# Is Obamacare causing layoffs? **URL:** \ **Category:** Great Debates\ **Created:** [November 21, 2012, 3:33am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685 "2012-11-21T03:33:18Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2012, 12:20am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/81 "2012-11-26T00:20:11Z")
> [@Sam\_Stone](#): > > What happened in an individual state is not the same as what will happen across the country. And Romneycare is not the same as Obamacare. For example, I don’t believe there is a penalty for employers who don’t provide heatlh care, thus eliminating one of the big costs to business of Obamacare. Full stop, you are really not checking the information provided and you do not know what you are talking about, there are penalties in Massachusetts and from the Urban Institute study: > [@](#): > > Although there are differences in the details, with penalties for firms that fail to comply higher under the ACA than in Massachusetts but fewer firms likely to be affected nationally, the broad similarities between the ACA and Massachusetts’ reform suggest that we can expect to see patterns in the response by employers under the ACA similar to those observed under health reform in Massachusetts. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [November 26, 2012, 12:23am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/82 "2012-11-26T00:23:03Z")
> [@Sam\_Stone](#): > > And for all I know, those bonuses could have been part of the executive compensation contract and unavoidable. And yet they have no problem breaking pension agreements. A bonus should not be promised in a contract. A bonus is a payment given after an exceptional performance. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [November 26, 2012, 12:24am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/83 "2012-11-26T00:24:48Z")
> [@Sam\_Stone](#): > > What happened in an individual state is not the same as what will happen across the country. And Romneycare is not the same as Obamacare. For example, I don’t believe there is a penalty for employers who don’t provide heatlh care, thus eliminating one of the big costs to business of Obamacare. > [@Wikipedia](#): > > Employers with more than ten full-time equivalent employees (FTEs) must provide a “fair and reasonable contribution” to the premium of health insurance for employees.[29] Employers who do not will be assessed an annual fair share contribution that will not exceed $295 per employee per year.[29] The fair share contribution will be paid into the Commonwealth Care Trust Fund to fund Commonwealth Care and other health reform programs.[27] The Division of Health Care Finance and Policy defined by regulation what contribution level meets the “fair and reasonable” test in the statute. The regulation imposes two tests. First, employers are deemed to have offered “fair and reasonable” coverage if at least 25% of their full-time workers are enrolled in the firm’s health plan. Alternatively, a company meets the standard if it offers to pay at least 33% of the premium cost of an individual health plan. For employers with 50 or more FTEs, both standards must be met, or 75% of full-time workers must be enrolled in the firm’s health plan. Regulatory and analytic information is available on the Division’s website. > There is an additional Free Rider Surcharge that can be assessed to the employer.[30] This surcharge is different from the fair share contribution. The surcharge is applied when an employer does not arrange for a pre-tax payroll deduction system for health insurance (a Section 125 plan, or a “cafeteria plan”), and has employees who receive care that is paid from the uncompensated care pool, renamed in October 2007 as the Health Safety Net.[28] > [@Sam Stone](#): > > In addition, Romneycare was an alternative to another plan that had been pushed by the Democrats for years which would have put a much larger burden on businesses, so it could be that businesses there had already adjusted to some kind of health care cost increase coming. Completely unlike the two year push against the Tea Party morons. > [@](#): > > Massachusetts also had a much smaller percentage of uninsured people, and higher per-capita incomes. > > But we’ll know soon enough. As this law rolls out and businesses are actually forced to make choices, we’ll see what kind of impact it has. > > By the way, I love the hypocrisy coming from you - claiming that a tax on employment won’t have any effect on employment, while at the same time advocating for carbon taxes in the belief that taxing something and raising its price will lower consumption. You can’t have it both ways. Either taxes on a good or service act as a disincentive, or they don’t. Which is it? Maybe carbon taxes aren’t exactly the same as a tax on a business. A carbon tax is designed to manipulate the market. No one is being put at a disadvantage if everyone has to buy health insurance. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2012, 12:31am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/84 "2012-11-26T00:31:05Z")
