The bullshitter ignores these demands altogether. He does not reject the authority of the truth, as the liar does, and oppose himself to it. He pays no attention to it at all. By virtue of this, bullshit is a greater enemy of the truth than lies are.
Avik Roy is a premium bullshitter when he ‘analyzes’ the premium changes that an unregulated, underwritten market will produce and Obamacare. Let me describe his ‘methodology’:
Our map compares the five cheapest plans available on the market today to the five cheapest plans available on Obamacare’s exchanges.
Let me give you some examples of the policies that he is using to argue rate shock:
Arkansas: $26 per month for a $25,000 deductible 23% applicants denied. 28% uprated.
Ohio: $25,000 deductible, 19% denied, 17% uprated.
Yep, when the comparison is between get hit by a bus and then have the bus back up and run you over again insurance and even Obamacare catastrophic coverage, the get hit twice by a bus insurance that significant number of applicants can’t get actual coverage, looks good. It is a product that does absolutely nothing for the few people that qualify for it. Most will look at $25,000 deductibles and laugh as that is a bankruptcy just as a $250,000 medical bill is a bankruptcy. Oh yeah, it also assumes the applicant is male as women will get higher rates.
Yatsuno
I have never seen a bigger steming pile of bullpuckey than Avik’s little adventure there. It totally bothers me that he gives zero sourcing for his non-ACA numbers, we’re just supposed to accept them as gospel. Then he throws up a bunch of charts that look pretty but are explained horribly and don’t really show shit. But hey, he has CHARTS!!!
jl
Thanks for giving us the numbers behind Roy’s misleading analysis.
From the info you gave, this is reliable and honest analysis from Roy, compared to some of his past work, especially on pharmaceuticals.
Patricia Kayden
How many years are we going to have to suffer through all this anti-Obamacare nonsense? Lawrence O’Donnell is now playing Ed Henry of Fox News asking Jay Carney if Carney and President Obama are going to enroll in Obamacare. Sigh.
RSA
Yay! Thanks for this post–I read Roy’s article and immediately wondered whether he was comparing apples with apples. Apparently it was apples with arsenic.
Yatsuno
@Patricia Kayden:
I just facepalmed.
jl
I really am thankful for Mr. Mayhew’s posts. Really useful info.
But some posts do case ‘commentariate stress’.
The rates are in
https://balloon-juice.com/2013/09/25/the-rates-are-in
started a fight among a vicious pack of rabid jackals, sorry, I mean a ‘frank and vigorous’ discussion, of whether healthy 27 year old male hipsters and brogrammers (just found out what that meant today and I want to show off) and working class stiffs would perceive themselves as getting ripped off by the ACA rates.
Is there any actuarial data on ex ante medical expenditures for 20 something males? I knew of CMS age and gender analyses, but finest cut is 19 to 44 year olds, and that is both sexes. Analysis by gender only does pediatrics, working age (19 to 64) and elderly. So nothing was settled.
Also would like to hear about risk adjustment and reinsurance, since that is arcane stuff hard to find, but I think important to understand whether the robot’s breakfast of metallic policies will hold up to attempts to cherry pick healthier populations.
Thanks again for great posts.
Big R
I need to talk to a historian to find out if this shit is unprecedented, or if it’s the Great Moderation’s tradition of comity that was unusual.
Suffern ACE
@Yatsuno: Yep. That’s a real gotcha there. Its rather hypocritical. I bet he doesn’t stand in line to check in at airports and doesn’t stand in line to buy postage stamps either.
Yatsuno
@Suffern ACE: Does this mean we can impeach him naow?
Suffern ACE
@Big R: Well, there was that whole point in time where we couldn’t even do something like add new states without militias forming and burning down houses of settlers. I’m thinking that period was kind of toxic.
The press, though, likes to roll out that example of Hamilton/Burr and Brooks/Sumner, and then they have a tough time forming a trendline.
I will say this, the stakes in 1850 were very very high. What we are talking about now is coming apart at the seems over healthcare, a problem that every other country that has modern medicine seems to have been able to overcome without resorting to civil war.
