Greg Sargent gets a great nugget from Democratic pollster Celinda Lake, who “recently conducted a statewide poll in Kentucky for an unnamed client and found that Kynect polls very positively, in contrast to Obamacare, which is underwater.”

Kynect is the Kentucky version of the Affordable Care Act exchange. To the extent the polling is correct, these results are another example of people loving the ACA but hating Obamacare.

Which just isn’t very surprising. People still don’t really know what “Obamacare” is. Why should they? There’s nothing labeled “Obamacare” that anyone has to deal with; almost nothing labeled “Affordable Care Act;” and there aren’t even all that many noticeable parts of the new system. Of course, Kynect is one of those new things, but there’s no reason for anyone in Kentucky to know that it has anything to do with the national law.

Hat Tip: Jonathan Berstein Thanks, But We Still Hate Obamacare!, Jonathan Bernstein

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This particular post was first picked up at Economist’s View and fits with Sandwichman’s posts on Labor. I have been watching Participation Rate in conjunction with U3 since 2001 along with others such as Laurent Guerby and while the US has decreased in the numbers of people in the Civilian Labor Force, our counterparts in Europe have seen increased numbers in the Civilian Labor Force. Krugman makes a statement “even the French Work harder than the Americans” which to me is rather bizarre given the French have a shorter work week and more time off than the American Labor Force. Perhaps it has nothing to do with working harder? We might find the reasons for an increased Civilian Labor Force in working smarter and more efficiently during a shorter work week. I think Krugman and the proponents of the 40+ hour work week tend to forget, it is all about throughput and efficiency and not about Labor as the latter can allow greater Labor participation. I find the comparison of the US to other countries interesting in that the other countries and associated appear to allow the citizenry to be more productive than the US by keeping more of them employed and working shorter hours. Maybe in the US we are just too militant for higher wages and time off???

Anyhoo, here the post by Antonio Fatas as taken from his blog “On The Global Front.” Antonio is certainly qualified to make such an analysis as he is on the Portuguese Council Chaired Professor of European Studies and Professor of Economics at INSEAD. INSEAD is a business school with campuses in Singapore and Fontainebleau (France). Antonio is a Senior Policy Scholar at the Center for Business and Public Policy at the McDonough School of Business (Georgetown University, USA) and a Research Fellow at the Center for Economic Policy Research (London, UK). His charts certainly provoke discussion as to what we in the US “are doing wrong.”

“In a recent post Paul Krugman looks at the dismal performance of US labor markets over the last decade. To make his point, he compares the employment to population ratio for all individuals aged 25-54 for the US and France. The punch line: even the French work harder than the Americans! And this is indeed a new phenomenon, it was not like that 13 years ago [Just to be clear, there are other dimensions where the French are not working as hard: they retire earlier, they take longer vacations,… but the behavior of the 25-54 year old population is indeed a strong indicator of how a society engages its citizens in the labor market. ]

So are the French the exception? Not quite. Among OECD economies, the US stands towards the bottom of the table when it comes to employment to population ratio for this cohort (#24 out of 34 countries).

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What is interesting is that most of the countries of the top of the list are countries with a large welfare state and very high taxes (including on labor). So the negative correlation between the welfare state and taxes and the ability to motivate people to work (and create jobs) that some bring back all the time does not seem to be present in the data.

What is interesting is that the US looked much better 13 years ago (see numbers for 2000 below, the US was 10 out of 34).

The US has gone through a major crisis after 2008 with devastating effects on the labor market but so have other countries. In fact, most European countries have done much worse than the US in terms of GDP growth during the last 6 years. In fact, with the exception of Portugal, Greece and Ireland, the US is the country with the worst labor market record for this age group if we compare the 2012 to the 2000 figures.”

Hat Tip to: Economists View

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Polk County, Arkansas 9th Street Ministries will be closing its medical clinic mission April 24, 2014. It has been in place since 1998 offering free medical services to those who did not have Medicare, Medicaid or commercial insurance. The reason for its closure has nothing to do with finances or lack of support although I imagine it was difficult during the Great Recession to raise funding.

