Michigan 8th District Congressman Mike Bishop’s ad:

“Additionally, under the American Health Care Act (AHCA), insurance companies cannot deny coverage based on pre-existing conditions – yet Elissa Slotkin continues to lie about Mike Bishop’s record.

Sec. 137 of H.R. 1628 of the AHCA states:

“Nothing in this Act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”

Under the bill, health status cannot affect premiums, unless a state asks for and receives a waiver — a condition of which is the state having other protections in place for those with pre-existing conditions. To obtain a waiver, states would have to establish programs to serve people with pre-existing conditions. No matter what, insurance companies cannot deny coverage based on pre-existing conditions.”

It is a tossup in Michigan and Mike Bishop and his campaign manager “Stu” are scrambling and slinging all the mud they can to sway many of the voters he ignored over the last two years when he was invited to meet in townhall meetings. He could care less and there was always an excuse not to be there and listen to the people talk about his priorities and what he is doing as their Congressional Representative. He will ignore many of his constituents again over the next two years if we return him to office.

Everyone can have access to buy anything they want to buy; but, can they afford it is the question? Charles Gaba at ACA Signups; “The AHCA did not protect pre-existing conditions” the same as the coverage under the Affordable Care Act (ACA). What the AHCA does do is allow states to strip away those protections via the waiver process.

Quickly, the ACA prevents insurance companies from: refusing to insure someone with pre-existing conditions, charging more for pre-existing conditions, denying coverage of the condition, not covering a minimum of 60% of enrollee medical costs, having an arbitrary maximum annual or lifetime claims cap, and capping maximum out-of-pocket costs for in-network healthcare expenses.

Except for preventing insurance companies from refusing to insure someone with pre-existing conditions, the AHCA Mike Bishop voted for allows states to opt out of all of the other protections of the ACA. If we were living in a state which sought to protect its citizens from predatory insurance companies and assist them in getting affordable healthcare and healthcare insurance, I would not worry as much as to what Michigan Republicans would do.

Since 1992 Michigan has been controlled by a majority Republican Senate, a Republican majority House 18 of 26 years, and a Republican governorship 20 of 28 years. During that time period, Republicans have favored business over its constituents. The Medicaid expansion barely passed in Michigan with Senator Joe Hune (Senate Insurance Committee Chair) proclaiming he was sick to his stomach with its passage. Lana Theis is running for his seat as well as Adan Dreher. Lana favors farming out the administration of Medicaid insurance to insurance companies such as what might be found in an Advantage Plan which produces no better results than Medicare and costs taxpayers and Medicare recipients 14% more. Adam Dreher is more in tune with the constituency.

In the end Elissa Slotkin is not lying about Mike Bishop and the AHCA as Congressman Mike Bishop’s AHCA which he voted for does not protect constituents with pre-existing conditions in Michigan in the same manner as the ACA. His vote for the ACHA allows states to wavie the ACA protections in favor of insurance companies who can charge more, limit coverage, or deny coverage.

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Last March, U.S. Senator Tammy Baldwin of Wisconsin sponsored a bill (Fair Care Act) to block President Trump’s plan to allow insurers to sell short term or what is frequently called junk plans. Senator Baldwin bill would reverse all of what the Republicans attempted to do with short term plans by reinstating protections for pre-exiting conditions, maintaining the community benefit costing of the plans, blocking life-time cost limits, etc.

Senator Tammy Baldwin:

“As someone who was branded as a child with the words, ‘pre-existing condition,’ I want to make sure that no parent, foster parent or grandparent has to choose between helping their child get better or going bankrupt,” said Senator Baldwin. “Republicans pushed repeal, but promised they would protect people with pre-existing conditions. The Fair Care Act is an opportunity for lawmakers to keep their word on guaranteed protections for pre-existing conditions.”

