Consulting and the Affordable Care Act 11

[Mr168]

I'm curious as to the thoughts of the Eng-Tips community as to whether we will see the Affordable Care Act have a significant impact on the Engineering Consulting industry.

For a moment, lets put aside the turmoil associated with Obamacare, and operate under the assumption that the ACA won't be repealed any time soon.

The single greatest factor in me not venturing into the world of private consulting has been healthcare. As someone with a number of preexisting medical conditions and a history of cancer, any sort of private health insurance is either a pipe dream, or tremendously cost prohibitive. As much as I hate to entertain the though, Obamacare does provide at least some inkling of a possibility that I could leave the big Fortune 100 EPC's and venture off on my own, with premiums and care much worse than my corporate policy, but not unbearable.

If the ACA manages to stick around, do the folks here anticipate any sort of significant influx of private consultants? Any other anticipated consequences or thoughts on the matter?

 

[cranky108]

What bothers me the most is having to pay for things I doubt I will ever need. Honestly if my risk is 0%, how do I have an insurable risk?

 

[JohnRBaker]

So you've figured out how to avoid falling down a stairs or getting food posioning, eh? Can you let the rest of us in on your secret?

How is this any different than buying car insurance? Even if you're a good driver who never breaks any traffic laws, how do you account for the unavoidable accidents, like blowing a tire at 60 mph or having a tree fall on your car while parked in your driveway?

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
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To an Engineer, the glass is twice as big as it needs to be.

 

[IRstuff]

"What bothers me the most is having to pay for things I doubt I will ever need. "

You certainly don't "need" to pay for someone else's ER visit, but you're already doing precisely that if they're indigent

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[cranky108]

Did I say I don't need any insurance? I said "having to pay for things I doubt I will ever need". Yes I have fire insurance, but I don't have flood insurance, or volcano insurance, etc.

What I intended to say is my risk of some things is very low, and I don't think I should be forced to purchance insurance for those.

Besides if I am paying for someone elses contreciptives, should I also not expect to recieve free sex?

 

[IRstuff]

Nonetheless, you can either pay for the contraceptive, or pay for the welfare to support the unwanted birth/parent, or pay to spay/neuter, or other, or worse yet, the resultant birth comes back to mug you.

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[cranky108]

I pay for free contractives now in my taxes for the poor people, and that dosen't seem to reduce anything. So now I pay again for the freeloaders, and I doubt that will reduce anything.
So it seems I pay and pay for nothing. Why should I keep paying.

Sort of goes back to my thoughts on the homeless. If you want to reduce the number of wild cats, stop feeding them.

 

[IRstuff]

You forgot that ACA has death panels specifically for that?

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[JohnRBaker]

Well if you've got coverage for pharmaceuticals, then some women out there is paying for your Viagra.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[cranky108]

Viagra! Without free sex who needs it.

 

[beej67]

"flying death robots"

beej67, I fear your tin foil hat may be on a little tight.

You do realize they have those now, right?

Here's what they look like:

See those things on the wing mounts? That's the "deathy" part.

Back on topic, I don't see how Ocare is going to affect the consulting industry any differently than it would affect any other industry. In fact, I think the ACA might make it easier to be a small company or a sole proprietor. I also think we're going to see some very interesting ways emerge for self-employed people to hide earnings under the 4*(poverty) cap and sneak some government assistance out of the deal.

Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[KENAT]

By that ridiculously ignorant & hyperbolic phrasing we've had 'flying death robots' since at least WWII - so I'm well aware of them thanks.

To see such phrasing such as that on a site like this is disappointing to say the least.

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(probably not aimed specifically at you)
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[beej67]

Don't see what's so ridiculous or ignorant about it, considering that's exactly what it is, and at a completely different and very important level than WWII. Regardless, my only point was that people should take care what they post in public forums nowadays, given the news. I presume you pay attention to the news.

Again, back on topic, I don't see the ACA affecting our industry any differently than it affects others. In fact, probably less than industries like retail who are having to try and dump full time workers without looking like they're dumping full time workers. The real effect of the ACA will be seen in three or four years as everyone starts to learn how to game the system, and the cost-benefit model unravels.


Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[JohnRBaker]

The real effect of the ACA will be seen in three or four years as everyone starts to learn how to game the system, and the cost-benefit model unravels.

Or perhaps when it becomes as ubiquitous as Social Security, and where, like Social Security and Medicare today, both the people and businesses come to accept the idea that our society could not long survive without it. I mean, it's not like America is the first nation attempting to provide some sort of 'universal health care' solution for their citizens or that the rest of the world is waiting around to see how this radical experiment in 'socialism' pans out before they try something on their own. After all, where is the outrage and condemnation coming from other parts of world over THEIR ruinous health care delivery systems if something like the ACA is, by definition, structurally doomed to inevitable failure?

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[beej67]

I mean, it's not like America is the first nation attempting to provide some sort of 'universal health care' solution for their citizens or that the rest of the world is waiting around to see how this radical experiment in 'socialism' pans out before they try something on their own.

