A decade ago, Richard Mayhew started writing at Balloon Juice.
A decade later, Dave Anderson is still writing for Balloon Juice. In that time I’ve written over 2400 health care and health insurance posts, another 600+ general purpose posts and engaged in 1.67 career changes while moving my family 400 miles to chase a dream. I never expected to be here for a decade, but here it is.
I always said I would stop writing snarky policy analysis when either I stopped enjoying writing snarky policy analysis or my boss told me to stop for the third time. Neither condition holds, so you guys are stuck with me for another year.
I’ve slowed down over the past two years as I have realized that I only have so many good deep thinking and writing hours a day. PhDing eats up most of those hours. And I know that some of the things that I find interesting and worth writing about might be of interest to eleven people nationally. Five of those eleven are Jackals. It is easier to just drop them an e-mail or get into the group chat for the esoteric and weird. And yes, I know that what I write here is esoteric and obscure and often weird, so please appropriately discount what I consider to be too damn esoteric for Balloon Juice and have pity on my friends and co-authors.
Right now, my big project for the next year is to complete my PhD training and find a job. The three aims for my dissertation are looking at how states implement the ACA and what they do with that discretion. The dissertation is a combination of looking at choice behavior and choice menus. I think how I got to this point makes a lot of sense but it is not the only plausible pathway I could have taken for intellectual curiousity in September 2013.
My proposed dissertation complements some of my other ongoing work. We just got a paper rejected with an invitation to resubmit a substantial revision on the outcomes of states switching from Healthcare.gov to their own state based marketplace. Sketching out our response to the reviewers that do not involve them stepping on a LEGO or mid-day author whiskey is this afternoon’s challenge. I’m involved in another group which is waiting for a decision on a manuscript that looks at reinsurance waiver outcomes. This is part of a recently funded Commonwealth Fund project where we will be looking at administrative burden. Finally, two co-authors and I have an econ paper under review on time and information related moral hazard.
This is FUN!
It is also much narrower and deeper than what I was doing a decade ago. I’ve learned a lot. Some of that learning is from PhDing or being at Margolis for five years. Some of it is just writing three to five posts a week for ten years. Hopefully one picks up things while writing and thinking deeply.
And for that, I’m always grateful to the community here. Watergirl and John for creating a place, and the Jackals for giving me the space to wander and wonder while occasionally being helpful.
Thank you…. and let’s see what decade #2 looks like.
japa21
You have been a great asset. Happy anniversary.
SiubhanDuinne
Thank you for marking this important anniversary with us, and congratulations to you for completing a decade as a Jackal! I honestly would not have guessed you had been producing
weird, esotericvaluable, accessible content for that long. But I trust your math.Good luck as you complete your Ph.D. and find a nice academic job in a place that suits you and your family.
rikyrah
You absolutely rock.
You have been such a blessing to BJ :)
Jerry
Huzzah for Mayhew/Anderson!
Is it getting to be time for a Triangle area meetup to celebrate this milestone?
Chris T.
Get your PhD, but remember the bigger picture. 😀
bluefoot
Happy Anniversary! I am very glad that you’re sticking with us. I don’t comment frequently, but I am always interested in your posts.
stinger
Happy anniversary, and thank you so much for your posts here, esoteric and otherwise!
narya
It never ceases to amaze me the incredible range of expertise and interests that populate this blog, both among the front pagers and the commenters, and I am glad you are one of the long-time participants. (It also amuses me to no end how your career path has included BJ.) Thanks for being here, and thanks for staying
ETA: I have to admit to missing the soccer ref posts a little, but I also like that folks evolve here.
Edmund dantes
I have always enjoyed your posts and learning more about the intricacies and interplay of all the different parts of health care and health insurance.
David Anderson
@Jerry: Let me submit my proposal to my committee first!
Elizabelle
We are fortunate to have you here. Happy personal blogiversary.
AnnaN
Congratulations and Happy Anniversary!
I don’t think I have ever responded to one of your posts but I certainly have read them. :)
Repatriated
Thank you.
la caterina
@David Anderson: Quick Medicare question- I turned 65 on Sept. 1. Am I late to sign up for Part A? I am insured through my job, which has more than 20 employees.
