App Companies Propose New Model For Worker Benefits (cio.com)

itwbennett writes: In late October, four delivery drivers for the app-based Amazon Prime Now service filed a class-action lawsuit alleging the company misclassifies its workers as contractors. In June, the California Labor Commission ruled that Uber drivers are employees, not contractors. Now, worker advocacy groups, companies offering services through apps (including Lyft, Etsy, Care.com, and Instacart), a variety of policy experts, and venture capitalists are proposing a new model for worker benefits that will be "portable" across the number of jobs they do in the new on-demand economy. "Self-employed workers choosing to engage in flexible work may also encounter unforeseen work disruptions or other hardships without the protections and benefits that may be provided through full time employment," the group said in a statement posted on Medium.

Comments

Yeah it's called being self-insured

[Anonymous Coward]

The model of relying on a business to provide benefits to its employees in lieu of the government or the employees themselves turns the employee into a serf, unable to leave in fear of losing their benefits. COBRA was the last grand experiment in government meddling in "portable" healthcare benefits and it was by all accounts a miserable failure.

Re:Yeah it's called being self-insured

[fluffernutter]

It's like being self insured without actually making enough money to afford insurance! How awesome is that?!?

Re:Yeah it's called being self-insured

[Anonymous Coward]

That's because they have a bad business model.

Use the Weather Generator as a sales tool!

Re:Yeah it's called being self-insured

[ShanghaiBill]

The model of relying on a business to provide benefits to its employees in lieu of the government or the employees themselves turns the employee into a serf

Indeed. In Maoist China, each factory ran their own schools. So if you changed jobs, your kids had to switch to a new school. This is clearly idiotic, but our system of employer provided healthcare/pensions is just as dumb. There are advantages and disadvantages to privatized and socialized healthcare and pensions, but the third option, of employer provided benefits, gives the worst of both, with the benefits of neither. Employees should be paid with money and only money. Benefits should be provided privately or by the government. They should not be tied to employers. That would be better for workers and companies.

Re:Yeah it's called being self-insured

[xxxJonBoyxxx]

This. At least once in my career I've taken a job with a potentially shaky company and negotiated that they would pay me extra to cover my existing benefit premiums rather than go on a company plan that could potentially go down the tubes (with the company) at any moment.

Cash and some arms-length-ness can be nice.

Re:Yeah it's called being self-insured

[bfpierce]

serf srf/Submit noun an agricultural laborer bound under the feudal system to work on his lord's estate. You aren't in any way bound to an employer for benefits. Retirement can be rolled, becoming a new employee automatically qualifies you for open enrollment. Technically relying solely on the government for said benefits more fits with this definition, much harder to expatriate than find a new job, although also not impossible.

Re:Yeah it's called being self-insured

[Pseudonymous Powers]

It's a nice idea, but Weather Generator operations are actually a very small part of the COBRA budget.

Many armchair accountants are surprised to learn that, by far, COBRA's major expenditures are, simply, blue lasers. Laser weapons capable of blowing up a aircraft in flight and compact enough to be wielded by a common foot soldier are almost impossibly expensive, and COBRA loses at least four hundred of these in every single engagement. When you add to this fact that not a single COBRA laser blast has ever managed to inflict a human casualty, it really exposes how desperately overdue they are for a shakeup in their tactics.

Re:Yeah it's called being self-insured

[jedidiah]

It is commonplace for employers to not even offer insurance before 90 days. The "cobra" price for most employer insurance plans is absurd. Plus employers are prone to change policies frequently or even midyear screwing you out of your deductible.

Fortunately in some states there were decent private health insurance options. Although those have kind of been trashed lately.

Re:Yeah it's called being self-insured

[ShanghaiBill]

Retirement can be rolled

Many pension plans require vesting, so if you quit or are fired, you forfeit the benefits. Also, many companies fund their pensions with their own stock, so if the company goes tits-up, you lose both your job and your savings at the same time.

becoming a new employee automatically qualifies you for open enrollment.

Not always. Companies can have a probationary period where new employees are ineligible for benefits. They can also exclude certain classes of employees, such as part-time, temp, union members (who get benefits through their unions), exempt/non-exempt, commission based employees, management, etc.

Re:Yeah it's called being self-insured

[Anonymous Coward]

Retirement can be rolled

Many pension plans require vesting, so if you quit or are fired, you forfeit the benefits. Also, many companies fund their pensions with their own stock, so if the company goes tits-up, you lose both your job and your savings at the same time.

Which is why it annoys me whenever someone expounds on the "glory days" of pensions. Just how many people actually got their full pension, if at all?

Re:Yeah it's called being self-insured

[Pseudonymous Powers]

...our system of employer provided healthcare/pensions is...dumb. There are advantages and disadvantages to privatized and socialized healthcare and pensions, but the third option, of employer provided benefits, gives the worst of both, with the benefits of neither. Employees should be paid with money and only money. Benefits should be provided privately or by the government. They should not be tied to employers.

Yeah, this is how I feel too. If employers are responsible for providing health insurance, why not just skip the middle man and pay your employees in surgical gauze and forceps?