The bill is more symbolic than anything as it will not get past Senate Republicans. Senator Baldwin was using it as a way of emphasizing the hypocrisy of Republicans promising constituents at home support of healthcare-for-all regardless of pre-existing conditions and then not supporting pre-exiting condition as we know it to be in healthcare while in Congress. As an example, the Republican AHCA which failed by one vote (McCain) would have established subsidized Risk Pools and insurance companies could have charged higher premiums for pre-exising conditions.

More on this beyond the 13 minute Risk Pool Part YouTube clip by Charles Gaba at ACA Signups which is an update to Why Republican Short Term Healthcare Plans “Suck”. In this version, Charles explores in depth what will happen when the Mandate is eliminated and people either drop out on healthcare altogether or go to short term plans. Charles also ads a solution to subsidies stopping at 400% FPL.

I am hoping you took the 13 minutes to view Charles Gaba review of the impact of the mandate elimination and short term plans implementation plus his solution to the needed relief for those beyond 400% FPL. In the end, we are back to where we were at pre-ACA.

Moving on to Tammy Baldwin’s Fair Care Act and the vote. Under the purview of the Congressional Review Act, which gives Congress the ability to reverse federal regulations within a certain time window; Senator Baldwin was able to introduce a resolution to unwind the Trump administration’s expansion (Executive Order) of short-term insurance plans. Senator Baldwin had the 30 votes needed to force a vote reversing the Executive Order on short term plans. Normally this vote would have never seen the light of day; but this time, McConnell could not stop it.

October 10, 2018 the Senate voted on Senator Baldwin’s S.2494 – Fair Care Act. Forty-nine Democrats and one Republican voted for Baldwin’s resolution, while fifty Senate Republicans voted for an expansion of junk insurance plans that can deny coverage to people with pre-existing conditions and do not have to provide essential health services like prescription drugs, emergency room visits and maternity care. Senator Susan Collins was the lone Republican voting with Democrats. It failed in the Senate.

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Senator Grassley tweeting: “Five times now we hv granted extension for Dr Ford to decide if she wants to proceed w her desire stated one wk ago that she wants to tell senate her story Dr Ford if u changed ur mind say so so we can move on I want to hear ur testimony. Come to us or we to u,”

I like how tweeting brings out the intellect in people and especially our politicians. And Chuckie the tweeting senator does this on a public forum with Ford and Kavanaugh so everyone can read along with him.

In New Jersey’s 2019 ACA marketplace, fruits of reinsurance, individual mandate, and silver loading.

New Jersey’s Dept. of Banking and Insurance has posted individual market health plan prices for 2019. Thanks to the state’s new reinsurance program, state-based individual mandate, and silver loading (actively encouraged by DOBI), unsubsidized enrollees will see price drops from 2018. For the subsidized, it looks pretty much like status quo ante — although network changes and plan design changes could alter that picture.

As was the case last year, AmeriHealth has sewn up all the lowest price points. AmeriHealth and Oscar are offering discounted silver plans off-exchange — presumably because of silver loading (Cost Sharing Reduction, available only with silver plans and only on-exchange, is not priced into off-exchange silver). Horizon is not offering any off-exchange discounts, but it has dropped prices about 7% from last year. A few salient year-to-year comparisons below. Quoted premiums are for a 46 year-old — where they’re a clean 1.5 times the base rate posted by DOBI. Andrew Sprung at xpostfactoid

More states should follow New Jersey’s lead.

Further evidence that the tax cuts have not led to widespread bonuses, wage or compensation growth. Economics Policy Institute.

Newly released Bureau of Labor Statistics’ Employer Costs for Employee Compensation data allow us to examine nonproduction bonuses in the first two quarters of 2018 to assess the trends in bonuses in absolute dollars and as a share of compensation. The bottom line is that there has been very little increase in private sector compensation or W-2 wages since the end of 2017. The $0.03 per hour (inflation-adjusted) bump in bonuses between the fourth quarter of 2018 and the second quarter of 2018 is very small and not necessarily attributable to the tax cuts rather than employer efforts to recruit workers in a continued low unemployment environment.

