Shopping Around Is the Key to Low Prices in Obamacare

| Wed Nov. 18, 2015 7:56 PM EST

Abby Goodnough writes today about switching health care coverage each year during Obamacare's year-end open enrollment period:

The Obama administration is encouraging switching as a way to avoid steep increases in premiums — and to promote competition among insurers, as the law intends. Next year will be no different: The price of plans will rise in most states, and the administration says that 86 percent of people who currently have coverage through the federal exchange can find a better deal by switching.

“This may be just one of those environments where there’s a new normal,” said Sabrina Corlette, a professor at the Health Policy Institute of Georgetown University.

For many consumers, the volatility in the markets has been a source of anxiety and disruption. To have any choice at all is a welcome development, many say. But switching plans is also becoming an unwelcome ritual, akin to filing taxes, that is time-consuming and can entail searching for new doctors and hospitals each year.

This is unquestionably a downside to encouraging competition in the health insurance marketplace. As carriers jostle for position, the lowest-price coverage is going to change from year to year—and if you're a price-sensitive shopper, that means your coverage is going to change from year to year too.

I suspect this problem will settle down after a couple more years, as insurance companies get more experience with the Obamacare pool and get better at pricing their policies. In the meantime, though, it really does pay to shop around. A new Kaiser study of 2016 rate increases provides some concrete numbers. If you bought the cheapest silver plan in 2015 and then you stick with it in 2016, your premium may go up quite a bit. But if you shop around for the plan that has the lowest price in 2016, your premium will barely change at all. The chart on the right tells the story. For low-income buyers, shopping around means virtually no premium increase at all. For middle-income buyers, it means a larger but still pretty modest increase.

Moral of the story: If price is a major issue for you, shop around! It's a pain in the ass, but it pays off.

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The Latest Issue of ISIS's Magazine Is As Terrible As You'd Think

| Wed Nov. 18, 2015 7:20 PM EST

Since the end of October, ISIS has claimed responsibility for the murders of almost 400 people in strikes against France, Russia, and Lebanon. As officials continue to investigate how these attacks were carried out, the so-called Islamic State released its own version Wednesday morning—in the latest issue of its digital magazine, Dabiq.

As Mother Jones has reported before, Dabiq is a recruitment tool for ISIS, which uses the publication to deliver "informative" updates from its territory and articulate lengthy religious arguments that the group says justify its brutal tactics. ISIS's propaganda arm, which began publishing Dabiq after the group's declaration last summer that it had established a caliphate, uploads the magazine online as an English-language PDF and distributes it on social media. (Dabiq takes its name from a farming town in northern Syria, where, according to Islamic prophecy, the caliphate will defeat the forces of "Rome," ushering in a series of events that will lead to the apocalypse—a story that is crucial to ISIS's recruiting tactics.)

Here's what the terrorist group had to say about recent attacks:

Dabiq doesn't add much to what we already know about the simultaneous attacks that killed 129 people Friday at the Bataclan Theatre, Stade de France, and other locations around the Boulevard Voltaire in Paris. As European authorities mount raids looking for anyone who might have been involved in the plot, the magazine states that a total of eight people were involved in carrying out the attacks.

Here's how Dabiq justifies last week's events in Paris: 

A year earlier, on "19 September 2014," France haughtily began executing airstrikes against the Khilāfah [Caliphate]. Like Russia, it was blinded by hubris, thinking that its geographical distance from the lands of the Khilāfah would protect it from the justice of the mujāhidīn. It also did not grasp that its mockery of the Messenger would not be left unavenged. Thus, the Islamic State dispatched its brave knights to wage war in the homelands of the wicked crusaders, leaving Paris and its residents "shocked and awed." The eight knights brought Paris down on its knees, after years of French conceit in the face of Islam.

The alleged mastermind of the Paris attacks, 27-year-old Abdelhamid Abaaoud, gave an interview to Dabiq earlier this year. In it, Abaaoud brags about being pursued by Western intelligence agencies and describes traveling between Syria and Belgium, where he claimed he was leading a terror cell that was broken up by Belgian officials.

Metrojet Flight 9268 crash
In a foreword to the issue, Dabiq's unnamed creators published an image of the bomb they say was used to bring down Metrojet Flight 9268, the Russian airliner that crashed on October 31 over Sinai, Egypt, killing all 224 passengers. The photograph shows a can of Shwepps Gold, alongside what appears to be a switch and detonator for the device.

New York Times reporter C.J. Chivers weighed in on the bomb on Twitter:

According to Dabiq, ISIS originally planned to attack an airplane belonging to the US-led coalition against ISIS, but switched its target to a Russian flight. An Egyptian branch of ISIS has previously claimed responsibility for the attack.

