Saturday, November 2, 2013

What Mattered This Week?

The latest filibuster showdown in the Senate matters, both because it might very well end the filibuster, and because it matters whether or not Barack Obama's choices wind up on the DC Circuit Court.

I'm not sure what I have for this week, so I'll just repeat the new research which confirms that open vs. closed primaries don't matter.

That's what I have. What about you? What do you think mattered this week?


  1. The continuing revelations of NSA spying on allies leaders and the administration's inability to explain or defend it.

  2. Agree with Jacob that the NSA spying on allies, plus on Apple/Google. Forget if it was Brooks or Shields last night who said something (jokingly!) Like "its o.k. to spy on Germany but you better keep your hands off Apple and Google". When the spying starts hurting US business interests it will stop.

    I also think some Americans losing their health insurance, and Obama getting caught, for real, in a big fib that everybody can see (not some right-wing concoction like "death panels") could put a big hurt on the future success of this Admin and the ACA.

    1. Obama's "big fib" doesn't matter... Already you see liberals making excuses for him, and conservatives acting like it's further proof that Obama is worse than Nixon. The end result of these partisan games is that everyone goes on believing about Obama what they were already inclined to believe.

      That said, if the ACA ends up forcing several million people into health insurance plans that are more expensive and not as good as pre-ACA plans, that's a HUGE deal. From what I'm reading, most of the cancelled plans are being cancelled for legit reasons (plans that don't actually provide coverage, or that have massive co-pays)... in those cases, I think that people are going to shrug off the change (after griping to the media). But it looks as if some people are going to end up paying more for the same (or for less) health insurance coverage. That's a very big deal for those people... and if enough people are effected in that way, then it may signal that the ACA needs serious tweaking.

      So then what? Can the GOP offer an alternative that doesn't terrify voters?

    2. OH! you haven't seen the graph, Brendan!

      The graph shows numerically that it's no big deal at all.

      Of course, if you're not a numbers guy, and a lot of conservative types aren't, you'll probably keep repeating this argument.

    3. @Pat Yeah, those conservatives are just so dumb. Nice argument. Apparently you're not a numbers guy either. After gagging at the obvious spin and bias in the categories of your chart, (exactly as @Brendan predicted) it still shows that 3% of Americans (the "Potential Losers") will lose their existing plan. Obama claimed, repeatedly, as a big selling point for the ACA, that 0% of Americans would lose their existing plan. Before you say "well, 3% isn't much", remember that, according to your own chart, only 20% are affected at all. 3/20 is 15%. So, of the Americans actually affected by ACA, your very own chart shows that 15% of them are potential losers.

    4. According to Sarah Kliff at the Washington Post, of the 5% of Americans who deal at all with the private individual market, most get out of it as soon as they can. Only 17% are in it for more than one year with the same plan. So we're really only talking about 17% of 5%, which is 0.85%. If half of them lose their current plan, we're talking about 0.425%. Most of those will qualify for subsidies.

    5. @Scott - I'm quite willing to wait and see just how many really lose insurance, and how many of them find good alternatives. But, if it turns out to be a lot, that is significant politically.

      Interesting point about most people leaving private insurance quickly. Even in typical job-covered group plans, people change coverage / providers frequently when they change jobs, or their HR dept. changes providers. This is a real problem for US healthcare since the insurers get relatively little financial benefit from keeping you healthy. If ACA brings some stability here that would be a good thing.

    6. It's more a problem for workers. A lot of people haven't been able to afford to leave a bad job because of insurance considerations.

      Here's a consideration about the ACA that I think people haven't really dealt with yet. You're probably aware that there's been a huge increase in the number of children with autism in the last 20 years. The rate of increase has topped out, and is running at 0.2 - 0.5% of the population. It's a brutal statistic, and the toll on families is unreal.

      There is a therapy for autism. It's not 100% effective, and it's very labor intensive for trained psychology personal. It has to start when the kid is two or three. We're talking up to $50,000 a year in costs for up to three years.

      However, without treatment, or with failed treatment, many autistic adults require full institutional care - also tens of thousands of dollars a year. That's for a normal lifespan.

      Most insurance plans don't cover treatment for autism. This is likely because they figure the family will change insurance between the toddler stage and adulthood for the child. The only group that does cover this treatment is the insurance for military families.

      But if we are all guarenteed insurance for life, then maybe these kind of longterm needs can be met.

    7. It's just too early to say whether or not Obamacare is going to work or not. I think that most signs suggest it will work okay once they get the Web site to work. But we don't know yet!
      As a left-winger, I think the end solution is single-payer. Maybe Obamacare will work poorly, and the government will finally give into common sense and switch to the lowest cost, most effective system (single payer). Or maybe we'll have to endure four years of Pres Cruz, and be stuck with a broken health care system for a little longer.

      Or maybe Obamacare will work fine, and we won't go single payer for another few decades. I don't know. Eventually we'll have those Star Trek science healing ray guns, and the whole debate will be moot.

