Under Cover of Darkness Open Thread: CPAC, ‘Preferrably Consensual’, Part the First

Back in 2014, DougJ quoted TPM’s Josh Marshall:

In recent years, especially since Obama became President, CPAC’s wild press popularity and attention has been driven by what we might call a tacit conspiracy of derp between the event organizers and the people who cover it. You be outrageous; we’ll be outraged. And everyone will be happy. (After all, crap like this doesn’t happen by accident.) This has become even more the case as the contemporary Conservative Movement has become less a matter of ideology than a sort of performance art…

So, not really outside the CPAC norms when “Dad to 5 angels, husband… American Conservative Union Chair” Matt Schlapp announced a spot at this year’s conference for the freshest Hot Young Contrarian ‘Conservative’…

Per the Washington Post:

[The announcement] came just hours after Yiannopoulos, who has told college audiences that “feminism is cancer” and that the gay rights movement should abandon transgendered people, appeared on HBO’s “Real Time with Bill Maher,” leading to progressive criticism of Maher.

Contrary to some reporting, Schlapp said, Yiannopoulos was not giving the conference’s “keynote” speech, which typically closes out the weekend. But his prominent invitation underscores how much the presidential victory of Donald Trump — whom Yiannopoulos calls “daddy” — changed the tone of mainstream conservatism.

Earlier this month, after University of California at Berkeley police canceled a talk by Yiannopoulos and put the campus on lockdown amid protests against his speech, Trump threatened to pull federal funds from the institution….

By 2015, the first year that Schlapp presided over the ACU — and thus over CPAC — the event was welcoming back some previously ostracized speakers. This year, Breitbart chief executive-turned White House strategist Stephen K. Bannon has a speaking slot; Kellyanne Conway, another key strategist, is on the ACU’s board…

But then!… some of the sulking True Conservatives who feel CPAC has gotten entirely too ‘edgy’ (not everybody is a fan of ‘performative’ anti-Semitism, or of sending an army of twitter-trolls to harass actress Leslie Jones) dug through Mr. Yiannopoulos’ copious online archives…

[Audio NSFW]

Oh, how the Lie-brals rejoiced!…


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Late Night California Nightmarin’ Open Thread: Guvernator Thiel

From the Politico article:

Thiel, who co-founded PayPal and was an early investor in Facebook, has been discussing a prospective bid with a small circle of advisers, including Rob Morrow, who has emerged as his political consigliere.

Morrow has worked at Clarium Capital, the San Francisco-based investment management firm and hedge fund that Thiel started.

Those who have been in touch with the 49-year-old entrepreneur are skeptical that he’ll enter the race. He is a deeply private figure, and California is unfriendly territory for a Republican — particularly a pro-Trump one. The president-elect won just over 30 percent of the vote there.

But they add that Thiel has conspicuously yet to rule out a bid and that those around him continue to discuss it…

Thiel, who is worth an estimated $2.7 billion, would fill an important need: the ability to self-fund. Waging a gubernatorial bid in California, where campaigns are famously expensive, could cost over $100 million.

He isn’t the only billionaire who may run. Environmentalist Tom Steyer, a prolific giver to Democratic causes, is also seen as a possible contender.

With Democratic Gov. Jerry Brown term-limited, several high-profile Democrats, including former Los Angeles Mayor Antonio Villaraigosa, Lt. Gov. Gavin Newsom and state Treasurer John Chiang have already launched campaigns…

I’m assuming, from my perch here on the opposite coast, that Thiel is just drafting in Trump’s slipstream, getting his vanity stroked by Repub apologists like Politico without having to task his highly evolved brain with grubby political calculation.

Another sign of the President-Asterisks’s negative effects on the general political sphere — he hasn’t even been inaugurated, and he’s already encouraging the worst sort of anti-human grifters to speculate about following his slimy path.



Brow-Raising Read: Peter Not-Bathory Thiel Has No Patience with Your Illogical Humanity

As Thiel would no doubt explain — possibly via a letter from his lawyers — someone who can plausibly style himself a ‘chess prodigy’ cannot be called stupid. (Clueless would be my term.) He simply fails to honor certain metrics popular with lesser beings, ‘soft’ terms like empathy and humor, or self-awareness.

To interview such a challenging subject, the NYTimes‘ Maureen Dowd is perhaps uniquely suited, given her long career of sucking up to those celebrities her bosses admire in combination with her natural instinct to take the mickey. As a brief interval of laughter — “Peter Thiel, Trump’s Tech Pal, Explains Himself“:

Let others tremble at the thought that Donald J. Trump may go too far. Peter Thiel worries that Mr. Trump may not go far enough.

“Everyone says Trump is going to change everything way too much,” says the famed venture capitalist, contrarian and member of the Trump transition team. “Well, maybe Trump is going to change everything way too little. That seems like the much more plausible risk to me.”

