Economics: Health Feed

Weekend Reading: Josh Barro: Healthcare: Republicans Lied. They Deserve Punishment

Clowns (ICP)

Weekend Reading: Josh Barro: Healthcare: Republicans Lied. They Deserve Punishment: "It's hard to decide which would be the more politically damaging outcome for Republican politicians...

...passing the American Health Care Act, and therefore owning the premium increases and coverage losses it would cause; or not passing the bill, and therefore failing to... "repeal... Obamacare." Each option is a political nightmare... an admission that Republicans cannot deliver what they have promised....

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Weekend Reading: Tom Levenson: Why I Hate The NY Times, Part [n]

Preview of Weekend Reading Tom Levenson Why I Hate The NY Times Part n

Weekend Reading: Tom Levenson: Why I Hate The NY Times, Part n: "This paragraph [by Margot Sanger-Katz]...

...There is most likely a middle way. Republican lawmakers might be comfortable with a system that shifts more of the costs of care onto people who are sick, if it makes the average insurance plan less costly for the healthy. But making those choices would mean engaging in very real trade-offs, less simple than their talking point.

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Live from the Orange-Haired Baboon Cage: Erik Loomis: Dumbasses of America: "The genre of 'let’s talk to idiotic white voters who support Trump even though he will decimate their lives' is already more stale than bread baked on November 8...

...However, it does lead to the occasional special anecdote that truly sums up the stupidity of many white people:

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John Peter Altgeld: Wednesday Economic History

John Peter Altgeld

Michael Maggidson (2000_: 1896: John Peter Altgeld: "John Peter Altgeld was born in the German village of Nieder Selters on December 30, 1847...

When he was about three months old, his parents brought him to the United States, settling in Ohio. After a brief stint in the Union Army during the Civil War, Altgeld read the law and was admitted to the bar in 1872. He served as city attorney of Savannah, Missouri and in 1874, was elected county prosecutor. He resigned this post after a year and moved to Chicago, where he established himself as a lawyer. He was married three years later. He soon began investing in real estate and made a small fortune.

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Should-Read: Two possibilities:

  1. Paul Ryan and company are simply not competent--somebody put a real, highly punitive continuous coverage requirement into the ObamaCare Repeal bill; somebody else said "that's too punitive" and changed it; and nobody did the addition.

  2. Paul Ryan and company want this bill--if passed--to lead to an adverse selection meltdown of their (or, rather, Trump's) health care exchanges.

Is there a third alternative?

Aaron Carroll: The AHCA Doesn’t Make Sense: "I’m having a really hard time with this...

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Live from the Republicans' Self-Made Gehenna: It would be interesting to hear what the real Republican health care experts say about the plan to repeal ObamaCare, if any of them dare say much of anything:

Kevin Drum: Emperor's Clothes Blogging: "I've been trying to figure out how to respond to the Republican health care plan...

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Reading: Robert Allen (2009): The British Industrial Revolution in Global Perspective

Notes for forthcoming Econ 210b discussion: Tuesday March 7, 2017; Evans 65: 10 am: Robert Allen (2009): The British Industrial Revolution in Global Perspective | <http://amzn.to/2mR3bKX>

Start with the mysterious "Pseudoerasmus": Random thoughts on critiques of Allen’s theory of the Industrial Revolution:

I love the work of Robert Allen... steel... the Soviet Union... English agriculture. And his little book on global economic history—is there a greater marvel of illuminating concision than that?... His point of departure is always the very concrete reasons that a firm or an industry or a country is more productive than another. I’m not rubbishing institutions or culture as explanations—I’m just saying, Allen’s virtue is to start with problems of production first. Yet I always find myself in the peculiar position of loving his work like a fan-girl and disagreeing with so much of it. In particular, I’m sceptical of his theory of the Industrial Revolution.

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Must-Read: The right moment for Republicans interested in health policy to intervene in the politics was back in 2010, when the "repeal and replace" meme was first decided on. They should have said: "Hell, no!--You really do not want to say that."

My suspicion is that they thought the battle was not worth fighting because the dog would never catch the car. The least they could do is apologize to the rest of us now...