“Saving the Planet Doesn’t Mean Killing Economic Growth”

Noah Smith: Hickel cites analyses by the United Nations Environment Program and others showing that even big improvements in resource efficiency, encouraged by very high carbon taxes, will be unable to halt overall resource use or global carbon emissions. But this evidence doesn’t support Hickel’s conclusions, which rely on several misconceptions about the nature and the importance of growth.

Hickel doesn’t seem to grasp the fact of most economic growth happening in countries that are relatively poor. From 2010 to 2015 as determined by estimates by the IMF emerging markets, developing countries were responsible for about 70 percent of global output and consumption growth and advanced economies were responsible for the rest. World Bank’s forecasts for 2017-2019 are similar.

China’s contribution to global growth will be double the U.S. growth and India’s will be larger than the whole of the entire euro zone. The same is true of greenhouse gas emissions. Since about 1990, emissions from the U.S. and EU have fallen, while emissions from developing countries such as (and especially) China and India have exploded.

In 2017, the International Energy Agency estimated that the growth in energy-related carbon emissions in China and the rest of developing Asia was more than five times the growth in the European Union while U.S. emissions declined.

If Hickel and others succeed in stopping economic growth in developing countries, it will not be rich countries bearing the brunt of the change. It will be poor and middle-income countries such as India and China. The desperately poor African countries will not a chance at increased prosperity.

$600,000 in Debt and the Crisis is Worsening “The student loan default rate more than doubled between 2003 and 2011, and 40 percent of borrowers are expected to fall behind on their loans by 2023.”

There is a long history of Congress favoring financial institutions with laws and regulation blocking students from debt relief. Yet, our president can bankruptcy relief multiple times without any court or law blocking him. For him it is business as usual, getting a new loan to buy property and increase profits, pay the old loan with then new loan, and declaring bankruptcy when costs exceed cash inflow. Students do not have the luxury of gaming the system.

With the cost of an education in this country is only rising, borrowing is unlikely to slow. State funding for public colleges fell by $9 billion between 2008 and 2017, and the gap has been filled with tuition hikes. For the first time, half of all states relied more heavily on tuition last year than on government appropriations to fund higher public education. Americans now spend an approximate $30,000 per student a year to gain a college education or twice as much as the average developed country.

The IBR and Repaye programs put in place by well-meaning advocates has been a failure due to a lack of understanding in how to manage it yearly and with some servicers such as Naviente deliberating misleading students into multiple postponements of loans instead of into the income-driven repayment plans. The plans cap monthly payments at a percentage of the borrower’s income. It is not the first-time commercial interests have lied to students and taken a predatory approach on student loans. Naviente is being sued by five states and the CFPB.

Indian sailor Abhilash Tomy injured on disabled yacht.

A multinational rescue effort is underway to try to reach an injured sailor whose yacht is disabled in the South Indian Ocean.

Abhilash Tomy, a 39-year-old Indian naval commander, was competing in the 2018 Golden Globe Race. The race is a nonstop, 30,000-mile solo yachting competition that bars the use of modern technology. To me, this sounds like a lot of fun and a lot of work. I always like to sail as the quiet of the water is soothing.

Abhilash Tomy boat the “Thuriya,” hit a storm in the South Indian Ocean. The 36-foot boat was one of several hit by 80 mph winds and 46-foot seas midway across the South Indian Ocean on Friday, day 82 days of the race. Thuriya’s mast was broken about 1,900 miles southwest of Perth, Australia and “at the extreme limit of immediate rescue range,” according to media statements.

Organizers became concerned after Tomy sent a text message reading: “ROLLED. DISMASTED. SEVERE BACK INJURY. CANNOT GET UP,” and then was unheard from for nearly 15 hours. In a later satellite text message, the sailor gave his location and wrote: “ACTIVATED EPIRB (Emergency Position Indicating Radio Beacon). CANT WALK. MIGHT NEED STRETCHER.”

