Blog on the Run: Reloaded

Wednesday, February 11, 2015 7:39 pm

Odds and ends for Feb. 11

Memo to the airlines: You whiny bitches can just pay your taxes like everybody else does.

Oh, good. Another war. Because we were running out of them, or something. People, ISIS is NOT an existential threat to this country. If you think otherwise, imagine ISIS trying to capture Detroit or Dallas, mmkay? Relatedly, if Chris Matthews wants a war so damned badly, let him go fight it himself.

Meanwhile, a committee of the Arizona Senate wishes to reprosecute the Civil War. Didn’t work out too great for their side last time, but what the hell, you know?

Our “allies” in Saudi Arabia, where women aren’t allowed to drive, apparently believe women drive in the U.S. and elsewhere because they don’t care whether they get raped. Evil AND stupid is no way to go through life, son.

FBI director James Comey is urging Americans to panic about possible ISIS militants under their beds. It’s a real shame the Snowden revelations and that lib’rul Obama cut back so badly on our nation’s intelligence-gathering capabilities; otherwise, we wouldn’t need to wet our pants like this. Oh. Wait.

#AdviceToYoungJournalists is trending on Twitter. Here’s mine: Run. Save yourself. While you still can.

Our new idiot senator, Thom Tillis, has hired a new idiot legislative director who thinks birth control causes cancer.

Cops in N.C. are spying on citizens. One would think the GOP-controlled legislature might want to do something about Big Gummint, but one would think that only if one believed Republicans are serious about stemming the overreach of Big Gummint.

NBC’s Brian Williams gets suspended for six months for misremembering what happened in Iraq. Good. But Alberto Gonzalez took the Fifth 67 times before Congress, and we’re still paying his ass. Just saying.

Our “divisive,” “obstructionist” president has, when his length of service is taken into account, vetoed fewer bills than any president since James Monroe.

Even in Colombia, there’s no uprising so nasty that the addition of Miss Universe might not ameliorate it.

I’m starting to think technology and Republicans just don’t mix. This week, the N.C. legislature’s main website went down after — no kidding — someone forgot to renew the domain.

What happens if the anti-ACA case King v. Burwell, now before the Supremes, results in the ACA (or at least the part about exchanges) being overturned? Insurance exec Richard Mayhew says it won’t be pretty, with most subsidized exchange policies being yanked this summer. But wait! There’s more!

After [those policies are yanked], the remaining individual insurance market now looks like the pre-PPACA New York State insurance market, where there is guarantee issue and no medical underwriting but no subsidies and no mandates to get healthy people into the risk pool.  We get a death spiral where average premiums for a 30 year old would almost double in two years, and most reasonably healthy people who otherwise would have qualified for subsidies now sit out of the market because they can’t afford the coverage.

 

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Tuesday, February 10, 2015 7:28 pm

Odds and ends for Feb. 10

Terrorists are winning the war on terror, primarily because, more than a decade after 9/11 and despite all the costly lessons we’ve learned since then, the U.S. persists in playing the terrorists’ game instead of its own.

Dean Smith‘s public memorial will be 2 p.m. Sunday, Feb. 22, in the Smith Center. Which leads me to wonder: Where will they hold Billy Graham‘s, once he passes on? Bank of America Stadium? Charlotte Motor Speedway? The National Mall?

There’s just one teeny-weeny little problem with the four plaintiffs in King v. Burwell, the case now before the Supreme Court that could, perhaps, lead to the Affordable Care Act’s being struck down: None of the four appears to have standing to be suing in the first place.

Could the hammer at long last be coming down on rogue Swiss(-ish) bank HSBC? I’ll believe it when/if it happens, but the Honorable Senator Professor Warren is on this like white on rice. (And just how rogue? Check this out.)

Jim Crow lynchings: significantly more common than previously reported.

I’m not the brightest bulb in the fixture, but I could tell in 11th grade U.S. history that “right-to-work” was Orwellian doublespeak. Unfortunately, that ain’t all it is.

Debtors’ jail, ostensibly illegal in the U.S., apparently is alive and well in Ferguson, Missouri. A lawsuit seeks to change that.

“Trials” at Guantanamo: No, Casey, nobody here can play this game.

If you’ve never worked in newspapers, you probably thought newspaper executive editors couldn’t get any stupider, and that if they did, it wasn’t your fault as a reader. You were wrong, as Robert Price of the Bakersfield Californian is pleased to demonstrate:

Several weeks ago, [director of audience development] Louis [Amestoy] and I introduced a set of new expectations for reporters and editors. Chief among them was that reporters and editors shall write publishable content every single day. Not blow-out, eight-source 30-inchers (although they have their place), but quick-hit 4-inchers based on as few as a one source or even personal observation — “what I saw driving in to work” stories. So far I have seen almost none of these.

These are required and will be measured on your annual reviews (which are coming up). Please think about how you might start creating these. If you’re like me, you may think some stories (weather related, seen on a business marquee, etc) just don’t clear the bar of importance. Not true, in most cases. Readers gobble this stuff up. [emphasis added; along with the unmistakable sound of Our Lord and Savior weeping bitterly]

#StealAlltheGrammys According to Google, Annie Lennox, Kristen Wiig, Prince (“almost”), Kanye West, Sam Smith, Frank Ocean, and Pharrell Williams’s funky park ranger hat, among others, “stole the Grammys.” Thought you’d want to know.

 

 

Saturday, February 7, 2015 11:11 pm

Odds and ends for Feb. 7

“Pro-life” Sen. Richard Burr doesn’t really give a rat’s ass if you or your unborn baby dies.

A British court has found seven years’ worth of surveillance by the UK’s counterpart to the NSA to be illegal. Question: Will anyone be punished? Answer: BWAHAHAHAHAHAHA …

So Brian Williams is giving himself a paid vacation while he waits for the stink about his lying about his Iraq experience to blow over. Yes, he should be fired. No, he shouldn’t be the only person to suffer consequences for lying about Iraq.

Rummage in your bedside cabinet; the current condom shortage in Venezuela has boxes going for the equivalent of $755US.

‘Night, y’all.

Friday, February 6, 2015 8:03 pm

Odds and ends for Feb. 6

Climate change: It’s a matter of national security.

Obama might be a socialist, but the country just completed its best three-month period of job growth in 17 years, bitchez. Still a long way to go — unemployment actually went up in January as more people resumed looking for work — but it’s definitely looking better.

Boko Haram is opening a branch office in neighboring Niger. Bloodshed and misery follow. World does little.

The annual silliness known as the National Prayer Breakfast was this week. And this year we got more proof, were more needed, about just how impossible it is for Americans conservatives to have an honest conversation about race.