“‘Because people are qualifying for insurance coverage through the Affordable Care Act, also known as Obamacare, our free medical clinic will not be needed anymore,’ Stacey Bowser RN, 9th Street Ministries Clinic Director, stated. ‘We’ve gone from seeing around 300 people a month on a regular basis, but as people were enrolling in Obamacare, the numbers we were seeing have dropped. We were down to 80 people that came through the medical clinic in February, all the way down to three people at the medical clinic in March. Our services won’t be needed anymore, and this will conclude our mission.’”

The clinic was offering medical assistance to first come first served the last Thursday of every month. You think it is difficult to get an appointment when you have insurance? Just imagine waiting a month at a time if you have a chronic illness?

But this closure of the 9th Street Ministries Medical Mission Clinic can not be true, the numbers as cited by the Rand study and Charles Gaba are highly inaccurate according to some at Angry Bear disputing the numbers of who have signed up through he state and federal exchanges or through commercial companies.

References: Crooks and Liars; Here’s The Best Obamacare Story Yet; The Menastar; 9th Street Ministries to conclude Medical Clinic mission; and Charles Gaba’s Blog

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Maggie Mahar on the Uninsured:

As I explain in an earlier post, Charles Gaba, the enrollment guru who has been tracking Obamacare sign-ups since October, now estimates that by April 15, some 17 million Americans will have purchased their own insurance policies either in the Obamacare Exchanges (8 million) or off-Exchange (9 million)

But how many of them were uninsured and how many were simply replacing policies that the Affordable Care Act (ACA) had forced insurers to cancel?  This is the question conservatives ask.  After all they argue, if most of these folks already had coverage, we have just wasted a great deal of time and money moving them from a policy they chose to one that President Obama prefers.

There are two answers to their question. The first is that while we don’t have an exact number as to how many of the new enrollees were uninsured,we do know (thanks to Obamcare),  the percent of Americans who are “going naked” has declined.

Gaba offers a second, even better, answer: “It doesn’t really matter.”

I agree. As he explains:

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by Maggie Mahar at The Health Beat Blog.

Charles Gaba, who has become the “Nate Silver” for Obamacare enrollment numbers; now predicts that by April 15, 17 million Americans will have purchased their own healthcare coverage.

His back-of-the-envelope estimate includes “a nice round 8 million”  who buy policies in the government marketplaces. In parentheses, he suggests:  Perhaps a little higher (1M even?) and then strikes that thought;  “As always,” he notes, “I’ll be more than happy to be proven wrong, as long as I’ve undershot the mark.”

Gaba then adds roughly  9 million who, (according to a Rand Corp. survey), have bought their own policiesdirectly from insurers, instead of using the Exchanges. Nine million plus 8 million brings us to an astounding number: 17 million.

Rand shared its analysis  with the LA. Times, though it has not yet released its report. Obamcare’s  skeptics scoff at Rand’s number; but, Gaba points out the Blue Cross and Blue Shield Association alone have confirmed its member plans have enrolled at least 1.7 million people in plans that  meet the ACA’s requirements outside the exchange system.

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Last Thursday (Jun. 27) I posted a piece here titled “Poetic Justice for Justice Alito.  Maybe.”, that discussed the concerted and deeply successful effort begun in the mid-1980s by the Reagan-era appointees to the federal appellate bench and continuing unremittingly since then, to invite virulent abuse of litigants and lawyers by judges—the more overt and ugly, the more the peer applause and emulation.  The occasion for my post was an article about Samuel Alito, by Mark Joseph Stern on Slate, which I linked to.

My post said Alito’s conduct was part and parcel of a defining characteristic and goal of the rightwing conservative legal movement of the last four decades—goal so thoroughly successful that it became, and remains, the norm among federal judges, irrespective of political affiliation.  Clinton appointees (including one who, twice, came precious-close to nomination to the Supreme Court by Obama) enthusiastically jumped on that bandwagon.

But there are two key facts that I decided not to mention in that post, and to instead leave for a later post: One is that state-court judges have, en masse, followed the lead of these federal judges.  The other is that that lead consists not only of now-routine denigration and defamation of litigants and counsel but also of jaw-droppingly in-your-face disregard of clear federal and state substantive and procedural law (including unequivocal statutory law).  A triumph of this juggernaut is that, regarding no-name litigants and no-name counsel, the more flagrant the deviation from unequivocal law, the cuter the judge feels. Abuse of office among judges—federal and (these days even more so) state judges—is deeply institutionalized now.