David Anderson: Governing Is Hard: "The Republican Party has an ACA problem.  The ACA is deficit reducing...

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Live from the Orange-Haired Baboon Cage: The orange-haired baboon is far from being the only baboon in the cage:

Scott Lemieux: Just How Monstrous is the Contemporary GOP?: "Matt Lewis discovers that why Republicans never have an alternative health care plan. Perhaps the most instructive part of the piece is this bit of throat-clearing:

Conservative philosophy—from Burke to Hayek—suggests that comprehensive plans are a fatal conceit; the world is too complex to plan. The notion that Republicans could magically “fix” the largest sector of the world’s largest economy is dubious, at best.

Sure, every other liberal democracy in the world uses more government intervention to deliver health care to everyone for considerably less money. But “philosophy” tells us that this is unpossible! Cf. Edumund Burke on the French Revolution.

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Michael DeLong: Will Competition in Health Insurance Survive? The Odds Are Better After Yesterday

Cursor and Preview of Michael DeLong Will Competition in Health Insurance Survive The Odds Are Better After Yesterday

Will competition in health insurance survive?

The answer now is “perhaps”.

The federal courts, at their lowest district court level, have just weighed in on the side of more competition and fewer behemoth health insurance companies; on the side of more competition and fewer monopolies and near monopolies. This matters for consumers: monopolies are bad news, and monopolies where what is being sold is a very expensive necessity—which health insurance coverage is—very bad news for consumers, and so for societal well-being. If we are to retain a market-based health insurance system, people need effective options. A market in which there is only one insurance company, or two companies that collude to match each other’s prices, has all the bureaucratic drawbacks of a single-payer system plus all the drawbacks of a monopoly.

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Reading: Jared Diamond (1997): Agriculture: The Worst Mistake in the History of the Human Race

Jared Diamond (1997): Agriculture: The Worst Mistake in the History of the Human Race http://tinyurl.com/dl20161210a

The coming of agriculture would seem to have only pluses:

  1. You can obtain a lot more food with less work compared with hunting-and-gathering.
  2. You no longer have to carry your babies around the landscape when they are most vulnerable.
  3. You don't have to carry all of your useful stuff with you--hence you can spend more time making durable, useful stuff because it will still be around when you need it.

What's the downside? Jared Diamond says that there are very powerful downsides to the invention of agriculture and the adoption of an agricultural lifestyle? What are they? Is he right?

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Must-Read: Looking forward at the Trump administration, it now seems very clear that under the Trump administration policy will be:

  • random
  • unmotivated by technocratic effectiveness
  • very interested in cutting taxes for the rich
  • very interested in entrenching the economic position of the rich who have Trump's ear
  • likely to produce a number of disasters--think Bush 43, only more so.

Therefore, it seems important that as much as possible should be done to encourage:

  • the neutralization of Trumpism at the state level.
  • the promising of future reimbursement of states that undertake said neutralization.
  • the highlighting--as a yardstick against which to measure policy--of what the plans were had the woman who won the majority of votes become president.

Nicholas Bagley has the ObamaCare front on this:

Nicholas Bagley: Patching Obamacare at the State Level: "If Congress zeroes out the individual mandate—and my hunch is that it will—it’s game over for the exchanges...

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(Early) Monday Smackdown: The Washington Post and Chris Cillizza

Duncan Black: Eschaton: America's Worst Humans: "Chris Cillizza. I'm sure Cillizza got his career opportunities through nothing other than the pure meritocracy...

...that exists in our free market Nirvana. Certainly he got none of the breaks that blah people do. Still if he wasn't doing this, I don't see how he wouldn't be under a bridge somewhere.

Scott Lemieux: Love Is Always Scarpering, Or Cowering, Or Fawning: "This month’s Cillizza Award for Outstanding Achievement in the Field Of Hackdom goes to… Chris Cillizza:

@TheFix: You should watch this Paul Ryan town hall on CNN. The guy is extremely impressive.

@OnceUponA: It is very difficult to have a working understanding of health policy and simultaneously be impressed by his answers on ACA. https://t.co/NTdpL9gTIw

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Memories of Past Policy Disasters, and the Likelihood of ACA Repeal

Clowns (ICP)

Ah. Memories of 1981...

