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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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Popular Science magazine shuts off comment section

I remember how much time it took to evolve a notion of the range of ‘appropriate’ comments and how difficult it was, excluding the easy ones to eliminate that were simply rude and crude.  There were lots of considerations for Angry Bear that are different than the magazine faced I am sure, but the struggle to maintain an open comment section was intense and took a lot of time.  I can feel a post is coming on the issue, but for now will take my cue from comments:

Signs of the time…lifted from the website of Popular Science.

Why We’re Shutting Off Our Comments

www.popsci.com

Comments can be bad for science. That’s why, here at PopularScience.com, we’re shutting them off.

It wasn’t a decision we made lightly. As the news arm of a 141-year-old science and technology magazine, we are as committed to fostering lively, intellectual debate as we are to spreading the word of science far and wide. The problem is when trolls and spambots overwhelm the former,diminishing our ability to do the latter.

That is not to suggest that we are the only website in the world that attracts vexing commenters.Far from it. Nor is it to suggest that all, or even close to all, of our commenters are shrill, boorish specimens of the lower internet phyla. We have many delightful, thought-provoking commenters.

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Maggie Mahar Healthbeat Blog: Reverse “ Sticker Shock”— Why are Insurance Rates in the State Marketplaces Lower Than Expected? — Part I

Even Forbes’ columnist Avik Roy is recanting. Earlier this month he acknowledged that under Obamacare, many Americans who buy their own coverage in 2014 will find that insurance is significantly more affordable than it was in the past: “Three states will see meaningful declines in rates: Colorado (34 percent), Ohio (30 percent), and New York (27 percent).”

Colorado, Ohio and New York are not unique. As states announce the prices that carriers will be charging in the online marketplaces (or “Exchanges”) where Americans who don’t have health benefits rate at work will be purchasing their own coverage, jaws are dropping. Rates are coming down, not only for those individuals, but for some small business owners who will be buying insurance for their employees in separate SHOP (Small Business Health Options Program) Exchanges.

What may be most surprising is that premiums will be lower, not only in liberal Blue states but in some Red states that are opposed to Obamacare.

What is making health insurance more affordable?

First, the majority of individuals shopping in the Exchanges will be eligible for government subsidies that will go a long way toward covering premiums. In the past I have written about how these tax credits will help young adults (18-34). But older Americans also will benefit. Fully 30% of those who receive tax credits will be 35-54, and 12.5% will be 55 or older. This is important because in the Exchanges, insurers in every state except New York and Vermont will be allowed to charge a 60-year-old three times as much as they would charge a 20-year-old for exactly the same policy. Without subsidies many would find insurance totally unaffordable.

The second reason premiums are significantly lower than expected is that as I have explained on healthinsurance.org in the state marketplaces insurers are forced to compete on price. All policies sold in the Exchanges must cover the same essential benefits, and follow other rules that will make the plans look very much alike. The only way for a carrier to distinguish himself from the crowd will be to charge less—or have a better network of providers. But the younger customers that carriers covet care far more about price than about the network.

Third, in many cases, state regulators have been clamping down. In Portland Oregon, for example, regulators forced insurers to cut their proposed rates by an average of nearly 10%. Three of the 12 insurance companies in that market had to lower their rates by more than 20% f

Finally, rates in many Exchanges are looking surprisingly affordable because many insurers are narrowing their networks to a group of hospitals and doctors who will offer higher-quality care for less. Meanwhile the fear-mongers argue that this means patients won’t receive the care they need.

Indeed, the New York Times just published an article suggesting that patients with complicated medical problems may have a hard time finding providers within an insurer’s network who can treat their problems.

What the Times neglected to mention is that the Obama administration had anticipated the possibility that a network could be too narrow and has already addressed the issue. As Modern Healthcare.com reports, “last year, the administration issued a rule” that insurers “must maintain a network of a sufficient number and type of providers … to assure that all services will be available without unreasonable delay.” The rule also requires that “essential community providers” be included in all plans.

This is an important fact. It is not clear why the Times ignored it.

Modern Healthcare.com goes on to quote Dr. Jeff Rideout, senior medical adviser for the Covered California state exchange, stressing that “all plans included in the exchange have to get state and federal regulatory approval for network adequacy.”

But will the in-network providers be as good as those who balk at the notion of charging less than top dollar? Study after study shows that there is little correlation between higher prices and better care. In fact, lower costs and higher quality go hand in hand: when more efficient hospitals co-ordinate care there are fewer “medical misadventures,” hospital stays are shorter; and both patient and doctor satisfaction is higher.

In the 1990s, HMOs that asked that t patients stay “in network” fell out of favor. But today, when Consumer Reports publishes NCQA ratings on quality of care as well as consumer satisfaction, it turns that that HMOs that rely on “networks” outrank other insurers. Networks that coordinate care are the future of medicine.

Ohio—In September the Truth Finally Emerged

Ohio serves a striking case study of “reverse sticker shock.”