What is the White House Deflecting from Now?

It is no secret one of the strategies used by the White House is to deflect attacks on their agenda by creating another emer . . . spectacle . . . gency when the news and the opposition gets close to defeating their plans. The attack on Rosenstein as led by the NYT is just too easy, convenient, and laughable (almost). The deflections have happened too many times already. Trump holds Fire

Continuing on this path; “Kavanaugh Accuser Agrees to Testify” I am sure Grassley and other members of the Senate, Hatch, Cornyn, Cruz, Hannity, and the tier two Senators such as Flake, etc. will make this debacle into another shameful attack on Ford, women, and the truth. What, no women on the Repub side? I am sure the 4 women on the Dem side can support Ford and strike back.

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Some History

In 1980, a letter to the editor of the New England Journal of Medicine by the Boston Collaborative Drug Surveillance Program stated “the risk of addiction was low when opioids such as oxycodone were prescribed for chronic pain.” It was a brief statement by the doctors conducting the study which was cited many times afterwards as justification for the use of oxycodone.

In a June 1, 2017 letter to the NEJM editor, the authors reported on the broad and undocumented assumptions made as a result of the 1980 Letter on the Risk of Opioid Addiction. Using bibliometric analysis of the impact of this letter to the editor, the citations of the 1980 letter were reviewed to determine the citation’s portrayal of the letter’s conclusions.

Identified in the bar chart are the number (608) of citations of the 1980 letter over a period of time from 1981 to 2017.

“72.2% (439) of the citations, quoted the letter or used it as evidence addiction was rare in patients when treated with opioids such as oxycodone. 80.8% or 491 of the citations failed to note the patients described in the letter were hospitalized at the time they received the prescription.”

There was a sizable increase of citations after the introduction of OxyContin (extended release oxycodone) in 1995. As the analysis noted “affirmational citations of the letter have become less common in recent years in contrast to the 439 (72.2%) positive and supporting citations of the 1980 correspondence in earlier years. The frequency of citation of this 1980 letter stands out as being unusual when compared to other published and cited letters. Eleven other published, stand-alone, and more recent letters on different topics published by the NEJM were cited at a median statistic of 11 times each.

Citations of the 1980 stand alone letter on “addiction being rare” from the use of opioids such as oxycodone failed to mention, the patients administered to were in a hospital setting as noted in the letter by Porter and Jick. Overlooked, a mistake by the people citing this letter? “In 2007, the manufacturer of OxyContin and three senior executives of Purdue Pharma plead guilty to federal criminal charges that they misled regulators, doctors, and patients about the risk of addiction associated with OxyContin.”

Organization: “An early manifestation of the opioid abuse, addiction, and overdose problem occurred largely in the rural regions of Kentucky and other parts of Appalachia after the introduction of Oxycontin. A brand name for oxycodone, OxyContin was introduced in 1996 by Purdue Pharma and aggressively sold to doctors. Sold as a less-addictive alternative to other painkillers as it was made in a time-release formulation, allowing for a slow onset of the drug, and not a hit all at once which is more likely to lead to abuse. When used as prescribed, Oxycontin was safe. When ground up, it’s slow release characteristics were marginalized.

The aggressive sales pitch led to a spike in prescriptions for OxyContin of which many were for things not requiring a strong painkiller. In 1998, an OxyContin marketing video called “I Got My Life Back,” targeted doctors. In the promotional, a doctor explains opioid painkillers such as OxyContin as being the best pain medicine available, have few if any side effects, and less than 1% of people using them become addicted.

Shortly after 1996, Porter and Jick’s letter citations doubled and continued to be cited in a positive fashion with few negative citations and a failure to mention the hospital setting where the drugs were administered.

More Recent

By 2015 over a six-year period, more than 183,000 deaths from prescription opioids were reported in the United States. Today, millions of Americans are now addicted to opioids.” In part much of this was the result of doctors being told there was a low risk to opioid addiction.

