Wednesday, December 21, 2011

Chart of the Day: Republicans and the Filibuster | Mother Jones

Chart of the Day: Republicans and the Filibuster | Mother Jones:

This isn't a big surprise or anything, but now you have the color-coded data to show to all your friends and relatives. Republicans are the party of obstruction, and they have been for more than four decades now.
Just wanted a bookmark for this great graphic...

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The downward path of upward mobility - The Washington Post

The downward path of upward mobility - The Washington Post:

This is only a surprise to those on the right, whose favorite policies all favor driving down wages in one way or another because they think it "works."

In fact, over the past decade, growing evidence shows pretty conclusively that social mobility has stalled in this country. Last week, Time magazine’s cover asked, “Can You Still Move Up in America?” The answer, citing a series of academic studies was, no; not as much as you could in the past and — most devastatingly — not as much as you can in Europe.

The most comprehensive comparative study, done last year by the Organization for Economic Cooperation and Development, found that “upward mobility from the bottom” — Daniels’s definition — was significantly lower in the United States than in most major European countries, including Germany, Sweden, the Netherlands and Denmark. Another study, by the Institute for the Study of Labor in Germany in 2006, uses other metrics and concludes that “the U.S. appears to be exceptional in having less rather than more upward mobility.”

A 2010 Economic Mobility Project study found that in almost every respect, the United States has a more rigid socioeconomic class structure than Canada. More than a quarter of U.S. sons of top-earning fathers remain in the top tenth of earners as adults, compared to 18 percent of similarly situated Canadian sons. U.S. sons of fathers in the bottom tenth of earners are more likely to remain in the bottom tenth of earners as adults than are Canadian sons (22 percent vs. 16 percent). And U.S. sons of fathers in the bottom third of earnings distribution are less likely to make it into the top half as adults than are sons of low-earning Canadian fathers.

Surveying all the evidence, Scott Winship, a fellow at the Brookings Institution, concludes in this week’s National Review: “What is clear is that in at least one regard American mobility is exceptional. . . . [W]here we stand out is our limited upward mobility from the bottom.”

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Sunday, December 18, 2011

How Ayn Rand Seduced Generations of Young Men and Helped Make the U.S. Into a Selfish, Greedy Nation | | AlterNet

How Ayn Rand Seduced Generations of Young Men and Helped Make the U.S. Into a Selfish, Greedy Nation | | AlterNet:

Only rarely in U.S. history do writers transform us to become a more caring or less caring nation. In the 1850s, Harriet Beecher Stowe (1811-1896) was a strong force in making the United States a more humane nation, one that would abolish slavery of African Americans. A century later, Ayn Rand (1905-1982) helped make the United States into one of the most uncaring nations in the industrialized world, a neo-Dickensian society where healthcare is only for those who can afford it, and where young people are coerced into huge student-loan debt that cannot be discharged in bankruptcy.

Ayn Rand’s personal life was consistent with her philosophy of not giving a shit about anybody but herself. Rand was an ardent two-pack-a-day smoker, and when questioned about the dangers of smoking, she loved to light up with a defiant flourish and then scold her young questioners on the “unscientific and irrational nature of the statistical evidence.” After an x-ray showed that she had lung cancer, Rand quit smoking and had surgery for her cancer. Collective members explained to her that many people still smoked because they respected her and her assessment of the evidence; and that since she no longer smoked, she ought to tell them. They told her that she needn’t mention her lung cancer, that she could simply say she had reconsidered the evidence. Rand refused.

So, I guess that explains why the anti-science crowd is so confident in its ignorance - Ayn Rand has their back!

Rand said, “Capitalism and altruism are incompatible....The choice is clear-cut: either a new morality of rational self-interest, with its consequences of freedom, justice, progress and man’s happiness on earth—or the primordial morality of altruism, with its consequences of slavery, brute force, stagnant terror and sacrificial furnaces.” For many young people, hearing that it is “moral” to care only about oneself can be intoxicating, and some get addicted to this idea for life.
Explains most of the Conservative "thought" on economics, doesn't it? Rand Paul, Paul Ryan, I'm looking at you.

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Monday, December 12, 2011

Koch Brothers funded study:: "ObamaCare Health Insurance Exchanges Get a Grade of ‘F’ "

» "Independent" Study: ObamaCare Health Insurance Exchanges Get a Grade of ‘F’ - :

The independent Mercatus Center at George Mason University has given a grade of “F” to the ObamaCare Health Insurance Exchanges regulation. The center studies the anticipated results and economic effects of proposed regulations. In other words, their researchers evaluate whether regulations are likely to accomplish what their supporters say they will.
I guess we shouldn't be surprised at what BS will be passed off as legitimate work, given enough money swirling around, but "independent?!?!" In this case, the "Mercatus Center" is a subsidiary of the Koch brothers war on rational discourse. But apparently they are, per the Wall Street Journal, “the most important think tank you’ve never heard of.”

I did review the document, and it has all the intellectual rigor of a teacher who really hates you grading your term paper.

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Sunday, December 11, 2011

Doubt is Their Product

Doubt is Their Product:

"Doubt is our product," a cigarette executive once observed, "since it is the best means of competing with the 'body of fact' that exists in the minds of the general public. It is also the means of establishing a controversy."

In this eye-opening exposé, David Michaels reveals how the tobacco industry's duplicitous tactics spawned a multimillion dollar industry that is dismantling public health safeguards. Product defense consultants, he argues, have increasingly skewed the scientific literature, manufactured and magnified scientific uncertainty, and influenced policy decisions to the advantage of polluters and the manufacturers of dangerous products. To keep the public confused about the hazards posed by global warming, second-hand smoke, asbestos, lead, plastics, and many other toxic materials, industry executives have hired unscrupulous scientists and lobbyists to dispute scientific evidence about health risks. In doing so, they have not only delayed action on specific hazards, but they have constructed barriers to make it harder for lawmakers, government agencies, and courts to respond to future threats.
Just bookmarking this for future reference...

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To Fix Health Care, Help the Poor -

To Fix Health Care, Help the Poor -

IT’S common knowledge that the United States spends more than any other country on health care but still ranks in the bottom half of industrialized countries in outcomes like life expectancy and infant mortality. Why are these other countries beating us if we spend so much more? The truth is that we may not be spending more — it all depends on what you count.

In our comparative study of 30 industrialized countries, published earlier this year in the journal BMJ Quality and Safety, we broadened the scope of traditional health care industry analyses to include spending on social services, like rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life.

We studied 10 years’ worth of data and found that if you counted the combined investment in health care and social services, the United States no longer spent the most money — far from it. In 2005, for example, the United States devoted only 29 percent of gross domestic product to health and social services combined, while countries like Sweden, France, the Netherlands, Belgium and Denmark dedicated 33 percent to 38 percent of their G.D.P. to the combination. We came in 10th.

What’s more, America is one of only three industrialized countries to spend the majority of its health and social services budget on health care itself. For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries, for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care.

Our study found that countries with high health care spending relative to social spending had lower life expectancy and higher infant mortality than countries that favored social spending. While the stagnating life expectancy in the United States remains at 78 years, in many European countries it has leapt to well over 80 years, and several countries boast infant mortality rates approximately half of ours. In a national survey conducted by the Robert Wood Johnson Foundation, four out of five physicians agreed that unmet social needs led directly to worse health.

It is also well understood in the public health communities that health has far more to do with overall poverty than access to health care, per se. But we have this hard headed approach in America to "punish" the "undeserving" poor. Therefore we shoot ourselves in the foot economically in order to feel better about our "values."
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The few, the proud, the very rich « The Berkeley Blog

The few, the proud, the very rich « The Berkeley Blog:

"Upon closer inspection, the Forbes list reveals that six Waltons—all children (one daughter-in-law) of Sam or James “Bud” Walton the founders of Wal-Mart—were on the list. The combined worth of the Walton six was $69.7 billion in 2007—which equated to the total wealth of the entire bottom thirty percent!"

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George Lakoff: Words That Don't Work

George Lakoff: Words That Don't Work:

Unfortunately, Luntz is still ahead of most progressives responding to him. Progressives need to learn how framing works. Bashing Luntz, bashing Fox News, bashing the right-wing pundits and leaders using their frames and arguing against their positions just keeps their frames in play.

