California doctors don’t ♥ Obamacare

The New Neo Posted on by

California may have one of the better state Obamacare websites, but it sure doesn’t seem to have one of the better rates of reimbursement for doctors. And that may have big consequences:

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said…

California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.

In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor.

In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.

Only in September did insurance companies disclose that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. That’s driven many doctors to just say no.

They’re also pointing out that Covered California’s website lists many doctors as participants when they aren’t.

“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.

As I’ve said before, the websites are turning out to be somewhat of a Potemkin village: a facade of something rather than the real thing. California seems to be a particularly egregious case, and it’s an important one because it is one of the most populous (and liberal, I might add) states in the union. If California fails to enroll a lot of people, it can’t end up very good for Obamacare. And if California does end up enrolling a lot of people and there are far too few doctors to serve them, it can’t end up very good for Obamacare.

I also wonder whether putting those doctors on the website as network participants when they are not was in fact an accident, or whether it’s a form of mild coercion that will soon become not-so-mild.

[NOTE: Regarding the title of this post—now that I’ve learned how to use HTML to make a heart, I seem to be doing quite a bit of it.]

72nd anniversary of Pearl Harbor

The New Neo Posted on by

[NOTE: This is an updated repeat of a previous post.]

Today is the seventy-second anniversary of the December 7, 1941 Pearl Harbor attack. The generation that reacted to it by mobilizing and fighting World War II is on its last legs. But they were the ones we still call “the Greatest.”

I was reminded of this while watching one of those Oliver North “War Stories” TV shows, about Pearl Harbor. It featured some of the elderly participants reminiscing about that long ago day. Before each one spoke, there was a photograph of him back in 1941: young, vibrant, handsome, full of life. Now they were ancient, and most only vaguely resembled their former selves. But they still transmitted great moral strength and a kind of Gary-Cooperesque stoicism and understated bravery as they told their stories.

A couple of facts: it’s become fashionable to believe that FDR knew about the attack in advance and let it happen anyway. But those 12/7-truthers are almost undoubtedly wrong. Roosevelt wanted to get us into the war, and he knew a Japanese attack was coming at some point, and informed his generals to that effect, but he knew none of the particulars in advance.

This idea of a government in cahoots with the enemy, willing to let innocent Americans die, keeps coming up again and again. A certain not insignificant segment of the population appears to favor such conspiracy theories, probably because we don’t like feeling vulnerable to sudden attack. We’d rather think Daddy in the White House could have stopped it but chose not to—that makes him powerful but amoral, rather than powerless to protect us.

Here’s a post I published fiver years ago on Pearl Harbor Day. It focuses on FDR’s famous speech afterward, and the will and resolve he amply demonstrated. Will and resolve in war remain extremely relevant these days, in Afghanistan (at least Obama hasn’t made any references yet today to “the bomb that fell on Pearl Harbor,” his gaffe from July, 2008).

Here is just a little bit of Roosevelt’s post-Pearl Harbor speech, in case we need reminding of what American resolve used to sound like:

”¦No matter how long it may take us to overcome this premeditated invasion, the American people in their righteous might will win through to absolute victory.

Here’s the speech itself:

The memorable phrase that began FDR’s address, “a date which will live in infamy,” wasn’t in Roosevelt’s earlier draft. It reads “a date which will live in world history.” That sounds like a high school essay; Roosevelt crossed out “world history” and added “infamy” in his own hand. A wise choice.

All presidents lie

The New Neo Posted on by

I suppose most of them—or at least many of them—do.

About sex.

About any number of things–usually minor things, or self-serving face-saving things when caught in error, or about things like smoking marijuana.

They also make errors: Bush on WMDs would be a good example, or Bush I’s promise not to raise taxes.

But I can think of no president who has lied in the way Obama has: about the fundamentals of who he is politically. About his plans for the United States. About the most basic details of a huge program he’s promoting, knowing he’s lying even as he’s promoting it.