Figure 2 shows each year being progressively worse and reaching a record high of 71,568 deaths (2017) in the US due to all drug overdoses as reported by the Centers for Disease Control (CDC) in their “Provisional* estimates on U.S. drug overdose. According to the CDC this is a record and represents a 6.6% national increase in overdose deaths over 2016.

At the end of the 12-month period of January 2018, the reported deaths was 69,703. The final and predicted number of deaths is expected to be as high as 71,568. 0.18 of 1% of the reports are pending the completion of investigation (numeric within chart). *Underreported due to incomplete data.

*Provisional counts of all drug overdose deaths are underestimated relative to final counts. The degree of underestimation is determined primarily by the percentage of records with the manner of death reported as “pending investigation” and tends to vary by reporting jurisdiction, year, and month of death. Specifically, the number of drug overdose deaths will be underestimated to a larger extent in jurisdictions with higher percentages of records reported as “pending investigation,” and this percentage tends to be higher in more recent months”.

In 2018 law makers questioned Miami-Luken and H.D. Smith wanting to know why millions of hydrocodone and oxycodone pills were sent (2006 to 2016) to five pharmacies in four tiny West Virginia towns having a total population of about 22,000. Ten million pills were shipped to two small pharmacies in Williamson, West Virginia. The number of deaths increased along with the company and wholesaler profits.

For context, the nearly 72,000 drug overdose deaths (spurred by the ongoing opioid painkiller addiction epidemic, including the increased use of more potent synthetic opioids [fentanyl]) outpaced fatalities from suicide, or from influenza and pneumonia, which claimed about 44,000 and 57,000 lives in 2016. It nearly rivaled the approximately 79,500 people who die from diabetes-related complications each year in the U.S. (the 7th leading cause of death).

Nearly 150,000 Americans die each year from accidents such as car crashes, injuries, or accidental overdoses. If the CDC’s latest figures are accurate, drug overdoses could account for nearly half of accidental deaths.

As tends to happen with public health epidemics, overdoses have an outsize effect in certain regions. For instance, the biggest spike in fatalities by percentage occurred in Nebraska, North Carolina, New Jersey, Indiana, and West Virginia (33.3%, 22.5%, 21.1%, 15.1%, and 11.2% rises, respectively). But areas like Wyoming, Utah, and Oklahoma experienced declines of 9.2% to 33%.

With the clamp down on opioid prescriptions by doctors due to the abuse, addiction, and overdoses, those addicted to opioids turned elsewhere. Again Recall Report;

“In 2015 heroin overdose deaths in the U.S. surpassed the number of deaths by gun homicide for the first time ever. In addiction treatment facilities around the country, heroin addiction is becoming the most common reason to enter treatment, surpassing even alcohol addiction.

In combatting the prescription painkiller addiction epidemic, public officials may have unwittingly contributed to the heroin epidemic. As prescription opioids became more difficult to obtain and more expensive, addicts turned to a cheaper similar high: “heroin.” Mexican drug cartels were more than willing to supply the demand and much of the cheap heroin in use in the country now comes through Mexico.”

The ease of accidentally overdosing can be a tragic consequence resulting from the abuse of opioids and heroin. Both drugs act upon areas of the brain controlling breathing and depress it. Too much opioid drug can cause a person to stop breathing and their subsequent death. Add alcohol or a sedative and the risk increases. To combat the impact of overdosing on opioids or heroin, Narcon in an injection or a nasal spray format acts as an antagonist reversing the effects of opioids and the overdose.

Stopping the abuse of opioids is an important measure in gaining control of the growing number of people becoming addicted to opioids and dying from its abuse. Once addicted, treatment is essential with detox and withdrawal the first painful step back to a normal life. Without supervised treatment and/or residing in a residential treatment center, the return to opioid usage and addiction is easy as the cravings for using it again are powerful. As a resident in a treatment center, therapy, support, and medical treatment with drugs is possible.

