I wish him luck. I had a very humbling discussion with an employment attorney when I was dealing with some clearly illegal stuff going on at work and their advice was "First, people don't keep employed people who are suing them so ask yourself how much money you'll have at the end of the next two years if you just quit and work somewhere else, or spend $15K - $30K on a lawsuit that may or may not result in a severance package?" And then the kicker, "Then ask yourself what a hiring manager of a company you are applying to work at will feel when they find out you sued a previous employer?"
It really is stacked against the worker here. That he is already retired is a good thing, one hopes there isn't a clause buried in his pension that cancels it if he ever sues IBM.
I think the amounts are big enough to warrant a lawsuit. He is retired. The program is for retirees so they have nothing to lose in terms of future employment.
The article hints at annual damages being 15-20K per retiree, and mentions impact on 3000 people (without actually calling it so precisely), so if 60 M is the annual savings to IBM, it is a lot of money to find lawyers and arrive at a retired-employee friendly outcome.
The best people to file these claims are those near retirement who have much less to lose. Otherwise, the situation for workers remains…suboptimal in perpetuity. It is full of peril as you mention.
> But with Medicare Advantage, "once you're in a Medicare Advantage plan for more than 12 months, you cannot then buy a Medigap plan unless you meet insurance requirements," he claimed. So if you have a preexisting condition, they can deny you coverage and the retiree then has to pay that 20 percent.
> Kadereit argues this state of affairs is being allowed to happen by Congress to avoid tough decisions about how to deal with spiraling healthcare costs. And business accounts departments like it because there's profit to be made.
But what we should really worry about are Obamacare death panels.
In hindsight,
the argument about Obamacare death panels should defer to the fact that they already existed, the question is do you want insurance adjusters on your panel, or doctors?
This was a standard rebuttal at the time. It was obvious then (as it is now) that insurance companies were playing the same roll as the supposed death panels. But the voices saying “government death panels” were just louder than the rebuttals which wasn’t that surprising since it was repeated ad nauseum by a certain political party as well as the largest news organization in the country.
My recollection is something about in the UK where they won’t spend a million pounds to do a 90 year old can live to 90.001.
If that’s the case, insurance companies are not death panels. They don’t make determinations about the value of life. They refuse to cover ineffective treatments, but they don’t make evaluations based on age or quality of life.
The fact that something like 80% of health care spending occurs in the last six months of life was something being talked about. Still is.
“Death panel” is an inflammatory word, and nobody is going to acknowledge running one. But I really don’t see how insurance companies can pushed into the definition.
> Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said. <rubber stamping computer algorithm's initial approval or denials>
> It’s especially complicated in oncology, said Dr. Barbara McAneny, a former president of the American Medical Association who runs a 6,000-patient oncology practice in Albuquerque, New Mexico.
> McAneny told me she spends $350,000 a year on a designated team of denial fighters whose sole job is to request prior authorization for cancer care — an average 67 requests per day — and then appeal the denials.
> For starters, she said bluntly, “we know everything is going to get denied.” It’s almost a given, she said, that the insurer will lose the first batch of records. “We often have to send records two or three times before they finally admit they actually received them. … They play all of these kinds of delaying games.”
> Her theory is that insurance companies save money by delaying spending as long as possible, especially if the patient or the doctor gives up on the appeal, or the patient’s condition rapidly declines in the absence of treatment.
> For an insurance company, she said, “you know, death is cheaper than chemotherapy.”
Who said anything about heroes? We just need choices about medical necessity to be made by something other than how it might benefit some company’s bottom line. It’s not exactly donning a cape.
And yes, it's far better for triage to be done by trained medical people than by insurance adjusters. But if given the option, I'd prefer just me and my loved ones making medical decisions about me. Of course we don't have this option, but it should still be something to strive for.
> But if given the option, I'd prefer just me and my loved ones making medical decisions about me.
But, in a system with limited resources, it makes not sense to have individuals that need the resources (but don't pay them) making the decisions. Clearly, nearly _everyone_ would say to use every possible medical option on themselves and their loved ones; even if doing so cost other people (with more established and inexpensive treatments) their lives.
For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them.
> For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them.
Actually it might be nice if all such decisions were made by a panel of people from just such a group. Regular people may prioritize some classes of people over others, but are probably less likely to than an elite panel.
Oh, certainly; though I'd argue they should have input from medical and financial experts, too. But regardless...
> just me and my loved ones making medical decisions about me
The decisions made by only the person needing treatment (and their loved ones) is definitely going to result in the resources being bled dry way too quickly.
US State (and subordinate) governments are forbidden by Constitutional law [0] from violating contractual obligations. They can be sued for any such violation without permission.
For the federal government there are a variety of federal statutes that govern various contractual obligations, and provide means to sue.
