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Balloon Juice

Come for the politics, stay for the snark.

People are weird.

You’re just a puppy masquerading as an old coot.

There is no compromise when it comes to body autonomy. You either have it or you don’t.

You can’t attract Republican voters. You can only out organize them.

They traffic in fear. it is their only currency. if we are fearful, they are winning.

Republicans got rid of McCarthy. Democrats chose not to save him.

Wake up. Grow up. Get in the fight.

Come on, media. you have one job. start doing it.

Good lord, these people are nuts.

The lights are all blinking red.

“I never thought they’d lock HIM up,” sobbed a distraught member of the Lock Her Up Party.

He really is that stupid.

It’s easy to sit in safety and prescribe what other people should be doing.

Fuck these fucking interesting times.

How can republicans represent us when they don’t trust women?

Whatever happens next week, the fight doesn’t end.

Stamping your little feets and demanding that they see how important you are? Not working anymore.

Their boy Ron is an empty plastic cup that will never know pudding.

Nikki Haley, who can’t acknowledge ‘slavery’, is a pathetic shill.

Impressively dumb. Congratulations.

If you still can’t see these things even now, maybe politics isn’t your forte and you should stop writing about it.

“Cheese and Kraken paired together for the appetizer trial.”

The truth is, these are not very bright guys, and things got out of hand.

Bark louder, little dog.

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You are here: Home / 2016 / Archives for May 2016

Archives for May 2016

Today In Unsolicited E-Mails

by Tom Levenson|  May 26, 20165:09 pm| 77 Comments

This post is in: Open Threads

I get mail.  This one came today, unsought, unanticipated, and unctuous, from some placement/staffing guy who clearly understands the extensive personnel needs of a writing teacher and sometime scribe:

I am representing the below talented professionals passively seeking their next permanent position.

“Passively seeking…”

A Maid Asleep *oil on canvas *87.6 x 76.5 cm *signed c.l.: I·VMeer·

I’m so using that one as soon and as often as I can.  “I’m passively seeking my Nobel Prize in procrastination…”

(Actually, it made me think of Zombie Eyed Granny Starver Paul Ryan’s non-candidacy for president this year, but that’s another story.)

Consider this a safe-zone thread, open to any and all commentary about anything other than Bernie Sanders’ campaign, character, prospects or destination.  Hell, save the Hillary and Drumpf talk too.  This one’s for the more comfy* absurdities that attend us every day.

*My fingers sped past my brain in my first attempt at that word:  confit.  Almost left it that way — I like the idea of confit absurdities.

Image:  Johannes Vermeer, A Maid Asleep,  c. 1656-1657

Today In Unsolicited E-MailsPost + Comments (77)

It’s All Over But the Crying

by John Cole|  May 26, 20164:27 pm| 253 Comments

This post is in: Election 2016, I Can No Longer Rationally Discuss The Sanders Campaign, Just Shut the Fuck Up

I honestly don’t give a shit if Bernie debates Donald Trump- it’s his god damned reputation he’s ruining. This is over, and this Molly Ball piece nails it:

But in the world Sanders’s supporters inhabit, this is all so much media manipulation. “Do you trust the media?” asked one of his introducers, the television host Cenk Uygur. “No!” yelled the crowd. “Do you believe they’ve treated Bernie Sanders fairly?” “Fuck the media!” yelled someone standing near the press riser. (Sanders was also introduced by two actors, Dick Van Dyke and Rosario Dawson.)

Sanders and his people have their own sets of rules. All you have to do is unskew the delegate counts, they explain, take out the superdelegates, imagine they all vote for Sanders, imagine certain primaries had been conducted according to different rules. Angry memes about missing votes and stolen precincts ricochet around social media. Did you see what happened in Nevada, when the party, Sanders’s supporters claim, changed the rules to keep them from getting more delegates at the state convention? The game is rigged!

