If You Like Your Healthcare Plan - Well, You Can't Keep Your Healthcare Plan

Got a letter from my health insurance provider.

Due to Obamacare regulations, the grandfathered status of my health insurance plan expires in 2025, and I can longer keep my plan.

The plan that I had, while a high deductible one, had a $4,000 individual out of pocket deductible after which practically everything was covered moving forward.  I only hit that cap in two of the years I've had the plan.  Very simple - hit the cap and no copays for in-network care moving forward. As plans go, it did what it needed to do at a relatively (for definitions of relatively) reasonable cost, would cover what I needed, has a good network, and does provide some useful discounts.

But, as a result of this ending of the grandfather period I need to switch to an Obamacare-approved plan.

All of the approved plans have higher individual deductibles, around $7,200-$8,000 rather than the $4,000, and all now have copays or coinsurance after the deductible is met. And some have much higher coinsurance, up to 100% to be covered by me for certain tiers (whatever the heck a tier is) compared to 0 now. So I have a out-of-pocket cost that is pretty much 100% more than I had before add in the new copays and it's over 100% easily.

The new plans offer more costs and less coverage. But hey, they offer maternity coverage - which I really don't need.

On top of that, these compliant plans are at a minimum 20% (with  potential out-of-pocket costs that are staggering) to 60% more per month (with  potential out-of-pocket costs that are less staggering but much more than I need to pay now) to again get less coverage and have to pay more out of pocket than my current plan.

So under the new Obamacare plans, I will pay more per month for the insurance, and more out of pocket when health care is actually delivered.  

I will be paying way more than double my current costs for health care to get less, whichever plan that I choose.

What a really wonderful deal.

Well That Cleared A Year's Worth Of Deductibles In A Month.

Got the bill in the mail for the surgery, which I have now paid.

Reading the top line I almost passed out.  Bottom line was quite a bit better by comparison, which is likely why they do it.

Our medical system is kinda crazy in terms of billing, but the level of care is rather great. 

A $60k top line, but then there's an insurance reduction of $47k.  Then followed by the  insurance company  payment of $10,842.82 and our deductible of $1,577.18.  So for a $60k charge, they actually got paid $12,420.00.  This is probably what they actually wanted to make from the outset in order to get a decent profit for a few rather intensive and high quality hours of care, so they had to raise the stated price to be able to get to where they wanted to be.

If anybody can make sense of this kind of system where the insurance company's contractual reduction is the majority of the stated charge, good luck with that.

Note that was just the surgery center and didn't include the separate bill from the surgeon, who, just like the surgery center, definitely deserved the money. So, understand that I'm not complaining at all, just remarking on the inanity of how the system works and how the top line price just has nothing to do with the actual final price paid.

Between the two invoices from them alone, we cleared our insurance company's annual High Deductible Health Care Plan out-of-pocket deductible for the entire year and all in the month of January! Ouch. 

We've only cleared that deductible in a year once before - last year when some other serious family health care problems occured and had to be dealt with, but then we hit the max in September, not January. 

Of course, some things aren't covered by insurance at all, such as the ice/compression machine so we paid that out of pocket, but the rental fee  for the 3 weeks for it was really, really worth it. Highly, highly recommended if you get offered it, do it.

Well, the rest of the year now has services without out of pocket deductibles so we've got that going for us, and that's nice.

The New Hip - Now With A Picture!

I'm officially part titanium and part ceramic, now with pictorial proof.

The doctor took off the dressing, examined the incision, and was happy with what he saw. 

The incision looks good, no signs of infection or other issues.  He covered it with a steri-strip and gave some more instructions for caring for it.

The area around the incision is rather raw and has razor burn from them shaving the area.Also still rather swollen, which is to be expected.

X-rays taken shows everything is in the right spot and the surgery was a great success.

The spike into the leg bone is titanium and was press-fit into the bone during the surgery. It has a rough-textured matrix on the outside designed for the bone to grow and attach to the spike, further securing it and cementing the two parts together.

The ball is ceramic.

The cup at the hip bone is titanium with a slippery smooth plastic insert.   The cup, like the spike, has a rough-textured matrix on the outside. It also will have the bone grow and attach itself to the cup and, like the spike, the cup will be cemented to the bone and the screw will become a backup rather than primary attachment point.

Yes, that is a titanium screw at the top securing the cup to my hip bone.

I can now honestly and 100% accurately say I've been screwed.