Government actors are immune from all liability, and can not be sued unless the government gives you permission to sue them
You are misunderstanding and wrongly extrapolating qualified immunity. Ready any newspaper and you will encounter multiple counterexamples to your statement. Please at least read the wikipedia entry. Here's a start:
"Qualified immunity applies only to government officials in civil litigation, and does not protect the government itself from suits arising from officials' actions.[4]"
I would also point out that you are similarly unable to sue individuals in a corporation, though you can sue the corporation itself. "Piercing the corporate veil" requires alot of special and onerous conditions to be met, somewhat similar to qualified immunity.
This is also incorrect. Tort law, for example, is very broad. There is no need for thousands of laws specifically enumerating permutations of how someone can be wronged. It's true that suing the government is different than an individual, but it isn't remotely as difficult as you seem to believe.
Under the Federal Tort Claims Act, you can sue the federal government if:
You were harmed by a federal employee
The employee was acting within their official duties when the harm occurred
The employee acted intentionally or negligently in a way that caused the harm
You experienced actual damages as a result of the employee’s action
you do understand that you just agreed with me right?
the Federal Tort Claims Act is the federal government waiving their immunity under limited cases.
None of the claims allowed by the Federal Tort Claims act would allow you to sue a federal single payer health system for denial of care that was part of offical policy, or procedure.
The government has a vested interest in my continuing to live via taxes. The insurance company would prefer you die quickly. I would prefer not having to sue while I'm dying to get an insurance company to do what I paid them to do.
There is more; the government has a vested interest in your whole family and friends, they are all affected if you die. They are just liabilities if you buy an insurance.
this should not even be something i need to say in a forum of adults, but let me make this very clear... The government does not care about you, at all, not even a little.
The government has no more concern for your well being than the insurance company, the government has the ability to simply create more money out of nothing. They do not need nor care about your taxes, your taxes is just a method of control and to provide some manner of legitimacy to their system on control.
This should not even be something I need to say in a forum of adults, but let me make this very clear, a government without citizens is nothing. The USA is not a small island nation with a lot of natural resources that can ignore it's people. Don't let your childish hatred of rules make you think that being ruled by corporations is a better alternative.
It’s worth pointing out that you’re dealing with a partisan libertarian who’s comments are constantly downvoted. If you’re looking for a coherent intellectual argument you won’t find it here.
First, you're missing the point that any private company is financially incentivized to end care. Their interests are the polar opposite of yours. Whereas government programs aren't rewarded at all for saving money. (E.g. Social Security doesn't "forget" to mail you checks 10% of the time, the way private reimbursement programs intentionally will. The IRS doesn't tack on surprise extra fees each year, the way your telecoms provider does in total violation of the "fixed price guarantee" they promised.)
And second, you're wrong about the ability to sue the government. There's no meaningful difference in being able to sue a company or sue the government. It's all the same court system. But in either case, if you're relying on suing them in an end-of-life situation, you'll almost surely be dead by the time a court hears the case and decides. So I wouldn't advise making that your deciding factor.
This is laughably naive, and ignores basically all of human history.
to believe that the government and worse agents with in the government has no financial incentive is crazy. It is absolutely the case that where are tons of both corrupt, and non-corrupt financial incentives with in the realm of public finance. Take a look at school funding, police funding, or the big one Military funding. This idea that medicine would be immune does not match reality even if we limit it to say medicare, or even COVID ...
your view that government only acts in "the best interest of he citizen" is also ignorant of history, in reality it is often the exact opposite, The nine most terrifying words in the English language are: I'm from the Government, and I'm here to help.
Government is not the solution to our problem, government is the problem
>>you're completely wrong about the ability to sue the government. There's no meaningful difference in being able to sue a company or sue the government. It's all the same court system.
No, I am not [1][2][3]. Both the federal and state government enjoy complete immunity from liability unless they agree to be sued,it was not until 1946 that you could sue the federal government at all, with the passage ot the Federal Tort Claims Act[4] the federal government graciously allows us mere mortals the ability to sue them in rare and limited circumstances but that authorization can be removed at any time, and often has been, and I have no reason to believe that congress would allow a single payer system to be sued for denial of care generally
Please don't be insulting, it's against HN guidelines.
> your view that government only acts in "the best interest of he citizen"
I didn't say that anywhere, please don't put words in my mouth.
> The nine most terrifying words in the English language are: I'm from the Government, and I'm here to help.
That's a conservative shibboleth. It's been completely and utterly discredited by the accomplishments of Medicare, Medicaid, or Social Security, the ACA. Or of federal disaster response, or of lifting children out of poverty. Etc. Government isn't perfect by any means, but it helps citizens on a massive scale, and thank goodness for that.