The current system doesn't really make any sense--it just sort of happened. It started out with the government taxing employees to pay for the unemployed, then it just sort of mutated from there, because elected officials never saw an unnecessarily complicated regulatory system they didn't immediately want to make worse. We need to separate these concerns.

Re:Yeah it's called being self-insured

[Joe_Dragon]

There weather channel used to be good and then they sold it off.

Re:Yeah it's called being self-insured

[Anonymous Coward]

Serfs actually had more worker protections that modern US workers. Lords were bound to give them time off for various religious feasts and protect them from raiders, plus they were morally bound not to mistreat them. Compared to what Uber contractors and other "gig economy" workers are getting, going back to serfdom would be an improvement.

Re:Yeah it's called being self-insured

[davester666]

It's not like GIJoe was any better at inflicting casualties, or even holding onto prisoners.

If anything, it was a huge military-industrial scam, two evenly matched sides, using incredibly expensive weapons, yet completely unable to even kill a few enemy soldiers.

And it was inappropriately set in the US, where something like this would never happen. They would at least manage to kill a whole bunch of civilians.

Re:Yeah it's called being self-insured

[davester666]

My dad told me a story of when he worked at Kenworth, where a co-worker of his had worked for 24 years+, and six months before his retirement and pension, the boss fired him for cause [gave him a bad review, first one ever], just to try to save having to pay out the pension. It took almost a year for the guy to get his pension back through the courts. Of course, this was back in the '70s. Employers don't have to do this now.

Re:Yeah it's called being self-insured

[mi]

Employees should be paid with money and only money.

And they were — until the US government imposed limits on salaries during the Second World War. Employers wanting to attract employees invented the "benefits packages" of various kind, that circumvented the government-imposed maximum wage limits.

As the consumers of and payers for services became different entities, the prices started to rise. Attempts at finding a government-based solutions to the government-created problem further exacerbated it, as always happens. And continue to.

Re:Yeah it's called being self-insured

[pnutjam]

Employees should be paid with money and only money. Benefits should be provided privately or by the government.

But how will I cheat on my taxes then...?

It sounds like they are asking for Universal Healthcare.

Re:Yeah it's called being self-insured

[CanadianMacFan]

Yes but that's because they were using it wrong. Tropical areas that depend on tourists would pay big money to guarantee to have sunny days and the rain between 2AM and 6AM. No more worries about the rainy season killing the tourist season.

Re:Yeah it's called being self-insured

[SeaFox]

It's not like GIJoe was any better at inflicting casualties, or even holding onto prisoners.

If anything, it was a huge military-industrial scam, two evenly matched sides, using incredibly expensive weapons, yet completely unable to even kill a few enemy soldiers.

I bet G.I.Joe's defense contractor is also selling weapons to COBRA under the table. All they have to do is change laser color.

Re:Yeah it's called being self-insured

[Anonymous Coward]

I am on Cobra now, How is it failing?

Re:Yeah it's called being self-insured

[Anonymous Coward]

Since the insurance Industry will give group pricing to individuals, The exacerbated the problem.
SO there is no private industry solution either.

Worse before WW2 there was the local doctor fee for service. Hi tech was X-Ray, No CAT Scans, No MRI, No $10,000 pills.
Back there if you could not afford it you died.

You listed the Problem, and history.
How do we fix it?

Re:Yeah it's called being self-insured

[david_thornley]

One problem is getting health care when it gets costly. If you've got a chronic expensive condition, then before the ACA your only hope of insurance was a group plan, which typically meant employer-provided insurance.

Re:Yeah it's called being self-insured

[david_thornley]

There aren't all that many pension plans anymore. They've pretty much been replaced by employer-run 401(k)s, in which the employer often matches the employee contribution to some extent. Typically, there is a vesting period on the employer match, but that isn't usually all that significant.

Re:Yeah it's called being self-insured

[Anonymous Coward]

the simple, easy answer is single payer, universal health insurance like all other developed economies. Screw the "sharing economy" CEOs and the politicians whose palms they grease. All this "sharing economy" model does is drive wages lower - it's nothing but a series of temporary, dead-end, part-time jobs with no future, while the assholes at the top take the cream off the top.

Re: Yeah it's called being self-insured

[jhoger]

Except you're not locked in anymore because of the ACA. You always have an alternative now if no employer is offering you sufficient insurance. This was one of the stated benefits of ACA, no job lock.

Re:Yeah it's called being self-insured

[Delwin]

My father has two full pensions and social security. He still has to work as a night shift security guard to make ends meet.

Re:Yeah it's called being self-insured

[Bengie]

Healthcare costs increase are mainly due to a lack of universal coverage and high administrative overhead of working with a complicated mess of insurance companies. Preventative costs are much cheaper than paying for an ER bill and lost time. If someone can't afford the cost of preventative doctor visits, they'e not going to be able to afford the 10x+ more expensive ER trip. That's a pure loss to the hospital that gets passed on to those who can afford it. Prices go up.

About $0.50 on the dollar goes to administrative overhead to pay someone to work with insurance companies to get money from them. I've not only learned this in class, but I've also talked to the owner of a clinic. Both my teacher and the clinic had ballpark similar figures for these costs. The clinic owner did give an additional figure. He also added that while private insurance has about a 100% additional overhead, social security only had about a 25% overhead. Working with the government is much simpler, which saves time, which saves money. He was also willing to cut your bill in half if you paid yourself.

