Kevin Drum - 2013

Most Americans Have No Clue How Health Insurance Works in America

| Thu Dec. 19, 2013 2:29 PM EST

EBRI has released its annual workplace benefits survey, and for the most part it's a triumph of status quo bias. Most people are fairly satisfied with their benefits and not especially eager for change. But there's one particular question that produced a different response. Here it is:

I'm scratching my head a bit over this. The thing is, employer health insurance is the gold standard of American health insurance. Sure, every year employee cost sharing rises and copays go up, but it's still great compared to nearly all individual plans. Deductibles are small and out-of-pocket maxes are low. Plus it's nontaxable. If you have a choice between employer insurance and individual health insurance, about 99 percent of the time you'd be crazy not to take the employer plan.

And yet, 66 percent (!) of respondents wanted to go out and choose a plan on the open market and then get reimbursed in one way or another. The only thing I can figure is that this demonstrates just how little most people know about health insurance. They have no idea that the full value of employer health insurance is free of income tax, which makes it a great deal compared to spending your own money. Nor, as so many people are suddenly discovering about Obamacare, do they realize that individual plans usually have large deductibles and stratospheric out-of-pocket maxes. For those reasons, buying an individual plan on the open market and then getting reimbursed for it is almost certainly a losing proposition.

Maybe I'm missing something here, and people understood the question differently than me. But on the surface, this sure seems to indicate that most Americans simply have no clue about how health insurance works in this country.

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How Not to Report on Test Scores and Free Lunches

| Thu Dec. 19, 2013 1:16 PM EST

Bob Somerby is complaining today about numerical illiteracy among our nation's elite reporting class. Item 1: the New York Times describes a 10-point improvement among fourth graders on the NAEP test as "small." In fact, it's roughly a full grade level. If you think that improving by a full grade level in a single decade is small, you're either crazy or innumerate.

Item 2: M. Night Shyamalan talks about the fact that American test scores are pretty high in "districts in which the poverty rate was less than 10 percent." However, the only income data we have for most test takers is related to the National School Lunch Program. Shyamalan is using eligibility for free or reduced meals as a marker of poverty. But it's not. And since here at MoJo we're dedicated to lighting a candle instead of cursing the darkness, here are the exact eligibility requirements for free and reduced-price lunches in 2013, courtesy of the Agriculture Department:

Obviously, folks eligible for reduced-price meals aren't exactly swimming in cash. Still, a family of three making $36,000 isn't anyone's idea of poverty, and it's misleading to say so. Eligibility for free meals would be a fairly decent proxy for poverty—they account for about a third of all NSLP meals—but unfortunately that data isn't collected separately. You either qualify for NSLP or you don't, and something like two-thirds of all schoolchildren qualify. It's a pretty broad brush, and there are damn few school districts in which fewer than 10 percent of kids qualify.

FWIW, this is why I've never bothered breaking down test scores by income. The only data available is eligibility for NSLP, and between the loose requirements and the virtual nonexistence of verification1, it simply doesn't mean very much. It can give you a very broad feel for how rich or poor a particular school or district is, but that's it.

1Which I'm all in favor of, by the way. This is a program that probably doesn't benefit from tighter scrutiny. Nonetheless, it makes it nearly useless as a proxy for poverty among test takers.

Even Doctors Believe in Obamacare's Death Panels

| Thu Dec. 19, 2013 12:19 PM EST

I learned something new this morning. Two things, actually. First, Sarah Kliff points us to a recent study telling us that even a lot of doctors believe that Obamacare institutionalizes death panels:

This is just a survey of head and neck doctors, so maybe they're just especially ignorant among the MD set. But probably not.

So what else did I learn? Well, Obamacare has never had death panels in the sense of the question above, but it does reimburse physicians for having end-of-life conversations with their patients. You know, so they can decide about things like DNR notices, how much extraordinary care they want, living wills, and so forth. All perfectly sensible, except that it's what prompted the death panel nonsense in the first place.

And it's gone. I didn't know that. Apparently, after the New York Times put it on the front page in 2011, this provision was eliminated. So the yahoos won another victory, and it didn't stop the death panel talk anyway. Hooray.

UPDATE: Thanks to a tweet from Austin Frakt, I did a little more digging and it turns out that a weakened version of end-of-life counseling remained in the bill and was implemented by a new regulation adopted in 2010:

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

So if a patient asks about end-of-life treatment, doctors are allowed to talk about it and bill the time as an office visit. Death panels!

UPDATE 2: Oh hell. It turns out that a couple of weeks after putting this rule in place, the Obama administration reversed itself. So I was right the first time: Reimbursements for end-of-life counseling have been eliminated after all. Thanks, yahoos.

