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	<title>Explananda &#187; Paul</title>
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		<title>Postmortem</title>
		<link>http://www.explananda.com/2010/11/03/postmortem/</link>
		<comments>http://www.explananda.com/2010/11/03/postmortem/#comments</comments>
		<pubDate>Wed, 03 Nov 2010 21:27:12 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3591</guid>
		<description><![CDATA[Isn&#8217;t the real story that 30% of Oklahoman voters are fine if judges rely on Sharia law in their decisions, or that 6% of Oklahoman voters want English to be the official language but don&#8217;t want to ban reliance on Sharia law in judicial decisions? What, dear readers, are some of your postmortem thoughts on [...]]]></description>
			<content:encoded><![CDATA[<p>Isn&#8217;t the <a href="http://thinkprogress.org/2010/11/03/oklahoma-sharia-law/">real story</a> that 30% of Oklahoman voters are fine if judges rely on Sharia law in their decisions, or that<a href="http://election2010.talkingpointsmemo.com/all#/Proposition/OK"> 6% of Oklahoman voters</a> want English to be the official language but don&#8217;t want to ban reliance on Sharia law in judicial decisions?</p>
<p>What, dear readers, are some of your postmortem thoughts on last night&#8217;s myriad midterm election results?</p>
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		<title>What goes around</title>
		<link>http://www.explananda.com/2010/10/25/what-goes-around/</link>
		<comments>http://www.explananda.com/2010/10/25/what-goes-around/#comments</comments>
		<pubDate>Mon, 25 Oct 2010 04:52:41 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3587</guid>
		<description><![CDATA[I had occasion recently to reread bits and pieces of the book that turned me into a lefty. There is really no good reason why this should have been the book, but it was on the right used bookstore shelf at the right time. The book is Frances Fox Piven &#38; Richard Cloward&#8217;s The New [...]]]></description>
			<content:encoded><![CDATA[<p>I had occasion recently to reread bits and pieces of the book that turned me into a lefty. There is really no good reason why this should have been the book, but it was on the right used bookstore shelf at the right time.</p>
<p>The book is Frances Fox Piven &amp; Richard Cloward&#8217;s <a href="http://www.amazon.com/New-Class-War-Reagans-Consequences/dp/0394706471/ref=sr_1_1?ie=UTF8&amp;qid=1287981005&amp;sr=8-1">The New Class War: Reagan&#8217;s Attack on the Welfare State and Its Consequences</a>. I did not really know the name then, but glancing now at the Acknowledgments I see the authors thank, in 1982, a one Paul Wellstone for his comments on a previous version of the manuscript.</p>
<p>In the opening pages of their book, Piven and Cloward address the claim that it was concerns over inflation in 1980 that induced voters to toss out Carter and replace him with Reagan. They cite a Walter Dean Burnham (who?) to explain why that explanation won&#8217;t fly:</p>
<p style="padding-left: 30px;">In both relative and absolute terms, the defections from Carter &#8220;were concentrated among those for whom unemployment was the most important problem. Among those selecting inflation, Reagan won by 67 percent, up only two points from Ford&#8217;s 65 percent showing in 1976.&#8221; By contrast, &#8220;among those worried about unemployment, the decline in Carter&#8217;s support was fully nineteen percentage points, from 75 percent in 1976 to 56 percent in 1980.&#8221;</p>
<p>We are seeing a similar defection away from Democrats now, and for the same primary reason. There is no need to cite the evidence in favor of huge Democratic losses next week. But <a href="http://www.pollingreport.com/prioriti.htm">here</a> is recent polling data showing that concern over the economy and, more specifically, jobs decisively dwarfs concern about the budget deficit and/or national debt. And yet talk of the deficit and &#8220;ballooning debt&#8221; is all I seem to hear from the MSM and from the GOP candidates here in Wisconsin. Absolutely no one&#8211;not even Russ Feingold&#8211;is making the point that if we had a smaller deficit, unemployment would be much, much higher.</p>
<p>Of course, the GOP today will be just as eager to address these concerns once they regain (partial) power as Reagan was once he took office. And there is still little reason to rule out a double-dip recession, which would mirror the early Reagan years. Perhaps the only ray of hope is that despite those early trials for Reagan, he was reelected in 1984. Then again, at least Reagan could in 1984 ask the electorate with a straight face <a href="http://noapparentmotive.org/blog/2010/10/24/before-and-after-1979/">if they were better off than they were in 1979</a>.</p>
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		<title>Mark Pauly on (Intra)class warfare</title>
		<link>http://www.explananda.com/2010/09/17/mark-pauly-on-intraclass-warfare/</link>
		<comments>http://www.explananda.com/2010/09/17/mark-pauly-on-intraclass-warfare/#comments</comments>
		<pubDate>Fri, 17 Sep 2010 18:27:14 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3568</guid>
		<description><![CDATA[The other day I noted a seemingly bizarre inconsistency in Mark Pauly&#8217;s 1995 analysis of why the Clinton health reforms failed politically. I didn&#8217;t say, and don&#8217;t believe, that Pauly&#8217;s endorsement of the inconsistent political explanations was designed to promote a given ideological viewpoint. True, he seemed eager to discount the extent to which monied [...]]]></description>
			<content:encoded><![CDATA[<p>The other day <a href="http://www.explananda.com/2010/09/15/intro-meet-conclusion-another-in-the-right-of-center-health-care-analysis-series/">I noted</a> a seemingly bizarre inconsistency in Mark Pauly&#8217;s 1995 analysis of why the Clinton health reforms failed politically. I didn&#8217;t say, and don&#8217;t believe, that Pauly&#8217;s endorsement of the inconsistent political explanations was designed to promote a given ideological viewpoint. True, he seemed eager to discount the extent to which monied interests influenced the debate over health care. But at least he was willing to draw attention to those interests in the first place. That said, the following passage from the <a href="http://dl.dropbox.com/u/6418638/Pauly%2C%20Reinhardt--Fall%20and%20Rise%20of%20Health%20Care%20Reform.pdf">same text</a> seems much less benign:</p>
<p style="padding-left: 30px;">I hasten to add that this is not my own personal preference; I would prefer more redistribution. But I realize that I am being out-voted by other middle-class people who do not want to play more taxes. Indeed, I strongly suspect that a major blow to bipartisan health reform was the success of the president’s budget plan, which sopped up (and then some) any surplus willingness of the upper middle class to pay more taxes. We could have had universal insurance coverage or a lower budget deficit, but not both.” (Mark Pauly, “The Fall and Rise of Health Care Reform: A Dialogue,” 1995, p. 12.)</p>
<p>Here Pauly is claiming that it was the &#8220;upper middle class&#8221; who felt the brunt of the 1993 Clinton tax increases. This made them less willing to pay for health reform. Is this explanation plausible?</p>
<p>No, it is not.</p>
<p>According to economist <a href="http://www.amazon.com/Contours-Descent-Fractures-Landscape-Austerity/dp/1859846734">Robert Pollin</a>, the 1993 Clinton tax increases &#8220;increased the levy on [family] incomes over $140,000 from 30 to 36 percent, with an addition 10 percent surcharge for incomes over $250,000&#8243; (p. 26). And according to the <a href="http://bit.ly/buyeno">Center on Budget and Policy Priorities</a>, these families had incomes in the top 5% of the national income distribution.</p>
<p>Here is a graphic from <a href="http://dl.dropbox.com/u/6418638/Fed%20analysis%20of%201993%20OBRA%20tax%20increases.pdf">a report</a> by the Federal Reserve Bank of Cleveland that shows the increase in taxes for families at different income levels:</p>
<p><img class="aligncenter" title="1993 Tax Increases by Family Income" src="http://dl.dropbox.com/u/6418638/1993%20tax%20increases.png" alt="" width="567" height="341" /><br />
