Sonia,
Thank you for very important information.

How does his mansion compare to John Forbes Kerry's mansions?

Does Heinz whine about providing insurance for its employees?

I think you missed something Charlie, Pappa John is making us pay for the insurance of their employees.

Mike, that is my point exactly, it is we the consumer that will be paying for all of this. Kind of like a tax...................

Or kind of like paying the actual cost of the Pizza, instead of paying for the pizza and then picking up the cost of the emergency room visit of the girl at the register, or paying her medicaid premiums....

You are acting like those are the only cost drivers of healthcare; your listening to just the large hospitals, or rather their lobbyists, when you make that claim. The biggest driver of all, by far, is when doctors practice defensive medicine. They order tests, that are often very expensive and redundant, when the preponderance of evidence already supports a sound treatable diagnosis. Why do they do this? Because they have to anticipate being sued and an "expert witness" who invariably disagrees. Medicine is not an exact science and there are always differing opinions . Malpractice insurance is the largest reoccurring cost practitioners face. This is not to suggest that lawsuits be thrown out or forbidden but rather that the current climate needs to change so that fear of arriving at a cost effective diagnosis does not drive the cost of that diagnosis out of the reach of the populous. That would have entailed going against a lot of very powerful lobbies so the ACA just punted on that.

Your veering off topic again Charlie.
Medical Liability Costs in U.S. Pegged at 2.4 Percent
http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

You post does not even attempt to quantify the costs of defensive medicine and rather focuses solely on actual costs. Those actual costs are AFTER the practice of defensive medicine not in lieu of them. It is my contention that if defensive medicine stopped without something offering the protection defensive medicine provides those costs would sky rocket. You can see it in medical coding all day long and is part of the reason for the new 5010 medical codes. Those codes will give more incite into the costs without having to look at each individual chart.

Mike, look, again I am trying to have a honest conversation with you, but if you would rather cross post and revert to tag lines and personal attacks who am I to say no. All I have is honest conversation, when you are willing to engage hopefully I will still be of the same mindset.

Charlie, dismissing my statements as "tag lines" does not give the appearance that you are "trying to have a honest conversation".

Attributing excessive testing to tort reform is not an idea based in reality. It is far more likely that Doctors test excessively because that is how they are paid. Per Service, and not on results.

That's a great "story", Charlie, it by itself could probably sway the uninformed. But much like most "stories" made up on the right, they have no basis in fact.

Well, I am looking at premium costs right now as it is that time of year to switch plans. Maybe you should look into them too. As it is in order to compete southern business who want to pull from the MA labor force already need to comply with Romney care minimum insurance, so this is something I know something about as it relates to the southern NH business climate.

Why are employers involved in insurance in the first place? It is only an accident that America's companies got into insuring employees. During WWII, companies started offering insurance as a perk when the job market was so desperate for workers.

Imagine how free the "free market system" would be if you weren't chained to your job with the fear of losing your insurance?

I mean honestly, do you know what current employer contributions to health care premiums are? A lot more per employee than the 2K fine if no healthcare is offered is a pretty safe bet across the board. The government really had no clue and set the fine WAY to low if the really wanted to have businesses remain the source of insurance. But given the way the fine was set, the current actual costs, and the formation of exchanges, and rhetoric about insurance following you from employer to employer without needing change; who is kidding who? All of that leads to single location insurance buying. From there it is easy for the government to step in and create a single payer environment without legislation to that effect. What is the alternative conclusion I am to derive given what I am seeing?

@ Mike if employers have nothing to do with insurance and that would be so good, then why fine them for not offering it? One could view that as a tax or a government mandated raise in the form of redistribution...........

Maybe your efforts to provide the minimum is your downfall. Have you ever though of not living on the margins? Maybe provide an honest wage? An Honest insurance policy? Maybe then your employees would have a little less uncertainty in their lives and they would be more productive?

It seem your okay with redistributing your employees health burden onto the rest of us, why shouldn't we try to recoup that cost from you?