Progressives have a basic morality, which is largely unspoken. It has to be spoken, over and over, in every corner of our country. Progressives need to be both thinking and talking about their view of a moral democracy, about how a robust pubic is necessary for private success, about all that the public gives us, about the benefits of health, about a Market for All not a Greed Market, about regulation as protection, about revenue and investment, about corporations that keep wages low when profits are high, about how most of the rich earn a lot of their money without making anything or serving anyone, about how corporations govern your life for their profit not yours, about real food, about corporate and military waste, about the moral and social role of unions, about how global warming causes the increasingly monstrous effects of weather disasters, about how to save and preserve nature.

Progressives have magnificent stories of their own to tell. They need to be telling them nonstop.

Let's lure the right into using OUR frames in public discourse.

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The Bomb Buried In Obamacare Explodes Today-Hallelujah! - Forbes

The Bomb Buried In Obamacare Explodes Today-Hallelujah! - Forbes:

This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time. Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.

Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.

Today, that bomb goes off.

Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.

As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.

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Sunday, December 4, 2011

Parting Shot at ‘Waste’ By Key Obama Health Official -

Parting Shot at ‘Waste’ By Key Obama Health Official - Republicans called him evasive. For political reasons, the administration did not want him to defend past statements in which he had extolled the virtues of the British health care system and had suggested a need to cap total health spending and limit the supply of costly high-technology medical care in the United States.

Dr. Berwick said most of the criticism by Republicans, who warn of a government takeover of health care, was “purely political, a world of sound bites.” In the interview, he lashed out at Republicans who depict him as an advocate of rationing health care.

In 2009, he told a biotechnology journal, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”

Dr. Berwick said Republicans had “completed distorted” his meaning. “My point,” he said, “is that someone, like your health insurance company, is going to limit what you can get. That’s the way it’s set up. The government, unlike many private health insurance plans, is working in the daylight. That’s a strength.”

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School Lunches and the Food Industry -

School Lunches and the Food Industry - An increasingly cozy alliance between companies that manufacture processed foods and companies that serve the meals is making students — a captive market — fat and sick while pulling in hundreds of millions of dollars in profits. At a time of fiscal austerity, these companies are seducing school administrators with promises to cut costs through privatization. Parents who want healthier meals, meanwhile, are outgunned.

Each day, 32 million children in the United States get lunch at schools that participate in the National School Lunch Program, which uses agricultural surplus to feed children. About 21 million of these students eat free or reduced-price meals, a number that has surged since the recession. The program, which also provides breakfast, costs $13.3 billion a year.

Sadly, it is being mismanaged and exploited. About a quarter of the school nutrition program has been privatized, much of it outsourced to food service management giants like Aramark, based in Philadelphia; Sodexo, based in France; and the Chartwells division of the Compass Group, based in Britain. They work in tandem with food manufacturers like the chicken producers Tyson and Pilgrim’s, all of which profit when good food is turned to bad.

Here’s one way it works. The Agriculture Department pays about $1 billion a year for commodities like fresh apples and sweet potatoes, chickens and turkeys. Schools get the food free; some cook it on site, but more and more pay processors to turn these healthy ingredients into fried chicken nuggets, fruit pastries, pizza and the like. Some $445 million worth of commodities are sent for processing each year, a nearly 50 percent increase since 2006.

The Agriculture Department doesn’t track spending to process the food, but school authorities do. The Michigan Department of Education, for example, gets free raw chicken worth $11.40 a case and sends it for processing into nuggets at $33.45 a case. The schools in San Bernardino, Calif., spend $14.75 to make French fries out of $5.95 worth of potatoes.

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Eagle Forum Contradicts Thomas Jefferson On Constitution's "Christianized" Roots | Right Wing Watch

Eagle Forum Contradicts Thomas Jefferson On Constitution's "Christianized" Roots | Right Wing Watch:

In fact, Jefferson skewers those in England who tried to implement biblical law, much like many on the Religious Right attempt to do today, arguing that the gospel was “intended by their benevolent author as obligatory only in foro concientiae” (obligations of conscience, not law), and that the Ten Commandments were never incorporated into common law:

In truth, the alliance between Church and State in England has ever made their judges accomplices in the frauds of the clergy; and even bolder than they are. For instead of being contented with these four surreptitious chapters of Exodus, they have taken the whole leap, and declared at once that the whole Bible and Testament in a lump, make a part of the common law; ante 873: the first judicial declaration of which was by this same Sir Matthew Hale. And thus they incorporate into the English code laws made for the Jews alone, and the precepts of the gospel, intended by their benevolent author as obligatory only in foro concientiae; and they arm the whole with the coercions of municipal law. In doing this, too, they have not even used the Connecticut caution of declaring, as is done in their blue laws, that the laws of God shall be the laws of their land, except where their own contradict them; but they swallow the yea and nay together. Finally, in answer to Fortescue Aland’s question why the ten commandments should not now be a part of the common law of England? we may say they are not because they never were made so by legislative authority, the document which has imposed that doubt on him being a manifest forgery.

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Wednesday, November 30, 2011

The American-Western European Values Gap | Pew Global Attitudes Project

The American-Western European Values Gap | Pew Global Attitudes Project:

As has long been the case, American values differ from those of Western Europeans in many important ways. Most notably, Americans are more individualistic and are less supportive of a strong safety net than are the publics of Britain, France, Germany and Spain. Americans are also considerably more religious than Western Europeans, and are more socially conservative with respect to homosexuality.

Americans are somewhat more inclined than Western Europeans to say that it is sometimes necessary to use military force to maintain order in the world. Moreover, Americans more often than their Western European allies believe that obtaining UN approval before their country uses military force would make it too difficult to deal with an international threat. And Americans are less inclined than the Western Europeans, with the exception of the French, to help other nations.

These differences between Americans and Western Europeans echo findings from previous surveys conducted by the Pew Research Center. However, the current polling shows the American public is coming closer to Europeans in not seeing their culture as superior to that of other nations. Today, only about half of Americans believe their culture is superior to others, compared with six-in-ten in 2002. And the polling finds younger Americans less apt than their elders to hold American exceptionalist attitudes.

This is a fascinating read. If I had to give it a subtitle, I'd say, "More Americans removing heads from butts - finally!" It is difficult to stay small minded in this increasingly globalized world, though many manage to do so, and do so with amazing arrogance.

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Insiders Sound an Alarm Amid a Natural Gas Rush -

Insiders Sound an Alarm Amid a Natural Gas Rush - “Money is pouring in” from investors even though shale gas is “inherently unprofitable,” an analyst from PNC Wealth Management, an investment company, wrote to a contractor in a February e-mail. “Reminds you of dot-coms.”

“The word in the world of independents is that the shale plays are just giant Ponzi schemes and the economics just do not work,” an analyst from IHS Drilling Data, an energy research company, wrote in an e-mail on Aug. 28, 2009.

Company data for more than 10,000 wells in three major shale gas formations raise further questions about the industry’s prospects. There is undoubtedly a vast amount of gas in the formations. The question remains how affordably it can be extracted.

The data show that while there are some very active wells, they are often surrounded by vast zones of less-productive wells that in some cases cost more to drill and operate than the gas they produce is worth. Also, the amount of gas produced by many of the successful wells is falling much faster than initially predicted by energy companies, making it more difficult for them to turn a profit over the long run.

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Wednesday, November 23, 2011

Amgen’s New Enbrel Patent May Undercut Health Care Plan -

Amgen’s New Enbrel Patent May Undercut Health Care Plan -

Something to really dislike about the PPACA!

Enbrel, which is used to treat rheumatoid arthritis and psoriasis, was one of several biotechnology drugs that were expected to face competition in the next few years from copycat versions, eventually saving the health care system billions of dollars a year.

The 2010 health care law established a way for such biologic drugs, which can cost tens of thousands of dollars a year, to face competition from near generic versions, which are often called biosimilars. A new law was needed because biologic drugs, which are made in living cells, were not covered by the 1984 law governing most pharmaceutical competition.

The main patent on Enbrel was to expire in October of next year. But the new patent could stave off such biosimilar competition until Nov. 22, 2028. By that time, Enbrel will have been on the market 30 years, far longer than the 20 years of protection expected in patent law.

Enbrel had sales of $3.5 billion in the United States and Canada in 2010, accounting for nearly one-quarter of Amgen’s revenue. The drug costs more than $20,000 a year. Pfizer sells Enbrel abroad.

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N.Y. Malpractice Program May Offer Model For Medical Liability Cases - Kaiser Health News

N.Y. Malpractice Program May Offer Model For Medical Liability Cases - Kaiser Health News:

At its core, the New York program, called judge-directed negotiation, is simple: When a medical malpractice lawsuit is filed, a judge with expertise in medical matters becomes the point person for that case. He or she supervises the entire process and brings the parties together as often as necessary to discuss the case and help broker a settlement.