The abuse of opioids and subsequent addiction will remain a problem for years to come until the supply of it is brought under control.

Prescription Painkiller Addiction: A Gateway to Heroin Addiction, Recall Report Organization

A 1980 Letter on the Risk of Opioid Addiction, NEJM, June 1, 2017

Supplementary Appendix NEJM, June 1, 2017; Copy of Porter and Jick’s letter to NEJM in 1980.

Provisional Drug Overdose Death Counts CDC, National Center for Health Statistics, August 5, 2018

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The Trump administration’s new policy of expanding the sale of “short-term” insurance plans as a cheaper alternative to ObamaCare is quickly running into opposition from state regulators.

The Department of Health and Human Services is urging states to cooperate with the federal government, but instead, insurance commissioners are panning the new plans as “junk” insurance and state legislatures are putting restrictions on their sales.

State insurance officials argue that, despite being less expensive than ObamaCare plans, the short-term plans are bad for consumers and aren’t an adequate substitute for comprehensive insurance.

“These policies are substandard, don’t cover essential health benefits, and consumers at a minimum don’t understand [what they’re buying], and at worse are misled,” California Insurance Commissioner Dave Jones (D) said.

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Sleepers in Hong Kong McDonalds

I have eaten at the McDonalds in Hong Kong over the years. Just smaller portions and only after I grew tired of fish and veggies. I think I told the story of coming off The Wall, making my way down a road with my Chinese associates towards a Chinese restaurant, and turning the corner to eat at a KFC (their choice). It back upped to The Wall. They loved it.

According to a survey, in just five years there has been a six-fold increase in so-called McRefugees in Hong Kong or residents who spend their nights sleeping in the 24-hour McDonald’s outlets across the city.

People Keep Shooting Up the Emmet Till Sign

Hate and bigotry dies hard in some places.

Shot-up Emmett Till Memorial

Kroger To Stop Accepting Visa

A California subsidiary of Kroger will stop accepting Visa credit cards next month in a dispute over swipe fees.

“Foods Co. Supermarkets said it would no longer take Visa credit cards beginning Aug. 14. The ban will cover 21 stores and five fueling centers in central and northern California. Shoppers will still be able to use Visa debit cards, as well as cards from other networks such as Mastercard, Discover and American Express.”

The cost of swiping using a debit card and computerized systems are getting out of hand. In 2014, Walmart filed suit against Visa alleging it cost $350 million in fees from 2004 to 2012.

Trump Admits to Meeting

“President Trump said on Sunday that a Trump Tower meeting between top campaign aides and a Kremlin-connected lawyer was designed to “get information on an opponent” — the starkest acknowledgment yet that a statement he dictated last year about the encounter was misleading.”

Too Little Too Late’: Bankruptcy Booms Among Older Americans

For a growing number of older Americans, traditional ideas about life in retirement are being upended by a dismal reality . . . bankruptcy.
The signs of potential trouble such as vanishing pensions, soaring medical expenses, inadequate savings have been building for years. Now, new research sheds light on the scope of the problem. The study found the rate of people 65 and older filing for bankruptcy is three times what it was in 1991 and the same group accounts for a far greater share of all filers.

Steel Giants With Ties to Trump Officials Block Tariff Relief for Hundreds of Firms

“Charlotte-based Nucor, which financed a documentary film made by a top trade adviser to Mr. Trump and Pittsburgh-based United States Steel which has previously employed several top administration officials have both objected to the 1,600 exemption requests filed with the Commerce Department.

To date, their efforts have not failed and resulted in denials for companies based in the United States but rely on imported pipes, screws, wire and other foreign steel products for their supply chains.

The ability of a single industry to exert so much influence on the exclusion process is striking even in Mr. Trump’s business-friendly White House, given the high stakes for thousands of American companies that depend on foreign metals. The boundaries of trade policy are being tested by the scope of Mr. Trump’s multifront trade war with allies and adversaries alike, which includes tariffs on up to $200 billion worth of goods from China and possible tariffs on automobiles and auto parts.”