Nobody else in the world has anything like the ACA. No other country's experiences with socialized healthcare are remotely applicable to the ACA. Australia, for example, just gave everybody their equivalent of Medicare and allows folks to supplement it at their leisure. That's how it's usually done around the world. The ACA doesn't do that - it holds a gun to everyone's head and forces them to buy health insurance from a for-profit company, and then you have a once-per-year window where if you can prove you're poor enough, you can use a highly disfunctional website to get the government to pay some of that cost for you with tax dollars.

No other country in the world does it that way. Somewhere along the line, the problem of rising healthcare costs was transformed by political rhetoric into a problem of lack of universal coverage, and the solution they came up with was simply to force everyone to buy the expensive, broken product. The reason they landed on this solution, is the solution was brewed up by the lobbyists of the people selling that same expensive, broken product. Free market (cash) medicine would be better. Socialist medicine would be better. Our system pre-ACA was the worst of both worlds, and it got yet worse with the ACA because participation was coerced by force.

It's all going to blow up in ten years anyway, but our business won't be affected any more or less by it than any other business. In fact, I'd speculate the only major effect it's going to have on engineering consulting will be felt in the overall economic ramifications of how it blows up, not in the details of how it "works" for now.



Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[cranky108]

I think it was intended to blow up, as a transisition to something the people don't want.

Back to the main point: What consultant would work without insurance? What employer would not offer health insurance?
The answer is that no large employer would not offer health insurance, nor would very many engineers want to work for a firm that dosen't offer it.

The only changes I see is what is covered, and what isen't.

What has changed is the cost to self insure, because you now have to pay a tax to do that.

If you don't like the system, get behind another because this was never intended to last very long, and dosen't even cover every body.

 

[JohnRBaker]

For the record, my personal preference would be Medicare 'Part E' ('E' for 'Everyone').

You have to remember that what we now have was the ONLY thing that could get through congress. And to be honest, the basis for the ACA, what you describe as "holding a gun to everyone's head and forcing them to buy health insurance from a for-profit company", was originally the plan that was first put-forward by the Heritage Foundation back in the early 90's to counter so-called 'Hillarycare' which was being proposed by Bill Clinton during his campaign for President. Later on it was adopted as the foundation for what was later referred to as 'Romneycare' in Massachusetts, which eventually become the model for the ACA. So the next time some conservative politician stands up and condemns 'Obamacare' as being 'socialized medicine' rammed-down the throats of Americans by the 'liberals', don't forget that the major provisions of the LAW (as upheld by a conservative Supreme Court) was the brainchild of an old style Conservative 'think tank' and which was embraced by a broad spectrum of main-stream Republicans not that long ago.

Trust me, if the Progressives in the country could have gotten their way, we would have had a true Universal Health Care system based on either Medicare or modeled on a system like Canada, Australia or Germany.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[beej67]

You have to remember that what we now have was the ONLY thing that could get through congress.

That right there should sound the alarm bells.

what you describe as "holding a gun to everyone's head and forcing them to buy health insurance from a for-profit company", was originally the plan that was first put-forward by the Heritage Foundation back in the early 90's

And the blues hated it back then, but they love it now. And the reds loved it back then but hate it now. Right?

That should sound even more alarm bells.

Here's a quick lesson: Nothing will ever get through congress that takes money away from the people who've bought congress. In this case, someone decided to try and take money away from the health care industry, and instead what we get is a law that forces everyone to give more money to the health care industry, and borrows/prints/taxes additional money to give to the health care industry for everyone who can't afford to be forced to give more money to the healthcare industry. And participation is mandatory. That's the ACA. Socialism would be better. Cash medicine would be better. The ACA synthesizes the worst features of both, for profit.

Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[JohnRBaker]

Socialism would be better.

I couldn't agree more!!!!!

A true 'single-payer' system would have gone a LONG way toward curing a LOT of the structural and cost problems with the heath care delivery system that we have in America today.

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.

 

[beej67]

It would indeed. And it would have made other problems worse.

A cash medicine system, more like we used to have back when things were actually affordable, would solve another bunch of problems with our current system almost instantly because people would start to become good stewards of their money again. But it would make the 'coverage problem' worse.

The ACA is the worst of all worlds. There is no incentive in the system to keep our own costs down. Providers can lobby on one side to have their procedures covered and on the other to convince the public to use these unnecessary procedures. The overruns are paid for by printing money. And the capstone is it all flows through a website that doesn't work.

And it was passed because people felt like they "had to at least pass something."

Hydrology, Drainage Analysis, Flood Studies, and Complex Stormwater Litigation for Atlanta and the South East -

http://www.campbellcivil.com

 

[JohnRBaker]

And it was passed because people felt like they "had to at least pass something."

Or accept the idea that the richest nation on Earth would be willing to continue to allow tens of millions of it citizens to go without proper health care leaving even middle-class working families only one catastrophic health event away from total bankruptcy.

If you have another plan that would have even an outside chance of working AND WHICH COULD GET THROUGH CONGRESS, please be my guest...

John R. Baker, P.E.
Product 'Evangelist'
Product Engineering Software
Siemens PLM Software Inc.
Industry Sector
Cypress, CA
Siemens PLM:
UG/NX Museum:

To an Engineer, the glass is twice as big as it needs to be.