Five things ACA supporters are just learning (Part III of III)

… that ACA opponents knew from the beginning.  That’s why we were ACA opponents in the first place (duh).

See the full article here. 

Continued from Part II –

“4. Obamacare is immensely complicated.”

Tell me, what part of “2,000-page bill that no one has read” said to you, “The ACA is simple, intuitive, and straightforward”?  Here’s a clue: the correct answer is “Nothing.”

“5. The exchanges offer limited choice of doctors.”

Not just the big, bad insurance companies here.  Doctors themselves are opting out.  Yes, those paragons of selfishness, who racked up hundreds of thousands of dollars in debt, actually want to make enough money to pay off their debt, provide for their families, AND live the decent lifestyle that they have worked for years to achieve.  The horror!

In all seriousness, this is one of the biggest ways that companies cut costs – by limiting the range of benefits and in-network providers.  That’s how HMO’s work.  They are crazy effective at cutting costs, but the price of cutting costs is limited choice.  The ACA’s effect on insurance policies is no different – if you mandate lower costs, the first thing to go is a range of choices.

My designer insurance reform:

1) Get rid of state-specific insurance plans.  Let coverage be nation-wide.  This would increase competition (lower premiums), give each company a wider policyholder base (lower premiums), reduce state-specific administrative difficulties (lower premiums), but would also mean more claims payouts (higher premiums).  On balance, I think this will result in lower premiums.

2) Ditch the insurance-through-employer model (See part II).  This will hopefully eliminate the moral hazard problem as people pay for exactly the coverage that it’s worth it to them to pay for.  I think this will result in lower premiums.

3) Subsidized risk pools (See part I).  This will result in higher premiums, but I think all three points together will result in lower premiums and more satisfaction with coverage, on balance.

If you have any other ideas, or if I am wrong about anything, or I forgot to address something really important, please let me know.  I am genuinely interested in how to help fix our healthcare system without the train wreck of the ACA.

Five things ACA supporters are just learning (Part II of III)

… that ACA opponents knew from the beginning.  That’s why we were ACA opponents in the first place (duh).

See the full article here.  

Continued from Part I – 

“2. Many people will lose their current insurance.”

You don’t say.

Supporters of the ACA accurately state that technically there’s nothing in the ACA that forces insurance companies to take your plan away from you.  It’s the big, bad insurance company’s fault that you can’t keep your plan.

Yes, the big, bad insurance companies are doing exactly what anyone who paid attention in Econ 101 said they would do – change in response to the new regulatory environment.  With the new “minimum essential coverage” guidelines, all these plans are being legislated out of existence.

If I could just digress a moment to discuss these theoretical “junk” plans.  It’s the new talking point that everyone is getting a better plan.  This is just straight-up not true.  Story after story abound *cough* about people having to pay an exorbitantly higher amount for the same or fewer benefits.

Now, that being said, here is an area where I am actually with the ACA supporters – ACA opponents are complaining everywhere that because of the way different types of people are now lumped together, men are having to pay for maternity care, breast cancer, and a host of other female-specific conditions.  They’re not complaining so much that women have to pay for male-specific conditions, so I guess that’s not as big of an issue to them.  /eyeroll.

Listen here kids – if men’s and women’s premiums are all lumped together to pay for BOTH male-specific and female-specific conditions (setting aside maternity care for a second), on balance it’s a wash, unless there’s some huge difference in how common certain conditions are.  Which I don’t think there is; if you can find something to prove me wrong, please do.

Now – returning to maternity care – how do women get pregnant?  What’s that you say?  Because a man voluntarily had sex with her?  Awesome.  Guess why I don’t care that men are griping about having to pay for maternity care?  Show me a man who’s a virgin – he’s the ONLY one with a legitimate complaint in this department. 

“3. You don’t have to buy through the exchanges.”

Now this one right here isn’t technically about the ACA.  This item has more to do with the lack of general knowledge about open market insurance options.  And that makes sense - if most people are getting subsidized premiums through their employer, they have no need to go anywhere else.  It wasn’t until I switched jobs and decided not to pay $2000 a month to insure my family that I investigated my open market options.

The purpose the exchanges serve is a guaranteed place where anyone could buy insurance.  But since no one is likely to get on the exchanges for quite some time, and also since many of the big carriers are opting out of the exchange, I don’t think it’s going to be very effective.

But while we’re on the subject, it’s bullshit that the only way to get an insurance subsidy is to buy through the exchange.  Why can’t I buy a policy on the open market and then claim a deduction on my 1040?  Would that have been so bad?