Our complicated private insurance healthcare system is extremely wasteful.

Re:Yeah it's called being self-insured

[Bengie]

Over here, Day 1 coverage for insurance, and while in the past decade they did change providers mid-year, our premiums were kept the same, the coverage was kept the same, and even the deductibles transferred. The next year the premiums were cut in half and coverage remained roughly the same. This was right after the Obamacare stuff kicked in a year or two ago. Losing track of time.

Re:Yeah it's called being self-insured

[mi]

Healthcare costs increase are mainly due to a lack of universal coverage

If this were the reason, we would've seen sharp increases before WW2 as well. We did not. Fail.

Working with the government is much simpler, which saves time, which saves money

That may be, because the government has unlimited pockets — if they run short, they can always take more money from taxpayers.

I've not only learned this in class

Ah, so you are still under the influence of the Illiberalism — college professors are overwhelmingly Left and getting worse. Themselves overwhelmingly paid by the government, their solutions to most problems are inevitably Statist as well. It will take you years to shake off their influence — until then discussions of such topics with you aren't going to be productive...

Our complicated private insurance healthcare system is extremely wasteful.

Because it is not really "private" — the heavy regulations, mandates, and the government-enforced absence of competition is keeping it inefficient. The health-care market in general — and the insurance market in particular — aren't really free: the barrier to entry is enormous — an Alabama insurer, for example, can not sell policies to Tennessee residents. Instead of using the Commerce-clause to force States to open-up their markets for health-insurance, the Federal government is looking the other way — since 1945... Any corporation will get slow and inefficient in the absence of competition — it may, indeed, become worse than government in that case.

Re:Yeah it's called being self-insured

[Anonymous Coward]

Something else may have happened before WWII - engineering and scientific advances during the war turned medicine into a high-tech field, where the price of treatment could vary wildly depending on how it was provided. Until then, medicine was practiced by individual artisans (doctors) using traditional techniques. So I think "fail" is a little smug, and not quite taking more aspects of what is an involved situation into account.

Re:Yeah it's called being self-insured

[Bengie]

If this were the reason, we would've seen sharp increases before WW2 as well. We did not. Fail.

You said "fail", which means you automagicaly win on teh intarwebs. Hospitals are saying this, teachers are saying this, insurance companies are saying this. Wait... Insurance companies are saying this? Why would a private insurance company argue that privatizing insurance is a bad idea.

That may be, because the government has unlimited pockets — if they run short, they can always take more money from taxpayers.

It doesn't really matter where the money comes from. If X consumes 5 man hours and Y consumes 2 man hours, Y is generally better for the economy as a whole.

Ah, so you are still under the influence of the Illiberalism— college professors are overwhelmingly Left and getting worse

Ahh, another person who can't think for themselves. Facts are facts. If they're not, then they're lies. I like to think for myself based on what facts are present. Show me some facts that conflict with their's and I'll reevaluate my stance.

As it stands, ER's are ethically and legally bound to service pretty much everyone, regardless of their ability to pay. They are also magnitudes more expensive to operate than a normal doctor's office. I've talked to nurses who claim to see regular ER visitors that cannot afford the bills, but come in once a year complaining of EVERYTHING. The ER is obligated to make sure the person is healthy and does not have any critical conditions. They get a $800 bill that they can't afford. Or for $80, they could have gone to a regular doctor and gotten the same treatment. Either way they can't pay.

FIRST

[darkain]

On-demand first posting!?

Re:FIRST

[NotInHere]

See, even here the system fails.

So... they reinvented the union.

[0100010001010011]

Right now when something is being built the builders call up the local unions and say "I'm going to need 5 Union plumbers and 2 Union electricians for 6 weeks".

Present a single front to all companies needing developers for work weeks, salary and benefits.

Just call it a Union. (And that's not a bad thing).

Re:So... they reinvented the union.

[Anonymous Coward]

That concept is called a "contractor", not a "union".

For unskilled labor, unions often provide a contractor-style labor pool. For skilled labor, that doesn't work as well.

Unions are technically supposed to be not-for-profit. Contractors are not. That's basically the only difference.

Re:So... they reinvented the union.

[bws111]

Unions and contractors are not the same thing at all. My friends father was a pipefitter, a highly skilled job. He was not an employee of any company, he was a member of the pipefitters union. When someone had industrial plumbing to be done they would contact the union, the union posted the job, and someone took it. That person then paid a percentage of their wages to the union, and the union in turn had pension and benefits services for the members. The union also determined the wages for pipefitters.

A contractor, on the other hand, is either self-employeed, or employees other people. People hire the contractor, and he pays his employees. The rate the contractor is paid may be much different than what he pays his employees.

Re:So... they reinvented the union.

[Anonymous Coward]

I don't think the IT version of Kelly Services is a union in any way, shape, or form.

Re:So... they reinvented the union.

[jrumney]

Present a single front to all companies needing developers for work weeks, salary and benefits.

I know they confused things by throwing the buzzword "App" in there, but they are talking about the "idiot behind the wheel" kind of driver, not the low level software for making hardware work kind.