Anyway
Congratulations and good luck with your dissertation.
twbrandt
Thank you for being here, for all you’ve posted, and for continuing on as front-pager. I’ll admit that what you write frequently goes over my head, but what I do grasp always makes more knowledgeable about that subject.
Congrats on 10 years at BJ, and best wishes for your degree and job search!
la caterina
@David Anderson: Not sure if I’m double posting- my post got eaten. Thanks for all the info for the last 10 years!
I just turned 65 on 9/1 but I have not signed up for Part A. I get my insurance thru my job, which has more that 20 employees, Am I late to sign up for Part A
Wvng
Glad to hear you will be staying around for a bit. I haven’t commented in many moons, but always enjoy reading your posts.
Albatrossity
I’d vote for the mid-day whiskey AND the reviewer stepping on a LEGO. But it’s your call.
Thanks for these posts; I learn a lot from them!
Brit in Chicago
Thanks for the decade of posts; since I discovered BJ a few years ago, I’ve been a steady reader of everything you write. Congratulations on the “revise and resubmit” response for the journal: that’s about as good as it gets these days, and with any luck will lead to publication. And good luck with the PhD. (I finished mine—I hate to say it—45 years ago. I was just a child, of course….)
Rusty
Thank you for the education on how we pay for healthcare in the US and particularly the ACA. Your wonkiness on the issues is appreciated and makes you an interesting read (even when I don’t really understand what I am reading). Best of luck finishing your PhD. and on the job search. Focus on those, we can live here with less posts as you square away your dissertation and employment.
David Anderson
@la caterina: You have a window after your birthday to sign up for Medicare. Given that you have equivilent coverage, I think you still have optionality.
Best advice is to speak to a certified Medicare navigator at the Area Agency on Aging. They know this shit cold!
Tom Levenson
We (I) have been so lucky to have you teach us a whole lot, not just about the specific content of your work, but about the techniques and habits of thought required to do that work.
I’m very glad you’ll be around for another year, and hopefully much longer.
David Anderson
@Albatrossity: That is my first response to every reviewer comment.
It is not the useful nor appropriate response that leads to long term success in the profession.
But yes, some reviewers should step on a LEGO.
Re-reading the reviews on this one, they are making reasonable and fixable points. We can do that!
Marcopolo
Learned a lot through your posts about refereeing soccer matches…oh, and also about healthcare 😇
Thanks for joining this circus a decade ago 🙏.
Yarrow
Congratulations on your blogiversary! I’m so grateful for your posts here, especially for helping us make sense of the options on the exchange and how to pick the best one for our needs. Your knowledge on healthcare is extensive. You don’t have to stick around and help us out but yet you’re willing to do so. I really appreciate that.
I’m also very appreciative of when you post saying, “Call your Representatives now!” about some new attack by Republicans on health insurance. Or when you’d post saying, “I know people are worried about [latest health insurance possible attack] but it’s unlikely to happen and here’s why.” It let me ignore the internet chatter and know when it was really time to take action. Thank you so much.
Ohio Mom
@la caterina: The sign-up period is three months before your 65th birthday and 3 months afterward. So you are safe (for now).
I will warn you that if you sign up after this window, at least one of your premiums (I forget which one, maybe it’s Part B) will be higher for the rest of your life. So hurry up and don’t be penalized!
What we did was contact our local Council on Aging and several phone calls later, we were meeting in the public library with a well-trained volunteer who taught us the basics.
There are all sorts of Medicare outfits that are selling plans but this fellow wasn’t, which made me trust him. No hidden agendas.
West of the Rockies
I very much appreciate your presence here, David. I know your insurance posts don’t always generate a ton of comments, but I almost always read them. Best wishes for post-doc success!
Brad F
Brad
It’s always a joy to see a new post from you, David. You are original and thoughtful and write equally for yourself as well as for your audience. On that latter, I wish more bloggers would adhere to that rule as it makes for more engaging and policy-focused content. Over the decade I’ve stiffed you on the free credits worth of learning you passed on gratis. Dont stop :)
Brad
tobie
I have no doubt that you will write an important dissertation quickly which even in a technical field will be more accessible than just about anyone else’s scholarship. You’ve honed those skills with an astonishing output on BJ and we are grateful for your expertise. Happy 10th anniversary posting and may the next decade bring you tons of accolades.
la caterina
@David Anderson: Thanks!
la caterina
@Ohio Mom: Thanks to you too, Ohio Mom!