This is very different from what typically happens now: The pre-trial discovery phase, in which depositions are taken and other evidence is gathered, sometimes drags on for months or even years. A number of judges may be involved over that period, and with no one person pushing the parties toward resolution, serious settlement discussions generally don't happen until late in the process, often after a court date has been set.

A judge overseeing the entire case can make sure the parties don't dawdle over such things as procedural meetings to set up discovery dates. From the beginning, that designated jurist can delve into the case with an eye toward settlement, says Judge Douglas E. McKeon, an administrative judge in the Supreme Court of Bronx County, who pioneered this approach in 2002. He discovered that "if you created a process that people knew had the potential to get a case settled sooner rather than later for significant sums of money, they came in and they were ready to talk," he says.
Sorry that a lot of these posts are just snippets, but I keep them for my own future reference, and it's either this or EverNote...

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Using new health law, HHS challenges Pa. insurer's rate increases -

Using new health law, HHS challenges Pa. insurer's rate increases -

Insurance premiums have historically been regulated by state governments. But oversight has varied substantially from state to state, with some doing almost no review and some actively blocking rates they deem excessive.

The Obama administration this year announced it would review any rate increase above 10% in states that do not have the capacity to do reviews themselves.

The Department of Health and Human Services is reviewing 35 such increases. And administration officials have completed two, including the Everence rate hike in Pennsylvania.

They have already determined that an 11% increase that Everence is imposing on customers in Montana is reasonable.

Another 77 rate hikes of more than 10% are being reviewed by state regulators around the country, according to the Department of Health and Human Services.

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To save pennies on food and fuel, we let industries poison our children

To save pennies on food and fuel, we let industries poison our children:

In 2005, researchers at Mt. Sinai Medical Center in New York released their finding that mercury air pollution was costing the U.S. economy $8.7 billion a year in lost earnings due to diminished IQs of children exposed to mercury in the womb.

Mercury is well known and well understood as poison -- to both children and adults -- but it also is a developmental toxin. It affects developing fetuses and children in a way that it doesn't affect adults, and its effects are permanent and irreversible.

Lowered IQ. Lessened ability to learn. Reduced capacity for life. Why?

Because we like cheap electricity, and in today's market coal-fired electricity is the cheapest. When coal is burned, mercury is released into the air. Then it makes its way into the nostrils, lungs and brains of our children.

The solution is simple: Require all coal-fired power plants to install equipment that captures mercury before it escapes into the air.

Try that idea out on the power and coal companies. You won't have long to wait for the denials, evasions, knee-jerk rejections of data, lobbying and the charming PR that is churned out by the industry resistance machine.

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The Fracturing of Pennsylvania -

The Fracturing of Pennsylvania -

This is less than 20 miles away from my home...

That same day, when Voyles told Range Resources she had developed blisters in her nose, it offered to put her up in a hotel, as it does for all nuisance complaints, but she didn’t want to leave her dogs and horses behind. (Range later said that it had no record of the complaint.) Next door on McAdams Road, Haney and her kids began to have intense periods of dizziness and nosebleeds. Of the three, Harley was the worst off. Haney took him to their family physician, Craig Fox, in the nearby town of Washington. Like most local doctors, Dr. Fox had never seen such symptoms before.

Haney says that Dr. Fox’s advice to her was unequivocal: “Get Harley out of that house right away. I don’t want him anywhere near there, even driving by, for 30 days.” So Haney took Harley to a friend’s house in Eighty-Four, a town named for the lumber company. She took her daughter to her parents’ house in Amity. Each day, she spent about four hours in the car shuttling the kids from school, to and from friends’ homes and driving to the farm to feed the animals, which were O.K. some days and vomiting or collapsing on others. Haney found a cousin willing to take her pigs, but she had nowhere to house the other animals, so they remained at the farm. She stayed home for less than an hour at a time, long enough to put a load of laundry into the washer. Every two days, she spent $50 on gas. Their farmhouse stood abandoned. “Our home has become a $300,000 cat mansion,” Haney said when I visited her in July.

Haney is no left-leaning environmentalist; she is a self-proclaimed redneck who is proud to trace her roots here back at least 150 years. This is not the kind of fight she usually takes on. “I’m not going to sit back and let them make my kids sick,” she says. “People ask me why I don’t just move out, but where would I go? I can’t afford another mortgage, and if I default on this place, we will lose it. ”

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Tuesday, November 22, 2011

Why Doesn’t No Mean No? -

Why Doesn’t No Mean No? -

We talk, as a society, of our need to get health care costs under control. Conservatives, in particular, insist that Medicare must be reformed. Here is an enormously expensive drug that largely doesn’t work, has serious side effects and can no longer be marketed as a breast cancer therapy. Yet insurers, including Medicare, will continue to cover it.

If we’re not willing to say no to a drug like Avastin, then what drug will we say no to?
This is the nub of the argument to control health care costs. We have to say no to things that don't work, whether they have excellent lobbyists or not.

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Monday, November 21, 2011

America's new poor - CBS News

America's new poor - CBS News:

In Forsyth County's rolling subdivisions near Atlanta, Easy Street seems to run forever. What recession? The average household here earns $88,000 - the highest in Georgia, 13th highest in America.

But for more families here, prosperity is a pretense. The job's lost, the savings are gone, and the big house is either in foreclosure or on its way. And just keeping food on the table is a struggle.

So Forsyth's newly-needy file into local food banks.

Yesterday's GIVERS have become today's TAKERS.

"People lost their jobs and went from great incomes to no incomes," said Sandy Beaver, Sandy Beaver leads The Place, Forsyth County's biggest non-profit center for social services. She calls those who visit The Place "the new poor."
Indeed, the poor you will always have with you. But what if "they" are you?

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Sunday, November 20, 2011

Charts: 6 Big Economic Myths, Debunked | Mother Jones

Charts: 6 Big Economic Myths, Debunked | Mother Jones: #1: The stimulus failed.

Everyone from the nonpartisan Congressional Budget Office (PDF) to private-sector forecasting firms have concluded that the 2009 stimulus package increased economic growth, reduced unemployment, and put millions of people back to work. It just wasn't big enough, or long-lasting enough.
Bust or Boost?

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amednews: [interactive graphic] How much do health plans make? - Revenue falls, but stock buybacks boost per-share earnings. ... American Medical News

amednews: [interactive graphic] How much do health plans make? - Revenue falls, but stock buybacks boost per-share earnings. ... American Medical News: - Sent using Google Toolbar

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Saturday, November 12, 2011

Study: Well fees still aren't enough

Study: Well fees still aren't enough:

Plugging an abandoned Marcellus Shale gas well in Pennsylvania could cost $100,000 or more, and well bonding changes proposed by the Corbett administration could stick taxpayers with almost all of that bill, according to a study from Carnegie Mellon University.

The CMU study found that the new Marcellus gas well bonding fees, recommended by Mr. Corbett's Marcellus Shale Advisory Commission and now under consideration in the Republican-controlled Legislature, would require drilling companies to cover only a fraction of the costs of plugging and decommissioning old, nonproducing and abandoned gas wells.

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Friday, November 11, 2011

Commitment to Development Index : Center for Global Development

Commitment to Development Index : Center for Global Development:

Just in case you were wondering how the US does in foreign aid.

2011 Commitment to Development Index

Which wealthy nations are helping poor ones most? Rich and poor are linked in many ways. Each year, the CDI scores wealthy governments on helping poor countries via 7 linkages: aid, trade, investment, migration, environment, security, and technology. It averages over the 7 for an overall score.
Here are the graphics for foreign aid, by itself. We in the US are 17th.

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Thursday, November 10, 2011

Patients’ Grades to Affect Hospitals’ Medicare Reimbursements -

Patients’ Grades to Affect Hospitals’ Medicare Reimbursements - Winning praise from patients has become a pressing — and often elusive — obsession for NYU and for hospitals nationwide. In the coming months, Medicare will start taking patient satisfaction into account when reimbursing hospitals. Disgruntled patients will mean reduced revenue, a frightening prospect for hospitals already facing empty beds because of the recession and pressure from insurers to hold down costs.

Medicare’s new rule, mandated in the Affordable Care Act, pits hospitals against one another in a competition to best satisfy patients; those with the best scores will receive more money.

But some hospitals are worried that assessments from patients like Ms. Schwartz can be influenced not just by the quality of their care, but also by amenities like single rooms, renovated units and tasty food. And hospitals in cities and certain regions, like the Northeast and California, tend to get lower ratings, raising concerns that their revenues will be reduced simply because patients in those places are more disposed to grumble about things that a polite Midwesterner or Southerner would forgive.

