving a trail of blotting papers and religiously buying "oil-free" products. But just as you now embrace "good" fats over fat-free foods, there may be a good case for considering oils in your beauty regimen.
Not all oils are created equal
Most notably, oils can be effective moisturizers. Plant oils, which have a presence in many beauty products, are primarily composed of glycerol and fatty acids. Each oil has a different number of carbons in its fatty acid structure, and the number affects how the oil gets absorbed by and stays on the skin or hair. For example, olive and jojoba oils work well on the skin because they have long chain molecules that stay close to the skin's surface. According to Perry Romanowski, a cosmetic chemist in Chicago, longer chain molecules moisturize the skin better than shorter chain materials that get absorbed into the lower levels of the skin. For the hair, coconut oil offers the best of absorption and hydration; it's primarily made up of 12-carbon fatty acids that penetrate the cuticle and give hair strength, too.
MORE: Which Cooking Oil is Healthiest?
Furthermore, oils offer side benefits, especially for the skin. "Many oils are rich in antioxidants, vitamins and essential fatty acids (EFAs), which can benefit all skin types," says Jennifer Linder, M.D., assistant clinical professor of dermatology at University of California San Francisco. For example, kukui nut oil naturally contains vitamins A, C and E, powerful antioxidants that have anti-aging effects on the skin. In another example, rose hip seed oils contain EFAs that are necessary for healthy skin but must be supplemented because they're not produced by the body.
In effect, oils may not replace your heavy-duty winter balm or a face treatment, but they can play a crucial role in hydrating and delivering nutrients when you want something light but potent.
However, note that just because an oil is billed as "natural" or "plant-based," it doesn't mean that it's not pore-clogging. "Oils are greasy by nature regardless of origin," explains Ni'Kita Wilson, YouBeauty Cosmetic Chemistry Expert. "Some natural oils can be lighter, like jojoba, palm or coconut oil, or very heavy, like wheat germ or castor oil."
How to use a multi-purpose oil
Similar to salves or balms, you can use oils anywhere you need moisturization. Unlike products that are only for the face or hands or feet, these oils don't have boundaries—and they can even work on hair. Just make sure to follow the instructions and not use too much (a little goes a long way).
Depending on your needs, you may want a product that is primarily for the face or body but can be used on the hair, or vice versa. According to Mona Gohara, M.D., assistant clinical professor of dermatology at Yale University, because the needs of the skin on the face are more specific than the body or hair, it's best to start off a light product for those areas that need gentle hydration and see if you need something stronger for another part of your body or hair.
MORE: Get Your Healthiest Hair With Three Natural Oils
Are multi-purpose oils right for you?
Multi-purpose oils are typically marketed for all types of skin or hair, but they may not be for everyone. If you have acne or eczema, consult your dermatologist before using them. "Oils may contain elements that are good for acneic skin, but I don't think they have to be delivered through an oil. The whole goal of acne is to equilibriate oil production, so adding oils doesn't make sense," says Gohara.
For those with sensitive skin, perform a test before you begin using a product, especially if the product contains essential oils, fragrances, or questionable ingredients, particularly if it's made for the hair. "Many ingredients may translate for skin use, but a hair product will typically have other ingredients that would not be appropriate for daily use on the skin," says Linder.
How to strike oil:
Some new multi-purpose oils promise hydration and benefits from head to toe.
Great sex does more than blow your mind—it's good for your heart, your head and your beauty.
Highlight your eye color. Flaunt your body shape. Harness your confidence. Take our quizzes to better know yourself and get science-based, individualized advice to embrace your true beauty.
Great sex does more than blow your mind—it's good for your heart, your head and your beauty.
Take QuizGood sleepers are beautiful, happier and enjoy better sex. Learn how to be better rested.
Take QuizLearn why your hair does what it does, and get styling and product tips to make it do what you want.
Take QuizIf shopping for eye makeup is one big guessing game, find your best colors here.
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200 Economists Against Stimulus
While the media and the new administration would like to have us believe there is no dissagreement among economists that President Obama's massive stimulus plan is absolutely necessary, here are 200 leading economists, which include Nobel laureates and other very respectable scholars from across the country, who beg to differ.