NBC’s Brian Williams lied about being in a helicopter that got shot down in Iraq (which is a firing offense where I’m concerned), but did he also lie about seeing a body floating outside his New Orleans hotel after Hurricane Katrina? Quite possibly not.

Relatedly, why is it such a bad thing for Brian Williams to lie when Fox News personnel do it day-in and day-out, constantly? That’s neither a rhetorical question nor an exaggeration of the network’s mendacity.

Hey, anti-vaxxers? When Autism Speaks says you should vaccinate your kids, you’ve pretty much lost the vaccination argument.

I love it when they throw each other under the bus. This time, it’s Bibi and Boehner, who both deserve all the tire tracks.

One would think that maternal health would be a human right. Sadly, the U.S. has not gotten the word.

Yes, health insurance premiums have gone up an average of $4,154 under Obama — but that’s less than half as fast as they went up under Bush.

Is police reform impossible? Could be.

Gov. Scott Walker of Wisconsin tried to rewrite the Wisconsin Idea (the state university system should benefit the entire state), then got busted for it, then lied about it, then got busted for lying about it. Great start to your presidential campaign, there, goob.

If there’s no war on women, it ain’t for lack of trying.

Intuit’s TurboTax, though not hacked itself, may be being used by scammers to file fraudulently for tax refunds.

The Trans-Pacific Partnership might be the most dangerous, and depressing, trade agreement you’ve never heard of.

The oldest living survivor of the U.S.S. Arizona has died at age 100.

The movie “Fifty Shades of Grey” opened today. Theater operators requested that patrons not dress up, or down, for the showings.

This is how the apocalypse will begin.

Or this, as a single penguin holds the entire crew of a Coast Guard vessel hostage. I, for one, welcome our new spheniscidaean overlords.

Y’all have a good weekend.

Thursday, August 7, 2014 8:31 pm

“With the ACA we have placed a lot of bets.”

Berkeley economist Brad DeLong offers 10 big-picture thoughts on the Affordable Care Act’s history, politics, and performance to date. It’s smart, it’s easy to understand, and, to my eye, it’s 100 percent right — even the parts where he criticizes President Obama.

Sunday, October 27, 2013 9:50 pm

Oh, I’M sorry, you were worried about the DEFICIT and not whether Americans had health care?

Read this and weep, you freakin’ sociopaths:

The Affordable Care Act is already working: Intense price competition among health plans in the marketplaces for individuals has lowered premiums below projected levels. As a result of these lower premiums, the federal government will save about $190 billion over the next 10 years, according to our estimates. These savings will boost the health law’s amount of deficit reduction by 174 percent and represent about 40 percent of the health care savings proposed by the National Commission on Fiscal Responsibility and Reform—commonly known as the Simpson-Bowles commission—in 2010.

Moreover, we estimate that lower premiums will lower the number of uninsured even further, by an additional 700,000 people, even as the number of individuals who receive tax credits will decline because insurance is more affordable.

In short, the Affordable Care Act is working even better than expected, producing more coverage for much less money.

And just because you’re evil and you suck, you should also read the whole damn report, while I make an adult beverage out of vodka and your bitter, bitter tears.

Thursday, August 29, 2013 7:24 pm

Also from Texas, news analysis …

Filed under: Fun,Journalism — Lex @ 7:24 pm
Tags: , ,

… courtesy of Juanita Jean, who, if she keeps up, is going to start getting mentioned in the same breath with Molly Ivins:

With Jon Stewart gone for the summer, Fox News has stepped up to fill the humor void.

This week, they had on an “expert” doctor who explained that gender bias in health care costs is not only legitimate, it is fair.  He said that women should have high health care costs because we have ta-tas, ovaries, and all manner of mysterious stuff going on inside us.

Men don’t have that messy stuff.  Men “only have the prostate,” he said.  Well, that does kinda explain why they are so freekin’ stupid.  You know, lacking a brain and all.  They are just one giant prostate walking around wearing socks with sandals.

I don’t know about you, but I find this notion even funnier than the giant, inflamed gall bladder walking around that I dreamed about last week while under the influence of Percocet and Trazadone after having my own gall bladder removed. And now that I’m healing up, that’s pretty damn funny.

Friday, July 12, 2013 7:51 pm

“Best [health care] in the world, my ass.”

Aaron Carroll at the Incidental Economist brings the pain:

There’s a ridiculously fantastic manuscript over at JAMA that you should go read right now. “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors“: …

I’m a health services researcher, and I’m obsessed with outcomes. One of the first major projects of this blog was a two-week series on quality in the US health care system. I’ve written numerous times about what kills us. This study specifically looked at the burden of disease, injuries, and risk factors in the US versus other countries. The methods are amazingly detailed.

So how did we do compared to other countries? Not well. Between 1990 and 2010, among the 34 countries in the OECD, the US dropped from 18th to 27th in age-standardized death rate. The US dropped from 23rd to 28th for age-standardized years of life lost. It dropped from 20th to 27th in life expectancy at birth. It dropped from 14th to 26th for healthy life expectancy. The only bit of good news was that the US only dropped from 5th to 6th in years lived with disability.

There’s a chart I’d like to highlight. This is the rank of age-standardized years of life lost rates among the 34 OECD countries in 2010.  The numbers in each cell show the rank of the country in years of life lost for each cause (1 is best). The countries are sorted overall on age-standardized all-cause years of life lost.  The colors show if the age-standardized years of life lost for a country is significantly lower than the mean (green), indistinguishable from the mean (yellow), or higher than the mean (red) for all OECD countries. …

Things don’t look so good for the US. There’s an awful lot of red there. A little bit of yellow. One green. Best in the world, my ass. …

What we have here is a prioritization issue. We spend a lot of time worrying about colon cancer. It’s ranked 11th in 2010. We spend a lot of time worrying about breast cancer. We have walks, and ribbons, and whole months dedicated to it. It’s ranked 13th. Prostate cancer? Men are obsessed with it. It’s ranked 27th. But more years of life are lost to lung cancer than to prostate cancer, colon cancer, and breast cancer combined. Ischemic heart disease causes four times as many years of life to be lost each year as prostate cancer, colon cancer, and breast cancer combined. Stroke is 3rd. COPD is 4th. Traffic accidents are 5th. Suicide is 6th. None of these things get the national attention, or resources, that they deserve. [emphasis added]

In short, we have a lousy health-care system, and the reason we have a lousy health-care system is because we choose to have a lousy health-care system. This isn’t about Obamacare, or health insurance in general, or even how much money we have available to spend on health care. It’s about where we put our research and treatment dollars, and the study shows we’re not putting them anywhere near where they would do the most good. That’s a problem we can fix, but we have to choose to fix it.

