Relevant and even prescient commentary on news, politics and the economy.

Just a little (semi)-personal note

Just about everyone who knows me well knows that I’m a WWII buff and have a very soft spot for veterans of that war.  So this really touched me. I thought some other Bears and readers, who don’t read the Washington Post regularly and would otherwise miss seeing this, might enjoy this little reason to smile.

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Italian Right Trying to Out do Republicans

Well today is a busy day. www.healtcare.gov is open for business, the discretionarily funded US Federal Government isn’t. There is a political crisis in Italy (no that doesn’t happen every day anymore) and there are crises both in the Republian party and in the PDL (Silvio Belusconi’s party which he considers his as his shoes are his).

Berlusconi wants to vote no confidence in Prime Minister Enrico Letta and have early elections (whenever he loses an election he demands a rematch starting the next day). Just to make it clear that he thins his party exists to serve him, the issue is whether he be expelled from the Senate because he has finally finally been finally convicted of tax evasion.

Some of the legislators in his party who are tired of being treated as his servants are threatening to split the party and send Berlusconi’s rump …. party into opposition.

All this reported with great delight in Italy’s leading daily La Repubblica (where Berlusconi is especially hated because long ago he tried to buy the paper and fire the staff). But best of all, it isn’t even their top story. They lead with an interview with the Pope (not because they are Catholic but because their former director is the informal leader of Italian atheists)

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Chris Hayes Explains the PPACA for Fox and Friends

Obama Care for Fox News and Friends

 

Not that they have any interest in reality at the moment. The Republicans have worked themselves into a frenzy that resembles the adolescent girls who accused the Salem townspeople of witchcraft at this point. This is how they look:

 

Maybe it is time to take away the beer? Hat Tip to Digsby

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Cruz, Tea Party, Hostage-Taking Budget Tactics (and the IRS)

by Linda Beale

Cruz, Tea Party, Hostage-Taking Budget Tactics (and the IRS)

The House, dominated by Tea Party/GOP politicians (or those fearful of their impact on upcoming primaries) passed a bill that attempted to tie the continuing operations of the government to compliance with Tea Party ideas about getting rid of the health reform legislation duly enacted four years ago.  See Weisman, House Bill Links Health Care Law and Budget Plan, New York Times (Sept. 20, 2013). Ted Cruz has now run his non-filibuster filibuster in the Senate, and then voted against his own “principled” filibuster position (presumably out of a quite justifiable fear that he would be shown for the fool he is as the only one voting in support of his “principles”, since the Senate vote was unanimously on the other side). Ted Cruz Filibuster, NY Daily News (Sept. 27, 2013).

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Water, Mars. and curiosity

Curiosity’s SAM Instrument Finds Water and More in Surface Sample
Sept 26, 2013

The first scoop of soil analyzed by the analytical suite in the belly of NASA’s Curiosity rover reveals that fine materials on the surface of the planet contain several percent water by weight. The results were published today in Science as one article in a five-paper special section on the Curiosity mission.

“One of the most exciting results from this very first solid sample ingested by Curiosity is the high percentage of water in the soil,” said Laurie Leshin, lead author of one paper and dean of the School Science at Rensselaer Polytechnic Institute. “About 2 percent of the soil on the surface of Mars is made up of water, which is a great resource, and interesting scientifically.” The sample also released significant carbon dioxide, oxygen and sulfur compounds when heated.

Curiosity

Mosaic image of Curiosity.

 

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October 1st, A New Republican Proposal, and the Bad News Bears

October 1st, the country and government will once again be held captive by minority political interests seeking to force their will upon a country which did not endorse them or their beliefs in the last election. Radical House Republicans have come back with another proposal which seeks to delay the PPACA for one year, removes the medical device taxation to appease the healthcare industry, and adds Huelskamp’s “conscience clause” to the amendment limiting the coverage of preventative birth control. Funding for the military was included in the latest amendment. This is a radical change from John Boehner’s efforts to concentrate on setting a new Debt Ceiling rather than funding the PPACA. The Republican’s actions strip those of healthcare coverage who can least afford it. Much of what is proposed by the Republicans lends credence to Independent Senator Bernie Sander’s speech “Lone Star Strategy.”

Republicans’ efforts to cut food stamps and defund the Affordable Care Act are just “the beginning of the game,” Senator Bernie Sanders said.

“All of these issues are related to something that is much, much larger and that is the transformation of American society in a radically different way than it is today,” Sanders said. “And what my Republican colleagues, almost without exception, want to do now is take us back to the 1920s where working people had virtually no protection on the job at all.”

In the midst of all of this, the Federal Government is releasing preliminary information on PPACA subsidies and coverage by states.

Obamacare and The Bad News Bears; Maggie Mahar; Health Insurance Org.

Why is the mainstream media downplaying the good news about affordable insurance rates in the state health insurance exchanges?