Given that the the <a href="http://bit.ly/bMlkxw">median family income was 54,369</a> in 1990, and given that only families in the top 3-4% (those above $200,000) really saw an appreciable increase in taxes, it seems to me quite inaccurate to say that the &#8220;upper middle class&#8221; paid for these increases. One might therefore think that the (upper) middle class <em>should</em> have been willing to pay higher taxes in order to finance universal health insurance for their fellow class-mates. That&#8217;s one way to look at it. Another way is to note that ostensibly non-ideological analyses misrepresented the nature of the tax increases, and thereby led the middle class to <em>think</em> their taxes had gone up. The point of such analyses, of course, would be to kill the increases politically. And the main reason one would want to do that is so that the rich would not have to pay higher taxes.</p>
<p>So I am beginning to question the sincerely of such Pauly pronouncements as, &#8220;I hasten to add that&#8230;I would prefer more redistribution.&#8221; That said, I&#8217;m still learning a ton from reading and re-reading Pauly&#8217;s latest book.</p>
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		<title>Intro, Meet Conclusion (Another in the &#8220;right-of-center health care analysis&#8221; series)</title>
		<link>http://www.explananda.com/2010/09/15/intro-meet-conclusion-another-in-the-right-of-center-health-care-analysis-series/</link>
		<comments>http://www.explananda.com/2010/09/15/intro-meet-conclusion-another-in-the-right-of-center-health-care-analysis-series/#comments</comments>
		<pubDate>Thu, 16 Sep 2010 01:26:34 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3563</guid>
		<description><![CDATA[I recently mentioned Mark Pauly&#8217;s recent book on reforming the individual insurance market, which I plan to write more on shortly. But tonight I&#8217;m reading an exchange between Pauly and Princeton health economist Uwe Reinhardt from 1995 or 1996, and I&#8217;m simply flabbergasted by two claims Pauly makes. One the one hand, we get this [...]]]></description>
			<content:encoded><![CDATA[<p>I recently <a href="http://www.explananda.com/2010/08/12/health-insurance-reform-and-welfare-economics/">mentioned</a> Mark Pauly&#8217;s recent <a href="http://www.amazon.com/Health-Reform-Without-Side-Effects/dp/0817910441/ref=sr_1_1?ie=UTF8&amp;s=books&amp;qid=1281642610&amp;sr=8-1">book </a>on reforming the individual insurance market, which I plan to write more on shortly. But tonight I&#8217;m reading an <a href="http://dl.dropbox.com/u/6418638/Pauly%2C%20Reinhardt--Fall%20and%20Rise%20of%20Health%20Care%20Reform.pdf">exchange</a> between Pauly and Princeton health economist Uwe Reinhardt from 1995 or 1996, and I&#8217;m simply flabbergasted by two claims Pauly makes. One the one hand, we get this statement from the introduction:</p>
<p style="padding-left: 30px;">It is..probably true in large part, that the health care reform proposed by the president [Clinton] failed because Harry and Louise were more effective at scaring the middle class than were Ira [Magaziner] and Hillary [Clinton].</p>
<p>Then there&#8217;s this from the conclusion:</p>
<p style="padding-left: 30px;">It might be helpful to point out a logical contradiction: if the middle class are so concerned about the welfare of the nonpoor uninsured that they will not force them to pay for the insurance coverage, why are the middle class unwilling to pay for that insurance for them? It appears that a little altruism is a dangerous thing&#8230;If we cannot convince the decisive voters of the value of what we value, then I think we need to accept the verdict of democracy.</p>
<p>So let me get this straight. Health reform failed because of a year-long insurance industry-funded campaign to scare the middle class. <em>And</em> it failed because the middle class decided in its infinite and dispositive wisdom that there is no social obligation to aid those without insurance. Huh?</p>
<p>To be fair, there is also this from the introduction:</p>
<p style="padding-left: 30px;">[It is] a little surprising that two economists are talking about what is essentially a political issue, but I suppose that is the way it has to be.</p>
<p>God I hope that&#8217;s not true.</p>
<p>More on Pauly&#8217;s more recent book and John Goodman&#8217;s <a href="http://www.john-goodman-blog.com/spend-on-health-care/?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+TheJohnGoodmanHealthBlog+%28The+John+Goodman+Health+Blog%29&amp;utm_content=Google+Reader">way of</a> <a href="http://bit.ly/bp5OrG">thinking</a> about health care anon.</p>
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		<title>Kevin Drum Explains Social Security Trust Fund</title>
		<link>http://www.explananda.com/2010/08/19/kevin-drum-explains-social-security-trust-fund/</link>
		<comments>http://www.explananda.com/2010/08/19/kevin-drum-explains-social-security-trust-fund/#comments</comments>
		<pubDate>Thu, 19 Aug 2010 22:35:18 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3555</guid>
		<description><![CDATA[An admirable explanation that hits on the distributional ins and outs I referred to earlier this week.]]></description>
			<content:encoded><![CDATA[<p>An <a href="http://motherjones.com/kevin-drum/2010/08/deal">admirable explanation</a> that hits on the distributional ins and outs I referred to earlier this week.</p>
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		<title>Howard Dean on Park51</title>
		<link>http://www.explananda.com/2010/08/19/howard-dean-on-park51/</link>
		<comments>http://www.explananda.com/2010/08/19/howard-dean-on-park51/#comments</comments>
		<pubDate>Thu, 19 Aug 2010 14:29:06 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Gay rights]]></category>
		<category><![CDATA[Political issues]]></category>
		<category><![CDATA[Religion]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3550</guid>
		<description><![CDATA[Howard Dean says of the community center proposed at Park51: I think another site would be a better idea. (Actually, he said it would be a &#8220;better i-deer,&#8221; but being from New England, I find this endearing.) In response to criticism from Glenn Greenwald, Dean writes (in part): My argument is simple. This Center may [...]]]></description>
			<content:encoded><![CDATA[<p>Howard Dean <a href="http://www.youtube.com/watch?v=h2GzuAw46Os&amp;feature=player_embedded#!">says</a> of the community center proposed at <a href="http://www.park51.org/vision.htm">Park51</a>:</p>
<p style="padding-left: 30px;">I think another site would be a better idea.</p>
<p>(Actually, he said it would be a &#8220;better i-deer,&#8221; but being from New England, I find this endearing.)</p>
<p>In response to <a href="http://www.salon.com/news/opinion/glenn_greenwald/2010/08/18/dean?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+salon%2Fgreenwald+%28Glenn+Greenwald%29&amp;utm_content=Google+Reader">criticism</a> from Glenn Greenwald, Dean <a href="http://www.salon.com/news/opinion/glenn_greenwald/2010/08/18/dean?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+salon%2Fgreenwald+%28Glenn+Greenwald%29&amp;utm_content=Google+Reader#postid-updateA4">writes</a> (in part):</p>
<p style="padding-left: 30px;"><strong>My argument is simple.</strong> This Center may be intended as a bridge or a  healing gesture but it will not be perceived that way unless a dialogue  with a real attempt to understand each other happens. That means <strong>the  builders have to be willing to go beyond what is their right and be  willing to talk about feelings whether the feelings are &#8220;justified&#8221; or  not.</strong> No doubt the Republic will survive if this center is built on its  current site or not. But I think this is a missed opportunity to try to  have an open discussion about why this is a big deal because <strong>it is a big  deal to a lot of Americans who are not just right wing politicians  pushing the hate button again. I think those people need to be heard  respectfully whether they are right or whether they are wrong.</strong></p>