> with the passage ot the Federal Tort Claims Act
Right, this allows citizens to sue. Contrary to what you claimed. The fact that the government could undo the act doesn't mean it's not currently the law. You might as well claim you don't have to pay taxes because the government might undo the IRS.
>>been completely and utterly discredited by the accomplishments of Medicare, Medicaid, or Social Security, the ACA.
I would not consider any of those programs a success, Social Security is going bankrupt and combined with the national debt pose a HUGE economic problem for the US over the next decade or 2
Medicare/Medicaid only survives by providers over charging private parties to make up for the terrible reimbursement rates to providers, in sort most workers in the US are charged 2x for medicare, once as a payroll tax, and then again by massive insurance premiums to subsidize medicare/Medicaid
ACA I am still amazed at the mental gymnastics that the court used to rationalized that as constitutional at all, but aside from that there is very little to be proud of in that law, it was designed to make insurance more expensive and less responsive as a prelude to Single Payer. The designers of it wanted to collapse insurance to make Single payer the only viable option.
>>Right, this allows citizens to sue. Contrary to what you claimed.
Incorrect again, I clearly stated that the government has immunity unless it allows you to sue them, nothing in the Federal Tort Claims Act would allow for a tort claim for what we are discussing here, the Federal Tort Claims Act has a very narrow and limited circumstance where it can be used to file a case against the federal government
> Social Security is going bankrupt and combined with the national debt pose a HUGE economic problem for the US over the next decade or 2
Funny how conservatives have been saying that for many decades now. Everyone was yelling about it back at the start of the 1980's, how it would never make it to the year 2000.
Yet... it hasn't gone bankrupt yet, and indeed shows zero signs of doing so. And indeed, pretty much all developed democracies manage something like it, and it goes just fine. And the debt continues to be a perfectly manageable amount relative to GDP, which is the only thing that actually matters.
And the ACA has been a godsend to many people I know, people who otherwise couldn't get private health insurance at all. There's an incredible amount to be proud of. Not to mention the ACA has worked to rein in health care costs, not increase them -- though sadly it hasn't been able to do enough.
Good thing I am not conservative, and anyone with a basic understanding of economics and demographics understands that the current model is not sustainable, this idea that "well people having been saying it would collapse for awhile now" means it will never happen is pretty dense, some how I bet you would reject the same position if I were to apply to say Climate Change?
>>all developed democracies manage something like it, and it goes just fine. And the debt continues to be a perfectly manageable amount relative to GDP, which is the only thing that actually matters.
Soo we do not have an economic crisis, high inflation, housing prices out of control, and various other economic problems? or do you believe all of that is disconnected from government spending?
Government needs to spend more to solve those problems? is that your solution/?
I looked through Medicare stuff recently and I came to the conclusion that, given that Advantage plans almost look too good to be true, and that every insurance company in the country is super anxious to sell you one, the catches (probably mostly about out-of-network) are more than one may want to deal with. Which is pretty much what I've read in the New York Times and elsewhere. They probably can be a good deal but are also probably something of a gamble relative to doing Part A, B, and D plus (probably) Medigap.
The basic pitch seems to be that you get Medicare PLUS all this additional stuff at no additional charge which doesn't make a lot of sense. It may work and work out for some but you're obviously giving up something.
It’s little known but when a retiree or on COBRA a company can functionally force you onto a drastically worse plan at any time, whenever they want, to save money. I was paying thousands to stay on my previous companies COBRA and suddenly my low ($1000) deductible plan had changed overnight to a plan with a $7000 deductible. Suddenly I was paying for the privilege of paying. This is devastating to a lot of people.
Technically, it is giving employers and employees a tax break if the employer buys the health insurance and sufficiently subsidizes it to incentivize sufficient employees to opt into the subsidized health insurance such that it passes the non discrimination testing. Roughly worth at least couple thousand dollars per year for individuals and quite a few thousand dollars per year for families.
Basically, a way to give bigger/better funded businesses an advantage over smaller businesses who cannot afford all that employment overhead, especially HR paperwork. Plus it helps obfuscate labor prices so labor sellers have a harder time shopping around for a better offer.
Retiree healthcare coverage is beyond stupid though, I would value it at zero as an employee unless it was the federal government offering it. I don’t think there are any protections for it either, so the employer holds all the cards.
I would prefer if all these tax advantages were nixed from employers and offered directly to all individuals, if that.
People need to understand the historical significance of why these things came into being.
Especially since we are on the verge of WWIII on multiple fronts. History should not repeat itself if we find ourselfs in a world war again
WWII price controls are directly responsible for Employer Benefit plans, it was illegal to raise wages, but it was not illegal to offer employee's health care, at the time this was direct health care, companies were employing nurses, doctors, etc that would not only see the employee but their entire family often free or very low rates.
This morphed over time into the employer insurance model we have today.
