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Truth Through Combat

Non-admitted patients: the latest baffling turn in health care finance

Key line: “…a striking example of just how impenetrable the US health care system can be for those who use it.”

http://www.bostonglobe.com/lifestyle/health-wellness/2013/08/24/despite-long-hospital-stays-some-patients-never-admitted-leaving-them-with-huge-bills/UjD0YLmFZE2XMtBee6KveN/story.html

Filed under: Health Care, , ,

Why college costs so much

http://online.wsj.com/article/SB10001424127887324619504579029282438522674.html and some reaction to the President’s Buffalo speech on college costs: http://chronicle.com/article/Obama-Proposes-Tying-Federal/141229/. How would Erie Community College fare under his plan?

Filed under: Higher Education Policy, Politics, ,

CBO Cost Estimates for Affordable Care Act (Obamacare)

Here’s the key table out of the report (click the image to see the details):

The seven-year total from years 2015-2022 (the full implementation years) is 1.187 trillion. That averages to a per-year cost of about 170 billion. If you project out to ten years, that gives an implementation cost (after revenues) of 1.7 trillion.

Filed under: Health Care, Politics, , , , , ,

Jonathan Cohn’s Obamacare Error

In today’s column, Mr. Cohn claims the following:

“When the Affordable Care Act became law, CBO estimated that the net result of all these changes, taken together, would be to reduce the deficit. Now, with this revised estimate, CBO has decided the law will reduce the deficit by even more money.

“Yes, you read that right: The real news of the CBO estimate is that, according to its models, health care reform is going to save even more taxpayer dollars than previously thought.”

The CBO estimate in question states the following:

“CBO and JCT have previously estimated that the ACA will, on net, reduce budget deficits over the 2012–2021 period; that estimate of the overall budgetary impact of the ACA has not been updated.”

Filed under: Health Care, Politics, , , ,

Euphemism of the Year: Post-Birth Abortions

In response to Julian Savulescu’s defense of the publication of this short paper on infanticide.

Let me grant – controversially – that there are bad “arguments” on the world wide web. Did you really need to highlight those arguments in defending the publication of this piece? It seems like rather a bit of a strawman. Surely there are better arguments against the publication of the article (some are in this very discussion thread). Why respond to the garbage?

Frankly, there’s a bit of hyperbole here as well: “More than ever, proper academic discussion and freedom are under threat…”

Really? “More than ever…”? Come now, Mr. Savulescu. Surely you know history better than this. The web has transformed dissent-with-a-bullet into dissent-with-a-fallacy. At least I know a red herring made of straw will never kill me.

I would argue that you are wrong to claim the paper is original, which is the real reason that it should not have been published. Singer expressly considers maternal/family interests in “Practical Ethics — Taking Life: Human,” and he certainly was not the first utilitarian to do so.

There’s certainly nothing novel about the rest of the paper. If reminding us that infanticide is happening overseas is a reason to publish the paper, then it would seem that the journal’s audience has become the uninformed layperson – how standards have fallen! Did you really write that, Savulescu? I’m shocked that a writer as original as you would stoop to such a shabby argument in defense of such a cursory piece. Maybe the shift from author to editor…? No, no, I must not go there.

The paper’s provocative. It sparked interest in the journal. As a serious piece, however, it’s just way too short and undeveloped. I am an unpublished academic philosopher, so I have little to hang my hat on as far as denying anyone else their moment in print. However, I would confidently maintain that this is just not substantial enough to be worthy of publication. Less than three pages as an argument in favor of infanticide? No argument by the authors for their take on personhood, but instead merely a “We take ‘person’ to mean…” comment? “We take…”?! That’s a lazy device.

There’s more: No defense of using the concept of a person to adjudicate the abortion debate? No attempt to draw a non-arbitrary line between those non-persons who are merely sleeping and those who are in PVS states or are otherwise incompetent? The inexcusable use of the undergraduate’s favorite phrase “…many humans are not considered…” as a way to deflect responsibility for crafting an argument of one’s own?