> [@Sam\_Stone](#): > > By the way, I love the hypocrisy coming from you - claiming that a tax on employment won’t have any effect on employment, while at the same time advocating for carbon taxes in the belief that taxing something and raising its price will lower consumption. You can’t have it both ways. Either taxes on a good or service act as a disincentive, or they don’t. Which is it? Besides noticing a personal jab, this is a straw man (for both the subject at hand and the unrelated carbon tax), I already noticed that some layoffs are coming, just not at the levels you expect as the evidence from Massachusetts reports. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2012, 12:33am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/85 "2012-11-26T00:33:16Z")
> [@Sam\_Stone](#): > > [How Obamacare’s $716 Billion in Cuts Will Drive Doctors Out of Medicare](http://www.forbes.com/sites/aroy/2012/08/20/how-obamacares-716-billion-in-cuts-will-drive-doctors-out-of-medicare/) > > > [@](#): > > > > There are 600,000 physicians in America who care for the 48 million seniors on Medicare. Of the $716 billion that the Affordable Care Act cuts from the program over the next ten years, the largest chunk—$415 billion—comes from slashing Medicare’s reimbursement rates to hospitals, nursing homes, and doctors. This significant reduction in fees is driving many doctors to stop accepting new Medicare patients, making it harder for seniors to gain access to needed care. Opinion piece, and then in the same article: > [@](#): > > (DISCLOSURE: I am an outside adviser to the Romney campaign on health care issues, but the opinions in this post are mine, and do not necessarily correspond to those of the campaign.) ---
**Author:** ![Ludovic](https://avatars.discourse-cdn.com/v4/letter/l/7ab992/32.png) [@Ludovic](https://boards.straightdope.com/u/Ludovic)\ **Post date:** [November 26, 2012, 12:39am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/86 "2012-11-26T00:39:58Z")
> [@Sam\_Stone](#): > > By the way, I love the hypocrisy coming from you - claiming that a tax on employment won’t have any effect on employment, while at the same time advocating for carbon taxes in the belief that taxing something and raising its price will lower consumption. You can’t have it both ways. Either taxes on a good or service act as a disincentive, or they don’t. Which is it? Sure you can have it both ways. Since health care is actually cheaper in countries with UHC, it is entirely plausible to be of the opinion that implementing it in America will result in more economic efficiency rather than less. One can also simultaneously believe that restricting carbon emissions will result in a short to medium term loss to the economy, but is still necessary in order to stave off long-term disaster. I have my own opinions on the matter but am not interested in debating them now. But it is plausible to hold those two beliefs simultaneously without being a hypocrite. ---
**Author:** ![Frylock](https://avatars.discourse-cdn.com/v4/letter/f/ce7236/32.png) [@Frylock](https://boards.straightdope.com/u/Frylock)\ **Post date:** [November 26, 2012, 3:03am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/87 "2012-11-26T03:03:51Z")
> [@Sam\_Stone](#): > > [How Obamacare’s $716 Billion in Cuts Will Drive Doctors Out of Medicare](http://www.forbes.com/sites/aroy/2012/08/20/how-obamacares-716-billion-in-cuts-will-drive-doctors-out-of-medicare/) > > > [@](#): > > > > There are 600,000 physicians in America who care for the 48 million seniors on Medicare. Of the $716 billion that the Affordable Care Act cuts from the program over the next ten years, the largest chunk—$415 billion—comes from slashing Medicare’s reimbursement rates to hospitals, nursing homes, and doctors. This significant reduction in fees is driving many doctors to stop accepting new Medicare patients, making it harder for seniors to gain access to needed care. So that doesn’t say the gov’t is limiting how much doctors may charge, it says it is limiting how much Medicare will reimburse. And it claims this is causing doctors to pull out of medicare. Even granting what it says (which is very different from the claim you said it supports) don’t you expect market forces to adjust what the doctors are asking for and what the seniors can pay etc, so that it ends up alright? ---
**Author:** ![ladyfoxfyre](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@ladyfoxfyre](https://boards.straightdope.com/u/ladyfoxfyre)\ **Post date:** [November 26, 2012, 3:21am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/88 "2012-11-26T03:21:13Z")
Medicare has always had a [set reimbursement schedule](http://www.cms.gov/apps/physician-fee-schedule/) that is well known to physicians. Claiming that the federal government will only now suddenly put caps on reimbursements for Medicare services is a special flavor of stupid. Try again Sam. ---
**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\ **Post date:** [November 26, 2012, 3:24am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/89 "2012-11-26T03:24:02Z")
> [@Sam\_Stone](#): > > That would be a neat trick, since Hostess’s current CEO was hired in 2010. Before that, he was a top executive at Kraft. So, then he did not deserve anything resembling a bonus if he did nothing to save the company with two years to run it. > [@Sam\_Stone](#): > > The bonuses they wanted to pay out totaled 1.75 million dollars, spread across 19 executives, or about $92,000 each. It’s a lot of money, but it’s not mega-yacht money. And for all I know, those bonuses could have been part of the executive compensation contract and unavoidable. Hostess had just come out of 4 years of re-organization. I have no idea