I’m posting this now (although I’m not much in the mood today) because of run75441’s post below from yesterday and because of a comment that reader Denis Drew posted to my Jun. 27 Alito piece. He wrote:

Get judges down to earth:
Just stand outside the courthouse — every courthouse — informing people: “If you don’t have to salute the flag, you should not have to rise when the judge walks in. Nobody will rise once they think of it. Game over.

I refused to remove my hat in an Illinois courtroom (the judge was not yet present — was a bully). I gave the court officer my little spiel and offered to explain to the judge when he came in (he didn’t ask).

I should have added: “If you think this is church, tell the ladies to put hats on (can they tell the ladies to take hats off?).

Gives me another pesky idea. Have “Freedom Hat Day”: hand out hats outside courthouses for the men to assert their First Amendment rights.

I call this “broken windows theory for cops and judges”: full application of First Amendment discipline — remind them they are no bigger than anybody else. Make them repair their small First Amendment misbehavior and you repair the lawless atmosphere that encourages more serious offenses.

I responded today in the Comments thread:

Exactly, Denis.  In writing this post, I considered saying also that state-court judges have, en masse, followed the lead of these federal judges, but I decided to leave that for a later post. The specifics are stunning and appalling.  The very essence of the American judicial system has changed dramatically in the last three decades.

This crowd of federal judges had for nearly three decades been regarded as untouchable.  But their unfettered, unquestioned, and under-the-public’s-radar-screen, at-will legal, ethical and moral freelancing may soon come with an actual price.  It was, and remains, great fun.  But times, I have reason to expect, are changing.  The judicial honorarium may soon cease to serve as license for the routine, joyful abuse of that little-scrutinized but profoundly powerful public office.  These folks may have to take up gardening or fishing instead as a hobby.

—-

UPDATE: In the Comments thread to this post, regular AB commenter and occassional AB contributor Dale Coberly posted a link to this breathtaking article on Alternet.  In response to Dale’s comment, I wrote:

Yes, this is a classic instance of something I’ve written about on AB several times now, including in one of my posts here last week: The Supreme Court’s bizarre several-decade juggernaut by which, in the name of states’ sovereignty, they foreclose access to federal court to enforce federal constitutional rights, however brazenly—and I do mean brazenly—denied by state-court judges in criminal and civil cases (e.g., family-law; adult-guardianship/conservatorship; various types of contract cases, including ones that harm small businesses such as franchisees and business-loan customers).

This 18-year-old should be able to file what’s known as a declaratory-judgment lawsuit in federal court asking for, and receiving, a declaratory judgment—a declaration of law pertinent to the facts—holding that this young man’s statements are protected under the First Amendment. Even though he’s not a corporation.  In the case of a criminal defendant, as this 18-year-old is, the issue is complicated by an outrageous federal “jurisdictional” statute enacted in 1996 and signed by Clinton just before his reelection bid to fend off soft-on-crime accusations, that in a juggernaut led by Anthony Kennedy (states’ sovereign dignity! By which he means state-COURTS’ sovereign dignity) is interpreted in ways that are clearly violative of the Fourteenth Amendment and the original Constitution’s writ of habeas-corpus clause. To the extent that the statute actually DOES bar a “collateral” declaratory judgment claim in federal court, it does violate those provisions of the Constitution.

That 1996 statute is, I think, finally— finally—very ripe politically for re-examination by a congressional coalition of progressives and Republican libertarians such as Rand Paul. I’d love to see this case get widespread attention; I certainly was unaware of it until now.  Maybe Justice Kennedy, if he learns of it, will give a moment’s thought to the dignity of this individual and whether under the ACTUAL Constitution, state court’s sovereign dignity really trumps individual dignity.

The Alternet article doesn’t say that his arrest was by local police and that he was charged in state, rather than federal, court, but that appears to be the case, and I’m assuming that it is.