Back in 1981 the Reagan administration promised big tax cuts for the rich; higher defense spending; no spending cuts in programs that were really useful but only in rent-seeking waste, fraud, and abuse; and a balanced budget. They didn't add up. They went forward anyway.

The consequence was the huge full-employment Reagan budget deficit, and gave America a Hobson's choice between:

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Weekend Reading: Mitt Romney: Full Transcript of the 47% Secret Video

Mitt Romney (2012): Secret 47% Video:

Romney: ...And I guess everybody here is a dignitary, and I appreciate your help. And by the way, I am serious about the food. Bring that... clear the place, but Hilary has to eat her beets... [Audience laughs.]

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Beating America’s Health-Care Monopolists: Fresh at Project Syndicate

J Bradford DeLong Project Syndicate

J. Bradford DeLong and Michael M. DeLong: Beating America’s Health-Care Monopolists: BERKELEY – The United States’ Affordable Care Act (ACA), President Barack Obama’s signature 2010 health-care reform, has significantly increased the need for effective antitrust enforcement in health-insurance markets. Despite recent good news on this front, the odds remain stacked against consumers.

As Berkeley economics professor Aaron Edlin has pointed out, consumer abstention is the ultimate competitor. Companies cannot purchase or contrive a solution to consumers who say, “I’m just not going to buy this.” But the ACA requires individuals to purchase health insurance, thus creating a vertical demand curve for potential monopolists. Under these conditions, profits – and consumer abuse – can be maximized through collusion. Read MOAR at Project Syndicate


Live from Trumpland: Who is attracted to voting for Trump? And why am I not--even as more than half of my income class is going to pull the lever for Trump this fall? Is it my urbanity? My education level? My unwillingness to fall for one of the most obvious grifts on the planet? The fact that I took too many American Studies courses as a child and so identify not as "white" but as "Yankee"--a descendant predominantly of East Anglian and Severn Valley Puritans, the position of whose culture and values in America today is not a result of relative numbers?

Josh Marshall wrestles with this hard problem, and comes up with a Polanyiesque interpretation: the disappointment by the market economic system of what had been thought as reasonable expectations leads to a politics of revenge--but not just of revenge against the Masters of the Universe, revenge against those who are somehow getting above themselves and getting free stuff:

Josh Marshall: Trumpism is a Politics of Loss and Revenge:

Trump support is highly correlated with areas experiencing rising mortality rates for whites--a massively important societal development, in addition to a tragedy....

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Must-Read: The extremely sharp Jonathan Chait sends me to one of today's must-reads...

Back when John Roberts as Chief Justice of the Supreme Court did not nullify RomneyCare--excuse me, ObamaCare--from the bench but did lawlessly and without precedent give states the option to nullify the Medicaid expansion part of ObamaCare, I thought that this was a meaningless sop thrown to the right.

My smarter wife Ann Marie Marciarille disagreed. I thought that every governor and state legislator who could add would do the math and note the expanding Medicaid would allow them to do lots of things at the state level--open hospitals and clinics, engage in initiatives, take money that would otherwise have been used to provide uncompensated care and use it for other programs and to fund tax cuts. It was certainly true that I could not find a Republican governor or state legislature who would, in private, say that they welcomed Roberts's nullification-option decision: they all would rather have been forced to expand Medicaid so that they could have spent the money and inveighed against unconstitutional big government tyranny. And so I expected that they would find some way to get it done: find some way to minimize the ideological hit and still get Medicaid expanded so that they could spend the money to expand programs to make their citizens healthier and lower taxes.

I was wrong.

Rather than being a symbolic victory for the right but a substantive nothingburger, John Roberts's lawless creation of the Medicaid expansion-nullification option, when interacted with the poisonous identity politics of Republicans, looks from any kind of technocratic policy perspective that values lower mortality and morbidity like a truly damnable deed--as we see now, as the icejam of cruel policy begins to break:

Noam N. Levey: In Louisiana, Rush to Sign Up for ObamaCare Highlights a 'Long Overdue' Demand for Health Insurance:

Patients burst into tears at this city’s glistening new charity hospital when they learned they could get Medicaid health insurance...

