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Archives for 2010
Posts of the year
Vagabond Scholar has the Jon Swift posts of the year nominated by the bloggers themselves. Check it out.
Yankee Ingenuity
New rules go into effect in January:
The MLR goes into effect in January 2011. The law requires that large-group plans spend 85 percent of premiums on clinical services and activities related to quality of care. Only 15 percent can go to other items, such as administrative costs, advertising and profits.
For small-group and individual plans, the ratio is 80 percent premiums and 20 percent other costs. If insurers fall short of the standards in 2011, they’ll have to issue rebates for that amount in 2012.
Maine has asked for an exemption, but only on the small-group and individual plans.
Days before a key and controversial provision of the health-care law is set to take effect, Maine is the only state to have asked the Obama administration for an exemption
Consumer advocates have hailed the new “medical loss ratio” standard as a ground-breaking protection against profiteering by insurers. But the law’s drafters were concerned that it could prove too onerous for plans selling to individuals, whose customer base is less stable and healthy than those of plans serving small and large businesses. So the law permits states to request temporary adjustments of the standard from the Secretary of Health and Human Services.
Until then, Maine has requested that the medical loss ratio required of its individual market plans be lowered to 65 percent. State officials have also asked that the ratio be calculated using the state’s own, potentially more expansive, definition of activities that can be counted as improving customers’ health.
Maine says that companies that sell small-group and individual policies can’t meet the new MLR rule (80% to medical care and 20% to administrative costs), but I’m wondering if this is about protecting commissions to insurance brokers who sell those small-group and individual policies, rather than any concerns about “onerous” regulation:
The law hits brokers on two fronts: First, it sets up online health insurance marketplaces called exchanges. Beginning in 2014, customers in the individual and small group markets will be able to compare and contrast health plans, which will be regulated by government, without the help of a broker.
Second, starting next year, insurers are required to spend at least 80 percent of their premium dollars on direct medical care. To save money, many are considering cutting or eliminating the commissions they pay brokers, which are considered an administrative expense. Some insurers have already started reducing broker fees.
Insurance brokers lobbied heavily to have their commissions excluded from “administrative” cost calculations during the federal rule-writing process, and failed. Maybe they found a sympathetic ear in Maine?
Speak To Me Your Song of Greed
“Liberal Democrat” Lanny Davis gets skewered in the New York Times. A taste:
When advocates for poor women with infant children began to question if all the federally subsidized baby formula sold in the United States should include fatty acids known as DHA and ARA — which are supposed to make the formula more resemble breast milk — Mr. Davis was hired by Martek Biosciences, the Maryland-based company that makes the additives.
No one was arguing that these additives were dangerous, but there was debate as to whether they were effective.
Mr. Davis stepped in, sending around an e-mail on Capitol Hill claiming that the legislation that would have mandated more research on the additives was being pushed by “lactivists” who want to force women to continue breast-feeding. The provision was dropped.
Lanny also lobbied for the corrupt leaders of the Ivory Coast and Equatorial Guinea, because “[W]hat am I supposed to do if the leader of a country comes to me and says he wants to get right with the world, and get right with the United States?”
Early Morning Open Thread: Reunited
From commentor Paul C.:
When my ex-girlfriend and I moved to Georgia from Myrtle Beach, just over 10 years ago, she promised her kids that they could each have dogs of their own. They took a long time to decide what kind they wanted and ended up with Border Collies because her son saw one on TV, a beautiful long-haired black and white dog, running dramatically across a field, herding sheep by whistled commands and doing amazing things. It said they were smart, and smart is good, and it said they were affectionate, and that is good too, and it said they were very active, which might be good, so he wanted a Border Collie. My girlfriend reasoned that hyperactive children needed hyperactive dogs. I found that reasoning obscure. We found an ad in the paper and took the kids to pick out puppies. I had my eye on one — a little girl with a white face who came running straight to me when I sat down and held out my hand. The daughter chose that one. On the way out, I whispered to her that it was the one I would have chosen.
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I’ve been a dog person all my life, even though I haven’t had a dog since I was a kid. I know people who rent sometimes get dogs and then discard them when they have to move, but I could never live with myself if I did that. Dogs have a deep emotional commitment to the pack, and that sort of behavior would be nothing short of betrayal. Owning a dog is a commitment for the life of the dog, sometimes longer. I tried to explain to the kids that being smart has problems as well as advantages, and you need to be prepared for them and be sure of your commitment ahead of time because it isn’t right to back out. Border Collies are indeed smart, and also highly active. That means they are a load of fun, and easy to train, but it also means they get bored easily, and a smart, bored dog will invent jobs for itself. This is why Border Collies are notorious for bad habits, frequently are given up by overwhelmed owners, and aren’t happy unless you work with them all the time. Bad habits are not endemic to the breed; they just need something to do. They are high maintenance dogs, with high rewards to be sure, but they are a lot of work. Besides, being herding dogs, they are given to some behaviors, like nipping, that others breeds don’t do much and that many people find undesirable.
