It seems to me having uninsured people fighting fires is not what you would call a good situation. Shouldn’t the headlines be reading, “Thanks to ACA, our brave volunteer fire fire men an women will now be insured.”
They don’t need to be insured to cover injuries sustained while fighting fires, because they’re already covered by workers’ compensation (except possibly in Texas.)
In my experience with rural fire districts, “on-call” volunteers are not at all the same as other types of “on-call” employees. but I have no problem with the need to get a clear resolution to this question, and to fix it if it would unreasonably impact the typical shoestring budget of a rural fire department.
Well, we can start with the House voting 40+ times for flat-out repeal. Can you site a single republican-supported proposal to amend the ACA to make it work better?
You are allowed one good pun per thread. Any man makes a terrible pun spends a night in the box.
My math is essentially that my old department would be right at the edge if each member only worked the minimum 12 hours per month. Many members easily exceed that number.
The IAFC fact sheet states that, per the IRS manuals, "time spent on-duty in a fire station, responding to calls, training, or handling administrative matters must be counted as “time worked.”
50 employees working the 30 hour per week minimum would be 1500 hours per week. That is 8.92 employees at all times, considering fire service is a 24/7/365 operation.
Our station maintained 10 persons on call plus at least one dispatcher in the station at all times. That amounts to a target minimum of 1848 man hours per week counting dispatch time and on call time together. Some of that on-call time would actually be spent responding to calls. At times more than one person might be on duty at the station doing other admin duties, training, etc…
For that reason, if time spent carrying an on call pager counts as time worked (like under DOL rulings. Unclear how IRS will rule) then our department would pretty easily be over the limit.
As far as I understand, PPACA would impose sharp limits on fire service operations if staying under the 30 hours per week limit were required to avoid being liable for insurance benefits and on call time counts as working time. The reality is that a core group of our members were routinely on call at least 2 nights (24 hours) per week. Often much more. If a member covered 2 on call nights per week and one day shift in the station then he/she has hit 30 hours before meetings, training, or other admin duties are considered.
I feel the need to point out that in a reasonable political environment, this would be identified (correctly) as the sort of glitch which inevitably happens in legislation of this size and magnitude, and would quickly be fixed in a bipartisan effort that would either exempt fire departments from the requirement, or subsidize them further, or do something. So… In short, I blame the republicans. And I think there’s no reason not to.
Any idea what proportion of those were uninsured?
No clue about actual numbers.
It was in a somewhat economically depressed region of the country, FWIW. Based upon that my guess would be a somewhat lower than average rate of employer provided coverage for our department members. Simultaneously perhaps there was a higher than average rate of Medicaid coverage. On a national scale that would all average out.
That’s 9 employees in the building at all times. You said that there’s typically only 1 person there at night. If you assume the department is manned by a single person for 56 hours a week, then for daytime workers to make up the remaining hours you’d need 13.3 per day (16 hour shifts, 7 days a week). You said there were 4, and I doubt they were working 16 hour shifts.
The IAFC fact sheet seems to think that the question is answered, although in their press releases they seem a bit coy about it.
Bolding mine.
Yes, in a worst-case scenario things could be very bad for the departments, which is why I’m giving this story some merit – questions need to be answered and rules need to be clarified. But under the IAFC’s own assumptions, I have a hard time accepting that your department would be anywhere close to borderline, unless buildings were burning down left and right. Headline’s like the Daily Mail’s “Obama care could close thousands of volunteer fire departments” aren’t based on any realistic analysis that I’ve seen.
To try to blame those who did not-and do not-support Obamacare for not fixing it is patently ridiculous, but is not, unfortunately, surprising.
To try to blame those who did not-and do not-support Obamacare for not fixing it is patently ridiculous, but not, unfortunately, surprising.
Why?
Isn’t this how adults do things?
At work, even when I don’t agree with what the boss is doing, I still do my very best to get the job done, and don’t sit back to let it fail.
When my clients are doing what I think are stupid ads, or poorly conceived websites, I still do my part to the very best of my ability and point out pitfalls, problems and roadblocks to them along the way rather than passive aggresively letting the project fail.
Mind you I guess, I do mean adults…
Well sure. Obamacare is a bastardized compromise hacked together, so there will inevitably be some issues, although I don’t see why that particular one couldn’t be easily patched up. But these things are not a sign that Obamacare goes to far, they are a sign that it doesn’t go far enough. It’s time for single payer.
But your job is not analogous to the job of those elected to Congress. You do not make policy at your job; those elected to Congress do. Your job is to carry out the policies set by your boss whether or not you think those policies are good or bad. The job of those elected to Congress is to make policies they and their constituents think are good, and to oppose policies they and their constituents think are bad.
I don’t understand all this shit.
In the UK you just go to Emergency (A&E) yourself, or go to the doctor you’re registered with and they refer you to the local big hospital. I’ve never seen any paperwork apart from the date and time of an appointment. It really is that simple: become ill > get treatment.
How many GDP percentage points are taken up with all this bullshit insurance administration?
And.
The job is both things. The Reps have gone so far off the deep end, I dont think they recognize any duty other than opposing.
Since they own half of Congress, they have to be involved in fixes, if those fixes are to happen. Instead, I expect them to parade each and every problem, and do everything in their power to prevent fixes to the very problems they claim to be upset about.
How many points are taken up by in countries that have good health systems, like the Netherlands and Germany, and how does that compare with the US? That would be an even better question.
Most Americans wouldn’t stand for the NHS drawbacks that are documented in your newspapers almost daily. Getting the US to universal coverage requires convincing Americans that ours will be much more like Switzerland than Britain.
Dunno. How often do British people read about some insurance company adjuster yanking somebody’s health insurance away on a technicality and think “Stupid fucking Americans, putting up with shit like that…”
Administrative (paperwork) costs for US physicians is 25% to 30%. cite
Medicare admin costs in the US are 2%. cite
This is overwhelming proof that the US government can do something right.
I would be very interested in knowing what medical administrative costs are in industrialized countries with single payer systems.
And what **elucidator **said.
[quote=“PhillyGuy, post:37, topic:676007”]
How many points are taken up by in countries that have good health systems, like the Netherlands and Germany, and how does that compare with the US? That would be an even better question.
[/QUOTE
It would certainly be a better comparison, unfortunately I can’t offer it.
But equal or better healthcare for 5-6 percentage points less might be a clue.
I presume you mean by “most Americans” the majority who do have healthcare insurance, not the very sizeable minority who don’t?
The anti-UHL lobby alwasy uses the NHS as it’s example exactly because it is absolutely the far, far end of the specturum: it is ‘cheap and cheerful’ and it covers the entire population - which lives longer. Maybe not so cheerful since bankers austerity.
You do however, always, have the option of private insurance.