Neither the photograph nor any of the group's claims about the attacks have been verified. Alexander V. Bortnikov, the head of the Russian Federal Security Service, said Monday that Russian investigators had determined that the plane was brought down in an act of terrorism, using an "improvised explosive device" that contained up to one kilogram, or 2.2 pounds, of TNT.

Dabiq explains how the attack on Metrojet Flight 9268 came about:

On "30 September 2015"…Russia decided to participate directly with its own air force in the war. It was a rash decision of arrogance from Russia, as if it held that its wars against the Muslims of al-Qawqāz were not enough offence. And so after having discovered a way to compromise the security at the Sharm el-Sheikh International Airport and resolving to bring down a plane belonging to a nation in the American-led Western coalition against the Islamic State, the target was changed to a Russian plane. A bomb was smuggled onto the airplane, leading to the deaths of 219 Russians and 5 other crusaders only a month after Russia’s thoughtless decision…This was to show the Russians and whoever allies with them that they will have no safety in the lands and airspace of the Muslims, that their daily killing of dozens in Shām through their airstrikes will only bring them calamities, and that just as they kill, they will be killed, by Allah’s permission.

Beirut, Lebanon
Dabiq also includes the November 12 suicide bombings in Beirut among a larger list of its recent "military operations":

The soldiers of the Khilāfah in Lebanon parked a motorbike rigged with explosives on al-Husayniyyah Street in the region of Burj al-Barājinah located in the southern suburb of Beirut, a Hizbul-Lāt stronghold, and detonated it on a gathering of Rāfidī mushrikīn. When the murtaddīn subsequently gathered at the site of explosion, one of the soldiers of the Khilāfah detonated his explosive belt in their midst. The operation succeeded in killing more than 40 Rāfidah and wounding over 200 more, and sent a clear message to the Rāfidī allies of Bashar in Lebanon that they are well within the vengeful reach of the Islamic State.

According to CNN, Lebanese investigators apprehended a would-be suicide bomber who survived the attacks, and who claimed to have traveled to Beirut from Syria as part of an ISIS cell.

Roanoke Mayor Makes the Most Appalling Argument Yet for Rejecting Syrian Refugees

| Wed Nov. 18, 2015 5:35 PM EST

Here is Mayor David Bowers of Roanoke, Virginia—a member of Hillary Clinton's Virginia Leadership Council—making perhaps the worst argument we've seen yet for rejecting Syrian refugees:

A take so bad that it prompted this member of Congress to weigh in:


Update: Bowers is off the Clinton team as of Wednesday afternoon.

Even in the Hands of an Expert, Mockery Is Tough to Control

| Wed Nov. 18, 2015 3:55 PM EST

I sort of promised myself that I wasn't going to comment again on the whole mockery thing, but President Obama's remarks yesterday are a pretty interesting case study of both the strength and weakness of mockery as a political tool. First, here's what he said about refugees at a press conference in the Philippines. I have a reason for including a very long excerpt, but feel free to skim it since the details aren't that important:

Because you have this vibrant, modern, open, diverse, tolerant Western city that reminds us of home, that reminds us of our own cafes and our own parks and our own stadiums, I understand why the American people have been particularly affected by the gruesome images that have happened there.

And it is important for us to be reminded that we have to be vigilant, that rooting out these terrorist networks and protecting the homeland is hard work, and we can't be complacent or lulled into thinking somehow that we are immune from these kinds of attacks. That's why we built an entire infrastructure over the last decade-plus to make it much harder for terrorists to attack us; to go after terrorists where they live and plan these attacks; to coordinate with our partners and our allies; to improve our intelligence. All the work that we've been doing in our intelligence communities and our military over the last decade is in recognition of the fact that this is something we should be concerned about and we've got to work hard to prevent it.

But we are not well-served when, in response to a terrorist attack, we descend into fear and panic. We don't make good decisions if it's based on hysteria or an exaggeration of risks. I think the refugee debate is an example of us not being well-served by some of the commentary that’s been taking place by officials back home and in the media.

Understand, under current law, it takes anywhere from, on average, 18 to 24 months to clear a refugee to come into the United States. They are subjected to the most rigorous process conceivable. The intelligence community vets fully who they are. Biometrics are applied to determine whether they are, in fact, somebody who might threaten the United States. There is an entire apparatus of all of our law enforcement agencies and the center that we use for countering terrorism to check and ensure that a refugee is not admitted that might cause us harm.

And, if anything, over the last several years that the refugee crisis has emerged in Europe, we’ve been criticized that it is so cumbersome that it’s very difficult for us to show the kind of compassion that we need to for these folks who are suffering under the bombings of Assad and the attacks of ISIL. They’re victims of this terrorism.

