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Sean
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Ok - hopefully we can keep this one from heading to the basement :whistling

As many of you know, NARI National has been reviewing the provision to the Patient Protection and Affordable Care Act proposed by Sen. Jeff Merkley (D-Ore.) which singles out the construction industry against every other industry to comply with the bill's employer mandates, unless the company has five (5) or fewer full-time employees.

In response to this unfair hardship on the construction industry, NARI has been carefully crafting a response on behalf of its members and related-industry partners. In a recent survey of NARI members, an overwhelming 96% opposed the new provision and therefore confirms NARI's position.

We are calling on NARI members and related-industry partners to help us have our voices be heard by faxing or e-mailing the letter below explaining the negative impact this provision will have on our businesses and our industry. We are asking that you address the letter to Senate Majority Leader Henry Reid (D-Nev.), Speaker of the House Nancy Pelosi (D-Calif), Senate Minority Leader Mitch McConnell (R-Ky.), House Majority Leader Steny (D-MD) Hoyer and House Minority Leader John Boehner (R-Ohio) in addition to your state representatives and senate leaders.


The bill is now being revised by both the House and the Senate, to forward to the president for signing before the State of the Union. We ask that everyone participate in this important event as soon as possible before the final decision is made. United as one, NARI members can make a difference.


Sincerely,




Fax Numbers:


House Speaker Nancy Pelosi (D-Calif) (202) 225-8259
Minority Leader John Boehner (R-Ohio) (202) 225-0704
House Majority Leader Steny Hoyer (202) 225-4300
Senate Majority Leader Henry Reid (D-Nev.) (202) 224-7327
Senate Minority Leader Mitch McConnell (R-Ky.) (202) 224-2499


To reach your Senator, click here.


To reach your Representative, click here.


January 15, 2010



The Honorable Harry Reid The Honorable Nancy Pelosi
Majority Leader Speaker
United States Senate U.S. House of Representatives
Washington, D.C. 20510 Washington, D.C. 20515


Dear Leader Reid and Speaker Pelosi:


On behalf of remodeling and construction business owners from every state in the nation, the National Association of the Remodeling Industry (NARI) is writing to express our views on one critical issue facing negotiators as they work to reconcile differences between the House-passed "Affordable Health Care for America Act" (H.R. 3962) and the Senate-passed "Patient Protection and Affordable Care Act" (H.R. 3590).


In an effort to mitigate the costs that will ultimately fall on the backs of the small remodeling and construction business owner community, NARI strongly urges you to strike this most exceptionally unfair provision in the bill while retaining and incorporating key provisions of importance to small employers.


Please strike and remove the following provision:


Construction Mandate
The recently-released December 2009 jobs report reinforces what so many in the construction industry already know: job loss is at historic levels. In December, 53,000 of the 85,000 jobs lost were in the construction industry. This narrowly-focused provision singles out one industry and excludes them from the small business exemption.


In an industry where the national unemployment rate is exceeding 22 percent, this is NOT the reform our nation's remodeling and construction industry needs or can afford. We strongly encourage you to support the removal of this arbitrary and onerous provision, as it will halt future job growth in the industry.


Thousands of small remodeling and construction firms, already struggling to survive, will face bankruptcy if this provision is signed into law.


We strongly urge the Senate to reconsider and pull this oppressive provision that threatens the viability of small home remodeling and construction businesses across the nation.


From the beginning of the healthcare reform debate, small business has been recognized as the constituency most in need of reform. Yet, as the legislative process enters its final phase, it is disappointing that for all the "lip service," small remodeling and construction businesses will be most harmed by this legislation. We urge you to keep small remodeling and construction business in mind by addressing the concern outlined above.


Sincerely,




CC: Senate Minority Leader Mitch McConnell, House Minority Leader John Boehner
 

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What does the "Construction Mandate" say, exactly? Can you post the wording so that we can make an informed decision?
 