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Sunday, November 6, 2011

Temperatures Rise Over Costs Of Care | Worcester Business Journal

Temperatures Rise Over Costs Of Care | Worcester Business Journal: Higher Sentiment For ‘Single Payer’?

Presumably, doctors are more familiar than the general public with the pressures driving up health care costs, and an overwhelming majority of them also say there needs to be some government involvement in the health care system. A survey by the Massachusetts Medical Society this fall found that 41 percent of doctors thought the best option for health care reform in the U.S. would be to adopt a single-payer system like Canada’s. That number was up from 34 percent in 2010.

Another 23 percent favor a mix of public and private plans, while 17 percent support reforms along the lines of the 2010 national health care reform act, including an individual mandate like Massachusetts’. Fifteen percent favor a system in which insurers can sell limited-benefit and high-deductible policies and the government gives subsidies to help low-income people buy insurance.

Lynda Young, president of the Massachusetts Medical Society (MMS) and a Worcester pediatrician, said doctors who favor a single-payer system may see it as a way to avoid administrative burdens. She noted that a recent article in the policy journal Health Affairs found that Canadian doctors spend two or three hours a week on administration, compared with about 10 to 15 hours for doctors in the U.S.
Pretty remarkable, especially when you look at the numbers in the graph. 41% plus 23% for 64% favoring either single payer or a 'public option' added to the current mix. 17% OK with the PPACA as it is, and another 15% seeming to favor high deductible plans.

That's a grand total of 81% favoring PPACA at least, the distinct minority,  with the significant plurality favoring single payer. Wow.

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Tuesday, October 25, 2011

Obama’s War Against Americans is Relentless. His Primary Attack Force is the EPA. « Conservatives on Fire

Obama’s War Against Americans is Relentless. His Primary Attack Force is the EPA. « Conservatives on Fire:

I'm taking an epidemiology/population health this semester, and we were reviewing the topic of environmental and occupational health. I Googled for the war on the EPA, and found the article linked to here, concerning how liberals and other tree huggers were were trying to ruin the economy and take us into a Communist police state through use of the EPA. Of course, this is not new.

But I was stunned by the absolute ignorance of several of the paragraphs, this one in particular:

Dear readers I would appreciate it very much if you would let me know if in fact you do live longer or if you have fewer non-fatal heart attacks or if you experience fewer sick days after this new rule takes effect. I mean we really should keep these records so we can verify if the EPA’s projections were correct or not. So, again, please let me know how it turns out and I will be happy to compile the record and I’ll report back once I have a statistically significant amount of data.
I don't have to explain to anyone with even the slightest amount of education in math or science how profoundly ignorant this is, and if it were just this one blogger, I'd laugh it off. But scroll through some of the comments if you have a strong stomach. Or Google for yourself and see more. Or look here to see Think Progress analysis of Fox News war on the EPA.

I refuse to believe that these people are as stupid as their statements make them sound. But it is deeply saddening to see how profoundly an ideology - Market Fundamentalism - can shut down critical thinking.

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Sunday, October 16, 2011

Wallison: Still Wrong About Genesis of Housing Crisis | The Big Picture

Wallison: Still Wrong About Genesis of Housing Crisis | The Big Picture:

If you’ve been closely following the housing finance reform debate, you may have come across a pair of shrill blog posts penned by Peter Wallison, a senior fellow at the American Enterprise Institute and a Republican appointee to the Financial Crisis Inquiry Commission. He responded to my February 2011 article, “Faulty Conclusions Based on Shoddy Foundations,” which criticized the research underlying Wallison’s dissent from the majority of the members of that commission, and his contention that U.S. affordable housing policies caused the global financial crisis.

In these blog posts on The American Spectator’s blog on May 24 and on AEI’s blog on May 26, Wallison criticizes ”Faulty Conclusions” as “fallacious,” “fraudulent,” and “deceptive”; claims that it contains a “fake” chart; and describes the article as a “political screed.”

As I describe below, these accusations are baseless and distract from the fact that Wallison does not actually address the main arguments of “Faulty Conclusions.” Wallison does not contradict the claim that his FCIC dissent depends critically on the categorization of millions of home mortgage loans as “high risk” that are not actually high risk. Wallison also fails to answer other serious issues with his arguments that were pointed out in “Faulty Conclusions.”
I was watching Bill Maher the other night and John Fund was again blaming Freddie and Fannie (and low income people via the Community Reinvestment Act - the bastards!) for the great recession, and I was disappointed that Thom Hartmann didn't protest more vigorously. I found this article via Brad Delong's economics blog.

Basically, from the viewpoint of a non-economist, the guy flogging these claims was a minority of one, even with other Republicans on the Financial Crisis Commission, and one would think responsible conservatives would recognize the lack of credibility, yet this is the favorite meme among Fund and others who want to minimize the role of deregulation and crony capitalism for this mess.

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How Medicare Fails the Elderly -

How Medicare Fails the Elderly -

"HERE is the dirty little secret of health care in America for the elderly, the one group we all assume has universal coverage thanks to the 1965 Medicare law: what Medicare paid for then is no longer what recipients need or want today. "

Goes on to delineate some of the problems with the Medicare payment system, that are not news if you've been paying attention, but always good to get it out there for further discussion.

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Tuesday, October 4, 2011

Is the Fed responsible for health care premium increases? | The Incidental Economist

Is the Fed responsible for health care premium increases? | The Incidental Economist:

Health spending is obviously relevant to premiums, but many other factors affect premium growth too. What everyone wants to know is why employer-sponsored health insurance premiums jumped up so much this year. Since health care spending growth has been low — at near 1990s levels — we can rule that out as an explanation.

Moving on, let’s consider some other things. For what follows, I’ve been aided by Charles Roehrig and colleagues of the Altarum Institute, with whom I exchanged email on this topic. The title of this post is explained in the final entry of the following list (“The underwriting cycle”).

Besides total health spending, what else affects premiums?

Profits. Insurers have been reporting a big profits lately, which implies premiums growing faster than costs.
If you are interested in understanding why premiums have risen far out of proportion to actual health care costs, please go to the link. There are no certain reasons, but this post offers lots of interesting (and plausible) possibilities, including the one in the title: Insurers are so heavily invested in bonds, that the low returns have "forced" them to turn to out-sized premium increases to keep profits up where they like them.

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Sunday, October 2, 2011

Daily Kos: An indecent proposal

Daily Kos: An indecent proposal:

That cut-up Grover Norquist suggest wealthy Americans like Warren Buffet contribute to the Federal government on an optional basis, and Hunter at DailyKos offers to accept the offer...

My proposal is that we make taxes for wealthy Americans and corporations entirely optional. That's it. If a corporation wants to pay zero percent in taxes, they should be allowed to, and if they want to pay the full tax rate, that is also allowed. The same for wealthy Americans.

The only caveat is that non-contributing corporations and individuals will be barred from taking advantage of any government services. It is the perfect free-market-based opt-out: If you do not want to support the American infrastructure and population to the same extent that your fellow citizens do, you can simply decline to, and live your life as the libertarian god you have always longed to be. You will be free! You will be allowed to go Galt, or not go Galt, to whatever degree you wish; as a special bonus, we shall prevent you from becoming that most dreaded of figures, the parasite, since if you are not contributing to the benefit of society it only stands to reason you should not gain profit from it either.

For starters, companies that do not pay the going tax rate will be barred from shipping their products on American roads. They will be prevented from connecting to the American electric grid, or from using municipal water or sewer systems. Instead, they will have to provide these services on-site. The good news: They can feel free to pollute as much as they like, as long as no pollution crosses the boundaries of their property (above, below or horizontally) into the rest of America. That would be considered an act of war.

Wealthy Americans that opted out of paying the going tax rate would also, of course, be prohibited from using American roads. This would not be a problem for them, as they generally can afford airplanes or helicopters, which would be similarly fine so long as they did not use American airspace (sorry, but the FAA costs money too, you know). But they could certainly fly around the property, which might be a pleasant experience.

Then we must consider the issue of security. Fire and police protection would be right out, so there would be no particular incentive for poorer Americans not to loot their properties (wealthy Americans tend to have nicer things than the rest of us). The American elite might consider the approach taken by wealthy Mexican families, which is to install a high perimeter fence around the property with a heavily armed private guard service. This would be expensive and unsightly, but it would be up to each individual to decide, for themselves, what the appropriate free-market level of protection for their own property might be. My one tip would be to spend a good deal of time on that decision.

