President Obama’s Final Press Conference: Live FeedPost + Comments (170)
Open Thread: Kiss Me As If It Were The Last Time
Looks like we could use an open thread…
Open Thread: Kiss Me As If It Were The Last TimePost + Comments (355)
1332 juiced up
Margot Sanger-Katz from the NY Times flags an interesting pre King vs. Burwell Republican plan that is actually interesting in a non-sarcastic manner.
The Cassidy Obamacare “replace” plan is interesting: Keeps most of Obamacare, but devolves indiv. market to states. https://t.co/C55kRF0akW
— Margot Sanger-Katz (@sangerkatz) January 17, 2017
Let’s look at it with the 53 page PDF here:
Section 101 is the three options a state has if the Supreme Court ruled in favor of the fabulist argument advanced in King. Option 1 would be to stay under PPACA and establish a state based exchange. Option 2 would be a complete withdrawal from PPACA with no subsidies. Option 3 would be to establish a HSA like equivilent of coverage with most of the regulator requirements, taxes and mandates of PPACA thrown out. This is actually interesting if the funding makes sense. The default assumption is a complete opt-out. States would have to to opt into either Option 1 or Option 3.
Section 102 talks about the state alternative with HSA. It wipes out mandates and federal regulation. Essential health benefits, minimal actuarial value coverage and other regulatory requirements of PPACA that define a qualified health plan also are junked in this section. 102-4-A authorizes an initial HSA grant and the rest of 102-4 describes the mechanics of that grant. 102-C establishes a public health block grant that is 2% of the eligible funds for the HSA.
Section 103 determines the size of the HSA subsidy. This is where the money matters. The HSA amount is age and geography adjusted which is very similar in function as the ACA benchmark Silver is determined by zip code and age of the recipient. Bingo — 103-1-B is good news.
Fee Schedule
The Society of Actuaries commissioned Milliman to do a great review of the different payment methodologies and their risk profiles for a wide variety of stakeholders in 2015. It is a great read (for the right definition of a great read). One of the things that I want to pull out is the chart below. It is a fairly standard commercial, employer sponsored insurance contract. The number is the multiplier applied to the Medicare fee for service fee schedule.
Let’s follow the money to see what we actually value.
There are a couple of very useful things to pull out of this table. First, the topline number is that the same services for a commercial plan will cost 170% or more than what Medicare pays. This is why one of the major goals of liberal health policy is to drive more services to pay providers rates closer to Medicare than Commercial.
The second most interesting thing to me is the payment for evaluation and management services. E&M codes are the primary care physician codes. These are codes that involve a good deal of time and talking and far less cutting and doing. We pay people lots of money to either cut something or do something. We don’t pay for talking as much. So we get a lot of cutting and doing and not as much talking.
Wednesday Morning Open Thread: Smart Takes
We all assume Honolulu will be renamed Barack H. Obama International at some point, right?
— Dave Weigel (@daveweigel) January 17, 2017
@daveweigel My guess is Trump and congressional Republicans will pledge their lives to keep that from happening.
— Rob Archer (@RobArcher) January 17, 2017
Obama’s leaving office with Reagan-esque fav ratings; I think it happens by 2024. https://t.co/axhwQQ1Vek
— Dave Weigel (@daveweigel) January 17, 2017
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Apart from planning for the Women’s March / Sister Marches, what’s on the agenda for the day?
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I applaud Josh Marshall, on “The Case for Not Being Crybabies“:
… Presidents don’t validate what is and isn’t news. If you’re expecting them to, you’re doing it wrong. Almost nothing that is truly important about the work of a free press is damaged by moving the press office across the street.