<p>What I&#8217;d like to ask Dean, proud defender of civil unions for homosexual couples, is this: couldn&#8217;t this same argument be made in favor of asking <a href="http://www.schoollibraryjournal.com/slj/home/886276-312/lesbian_teen_constance_mcmillen_talks.html.csp">those pesky lesbians</a> to refrain exercising <a href="http://news.yahoo.com/s/ap/us_lesbian_prom_date">their right</a> to attend their high school prom?</p>
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		<title>Right Wing Health Reform Alternatives (I)</title>
		<link>http://www.explananda.com/2010/08/17/right-wing-health-reform-alternatives/</link>
		<comments>http://www.explananda.com/2010/08/17/right-wing-health-reform-alternatives/#comments</comments>
		<pubDate>Tue, 17 Aug 2010 22:39:59 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3539</guid>
		<description><![CDATA[I have moved on today to taking a look at John Goodman&#8217;s &#8220;Characteristics of an Ideal Health Care System.&#8221; Goodman has an informative and always pointed Health Policy Blog. He is President of the National Center for Policy Analysis, and the last page of his paper notes that the Wall Street Journal once called him [...]]]></description>
			<content:encoded><![CDATA[<p>I have moved on today to taking a look at John Goodman&#8217;s <a href="http://www.ncpa.org/pub/st242?pg=4">&#8220;Characteristics of an Ideal Health Care System.&#8221;</a> Goodman has an informative and always pointed <a href="http://www.john-goodman-blog.com">Health Policy Blog</a>. He is President of the National Center for Policy Analysis, and the last page of his paper notes that the <em>Wall Street Journal</em> once called him &#8220;the father of Medical Savings Accounts.&#8221;</p>
<p>I expect I&#8217;ll be writing more about Goodman&#8217;s Ideal Plan, but one thing leaped out at me straightaway as somewhat curious. Like most proponents of Medical Savings Accounts, Goodman appears to want insurance to come in the form of low-premium/high-deductible plans.</p>
<p>Not being utterly callous, Goodman is willing to subsidize the purchase of insurance, to some extent (although he&#8217;s willing to offer subsidies of identical amounts to rich and poor alike). In order to determine the level these subsidies should be set at, Goodman argues that we already a socially set number: it is &#8220;the amount we expect to spend (from public and private sources) on free care for that person when he or she is uninsured.&#8221; Goodman then cites Texas, which he says spends an average of about $1,000 per year per uninsured person on free care. He then notes, &#8220;Interestingly, $4,000 is a sum adequate to purchase private health insurance for a family in most Texas cities.&#8221;</p>
<p>Although writing in 2001, Goodman&#8217;s $4,000 Texas insurance policy must have been a high-deductible policy. According to <a href="http://content.healthaffairs.org/cgi/content/abstract/20/5/180">this</a> Health Affairs article, average job-based family coverage was $588 per month in 2001, or $7,056 per year.  Surely a $4,000 policy, in the non-group market no less, would involve a significant deductible. If so, then the following is what I find curious:</p>
<p style="padding-left: 30px;">A common misconception is that health insurance reform costs money. For  example, if health insurance for 40 million people costs $1,000 a  person, some conclude that the government would need to spend an  additional $40 billion a year to get the job done. What this conclusion  overlooks is that we are already spending $40 billion or more on free  care for the uninsured, and if all 40 million uninsured suddenly became  insured they would &#8211; in that act &#8211; free up the $40 billion from the  social safety net.</p>
<p>If those $4,000 policies (in 2001) were high-deductible policies, then at least some, and perhaps many, trips to the ER by those with such policies will incur expenses that would not be reimbursed by their insurance. But if so, then the $40 billion that would go toward subsidies to insure the currently uninsured would not necessarily offset the entire $40 billion in free care that we provided to them now.</p>
<p>I really feel scummy pointing out that this health reform proposal with which I wholly disagree is not the free lunch Goodman presents it as. Ick.</p>
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		<title>Health Reform and Marginal Tax Rates</title>
		<link>http://www.explananda.com/2010/08/17/health-reform-and-marginal-tax-rates/</link>
		<comments>http://www.explananda.com/2010/08/17/health-reform-and-marginal-tax-rates/#comments</comments>
		<pubDate>Tue, 17 Aug 2010 17:38:58 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3533</guid>
		<description><![CDATA[I&#8217;ll hopefully have more thoughts on this soon. This post is just to get the two money quotes down. In designing my upcoming course on ethical issues in health reform, I&#8217;ve been reading a lot of health economics, despite not knowing very much at all about the subject. And not knowing much at all leaves [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;ll hopefully have more thoughts on this soon. This post is just to get the two money quotes down.</p>
<p>In designing my upcoming course on ethical issues in health reform, I&#8217;ve been reading a lot of health economics, despite not knowing very much at all about the subject. And not knowing much at all leaves me helpless to evaluate disputes between health economists. A rule of thumb in these cases is to find out which experts are considered level-headed and always worth listening to by most of their peers. Again, how else could I proceed.</p>
<p>Two such experts in health economics are Victor Fuchs and Joseph Newhouse. Fuchs is well-known in many circles for his book, <a href="http://www.amazon.com/Who-Shall-Live-Economics-Economic/dp/9810232012"><em>Who Shall Live?</em></a> Newhouse is well-known for leading the <a href="http://en.wikipedia.org/wiki/RAND_Health_Insurance_Experiment">RAND Health Insurance Experiment</a> in the 1970s-80s. This week I have been reading article from Fuchs&#8217; book entitled &#8220;Economics, Values, and Health Care Reform,&#8221; and a <a href="http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0595">recent article</a> by Newhouse on the recent health care reform law and the residual issues we are left with. Each is worth reading, but the latter is really, really informative, especially because Newhouse both praises the law for (what I see as) its virtues and expresses deep skepticism and concern over other elements. (If you want the paper, let me know in the comments.)</p>
<p>Here are two quotations from the aforementioned papers that I hope to return to in the coming weeks. First, Fuchs:</p>
<p style="padding-left: 30px;">There are only two ways to achieve systematic universal coverage: a broad-based general tax with implicit subsidies for the poor and the sick, or a system of mandates with explicit subsides based on income. I prefer the former because the latter are extremely expensive to administer and seriously distort incentives; they result in the near-poor facing marginal tax rates that would be regarded as confiscatory if levied on the affluent.</p>
<p>And here&#8217;s Newhouse:</p>
<p style="padding-left: 30px;">Although necessary to achieve compliance, the subsidies will have the negative effect of increasing marginal tax rates. Consider a family of four whose income is $55,250, or 250 percent of the federal poverty level. Their current marginal tax rate is 22.65 percent plus any state or local income taxes. Assuming that, as of 2014, the family buys the most generous health insurance plan covered by the subsidy, the premium will be limited to 8.05 percent of the family’s income. This feature of the law will effectively add 8.05 percentage points to the family’s marginal tax rate, since any additional dollar of income will reduce the subsidy by eight cents. Thus, the family’s marginal tax rate will rise by roughly a third. Economic research suggests that this would be likely to reduce the labor supply of those who are not the principal income support of the household.<strong> </strong></p>
