Many fields have what has been determined to be “best practice”, the accumulated wisdom on what is most effective. Physicians employ what is called the “standard of care”. Laboratories, manufacturing, and agriculture all have what are thought of as good operating practices.
Web pages are computer programs. They are software. In software development for many years best practice has been to subject developments to beta testing in limited release prior to general release.
Whether you support the PPACA or oppose it, I think we need to agree that best practice was not followed in the rollout of the federal government’s entry point to the healthcare insurance exchanges, healthcare.gov. As was expected, there were some “glitches”.
I have a question and the goodness or badness of the PPACA or of healthcare.gov are, in the final analysis, irrelevant to it. Is it impossible for the federal government to follow best practice in software development projects? I believe it is both for political and budgetary reasons (among others) but I’d be interested in hearing differing opinion on the subject.
WASHINGTON — Two days in, Congress is no closer to resolving the first government shutdown in 17 years.
President Obama is calling the top four congressional leaders down to the White House for a meeting Wednesday afternoon. A White House official said the president will urge the House to pass a stopgap funding bill to reopen the government, and ask Congress to raise the debt ceiling ahead of an Oct. 17 deadline.
“We’re pleased the president finally recognizes that his refusal to negotiate is indefensible. It’s unclear why we’d be having this meeting if it’s not meant to be a start to seriou
House Republicans are moving forward again Wednesday with a legislative strategy to advance piecemeal funding bills to reopen popular parts of the federal government including parks and national memorials and the Department of Veterans Affairs until a broader budget agreement is reached. Republicans continue to seek concessions on the Affordable Care Act in exchange for passage of the funding bill.s talks between the two parties,” said Brendan Buck, a spokesman for House Speaker John Boehner, R-Ohio.
“What I don’t understand is why the president and the Senate Democrats will not agree to come talk to those of us that have deep concerns about the fairness of what is Obamacare. And that to me, is just not understandable to people in my district and across the country,” Rep. Jason Chaffetz of Utah, a conservative Republican, told CBS’s This Morning.
Senate Democrats and Obama oppose the piecemeal approach and continue to call on Republicans to approve the Senate-passed stopgap funding bill through Nov. 15 that has no provisions affecting the health care law. Senate Majority Whip Richard Durbin, D-Ill., challenged Boehner to allow a vote on the bill, which appears to have the support to pass on the votes of Democrats and moderate Republicans.
or, said another way, as of this writing matters are no farther along than they were yesterday at this time.
A host of different opinions are being offered on the shutdown.
The president isn’t telling the whole story when it comes to the government shutdown. The fact is that Washington Democrats have slammed the door on reopening the government by refusing to engage in bipartisan talks. And, as stories across the country highlight the devastating impact of Obamacare on families and small businesses, they continue to reject our calls for fairness for all Americans.
This is part of a larger pattern: the president’s scorched-Earth policy of refusing to negotiate in bipartisan way on his health care law, current government funding, or the debt limit.
By Tuesday morning, the leadership failure of Speaker John Boehner was complete. In encouraging the impossible quest of House Republicans to dismantle health care reform, he pushed the country into a government shutdown that will now begin to take a grievous economic toll.
At any point, Mr. Boehner could have stopped it. Had he put on the floor a simple temporary spending resolution to keep the government open, without the outrageous demands to delay or defund the health reform law, it could easily have passed the House with a strong majority — including with sizable support from Republican members, many of whom are aware of how badly this collapse will damage their party.
But Mr. Boehner refused. He stood in the well of the House and repeated the tired falsehood that the Affordable Care Act was killing jobs. He came up with a series of increasingly ridiculous demands: defund the health law, delay it for a year, stop its requirement that employers pay for contraception, block the medical device tax, delay the individual mandate for a year, strip Congressional employees of their health subsidies. All were instantly rejected by the Senate. “They’ve lost their minds,†Senator Harry Reid, the majority leader, said of the House Republicans. “They keep trying to do the same thing over and over again.â€
Finally, at the last minute, when there was still time to end the charade with a straightforward spending bill, Mr. Boehner made the most absurd demand of all: an immediate conference committee with the Senate. Suddenly, with less than an hour left, he wanted to set up formal negotiations?
AMERICANS’ RESPECT for their Congress has, sad to say, diminished in recent years. But citizens still expect a minimal level of competence and responsibility: Pay the bills and try not to embarrass us in front of the world.
By those minimal standards, this Congress is failing. More specifically, the Republican leaders of the House of Representatives are failing. They should fulfill their basic duties to the American people or make way for legislators who will.