Mr. Thiel is comfortable being a walking oxymoron: He is driven to save the world from the apocalypse. Yet he helped boost the man regarded by many as a danger to the planet.

“The election had an apocalyptic feel to it,” says Mr. Thiel, wearing a gray Zegna suit and sipping white wine in a red leather booth at the Monkey Bar in Manhattan. “There was a way in which Trump was funny, so you could be apocalyptic and funny at the same time. It’s a strange combination, but it’s somehow very powerful psychologically.”…

He recalls that he went through a lot of “meta” debates about Mr. Trump in Silicon Valley. “One of my good friends said, ‘Peter, do you realize how crazy this is, how everybody thinks this is crazy?’ I was like: ‘Well, why am I wrong? What’s substantively wrong with this?’ And it all got referred back to ‘Everybody thinks Trump’s really crazy.’ So it’s like there’s a shortcut, which is: ‘I don’t need to explain it. It’s good enough that everybody thinks something. If everybody thinks this is crazy, I don’t even have to explain to you why it’s crazy. You should just change your mind.’”…

(This is the high-IQ, expensively-educated version of “How do you know it’s dangerous to drink bleach? Just because a bunch of quote-unquote scientists told you so?”)

I ask if he’s comfortable with the idea that Vice President-elect Mike Pence, regarded in the gay community as an unreconstructed homophobe, is a heartbeat away from the presidency.

“You know, maybe I should be worried but I’m not that worried about it,” he replies. “I don’t know. People know too many gay people. There are just all these ways I think stuff has just shifted. For speaking at the Republican convention, I got attacked way more by liberal gay people than by conservative Christian people.”…
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Geographic disparities and HR2300

HR2300 is the incoming Secretary of Health and Human Services, Rep. Price (R-GA), PPACA replacement bill. It does lots of things. One of those things is it replaces income based subsidies with age based subsidies.

Sec. 101. Refundable Tax Credit for Health Insurance Coverage
 Provides for refundable, age adjusted tax credits with amounts tied to average insurance on individual
market adjusted for inflation.1
o $1,200 for those between 18 to 35 years of age
o $2,100 for those between 35 and 50 years of age
o $3,000 for those who are 50 years and older
o $900 per child up to age 18

Besides being grossly inadequate in size, there is another problem with these subsidies. These subsidies will have massive geographic disparities. Individuals who live in low cost medical markets with large and healthy risk pools will see their subsidy cover a far higher percentage of their premium costs for a given actuarial value. Individuals who live in high cost medical markets will pay a lot more out of pocket for their premiums. Below is a map of every county on Healthcare.gov excluding Alaska. The pricing is the least expensive Silver plan with no subsidies for a forty year non-smoker. The range is significant. The least expensive Silver in the data set is thirteen counties in Texas at $199.28 per month. The most expensive non-Alaska coverage is three counties in Arizona at $754.74.

least-expensive-silver-2017

The subsidy in the price plan will let the Texas 40 year olds buy 70% AV coverage for less than $20 a month out of pocket. Given quite a few other moving parts in HR0-2300 I can’t get a firm estimate but this is a good ballpark estimate. However the subsidy for the three Arizona counties for a forty year old would be sufficient to buy 25% AV coverage and the individual is paying $500 out of pocket every month.

We’ve talked about county level inequities within PPACA through Silver Gapping and Silver Hacking

More importantly, people in Perry County who are getting subsidized will see the ACA working really well. They have good, cheap health insurance. However their cousins across the state are getting a raw deal compared to the great deal that they get in Perry County. This is especially true as we move up the income scale which means moving up the likely voter scale and influence scale.

The people in the cheap Texas counties will see the Price plan as a great deal, especially higher up the income scale as the current subsidies fade out and then fall off a cliff. The people who make under 400% FPL in Arizona will be getting a raw deal.



Open Thread: Cheap Laffs from the Peanut Gallery



Oscar lays off their underpants gnomes

 

February:

Oscar is able to get young and healthy people on an expensive network and high risk adjustment payments.  I can’t figure out their business model past the buzzwords.

March:

Oscar is incurring losses of roughly $145 Per Member Per Month (PMPM) in its biggest market.  It is charging roughly $190 PMPM in net premiums.  Some of the loss is due to risk adjustment (~$20 PMPM) as Oscar’s entire business strategy is to cater to tech savvy individuals who tend to be young and healthy…

I think there are two take-aways.  First, I still can’t figure out Oscar’s business model.

Secondly, setting up an insurance company or expanding an incumbent carrier into new lines of business and new areas is tough.

 May:

Oscar’s strategy has been to use their web/mobile technology platforms to be the hip/cool/disruptive insurer for the next generation.

The market segment that both of these plans seem to be aiming for are people who are fairly young, active, technologically savvy and very healthy….

Assuming a hypothetical individual could be covered by both insurers for the same treatment, Centene is paying significantly less per service than Harken because Centene’s basing its provider contracts on Medicaid rates instead of commercial or Medicare rates.