<p>Being a liberal and being largely ignorant in the way of health economics, I&#8217;m often too tempted to dismiss the sorts of concerns expressed here by Newhouse. Sometimes I have good evidence for this, as when I dismiss claims that <a href="http://docs.google.com/viewer?url=http://www.epi.org/briefingpapers/minimumw_bp_1996.pdf">raising the minimum wage will eliminate jobs.</a> Sometimes I have to admit that I&#8217;m just not sure what to think about claims that it would be easier to ignore.</p>
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		<title>Krugman, Laniel, and Baker on those Gov&#8217;t Trust Funds</title>
		<link>http://www.explananda.com/2010/08/14/krugman-laniel-and-baker-on-those-govt-trust-funds/</link>
		<comments>http://www.explananda.com/2010/08/14/krugman-laniel-and-baker-on-those-govt-trust-funds/#comments</comments>
		<pubDate>Sat, 14 Aug 2010 16:49:08 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3528</guid>
		<description><![CDATA[Paul Krugman explains how we should think about all those claims that this or that trust fund is going broke. But one of my favorite explanations comes from Explananda&#8217;s friend Steve Laniel from an October 2009 post: In any case, Medicare is “headed for insolvency” because it works off a fixed budget. Well, Part A [...]]]></description>
			<content:encoded><![CDATA[<p>Paul Krugman <a href="http://krugman.blogs.nytimes.com/2010/08/13/social-security-finances/">explains</a> how we should think about all those claims that this or that trust fund is going broke. But one of my favorite explanations comes from Explananda&#8217;s friend Steve Laniel from an October 2009 <a href="http://stevereads.com/weblog/2009/10/21/medicare-insolvency/">post</a>:</p>
<p style="padding-left: 30px;">In any case, Medicare is “headed for insolvency” because it works off a  fixed budget. Well, Part A (hospital insurance) does. Parts B  (reimbursing doctors), C (Medicare Advantage), and D (the drug benefit)  are funded out of general revenues, so they can only go insolvent when  the U.S. government goes insolvent. Medicare Part A is forced to be  responsible in a way that the rest of the U.S. government is not. Why  does no one ever talk about the Department of Defense being “headed for  insolvency”? If Landrieu is so concerned about the public fisc, why  doesn’t she push for the DoD to be funded out of a dedicated payroll  tax? Then every few years, we could go through a public  rending-of-garments ritual over the DoD’s impending bankruptcy. I would  enjoy this very much. At least then we’d have parity: conservative  Republicans shedding crocodile tears over how Medicare will have to be  cut to keep it afloat, and my party doing the same for the military.</p>
<p>Finally, a <a href="http://www.cepr.net/index.php/blogs/beat-the-press/social-security-trust-fund-its-real?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+beat_the_press+%28Beat+the+Press%29&amp;utm_content=Google+Reader">point</a> from Dean Baker that I&#8217;ve not seen made before:</p>
<p style="padding-left: 30px;">[W]orkers, and only workers, pay Social Security tax. It is a payroll tax  that is capped at just $106,000, so the chairman of Goldman Sachs pays  no more in Social Security tax than a senior teacher or firefighter who  may also hit the wage cap. By contrast, most of the general budget is  financed through personal and corporate income taxes, which  disproportionately come from higher income taxpayers. So it matters  hugely that the bonds held by the trust fund are repaid from general  revenue, as opposed to coming from additional Social Security taxes.</p>
<p>I need to think more about the full distributional implications of this point. But I think the takeaway is that while a regressive payroll tax raised general funds for years under the guise of a medicare or social security &#8220;trust fund,&#8221; the accounting vehicle of the Trust Fund ensures that the inevitable &#8220;fix&#8221; when outlays outstrip revenues will not add insult to injury by also being regressive. Instead of increasing the regressive payroll tax, the revenues used to fix program deficits are those supplied by more progressive taxation on upper income individuals and corporations.</p>
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		<title>MLK on Drugs?</title>
		<link>http://www.explananda.com/2010/08/12/mlk-on-drugs/</link>
		<comments>http://www.explananda.com/2010/08/12/mlk-on-drugs/#comments</comments>
		<pubDate>Fri, 13 Aug 2010 01:42:00 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3520</guid>
		<description><![CDATA[So everyone knows about Robert Gibbs&#8217; remarks quoted in The Hill: “I hear these people saying he’s like George Bush. Those people ought to be drug tested,” Gibbs said. “I mean, it’s crazy. The press secretary dismissed the “professional left” in terms very similar to those used by their opponents on the ideological right, saying, [...]]]></description>
			<content:encoded><![CDATA[<p>So everyone knows about Robert Gibbs&#8217; remarks quoted in <a href="http://thehill.com/homenews/administration/113431-white-house-unloads-on-professional-left">The Hill</a>:</p>
<p style="padding-left: 30px;">“I hear these people saying he’s like George Bush. Those people ought to be drug tested,” Gibbs said. “I mean, it’s crazy.</p>
<p style="padding-left: 30px;">The press secretary dismissed the “professional left” in terms very  similar to those used by their opponents on the ideological right,  saying, “They will be satisfied when we have Canadian healthcare and  we’ve eliminated the Pentagon. That’s not reality.”</p>
<p>Today Think Progress has a <a href="http://thinkprogress.org/2010/08/12/professional-left-obama/">post</a> documenting many occasions on which Obama himself has insisted that the American people hold him accountable. But they forgot one:</p>
<p><object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" width="480" height="385" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0"><param name="allowFullScreen" value="true" /><param name="allowscriptaccess" value="always" /><param name="src" value="http://www.youtube.com/v/-pkkdjngBu0?fs=1&amp;hl=en_US" /><param name="allowfullscreen" value="true" /><embed type="application/x-shockwave-flash" width="480" height="385" src="http://www.youtube.com/v/-pkkdjngBu0?fs=1&amp;hl=en_US" allowscriptaccess="always" allowfullscreen="true"></embed></object></p>
<p>It is also worth noting that in this clip Obama praises the grassroots &#8220;agitating&#8221; that ultimately &#8220;forced elected politicians to be accountable.&#8221; This marks an interesting contrast with his Nation magazine <a href="http://davidsirota.com/index.php/mr-obama-goes-to-washington/">interview</a> with David Sirota, in which Obama</p>
<p style="padding-left: 30px;">gently but dismissively labeled Wellstone as merely a “gadfly,” in a  tone laced with contempt for the senator who, for instance, almost  single-handedly prevented passage of the bankruptcy bill for years over  the objections of both parties.</p>
<p>I&#8217;ll admit that I have always wondered whether Obama took the tone and stance that Sirota ascribes to him.</p>
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		<title>Food and Inflation</title>
		<link>http://www.explananda.com/2010/08/10/food-and-inflation/</link>
		<comments>http://www.explananda.com/2010/08/10/food-and-inflation/#comments</comments>
		<pubDate>Tue, 10 Aug 2010 20:45:13 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Political issues]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3500</guid>
		<description><![CDATA[Matt Yglesias recently had a post on the proposed cuts in the SNAP program (a.k.a. foodstamps program) intended to offset proposed increases in child nutrition programs (e.g. school lunch programs). Yglesias cites this Monica Potts post that gives some background: It&#8217;s worth noting that the increases in the food-stamp program were designed in the stimulus [...]]]></description>
