Maybe the world is ThreeSources -- add a #3src hashtag to post your tweets
December 5, 2013
Not a parody! (I will apologize if it is shown to be, and drink a cup of cold Folgers coffee in recompense.)
The winner of the ObamaCare Video Contest:
UPDATE: Legit: "Erin McDonald was named the Grand Prize winner with her video 'Forget about the Price Tag' in a Google+ Hangout featuring Kal Penn and White House Health Care policy expert Christen Linke Young on December 2. Watch Erin's video below."
Never watching House or Harold & Kumar again, that's fer damn sure...
Here' s an early gift -- or perhaps, for Haaahvy, an on -time Hanukah gift.
I just finished his "Three Felonies a Day" and a glowing Review Corner is on the way. The review will point out that all the villains happen to be Repblicans. But I agree with every word.
While you wait -- eagerly I hope -- for Review Corner, just enjoy Haaahvy and the broad he married:
Meanwhile, in Buffy News...
Five Reasons to keep watching SHIELD.
The show started out with a bang, but a good number of people have dropped off along the way. "SHIELD's" meandering pace this season likely is part of the reason, but as the series heads towards its midseason, our vote is that people should keep watching.
Mmmmkay, but most of them could be applied to ObamaCare®...
Income Inequality Quote of the Day
Mr. Obama returned to his favorite theme of rising income inequality on Wednesday, which he called "the defining challenge of our time." He ought to know since few Presidents have done more to increase inequality than he has. Median household income has fallen since the economic recovery began, while the rich who own capital assets have done very well thanks to the Federal Reserve's focus on reflating stock and home prices. Mr. Obama is the Chief Economist of Nottingham posing as Robin Hood. -- WSJ Ed Page
Fool millenials twice, shame on them. If they will believe that employers will hire just as many of them at a 50% higher cost, why not just promise them they can get paid for not showing up? A law mandating that might really "lift liberal voter turnout in 2014." Kinda like the law that mandated free insurance for the uninsured while not affecting the insurance anyone already had. "Hey, kid, I got a really sweet deal on a beach front condo for ya."
December 4, 2013
When applied to insurance by government, none of the standard definitions are adequate. A new definition is required:
3. c. indicates coverage of cancer treatments but not maternity or birth control treatments.
"Now with ObamaCare, the man that I've got looked into it, they are not going to pay for pharmaceuticals or medical devices. MRI that I had last month before I got canceled was $3,000. Now, if I have to have another one, it costs me out of my pocket $3,000," Elliott told Kelly on Nov. 7.
"I've thought about this long and hard," Elliott said. "When my insurance comes out, just for me, it will be $1,500 a month with a $13,500 deductible. I'm not going to pay that. If I make it that long, I will pay the $95 fine and let nature take its course."
Elliott told Kelly he actually voted for Obama over Mitt Romney last year specifically because he liked what Obama had promised about being able to keep your doctors and your insurance plans.
The election being over, the Obama administration said his plan was "substandard" and this is a better plan and deal for his family.
The government definition of "better" is left as an exercise for the reader.
Ingrate! That birth control is absolutely free! No copays, no out of pocket!
Yessir, you got it brother... "free." Remain calm, dagny.
Pendulum Swings Right in Partisan Divide
From the IBD Editorial Dems Are The Out-of-Touch Extremists
The only reason Obama and his fellow Democrats aren't constantly tagged as extreme is because the press is so far left that it treats them as reasonable centrists. Meanwhile, by skewing the polls, the increasingly radicalized Democratic Party manages to make the country appear more liberal than it really is.
I would say "more socialist" instead of more liberal. I still believe Americans are quite liberal in the classical sense, i.e. individual liberty.
I thought "maybe I should turn pro," reading that I had left $58 on the table helping a friend navigate.
Blog friend Attila set me straight:
AEI Wheat of the Day
Retired Buffalo Police Captain Peter Christ speaks out against the "War on Drugs:"
When you institute a prohibition like we have with drugs in this country, what you are doing is not protecting people from other people, you are attempting to use law enforcement to protect people from themselves. Protecting you from yourself is a function of family, church, education, and the health care system. It never is, and never should have been intended to be, a law enforcement function. We are out there enforcing morality when we enforce drug laws, and that is not our job. We were not trained to do it, we are not capable of doing it, and if anything else you see the failure of it.