how many of those 19 executives were ‘part of the problem’ - and neither do you. But unlike you, I’m not making sweeping claims about what was ‘stupid’ and what wasn’t. “Unavoidable”? So the observation I made about executive compensation and the fact that even _Fortune_ has indicated that it is out of control was accurate. > [@Sam\_Stone](#): > > And if those managers didn’t get those bonuses, they could have given every employee a grand total of a one-time bonus of $94. Do you honestly think that would have made a difference at all? Not my point, so it is irrelevant. You are the one claiming that folks thought that the bonuses should have been distributed to the employees. I have never made any such claim. I only note that top executives have enjoyed inflated compensation that has been recognized for over a decade and that they have found ways to protect their gains even when the rest of the economic bubble has collapsed. > [@Sam\_Stone](#): > > You guys just love to demagogue those evil CEOs and their high pay, and that’s your prerogative. But ‘fixing’ that problem doesn’t solve anything other than maybe making you feel better that you ‘got’ someone you disdain. Hostess would still be bankrupt even if those CEOs were working for free.. Ignoring your straw man for the moment, I suspect that Hostess would not have been bankrupt if the board of directors had spent more energy looking for competent people rather than letting a bunch of overpaid idiots, who had already spent twenty years failing to improve the company, play “Let’s reorganize the deck chairs on the Titanic” for the last two years. I am in that industry and Hostess has been looked on as an inefficient and poorly run outfit for years, yet the board has continued to see fit to hand out bonuses. Interestingly, in any company for which I have worked, (heavy industry, transportation, and retail, with touch of insurance), middle management and labor never gets bonuses when the company is in trouble. That is reserved for executive compensation. I am well aware that if executives donated their entire salaries to the rest of the work force, they would not extend those wages by a month, often not even a week or a day. However, it is still obscene that they are granted bonuses when they repeatedly fail to meet minimum standards of performance–keeping a company alive. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [November 26, 2012, 7:29am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/90 "2012-11-26T07:29:04Z")
That compensation committees promise bonuses without requiring that the company make a profit is not surprising - but it is hardly justification of CEO bonuses. In the US today, in lower salary positions, some companies offer health benefits and some do not. Clearly paying more for employees is uncompetitive. Obamacare levels the playing field, so the only companies who will be suffering are the ones who have screwed their workers. Companies who have offered health care will be in good shape, and might pick up market share. If the entire industry screws its workers, those companies who can be more efficient while providing benefits will win. I don’t mind paying a tiny bit more so the guy on the other side of the counter can go see a doctor and still eat. I also don’t mind paying a bit more to ensure that 12 year old kids aren’t making my clothing. I believe in capitalism, and I believe that the competitive market can find solutions for good prices and good working conditions - like it has for the past century. I’ve heard it all before - how the EPA and OSHA would be the ruin of American business. ---
**Author:** ![apriori234](https://avatars.discourse-cdn.com/v4/letter/a/e19b73/32.png) [@apriori234](https://boards.straightdope.com/u/apriori234)\ **Post date:** [November 26, 2012, 8:21pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/91 "2012-11-26T20:21:16Z")
> [@GIGObuster](#): > > I would wonder also if the other poster is a health analyst, I mean, missing what did happen in places like Massachusetts that implemented a very similar reform puts doubts on what he claims. Look, folks, I am who I am, and I understand what’s going on because it’s been my professional field for the last 15 years. You don’t have to believe a word I say. Unless I say that Obamacare is great and awesome, you’re going to disagree with me. You supported Obamacare from the start simply as a validation of your pre-determined political leanings. Your response to criticism of the law are not measured, logical responses, but instead knee-jerk reactions in an effort to support your worldview. Anybody who would respond to my post with “He must not actually be a health policy analyst…” is what we in government affairs call “Kool-Aid drinkers.” We see people like you all the time. You’ll believe anything you’re told that supports the implementation of the law, and outright discount any evidence that supports the law is not as effective as it was claimed it would be. I’ll say this: It simultaneously cracks me up and depresses me to see that people will lecture me about what this law does, given my professional background. Do you go to your doctor and tell him how you need to be treated? Do you tell your lawyer the legal nuances on which your case should proceed? You don’t? Then don’t tell me what’s going on with the ACA. You’re not qualified. Everything you know about it are political