Cephalus Max
I like your esoteric and weird! Good luck on the PhD-ing
p.s. I still want to have a Triangle meet-up. But maybe we wait until we can toast your doctorate.
Betty Cracker
Congrats! Even with the hookers and blow, your work here classes up the joint!
Ohio Mom
Happy Anniversary!
Every time someone I read announces an anniversary of one sort of another, I realize how many years I have been spending too much time on the internet and I gulp. It’s a cliche but time really does fly.
Not everything you write is esoteric or above my level of comprehension — several years ago, you very plainly explained the answer to an insurance conundrum Ohio Family was facing, and saved us much money (when things were tight for us) and worry.
I know I am not the only Juicer you have helped with insurance issues and I am sure the others remain as grateful as Ohio Dad and I are.
feebog
A decade, whew. Thank you for all the posts, many of them have been educational and quite useful. Glad you are sticking around.
MazeDancer
You make us proud, Mr. Anderson. Happy Juiciversary!
Sandia Blanca
Count me as another who is grateful and admiring of your big brain! Your posts are always welcome, and sometimes I even understand them. We are fortunate to have you educating us. Getting your PhD will be a huge milestone.
catothedog
Thanks a lot for posting here.
I have learned a lot about the economics of medical care and insurance, and it has made me a much informed citizen and voter. I rarely comment on BJ, and hardly ever on your posts, but I read every one of your posts and try to understand them
I do try to share what I learned from you to all my friends and family circle whenever such things come up. I wish a lot more of the people in this country had access to information like your posts (maybe a simpler edition? ) so that they could make informed choices about public policy on healthcare, instead of “death panels” and “moochers”.
Brachiator
Happy anniversary.
I greatly value your contributions here and look forward to more.
MaryRC
Happy Anniversary! I’ve always found your posts interesting.
Kay
Thank you David. You’re great. Good luck with the degree.
Chief Oshkosh
@Chris T.: Having spent a lot of time with people who have PhDs and who are working towards PhDs, I think the size of the PhD bump in the visual aid at the link you provided is…optimistic. But then, it is just a visual aid, and it does make a very important point. Thanks for the link.
JPL
Dave/Richard Thanks for all you do. BTW How’s Claire?
Victor Matheson
Congrats! Thanks for the writing.
David Anderson
@JPL: all good with Claire
David Hyland
I confess to not being smart enough to follow the intricacies of your health insurance posts; however, I hugely enjoyed your soccer refereeing musings. I presume that you no longer have time for that but a post on current soccer ‘issues’ would be welcome… Spain, for instance:)
JPL
@David Anderson: 🥰
There’s always good news.
Capri
I always enjoy your posts, although rarely comment. As someone who is human medicine adjacent they are of great interest. Thank you for your contributions.
What journal will your paper be published in once accepted?
Suzanne
@SiubhanDuinne:
Agreed. I find your posts fascinating and just incredibly informative. I comment rarely, read them frequently, learn something always.
Happy anniversary!
Meyerman
Thanks for your more theoretical contributions and your willingness to address at ground level some of the health insurance woes that plague us all. When I deal with the health care / health insurance system, I am always amazed how the whole thing was concocted by a bunch of sadists who deeply enjoy that our bodily suffering can be conjoined with fear of financial ruin. At times, it really does seem that is the goal of the whole game.
I’m 57. An age at which minor medical problems that can be ignored are beginning to shade into problems that are not to be ignored unless I want to live a markedly shorter life. The interventions that are necessary are larger, last longer, and are more expensive. I’m just slightly terrified. Don’t pull the alarm and that puzzling bump turns out to be malignant melanoma, that sadly just got a little bit too deep and has now escaped. Pull the handle and you’re fine, but do any of us really plan on how spending $25,000 per year on treatment for the rest of our natural life will affect us. (Yeah my HMO plan has $5,000 MOOP per year, but none of us ever need to see a specialist outside of plan, right?)