			<content:encoded><![CDATA[<p>Matt Yglesias recently had a <a href="http://yglesias.thinkprogress.org/2010/08/policy-response-to-unexpected-developments/?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+matthewyglesias+%28Matthew+Yglesias%29&amp;utm_content=Google+Reader">post</a> on the proposed cuts in the <a href="http://en.wikipedia.org/wiki/Supplemental_Nutrition_Assistance_Program">SNAP program</a> (a.k.a. foodstamps program) intended to offset proposed increases in child nutrition programs (e.g. school lunch programs). Yglesias cites this Monica Potts <a href="http://www.prospect.org/csnc/blogs/tapped_archive?month=08&amp;year=2010&amp;base_name=child_nutrition_and_food_stamp">post</a> that gives some background:</p>
<p style="padding-left: 30px;">It&#8217;s worth noting that the increases in the food-stamp program were  designed in the stimulus bill to be phased out once food-price inflation  caught up to the expanded benefits, but because inflation was lower  than expected, the benefits were going to last longer than anyone  originally expected. It&#8217;s hard to imagine a situation in which  politicians wouldn&#8217;t view those bigger-than-expected increases as free  money. And it&#8217;s a small comfort to know the pot was raided for good  rather than for ill.</p>
<p>This got me thinking of Mollie Orshansky, the brains behind the U.S. official poverty measure. That measure took the cheapest of four &#8220;economy food plans&#8221; and multiplied it by three, since at the time, in 1963, food constituted roughly one-third of the average family budget. Longtime critics of this measure have pointed out that the cost of food has increased much more slowly than the price of nonfood staples in the average family&#8217;s budget. Since the amount allocated for nonfood items is determined by the amount &#8220;needed&#8221; for foodstuffs, the official poverty measure fails to take differential rates of price growth into account.</p>
<p>This historical lag in food prices doesn&#8217;t necessarily entail a similar expected lag after the passage of the stimulus bill; but it is somewhat ironic that the issue of slow food price inflation has come up again in the context of policies ostensibly designed to aid the poor and near-poor but which end up adding insult to injury. After all, perhaps one way to make amends for screwing over the poor with an inadequate measure of non-food related resource deprivation might be to allow them a bit more in the way of food-related resources.</p>
<p>For more on recent and salutary developments in how the U.S. measures poverty, see this <a href="http://yglesias.thinkprogress.org/2010/03/a-better-poverty-measure/?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+matthewyglesias+%28Matthew+Yglesias%29&amp;utm_content=Google+Reader">Yglesias post</a> from March.</p>
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		<title>Hiatus</title>
		<link>http://www.explananda.com/2010/08/05/hiatus/</link>
		<comments>http://www.explananda.com/2010/08/05/hiatus/#comments</comments>
		<pubDate>Thu, 05 Aug 2010 04:17:17 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Odds and ends]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3491</guid>
		<description><![CDATA[I will be away from the blog until late August/early September. Apologies for the inconvenience. (Seriously though: I&#8217;m teaching a course this semester on ethical issues in the recent health care reform debate. I expect, therefore, to be posting a lot of posts soon that should have 2009 in their date, but don&#8217;t.)]]></description>
			<content:encoded><![CDATA[<p>I will be away from the blog until late August/early September. Apologies for the inconvenience.</p>
<p>(Seriously though: I&#8217;m teaching a course this semester on ethical issues in the recent health care reform debate. I expect, therefore, to be posting a lot of posts soon that should have 2009 in their date, but don&#8217;t.)</p>
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		<title>Can we Distinguish Insurance from Stereos?</title>
		<link>http://www.explananda.com/2009/10/11/can-we-distinguish-insurance-from-stereos/</link>
		<comments>http://www.explananda.com/2009/10/11/can-we-distinguish-insurance-from-stereos/#comments</comments>
		<pubDate>Sun, 11 Oct 2009 15:55:55 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Economics]]></category>
		<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Political issues]]></category>
		<category><![CDATA[Political philosophy]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3380</guid>
		<description><![CDATA[In response to what he dubs &#8220;the stupidest argument against health reform&#8221;&#8211;namely the argument that universal health insurance requires people to pay for someone else&#8217;s health care&#8211;upyernoz writes: &#8220;paying for someone else&#8221; is the whole concept behind insurance. the idea of insurance is that there are certain things (floods, catastrophic medical costs, car crashes) which [...]]]></description>
			<content:encoded><![CDATA[<p>In response to what he dubs &#8220;the stupidest argument against health reform&#8221;&#8211;namely the argument that universal health insurance requires people to pay for someone else&#8217;s health care&#8211;<a href="http://upyernoz.blogspot.com/2009/10/stupidest-argument-against-health-care.html">upyernoz writes</a>:</p>
<blockquote><p>&#8220;paying for someone else&#8221; is the whole concept behind insurance. the idea of insurance is that there are certain things (floods, catastrophic medical costs, car crashes) which can be so economically devastating that individuals would be ruined if they had to pay the entire thing out of their own pocket. insurance is a way of pooling risk, everyone pays in, only the unlucky ones draw out. but then everyone can feel more secure knowing they have insurance to fall back on if disaster hits.</p>
<p>in other words, all insurance involves you paying other people&#8217;s bills (or other people paying your bills). that&#8217;s what insurance is all about. you can call it &#8220;socialism&#8221; if you want, that&#8217;s not an argument, that&#8217;s just slapping a label on something. but if you happen to believe it&#8217;s evil to pay for other people, then cancel all your insurance policies.</p></blockquote>
<p>While I&#8217;m certain &#8216;noz and I stand united on the moral imperative of health reform that gives all Americans access to high-quality affordable healthcare, I don&#8217;t think his account of the argument he targets is fair, and thus I don&#8217;t think he offers a very satisfying response to the person who endorses that argument. Here, as I understand it, is &#8216;noz&#8217;s line of argument:</p>
<blockquote><p>1. Proponents of the Stupidest Argument Against Health Reform maintain that they should not be forced to pay for another&#8217;s medical care.</p>
<p>2. But proponents of the Stupidest Argument willingly buy various forms of insurance without complaining.</p>
<p>3. But buying insurance just is the paying for another&#8217;s medicare care.</p>
<p>4. So to be consistent, the proponents should either withdraw their objection to health care reform, or else &#8220;cancel all [their] insurance policies.&#8221;</p></blockquote>
<p>I think we can see clearly where &#8216;noz&#8217;s line of argument fails by changing the story a bit:</p>
<blockquote><p>1. Opponents of income maintenance policies maintain that they should not be forced to pay for another&#8217;s wages/income.</p>
<p>2. But opponents of income maintenance policies willingly buy stereos without complaining.</p>
<p>3. But buying stereos just is the paying for another&#8217;s wages (namely those who make stereos).</p>
<p>4. So to be consistent, the opponents should either withdraw their objection to income maintenance policies, or else stop buying stereos.</p></blockquote>
<p>It seems clear that while purchasing a stereo does in fact pay another&#8217;s wages, it is false to say that paying another&#8217;s wages is the &#8220;whole concept&#8221; of purchasing a stereo. But then what distinguishes purchasing insurance from buying a stereo? Each seems to amount to the same thing: parting with a sum of money to procure a good or service which is available to one only because certain others are willing to help produce that good or provide that service only because they too get something out of the economic arrangement.</p>