Ruckus
Why are we amazed that conservatives lie? They have been lying for my entire life. And I’m old. So old someone called me gramps the other day and I am definitely not related to him.
So back to my question. Is there anything else that comes out of conservatives mouths besides lies?
Richard Mayhew
@jl: Honestly, I think the finely detailed stratified and curated data sets that you are wanting to see are propiertary data.
As a fun research project, we could create our own data set by faking an application for the same person @ 401% of FPL (zip code, smoking status, plan and network) and vary the age and then take the resultant raw premium and multiply it by 0.85 (acceptable MLR) to get a decent idea of what a single company thinks the age adjusted risk cost is. I don’t have time for that.
And yeah a 27 year Brogrammer making 60K or more a year as a contract worker will probably be a loser under Obamacareas the subsidies don’t help and all the underwriting that favored young, single males is now out the window. The 27 year old male barista is massively better off.
Suffern ACE
@Ruckus: Smug self-deception? Sometimes there definitely is smug self-deception.
Yatsuno
@Richard Mayhew:
Please tell me you’re not serious.
Oh thank the FSM. I feel inadequate as it is on this blog half the time.
Origuy
Someone should ask Canadian-Cuban-American Rafael Cruz about his health insurance. He gets it through his wife, a regional division head of Goldman Sachs.
Ruckus
@Suffern ACE:
OK that’s two things that are worse than fucking useless. Lies and smug self-deception. Conservative charm school must be a hoot. No charm and it rains bullshit when anyone opens their pieholes.
ruemara
Thanks, Richard. Made my day, because I am so fucking sick of glibertarian bullshit analysis and when one of them has the gall to say Ted Cruz is smarter than Obama because Obama only had a 3.5 average… just fuck it.
jl
@Richard Mayhew:
“As a fun research project,…”
If you show me where to go, I might have time to do a half ass job over the weekend.
My take is that rates can vary by age, but have to be compressed into a bound of no more than three times premium for one age group versus another (I don;t know where to find the details). So age specific rates should roughly track actuarial estimate, and only question if certain age groups get extra distorted because of that 3x rule. So that is my qualitative BS probably barely worth typing.
” The 27 year old male barista is massively better off. ”
That dude was the source of the problem Nobody cared about the 60K 27 year okd brogrammer. If you could help us out on a working stiff or hipster dude or hapless recent college graduate working 1 to 3 jobs and earning 15 to 20 K a year would be better off, that would probably be appreciated. Would keep us kids from having another fight before bedtime.
Edit: though you did say that in states that did not expand Medicaid, that guy loses (in response to a comment), right?
Jay S
OK, I needed to figure out some market speak. Apparently uprated means charged a higher premium than the one listed.
Comparing bronze coverage to catastrophic coverage plans is nonsense.
So, are there any catastrophic coverage policies left to marry with a medical savings account? This seems to be one place where people are losing their old coverage and may be paying more for improved coverage, at least if they don’t look at their options.
Tim F.
In related news, lemon laws made it much harder to find a dirt-cheap car.
jl
@Jay S: click on the state name links and you will see the details on the policy benefits and historical performance. Actually, the details in the links make the policies look worse than the highlights Richard extracted.
Jay S
@jl:
Not if those jobs get him over 100% of poverty, about 11k for an individual I think.
Jay S
@jl: I clicked on the links. Thats how I figured out what “uprated” meant. While I appreciate Mr Mayhew’s posts, he can be a little terse.
psycholinguist
I think there is still a catastrophic plan available under Obamacare, isn’t there? And the giant bag of dicks that wrote the article, if you follow his “methodology” link, chose to exclude those plans in his comparison. How nice for him. And by the way, even those catastrophic plans appear to be better than the cheap plans in that they give you a reasonable number of visits to primary care physician with no copay, if I read them correctly.
Ruckus
@Jay S:
Richard is not being terse, health care insurance is a complicated product with it’s own language. Not because it necessarily needs to be but making it that way makes it harder for the uninitiated to have any clue, which has always made health care insurance a sellers product. I used to purchase hci for my business and trying to make sense of it so that I could compare offerings took way too much of my time. That should be one good side effect of the ACA and that is making the product a little more understandable to the average person. But it will take time and a little education. It is easier if you’ve had to purchase it for a number of years. Not a whole lot easier mind you but some.
