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Health Care Thoughts: Carrot and Stick

by Tom aka Rusty Rustbelt

Health Care Thoughts: Carrot and Stick

The Obama administration has issued regulations allowing employers to use both incentives and penalties in wellness programs.

There is some controversy here, such as:

employer plans setting and enforcing blood pressure and cholesterol standards

punishing smokers (less controversial perhaps) – is this punishing addicts?

there are many age and racial determinants in health, and civil rights advocates worry about back door age and race discrimination

There are limits and requirements on employers and the incentives/penalties. Employer cannot enforce penalties without offering wellness programs and services (smoking cessation tied to a smokers penalty). Nothing in the rules negates any ADA standards.

Really complicated. HT: New York Times 5/30/2013

 

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Reader rjs sends us several links

Reader rjs sends us several links:

Washington ‘Spends’ More on Tax Breaks Than on Medicare, Defense, or Social Security – Tax expenditures are funny, They’re not taxes, exactly, because they save us money. They’re not spending, exactly, because the dollars are never actually spent. They’re somewhere in between. So think of it as tax spending. Or just think of it as the ultimate nudge. The carrot hiding behind the tax code’s big stick, tax spending guides us by making certain behaviors and actions cheaper. We encourage employers to provide health care by taxing wages and not taxing health benefits. We encourage investing by making a dollar earned from dividends cheaper than a dollar earned from a salary. And as the CBO reports in a new study today, Washington’s tax spending budget — comprised of everything from mortgage deductions to the child tax credit to lower tax rates on capital gains — is so massive, it’s technically larger than Medicare, Defense, or Social Security. The tax spending budget is equal to 1/17th of the US economy.

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Another False Media-Generated IRS "Scandal"

by Linda Beale

Another False Media-Generated IRS “Scandal”

Fox News and similar outlets (and even some of our esteemed Congresspeople, like Jim Jordan) have been fuming that Doug Shulman, the former IRS Commissioner, had more visits to the White House than any other cabinet officer. See, e.g., Evan McMurray, Bill O’Reilly Rails: IRS Commish’s 157 White House Visits “A Smoking Gun”, Mediaite (May 30, 2013).

“The President of the United States should explain tomorrow what Mr. Shulman was doing at the White House so many times,” O’Reilly added. “There’s no way on earth this Shulman should not have to explain in detail what he did inside of the IRS. So again we call upon President Obama to clarify the situation. Make Shulman testify as soon as possible.” Id. (quoting O’Reilly on Fox program).

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Forbes Fight

Avik Roy wrote an extremely misleading article on Obamacare in California.

It seems that Roy is the latest R-team player to be sacked.

 

Basically Roy compared Obamacare exchange rates (without subsidies) to the teaser rate from a web site which has received many extremely unamusing negative reviews for baiting and switching.

R. Unger totally demolishes Roy in an in house Forbes fight.  Good thing that they can e-mail in stories as meeting at the Forbes building would be very awkward.

Ezra Klein brings the Klein courtesies which matter so much (plus a funny photo).  Pity he’s such a good journalist as the man was born to be a diplomat.

Paul Krugman brings the shrill

All via Brad DeLong who admits he was beginning to wonder if Krugman is more than optimally shrill (don’t feel bad Brad, I’m sure Krugman has had the same doubts about you).

 

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“Per qualche dollaro in più” or For A Few Dollars More . . .

Having helped quite a few younger people rearrange student loans from the private sector to Direct Loans or consolidate loans to achieve lower interest rates or payments; I just find this market-place-staging by some politicians offensive. July 1st the rates are expected to double (3+% to 6+%) for subsidized and unsubsidized Stafford loans and probably Perkins loans which all typically go to students who can least afford the “few extra dollars” as suggested by this newly minted Congressman from Indiana who appears to not be able to tie a decent knot in his tie. Student debt is on the upswing and appears to be the next bubble in which to contend. The rising deficit as suggested by Congressman Luke Messer is not increasing but is in a steady rate of decline and the economy is mediocre with slow job growth slow but is still far better than 1,2 or 3 years ago although it could use a shot of stimulus again. What is also insidious about this foray of increasing interest rates for those who can least afford it is there is “almost” no-way-out of it once students sign up for a loan. Those who have defaulted on ninja-style mortgages or did not pay hospital bills might understand the relentless pressure brought to bear; however, student loans have the official distinction of being cast in stone by Congress once a student signs his name. With only death, disability, or a lack of income over 20-or-so years being reasons for discharge can a person escape a student loan. We would not tolerate such for a mortgage or healthcare; but yet, we have locked our youth into such an arrangement.

Read or listen in to a few comments Indiana Congressman Luke Messer makes:

Visit NBCNews.com for breaking news, world news, and news about the economy

The real threat to a college education today is not a few more dollars on their student loans today, it is the fact of the explosive growth of debt; the fact the jobs in this economy for young people entering this economy have been the people most hurt by Obama’s policies

The bottom line is, what you’re saying is the president’s an effective politician. He does a good job of distracting people from things that they ought to be focused on, and sometimes focusing them on things that while important, listen, none of us want to see student-loan rates spike, are only part of the larger problem.”

“I think, as Republicans, we’ve got to do a better job of explaining how our ideas apply to young people. Sometimes it sounds like he’s selling ice cream and we’re selling spinach. But I think personal responsibility is pretty cool. There is nothing out of date about freedom, and we need to have the policies that get this budget back in line, stop the explosive growth of spending — spending that will be paid for by this generation. And we’ve got to do a better job of explaining that.”

Student debt as a result of high interest student loans is becoming more of a threat than the mortgage market ever did as there is no simple discharge. If one wanted to see the financial rats flee the commercial student loan business ship which this Congressman evidently supports, the president should propose simple interest for student loans.

http://maddowblog.msnbc.com/_news/2013/05/31/18660880-house-goper-sees-student-loans-as-trivial-distraction?lite “House GOPer sees student loans as trivial ‘distraction’

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