[Heh: the headline refers to a kind comment
by blog friend tg, complementing my separating "the wheat from the chaff" on AEI. I'm a pretty big AEI fan and am torn between voraciously defending a friend of liberty and graciously accepting kind words...]
GOP War on Workers
I've been silent because I have agreed with many of their policies, but this is a bridge too damn far: Republicans force staffers to use ObamaCare! It's a War on Women! It's a War on Men! It's a War on The Transgendered!
CNN Buries the lede, and makes it about Leader Reid:
Washington (CNN) --- Democratic Senate Majority Leader Harry Reid, one of Obamacare's architects and staunchest supporters, is also the only top congressional leader to exempt some of his staff from having to buy insurance through the law's new exchanges.
Reid is the exception among the other top congressional leaders. GOP House Speaker John Boehner, House Democratic Leader Nancy Pelosi and Senate Republican Leader Mitch McConnell have all directed their staffs to join the exchange, their aides said.
December 3, 2013
All Hail Taranto!
Best of the Web
Otequay of the Ayday
I like to call myself "blog optimist" and I'll dub John Tamney "IBD Ed Page Optimist" for this piece.
"Republicans should be thankful for Obama precisely because his comical rollout of ObamaCare has Americans once again skeptical of politicians promising the world."
And a bonus quote that paraphrases my dear dagny:
There are no "free goods" in any society. Someone is always paying, and as ObamaCare promised something for nothing, logic dictated that it would fail even without advance knowledge of a "website malfunction."
Blog friend SugarChuck is a prolific and in-demand sideman who excels at escaping the "entangling alliances" inherent in band membership. An exception was made to create a CD with Annie Mack. I've talked it up 'round these parts a little.
The work has grabbed some great reviews, but the important one in this space would be Living Blues Magazine. Spoiler Alert: They Loved it! (Scroll down a bit, they don't like <a> tags over there -- not authentic enough HTML for the blues purist.)
Vocalist Annie Mack is the best kind of "roots" artist--dedicated to the heritage she's embraced, but resolute in her refusal to be pigeonholed. The title tune on this, her debut CD, is full of shout-outs to blues tradition, but it's propelled by a boogity-shoe funk backing. The disc’s most straightforward gospel number, Call On Jesus, owes as much to classic-era, Latin-tinged R&B as it does to the gospel tradition; the wronged lover's lament Fool to Believe grafts a Love Light-like groove onto a proto-funk, New Orleans-tinged rhythmic pattern. Elsewhere, Mack delves into roadhouse rock, neo-Kimbrough trance boogie, country-tinged deep-soul balladry, and blues/rock/pop mélange in the contemporary mix-and-match mode. Her alto delivery is strong, and she seems to gain flexibility as she immerses herself more deeply in her material--any hint of rookie self-consciousness is erased when the spirit hits. Her band, meanwhile, summons high energy without succumbing to overkill, and they always remember to play ideas, not just notes, even at their most exuberant and hard-charging.
Perfect Stocking Stuffer...
A special word about Mack's lyrics: Her storylines portray everything from the struggles of a woman with "calloused hands [and] broken dreams" who finds solace in "a little taste of whiskey [and] them old blues songs" (Hey, Hey Mama) through the triumph of a street urchin, traumatized by "bullets . . . flying through her world," who eventually faces down the Devil in human form ("A two legged snake") and resolutely keeps "moving on the road of life" (Little Girl Blues), to the determination of a woman "tired of whiskey-laced love" who vows to find "a way to make myself truly mine" (Walking Dead). Along the way, she reaffirms her faith (Call On Jesus, Revolution), faces down despair (Seems Like Sorrow), cries out again for love (G-Groove), and opens her heart to a beloved child (the folkish Saving Grace). In a blues world overrun with bad-mama posturing on one hand and hoochie-mama silliness on the other, it's refreshing to hear a lyricist with deeper ideas on her mind. That alone makes Annie Mack worth checking out; the vocal and musical quality of this set only adds to the pleasure.