Unemployed

[Anonymous Coward]

"Self-employed workers choosing to engage in flexible work may also encounter unforeseen work disruptions or other hardships without the protections and benefits that may be provided through full time employment,"

Is this our new term for the under and unemployed? They "choose" to struggle now?

Re:Unemployed

[Zantac69]

Well...you can choose a 9-5 type job, or you can choose a different style...

Re:Unemployed

[fluffernutter]

I can't believe anyone would choose an Uber-type job if they were eligible in any way for a 9-5 job. People take Uber jobs because they either can't find alternative employment or they can't hack it in a standard job interview.

Re:Unemployed

[Anonymous Coward]

I'm sure there are exceptions to this in people who just choose to work less, but it is likely that people working these crappy on-demand jobs are trapped in their situation. People who choose to not have a 9-5 and have skills can earn a lot more as consultants than these on-demand non-employees make.

-Posting as AC because I've upmodded someone in this thread.

Re:Unemployed

[ShanghaiBill]

I can't believe anyone would choose an Uber-type job if they were eligible in any way for a 9-5 job.

I know several people that do that. My sister drives for Uber. She has a day job, but drives for a couple hours each evening to earn some extra cash. She enjoys meeting new people, and although driving is stressful for me, she says it is relaxing.

Re:Unemployed

[GameboyRMH]

And there you go, proving the GP's point.

Re:Unemployed

[Anonymous Coward]

That's new American economy. You have the freedom to die of starvation, exposure, and treatable illnesses. FREEDOM!

Re:Unemployed

[fluffernutter]

Right but the conversation is about benefits, and the practicality of doing *only* an uber type job or jobs.

This is game playing

[Bruce66423]

You pay them one rate as contractors, more cash with limited benefits, or as employees, with less cash but more benefits. Given the need for start ups to employee people on highly variable contracts, and the existence of people for whom variability is acceptable, this can be worked out. Where the problem lies in the growing tendency of firms such as supermarkets to keep a stock of variable hours labour. The ideal is to have a civilised conversation about this whole area; the danger is that we lose the ability to grow new start ups cheaply.

Re:This is game playing

[TWX]

There never will be an ideal. That's why it's an ideal, it's a fictional asymptote that never be reached.

This is why I am in favor of single-payer. Remove the concept of insurance altogether, it isn't insurance that people need, it's the ability to go to the damn doctor or hospital. Worried about fraud? The current system already has loads of fraud in the form of the screwed-up billing, fraud against the patient. Make fraud by the billing-entity (ie, the clinic or doctor) a federal crime.

With medical care decoupled from the workplace, employers would have less incentive to restrict employee hours to the numbers needed to legally be part-time. More people that struggle to find full-time work could actually work full time in jobs that of-late have been part-time, like retail. It still has its downsides but if employees now can actually afford to make rent by working one job then quality of life is much improved.

Re:This is game playing

[Anonymous Coward]

Start ups are already cheap enough to grow. There failure is typically tied to one of a few things like misjudging the size of their target market, misjudging the effort necessary to achieve their goals, and over compensating some or all employees based on a poor assessment of their skills and abilities rather than over compensating them because of legal or market pressures.

Re:This is game playing

[Anonymous Coward]

youre ignoring some important things.

overwhelmingly, the people who use healthcare are women and old people. Women use at least twice as much healthcare services as men. By making healthcare universal, men have to PAY FOR WOMEN'S HEALTHCARE. I personally don't want to do that.

Benefits my ass

[PopeRatzo]

Stop calling them "benefits" and just call them what they are, which is compensation. Corporations (and politicians) have used the term "benefits" to be the equivalent of the corporations giving their employees welfare. They've actually used this term, "benefits" in PR campaigns to steal employees retirement packages.

If you get health insurance, sick days, retirement, it's because you earned them. They are yours. It's not company largesse.

Re:Benefits my ass

[Anonymous Coward]

If you get health insurance, sick days, retirement, it's because you earned them. They are yours. It's not company largesse.

Depends on the state that you live in.

In Wisconsin, for example, vacation days are pretty much down to company largesse. They can set nearly any policy they want; use it by X or lose it, we're not going to pay it out if you leave, taking vacation has to be approved by two levels of management on forms submitted in triplicate, etc.

Re:Benefits my ass

[PopeRatzo]

In Wisconsin, for example, vacation days [ehow.com] are pretty much down to company largesse. They can set nearly any policy they want; use it by X or lose it, we're not going to pay it out if you leave, taking vacation has to be approved by two levels of management on forms submitted in triplicate, etc.

Wisconsin got what Wisconsin voted for, an anti-worker governor and legislature.

They'll learn.

Re:Benefits my ass

[Anonymous Coward]

They can set nearly any policy they want; use it by X or lose it, we're not going to pay it out if you leave, taking vacation has to be approved by two levels of management on forms submitted in triplicate, etc.

Yea, but as an employer why would you want to? I run a company for my employees and my customers; why would I want to be such a dick to my employees just because the law says I can?