The titanium is actually stronger than the bones it now holds together.  The worry from falling is dislocating it as everything settles in, or breaking the bones around it. So falling is highly undesirable and contra-indicated at this point.

Theoretically, I can have a normal and full range of movement in all directions as the leg will no longer be impinged by the arthritic hip.  Pretty impressive what modern medicine can do.

Looking forward to making that full range of motion happen.

Got discharged from at-home physio and had my first out-patient PT session today.

Started with a warm up and then we got right to it.  I had walked in with a cane.

They put a belt around my waist for safety, with the therapist holding an end and then had me walk unsupported for the first time since January 13.  

A very strange feeling. I walked essentially unsupported: forward, tip-toe, heel-toe, sideways, and backward and then marching in place.  

Then onto a balance board which was fun.  Then lying down doing all sorts of exercises.  Finally the exercises were done and I got a heat-wrap around the hip, and then a special ultra-sound machine designed to relax the muscles and break up some of the swelling and scar tissue.

A rather intense hour and I'm definitely feeling it now. This is going to be a lot of effort but it's going to be good.

How About "None of Your Business"?

One other interesting anecdote from the Covid testing experience.

At the facility we went to, you have to register as a patient, as one often does.

Instead of simply signing up and giving your drivers license and health insurance to take the test you have to give a pretty full health history.

 Note - Photo ID is required for Covid testing - interesting isn't it?

Now, at least it was electronic history so you didn't have to write things out in quadruplicate as at other medical offices.

But it was a very invasive medical history that was requested, especially for simply getting a Covid test.  Quite a few question asked had nothing to do with your medical condition at all, especially this one:

How is having guns present in your home a part of your medical history, exactly?

Sadly, there is no "None of your business" or "Stay in your lane, Doc"option to select. So, I simply skipped over it, as I did with most of the intrusive and non-applicable questions, which meant the medical history was rather quick to do.  But, as usual one spends more time doing paperwork than actually having the test itself performed.

The progressives in the medical establishment  are certainly not giving up their false and inapt gun control as health/epidemic model anytime soon.

A Rather Unpleasant And Unforecast Vaccine Interaction

My mother-in-law at 85-years-old, plus health issues, is in the cohort that is rather vulnerable to the more dangerous effects Covid.  

Since she lives in Canada it took for-bloody-ever to get her a vaccine. 

Canadian health care is a mess at the best of times.  

Now it's even worse.  Getting to see a doctor promptly is well-nigh impossible with lengthy delays and even then many are just doing telemedicine which really doesn't help much.

Well, she finally got her shots and then a few weeks later got a rash, which became an even more painful rash and fever, fatigue, and headaches.

It took two weeks since the rash began to get her in to see a doctor and the diagnosis is shingles.  She has had them before so she didn't get them from anyone else. The shingles virus can apparently hang around in your system kept in check by your immune system.

Apparently, per the doctor that examined her, the Covid vaccine depressed her immune system enough for the shingles to break through.  Did not know about this at all before, but apparently it is a known possibility.

 So far she's doing ok, but certainly not comfortable.

So if you have had shingles in the past, there is a possibility you'll get a shingles breakthrough after getting your Covid shots.    At her age and health Covid is likely more dangerous than shingles, but knowing that was a possible interaction would have been good to know so she could have gotten care earlier.  

So if you get the Covid vaccine and have had shingles in the past, be on the alert for a possible rash and get treatment for shingles earlier rather than later.  Not fun.

Gov Half-Whit To Healthcare Workers: Thank You Medical Heroes, You (Checks Notes) Racist Bastiges!

3WWMT: Whitmer: Michigan healthcare workers must receive implicit bias training

Yep, she's passed an executive directive (as opposed to her typical executive order) that in order for any healthcare worker to have their license renewed, they must receive implicit bias training because healthcare workers must be unconsciously racist.

After all, how else could the disparities in Covid results that proportionally more Black people than White people are being hospitalized be explained, along with Blacks having higher mortality from heart disease and stroke? Quick note - Don't you dare raise lifestyle choices nor the many gas station parties held by Blacks in Detroit during the initial outbreak of the virus in this state under their rather head-shaking belief that they were were immune due to their race?

Well, her Lieutenant Governor did suggest the disparity was due to some Anti-Black conspiracy theory -

Lt. Gov. Garlin Gilchrist II said the challenges that communities of colors face during the pandemic, were not "ordained by God, instead they were designed."

You just may have that tinfoil hat on a little too tight there Lt. Governor.