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by run75411

Smoking is All About Poverty 

I raised the issue of why the elderly pay more than smokers for healthcare insurance since growing old is a natural occurrence and smoking and its associated disorders is self-inflicted. I raised it after STR said smokers are being robbed and I pointed out the elderly non-smokers and smokers pay 3 times the lowest cost insuree as determined by the MLR. Coberly believes there should be Medicare for all. The idea is a great one once we get a Congress who will support it. Even with a Senate majority of Democrats and faux Democrats, any alternatives to the PPACA went nowhere. For now and until Congress gets more sympathetic to its constituency, we have the best which can be conjured up today. With her reply, my fellow healthcare writer and expert in healthcare answered my post to one of her articles:
 
Me: I am crying crocodile tears for smokers paying 50% more than the lowest cost insuree. This is a tough pill to swallow for smokers who self-inflict this damage to themselves. The 50% premium for smokers pales in comparison to the 300% above the lowest cost insure, the elderly will pay for just being old a condition which is unavoidable. Come on Louise, you can not be serious.

Maggie Mahar: Most people don’t know the vast majority of adult smokers in the U.S. are low-income, didn’t complete high school, and leading very stressful lives. This is why they smoke. As a recent study of smokers in New Orleans and Memphis quotes one of the research subjects:

“”So many things fill your mind and you go through so much, you need your cigarette to smoke to calm down and get things off your mind,” says one of the participants, quoted in an article about the study in the March/April issue of the American Journal of Health Promotion.

“In our study, cigarette use was defined as a ‘buffer’ for dealing with multiple demands, financial insecurity and daily hassles,” say Bettina M. Beech, Dr. P.H., M.P.H., of the University of Memphis, Department of Psychology and colleague.

More affluent better-educated Americans are far more likely to quit smoking than low-income very poor Americans for several reasons.

1) they have a reason to want to live. If you’re a black male who can’t find work, can’t put enough food on the table to feed your kids, and worry about what’s going to happen to them on the street, you’re angry, depressed and stressed. You are far more likely to engage in self-destructive behaviors –smoking, drinking, drugs. No matter how hard you try, chances are slim that your life is going to improve.

2) if you’re poor you cannot afford the nicotine patches and other drugs that making stopping so much easier for more affluent people. You probably also don’t have a doctor to prescribe these things. Louise is right– we need free smoking cessation clinics. The VA and Kaiser have both shown that they work. Of course poor people would like to quit smoking. A recent study in New York state shows that they spend 25% of their income on cigarettes. So why don’t they save up that money and buy a nicotine patch? Depression and stress sap a person’s will–and their ability to hope. Even if they stop smoking, they know that their lives are not going to suddenly get better. As the U. of Santa Clara points out on its Ethics home page:

“penalizing individuals for unhealthy behaviors could result in great injustice and social harm.”

While 18 percent of U.S. citizens with incomes above the poverty line smoke, the figure almost doubles to 33 percent for those with incomes below the poverty line. A one-dollar cigarette tax would have a strongly regressive effect on the low incomes these individuals receive. Consider the added problem of tobacco addiction and the probable result of a tax is not less smoking or lower health care costs, but fewer dollars spent on nutritional food and other essentials – conceivably leading to more illness and higher health care costs.”

By charging smokers more for insurance, you increase the chances that they won’t be able to afford it. Given the choice between cigarettes– which they are addicted to and which they associate with relief of stress–and insurance, they’ll choose the cigarettes. Bottom line, when we blame smokers for smoking, we are blaming the poor for being poor. Tobacco companies know why people smoke.

Consider this confidential internal Philip Morris report:

”Lower class panelists smoke more and are much more likely to be smokers than upper class panelists…”

It also found that lower class people tend to smoke non-filtered cigarettes (tend to “avoid health filters”) and that they also tend to avoid 100 millimeter-length brands. The writers also observe that lower class people have more incidence of poor mental health, hypothesizing that people use smoking as a “strategy” to combat the stress of low class status as well as poor mental health:

“…the incidence of poor mental health is greatest among the lower class…To the extent that smoking is one of the available strategies people can adopt to combat stress, we therefore would expect greater incidence of smoking among the lower social classes.”

This is why in recent years, tobacco ads have targeted low-income people and African Americans. (Btw–they’re right, smoking is also associated with mental health problems.)

Me: I had to reconsider my stance on smokers being let off easy  given the weight of the evidence presented on why smokers should not pay more.  http://www.healthbeatblog.com/2013/01/the-newest-health-wonk-review-on-health-affairs/#comment-17887 “Health Wonk” Health Beat  blog

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