Sly
Roy tried to peddle this bullshit months ago when the rates started coming in from states like New York and California. It’s perfectly designed to be promulgated by people who know little about health insurance (and even less about proper apples-to-apples comparative analysis) but who are convinced that the ACA will destroy all life in the universe and that the evidence for this is one Drudge or RedState link away. I’ve seen it pop up repeatedly on non-political forums and blogs over the past week or so, so I guess its rapidly gaining “zombie lie” status.
pseudonymous in nc
Thanks, Richard: like I said in the earlier thread where Roy’s piece got mentioned, this isn’t comparing apples and oranges: it’s comparing apples and balls of shit painted orange.
Omnes Omnibus
@Suffern ACE: Hamilton/Burr was largely – almost completely personal. They were both young war heroes and lawyers fighting for influence in NYC. Almost everything between them stems from that.
pseudonymous in nc
@Tim F.:
Why oh why do those damn bureaucrats stop us from getting our lunches from Joe’s Salmonella Shack and Hank’s Hepatitis Hut?
Villago Delenda Est
@pseudonymous in nc:
I have a friend who has a glibertarian boss who cannot fathom why any safety regulations of any kind are needed, nor environmental laws, because neighbors would never do anything to damage anyone else’s property values. You know, like building a rendering plant right next to your new swimming pool. They just wouldn’t. It’s not neighborly!
Sinned Backwards
@Big R: The period after the Second World War until the eighties, or even later, is the unusual one.
Back when there were multiple newspapers per town and no radio or tv, this shit was normal. Just didn’t travel very fast.
The thirties were pretty bad too.
After WWII, with the single great enemy, the partisan cooperation on foreign policy, the emergence of a public airways using oligopoly in the electronic media, and reduction of most cities to two or fewer newspapers, the press went through the Edward Murrow/Walter Cronkite age of public responsibility. They ignored or belittled anything that didn’t fit into the Overton window but otherwise they were very fair.
Most of us older folk grew up under that and think it is normal.
Go read newspapers from 150 or 200 years ago to see the real American free press normal.
It was the repeal of the Fairness Doctrine for the public airways, the allowance of antitrust violating media consolidation and finally the innertubes which has led us back to a normal American free-for-all believe-it-at-your-peril public press.
Markos Moulitsas believes the tubes will be our salvation. I see his argument, but we need to tune in for the next episode.
Also, too, 1984 and Animal Farm. Closer than is comfortable.
Have a nice day,
Sinned
pseudonymous in nc
@Villago Delenda Est:
Find out where he lives and I’ll arrange this.
The Dangerman
From the LAT:
They can’t support a bill that’s DOA beyond the House; clearly, these fuckers have lost their minds.
pseudonymous in nc
Basic point: if the non-ACA individual insurance market is such good value, why haven’t people dumped their work-based insurance for it? Could it be because the low end of the individual market has long been a cesspit that preys upon people who want a card that says they’re covered, even if in practice the insurers don’t pay out?
Roy’s argument doesn’t even pass the smell test. The pre-ACA status quo was “get insurance through work, or say your prayers before bedtime”, because even if people didn’t think hard about it, they knew that the individual market was bullshit.
Tissue Thin Pseudonym (JMN)
@psycholinguist:
There are, but even the catastrophic plans under Obamacare have lower deductibles than the ones that Roy is comparing it to.
YellowJournalism
@Patricia Kayden: Journalism at its finest.
Tissue Thin Pseudonym (JMN)
And fuck all the insurance talk. Hockey season started tonight. Or at least the preseason did. Every one of those days in Xi’an when it was 98 degrees and almost that hot in my classroom I thought about how wonderful it would be to be in a building cold enough to have a sheet of ice in it.
And let me tell you, sometimes real life does manage to live up to expectations.
Yatsuno
@The Dangerman: Nancy is going to be bailing out the Oompa-Loompa. Again.
The Raven on the Hill
@jl: “started a fight among a vicious pack of rabid jackals, sorry, I mean a ‘frank and vigorous’ discussion, of whether healthy 27 year old male hipsters and brogrammers (just found out what that meant today and I want to show off) and working class stiffs would perceive themselves as getting ripped off by the ACA rates.”
