Annals of the Exchanges

More annals of the healthcare exchanges from Sally Pipes at Forbes:

Fourteen states and the District of Columbia have set up their own online exchanges. They’re faring little better than the federal exchange.

Take Vermont. In the Green Mountain State, 4,300 residents created state insurance accounts. But only 700 were able to apply for insurance — and just 115 of these folks were able to enroll.

In Maryland just 1,121 of the 25,781 people who created accounts were able to finish their online applications and get enrolled. That’s less than 5 percent.

And the exchanges in Vermont and Maryland are among the better-working ones.

Remember: the relevant metrics are not accesses, registrations, or even enrollments. The relevant metrics are enrollments for insurance (rather than Medicaid) under the healthcare insurance exchanges and the number of those enrollments of people who are young and healthy.

It’s still very, very early in the game.

4 comments

Feeding Frenzy

There is no dearth of criticism from center-left journalists in a similar vein to my remarks of yesterday. In his most recent column, Richard Cohen:

Where is Casey Stengel when we need him? In 1962, as the manager of the brand new and determinedly hapless New York Mets — 40 wins, 120 losses — he looked up and down his bench one dismal day and wondered, “Can’t anybody here play this game?” That phrase kept coming at me recently as I watched the impressively inept performance of the Obama administration in both foreign and domestic policy. On a given day, this administration makes the ’62 Mets look good.

Dana Milbank:

On one level, it would be reassuring — and much more credible — if the White House admitted that Obama is more in the loop than he has let on. On another level, it would be disconcerting: Is it better that he didn’t know about his administration’s missteps — or that he knew about them and didn’t stop them?

Or that he fomented them.

The center-right is not being left behind. Bret Stephens presents a lengthy list of quotations which create an impression of a White House uninterested in the process of governing but vitally interesting in holding the reins of power for its own sake. I don’t believe that’s an impression that the Obama Administration should wish to convey. Even at the expense of acknowledging what the president does, indeed, know and that he has actually made some mistakes.

3 comments

It’s the Policies, Stupid!

Writing in the Wall Street Journal, John B. Taylor takes the present common wisdom to task:

In the years leading up to the panic, mainly 2003-05, the Federal Reserve held interest rates excessively low compared with the monetary policy strategy of the 1980s and ’90s—a monetary strategy that had kept recessions mild. The Fed’s interest-rate policies exacerbated the housing boom and thus the ensuing bust. More generally, extremely low interest rates led individual and institutional investors to search for yield and to engage in excessive risk taking, as Geert Bekaert of Columbia University and his colleagues showed in a study published by the European Central Bank in July.

Meanwhile, regulators who were supposed to supervise large financial institutions, including Fannie Mae and Freddie Mac, allowed large deviations from existing safety and soundness rules. In particular, regulators permitted high leverage ratios and investments in risky, mortgage-backed securities that also fed the housing boom.

He continues by criticizing the bailout of Bear Stearns, the failure to bailout Lehman Brothers, TARP, the stimulus, Dodd-Frank, and the PPACA. While I agree that the monetary and regulatory policies of the Aughts set the stage for the financial crisis and subsequent economic doldrums, I think it’s important to recognize that none of the policies of which Dr. Taylor is so critical arose in a vacuum.

All other things being equal without the housing bubble there would have been virtually no growth at all in the economy and, especially, in employment. Other than healthcare and education that is which can hardly be called growth at all. The reason I put it that way is that when the increase in borrowing exceeds the increase in GDP the growth is illusory.

I think you’ve got to go a lot farther back than the Aughts and consider the problem much more deeply than that. One-way free trade undermines the mass employment-mass consumption paradigm of the post-war economy and we haven’t found a ready substitute.

8 comments

A Scary Halloween Costume

I found this picture of one of my nephews

on his fiancee’s Facebook page, presumably in Halloween costume. As you can see, he’s dressed as Ron Burgundy. I find it rather disturbing.

1 comment

Where Is the Left Blogosphere?

Ian Welsh, remarking on the moribund Left Blogosphere:

Unlike the Tea Party, most left wingers don’t really believe their own ideology. They put partisanship first, or they put the color of a candidate’s skin or the shape of their genitals over the candidate’s policy. Identity is more important to them than how many brown children that politician is killing.