Compared to all your other failures, this is really bad
Attention, White House staffers: This is not Syria, some far-off land that people will eventually forget about. This isn't Benghazi; the country won't eventually move on and forget about your lies. This is not "Fast and Furious;" most Americans can't just shrug that it doesn't affect them. This is not the IRS abuse scandal, which you can blame on some low-level employees in a Cincinnati office, or GSA employees spending taxpayer dollars on luxury hotels in Las Vegas. This isn't Solyndra. This isn't wiretapping AP telephone lines or preparing a conspiracy charge against Fox News's James Rosen. This isn't even the NSA domestic-surveillance scandal, a revelation that really aggravates people but that fades from the headlines over time.
No, this is the health care of millions of people that you're botching, after years and years of assuring the public that you can handle this and that they'll love the results of your efforts, hammered through Congress on party-line votes. -- Jim Geraghty
"...and that will only affect the uninsured because everyone who already has a doctor and insurance that he likes, or at least likes better than what you're offering, can keep things the way they are. Or perhaps could have, until you #ucked it up."
President Obama has managed, more or less, to sidestep responsibility for the economic malaise that grips the country, and has done so for more than five years. Now, he and the Democrats own not just the health insurance problems that O-care the Patient Protection and Affordable Care Act has created, but everything that anyone doesn't like about doctors, hospitals, and insurance companies. Way to step in front of a bus, Dems!
December 2, 2013
Rapacious Piano Teachers
Had a little fun with this on Facebook (actually, somebody else started it). But it is Kim Strassel, and it cannot pass without post:
In March of this year, a small nonprofit in Cincinnati--the Music Teachers National Association--received a letter from the FTC. The agency was investigating whether the association was engaged in, uh, anticompetitive practices.
This was bizarre, given that the MTNA has existed since 1876 solely to advance the cause of music study and support music teachers. The 501(c)(3) has about 22,000 members, nearly 90% of them piano teachers, including many women who earn a modest living giving lessons in their homes. The group promotes music study and competitions and helps train teachers. Not exactly U.S. Steel.
The association;s sin, according to the feds, rested in its code of ethics. The code lays out ideals for members to follow--a commitment to students, colleagues, society. Tucked into this worthy document was a provision calling on teachers to respect their colleagues' studios, and not actively recruit students from other teachers.
That's a common enough provision among professional organizations (doctors, lawyers), yet the FTC avers that the suggestion that Miss Sally not poach students from Miss Lucy was an attempt to raise prices for piano lessons. Given that the average lesson runs around $30 an hour, and that some devoted teachers still give lessons for $5 a pop, this is patently absurd.
Anti-competitive price fixers!
The Commercialization of Cyber Monday Continues...
I love Professor McCloskey's books (I may have mentioned that once or twice...) but I had never seen her until, oh, two minutes and 55 seconds ago. Pretty good:
Pontiff - Professorial Pugalistics
N. Gregory Mankiw responds to Pope Francis. My Tweeps called it "a smackdown." I don't want to perpetuate discord, but I can't resist a pedantic and alliterative headline.
First, throughout history, free-market capitalism has been a great driver of economic growth, and as my colleague Ben Friedman has written, economic growth has been a great driver of a more moral society.
Second, "trickle-down" is not a theory but a pejorative used by those on the left to describe a viewpoint they oppose. It is equivalent to those on the right referring to the "soak-the-rich" theories of the left. It is sad to see the pope using a pejorative, rather than encouraging an open-minded discussion of opposing perspectives.
Third, as far as I know, the pope did not address the tax-exempt status of the church. I would be eager to hear his views on that issue. Maybe he thinks the tax benefits the church receives do some good when they trickle down.
Iiiiiiiiiin this corner, representing the Chair of St. Peter: His hooooooliness pooooope Francis! Iiiiiin this corner, representing Haaaahvaaaahd Yaaaaahd, The Crimson, and "In Vino Veritas," theeee professssor himself, Greg Mankiw.... I want a fair fight, no Latinate below the belt, Shake hands and come out swingin'...
Quote of the Day
Isn't It Awful the Way Cyber Monday Has Gotten So Commercialized? -- Jim Geraghty
December 1, 2013
Hmm. Now that I have possibly facilitated the enrollment of a human being in Medicare, what better time to review Avik Roy's How Medicaid Fails the Poor?
We should make one thing clear: while Medicaid costs too much, its principal problem is that it doesn't make Medicaid patients healthier. It's not wrong to spend a large sum of money on health care for the poor. It is wrong to waste large sums of money on health care for the poor. There are so many market-based alternatives to Medicaid, alternatives that would offer uninsured, low-income Americans the opportunity to see the doctor of their choice and gain access to high-quality, private-sector health care.
