Another year, another look back post

Six years in, and almost 1,800 Mayhew Anderson on Insurance posts written. Another anniversary and another exploration of the odd esoterica of the US healthcare system completed as I begin writing for a seventh year at Balloon Juice. I need to say the same thing that I said last year:

Writing here at Balloon Juice has been and continues to be an amazing experience. I get to play with ideas that fascinate me, and John gives me the keys to write to an audience…..

One of the big changes since I’ve come to Duke, beyond saying good bye to the persona of Richard Mayhew, is that I’ve changed my writing targets. When I was Richard Mayhew, I had to write at Balloon Juice…. Now, the audience is sometimes all jackals. Other days, the intended audience is a few score of geeks and policy professionals who need to know about some esoteric corner case. I apologize when I take over the blog for those purposes as I feel like I am hijacking your attention to pay the cost of entry into conversations that I want to be in….

But mainly, I just want to thank all of the jackals, the front-pagers and John for a community where I can nerd out on something that I find fascinating. I’ll figure out what Year Six SEVEN looks like, but the first five six have been wonderful.

My writing has become even more narrowly focused over the past year. Part of that has been that I set a goal for myself to play in the peer review space this year. And the very nature of that space requires far more targeting. At this point last year I had a single peer reviewed research project that was almost to the point of acceptance at the Journal of Health, Politics, Policy and Law and a letter to the editor for Health Affairs where I made the point that 2018 is an analytically weird year.

This summer I had a cluster of original research come out and an invited commentary already published. I have an article forthcoming in two weeks where a co-author and I will be looking at one of two topics which will dominate the 2021 rule making process for the ACA exchanges. The two of us have another paper accepted last night  which engages on the other major topic of the 2021 rule making process. We, along with a third collaborator, are again looking at that question from a different angle with a paper that is likely to come out this fall. I had a moment of quasi-maniacal super-villain laughter this summer when I looked at a revised version of Exhibit 3 for that manuscript and realized it will be entered as evidence in future litigation.

This afternoon, I am expecting to get back a second round of co-author edits for a manuscript that uses public use files to show something bloody obvious but not recorded. Insurance is complicated and this project shows some additional forms of complications in a way that no one else has even thought about. We’re using public, downloadable data, and part of our analytical data set has less than fifty downloads (and I am responsible for 6 of them as I lost track of the file a few times). Over the weekend, I need to make edits to the discussion section of a methods paper on matching for a small and unusual population (TLDR: It is really tough to do with reasonable assumptions). We hope to get that manuscript submitted for the first time next week. Another half dozen projects are in various stages of review, revision, and rewriting even as I’m building my 2020 project pipeline that builds on what I did in 2018 and 2019.  Under the most pessimistic assumptions I anticipate having six accepted manuscripts this year, median assumptions are eight or nine acceptances while wildly optimistic assumptions have a bakers dozen acceptances.   I will have four first or solo authorships from this current tranche of papers.

From an academic point of view, that is a wildly productive year especially as a good number of those manuscripts will be landing at very good journals.

But there are trade-offs. I have narrowed my thinking a lot and it shows that a lot of my Balloon-Juice writing is technocratic tinkering. Beyond that, my non-Balloon Juice public writing has crashed. I have only published three blogs at Health Affairs this year. I have not written an op-ed although I am in the process of prepping one around a topic that will be relevant around Thanksgiving. I became very narrow this year.

I needed a year to demonstrate that I can work well within the peer review paradigm. I think I achieved that. I enjoyed myself as I would like to think that I have added some unique value to the conversation and the knowledge that my co-authors, collaborators, colleagues and I are sharing will be meaningful and important in policy development. Next year will also be a productive but hopefully at a slightly less insane pace of production in the peer review universe. I hope I can grab some of those thoughts back from the ultra-specific to slightly broader questions that are more important that describing a particular form of financial plumbing.

I still get tremendous energy writing here.  I would like to de-geekify and make some of my writing more pragmatic over the next year.  I would really appreciate help on that and suggestions as to how to be more responsive to the needs of Jackals instead of merely paying the cost of entry to other conversations. But that is a thought for another day and another post, so onto year seven.