So progressives have no power, because they have no principles: they cannot be expected to actually vote for the most progressive candidate, to successfully primary candidates, to care about policy first and identity second, to not take scraps from the table and sell out other progressive’s interests.

I think there’s a kernel of truth in that observation. When you support the party regardless of what the party does, you lose the power, maybe even the right, to change the party. You just go along and accept whatever the party doles out.

Additionally, it has been my impression, remarked on frequently here, that a very large proportion of the most important left-leaning bloggers routinely give the impression that they’re producing writing samples for a present or future Democratic administration. When what’s really important to you is the job, you won’t sacrifice that for a few pesky principles.

6 comments

The Roosting Chickens

The transcript of last night’s 60 Minutes program about the attack on the U. S. embassy in Benghazi, Libya in 2012 makes for sobering reading. To my eye CBS’s account comports more closely with those of the administration’s opponents than with the one purveyed by the administration and enormously more than its dismissal by some as insignificant.

The broadcasting of this report comes at an uncomfortable time for the White House, following the furor of the bungled debut of Healthcare.gov, by just about any account an unforced error. As Abraham Lincoln pointed out 150 years ago, you can manage the politics of every issue perfectly but if you don’t handle the issues of governance it will eventually come back to haunt you.

This would be a very good time for the White House to put its head down and devote its energies to the business of governing. I’ll bet a shiny new dime that won’t be the strategy. “My center is giving way, my right is retreating, situation excellent, I am attacking.”

18 comments

Puccini’s Madama Butterfly at Lyric Opera, 2013-2014

Last night we saw the first performance in our abbreviated Lyric Opera subscription, Madama Butterfly. Butterfly’s libretto takes its plot from the 1900 David Belasco play which itself is an adaptation of John Luther Long’s 1898 short story, “Madame Butterly”, from which it deviated somewhat. Belasco really knew how to work an audience.

The pathos in Madama Butterfly arises from the tension between what the audience knows and what Butterfly believes. The audience knows that Pinkerton is a shnook and that their love is doomed. Butterfly loves Pinkerton and believes he loves her and her faith in him is unshakeable. Events flow inexorably on, buoyed by Puccini’s glorious music, to its tragic end.

The production we saw last night is a new production, from the Houston Opera company. For the last twenty years we’ve been seeing the brilliant Hal Prince production of Butterfly and, frankly, the new production suffers somewhat in comparison. It’s workmanlike but not brilliant.

James Valenti’s performance as Pinkerton was functional, which is typical of Pinkertons. I don’t think that Puccini was capable of writing an unlovely note but Pinkerton’s music is fairly typical Puccini tenor but has no great aria. The character of Pinkerton is so unsympathetic I’m not sure what a great performance as Pinkerton would be like.

I found Amanda Echalaz’s performance as Cio-Cio San unsatisfying. She wasn’t horrible but I don’t think she really did justice to the role. I think I’ll leave it at that.

Christopher Purves’s portrayal of Sharpless was perhaps the best Sharpless I’ve ever seen. His Sharpless illustrated what a fine singer-actor can do with a part and I’ll look forward to appearances by Mr. Purves at Lyric in the future.

We were astonished at the tiny Tye Oren Pauley’s performance as Pinkerton and Butterfly’s child. The kid did a great job and put up with an enormous amount, especially for one so young. Bravo.

One last note on last night’s performance. The orchestra section of Civic Opera was about a quarter empty for the performance. I honestly don’t see how Lyric can survive without filling the house, especially when they’re staging one of the most beloved operas in the repertory. Whether the problem was the economy, the production, the lack of bankable stars in the production, or bad advance press for the production, clearly there’s a problem and Lyric needs to address it.

The Critics

John Von Rhein:

A large, raked semicircular ramp snakes around the back of the stage. For the “Humming Chorus” and Butterfly’s all-night vigil as she awaits Pinkerton’s return, the ramp revolves so that she is gazing out at the audience from downstage. A sliding Japanese screen is all that’s needed to suggest the house she shares with her devoted maid, Suzuki. Other artful design touches – a blushing-pink dawn, orange paper lanterns set against an azure sky, wispy suggestions of pines and cypresses – are there to frame the emotional arc of Puccini’s lyric tragedy.

