Five years now

Five years ago, I made a serious miscalculation.

I was a low level bureaucrat trying to get Exchange networks to work for UPMC Health Plan.

I was exhausted that first fall as we were scrambling with interim solutions for several months after the ACA individual market went live.  We then had to go crazy to ramp up HealthyPA, a convoluted Medicaid expansion waiver program in Pennsylvania.

I was in Pittsburgh living an anonymous life.

I thought I would only have a couple dozen health insurance related posts spanning twenty or thirty thousand words in me.

Now I’m in Durham.

I’m now at 1,550 + Mayhew on Insurance posts and several hundred other general purpose posts.  My health policy word count is closer to a million words than half a million words.  There is a mostly written book somewhere in these posts and I will sooner or later need to convince myself that I can write a book on health policy.

 

Then, I could never be quoted nor would anyone want to hear what I wanted to say besides a couple of co-workers as we slammed espresso shots before another analysis run cycle.  Now, I’m part of the usual quotable suspects when major ACA news breaks out.

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.  I could and would poke a few people here and there that something big was coming down the pipe but I was limited.  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.

As I have been drafting this post over several days, I’ve talked to reporters from local and national general interest press, I talked to a reporter from the trade press, I submitted a pair of long and very technical pieces to Health Affairs, and a revise and resubmit just went back to the editors of a good peer reviewed journal.  If you spend enough time reading Balloon Juice, you could figure out 85% of the article excluding some of the regression based analysis.

I feel guilty about this at times.

Last week, was a good example.  I wrote a Medicare shared savings post that I was aiming at a few dozen academics and several dozen think tankers, journalists and very targeted policy wonks. It is a very specific, nerdy, and incomplete idea.  It was not worth an op-ed as it it too geeky. It was not a Health Affairs blog or a journal perspective piece as the idea was not polished enough for that purpose, so I went Balloon Juice. And that post got three comments.  And I was fine with that as this was not a general purpose post but a very small part of a very different conversation that I participate in.

I’ve moved away from some general purpose health insurance and ACA blogging and at times over the past year, I’ve chased personal shiny objects down rabbit holes.  And you guys put up with that. And for that I am greatly appreciative as I love writing here at Balloon Juice.  I have a scratch pad and a place to get first drafts (seldom second drafts as you see my grammar and spelling) of reactions and thoughts.  I can dig into something that fascinates me on my own time and my own schedule until it makes sense to me.  I hope that this is not pointless intellectual public indecency as this entire creative process is extraordinarily valuable for me.

Balloon Juice is a very different form of writing than writing a journal article.  Under the best case scenario, a fast journal timeline from “umm, that is a cool question” to publication is a year or more.  It is very different writing than a multi-author Health Affairs blog where commas can become fighting marks while the critical point that I want to make might be the lead melody or become subsumed as a backing bass line.  It is a very different writing process than pumping out a New York Times op-ed where I first truly appreciated the value of a wonderful editor.  That process makes me sound a whole lot smarter by the end.  The final 750 words are a tight 750 words instead of a 5 post, 3,000 word series here.  But I was worn out both times I went through that process.  This is a fun place to write  and it allows me to get into awesome conversations of a variety of stripes.

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 looks like, but the first five have been wonderful.

 



Samwise Open Thread / An Introduction, for the Unfamiliar

Hello, my pseudonym is Major Major Major Major, and I am, apparently, a blogger.

As many of you already know, I’m a prolific commenter here. (For those who didn’t know that, now you do.) Recent-ish-ly, I’ve been working with Alain on various improvements to the site. These efforts kept hitting the same snag: developing anything for a system you don’t have access to is terrible. So Alain gave me the keys to the production server. Somebody had the bright idea to give me the keys to WordPress too, so here we are.

I know I’m supposed to say something snarky here, but I really do think it’s kind of an honor, so hey, thanks!

Now. Before you complain about the site in the comments, let me say that we are aware there are many issues. We might even be aware of yours! But BJ is nobody’s full-time job, so, well, you know how triage works.

As for posting, I’m going to keep that light. As Alain mentioned, I’d like to start a twice-monthly series where we can all talk about good books to read. I may do the first one on Sunday. If there’s interest, I may also start a feature where we can talk about video games. Let me know. Finally, I may jump in with a west coast late night open thread on evenings where there’s a need.

Bio and pet pics below the fold…

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That Plutonium In San Antonio And Live Stream Putin-Trump Press Conference

A couple of reporters who take their job to be spreading maximum fear about nuclear radiation have found a story in San Antonio, Texas.

Staff from Idaho National Laboratory were picking up cesium and plutonium sources from a laboratory and left them in their rental car overnight. The car was broken into and the sources and other equipment stolen.

That was carelessness and should be looked at in the light of other careless incidents in the DOE system. When I’m traveling, I always bring in anything from the car that looks like it might be worth stealing. Even the stuff that is worth stealing but doesn’t look that way.

But the sources probably contain a few milligrams of cesium and plutonium. I haven’t done the calculations, but it probably would take a couple hundred years to accumulate enough plutonium for a fission bomb and cesium for a “dirty bomb” at that rate.

