Risk Adjustment:Vox::Narrow Networks:538

There are two recent health policy articles by interested lay expertise sites that have me scratching my head. In Vox’s case, I am seeing a conclusion without context. For 538, I can not figure out the model that leads to a core assumption. These sites’ jobs are to inform the public and in these cases I think they can do a better job of their job.

Let’s start with Vox as Sarah Kliff looks at a Society of Actuaries analysis of risk scores on the individual market. She draws a very strong conclusion.

Between 2014 and 2015, SOA finds that Obamacare’s average risk scores went up by 5 percent. This means that the overall pool of people on the marketplace were sicker in 2015 than 2014. You can see the data here, in a table from the report.

The Society of Actuaries draws a much weaker conclusion

Risk measures published in the CCIIO release show that the average measure of risk increased from 2014 to 2015. Increased risk scores may be a combination of identification through better coding as well as a measure of the actual population health….

The program is still too immature to draw conclusive inferences about the future of the pool or marketplaces.

Vox saw a number that went up (bad) and wrote a story with no context.
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Overnight/Early Morning Open Thread

England Prevails! Or not. The Invisible Hand is weighing in now.

 



Further Airing of the Grievances

So, Bernie Sanders gave a speech last night. We’ve been talking about it. I’m sure some of y’all are sick of the entire discussion, which is fine — lots of other interesting threads below, or, if your scroll is sticky, there’s sure to be another up top soon.

But I’m one of those annoying assholes who believe the only way to work through a conflict is to get everything on the table. (The four scariest words in my family are “we need to talk…”)

It’s not that I enjoy picking at scabs (well, maybe a little). It’s that only in this way can we come together and move forward. Or decide that each other are irredeemable morons upon whom we should not bother to waste another pixel and look for other allies instead. Either outcome is progress! Read more



Friday Morning Open Thread: Now Every Day Is April Fool’s Day!

gop obama appreciation conspiracy luckovich

(Mike Luckovich via GoComics.com)
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Yes, once again we’re going to have to grit our teeth and ‘celebrate’ the favorite holiday for twelve-year-old boys of all ages and genders. While we wait for the Blogmaster to post his favorites, here’s the Washington Post with some “terrible history of this garbage holiday”:

… How did we get into this mess? We asked Alex Boese, curator of the online Museum of Hoaxes. He says you can blame the Dutch (who first referenced April Fools’ in a 16th-century text) or the French (who overhauled their annual calendar in the 1500s, confusing “fools” who didn’t adapt). Or maybe the U.K., home of the first April Fools’ Day prank on record, or Germany, which popularized fake April Fools’ news stories. And certainly the good ol’ U.S.A. — because who else would be tickled by the idea of renaming a national monument the “Taco Liberty Bell?”…

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While we brace ourselves — how the hell can you tell a Trump or Cruz hoax from the real thing, not to mention anything coming from Reince Priebus? — what’s on the agenda as we wrap up the week?



Open Thread: Well, It’s A Worthy Cause

When I first saw this on the twitter feeds yesterday, I assumed it was a photoshopped image, but The Hill is profoundly anti-japery.

And it’s probably because I’m old — I grew up in the Bronx, and left at the height of the ‘Fort Apache’ days — but as a hashtag #TheBronxIsBerning is so.very.NO.



Three ways in the House

Reading the Huffington Post, I saw this political bodice ripper and I still can’t figure out how to make the mechanics of the piece actually work in our shared reality:

Suddenly they realize, “holy shit, what if we could stop Donald Trump and keep Hillary Clinton out of the White House?”

So they run a moderate establishment Republican as a third-party candidate — 100 percent as a spoiler candidate. Worst case scenario oh, they prevent Donald Trump from winning the White House. Best case scenario they pull enough votes away from Hillary Clinton to prevent her from securing the necessary majority of 270 electoral votes.

Then the election goes to a House of Representatives ballot presided over Speaker Paul Ryan, Mitt Romney’s former running mate in 2012.

If neither candidate gets 270 electoral college votes, Congress picks the president. And he will be called President Mitt, the one who is laying the groundwork for this doomsday electoral scenario.

The basic theory is that a third party candidate who is Generic Republican Establishment (no not Pawlenty) would be able to do three things at the same time:

  • Insure that Trump does not get 270 electoral votes
  • win at least one electoral vote
  • Insure that Hillary Clinton does not get 270 electoral votes

In an alternative universe, that could work, but in this universe, I am having a hard time seeing how to actually make it work with a generic Republican running as a non-Trump alternative.

