Posts tagged ‘Obamacare’

December 20, 2013

Is the Pajama Boy message directed to moms?

by Grace

The Obamacare Pajama Boy has been getting a lot of ribbing this week.  Most people seemed to agree it was not the best image to use for the purpose of encouraging young people to buy health insurance.


Surprisingly, pajama onesies in adult sizes are available for purchase, just in case anyone would like to recreate that look.

It’s true that many young people could use some advice on appropriate job interview attire, but I hope Pajama Boy at least knows that red plaid does not convey a sense of professionalism.


Ann Althouse suggests the Pajama Boy message is directed not to young people, but to their parents.

What is the message in the original Pajama Boy tweet? Pajama Boy is home for the holidays, reintegrated into his parents’ concept of him, as if he is still a little boy. He accepts that — the chocolate and the Christmas/holiday pajamas — because he loves his parents and he wants a good visit. But the subject of health insurance can be talked about in that milieu. For some reason, it won’t be inappropriate, won’t spoil the home-for-the-holidays spirit, it can fit. Pajama Boy is not a “douchebag.” He’s an average young guy, trying to do what’s right, including visiting his parents and living up to their expectation,s and he needs a little prodding to talk about getting insurance, which is part of what a good little boy should do.

But maybe the message is not so much for the boy but for the parents. The parents may think that when their little guy comes home for the holidays, they just want to baby him. But they really should also make sure he’s got his insurance. Don’t completely pretend he’s still a child. He’s your kid and you need to make sure he’s safe and sound. Jammies and warm milk are comforting, but he needs more protection than that. Do what you can to protect your little sweetheart now, before he once again leaves the bosom of the family and exposes himself to the danger of the world beyond the home. He may not quite yet realize what the risks and helping the “young invincibles” get insured is a parental responsibility just like the clothing and feeding you did when he was young. He doesn’t really need those jimjams and cocoa. He needs insurance. Help this dear boy one last time, Mama.

Appealing to helicopter moms, perhaps?

Related:  Can young college graduates burdened by student loans be convinced to buy health insurance? (Cost of College)

November 21, 2013

The Obamacare debacle is not helping the Common Core roll-out

by Grace

Implementation challenges have made the Common Core look more and more like Obamacare.

… States that raced to adopt the standards in 2010, including Oklahoma, Georgia, Florida and Alabama, have expressed second thoughts on participating. In New York, Common Core critics have called for the resignation of education commissioner John King after he threatened to cancel a series of town halls on the topic. At a convening hosted by the Education Writers Association earlier this week, the president of the American Federation of Teachers declared that the implementation of the Common Core is “far worse” than the troubled launch of Obamacare.

Glenn Reynolds finds it interesting “that the opposition comes from a broad political spectrum”.

U.S. Education Secretary Arne Duncan probably regrets injecting race into the debate with this clumsy declaration.

“It’s fascinating to me that some of the pushback is coming from, sort of, white suburban moms who — all of a sudden — their child isn’t as brilliant as they thought they were and their school isn’t quite as good as they thought they were, and that’s pretty scary,”

He later “apologized” by basically slapping “himself on the wrist for calling out one group instead of everybody who objects to top-down standardization”.

The reality is that education standards have fallen.

As a “suburban mom”, I agree with Duncan in feeling frustrated at “the educational reality” of low standards that falsely show our children are achieving at high levels.  At the same time, I sympathize with the opponents of the top-down, heavy-handed design and implementation of Common Core.

Its similarities to Obamacare leave Common Core more open to criticism.

In his blog post about problems with Common Core implementation, Andy Smarick writes about the federal government’s promise that “If you like your federal education policy, you can keep it!”  At one point the Department of Education found itself “offering states a waiver from their waivers“.


October 29, 2013

Can young college graduates burdened by student loans be convinced to buy health insurance?

by Grace

Young college graduates saddled with student loan debt may find it difficult to comply with new Obamacare mandates.

The success of Obamacare depends on young people buying health insurance.