That’s why I get so angry when I hear Obama supporters excusing him by saying “all presidents lie.” Not like Obama, they don’t.

Not to mention that long, long ago, in that time of hope and change and dewy-eyed voter optimism known as 2008, Obama was considered by his supporters to be someone who was above all that. Now they are reduced to shrugging their shoulders cynically and saying he’s no worse than all the others.

But actually, he is. Much worse. All lies are not created equal.

Whose work is this?

The New Neo Posted on by

Who was the artist, and when?:

durerPillows

It’s a drawing by Albrecht Dé¼rer, made in 1493 when he was 22 years old. It seems remarkably contemporary to me, considering. I guess pillows haven’t changed all that much—except for the invention of Memory Foam.

I don’t much care for memory foam. Sometimes it seems too hard and heavy; just not right. I prefer a pillow I can pummel and fold and wrestle with.

Here’s one of my very favorite (and timeless) Dé¼rer works. It is hyper-realistic, but unlike some art of that type it isn’t sterile. It conveys the character of a living, breathing animal:

DurerHare

Oh boy, now we have to worry about…

The New Neo Posted on by

…the destruction of the human race by artificial intelligence:

In 267 brisk pages, Barrat lays out just how the artificial intelligence (AI) that companies like Google and governments like our own are racing to perfect could — indeed, likely will — advance to the point where it will literally destroy all human life on Earth. Not put it out of work. Not meld with it in a utopian fusion. Destroy it…

ASI is unlikely to exterminate us in a bout of Terminator-esque malevolence, but simply as a byproduct of its very existence. Computers, like humans, need energy and in a competition for resources, ASI would no more seek to preserve our access to vital resources then we worry about where an ant’s next meal will come from. We cannot assume ASI empathy, Barrat writes, nor can we assume that whatever moral strictures we program in will be adhered too. If we do achieve ASI, we will be in completely unknown territory.

The theme of countless science fiction plots, come to life (or death)? Frankenstein, or the Modern Prometheus? Those of you with more scientific acumen than I can read the article and decide for yourself whether such a scenario is likely. Quite a few of the article’s commenters are skeptical.

RIP Nelson Mandela

The New Neo Posted on by

Nelson Mandela has died at the age of 95, and the inevitable articles have appeared summarizing his life and accomplishments. Some laud him as a saint, or at the very least, saintly. Others use the occasion to make political points of various kinds.

Mandela was a complex figure whose long life encompassed many changes and some contradictions and flaws. For example, he was an advocate of violence in his youth, and if not a Communist certainly a Communist sympathizer (a buddy of Castro) and a socialist. He was pro-Palestinian and pro-Arafat.

But he was a great man and turned out to be a surprising one, given his earlier history. When Mandela emerged from prison into a changed world and South African leadership, he decided to go a different way than the rest of the new black leaders of Africa:

In the half century since white colonial rule ended in Africa, leaders in country after country have promised freedom and democracy only to become corrupt dictators, often unleashing killing fields of violence. Uganda’s Idi Amin. Zimbabwe’s Robert Mugabe. The list is long.

Mandela had more reason than most to follow this very human path of vanity and racial revenge: he spent 27 years in white-run prisons, many in solitary confinement, many doing hard labor. But Mandela responded by doing the opposite, the unexpected. He became the anti-dictator. He became, in his own lifetime, a history-changing figure with powerful moral authority like India’s Mahatma Gandhi or Burma’s Aung San Suu-Kyi…

…[W]hen he was finally freed [from prison] in 1990, he worked with white President F.W. de Klerk to keep whites from fleeing, to prevent a wave of racial violence…[W]hen Mandela won the first democratic elections in 1994, he appointed de Klerk his deputy and kept many whites in the government, the exact opposite of the cruel, kick-them-out revenge others wanted…[H]e established Truth and Reconciliation Commissions, offering amnesty for the truth…[H]e used sports to promote reconciliation, encouraging blacks to support the once-hated Springboks, South Africa’s white rugby team…[A]fter just one term as president, he stepped down.