But something appears to have gone missing in the translation from Houston to Chicago, or at least did so on opening night. Routine staging by Louisa Muller, the revival director, failed to get much out of anybody during the first act. The orchestra also sounded out of sorts at the outset, until it, too, hit its musical stride in the second and third acts.

As the delicate child-bride of the first act, Echalaz’s Butterfly came across as self-possessed, very much in control, so that the heroine’s childlike innocence and vulnerability had to be guessed at. The love duet between her and Pinkerton came off stiffly, with little apparent chemistry between the characters, and neither performer appearing in his or her best vocal form. Her vibrant, voluminous soprano turned hard and edgy, losing steadiness and going astray of pitch at the top whenever pressure was applied. He had no top to speak of.

“Un bel di,” the opera’s best-known music, in which Butterfly affirms her undying faith that her lover will return, was capably sung but its impact was undermined by awkward, semaphore-like hand gestures that detracted from the persona this intelligent artist was trying to project. While Valenti certainly cut a tall, dark, handsome figure in Pinkerton’s naval whites, his singing lacked line and nuance and he didn’t do much with the character dramatically beyond striking conventional, all-American-jock stances.

Last night “Un bel di” was not executed well. Clearly, Mr. Von Rhein saw the same opera I did.

The Sun-Times’s Kyle Macmillan saw something different:

But as handsome as the visuals are, the focus here is squarely on the principal singers (all but one making their Lyric debuts), and all deliver first-rate performances, starting with soprano Amanda Echalaz in the title role as Cio-Cio-San.

Possessing a rich, vibrant voice and moving seamlessly from high to low register, she vividly captured both the geisha’s starry-eyed youthfulness and steely fortitude. Echalaz delivered one vocal highlight after another, from Butterfly’s beautiful love duet with Pinkerton in Act 1 to the character’s final tortured acceptance of her fate.

Looking every bit a strapping naval officer and possessing a fluid, full-bodied tenor voice that could hardly be better suited to this opera, tenor James Valenti seemed completely at home in the role of Lt. B. F. Pinkerton. He made the most of the character’s soaring arias and managed to convey both the character’s blithe self-centeredness and authentic remorse at the end.

Katy Walsh, writing for Chicago Theatre Beat was more impressend than I as well:

I’ve seen Madama Butterfly three times. I’m always blown away by Puccini’s haunting composition that is the epitome of every break up song ever written. He has captured the misery of loving deeply and tragically. For diehard and wannabe opera lovers, this Madama Butterfly is especially exquisite.

Frankly, I think that Ms. Walsh is reviewing Madama Butterfly rather than the performance we saw last night.

0 comments

Why a Carbon Tax Won’t Work in China

Every so often someone produces an op-ed or article with a proposal to solve this or that problem in China. This op-ed by Chris P. Nielsen and Mun S. Ho at the New York Times, proposing a carbon tax to bring China’s air pollution problems under control, is a good example:

While a carbon tax cannot substitute for a comprehensive air quality strategy — including expanded support for atmospheric sciences — it would be a powerful jump-start in the right direction.

This approach offers a real chance for China to limit both carbon emissions and air pollution at little cost to economic growth, all in one relatively straightforward policy. It may be an opportunity that nobody, in or out of China, can afford to ignore.

I’m sure that this proposal is well-intentioned. However, it ignores the one thing that China needs most to cope with its most serious problems: a robust system of civil law. I could produce a list of proposals as long as the Great Wall and without that every one of them would be useless.

China’s laws respecting intellectual property are more restrictive than ours and even more widely ignored because they can only be enforced with the cooperation of the Chinese Communist Party and that will only be forthcoming if it’s in the party’s interests.

It can hardly be denied that air, water, and soil pollution in China have reached dangerous proportions. Solutions will elude the Chinese until China has the institutions to support them.

4 comments

Wobbly On the PPACA

The editors of the LA Times make a somewhat overwrought plea to postpone the individual mandate:

Not long after she uttered that infamous phrase, Pelosi got her way. She stampeded House Democrats to vote for a massive, complex Obamacare plan that few lawmakers in either party had time to understand. She and Democratic Senate leaders ramrodded Obamacare without a single Republican vote.