Your examination of various specific problems shows that due to the complexity and fluidity of the system it is hard for any of the players to succeed (unless you own more than few people in Congress). Looking forward to many more years of enlightenment!
CaseyL
We’ve been insanely, unbelievably lucky to have you here for lo these many years. I’m glad that being here benefited you as well, helping sharpen your arguments and focus. I look forward to at least one more year of your insights and good humor.
Best of luck with the PhD and job search! I can’t wait to be able to address you as Dr. (and would be ecstatic to see you come to Washington state).
StringOnAStick
I have learned so much from you about insurance, and even better it was mostly before my husband and I needed to navigate (heh!) the ACA in our run up to age 65 after retiring early. Without what I learned reading your articles, we would have been paralyzed with indecision.
Your research and PhD provide very important understanding needed by policymakers and regular humans; you should be proud! Thank you for continuing to write here, and I am sure your future is as bright as the sun!
Villago Delenda Est
Richard/David, I’ve always enjoyed your herculean efforts to explain the mindless complexity of a totally unnecessary industry that nevertheless rules our lives with an iron fist. It’s appreciated!
Lobo
Keep writing. I also enjoy the discussion. The Rube Goldberg machine that is our health care system does not lack for ideas on improvement.
Baud
Congratulations to both of you.
Rugosa
Happy anniversary! I was laid off in late 2013 and your posts were invaluable in helping me navigate health care.
HumboldtBlue
You’ve been here a decade and not ONCE have you brought in bagels. Not ONCE
Embra
David, I have to confess I don’t read the entirety of every one of your posts. But every one of your posts brings me a flash of joy that you still grace us with your thoughts. I think of you as my friend with expertise that I could call on for advice if I ever had a problem that was up your alley. Happy 10th!
Burnspbesq
Hope you’re enjoying the euphoria on the Duke campus today.
Youre absolutely an asset to this joint. Glad to have you for as long as you can keep it up.
patrick II
David,
Thank you for your efforts here. I am one of those people who reads all your posts but seldom comments. It is appreciated. So we have experts here on three of the most important things in life, war (how sad), medical care, and pets, plus all of the miscellany. Oh, yeah, plus grouching. Thanks again.
Patrick
Redshift
Glad to hear you’re sticking around! I’m (almost) always interested, even if I don’t have anything to say.
RAVEN
@patrick II: Ditto
scribbler
My husband and I have been self-employed for over 30 years, and finding health insurance was never easy (and often horrible). But your posts have helped tremendously, especially once we got on board the ACA train. Thanks for sharing all your knowledge and know-how about how to get the best coverage for the best price.
One of the Many Jens
Happy anniversary! Thank you for all of the help understanding the ACA and other health policy issues – along with the occasional political snark! I’ve appreciated being able to refer folks to your writing as well.
Here’s to another year! (Decade?) Huzzah! :)
Gin & Tonic
As one of presumably a very small cadre of jackals who knows what IBNR is, I value your knowledge and insights. Best of luck on the remainder of your doctoral work.
Ionize
Thanks for your advice years ago (as Mayhew). Are you still a soccer referee?
sab
@scribbler: Agreed. Ten years we have had the benefit of Mayhew Anderson, and that has taken me from being fired when my husband’s health issues blew up my small employer’s insurance, to desparately seeking insurance as self-employed, to finding out the insurance I did have wasn’t real because of pre-existing conditions, to employer provided insurance that only covered me in the next county not the one where I lived.
I cannot believe my husband and I survived all that to be grateful but grumbling Medicare recipients. But here we are.
Mayhew Anderson explained a lot about Obamacare back in the day, and later a lot about Medicare. His expert commenters (Barbara amongst others) explained more.
There really weren’t a lot of other places to go to learn this stuff if you weren’t already an expert in the field. We didn’t even know which navigators we could trust.
Thank you so much. It’s meant a lot to have this resource.
trollhattan
👍 👍 👍
Your efforts are much appreciated, even as a good portion whooshes past by noggin.
I do miss the tales of the D1 soccer referee, but understand that’s not an easy thing to do while having an actual life as well. Just Sunday attended a match at my kid’s college and had all sorts of constructive criticism for the day’s crew. Once a soccer dad, always a soccer dad (not a yeller, just well-informed opinions).