The Cato Institute is running a full page ad in the Washington Post, New York Times and Roll Call this week with a letter showing that whoever says, "all economists agree on stimulus" is wrong.
The letter, which is signed by 200 economists, reads:
Notwithstanding reports that all economists are now Keynesians and that we all support a big increase in the burden of government, we the undersigned do not believe that more government spending is a way to improve economic performance.More government spending by Hoover and Roosevelt did not pull the United States economy out of the Great Depression in the 1930s. More government spending did not solve Japan's "lost decade" in the 1990s. As such, it is a triumph of hope over experience to believe that more government spending will help the U.S. today. To improve the economy, policymakers should focus on reforms that remove impediments to work, saving, investment and production. Lower tax rates and a reduction in the burden of government are the best ways of using fiscal policy to boost growth.
Full disclosure: Chris Moody is the Manager of New Media at the Cato Institute.
so tell me, how many economists here are actually respected members of their field?
Also, just who are these nobelprizewinning economists? Pity my poor eyes and explain them to me.
New quote from Dr. Doom!
All this fiscal stimulus is necessary, cause the alternative is a depression.
Roubini, Jan 27, 2009
Conjure's global depression clock is at 12:59:59.5.
It's good to see spirited debate, and by no means do I say that the stimulus will categorically fix anything. But as my economist friend puts it, "all I hope is that Obama won't do anything to hurt us" ... and that means putting in a stimulus that will make lasting contributions to our infrastructure, and enable joe-public to sell electricity back to the grid, among other things!
Reagan's economic advisor
Martin Feldstein, chairman of President Ronald Reagan's Council of Economic Advisors and president of the National Bureau for Economic Research.
Governments around the world are now developing massive fiscal stimulus packages that will cause unprecedented peacetime budget deficits. The fiscal deficit in the United States this year is likely to exceed 10% of GDP. A substantial part of the increased deficit will be due to a wide range of new government spending.
Under normal circumstances, I would oppose this rise in the budget deficit and the higher level of government spending. When an economy is closer to full employment, government borrowing to finance budget deficits can crowd out private investment that would raise productivity and the standard of living. Budget deficits automatically increase government debt, requiring higher future taxes to pay the interest on that debt. The resulting higher tax rates distort economic incentives and thus weaken future economic performance.
Of course, some government spending is desirable or necessary. But an increase in government outlays often means wasteful spending that produces less value than consumers would get from those same dollars.
Now, however, increased government spending and the resulting rise in the fiscal deficit are being justified as necessary to deal with the economic downturn — a sharp change from the reliance on monetary policy that was used to deal with previous recessions. Countercyclical fiscal policy had been largely discredited because of the delays involved in implementing fiscal changes and households' weak response to temporary tax cuts. By contrast, the central bank could lower interest rates rapidly, which worked to raise household and business spending through a variety of channels.
Nevertheless, I support the use of fiscal stimulus in the US, because the current recession is much deeper than and different from previous downturns. Even with successful countercyclical policy, this recession is likely to last longer and be more damaging than any since the depression of the 1930's.
The 40% decline in the US stock market and the dramatic fall in house prices have reduced American households' wealth by more than $10 trillion, which is likely to reduce annual consumer spending by more than $400 billion. And the collapse of housing starts has lowered construction spending by another $200 billion. This $600 billion fall in demand is more than 3% of GDP. If not reversed, it will cause further cuts in production, employment, and earnings, leading to further reductions in consumer spending.
The usual monetary-policy response of lowering interest rates is unable to reverse this sharp drop in demand. The dysfunctional credit markets caused by the uncertain value of asset-backed securities means that banks and other financial institutions are unable to raise funds and are unwilling to lend. As a result, the central bank's lower interest rates do not translate into increased spending on interest-sensitive investment and consumption.
So there is no alternative to fiscal policy if we want to reverse the current downturn. The resulting increase in the national debt is the price that we and future generations will pay for the mistakes that created the current economic situation. Those mistakes led to an underpricing of risk and the resulting increase in excessive leverage.