It goes without saying that non-contributing Americans, corporate or otherwise, would not have access to the courts. This should be fine with them, since we know that meddlesome lawsuits are the biggest non-tax-related threat to America today. There is the minor issue of no recourse, if armed mercenaries do manage to overpower your guards and make off with your antique commodes or whatever it is you rich people hoard these days: Again, though, think of the tax savings.
This is a nice echo of Elizabeth Warren's comments on the arrogance of the John Galt wannabees.

UPDATE: I posted this to the comments section:

Don't forget the socialism of WWII 

Let me add another item to your great piece, Hunter, and to Elizabeth Warren's recent speech: Did the fathers of any of these captains of industry go to college on the GI Bill?
See here:
Within the following 7 years, approximately 8 million veterans received educational benefits. Of that number, approximately 2,300,000 attended colleges and universities, 3,500,000 received school training, and 3,400,000 received on-the-job training. By 1951, this act had cost the government a total cost of approximately $14 billion.
The effects of increased enrollment to higher education were significant. Higher educational opportunities opened enrollment to a varied socioeconomic group than in the years past. Engineers and technicians needed for the technological economy were prepared from the ranks of returning veterans. Also, education served as a social safety valve that eased the traumas and tensions of adjustment from wartime to peace. For the American colleges and universities, the effects were transforming. In almost all institutions, classes were overcrowded. Institutions required more classrooms, laboratories, greater numbers of faculties, and more resources. House facilities became inadequate and new building programs were established. New vocational courses were also added. This new student population called for differential courses in advanced training in education, commerce, agriculture, mining, fisheries, and other vocational fields that were previously taught informally. Teaching staffs enlarged and summer and extension courses thrived. Further, the student population was no longer limited to those between 18-23. The veterans were eager to learn and had a greater sense of maturity, in comparison to the usual student stereotype. Finally, the idea that higher education was the privilege of a well-born elite was finally shattered.

And of course, it was continued after WW II: Continuation of the Bill
The original G.I. Bill of 1944 expired in 1956, but the concept of veteran compensation continued, with all subsequent legislation still referred to as G.I. bills. In 1952 Congress passed the Veterans’ Adjustment Act to compensate veterans of the Korean War (1950-1953). There were some minor differences between the World War II and Korean G.I. Bills, but the outcome was broadly similar. More than two million Korean War veterans used the G.I. Bill to go to college, and 1.5 million financed new homes. The G.I. Bill underwent a significant change in 1966, when Congress passed the Veterans Readjustment Benefits Act (VRBA) as part of President Lyndon B. Johnson’s Great Society slate of social programs. The VRBA removed the requirement of serving in combat to receive government benefits, and instead made G.I. Bill benefits available to anyone who served in the military, whether in wartime or peacetime. Since 1966 the G.I. Bill has undergone a series of modifications and adjustments, but the fundamental benefits subsidizing education and home ownership remain the same. The Montgomery G.I. Bill (MGIB), enacted by Congress in 1985, provides educational stipends to former members of the military who contribute a small portion of their pay during their time in the service. The Post 9/11 Veterans Assistance Act of 2008 (effective date August, 2009) substantially increased the amount of tuition and housing assistance, allows veterans to transfer benefits to their spouses and children, and provides tuition benefits for National Guard and Reserve members.

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Thursday, September 29, 2011

Medicaid funds allegedly misused: U of L doctors used $4.8 million in Medicaid money for bonuses, Shaughnessy says | The Courier-Journal |

Medicaid funds allegedly misused: U of L doctors used $4.8 million in Medicaid money for bonuses, Shaughnessy says | The Courier-Journal |

Doctors at the University of Louisville medical school used about $4.8 million in state Medicaid funds to pay themselves “financial bonuses” — money that was supposed to be used for indigent care, state Sen. Tim Shaughnessy says.

And they used another $5.2 million for an electronic records system that would make U of L doctors eligible for additional bonuses from the federal government, according to new details of a controversial transaction that Shaughnessy said he recently obtained from Attorney General Jack Conway’s office.

A spokeswoman for Conway said Wednesday that the office determined only that the $4.8 million was compensation for U of L doctors. But Shaughnessy insisted that Conway’s staff described the money as “bonuses” at a recent meeting.

“I was shocked,’’ said Shaughnessy, a Louisville Democrat who was the first to publicly question a transfer of about $30 million in surplus health funds in 2008 and 2009 from Passport Health Plan to U of L, University Physicians Associates, or UPA, and others represented on Passport’s board.
Under a settlement Conway announced in July, UPA will repay the state $9 million over five years. Other groups that received funds from Passport’s $30 million transfer agreed to repay the funds according to various schedules. They include U of L, University Medical Center and local hospitals that provided capital to start Passport.

But Shaughnessy said the repayment doesn’t address his basic concern — that U of L’s board wasn’t involved in major financial transactions involving groups with which it is affiliated, including Passport, UPA and the U of L medical center.

“There was no involvement of the U of L Board of Trustees,” Shaughnessy said. “How did these millions of dollars get allocated without any involvement of the board?”

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Heads Of Largest Children's Hospitals Receive Big Salaries And Rich Benefits - Kaiser Health News

Heads Of Largest Children's Hospitals Receive Big Salaries And Rich Benefits - Kaiser Health News:

The pay packages have continued to climb even as the economy has languished and millions of Americans struggle to pay their health care bills. For some, the generous compensation raises questions about the mission of children’s hospitals, which operate as tax-exempt charities.

"Hospital CEOs, including those at children's hospitals, are among the most lavishly compensated executives in the nonprofit field," said Daniel Borochoff, president of the American Institute of Philanthropy, a charity watchdog group based in Chicago.

"These seven-figure CEO pay packages make it hard for nonprofit hospitals to justify their tax-exempt status," he added. "If hospital CEO compensation were more in line with other large nonprofits then there could be more funding for community benefits such as free or discounted health care or important medical research."

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Sunday, September 25, 2011

The Social Contract -

The Social Contract -

According to new estimates by the nonpartisan Tax Policy Center, one-fourth of those with incomes of more than $1 million a year pay income and payroll tax of 12.6 percent of their income or less, putting their tax burden below that of many in the middle class.

Now, I know how the right will respond to these facts: with misleading statistics and dubious moral claims.
Go read the whole thing!

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A glimpse at the high pay for children's hospital CEOs - Sacramento Living - Sacramento Food and Wine, Home, Health | Sacramento Bee

A glimpse at the high pay for children's hospital CEOs - Sacramento Living - Sacramento Food and Wine, Home, Health | Sacramento Bee:

"Hospital CEOS, including those at children's hospitals, are among the most lavishly compensated executives in the nonprofit field," said Daniel Borochoff, president of the American Institute of Philanthropy, a charity watchdog group based in Chicago. "If hospital CEO compensation were more in line with other large nonprofits then there could be more funding for community benefits such as free or discounted health care or important medical research."

In 2009, an advocacy group for nonprofit hospitals and other health care groups warned its members that the pay packages were coming under increasing scrutiny. "Boards would be wise to streamline their executive compensation programs to make them less tempting targets," a report prepared for the Alliance for Advancing Nonprofit Health Care stated.

The report pointed to cars, bonuses, generous retirement payouts and country club memberships as likely to attract criticism. "Many nonprofit organizations have been pressing their luck by imitating patterns in the for-profit sector," it noted.

That year, CEO compensation at the 25 largest independent children's hospitals ranged from a high of nearly $6 million to a low of $686,125, records show.

In all, CEOs collected more than $38 million, including deferred income and supplemental retirement awards, for an average of $1.5 million each.

If you are interested in looking up data for your own hospital or for any non-profit, go to Guidestar at and search for the organization. When you have found it, go to the Form 990 section (you will have to register - it's free). Then you will have to look for either page 7, which is where the data may be, or go to an appendix/attachment at the end. Happy hunting.
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How Do You Say ‘Economic Security’? -

How Do You Say ‘Economic Security’? -

"In 1934, the government was us. We had shared circumstances, shared risks and shared obligations. Today the government is the other — not an institution for the achievement of our common goals, but an alien presence that stands between us and the realization of individual ambitions. Programs of social insurance have become “entitlements,” a word apparently meant to signify not a collectively provided and cherished basis for family-income security, but a sinister threat to our national well-being.

"Over the last 50 years we seem to have lost the words — and with them the ideas — to frame our situation appropriately. "

I firmly believe that one of our major problems today is that conservatives view our government, the one established in our Constitution by the people, for the people, to provide for the General Welfare, is "them," while liberals view it as "us," and thus we must take responsibility for making it better, rather than just tearing it down.

