The One-L “Hilary” Mafia Strikes Again

We’ve got them on the ropes, but they did manage to get a good one in.

one-l-hillary



From a commemorative ticket given to debate attendees.

 








Staying in a silo

The parents of my childhood best friend are on their local Blue Cross/Blue Shield (BCBS). They’ve almost always been on BCBS. And that is how they see their insurance. BCBS gets a premium and they get to go today to wherever they could go in the past because that was what BCBS covered. They got hit with an out of network bill for a podiatry visit as they went to a podiatrist that they have seen for years.

The problem is that they just retired. Mr. H hit 65 in May, and Mrs. H turned 65 in June. They had switched their coverage from a BCBS large group employer sponsored plan with a gigantic network to a BCBS Medicare Advantage plan with a large but not gigantic network. One of the fall-out providers was their podiatrist.

They did not know that their networks changed when they changed product lines. They talked with the billing manager at the podiatrist and they’ll get it sorted out but they were surprised that there was no single BCBS network.

They had been in BCBS since their late 20s. Since then they had large group BCBS, they had small group BCBS, they had BCBS CHIP, their grandson (who is quite adorable as he discovers his toes) was born on BCBS Medicaid, their older grandson is on BCBS CHIP, their son and his wife are on BCBS Exchange. One of their parents was on BCBS Dual Eligible Medicare/Medicaid Special Needs Plan (SNP). They thought it was all basically the same with different ID cards and different marketing material. They were extremely sticky to the local BCBS.

From a business point of view the stickiness was a significant objective of BCBS to offer a full suite of products for all lines of business. The data geeks at BCBS have thirty five years worth of claims data, thirty five years of phone call data, thirty five years of prescription data, thirty five years of text data. The data geeks are fairly confident that if Mr. or Mrs. H. go in for cost-efficient preventative care, the insurance company is likely to see profitability gains through claims avoided six months, twelve months and thirty six months down the road.

That is the upside of being a comprehensive carrier participating in all lines of business with a diverse array of products. People may bounce around within the company, but their data stays within the boundaries of the firm. And from there, the challenge is managing the data to maximize health while minimizing claims expense.

The downside of course to running a diverse set of businesses is that each segment has its own quirks and developing the expertise to be a great Medicaid plan will often conflict with the the imperatives of being an extremely attractive large group employer sponsored carrier. The work around is kludges such as seventeen distinct networks with marketing derived identification that really does not say much about who is in and who is out.








Wednesday Morning Open Thread: Deep, Cleansing Breaths

What’s on the agenda for the new day?



Early Morning Schadenfreude Open Thread: Random Observations from the First 2016 Presidential Debate

When you’ve lost Megan McArgleBargle…

Smiling, serene, egged on by each groan and grunt and interruption she goaded from her rival, Clinton provoked Trump again and again—over his refusal to release his tax returns, his years-long “racist lie” about President Barack Obama’s birthplace, his foreign-policy views, and his treatment of women. Meanwhile, Trump drew some blood on the issue of trade, specifically calling out crucial battleground states in the process, but found little on Clinton’s most vulnerable fronts: e-mail, family foundation and policy crises of her tenure as secretary of state…

Trump started the debate relatively subdued, but grew increasingly testy as the night went on—and as Clinton’s jabs kept coming. He used negative emotion words like “terrible,” “stupid,” and “disaster” about 50 percent more often at the end of the debate than the beginning, according to a Bloomberg Politics analysis with Quantified Communications

A CNN snap poll found that 62 percent of voters who watched said Clinton won the debate compared to 27 percent for Trump.

His son Donald Trump, Jr. defended his father after the debate: “There’s a time for temperament, and there’s a time where you actually have to defend yourself,” he said…

Thing is, though — for all the well-deserved mockery, Trump said a bunch of stuff that in any other election cycle would have even the Media Village Idiots perturbed. He once again advocated “taking the oil” from Iraq (which would be a war crime, if it were physically possible); he said “we” should be demanding protection money from NATO; he thought “China should just go into North Korea” (because a manly commander like Douglas MacArthur would’ve done just that); he derided the Fifth Amendment; he said that stop & frisk was “extremely effective in reducing crime” (it wasn’t) until “a very anti-police judge” ruled against it, and repeatedly contradicted the moderator who pointed out that it had been found unconstitutional…
Read more



More Afterglow

Another recap of last night’s debate:

recap








Breaking: Shimon Peres Has Died at Age 93

peres_postcard

(Shimon Peres)

The BBC is reporting that Shimon Peres has died (h/t LAO). Here’s the BBC’s obituary for him:

He held almost every public office, including those of prime minister and president, although he never led a party to an election victory.