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What does the "Construction Mandate" say, exactly? Can you post the wording so that we can make an informed decision?
SLS, While your at it, go get some coffee for me. And when you get back, I'd like to do some dictation. :laughing:

Just havin a beer and clowning with my buds.:drink:
 

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Who are the 4% that approve of the new provision?:rolleyes:
That would be me, I suppose. Most contractors here provide health insurance in their benefit package if nothing else.
Personally, I feel it is one of our obligations to our employees.
When I was working for other outfits, I wouldn't take a job that didn't provide health benefits.
I don't understand why NARI is so opposed to this.
 

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What does the "Construction Mandate" say, exactly? Can you post the wording so that we can make an informed decision?
SLS, While your at it, go get some coffee for me. And when you get back, I'd like to do some dictation. :laughing:
All I am saying is that the letter doesn't really tell us what the "Construction Mandate" says. We are just expected to accept that it is bad for contractors. Before I will forward something to my representatives (which I have done many times) I need to know what I am talking about.

If SLS can post a link then we can all read what it says and make an informed decision about it.
 

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That would be me, I suppose. Most contractors here provide health insurance in their benefit package if nothing else.
Personally, I feel it is one of our obligations to our employees.
When I was working for other outfits, I wouldn't take a job that didn't provide health benefits.
I don't understand why NARI is so opposed to this.

So imposing their will on others is OK when it's something you like??
 

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Sean
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Discussion Starter · #9 ·
All I am saying is that the letter doesn't really tell us what the "Construction Mandate" says. We are just expected to accept that it is bad for contractors. Before I will forward something to my representatives (which I have done many times) I need to know what I am talking about.

If SLS can post a link then we can all read what it says and make an informed decision about it.
MudPad - if one is not informed on a subject, generally one does there own research. I don't expect, nor does anyone else here really expect you to just blindly follow the "we are looking out for you", "change you can believe in" etc... lines thrown out

Good luck finding the exact amendment as most of the original bill & amendments were not released, but basically any construction firm with 5 or more employees OR with a payroll above 250K would have to provide insurance, instead of the 50 employee limit imposed on everyone else.(Quick note - some reports use the word AND instead of OR - if it is AND, I guess that just means that all the self centered bosses will have to keep payroll down :whistling)

That being said: The Pro Amendment side http://www.ibew481.org/ContentUploads/Merkley Amendment Talking Points.pdf

NY Times piece http://www.nytimes.com/2010/01/04/health/policy/04health.html

Judge for yourself - personally the whole mess needs to go, not just one amendment

That would be me, I suppose. Most contractors here provide health insurance in their benefit package if nothing else.
Personally, I feel it is one of our obligations to our employees.
When I was working for other outfits, I wouldn't take a job that didn't provide health benefits.
I don't understand why NARI is so opposed to this.
I will admit - I am not affected by it at the moment & when I do grow that large, I will definitely try adding in benefits like that. But it is not my obligation to provide them with insurance, gas money, food, etc... My obligation is to provide them with a well paying secure job and a safe work environment. It is up to them to spend their money wisely on necessities.

NARI, NAHB, and most other non-union associations are opposed for quite a few reasons. The primary one is their members are opposed & they represent the members. 96% of NARI's membership that took part in the poll was opposed.

If you truly want health care reform - have them work on cleaning up all the regulations they already apply to the medical industry. Most Insurance companies have a small group dedicated to nothing but HIPPA, another small group dealing with nothing but Medicare, and basically 1 person for each state they offer policies in.

Then when you get down to the small doctors offices, clinics, etc... you have at least 1 person that only deals with the government regs, not patient care or anything related to taking care of patients. The cost of business for them escalates yearly because of the regulations imposed on them. The same is happening to us (Lead, this amendment, OSHA, etc...)
 

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Good luck finding the exact amendment as most of the original bill & amendments were not released, but basically any construction firm with 5 or more employees OR with a payroll above 250K would have to provide insurance, instead of the 50 employee limit imposed on everyone else.(Quick note - some reports use the word AND instead of OR - if it is AND, I guess that just means that all the self centered bosses will have to keep payroll down :whistling)

Judge for yourself - personally the whole mess needs to go, not just one amendment



I will admit - I am not affected by it at the moment & when I do grow that large, I will definitely try adding in benefits like that. But it is not my obligation to provide them with insurance, gas money, food, etc... My obligation is to provide them with a well paying secure job and a safe work environment. It is up to them to spend their money wisely on necessities.