First of all, the decision is not mine to make, and health care IS EXPENSIVE. There is no current minimum except in MA, and all of our plan options meet MA requirements. I am not 'ok' with redistributing anything, in fact I am in favor of the burden being on the individual so that they have some visible "skin in the game" and maybe live healthier lifestyles, ie don't smoke, don't eat this from crinkly wrappers sitting on a shelf, no fast food, reasonable portions and dear god EXERCISE. Not to mention I am also in favor of reducing medical costs, some of which is borderline criminal in my opinion. As for a fair wage? Well that is easy to proclaim, but in reality the consumer has to willing to pay more and that is the cold fact of the matter; American society thrives on a deal and will flock to it, which is at the heart of capitalism to which I most certainly agree with.

And yes, the thought of offering a very ritzy insurance plan with low deductibles and many included benefits is something we offer, in fact it is the most costly for us to offer and we disproportionately pay for more of that plan than any other plan. You know what, our highest risk employees do not even take that plan at a mere 20 dollars a week more to them. In fact we increasingly see more employees who do not even want a healthcare benefit! That actually makes it harder to offer one because it reduces our bargaining power with insurance companies.

Taxes are redistribution.
Schools, roads, infrastructure, military, social safety nets, police, fire, the FAA, EPA, etc, etc, etc, are all redistribution of wealth. Do you do away with all of them in your fantasy world?

You don't always have to chase after the cheapest customers.
If cheap was the only factor we would all be driving Ford Fiesta's.

I win customers with Quality, Quick Delivery, and Intelligent Support.

I understand that there is more to a purchasing decision than price alone, lets not be remedial here, I am actually trying to engage you in a real discussion; if we can't do then how on earth can we expect our politicians to?

I am not against taxes at all; and the reasoning you cite and the items you put forth are reasonable. I am against giving that to whom, which who would not otherwise strive for. I am against an equal outcome but am 100% behind an equal opportunity. The difference is effort, skill, ability, and unfortunately chance. We need everyone producing to their best to make the "fantasy world" you want as reality. That means we need the best effort from all, not handouts to all with no return. Even FDR's Square Deal recognized that, but somehow we have lost that.

"I am against an equal outcome but am 100% behind an equal opportunity."
Who is trying to sell Jingle's now?

No one would every confuse America as a equal outcome country.

I do not believe the touted 14 cent raise to a pizza would cover the cost of Obamacare to Papa Johns. The information I have seen, at current rates assuming no cost rise at all, would be roughly 20-25% more than current premiums assuming a flat employee contribution. This also assumes that no benefits are added.

It is a great tag line, Healey, it by itself could probably win an election. But like much of those tag lines right or left they are factually questionable at best.

Of course Charlie,
Why would we listen to the guy who owns Pappa Johns and his assessment of how much ObamaCare costs when we could use "Charlie W"'s guestimations......

Actually Mike, it is worse than that, an independent source estimates the rise in pizza cost to be only "3.4-4.6" cents a pizza.

http://www.huffingtonpost.com/2012/11/13/papa-johns-obamacare_n_2123207.html

As for my "guestimation"; well sadly it is not. Those are the today's primium increases on at least two ~100 employee companies right here in NH. Papa johns sells a lot of pizza, the total cost is between 5-8 million dollars for insurance and I bet given their size can probably broker a better deal than the two smaller companies I am familiar with here in NH.

Your all over the place Charlie.
Your example says it will cost only a fraction of what Pappa Johns estimates.
Then you start talking about insurance RATE increases.
Insurance Premiums are going to go up, that's our free market system.

I am all over the place, I was incorrectly assuming Papa John's had a similar cost structure to that with which I am familiar with here in the Southern NH small business climate. My familiarity is with ~100 employee companies not organizations the size of Papa Johns. In fact I am a little surprised at the differing cost structure per employee due presumably to economies of scale............

Again,
We are now building an insurance system that will allow the Small Business owner to have the same insurance rates as the conglomerates.
Another Free Market Bonus of ObamaCare.

Well if Obamacare was serious about competitive rates they would have allowed insurance to be sold across state lines creating that market immediately. I am skeptical that that is the intention as they would rather have individualized, and separate, exchanges in every state. Wouldn't it have been more cost effective to have a single national exchange?