soundbites. And to answer your question about how “great” the law was in Massachusetts - it wasn’t. Yes, the state acheived 96% insurance coverage (gee, how would I know the exact number… could it be that I work in the field… naaahhhhh…), but can you tell me what happened? What? You mean you can’t tell me what happened? How can you not tell me what happened, especially if you know more than I do about it? I’ll refresh your memory. What happened was that the newly insured couldn’t get in to see a doctor, at least within the state of Massachusetts. Why? Well, you tell me why. You can’t? Let me refresh your memory as to why. It was because the physician shortage meant that there weren’t enough doctors in the state to see the influx of new patients. If somebody needed to see a doctor, they had to wait two to three months on average, and simply because there weren’t enough doctors. Then can you tell me what happened? You can’t? Then let me refresh your memory. These newly insured patients went to the ER instead to be treated, where they crowded the emergency room. Luckily, Massachusetts is a geographically small state. The newly insured had to start seeing doctors out of state to be treated. But you knew all that. ---
**Author:** ![apriori234](https://avatars.discourse-cdn.com/v4/letter/a/e19b73/32.png) [@apriori234](https://boards.straightdope.com/u/apriori234)\ **Post date:** [November 26, 2012, 8:31pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/92 "2012-11-26T20:31:03Z")
> [@Frylock](#): > > So that doesn’t say the gov’t is limiting how much doctors may charge, it says it is limiting how much Medicare will reimburse. And it claims this is causing doctors to pull out of medicare. > > Even granting what it says (which is very different from the claim you said it supports) don’t you expect market forces to adjust what the doctors are asking for and what the seniors can pay etc, so that it ends up alright? Frylock, Medicare/Medicaid pay about $40-$50 for an E/M office visit, versus private insurance plans that pay about $200 on average per visit. Unless a senior/poor person has secondary insurance, the physician takes a huge loss on seeing these patients. In some states (not all), doctors can balance bill the patient, but trying to get money from these patients is like getting water from a rock. As a result, a lot of physicians siomply will not tak Medicare/Medicaid patients. In fact, a lot of physicians won’t take patients with high deductible health insurance plans, either. Concerning market forces, you’re right, there’s pressure from market forces that affect what physicians bill. However, these market forces have been what caused a need for reform in the first place, since they were pushing the cost of health care up between 8%-12% a year since the 1990s. If anything, physicians have to charge more, and thanks to Congress having not fixed the Sustainable Growth Rate formula, since about 2005 this has meant that Medicare reimbursement hasn’t even closely matched cost increases. Each year since 2005, Congress has had to vote extra money to Medicare to keep it afloat. Amazingly, the ACA did not do anything to fix the payment issues, which were the root cause of the problem. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 26, 2012, 8:58pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/93 "2012-11-26T20:58:06Z")
> [@apriori234](#): > > Frylock, Medicare/Medicaid pay about $40-$50 for an E/M office visit, versus private insurance plans that pay about $200 on average per visit. If your doctor lives in Vail, maybe. Most PCPs receive $80ish per visit. ---
**Author:** ![Frylock](https://avatars.discourse-cdn.com/v4/letter/f/ce7236/32.png) [@Frylock](https://boards.straightdope.com/u/Frylock)\ **Post date:** [November 26, 2012, 9:10pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/94 "2012-11-26T21:10:54Z")
> [@apriori234](#): > > Frylock, Medicare/Medicaid pay about $40-$50 for an E/M office visit, versus private insurance plans that pay about $200 on average per visit. Unless a senior/poor person has secondary insurance, the physician takes a huge loss on seeing these patients. In some states (not all), doctors can balance bill the patient, but trying to get money from these patients is like getting water from a rock. As a result, a lot of physicians siomply will not tak Medicare/Medicaid patients. In fact, a lot of physicians won’t take patients with high deductible health insurance plans, either. This is twice now that you’ve replied to my posts in a way that seems to show you don’t know what you’re reeplying to. I wouldn’t deny that many doctors don’t take medicare/medicaid patients, but your great effort in explaining to me why they do that wwould seem to indicate you think I’d deny it. I wouldn’t. I haven’t. ---