The Sanders movement has become impervious to reality. Some have even called into question the nature of reality itself: “Bernie Sanders’ ‘political revolution’ is political only inasmuch as thought is political,” a self-described “metamodernist creative writer” named Seth Abramson wrote in the Huffington Post a few days ago. “By the very nature of things—we might call it perceptual entropy—the impossible, once perceived, enters a chain of causation whose natural conclusion is realization.” By this logic, Abramson reasons, Sanders is actually winning. It’s, like, the Matrix, man, or something.

The Abramson piece is priceless and a must read for Sokol fans. This was my reaction the other day when I read it:

oh good lordhttps://t.co/xtkE7RJWth

— John Cole (@Johngcole) May 25, 2016

Ball continues:

The question is what it will take for Sanders to be satisfied with some sort of moral victory short of the nomination. This week, he was given five slots on the Democratic platform committee, which will allow him to influence what the party stands for—presumably an important goal. Sanders is also thought to be interested in reforms to the nominating process that he has derided as “rigged.”

But while his aides have occasionally alluded to these sorts of goals, Sanders continues to behave like a candidate who still believes he can win. On Monday, he criticized Clinton for turning down one last debate; on Tuesday, he sought to wring an additional delegate out of Kentucky by challenging the vote count in one district. His speeches give about as much critical time to both Clinton and Trump, and his crowds boo both with equal vehemence.

Is Sanders—the onetime liberal gadfly whose views few of his colleagues heeded—simply enjoying the spotlight’s validating glow for as long as it lasts? Or is he as delusional as some of his dead-ender fans? It’s impossible to tell.

Alternate working theory- he’s just a cranky old asshole and we’re finally seeing the Bernie Sanders that his colleagues have been putting up with for decades. That’s why all the Super Delegates went with Hitlery.

It’s All Over But the CryingPost + Comments (253)

I Think I Can Barely See the Light

by Alain Chamot (1971-2020)|  May 26, 201612:04 pm| 181 Comments

This post is in: Climate Change, All we want is life beyond the thunderdome, Looks Like I Picked the Wrong Week to Stop Sniffing Glue, We Are All Mayans Now

So I’ve been kicking around this idea for some years now, and it’s been greatly on my mind for the past few weeks. As time goes on, things appear to be getting clearer, and I’m getting a stronger hold on my thesis. This is the beginning of what I hope to be a much longer treatise or series on this theme, and your comments and feedback are very welcome either in public or private to help challenge, develop and hone it. I’ll be around to discuss and explore with commenters, but please, no tech issues or questions today. That’s soon, not today.

Succinctly, I think we are already deep into the effects of Climate Change without realizing it. To be clear, I’m not talking about the alarming carbon dioxide levels or growing average high temperatures, recurring new monthly record high temperature, fires in Alberta, abnormal highs in Alaska, drought in the Southwest, diminished Arctic ice, or decreased reflectivity of glaciers and snow deposits world-wide due to pollution and soot. This is not about any physical aspect of Climate Change and the Anthropocene era. I’m concerned with the internal psychological, value, and cultural effects, those subsequent effects on populations, and what I see as larger trends worldwide.

I’m not usually a doom-and-gloomer, but there are a lot of powerful and scary currents across a wide swathe of humanity right now that seem, at their root, to share some intangible motivation. I think it’s fear – not of the other, not of progress or modernism or capitalism or Judgement Day or gay rights or transsexuals or Donald Trump or women’s rights or blasphemy or sacrilege or hippies or ethnic minorities or anything else rooted in our normal experience.

I think we, as a species, are already waist-deep into Climate Change and we’re acting like many other species do when put under serious, unseen-from-their-perspective environmental stress: we’re freaking out, and as tension rises, striking out against others and tearing down social and cultural edifices and the order that has served us well for the past few hundred years.

I fear that the future truly is undiscovered country as human history, norms, rules, etc. did not develop under this type of environmental stress – we’ve flourished coincident with a mild climate, and moved on when local climate changed too much or too quickly. Too many ascendant disharmonic forces across the globe strongly question, challenge, threaten, or violate their previous norms of behavior, treatment, principles, values, and history for me to not feel there is a trend, and it’s related. And no, it’s not the plants working together to drive us insane and reclaim the Earth for Mother Nature. And yes, for you wiseacres and cynics, in a way, the ascendency of women’s, gay, and transsexual rights is a positive effect of this break with who we thought we were.