Born Szymon Perski in Wiszniew, Poland (now Visnieva, Belarus), on 2 August 1923, Shimon Peres was the son of a lumber merchant.

His parents were not Orthodox Jews but the young Shimon was taught the Talmud (compendium of Jewish law and commentaries) by his grandfather and became a strong adherent of the faith.

In 1934 the family moved to the British Mandate of Palestine (Peres’ father had emigrated two years earlier) and settled in Tel Aviv.

After attending agricultural school Peres worked on a kibbutz (agricultural commune) and became involved in politics at the age of 18 when he was elected secretary of a Labour Zionist movement, Hanoar Haoved Vehalomed.

In 1947 Israel’s founding Prime Minister, David Ben Gurion, put him in charge of personnel and arms purchases for the Haganah, the predecessor of the Israel Defense Forces.

He secured a deal with France to supply the new state with Mirage jet fighters and also set up Israel’s secret nuclear facility at Dimona.

Peres was elected to the Knesset (Israeli parliament) in 1959, standing for the Mapai party, the forerunner of the modern Labour movement in Israel, and was appointed deputy defence minister.

In 1965 he resigned after being implicated in a reopened inquiry into Operation Susannah, an Israeli plan to bomb British and US targets in Egypt in 1954 to try to influence Britain not to withdraw its troops from the Sinai.

A review of the original inquiry into the operation found inconsistencies in the testimony, and Peres, together with Ben Gurion, left Mapai to form a new party.

When Golda Meir resigned as prime minister in 1974 after the Yom Kippur war, Peres unsuccessfully fought Yitzhak Rabin for the vacant post.

Secret negotiations

Rabin stood down as the Alignment party leader in 1977 after a currency scandal involving his wife but a quirk in the Israeli constitution meant he could not resign as prime minister.

Peres became party leader and unofficial prime minster before leading the coalition into a defeat by the Likud party under Menachem Begin.

He suffered five further election defeats, all of which resulted in him being given ministerial positions as part of a coalition government.

In 1992 Peres failed to win the leadership of the Israeli Labour Party after being defeated in the preliminary stages of the contest by Rabin.

As Rabin’s foreign minister, Peres began secret negotiations with Yasser Arafat and the Palestine Liberation Organisation, which led to the historic Oslo peace accords of 1993.

For the first time the Palestinian leadership officially acknowledged Israel’s right to exist.

A year later Peres became a joint winner of the Nobel Peace Prize along with Rabin and Arafat.

Once an advocate of Jewish settlements in the occupied West Bank, Peres became a leading political dove, often speaking of the need for compromise over territorial demands in Palestinian areas .

“The Palestinians are our closest neighbours,” he once said. “I believe they may become our closest friends.”

Peres became prime minister in 1995 after Rabin’s assassination but held office for less than a year before being defeated by Benjamin Netanyahu of Likud.

Reconciliation

In 2000 he failed in his effort to secure the ceremonial post of president, losing to the relatively obscure Moshe Katsav.

When his successor as Labour leader, Ehud Barak, was defeated by Ariel Sharon in the 2002 elections, Peres led Labour into a coalition with Likud and won the post of foreign minister.

He was able to extend a “safety net” in parliament to Sharon, enabling the latter to pursue a plan to disengage from Gaza and parts of the West Bank in the face of opposition from his own Likud party.

In 2005 Peres announced his resignation from Labour and his support for Sharon, who had formed a new party called Kadima.

When Sharon suffered a major stroke there was speculation that Peres might have become leader of Kadima but he was blocked by former Likud members who were the majority in the party.

In June 2007 he was elected president of Israel, resigning form the Knesset where he had been the longest-serving member of parliament in the country’s history.

His served seven years as president, before stepping down in 2014, the world’s oldest head of state.








Open Thread: Spearing the Old Boar Boor

Trump didn’t have to respond to Clinton baiting him about his treatment of women. A smarter man would’ve remembered it didn’t go over well when Megan Kelley did it the first time. And a more capable campaign team would’ve figured out that Hillary had something up her sleeve, especially after the ‘Mirrors’ ad. But nooooo….

And then he spent the next day trying to re-litigate the question! As though behaving like a pig and a bully after the fact was going to convince anyone that he wasn’t a pig and a bully!

You go, Ms. Machado! Enséñales, chica!