There are many reasons for the underpricing of risk and the rise in leverage. The exceptionally easy monetary policy at the start of the decade contributed to financial investors' willingness to buy low-quality financial assets in order to get higher yield and to an explosive rise in house prices. The rating agencies miscalculated the value of asset-backed securities.
The increase in leverage was driven in part by government policies aimed at expanding home ownership among lower-income groups that have proven unable to afford that life style. Banking supervisors did not deal with many institutions' low levels of capital and poor asset quality. A major challenge for the future is to fix the institutional policies that led to these problems.
The new Obama administration and the Congress are still working out the structure of the fiscal stimulus for the US. Although I support the need for a large fiscal package, I disagree with many of the specific features of the plans now under consideration.
Regardless of what is done to provide a fiscal stimulus, governments around the world must act to fix dysfunctional credit markets. Otherwise, credit will not flow and growth will not resume. In the US, reviving the credit markets requires stopping the mortgage defaults driven by negative equity. The US Treasury Department wasted valuable time in 2008 by not using the funds provided by Congress to deal with those housing-market problems. There is hope that the Congress and the new administration will now address that issue.
When the recession is over, the US and virtually every other country will have substantially higher debt-to-GDP ratios. At that point, it will be important to develop policies to reduce gradually the relative level of government spending in order to shift to fiscal surpluses and reduce the debt burden.
<<remove impediments to
<<remove impediments to work>>I don't know what that is. Unions nearly broken, loss of jobs, lower wages, loss of healthcare coverage, loss of pensions, lean manufacturing.
<<saving>>If you are talking of employees saving. How is one going to save with less pay and also to take care of their own healthcare.
<<investment and production>>not sure what that means. Jobs can go overseas and production will increase more in China.
<<lower tax rates>>Well, we have had lower tax rates for 8 years and we are back into a recession.
Still see no adequate answer.


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Extra, Extra! Read All About Bookstock 2014!
The CW50 Street team was on the hunt for a good read at the 12th annual Bookstock in Laurel Park Mall. Tons of readers came out to share their passion for books and pass that […]
WATCH Street Beat: Poverty In Metro Detroit
This week on Street Beat, host Roxanne Steele from AMP Radio looks into the issue of poverty in metro-Detroit.
Street Beat: Bookstock And The Environment
This week on Street Beat, Host Rob Stone from WYCD is profiling several local groups who are trying to help preserve the environment.
WATCH NOW – Street Beat: Multiculturalism & Literacy
This week on Street Beat, Host Syma Chowdhry learns about the several events supporting multiculturalism and literacy.


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If you are a practice lead at one of the world's ESPs – external service providers – you are very happy that this blog has a minuscule readership. This is just among us, so you have no worry of it going viral or appearing anywhere. The message is: we are on to your inside joke of supporting your clients' efforts to move into a new generation of software as a service (SaaS) and modern Cloud architectures. We get that 'Social' and Social CRM are aimed to transform your client's business using yesterday's thinking. Like you put yourself behind a Mosin-Nagant when you could step up to a Pro-Series 2000 HTR with parallax compensation. That is: old but very good technology and process at a time when things have changed.
Why change? The real sweet spot of your business is skimming off as much of the traditional spending on IT software and services and gear, and that is the big $3.5+ Trillion spent across the world. That number compares to just $5+ Billion spent on SaaS software, including Social. OK: we are in a world of transparency – is that so? Could you show us the numbers? How much have you – the partners and leadership – invested in retooling yourselves and your innovation centres and your consultants to understand the new social processes and the new Cloud infrastructure and the new metrics. I recently read a little-seen research piece on how to staff for the new Social rules in the customer service centre (if you are a Gartner client, http://www.gartner.com/resId=2111015 ) only after we failed to turn up any advice from any of the monster-size consultancies.
Net: isn't it time to move beyond the fancy Marketing studies and high level thoughts about the impact of Social on the Customer Strategy? Isn't it time to build aggressively so that you have a sound, scalable Cloud practice? Marketers need you. Customer Service organizations need you. There has to be a financial model that will get you to push off from the mooring of the status quo.
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