That last sentence is especially telling: he did not consolidate and extend his personal power in the way of so many dictators. Perhaps something about his 27 years of prison acted as a crucible to allow him to emerge a better and wiser person than when he went in. But there was nothing inevitable about that result, and it speaks to Mandela’s own strength of character that it happened that way.

What will happen to South Africa now? It may go down the dreadful path of some of its neighbors. But if it does not, it will be no small thanks to Nelson Mandela.

RIP.

This may make people think twice before they steal a truck

The New Neo Posted on by

I guess you never know what’s in it.

A nightmare:

Federal police and soldiers formed a cordon of several hundred yards around the highly radioactive container of cobalt-60, stolen earlier in the week in a carjacking as the material was being moved from a public hospital in the border town of Tijuana to a storage facility in central Mexico, news reports said.

The carjackers, who set off international alarm bells by absconding with the material, most likely had no idea what they were stealing and will probably die soon from exposure, Mexican authorities said at the end of a brief national scare.

The material had been in a Volkswagon truck that was equipped with a crane. The drivers had been waiting at a gas station until the facility to which they were delivering the material would be opening, when they were jumped and beaten by two men who then stole the truck. Speculation is that the thieves were interested in the crane, but their curiosity about the box most likely will do them in:

The cobalt-60 was found, removed from its casing, in a rural area…Jimenez said he suspected that curiosity got the better of the thieves, and they opened the box…

“The people who handled it will have severe problems with radiation,” he said. “They will, without a doubt, die.”

What will happen with health insurance on January 1?

The New Neo Posted on by

Aside from having to date your checks “2014,” that is?

Ace speculates:

We tried to figure out exactly what the hell was going to happen on January 1st, given that Obamacare kicked five million people off their insurance, and would certainly not manage to sign up that many by the deadline…

John Ekdahl suggested that Obama will just order hospitals and doctors to treat anyone who says he has insurance, whether he does or not. I believe Ekdahl’s term was that Obama will order everyone to be “deemed” as covered by insurance…

So is it actually inconceivable that Obama will simply issue a Kingly Edict and instruct insurers to insure people whether they actually are insured or not? Or that hospitals and doctors must, through this “transition period” which may contain “some disruptions,” must provide care without actual promise of payment?

Not only not inconceivable, but extremely conceivable that Obama will do this.

Remember that Obamacare is founded on estimates/supppositions (with a reckoning to come later) in several other ways. For example, the self-employed are given subsidies based on estimates of their income, and if the figure on line 37 of their federal income tax return ends up higher, the person will have to pay back the difference, and vice versa (if it’s lower they could get more government money). The insurance companies also are protected against loss and will be bailed out by the government under certain circumstances, or penalized (I explained how it will work here). Many deadlines and rules have been suspended by other Kingly Edicts of Obama’s, such as the one about group health insurance, and waivers he has given.

So why not this? As a practical matter, if Obamacare will still be chaotic on January 1—and it almost certainly will—something must be done. The damage to the health insurance market has already occurred, which may have been a feature and not a bug as far as Obama is concerned. Personally, I think it was a feature for him, but it wasn’t supposed to happen so dramatically and catastrophically, and the website was supposed to function properly to take up the slack.

When I try to imagine how I would fix it so that people were covered on January 1, I’m hard-pressed to come up with a solution. Any takers?

White blue-collar women do not ♥ Obamacare

The New Neo Posted on by

The results of a recent Kaiser poll are somewhat of a surprise to me. It found that one of the groups most down on Obamacare right now is white blue-collar women, otherwise known as “waitress moms,” who have turned against the law in the last month or so:

…50 percent [of this group] have a “very unfavorable” view of the law””9 points higher than in October. An additional 13 percent view it “somewhat unfavorably.” Indeed, antipathy among blue-collar white women runs even deeper than the most conservative white demographic group, blue-collar white men (59 percent of whom hold an unfavorable view, Kaiser found).