Yesterday, when I read the new HHS report on premiums in the individual exchanges in 36 states, I was impressed by the good news. In the marketplaces where people who do not have access to employer-sponsored insurance will be purchasing their own coverage, rates will be much lower than expected. This is true even in Red States that have resisted Obamacare. For instance in Houston, Texas, a 27-year-old earning $25,000 would pay $81 monthly for the least expensive Bronze plan – after using his government subsidy – while a family of four with income of $50,000 would owe just $52. What we are seeing is “reverse sticker shock.”

Then I began to read what the press had to say about the report, and found myself frustrated by the misleading, fear-mongering response. It sometimes seems as if the mainstream media is bent on downplaying any good news about reform.

Was it wrong for HHS to focus on costs?

Even the New York Times – a highly-respected publication that is often viewed as “liberal” – took a dour view, warning that “the data” in the HHS report on premiums “provides only a partial picture of the reality that consumers will face  … The figures, almost by definition, provide a favorable view of costs, highlighting the least expensive coverage in each state.”

What Times reporter Robert Pear overlooks is the fact that the vast majority of individuals shopping in the exchanges live in middle-income or low-income households. (More affluent Americans tend to have access to comprehensive insurance through their employer, a spouse or their parents.)

What folks purchasing their own coverage in the state marketplaces want to know is what the least expensive Bronze and Silver Plans will cost. Those are the plans they will be buying, and that is why the HHS report focuses on those policies.

Ignoring ACA’s subsidies

Pear goes on to stress how much premiums will vary – even within a given state – and how high they will be in some cities: “… a 40-year-old buying the least expensive silver plan would pay $240 a month in Los Angeles, but $330 in Sacramento, about 38 percent more.”

True. But Pear doesn’t take into account the fact that most Americans shopping in the exchanges will be eligible for government subsidies. They won’t be paying $240 or $330 a month. Thanks to the government help, some 60-year-olds will have to pay nothing for insurance.

Indeed, after applying his subsidy, a 40-year-old living on $22,980 in either Los Angeles or Sacramento would pay only $120.65 a month for coverage. This is because the lawmakers who wrote the Affordable Care Act believed that someone earning $22,908 should not be expected to spend more than 6.3 percent of his income on insurance. As the table in this post shows, the IRS will calculate tax credits to make up the difference between the percentage of income that someone is expected to contribute and the “sticker price” on a Silver plan.

Forbes columnist Avik Roy also ignores subsidies when writing about the HHS report. This allows him to claim that the newly announced rates will force individuals buying their own coverage to shell out 99 percent more than they are paying today.

Moreover, when Roy compares today’s rates to the premiums that individuals purchasing their own insurance will pay next year, he overlooks the fact that many of the plans now sold in the individual market are “bare-bones” plans. Most don’t cover maternity benefits. Some don’t pay for chemotherapy. Many carry huge deductibles. When he compares the policies that will be sold in the exchanges to these plans, Roy is not making an apples-to-apples comparison. He is comparing apples to rotten apples.

Narrow networks

Meanwhile, Pear appeals to his readers’ worst fears by cautioning that, according to “consumer advocates … people shopping for health insurance should consider not only price, but also other factors like the list of covered drugs and the doctors and hospitals available in a health plan.”

Not long ago, the Times reported on the dangers of insurance plans with “narrow networks” that may not cover the doctors and hospitals that a patient knows best. The truth is that most of the currently uninsured and underinsured Americans who will be shopping in the Exchanges don’t have a list of favorite specialists. Many don’t have a doctor; when they receive care, they are treated in an ER or a community clinic.

Polls also show that the young Americans who will be flooding the exchanges are three times as likely to be willing to give up their choice of doctor for a lower premium.

Insurers are holding down premiums by excluding marquee healthcare providers who charge more than others for the even the simplest procedures. The Times has suggested that, in “narrow networks,” patients with “complex conditions” may not be able to get the care they need.

In fact, the Obama administration addressed that problem last year, issuing a “rule” that ensures that networks will not be too narrow. In order to win state and federal approval insurers will have to show that their network includes “a sufficient number and type of providers.”

Meanwhile, study after study shows that there is little correlation between what a health care provider charges an insurer and the quality of care provided. Pricing is all about market clout. Some hospitals charge more “because they can.”

But Americans can no longer to afford to pay exorbitant prices for brand healthcare. HMOs that charge less if the patient stays “in network” fell out of favor in the 1990s, but today they’ve become increasingly popular. Indeed when Consumer Reports ranks insurers, HMOs that rely on a network of providers to coordinate patient care receive the highest rates both for quality of care and consumer satisfaction. Networks represent the future of American medicine – and not just in the exchanges.

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Matt Yglesias says the median household is probably richer than the median household in 1989

by Robert Waldmann

Matt Yglesias says the median household is probably richer than the median household in 1989.  Oh that we have come to this.  Take the mike Matt

Despite rising health care and education prices, we don’t have fewer people going to college or seeing the doctor and we do have bigger houses, more and better cars, better food, and much better gadgets and entertainment.