 

Wednesday, April 4, 2012 8:22 pm

Just Die Already, Washington Post, Ruth Marcus ahistoricity edition

In the place, time and culture in which I was reared, it was considered rude to draw attention to the fact that members of the fairer sex might have had the unmitigated gall to have survived on the planet in excess of four decades. Indeed, acknowledging the passage of three decades since a gentlewoman’s birth was permitted only on the occasion of her 30th birthday, whereupon she was then presumed to be 29 for the remainder of her days.

I’m so over that now.

I am 52 years old. Ruth Marcus of the Washington Post is, I believe it is fair to say, older than I am, which point I mention to highlight the fact that in both her recent criticism of President Obama for criticizing the Supreme Court and, in the same piece, her defense of that court — in whose recent oral arguments on the Affordable Care Act one could effortlessly find some of the most mendacious arguments in recent American jurisprudence — this one-time finalist for the Pulitzer Prize demonstrates that she is a contextual liar, a lousy reporter, an incipient dementia patient or just batshit insane and, in any of those cases, unfit to hold her current job, because even during her adult lifetime, other presidents have said much worse things about the courts.

First, here is what President Obama said during a news conference:

Ultimately, I’m confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.  And I’d just remind conservative commentators that for years what we’ve heard is, the biggest problem on the bench was judicial activism or a lack of judicial restraint — that an unelected group of people would somehow overturn a duly constituted and passed law.  Well, this is a good example.

Marcus called the president’s remarks “rather unsettling” and added:

… Obama’s assault on “an unelected group of people” stopped me cold. Because, as the former constitutional law professor certainly understands, it is the essence of our governmental system to vest in the court the ultimate power to decide the meaning of the constitution. Even if, as the president said, it means overturning “a duly constituted and passed law.”

Of course, acts of Congress are entitled to judicial deference and a presumption of constitutionality.  The decision to declare a statute unconstitutional, Justice Oliver Wendell Holmes wrote in 1927, is “the gravest and most delicate duty that this court is called on to perform.”

But the president went too far in asserting that it “would be an unprecedented, extraordinary step” for the court to overturn “a law that was passed by a strong majority of a democratically elected Congress.”  That’s what courts have done since Marbury v. Madison.  The size of the congressional majority is of no constitutional significance. We give the ultimate authority to decide constitutional questions to “a group of unelected people” precisely to insulate them from public opinion.

I actually agree with her in principle, and if this discussion were only about principle, her column would be unremarkable. But it isn’t only about principle, as any halfway conscious follower of the Supreme Court must know, because Obama’s remarks were not delivered in a vacuum.

A former constitutional law professor himself, he appears aware, as Marcus does not, that the conservative wing of the current court has abandoned its longstanding pretense that its rulings were based not on rightist ideology so much as on wanting to avoid “judicial activism” — making law from the bench rather than soberly assessing the constitutionality of congressional legislation and overturning it only when it violated the Constitution.

Now, that group — John Roberts, Antonin Scalia, Clarence Thomas and Samuel Alito, with Anthony Kennedy and on-again, off-again member — is behaving as if the authority to decide major constitutional questions even at the expense of overturning legislation is not Holmes’s “grave and delicate duty” so much as it is Archimedes’s lever to move the world — back to a place and time in which the wealthy and corporations called the shots, a time both economically inefficient and thoroughly un-American.

And this trend is not new, not anything that could have sneaked up on Marcus; Jeffrey Rosen identified the trend five years ago in The New Yorker. After last week’s oral arguments on the health-care law, Jonathan Chait comments:

What made Rosen’s piece so shocking was that, for decades, judicial activism had been primarily associated with the left — liberal judges handed down broad readings of laws to expand rights, enraging conservatives who believed they were taking upon themselves decisions better left to democratic channels. Their complaints were not wholly unfounded — even if you support, say, abortion rights, as I do, the notion that the Constitution requires the right to an abortion is quite a stretch of judicial activism. The whole conservative legal and political movement had come to orient itself around opposition to judicial activism, which actually remains the term Republican politicians use to disparage liberal judges.

The only thing Rosen truly failed to anticipate in his piece was how quickly Republican judges would pivot from impassioned defenses of judicial restraint to judicial activism when the opportunity arose to deploy it in their party’s behalf. In the piece, he described Antonin Scalia as a fierce opponent of this movement. Scalia, wrote Rosen, “was not in favor of striking down laws in the name of ambiguous and contestable economic rights.” At one point Scalia attacked the movement to read economic rights into the Constitution as a “threat to constitutional democracy.”

The spectacle before the Supreme Court this week is Republican justices seizing the chance to overturn the decisions of democratically-elected bodies. At times the deliberations of the Republican justices are impossible to distinguish from the deliberations of Republican senators.

The blogger NYCSouthpaw explains exactly how Scalia, in particular, has flip-flopped dramatically in a relatively short time. In the 2005 case Gonzalez v. Raich, Scalia wrote in a concurring opinion that a 1937 case, National Labor Relations Board v. Jones & Lauglin Steel Corp., gave Congress the right not only to regulate interstate commerce but also to regulate things that, while not commerce themselves, could substantially affect interstate commerce. The court in that case found that Congress had the power to do so under the “necessary and proper clause” of the Constitution, which basically holds that Congress can do anything not otherwise banned by the Constitution if it is a “necessary and proper” way to carry out constitutionally permitted responsibilities.

Scalia made that argument in support of prosecuting a guy in California who was growing marijuana in his own back yard for his own personal use, so as you can see, he took a very broad view then of what Congress can do to regulate “interstate commerce.” Writes NYCSouthpaw:

So, two things to note that Scalia says [in his Raich concurrence]:

  1. Activities that substantially affect interstate commerce are not, themselves, commerce.
  2. A 1937 labor rights case, NLRB v. Jones & Laughlin Steel Corp., permits the regulation of activities that have a substantial effect on interstate commerce (i.e. not commerce).

Now look back up at Scalia’s exchange with [Solicitor General Donald] Verrilli [during health-care act oral arguments].  That 1937 case, Jones & Laughlin, is the very one that Verrilli is referring to.  Verrilli uses Jones & Laughlin to try to persuade Scalia that the Supreme Court often extends Commerce Clause authority to new areas that have a substantial effect on interstate commerce (in that case, unions, in this case, health care).

But Scalia shuts him down, saying that “there was no doubt” that “what was being regulated” in Jones & Laughlin “was commerce.”  That’s the flip flop.

