It’s an overcast day, and all I wanted to do was sit in bed and read (Neil Gaiman’s Norse Mythology, fyi). The herd was having none of that shit:
I suppose I need to go water all the plants and weed the peas and tomatoes and check on the birds.
by John Cole| 97 Comments
This post is in: Open Threads
It’s an overcast day, and all I wanted to do was sit in bed and read (Neil Gaiman’s Norse Mythology, fyi). The herd was having none of that shit:
I suppose I need to go water all the plants and weed the peas and tomatoes and check on the birds.
by David Anderson| 31 Comments
This post is in: Anderson On Health Insurance
Medicaid Expansion (with work requirements) has passed the Virginia Senate.
22-18 #Hanger budget passes the @VASenate. Medicaid expansion is included in proposal. House of Delegates have already passed this proposal and @GovernorVA has supported it @CBS6 #VaGA #vapol #MedicaidExpansion pic.twitter.com/MJNGF3DXUu
— Jake Burns (@JakeBurnsCBS6) May 30, 2018
It is almost a go as the House has to vote on the Senate package again.
Enrollment is highly likely to start 1/1/19.
by John Cole| 79 Comments
This post is in: Just Shut the Fuck Up
From the no shit files:
Secretary of State William Gardner, other officials from his office and a top election law attorney from the attorney general’s office made a more than two-hour presentation to the state Ballot Law Commission, which is charged with resolving disputes related to election laws. The review consumed 817 work hours by members of the attorney general’s office with help from the Department of Safety.
The key results were:
— Out of more than 94,000 names of people with the same first and last names and dates of birth who voted in New Hampshire and at least one of the other 27 states in the Interstate Voter Registration Crosscheck program, all but 142 were accounted for as being different voters in each state
— In New Hampshire, out of 86,952 people who registered to vote on state primary or general election day in 2016, a total 6,033 did not present photo IDs and as a result signed affidavits swearing that a New Hampshire community was their domicile.
— The secretary of state’s office verified that all but 458 cases were legitimate New Hampshire voters, and referred those 458 cases to the attorney general’s office. The attorney general’s office was able to verify that 392 of those voters were in fact domiciled in New Hampshire and registered and voted properly.
— The attorney general’s office was unable to verify the domiciles of the remaining 66 after exhausting all investigative resources, but a top attorney in the office said it does not mean an unlawful vote was cast in any of those 66 cases.
The notion of widespread voter fraud is such a load of bullshit that even Trump and company couldn’t keep the con running.
Voter Fraud is Not a Problem, It’s An Excuse to Disfranchise MinoritesPost + Comments (79)
by Betty Cracker| 153 Comments
This post is in: Open Threads, Sweet Fancy Moses!
Via TPM, here’s a crazy story out of Ukraine about a Russian journalist (and Kremlin critic) who was reported killed yesterday:
Russian journalist Arkady Babchenko turned up at a news conference in the Ukrainian capital Wednesday less than 24 hours after police reported he had been shot and killed at his Kiev apartment building. The country’s security services said Babchenko’s death was faked to foil a plot to take his life.
Ukrainian police said Tuesday that Babchenko, a strong critic of the Kremlin, was shot multiple times in the back Tuesday and found bleeding there by his wife. Authorities said they suspected he was killed because of his work.
Vasyl Gritsak, head of the Ukrainian Security Service, announced at a news conference Wednesday that the security agency and the police had solved Babchenko’s slaying. He then startled everyone there by inviting the 41-year-old reporter into the room.
To the applause and gasps of the press, Babchenko took the floor and apologized to the friends and family who mourned for him and were unaware of the plan.
“I’m still alive,” he said.
Ukrainian investigators detected an assassination plot and faked the journalist’s death to foil it, then arrested the conspirators. Maybe all countries targeted by Russia need to get more creative to keep Putin’s henchmen from acting with impunity.
This post is in: Free Markets Solve Everything, Open Threads, Blatant Liars and the Lies They Tell, Ever Get The Feeling You've Been Cheated?, General Stupidity, hoocoodanode
I’ve been following the Theranos story. From the first I heard about their objective to do hundreds of analyses from less than a cc of blood, I was doubtful. There are basic and fundamental reasons that more blood might be required for an analysis. Many analyses are to find extremely small quantities of hard to distinguish molecules. Those two qualities together mean that you need a large quantity of the medium in which you are trying to find them – in this case, blood.