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Thursday, September 22, 2011

It’s not ‘class warfare,’ it’s Christianity - - The Washington Post

It’s not ‘class warfare,’ it’s Christianity - - The Washington Post:

"Let me be clear as I can be. We need to understand the so-called “Christian” underpinnings of the anti-tax, anti-government, anti-the-poor, “let him die” approach to economics and public policy today as completely un-Christian, as well as un-American. What we need to do is re-establish our national values of fairness, equality and opportunity for all, values that I believe are actually the core of the Christian faith, (as well as of other religious traditions and of humanist values)."

A nice summary of how un-Christian the Americanus Christianus really is!

Many of the same points I mad a while back in my "Tea Partiers as Christians - Big Fail" post a while back.

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Wednesday, September 21, 2011

The human face of disability - and one of the doctors assessing it : The Pump Handle

The human face of disability - and one of the doctors assessing it : The Pump Handle:

"If you hold a job right now, here's something to think about: If you became disabled and were no longer able to work, how would you pay your bills? If your disability were due to an on-the-job injury or an occupational illness, you might be able to get workers' compensation benefits. But what if you were paralyzed after falling down a flight of stairs at home or suffering a stroke? If you're lucky, you'll have disability insurance, which some employers offer as a benefit. But for most people whose ability to work becomes compromised before they're able to retire, disability payments from Social Security become a crucial source of income. "

A sobering look at the Social Security Disability Income program. Our safety net is strung so that most of it lies on the ground.

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Monday, September 19, 2011

NJ Spotlight | Filling in the Details of NJ's Health Insurance Exchange

NJ Spotlight | Filling in the Details of NJ's Health Insurance Exchange:

"In Massachusetts, officials have tailored the requirements for participating insurance companies to ensure a certain high level of benefits; in Utah, the exchange is open to most of the companies that wish to do business in the state. The website for the Massachusetts exchange includes tools to help consumers select the best product, and the signup process takes less than ten minutes, researchers found. Utah’s exchange is more of an online portal, linking customers to existing insurance products, and the state has received a number of complaints about the complexity of the enrollment process.

"According to the Georgetown report, 'you get what you pay for.' Massachusetts’ exchange has a $30 million annual budget and 46 full-time workers, whereas Utah spends $600,000 and employs two staff members. With greater resources and outreach, Massachusetts has reached some 220,000 people, compared with 2,200 now in Utah’s program. According to 2009 data, after a few years with the exchanges in operation, Massachusetts had insured more than 95 percent of its residents and Utah had about 85 percent covered, when including those who obtain insurance through their jobs or the private market.

"The healthcare coalition in New Jersey did not focus on any single state in developing its list of principles, Snedden said, but worked with members to determine what was most critical here. The group also plans to launch a public campaign this summer to help individuals and business owners become more familiar with the concept of the exchange.

"'What we’re doing is getting the conversation started,' Snedden said. 'We want to make 'exchanges' a word that actually rings a bell.'"

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The Independent Payment Advisory Board — Congress’s “Good Deed” | Health Policy and Reform

The Independent Payment Advisory Board — Congress’s “Good Deed” | Health Policy and Reform:

"Among the most important attributes of legislative statesmanship is self-abnegation — the willingness of legislators to abstain from meddling in matters they are poorly equipped to manage. The law creating the Federal Reserve embodied that virtue. Congress recognized the abiding temptation to use monetary policy for political ends and realized that it would, at times, prove irresistible. To save themselves from themselves, wise legislators created an organization whose funding and operations were largely beyond the reach of normal legislative controls. Short of repealing the law, Congress denied itself the power to do more than kibbitz about monetary policy.

"In establishing the Independent Payment Advisory Board (IPAB) in section 3403 of the Affordable Care Act (ACA), Congress may once again have shown such statesmanship. For several reasons, however, it is too early to be sure. The board must surmount major challenges — first to survive and then to function effectively. Harold Pollack has neatly summarized the problem, the solution, and the problem with that solution: “Every Democratic and Republican policy expert knows that we must reduce congressional micromanagement of Medicare policy. Unfortunately, every Democratic and Republican legislator knows that mechanisms such as IPAB that might do so would thereby constrain their own individual prerogatives.”1

"Medicare’s founding legislation stated that “Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine.”2 Duly warned, Medicare administrators have largely forborne from using coverage policy or financial incentives to discourage ineffective or needlessly costly methods of care. Members of the legislative branch have not, however, displayed similar restraint. They have pressured those same administrators on coverage policies and passed laws to impose them.

"In the view of many observers, both executive inactivity and legislative intrusiveness have been unfortunate — the former because the leverage that the country’s largest single buyer of health care could wield to effect reforms has gone largely unused, the latter because few members of Congress are well enough informed to make such decisions wisely, and some are in thrall to campaign contributors and producers and suppliers of medical services."

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Squandering Medicare’s Money -

Squandering Medicare’s Money -

"MEDICARE has suddenly taken center stage in American politics, with Democrats now trying to score an advantage from the unpopularity of the Republican plan to overhaul the government health insurance program. Apart from the politics, though, Medicare’s financing challenges are worsening: this month, Medicare’s trustees projected that the insurance program would become insolvent by 2024, five years earlier than previously estimated.

"Much has been said about the growing gap between the program’s spending and revenues — a gap that will widen as baby boomers retire — but little attention has been focused on a problem staring us in the face: Medicare spends a fortune each year on procedures that have no proven benefit and should not be covered. Examples abound:"

Go to the original piece for the rest!

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What Is a 'Just' Physician's Income? -

What Is a 'Just' Physician's Income? - "The payment of physician income has been the subject of a lively debate for centuries. In fact, one finds it addressed at length in the famous Code of Hammurabi, chiseled into stone tablets some 4,000 years ago by edict of the Babylonian King Hammurabi along, by the way, with a malpractice system that makes today’s look like a pussycat.

Adam Smith, who generally is regarded as the father of modern economics, mused at length on the compensation of physicians in his celebrated book “An Inquiry Into the Nature and Causes of the Wealth of Nations” (1776).

Chapter 10 of Book 1, titled “Wages and Profit in the different Employments of Labour and Stock,” is a gracefully written treatment of what we now call labor-market theory. It is well worth a read.

“Honour makes a great part of the reward of all honourable professions,” Smith wrote. “In point of pecuniary gain, all things considered, they are generally under-recompensed, as I shall endeavour to show by and by. … Disgrace has the contrary effect. The most detestable of all employments, that of public executioner, is, in proportion to the quantity of work done, better paid than any common trade whatever.” (Italics added.)

Today we teach students that seemingly mysterious differences in the pecuniary income of different occupations can be explained in part by what we call “compensating variations in the psychic income” associated with different occupations.

Remarkably, in his treatise on compensation, Smith then departed sharply from the traditional demand-and-supply framework he popularized and we economists usually employ to explore employment and wages. Instead, for physicians and lawyers he appeared to lean on the medieval doctrine of “just price.” Thus he wrote:

We trust our health to the physician: our fortune and sometimes our life and reputation to the lawyer and attorney. Such confidence could not safely be reposed in people of a very mean or low condition. Their reward must be such, therefore, as may give them that rank in the society which so important a trust requires. The long time and the great expense which must be laid out in their education, when combined with this circumstance, necessarily enhance still further the price of their labour.

Although I’m a card-carrying economist who normally is quite comfortable with our supply-demand framework for virtually anything, I do find Adam Smith’s perspective persuasive.

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Bruce Bartlett: Are Taxes in the U.S. High or Low? -

Bruce Bartlett: Are Taxes in the U.S. High or Low? -

"The truth of the matter is that federal taxes in the United States are very low. There is no reason to believe that reducing them further will do anything to raise growth or reduce unemployment.

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[Originally posted at Doctors for America's Progress Notes Blog]

Andrew Sullivan's tag line, via George Orwell, is that "It is a constant struggle to see what is past the end of one's nose." One of my favorite lines is from Upton Sinclair, "It is difficult to get a man to understand something if his livelihood depends upon his not understanding it."

When I say "favorite," I mean I like it because it says a lot about the human condition in general, and about our political struggles in particular. Unfortunately, in these times, this myopia in our world views has the potential to lead to human misery, and to continue America on the road to tragedy, as we already have passed farce. I consider myself an optimist, but recent events including our world class embarrassment of a debt ceiling "deal" have left me pessimistic for our short term prospects of reinvigorating our priorities as a nation and consequently our intermediate term prospects of leaving the nation better than we found it.

