EPI’s Elise Gould reports on the impact of Social Security as a safety net keeping another 25 million people out of poverty.
I was going to write a post called “Barack Obama Fellates the Shark, then Wonders Why It Bites Off His Lower Half,” but decided instead to go for comedy instead of pointing out that the 2014 midterms are going to make 2010 look like the peak of LibDem activism.
Academia.edu is “a place to share and follow research”; think JSTOR without the cachet of the Springer/Pearson/Addison/Blackwell/Wiley Publishing MAFIA, or maybe a low-rent, open-source NAP. So when friend of this blog and professional Health Economist Michael Halasy signed on and reached out, I figured it only made sense that I would follow his postings as well. (After all, he might actually write something. But I digress.)
So I clicked the link on the email and got this screen:
I do understand that maybe I don’t have the appropriate cookie on this machine. But look at the listing at the Connect with Facebook link.
Really, guys: I should connect with Facebook because people I know on Facebook–myself, for instance–connect with Facebook.
One has to laugh. The alternative is to think about Obama’s attempt to destroy my childrens’s lives for No Good Reason. Which someone else will blog about much more politely than I.
“For goodness sakes, of course the employees and the retirees like it, it’s free,” says Republican State Sen. Dave Lewis.
11,000 Helena state employees, retirees, and dependents now go to a state run healthcare clinic which is free. No co-pays, no deductibles, doctors are salaried, wait time is a few minutes, and visits are up 75%. Of course, the skepticism is high:
– “I thought it was just the goofiest idea”
– “If they’re taking money out of the hospital’s pocket, the hospital’s raising the price on other things to offset that,” Lewis suggests . . .
– He (Lewis) and others faulted then-Gov. Brian Schweitzer for moving ahead with the clinic last year without approval of the state legislature, although it was not needed.
One year has passed and what about today’s feelings ?
– “They’re wonderful people, they do a great job, but as a legislator, I wonder how in the heck we can pay for it very long,” Lewis says. (me)Someone changed his mind.
– division manager Russ Hill says it’s actually costing the state $1,500,000 less for healthcare than before the clinic opened. (me) Sounds like it will fund itself in the end.
– “Because there’s no markup, our cost per visit is lower than in a private fee-for-service environment,” Hill says.
Some of this may not sit well with physicians; but, why the big difference ? ? ?
– Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices.
– Bottom line: a patient’s visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it’s free to patients, hundreds of people have come in who had not seen a doctor for at least two years.
– Hill says the facility is catching a lot, including 600 people who have diabetes, 1,300 people with high cholesterol, 1,600 people with high blood pressure and 2,600 patients diagnosed as obese. Treating these conditions early could avoid heart attacks, amputations, or other expensive hospital visits down the line, saving the state more money. and lower costs over all in the end (me).
– That personal attention has proved valuable for library technician Pamela Weitz. A mammogram late last year found a lump. “That doctor called me like three or four times, and I had like three letters from the clinic reminding me, ‘You can’t let this go, you’ve got to follow up on it,’ ” she says.
This is what is meant by improved quality and better outcomes from healthcare as opposed to a services for fees scenario.The patients appear to be happier as well as the doctors employed by the state run clinic.
– Clinic operations director and physician’s assistant Jimmie Barnwell says this model feels more rewarding to him. “Having those barriers of time and money taken out of the way are a big part [of what gets] people to come into the clinic. But then, when they come into the clinic, they get a lot of face time with the nurses and the doctors,” Barnwell says
Maybe it is a fluke; but at least, one state tried it with what appears to be good results. I live in Michigan where the state Repubs have been haggling with the teacher and state employee’s unions over paying for healthcare insurance. I could see this model working here for both groups as well as Detroit workers and retirees where the city is seeking to end it for retirees and cut it for workers. In the end, it appears it could save Michigan and Detroit money which is sorely needed in “some” cases. It is interesting a state which is 50-50 in politics appears to have found a way out of the healthcare cost and insurance quagmire. Montana’s State-Run Free Clinic Sees Early Success
This is an article published yesterday by an acquaintance of mine who lives in the Dominican Republic, Felix Santana Garcia. He writes a weekly article for an online newspaper there. (I translated the article from Spanish.)
The People Lie Helpless
By FELIX SANTANA GARCIA
* The author is a financial manager and university professor. Living in Santo Domingo.