Theranos would have had to find a new way to do those hundreds of analyses, which rely on different chemistries, so there would be many new ways they needed to find. Laser enthusiasts at one time believed that they could do this spectrally, which has the feel of initial plausibility, but many unsuccessful attempts have convinced them otherwise. And Theranos wasn’t talking about lasers.
They weren’t talking about any specifics, which was also suspicious. Those alternative analysis methods would require big scientific advances, which would be worth publicizing. Those advances would have to be built on available science, which Theranos wasn’t talking about either.
John Carreyrou of the Wall Street Journal did the digging while other reporters had stars in their eyes over Elizabeth Holmes’s Steve Jobs imitation. Now he has a book out that sounds very worth reading. I am contemplating adding it to my pile of books to read.
It’s quite a story, about which I still have questions. How did Holmes flummox national security experts like George Schultz and James Mattis into being on her board? Why national security types rather than health experts? Was she consciously lying or deluded?
It’s a story of Silicon Valley overreach by many people.
And open thread!
This post is in: Anderson On Health Insurance
California just passed AB-2472, a bill that requires a feasibility study of a set of waivers and options for the California Exchange (Covered California).
This bill would require the board to prepare an analysis and evaluation, known as a feasibility analysis, to determine the feasibility of a public health insurance plan option to increase competition and choice for health care consumers. The bill would require the feasibility analysis to contain, among other things, an actuarial and economic analysis of a public health insurance plan and an analysis of the extent to which a new public health insurance plan option could address the underlying factors that limit health plan choices in some regions.
The legislative history expresses a concern for single insurer counties as well as duopoly counties. I want to go back to some of my Health Affairs pieces to highlight some things that will be discussed. Last August, I suggested that Medicaid be a functional backstop for bare counties:
Medicaid is better suited as a reserve parachute for bare counties. Temporary Medicaid buy-in would be a useful tool for state regulators to improve the quality of plans offered in counties that otherwise would have been bare….The combination of narrow networks, low premiums, and the ACA’s current risk adjustment formula will lead to an unstable equilibrium…However private insurers that offer broad and expensive networks at a higher premium would likely attract a dis-proportionally sicker population who use more services at a higher per unit cost. The risk adjustment formula is based on the average premium in the state. The low premiums of Medicaid would decrease the average state-wide premium. This would result in net flows to the insurers with relatively sicker populations to decrease and those insurers would incur losses. This would likely deter many private insurers from entering a region with a permanent Medicaid competitor.
Covered California uses an active purchaser model so they will be able to mitigate some effects of a Silver Spamming strategy where the lowest cost structure insurer offers several plans priced within a few dollars of the benchmark Silver. Silver Spamming reduces the premium spread and increases the net of subsidy costs for healthy, price sensitive subsidized buyers.
Emma Sandoe and I also noted that Medicaid buy-in options attempt to solve several different problems and we must be specific in asking what problem is being addressed:
The primary reason that many state legislators are advocating for this policy is a hypothesis that it would increase the coverage options for people. More options would then lead to more people gaining coverage. The two most common reasons that people cite for their lack of coverage are the lack of any options and the lack of affordable options. Medicaid buy-in proposals address both options by providing another option at presumably lower-than-typical premiums. …
The critical premium here is the non-subsidized premium.
Politicians have pointed to “bare counties” as a rationale for Medicaid buy-in proposals. At various points in 2017, more than 100 counties faced the possibility of no insurers to serve the exchange population in 2018. Here, the goal of providing a Medicaid coverage option to higher-income families would give them the ability to purchase coverage where no individual market plan was previously available. Bare counties are an ongoing concern of state leaders and citizens as the community-rated, guaranteed-issued market of the ACA is being undermined by recent policy actions such as the elimination of the individual mandate and the proliferation of underwritten short-term policies.