Miss Bianca
We love you, Dick David Mayhew Anderson!
Ixnay
All of the above. Best of wishes for luck and whatever on your academic writing and research. And many thanks for your presence here.
Kelly
Best wishes on your endeavors. Thanks for the tremendously useful information.
mainsailset
Your pieces are among my must reads everytime one pops up. Thanks for all your research and insights!
Eduardo
Total normie here, still I read carefully some of your posts, and read to get a gist of the issue(s) most of the others. Only don’t read them when I have too much stuff to do. I find them interesting, informative, an engaging read and give me somehow an idea of where the US healthcare system is/is going. Your job make the site better.
Trying to say it has to be way more than 11 people that benefit and look forward to your posts here.
nickdag
I’m very happy you decided to make this site your home. I’ve been reading most of your posts for years, and I’ve often recommended your writing for anyone who wanted to truly learn more about the nuts & bolts of health insurance in the US. You’re hands down the best resource I know of for lay people to understand the impact of policy changes in this space. Thanks!
Also, I can’t see the phrase “hookers and blow” without thinking of your many posts about insurance executives! :)
eversor
Lost me job! Not sad about it. The place was crazy and I’d been cussed out and even physically threatened a few times. To which my response was “there is a parking lot right there with no cameras nut up or shut up”. Don’t threaten me. I’ll take you up on it.
In the end they didn’t have a position for what I do. They needed a jack of all trades IT guru (I am this), an office/operations persion (I am kinda this), and an events manager (not this). The directors were at issues over what I should be doing and when so all things kept not being done on time. Though, they did get done. Just not by the arbitrary times they made up out of thin air to report to their superiors. Which, shit rolls down hill. It’s not possible to do all three. Especially when dealing with the internal drama of the place. I wanted out, but I didn’t have the guts to do it. I’ve got enough funds to couch surf for a bit and find a better fit and the job market is hot.
What I want is, and this will sound odd, a basic sort of help desk job. I don’t want to be locked away in a server room or filling out reports that shit sucks. I like interacting with people. I’m a guru but despite what people here may think I’m a people person and damn good at it. I’m way over qualified for it but a nice senior help desk position at a non profit would suit me just fine. Don’t need the silly money either.
Wasn’t a full firing firing either. Just a more “we adjusted your role” and I just noped at them, they came back with papers and I laughed. What’s utterly fucking comedic about this is I missed the last deadline as the CEO jacked me to do a bunch of office services stuff (hanging pictures of all things and other bullshit) and then I got reamed by the IT director for not doing their stuff. Then got reamed and threatened to be strangled by a partner to which I mentioned the parking lot.
I’m done dealing with crap like that. I’m in my 40s now, I don’t need to put up with this shit. I just need a nice basic job with benefits and to sit at home with the cat after work. I do not need to be threatened to be choked out at work by some lunatic.
pluky
As someone who spent a good chunk of his career as a health pricing actuary, your posts on the game theory of ACA tier pricing were more informative than just about anything else I’ve come across. Kudos sir!
Anonymous At Work
My father was a researcher who talked about “Elvis’s ghost” when responding to reviewers. As in, “You can’t disprove that Elvis’s ghost change the lab results at night” to the bad reviews. He did manage to get some big dawgs, R01s, in his lifetime, so he’s credible on good science/bad science.
Good luck
pluky
@Gin & Tonic: For the non-cognoscenti: Incurred, but Not Reported, claim Reserves.
https://en.m.wikipedia.org/wiki/Incurred_but_not_reported
p.a.
Happy anniversary! And thank you!
Ohio Mom
@eversor: I often say that everyone in the world has the exact same job: make the boss happy.
Yeah, people think they have a profession or a line of work or such but it doesn’t matter what education, skills and talents you have, or what is listed on your resume, just make that boss happy.
BruceFromOhio
Your timing is impeccable, with advent of ACA and all that follows. Thank you for your writings, I am most grateful, and this community most fortunate.