We have been at our best as a nation when we have had visionary leadership, from Teddy Roosevelt's "Square Deal," to Franklin Roosevelt's "New Deal," to LBJ's "Great Society." Even Eisenhower's more mundane Interstate Highway System and JFK's goal to put a man on the moon represent aspirational goals for America. ("We chose to do these things, and the others, not because they are easy, but precisely because they are hard!") Now, our political will has been demeaned to the lowest common denominator: how will I keep more of my meager income for myself in the short term?

Paul KrugmanRobert Reich, and others have been banging this drum for over a decade now: investing in human capital is the way to grow the economy and keep us a great country. Many wish to continue the defunding of our societal investment in human capital: reducing investments in education and research, reducing money spent on the health of the population, demolishing our social welfare programs like Medicare, Medicaid, SCHIP and Social Security. This is short sighted and a recipe for disaster (with all the ingredients mise en place).

We now have plugged in a small group of Congress Persons in the wildly inappropriately named "Super Congress," with the stated goal of resolving our budget stalemate. I am skeptical, to say the least, and two articles in this week's New England Journal of Medicine reinforce my pessimism.
Jonathon Oberlander points out that "austerity politics" are now in force, and there are real potential dangers that Medicare and Medicaid funding could be cut substantially, including reduced payments to providers, reductions in federal funds for state Medicaid programs, increasing cost-sharing for enrollees, repealing the long term care insurance provisions in the ACA, and - per Paul Ryan's plan - changing Medicare into a voucher plan.

While Oberlander doesn't say it, I will: the "austerity politics" manufactured in Washington by power brokers with lots of money behind them are designed to take an axe to the programs that provide medical care to those who need it and prevent expansion to those who need it even more. We at DFA are all too aware of deficiencies in our current health care system and are not shy at all about pointing them out. But we also know that reforming health care requires a greater intellectual effort than unthinking cuts born out of myopic political calculations.

In the same NEJM issue, Christopher Jennings notes that many stakeholders in health care are coming to realize that there is almost no good that can come out of the work of the Super Committee. Because of the construction of the debt ceiling deal, if the Super Committee reaches no deal and the "automatic cuts" are enacted, Medicaid is exempt from cuts and Medicare would face "only" a two percent cut. As he explains, it is hard to imagine a deal crafted by the twelve that would so good to health care funding:

From the current vantage point of these stakeholders, the choice is therefore not a close call; the automatic cuts are by far the best poison to be forced to take, particularly in comparison to the concoction they fear the super committee could produce. It would meet the requirement of the law, protect against unknown and much larger cuts, and preserve resources and bargaining chips for the next big deal, which will probably take place in 2013 after the presidential election.
So, there is hope, if I ditch my own myopia and hope and pray and work for a new, better Congress in 2013, we may be able to get on the path to becoming a great country again, instead of the "dollar store" nation that so many seem to believe is our destiny!

Sphere: Related Content : Premium Nonsense On Medicare : Premium Nonsense On Medicare:

My sister-in-law sent me one of those BS right wing chain emails (they try to misinform while staying under the radar of actually informed people by sending it to their fellow in-the-Fox-bubble friends) about rising Medicare premiums because of the Affordable Care Act. Here is the original quote, in the hopes that people Googling for this nonsense will find the correct information, then the FactCheck response (the full response is at the link at the top):

The per person Medicare insurance premium will increase from the present monthly fee of $96.40, rising to: $104.20 in 2012; $120.20 in 2013; And $247.00 in 2014. These are provisions incorporated in the Obamacare legislation, purposely delayed so as not to 'confuse' the 2012 re-election campaigns. Send this to all seniors that you know, so they will know who's throwing them under the bus.

The Real Effect of the Health Care Law

That’s not to say that the health care law won’t have an effect on the premiums paid by some seniors. It will, but not in the way this bogus message claims. The change will affect only a small minority of upper-income Medicare beneficiaries.

Currently, about the top 5 percent of seniors pay an "income-related premium" that was enacted as part of the same 2003 law that created the new Medicare prescription-drug benefit. Upper-income seniors have been paying more than the standard premium since 2007. Currently those earning between $85,000 and $107,000 for individuals (between $170,000 and $214,000 for couples) pay a total of $161.50. The amounts grow larger for higher-income groups, reaching $369.10 per month for seniors making more than $214,000 (or $428,000 for couples).

The new law doesn’t increase those premiums, but does ensure that more high-earning seniors will pay them. It does this by freezing the income brackets at 2010 levels through 2019, rather than allowing them to rise with inflation as originally enacted. The Kaiser Family Foundation released a report in December projecting that in 2019 the top 14 percent of seniors would be paying the income-related premiums — an additional 3.5 million seniors.

The law also established a separate set of income-related premiums for Medicare Part D — the prescription-drug benefit — which previously had charged only a standard premium for all. Taken together, these changes are expected to bring in an additional $36 billion over 10 years, Kaiser’s study said.

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Saturday, September 10, 2011

GOP and Obama's jobs plan: Do Republicans oppose the president's economic policies for ideological reasons or political ones? - By Jacob Weisberg - Slate Magazine

GOP and Obama's jobs plan: Do Republicans oppose the president's economic policies for ideological reasons or political ones? - By Jacob Weisberg - Slate Magazine:

"You can group the conservatives who reject the economic consensus into three rough categories: fundamentalists, cynics, and sheep. The fundamentalists are ideological and come in several varieties. The more primitive prefer Hoover to Keynes, or in some cases God to Hoover. Rick Perry, the Texas governor and presidential candidate, believes that the purpose of the economic crisis is to bring us back to "Biblical principles." Asked on the campaign trail how he would create jobs if he were in office, Perry responded: "You won't have stimulus programs under a Perry presidency. You won't spend all the money." This is a pretty good summation of the Tea Party's know-nothing view that all government spending makes all things worse, always.

"That's not to say that everyone who rejects Obama's stimulus spending is a default-welcoming ignoramus. Libertarians or libertarian-leaners don't necessarily think stimulus won't grow the economy; they just worry that it will grow the government at the same time and that it won't ever shrink back. But they don't mind stimulus tax cuts, which reduce the resources available to government. Rep. Paul Ryan, for instance, the government-slashing chairman of the House budget committee, has argued that stimulus spending is an evanescent sugar high that produces no lasting economic benefit.

"The cynics, by contrast, don't offer any economic analysis at all. They simply reject whatever President Obama proposes. In the now immortal words of Senate Minority Leader Mitch McConnell: "The single most important thing we want to achieve is for President Obama to be a one-term president." McConnell, like Boehner and House Majority Leader Eric Cantor, happily voted for the stimulus bill George W. Bush proposed in 2008, which cost $152 billion. Back then, they felt some responsibility for the economy. Now it's Obama's problem. Mitt Romney knows enough about finance to understand that shrinking spending would raise unemployment. But he also knows that running against Obama with a 9 percent unemployment rate is a better bet than running against Obama with an 8 percent unemployment rate. "

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Monday, September 5, 2011

Trying to understand income inequality, the most profound change in American society in your lifetime. - By Timothy Noah - Slate Magazine

Trying to understand income inequality, the most profound change in American society in your lifetime. - By Timothy Noah - Slate Magazine: Timothy Noah's 10-part series on inequality, published in Slate last September, has won the 2011 Hillman Prize for magazine journalism, an honor awarded annually by the Sidney Hillman Foundation for reporting that "fosters social and economic justice." It was clear from the moment of publication that "The Great Divergence" struck a chord, treating a profound and complicated issue in an engaging and understandable way, and we're delighted that the Hillman Foundation has recognized Noah's work. You can read the series below, or print a PDF.

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Wednesday, August 31, 2011

Study compares CEO pay with taxes

Study compares CEO pay with taxes: Three Pittsburgh companies are among 25 U.S. corporations that paid their CEOs more last year than the company paid in U.S. corporate income taxes, according to a study by the Institute of Policy Studies.

The local companies on the list are Bank of New York Mellon, specialty metals producer Allegheny Technologies and Mylan, which makes generic drugs.

The institute compared CEO pay with the federal tax liabilities companies disclose in their 10-K, an annual report filed with the Securities and Exchange Commission. The institute states the figure is "the best approximation of actual taxes paid to the U.S. Treasury."

The Washington research report examines CEO pay every year. Last year it found the CEOs of companies that announced the largest layoffs earned, on average, 42 percent more in 2009 than the average CEO of an S&P 500 company.