Also, why are premiums paid through my employer deducted straight from my W-2 wages (thus lowering my AGI), while premiums paid myself are deducted elsewhere on the form and do not lower my AGI?  My AGI is used as a base to calculate the allowability and amount of several different deductions, so buying insurance myself (as opposed to through my employer) is essentially a penalty.

If it were up to me, I would scrap the insurance-through-employer model.  I would also scrap the insurance-pays-for-everything model.  I would make health insurance more like auto insurance.  You buy it on the open market, decide who you want on your policy (self, kids, grandma, down-on-her-luck friend, neighbors, parents, ANYONE), decide what your catastrophic illness deductible is (with the understanding that regular doctor visits are out-of-pocket*), and your price is adjusted accordingly. 

*One thing to remember with health insurance – if you have a high deductible plan and go to the doctor before you hit your deductible, look at your bill.  Your bill will show gross charges, “plan discounts” or some such, and the amount you owe.  Even though you’re paying out-of-pocket, you’re still not paying 100% of charges.  Whenever I’ve gone to the doctor with my high deductible plan, my actually out-of-pocket cost has actually been pretty darn good.

To be continued …

Cartoon roundup!

All right, everyone, it's time for a cartoon roundup!  In which I comment on cartoons that have struck my fancy, in no particular order -

Now here is one where I actually would appreciate reader commentary, since I'm too busy lazy to do my own research.  Also, I want to hear people present the best of the other side.  I am as pro-life as you can get, but in the meantime, it makes sense to hold physicians who do that sort of procedure up to a high standard.  Especially given the fact that abortions DO go wrong, and when they do, they leave the mother AND the baby dead (as opposed to just the baby).  My (unsupported) understanding is that there are some politics regarding who has hospital admission privileges such that a rule regarding hospital admission privileges wouldn't solve anything.  Also, that supposedly Gov. Brown's bill doesn't result in any reduction in safety to the woman.  Anyway - I'm open to thoughts here.

Yeah.  This one pretty much goes without saying.  More costs to insurance companies, healthcare providers,  businesses, and policyholders.  It just sucks all around.  Tell you what, let's pass a law that sucks up all sorts of costs from various sources and wonder why the economy doesn't recover!

The only thing I would add is that this seems to be a first resort (rather than a last resort) when it comes to criticizing the President.

To be honest, I'm pretty tired of hearing the "you can keep your health plan" drumbeat.  We get it - the President lied.  But I've heard it so much I don't care anymore.  So why did I include this cartoon?  Three words: Smoky the Bear.  Such a well-recognized symbol of good forest stewardship whom I was introduced to in kindergarten; he makes me smile.

This.  Is there anything on the news that's NOT alarmist and sensationalist anymore?

Yeah.  Exactly.  Never mind that the House Republicans were using their Constitutionally designated powers.  Never mind that the Senate Democrats could have agreed at any time to Republican bills that authorized funding the government if only Congress's ACA exemption was lifted.  Nope.  It's all 100% the Republicans' fault.

I think that's enough for now.  Enjoy!

Five things ACA supporters are just learning (Part I of III)

… that ACA opponents knew from the beginning.  That’s why we were ACA opponents in the first place (duh).

See the full article here.  

“1. Premiums will go up for many people.”

Tell me, those of you who paid attention in Econ 101, what happens when you simultaneously:

1) Increase costs of suppliers (forcing insurance companies to cover more services and more people)
2) Increase risks to suppliers (forcing insurance companies to cover those with pre-existing conditions)

Guess what?  Suppliers will grab additional revenue from wherever they can.  In this case: you, the esteemed policy-holder.

Now, I know I’m oversimplifying a bit for the sake of brevity and clarity, but nothing I omitted changes the underlying principles of how market participants respond to market changes.

Having said that, I know that in our current healthcare marketplace, insurance companies essentially function as the gate-keepers to at least half-way decent care.  I also know that these same insurance companies have regularly abused the pre-existing condition disqualifier.  If you have a cold when you attempt to sign up for insurance, oh look!  You have a pre-existing condition and are not covered for anything.  I’m exaggerating, but not by much.

Normally I’m in favor of free market solutions, but when abuse of the little guy is so rampant and widespread, I think we need to do something via government channels.  To address the pre-existing condition issue, assuming no other health reform was taking place, I would have supported simultaneous:

1) Limits on what is considered a pre-existing condition such that any given insurance company could deny someone coverage.

2) When a person applies for insurance, a decision will be made whether to cover them or not within 72 hours.  If that person is denied based on one of the allowable pre-existing conditions, the insurance company issuing the denial has 72 hours to both notify that individual’s state Department of Health and Human Services (or whatever it’s called in their state) AND send a denial letter to that individual either electronically or by mail so they have evidence of being denied coverage.