It’s Happening Everywhere
I spend a lot of time reading about, thinking about, reading and listening to the Far Right so-called fever swamp. And to my ears, things have changed, and it truly scares me. Trump is like a stumbling, wind-up toy with lit sparklers sticking out of its head in a dry and dusty storeroom filled with rich fuel. But he’s no more than a match, which is horrible enough and will likely be tragic. He’s just one example, too close, gaudy and loud to ignore, and even if we Americans dodge the bully bullet, the rest of the world is also being challenged, and the good guys won’t win everywhere, certainly not every time.

Trumps scares me and it’s taken a lot of introspection to figure out why – it’s what he’s building off of that really scares me. He’s tapped into something for, although I don’t think he’s very smart in a traditional sense, he is a genius (not used lightly) at reading people and getting under their skin, intuiting what will anger them or put them off-balance so he has an advantage. The thing is, the people he’s appealing to are not just in the South or rural areas, or even just the US, or even the Western or developed world. There are far-right/quasi-fascist movements rising across Western and Eastern Europe, even Western Asia that share an anger, rooted in fear. And they are sharing, working together, learning and cross-training. These are movements that promise a return to greatness, incorporating a fundamental theme of palingenesis. They are organizing, recruiting, training, influencing, even winning (or almost winning, thank you Austria!) elections. Far-right leaders across Europe have reached out to or attended meetings or rallies with Trump!

It’s familiar to those of us who have studied the Right or Fascism – a focus on purity, on land, on blood, on heroes of old, on a strong leader who has the will to set things right. On rebirth, trying to recapture some idealized past when things were better and those “others” knew their place and it was at our feet or cowering in fear. When the future was exciting and not full of dread.

The thing is, it’s not just in Russia, the ‘stans, Europe, or the US. It’s ISIS. It’s the LRA. It’s Boko Haram. It’s Somalia/Kenya. It’s Y’all Queda and other resurgent secession and Confederate movements. It’s the Zetas and other drug gangs that are just as horrible as ISIS. (yes, they’re a drug gang but they are also powerful rebellions and mini chiefdoms that control large parts of Mexico’s territory) It’s a dozen more groups spread across the world. It’s happening almost everywhere, and where there’s not such a growing movement, there are established powers that are dropping their masks and embracing division and cultivating fear, selfishness, scarcity, and envy. And not being called on it like they would have been in the past. It’s like norms and expectations no longer are considered important. And it’s happening everywhere. It’s never been this way before, never so pandemic.

The Era of Migrants
Into this maelstrom of psyche and influence, a new problem has emerged. It’s here, and it won’t stop for hundreds of years – the era of mass human migration. Many point to the unprecedented drought in Syria as leading to the mass migration of the rural population to the cities, the subsequent overcrowding, scarcity of jobs, food and relief, the subsequent rebellion and fracturing of the formerly-strong Syrian state, and it did. You move lots of people and things change.

This instability, coupled with the US-caused fractures and instability in Iraq, and touched off by a millennial cult wishing for an end-times-inducing battle between the powers of the West and their holy warriors bathed in blood, has resulted in ISIS and it has spread. And so we now see millions of refugees, internal and external, and this Era is just beginning.

Germany has been at the lead in accepting their brothers and sisters in humanity, but I fear that a few more exploitations by ascendant movements in Europe coupled with inevitable ISIS attacks will result in walls and dogs and machine guns and barbed wire being first tolerated, then accepted, then embraced as these pressures transform us into something different: more reptilian, less Enlightened.

The thing is, climate migrants are not just far away. Certainly, a not-insignificant portion of Central American emigrants are seeking escape from social fractures heralding collapse of their fragile governments and systems. Just a few weeks ago, an entire city of 125,000 people evacuated due to Climate Change-caused fires in Alberta. Luckily, this was a temporary evacuation, but next time, it may be permanent.