<p>The fact seems to be that those who wish to buy stereos and those who wish to buy insurance may not really care about the economic arrangements and contracts that lie in the background of these purchases. They do not really care that buying a stereo and buying insurance <em>involves</em> paying an amount of money a portion of which ends up paying another&#8217;s bills. The one person wants a stereo, and parts with a certain amount of money to get it. The other wants protection from the economic risks associated with (the treatment of) ill health, and pays an insurance premium to get it. It just so happens that, in our world, the reason why these purchases are available to one at all is that other people, who play different roles in the relevant economic domain, also get something out of their involvement. So, again, what could make the purported difference between buying stereos and buying insurance?</p>
<p>If this analogy is as revealing as I think it is, it shows why the proponent of the Stupidest Argument may not be making the silly mistake that &#8216;noz ascribes to him. To extend the analogy: Assume a tax is levied on all stereo purchases in order fund income maintenance policies for the unemployed. And assume that a would-be stereo-purchaser objects to this. Then that objection cannot be met simply by pointing out that he didn&#8217;t have a problem paying another&#8217;s wage through his purchase before the tax was levied.</p>
<p>In the case of health insurance, what would be the analog to the stereo tax that the proponent of the Stupidest Argument objects to? Since insurance is typically paid for through premiums, the proponent will likely claim that he should not have to subsidize another&#8217;s premium. But this raises the question of whether the initial distribution of income is itself fair, as that is the distribution that determines who has what to put toward premiums. To the extent that it is unjust that some work long hours in dreary jobs for what is now a largely depreciated compensation package, that can provide a reason to ask those who are favored by the structure of the economy to give some back to subsidize the premiums of those who get the short end of the stick.</p>
<p>Another barrier to insurance access has to do with differentials in health status (of which &#8220;pre-existing conditions&#8221; are one kind). To use a stylized example, assume that you and I form a two-person health insurance market, and that I am fairly healthy and you have a disease that can be treated with only very expensive health interventions. In this situation, each of us is presented with the option to buy insurance. But which insurance we buy, if any, will be influenced by which insurance products are available. If the only insurance product is one that pays for the sort of interventions you need, that product will be very expensive. In that case, I may choose not to buy it, since I feel there are other things I&#8217;d rather spend that amount of money on. But that may leave you without the prospect of insurance, since the resulting premium for you will be the same price as the expensive medical care you were hoping to avoid having to pay for directly by purchasing insurance in the first place. You will face a similar problem if there are in fact several insurance products available, and if I choose one that is cheaper. For that one will be cheaper precisely because it doesn&#8217;t not cover the expensive treatment you need. So while you may be able to afford that cheaper product, it doesn&#8217;t do you much good.</p>
<p>These thought experiments seem to show that the proponent of the Stupidest Argument is also probably objecting to having to subsidize the insurance choices that the market makes expensive for others because they are either more risk averse than he his, or because they in fact require more expensive insurance than the proponent himself wishes to purchase with the funds he has chosen to dedicate to health risk reduction. This is in fact not an objection we should dismiss as stupid, as I think the two-person example shows.</p>
<p>I&#8217;m sure &#8216;noz and I agree that when the simple two-person example is replaced with the much more complex picture presented by the macro situation in the U.S. today&#8211;a situation in which income is not distributed fairly and where individuals&#8217; health status is profoundly influenced by myriad social circumstances beyond their control&#8211;there is a solid argument in favor of providing all Americans with at least basic health care paid for by general, progressive taxation. But even if we are right, we cannot dismiss the objections of those who disagree with us simply by pointing out that all insurance involves using what was once one person&#8217;s money to pay for the health care of another.</p>
<p>The moral of the story is this: it is false to say that the &#8220;whole concept&#8221; of insurance <em>as such</em> is to pay for another&#8217;s care. Yes, it <em>involves </em>that, but the sense in which it does is just the sense in which buying stereos involves paying another&#8217;s wage. Not much of moral relevance follows. <strong><em>But</em></strong>, it is absolutely true that the whole concept of certain <em>social</em> <em>insurance <strong>schemes</strong></em> is to spread risk and cross-subsidize care for appropriate moral reasons. But those reasons cannot themselves be teased out of the idea of insurance as such.</p>
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		<title>Some geniuses</title>
		<link>http://www.explananda.com/2009/05/12/some-geniuses/</link>
		<comments>http://www.explananda.com/2009/05/12/some-geniuses/#comments</comments>
		<pubDate>Tue, 12 May 2009 14:21:36 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Odds and ends]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3270</guid>
		<description><![CDATA[The first question of a Mensa Quiz I found in a recently published in-flight magazine: Jerry was buying some candy. He paid 23 cents per caramel, 28 cents per lollipop, and 33 cents per spice drop. Based on this logic, how much will a chocolate bar cost? My first response was that these so-called geniuses [...]]]></description>
			<content:encoded><![CDATA[<p>The first question of a Mensa Quiz I found in a recently published <a href="http://www.americanwaymag.com/mensa-quiz-04-15-2009">in-flight magazine</a>:</p>
<blockquote><p>Jerry was buying some candy. He paid 23 cents per caramel, 28 cents per lollipop, and 33 cents per spice drop. Based on this logic, how much will a chocolate bar cost?</p></blockquote>
<p>My first response was that these so-called geniuses clearly flunked Logic 101. I assumed they wanted an answer of 38 cents, with each item increasing in cost by 5 cents. But obviously no way of thinking classifiable as &#8220;logic&#8221; would entail this answer.</p>
<p>Turns out they are not asking a question of logic at all, but rather giving something more like a crossword puzzle clue.Â  (Answer <a href="http://www.americanwaymag.com/puzzle-quiz-answers-04-15-2009">here</a>.) Turns out you need to be a member of the club in order to even understand the question. I wonder, then, how the club got started.</p>
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		<title>Of Rawls and Self-Improvement</title>
		<link>http://www.explananda.com/2009/04/06/of-rawls-and-self-improvement/</link>
		<comments>http://www.explananda.com/2009/04/06/of-rawls-and-self-improvement/#comments</comments>
		<pubDate>Mon, 06 Apr 2009 17:22:17 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Anecdotal]]></category>
		<category><![CDATA[Moral philosophy]]></category>
		<category><![CDATA[Philosophy]]></category>
		<category><![CDATA[Political philosophy]]></category>
		<category><![CDATA[Religion]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=3095</guid>
		<description><![CDATA[In the growing-up department, I still have a long way to go. Many of my habits are bad bad bad, and I have myriad tendencies that I don&#8217;t endorse and that leave me feeling full of self-reproach if acted upon. But I must say that I felt some sense of pride when I saw this [...]]]></description>