If you truly want health care reform - have them work on cleaning up all the regulations they already apply to the medical industry. Most Insurance companies have a small group dedicated to nothing but HIPPA, another small group dealing with nothing but Medicare, and basically 1 person for each state they offer policies in.

Then when you get down to the small doctors offices, clinics, etc... you have at least 1 person that only deals with the government regs, not patient care or anything related to taking care of patients. The cost of business for them escalates yearly because of the regulations imposed on them. The same is happening to us (Lead, this amendment, OSHA, etc...)
I would be the first one to agree that the current system is a disaster. Personally, I would like to see something that preserves the status of health care providers, but erases the insurance companies altogether. What we have now makes as much sense to me as having to get insurance for police and fire protection. My sense of obligation stems from the fact that under California law Group plans cannot deny coverage or membership based on pre-existing conditions. Private plans not only can but notoriously do. (My mother in law was recently turned down because she was 20 lbs overweight and she is by no means obese.) In addition to that, money spent on insurance through an employer is pretax so this saves a considerable amount of money.
Neither of these "wise choices" are available to them unless I provide them.
If they were denied access to food and gas I would be inclined to do the same, although some of my guys have been abusing the system in that regard and probably should be cut off.

My issue is not with the amendment, but rather the rule. Instead of pushing for the same exemption, I would like to see this requirement for all industries.

San Francisco has had a mandated requirement in place for a couple years now. Employers with 20-99 employees are required to either provide insurance or pay $1.31 per employee hour into a fund. 100 and above it goes to $1.96. In addition to that we are required to provide 1hr for every 30 worked in paid sick leave. I don't know of anyone who has been put out of business by this and so far none of the contractors I know of are complaining about this. The restaurant association is fighting it of course. I used to be a member of the restaurant assoc., trust me, we don't want to get in bed with those guys, if they had their way we would repeal the prohibition against slavery.

Our insurance benefit adds about 5% to our labor burden. We can cope with that. Our Worker's comp on the other hand runs 15% (if we paid anyone in the field less than $26 per hour it's 42% for them) plus a 33% deposit in advance. I can work up some outrage over that.

In the interest of full disclosure I have to say that if our company didn't offer insurance, my wife and I would be included in the group of uninsured.
Wife is diabetic. At age 22 she wakes up one morning with cataracts in both eyes. Her pre-existing diabetes prevented us from having insurance. Required to sell house, business and all of our assets just to get the debt to a manageable level to avoid bankruptcy.
Fast forward 10 years. Again due to diabetes wife needs kidney/pancreas transplant. This time we were covered by my employers insurance. Total cost: $800,000. Total cost to us $1500.
My wife's anti-rejection and other required meds alone run retail a little over $2000 per month.

As to the burden placed on providers by the regulation of the industry. It goes without saying that I talk to a lot of doctor's. I've been asking them what they think about health care reform in general. The general consensus from them has been that their biggest problem has been so many of their patients losing coverage because they've been laid off and can't afford Cobra.
I have Kaiser though and they let their doctor's spend all their time treating patients and hire administrators to administrate. I strongly Believe that Kaiser should be the model for our health care system.

If we ever resolve the access and affordability issues, then I wouldn't feel a responsibility to be involved.
 