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Cleared of wrongdoing, Penn State climatologist still sees 'smears'

Cleared of wrongdoing, Penn State climatologist still sees 'smears': Mr. Mann, a doctor of geology and geophysics who serves as director of Penn State's Earth System Science Center, already was a central figure in the controversy over climate-change science before emails were hacked in late 2009 from the University of East Anglia Climatic Research Unit in the United Kingdom.

Now he's an even stronger lightning rod for critics of climate-change science, including Texas Gov. Rick Perry, the Republican presidential candidate who continues to claim data was manipulated to prove climate change.

But on Aug. 15, the NSF and the U.S. inspector general concluded that emails did not reflect flawed or fraudulent science and closed the case. It represents the last of seven investigations of the heisted personal emails that included flippant statements and others that were described as reckless and injudicious.

But three investigations in the United Kingdom and four in the United States including ones by Penn State, the U.S. Environmental Protection Agency, the National Oceanic Atmospheric Administration and now the NSF all have dispelled claims that climate-change research by Mr. Mann and others was manipulated to justify false conclusions.

"It's the seventh investigation that's arisen out of the leak of emails and false allegations by climate-change deniers who were mining for words and phrases out of context," Mr. Mann said. "This should be the final nail in their coffin."

But he said critics of his research continue saying "up is down and black is white in their climate-change denial."

"I'd be lying if I didn't say this was a major distraction for me and my colleagues," he said. "I've been wasting a lot of time responding to allegations. That being said, the scientific community has understood from the start that this was a manufactured scandal and smear campaign against scientists.

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Monday, August 29, 2011

An Insurance Maze for U.S. Doctors -

An Insurance Maze for U.S. Doctors -

"Researchers asked hundreds of physicians and administrators in private practices across the United States and Canada how much time they spent each day with insurers and other third-party payers, tracking down information for claims that were denied or incorrectly paid, resolving questions about insurance coverage for prescription drugs or diagnostic tests, and filing the different forms required by each and every insurance company.

"Physicians in Canada, where health care is administered mainly by the government, did spend a good deal of time and money communicating with their payers. But American doctors in the study spent far more dealing with multiple health plans: more than $80,000 per year per physician, or roughly four times as much as their northern counterparts. And their offices spent as many as 21 hours per week with payers, nearly 10 times as much as the Canadian offices.

“The amount of time we spend on this is just crazy,” said Dr. Sara L. Star, a partner in a three-physician pediatrics practice in suburban Chicago. “But each insurance company has its own language, its own set of rules and specific contracts with certain laboratories, hospitals, physicians and pharmaceutical companies.”

The Health Affairs article is here.

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Wednesday, August 10, 2011

The rich are different — and not in a good way, studies suggest - Health - Behavior -

The rich are different — and not in a good way, studies suggest - Health - Behavior -

"In other words, rich people are more likely to think about themselves. “They think that economic success and political outcomes, and personal outcomes, have to do with individual behavior, a good work ethic,” said Keltner, a professor of psychology at the University of California, Berkeley.

Because the rich gloss over the ways family connections, money and education helped, they come to denigrate the role of government and vigorously oppose taxes to fund it.

“I will quote from the Tea Party hero Ayn Rand: “‘It is the morality of altruism that men have to reject,’” he said.

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Monday, August 8, 2011

What Republicans get wrong about capitalism - Great Recession | Economic Recession, Economic Crisis -

What Republicans get wrong about capitalism - Great Recession | Economic Recession, Economic Crisis - "Smith would be highly skeptical of such claims. In the final edition of the 'Theory of Moral Sentiments,' written over a decade after 'The Wealth of Nations,' he added a chapter in which he describes the 'disposition to admire, and almost to worship, the rich and the powerful, and to despise, or, at least, to neglect persons of poor and mean condition.' This disposition, Smith says, colors the way we view the world, leading us to conflate wealth and greatness with virtue and poverty and weakness with vice.

It also leads to confusion in thought. Who makes capitalism work? is a very different question from For whom has capitalism worked best? We should guard against presuming the answers are necessarily one and the same.

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Sunday, August 7, 2011

9 Things The Rich Don't Want You To Know About Taxes

9 Things The Rich Don't Want You To Know About Taxes: "For three decades we have conducted a massive economic experiment, testing a theory known as supply-side economics. The theory goes like this: Lower tax rates will encourage more investment, which in turn will mean more jobs and greater prosperity—so much so that tax revenues will go up, despite lower rates. The late Milton Friedman, the libertarian economist who wanted to shut down public parks because he considered them socialism, promoted this strategy. Ronald Reagan embraced Friedman’s ideas and made them into policy when he was elected president in 1980.

For the past decade, we have doubled down on this theory of supply-side economics with the tax cuts sponsored by President George W. Bush in 2001 and 2003, which President Obama has agreed to continue for two years.

You would think that whether this grand experiment worked would be settled after three decades. You would think the practitioners of the dismal science of economics would look at their demand curves and the data on incomes and taxes and pronounce a verdict, the way Galileo and Copernicus did when they showed that geocentrism was a fantasy because Earth revolves around the sun (known as heliocentrism). But economics is not like that. It is not like physics with its laws and arithmetic with its absolute values.

Tax policy is something the framers left to politics. And in politics, the facts often matter less than who has the biggest bullhorn.

The Mad Men who once ran campaigns featuring doctors extolling the health benefits of smoking are now busy marketing the dogma that tax cuts mean broad prosperity, no matter what the facts show.

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S&P's credit rating cut: Downgrading our politics | The Economist

S&P's credit rating cut: Downgrading our politics | The Economist: "Investors largely tuned out the debt-ceiling debate until its final days out of a belief based on long experience that for all the antics and rhetoric of the Tea Party, the people who actually run Capitol Hill would never compromise the country’s credit worthiness. After all, it was Mr Boehner who reminded his freshmen colleagues that on the debt ceiling they’d have to act like “adults.”

That is not what happened. As the fight dragged on, the leadership moved closer to the Tea Party, not the other way around. And they seem happy with the results. Why else would Mitch McConnell have promised on August 1st to do exactly the same the next time the debt ceiling must be raised?

It is striking that the proponents of this strategy seem so oblivious to its impact. Our economy is lubricated by a sophisticated and stable credit market whose most vital component is also the most ephemeral: trust. As the crisis amply demonstrated, when trust erodes, the system freezes up. America has built a reputation for responsible and credible management of its finances over the centuries, and that reputation has been reduced to a political football, like a federal judgeship. Henceforth a foreign pension fund or central bank that once mindlessly ploughed his spare cash into Treasurys will have to think twice.

I never had much sympathy for the view that America’s economy was about to be eclipsed by China’s, and the main reason was our political institutions. Those checks, balances and laws provide an orderly means to change course in response to new challenges. China’s authoritarianism deprives the government of a feedback mechanism to tell it when it is meeting the needs and aspirations of its people. That makes its system intrinsically fragile.

Events of the last few weeks have forced me to reconsider.

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Thursday, July 7, 2011

The Oregon Health Insurance Experiment: Evidence from the First Year

The Oregon Health Insurance Experiment: Evidence from the First Year: "In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides a unique opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.

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Wednesday, July 6, 2011

Taking a Side | Crooks and Liars

Taking a Side | Crooks and Liars:

Just a terrific paragraph:

To me, that question is the most critical one there is when it comes to government policy. I don’t believe that government is inherently good — having lived through Vietnam, Watergate, J. Edgar Hoover’s corruption at the FBI, the massive deficit producing tax-cuts-for-the-rich policies of Reagan and Bush, the S&L crisis, financial deregulation, media consolidation, the Iraq war, Katrina, and the utter economic incompetence of the President George W. Bush economic years. I have no illusions that government as a whole is always on the side of most people. But what I want and believe in is a government of, by, and for the people — most especially for the people. Given the size and power of the financial industry, and other huge multinational corporations, I want a government that is on our side in making sure these massive companies don’t destroy our economy (again), and then demand bailouts (again) because they are too big to fail. I want a government on our side so that big insurance companies don’t tell people they can’t have coverage anymore because they got sick. I want a government on the side of senior citizens who have worked hard their whole lives and now want to live with some modest measure of dignity and economic security through Social Security, Medicare, and Medicaid coverage. I want a government on the side of working class families thrown out of their jobs and homes through no fault of their own. I want a government that is on the side of our kids and helps them get a good education. I want a government that is on the side of small business and start-up entrepreneurs as they work their butts off trying to compete with huge corporations.

This is the converse of the argument I often make about how wonderful people think private business is viz the government: Ever try switching cell phone carriers? Cable companies? Understand your credit card agreement?

To paraphrase Barney Frank. "If you think government is terrible, private businesses aren't so hot, either!"

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