Some Democrat-connected diversity consultant is about to make serious bank. Maybe NGVP will be awarded the training contract on a no-bid basis.

So anyways, thank you healthcare heroes for your service. You're apparently all racists according to our governor, but you're heroes, so you've got that going for you, which is nice.

While You Were On Lockdown From Corona, Other Health Issues Weren't On Break

Well, Gov Half Whit is now graciously allowing elective medical procedures to resume this week.

These "elective" surgeries and appointments are now seriously backlogged.

This means people's quality of life is going to decrease, people who had treatable ailments may now find themselves requiring far more severe treatment than they otherwise would have needed, or even worse may now find their condition is now untreatable.

The Detroit Free Press: Backlogged surgeries from COVID-19 shutdown could take months to reschedule

You know, little things like mammograms, prostate exams, colonoscopies, hip surgery, wisdom teeth removal, pacemaker installations...the list goes on.

Also immunizations for kids (and adults too for that matter) were also not administered during this time, leaving exposure and potential outbreaks of yet more fun diseases waiting in the wings: The Detroit News: Health experts: Drop in Michigan immunizations during COVID crisis could lead to outbreaks

It's bad enough with the anti-vaxxers out there, now add in all the people who wanted the shots and couldn't get them due to the closures and we can expect outbreaks of stuff that should not be breaking out at all.

The rather macabre questions is will more people die due to the lockdown and its effects on our health and the economy, or will more people die due to the Coronavirus the lockdown was put in place to address?

Affordable Care, Accessible Care, or Amazing Care - Pick Two, or Maybe Just One

There's an interesting article over how on Doctor found out how insurance preauthorization requests for medicine are dealt with, and to someone with no idea of economics, nor of the messed-up state of our health system it seems shocking.

Medpage Today: Who Actually Is Reviewing All Those Preauthorization Requests?

While it is on the Internet, there's no reason to disbelieve the veracity of the account. Some Facebook friends were in high dudgeon over how dare an insurance company deny requests due to cost, after all how dare they?

As explained in the account, if they approve every expensive treatment to everyone who requests it the system goes broke - and fast.

Obamacare isn't making it any better and if anything is making it worse combining even more byzantine regulations, taxes, and fees that serve to subsidize one portion of the population at the expense of everyone else.

While some people demand we adopt the Canadian health care system, that system scores high on affordable (to the patients if not the government and overall payers) but low on accessibility due to wait times and low on amazing as many treatments are withheld or denied due to lack of resources as everyone is scrambling for all of it. You'll get access to care all right, in a few months or years, eventually, if you don't die first. Canada while excellent for access to emergency medicine is pretty lousy for access to non-emergency issues - average time in Ontario for an MRI for example is 101 days. Depending on the situation, you may not have that time to wait, not to mention waiting possibly in pain for 100 days to get whatever is wrong diagnosed. Looking over that site, while they often claim they're close to hitting their targeted date, the date itself for many procedures is set pretty darn far out beyond what would be acceptable to people in the USA to make it an achievable goal with the resources they have, and they often can't hit it even after they set it up with that in mind.

Yes, the US Healthcare system is a complete mess, so much so that it's hard to tell what the cost for a procedure even is before you have it, and depending on the insurance you have, you might pay for some, all, or none of it. Even the amount actually paid for the procedure after it is billed can also vary dramatically.

Adding to the fun the US Pharmaceutical market subsidizes the world market in pharmaceuticals as the same drug s sold cheaper elsewhere due to either government purchases and formularies or because the company knows that Americans can be made to pay more. Since people in other countries can't, the companies decide to make less overall profit in those countries but maintain some volume there and make at least something for their drugs and they then makeup the profit margins back in the US.

No easy answers to the problem, and anyone who tells you they can get you Affordable Care, Accessible Care, and Amazing Care all together just by adopting their genius plan to revise the American healthcare system is lying to you.

Why Thank You So Bloody Much Obamacare

Just received my Health Insurance Co's bill for this month.

The bill jumped 23%.

Why? Well, the premium didn't change but all sorts of new Obamacare ACA and related taxes and fees listed below did, including retroactive taxes:

Other ACA fees $43.36

Retroactivity Other ACA fees $65.04

Federal and State Taxes and Fees PHIC $16.03

Retroactivity Federal and State Taxes and Fees PHIC $.88

Retroactive Adjustments $38.50

Sadly I certainly did not receive any retroactive benefits.

