But back to the meat of Avik Roy’s “fact-checking” the president’s apology. Things have come to a pretty pass when you must fact-check apologies. The president made an awful lot about the relatively small 5% of people who will be affected. For me, that was a serious problem with the PPACA as written. An awful lot of pain was going to be imposed on an awful lot of people with an awful lot of attendant political sniping on behalf of so small an outcome. In my early posts on the subject I referred to it as a sort of “Wales syndrome”, hearkening back to a line from Robert Bolt’s A Man for All Seasons.
The 5 percent reference is about folks who bought individual policies after the law became effective in 2010. Under the new law kicking in now, if those policies don’t pass federal muster, insurance companies must stopping selling them.
What the administration never appreciated was that people get new plans all the time — but they hardly noticed because it seemed more like an automatic renewal, albeit often with higher costs. A cancellation letter gets your attention.
The Obama team has been relying on legalistic technicalities in keeping the misleading language in his remarks.
Obama kept using that 5 percent figure in his interview with Todd in an attempt to put the situation in perspective. But if you are one of the 5 percent and are angry and feel duped — I don’t blame you. You are entitled to your story.
Now the president and his surrogates are rushing around, lying about lying, making excuses for the, in their own words, inexcuseable over a trade-off. They have decided to help 2% of the people (that’s the number the CBO estimated would enroll for insurance through the exchanges) at most certainly the expense of 5% of the people and probably of 98% of the people.
The gamble is that in November 2014 everyone will have forgotten all about it. Frankly, I doubt it. They’ll be reminded every time they get a premium increase and, fair or not, Democrats will own those since they’ll be blamed on the PPACA whether the PPACA had anything to do with them or not.
I’m disappointed with Avik Roy’s sloppy diction in his article at Forbes fisking the president’s apology for lying (and however the president dresses it, he lied) about people in the individual healthcare insurance market keeping their insurance. Mr. Roy writes:
It’s for these reasons that Delta Air Lines has said that it will spend $100 million more on health insurance on 2014 than it did in 2013, and why labor unions have complained that Obamacare “will drive the costs of collectively bargained, union administered plans, and other plans that cover unionized workers to unsupportable levels.â€
Mr. Roy knows very well that Delta Airlines has been “self-insuring” its employees’ healthcare since 1997. He reported on it here:
It turns out, however, that even America’s largest companies face higher costs due to the health law. A recently-leaked letter from Delta Air Lines to the Obama administration states that the “cost of providing health care to our employees will increase by nearly $100,000,000 next year,†much of it due to Obamacare.
Note the distinction: Delta is claiming they’ll pay more for healthcarenot for insurance. Delta doesn’t carry insurance and they don’t pay premiums. They pay claims. It’s possible that Delta also pays an insurance company to process the claims; I don’t honestly know. Since most processing charges are based on claims paid, Delta’s processing charges are likely to rise but those aren’t insurance costs. They’re processing costs.
More than half of all companies that subsidize the healthcare of their employees as part of the employment package self-insure and I presume it’s 100% among large companies. I strongly suspect we’ll hear increasingly loud squeals of complaint from them as they pay the higher costs that meeting the standards required by the PPACA will demand of them.
At long last the leaves on the trees hereabouts have begun to change their colors in earnest. Some have gone from green to fallen with only the briefest transition.
After we put the addition on our house a few years back, we redesigned our front bed. We removed the 70 year old pfitzers and hemlock, so typical of the landscaping of the 1940s and 50s, created a bed outlined by dry-laid limestone, and planted it with two Japanese maples, azaleas, and rhododendrons. In the spring and summer we plant annuals.
The picture above is one of the two Japanese maples. Rather than the more commonly seen Acer palmatum varieties it’s Acer shirasawanum ‘Aureum’. As you can see rather than the purplish-red typical of the leaves of the palmatum, its leaves turn a beautiful orange and gold. During the year it’s a light green.
Our other Japanese maple, also not a variety frequently encountered, is most dramatic in the spring but I may take its picture in a day or so if it develops nice color.
If you look closely through the window, you can see Nola wondering what the heck I’m up to out here and why she isn’t with me.
WILMINGTON, Del. — More than a month after the launch of Delaware’s health insurance exchange, officials report only four Delawareans enrolled for insurance coverage under the Affordable Care Act.
As of Wednesday, Delaware’s marketplace guide organizations reported four enrollments, 31 enrollment applications completed and 218 accounts created for possible enrollment.
This would probably be a good time for me to repeat the back-of-the-envelope calculation I made a month ago. To enroll 7 million people in the exchanges, the number projected by the CBO, over a period of 200 days requires that 35,000 people be successfully enrolled per day. If you move the deadline up to, say, the end of February 2014, a more practical date, it’s more than 45,000 people successfully enrolled per day. If you move the deadline up to the end of 2013, the date required for technical compliance, more than 75,000 people must be successfully enrolled per day.
If the total number of enrollments is measured in the dozens or even the hundreds or thousands, reaching the 7 million number by the end of the year will require an enormous flood of enrollments between now and the end of the year. Keep that in mind when you hear administration officials quoting statistics about Healthcare.gov’s capacity.
It will be interesting to see what numbers they give us next week.