			<content:encoded><![CDATA[<p>In the growing-up department, I still have a long way to go. Many of my habits are bad bad bad, and I have myriad tendencies that I don&#8217;t endorse and that leave me feeling full of self-reproach if acted upon.</p>
<p>But I must say that I felt some sense of pride when I saw <a href="http://philosophersanon.blogspot.com/2009/03/new-rawls-book.html">this</a> and felt revulsion at the thought of reading it. (The fact that it exists at all, in published form, is more than a bit nauseating, as well.)</p>
<p>There is some hope for me after all, I guess.</p>
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		<title>Mild-Mannered</title>
		<link>http://www.explananda.com/2009/02/06/mild-mannered/</link>
		<comments>http://www.explananda.com/2009/02/06/mild-mannered/#comments</comments>
		<pubDate>Fri, 06 Feb 2009 16:40:08 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Anecdotal]]></category>
		<category><![CDATA[Add new tag]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=2894</guid>
		<description><![CDATA[I wonder which group blog this poor bastard writes for.]]></description>
			<content:encoded><![CDATA[<p>I wonder which <a href="http://www.explananda.com">group blog</a> <a href="http://tpmmuckraker.talkingpointsmemo.com/2009/02/how_theresa_hatt_caused_the_financial_crisis.php">this poor bastard</a> writes for.</p>
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		<slash:comments>21</slash:comments>
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		<title>Cool it?</title>
		<link>http://www.explananda.com/2008/11/26/cool-it/</link>
		<comments>http://www.explananda.com/2008/11/26/cool-it/#comments</comments>
		<pubDate>Wed, 26 Nov 2008 16:16:38 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Barack Obama]]></category>
		<category><![CDATA[U.S. politics]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=2636</guid>
		<description><![CDATA[Josh Marshall tells those of us wringing our hands over some of his (potential) appointees to cool it. Appointees implement policies; they don&#8217;t set them. Maybe Josh can forgive us for taking Obama at his word: One of the great economic minds of our times, Larry [Summers] has the global reputation for being able to [...]]]></description>
			<content:encoded><![CDATA[<p>Josh Marshall tells those of us wringing our hands over some of his (potential) appointees to <a href="http://www.talkingpointsmemo.com/archives/245921.php">cool it</a>. Appointees implement policies; they don&#8217;t set them.</p>
<p>Maybe Josh can forgive us for taking Obama <a href="http://www.democracynow.org/2008/11/25/naomi_klein_robert_kuttner_and_michael">at his word</a>:</p>
<blockquote><p>One of the great economic minds of our times, Larry [Summers] has the global reputation for being able to get to the heart of the most complex and novel policy challenges. With respect to both, our current financial crisis and other pressing economic issues of our time, <strong>his thinking, writing, and speaking have set the terms of the debate.</strong> <strong>I am glad he will be by my side</strong>, playing the critical role of coordinating my administrationâ€™s economic policy in the White House and <strong>I will rely heavily on his advice as to navigate the unchartered waters of this crisis.</strong></p></blockquote>
<p>Obama tells us that Larry Summers, who <a href="http://www.washingtonpost.com/wp-dyn/content/article/2008/10/14/AR2008101403343_pf.html">argued </a>that regulating financial derivatives markets would &#8220;cast[ ] a shadow of regulatory uncertainty over an otherwise thriving market,&#8221; will be a guiding force. Why shouldn&#8217;t we believe that?</p>
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		<title>The Health Care Industry&#8217;s Insufficient Offer</title>
		<link>http://www.explananda.com/2008/11/20/the-health-care-industrys-insufficient-offer/</link>
		<comments>http://www.explananda.com/2008/11/20/the-health-care-industrys-insufficient-offer/#comments</comments>
		<pubDate>Thu, 20 Nov 2008 16:47:57 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Odds and ends]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=2621</guid>
		<description><![CDATA[Ezra Klein is right, the news this morning out of the insurance industry&#8217;s bunker is a big deal. They have offered a deal. They will agree to offer insurance to everyone, in exchange for a mandate forcing all to obtain coverage. Ezra explains the logic of current arrangements: The individual health insurance market, fundamentally, is [...]]]></description>
			<content:encoded><![CDATA[<p>Ezra Klein is <a href="http://www.prospect.org/csnc/blogs/ezraklein_archive?month=11&amp;year=2008&amp;base_name=lets_make_a_dealplease">right</a>, the <a href="http://www.nytimes.com/2008/11/20/us/20health.html?partner=permalink&amp;exprod=permalink">news this morning</a> out of the insurance industry&#8217;s bunker is a big deal. They have offered a deal. They will agree to offer insurance to everyone, in exchange for a mandate forcing all to obtain coverage. Ezra explains the logic of current arrangements:</p>
<blockquote><p>The individual health insurance market, fundamentally, is incoherent: Insurers try to deny coverage to those who want it and to sell to those who don&#8217;t. That&#8217;s because the most profitable customer for an insurer is one that never gets sick, and the least profitable is one who falls very ill. But that&#8217;s not how you want your health insurance market to work. We want sick people to get care. That&#8217;s the point.</p></blockquote>
<p>But perhaps they see the writing on the wall, and know that at some point, they will face legislation enjoining them to adopt &#8220;guarantee issue.&#8221; Hell, even the vast majority of Republicans voted for <a href="http://www.iht.com/articles/ap/2008/05/01/america/Genetic-Discrimination-Optional.php">a recent bill</a> prohibiting insurance companies from &#8220;discriminating&#8221; against customers whose genetic tests indicate future health problems. But in order to cover the costs of insuring those who have been traditionally denied coverage precisely because covering them would be expensive, the insurers say they&#8217;ll need healthy people to buy insurance. That way when the risky get sick, the premiums of the healthy can be used to pay for their treatment. As Donald G. Hamm Jr., president of Assurant Health, puts it,</p>
<blockquote><p>In the individual market, people can choose whether or not to apply for coverage,â€ Mr. Hamm said in an interview. â€œIf they know they can obtain coverage at any time, many will wait until they get sick to apply for it. That increases the price for everyone.</p></blockquote>
<p>But Ezra is on to Mr. Hamm:</p>
<blockquote><p>The question is not whether they&#8217;ll offer to sell coverage at all, but <em>at what price?</em> Selling insurance products that no one can afford may mean you&#8217;re not technically denying people access to insurance, but it doesn&#8217;t guarantee accessibility, which is a necessary precondition for a universal system. For that, you need &#8220;community rating,&#8221; which would force insurers to offer coverage at the same price to everyone, spreading risk equally and ensuring that coverage is no less affordable for the sick than the well.</p></blockquote>
<p>Actually, even community rating is insufficient. Community rated plans are designed to lower the insurance costs faced by high risk individuals by requiring that any particular health planâ€™s premium be priced to reflect the population&#8217;s average anticipated individual health care costs. While such regulations are well-meaning&#8212; high risk individuals will not be charged more than low risk individuals <strong>for the same level of coverage</strong>&#8212;<a href="http://laniels.org/weblog/2008/07/12/some-thoughts-on-health-insurance/">adverse selection</a> can remain a problem. Unless there are also government restrictions on the <strong>levels of coverage</strong> in the available plans, <strong>especially on whether there is a robust minimum that every plan must provide</strong>, low-risk individuals may choose bare bones plans that would benefit medium- and high-risk persons little. When this happens, plans providing a robust level of health care will attract only those individuals with higher risks, and this will drive up premiums and drive away healthier buyers interested in cheaper plans. So even if everyone is charged the same price for a community rated plan, the plans providing robust coverage will be avoided by the healthy, thus making them more expensive for those who will actually want them. This leads to premiums that still significantly reflect health status even when community rating regulations are in effect. Here&#8217;s one recent <a href="http://www.nber.org/papers/w1250">NBER working paper</a> on the issue.</p>