In case you missed it, our first domestic climate migrants are escaping the rising water and sinking land. From Southern Louisiana, very poor rural refugees are being helped by a new model program that will become commonplace the rest of our lives – helping Americans, our brothers and sisters, to relocate and not be thrust into abject poverty and hopelessness.

This is good – while our issues are still small and before they grow, we’re trying to figure out how to best handle this type of situation domestically. But as evidenced by a not-insignificant portion of our governing class (ahem, Republicans) not seeing the importance of fully funding our efforts against Zika before it becomes a much bigger problem (and it will), I fear that we will not continue to develop the capacity and mechanisms to move and incorporate internal climate migrants. So when we need to relocate millions of Americans permanently, we will not be able to do it well, and we will have discord and likely pockets of rebellion and retributive violence against falsely-accused “others”. This is what animals do when under extreme environmental pressure.

When an environment changes and the stresses on a population increase, we humans move on or we fade away. That’s been our history as a species, and one of the chief reasons that we’ve been so successful on this planet the past 500,000 years or so. But in this case, we’re all on the Titanic and we’re all just re-arranging the deck chairs since there are no lifeboats. I think that at a very low, primeval level, we, as a species, know that. And so we are already well into freaking out. We just haven’t realized it yet and we don’t have the leadership and level of trust in our cultures to identify, manage, and overcome our animal nature at the worldwide scale.

So while I look around and marvel at the wonders of everything from our technology, art, science, the beauty and glory of this planet, and the wonderful, kind, silly, beautiful things billions of people do for each other every day, I am filled with optimism and joy. But no matter how much I smile and greet the day, I fear that things will quickly devolve.

The only reason we as a planet survived the Cold War was through wisdom, procedure, communication, fear, and the knowledge that one small mistake could blow everything up. I fear that because this is not as much of a conflict and certainly lacks a clear enemy and intuitive visual of the results of failure – a barren, lifeless radioactive planet -we are not going to be able to adapt well to this ever-growing pressure. Although it seems logical that if there’s a major climate-related issue before the election, the Democrat would be elected, I fear that we’re gibbering apes, and the cocky bully baboon will step into power.

I Think I Can Barely See the LightPost + Comments (181)

Trump-Sanders Debate, Dog Help Us (Updated)

by Betty Cracker|  May 26, 201610:45 am| 366 Comments

This post is in: Election 2016, I Can No Longer Rationally Discuss The Sanders Campaign, Open Threads, Politics, Assholes, General Stupidity, Our Failed Media Experiment

So last night on Jimmy Kimmel, Donald Trump kinda agreed to debate Bernie Sanders “for charity,” and Sanders tweeted, “Game On. I look forward to debating Donald Trump in California before the June 7th primary.” Two questions — the first rhetorical, the second sincere:

1) Is Sanders out of his fucking mind?
2) Any chance this debate actually happens?

Fox News is the network that was going to sponsor the California Clinton-Sanders debate before Clinton declined to participate, which is what frontrunners do when they develop an insurmountable lead. I’m sure Fox News would field impeccably impartial moderators with 100% fair questions that advanced no partisan agenda whatsoever. Not.

Trump left himself plenty of wiggle room in his comment to Kimmel, but if I were him, I’d damn sure try to make this thing happen – what a golden opportunity to ingratiate himself to Sanders dead-enders while bashing Clinton nonstop. It’s all upside for Trump.

Oh, and let’s pause for a moment and imagine the ear-splitting hissy fit the Sanders people would pitch if Hillary Clinton agreed to debate Trump before the primary ends. This kind of shit right here is what made me evolve from “I’m glad Sanders is in the race — he’s pulling Clinton to the left” to “STFU and go away, Bernie.”

UPDATE: From CBS: “Multiple sources told CBS News Thursday morning, however, that the presumptive nominee [Trump] was just kidding about debating Sanders — it will never happen, they said.” H/T: Commenter Mike J.