BREAKING: Voter Fraud Continues to Be a Non-Problem

| Thu Dec. 19, 2013 11:30 AM EST

Dave Weigel highlights the following from Fox News:

Ohio Secretary of State Jon Husted announced Wednesday that his office found 17 non-citizens illegally cast ballots in the 2012 presidential election — and has referred the case for possible prosecution... Husted also found that 274 non-citizens remain on the voting rolls. President Obama beat Mitt Romney in Ohio by just 2 percentage points in November 2012.

Hmmm. So how does 17 citizens compare to Obama's 2 percent winning margin? Weigel does the math. That's 17 out of a winning victory of 166,272 votes. Not exactly a deal breaker.

Oh, and these 17 all had driver's licenses, so a photo ID law wouldn't have helped here. Nor was there any plot to steal votes. Just a minuscule thimbleful of random folks who cast votes they shouldn't have. Maybe by accident—in fact, maybe not at all, since how these cases often turn out—but in any case, an absolute maximum of 17. Weigel concludes by comparing this to the 200,000 votes that were spoiled in Ohio in the 2004 election:

The situation's improved since then, but there remain many, many more votes lost because of flawed ballots or attritition from long lines than votes canceled out out by the confirmed ballot of a non-citizen. And a great deal of legal work has come up dry in the hunt for the mythical "buses of illegal voters" being spirited in from cities or campuses to stuff the polls.

But if you just read Fox, you've learned that the voter fraud problem is very real.

Roger that.

New Jersey Bridge Scandal Suddenly Gets Worse For Chris Christie

| Thu Dec. 19, 2013 1:54 AM EST

Last week I mentioned the peculiar story of David Wildstein, an executive at the Port Authority of New York and New Jersey, who closed down several lanes of the George Washington Bridge last October in apparent retaliation against the mayor of Fort Lee for not supporting Chris Christie's reelection campaign. It all seemed pretty sleazy, but I also figured it was "vanishingly unlikely" that Christie himself had anything to do with this. It was embarrassing for him, but that was all.

Today, that may have changed:

Bill Baroni and David Wildstein, former executives at the Port Authority of New York and New Jersey, have sought outside counsel amid an investigation into why traffic lanes leading to the nation's busiest bridge were closed, the documents showed.

....Mr. Wildstein recently hired Alan L. Zegas, a criminal lawyer from Chatham, N.J., to represent him, according to an email sent from Mr. Zegas to the state Legislature Tuesday....Mr. Baroni retained Michael Himmel, of Lowenstein Sandler LLP. Mr. Himmel works at the firm's New York City and Roseland, N.J. offices, and specializes in white collar crime, according to his biography.

Read Mark Kleiman for more on just why this is such bad news for Christie. This scandal is starting to look like it has more legs than I thought.

Brazil Has No Plans to Offer Edward Snowden Asylum

| Thu Dec. 19, 2013 1:21 AM EST

Edward Snowden would like Brazil to grant him political asylum. And why not? The Brazilian public was pretty ticked off over revelations that the NSA had hacked into Petrobas, and Brazil's president, Dilma Rousseff, was pretty ticked off when she learned that the NSA had been monitoring her email and cell phone. But apparently canceling a state trip to the United States is about as far as she's willing to go:

Brazil has no plans to grant asylum to Edward Snowden even after the former U.S. National Security Agency contractor offered on Tuesday to help investigate revelations of spying on Brazilians and their president, a local newspaper reported.

The Folha de S.Paulo newspaper, citing unnamed government officials, said the Brazilian government has no interest in investigating the mass Internet surveillance programs Snowden revealed in June and does not intend to give him asylum.

In the end, no matter how annoyed they are and how much public posturing they do, very few countries are willing to risk the massive breakdown in relations that would be the likely result of harboring a wanted American fugitive. Snowden is going to have a helluva hard time finding a permanent home anywhere other than Russia.

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The Origin of the War on Christmas

| Wed Dec. 18, 2013 8:57 PM EST

I'm thinking about switching to Chrome as my default browser, but first I need to check and see if I can still blog successfully using it. It's not officially supported by MoJo's tech staff, you see. So I need something to write about.

I know! How about the War on Christmas™? Dan Amira shares with us the video clip on the right, which is certainly amusing. It turns out that Fox News, which is ground zero for outrage over this stuff, airs house spots that wish everyone "Happy Holidays." Hah!

But I have a question. The conservative take on all this is that "Happy Holidays" is some kind of secular leftist plot. Or a multi-culti plot. Or something. But at least as far back as when I was a kid, we got cards wishing us "Holiday Greetings" or "Greetings of the Season," or some such. And since we were all one big Christian nation back then, and no one cared about Eid or Kwanzaa or atheists or even Hanukkah, really, I always assumed that this particular greeting was about New Year's. "Happy Holidays" meant you were including both Christmas and New Year's, not that you were including Christmas and some godless pagan festival.

Am I crazy? Or is that where it started?

