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

State Run and Free Healthcare Clinics ? ? ?

“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

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Watch for testimony on NSA surveillance

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.

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Added information to the context for NSA legislation

Wired points to lawsuits fizzling so far, but also more secrecy and claims it is off limits to courts.

The Obama administration for the first time responded to a Spygate lawsuit, telling a federal judge the wholesale vacuuming up of all phone-call metadata in the United States is in the “public interest,” does not breach the constitutional rights of Americans and cannot be challenged in a court of law.

Thursday’s response marks the first time the administration has officially answered one of at least four lawsuits challenging the constitutionality of a secret U.S. snooping program the Guardian newspaper disclosed last month. The administration’s filing sets the stage for what is to be a lengthy legal odyssey — one likely to outlive the Obama presidency — that will define the privacy rights of Americans for years to come.

By the numbers also from Wired.

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National Security at Any Cost

We do have Fourth Amendment Rights. Fourth Amendment Rights are for everyone: Tea Partiers, Republicans, Democrats, Independents…. The Obama administration is moving us step by step towards a totalitarian regime, where the interests of the few over-ride the democracy of the many. Read the Fourth Amendment carefully:

The right of the people to be secure in their persons, houses, papers, and effects against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, or the things to be seized.

Those who plead National Security at all costs are no different and no less dangerous that Joseph McCarthy. He, too, pleaded National Security, as he destroyed countless lives and reputations. Nor are those who plead National Security at all costs any different from J. Edgar Hoover who spied on Martin Luther King in the name of National Security.

Do you really think that the kind of free hand the NSA is asking will protect us from the likes of McCarthy and J. Edgar Hoover? I do not think so.

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Round and around the revolving door does spin…

Lifted from comments from open thread July 23 by reader Jack

Round and around the revolving door does spin. Those who take the ride are 
guaranteed to win, in the game of securities enforcement law. In yet another 
move between public and private practice John Khuzami moves from the SEC to “….a 
job that pays more than $5 million a year at Kirkland & Ellis, one of the 
nation’s biggest corporate law firms. In doing so, he is following the 
quintessential Washington script: an influential government insider becoming a 
paid advocate for industries he once policed.” NY Times, July 23, 2013.

    “We started out knowing that everybody and anybody wanted him,” said Mark 
Filip, who leads Kirkland’s government and regulatory defense group.”
    Mr. Khuzami’s skills were so sought after that “…Visa and Bridgewater, the 
giant hedge fund, were among the companies that approached Mr. Khuzami for 
in-house counsel jobs. The fervor grew so great that Fox Business declared it 
the “biggest bidding war on Wall Street.”

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Say it like it is?

Via the Washington Post comes some interesting language.

Employers are raising education requirements even for entry-level positions.

Thirty-two percent of hiring managers and human resource professionals said they are hiring more employees with college degrees for positions that were historically held by high school graduates, according to a survey by CareerBuilder.

“While some of this may be attributed to a competitive job market that lends itself to college grads taking lower skill jobs, it also speaks to companies raising performance expectations for roles within their firms to enhance overall productivity, product quality and sales,” said Brent Rasmussen, president of CareerBuilder North America.

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Hunger Games USA

Paul Krugman writes in Hunger Games USA. Facts and figures at his column.

To fully appreciate what just went down, listen to the rhetoric conservatives often use to justify eliminating safety-net programs. It goes something like this: “You’re personally free to help the poor. But the government has no right to take people’s money” — frequently, at this point, they add the words “at the point of a gun” — “and force them to give it to the poor.”

It is, however, apparently perfectly O.K. to take people’s money at the point of a gun and force them to give it to agribusinesses and the wealthy.

Now, some enemies of food stamps don’t quote libertarian philosophy; they quote the Bible instead. Representative Stephen Fincher of Tennessee, for example, cited the New Testament: “The one who is unwilling to work shall not eat.” Sure enough, it turns out that Mr. Fincher has personally received millions in farm subsidies.

Given this awesome double standard — I don’t think the word “hypocrisy” does it justice — it seems almost anti-climactic to talk about facts and figures. But I guess we must.

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McDonalds’ Suggests a Budget for Employees . . .

Partnering with Visa, McDonalds’ Suggests a Budget for Employees which Ironically Shows in the End Just How Impossible It is to Get by on the Minimum Wage. The budget does not include gasoline, food, or heating expenses and incorporates $20/month for Healthcare Insurance.