For a good recent example of the court’s situational jurisprudence, one need look no further than Citizens United — not only for the substance of the ruling, which not only continued but expanded the conflation of speech with purchased audience begun by the court in 1976 in Buckley v. Valeo, but also for the unseemly and actually unprecedented way in which the court practically begged other parties to bring challenges to the law as it then stood. Normally, the Supreme Court lets cases  “ripen” — letting real litigation involving real people work its way through trial courts and appeal courts in the ordinary course of time. As Henry Aaron, senior economics fellow at the Brookings Institute, points out, the argument that the act’s requirement to buy health insurance constitutes a “tax” normally couldn’t even have been litigated, let alone gotten to the Supreme Court, until someone had first actually been made to pay for insurance. And that requirement doesn’t take effect until 2015. (Granted, the ACA cases appear to have been heard on a somewhat accelerated schedule once appeals courts ruled, but only because proponents, opponents and the justices alike all saw benefit, for various reasons, resolving the contradictions among the appeals rulings quickly. And it is hard to argue that the American people, many of whose lives will be dramatically affected by the outcome either way, were harmed by that acceleration.)

Marcus, with her Harvard Law degree and her years of covering the Supreme Court for The Washington Post and her near-Pulitzer-worthy status, either is unaware of this context of conservative justices’ recent behavior, or she is deliberately ignoring it.

She also appears historically unaware — almost a capital offense among students of Supreme Court jurisprudence — that Obama is far from the first president to gripe about unelected justices. That griping has continued without surcease at least since Marbury v. Madison 200 years ago, a case of which Marcus, at least, claims to be aware. But Marcus, like many denizens of what blogger Digby likes to call The Village — the Washington government/media establishment that vigorously defends any encroachment on the privileges of wealth and power, leaning Republican although it’s frequently less a matter of partisanship than of differences with those who are Not Our Kind, Dear — criticizes Obama’s recognition of reality without the slightest hint of acknowledgment that far worse has gone before. Consider this remark from then-presidential candidate Ronald Reagan in 1980:

The former California governor, campaigning in Birmingham, Ala., Thursday, blasted the court’s most recent abortion ruling as “an abuse of power as bad as the transgression of Watergate and bribery on Capitol Hill.”

Yeah, because engaging realitically with the practical ramifications of a law is just like felony bribery, burglary, tax evasion and obstruction of justice. (Also, isn’t it quaint how Republicans a generation ago acknowledged that Watergate really was a crime rather than a liberal media coup? But I digress.)

(UPDATE, 4/6: And how could I forget this not-so-golden not-so-oldie from Newt Gingrich, which Marcus appears to have let go by without comment, let alone criticism? Newt Gingrich pledged not only to “abolish whole courts to be rid of judges whose decisions he feels are out of step with the country” — which is constitutional, but only if Congress legislates it and the president signs off or allows the bill to become law without his signature; Congress also can, of course, impeach federal judges individually and remove them from office without affecting the existence of the judgeships themselves  — but also to “send federal law enforcement authorities to arrest judges who make controversial rulings in order to compel them to justify their decisions before congressional hearings,” which is unconstitutional on its face.)

That’s bad enough. But then consider Marcus’s expert’s summary of what the justices actually did during oral arguments:

I would lament a ruling striking down the individual mandate, but I would not denounce it as conservative justices run amok.  Listening to the arguments and reading the transcript, the justices struck me as a group wrestling with a legitimate, even difficult, constitutional question.  For the president to imply that the only explanation for a constitutional conclusion contrary to his own would be out-of-control conservative justices does the court a disservice.

Contrast that analysis with this one from Amy Davidson of The New Yorker. Granted, Ms. Davidson has never come within sniffing distance of a Pulitzer Prize that I know of, but unlike Marcus, she appears actually to have been present at the arguments and/or read the transcripts:

Here’s where a person could lose just a little bit of patience with the Supreme Court: in the midst of an exchange with Deputy Solicitor Edwin Kneedler, Justice Antonin Scalia saw an obstacle he didn’t like:

JUSTICE SCALIA: You really want us to go through these 2,700 pages?

(Laughter.)

JUSTICE SCALIA: And do you really expect the Court to do that? Or do you expect us to give this function to our law clerks?

(Laughter.)

JUSTICE SCALIA: Is this not totally unrealistic? That we’re going to go through this enormous bill item by item and decide each one?

The twenty-seven hundred pages make up the text of the Patients Protection and Affordable Care Act. Put aside, for the moment, the matter of the mandate and “severability” and “community ratings” and all the rest. If the Justices—or their clerks—need to read through a law to figure out whether it’s constitutional, it shouldn’t matter whether the law is twenty-seven pages or twenty-seven thousand (those numbers are divisible by nine, so they can split them up). Perhaps that’s a civilian’s view, and that’s not how things work in the Court these days. … But it’s a good bet that there are many, many Americans whose chronic illnesses or health crises have generated far more than twenty-seven hundred pieces of paper, from doctors and hospitals and labs and insurers and, in too many cases, ultimately from collection agencies. Even if you’re covered, the broken state of the health-care system has meant hard work, and hardship, for millions of people.

One might be inclined to give Scalia the benefit of the doubt on a bad joke here, if not for the fact that, as Davidson’s colleague Ryan Lizza noted, he actually didn’t know what was in the bill:

2. Justice Antonin Scalia: “All right. The consequence of your proposition, would Congress have enacted it without this provision, okay that’s the consequence. That would mean that if we struck down nothing in this legislation but the—what do you call it, the corn husker kickback, okay, we find that to violate the constitutional proscription of venality, okay? (Laughter.) When we strike that down, it’s clear that Congress would not have passed it without that. It was the means of getting the last necessary vote in the Senate. And you are telling us that the whole statute would fall because the corn husker kickback is bad. That can’t be right.” (N.B.: The so-called Cornhusker kickback was repealed by Congress only days after the Affordable Care Act was signed into law.)

Sadly, that wasn’t the only example.  I know no more about insurance than any other insurance agent’s son, but it was clear even to me that the conservative justices either didn’t know or were pretending now to know how insurance works. Put simply, and this has been the case since the English began colonizing North America, it is a mechanism for spreading risk. But don’t take my word for it; Aaron at Brookings, linked above, discusses it in pretty simple language:

Several of the justices, notably Scalia and Alito, responded to the externalities argument by saying that every economic transaction creates similar externalities. “If I don’t buy a Volt, I raise the price of Volts,” said Scalia. Alito said much the same thing. So did Paul Clement’s brief for the plaintiffs.

This response was and is bad economics. It is true that every commodity is produced along what economists call a “cost curve”—raising output may lower average or marginal unit costs by spreading overhead or achieving economies of scale, but it may also raise costs by forcing up the cost of inputs or incurring diseconomies of scale. None of this occasions concerns about fairness or free-loading or, to use the economist’s term, “externalities.” But the cost shifting that occurs when uninsured patients fail to pay their bills does; it causes one group—the insured—to have to pay part of the cost of services others use.