I think the first part is achievable.  However, the third party Republican spoiler is not needed.  Continual video playback of Trump’s speeches to non-Trump fans will isnure that.  If the Republican establishment decided it needed at least one electoral vote, it’s sock pocket could probably win Utah or a Congressional district in Nebraska.  Worse comes to worse, an elector could be a faithless elector.  I’ll concede the mechanics on this one.

The problem with this pre-emptive pants shitting is the third part.

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This Is Not Hard- They Just Have a Different Perspective

A lot of people surprised by the youth vote for Bernie and then dismissing his policies as unattainable seem to be missing a few things. First is that with a Republican House and Senate, everything Clinton and Sanders propose is pie in the sky. Fer fuck’s sake, the House broke tradition this year and isn’t even going to pretend that Obama is offering a budget:

The president’s budget is traditionally declared dead on arrival on Capitol Hill. This year, President Obama’s final budget proposal is just dead.

In a harsh partisan snub, the Republican chairmen of the Senate and House budget committees — Senator Michael B. Enzi of Wyoming and Representative Tom Price of Georgia — have chosen not to invite Shaun Donovan, the director of the Office of Management and Budget, to testify about the administration’s plan, set to be released on Tuesday as part of the traditional budget week festivities.

“Rather than spend time on a proposal that, if anything like this administration’s previous budgets, will double down on the same failed policies that have led to the worst economic recovery in modern times, Congress should continue our work on building a budget that balances and that will foster a healthy economy,” Mr. Price said in a statement.

So dismissing the Sanders proposals as uniquely optimistic or unattainable makes me think that the harsh realists uttering said statements don’t have as harsh a grip on reality as they think they do. They won’t work with Obama, so I have no idea why some of you think they’re going to work with “Hitlery”- you know, the person they have been savaging for what? Four decades? How could Sanders be worse?

Second, when we are talking about the youth vote, we’re talking about the people who have been straight up fucked by the current political establishment, and fairly or unfairly, Hillary is, in their minds, more reflective or representative of the establishment. Those of you saying “Hillary can work with the system and get things done where Bernie can’t” have to realize that is a double edged sword, right? The youth, rightly, IMHO, think the system has fucked them. They don’t want someone working in the system. They want the system ripped down and rebuilt from the ground up. And it’s not too hard to figure out why.

As a group, they’re fucked. They are saddled with debt, their economic opportunities are far more limited than that of any recent generation, and while they are working three jobs and paying for the SS benefits of current and soon to be retirees, they’re fed catfood commissions by “reasonable” Democrats and told they are being selfish by the Boomer generation- the generation that while achieving many great things, has left a fucking mess to deal with.

And when they look at Sanders, they see someone speaking and thinking outside the box. When they see Hillary, they see the establishment. And again, you don’t get to say Hillary is not the establishment while sitting back and stating Hillary has the majority of the Super Delegates and all the endorsements from, I dunno, establishment Democrats.

And in this case, Hillary has not helped herself at all. There was no sane reason for her to hoover up millions of dollars in speaking fees from Wall Street and trade organizations in between being SoS and her candidacy other than cashing in- the “I wasn’t sure I was going to run” line doesn’t cut it any better than That’s what they offered, Anderson.”

You can argue she didn’t do anything wrong (she didn’t), you can read the speeches and argue she didn’t say anything that would suggest she was bought (I haven’t seen anything to suggest that), and you can argue that everyone does it (and they do!). But that doesn’t change the fact that the kids see one candidate in an ill-fitting suit talking about income inequality and taking the bankers to task and all the other parts of their platform and another candidate cashing checks from the people shipping their jobs overseas and holding the IOU’s to their student loans and funding all the groups fighting living wages. Your arguments are good and true, but they don’t change that perception or reality for the youth vote. The kids voted the way they did just like certain demographics voted for Hillary in New Hampshire.

So stop shitting on the kids. They aren’t stupid. They’re experts on their situation, and you aren’t, and many of them think Bernie is a better option for them, just like right now many African-Americans think Hillary is a better option for them.

I’m having flashbacks to the PUMA wars and the Magical Unity Pony bullshit and how Obama will never get anything done. Not to mention, things are about to get real ugly racially the next few weeks, so maybe we should all start from a happy place right here and now before the shit really hits the fan. And yes, I will still vote for Hillary or Bernie in November. I’ll campaign. I’ll phone bank. The fucking Democrat has to win.

Drops mic. On foot.