Re:Benefits my ass

[Anonymous Coward]

According to CNN Money, workers with 10 years of tenure at large U.S. firms average 15 paid vacation days per year

Ouch. I work in Wisconsin and I currently get 22 days of paid personal vacation plus 9 paid national holidays. If they land on a Saturday, then we get Friday off, if they land on Sunday, we get Monday off. HR is very serious about management not allowing workers to take their time off within the year. We had a recent issue where the engineers were not given time to take off all year, and were about to lose their vacation time. Just when the new product went live. HR slammed engineering's management and said all of the engineers MUST take their paid time off immediately as to not lose their time.

Management got in a lot of trouble for pushing a new product and nearly all of the engineers taking vacation at the same time just as the product was released. It was chaos. The CEO sent a company wide email saying that denying employees from using vacation time is against company policy. This was when we were a publicly traded company. Now that we're a private company and partially owned by Google and Microsoft, our R&D budget has over tripled and we now have a lot more engineers to reduce the need to not let people take vacation for large chunks of time.

What a load of self-serving crap

[BarbaraHudson]

The only reason they're putting this out there is to avoid liability.

Re:What a load of self-serving crap

[Austerity Empowers]

Close one loophole and they make another.

Wonder what they'll do when enough people complain about how often salaried employees are misclassified as 'management' or "exempt" such that they can get infinite labor out of them. Amazon in particular ought to be worried.

Re:Fuck the unions.

[fluffernutter]

I don't think it is forcing companies to 'hand out' benefits to employees so much as that employee should be able to *afford* benefits if the company is not 'handing them out'.

Umm, NO.

[Anonymous Coward]

The current system lets too weak of benefits already reach full-time employees in many segments, much less those [illegally] mis-classified as contractors. This is just a underhanded attempt to prevent any form of unionization or uprising against contractor classification.

Once this new "flexible class" is created, how many more full-time employees will due to title and pay be shifted under this grouping? Certainly food & beverage / service industries will try to shift salaried and hourly "management" positions here, they've already shown more than enough willingness to break exempt from overtime laws and abuse of tipped wage classes.

The current full-time employee class already provides very minimal protections and benefits that any company just following those guidelines should be ashamed to offer (e.g. no guarantee of: PTO / sick time, 401k / pension / retirement, guarantee of working hours, etc.).

Not really a Union

[rsilvergun]

They won't have any strike power or collective bargaining rights to speak of. This is just a permatemp agency these companies want to form to get out of paying for health care and unemployment. It's another way for them to externalize their costs onto the employee or the taxpayer. Don't be fooled.

single player healthcare is needed other stuff has

[Joe_Dragon]

single player healthcare is needed other stuff has law issues.

Like uniforms cost can't pull some one under min wage and in some states uniforms must be free.

Forcing an 1099 worker to use uniforms is not really legal and it limits them working for more then one place at the same time / limits them subbing work out.

Forcing workers to buy / rent your tools has issues the big one is can't pull someone under min wage others very state to state / etc and for a 1099 it's dicey as well.

Car Reimbursement you can't pay some one min wage and make them drive around on there own dime under the law.

CA has a cell phone reimbursement law.

Under the law you can't really pay someone the tipped min wage for app work and if they make under they need to be payed the difference not counting experiences / reimbursement.

Universal Healthcare

[Moof123]

So if the problem is portability and income security, lets take that off the table.

Solution: Universal healthcare, paid for by a corporate value added tax (rate to be set by actual costs from the previous few years costs).

Job retraining issues?

Solution: Free university tuition and subsidized apprenticeships for trades. Pay for that with a flat 50% income tax for income above ~200k (or whatever income level keeps the budget balanced, set by recent year incomes and projected budget costs).

Any questions?

Re:Universal Healthcare

[Anonymous Coward]

Any questions?

Are you a Kenyan Marxist Muslim Anti-colonial Socialist Cylon?

Re:Universal Healthcare

[Moof123]

Best compliment I've gotten all day.

Re:Universal Healthcare

[Anonymous Coward]

Yes, I have a question. If healthcare portability is still an issue, how come? I was told the ACA was going to fix that along with all the other healthcare issues we were having in the US. I was told anyone who told me different was an idiot and a racist.

Why are we asking the people who already "solved" the healthcare problem to solve it again? Its either solved or they are too incompetent to be able to solve it after spending $1 Trillion dollars.

Re:Universal Healthcare

[jedidiah]

> Any questions?

What happens when the government kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

Re:Universal Healthcare

[Anonymous Coward]

If it's like the UK, you will always have the option to purchase private insurance that covers more than the government minimum. It's not an either/or proposition.

Re:Universal Healthcare

[Anonymous Coward]

What happens when the government kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

The same thing that happens when you can't afford to buy the diagnostic tests or the expensive cancer drug keeping you alive, yourself. The same thing that happens when you can't afford the insurances being offered and still keep a roof over one's head. Which is, coincidentally, the same thing that happens when the insurance company decides to make more profits by restricting the tests they feel your doctor should order or forcing alternative treatments upon your doctor which have a better cost-success ratio.

The difference being those times when someone who can't afford the insurance because they're minimum wage, paying it yourself, or commercial insurance decides via medical policy that your life is not worth what they'd have to pay out, a single payer universal healthcare plan would still save more individuals who otherwise wouldn't have care.

Re:Universal Healthcare

[Anonymous Coward]

What happens today when your insurance company does the same thing?