But the article goes on at length about bombs and such, as these reporters often do. It’s a strategy of fear for clicks, or perhaps these two really are terrified of anything to do with radiation. They also hyperventilate at the thought of terrorists taking the long view and waiting a couple of hundred years to get that TERROR BOMB.

IT’S ALL AROUND US! BE VERY AFRAID!

 

There’s not enough happening today, so here is the live stream of the two-president press conference.



Mother, don’t you recognize your son

I was thinking of doing a post about songs that mention mothers and it got me thinking of Lady Madonna and that got me thinking of What I Got (because it’s the same tune) and that got me thinking about how I think one of the Sublime albums has the best title of all time and that got me thinking about seeing Cadillac Records and how everyone involved had a great name (you can’t beat Howlin Wolf or Muddy Waters for names and I Can’t Be Satisfied and Killing Floor aren’t bad name either)…and that gave me an idea for a post.

What’s the best title for an album ever?

For me, this is a slam dunk. Forty Ounces To Freedom.

What’s the best name for a band ever?

I know you all think I’m a dad rock kind of a guy but I’m going to get a little contemporary here and go with Hurray for the Riff Raff.

What’s the best name for a song ever?

I think when you get down to it you can’t beat some of the old blues stuff — I Can’t Be Satisfied, Dark Was The Night Cold Was The Ground, Stones In My Passway. I mean, that says it all, right? I also like Your Pretty Face Is Going To Hell, though.

Finally, how about songs about mothers?

I’ll go with the one in the title here. There’s one I like even better but it’s a little dark (though very upbeat!) because it begins with a hearse.



Auf Wiedersehen

Looks like this second rate blog outlived Red State:

The influential conservative website RedState fired a handful of prominent writers on Friday in a move that appeared motivated, at least in part, by purging the outlet of anti-Trump voices.

The Daily Beast confirmed that among those laid off by RedState and its parent company Townhall Media were top editors and writers Caleb Howe, Jay Caruso, Ben Howe, Patrick Frey (who writes under the pseudonym Patterico), Neil Stevens, and Susan Wright—all of whom are often critical of the president.

Fired staffers learned about their dismissal either through their email accounts being locked or via a memo from Townhall general manager and vice president Jonathan Garthwaite. “[W]e are having to make changes to RedState effective today,” the memo read. “Unfortunately, we have reached the conclusion that we can no longer support the entire current roster of writers.”

RedState was founded in 2004, and soon after conservative pundit Erick Erickson was hired as its editor in chief. The site quickly grew into an influential blog among both Republican lawmakers and conservative activists. But the shedding of staffers on Friday marks a new chapter in its history and for some of those let go, it is a reflection of the drift that the conservative movement has taken during the Trump era.

It’ll just pivot into a more pro-Trump website and continue to serve as an important cog in the wingnut puke funnel. Basically, the owners wanted it to be more like the puddle of choad that is Ben Domenech’s Federalist.



Sandinista!

The big thing in American politics is a generational divide where older Americans vote like racist, xenophobic idiots and kids vote like socialists. How did it happen? Well, old people have always been stupid. Trust me, when I was seventeen I was a sharp as a tack and now, well, you read my posts. And I’m not even a fully fledged old yet. I don’t care how much hot teen blood Peter Thiel drinks, he’s going to struggle with the daily jumble when he’s a 120. But olds weren’t always this right-wing and the kids weren’t always commies.

I was reading once that the CIA had a theory about blowback, that they knew there was a pattern where they whacked countries with propaganda/coups/right-wing strongmen and ended up with strong socialist movements (or Islamic fundamentalist movements in the case of Iran) coming to dominate the country.

Do you think that’s what happened, or is happening, here? That the American right, with an assist from corporations, an Aussie media mogul and Russia, has whacked us with an endless stream of propaganda (that works brilliantly on the old) and two near-coups (2000 election and 2016 election), and that the end result is a sort of Sandinista generation?



We never got if off on that revolution stuff

It’s been kind of a brutal week politically. There’s something to remember though: things will change politically when the baby boomers die off and millennials become the dominant political block in our country.

I don’t know that well how baby boomers think, but I do understand how my generation, Gen X, does, to some extent. And I think millennials see the world very differently than my generation does. It’s fair to say that I, and many of you, grew up in a world where Broderism, and worse yet Reaganism, was pushed on us by the media in a way that is not that different from what goes on in North Korea. I try very hard not to be both sides person, but the truth is…it’s hard not to have it in the back of your mind sometimes. It was pushed into our heads for so long. And also too, my generation always felt (correctly) that the world is a shitty place that we’d never be able to change. In a lot of ways, we are, to quote the boomers’ biggest obsession, like a dog that’s been beaten too much.

And a huge proportion of people over 60 have been completely brainwashed by Murdoch media.

A lot has been made about the how the kids at Parkland have reacted eloquently and angrily to the school shooting. They think it’s outrageous that we don’t have gun control but they don’t think gun control is a lost cause, and it’s not in their lifetimes. (It will be quite a while.)

I truly believe that the current political situation is just a phase. It’s a damaging one, unfortunately, but it will end. The group of people my age and older are a lost cause, but the next generation, whatever problems it may have, lacks the political pathologies that have taken our government into a ditch.