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The only reason health care is so expensive is because of the damn insurance company's.
Sorry I even jumped into this:whistling
Health Insurance expensive because insurance companies? Maybe that needs thought threw a little harder? Reason why insurance is so high: lawsuits. R&D on new prescriptions can't be brought to the market for fear of the lawyers, doctors have to run multiple unneeded services to protect being sued. Friend of mine is a transplant surgeon and he said that nearly 200% of the medical procedures done is not needed but for fear of the lawsuit that will come. Its not if a lawsuit but when.
What is needed is not "national health insurance" but insurance AND tort reform. I feel the "end is near" for quality care.
Sorry abt your wife Afkama but "for now" she got the best Health Care the world has to offer but I think that will be changing soon.
JMO
 

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Sorry I even jumped into this:whistling
Health Insurance expensive because insurance companies? Maybe that needs thought threw a little harder? Reason why insurance is so high: lawsuits. R&D on new prescriptions can't be brought to the market for fear of the lawyers, doctors have to run multiple unneeded services to protect being sued. Friend of mine is a transplant surgeon and he said that nearly 200% of the medical procedures done is not needed but for fear of the lawsuit that will come. Its not if a lawsuit but when.
What is needed is not "national health insurance" but insurance AND tort reform. I feel the "end is near" for quality care.
Sorry abt your wife Afkama but "for now" she got the best Health Care the world has to offer but I think that will be changing soon.
JMO
I don't blame you for your reluctance to jump in to this. I can't think of a more contentious issue.
Given the amount of involvement we have had with the health care industry this is something I have given a lot of thought to.

Take Tort reform. I am no friend of the lawyers- they are worse than the insurance companies. According to actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs at 1 to 1.5 percent of total medical costs. The CBO says $54 billion- still a small percentage. And while health care spending has more than doubled since the eighties claims have remained the same. That means we have a declining rate of lawsuits relative to numbers of injuries.

Medical Malpractice insurance runs about $50 to $60 billion a year, which is a lower percentage than I pay for GL by the way.

As to the amount of money spent practicing 'defensive medicine'- nobody knows-there are no reliable studies out there. I've seen numbers that range from $20 billion to $200 Billion none of them really unbiased or credible to me.
The one study that seemed believable was a study done in Florida. It was published in The Quarterly Journal of Economics by Stanford economist Daniel Kessler and Dr. Mark McClellan, who was head of the Centers for Medicare & Medicaid Services under President George W. Bush. For two types of heart disease — heart attacks and ischemic heart disease — the authors found that 5 to 7 percent of the additional costs in Florida, compared to other states with lower medical malpractice liability, could be attributed to defensive medicine. This was based on 1980s data. Furthermore, a second study, published in 2002 in The Journal of Public Economics, found that much of the difference disappeared as managed care took hold in Florida in the 1990s. I am a big proponent of Managed care. I realize that your friend's percentages are anecdotal, but I haven't heard anyone, even rabid health care reform opponents, suggesting the number is 200%.

As to the claim that we have the best health care the world has to offer, I think this is just more BS that the industry tries to snow us with. According to the Wold health organization see the attached table for how it stacks up.
I'm hoping our Canadian members chime in with their assessment of their system, which seems to rate so high.

You're talking to someone who's wife went blind and needed an operation that is run of the mill and done countless times across the country every day. We were told that it was no problem- just show us the money.
So convincing me that we have the 'best' system is going to take some doing.

My wife is doing great now though- she's working and we're getting ready to make babies.

BTW thanks for jumping in- your contribution to this discussion is valuable.
 

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The Canadian system works great. Everyone is covered for Medical services here. It costs me $56 per month (single) (I think) to have all the Doctor and Hospitalization services. Prescriptions as an out-patient are not covered, but the ones administered in a Hospital are.
Our health care is as good as it gets. Contrary to the announcements in the US media, the length of any 'waiting period' is not excessive. Triage handles the most critical patients first, those who can wait next and the rest follow. I am not personally aware of anyone dying from lack of Medical attention. On the other hand, you can't 'buy' an service just because you are able to pay for it. I have a frriend (wealthy) who travelled to Europe for a hip replacement, but only because he wanted it done quicker so he could meet some schedule that he preferred. It cost him $15,000, but he can afford it, so he left the country to get it done. No big deal to him, and it freed up the surgery time for someone else.

You folks might view it as Socialism, we view it as a fair and equitable system that benefits everyone, paid for by those who can afford it. General Tax Revenues supplement the monthly fees to finance anything the fees don't actually pay for.