WW2 ended 80 years ago, that is plenty of time for Congress to change the rules if it were so inclined.
The fact that they don’t even want to level the playing field on this specific issue, which is already overall tilted towards big business and the rich, speaks volumes.
My dad had some retirement healthcare through an employer. As I recall, it wasn't especially cheap and then, to his surprise, it turned out there was a cap. So basically was a pretty lousy deal.
I agree with the broader point. There are historical reasons in the US for good health insurance benefits being so tied to, mostly, large employers. But it's just bad policy.
Decoupling health insurance and retirement investment plans from one's employer reduces friction for individuals selling their labor to switch jobs without worrying that it is going to blow up some other facet of their lives.
How it works here in Australia: there's a public health system (~15% of federal government budget). Individuals or families can also purchase varying degrees of private health cover, if they so wish. Health insurance isn't coupled to employment. There's no standard or expectation that employers directly provide health cover to employees as part of the deal of being an employee.
Similarly, choices for how to invest for retirement are decoupled from employment. 11% of gross wages must be paid into a "superannuation" fund, a special kind of tax-advantaged investment fund. The employee has the choice of which superannuation fund they want to use, and can elect to switch between funds.
There is a marketplace of private health insurers and superannuation (retirement investment) funds. Both the private health insurance sector and the superannuation sector are regulated, which reduces the potential for the degree of criminality and grift. Competition is essential, but regulation is also essential and in the public benefit.
Large companies may choose to set up and offer their own proprietary superannuation funds to their employees, but employees have the freedom to ignore this and choose a different externally managed fund. E.g. LiarsGriftersThievesMountebanks LLC might offer their employees the option of directing their superannuation contributions to the proprietary LGTM retirement fund, which invests employees funds in bonded whisky barrel scams run by parties related to the directors, and charges 2% p.a. management fees, but employees have the freedom to ignore this deal and use some other super fund. There are giant "industry funds" that historically were set up by trade unions & only open to people working in a specific industry -- they're often operating at a large enough scale to provide good investment returns, have low fees, and are operated as not-for-profits.
I can assure you if given the choice employers would stop offering health insurance to employee's, it is one of the larges increased in employment costs, and has a HUGE unpredictable factor given more and more companies are opting for direct payment (meaning they pay the costs of all health expenses directly)
It's not a surprise that corporations prioritize financial interests over the lives of employees and retirees because they can. The mistake employees make is depending on hollow, unenforceable promises for financial and health security. The current only recourse is a lengthy, costly gamble in the courts that could be delayed until the plaintiff runs out of money or dies.
It behooves potential employees to instead form worker-owned co-ops, that like credit unions, have different interests aligned to serve their members.
In my brief tenure at IBM after they acquired Blekko I quickly came to realize that the near death experience in the 90's fundamentally changed the company. It gave their Finance team an iron lock on all decisions and all of their decisions were based on 'how much will this cost?' and 'how much will this save?' It made corporate politics easier, if you pitched a project all you had to do was code the language that Finance wanted to hear and even if people didn't "want" it, it could get approved. Quite sad in a way.
I would rather honesty. I don't want to be told to bring my authentic self to work, when that's not really what they want.
I'm also not a fan of the company providing food, laundry, transportation, travel arrangements, etc, etc, etc and claiming that they want to ease my life or whatever, when really they just want to make it harder to leave to another job.
On those little lifestyle perquisites, those can be good for morale, and can also mean a person spends more time and attention working.
Before dotcoms, I worked places that would pay for delivered dinner for anyone working late (otherwise, as soon as you leave the office, you call it a day, plus company is feeding you like parent, plus little social camaraderie break with other people working late), or would provide cab vouchers for people who worked late (no going home only because don't feel safe walking home after dark), etc.
I don't think anyone has illusions about the motives there, and there's some alignment.
The "make it harder to leave to another job" I dislike is things like stock options that must be exercised within 90 days of leaving, before the stock is liquid and before you know whether it'll be worth anything. Or health insurance situations for some people (improved since ACA). Or bonus or retirement contribution schedules that mean waiting until the end of the year (and with no guarantee there won't be layoffs shortly before, especially given that a sociopathic company has incentive not to pay). (One of the big reasons I didn't take a nice non-blockchain fintech job offer with FAANG-like TC level was because of all the complex structuring of the compensation, with several kinds of bonuses and shares and retirement contributions, which supposedly were all but guaranteed, but all on annual schedules, and the salary alone wasn't going to elevate my lifestyle from an early startup. Contrast with a company that routinely deposits so much money into your bank account that you don't much have to think about money -- that's a nice way to retain people and let them focus on the work.)
It really is stacked against the worker here. That he is already retired is a good thing, one hopes there isn't a clause buried in his pension that cancels it if he ever sues IBM.