3) Such individuals are covered through a federal or state-run subsidized risk pool which would hopefully provide better reimbursement than Medicaid.  Such a risk pool would be funded by ….

4) A tax levied on all health insurance companies operating in that state (or at a national level – either way).  The amount would be determined annually by actuaries and would use a company’s premium revenue less claim payouts as a tax base.  Additional reductions to the tax base are allowable for claims paid for any individuals who could have been denied coverage based on the list determined in step #1.

This approach would ideally accomplish:

1) Limitations on pre-existing condition denial abuse by insurance companies (step #1).

2) Incentives for the insurance companies to nevertheless absorb the cost of people with pre-existing conditions (step #4).

3) For those companies who would rather someone else pick up the tab – fine.  But they are going to give the applicant a quick decision (step #2), help pay for it (step #4), and timely provide the necessary documentation to allow that applicant to get coverage (step #2).

4) Coverage for anyone who applies for it (step #2 or #3).

5) Incentives to keep premiums from rising too much (step #4 and the lack of “minimum essential coverage” guidelines) and incentives to keep collections from insurance companies reasonable (step #4).  Any funding shortfalls would have to be made up the next year.

Let me know if I missed anything.

To be continued ….

Classy Rielle

I never thought I would defend Rielle Hunter and call her “classy,” but I guess today is the day.  In other news, I saw some pigs flying around earlier today.

Anyway, let me start by saying that there is nothing amusing to me about adultery.  One little affair has the potential to cause so much pain to so many people.  I don’t even generally enjoy movies that have an affair as a plot device, although I suspect I am in the minority from such hits as Closer.  This affair is no exception.  I will not be buying Ms. Hunter’s book to find out “What Really Happened.”  I already know the answer to that – what really happened is that some guy with political aspirations cheated on his wife and fathered a beautiful little girl.  No other details are needed to understand that he caused his family a lot of very public pain; as such, nothing else is terribly relevant.

Ok, now that that’s out of the way, check this out:

And now, the commentary:

“Her lack of self-awareness would make her a great Bravo star.”

Is that so?  Let’s think about this.  That story itself has been very public for a while.  She is not revealing anything new by her “tell-all” book.  She may think she is, and she apparently really wants to tell us all her perspective.  As much as I have no interest myself, I know I don’t speak for everyone.  I can’t blame her for wanting to put her side out there.  In fact, she raises a valid point – her baby girl is completely innocent and yet she will suffer because of her parents’ abominable behavior.  I certainly understand Ms. Hunter’s motivations in defending her daughter:

“People make judgments based upon misinformation, and my daughter goes to school with those people.  Those parents have judgments about her mother … and my daughter interacts with those people, so I think that she has a right to have it in the public domain.”

Now, I am not a mind-reader, so I am not in a position to know to what extent (if any) Ms. Rielle’s motivations have a self-interested component.  But since I’m not a mind-reader, I’m going to proceed with the presumption of good faith, and not go down this road any further.

So, the question from this video is – is everything about everyone’s lives is somehow public because of one very public incident?  That’s ridiculous, but that’s what the interviewers are trying to pull out of Ms. Hunter.  Ms. Hunter, for her part, is very clear: the story itself is public, but as far as anything outside that story, “you are not entitled to that.” 

But the interviewer is not be deterred!  “I’m trying to get a straight answer on things that I see as completely in conflict.”  She gave you the straight answer several times – “that time period is very public.”  The fact that you are struggling with her straight answer being anything other than what you want to hear is not her problem.

And she holds firm.  Good for her.

Best quotes (lately)

Best Ron Paul quote ever:

"[Ron Paul’s] supporters are akin to ‘Battlestar Galactica’ loyalists at a ‘Star Trek’ convention, incapable of winning many converts and themselves unwilling to switch teams."

As a (current) Ron Paul supporter, BSG fan (BSG4life!), AND Star Trek fan, best. Quote. Evah.  Nuff said.

Best quote about Texans:

Following Rick Perry’s entry into the GOP race: “The Texan enters with one heck of a handicap, namely: He’s a Texan.  And the rest of the country, to indulge in the broadest-based, unfairest, most stereotypical of generalizations (my specialty), doesn’t much like Texas.  Which is just fine with Texans, who (a) don’t much care, being Texans, and (b) may not like the rest of the country, either."

LMAO!!!  This quote is SO true.  I lived in Texas for a while, and I actually found the state pride rather charming.   It's the only state where I have seen people paint the state flag on their curb.  Of course, it helps that the state flag is a rather simple design, but still.  I liked it.


Seen any good quotes lately?