Well, I already know a working stiff who feels that way, so part of that question is not in dispute. How many of those stiff there are, that I don’t know.
@Richard Mayhew: “The 27 year old male barista is massively better off.”
Only if he can still make his rent. Most service jobs have gotten really bad. Beyond that—I think it depends on whether or not he gets an injury on the weekend he takes his hot date skiing. It’s like backing up hard disks; many people don’t take it seriously before disaster.
This plan does not seem to have been developed with human psychology in mind.
BTW, I really appreciate your comments, both of you. I don’t like this plan, but it seems we are going to be making the best of it until Congress returns to sanity and fixes its problems.
David M
As much of a sniveling weasel as Avik Roy has turned into, he still is one of the more knowledgeable GOP authorities on health care. Seriously, think about that for a while. He is basically the best they’ve got as far as health care policy goes.
He’s written about this issue enough that he knows he’s lying.
Suffern ACE
@The Raven on the Hill: unfortunately, those problems stem from the fact that healthcare costs are very high in this country and it is doubtful much is going to be done about that. One way or another, your barista is going to pay for a solution. I doubt he is going to be happier with a public option. Or a single payor scheme which taxes him more. His taxes weren’t raised last year because this expense was anticipated. Would he like us to raise those?
aimai
@The Raven on the Hill: I really don’t understand the assertion that the entire of the health care law should be constructed to flatter the illusions of a vanishingly small minority of white males who think everything should be free for them. Poor people get subsidies for their health care. Slightly wealthier people don’t. Buying the health insurance is cheaper than having a major accident without coverage. So it has to be bought. I’m sorry if some dudes somewhere thought they could skate but dudes get sick and get hurt just like anyone else and are a massive drag on the health care industry just like everyone else who doesn’t have or see a primary care physician.
scuffletuffle
@Ruckus: I hope you whacked him with your cane…
Barry
@Big R: “I need to talk to a historian to find out if this shit is unprecedented, or if it’s the Great Moderation’s tradition of comity that was unusual.”
I’ll bet both that (a) it’s not unprecedented, and (b) ‘the Great Moderation’s tradition of comity ‘ is something that the media presents us, regardless both of reality and what they were saying at the time.
The Raven on the Hill
@aimai: your sympathy for the poor is touching.
My personal example of a person who’s going to be hurt is a woman in her 20s, just squeaking along, who is going to have a bite taken out of her skimpy paychecks. She’s not alone. Her co-workers are all in a similar situation. There are a lot of people in their 20s like her.
Besides, are you really that much better off? Is everyone you know? What will you say to young people who ask why, in the middle of a depression, they are required to spend money they don’t have?
The Raven on the Hill
@Suffern ACE: yes.
There’s no reason for us to defend the people who are gouging the whole damn country, any more than there’s a reason for us to side with the banksters. We need another sort of health care advisor: one who teaches people to get the best deal out of this thoroughly corrupt system. I am trying to do my part.
Ruckus
@scuffletuffle:
I think it’s funny.
I am in fact old enough to be his dad. I may not like being grandpaw age but the fact is that I am. Not ashamed of it, kind of amazed that I’ve made it this far. The number of times I’ve come within inches of being dead and not ending up that way is more than I like to count. And a lot of them were not of my making or stupidity. That’s even more amazing.
Ruckus
@The Raven on the Hill:
Well you can pay for your bankruptcy over time or all at once. Which is easier? Which is better long term? Not only that but you get something in return paying over time, something that has real value and that one does need, even if they don’t know it. And subsidies are there to make it work for that 20 yr old who makes shitty money in her shitty job. Those things might just make it possible for her to have a life when she hits 30 or whenever.
And of course nothing is the entire answer. Better pay would be nice. A better job would be nice. But living better or at all isn’t all bad in of itself.
Mnemosyne
@The Raven on the Hill:
What’s going to be a bigger bite out of her skimpy paychecks — the Obamacare that pays for her birth control pills, or the accidental pregnancy that results because she couldn’t afford to pay out of pocket for that birth control? What’s cheaper for her, being able to get the annual exam that checks her for cervical cancer, or foregoing that exam until she finds out she’s in Stage IV?