Some of the fees hidden under the line ACA fees include paying for other taxes for Obamacare including:

An Annual Fee on Health Insurance Carriers; the Transitional Reinsurance Program; the Risk Adjustment Admin Fee; the Patient-Centered Outcomes Research Institute (PCORI) Fee; and the Marketplace User Fee which is used to fund the operations of the Health Insurance Marketplaces.

In other words, my plan is becoming a 23% less affordable in order to subsidize affordable care for others and for supporting a broken marketplace I don't use.

Thanks oh so very much.

Here's to hoping the Obama true believers got hit with these fees as well and that shakes them out of their love fest with Obamacare.

To Be Fair, Obama Didn't Say "If You Like Your Hospital, You Can Keep Your Hospital"

Just announced, a $6.4 billion merger of two of the biggest hospital networks in Michigan - Henry Ford and Beaumont.

Why now? One word - Obamacare.

The Detroit Free Press: Obama's health care plan, cost savings drives merger of Beaumont, Henry Ford

Several long-term trends help explain why the merger of Henry Ford Health System and Beaumont makes sense.

One is the coming implementation of the nation’s new health care law, known informally as Obamacare. The law, and particularly the individual mandate to obtain health coverage in 2014, will swell the number of people seeking health care.

The expected Medicare reimbursement cuts that will necessarily go hand-in-hand with the Obamacare expansion are also a reason:

At the same time, the financial stresses facing the nation’s Medicare and Medicaid systems means hospitals that provide care are facing shortfalls on reimbursement for their services. For hospital systems that treat a lot of poor people in places like Detroit, cutbacks on Medicare and Medicaid reimbursement can be particularly worrisome.

There's no such thing as free health care.

Hospitals can look ahead and see that under Obamacare, they'll be one of those taking the hit with reduced Medicare reimbursements to keep the true costs as distant and opaque as possible to the American health consumer/voter and they're planning and acting accordingly.

The ACA Tax That Was Not A Tax Upheld As A Tax

I'm not sure I agree with some commenters that I highly respect that this decision was a form of political judo by Roberts that keeps the chance of an ACA repeal and Obama defeat alive.

I fear that's more a form of wishful thinking than anything else.

Even if the Commerce Clause in in eclipse, and that's a big if considering it wasn't needed to uphold this Act so that ruling might well be considered mere dicta, the taxing power is now newly ascendant.

If any regulatory regime that requires an expenditure can now be construed constitutional because it is a tax we're duly and truly hosed.

So ACA Act, with its mandate sold as not being a tax, is then argued before the Court as being both a tax and not a tax, and is then upheld by the Court as a tax.

After all, repealing bad legislation is quite difficult and just because it is upheld because it is a tax is likely to shift any voter's positions come November. Indeed, the left is already trumpeting this as a win with no mention of the little detail that the commerce clause was restricted but the taxing power unleashed.

In short, I fear Judge Roberts just punted and we're going to look back at this case as a lost, and possibly the last, real chance to step back from the morass that is the (un)Affordable Care Act.

Toronto Visit

Blogging has been light as I've spent the past few days at a hospital in Toronto with my dad as he's recovering from surgery.

On the upside, the surgery went very well and there's an 80% chance it solved the problem so we'll see how it goes. He's done well and is now back at home since last night to continue his recovery.

On the downside, some of the strain to Ontario's medical system is showing: the hospital was dingy and appeared quite dirty. More importantly, the nurses while typically delivering good though often delayed care, seemed very short-staffed and overworked. It took quite awhile to get my dad's IV removed after it was empty and other very obvious delays were experienced. At least there was a dispenser of hand sanitizer about every 6 feet, and it was certainly used a lot.

Right beside my dad in the hospital was an older Italian-speaking gentleman who was in recovery after getting a knee replacement. His family also was visiting and in a pleasant conversation we learned that one of his daughter's children is serving in the Canadian Forces as a private and is deployed to Afghanistan with 3 PPCLI.

Here's to hoping he comes home to his family safe and well.

Obama by executive order gets FDA to have Drug Manufacturers become fortune tellers

The Detroit Free Press: Obama to order FDA to help reduce drug shortages

President Barack Obama is directing the Food and Drug Administration to take steps to reduce drug shortages, an escalating problem that has endangered patients and raised the possibility of price gouging.

.....

Obama also will announce his support for House and Senate legislation that would require drug makers to notify the FDA six months ahead of a potential shortage, the official said.