Your case is very strong. The point is that neither the BLS nor the Bureau of the Census consider the increase in living standards due to new cool gadgets at all.  See DeLong on Baker arguing this is no big deal for the median consumer http://delong.typepad.com/sdj/2006/09/the_meaning_of_.html

When a new good is introduced, it is as if the price declines from infinity (you just can’t buy it because it doesn’t exist is just the same as you can buy it for infinity dollars because it doesn’t exist). But the price indices assume that the introduction of a brand new good makes no difference.  Effectively they assume that there is an old good which is a perfect substitute for the new good so people are indifferent between buying the old good or the new good for it’s new price.

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Comment sections debate

LOL….  ah well, I hadn’t read the comment section of Kenneth Thomas’s and Maggie Mahar’s posts  before I put up the Popular Science post.     Lifted from comments.
Hans
September 25, 2013 12:00 am

Anything is more affordable especially when someone picks up the tab..

I sorry Ms Mahar, but you are a dolt for the administration…

Bruce Webb
September 25, 2013 12:54 am

Yes Hans that is exactly how upper middle class people afford health insurance – someone else picks up the tab. And the person/company that does pick up that tab actually gets a tax deduction for doing so, meaning that THEIR tab is partially picked up by every taxpayer. In fact the people who are really getting screwed under the current deal are those who make enough to actually pay taxes but whose employers provide them sub-standard plans with high deductibles even as executives routinely get what are known as ‘Gold Plated Plans’.

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Senator Sanders on the The Transformation of American Society

This is an 11 minute clip of his speech, “The Lone Star Strategy.” It is worth a listen.

The Lone Star Strategy

Senator Bernie Sanders

Republicans’ efforts to cut food stamps and defund the Affordable Care Act are just “the beginning of the game,” Sanders said.

“All of these issues are related to something that is much, much larger and that is the transformation of American society in a radically different way than it is today,” Sanders said. “And what my Republican colleagues, almost without exception, want to do now is take us back to the 1920s where working people had virtually no protection on the job at all.”

I listened to Senator Ted Cruz who looks and sounds a lot like Bill Murray (sorry Bill) in “Meat Balls or Stripes”  .  .  .  fun to listen to and get a laugh ; but who takes him seriously? He needs to go home to Texas and watch the corn grow.

 

More from Senator Bernie Sanders on CSpan:

 

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Kochcare vs. Obamacare: Finally, Finally, Obama Comes Out Swinging

Mr. Obama also singled out sponsors of a “cynical ad campaign” discouraging Americans from signing up for the new health care program by arguing that it would effectively put the government into the room when women undergo gynecological exams and men undergo colonoscopies.

“These are billionaires several times over,” Mr. Obama said, evidently referring to the conservative political activists Charles and David Koch, without naming them. “You know they’ve got good health care.” But if people who turn down the new health care subsidy get sick, he said, the Kochs would not care. “Are they going to pay for your health care?”

Obama Makes Impassioned Defense of Health Law, Peter Baker, New York Times, today

Damn!  A few days ago, when I first read about these silly Koch-sponsored ads, I thought I would post here commenting on the good news: The Koch brothers are promising to pay the medical expenses of young people who forego healthcare insurance now available to them via Obamacare!

That was how I interpreted the ads, anyway.  I mean, after all, the only other option for these newly christened “young healthies” who do have the option of gaining affordable healthcare insurance through Obamacare is to not have healthcare insurance at all. Sort of like the many millions of seniors who, without Medicare, would have no access to healthcare insurance at all, because of its high cost or because of preexisting conditions.

But since the Kochs aren’t urging seniors to forego Medicare in order to keep the government out of, say, the chemotherapy room or the coronary-bypass-operating room, I figured the difference was just that the Kochs aren’t willing to pick up the tab for the elderly, who will have no choice but to continue to let the government into the examining room with them and their doctor.  I mean, what other possible reason would there be for the Kochs to not run ad campaigns similar to those directed at young people but instead directed at Medicare recipients?

None, I thought!

But I was wrong.  According to Obama, the Kochs have no intention of paying the medical bills of the young people who, at their urging, and misunderstanding the ads just as I did, forego Obamacare in order to keep the government out of the physician’s examining room. And out of the delivery room. And out of the orthopedic surgery room.  Among other rooms.

How disappointing. All those young people who thought from that ad that they’d be inviting the Kochs into all those medical rooms, and that the Kochs would accept the invitation!  Or at least have United Health Care, WellPoint and Blue Cross Blue Shield stand in for them in those medical rooms. Only to hear the president say that that’s not what the Kochs meant.

Of course, what the Kochs actually are doing is trying to keep United Health Care, WellPoint and Blue Cross Blue Shield from being ushered into the examining room via Obamacare. And also from keeping their targets—the young currently-healthies—from themselves entering the examining room, at all, or from entering it and then having to pay large out-of-pocket retail costs (should they happen to have a savings account or a decent-sized regular paycheck, and can pay it).  Even if they suddenly become unhealthy.

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