Remarkably, only 16 percent of blue-collar white women have a favorable view of Obamacare. They disapprove of it by a 4-1 ratio. (The poll found 21 percent did not know enough about the ACA to hold an opinion.)

Women are Obama’s natural constituency. But the article reminds me of something I had forgotten: it’s not “women” as a whole:

These voters [white blue-collar women] are by no means a strongly Democratic group: Obama won just 39 percent of them last year.

And the article also reminded me of something else that had slipped my mind, which is that white college-educated woman are not far behind:

40 percent of college-educated white women hold a “very unfavorable” view of the law””10 points higher than a month ago. An additional 10 percent view the law “somewhat unfavorably.” A month ago, those two groups together totaled just 42 percent.

That’s not damning in and of itself, but this is the one slice of the white electorate where Democrats usually perform well. President Obama won 46 percent of the group in 2012, and even that was an underwhelming showing compared with recent Democratic presidential candidates.

Because the white college-educated women I know are so overwhelmingly liberal Obama voters (the total is nearly 100% among them and that goes for their husbands, too; I am acquainted with only one couple where the wife is for Obama and the husband not) I tend to forget that, statistically speaking, such overwhelming support is not the norm. Obama won the female vote, but in particular he won the vote of single women, and single women are disproportionately young (another group he won) and minority (another group he won).

Unfortunately, the Kaiser poll does not break down its results into either marital status, age, or race (although if you look at the data, it did gather those facts and could break down the results that way if it chose to do so). I’d be very interested in learning whether single women and/or minority women have soured on Obamacare as well.

We already know that a great many of the young have turned on Obamacare. My guess is that the website fiasco has been particularly galling to them, as well as a perception that young people are being overcharged to pay for older people. Looking at the more detailed data from the millennial poll, here are some hints about the rest of the demographics, although the question being answered here was not about Obamacare but rather about approval of Obama:

…[Obama’s] approval rating among college students is down 11 percentage points to 39 percent, young male voters slipped 9 percentage points to 41 percent approval and this rating is now statistically tied with young female voters, whose approval of the president dropped 15 points to 40 percent. Young white voters’ approval dropped by 10 points to 28 percent, Hispanics decreased by 18 points (53% approval) — and approval among young Black voters slipped 9 percentage points, but was still strong at 75 percent.

That’s pretty powerful. Remember, though, that Republicans’ approval ratings—already low among this group—have dropped as well. So I’m not at all sure this measures anything more than a general disillusion with government. But as I pointed out yesterday, this could at least theoretically favor conservatives in 2014, if there’s any way to convey more about the fact that small government advocates are not just being meanies, but have a coherent philosophy that they hope will benefit people and the nation as a whole.

This latter idea ties into another finding of the poll on millennials, which is that the number of young people who believe the country “is moving in the right direction” is abysmally small:

Less than one-in-five (14%) young Americans in our poll indicate that the country is headed in the right direction, 49 percent believe its headed in the wrong direction, while 34 percent are not sure.

This drop in optimism was very pronounced among 18- to 29- year old females. The percent responding that the nation is moving in the right direction decreased by 14 percentage points from 2012 to 2013, compared to just 7 percentage points for males over the same time period. The percent of Black Millennials under 30 believing that the country is moving in the direction also dropped significantly from 2012 to 2013. In 2012, 49 percent of Black respondents believed the country was moving in the right direction. Now, less than one-in-four (24%) believe the country is moving in the right direction.

Of course, one must be careful in interpreting such numbers. Many of the respondents might consider that “the right direction” is ever more leftward. Many may be upset with Obamacare because it isn’t single payer. Both surveys would have done well to ask questions that probed these issues, but as far as I can tell they did not.

[NOTE: Notice from the title of this post that I’ve mastered the skill of making a heart in HTML code. I ♥ that.]

[ADDENDUM: The polls are even worse for Obama on the issues.]