Experts say that young, healthy people must enroll in ObamaCare’s health exchanges to cover the cost of insuring sicker, older people. It’s a simple math equation: Charge everyone roughly the same rate for access to basically the same product. The people who use it less will subsidize the people who use it more.

It may be hard to convince young adults to buy insurance, as illustrated by the example of Ron Geibel, a young college graduate recently profiled by  Geibel is considering his options among the New York state health plan marketplace created as part f the Affordable Care Act..

Profile:  Ron Geibel is a 28 year-old artist living in White Plains, New York.

  • Currently has no insurance
  • Income is less than $25,000 a year
  • In good health
  • Student loan has been deferred, but requirement to start paying will soon kick in

Geibel can choose from among seven plans with varying options.

Cost: A bronze plan from Health Republic is $307 a month ($3,000 deductible, pays 60 percent), but Geibel would pay $55. A silver plan from the same company is $387 a month ($2,000 deductible, pays 70 percent); Geibel would pay $135. A catastrophic plan would cost $186 to $418 a month, with a $6,350 deductible. The maximum out-of-pocket he would pay per year is $6,350 for the bronze or catastrophic plan; $5,500 for the silver.

Assuming a student loan balance of $26,600, the average for 2011 graduates, Geibel’s monthly payments would be $306*.  Here’s a hypothetical illustrations of his overall monthly income and expenses if he were to choose the silver plan.


The illustration shows a very tight budget, with little room for “extras” like health insurance.  Here’s how this young college graduate puts it.

“So for me if I have to prioritize right now it’s feeding myself and living as opposed to worrying about the health insurance.”

Like many young people, he thinks his odds are good enough to run the risk of foregoing health insurance.  The ACA penalty in this case would be $250, so his annual net savings for not buying insurance would be $1370 if he does not get sick.

New York is one of five states where health insurance premiums for millennials are not expected rise, so Geibel might be considered lucky in that respect.  For residents of the other 45 states and for many who do not want the type of coverage mandated by the ACA, it remains to be seen if enough young people will sign up for the new policies.

* Payments will be less if borrower qualifies for the IBR.

Related:  It’s not always possible to avoid college debt, but try anyway (Cost of College)

August 26, 2013

Obamacare may boost some careers

by Grace

From MarketWatch comes positive news amid recent negative reports about job losses caused by Obamacare.

… lost in the debate over whether the law will result in layoffs and shorter hours, recruiters and hiring analysts say Obamacare is certain to create a number of new positions — and not just in health care.

10 careers boosted by Obamacare

Nurse practitioners and physician assistants

When an estimated 25 million to 30 million people gain health coverage through the Affordable Care Act next year, many of them will likely pay a visit to the doctor . . . Demand for physician services is expected to increase at least 2% to 3%, especially for regular checkups and other preventive medicine . . .

. . . physician assistants and nurse practitioners, who can perform many of the same services at a fraction of a doctor’s salary, are filling the ranks. The BLS forecasts PA jobs will grow 30% to more than 108,000 from 2010 to 2020; registered nurses will increase 26% to more than 3 million. . .


The law requires employers to offer insurance to employees who work an average of 30 hours a week or more, at a cost for workers of not more than 9.5% of their annual salary. The responsibility of tracking work hours and health spending will fall to payroll departments, or companies that provide paycheck services such as ADP, human resources professionals say. Indeed, ADP’s new business bookings for its employer services, including payroll, grew 9% in the third quarter, CEO Carlos Rodriguez said when the company released earnings in May. . .

Computer programmers

Under the Affordable Care Act, doctors and hospitals must use electronic medical records, but taking their old paper system into the digital age is a giant technological construction project. “You need an army of programmers to put these things together,” says Osborne, of Staffing Industry Analysts. Indeed, the number of medical records and health information technicians employed in the U.S. has grown 7% to more than 182,000 since 2009, before the ACA was enacted, according to BLS data. Employment in other occupations, meanwhile, decreased or stayed flat during the same period, Osborne says. . .