If you don't earn enough to pay the freight, it is a reduced rate or free at lower income levels on a graduated scale. At $20,000 you begin to pay a fee. At $28,000 you are paying full fees. (see the stated rate above). Each Province administers its own service, so I am speaking only about the fee structure for the Province I live in. Your mileage may vary. Alberta has $0 fees for everyone.

I think it is a great system compared to an American friend who pays $750 a month for lesser coverage. And there are no 'pre-existing' conditions which are not covered. You need the services, you get it. period.
 

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if the gov't can create an efficient, effective low cost system that would be a 'personal' choice, I would LOVE to help an employee buy in. However, being forced into something is unfair b/c the circumstances of each business are unique. Especially in our industry. We already get hammered for WC and taxes. The customers we are chasing DO NOT WANT TO PAY MORE, they want to pay less, and we won't be able to compete. For every contractor in this area, there are 5 hacks with a crew of illegal employees who work with no WC, liability ins. or taxes and related OH. What about them? Who will level the playing field for us?
Perhaps the system is OK in Canada, but many things that work in Canada will not apply here. Canada does not have the same set of issues the US does.
Bottom line, I'm building my company to be able to offer top shelf benefits to my employees because they deserve it. It's also the best way to hold onto great talent. I believe my company should provide good paying jobs and security to my employees, they should be proud and happy to come to work everyday. But no gov't should ever force me or try to dictate to me when my company is prepared to make those steps.
 

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Here are the IBEW talking points for the Merkley Amendment as provided by the OP. (thanks Sean)

Opposite position follows.



The Merkley Amendment to the Patient Protection And Affordable Coverage Act (H.R. 3590) simply requires that employers in the construction industry with over $250,000 in payroll or more than five workers provide health insurance for their employees or pay a penalty.

The Merkley Amendment is necessary because the Senate bill exempts businesses with less than 50 workers. Under H.R. 3590 almost no construction companies would be required to provide health insurance for their employees, as the industry is dominated by small contractors; 90% employ less than 20 workers. In electrical construction, 70% of contractors that belong to the National Electrical Contractors Association (NECA) employ 10 or fewer workers. Even at its threshold of five workers, the Merkley Amendment still exempts 65% of construction employers from having to provide health care.

The Merkley Amendment is also necessary because construction is an extremely competitive, low-bid industry. As such, very few small non-union construction employers provide health insurance. Its one way they gain an advantage over union contractors.

Health care costs for union contractors, who have provided health insurance through Taft-Hartley, multi-employer funds for years, are between 12.5 and 20% of payroll.

H.R. 3590 adds to these costs by placing additional burdens on employers who provide health insurance for their workers. Both the House and Senate bills ban yearly and lifetime caps. Additional stop-loss insurance made necessary by these bans will cost Taft-Hartley plans between $40 and $120 per member monthly. The proposed legislation will also require plans to carry dependents to age 27. Together, these requirements will drive-up costs an additional $1,000 per member every year further tilting the playing field against construction employers who provide health insurance for their workers.

Creating a stand-alone provision for construction is not unusual. Congress has recognized the construction industry as unique and many laws, including the National Labor Relations Act and Occupational Safety and Health Act acknowledge this. Both have special provisions for construction only.

NECA and five other building trades’ business organizations support the Merkley Amendment. Collectively, they represent almost 30,000 small businesses in the United States.

President Obama and supporters of health insurance reform have repeatedly said if you like your health insurance you can keep it. But without the Merkley Amendment the additional requirements placed on health insurance plans will force Taft-Hartley trustees to drop benefits it order to make union construction contractors competitive.

And here is the opposing view also provided by the OP (thanks again Sean)

In Health Bill for Everyone, Provisions for a Few






By ROBERT PEAR
Published: January 3, 2010
WASHINGTON — Early versions of the Senate’s far-reaching health care bill said that small businesses with fewer than 50 workers would not be penalized if they failed to provide insurance. That was before labor unions in the construction industry went to work and persuaded Senate leaders to insert five paragraphs.
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Paul J. Richards/Agence France-Presse — Getty Images
In a provision of the Senate health care reform bill, construction companies with five or more workers would generally have to provide health insurance or pay a penalty.