That's the dirty secret of Medicaid. You might have heard the rumor that uninsured people are clogging emergency rooms because the law allows them to get free care there. But the unreported story is that it is Medicaid patients who clog the emergency rooms because they can't persuade regular doctors to see them.
Roy (people in Montreal and Denver struggle to pronounce it like Mr. Rogers's first name and not Evelyn Waugh's last -- to compound it, the author's first name is pronounced OH-vick) highlights studies that show Medicaid patients' outcomes statistically below those of the uninsured. While it would be easy to think that anomalistic, Roy details several good reasons why this could be.
The book opens with the heartbreaking story of Deamonte Driver, a seventh grader in Maryland who died of a toothache. His indigent mother was unable to find a dentist to accepted a new Medicaid patient, and over time -- government programs excel at eating time -- the infection spread to his brain. Much as I rail against government, I hesitate to pin this single tragedy on them. But we are -- courtesy of ObamaCare and my facilitatorship -- adding to the Medicaid rolls without addressing the physician shortage on the other side.
Medicaid was a statistically significant predictor of death three years after transplantation, even after controlling for other clinical factors. Overall, Medicaid patients faced a 29 percent greater risk of death. You'd think that Medicaid’s poor health outcomes would be a scandal on the left. You'd be wrong. After all, Obamacare puts 17 million more Americans into the Medicaid program.
The difference between insurance and care matters not to the left. The difference between a card and a doctor seem to elude them as well. An Oregon program to expand membership held a lottery where the lucky winners could enroll under relaxed qualifications.
Finally, on May 1, 2013 -- 10 months late -- the New England Journal of Medicine published the second-year findings. Did Medicaid save lives? No. It "generated no significant improvement in measured physical health outcomes," including death, diabetes, high cholesterol, and high blood pressure. What's almost as striking as this nonresult is how few Oregonians felt the need to sign up for this allegedly lifesaving program. The authors report that of the 35,169 individuals who "won" the lottery to enroll in Medicaid, only 60 percent actually bothered to fill out the application. In the end, only half of those who applied ended up enrolling.
But, what about the security of coverage?
Nonetheless, Medicaid's cheerleaders seized on this qualified bit of good news. "This is an astounding finding ... a huge improvement in mental health," said economist Gruber. To which conservative blogger Ben Domenech responded, "I wonder whether we'd be better off replacing the [Medicaid] expansion with a program that hands out $ 500 in cold hard cash and a free puppy."
Roy suggests a replacement, not with the puppy, but with a catastrophic plan and a voucher for concierge medicine. We could provide the poor with coverage chosen by many well-off Americans (well, until ObamaCare makes it illegal) for the same amount, and get more predictable and controlled spending rates as well.
This is a "Broadside" (very short book by Encounter Books). Five bucks on your Kindle and an hour before Kickoff. Five stars.
I like his plan.
I would think it is a good model for getting rid of most all ss type benefits.
Your Certified PPACA Facilitator
Not sure I could pass the rigorous background check required to go pro, but I did a little navigatin' and facilitatin' yesterday. I helped a slightly nervous friend out. She had a private, individual policy which she liked but she was unable to keep it. It seems I had heard something about that somewhere, but her insurer sent a notice of cancellation and the suggestion to enroll in a more expensive and higher deductible policy or to shop at the exchange.
I thought it likely that this person would qualify for subsidies, so I suggested the exchange. And volunteered my not insignificant browsing, pointing, and clicking skillset.
It was not a third-world experience. I think Colorado is a little ahead of the game, and while I would not describe the web application or workflow as slick, it was serviceable and completed all requested tasks without crashing. Here's how it works:
- You create an account at ConnectForHealthColorado.
- You can browse plans without giving information. Zip code. tobacco consumption, and birth month gets you a list of plans. In the East Metro area, there were six or seven. All were at least 33% more than the plan they were replacing, but two were less than the replacement suggested by Kaiser Permanente (even one Kaiser plan).
- I was wary of the Washington State woman who was enrolled in Medicaid without consent, but the only way to see if you qualify for subsidies is to be turned down by Medicaid; you have to provide a case ID from your rejection to inquire about subsidies.