The Affordable Care Act is now required reading at many law schools. If there is one thing about Obamacare that everyone agrees on, it is that the regulations are highly detailed, complex and still in flux — requiring experts to continually break down what they mean and how they should be followed. As a result, many companies are bringing in attorneys: “Everybody’s in sort of a muddle about it, so there is going to be an army of people at least in the short-term trying to figure out what people are supposed to be doing,” Osborne says. . . .

Medical billing coders

With millions of new patients comes millions of bills. And even before those bills come in, the work is piling up for physician and hospital billing offices, which are racing to prepare for the new ways they will have to submit patient claims to insurance companies. . . .


Employers, especially those who will offer health insurance for the first time or dramatically overhaul their plans to comply with the law, are struggling to figure out what type of coverage makes the most sense for their workers. Teams of consultants are being brought in to analyze the health risks and needs of their employees and design health benefits to suit them. . . .

Customer service reps

Opening the new exchange marketplaces, where consumers will be able to purchase health insurance, will also require huge customer support staff. Known as “navigators,” these employees will combine a form of customer service with health insurance knowledge. . . .

Occupational therapists

Insurers will no longer be able to deny coverage to people with disabilities in 2014, so more of them will likely have health insurance. Occupational therapists, which help optimize disabled people’s homes and workplaces to meet their mobility needs, were already in high demand: The unemployment rate in the field is just 1%, according to Osborne, at Staffing Industry Analysts. . . .

Human resources

Between administering companies’ health plans, tracking employees’ hours to determine whether they are eligible to enroll, and making sure the employer is in compliance with new regulations, human resources departments have been swamped gearing up for the ACA. . . .

Wellness and fitness coaches

The law puts pressure on employers to reduce their health spending by making workers healthier. That movement is taking the form of new worksite-based wellness programs and classes, such as Weight Watchers and fitness challenges. Often, companies will hire coaches to help strategize with employees and design personalized nutrition and fitness programs, and offer workers incentives to participate. Indeed, health educators, who teach people about healthy habits and develop programs to promote those behaviors, are on the Bureau of Labor Statistics’s list of fastest-growing jobs: The field will grow 37% to nearly 87,000 positions in 2020, according to the BLS. Many of these coaches, who specialize in helping people manage chronic conditions and diseases like diabetes, are employed by wellness companies that sell their services to employers.

More research is advised.

College students may want to research these fields as they decide upon their majors.  Some of these occupations seem to have more staying power than others, keeping in mind that technology will continue to undercut employment numbers in many areas.  I shudder to think of the growth in bureacracy.  And I wouldn’t count on Obamacare to put a significant dent in the huge slump in jobs for lawyers.


February 14, 2013

Nurse practitioners are projected to nearly double in number by 2025

by Grace

Obamacare may fuel demand for physician assistants, nurse practitioners, and other jobs in the wake of a doctor shortage.

SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama‘s healthcare law, it faces a major obstacle: There aren’t enough doctors to treat a crush of newly insured patients.

Some lawmakers want to fill the gap by redefining who can provide healthcare.

They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.

Replacing doctors with other professionals may end up costing more and could lower the quality of care.

Doctors say giving non-physicians more authority and autonomy could jeopardize patient safety. It could also drive up costs, because those workers, who have less medical education and training, tend to order more tests and prescribe more antibiotics, they said.

“Patient safety should always trump access concerns,” said Dr. Paul Phinney, president of the California Medical Assn.

Doctors want more funding for medical school tuition, but that would not fix the short-term staffing shortage.

“We’re not going to produce thousands of additional doctors in any kind of short-term time frame,” said Assemblyman Roger Dickinson (D-Sacramento). “It makes sense to look at changes that could relieve the pressure that we’re going to undoubtedly encounter for access to care.”

Nurse practitioners and other non-physician providers already provide health care services in growing numbers.

The number of physician assistants in the U.S. more than doubled from 2000 to 2010….

The nurse practitioner population will nearly double by 2025, according to an analysis published in the July Medical Care, the official journal of the medical care section of the American Public Health Assn.

I’ve been very happy with the nurse practitioner who staffs our local drug store care center.  Their location and hours are convenient, and she usually offers to call the next day to check how the patient is doing.


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