Perhaps the most glaring instance of the failure to appreciate what an externality really is came from Justice Alito who at one point challenged the solicitor general by positing that the cost of all of the care currently used by those who are uninsured is less than would be the cost of the insurance they would be forced to carry. That being the case, Alito asked, how can one say that the uninsured are shifting costs to the insured? This query is painfully detached from an understanding of what an externality really is, how insurance works, or what the impact of insurance would be on service use.

Kevin Outterson, a Boston University law professor who co-directs the No. 2 health-law education program in the country, is even blunter:

On Tuesday, several Republican Justices and the Solicitor General displayed remarkably limited understanding of the nature of health insurance risk pools. If a healthy person stays out of the pool, the average costs for those left in the pool are higher. That’s not true for underwritten insurance products (such as life or auto).

So at least several of the justices didn’t understand the very nature of the industry upon which they were being asked to rule.

That’s bad enough. What worse, and has been widely remarked upon, is that not only were the justices ignorant of the industry, they were ignoring decades of settled law with respect to what Congress can and cannot do under the Constitution’s grant of power to regulate interstate commerce, spouting discredited right-wing talking points during the oral arguments and in general behaving so ignorantly that even Charles Fried, the notably liberal (that’d be irony) solicitor general during President Reagan’s second term, felt obliged to call the court out on both its tea-party talking points and its lack of principle in this Q&A, which Marcus might even have read, inasmuch as it was published by The Washington Post:

Ezra Klein: Tuesday’s arguments seemed to focus on the question of a “limiting principle.” So is there a limiting principle here?

Charles Fried: First of all, the limiting principle point kind of begs the question. It assumes there’s got to be some kind of articulatable limiting principle and that’s in the Constitution somewhere. What Chief Justice John Marshall said in 1824 is that if something is within the power of Congress, Congress may exercise that power to its fullest extent. So the question is really whether this is in the power of Congress.

Now, is it within the power of Congress? Well, the power of Congress is to regulate interstate commerce. Is health care commerce among the states? Nobody except maybe Clarence Thomas doubts that. So health care is interstate commerce. Is this a regulation of it? Yes. End of story.

Here’s another thing Marshall said. To regulate is “to make the rule for.” Does this make a rule for commerce? Yes!

EK: The Court seemed to see it as considerably more complicated than that.

CF: There’s all this stuff that got in there about creating commerce in order to regulate it. … But quite apart from that, what is the commerce? The commerce is not the health insurance market. The commerce is the health-care market, as [current solicitor general Donald] Verrilli said a million times. And it’s very hard to deny that.

There is a market for health care. It’s a coordinated market. A heavily regulated market. Is Congress creating the market in order to regulate it? It’s not creating it! The market is there! Is it forcing people into it in order to regulate them? In every five-year period, 95 percent of the population is in the health-care market. Now, it’s not 100 percent, but I’d say that’s close enough for government work. And in any one year, it’s close to 85 percent. Congress isn’t forcing people into that market to regulate them. The whole thing is just a canard that’s been invented by the tea party and Randy Barnetts [i.e., extreme libertarians; link added — Lex] of the world, and I was astonished to hear it coming out of the mouths of the people on that bench.

And yet Marcus and her Post editors seem to think that this behavior, called out far and wide by conservative and liberal legal experts alike, constitutes “wrestling with a legitimate, even difficult, constitutional question.”

You know, it’s one thing for a fascist, racist, lying demagogue like Rush Limbaugh to call the president a thug (a word which, these days, tends to have unmistakably racist connotations) for daring to draw attention to this pattern of behavior on the part of the nation’s highest court. It’s quite another for someone who is supposed to be one of the most capable and credentialed observers of that court to write a column so contextually lacking as to constitute a major — indeed, fatal — distortion in order to make an invalid point.

But that’s what passes for journalism today at The Washington Post, which is why Marcus needs to find another line of work and the Post needs to go ahead and die.

UPDATE: And James Fallows catches the AP going all Politifact on us. Sheesh.

Thursday, March 29, 2012 12:25 am

Is it too late for John Cole to file an amicus brief with the Supremes?

 

Because he has a good point:

I just discovered what it [“the broccoli mandate”] is, and it distresses me to no end that our wingnuts are actively trying to make us dumber. Of course no one is going to be mandated to buy broccoli, you wankers. But you know what I am mandated to buy because of the actions of a bunch of midwestern conservative pols? Corn. There is a live, actual corn mandate. Every time I go to the gas station to buy gas, I am forced, against my will, to buy corn products.

So you know where you jackasses can stick that broccoli…

I also don’t see the Supremes objecting to the fact that I have to pay for wars I don’t support.

Oh, and while we’re on the subject, Antonin Scalia stumbled onto something very interesting with his point about legislative inertia. And, by interesting, I mean, “damning.”

Scalia, remember, is a guy with a long track record of claiming that congressional gridlock is a feature, not a bug. Now, however, in today’s “severability” argument — that is, what, if anything, else should the Supremes do if they find the Affordable Care Act’s requirement to buy health insurance unconstitutional: toss out that part only and leave the rest to Congress, or toss the whole thing and order Congress to start fresh?

A couple of points:

First, I was listening to this on the car radio, but it sounded to me as if Scalia was arguing that the court should toss the whole enchilada because Congress, which he believes should, can’t. If that’s in fact what he meant, it’s an interesting 180-degree switch from his view up until now that it ought to be hard to get Congress to do things.

Second, it’s interesting in that he appears to be arguing that the Congress isn’t just inertial, it’s dysfunctional. Given that the reasons for that are well-known and objectively attributable in the main to one and only one party, Scalia’s party, it’s kind of damning in terms of how it characterizes congressional Republicans.

Third, he appears to be making the case, then, that separation of powers means nothing if that separation leads to an outcome he doesn’t want (or, technically, fails to lead to an outcome he desires). This is the apotheosis of judicial activism, which, of course, we have been roundly assured that conservatives such as Scalia oppose. Relatedly, given the fact that the GOP has no alternative — not even an unworkable one; they literally have nothing — to the Affordable Care Act, I eagerly await Scalia’s leaping in to craft health-care law from the bench once the ACA is struck down, 30-million-plus currently insured Americans get kicked back off the rolls and all hell breaks loose. Ahem.