We don’t come to that view as rabid partisans. On many of the issues stalemating Washington, we find plenty of blame to go around. We’ve criticized President Obama’s reluctance to pursue entitlement reform. The last time the country reached the debt ceiling, we urged both sides to compromise on revenue and spending in the interest of long-term fiscal soundness.
This time, fiscal responsibility isn’t even a topic. Instead, Republicans have shut much of the government in what they had to know was a doomed effort to derail the Affordable Care Act.
A government shutdown is a mighty weapon to wield in American politics. It towers over a Senate filibuster, the gerrymandered district, or the walkout of one party in the House. It goes far beyond the tools of blockage provided in the Constitution, such as the presidential veto or the Supreme Court ruling overturning a law of Congress. It is gridlock writ large upon the daily lives of the American people.
Yet even as blame for a shutdown is assigned to one party or both – or only the tea party – Americans need to recognize how much they created this gridlock instead of a Goldilocks government of not-too-hot-not-too-cold cooperation.
In the political blogosphere comment is mostly along the expected lines—where you stand depends on where you sit. There have been some useful contributions. Kathy Gill of The Moderate Voice puts the shutdown into some historical perspective:
Democrats have led more shutdowns than Republicans. Federal government shutdown begins in the House of Representatives. Republicans have controlled the House for eight sessions since 1976; Democrats have controlled the House for 12.
I believe that government shutdowns can always be attributed to a failure of leadership and Kathy’s graph certainly supports that. The heavyweight champ of government shutdowns was Jimmy Carter who managed to shut down the federal government for 56 days of his single four year term with Democrats in control of both the House and the Senate.
I don’t mean just presidential leadership. I mean Congressional leadership as well.
I reject the CSM’s contention. If I had not voted for Mike Quigley for the House of Representatives, how would that have changed the outcome? It wouldn’t have changed it at all. And, contrary to the Monitor’s beliefs, Chicago voters are plenty engaged with politics. Over-engaged, if anything. In the precincts in which I’ve served as election judge, 75-85% of the voters turn out for a typical general election. How would 100% turnout have changed things? Nothing but heroic efforts on the part of ordinary citizens will effect change. Is it reasonable to demand heroic efforts from ordinary citizens and not demand basic honesty or competence from elected officials?
Overshadowed by the federal government shutdown (for which they are likely to be somewhat grateful), the PPACA’s health insurance exchange web site went alive today, marking a major milestone in the program’s slow emergence from its cocoon.
Here’s my prediction: there is no level of problems with the web sites or with the exchanges themselves which will be deemed a failure. Just showing up will be enough to declare victory.
While the GOP’s tactics are similar to those employed in the mid-’90s, the goals are different.
John Boehner is not Newt Gingrich, and Barack Obama is not Bill Clinton.
The net effect of the shutdown was small in the 1990s.
What happens to red state Senate Democrats?
His bottom line is that the shutdown is likely to be an unforced error by the Republicans:
In other words, there’s a decent chance that we’ll encounter a downturn in the economy in the next year, and a very good chance that we’ll encounter one in the next three years. Obama is probably reaching the end of the time period where his predecessor can be blamed for the state of the economy. But a lengthy shutdown could conceivably give Democrats ammunition to place the blame back on Republicans.
The bottom line is this: The shutdown will probably not be a good thing for the GOP, and there’s a good chance Republicans won’t achieve their intended goal of limiting Obamacare’s reach. But at the same time, a lot of the prophecies of doom for Republicans are heavily overwrought. Unless things get too far out of control, the predictions of heavy GOP losses from a shutdown are likely overstated.
My position is not that the shutdown will be an economic disaster but that it won’t help. The political outcome will depend entirely on its effect on the Senate. If the shutdown results in the Republicans losing a few seats in the House while gaining control over the Senate (for the reasons Mr. Trende describes), it will be a disaster for the president, both politically and personally.
The U.S. government began to shut down for the first time in 17 years early Tuesday, after a Congress bitterly divided over President Obama’s signature health-care initiative failed to reach agreement to fund federal agencies.
Thousands of government workers arrived at federal office buildings to clean off their desk, set out-of-office e-mail messages and make whatever arrangements were necessary so they could stay off the job indefinitely.
Others, including border patrol officers, prison guards and air traffic controllers, were required to work but were told they may not be paid.
Washington’s iconic monuments and memorials were still open in the early morning hours, but the National Park Service soon dispatched workers to shut them down and move barricades into place. Signs posted on the barriers erected at the entrance to the Lincoln Memorial read: “Because of the federal government shutdown all national parks are closed.â€
Most of the people most of the time may hardly notice the shutdown. I think we should all be worried and here’s why.