POSTSCRIPT: In case you're wondering, Chrome seems to work fine, as you can see by the fact that this post exists. Oddly, though, our (supposedly) WYSIWYG editor and preview function don't display YouTube embeds in Chrome. In fact, this particular embed didn't even show up when I published the post. Then after a few minutes it finally did. But even then, it still didn't show up when I went back into editing mode. That's pretty strange.

Everything else seems to work fine, though Chrome lacks some useful features I've gotten used to. But I guess that's life.

The 9 Most Important Recommendations From the President's NSA Surveillance Panel

| Wed Dec. 18, 2013 5:04 PM EST

The report of the president's NSA review panel is out. It has a grand total of 46 recommendations. Here are the most interesting ones: 

  1. Phone records should be stored privately, not by the government. If the NSA needs phone records, it should get a warrant for them. Like a subpoena, the warrant should be "reasonable in focus, scope, and breadth."
  2. More broadly: "As a general rule and without senior policy review, the government should not be permitted to collect and store mass, undigested, non-public personal information about US persons for the purpose of enabling future queries and data-mining for foreign intelligence purposes."
  3. The FBI should no longer be allowed to issue National Security Letters on its own. NSLs should be issued only if a warrant is approved. Nondisclosure orders should be more restricted; should last no more than 180 days; and should not prevent the target of the NSL from challenging its legality in court.
  4. Generally speaking, companies that are ordered to produce information should be allowed to "disclose on a periodic basis general information about the number of such orders they have received, the number they have complied with, the general categories of information they have produced, and the number of users whose information they have produced in each category."
  5. Surveillance of non-US persons "must be directed exclusively at protecting national security interests....[and] must not be directed at illicit or illegitimate ends, such as the theft of trade secrets or obtaining commercial gain for domestic industries."
  6. If a US person is inadvertently surveilled, that information cannot be used as evidence in any court proceeding.
  7. The NSA should be headed by a civilian. Leadership of the NSA should be separated from leadership of the military's Cyber Command.
  8. "Congress should create the position of Public Interest Advocate to represent the interests of privacy and civil liberties before the FISC." In addition, more FISC decisions should be declassified.
  9. The government should commit itself to stop trying to undermine public encryption standards.

These are useful recommendations, especially 1, 2, 3, 6, and 8. Recommendation 7 is already a dead letter, since President Obama has said he plans to keep dual-hatted leadership for the NSA and Cyber Command.

How much of this will survive the president and Congress? I'd like to say I'm optimistic, but I'm not, really. These recommendations are useful but modest, and I suspect that Congress will whittle them down even more. Stay tuned.

Fed Announces Beginning of the End of QE3

| Wed Dec. 18, 2013 2:09 PM EST

It's official: we are tapering. The Fed announced today that it would reduce its QE3 bond-buying program from $85 billion per month to $75 billion per month.

So what does this mean? In a nutshell, markets will probably freak out temporarily. Econ pundits will write about a hundred thousand words today exploring every possible nuance of the decision. Ben Bernanke will tell everyone to calm down. In a day or two, there will be some news about the holiday buying season and the whole thing will be forgotten. Five years from now, there will be several doctoral dissertations about what it all really meant.

Substantively, though, this just isn't that big a deal. You may now return to your regularly scheduled Obamacare bashing and/or defending.

UPDATE AT 11:12 AM: Apparently the Dow is up 100 points on the taper news. So markets don't seem to be freaking out after all. If this holds, it will be the most quickly disproven prediction I've ever made, and yet another lesson that you should never make predictions. Will I ever learn?

Nuclear Talks With Iran Not Going Very Well

| Wed Dec. 18, 2013 1:26 PM EST

Paul Richter of the LA Times reports that talks with Iran aren't going very well:

Three weeks after President Obama hailed a landmark deal to suspend most of Iran's nuclear program for the next six months, the mood among U.S. officials about the next round of negotiations has shifted from elated to somber, even gloomy.

....Problems already have emerged. Technical talks in Vienna aimed at implementing the initial deal stopped Thursday when Iranian negotiators unexpectedly flew back to Tehran, reportedly in response to the Obama administration's decision to expand its blacklist of foreign companies and individuals who have done business with Iran in violation of sanctions.

....Even before Thursday's interruption, experts had struggled to determine how to sequence the complex next steps involved: neutralizing a stockpile of medium-enriched uranium and freezing most other enrichment operations in exchange for granting Iran access, in installments, to $4.2 billion of its own funds held in banks overseas and easing sanctions on petrochemical and auto exports.

None of this surprises me. Even with the incentive of shucking off the sanctions that have crippled their economy, the price the Western allies is asking might just be too high for Iran to accept. In the end, ensuring that Iran can't build a bomb requires dismantling nearly all of Iran's nuclear infrastructure and putting in place extremely intrusive monitoring of what's left. There are a hundred different ways this could run aground on both sides.

Hopefully, this is just the normal trough in negotiations after the initial bloom of goodwill from getting talks started. After all, both sides have good reason to want to make a deal. But if I had to guess, I'd put the odds of success at 50 percent or less.