Don’t get me wrong. I’m not saying that these things are not important or that all these threats aren’t a very bad sign. It is vastly preferable to have a President who believes in or at least respects American and democratic values. But let’s get real: we don’t or won’t as of Friday. Trump is a would-be authoritarian and a bully. He’s surrounded by mediocrities who owe all to him and feel validated by enabling his endless transgressions. Of course, he’s doing these things. We know Trump’s MO. He will bully people until they’re cowed and humiliated and obedient. He’ll threaten to kick the reporters out of the White House and then either cut a ‘deal’ or make some big to-do about ‘allowing’ the reporters to stay. These are all threats and mind games meant not so much to cow the press as make them think Trump is continually taking things away from them and that they need to make him stop.
They don’t need to. That access isn’t necessary to do their jobs. And bargaining over baubles of access which are of little consequence is not compatible with doing their job. Access can provide insight and understanding. But it’s almost never where the good stuff comes from. Journalists unearth factual information and report it. If Trump wants to turn America into strong man state, journalists should cover that story rather than begging Trump not to be who he is. America isn’t Russia. And I don’t think he can change us into Russia. So unless and until we see publications shut down and journalists arrested or disappeared, let’s have a little more confidence in our values and our history and our country…
Trump wants to bully the press and profit off the presidency. He’s told us this clearly in his own words. We need to accept the reality of both. The press should cover him on that basis, as a coward and a crook. The big corporate media organizations may not be able to use those words, I understand, but they should employ that prism. The truth is that his threats against the press to date are ones it is best to laugh at. If Trump should take some un- or extra-constitutional actions, we will deal with that when it happens. I doubt he will or can. But I won’t obsess about it in advance. Journalists should be unbowed and aggressive and with a sense of humor until something happens to prevent them from doing so. Trump is a punk and a bully. People who don’t surrender up their dignity to him unhinge him…
Wednesday Morning Open Thread: Smart TakesPost + Comments (160)
Late Night Endless Smoke & Mirrors Open Thread: Anonymous Discusses Wikileaks
Timely! New NBC/WSJ on views of Wikileaks
All: 18% positive, 34% negative
Trump voters: 27% pos, 23% neg
Clinton voters: 10% pos, 51% neg— Carrie Dann (@CarrieNBCNews) January 17, 2017
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Speaking of subverting the deep state — Commentor Magurakurin flagged this series of tweets a few days ago. Excerpts:
.@Wikileaks was built/ created by many ppl; many of the ideas attributed w/ it are not in line w Assange's politics. (5) @Khanoisseur.
— Anonymous (@YourAnonCentral) January 12, 2017
This is because the software developer behind it (leak platform) left the project. We assume he is still writing software. (7) @Khanoisseur
— Anonymous (@YourAnonCentral) January 12, 2017
Her (@xychelsea) principles appear unchanged. (11) @wikileaks @Khanoisseur
— Anonymous (@YourAnonCentral) January 12, 2017
From earliest interviews, Assange is a racist, sexist, right wing libertarian who loved Rand Paul and the US constitution. (20) @Khanoisseur
— Anonymous (@YourAnonCentral) January 12, 2017
You are just left with the fascist (Assange), all the people whose work he rode off of are still around but not there. (24) @Khanoisseur
— Anonymous (@YourAnonCentral) January 12, 2017
Journalist's tend to p-shop what @Wikileaks really is into a story of the 'great man & his struggle'. It sells but it's wrong. @Khanoisseur
— Anonymous (@YourAnonCentral) January 12, 2017
It’s never as simple as Four legs good, two legs bad. Or even Four legs good, two legs BETTER…
Late Night Endless Smoke & Mirrors Open Thread: Anonymous Discusses WikileaksPost + Comments (24)
I Don’t Have to Outrun the Bull Alligator, I Just Have to Outrun You
This wee fellow was caught on video near Lakeland, FL yesterday.
This truly massive alligator was spotted casually walking across a path in Central Florida. The locals call it "Hunchback." pic.twitter.com/yRkXtuDU0K
— CNN (@CNN) January 16, 2017
That’s a big boy!
I Don’t Have to Outrun the Bull Alligator, I Just Have to Outrun YouPost + Comments (143)