An awful lot of really smart legal scholars, even some who worked in the Bush 43 administration, predicted that the court would uphold the Affordable Care Act, individual mandate and all, and now many of them are horrified to find out that this case might not be decided on the facts and the law after all. In point of fact, the scales fell from my eyes more than a decade ago, with Bush v. Gore. I figured that any court that could issue that ruling might well find public sodomizing of kittens constitutional as long as a GOP solicitor general argued for it, and Scalia’s questions and tone in this week’s oral arguments on the health-care law seem to bear that out.

Well, OK, that’s not exactly what I said seven months ago, but it’s close:

So this puppy is headed to the Supreme Court, where a ruling against the mandate would be both the overturning of 70 years of case law and not all that surprising, given the predilection the Roberts Court has shown for legislating from the bench. … But were I forced at gunpoint to make [a] prediction, I’d call for no worse than a 5-4 majority to uphold. The bottom line is that Justice Kennedy hasn’t gone crazy. Yet.

Kennedy’s sanity isn’t as much of a lock now as it was in August.

 

Tuesday, March 27, 2012 8:09 pm

Where has Louie Gohmert been?

Say what you will about the constitutionality, or lack thereof, of the Affordable Care Act’s requirement that people buy health insurance, most people on both sides have been arguing strictly on the basis of whether or not they think Congress has the constitutional power to impose such a requirement under the authority granted by the Constitution for Congress to regulate interstate commerce (the so-called “commerce clause” you hear about). As I understand commerce-clause law — and, say it with me, kids, I Am Not a Lawyer — the Congress probably does, but that’s neither here nor there for the purposes of this post. What’s important is that up until now, the arguments I’ve heard all around the subject have tended to bear directly on that question.

Up until now. Because now, here’s Rep. Louie Gohmert, who is giving Oklahoma Sen. James Inhofe a run for the title of Dumbest Sitting Congresscritter, conjuring up a really, well, interesting slippery-slope argument:

It ought to scare liberals to come run and join conservatives, because what it means is when this president’s out of the White House and you get a conservative in there, if this president has the authority under ObamaCare … to trample on religious rights, then some redneck president’s got the right to say, “You know what, there’s some practices that go on in your house that cost people too much money and healthcare, so we’re going to have the right to rule over those as well. “

Yeah, he’s right. It would be awful if that happened. And it’s interesting that he explicitly concedes that it’s “redneck” right-wing government makes unconstitutional, un-American personal intrusion more likely and not Big Gummint Liberals.

Sunday, March 25, 2012 4:21 pm

Quote of the day, Affordable Care Act edition

Filed under: We're so screwed — Lex @ 4:21 pm
Tags: , ,

From commenter Barry Friedman at Charlie Pierce’s blog:

Twelve milliseconds before ACA was passed, there wasn’t a rube in this country who actually liked his or her insurance company; twelve seconds after the Supreme Court strikes down the law, the rubes will remember why.

Friday, September 23, 2011 8:31 pm

Susan Grigsby has a question for the 2012 presidential candidates

Filed under: Evil — Lex @ 8:31 pm
Tags: ,

And a news media that was worth a damn would keep after the candidates until every single one was on record as having answered — and I mean a real answer, not a nonanswer, not an evasion, not a change of subject. Because this is a very basic question about what kind of country we’re going to be, and if you’re going to run the place, I want to know how you feel about it.

Tuesday, September 13, 2011 8:54 pm

“TONIGHT’S LOSER: Hypothetical sick 30-year-old. TONIGHT’S WINNER: Death. Good night.”

I didn’t watch the GOP presidential debate last night because I had to study. But apparently I missed something interesting.

Do you remember when then-Rep. Alan Grayson said this?

Do you remember how much grief he caught for it?

Well, last night, CNN’s Wolf Blitzer asked Rep. Ron Paul, R-Texas, a very good question, one that, in this country, isn’t entirely hypothetical. Suppose some 30-year-old guy with no insurance lapses into a coma. Do we taxpayers let him die?

Several members of the crowd yelled, “Yeah!” and applauded.

Paul took the usual libertarian “And a pony!” tack of assuring us that in real life, no one like that would die, that volunteers and nonprofits would fill the role currently played by government. (Right.) Moreover, he claimed that government health care is the reason why U.S. health care is so expensive (although the facts quite clearly show otherwise).

But those buzzards in the crowd …

Afterward, Ryan Grim contacted Grayson to ask what he thought of what had happened. Grayson responded:

My speech was about the fact I had been listening to the Republicans for months, and they literally had no plan to help all those millions of people who can’t see a doctor when they’re sick. So I said, in sort of a wry manner, that their plan was “don’t get sick.” All I really wanted to do was just call attention to the stark absence of a Republican plan. But Fox, trying to take the heat off Joe Wilson and Sarah Palin I guess, transmogrified that into a charge that Republicans want to kill people.

What you saw tonight is something much more sinister than not having a healthcare plan. It’s sadism, pure and simple. It’s the same impulse that led people in the Coliseum to cheer when the lions ate the Christians. And that seems to be where we are heading – bread and circuses, without the bread. The world that Hobbes wrote about – “the war of all against all.”

Congratulations, folks. We’ve evolved from “We, the People of the United States, in order to form a more perfect Union …” to, “I’ve got mine; f— you.”

Wednesday, August 17, 2011 8:09 pm

That silence you hear is the sound of exploding health-care costs not exploding anymore

Filed under: More fact-based arguing, please — Lex @ 8:09 pm
Tags: ,

and the media not covering the fact.

While our elected representatives wrangle over slicing entitlements, virtually no one seems to be paying attention to an eye-popping fact: Medicare reimbursements are no longer accelerating at a breakneck pace. The new numbers should be factored into any discussion about healthcare spending:  From 2000 through 2009, Medicare’s outlays climbed by an average of 9.7 percent a year. By contrast, since the beginning of 2010, Medicare spending has been rising by less than 4 percent a year. On this,  both Standard Poor’s Index Committee and the Congressional Budget Office (CBO) agree. (S&P tracks healthcare spending with the help of Milliman Inc., an independent actuarial and consulting firm.)

What explains the 18-month slow-down?  No one is entirely certain. But at the end of July David Blitzer, the chairman of Standard &Poor’s Index Committee, told me: “I’m hesitant to say that this is a clear long-term trend.  But it’s more than a blip on the screen.” …

In the S&P report on healthcare spending released on July 21, [Blitzer] wrote: “many participants [in the healthcare system] have indicated that providers are trying to address health care reform and are looking for ways to control costs. If true, this combination certainly would be a contributory factor to the moderation in cost we have witnessed since early 2010.”