And so if there are concrete, actual suggestions to enhance this extraordinary screening process that’s already in place, we’re welcome — we’re open to hearing actual ideas. But that’s not really what’s been going on in this debate. When candidates say, we wouldn't admit three-year-old orphans  that’s political posturing. When individuals say that we should have a religious test and that only Christians — proven Christians  should be admitted  that’s offensive and contrary to American values.
I cannot think of a more potent recruitment tool for ISIL than some of the rhetoric that’s been coming out of here during the course of this debate. ISIL seeks to exploit the idea that there is a war between Islam and the West. And when you start seeing individuals in positions of responsibility, suggesting that Christians are more worthy of protection than Muslims are in a war-torn land, that feeds the ISIL narrative. It’s counterproductive, and it needs to stop.

OK. Got that? That was the first two minutes of Obama's remarks. He acknowledged the problem. He also acknowledged that a renewed fear of terrorism in the wake of the Paris attacks was understandable. He explained that our screening process for Syrian refugees is extremely stringent. He said he didn't want to play into the hands of ISIS by stoking fear of Islam, and he criticized politicians who did so. No mockery. Just plenty of education and some tough words for partisan fearmongers.

Then he said this:

And I would add, by the way, these are the same folks oftentimes who suggest that they’re so tough that just talking to Putin or staring down ISIL, or using some additional rhetoric somehow is going to solve the problems out there. But apparently, they’re scared of widows and orphans coming into the United States of America as part of our tradition of compassion. First, they were worried about the press being too tough on them during debates. Now they’re worried about three-year-old orphans. That doesn’t sound very tough to me.

That's mockery. And here's the problem. Obama started off by speaking for a full two minutes calmly and rationally—exactly what I think he should have done. Then he briefly offered up a bit of mockery. I actually think that's OK too because it was prefaced with a deep and sustained acknowledgement of the problem at hand.

But can you guess how much of that first two minutes has been quoted? Can you guess how much of the mockery has been quoted? That's right: barely any of the former and mountains of the latter.

This is hardly surprising. The explanatory stuff is boring. How many of you read it all the way through? The mockery, on the other hand, is short and it makes great copy. Of course that's what everyone is going to focus on.

On the bright side, this means Obama got some press and the liberal base got stoked. On the downside, it means that your average reader got the impression that Obama tossed out a few jibes at Chris Christie and Ted Cruz and that was it. You don't even have to quote him out of context to make it look like he doesn't really care much about fears of refugees.

That's the risk of using mockery. Used on its own, it makes ordinary people feel like you're clueless and condescending. But even if you do it right, as Obama did, the way it's reported can end up having the same effect. And that effect is exactly the opposite of what liberals would like to accomplish. So if you care about the real world, and you care about public opinion, keep the mockery to a minimum. That doesn't mean you can't fight back, and it doesn't mean you have to go easy on the fearmongers. You can do both. Just do it in a way that doesn't immediately turn off the very people you'd like to persuade.

The SALt Lamp Explained

| Wed Nov. 18, 2015 2:36 PM EST

You might have seen this in the New York Times today:

The president hosted a discussion of climate change at the chief executives’ forum along with Jack Ma, founder of the e-commerce giant Alibaba, and Aisa Mijeno, a Filipino entrepreneur who invented a lamp that runs on saltwater.

In response to a question about her lamp from Mr. Obama, Ms. Mijeno said that it provided about eight hours of light, as well as power to a USB port for charging a phone. “And all you need to do is you just have to replenish the saltwater solution,” she said, “and then you have another eight hours of lighting.”

Just saltwater? Doesn't that seem like it violates some kind of energy conservation law?

Yes and no. The SALt lamp uses a fairly ordinary galvanic battery that consists of two electrodes and an electrolyte solution of salty water. Replenishing the saltwater will indeed get the lamp going again, but you also need to replace the anode every six months or so. There's no magic here, but there is a substantial engineering challenge. "It is made of tediously experimented and improved chemical compounds, catalysts, and metal alloys that when submerged in electrolytes will generate electricity," Mijeno explained earlier this year.

The other challenge is being able to manufacture the lamp so that it's reliable, cheap, and easy to maintain. If Mijeno's lamp works as advertised, it will produce about 90 lumens of light at a cost of $20, plus $3 every six months for a replacement anode. It's designed for areas with no electricity grid, and should be safer than kerosene lamps. She hopes to have it on the market in 2016.

The One Country You'd Expect to Reject Syrian Refugees Wants to Take 30,000 of Them Instead

| Wed Nov. 18, 2015 1:45 PM EST

A growing number of politicians in the United States have used last Friday's terrorist attacks in France to argue for tighter restrictions, if not an outright halt, on accepting Syrian refugees. But in France itself, the government is keeping its doors open.