      Regarding autism, there's actually not solid research to show a dramatic increase in diagnosis rates. There has been some increase, but researchers theorize that the rise in the number of children diagnosed has more to do with improved diagnostic procedures. Did you know, for example, that as the number of children diagnosed each year with autism spectrum disorder has increased, the number of children diagnosed with mental retardation has decreased? That said, researchers are desperately trying to figure out what's causing ASD and what parts of the brain ASD is "located." As you say, the only methods currently effective in teaching children with ASD adaptive living skills are evidence-based procedures based on the applied behavior analysis research. Deemed medically necessary by several states, including Texas, California, Oregon, New Mexico and others, ABA-based procedures are covered by health insurance in those states. I think the long-term solution is going to be for the federal government to mandate that ABA-based procedures be covered by health insurance companies nation-wide. I also think that the government should mandate that any child diagnosed should receive 40 hours of services per week, as research has shown that that level of intensity is most effective in teaching necessary adaptive living skills.

      Yes that would be expensive, and the community might have to cover the cost in the form of slightly higher premiums. But if those children were able to become more independent, their parents would be able to have more of a life and a career outside the home. If those parents are able to work jobs (many parents of children with ASD are unable to work, or unable to work full-time), those families will have a higher income. Those families might not have to pay to institutionalize adult children, and that money might go instead to the neuro-typical siblings so that they could go to college and graduate with less student loan debt. Allowing those neuro-typical children to spend more and start households earlier. Families of children with ASD have a higher rate of divorce... possibly having access to those services early in the child's life will lower the pressure on the family and prevent those divorces.

    8. This is super that you're so conversant on this topic. Here's my question:

      How do we get Medicaid to cover ABA?

      Why Medicaid? First, it's the insurer of last resort, so Medicaid will by necessity be covering a lot of children with ASD. Medicaid will also be on the hook for their care if no intervention occurs. So it's in the best interest of the budget, the children, and society to have Medicaid cover ABA. It's rare that we get all these interests aligned!

      Second, once the federal insurers all cover ABA, it'll be harder for private groups to deny coverage. It will take time for them to incorporate it in, because as you say, ABA may well raise rates for everyone.

      Third, every child we can get therapy for is one more family helped.

      So how is this done?

  3. Sox winning the WS after what happened 5 months ago... The rest of the country moved on pretty quickly from it, but Boston will be forever affected.

    1. This is a good point. Sports don't matter much in the grand scheme of world events, but they matter greatly to individuals and communities, and that's something worth respecting.

  4. Not a new happening this week, but here's solid evidence showing how the GOP is only seemingly "post-policy" when it's not in power. When it's in power, it gets to work quite effectively. The upcoming Republican politicians in the states have plenty of policies they're sheparding through their legislatures with the support of both their donors and their tea-party voters, with only limited push back and electoral threats from their larger electorates:

  5. There seem to be a lot fewer stories about Obamacare website woes, I'm tempted to say that's because it's actually improved somewhat (although some people are still probably having problems) if that's true it certainly matters. And although the polls have tightened somewhat it looks like we are at the point where we can bet the farm on McAuliffe wining in Virginia.

    I guess we've already gone 100 times around the barn with this one, but since in Saturday I'm going to say that I enjoyed Alex Seitz-Wald's article on blowing up (his term) the Constitution:

    Not because it makes the case well that we should blow up the Constitution, but because of the insane alternatives anti-Maddison people are actually offering. Larry Sabato thinks we can fix politics by making Dick Cheney and Dan Quayle Senators-For-Life Pinochet style:

    "The Senate, he says, should be expanded to give more populous states at least a bit more representation, and it should also include "national senators"—all former presidents and vice presidents, maybe others—whose job it is to guard national interests over parochial ones. Sabato's plan would also double the size of the House (to make representatives closer to the people) and enforces a nonpartisan redistricting process to end gerrymandering. Elections for president, Senate, and House, in Sabato's vision, are rescheduled to coincide more often, while presidents would serve a single, six-year term (the idea is to make their governing less political, while giving them enough time to implement change)."

    I love that "maybe others" line (is this a call for making Tom Friedman a Senator-For-Life? It should be!) Does anyone have links to what a new system might look like practically? I've seen a few ideas but usually they are pretty vague and just mention proportional representation.

    1. You don't need to go to Pinochet for Senator-For-Life scandals, you only need to head up to Steven Harper's Canada...

  6. For some reason, I thought of this today (for the first time), after having been reading your blog for several years. It's a rock-and-roll album title, one of my favorite album titles...John Mellencamp's "Nothin Matters & And What If It Did?"

  7. The newest Snowdon leak, which tells us that the NSA does not recognize fourth amendment protections for personal files stored in "the cloud."

    Obviously, there are some big policy implications to this. But it also tells us that James Clapper was lying even when he said he was coming clean. In the aplogy letter, he said that his answer to Senator Wyden, that the NSA does not collect the data of millions of Americans, was false -- because he read "data" as being content, not metadata. Well, it turns out that the NSA is also collecting content from the millions of Americans who use Yahoo and Google services.

  8. By the way, Jonathan, I am curious what you think about the filibuster of Rep. Watt. Ostensibly, the Senate GOP doesn't like *him* - they say it's a question of experience and qualification. They aren't threatening to block others and they aren't objecting to the job itself (well, they'd like to reform Fannie and Freddie but then so would alot of Democrats).

    How legitimate do you think those objections are?


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