Zeke Emanuel, an oncologist and former special adviser for health policy to White House Office of Management and Budget director Peter Orszag, is certain that this is what is happening.  When I spoke to him last week, Emanuel, said:  “This is not mere chance: this is directly related to the initiation of health care reform.”  It is  not the result of reform, Emmanuel emphasized.  The reform measures that will rein in Medicare inflation have not yet been implemented.  But, he explained, providers are “anticipating the Affordable Care Act kicking in.”  They can’t wait until the end of 2013: “They have to act today.  Everywhere I go,” Emanuel, added, “medical schools and hospitals are asking me, ‘How can we cut our costs by 10 to 15 percent?’

“This is doable, since there is so much fat in the system” said Emanuel,  a doctor who is well aware of just how often unnecessary tests and procedures hike medical bills, while exposing patients to needless risks.  It is worth noting that Emanuel is far from cavalier about cutting Medicare benefits that could help patients.  A medical ethicist, he has recently been chosen to lead the medical ethics department at the University of Pennsylvania’s Perelman School of Medicine. But Emanuel understands that patients do not benefit from waste, and that today, our medical culture encourages health care providers to “do more,” without always considering whether medical evidence justifies another test or treatment.

A couple of points to ponder here:

  • The mechanisms of the Affordable Care Act that most directly limit growth in health-care costs haven’t even kicked in yet. So we don’t know how much the act has saved or is likely to save. But the early, not-directly-probative evidence is that those savings are likely to be substantial — at least enough that the act pays for itself (which means, among other things, insuring 30 million previously uninsured Americans).
  • If, in fact, this slowing in the growth rate continues, then all of a sudden, one of the most widely used arguments for draconian cuts in federal spending gets a leg knocked out from under it. Given Washington Republicans’ imperviousness to fact in a wide range of public-policy issues, I do not expect this outcome to change the tone or substance of what they say. But, if this info gets a wider hearing, it might well change the way in which voters respond to what they say.

  

 

Monday, August 15, 2011 7:31 pm

Affordable Care Act: SCOTUS, here we come

Five federal district courts have had the opportunity to address the constitutionality of the Affordable Care Act’s requirement that people buy health insurance. Three courts have ruled that it is constitutional, while two have ruled that it is not.

At the appeals level, a 6th Circuit panel has ruled in favor of constitutionality. Last week, a three-judge panel of the 11th Circuit ruled against it. What’s interesting, however, is that while the district judges have ruled along partisan lines, the appellate rulings have been more mixed, as Steven Benen observes: On the 6th Circuit, Bush 43 appointee Jeffrey Sutton voted to uphold the law, while on the 11th, a Clinton appointee, Frank Hull, voted with the majority against the mandate. (Reagan appointee Stanley Marcus dissents furiously, just to keep things interesting.)

So this puppy is headed to the Supreme Court, where a ruling against the mandate would be both the overturning of 70 years of case law and not all that surprising, given the predilection the Roberts Court has shown for legislating from the bench.

UPDATE: Fred points me to this dispatch by former Anthony Kennedy clerk Orin Kerr at SCOTUSblog, who boldly predicts the mandate eventually will be upheld, if the current Court personnel decide the case, by a vote of anywhere from 6-3 to 8-1, with only Clarence Thomas a lock against the constitutionality of the mandate. I think Kerr overestimates Roberts’s philosophical consistency, but were I forced at gunpoint to make the same prediction, I’d call for no worse than a 5-4 majority to uphold. The bottom line is that Justice Kennedy hasn’t gone crazy. Yet.

Thursday, July 7, 2011 8:46 pm

“It is the Industrial Revolution — in reverse”

Filed under: We're so screwed — Lex @ 8:46 pm
Tags:

Murca. Hail. yeah:

In December, the Los Angeles Times reported — very briefly — that from 2007 to 2008, life expectancy in the United States declined by 0.1 year. It should have been the lead story of every newspaper in the country with the largest possible headlines (“LESS LIFE“). Did 9/11 reduce life expectancy this much? Of course not. Did World War II? Not in a visible way — American life expectancy rose during World War II. I can’t think any event in the last 100 years that made such a difference to Americans. The decline is even more newsworthy when you realize: 1. It is the continuation of trends. The yearly increase in life expectancy has been dropping for about the last 40 years. 2. Americans spend far more on health care than any other country. Meaning vast resources have been available to translate new discoveries into practice. 3. Americans spend far more on health research than any other country and should be the first to benefit from new discoveries.

Maybe I’m biased (because my research is health-related) but I think this is the biggest event of our time. It is the Industrial Revolution in reverse — progress grinding to a halt. For no obvious reason, just as the Industrial Revolution had no obvious reason. Health researchers have been given billions of dollars to improve our health, the whole system has been given tens of billions of dollars, and the result is … nothing. Worse than nothing.

No journalist, with the exception of Gary Taubes, seems the least bit aware of this. It is a difficult story to cover, true. But several journalists, such as health writers for The New Yorker (Atul Gawande, Michael Specter, and Jerome Groopman) are perfectly capable of covering it. They haven’t. With a few exceptions, they write about progress (e.g., Peter Provonost’s checklists). It is like only reporting instances when Dirk Nowitzki missed a free throw. Each instance is true but the big picture they create — he misses all free throws — is profoundly false.

I’m not sure whether I agree with Seth Roberts’s explanation for why journalism is working (or failing to work) this way; I think, for one thing, that he’s overlooking significant flaws within the current practice of professional journalism in the U.S. aside from anything having to do with health care that also just happen to affect health-care coverage. But in any event, the larger point is what I want to emphasize here.

I also want to raise a question, one Roberts, at least in this post, does not: Is the same thing happening in the many other countries with more cost-effective health-care systems? I don’t have time right this minute to try to find out, but I’ll see what I can find out when I do get some time.

Monday, September 6, 2010 2:24 pm

We’re talking about “equality” here. No wonder a Republican senator is having trouble.

Filed under: Aiee! Teh stoopid! It burns! — Lex @ 2:24 pm
Tags: , , , ,

I have long believed that the Congressional Budget Office is staffed by robots — not because of the quality (or lack thereof) of their work, but because I think carbon-based life forms would be unable to respond to idiotic question after idiotic question from congresscritters and their staffers, day in and day out, year in and year out, without allowing at least a modicum of snark to seep into their reports and responses. And yet, as with the watchdogs of the Governmental Accountability Office, they manage to continue to produce reports and analyses from which every last bit of partisanship, emotion and edge has been thoroughly expunged.

If you think I exaggerate, consider the recent question posed by the felicitously named Sen. Mike Crapo, Republican of Idaho (flagged by Sarabeth at 1115.org): If passing certain provisions of the Affordable Care Act was estimated to reduce the deficit by $455 billion over 10 years; what effect would repealing these same provisions have on the deficit?