Oh HUD, my HUD! Our fearful trip is done!

http://www.msnbc.msn.com/id/44375023

OMG!  The government owns repossessed homes!!!

 
You don’t say?! If you REALLY want to know what to do, how about you let people actually buy them, hmmmm?  (See my upcoming novel about how not to buy a house)

Phoebe Prince

So I was reading this article on the Phoebe Prince situation and the aftermath.  First of all, it’s a good article and a valuable piece because it’s important to read a logical, articulate piece that runs contrary to the dominant reporting in the media.  So check it out.  And while you’re at it, check out the interview with Flannery Mullins (one of the girls involved).

Overall, the tone of these pieces is very sympathetic to the kids who were in conflict with Phoebe before she died.  To be honest, I have limited sympathy because I know what it’s like to be on the receiving end of the bullying that girls do.  I did go to middle school like a normal person, after all.  But then again, I am perfectly aware that because of what I’ve experienced, I have a hard time being rational about all this.

In these pieces, the conflict has been chalked up to “normal teenage drama.”  Well, why is it “normal,” hmmm?  Perhaps because we allow it?  In her interview, Flannery said that in hindsight, she would have talked to Phoebe directly about all the rumors that were circulating instead of reacting aggressively.  Oh?  And what does it take to learn these lessons?  Is it possible to teach teens to treat each other like human beings WITHOUT heaping felony charges on them for “normal” (but unjustifiable) teenage drama?

The naïve side of me wants to say that “well, maybe these teens strung up on the gallows of public opinion will serve as an example to other teens who would otherwise bully.”  But the realistic side of me understands that the LAST word you can reliably use to describe people (let alone teens) is rational.

So … what was the point of charging them with everything but the kitchen sink?  The DA (Elizabeth Scheibel) HAD to have known (unless she was totally incompetent) that the charges would never stick.  You know, burden of proof on the prosecution and all.  There’s a possibility that maybe she was bullied as a pre-teen / teen and she was emotionally sensitive to the issue (I didn’t find anything) in which case she was unfit, if she couldn’t get past it to be impartial at her job. 

Emily Bazelon makes the case that Scheibel has a history of overreaching.  The prime example she provides was of a 17-year-old who put his hand inside the back of a gay student’s pants and put a finger in his butt.  (!)  Call me crazy, but that goes FAR beyond “normal drama” in my book.  And why would you even want to do something like that?  Gross.  Anyway, Scheibel’s office prosecuted the kid (good!) and recommended some prison time, probation, and a listing on the sex offender registry.  We don’t know the outcome yet (I couldn’t find any sort of final outcome) but the kid came out in support of the kids accused in Phoebe’s death, saying, “I can relate to him probably really well because I know what its like to fuck up and make a mistake and have your whole life spiral downwards on you in the blink of an eye.”  Hmmm.  Excuse me while I cry a river for this poor, innocent soul … maybe not.  I can tell by the way this is written that I am supposed to feel sorry for the kid, but why should I?  Need I remind you, he stuck a finger in a gay kid’s butt.  Yes, I would argue that it’s abnormal behavior to the degree that some sex offender registry time would be appropriate.

In response to the idea that she is overzealous, Scheibel said: “I’ve been doing this a long time.  I’ve been working with ‘blame the victim’ and ‘you overreach’ and all that.  I don’t agree with [Bazelon’s] assessment, that’s all.”  That was all I found on Scheibel’s response.  Bazelon’s article quotes an online bio of her where a childhood friend described how she beat up a bully who was picking on her younger brother (you go, girl!), but when I tried to follow the link it was no longer there.  Hmmm.  But that’s all the background info I found.  (If you find anything, let me know please.)

The accused kids had some pretty serious repercussions – the irrational part of me says “Good!  They deserve it!  Normal teenage drama, my foot.”  But the rational part of me says, “Now, now – the punishment should fit the crime.  And it doesn’t.”

This is one of those situations that make me glad it’s not my responsibility to run the world.  What about you?  What would you have done differently if it were up to you?

Yay!

Juan Williams is subbing for Bill O'Reilly tonight!  Williams invariably does a much better job than O'Reilly.

*rubs hands in excitement*

Looking forward to it!

Burning the Koran

Sometime last month, on MSNBC’s “Hardball,” Time Magazine World Editor Bobby Ghosh said the following:

“The Bible is a book written by men.  It is acknowledged by Christians that it is written by men.  But the Koran … is directly the word of God.  That makes it sacred in a way that is hard to understand if you are not Muslim.  So the act of burning a Koran is much more inflammatory than if you were to burn a Bible.”