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James Kwak Thinks About Lessons from Steve Cohen's and My "Concrete Economics"

Over at Equitable Growth: James Kwak has, I think, an attack of pessimism of the will--declares that our current dysfunctional economic institutions and policies benefit the "financial institutions, financial professionals, corporate executives, and rich people" who "basically control the American political system", and so "things are unlikely to change anytime soon".

I disagree:

Thanks Obamacare America s Uninsured Rate Is Below 10 For First Time Ever Forbes

And the uninsured rate is likely to dip below 8% when the remaining nullification states finally expand their Medicaid programs.

Read MOAR Over at Equitable Growth

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Can This Capitalism Be Saved?

Robert reich saving capitalism Google Search

Can This Capitalism Be Saved?

Here is piece of mine left on the cutting room floor elsewhere. So I might as well throw it up here.

Reviewing: Robert Reich: Saving Capitalism: For the Many, Not the Few http://amzn.to/29Viz6w

Robert Reich’s Saving Capitalism: For the Many, Not the Few http://amzn.to/29Viz6w is an excellent book. It powerfully argues that America needs once again—as it truthfully reminds us that we did four times in the past—restructure its institutions to build both private and public countervailing power against the monopolists and their political servants in order to right the distribution of income and boost the pace of economic growth.

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A Man for All Seasons Trial 2 of 3 YouTube

Live from the Republicans' Self-Made Gehenna: Zack Beauchamp finds a Republican validator--one of those who has spent most of the past decade stridently arguing that ObamaCare will make America a worse place and needs to be repealed-and-replaced--in the midst of what appears to be a nervous breakdown:

Zack Beauchamp: A Republican intellectual explains why the Republican Party is going to die:

[Avik Roy:]

I don’t think the Republican Party and the conservative movement are capable of reforming themselves in an incremental and gradual way.... The conservative movement is fundamentally broken. Trump is not a random act.... Goldwater... a historical disaster....

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(Late) Monday Smackdown/Tuesday Hoisted Idiocy: Embarrassingly Poor Legal Reasoning from Michael Cannon and Jonathan Adler

Hoisted from Four Years Ago: What passes for Republican think-tannery these days. Judge Paul Friedman's smackdown should have ended this then--rather than later, at the Supreme Court, 6-3, with John Roberts writing:

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible we must interpret the Act in a way that is consistent with the former, and avoids the latter...

The idiocy, from Michael Cannon and Jonathan Adler:

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The Supreme Court's RomneyCare Decision and the Future of Health Care Reform: Hoisted from Four Years Ago

NewImage

J. Bradford DeLong: The Supreme Court's RomneyCare Decision and the Future of Health Care Reform: 07/02/2012: As delivered at the U.C. Berkeley SCOTUS ACA Forum, July 2, 2012:

With respect to last Thursday: One piece of background is all-important in assessing the decision: ObamaCare is RomneyCare.

The health-care reform plan that Mitt Romney proposed when he was Governor of Massachusetts is the health-care reform plan that Barack Obama proposed.

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Underappreciated Weblogger of the Month: A Baker's Dozen from Richard Mayhew

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Another in my series of webloggers who I think are underappreciated--of people who, by accidents of chance and historical contingency, are just as smart (or more) and are as (or more) worth reading as I am. Richard Mayhew of Balloon Juice is doing some of the very most interesting blogging-from-the-trenches of our health care financing system.

Here's a baker's dozen of worthwhile reads:

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ObamaCare Increases the Salience of Antitrust in Health Insurance Markets

From Last January: ObamaCare Increases the Salience of Antitrust in Health Insurance Markets from "Important" to "Essential": As the extremely-sharp Aaron Edlin has taught me, apropos of the current wave of proposed health insurance mergers--Aetna-Humana, Anthem-Cigna, and Centene-HealthNet:

The coming of ObamaCare makes any willingness on the part of antitrust authority to allow these mergers to go through extremely dangerous and destructive policy indeed.

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