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Their provision, added to the 2,074-page bill at the last minute, singles out the construction industry for special treatment, in a way that benefits union members and contractors who use union labor.
In this one industry, the exemption from the penalty would be much more limited, available only to employers with fewer than five employees. Construction companies with five or more workers would generally have to provide health insurance or pay a penalty — an excise tax of $750 per employee.
Senator Lisa Murkowski, Republican of Alaska, asked: “Why this assault on the home builders? I don’t get it.”
Labor unions that have negotiated health benefits for construction workers lobbied for the provision. Without it, they said, small nonunion employers would have an unfair competitive advantage over companies that they say do “the right thing” by providing health benefits to plumbers, electricians, carpenters, roofers and other workers in the building trades.
The provision was one of many added to the bill as senators rushed to finish the legislation by Christmas Eve. It illustrates the difficulty of establishing uniform national requirements in a country where employers have, over decades, devised myriad different arrangements for providing health insurance to employees.
The construction industry provision is receiving a second look as work begins in earnest this week to resolve differences in bills passed by the Senate and the House to remake the nation’s health care system. Other provisions sure to be scrutinized include a tax break for the Blue Cross and Blue Shield plan in Nebraska; Medicare coverage for residents of Libby, Mont., sickened by a mineral mine; extra Medicaid money for Massachusetts, Nebraska and Vermont; and a special dispensation for a handful of doctor-owned hospitals.
White House officials have generally acquiesced in the provisions, which they see as a normal part of the legislative process, required to secure votes for a bill overwhelmingly opposed by Republicans.
Republicans complained of “sweetheart deals,” payoffs and kickbacks. But the Senate majority leader, Harry Reid, Democrat of Nevada, brushed aside the criticism.
“There’s a hundred senators here, and I don’t know if there is a senator that doesn’t have something in this bill that was important to them,” Mr. Reid said. “If they don’t have something in it important to them, then it doesn’t speak well of them. That’s what this legislation is all about. It’s the art of compromise.”
Health insurance for all Americans is the overarching goal of the Senate and House bills.
Employers would be subject to financial penalties if they do not provide workers with health insurance that meets federal standards. Under the Senate bill, businesses with fewer than 50 employees would be exempt from the penalties in every industry but construction.
Senator Jeff Merkley, Democrat of Oregon, proposed the special rule for the construction industry. Mr. Reid accepted it when he was assembling the final bill.
Daniel V. Gardner, a lobbyist at the International Brotherhood of Electrical Workers, said: “The Merkley amendment is necessary because construction is an extremely competitive, low-bid industry. Very few small nonunion construction employers provide health insurance. It’s one way they gain an advantage over union contractors.”
At union contractors, Mr. Gardner said, health benefits account for 12.5 percent to 20 percent of payroll. The Senate and House bills would significantly increase these costs, he said, by banning most annual and lifetime limits on coverage and by requiring insurers to allow children to stay on their parents’ policies through age 25 or 26.
“Together,” Mr. Gardner said, “these requirements will drive up costs an additional $1,000 per member every year.” While small union contractors would be required to pay the costs, he said, nonunion contractors of similar size could avoid the expense.
Labor unions tried unsuccessfully to get a similar provision inserted into the House bill.
Senator Merkley said, “Construction contractors are overwhelmingly small businesses,” with 90 percent of them employing fewer than 20 workers. If companies with fewer than 50 workers received an exemption, he said, that “would effectively exempt the entire construction industry.”
Lake A. Coulson, executive director for government affairs at the National Electrical Contractors Association, which represents many union contractors that already provide health benefits, shares that concern and lobbied for the Merkley amendment.
But in a letter to Congress, other business trade associations, including the National Association of Home Builders and the United States Chamber of Commerce, expressed dismay. The construction industry provision looks like “a political payoff to satisfy the desires of a small constituency,” the letter said.
Joe Robson, chairman of the home builders group, said the requirement would “kill jobs at thousands of small builder firms” struggling to stay afloat in the worst housing downturn since the Depression.
The Bureau of Labor Statistics said the unemployment rate in the construction industry was 19.4 percent in November, nearly twice the national rate.
Under the Senate bill, if an employer with at least five employees does not offer coverage and has at least one full-time employee who receives federal subsidies to buy insurance, the company would have to pay the penalty of $750 a year for each of its full-time employees, regardless of how many got subsidies.
The biggest source of revenue in the Senate bill is a tax that would be imposed on high-cost insurance policies, the so-called Cadillac plans. Construction worker unions oppose the tax because they believe their health plans could be affected by it.
Under a separate provision of the Senate and House bills, the government would provide tax credits to help small businesses buy health insurance for two years. But the National Federation of Independent Business, a trade group, said that many small businesses would still find insurance difficult to afford.
 