Trump-Sanders Debate, Dog Help Us (Updated)Post + Comments (366)

Zika Cost update

by David Anderson|  May 26, 201610:11 am| 18 Comments

This post is in: Anderson On Health Insurance

Thanks to Liz Szabo for willing to chase down a number that we needed in yesterday’s Zika post:

@bjdickmayhew The CDC’s Tom Frieden says lifetime costs for microcephaly could be $10 million.

— Liz Szabo (@LizSzabo) May 26, 2016

 

From the CDC on 3/10/2016:

we know the cost of caring for one infant with a birth defect can be up to $10 million or more.  Funding is crucially important and urgently needed.  The rains are coming and with the rains will come mosquito season and with mosquito season will be the risk of explosive spread of Zika as well as dengue and other Chikungunya.

 

 

That works out to be $120,000 in incremental costs assuming an 85 year lifespan. If we assume a 50 year life span, we’re looking at $200,000 per year in incremental costs.

Depending on the life span assumptions, a Zika birth defect case ranges from the equivilent of an additional Hep-C treatment year to a Cystic Fibrosis treatment year. If there are widespread but low level infections and a low probability of significant birth defects from Zika, then state budgets can handle a few more catastrophic on-going claims. If there are concentrated areas of infection with significant birth defects then state budgets will blow up.

Zika Cost updatePost + Comments (18)

Exchange Strategery thoughts

by David Anderson|  May 26, 20168:37 am| 1 Comment

This post is in: Anderson On Health Insurance, C.R.E.A.M.

Exchange strategy is dynamic and I think the new round of pricing plus additional insurance company learning by doing will see some significant changes this during this Fall’s open enrollment period.

@YFeyman we should expect either a big risk Adjustment play for hi cost plans by 2018 or market exits due to low + expensive membership

— Richard Mayhew (@bjdickmayhew) May 25, 2016

This is in reference to New York state pricing. The cost of the second lowest Silver in some regions is projected to go down dramatically from 2016 and 2017 even as the median insurer in the state is asking for an increase. This means there looks to be two clusters on the Silver Exchange market. The first cluster is Medicaid like pricing near the subsidy attachment point of the second least expensive Silver. The other cluster are plans that pay near standard commercial rates to providers and they are much more expensive. The first cluster will get most of the membership and even more of the healthy membership.

Insurance administration needs scale. As I have said before, my job when I was a plumber, was effectively membership scale invariant. A product with 300 people took me as much time to plumb as a product with 30,000 people but my costs were spread out over a much larger population. High cost insurers will be facing administrative scaling problems in markets where there is a Medicaid like provider that gets most of the healthy membership.

Risk adjustment based strategies are a plausible path forward. High cost insurers could offer disease specific plans and make their money by offering good chronic disease control while getting risk adjustment inflows from the low cost plans. The problem with this strategy is the risk adjustment inflow is calculated based on average premiums in the region. The low cost plans bring down regional average premium which means the risk adjustment transfer payment does not fully compensate the high cost plan’s provider reimbursement.

Over the long run (2018/2019), high cost insurers are likely to get off Exchange in regions where there are low cost Medicaid like insurers that get most of the membership.

The other major modification to my thought process on Exchange strategy is on the issue of spamming the exchanges with isomorphs in order to capture the #1 and #2 Silver. This is not a bad strategy but it is a suboptimal strategy.

Let’s use the Chicago zip code 60290 on Health Sherpa as an example for a 40 year old non-smoker.  Ambetter Chicago The chart to the right is the 2016 Silver prices.  As you can see, Ambetter effectively   spammed the Exchanges.  They had the low cost Silver and then another six plans before the first plan offered by another (high provider reimbursement) insurer.  This plan offering configuration means the subsidized individual who chooses the lowest cost Silver pays $3 less per month in out of pocket premiums then they would have if they chose the 2nd Silver.

Right now there is a $54 gap between the first Ambetter product and the first product offered by a competitor.  However there is only a $3 gap between the first Silver and the second Silver.

This is a business opportunity.