Commerce Department: 59% of the denials come in cases where United States Steel, Nucor, or a third large steel maker AK Steel Holding Corporation have filed an objection. Nearly all of the rest were in cases where the company applying for an exclusion erred in its submission.

Economy Adds 157,000 Jobs in July, Little Evidence of Pick-up in Wage Growth Mark Thoma cites Dean Baker’s Report

“In spite of the healthy pace of job growth and the low unemployment rate, there continues to be little evidence of accelerating wage growth. Over the last year, the average hourly wage has risen by 2.7 percent. There is a very small uptick to 2.87 percent if we annualize the rate of wage growth for the last three months (May, June, and July) compared with the prior three months (February, March, and April).

Interestingly, there was a modest fall in hours in July, which led to a decline in the index of aggregate weekly hours from 110.0 to 109.8. As a result, the average weekly wage actually declined slightly in July.

The leading sector for job gains in July was manufacturing, which added 37,000 jobs, all but 5,000 of which were in the durable goods sector. Employment in the sector is up by 327,000 over the last year, an increase of 2.6 percent.”

NDD has covered similar in his posts at Angry Bear.

Notes On A Butter Republic

Paul Krugman: Denmark, where tax receipts are 46 percent of GDP compared with 26 percent in the U.S., is arguably the most social-democratic country in the world. According to conservative doctrine, the combination of high taxes and aid to “takers” must really destroy incentives both to create jobs and to take them in any case. So, Denmark must suffer from mass unemployment, right?

Yep, Danish adults are more likely to be employed than their U.S. counterparts. They work somewhat shorter hours, although that may well be a welfare-improving choice. But what Denmark shows is that you can run a welfare state far more generous than we do – beyond the wildest dreams of U.S. progressives – and still have a highly successful economy.

Indeed, while GDP per capita in Denmark is lower than in the U.S. – basically because of shorter work hours – life satisfaction is notably higher.

Short Term Healthcare Policies

Good Discussion at Kaiser on Trump/Republican Compliant Short Term Policies and what they will and will not cover.

The Affordable Care Act (ACA) exempted short-term policies from market rules that apply to most major medical health insurance policies sold to individuals in the non-group market: rules that prohibit medical underwriting, pre-existing condition exclusions, and lifetime and annual limits, and that require minimum coverage standards. By contrast, short-term policies:

• are often underwritten with pre-existing medical conditions in mind. Applicants with health conditions can be turned down or charged higher premiums, without limit, based on health status, gender, “age,” and other factors;
• exclude coverage for people with pre-existing conditions – policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition can be considered pre-existing and excluded from coverage;
• do not have to cover essential health benefits – typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways;
• can impose lifetime and annual limits – for example, many policies cap covered benefits at $2 million or less;
• are not subject to cost sharing limits – some short term policies may require cost sharing in excess of $20,000 per person per policy period, compared to the ACA-required annual cap on cost sharing of $7,350 in 2018 ; and
• are not subject to other ACA market requirements – such as rate review or minimum medical loss ratios.

In comparison, an ACA Catastrophic plan covers all essential benefits, allows 3 PCP visits per year, and will cover certain preventative services at no cost for people under 30. If your income is that low for either Trump’s plan or the ACA plan, you are better off to get a Bronze or Silver plan as you will be eligible for a subsidy. The new version by Trump and Azar is a ripoff.

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Click this link. Data For Progress decided to ask people about policy proposals which very serious centrists consider way too far left for America. American voters respond differently.

As should already be clear from existing polls (click and search for “fair”), there is strong support for egalitarian populist redistributive public policy. At Data For Progress, they chose to emphasize the positive — four proposals with overwhelming support, but I think it is just as striking that opinion is almost equally split on a top marginal income tax rate of 90% (2% more oppose than support) and universal basic income (2% more oppose than support).