El Cid
I am so sick of seeing Avik Roy’s bullshitting face on talk programs (especially MSNBC) as another one of these lying, filibustering, full-of-shit “reasonable” conservatives that apparently must be invited on, because why would you want a political analysis show in which the people on the show say reasonable, supportable things instead of spin hack bullshit?
Raven on the Hill
@Ruckus: “And of course nothing is the entire answer. Better pay would be nice. A better job would be nice. But living better or at all isn’t all bad in of itself.”
It would be nice if she could continue to be able to pay her rent.
I’d like to see the “you poor people should be grateful for the PPACA” crowd say it to the faces of those poor people. I’d like to see you to say it to the under-employed 55 year olds who have to wonder if taking a better job will wreck their household budgets.
Oh, on average this will be an improvement. But I don’t know any family which has 2.58 children, or whatever the number is nowadays. We don’t live on the average. There are going to be winners and losers, and the losers will disproportionately include young people and out-of-work people aged 55-64. Insurance companies will be winners.
I think our legislative priorities need some adjustment.
Look. I feel like I’m beating a dead horse. I’m horrified by the class attitudes some of these comments are revealing. I’m working to do my best with this barrel of lemons our gummint has handed us, and to help my friends do likewise. The authors of the PPACA didn’t make that job easy and the repugnant Republicans are making matters even worse.
And 2016 is coming. Ted Cruz, who is riding an anti-PPACA platform to the Republican Presidential nomination, will be there to tell us about every loser.
Mnemosyne
@Raven on the Hill:
Actually, no, the losers will disproportionately be people who are currently overextended but make “too much” money to get a subsidy. Low-income people in most states will be fine, because they’ll be covered by Medicaid, or they’ll get a pre-paid subsidy that lowers their cost to almost zero.
It’s the people with two kids who are making $100,000 a year and so don’t qualify for a subsidy who will be pretty screwed, not the poor. But that just won’t sink into your head no matter how many times we point out to you that you are wrong. You have paid no attention to the actual facts and continue to live in your fantasy world.
Raven Onthehill
@Mnemosyne: wow. You write like a single man with a comfortable steady job and good health insurance, who literally cannot imagine what it means to spend an additional $75 a month (that’s an actual figure from the BLC calculator), when you can barely make the rent, who doesn’t know what a middle-class family budget is like these days.
We don’t seem to live in the same world.
Raven Onthehill
There are several different ideas of “success” being used here. Early indications are that the PPACA will, on the average, fund health care for many people who currently can’t afford it. That’s some sort of success. On the other hand, many working poor friend may be pushed over the line, and have to move back in with her parents. Other working poor will simply become homeless. That’s some sort of failure. But for a social insurance program to be a political success, the public has to believe it’s a cooperative program; that it’s something we are doing for ourselves. Here, the PPACA has a much harder row to hoe. Its model was, after all, deliberately designed to project an illusion of individual choice, as well as guarantee profit to health insurance companies. It’s obvious that the system was designed to preserve the business of the health insurance companies, and it’s going to become obvious that the bronze plans are a poor deal—insurance many cannot afford, or afford to use. I think the PPACA is not going to stand politically without major reforms, and I can only hope these reforms will be made, rather than the whole thing repealed, as the leadership of one of our major political parties advocates.
Mnemosyne
@Raven Onthehill:
Yes, the reason I’m able to point out that Obamacare pays for basic preventative care like birth control and annual gyno exams is because I’m a man. You certainly are perceptive.
You definitely write like someone who has no idea what it’s like to decide that you and your boyfriend are going to have to forego having sex for a month because your pill is $50 a month even for the generic, or wonder if that stabbing pain is a yeast infection or a kidney infection. You also seem to have a strange conviction that pregnancy, childbirth and caring for a baby couldn’t possibly cost more than $75 a month, so it’s cheaper to go without birth control than prevent that pregnancy.
