Does this election season seem to have a higher than normal level of suspected rodent copulation activities and/or incidents that could easily be mistaken for such? It’s early yet, but it kinda seems that way to me.
Open thread!
This post is in: Open Threads, Politics, General Stupidity
Does this election season seem to have a higher than normal level of suspected rodent copulation activities and/or incidents that could easily be mistaken for such? It’s early yet, but it kinda seems that way to me.
Open thread!
by David Anderson| 35 Comments
This post is in: Anderson On Health Insurance, Free Markets Solve Everything
Wellmark in Iowa has a great example of the benefit changes of the ACA and their costs:
Wellmark Blue Cross & Blue Shield is sending letters this week telling about 30,000 customers it plans to raise their premiums by 38 percent to 43 percent next year….
She said about 10 percentage points of the increase stem from the costs of a single, extremely complicated patient who is receiving $1 million per month worth of care for a severe genetic disorder.
Pre-PPACA or with current grandfathered/grandmothered plans that are not ACA compliant, Wellspan would have had a pair of outs. The first one would be that they could have underwritten individuals with severe genetic risks out. They might not be able to say that they are writing out based on genetics but they could write them out on the basis of past service history. The second out would be the lifetime limit. Most individual policies would have stopped paying after $1 million or $5 million in claims.
So what would that have meant in a pre-PPACA world for the patient? Most likely the patient would quickly run through their private insurance. At that point, s/he would most likely either qualify for Medicaid, put on charity care or left to die.
From a policy perspective, it is completely unreasonable to expect a 30,000 person risk pool to absorb one of the top ten claims in the nation. I am slightly surprised that Wellmark does not have reinsurance or stop loss policies on their plans unless they figure that they can self-insure because they are big enough as a corporation to eat the loss of one unlucky division. Risk adjustment does not help as risk adjustment does a decent job of calculating average costs of conditions. A $12 million dollar a year claim episode is an extreme outlier so a risk adjustment transfer might only move a small fraction of the total claim cost to Wellmark.
National re-insurance could be a viable solution. We had talked about a life panel approach where Medicare would act as a claims repricer for a certain set of conditions before.
we identified a set of big chronic conditions that are impossible to game or upcode, this could be an interesting proposal that reduces private medical premiums, and total net medical spend.
Let us take cystic fibrosis and hemophilia as examples. These are conditions that can’t be faked on a chart and can be easily verified. They are also very expensive conditions. Insurers with small risk pools in a particular region/product can be destroyed by having an unnatural cluster of CF or hemophilia members that they cover. Each condition can cost $300,000 or more per personper year to treat. Fifty or more very low utilizers in an exchange or commercial plan are needed to generate sufficient surplus to cover one CF person.
Moving these very high cost individuals to Medicare immediately lowers the medical expenses of the privately insured groups as some of their highest cost members have been removed. This means lower premiums (and for those who think insurers are inherently evil, lower potential profits as the MLR requirements kick in). Medicare tends to pay a lower rate for services than commercial and Exchange plans. The rate for Exchange plans is usually Medicare plus a bit, while large employer groups tend to pay at Medicare plus a lot.
A plan like this could be financed by a covered life set-aside. Every month, every person covered by a fully insured product would see $5 of their premiums go to the national super catastrophic risk re-pricer pool to cover the people who have $8 million/year claims. This would create a defacto national super high cost risk pool that is adequately funded while removing some of the expensive cases from insurers’ books by paying those claims at Medicare rates instead of higher Exchange or commercial rates.
And yes, this type of plumbing work-arounds would not be needed in single payer system but we’re not in that world today nor likely to be in it next year.
This post is in: Cat Blogging, Dog Blogging, Open Threads
Attached is my favorite picture of my current cat and dog (Gracie and Lucy)…
Just for the heck of it, also attached is one of our Gracie as a baby with her previous dogs, James and Patty.
***********
Apart from applauding comity among all species, what’s on the agenda as we start another week?
Monday Morning Open Thread: Cat and Dog, Living Together!Post + Comments (196)
This post is in: Election 2016, Hail to the Hairpiece, Open Threads, Republicans in Disarray!, Assholes
Priebus dodges questions on Trump impersonating spokesman: " I don't know what to tell you" https://t.co/2teRREOFba pic.twitter.com/oEMGEgCIc2
— Talking Points Memo (@TPM) May 14, 2016
From the TPM article, “Priebus: Trump ‘Trying Very Hard To Be Presidential’” —
… In a brief interview with The Associated Press, Reince Priebus also expressed uncertainty about whether the party’s presumptive presidential nominee needs to heal his frosty relationship with House Speaker Paul Ryan before the GOP launches fall campaigns to capture the White House and defend its control of Congress. Ryan, the top Republican in Congress, has declined to endorse Trump, though the two men met privately Thursday in a session both said was positive.
“I’m not sure,” Priebus of the need for a Trump-Ryan embrace. But he added, “I do think that Donald Trump understands, and I certainly understand and believe, that the more unity we have, the better off we’re going to be.”…
Priebus, who attended Thursday’s meeting between Trump and Ryan, said the session “was more Midwest than New York” and said he believes Ryan will end up chairing the party’s July national convention in Cleveland. Trump had threatened to keep Ryan from that largely ceremonial role but has since backtracked.