Re:Universal Healthcare

[Moof123]

ACA was a conservative patchwork solution, and is far less of a clean solution than single payer. It has helped to a great degree in reducing the ranks of the unemployed, and greatly eased suffering for many. It should be lauded for this.

However it was never a 100% solution like single payer would be. It left hospital system in place with their huge waste and lack of transparency. It left most people with the same insurance they had, meaning that for the middle class if you change jobs you change insurance. For most workers their insurance is still tied to their job. Lose your job and you can go on the exchanges and find something affordable (better than COBRA provided for), but you are still likely dealing with a fresh set of doctors in a new network. Anyone with someone in their family going to a specialist, this can be a major disruption.

Single payer was politically too big of a leap, even implementing the conservative invention of RomneyCare nationwide was used as proof of a socialist takeover by death panels.

I still see single payer being inevitable, but probably still 10-20 years away.

Re:Universal Healthcare

[Anonymous Coward]

Yes, just don't call me a Republican.

Re:Universal Healthcare

[Moof123]

They die.

What happens when the private insurance kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

They die.

No system is perfect. None.

Our system has worse outcomes for more money than comparable countries with single payer healthcare. ACA has snubbed the costs and put in measures to improve outcomes, but these are just stopping our system from getting much worse rather than closing the gap of outcomes and competiveness that other countries enjoy.

Re:Universal Healthcare

[Anonymous Coward]

Sorry, DNC wrote it in secret and left out the GOP. Remember "we have to pass it to see whats in it". Not 1 GOP vote for it.

You fail in debate. You lied to make your point and you just got called out.

Re:Universal Healthcare

[DogDude]

What happens when the government kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

With the government, you have an appeal process. When it's private insurance, you're fucked.

Re:Universal Healthcare

[Anonymous Coward]

> Any questions?

What happens when the government kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

You buy the drugs yourself. Unless you're dirt poor, and can't afford to buy it yourself, but in that situation you wouldn't have afforded insurance and you'd be in the exact same situation.

This isn't hypothetical. This is exactly how it works in the UK and in my country (NZ). I have relatives who have to buy non-funded drugs, and it's no big deal, I mean they are expensive, but so is dying. Usually these are the same drugs that your private health insurance in the US wouldn't cover, so it's not like you're losing anything.

Re:Universal Healthcare

[ultranova]

What happens when the government kills one of my relatives through penny-pinching on diagnostic tests or it decides that expensive cancer drug keeping you alive is just too expensive?

They lose your vote, I'd imagine. What happens when a private insurance company does the same? Nothing.

Re: Universal Healthcare

[jhoger]

Talking points.

Good concept

[parallel_prankster]

I like this model of portable work. However, what needs to happen is that the companies that want to use this must allocate a fund or must pitch in so that they are paying some amount even if they dont have any work requirements currently. Its a sacrifice they need to make in return for the flexibility to hire people for only a short duration as per their work needs. In return, the workers get a little extra security and maybe some flexibility in deciding what they want to do as well.

Re:Fuck the unions.

[Chris Johnson]

Meritocracy only works if it's not a lie. It doesn't magically happen out of nowhere, it's a consequence of a system that can cull bad actors.

Real life is not that system. In real life, bad actors, con artists and CEOs run amok exactly as much as they're allowed to.

Completely deregulate and go full retard (to use what ought to be, but isn't, a more politically correct and inoffensive term for 'free market') and you only guarantee without a shadow of a doubt that your OCRACY is the farthest possible thing from MERIT.

In the best of all possible hypothetical worlds, the best you could hope for is that merit is not actively a disadvantage: nobody's penalized for wasting time and effort getting good. In this world, that's time better spent learning to con people, or building up a social media herd of suckers to fleece, and choose wisely.

Please never all-capitalize meritocracy again. As it is a malicious lie in the absence of a serious and well-organized and administered system with coherent goals and definitions of 'merit', it doesn't deserve even one capital letter, really.

Next you'll be telling me Google, and YouTube, are meritocracy in action. Or Uber.

You Gotta Know

[Anonymous Coward]

These guys are watching out for us and don't want the little guy to get hurt.

Better Idea

[prefec2]

Instead make insurance compulsory and a general service for all without any deductibles. Your payment is determined based on your income. So if you do not have any income you are insured but have to pay nothing. Yes you call that socialism. I call it security. For example, until last month, I was working for the university. Presently, I am unemployed, because the project funding ended and a follow up project is still in the process to be granted (or not granted). So in the mean time, I get my money from unemployment insurance, they also pay my healthcare insurance, and my retirement fund.

Re:Better Idea

[Anonymous Coward]

You are correct. It is the Republicans that are selfish and don't want to pay for things for us.

Re: Better Idea

[Anonymous Coward]

And they hate us so they immorally refuse to pay for things for us.

Re:Better Idea

[DogDude]

Exactly. It is the government's job to force people at gun point to pay for good and services that you want.

Yes, it's called "taxes", dipshit. Did you personally pay for the utility lines that delivered the electricity that allowed you to write that moronic post?

Re:Fuck the unions.

[Anonymous Coward]

That's cute.