Before next year’s rates for individuals buying their own insurance were announced, many Red state officials had warned that prices would spiral. In June, for example, Ohio Lt. Gov. Mary Taylor, a Republican who heads the state’s insurance department, took fear-mongering to a new level by announcing that in 2014, the average cost of coverage would rise by an estimated 88 percent. l

Two months later, when Taylor’s department disclosed the actual premiums that insurers will be charging in Ohio’s marketplace, reality forced her to amend her estimate. Nevertheless, she still insisted that in 2014, premiums for individuals will be a whopping 41 percent higher than they were this year. Republican House Speaker John Boehner then picked up his megaphone, calling her announcement “irrefutable evidence” that Obamacare will hurt the economy as it drives up costs.

The Cleveland Plain Dealer wasn’t buying any of this. Reporting on Taylor’s revised numbers, it immediately observed that her statement “masks the fact that for many individuals, premiums and out-of-pocket medical expenses will go down” because the vast majority of Americans buying their own insurance in the state exchanges “will be eligible for income-based federal subsidies to reduce or eliminate their costs.” (It would be difficult to accuse the Plain Dealer of liberal bias. In 2012, the paper endorsed Mitt Romney for president.)

The paper then pointed to a second flaw in Taylor’s reasoning. When she compared the average cost of insurance to 2013 to the average cost of 2014 policies, she included bare-bones plans sold in 2013 that “require deductibles of $10,000 or more and offer only catastrophic coverage.”

This distorts the comparison between 2013 and 2014 prices in two ways:

1) All of the plans sold in the Exchanges in 2014 will offer far better protection and much lower deductibles than the bargain basement plans Taylor used in her comparison. She was comparing apples to rotten apples.

2) More importantly, as the Plain Dealer went on to explain, even in 2013 “relatively few people bought these plans (because of super-high deductibles and crummy coverage).” In other words, in order to draw a fair comparison between “average” prices in 2013 and 2014, one needs to look at the plans that most people purchase.

By September Forbes columnist Avik Roy, a senior fellow at the conservative-leaning Manhattan Institute for Policy Research agreed: rates in Ohio would plunge.

In June, Roy had trumpeted Taylor’s projections that healthcare reform would lift rates in Ohio’s state marketplaces by 88%. But as states announced the premiums they had approved, Roy and his team re-crunched the numbers, and acknowledged: “rates on average will go down for Ohioans” by “30 percent. . . even before even considering the effect of subsidies.” /

Let me be clear: Roy continues to claim that most Americans buying their own coverage will see their premiums rise in 2014. On that point, he still is wrong: in his state-by-state analysis of rates, he doesn’t include the impact of the subsidies.

But a policy’s “sticker price” won’t matter to someone purchasing insurance in the state marketplaces. What will matter is what he actually has to lay out, after applying his tax credit. That will determine whether he believes that the “Patient Protection and Affordable Care Act” is actually offering affordable insurance.

(Keep in mind that most people shopping for insurance in the Exchanges live in low-income and median-income households– and thus are eligible for subsidies. More affluent Americans are far more likely to work for employers who offer good health benefits– or to have coverage through a spouse or a parent. The Exchanges will not be open to them because an employer already subsidizes their insurance.)

Still, I greatly respect Roy’s honesty regarding Ohio. In these polarized times, retractions have become rare, even in highly-respected publications. A hat-tip to Roy and to Forbes.

Maggie Mahar Healthbeat Blog

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What’s with Taper Talk and Assets Prices

I have gone a bit quiet on the QE front. Obviously, this is because I have been surprised and my pet theory has taken a beating. The theory was that QE amounts to basically nothing much. The dramatic effects on asset prices due to Abe/Kuroda announcements in Japan were seriousy damaging. But now not all is quiet on the Western QE front. There were huge asset price responses to loose talk about tapering QE3 (down to just the third most hugely expansionary US monetary effort after QE1 and QE3 so far) and then recently a huge response to the announced decision to not taper. I am puzzled, but I have a story.

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Do investors really not get it regarding US paying it’s debt?

A question has been nagging me. First, does the rest of the world not get that the republicans are playing a game with the US’ bank account? Does anyone really believe that the US won’t pay as in the renter just skipped out the back door? Or maybe I should say; as in the capital venture company just loaded up the latest purchase with debt, pocketed that money and filed bankruptcy?

Really, the US won’t pay it’s bills? Oh no, the nation is going Detroit?

It’s a game folks. Don’t play it. If you don’t play it then the republicans have no threat because the financial world is not really threatened.