HealthCare.gov may have claimed its first casualty from the Obama administration: a veteran official who helped oversee development of the federal government’s glitch-ridden online insurance exchange.
The Centers for Medicare and Medicaid (CMS) said on Wednesday that Tony Trenkle, the agency’s top technology executive, will step down on Nov. 15 “to take a position in the private sector.†CMS Chief Operating Officer Michelle Snyder delivered the news in an e-mail to employees.
Trenkle was in charge of determining whether private information entered into the exchange system would be safe from hackers and identity thieves. An inspector general’s report released in August said CMS had delayed the deadline for making that decision until the eve of the site’s launch.
“If there are additional delays in completing the security authorization package, [Trenkle] may not have a full assessment of system risks and security controls needed for the security authorization†in time for the rollout, the report said.
I would very much like to know whether he is now looking for a job or has one lined up and if so whether he’s received a raise as a result of the move.
The original title I’d planned to use for this post was “Rat Deserts Sinking Etc.” but I decided that was too uncharitable.
Leaving aside the actual merits of the argument about the woman with bladder cancer who’s in danger of losing her oncologist due to the consequences of the PPACA, there’s something about the discussion I’m curious about. Why is the woman’s insurance company being accused of profiteering while her oncologist and other healthcare providers aren’t?
Is the reason due to some preference for labor over capital? I think that’s a particularly weak argument. Without the insurance company the woman would have been forced to bear the entire cost of her treatment herself which means, presumably, she would have gone without and, possibly, died. The insurance company is performing a service and the service deserves to be compensated. Judging by the estimates of the cost of her treatment, it’s a pretty darned valuable service.
The median hourly wage of an oncologist is about $100 per hour. Frankly, I’m skeptical that any hourly wage over about $30 per hour earned by anybody for anything is actually the cost of labor. I think it’s some combination of the actual cost of labor, a premium for capital investment, and the result of restrictions on the distribution of medication, barriers to entry, and other anti-competitive measures.
If the law works — if the website is repaired, if people sign up through the exchanges in sufficient numbers, if competition on the exchanges really does bring costs down without undermining the kind of care consumers want, if Medicaid expansion goes smoothly where Republican opposition allows — then there’s no chance that it’s going to be repealed, or delayed.
but I’m not so sure about this:
If it really does collapse, then it’s certain that it will be delayed or even replaced, although again that would mean building on what’s been done.
I suppose it depends on what the operative definition of “collapse” is. I strongly suspect that regardless of what happens supporters of the PPACA will be proclaiming its success while its opponents will be declaring its failure. Once again, they each have their own facts.
Mr. Bernstein has some signficant omissions in his list of “ifs”. The anecdotal reports suggest that most of those who’ve signed through Healthcare.gov are enrolling in Medicaid and that some of those qualified under the old eligibility rules. The states will not receive 100% reimbursement for them as they will for those who qualify under the new eligibility rules. If a very large proportion of those enrolling for Medicaid via Healthcare.gov would have been eligible for Medicaid anyway, I’d say the system will have collapsed then and there. The states are already unable to keep up with their share of Medicaid and thousands or millions of new participants will already aggravate a bad situation. Providers are already waiting many months for reimbursement under Medicaid in some states, notably Illinois. And that 100% reimbursement will be phased out after three years. That has been one of the things I’ve been most skeptical about in the plan. What happens after three years? Here in Illinois the cupboard is already bare.
I also wonder what proportion of those who actually enroll for insurance under the exchanges will be older people with pre-existing conditions as opposed to people who are young and healthy. If the young and healthy just don’t participate the entire plan will be ineffective from the outset but the shoe won’t really fall until next year when new and presumably higher premiums will be charged.
IMO we’re probably stuck with the PPACA as-is for the foreseeable future and as to what its impact will be we can only say “we’ll see”.
Of course economics is a science. It’s a descriptive science like anthropology or sociology not a predictive science like physics. Gussying it up with numbers to support your political preferences doesn’t change that.
Alex Tabarrok is concerned that all of that information the NSA is gathering will be used for political purposes:
The Nixon administration plumbers broke into the offices of Daniel Ellsberg’s psychiatrist in order to gather information to discredit him. They busted into a single file cabinet (pictured). What a bunch of amateurs.
The NSA has broken into millions of file cabinets around the world.
Nixon resigned in disgrace. Who will pay for the NSA break-ins?
I think that this is actually a more serious issue than his title or mine might lead you to believe.
My preference would be that the NSA not cast so broad a net. Indeed, I think that nearly every response of American politicians to the attacks on September 11, 2001 has been wrong-headed. I think they’re understandable but indefensible. At this point the only way the scope of the security state will be reduced will be through the democratic process and, since the incentives of both major political parties favor excess and neither major political party opposes it, such a reversal of course is far, far away.
I also think that if any U. S. administration exploits the vast amount of information we’re gathering for domestic political purposes the president whose administration it is should be removed from office whether he or she knew about it or not. To encourage the others.
However, in the absence of any real evidence that such a thing has actually transpired, I think that Dr. Tabarrok’s fears are overblown.
You might want to take a gander at this very interesting post at The Crime Report on big city policing in the post-Bloomberg era. Of course, here in Chicago we avoid all of this hugger mugger by ceding large portions of the city to street gangs.