Democratic lawmakers voted for a bill without a clear idea of how well it would work.

Now they know.

Obamacare is faltering under its own bureaucratic weight. Massive computer problems are preventing people from signing up for coverage in the new online marketplaces. Worse, many people who finally manage to log in suffer sticker shock at high insurance premium or deductible prices.

[…]

Congress can start to fix this mess by delaying the mandate that everyone have insurance or pay a penalty. As it is now, people must sign up for insurance by March 31 to avoid penalties.

The feds already have granted a one-year reprieve on the companion mandate that employers provide insurance or pay fines. The administration has allowed any number of carve-outs for other special pleaders.

A delay in the individual mandate isn’t a special break. It’s simple fairness.

In the rush to pass Obamacare, Democratic leaders reassured lawmakers that Americans would love it, once they understood it.

Uwe Reinhardt gives Obamacare an “F” on the midterm:

Woe to the members of the management team in a corporation if problems with a project are hidden from the chief executive when they become known, exposing the chief executive to embarrassing public relations surprises. Heads would roll. The board, however, would assign the blame for such problems not primarily to the management team and instead to the chief executive himself or herself. He hired and supervised the team.

From that perspective, the blame for the disastrous rollout of HealthCare.gov goes to its entire management team, to be sure, but primarily to the chief executive on top of that project. In my view, not only the proverbial buck stops on the chief executive’s desk, but, for the management of this particular project, the grade of F goes there as well.

It is worth reminding readers, however, that grades on midterm papers or tests do not constitute the overall grade in a course. Students receiving an F on a midterm paper or test often end up with a respectable overall course grade, spurred on in part by that very failure.

Similarly, with enormous effort and, one hopes, constant future supervision by the chief executive, there is hope that the technical problems encountered so far can be fixed in time, with the celebrated A-team of software experts now on the scene.

As I’ve said before, I think these assessments are grossly premature. All they’re rating is the user experience. That’s only the tip of the PPACA iceberg. Beyond the user experience there’s the inner workings—the accuracy of the information presented, data exchange with insurance companies, and so on. The user experience could behave flawlessly but if the guts of the system remain broken the system itself will remain broken.

In the final analysis we won’t really know whether the PPACA is working unless more people have healthcare insurance after it’s fully implemented than did before and it’s actuarially sound. That won’t be for years.

9 comments

What Were the Greatest “Breakthroughs”?

There’s an interesting article by James Fallows of The Atlantic on the fifty greatest “breakthroughs” of all time that you might want to take a look at. Many of those in the list are obvious: the lever, the printing press, penicillin. Some are slightly less so: paper, the Pill.

Most I’d agree with but some I’d argue with. For example, I think the personal computer is too obvious a development. I’m not convinced that gunpowder is so major a “breakthrough”. And I don’t think the people who compiled the list understand why the Internet is a breakthrough. It’s not the Internet (which is just a set of protocols). It’s that the protocols of which the Internet consists are not proprietary. I wouldn’t have included it in the list.

There are some breakthroughs I think they missed. So, for example, modern commerce would be impossible without double-entry bookkeeping. It dates from the 14th century. If you include the compass and the sextant among great breakthroughs, I don’t know how you can omit the marine chronometer. The compass tells you what direction you’re moving in and the sextant can tell you where you are relative to the equator but the marine chronometer made precision navigation possible. It’s the basis of longitude.

I also think that, if you include the telegraph, the telephone, photography, radio, and television in the list, the phonograph is a notable omission. It was the first method of recording from life. Photography just records a single, static image—that’s not what I mean by “from life”. Prior to photography there were ways of telling what people, animals, buildings, etc. looked like in the past. Prior to the phonograph there was no way to know what people sounded like. That’s a real breakthrough.

Any other suggestions for the list?

Update

I’ve thought of a few more. The Jacquard loom was at least as influential as the steam engine or the digital computer. Mass production with interchangeable parts was introduced by Josiah Wedgwood in the 18th century as was the assembly line (which is on their list). Distillation is at least 2,000 years old and is used in all sorts of industrial processes (not to mention in making brandy).

22 comments