In recent years the Dominican people have lost their courage and spirit of defense to the extent that the authorities will increase costs, expenses and prices, and they do not flinch or react to protect themselves from measures that are adverse to their limited or low family budget. The people act as if anesthetized or masochistic.
It is surprising to see that every week fuel prices increase steadily. All goods and services in one way or another are impacted by these increases and the Dominican people whether healthy or hard-worker don’t raise their voice in protest.
The reason may have to do with the opposition that today is divided in some cases and in others silenced by corrupting money.
While inflation is reported from January to May 2013 at 1.72% and the annualized (May 2012 to May 2013) 4.99%, the people see in the markets that this is not so as the prices of a basket of necessary household items is estimated at more than RD $ 25,000.00. The situation is made worse because in many households with more than four members one person barely works with a net income of only RD $ 7,000.00.
No surprise to anyone to see how people entering the malls and supermarkets come out with one little pillow or perhaps empty handed, except for employees of public and private administrations who come out with lofty and luxurious emoluments and associated accessories.
So far this year, there are no signs of improvement in the pronounced inactivity of the economy that is on the verge of falling into recession, despite the injection of RD $ 20,000 million easing of reserve requirements and RD $ 9,000 million of assumed budget savings.
Nothing has been able to push the car of the Dominican economy and all because of the abysmal fiscal deficit over RD $ 205,000 million. All the while Mr. Leonel Fernández, the intellectual and material author of such deficit, has not been invited to go through the Dominican courts when for less foul or violations of the laws of the United States and Mainland China, a common citizen or a senior official would be processed to even the extreme of the death penalty.
For this, there are many Dominican families who are now deprived of a crust of bread and a mabí (sugar water, popularly known as tennis water) if not a glass of milk to sustain their lives.
Whole families with sorrow, eat something only once a day, others have to go to bed with a grain of salt under the tongue and a glass of water, in some cases non-potable water, living below the poverty line. This includes families who will never even reach the point of balance (equality between income and expenditure before taxes and interest, that is if they have a loan).
While all this happens, employees and high officials and the people related to the Executive party of the government enjoy high incomes and cushy benefits that allow them to eat and drink like kings and enjoy good resorts and travel abroad.
Poverty increases as an expense of correcting irregularities among other public finances over the past years. What a shame that it is the dispossessed people who are paying the costs of a party to which they were not invited and the party has not ended yet.
Neither was it felt in the shops or on public roads on mothers day or fathers day and many other traditional celebrations, as the purchasing power is at a minimum. So people only spend money when they find a bit on a piece banana only to live poorly.
The Defender of the people is not present, as this problem has no office or budget in the government, but neither is the Pro-consumer present as seen previously. It is forbidden to punish violators of the laws who sell expired products at inflated prices.
Definitely the people are defenseless, and perhaps, due to a poor diet, the people have no strength to raise their voice in protest, so that if the living forces, now dead, are not resuscitated as recently seen in Brazil by corruption and the high cost of living, soon the Dominican people will be a nation of the dead, ghosts or zombies.
David Zurin from The Nation writes The headline juxtaposition boggles the mind:
The headline juxtaposition boggles the mind. You have, on one day, “Detroit Files Largest Municipal Bankruptcy in History.” Then on the next, you have “Detroit Plans to Pay For New Red Wings Hockey Arena Despite Bankruptcy.”
Yes, the very week Michigan Governor Rick Snyder granted a state-appointed emergency manager’s request to declare the Motor City bankrupt, the Tea Party governor gave a big thumbs-up to a plan for a new $650 million Detroit Red Wings hockey arena. Almost half of that $650 million will be paid with public funds.
If you listen to CNBC or read right wing blogs you would think that the Obamacare regulations that require large employers — over 50 full time equivalent employees –to provide their employees insurance or pay a penalty is leading to a massive shifting of employees from full time to part time. CNBC is constantly interviewing business owners who say they are shifting time workers from full time to part time. It makes for a logical argument, but the data does not support it. So far this cycle part time employment is growing slower than full time employment so part time employees share of employment is falling. Part time share of employment seems to be following a normal cyclical development of surging during recession and declining during the recovery. At a minimum this ratio says that shift full time employees to part time employees is not large enough to show up in the the data.
Another way to look at the issue is to look at the average workweek. The average workweek is impacted by two types of changes. One, is employment growth in different industries with different work practices. For example, manufacturing uses very little part time labor and the average workweek is actually over 40 hours. While retail has long used part time labor extensively and the average workweek in retail is now only 30.1 hours. If manufacturing employment is growing faster than retail employment
the average workweek will tend to lengthen. But it will shorten if retail employment is growing faster than manufacturing employment. What we have this cycle is that employment in these two industries appear to be in balance, and so generating a flat workweek.