<p>So what we need is a mandate, community rating, <em>and</em> legislation establishing a robust minimum that each health care plan must satisfy. Only then will low-risk individuals actually subsidize the care that high-risk individuals need.</p>
<p>Unfortunately, the problem is not solved even then, since general health costs are growing unsustainably. But that is a problem we can discuss another day.</p>
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		<title>The Collaring</title>
		<link>http://www.explananda.com/2008/11/19/the-collaring/</link>
		<comments>http://www.explananda.com/2008/11/19/the-collaring/#comments</comments>
		<pubDate>Wed, 19 Nov 2008 15:57:39 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Odds and ends]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=2619</guid>
		<description><![CDATA[A friend is getting married next year in New Zealand. While she already has a celebrant in mind, she thought she&#8217;d check out the country&#8217;s list of official celebrants, in part to see if anyone she knows is one. She then noticed that only one of them seemed to have a website, so she thought [...]]]></description>
			<content:encoded><![CDATA[<p>A friend is getting married next year in New Zealand. While she already has a celebrant in mind, she thought she&#8217;d check out the country&#8217;s list of official celebrants, in part to see if anyone she knows is one. She then noticed that only one of them seemed to have a website, so she thought she&#8217;d take a look. And there, amidst a sea of quite normal sample vows that Geoffrey Vine has used in the past, is <a href="http://www.otagocelebrant.co.nz/W2.html">this</a>:</p>
<blockquote><p>THE COLLARING</p>
<p>Celebrant: This is a special day with a twofold purpose. In addition to exchanging vows and rings, AAA is going to place his collar on XXX as a symbol of their bond as Master and submissive.</p>
<p><em>CCC presents the studded leather collar to celebrant</em></p>
<p>Celebrant: A collar is not a thing to be taken lightly.Â  It is an outward symbol of a way of life, the ownership and guidance of one person by another.Â  In this, the Master undertakes to protect, guide and nurture the submissive, who in turn pledges herself to Him with all her being.Â  This is a bond of love, trust and honour.Â  As submission is the greatest gift, Dominance is the greatest responsibility, for without one, the other cannot be.</p>
<p><em>XXX kneels</em></p>
<p>Celebrant: XXX, do you of your own free will take AAAâ€™s collar? Will you fulfill His needs, serve His pleasures and meet His wishes, acceding in all things to Him?</p>
<p><em>XXX responds</em></p>
<p>Celebrant: AAA, do you accept XXX as your submissive? Will you treasure her gift, tempering power with duty, keeping her wellbeing first in your heart?</p>
<p><em>AAA responds</em></p>
<p><em>Celebrant hands the collar to AAA</em></p>
<p><em>AAA places the collar on XXX. AAA then helps XXX stand and they kiss.</em></p>
<p><em>XXX will then pour mead into the chalice.</em></p>
<p>Celebrant: Let this cup of mead be a symbol of the cup of life. As you share this one cup, may life be that much sweeter because you share it; may the past you have put behind you seem less bitter because of it.</p>
<p><em>XXX kneels and offers the cup to AAA, who drinks and then offers the cup to XXX, who drinks. XXX hands the cup back to celebrant and AAA helps XXX to her feet.</em></p>
<p>Celebrant: AAA and XXX, you have made the important step of making public, in front of these people, your full commitment to one another for the rest of your days.</p>
<p>Above you are the stars, below you are the stones. As time passes, remember only this: like a star should your love be constant. Like a stone should your love be firm. Be close, yet not too close. Possess one another, yet be understanding. Have patience each with the other, for storms will come but they will go just as quickly. Be free in giving affection and warmth. Make love often, and be sensuous to one another. Have no fear, and let not the ways or words of the unenlightened give you unease.</p>
<p>Go from this place in joy and in peace and may the spirit of all life travel with you throughout your days together.</p>
<p><em>CLOSING MUSIC (Nothing Else Matters &#8211; Metallica)</em></p></blockquote>
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		<title>Harbinger?</title>
		<link>http://www.explananda.com/2008/11/12/harbinger/</link>
		<comments>http://www.explananda.com/2008/11/12/harbinger/#comments</comments>
		<pubDate>Wed, 12 Nov 2008 14:45:56 +0000</pubDate>
		<dc:creator>Paul</dc:creator>
				<category><![CDATA[Odds and ends]]></category>

		<guid isPermaLink="false">http://www.explananda.com/?p=2616</guid>
		<description><![CDATA[I realize that tea leaf-reading ill befits a serious blog like this one, but I couldn&#8217;t resist. You see, for an Obama Presidency that may&#8211;may&#8211;mark the decisive turn away from the philosophy of the Reagan revolution that many say began with this, this item is a welcome harbinger: An air traffic controllers group says it [...]]]></description>
			<content:encoded><![CDATA[<p>I realize that tea leaf-reading ill befits a serious blog like this one, but I couldn&#8217;t resist. You see, for an Obama Presidency that may&#8211;may&#8211;mark the decisive turn away from the philosophy of the Reagan revolution that many say began with <a href="http://en.wikipedia.org/wiki/Professional_Air_Traffic_Controllers_Organization_(1968)#PATCO_Strike">this</a>, <a href="http://www.nytimes.com/2008/11/12/us/12brfs-UNIONFORGUAN_BRF.html?partner=permalink&amp;exprod=permalink">this item</a> is a welcome harbinger:</p>
<blockquote><p>An air traffic controllers group says it has become the first union to represent workers at the <a title="More news and information about GuantÃ¡namo." href="http://topics.nytimes.com/top/news/national/usstatesterritoriesandpossessions/guantanamobaynavalbasecuba/index.html?inline=nyt-geo">GuantÃ¡namo Bay</a> Navy base in Cuba. The Professional Air Traffic Controllers Organization says it will represent eight employees who direct flights at the Caribbean outpost. Ron Taylor, president of the group, said the vote was its first organizing campaign victory outside the United States. The GuantÃ¡namo workers are employed by Midwest Air Traffic Control Service of Overland Park, Kan.</p></blockquote>
<p>Also, persuant to my last post, Robert Kuttner does his best to <a href="http://www.democracynow.org/2008/11/7/can_grassroots_movement_that_propelled_obama">talk me down</a>.</p>
<blockquote><p>But I may beâ€”call me crazy, call me an optimist, <strong>we have reality on our side. Events are going to drive this, and heâ€™s either going to rise to the occasion or heâ€™s going to fail. </strong>And I think heâ€™s a very smart, very decent guy who doesnâ€™t want to fail. And unlike certain recent presidents, heâ€™s also very intelligent. And I donâ€™t think this is going to be a man whoâ€™s going to be steered by his staff. At all the key meetings, the meetings were run by Obama himself. And itâ€™s going to beâ€”I donâ€™t think the die is yet cast. I think this is still a very fluid moment. Iâ€™m unnerved by the people heâ€™s appointing. There are deep structural forces that weâ€™ve talked about that put so much power in the hands of Wall Street, that push him in that direction. But this is one of those moments when things could change, if we get counterweights on the part of organizing at the grassroots.</p></blockquote>
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