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Reason why insurance is so high: lawsuits.
NJ auto insurance tried to use this argument for why rates were so high. The insurance regs were changed to make it a lot more expensive to have a policy that lets you sue in the case of an accident.
Last month there was an article in the paper touting how insurance rates have dropped in NJ since they did this. Give up your right to sue and the average driver saved..............2% on their insurance rate.
ME: 51, no points, excellent credit, $1900 year per truck.
YeeHa I saved $76.
Don't believe the insurance companies for a minute.
 

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NJ auto insurance tried to use this argument for why rates were so high. The insurance regs were changed to make it a lot more expensive to have a policy that lets you sue in the case of an accident.
Last month there was an article in the paper touting how insurance rates have dropped in NJ since they did this. Give up your right to sue and the average driver saved..............2% on their insurance rate.
ME: 51, no points, excellent credit, $1900 year per truck.
YeeHa I saved $76.
Don't believe the insurance companies for a minute.
Well, NJ is a state where drivers cant make left turns or pump their own gas either, so.....

Here in MD i really only have 1 choice for private health insurance. Imagine you were the only remodeler in NJ, you could charge whatever you wanted. Imagine that your state actually had a board set up to make sure you were the only game in town.

Imagine that in order to be a remodeler in NJ, you needed to attend 8 years of remodeling school, at a state run college, where the state determines tuition, and pay for student loans plus interest.

Imagine that was was actually kinda hard to be a remodeler, and that not every illegal immigrant could "hang sheetrock", and that you actually had to be reasonably intelligent.

Imagine that at any time, of any day, someone that cant afford emergency remodeling, could walk into your office, and legally you would have to provide their remodeling, regardless of their ability to pay. Imagine, that these "clients" account for 50% of your "walk-in" business. Imagine that many of these walk-ins have chronic problems due to drug and alcohol abuse.

Imagine that in order to "remodel" a liver, that instead of one carpenter, you needed 3 (with their college degrees and individual liability insurances), and a whole team of RN's (with 4 year degrees and insurances), and you had to perform the "remodel" in 4 hours or less or someone would die.

Imagine that instead of being sued for the price of a contract or repair, you could be sued for those, plus pain and suffering, and the cost of a lifetime of care, +/- several million.

Imagine the cost of auto insurance, if drivers were insured regardless of "pre existing driving records". Like DUIs and vehicular manslaughter charges, and having a couple high speed chases under their belts.


Do i need to continue with the analogies, or are we all smart enough to understand the costs of doing business?
 

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Health insurance and the health care system in the US is very complex. It's not just the insurers, or the lawyers or the doctors or the government or employers or others. It is the whole complex system that doesn't work.

Mainly, I think the payment/incentive structure is all messed up. Providers are paid to provide as many services and bill for them (perhaps to CYA from lawsuits), these may or may not help to keep people healthy. Insurers have the incentive to take in more premiums than they pay out but not necessarily find out what works to keep people healthy.

What if we had a system with a payment structure that rewarded keeping people healthy?

As I said, this is complex and there is no easy or simple solution.
 
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