French President Francois Hollande said on Wednesday at a meeting of French mayors that France will accept 30,000 refugees over the next two years, calling it his country's "humanitarian duty." The announcement earned a standing ovation from the mayors, according to the Washington Post.

France had already committed to take in just over 24,000 refugees under the terms of a mandatory EU quota plan that was adopted in September. Extending that commitment to 30,000 is one of the few positive signs for the EU's efforts, largely led by Germany, to spread refugees more equitably across the continent. The plan was opposed by Eastern European and Balkan countries through which large numbers of refugees have crossed in recent months, and opposition has increased following the Paris attacks. The government of Hungary announced on Wednesday that it will sue the EU to overturn the quota plan. "Most of Europe's population doesn’t agree with the quota. Its social legitimacy is lacking," said Laszlo Trocsanyi, the Hungarian justice minister.

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Health Update

| Wed Nov. 18, 2015 1:20 PM EST

I'm afraid the news can't always be good on the health front. I got my latest lab work yesterday and it wasn't encouraging. My immune system, after stabilizing last month, weakened again. My neutrophil count is down to 1500, which isn't quite in the danger zone but is mighty close. At the same time, my M-protein marker, which measures the level of cancerous cells in my bone marrow, went up from 0.55 to 0.61. It looks like 0.55 might be as good as it gets, and that's nowhere close to zero. Unfortunately, it's unlikely that I can try a higher dose of my current chemo med with my immune system already so compromised.

Any single month can be an outlier, so there's no need to panic yet. I'll have another set of lab work in December, and I'll see my oncologist shortly after that. If the numbers haven't improved, I'll try a little harder than usual to drag some actual information out of her.

Medicaid Provides Pretty Good Health Coverage for Children

| Wed Nov. 18, 2015 12:30 PM EST

Via Harold Pollack, here's an interesting study of children's health care. The researchers investigated how good Medicaid coverage was, and the results were surprisingly positive. I have painstakingly modified the chart so that higher numbers are always better, and as you can see, reported satisfaction with Medicaid was equal to or better than private insurance on most measures, and very close on the others.

Now, this is only for children, and the results might be different for adults. Still, a lot of people—including me—generally think of Medicaid as fairly lousy coverage. If this study is correct, we need to rethink this.

Could Obama Have Prevented the Rise of ISIS in 2012?

| Wed Nov. 18, 2015 11:44 AM EST

Back in 2012, Fred Hof was President Obama's advisor for Syria. Today, Zack Beauchamp asks him if there was anything we could have done back then to prevent the rise of ISIS:

In mid-2012, President Obama's key national security officials — Clinton, Panetta, Petraeus, and Dempsey — all recommended a robust training and equipping effort designed to unite and strengthen nationalist anti-Assad rebels. One of the justifications for the recommendation was that they were beginning to see the rise of al-Qaeda-related elements in Syria.

Had that recommendation been accepted and then implemented properly, the ISIS presence in Syria would not be what it is today. Had the US been able to offer Syrian civilians a modicum of protection from Assad regime collective punishment — barrel bombs and all the rest — a major ISIS recruiting tool around the world and inside Syria could have been diluted and even neutralized.

That bolded phrase is doing a helluva lot of heavy lifting here. I wish Beauchamp had followed up and asked Hof if he thinks the US intelligence and military communities could, in fact, have implemented this policy effectively. Their recent efforts, which produced something like five trained rebels, don't inspire a ton of confidence. My guess is that Obama listened to their recommendations but concluded that in the real world, it wouldn't have worked. I suspect he was right.

We'll never know, of course, which means this can be a subject of debate pretty much forever. But there's sure nothing in the recent historical record to inspire a lot of faith in our ability to carry out a plan like this.

New York Daily News Compares the NRA to Jihadists

| Wed Nov. 18, 2015 11:01 AM EST

In three words, the front page of Wednesday's New York Daily News launched one of the boldest attacks on the National Rifle Association in recent memory.

The tabloid's cover denounced "NRA's Sick Jihad," in characteristically huge typeface. The story inside accused the gun rights group of tacitly abetting the arming of terrorists by blocking a proposed bill that would make it more difficult for terror suspects to buy guns in the United States. The Denying Firearms and Explosives to Dangerous Terrorists Act of 2015, formally known as H.R. 1076, was introduced in February, and includes a ban on the "sale or distribution of firearms or explosives to any individual whom the Attorney General has determined to be engaged in terrorist activities."

The earliest version of the legislation was originally introduced under President George W. Bush in 2007, but it has yet to be signed into law. According to the Daily News, more than 2,000 suspects on the FBI's Terrorist Watchlist have been able to purchase weapons in the United States in the last 11 years.

The story begins, "The NRA—and their gun-loving Republican cohorts—are refusing once more to stop terrorists intent on getting armed in the U.S.A."