Picture, if you will, the CBO office in which this communication is first received. Normal, carbon-based life forms would be saying things to an imaginary Crapo like, “OK, Mike, it’s like this. See this cookie? This cookie is the part of the deficit affected by the act. If we enact the act [holds cookie behind back], the cookie goes away. But if we then repeal the act [brings hand forward again], the cookie comes back. Got it?”

But because normal, carbon-based life forms aren’t involved, instead we get this:

Finally, you asked what the net deficit impact would be if certain provisions of PPACA and the Reconciliation Act that were estimated to generate net savings were eliminated—specifically, those which were originally estimated to generate a net reduction in mandatory outlays of $455 billion over the 2010–2019 period. The estimate of $455 billion mentioned in your letter represents the net effects of many provisions. Some of those provisions generated savings for Medicare, Medicaid, or the Children’s Health Insurance Program, and some generated costs. If those provisions were repealed, CBO estimates that there would be an increase in deficits similar to its original estimate of $455 billion in net savings over that period.

In other words, a = a. It’s standard pre-algebra. It’s called the Reflexive Property of Equality. Learn it, love it, live it.

And then there’s this lagniappe, which I am not making up: Crapo is considered such a whiz on this subject that his party has made him the ranking minority member on the Senate Finance subcommittee on healthcare.

Friday, May 14, 2010 10:35 pm

The banksters (and their pet journalists at the Times) are trying to bring more pain to us …

Filed under: I want my money back. — Lex @ 10:35 pm
Tags: , ,

… so world-class economist Dean Baker brings the pain to them:

New York Times columnist David Leonhardt told readers today that the problem of the debt is “we, the people.” Is that so?

Was it we the people who were too dumb to see an $8 trillion housing bubble and recognize that its collapse would wreck the economy? No, that was the job of the great Maestro Alan Greenspan and his sidekick Ben Bernanke, the brilliant scholar of the Great Depression. It was also the job of all the economists who do research and opine to the public on the macroeconomy. Virtually all of these highly educated highly intelligent economists either did not see the bubble or insisted it was not worth their time.

Our deficit today is due to the collapse of this bubble. There is no dispute about this. If there had been no bubble and the economy was still chugging along with 4.5 percent unemployment, the budget would either be balanced or close enough that no serious person would be expressing alarm (check out the pre-crisis CBO projections).

Is our huge deficit a problem today? Not if you think people should have jobs. Private sector demand has plunged because of the collapse of the bubble. If the public sector does not fill the demand gap with deficit spending, then we have less demand and fewer jobs. That’s worth saying a few hundred thousand times since the deficit hawks have filled the airwaves and cyberspace with so much nonsense.

People who want smaller deficits want fewer jobs – that is the way the economy works right now. There is no plausible story through which cutting demand from the public sector will generate more jobs in the private sector.

How about those scary long-term deficit stories? It’s all health care; it’s all health care. Those who know arithmetic know this.

The deficit hawks tell us we can’t fix our health care system. What they actually mean is that they don’t want to confront the powerful interest groups that cause the United States to pay two or three times as much per person – with no obvious benefit – as people in other wealthy countries. It is easy to devise mechanisms that will get our costs more in line with other countries (e.g. this or this).

Because such measures threaten the incomes of powerful interest groups the politicians won’t push them. And, because they have not been endorsed by enough elite economists (you know, the folks that couldn’t [see the] $8 trillion housing bubble), elite journalists will not talk about them either. Instead, they will blame ordinary workers for thinking that they should be able to get a decent retirement and have the same sort of health care coverage as people in every other wealthy country.

You say we face tough choices? The wusses at The New York Times can’t handle tough choices. Neither can the ones in Congress or the White House, to say nothing of those on Wall Street.

Tuesday, August 4, 2009 8:31 pm

Health-care horror story … and what we can(‘t) learn from it

Filed under: More fact-based arguing, please — Lex @ 8:31 pm
Tags: ,

This Navy veteran has a horrible story to tell about how badly he was treated by the Veterans Administration health-care system. I have no reason to doubt a word of it.

The problem I have with it is that either the vet, the people who run the Pajamas Media site on which his piece appears, or both suggest, using the phrase “ObamaCare for Vets,” that his experience will be typical of how our health-care system will operate once Congress enacts changes (assuming it ever does). This is highly unlikely, for the simple reason that this guy’s experience, bad as it was, is grossly atypical of how the VA health-care system works right now.

Two years ago, journalist Phillip Longman published a book called “Best Care Anywhere: Why VA Health Care Is Better Than Yours.” And that’s exactly what the book found: lots of studies that led inescapably to the conclusion that overall, VA health care almost certainly is, in fact, better than yours. A partial list of those studies:

  • New England Journal of Medicine, May 29, 2003: VA “significantly” tops fee-for-service Medicare in 11 criteria out of 11.
  • Annals of Internal Medicine, 2004: VA’s diabetes care tops commercial managed-care systems in seven of seven criteria for diabetes care.
  • RAND Corp. study, 2004: VA outperforms all other American health-care sectors in 294 areas of patient care.
  • Medical Care, 2006: Patients in Medicare’s Advantage Program had “significantly higher” mortality than corresponding VA patients.
  • American Journal of Managed Care, 2004: VA topped both Medicare and best available non-Medicare programs in 18 of 18 criteria.

(These are footnoted in the book. I followed the footnotes to the original sources wherever I could, to make sure Longman wasn’t pulling a Coulter with his citations, and in fact those studies said pretty much what Longman said they said.)

There are a number of reasons why this is the case, and Longman examines them in the rest of his book.

One other thing I observed from covering medicine from the paper: chronic, long-term pain frequently is the result of orthopedic or neurological problems. Even the state of the art in treating those problem areas cannot always “cure” or “fix” the patient. That’s as true of any patient in private care as it is for anyone in the VA system.

So, yes, it’s an awful anecdote. But it doesn’t prove a thing about VA health care in general, let alone offer any basis for supposing what a modified U.S. health-care system (or health-insurance system) would look like.

(h/t: Phred)

Wednesday, July 22, 2009 8:56 pm

David Kurtz at TPM …

Filed under: Hold! Them! Accountable! — Lex @ 8:56 pm
Tags: , ,

… says it all:

Cheney Obama refuses to release visitor logs showing which energy health care company executives visited the White House.

UPDATE: Obama reverses course, releases names of visitors.

Odd: This account has Obama saying the original call to withhold came from the Secret Service. I can see not releasing visitor names in advance of the event for security reasons, maybe. (Although why should health-care execs’ White House visits not be just as telegraphed as are visits by, say, college sports national champions?) But once the event is over, it shouldn’t be any of the SS’s business whether the names are released.

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