Serf v. "independent"

[AutodidactLabrat]

if THEY set your schedule, like Lyft or any of the other 'shared jobs" YOU ARE A SERF.
This is just the corporate attempt to not pay for the value of that availability at schedule and submission to working conditions without prior knowledge or leverage.
Face it, the goal isn't serfdom
It is slavery

The joys of the NHS

[Bruce66423]

As a Brit who enjoys the benefit of the NHS - which REALLY is free at the point of demand - I tend to forget just how messed up the US system is. If we spent the same proportion of our GDP on health as you do, it would give us an amazing service. We spend about half, and achieve about 95% of what you do.

Re:The joys of the NHS

[cas2000]

and that 95% service is available to everyone, not just a minority (mostly white and mostly upper-middle class or higher with good jobs)

Re:The joys of the NHS

[Anonymous Coward]

I wondered about this; do you have private hospitals in Britain or are all hospitals part of the NHS?

Because I keep seeing arguments from Americans (I'm a kiwi) that public health care means everyone will just die from lack of care; but in New Zealand we have public health care, it's somewhere between good and pretty crap, depending on what particular affliction you have, but we also have private health care and private health insurance which you can elect to buy if you think the public health care system is doing a crap job (and can afford it).

So I was wondering, are there really places in the world where private hospitals and health insurance do not exist, or is it just a crazy strawman?

Re:The joys of the NHS

[TWX]

Just to hazard a guess, but in the same way there are very expensive, exclusive spas, country clubs, resorts, and the like, there are undoubtedly expensive and private heath clubs, sanitariums, and other facilities available to the wealthy outside of the normal everyman system.

Re:The joys of the NHS

[Anonymous Coward]

I wondered about this; do you have private hospitals in Britain or are all hospitals part of the NHS?

We have both, much as you describe.

Portable health care

[sjbe]

The model of relying on a business to provide benefits to its employees in lieu of the government or the employees themselves turns the employee into a serf, unable to leave in fear of losing their benefits.

Which is I think a part of why Republicans seem to hate "Obamacare" so much. They've lost their leverage to keep people subservient.

COBRA [dol.gov] was the last grand experiment in government meddling in "portable" healthcare benefits and it was by all accounts a miserable failure.

It wasn't a failure. COBRA did more or less what it was designed to do. It was designed to be a bridge, not ongoing portable insurance. The system around it was the failure. Used to be that if you lost your job you lost your health insurance too so you were doubly screwed. COBRA gave an (expensive) safety net option but it couldn't possibly solve the actual problem that was eventually solved with the Affordable Care Act. I've used COBRA insurance twice and it was fine for what it was.

Re:Portable health care

[Anonymous Coward]

Thank you Democrats. I've got more freedom to change jobs because my daily needs are less tied to my job. And by that I mean that my job no longer fills my family's basic needs. Where do I send my letter of gratitude and donation to the cause?

Re:Portable health care

[DarkOx]

Affordable Care Act did not solve the problem at all in some ways it made it worse.

Under the ACA a job loss for most folks means the same insurance loss or COBRA situations as before. We get our insurance as an employee benefit, which our employers offer because they will be punatively taxed otherwise. So in addition to a job loss and the need to find a new job you also need to find a new insurance carrier, that you might only use for months or weeks while you are out of work, or pay some hugely expensive COBRA bill.

At the same time the ACA more or less eliminated minimal coverage and high deductible plans that people could have switched into in that situation. You don't need a plan that covers all that preventative care for example while you are unemployed and expecting that situation to be temporary. You do probably need/want to save money. The Affordable care act has ensured only expensive choices are available. Affordable my ass.

What the ACA should have done is destroy the group market rather than the individual market. Everyone could have just purchased individual insurance but not everyone is a member of a group. The sensible thing to have done would have been start taxing employer benefits as regular income, and DISCOURAGING employers from offering them. Then individual mandate or not (I would say not because I care about freedom) you could have simply made health/dental/vision insurance costs tax deductible on the individual income tax side.

The ACA was the most abject stupid design possible!

Re:Portable health care

[ebusinessmedia1]

The ACA was compromised because Obama - instead of CRUSHING the private insurers when he had the votes - agreed to keep them in the system and negotiate terms with them in secret. We need a single payer system, like all other developed economies. Yes, that means higher taxes. Either we take care of one another, or we don't. If we want to maintain a "winner-takes-all" meme in America, where everything is rated in dollars,then we are finished as a culture, long term.

Re: Portable health care

[jhoger]

Yeah except everything you just said is bullshit

Re:Portable health care

[DarkOx]

My suggestion to dismantle the group market does not crush private insurance either. It just shifts who the client and payers are. If you kept the individual mandate (something I DO NOT SUPPORT) the size of the pool would remain about the same the nature of the participants would remain about the same. The difference is people's insurance would be as decoupled from their employer as their cable bill is and that would be a good thing! It would mean that changing jobs does not mean changing insurance providers, which in turn does not mean changing hospital networks or primary care providers, as is frequently required if you change insurance plans. Ask anyone with an ongoing condition if they want to change doctors. If the ACA was about allowing people to get the care they need in a cost effective way it would not have been done this way period. ALL of the major arguments for it offered the public were LIES. Its about time someone stand up during the state of the Union and shouts down the president again.