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McCutchen vs. Federal Trade Commission

In response to my e-mail on an Oct. 8th  decision on McCutchen vs Federal Election Commission by the Supreme Court that could expand the role of money in elections, Beverly Mann writes:
  … the argument in McCutchen is that it makes no sense to have this artificial divide between “issue” advocacy and candidate advocacy—that is, to allow unlimited donations for “issue” advocacy (e.g., PACs) while retaining the limitation on donations directly to parties or candidates.  Everyone, including me, expects that the 5-4 majority will strike down that distinction and say that the so-called First Amendment grounds for striking down McCain-Feingold in Citizens United—speech is money—regarding limitations on “issues” advocacy pertains equally to the limitations on donations directly to parties and candidates.  (bolding mine)
 Beverly

The LA Times adds:

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Will You Be Eligible for A Government Subsidy When You Buy Health Insurance in 2014? Check out Your “Modified Adjusted Gross Income” (MAGI) –You May Be Pleasantly Surprised

Maggie Mahar comments on the Modified Adjusted Gross Income and how this may positively impact your eligibility for healthcare insurance on the state exchanges.

Before writing this post, I had no idea how to calculate my “Modified Adjusted Gross Income” (MAGI). But I did know that this is the number the IRS will use when deciding whether people purchasing their own insurance in their state’s online marketplace (a.k.a. Exchange) will qualify for a tax credit to help them cover their premiums.

This piqued my interest.

The first thing you need to know is that your modified adjusted gross income (MAGI) may well be lower than your gross income.

When calculating your MAGI, you can subtract certain items from your adjusted gross income including: student loan interest, certain moving expenses, contributions to an IRA, some self-employment expenses, and any alimony that you pay.

As a result, an individual grossing $50,000 (or a family of four with income of $98,000) might well discover that after they deduct these items from, their MAGI falls under the cut-off for subsidies ($45,960 for an individual, $62,040 for a couple, $78,120, for a family of three, $94, 200 for a family of four)

This is why, even if think you earn a few thousand too much to qualify for government help, you should ask whoever prepares your taxes about your MAGI—and perhaps think about upping your contribution to an IRA.

Kiplinger’s Kimberly Lankford, suggests other ways to lower your MAGI by “selling losing stocks or boosting business expenses to offset self-employment income.” But, she warns, “Be careful with moves that could boost that your MAGI and make it more difficult to qualify for the subsidy — such as converting a traditional IRA to a Roth.” .

Clearly MAGI is a tricky number. For more detail see this -page definition from UC Berkeley’s Labor Center. It is far and away the best, and clearest description of how to calculate MAGI that I have found.

Cross Posted from The Health Beat Blog, Maggie Mahar, Will You Be Eligible for a Government Subsidy .  .  .

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“The Rest of The Story”

Somewhere along the way, the naysayers and the Repubs will find a way to turn this into a negative “Trader Joe’s Cut Health Benefits Last Week”  Last week Ezra Klein wrote about Trader Joe’s decision to cut health insurance benefits for employees who work fewer than 30 hours a week. After that, one reader forwarded a Trader Joe’s response to his letter inquiring about the change in benefits.

“Thank you for writing to us. It’s possible you have been misled, at least to some degree, by the headlines in some articles regarding our reasons for implementing the [Affordable Care Act] in January. We’d like to take this opportunity to clarify some facts.

For over 77% of our Crew Members there is absolutely no change to their healthcare coverage provided by Trader Joe’s.

The ACA brings a new potential player into the arena for the acquisition of health care. Stated quite simply, the law is centered on providing low cost options to people who do not make a lot of money. Somewhat by definition, the law provides those people a pretty good deal for insurance … a deal that can’t be matched by us — or any company. However, an individual employee (we call them Crew Member) is only able to receive the tax credit from the exchanges under the act if we do not offer them insurance under our company plan.

Perhaps an example will help. A Crew Member called in the other day and was quite unhappy that she was being dropped from our coverage unless she worked more hours. She is a single mom with one child who makes $18 per hour and works about 25 hours per week. We ran the numbers for her. She currently pays $166.50 per month for her coverage with Trader Joe’s. Because of the tax credits under the ACA she can go to an exchange and purchase insurance that is almost identical to our plan for $69.59 per month. Accordingly, by going to the exchange she will save $1,175 each year … and that is before counting the $500 we will give her in January.

While we understand her fear of change, at her income level this is a big benefit that we will help her achieve.

Clearly, there are others who will go to the exchanges and will be required to pay more. That is usually because they have other income and typically a spouse who had a job with no benefits and they do not qualify for the subsidies under the ACA.

One example of that we had yesterday was the male Crew Member who worked an average of 20 hours per week but had a spouse who is a contract consultant who makes more than $200,000 per year. The Crew Member worked for the medical benefits and unfortunately for them they are likely to have to pay more because of their real income. We understand how important healthcare coverage is to our Crew Members and we are pleased to be able to provide and support this program.

We do hope this information helps, and we appreciate your interest in Trader Joe’s.”

It is rare to see a company which actually thinks beyond the profit margin. Maybe I will be proven wrong on this; but, it looks like TJ may have done the right thing. For those employees who may have other income, TJ provided an $500 to compensate for differences. Hat Tip to Hullabaloo, Digby – Trader Joe Explains Itself (and Does It Well)

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