BruceFromOhio
@eversor: Not clear on your location, but the job search agent on LinkedIn has been the bees knees. What you seek is out there!
laura
You’ve been terrific! Because of YOU, I was able to help Roadie Brother the Elder who turned 65 today shop for a Medi-Gap plan on the Government’s Web-site and discuss the available plan offerings. He’s culled the list to weed out Texas or Humana plans and is cross referencing his culled list with Consumer Reports. He will benefit from the portability and be able to advise others. All because of you.
Barry
It’s been good having you here, David!
Madeleine
Thanks, congratulations, and happy anniversary! I’ve enjoyed traveling along with you and expect to continue enjoying the journey.
David Anderson
@Ionize: No, I retired from refereeing a few years ago as my ankles have accumulated too much incremental damage to trust them enough to turn and accelerate several dozen times a game if I’m running a line and several hundred times if I have a whistle.
I still cheer on the refs when I watch soccer and I think that I will never watch a match except from a referee’s perspective. I might pick up the whistle again in the future once the kids are out of the house as low level rec leagues need referees who are vaguely competent or better and I’ll hit that mark even at 3/4th speed for a long time.
dnfree
Thanks again for everything you have shared over the years. I was a computer systems analyst, and even if I don’t understand the health/insurance field, I always enjoy contemplating the complexities of how things work or don’t work, and what unforeseen consequences can occur.
dnfree
@eversor: I used to tell bosses at different jobs that if I had input into the deadline for a project, and I accepted the deadline, I’d do whatever I could to meet that deadline, if it was doable. If someone just came and gave me an arbitrary deadline before I’d even looked into what the project entailed, I’d meet it if I could, and if I couldn’t I’d tell them why, but I wasn’t just signing on to someone else’s idea of how long it would take.
The hardest summer I ever worked I had three bosses over three very visible projects, and they all thought theirs took priority.
Good luck with finding a better job!
eversor
@BruceFromOhio:
Washington DC! I’m not nervous about it, just frustrated.
I’m skilled enough I’d fall into the senior systems admin/site manager role but that’s not what I want. It sucks! It’s too much paperwork and other crap I don’t want to deal with. I’ll take 30k a year less to get a nice help desk job where I can walk about the office and talk to folks.
I put in for Gallup and WETA today.
eversor
@dnfree:
We had an MSP (managed service provider) rollover and like five other balls in the air. This was all dumped on my plate. With hard dates that I didn’t agree to and I knew were not going to be hit. I did hit most of them. Then I got slammed with on site office stuff and other crap that took me out.
Towards the end I realized I was fucked. They’d killed three positions and only had the funds for the IT position. But the other groups assumed I’d be doing the other positions as well. It was a no win. And my attempt to just white knuckle the fuck out of it was futile. My boss needed a scape goat to cover up the multiple internal issues and she and I never saw eye to eye on things and she got her scape goat.
It’s sad in that I met a lot of great people there and it was only a couple months but it’s good in that I wasn’t happy. Rather than taking two months to find a job I think I’m going to take my time and find some sort of senior help desk style thing that pays like 80k and take less money but be happier. I don’t need this shit. I certainly don’t need some partner threatening to beat my ass. Again, parking lot, right there! You wanna go, let’s go. Don’t you dare threaten to kick my ass let’s do this. Working in IT you get used to hostile situations but I haven’t been physically threatened before. I’m not going to take that. I don’t have to take that shit. I can walk the fuck out, as I did, and go find another job.
They fucked up though. They didn’t make me sign an NDA when I left! Which just LMAO, congrats geniuses.
surfk9
Thanks for all of your writing. I have learned so much about health insurance that I never would have otherwise learned.
Ben Cisco
Happy Anniversary, and thank you!!
cain
Love the title! It’s been wonderful listening to your observations on our health care system from a nuts and bolts perspective.
I’ve gained some idea of some of these things and how the ACA works. Thank you for being such a valuable resource.
karen marie
Thank you, David Anderson, for persisting. Reading about health insurance gives me the heebie-jeebies but I take comfort in knowing that there are smart, kind people like you asking and answering Big Questions that will, hopefully, improve healthcare access to all.
Balconesfault
Thanks … I often find myself over my head in the middle of your pieces … but I always learn something.
MMM
Thank you for your contributions. My brother had needed health insurance this year in part due to posts you made here on BJ.
Noname
You’re making people’s lives better including mine. Thank you.