Lets face the ACA's structure was designed not to avoid crushing private insurance but as a give away to private insurers. There were plenty of ways to make insurance more affordable without doing single payer, fixing rather than exacerbating the insane employer benefit tax structure would been a good start. More cynically I think its the typical leftist elites hatred of lower class, who they pretend to champion. It should have been painful obvious that group was going to be disproportionately sent to the exchanges and that group subsides or not would be least likely to be able to afford care, and would end up paying additional taxes. It was well known states would refuse the medicare expansion, even that has a bomb in it where the Federal contribution goes away after a time. So its essentially an unfunded state mandate. The entire ACA is really a poor tax!

Pay vs. Benefits

[tomhath]

Contractors need to realize that they already get healthcare, retirement, sick days, etc., it's just that they need to manage them. The company manages some or all of those things for employees, but if a contractor wants the company to manage it for them there will be a commensurate cut in pay. It really is that simple

pretty simple, and not new

[raymorris]

Yeah this is pretty simple, and not new. One of the major reasons contract jobs pay more in cash is because they don't provide payment in the form of the employer paying your insurance and vacation. So you use some of the extra cash to buy insurance, on the Blue Cross web site - just like you'd buy anything else.

I recently had two job opportunities - a regular employee at a IT security company for $x + insurance, or a contract with Apple for $20,000 more, and no insurance . The insurance and such included with the employment is worth about $14,000, and the stability is worth something, so I took the employment offer. I didn't expect $20,000 more PLUS they'd pay my insurance.

Freelancer's Union, all the way

[AnAlchemist]

For those of you as contractors, I highly recommend The Freelancer's Union (https://www.freelancersunion.org/). Liability, disability, and life insurance, all reasonable. Even medical and dental insurance in some places, like NYC.

Reasonable prices, and fast customer service.

Disclaimer: I'm just a happy customer/client/member, whatever you wanna call it.

Re:Freelancer's Union, all the way

[ItsJustAPseudonym]

Thanks for the link.

The law thinks otherwise

[thegarbz]

Compensation is codified in the law. Benefits are not.

What they company must legally provide for you is not called a benefit. Sick leave, health insurance, etc in America provided by the employer is most definitely a benefit. Much of the rest of the western world doesn't use this term "benefit" to describe these as they are mandated part of the compensation packages for employment.

I.e. even in Australia if you want to pretend you're a contractor you're legally required to separate a portion of your earnings for pension, sick leave and holiday leave.

Re:The law thinks otherwise

[Anonymous Coward]

"Benefits" are compensation in the US too. You pay taxes on them. If you're a self-employed contractor, you are legally required to set aside part of your earnings for social security, worker's comp, and other federally-mandated compensation programs.

As for how much sick leave or vacation time you get, well, you're free to negotiate your compensation during the hiring process. Do so.

Car (Insurance) Analogy!

[xanthos]

In the US all or most states require you to have liability insurance to pay for any injuries or death, required just like the ACA mandates/requires you to buy health insurance.

Guess what, some people don't. Or they just pay the initial premium to show coverage and then let the policy lapse.

So some states also mandate that you have additional coverage in case the other guy is un-insured or under-insured (i.e. not enough to cover your co-pay).

These APP companies are the un-insured guys. They could be responsible and provide benefits typical of the jobs they provide, but instead they want it to be somebody else's problem.

Did anyone notice that they didn't actually propose anything beyond 1) we shouldn't have to pay and 2) stop suing us.

Re:Car (Insurance) Analogy!

[viperidaenz]

Or have a health care system that doesn't require anyone to have insurance. It could cover accidents and compensation as well, so there is no need to sue someone who injures you for rehabilitation and lost wages.
Perhaps you could pay it from a levy on income. You could take a fixed % from employees/self employed people and a % based on the industry risk for the company making the income payment. That way every person pays the same % and the industries with the most accidents pay the most.

You could call it something like Accident Compensation Corporation.

Get paid more

[viperidaenz]

That's why contract workers should be paid a lot more than an employee.
If I find myself without a contract, I don't go bitching to a lawyer that I should have been classified as an employee and was unjustifiably dismissed.
I accept that fact I am self employed. It helps I get paid twice as much as the employees I sit next to for doing the same job.

You mean Temp agency?

[trout007]

When I started in Engineering some of my friends decided to become contractors. They would typically make about twice my pay when they had work. The temp agencies they worked for took a cut and provides the benefits like health insurance. Of course this was 20 years ago so it was easy to find a cheap high deductible policy before they were banned.

Somewhat simple workaround

[PPalmgren]

My industry uses something akin to a "collective benefits association" that handles benefits for employees that would work for multiple locations in the same industry. The company pays that association $X/hr for the employee and the benefits are distributed centrally by that association to the employees for all the pay received from multiple companies. This is for people classified as employees, not contractors. The association has to be adequately staffed though because their benefits are pro-rated by employer by work share, and each employer must report those benefits (like vacation pay) to unemployment agencies for taxation. The pro-rating and reporting to employers by the association helps avoid double taxation of unemployment and FICA matching for the employers. Its a lot of work, but it gets the job done and is probably the best solution manageable for employees who are classified as employees and work at multiple locations for multiple employers.