Besides skipping certain expenses and skimping on others; to meet the income levels portrayed in the budget, McDonalds suggests associates to work not one but two jobs. A full time job at McDonalds and a part time job elsewhere totally 62 hours per week (if the worker resides in Illinois where the minimum wage is $8.25/hour). If perchance, the worker resides in one of the other 48 states; the total hours needed to hit the suggested income level jumps to 74 hours/week due to a lower minimum wage (the equivalent of a second full time job). The same as Wal-Mart employees, McDonalds associates will end up seeking public aid to get by because of low wages.

If you recall Spencer’s post of Labor’s Share; Spencer pointed out how Productivity Gains have been heavily skewed towards Capital and away from Labor (wages) since the seventies. The CEPR provides a graph with a another take on Productivity Gains when compared to Real Minimum Wage. When compared to Productivity Gains, Minimum Wage has trending downward.


In earlier posts, Edward Lambert addresses the loss of real wages and the potential impact on the economy. As we can see, the only real option to avert another collapse is to raise labor’s share of income. This is not likely as businesses are even now fighting an increase in just the minimum wage. Businesses are trying to maximize their profits and do not want to raise labor costs. Yet this objective of theirs is going to kill the economy. The time bomb is ticking.

If you remember in the PPACA Healthcare Debate:

McDonalds was one of the restaurant employers (Papa Johns, Olive Garden, Applebys, etc.) stating the excessive cost of the PPACA would force them to cut workers hours to <30 hours to avoid providing healthcare insurance (doing so would not alleviate restaurants from penalties as the PPACA looks at total hours worked and not just employees working >30 hours). To my point, McDonalds is advocating >30 hours at its restaurants in its budget and also providing healthcare insurance(?) which by law has to be minimally equivalent to the least costly PPACA Bronze Plan. It would be interesting to see if McDonalds could provide healthcare insurance similar to the Bronze Plan at $20/month. If the plan is not the equivalent, a McDonalds associate could go on the State Exchanges and get a Bronze Plan with all of the free preventative care for ~$97/month (215% FPL – single 21 yr. old Adult) after subsidy. McDonalds would pay a penalty if full time workers sought insurance outside of McDonalds and onn the exchanges. Workers, however, under 30 years and those unable to find affordable insurance are exempt from the mandate and could purchase substitute catastrophic coverage (ACA – Standardizing Health Plans). Perhaps too, this is McDonalds strategy for providing healthcare insurance (catastrophic) to much of its workforce who are <30 years old and working within the PPACA.

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Elizabeth Warren and Glass Steagall

Via Truthout 21st centurty Glass Steagall Act

You need to know this. Senator Elizabeth Warren wants to make banking boring again. Yesterday, the freshman senator introduced the 21st Century Glass Steagall Act, which would break up the big banks, and rebuild the wall between traditional banking and Wall Street gambling. In a statement, Senator Warren said, “Despite the progress we’ve made since 2008, the biggest banks continue to threaten the economy.” Senators John McCain and Maria Cantwell, the pair who attempted a similar bill back in 2009, joined Senator Warren as she introduced her new legislation. Of course, taking on the “too-big-to-fail” banks won’t be an easy challenge. Previous attempts to reign in bank size and power were met with huge resistance from the banksters, who railed against proposals to break up the banks.

PDF is here.

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Oil Prices

The last few weeks oil prices have been moving higher and few analysts seem to understand the full story.

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If there is any commodity that trades at a one world price it is oil.  So the recent weakness in West Texas Intermediate ( WTI)  is very unusual and stems from temporary bottlenecks.  Over the last few years a new major source of oil has emerged from fracking in North Dakota and other interior locations. The problem was that over the years pipelines and other supply chains for oil had been built to move crude from  coastal ports to interior locations  and refiners like Cushing, Oklahoma, not from the interior to ports. A s a consequence, when mid-western oil supplies expanded it created local surpluses and price weakness.  But now these bottlenecks are being eliminated.  In particular, two pipelines from Cushing to the Gulf Coast have been reversed and large quantities of oil are now flowing from Cushing to the Gulf ports and refiners.  As a consequence the spread between  WTI and Brent crude is  collapsing.

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Since the June low, Brent crude has risen some 6.5% while WTI has jumped some 15.7%.  This has caused the spread to collapse back to near its old pre-2011 values.  Butt in evaluating the impact of the Egyptian unrest on world oil prices the number to watch is the 6.5% increase in Brent crude, not the 15.7% increase in WTI.  But the impact on domestic gas prices is more complex.  On  the coast gas prices are experiencing small price increase in line with the move in Brent while in the interior gas prices are moving up some 10% to 20% in line with the jump in WTI.

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