Bill Moyers: Foul Play in the Senate

Bill Moyers: Foul Play in the Senate

The Times story described how Amgen got a huge hidden gift from unnamed members of Congress and their staffers. They slipped an eleventh hour loophole into the New Year's Eve deal that kept the government from going over the fiscal cliff. When the sun rose in the morning, there it was, a richly embroidered loophole for Amgen that will cost taxpayers a cool half a billion dollars.

Amgen is the world's largest biotechnology firm, a drug maker that sells a variety of medications. The little clause secretly sneaked into the fiscal cliff bill gives the company two more years of relief from Medicare cost controls for certain drugs used by patients who are on kidney dialysis, including a pill called Sensipar, manufactured by Amgen.

The provision didn't mention Amgen by name, but according to reporters Lipton and Sack, the news that it had been tucked into the fiscal cliff deal "was so welcome, that the company's chief executive quickly relayed it to investment analysts." Tipping them off, it would seem, to a jackpot in the making.

Amgen has 74 lobbyists on its team in Washington and lobbied hard for that loophole, currying favor with friends at the White House and on Capitol Hill. The Times reporters traced its "deep financial and political ties" to Baucus, McConnell and Hatch, "who hold heavy sway over Medicare payment policy."

All three have received hefty campaign donations from the company whose bottom line mysteriously just got padded at taxpayer expense. Since 2007, Amgen employees and its political action committee have contributed nearly $68,000 to Senator Baucus, $73,000 to Senator McConnell's campaigns, and $59,000 to Senator Hatch.

And lo and behold, among those 74 Amgen lobbyists are the former chief of staff to Senator Baucus and the former chief of staff to Senator McConnell. You get the picture: Two guys nurtured at public expense, paid as public servants, disappear through the gold-plated revolving door of Congress and presto, return as money changers in the temple of crony capitalism.

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Hurray for Health Reform - NYTimes.com

Hurray for Health Reform - NYTimes.com: It’s said that you can judge a man by the quality of his enemies. If the same principle applies to legislation, the Affordable Care Act — which was signed into law two years ago, but for the most part has yet to take effect — sits in a place of high honor.

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Elder Law: Kin may be held liable for care - Pittsburgh Post-Gazette

Elder Law: Kin may be held liable for care - Pittsburgh Post-Gazette: In July 2005, the Pennsylvania General Assembly passed the "Filial Support Law," commonly known as Act 43. As we approach the seven-year anniversary of the re-codification of this law (it previously existed in the Welfare Code from the 1930s and was re-codified in the Domestic Relations Code for modern usage), there have been increasing instances of facilities pursuing family members to pay for care, usually for parents' care in a long-term care facility.

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Five Obamacare Myths - NYTimes.com

Five Obamacare Myths - NYTimes.com

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Gov. Bobby Jindal’s administration reverses planned elimination of Medicaid hospice program - The Washington Post

Gov. Bobby Jindal’s administration reverses planned elimination of Medicaid hospice program - The Washington Post

BATON ROUGE, La. — Louisiana Gov. Bobby Jindal’s administration scrapped plans Wednesday to shutter the state’s Medicaid hospice program in February, meaning the state will continue to provide end-of-life care to people on their death beds who can’t afford private insurance.

Jindal’s health secretary Bruce Greenstein made the announcement as hospice program supporters were gathering for a candlelight vigil on the state capitol steps to protest the cut. Greenstein said his department will use grant funding to cover the hospice costs this year.

The stupidity, economically speaking, and the heartlessness, you know, human being-wise, of some of these self described "Christians" (ChristoRepublicanus Americanus?) is astounding.

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Canada's physician density remains stagnant

Canada's physician density remains stagnant

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Newsroom - Organisation for Economic Co-operation and Development

Newsroom - Organisation for Economic Co-operation and Development

The tax burden is measured by the ‘tax wedge as a percentage of total labour costs’ – or the total taxes paid by employees and employers, minus family benefits received, divided by the total labour costs of the employer. Taxing Wages also breaks down the tax burden between personal income taxes (PIT), including tax credits, and employee and employer Social Security Contributions (SSC)

Key Taxing Wages results in 2011 included:

• The highest tax wedges for single workers without children who are earning the average wage in their country were observed in Belgium (55.5%), Germany (49.8%) and Hungary and France (49.4%). The lowest tax wedges on the same basis were in Chile (7%), Mexico (16.2%) and New Zealand (15.9%) The average for OECD countries was 35.3%. (See Table 1)
• The average overall tax wedge, for those earning the average wage, increased by 0.3 percentage points between 2010 and 2011. This was largely due to PIT. Of the 26 countries where the tax wedge rose, in 18 the PIT wedge also rose, most notably in Ireland (+3.8 percentage points), Hungary (+2.4 percentage points) and Portugal (+1.4 percentage points). Falls in the overall tax burden were also primarily due to PIT changes - the largest decrease was in New Zealand where the tax wedge fell by 1.1 percentage points due to changes in the income tax rates in 2011.
• The United States was the main exception to the rule. The overall tax wedge fell by 0.9 percentage points in 2011, due to a decrease in employee social security contributions which outweighed an increase in income taxes resulting from the expiry of the temporary “Making Work Pay” non-wastable tax credit.
• The highest tax wedges for one-earner families with two children at the average wage were 42.3% for France, 40.3% for Belgium and 38.6% for Italy. New Zealand had the smallest tax wedge for these families (-1.2%), followed by Chile (7%), Ireland (7.1%) and Switzerland (8.4%). The average for OECD countries was 25.4%. (See Table 2).
• Single people in Hungary faced the biggest increase in the tax burden, but families with children enjoyed the biggest reduction due to a reform of the child tax relief scheme that changed from a tax credit to a more advantageous tax allowance in 2011.