- So, you are redirected to Peak.gov where you create another account and apply for Medicaid in a one-stop shopping for several state aid programs. A long but not particularly grueling form gets you a real-time online answer, though verification and enrollment is done by mail.
My client -- like the Evergreen Stater -- did not want to enroll in Medicaid. To Colorado's credit she was not automatically enrolled. And to Colorado's credit, I quickly reached a helpful person on the telephone to clarify. If you are eligible for Medicaid you can decline. But you cannot get any subsidies for a private plan if you qualify for Medicaid.
So that is where this lugubrious tale ends. My client, who has been only able to secure part-time work (no way that is related to ObamaCare in any way shape or form), can now choose between a more expensive plan with higher copays and deductibles, or the public dole. Not my choice but I counseled -- Bastiat aside -- Medicaid. One more moves from the ranks of the self sufficient.
You recommended Medicaid? Even though people with no insurance at all are better off?
(You were waiting for this one, weren't you.)
I was waiting for burning crosses on the golf course outside le condo d'Amour... To be fair, government created quite a bit of this person's difficulty.
I think the outcome failure is statistical. I expect that a responsible person would exercise good judgment about when to see a physician and do okay on Medicaid. Roy is correct to oppose it as a panacea but I am not incorrect in advising an individual's selection.
The decision has yet to made as far as I know. But $400 versus nothing is a compelling choice to a part-time worker.
Typing this, I just had the genius insight to save the entire country (uh-oh): Medicaid + Concierge medicine. Take the gub'mint card, but pay in $80/month directly to a physician. You now have a place for colds, routine exams, &c. If a more serious problem occurs you have to go into the Medicaid network but you retain your physician as advocate and primary counsel.
This is not a philosophical fix for ThreeSourcers; taxpayers are still on the hook for large swaths of the population. But it is a pragmatic fix to ameliorate the physician shortage in Medicaid. The purchaser gets an immediate fix, the others now compete with one fewer patient for the available pool.
Ultimately, we are headed toward the Irish model and I am resigned to it. Government provides bad care to everybody. Responsible people buy private insurance to gain greater access. Because the socialized model is backstopping catastrophic care, the private plans are not that expensive.
Would I prefer freedom, yup. But I don't think that is on the menu whatever happens in '14 or '16. This is a non-legislative fix.
November 29, 2013
O-Care: What the people want, good and hard
The "Patient Protection and Affordable Care Act" rations medical services more than the mere use of a panel of bureaucrats that decides who gets what treatments. It also rations in the way it was ostensibly created to eliminate - by price.
Ms. Cantwell of the Department of Health Care Services said federal and state rules assured "geographic and timely access" for Medicaid patients, and the state closely monitors managed-care plan networks to make sure they include enough doctors. In California, she said, some 600,000 of the people entering Medicaid in January have already been assigned primary care doctors through an interim health care program for low-income residents that will end next month.
She also said that since the expansion population will be older on average than current adult Medicaid beneficiaries - until now, most adults who qualified were pregnant women or parents of young children - the state had decided to pay doctors a rate "somewhere in between that for our regular adult population and our disabled adult population" for their care.
But when government mandates that doctors see more patients, and pays them less to do so, wait times become downright, well, NHS-like.
Oresta Johnson, 59, who sees Dr. Mazer through the state's interim health care program for low-income residents but will switch to Medicaid in January, said she had faced "excessively long" waits to see specialists who could treat her degenerative joint disease. Dr. Mazer is monitoring her thyroid gland, she said, and she is hoping she will not have a problem getting back in to see him next spring, when she may need a biopsy.
"I understand there's a lot of people who need help," she said. "But am I not going to be able to see who I need to see?"
So tell me again how single-payer helps low income people get the same level of medical attention as middle and high income folks? Oh, right, by taking away the private insurance that 200 million already have and replacing it with a government approved alternative that is no more attractive to doctors than Medicaid. Be patient Ms. Johnson, and soon everyone else will receive the same crappy care that you do. Because it's "not fair" that people with more money should be treated better.
Don't wait for Review Corner, get Avik Roy's "How Medicare fails the poor" ($5 on Kindle and a quick read). Stunning indictment and expansion of this.
Studies show that Medicaid patients do worse than those with no insurance at all.