So now manufacturers will have to prognosticate 6 months ahead reagrding the potential supply and demand for any given drug they manufacture. I wonder if the FDA will be supplying Magic 8 Balls to the copmpanies as part of the regulation?

The FDA reported 178 drug shortages last year, and the agency says it continues to see an increase in shortages this year. Major causes of drug shortages are said to be quality or manufacturing problems, or delays in receiving components from suppliers. Drug makers also discontinue certain drugs in favor of newer medications that are more profitable. The FDA does not have authority to force drug makers to continue production of a drug.

Not yet anyway, but I'm sure that will be the next executive order.

Unexpectedly? You keep using that word. I do not think it means what you think it means.

Both Vodkapundit and Transterrestrial Musings note a newly discovered, unexpected "glitch" in Obamacare that will add another 450 Billion, give or take, to the deficit.

If you see Obamacare not as an insurance reform measure but merely a planned step towards government-controlled and “paid”-for health care, it all makes much more sense.

These “unexpected" costs aren’t unexpected at all, but a step on the path to get more and more people on the taxpayer funded program, to drive the insurance companies out of the market and get employers to dump their employees into the government exchanges, leading to a mandatory single-payer regime.

You really should see a doctor about that stabbing pain in your head......

From The Detroit News: Doctors remove knife from man's head after 4 years

(Insert jokes about comparable anticipated wait times under Obamacare here)

Surgeons in southern China successfully removed a rusty, 4-inch knife from the skull of a man who said it had been stuck in there for four years, the hospital said today.

Li Fuyan, 30, had been suffering from severe headaches, bad breath and breathing difficulties but never knew the cause of his discomfort, said the senior official at the Yuxi City People's Hospital in Yunnan Province. Li told doctors he had been stabbed in the lower right jaw by a robber four years ago and the blade broke off inside his head without anyone realizing it, said the director of the hospital's Communist Party committee's office who would only give his surname, He.

Happy New Year 2011

I just got back from Toronto after spending some time with a celebrating New Years with the folks.

It was a good time tempered by the fact that my Dad spent the entire week pretty much confined to bed, doubled over in pain due to intense and continuous back pain that had flared up without any warning or immediate cause. He had spent the prior two weeks also in bed due to the pain and we went on Thursday night (via medical transport with some very nice paramedics as he couldn't sit or get into a car) for his MRI scheduled at 12:15 am at the hospital (yes, not the afternoon, we're talking 0 dark fifteen, as there's one heck of a lineup in Toronto for the few available MRI machines. The scan procedure was done by 1 am and we then went home.

We found out Friday the results - he has a bulged disc that is pressing on a nerve and causing the pain. We'll have to wait on the 'speedy' Canadian health-care system to see when he can see a specialist and get an opening for what will most likely be an operation. On the upside, he's in great spirits, and this being the time of Festivus, I could finally take him at feats of strength.

We spent a fair bit of time together, chatting and watching The Pacific
that I had brought him as a gift.



The Pacific is a fantastic mini-series and does for the Marines in the Pacific Theater of World War 2 what Band of Brothers
did for the 101st Airborne in the European Theater of Operations. Highly, Highly recommended.

We also spent the time watching some of NHL and World Junior Hockey games, including Canada's loss yesterday to Sweden 6-5 by a shootout which was an exciting game but one Canada should have won.

We also had a chance to visit Great Aunt Bayla (my Great Aunt and my kids Great-Great Aunt, 95 years old and still sharp as a tack), Leon Panzer's widow, and I will be posting some great stuff as a result of that visit shortly.

I then spent New Year's with Tash's family with the traditional Russian feast, and on waking and sobering up we headed home. Traffic was light, the border crossing pleasant and uncrowded and we made good time, hopefully a good omen for a pleasant 2011 to come.

So a Happy and Healthy 2011 to all.

Thanks for the Health Cost and Tax Increases Mr. President

We're starting "Benefits Open Enrollment" at the firm where I work. Open Enrollment is the one time a year where you get to try to prognosticate into the future and figure out what health care you and your family may need. If you're wrong, you'll spend or lose a lot of money.

Of course, with Obamacare having passed things are changing, and not for the better as we find out whats in the bill.

The Blue Cross / Blue Shield plan we have (with 3 possible different and confusing deductible/co-pay options) is having quite a jump in rates. From a 6% increase last year we face a 14% increase - any bet its to cover all those costs BCBS is about to take on by having to cover those with preexisting conditions? So thanks for that one. Any bets the cost increases will eventually cause it to be labeled a "Cadillac" plan as the costs continue to rise to subsidize the Obamacare caused costs?