New Website Design Live Q&A: Ask the People Advising Cole Questions (About Almost Anything)!

The members of the commentariat who are advising Cole on the new website design asked me to schedule a live question and answer post for them and you. Here it is.

Open thread.

Balloon Juice and the invisible primary

The invisible primary component of the 2020 cycle is upon us:

The invisible primary is when candidates or proto-candidates assess their strengths, test potential coalitions and reach out to rare and valuable resources such as critical staffers and validators. There will be far more people running for president on the Democratic side who will never file an FEC report because the time between waking up in the morning and deciding that the person in the mirror should be in the White House and the end of the day will be quite informational. Quite a few people will have that thought but an inventory of their ability to access resources will show that there is no chance in hell of them even getting to a three way tie for third place in a delegate poor state.

We’re part of this invisible cycle. Balloon Juice is part of the liberal/Democratic extended party infrastructure. This community is part of the wide web of diverse stakeholders that slowly, somewhat haphazardly filters the field. It won’t be perfect; there will be some cranks and there will be one noters. We are part of the filtering process.

Balloon-Juice raised significant money in the 2012-2014-2016 and most recently the 2018 cycle. We generate analysis that is trusted and disseminated to other allied thought leaders and activists. We’ve shown an ability to push pithy responses (“tire rims and anthrax” and “hookers and blow”) to key analytical problems. The commenters and the front-pagers reactions to policies, positions, events and affects are important feedback for a slice of the activist base.

So as the primary season evolves, just remember that the collective zeitgeist of Balloon Juice is part of the invisible primary — not too bad for an almost top-10,000 pet, cooking, health policy, science writing, national security, screaming into the void blog.

Jon Swift

It’s time once again to continue a tradition started by Jon Swift/Al Weisel, the “Best Posts of the Year, Chosen by the Bloggers Themselves.” Jon/Al left behind some wonderful satire, but was also a nice guy and a strong supporter of small blogs. (Here’s Jon/Al’s 2007 and 2008 editions.  Our revivals from 2010 through 2017 can be found here.)
If you’d like to participate, just reply to this e-mail or write to me (Batocchio9 AT yahoo DOT com) with your best post of the year before 12/25:
Blog Name
Title of Post
Author of Post
Brief Description/Pitch of the Post (1–2 sentences)
(If it’s not a reply, adding “best post” in the subject line would also help.) 
To modify Jon Swift’s 2008 solicitation:
I would be very honored if you would participate and send me a link to what you think was your best post of [2018], along with a short description of it.  Please make the hard choice and send me only one link.  I would like to post it before the end of the year, so if you could get it to me before Christmas, I would really appreciate it.
One submission per blog, please, otherwise things can get messy. Group bloggers can pick a piece among themselves, but are also welcome to submit their work via their individual blogs, if they have them. 
As usual, I’m aiming to find the right balance between “inclusive” and “manageable.”  If you know a few excellent blogs (preferably on the smaller side) that you suspect might not be on my radar, feel free to send me their website address (and contact info, if you have it).
Contact Batocchio <>.

Quick Housekeeping Note Regarding This Weekend

I will be away on temporary duty from early tomorrow morning through Sunday night. I do not expect, based on the itinerary I was given today, that I’ll have any time to post, let alone comment over the next three days. So try to stay out of moderation as I won’t be here to release your comments.

For those of you who are nosey, which is pretty much all of you, I’m going up to Ft. Bragg. I was given the honor of being asked to give the keynote address at the 100th anniversary regimental dinner for the US Army Psychological Operations Regiment. (they didn’t get my bio quite right…)

Anyhow, it is also the 100th anniversary celebration weekend for US Army Civil Affairs Branch, where I was the Cultural Advisor (under Temporary Assigned Control) in 2012 and 2013. I’ll be participating in some of their events as well. And, of course, it wouldn’t be an Army event if I didn’t have some meetings! All in all, it’s going to be a busy weekend. So you all play nice and stay out of moderation!

Open thread!