The argument at the end of the “potential persons” section did interest me, however: its conclusion is to argue that while there is no obligation to preserve the life of this particular individual since it is not a person and we must therefore privilege the actual lives extant persons, there is an obligation to think about the totally non-existent lives of future generations because such people “will exist” (emphasis on “will”). So, this living thing in front of me exists, but not as a person. It can die because it’s not a person. But this future person that doesn’t exist can’t be harmed/killed because it will exist as a person (no, wait — I think it already exists as a future person). So as long as the newborn in front of me was one of the future persons that I thought about nine months ago before getting pregnant, then it can’t be harmed since it was going to exist as a person when I thought of it. Now, since this article has forced me to think about all future persons (whoever they may be), I can’t justify harming/killing any of them, since I would be killing persons. Therefore people not reading this article can kill any newborn (and maybe any sleeping philosophers), but those of us who have read it are doomed to preserve the lives of all future generations — after all, they’ll be persons. It makes perfect sense.

Now, is this engagement reasoned enough to pass peer review at JME?

Filed under: Philosophy, Politics, , , , ,

Paul Krugman’s “Obama is Missing”

Dr. Krugman alleges in his April 11 column that the $2.9 trillion dollars that would have to be made up by Mr. Paul Ryan’s tax cut could not easily be made up by merely closing tax loopholes because, as he writes:

“The nonpartisan Tax Policy Center puts the revenue loss from these tax cuts at $2.9 trillion over the next decade. House Republicans claim that the tax cuts can be made “revenue neutral” by “broadening the tax base” — that is, by closing loopholes and ending exemptions. But you’d need to close a lot of loopholes to close a $3 trillion gap; for example, even completely eliminating one of the biggest exemptions, the mortgage interest deduction, wouldn’t come close.”

In fact, it appears that closing that particular loophole would net $210 billion a year. This author claims $400 billion. The White House claims the figure is $131 billion. The St. Petersburg Times’ analysis claims that the impact is decreasing and is down to about $93 billion per year.

At worst, then, the loophole — if fully closed — would make up for one third of the lost tax revenue. At best, it would be in the neighborhood of 75%.

Filed under: Politics, , ,

Health Care Update — April 4 2011

Articles on Health Care Reform — Most of them are from the first three months of 2011:

Filed under: Health Care, Politics

Does Universal Health Care Improve Health?

Here’s one post on the subject:

http://www.nationalreview.com/corner/261322/would-universal-healthcare-coverage-actually-improve-health-jim-manzi

Filed under: Health Care, Politics

Is this how a president should act?

A piece on President Obama’s apparent efforts to organize protests in Madison, WI: http://reason.com/blog/2011/02/18/is-this-how-a-president-should

Filed under: Politics

Recent Health Care Reform News

From September 2010 – 6 months after passage:

  • The law calls for each state to set up health insurance exchanges. Here’s a story about how that process is going.
  • An argument on how the plan to create exchanges “undermines quality health care.”
  • McDonald’s is considering dropping its minimum-benefit plans for approximately 32,000 of its workers. The company has sought a waiver from federal regulations that require it to spend 80% or 85% of the money spent on the package on patient benefits. McDonald’s argues that mini-med plans, as they are known, can’t meet that requirement due to high enrollment turnover. Here’s the Wall Street Journal story. Immediately after the story went online, McDonald’s issued a partial retraction.
  • Several companies have been dropping their Medicare Advantage health plans. Here’s one story. Here is the Politifact page evaluating the claim that President Obama has repeatedly made about his plan not forcing anyone to lose their current coverage.
  • Several health insurers have decided to stop offering child-only health plans in response to the law.
  • An article on the increases in health care costs that are forecast for 2011. More on costs, this time on the Dallas market. And another piece on Cincinatti’s costs.

Filed under: Politics, , , , , , ,