I’m also wondering why Medicaid doesn’t exist in your world. It exists in mine. What parallel universe do you live in where Medicaid and subsidies don’t exist and everyone is going to have to pay the full amount out of pocket?
TopClimber
@Raven on the Hill: Insurance companies will win even more than the ACA first allowed, now that some of the holdout states are going to use the exchanges in lieu of expanded Medicaid (AR,MI,PA). But such is the deal we are stuck with until real reform (vs. bullshit repeal) comes to Obamacare, hopefully in the next decade or so.
At least some of the struggling young folk out there benefit from parents who can carry them to age 26 on their own policies. Some beyond that age may get help from parents–an easier task when net premiums are hundreds of dollars less than current COBRA or individual policies. Is it ideal or does it cover young adults without the support of at least lower middle class parents? Certainly not. But as you point out, knowledgeable friends and family can help minimize how many losers there will be.
Raven OnTheHill
@Mnemosyne: I ran the numbers for my working poor friend. She’s just over the threshold that takes her out of Medicaid. She ain’t the only one.
Why do you persist in arguing that these people don’t exist and if they do exist the should suck it up and—become homeless, I guess.
@TopClimber: agree.
Raven OnTheHill
Oh, yes, and there’s another complication. Greedy insurance companies who are messing with their customers. What Digby said:
Michelle Malkin, naturally, is making hay from a similar notice. Thanks, guys.
Read the whole thing.
Mnemosyne
@Raven OnTheHill:
How much is her subsidy? Or did you forget to look at that part of the calculation?
Mnemosyne
@Raven OnTheHill:
Dude. Read the whole thing. Here’s what Digby actually says:
Digby is happy with Obamacare. She’s going to get more value for less money. And yet you tried to pretend that she’s unhappy and will get screwed when that is, frankly, a lie.
Raven OnTheHill
@Mnemosyne: Where did I say that?
What I did say was, @Raven on the Hill: “on average this will be an improvement. But I don’t know any family which has 2.58 children, or whatever the number is nowadays. We don’t live on the average.”
And the problems of this plan fall disproportionately on people who are already struggling due to the depression, and the widening of the income gap between rich and poor. Digby isn’t in the poorer of the groups, but she may fall into the second—the one that is at risk from making too much money.
In analyzing my friend’s situation, I counted the subsidy. My friend will be required to take her employer’s insurance, which is currently $45 every two weeks—$97.50/mo. If she were in the exchange system, with the subsidy, the Berkeley Labor Center calculator put her insurance price at $75/mo. Now, the exchange isn’t live yet, and I don’t know what her employer will do in 2014. They might cut her insurance prices, cut their insurance plan, or cut her hours; all are possibilities.
Raven OnTheHill
@Mnemosyne: What worries me about this is that if this doesn’t go politically, we’ll never get the chance to fix it. And the insurance companies and the Republicans seem to be conspiring to make the plan fail.
Richard, if you’re still there, any idea why the insurance companies are up to that? I mean, the plan more-or-less guarantees them 15% gross on a much larger group of subscribers. From the viewpoint of an insurance company, what’s not to like?
Mnemosyne
@Raven OnTheHill:
Digby’s already checked the numbers. She will be paying less for better coverage.
Facts just don’t sink in with you, does it? Even when people give you information, you insist that they really mean the contrary of what they just said.
Actually, she’s not required to take what her employer offers. I just got a letter from my California employer informing me that I have the right to buy from the exchanges rather than accept what they offer me, and they have to let me do that. I really hope your friend is not taking your advice about insurance, because you’ve already misinformed her at least once just by what you’ve said here.
Raven OnTheHill
@Mnemosyne: You really don’t read what I say, do I? You just go on and on and on. Yes, she’s glad. She may not know—because it hasn’t been publicized yet—that there is an effective “windfall tax” built into the subsidy.
We’re not in California, and healthcare.gov said just the opposite; that the only choice for her was the insurance offered by her employer. This may be at the employer’s discretion. We await October first, the opening of our state’s exchange, and the release of more information from our state Exchange and her employer.
Raven OnTheHill
And, to put all this in perspective, I asked a checker at my local super-mini-market what his health care plans were. He didn’t even know if he had insurance through his employer! Ah, youth.