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You know kids. With the best of intentions, they got the dogs and, once they were no longer puppies, proceeded to ignore them pretty much of the time. What they really wanted was Platonic dogs who could be relied on to take care of themselves for the most part and, once in a great while, be available for hugging and petting and perhaps the occasional ideal fetch. The dogs, Sugar and Bam-Bam (ok, named by a 16 year old girl and an 8 year old boy), fell into some pretty destructive habits, like creating a cratered moonscape in the back yard and eating the drywall. I did what I could. When I was in Athens, I would always take the dogs for walks, or runs in the park. I managed to redirect their digging behavior. I would try to train them in some basic obedience, and I showed the kids how to do it. But I was only there one day a week, at most, and that simply isn’t enough to have a huge effect. Nobody else held up their end of the deal.
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Nevertheless, I loved those dogs. It surprised even me. They were so sweet, and eager to please and would do whatever you asked of them. All they really wanted was for someone to do something with them. It didn’t matter what. They just needed a job and a companion and they were happy. I looked forward to working with them. I loved them so much I even figured out a way to work their picture into a middle school science book that I was writing at work.
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My girlfriend broke up with me in February when the dogs were about a year old… I missed the dogs terribly. I used to have their picture as wallpaper on my computer monitor at work, but I took it off at that time. I couldn’t bear to look at it anymore, knowing that I would never see them again.
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I bought a house in August of that year and, figuring this was about as stable as I was ever likely to be, started planning to get a couple of dogs. I wanted two because I learned from Sugar and Bam-Bam that it is good for the dogs’ mental health. They are pack animals, and it helps to have part of the pack always nearby. I had learned a lot about Border Collies from Sugar and Bam-Bam and they taught me a lot about myself as well. I had always sort of toyed with the idea of getting BC’s, off and on, but after a little reading I always got nervous about the effort that would be involved with such active dogs. What I learned about myself is that, with Border Collies, that effort is not work. Work is what I do at Tech. Being involved with my guys is playtime. So I started seriously thinking about Border Collies…
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I searched the web to see if there were any local breeders with web pages. After plugging “Border Collie Georgia” into Google, one thing that turned up, aside from breeders, was a group called Border Collie Rescue Society of Georgia, a home and adoption service for abandoned dogs. I thought, “Well, that would be pretty responsible — get a dog that nobody else wants, one that really needs me.” So I looked at the pictures of dogs that they had for adoption. The last two on the page were a brother and sister, 2 years old, who had been seriously neglected, and had only each other now. They were separated in their foster homes for the first time in their lives, and she cried for her brother every night. The guy who maintained the web page was asking for someone to adopt both, if at all possible.
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They were named Sugar and Sam, and I thought “I know those dogs.” I’d know them anywhere. Sugar is the most beautiful dog I’ve ever seen; I’d recognize her elegant lines from a thousand miles away. And Bam-Bam has this permanent hangdog expression, but you can tell that he’s up to something. And there they were. Same markings, same posture, everything. I was stunned. Someone could easily have changed Bam-Bam to Sam to make it less silly but close enough for the dog to still answer to it.
College Football Open Thread
Apparently there are some games on…
BTW- I meant to link to this piece on Kodachrome earlier and forgot. For some reason, I found it very sad.
Open Thread: Thursday Night Menu
Courtesy of our Food Goddess, TaMara:
I hope all of you survived the monster winter storm that hit the east coast. As I write this, we are predicted to get about 12 inches of snow today. It’s coming down pretty heavily right now and I’m not looking forward to my drive home. I will set this up to post automatically, just in case. See how much I love you? (Edit: Home safe and sound, roads are ugly)
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Keeping it simple tonight. If your house is like mine, you’re still suffering holiday goodie hangovers, so no dessert tonight, just fresh fruit. Lots of fresh vegetables in this one, too. Trying to help you get ready for those New Year’s resolutions.
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On the board tonight:
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1. Sausage Pasta
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2. Italian Green Bean Salad
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3. Bread Sticks
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4. Sliced Pears
Recipes and shopping list at the link.