The big question I have with tying Medicaid managed care (MCO) contracts to ACA Exchange participation is one of motivation. Most MCO’s have pre-exisiting low cost, narrow networks built in regions that they serve the Medicaid population and they have current knowledge and relationships that could be leveraged. Some insurers have elected to participate in the Exchanges and some have not. I am assuming that most MCOs are reasonably rationally run and that there is a specific reason why insurers with MCO contracts have entered or exited particular regions. Tying MCO participation to Exchange offerings may increase Medicaid costs.
I think that if California is interested in decreasing net of subsidy premiums for individuals in single insurer regions, they should soften the product restrictions. This would allow the monopoly insurer to offer two Silver plans instead of the single Silver plan. The second Silver should be a higher premium plan that leverages the subsidy formula.
I am sure that the analysis that California performs will address these points quickly and professionally as they have good people with a supportive technical infrastructure that is able to support creative policy making but those would be some of the initial questions… just what does the state mean by a “public option” and how does that play with the markets as they are currently constituted?
by Alain Chamot (1971-2020)| 21 Comments
This post is in: On The Road, Open Threads, Readership Capture
Good Morning All,
This weekday feature is for Juicers who are are on the road, traveling, or just want to share a little bit of their world via stories and pictures. So many of us rise each morning, eager for something beautiful, inspiring, amazing, subtle, of note, and our community delivers – a view into their world, whether they’re far away or close to home – pictures with a story, with context, with meaning, sometimes just beauty. By concentrating travel updates and tips here, it’s easier for all of us to keep up or find them later.
So please, speak up and share some of your adventures and travel news here, and submit your pictures using our speedy, secure form. You can submit up to 7 pictures at a time, with an overall description and one for each picture.
You can, of course, send an email with pictures if the form gives you trouble, or if you are trying to submit something special, like a zipped archive or a movie. If your pictures are already hosted online, then please email the links with your descriptions.
For each picture, it’s best to provide your commenter screenname, description, where it was taken, and date. It’s tough to keep everyone’s email address and screenname straight, so don’t assume that I remember it “from last time”. More and more, the first photo before the fold will be from a commenter, so making it easy to locate the screenname when I’ve found a compelling photo is crucial.
Have a wonderful day, and enjoy the pictures!
Folks, before today’s fare, a quick note about the form – it works again! It was using a bad source for verifying your commentor identity and so failed for more and more folks over time. This HAS been fixed, so please do submit pictures you may have submitted but never ran. I’ve run every set of pictures that came in from the form except for pictures today or yesterday. Basically, form-submitted pictures from early on until this week, if your picture never ran, do re-submit.
Ok, onto today’s glory.
Today, pictures from valued commenter Schlemazel.
SPent a day hiking Monson Lake State Park in West Central MN. I have never seen a swarm of dragonflies, generally they are solitary creatures in my experience. We walked over a mile thought clouds of them. Unfortunately the weather was mostly gray and overcast so the pictures are not great but you will get the idea
A shot against the sky
Taken on 2018-05-27
Monson Lake State Park, MN
everyone of those black dots is a dragonfly & there are more that that don’t show up well
better background
Taken on 2018-05-27
Monson Lake State Park, MN
got a little break from the rain
on a bush
Taken on 2018-05-27
Monson Lake State Park, MN
hard to see unless you zoom in
And a brief video of the swarm, may require download.
Just wonderful. Dragonflies are some of my favorite creatures on this world. Besides their obvious life flying around, they spend a lot of time growing in water, and as a longtime koi pond owner who cleans it out by hand, I’m very familiar with their water stage. I admire dragonflies a lot and have art and decorative items adorned with them.
Although not quite as awe-inspiring as your clouds, I did encounter, two years running, a pond in Colorado where rival species (colors!) of dragonflies lived and battled. And I mean battled. Spearing each other, swarm-attacking lone wanderers, waiting for newly-emerged dragonflies drying off before first flight, just crazy air combat. I got some video and a few pictures, so I’ll try to dig them up and share. These are very amazing creatures, but I fear that pond’s life may have been wiped out during a fire and its aftermath. I know it’s walk-in-only now.
Thank you so much Schlemazel, do send us more when you can.
Travel safely everybody, and do share some stories in the comments, even if you’re joining the conversation late. Many folks confide that they go back and read old threads, one reason these are available on the Quick Links menu.
One again, to submit pictures: Use the Form or Send an Email