In addition, the Obamacare bill also removes all over the counter medications and items from Flexible Spending Accounts, and reduces the max contribution to $2,500 from $5,000. In other words, it is a tax increase as a tax savings method's utility is being drastically reduced by this law leaving items and income once untaxed to be taxed.

The FSAs are rather strange but useful tax-saving systems. You have to guess what amount of medical costs you and your family will have in the upcoming year. Put too much money in and you lose it and your employer gets it. Put in too little and you lose some of the advantage of paying for medical supplies with pre-tax dollars.

Then you have to submit your receipts to your plan administrator and you're reimbursed from the account for eligible medical expenses - up until the law passed that included contact lens fluid, contact lenses, over the counter pain and flu medication and suchlike. Now it doesn't.

While my family never incurred $5k in medical expenses in our FSA (not even close), I can easily see large families, and families with sick kids or serious medical problems having that amount of expenses so they'll certainly appreciate the reduced contribution amount and the higher taxes they're going to pay.

Thanks to the wonders of Obamacare, I can now look forward to increased insurance costs and higher taxes, and no real benefit in return. Thanks so much Mr. President! I can't wait to thank you personally by voting for your opponent in 2012.

Obama going to go for the gold?

Remember Pelosi saying they had to pass the Health Care bill so we could find out what's in it:

We're finding out and not liking it much.

From Instapundit:
ABC News: Gold Coin Sellers Angered by New Tax Law
Amendment Slipped Into Health Care Legislation Would Track, Tax Coin and Bullion Transactions

Those already outraged by the president's health care legislation now have a new bone of contention -- a scarcely noticed tack-on provision to the law that puts gold coin buyers and sellers under closer government scrutiny.

Ever since FDR confiscated American's privately held gold, Democrats keep lustfully wanting to get their hands on it yet again. Given gold's main function as a hedge against inflation and watching the Democrats run the inflationary money-machine until the economy drops it seems that taxing and tracking gold sales is all part of a repeat of FDR's cunning plan to seize wealth, keep businesses confused and drowning in red tape, and worsen the recession.......

Brown Wins in MA - First Republican Senator From Massachusetts in 37 years!

Since 1972, MA has had two Democrat Senators.

Not anymore.

Democrats seek back footing after epic loss in Massachusetts election Yes it was an epic victory when you consider that Brown started with no national Republican support against an entrenched Democrat establishement.

In one of the country's most traditionally liberal states, Brown rode a wave of voter anger to defeat Coakley, the attorney general who had been considered a surefire winner until just days ago. Her loss signaled big political problems for Obama and the Democratic Party this fall when House, Senate and gubernatorial candidates are on the ballot nationwide.

To have it most simply put, voters, even in Massachussets of all places, decided Obama and the Democrats were pushing too far left, too fast and taking the nation down with them.

A special thanks to the voters of Massachussets today for making a great decision and trusting the Republicans to put things right. Here's to hoping Brown and the Republicans are worthy of that trust. If they are, expect a massive sea change in Congress in 2010.

UAW to the Obama(croco)dile - Tax Me Last

The Detroit News reports that the UAW is now supporting Obama and the "Cadillac tax" funnily enough the Detroit news neglects to explain why: Union leaders won't fight tax on 'Cadillac' insurance plans

In a major breakthrough, union leaders bowed Thursday to White House demands for a new tax on high-cost health plans as part of landmark health care legislation taking final shape in intensive negotiations.

"We are on the doorstep" of success, President Barack Obama said.

The tentative agreement on the tax, which included significant concessions by the administration, was disclosed as leading lawmakers set an informal timetable of today for a compromise on the health care bill that Obama made a top priority in taking office a year ago.

Notice how these "significant concessions" ar e not identified and reported on by the Detroit News?

Instead, you have to go to Megan McArdle's Blog to find out what the concessions are: Special Deal for Labor Unions in Health Care Bill

And so it looks like they may have reached a deal sooner than otherwise expected: unions get a special two-year exclusion from the tax.
...Early reports understated the deal, which now has the excise tax kicking in for labor unions in 2018.

In other words you will be subject to the 40% tax if you're not in a Union immediately, meanwhile the Union members' benefits aren't taxed until 2018, and expect an extension then, if not before then, if the Democrats can get away with it.

There's certainly no amount of special deals and outright bribes using taxpayer's money that this administration won't do to get this abominable health care "reform" bill passed.