Priebus repeatedly referred to the problems political professionals have had assessing Trump’s candidacy, saying people have been “completely wrong about Donald Trump and the playbook.”…
… Especially the Repub professionals who thought they could use Trump as an attention-getter before one of the ‘serious’ candidates took the Trump voters. Not everybody looks forward to Monday mornings, but at least we’re not Reince Priebus.
Ya think it's getting to him? pic.twitter.com/MVkLwb4SLk
— Bob Schooley (@Rschooley) May 15, 2016
Late Night Open Thread: At Least You Don’t Have This Guy’s Job…Post + Comments (85)
This post is in: Meetups and social events, Readership Capture
In case you need to set your plans for tomorrow, Shakezula of Lawyers Guns & Money (here), beloved Balloon Juice commentor EFGoldman, and other blog readers will be getting together tomorrow evening at Fado Irish Pub, “5:30ish until the authorities arrive”.
Fado is at 808 7th Street N.W., near Metro Center and Gallery Place stations, i.e. all of the Metro lines. Reservation is under the name Goldman.
Lurkers, friends & spouses always welcome. Leave a comment below if you’ve other questions/suggestions.
Reminder: D.C.-Area Joint BJ/LGM Meetup TOMORROW, Monday May 16Post + Comments (40)
by Randinho| 47 Comments
This post is in: Sports
Some exciting finishes the past few weekends in Europe:
As some of you may remember, in my last post I bemoaned Arsenal’s recently sloppy form. I was also teased by some Tottenham Hotspur fans in the comments. Today, on the last day of the season, all Tottenham needed to do to seal second place was to tie at Newcastle United, the third team from the bottom. Instead, they lost 5-1, giving up three goals after Newcastle had a player sent off (in fairness, one goal was on a very dodgy penalty). Still, if Arsenal did not win against Aston Villa, Spurs could still finish above them.
Alas, no such luck: Arsenal won 4-0 and claimed second place by a point. I’ll let this picture speak for me and all Arsenal fans.
This post is in: C.R.E.A.M., Election 2016, Hail to the Hairpiece, Open Threads, Republicans in Disarray!, Ever Get The Feeling You've Been Cheated?, hoocoodanode
Trump lacks the money to self-finance, subjecting himself to the same pressures he has claimed to abhor. https://t.co/ZVzLTiMiw0
— Steve LeVine (@stevelevine) May 15, 2016
Well, the reactions to this analysis should be interesting. The Wall Street Journal goes there — “As Trump moves to raise big sums, an estimate of his 2016 income shows it short of the big money needed for general election run”:
… When his campaign began last summer, a financial disclosure Mr. Trump filed said he had between about $78 million and $232 million in cash and relatively liquid assets such as stocks and bonds.
That would go fast if Mr. Trump spent an amount close to the $721 million President Barack Obama spent in 2012 up to Election Day, or the $449 million Mitt Romney spent in the same stretch.
This would leave hundreds of millions to be made up. And Mr. Trump’s businesses don’t produce that much in a year, a Wall Street Journal analysis shows. His 2016 pretax income, according to the analysis, is likely to be around $160 million.…
The Journal analysis is based on 170 items of “employment assets and income,” such as real estate, golf courses, management companies and licensing deals, listed in the financial disclosure form Mr. Trump filed last July. The Journal estimated how much pretax income each item should yield this year, relying on public documents and interviews with dozens of former and current Trump Organization executives and people who are familiar with his businesses.
In the absence of Mr. Trump’s tax returns, which he has declined to release, the analysis helps answer a question many wonder about: just how much the candidate earns…
The cash issue looms now because the political season is growing more expensive. The Trump campaign spent about 50% more in March than in February, facing higher expenses for field workers, telemarketing and voter-data operations.
Mr. Trump noted that once the general election campaign begins, the Republican National Committee will be spending heavily on his behalf. The RNC spent $386 million during the 2012 presidential campaign. A clutch of other entities such as political-action committees spent $419 million to back Mr. Romney.
This year, officials at some big Republican PACs are saying they are going to turn their funds toward keeping the Senate and House in the Republican hands, meaning their support for Mr. Trump could be diminished.
On the other hand, legal changes since 2012 make it possible for political parties to raise larger individual donations, via joint fundraising committees with their presidential candidates. Such a joint fundraising committee is what Mr. Trump said in early May that he planned to set up with the Republican Party…
And aren’t the Permanent Repub Party bigwigs with their hands on the purse strings — not to mention the ones required to fill that purse — going to enjoy giving the short-fingered vulgarian their money to waste on futilely challenging Hillary Clinton?
The whole article (I found it by Googling its title) is replete with the sort of details that will fascinate wonks, but it reinforces what non-Trump-partisan observers have been saying since Deadbeat Donald first rode that gilded escalator to announce his run: While $160 million (more or less) would be a more-than-satisfactory income to you or me or most normal human beings, it’s nowhere near enough to qualify Trump for “Really Rich Person” status. Assuming he started this shitshow in the first place to enhance his brand/salve his Obama-wounded feelings/bigly assert his yoooge hand size, the media response to this it will not be fun for him. Watching his noisy rage should provide some tasty schadenfreude for the rest of us, though!
Is Trump Lying About His Bankroll Size, Too?Post + Comments (140)