This is the factor that accounts for most of the long term secular decline in the average workweek. But interestingly, the average workweek has been amazingly stable over the past year, not at all what you would expect if Obama care was causing employers to shift their employes from full time to part time work.
The other way the average workweek would change if some industry is changing its practices and shifting employment from full time to part time work. The BLS publishes detailed data on the workweek for 13 different industries. Over the past year only 3 of the 13 industries have experienced a drop in the average workweek while the workweek lengthened for 10 industries. In the table goods producing and service producing are sub categories, not individual industries.
So, on balance it seems we have another example of the right wing developing another beautiful theory that is strongly contradicted by the data. Why am I not surprised?
Glenn Greenwald offers his thoughts on the issue of NSA surveillance:
On Wednesday morning, I’ll be testifying, by remote video, before an ad hoc committee in the House of Representatives about NSA disclosures. It begins at 9:30 am ET and will, I believe, be broadcast on C-SPAN. Following my testimony will be an excellent panel featuring representatives of the ACLU and the Cato Institute on the dangers and excesses of the NSA.
This is likely to be a hot issue tomorrow. Today, Italy’s highest court of appeals is hearing Berlusconi’s appeal of his conviction for tax evasion and embezzling from his firm. As I wait for their decision, I write about the issue in general.
Things are very different here East of the Channel. There is a very strong tradition of judicial independence. Importantly, prosecutors are magistrates (as are judges) and also independent from elected officials (defence lawyers absolutely hate the fact that prosecutors and judges are part of the same corporate body). Together judges and prosecutors are the “Magistratura”. One becomes a magistrate by scoring high on an exam which is grade anonymously. The magistratura is governed and disciplined by the CSM a committe the majority of whose members are elected by magistrates. Magistrates control promotion and assignment of magistrates. They are really independent.
The magistratura retained some independence during the ventennio (20 years of Fascist rule). The Fascists set up separate special tribunals to persecute their opponents, while the normal magistrates continued semi hemi demi normally. From WWII about until my arrival in Italy in 1989, the legal separation of magistrates and elected officials was one of those things which are important in theory but not in Italy. They were part of an establishement united by anti-communism and corruption. Then a new generation of magistrates became senior enough to be independent and the corruption was prosecuted. Very few powerful people actually went to jail, but the division of power with two independent and hostile parties became explicit.
Aside from criminal prosecution of criminal politicians, there is actually a lot of judicial activism. One judge decided to enforce the provision of the Italian Constitution which guarantees a right to health (not health care health) and ordered doctors to cure cancer (really to provide a quack’s cure). The important and deadly boring part is the TAR di Lazio (regional administrative tribunal of the region which contains Rome). They are constantly ordering ministers to do this or that. They are always ignored.
Huh ? Yes this is another way in which the Channel is very wide. In Italy, judges don’t make the winner of the case own the contested property say. They instruct the loser to instruct some bureaucrats to update an correct the property records. But the loser of the case keeps title until the bureaucrat does something. Failure to obey a judge is not a special crime — contempt of court. It is just failure to do ones job (which is what we Italian public employers do best).
Also civil cases typically take about 10 years. The Supreme Court decided that the rule of law meant it was impossible to force Paula Adams to wait 2 to 6 years to have her absurd case against Clinton thrown out because, according to her version of events, he owed her $0.00 in damages, cause being a jerk isn’t a tort. It is impossible to explain this to Italians. In fact, Italians don’t grasp the idea that sexual harassment is a tort not a crime, because accusations of sexual harassment have effects and, in Italy, torts don’t.
My point, if any, is that I think there is a close connection between the independence of magistrates and the paralysis of the judicial system. Elected officials can’t appoint magistrates, but they do finance the judicial system and write the code of procedure which must be followed. The judicial system is extremely underfunded with unfilled vacancies in support positions, so everything is very slow. The proceudures are extremely complicated and time consuming. Non violent crimes can’t be prosecuted after a statue of limitations expires. This means they are punished only if the time doesn’t expire before all appeals are exhausted. Defence attorneys for crooked politicians basically devote their entire effort to delaying things until their client (who clearly did the deed) gets off because of the time limit (note one for Berlusconi expires tomorrow).
The system is designed to not work, because if it did it would be a threat to the people who make the rules.