Insurance over state lines is a states right issue, you want New Hampshire to give up its control over what minimum requirement insurance should provide? Sounds awful socialist to me......

We already did create a minimum with the ACA................so what is the excuse now? Why are we letting the insurance companies win on this issue? (Hint it involves tort reform, as each state has its' own standard of medical malpractice and dispute resolution) As true to fashion the left only wanted to give the handouts not deal with the actual costs or what they entail which in effect leaves that to the next generation in the form of debt. There are more ways to deal with expense of things than taxes, by reforming aspects of the tort system you can drive the costs of practicing down at the expense of lawyers (who often matriculate to politician) and thus make care more affordable for all.

Medical Liability Costs in U.S. Pegged at 2.4 Percent
http://www.hsph.harvard.edu/news/press-releases/2010-releases/medical-liability-costs-us.html

We need to stop crying, roll up our sleeves, and get America Back to work.

You post does not even attempt to quantify the costs of defensive medicine and rather focuses solely on actual costs. Those actual costs are AFTER the practice of defensive medicine not in lieu of them. It is my contention that if defensive medicine stopped without something offering the protection defensive medicine provides those costs would sky rocket. You can see it in medical coding all day long and is part of the reason for the new 5010 medical codes. Those codes will give more incite into the costs without having to look at each individual chart.

I'm not sure where you are getting your information, but the new 5010 codes were developed to "enable clearer instructions, reduced ambiguity in the data that is used in electronic transactions and the elimination of redundant and unnecessary data elements"

What do you think the conspiracy is behind the new codes?

Yes those are without question rational behind the 5010 codes. But honestly, the benefit to the statisticians and auditors will be more pronounced. Prior to 5010 the granularity of the codes was far less often forcing access to the medical chart itself in order to itemize medical costs in a more meaningful way. (so on the reduction of redundancy, what is really being said is that a single code for 10 different types of related procedure is no longer the case, in fact the code type expands exponentially with 5010 providing that clarity as to exactly what was done) Going to the chart for that information is next to impossible logistically, let alone legally, and thus not practical. Pretty much exactly why your harvard citation does not even attempt to quantify defensive medicine costs, how can they without knowing what was spent on what and when? The old codes simply did not provide the visibility needed. With the new codes auditors can more easily find defensive medicine or alternatively erroneous medicine for money, which is also an issue for sure. All in all this visibility into cost is far and away the value of 5010 to all involved; it certainly is not easier or less "paper work", the only efficiency it provides is a more granular look at medical costs to the insurer as the patients has direct access to the chart and is provided an explanation of services as require by law.

Or they just want a clearer system for coding medical care.....

So it is you position that 5010, very expensive for the industry and government to implement, is simply being done for a clearer system and nothing else..... All that cost with zero tangible return..... Well I guess I can't really argue with or even explain that logic.

I guess the same cynicism surrounded the change from horse and buggy to automobiles.
But don't let me pretend to be an expert, here is what the AAPC had to say about why:
"ICD-9-CM has several problems. Foremost, it is out of room. Because the classification is organized scientifically, each three-digit category can have only 10 subcategories. Most numbers in most categories have been assigned diagnoses. Medical science keeps making new discoveries, and there are no numbers to assign these diagnoses.

Computer science, combined with new, more detailed codes of ICD-10-CM, will allow for better analysis of disease patterns and treatment outcomes that can advance medical care. These same details will streamline claims submissions, since these details will make the initial claim much easier for payers to understand."
http://www.aapc.com/icd-10/faq.aspx#why

"for payers" to understand.......thats right your starting to see. The Dr. and the Patient already have that information. As for Payers please substitute Government and Insurance companies. Now mind you I have zero problem with all of this, although I am sure some tin hat privacy people will go zonkers when they put together the data that those entities have. Nonethe less this will most definately pave the way for the quantification of both medicine for money and defensive medicine. The point being that your havard citation is inocmplete at best and that the ACA makes no attempt to even address either issue. Liek I said though, that is really difficult to explain as opposed to a snarky tag line. I could have responded with the regular right wing line and called it the begging of a death panel that uses such information to dole out care based on cost / effectiveness; which is another potential use of the same information.................you be the judge.