Nightmare Open Thread: Overgrown Toddlers with Weapons of Mass Destruction

A-B-C! One spoilt princeling with Chemical weapons, trumped by another with Atomic fantasies…

Thanks for breaking the world, Repubs!



This Is Where We Are 2-7-17

So I just got off the phone with my mom and she shared some disturbing news. Especially so for me as the son of an immigrant, a Green Card holder until his death.

My former sister-in-law returned in the last couple of days from a family funeral in Peru. She’s an American, with passport, but originally from Peru. When her plane arrived at SFO, there were armed immigration/customs agents on the boarding ramp, right outside the plane’s door.

Every person exiting the plane was asked for their papers and scrutinized. This was a normal international flight, not from the countries of current trumpian concern. The next day, her friends told her that all international flights are being greeted thusly.

I’ve been traveling since I was two weeks old. I’m a dual national, but my US issued birth certificate shows I was born in Africa to an American woman and a Swiss man. This country has ALWAYS been the land of the free and customs and immigration folks are in their booths, lanes, aisles, etc. Not intimidating folks getting off the plane.

It’s beginning my friends. A moat is being created around us, between us and the rest of the world.



Late Night Open Thread: #SCROTUS

Which would all be fun and games, until…

Say it with me: YOU DID THIS, REPUBLICANS!



Market capitalism — how does that work?

I was not surprised when United Healthcare pulled out of the Exchanges. I could not see how they could make money given the combination of their network and premiums.

TLDR: United Healthcare is losing money because they did not think their strategy through. Sucks to be them but this is not a systemic Exchange problem….
We know that the Exchanges are an extremely cost sensitive market…I would bet that United did fairly well in the eight markets where they had either the 1st or 2nd Silver. They’re getting killed in markets where their products are not price competitive…..United Healthcare is offering a product in my region. The network for their least expensive Silver (which is 10% more expensive than the benchmark Silver) is significantly broader than the networks of two competitors low price Silver options.

The New England Journal of Medicine has a very interesting article by Craig Garthwaite and John Graves** that provides a lot of support to my Exchange analysis and why United Healthcare and other insurers were in trouble on Exchange.

To examine more systematically whether poor insurer strategies may have contributed to market exits, we combined information on insurer participation in the marketplaces for the 34 states with available data for 2016 and 2017. These data included information on premiums, provider networks, and insurers’ local experience with other populations such as Medicaid beneficiaries. We used this information to investigate factors associated with a sustained presence in the ACA’s nascent insurance markets….
Our data show that the exiting plans offered an unappealing combination of smaller provider networks and higher premiums. For example, an unsubsidized 35-year-old person enrolled in one of the plans that was discontinued would have paid, on average, $16 more per month for a plan with 8% fewer local in-network hospitals than a similar person enrolled in a plan that was not discontinued….
In supplementary analyses, we also compared characteristics of insurers and plans entering the exchange market in 2017 and found that new plans had substantially lower premiums than their local competitors (premiums are $30 per month lower for a 35-year-old enrollee). Moreover, issuers of these new plans were more likely to have experience with Medicaid managed care but less likely to have direct experience in the markets they entered. This finding is consistent with the existence of a functioning market in which firms that were initially successful are moving into new geographic areas.

The one question I have is if there was a flag for co-ops as I think some of the results would change if we can stratify the data that way.

But the story Garthwaite and Graves tell is that firms that offered bad products with little experience in a comparable market and not a lot of experience actively managing population actuarial risk were far more likely to leave. Firms that offered low price, modestly broad networks with experience in fully insured risk managment and Medicaid managed care are more likely to survive and expand.

Or basically, firms that knew what they were doing and could offer decent products beat out firms that offered really bad values.

Is that shocking? No, it is market capitalism doing what it is designed to do.

**Garthwaite, Craig, and John A. Graves. “Success and Failure in the Insurance Exchanges.” New England Journal of Medicine (2017): n. pag. Web. 1 Feb. 2017.



Making Some Tweaks…You Have Been Warned

First – thanks to all who donated.  All of you/John shocked me with that last night…much more than I was expecting. I truly thank each and every one of you who donated (or who did in the past).

 

So that said, I’m going to be doing a few things over the next few days:

  1. Update remaining items on the list.
  2. Re-apply the customizations post-update.
  3. Add up/down buttons to the mobile site
  4. Fix the mobile site (style, mostly)
  5. Figure out a better way for embedded video
  6. Perhaps Twitter cards?
  7. Read More will work, darn it
  8. Hopefully, a return of the apostrophe in nyms.
  9. A number of other smaller tweaks and fixes.
  10. Larger text or “Reader” view for iOS for mobile site.
  11. Add comment count to prev/next post buttons
  12. Twitter and/or images for FPers in comments
  13. Back button (once theme update done) will be back
  14. apostrophe in nym makes comments go to moderation – this is a FYWP bug that may be fixed today, but is dependent on WP fixing that code.

 

That said, I’ll be using this post as a testbed and general problem reporting area.

Requests, suggestions, etc are very welcome. For those with the knowledge/skillset, specific references to CSS files/lines/classes/etc. that you think could be improved are very welcome. I am a jack of all trades, master of none, so I know that many readers have much more in-depth design knowledge and I welcome their advice.

I don’t expect any major bumps, but there will be minute or two here and there where the formatting may look screwy – I have to update the theme, then copy the new files to a work folder, then restore the current version of the theme so I can work on the tweaks without affecting the main site.

Once all updates and the above list are done, I’m going to work with our wonderful hosting company, Hosting Matters, to figure out why the repository-restoration kills the site by doing an incomplete recovery.  It’s always tougher to function in someone else’s hosting environment than in a server where you have complete control, but I have faith in their excellent technical chops and incredible customer service.

Once again, if you’re looking for a good host for a personal, professional, or corporate web site, give them a look. They’re a great value, have great tech, and are very knowledgeable and skilled – true pros, ahead of the game, and incredibly responsive. Did I mention that they’re proactive too? Over the past year, they’ve notified me a few times that they detected a DDOS attack and similar brute-force pushes and that they’ve taken care of it, before we had a chance to report the slowdown!

Once again, thanks to all for your generosity and general good-will. These days there’s nothing more important than maintaining our bonds and collectively realizing that no, we’re not crazy – those fucks in charge (gods help us!) ARE. I will do my part to help keep this fantastic community of grumps, animal lovers, and wiseacres going strong.

Truly, y’all are the best.

 



Trump’s EO on the ACA

The Trump administration issued its first executive order. The subject is the ACA. The order seeks to destabilize the non-subsidized and off-Exchange portions of the risk pool by minimizing enforcement of the individual mandate.  Dan Diamond at Politico had the first link to the actual order that I saw:

Section 2 is the critical component for the individual market. Section 3 has significant impact for both Exchanges and Medicaid.

Analysis below the fold:
Read more



Pessimism Index update

I have moved from 70% pessimism to 80% pessimism given the fast Senate and House vote to kick off reconciliation and a few other things that I’ve heard that the plan really is to jump off a cliff and weave a parachute out of pubic hair and pocket lint on the way down.