Comparisons between today’s shutdown and the one that occurred in 1995/1996 are invidious. During the last shutdown we were in the middle of a boom. Now the economy is recovering phlegmatically from a serious recession. Seventeen years ago employment was high and unemployment was low. Today unemployment is relatively high and employment is lower than it has been in 30 years. More people have been unemployed longer today than at any time since the Great Depression of the 1930s.
Government at all levels plays a larger role in the economy than it did seventeen years ago. Then, government spending accounted for about 30% of the economy. Now, it accounts for nearly 40% of the economy.
There are probably as many explanations for our low employment and high unemployment as there are people trying to explain them but I don’t think that it is arguable that more economic activity wouldn’t improve the situation.
There are only five sources of economic activity: personal consumption, business investment, government spending, exports, and imports (which reduce economic activity). Reduced government spending means reduced economic activity. None of the other factors can step in and fill the gap, at last in the near term. That means that economic activity will decline as a result of the shutdown and whatever role economic activity plays in unemployment the shutdown will make things worse.
Regardless of your views on the merits of the House Republicans’ beef with the Senate Democrats and the president, this is the wrong thing to do at the wrong time. Worst of all I see no obvious basis for a compromise. Both sides have been poisoning the well for the last five years (if not the last fifteen years). It’s a game of Chicken all the way to the bottom of the cliff.
Forest Glen is a neighborhood in the Forest Glen community area of the Far North Side of Chicago. Officially, it is in Community Area #12. It is a small, quite suburban, largely residential neighborhood and one of the oldest neighborhoods in the now-obsolete Jefferson Township. Jefferson Township was annexed by Chicago in 1889. Prior to that Chicago stopped at Fullerton. The neighborhood of Forest Glen is bounded by Lawler on the north, the Edens Expressway on the east, Elston Ave. on the south, and the railroad tracks on the west.
Forest Glen’s history goes back to 1866. It was in that year that Capt. William Cross Hazelton, a Union veteran of the American Civil War, built the first structure in the neighborhood, a barn, at the vicinity of what would now be Foster and Lawler. Capt. Hazelton is pictured at left in the uniform of an officer in the 8th Illinois Cavalry in what I take to be a mustering-out photo. Folklore says that he received land in the neighborhood for his service but I have not been able to locate a record of his receiving any public domain land. What I believe to be the case is that he used his mustering-out pay to purchase the land which he would farm and which would later become the town of Forest Glen.
Capt. Hazelton was an enterprising sort. By 1881 he had not only the farm but had also built the first general store. His farm was said to have become the chief supplier of cherries for the Chicago market. In that same year he built a house which is pictured on the right in a photo that I estimate to have been taken sometime between when the house was built in 1881 and 1886. In roughly 1883 he was also postmaster for the community and was receiving a pension from the federal government for his services during the Civil War. Here is the house as it appears now:
The Congregational church he built for the community stood until 1955 when it was destroyed by fire. The original church is pictured below in a photo of a reunion of the 8th Illinois Cavalry Veteran’s Association taken in 1910.
In this picture Capt. Hazelton is pictured sitting on the ground with his daughter and granddaughter on either side of him.
The present 1st Congregational Church, pictured on the left, is on the site of the original church. As befits a neighborhood largely settled by people of English and Swedish descent, the neighborhood includes a Congregational church and has a large Lutheran church on its southern border but not a Catholic church. The neighborhood is and always has been dry.
The original homes in Forest Glen were built in the late 19th and early 20th centuries. A number of them still stand. In 1920 the Hazelton house was moved from its original location to its present location at 5453 N. Forest Glen Ave. It has been designated a Chicago landmark. The house faces the forest preserve, giving it a rather rustic, picturesque view. There was another round of home-building in the 1950s.
As you can see the neighborhood includes homes built in vernacular, Spanish revival, Chicago bungalow, Tudor revival, brick Georgian, and ranch styles. Its streets are lined with mature trees. According to the 2010 census the median family income for the neighborhood was approximately $80,000. There is one small strip mall in the neighborhood which includes a Chinese carry-out, a pizza place, and a laundromat.
Well, it looks all but unavoidable that the federal government will shut down the day after tomorrow and there’s even a possibility that the federal government will default. I’ve already given my opinion: I think the actions by the House Republicans are bad politics and bad policy.