Millennials: hope…

The New Neo Posted on by

…for a change.

What a difference a year—and some personal experience with Obamacare—makes.

However, before you think this reaction translates into support for conservatism, note that there’s a general dislike of all politicians, and Republicans come off even worse than Democrats. I’m not sure what that means for the future. Will young people refrain from voting? Will they turn to libertarians or even more extreme fringe movements and candidates? Or will their dislike of government translate into a desire for smaller government, and therefore to votes for conservatives?

Note also that the survey is of 18-to-29-year-olds. Time marches on, and it may be significant that today’s 18-year-olds were only thirteen when Obama was first elected. They hardly know anything else. They also were very small children when 9/11 occurred. Their world has been shaped by very different forces than the world of people even slightly older.

Tyranny testimony

The New Neo Posted on by

One of the courses that George Washington University law professor Jonathan Turley teaches is constitutional law. He is also an Obama supporter and a liberal, although he doesn’t always toe the party line. Turley certainly didn’t pull his punches in this article, or in his testimony before the House yesterday, on the topic of Obama’s presidential overreach and the possible remedies for it.

The entire article is worth reading (although I’ve only gotten through the first few pages so far). Here’s an excerpt:

Despite the fact that I once voted for President Obama, personal admiration is no substitute for the constitutional principles at stake in this controversy. When a president claims the inherent power of both legislation and enforcement, he becomes a virtual government unto himself. He is not simply posing a danger to the constitutional system; he becomes the very danger that the Constitution was designed to avoid…

…[T]he loss caused by the circumvention of the legislative branch is not simply one branch usurping another. Rather, it is the loss of the most important function of the tripartite system in channeling factional interests and reaching resolutions on matters of great public importance. The importance of this central function of Congress is magnified when the country faces questions upon which there is great division. Ironically, these are the same areas where presidents are most likely to issue nonenforcement orders due to opposition to the underlying legislation. Consider illegal immigration. There are few issues that are more divisive today. The immigration laws are the product of prolonged debates and deliberations over provisions ranging from public services to driver’s licenses to ICE proceedings to deportations. Many of these issues are considered in combination in comprehensive statutes where the final legislation is a multivariable compromise by legislators. Severity in one area can at times be a trade-off for leniency in another area. Regardless of such trade-offs, the end result is by definition a majoritarian compromise that is either signed into law by a president or enacted through a veto override. The use of executive orders to circumvent federal legislation increases the shift toward the concentration of executive power in our system and the diminishment of the role of the legislative process itself. It is precisely what the Framers sought to avoid in establishing the tripartite system.

There is no question that Turley is very alarmed by what’s been happening during the Obama administration. But today he reflects on something different but related—press coverage of the hearing at which he testified:

The Washington Post has a controversial take on yesterday’s hearing in its coverage by Dana Milbank. The hearing raised the serious question of a pattern of allegedly unconstitutional actions by President Obama in either barring enforcement of federal law or directly violating those laws. However, the Washington Post only reported on the fact that impeachment was raised in the hearing in the discussion of the constitutional means left to Congress to address presidential abuse. Republicans object that the Post piece misses 99 percent of the hearing detailing the rise of an imperial presidency under Obama and four hours of discussion of the dangerous shift of power in the tripartite system.

Turley goes on to analyze the testimony vs. the coverage and concludes the coverage was incorrect and misleading, mischaracterizing both the substance of the hearing and Republicans’ role in it. To those of us on the right, such news is no news at all. In fact, seeing this happen over and over again was one of the things that sparked the beginning of my political change experience.

When one first notices it, it’s hard to believe how blatant and shameless the distortions are. Turley was struck by it in part because he knew from personal experience, having been a major player in the hearings, how badly the WaPo misrepresented what happened there. I haven’t followed Turley’s work before, although I plan to do so now. But I wonder whether he knows how commonly this happens, and how pernicious are the effects on the voting public and its perceptions of reality.

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