He is correct that there is a difference in how the Muslims and the Christians see their respective Scriptures (would someone please remind the overzealous Evangelicals?).  But it’s not fair to the Christian belief that Scripture was “divinely inspired” to say that the Bible was “written by men.”  If you are curious about exactly what “divinely inspired” means and what it implies, catholicanswers.org is a great resource.  But this topic is tangential to what I really want to talk about, so I won’t go into it here.

From what I read, Mr. Ghosh was discussing the relative sacredness of Muslim and Christian Scriptures to explain why we see such strong, violent reactions from the Muslim world whenever someone burns (or threatens to burn) a Koran.  Also, by extension, why Christians are comparatively calm when the converse happens. 

But the relative sacredness of Koran vs. Bible doesn’t explain the disparity in reaction.  For example, let’s take the Eucharist (body, blood, soul, and divinity of Christ), which is infinitely more sacred than the direct word of God.  There are plenty of examples of actual or threatened Eucharist desecration – google or youtube “Eucharist desecration” and you’ll see what I mean.  But do you see Catholics getting violent?  Noooo.  Why not?  Well, most of us live in societies where most people have an inherent respect for the rule of law and individual rights (i.e. in this case, the offending individual’s right not to be murdered / violently assaulted).  But also, you don’t solve anything when you retaliate by depriving someone else of their sacred, God-giving right to life. 

So let’s go back to the Koran-burning, shall we?  Shall we get all violent / murderous in response?  In comparison with the desecration committed by burning the holy book, murdering someone created in the image of God in response is an infinitely greater desecration.

Death of bin Laden

I am not all that timely in bringing my thoughts together – it can take a while for how I want to say things to coalesce.

I have been struggling with how to organize my thoughts on this – more like a series of gut reactions.  I didn’t really have an initial emotional reaction to his death – I just don’t do initial emotional reactions.  To big things, anyway.  But then I started seeing “Rot in hell!” and the like on Facebook, and my reaction was “How ugly!”  I get that he’s an awful person, and we have a vested interest in seeing him dead, but it just seems so awful and hateful to take pleasure in someone’s violent death.  Regardless of how much that person would have celebrated OUR violent death.

Then I start to see things like “hate cannot drive out hate; only love can do that” or some such.  Invariably the people that are posting these things are coming across as self-righteous and holier-than-thou.  My reaction: “how snotty!”

Long after we got the news and my husband and I drank our celebratory beers, I think I have finally figured out what my reaction is.  I’m glad.  Very glad.  If I had the time, I would be dancing in the street, waving a flag, and chanting “USA!  USA!” along with the rest of ‘em.  It’s not that I relish the thought of Osama’s violent death – as much as 9/11 felt like a punch in the stomach, I don’t feel any anger or hatred for him.  After a couple of awful exes, I have had much practice in moving forward emotionally, and there isn’t anything that I can’t forgive and move past.  Not forget, mind you, just move past it emotionally.  So since I feel so neutral, why am I happy at the news?  Well, I’ll tell you:

1)      We have neutralized a security threat

2)      We have sent a strong message to anyone thinking about attacking us: If you do, we will hunt you down and kill you.  See exhibit A: Osama bin Laden.

3)      We have the military and intelligence capability to successfully execute #1 and #2

All of that is reason enough to celebrate, so why get all caught up in revenge?  He can’t hurt anyone ever again, and that’s all I need to know.  There is plenty to be happy about without crossing the line and getting excited over someone’s death, and frankly it’s really snooty to assume that everyone who is celebrating is caught up in bloodlust and revenge.  That’s why the holier-than-thou posts rub me the wrong way so hard – they are assuming that because someone is celebrating, they are hating.  Nowhere close to true.

Tragedy in Japan

I am sure you have seen the coverage of the earthquake and tsunami in Japan.  Here, a depiction of mourning -



and strength -



I couldn't have said it any better myself.  Please pray for the Japanese and help out any way you can.

Cartoons as art

I really, really love political cartoons as an art form.  Just something about the way they make a succinct, heavy-hitting point – it’s as close to instant communication as you can get.  I enjoy the way one can almost physically strike with poignancy …

Or make you laugh in an instant …

Take the first one – I love how all our political worries and gripes (both serious and silly) just pale in comparison to their sacrifice.  Always worth remembering – in all things, a dash of perspective.

And now take the second one – I don’t know about where you live, but here in Alaska, winter driving is MUCH smoother than summer driving.  Except for the lack of any sort of traction on the road in winter.  But that’s a mere technicality!  /wink  You just kinda learn to manage the glide, if you’re like me and too lazy to switch over to your winter tires.

In sum, I <3 political cartoons.  I will probably be using a lot of them.