As I have been pointing out almost from the inception of this blog, moderation is the essential virtue of a republic and, frankly, I’m beginning to despair for the survival of the republic. This morning on the various “talking heads” programs what I’ve mostly seen has been a mass exercise in special pleading. Their refusal to compromise is stupid, harmful, and traitorous. Our refusal to compromise is practical, principled, and patriotic. I honestly don’t see how the republic can survive without a mutual willingness to compromise.
I don’t relish the idea of real shooting revolution but sitting here in Chicago it looks to me that it’s already under way. I think the simplest explanation for the violence that’s been going on in South Side neighborhoods here is that the police have given up on those neighborhoods and people there are taking matters into their own hands. The gangs are an alternative form of government. That the civil authorities are more concerned about producing the appearance of concern rather than materially changing the situation is an indication of how desperate the situation has become.
Megan McArdle lists eleven “talking points repeated as if they’re facts” and attempts to explain the factors behind them. Are they correct or incorrect? No one knows for sure but they are not facts. They are either predictions or opinions with more or less basis. Here they are:
Once Obamacare goes into effect, it will be impossible to substantially cut it back.
Accountable Care Organizations are certain to bring down overall health spending.
Obamacare works because it gets money from deadbeats who go to the emergency room and then stiff the rest of us for the cost.
Emergency room use will decline.
People can game the system by going without insurance and then buying it when they get sick.
Breaking the link between health insurance and employment will spur entrepreneurship.
Obamacare will reduce the budget deficit.
The Independent Payment Advisory Board is going to radically change the relationship between you and your doctor.
People with pre-existing conditions will be able to buy insurance in the private market for the first time.
Obamacare will bend the cost curve.
Obamacare will make bankruptcy a thing of the past, at least for the people who gain coverage.
Some of these are likely, some are possible, some are unlikely. I don’t think that any of them is impossible.
This might be a good time for me to remind people of my views on the PPACA: I think it’s inadequate and will mostly serve to kick the can down the road. However, my objectives are very different from those of most people—I think that we need to constrain the increase in healthcare spending to the increases in costs in the non-healthcare part of the economy.
I’m occasionally taken to task for not rejoicing in this or that new development in the healthcare system. That’s easy to explain. I don’t care that premiums in the exchanges won’t be as high as some of the PPACA’s opponents were predicting. I never predicted one way or another and that’s just a test of predictions rather than a test of the program. I don’t care that healthcare spending is only increasing four times as fast as increases in the non-healthcare parts of the economy rather than six times as fast as it was just a few years ago—it’s still increasing far too fast, unaffordably high. And nobody really knows why that is.
I do agree with this observation of Megan’s:
The consensus about Obamacare among health economists is narrower than the range of opinion among the broader community of public intellectuals, and much narrower than that in the general public. Mostly the experts think that it will be good for the individuals it covers, but that the other beneficial effects promised — such as bending the cost curve — aren’t particularly likely. Increasing the demand for a service does not usually drive the price of that service down, especially when supply is constrained, as the supply of doctors is in the U.S.
I don’t really see how we can constrain the supply of healthcare as we do in the United States, increase the demand of healthcare as has been the case even without the PPACA which, if it functions perfectly, will further increase the demand for healthcare, and still reduce costs as I think the sine qua non of healthcare reform must be.
But the fact is that, five days before the launch of this massively ambitious redesign of national health care, the insurance policies to be offered in Illinois are still a mystery.
Copays? Deductibles? Premiums? Still a mystery.
Will your doctor and your hospital be included in the insurance networks? Still a mystery.
State officials assured us those details will be cleared up on Oct. 1, when the Illinois health care exchange opens for business. We hope so. But the officials also told us that federal regulators still haven’t quite finished tweaking the plans and rates. That’s probably why insurers we contacted this week couldn’t answer our most basic question — will people pay more or less for insurance than they do now?
We do know that the dizzying number of plans and their costs will differ dramatically depending on where you live in the state. Apparently, there’s more competition in Chicago so Chicago has cheaper healthcare. If that’s the case “slim networks”, limiting competition, would seem to be a perverse approach.
They conclude:
Our best advice for Obamacare consumers is: Caveat emptor. Watch for insurance plans that hold down premium prices by restricting the choices of doctors and hospitals available to customers. Insurers “passed over major medical centers in Chicago” and elsewhere in an effort to tamp down costs, according to a new report from the Health Research Institute of PricewaterhouseCoopers, the consulting firm. That’s a way for insurers to squeeze bigger discounts out of doctors and hospitals.
The state promises to have 1,200 “navigators” available to help guide people through the maze. We’d like to tell you the phone number or website to reach them but … that’s still a mystery.
The Watcher’s Council has announced its winners for last week.