Ambetter can make themselves significantly better off (with the side effect of making most subsidized buyers better off) by rejiggering their product offering profile.  Offering fewer silver plans would lead to higher enrollment of healthy people who are heavily subsidized.

They continue to offer the low cost Silver plan at $195 per month and then either discontinue their other low cost Silver plans so that the second Silver  is the Blue Cross Silver plan or offer a medium cost Silver as the new second Silver priced below the Blue Cross offering.  This would increase the Silver subsidy gap bonus.  This would improve their retention of heavily subsidized, healthy members.

Right now, an individual who makes $18,000 a year pays $63 per month for the Second Silver, and they would pay $60 per month for the low cost Silver.  Under this gap maximization plan the Blue Cross Silver would be $63 per month for this individual but the low cost Silver plan would be $9 per month.  Healthy individuals with low incomes are the most likely people to drop coverage because they can’t afford it.  A premium of under $10 per month is far easier for a poor 23 year old Young Invincible to handle than a $60 per month premium.

This is an extreme example as it excludes the relative price dynamics of making the Blue Cross plan much cheaper, so the Blue Cross risk pool will get comparatively healthier as some of the sicker people who are currently in the Ambetter pool buy Blue Cross broader network coverage plans so Ambetter would have even larger risk adjustment outflows.

The highly probably strategy for companies that are very confident that they will offer the # 1 Silver with a large gap between their low price offerings and the next insurer’s lowest priced Silver is a modified plan spam approach with the aim of maximizing the gap without losing too much profitable membership. In this example, that would mean Ambetter would offer the #1 Silver at $195 per month and then the current #5  as their second, benchmark setting Silver plans at $213 per month.  This would make the gap $18 .  For an individual making $18,000 per year, the low cost Silver now costs them $45 per month while there is still a plan choice owned by Ambetter between the subsidy point and the first offering by a competitor.  This will lead to higher initial uptake of healthy, subsidized members during open enrollment as well as less attrition due to failure to pay.

 

 

Exchange Strategery thoughtsPost + Comments (1)

Thursday Morning Open Thread: Working Hard

by Anne Laurie|  May 26, 20165:13 am| 176 Comments

This post is in: Cat Blogging, Excellent Links, Hillary Clinton 2016, Open Threads, Women's Rights Are Human Rights

dave c josephine

Per commentor Dave C:

I work from home. Josephine helps!

***********

Because I can: In the NYTImes, Elizabeth Word Gutting, “What My Mother Sees in Hillary”:

IN 1973, my mother’s first husband was killed in a car crash in downtown St. Louis. My brother, Jason, was nine months old. In swift succession, my mother lost the following things: the father of her first child; access to a credit card; her car insurance; and the ability to take out a loan. The first was terrible luck. The other things were taken from her because she was a single woman — with a son, to boot — it was the 1970s, and, as she put it, “you were not considered legitimate at that time unless you had a man in your life.”

Four decades later, my mom is looking forward to having the chance to vote, she hopes, for this country’s first female president. She and Hillary Clinton are a year apart in age. Though my mom’s experiences are so different from my own, they serve as a constant reminder to me of the work it’s taken for Mrs. Clinton to get where she is today, and the force of society’s attitudes about women, and their value, that she has been pushing against…

At a town hall a few months ago, a young man asked Mrs. Clinton why young people lacked enthusiasm for her.

She sounded a bit wounded, but she tried to explain what she’d been up against for so many years. Despite all the criticisms, she said, over the course of several decades in the public eye, all she could do was continue to stand her ground…

In the years when my mom was a single mother, people commented on her lifestyle with alarming frequency. Why wasn’t she living with her parents, they wanted to know. Wasn’t she worried that if she didn’t marry again soon, her son would grow up to be gay? Her landlord came over after her husband died, hemming and hawing, saying how sorry she was, but also that she was hoping my mom might move out to be closer to family, which would probably be better for everyone.

Well. My mother persevered. She smiled politely and bit her tongue and did what she had to do to survive those rough years…

Thursday Morning Open Thread: Working HardPost + Comments (176)

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