Centene and other Medicaid like Exchange providers are targeting roughly the same type of population but since they are much cheaper post subsidy, they are probably getting a far larger population to amortize their fixed costs over plus any service that they do need to pay for, they are paying for at a lower rate.

From here, I am having a hard time seeing how plans that have a “lifestyle” component can compete against Medicaid like Exchange providers.  Maybe it is different off-Exchange where everyone is paying full premium and “cheapness” is not a strong selling point.

June

I’ve been skeptical about Oscar as I can’t figure out their business model besides build a cool app and then profit???

Ohhh… no one has ever thought about medical management and early chronic care intervention.  My cube wall mate spends 90% of her time working on our algorithms to identify members who are likely to be expensive before they become expensive so that we can intervene. …

Oscar is trying to go narrow network or quasi-TPA support for health systems that want to run a home host insurance product that should allow them to control costs. But those strategies are common.  That is what I spent most of 2013 working on building hyper narrow networks for both Exchange and Commercial ESI.  That is what my 11:30 meeting tomorrow is about.

And August from Bloomberg:

Oscar, which pitches itself as a tech-savvy alternative to traditional health insurers, plans to end sales of Affordable Care Act plans in Dallas, a market it entered this year, and New Jersey. It’s part of a more conservative approach by the New York-based company as it plans to introduce insurance products for businesses next year….

The company said it’s quitting New Jersey mainly because its network of doctors, hospitals and other health providers isn’t a “narrow network” — a relatively closed, but lower cost, group of providers that many in the industry see as a way to keep expenses down….

In the interview, Schlosser said the company’s new plans focus more on Oscar’s strengths, particularly narrow networks. Along with lower costs, using more narrow networks gives the company a larger role in coordinating the care of its customers…

By the end of next year, Oscar wants to begin offering health plans for larger employers, Schlosser said.

I have not been able to figure out Oscar’s business model.  It was always a flashy app/front end with loads of good marketing and Venture Capital buzzword bingo, handwaving about disrupting the marketplace and then PROFIT!!!

The little bit about Oscar trying to go to the large group market segment is interesting as in some ways that is the easiest segment to operate.  Bills get paid on time, there is no risk adjustment payment flows to worry about and the population is comparatively health with comparatively low variance.  It is also a segment that is most inclined to want big networks and is the least price sensitive.  It is a hard market to get into but a fairly easy market to set up the plumbing for.

But as the reality that being an insurer is HARD sinks in, let us all have a moment of silence for all of the now laid off underpants gnomes who have nothing to do between deploying cool frontward facing tech and PROFIT.  They have a rough life so let us appreciate those gnomes.



Weirdness Open Thread: Peter ‘Bathory’ Thiel Vants to Transfuse Your Plasma

And here we all assumed Ayn Rand fanatic Thiel was just encouraging strapping young men to drop out of college and visit his palatial seasteading for the usual reasons. According to Inc:

More than anything, Peter Thiel, the billionaire technology investor and Donald Trump supporter, wants to find a way to escape death. He’s channeled millions of dollars into startups working on anti-aging medicine, spends considerable time and money researching therapies for his personal use, and believes society ought to open its mind to life-extension methods that sound weird or unsavory.

Speaking of weird and unsavory, if there’s one thing that really excites Thiel, it’s the prospect of having younger people’s blood transfused into his own veins.

That practice is known as parabiosis, and, according to Thiel, it’s a potential biological Fountain of Youth–the closest thing science has discovered to an anti-aging panacea. Research into parabiosis began in the 1950s with crude experiments that involved cutting rats open and stitching their circulatory systems together. After decades languishing on the fringes, it’s recently started getting attention from mainstream researchers, with multiple clinical trials underway in humans in the U.S. and even more advanced studies in China and Korea

In Monterey, California, about 120 miles from San Francisco, a company called Ambrosia recently commenced one of the trials. Titled “Young Donor Plasma Transfusion and Age-Related Biomarkers,” it has a simple protocol: Healthy participants aged 35 and older get a transfusion of blood plasma from donors under 25, and researchers monitor their blood over the next two years for molecular indicators of health and aging. The study is patient-funded; participants, who range in age from late 30s through 80s, must pay $8,000 to take part, and live in or travel to Monterey for treatments and follow-up assessments…

Because the RNC convention was such a multi-ring circus, I never found time to link to the NYTimes essay on Thiel’s speech endorsing Trump there. “Peter Thiel’s Heroic Political Fantasies,” frankly, presented Thiel as someone who thinks of himself along the lines of the genetic vampires in Peter Watts’ novel Blindsight — a member of a predator species only distantly related to Homo Sap.

But that’s an unduly heroic fantasy. Thiel’s just another Dives trying to avoid the final judgement — during the first Gilded Age, he’d have been visiting Switzerland to have monkey glands (or the testicles of executed criminals) sewn into his scrotum.