Is Pittsburgh Too One Dimensional? (Ford City, Export: sales, insurance, loans)

[WILWRadio]

Right now the Supreme Court is hearing arguments from the states that are challenging the mandate that every citizen must carry health insurance or be fined and/or imprisoned for non payment. I believe some others are challenging the legality of the entire health care plan and also are a part of this lawsuit. We should know before the next Presidential election takes place which side wins its case.

I am going to try to hold off on making a decision about where to relocate until after this decision is rendered. If Obamacare becomes fully operational then I am going to avoid moving to an area where health care is a dominant force in the local economy. And also, a move to a state that has already passed legislation removing the mandate that its citizens must carry health insurance also seems likely. Missouri passed this kind of legislation recently and so have at least a couple other states. If worse comes to worse I may have to stay in Missouri if I want to avoid having health care services that I do not desire, forced upon me.

[Goinback2011]

Obamacare will simply shift the health care dollars from the elderly to the under-65 underclass.

The problem will remain - the federal government doesn't have the kind of money it would need to provide Cadillac healthcare to the entire population of over and under-65 dependents. They're counting on the 'fines' for not providing (employers) or carrying (employees) insurance to fund healthcare for the underclass. I think it will simply create a much larger underclass in health terms.

At some point, the deficits will have to be cut, and that will mean cuts to medicare, medicaid and (when implemented) Obamacare.

[BrianTH]

"Obamacare" might slow the growth rate of health care spending, if we are lucky, but it isn't going to reverse those trends.

And in fact the basic structure of Obamacare (providing state insurance exchanges for people who don't qualify for Medicare/Medicaid and don't have employer-provided health insurance, plus subsidies for lower-income people using the exchanges) probably won't save much, if any, on total health care costs. It is various smaller efficiency programs that might have that effect, and those would have to be scaled up if they prove successful to get really substantial savings.

Edit: Here is a quick summary on the issue of how Obamacare will affect national spending on health care:

http://en.wikipedia.org/wiki/Patient...ional_spending

Edit: Also an interesting discussion, from when Obamacare was still in the legislative process:

http://businessroundtable.org/studie...e-marketplace/

Key quote:

We estimate that [the cost reforms in Obamacare] could potentially reduce the rate of future health care cost increases by 15% to 20% when fully phased in by 2019. This assumes the government implements the initiatives quickly, accurately, and consistently, and that private payers follow by implementing similar measures in a disciplined and timely way.

Slowing the rate of future health care cost increases by 15-20% would be great, and over time would add up to huge savings, but that isn't remotely the same thing as entirely stopping or reversing future health care cost increases.

[markson33]

I don't think the governments stance will have a significant impact on the overall employment numbers of the medical centers. I could understand the argument that they may become less profitable, or certain bureaucratic jobs may come and go, but the medical need will only grow. Whether Obamacare, Romneycare or some other type of government intervention, the simple fact is that the population is aging and growing and will require medical services for the foreseeable future.

Does anybody know how many people AHERF employed at its peak? I would guess that there are more health care jobs in Pittsburgh now than there were during the height of AHERF. The point being that the organization can collapse, but the need for a service provider will never go away.

[WILWRadio]

Originally Posted by markson33

I don't think the governments stance will have a significant impact on the overall employment numbers of the medical centers. I could understand the argument that they may become less profitable, or certain bureaucratic jobs may come and go, but the medical need will only grow. Whether Obamacare, Romneycare or some other type of government intervention, the simple fact is that the population is aging and growing and will require medical services for the foreseeable future.

Does anybody know how many people AHERF employed at its peak? I would guess that there are more health care jobs in Pittsburgh now than there were during the height of AHERF. The point being that the organization can collapse, but the need for a service provider will never go away.

One company (customer) in the medical industry that I deal with on a daily basis here in KC told me that they stand to lose at least 25% of their business if Obamacare is passed.

I suspect virtually every aspect of the health care industry in Pittsburgh will also feel the effects of these cuts and the result will not only be fewer jobs but also a decline in service.

[MathmanMathman]

Healthcare is only a REAL industry if it brings in money from outside the region.

[markson33]

Originally Posted by WILWRadio

One company (customer) in the medical industry that I deal with on a daily basis here in KC told me that they stand to lose at least 25% of their business if Obamacare is passed.

I suspect virtually every aspect of the health care industry in Pittsburgh will also feel the effects of these cuts and the result will not only be fewer jobs but also a decline in service.

Are they a for profit medical company, or are they a hospital? I could easily imagine that some companies lose out because of the government intervention, but overall medical employment is growing at a pretty fast rate throughout the country (some would say creating the cost problem). The idea that Pittsburgh, or any city, will see shrinking healthcare employment is not backed up by the data. I'm not trying to make any argument about whether this is good or not.

[BrianTH]

Originally Posted by MathmanMathman

Healthcare is only a REAL industry if it brings in money from outside the region.

Note you only need exports to the extent you want imports, and otherwise your economy can be locals doing productive things for each other. Which in fact is what the vast bulk of large metro economies is about (last I knew exports only made up about 10% of GMP in large metros on average).

[WILWRadio]

Originally Posted by markson33

Are they a for profit medical company, or are they a hospital? I could easily imagine that some companies lose out because of the government intervention, but overall medical employment is growing at a pretty fast rate throughout the country (some would say creating the cost problem). The idea that Pittsburgh, or any city, will see shrinking healthcare employment is not backed up by the data. I'm not trying to make any argument about whether this is good or not.

One is a for profit pharmaceutical company and the other is a short term and long term assisted living facility.

[MathmanMathman]

Originally Posted by BrianTH

Note you only need exports to the extent you want imports, and otherwise your economy can be locals doing productive things for each other. Which in fact is what the vast bulk of large metro economies is about (last I knew exports only made up about 10% of GMP in large metros on average).

Chances are your car was not entirely locally produced. And much of your food too. If a region is not self-sufficient and it buys stuff from the outside, it has to sell to the outside to bring in money. These "export" industries and businesses are the most important wealth producers. Without them a region goes into and economic death spiral. When Ford City lost its Eljer and PPG factories, that pretty much pulled the plug on its economy.