**Author:** ![Frylock](https://avatars.discourse-cdn.com/v4/letter/f/ce7236/32.png) [@Frylock](https://boards.straightdope.com/u/Frylock)\ **Post date:** [November 26, 2012, 9:14pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/95 "2012-11-26T21:14:51Z")
> [@apriori234](#): > > Look, folks, I am who I am, and I understand what’s going on because it’s been my professional field for the last 15 years. You don’t have to believe a word I say. Unless I say that Obamacare is great and awesome, you’re going to disagree with me. You supported Obamacare from the start simply as a validation of your pre-determined political leanings. Your response to criticism of the law are not measured, logical responses, but instead knee-jerk reactions in an effort to support your worldview. Anybody who would respond to my post with “He must not actually be a health policy analyst…” is what we in government affairs call “Kool-Aid drinkers.” We see people like you all the time. You’ll believe anything you’re told that supports the implementation of the law, and outright discount any evidence that supports the law is not as effective as it was claimed it would be. > > I’ll say this: It simultaneously cracks me up and depresses me to see that people will lecture me about what this law does, given my professional background. Do you go to your doctor and tell him how you need to be treated? Do you tell your lawyer the legal nuances on which your case should proceed? You don’t? Then don’t tell me what’s going on with the ACA. You’re not qualified. Everything you know about it are political soundbites. > > And to answer your question about how “great” the law was in Massachusetts - it wasn’t. Yes, the state acheived 96% insurance coverage (gee, how would I know the exact number… could it be that I work in the field… naaahhhhh…), but can you tell me what happened? What? You mean you can’t tell me what happened? How can you not tell me what happened, especially if you know more than I do about it? I’ll refresh your memory. > > What happened was that the newly insured couldn’t get in to see a doctor, at least within the state of Massachusetts. Why? Well, you tell me why. You can’t? Let me refresh your memory as to why. > > It was because the physician shortage meant that there weren’t enough doctors in the state to see the influx of new patients. If somebody needed to see a doctor, they had to wait two to three months on average, and simply because there weren’t enough doctors. Then can you tell me what happened? You can’t? Then let me refresh your memory. > > These newly insured patients went to the ER instead to be treated, where they crowded the emergency room. Luckily, Massachusetts is a geographically small state. The newly insured had to start seeing doctors out of state to be treated. > > But you knew all that. It makes no difference to me whether you’re “really” a health policy analyst or not. I’m sure you are. I don’t doubt you for a second. But assertions don’t cut it around here, whatever your profession. What you’re saying about MA in the above requires citation in order to be taken seriously. It’s not that I doubt it. It’s that I don’t even _hear_ it unless it is accompanied by a link or reference. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [November 26, 2012, 9:26pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/96 "2012-11-26T21:26:18Z")
> [@apriori234](#): > > Look, folks, I am who I am, and I understand what’s going on because it’s been my professional field for the last 15 years. You don’t have to believe a word I say. Unless I say that Obamacare is great and awesome, you’re going to disagree with me. You supported Obamacare from the start simply as a validation of your pre-determined political leanings. Your response to criticism of the law are not measured, logical responses, but instead knee-jerk reactions in an effort to support your worldview. Anybody who would respond to my post with “He must not actually be a health policy analyst…” is what we in government affairs call “Kool-Aid drinkers.” We see people like you all the time. You’ll believe anything you’re told that supports the implementation of the law, and outright discount any evidence that supports the law is not as effective as it was claimed it would be. > > I’ll say this: It simultaneously cracks me up and depresses me to see that people will lecture me about what this law does, given my professional background. Do you go to your doctor and tell him how you need to be treated? Do you tell your lawyer the legal nuances on which your case should proceed? You don’t? Then don’t tell me what’s going on with the ACA. You’re not qualified. Everything you know about it are political soundbites. > > And to answer your question about how “great” the law was in Massachusetts - it wasn’t. Yes, the state acheived 96% insurance coverage (gee, how would I know the exact number… could it be that I work in the field… naaahhhhh…), but can you tell me what happened? What? You mean you can’t tell me what happened? How can you not tell me what happened, especially if you know more than I do about it? I’ll refresh your memory. > > What happened was that the newly insured couldn’t get in to see a doctor, at least within the state of Massachusetts. Why? Well, you tell me why. You can’t? Let me refresh your memory as to why. > > It was because the physician shortage meant that there weren’t enough doctors in the state to see the influx of new patients. If somebody needed to see a doctor, they had to wait two to three months on average, and simply because there weren’t enough doctors. Then can you tell me what happened? You can’t? Then let me refresh your memory. > > These newly insured patients went to the ER instead to be treated, where they crowded the emergency room. Luckily, Massachusetts is a geographically small state. The newly insured had to start seeing doctors out of state to be treated. > > But you knew all that. And that is not the subject, it was layoffs… but you knew that. ---