In all OECD countries except Mexico and Chile, the tax wedge for families with children is lower than that for single individuals without children. The differences are particularly large in the Czech Republic, Luxembourg, Belgium, Germany, Hungary, Ireland, New Zealand and Slovenia.

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Government investment needed in new economies - latimes.com

Government investment needed in new economies - latimes.com

For more than three decades American venture capitalists have concentrated their activities and earned their returns in a very small number of industrial domains. In booms and in slumps, in bull markets and in bear markets, the information and communications technology and biomedical sectors together have consistently accounted for 80% of venture capital investment.

Why has it been in the world of information technology and, secondarily, biomedicine that venture capitalists have been successful? In brief: Only in these sectors did the state invest at sufficient scale in scientific research and in its translation to working technology. In over 40 years as a working venture capitalist, I learned that my colleagues and I and the entrepreneurs whom we backed were all dancing on a platform constructed by the federal government.

Let's focus on information and communications technology. National funding of the basic research that enabled the IT revolution was overwhelmingly provided by the Defense Department. The Soviet threat, crystallized in the years after 1945 and amplified by the Korean War in 1950 and the launch of Sputnik in 1957, was the context for the U.S. military's massive commitment to renewing its wartime role as the principal financier of technical research and the principal customer for the products that generated.

The scale of research and development funding was substantial. For 25 years through 1978, federal sources accounted for more than 50% of national R&D expenditures and exceeded the R&D expenditures of the other governments in the Organization for Economic Cooperation and Development combined. From microelectronics and semiconductor devices through computer hardware and software and on to the Internet, development of all of the components of digital information and communications technology reflected state policies for R&D and procurement.

There is a larger lesson here. Over some 250 years, economic growth has been driven by successive processes of trial and error and error and error: upstream exercises in research and invention, and downstream experiments in exploiting the new economic space opened by innovation. Each of these activities necessarily generates much waste along the way, such as dead-end research programs, useless inventions and failed commercial ventures. In between, the innovations that have repeatedly transformed the architecture of the market economy, from canals to the Internet, have required massive investments to construct networks whose value in use could not be imagined at the outset of deployment.

At every stage, the innovation economy depends on sources of funding decoupled from concern for economic return. As economists have long recognized, such funding will not be delivered by competitive markets. Only an active state in pursuit of politically legitimate missions — national development, national security, conquering disease — can play the required role.

Thus, from the Erie Canal to the Internet by way of the transcontinental railroads and the Interstate Highway System, the American state has played a strategic role in the deployment of the transformational technologies that have created a succession of "new economies." In disregard of this history, forces have been at work for a generation to delegitimize the state as an economic actor — even as the next new economy can already be defined in broad strokes.

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CARPE DIEM: AMA: The Strongest Trade Union in the U.S.A.

CARPE DIEM: AMA: The Strongest Trade Union in the U.S.A.

From Mark Perry's Carpe Diem blog:

As a follow-up to the post below on Milton Friedman's Mayo Clinic talk on the "economics of medical care," I present the two charts above.  

The top chart shows the number of annual graduates from U.S. medical schools (AMA data here) per 100,000 U.S. population, from 1962 to 2011. Between about 1970 and 1984, there was a significant increase in medical school graduates that pushed the number of new physicians from 4 per 100,000 Americans in 1970 to almost 7 per 100,000 by 1984.  Since 1984, the number of medical school graduates has been relatively flat (see red line in bottom chart), while the population has continued to grow, causing the number of new physicians per 100,000 population to decline to only 5.3 per 100,000 by 2008, the same ratio as back in 1974.  Over the last few years the number of medical school graduates has increased slightly, and the ratio of graduates per 100,000 increased to 5.56 last year, the highest in a decade.

The bottom chart compares the actual number of medical school graduates (red line) to the projected number of graduates if the number of new physicians had keep pace with U.S.  population increases, i.e. the ratio of graduates per 100,000 Americans had stayed at the 1984 level of 6.91.  In that case, we would now be graduating close to 22,000 new doctors annually, and the cumulative increase in medical school graduates from a rate of 6.91 per 100,000 population over the last 27 years would mean that we would have 84,000 additional physicians today. 

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