In particular, a (very narrow) plurality of whites without a bachelors degree support a universal basic income. One way to summarize the results is that pundits’ guesses about public opinion match the opinions of college educated whites (surprise surprise). That is the group least enthusiastic about universal basic income (by far) (OK I admit I am white and have university degrees so I should say “we are” but like hell i’m going to be classed with my fellow White American College educated opponents of UBI).

I suppose it is important that an overwhelming majority support a jobs guarantee. The problem of finding useful work for millions of people (and not crowding out unsubsidized private sector employment) doesn’t worry people anything as much as the risk that one lazy person takes advantage of cash welfare once.

The key question for Democrats (and the USA) is why did most of a group of people more of whom support than oppose UBI vote for Trump ? How can there be such a huge gap between bread and butter big dollar issue polling (where the median US adult is to the left of the mainstream of the Democratic Party) and voting ?

I think the explanation is that the partisan gap is a partisan gap in beliefs about matters of fact (what has happened) not on policy proposals. Do click the link (I can’s summarize all the data) but one of the key patterns is that responses are surprisingly similar for rural and urban voters, the white and non-white working classes, and Trump voters and Clinton voters. It is clear that opinions the polled issues are not key to deciding votes. I’m sure that the authors are sure this is because Democrats are too timid to appeal to the public (at least that’s one of the things I think). But I want to stress another point.

There are some fact polls — people are asked to answer questions which have a correct answer (where was Barack Obama born — what fraction of the US Federal Budget is spent on foreign aid). On those questions, the answers given by Republicans and Democrats are very very different.

I want to see polling data on 2 dimensions — not the usual equaltiy on the x axis, liberty on the y axis, but values (or priorities or policy preferences) on the x axis and questions of fact on the y axis. Dataforprogress.org makes more convinced than I used to be (which is barely possible) that the Republicans are a coalition of the rich and selfish (college educated white Republicans) and the misinformed (patriotic populist voters who support universal basic income and voted for candidate bone spurs next to his golden toilet).

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Healthcare Insurers Lose in Court Over Risk Corridor Funds

I have written a couple of times about Sessions, Upton, Kingston, and Republicans sabotaging the ACA Risk Corridor Program with the insertion of Section 227 in the CRomnibus Bill signed in December 2014. Not only did Senator Sessions, Representative Upton (MI), and Representative Kingston (CO) block the funding of the Risk Corridor Program; with the insertion of Section 227 by Representative Kington, they blocked any transfer of funding from other programs as well. A rehash of the results of Republican sabotage shows, it caused a rise in premiums for the unsubsidized (others were picked up), Coops to go bankrupt, and insurance companies to withdraw from the healthcare exchanges.

Today a Federal Appeals Court ruled; “the U.S. government does not owe health insurers $billions in unpaid risk-corridor funds meant to offset losses during the early years (3 years) of the Affordable Care Act exchanges.

More than three dozen insurers claimed the federal government owed them more than $8 billion in risk corridor payments. Ruling 2-1 the COA determined the payments were not necessary since Congress deemed the program had to be budget neutral after the legislation was passed.”

In other words, the court decided a different Congress and/or the administration made up of different political interests can change the intent of another Congress or Administration.

A similar Risk Corridor Program exists in the Medicare Part D program for drugs which has no life time limit and was put in place by Republicans and Bush to cover any risk which may occur from getting too many higher cost insured.

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Robert J. Samuelson Also Exaggerates Social Security Problems

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Charles Gaba at ACASignups talks about the three legs of healthcare supporting it, the composition of them, and why each of those legs are necessary for healthcare.

Charles reviews Enrollee Responsibility, Career Responsibility, and Government Responsibly (the three legs) necessary to support Healthcare in the US, explains how each Republican bill has or would have impacted the ACA, and what needs to be changed in the ACA to make it more effective for all people in the US.

It is an excellent summary of the ACA, Politics impacting the ACA, ACA Issues, and many of the things I have talked about since 2008 in one 17 minute clip.

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