**Author:** ![Sitnam](https://avatars.discourse-cdn.com/v4/letter/s/6a8cbe/32.png) [@Sitnam](https://boards.straightdope.com/u/Sitnam)\ **Post date:** [November 26, 2012, 10:19pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/97 "2012-11-26T22:19:31Z")
> [@apriori234](#): > > Frylock, the major difference between health insurance and auto insurance is that people try not to use their auto insurance. The desire not to get in an accident and cause injury to oneself, others, and their personal property is what motivates people to drive carefully, and thus puts an inherent limit on the number of auto insurance claims filed. In turn, this keeps payouts down and therefore the cost of insurance affordable. A family might pay $3,000 a year in auto insurance. > > By stark contrast, even if the employer pays 50%, a family will still shell out upwards of $8,000 a year for health insurance. At this steep cost, the impetus to use their health insurance is far stronger than that of auto insurance. This keeps claims pouring in and contributes to the rising cost of health care. This line of logic might stand if diseases and medical problems typically fixed themselves over time. If I don’t have insurance I’ll wait till it gets real bad and then your insurance will have to cover my emergency expenses, in the same why you pay for every shoplifted book with your purchase at Barnes & Noble. Everyone needs coverage, or everyone is on their own. What exists now is what is unfair. ---
**Author:** ![rogerbox](https://avatars.discourse-cdn.com/v4/letter/r/76d3ee/32.png) [@rogerbox](https://boards.straightdope.com/u/rogerbox)\ **Post date:** [November 26, 2012, 11:12pm UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/98 "2012-11-26T23:12:40Z")
> [@GIGObuster](#): > > Indeed **BrokenBriton** , the sad reality is that to make some of the opposition points to work in the real world one would have to ignore the big elephant of the insane costs that appeared with no Obamacare in place, and **also ignore that the elephants in congress still think it is a good idea to continue with this rip-off old system.** …While _they_ get government healthcare, no less. ---
**Author:** ![apriori234](https://avatars.discourse-cdn.com/v4/letter/a/e19b73/32.png) [@apriori234](https://boards.straightdope.com/u/apriori234)\ **Post date:** [November 27, 2012, 2:55am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/99 "2012-11-27T02:55:09Z")
> [@Frylock](#): > > It makes no difference to me whether you’re “really” a health policy analyst or not. I’m sure you are. I don’t doubt you for a second. But assertions don’t cut it around here, whatever your profession. What you’re saying about MA in the above requires citation in order to be taken seriously. > > It’s not that I doubt it. It’s that I don’t even _hear_ it unless it is accompanied by a link or reference. Okay, Frylock, what you’re failing to understand is that I AM the reference people quote. It does not make sense that you could: 1) admit I’m a professional in the health policy field; and then 2) say my opinion doesn’t count without a reference. That’s contradictory logic. What do you think I do all day long? Your federal government pays me quite a bit of money to know this stuff so I can advise senior health care leaders. This attempt at disingenuity makes it obvious you’ve supported the ACA from the beginning and are only making veiled attempts to discredit the law’s detractors. Like I said, I’ve seen you people many times in the past. I started in politics before I focused on health care, and I can spot you guys. I will admit, however, that you do a very good job at concealing your partisanship and could fool most people. If you want to get better at it, however, I suggest practicing a few things. First, make an effort to admit what the bad parts of the law are. This gets your opposition to lower their guard and start listening to you. Second, practice focusing your arguments on concepts, not politics. For example, instead of challenging me based on a “lack of references,” you could have, for example, replied that emergency room wait times did not increase substantially under the Massachusetts law. Whether or not this is true, I don’t know, but you could have feigned a compelling argument that could have had me rechecking my sources. I don’t suggest admitting somebody is a professional health policy analyst, and then flat out contradicting said professional for not quoting references, for the same reason you wouldn’t tell your doctor to start quoting the literature to you before he treats you. It’s implied that a professional in his field has an intimate understanding of the subject matter. ---
**Author:** ![apriori234](https://avatars.discourse-cdn.com/v4/letter/a/e19b73/32.png) [@apriori234](https://boards.straightdope.com/u/apriori234)\ **Post date:** [November 27, 2012, 2:58am UTC](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685/100 "2012-11-27T02:58:04Z")
> [@GIGObuster](#): > > And that is not the subject, it was layoffs… but you knew that. Of course I knew that, and my primary post reflected that. Then you said I wasn’t who I was, which changed the subject. What you quoted was my response to your having changed the subject. [Previous page](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685.md?page=4) [Next page](https://boards.straightdope.com/t/is-obamacare-causing-layoffs/641685.md?page=6)