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Wednesday, October 16, 2013

Cruising the Web

Take Esquire's ideology quiz. Quite a few people on my Facebook feed are upset that they are coming out as "radio talk head." Esquire is trying to find the political center. It figures that their center is further to the left thus pushing people who think of themselves as moderates over to the right.

Yes, indeedy. Incentives matter when making public policy. This would be a good practice for all lawmakers.
if you want to figure out the end effect of any policy proposal, examine how it will change people’s incentives.
A giant duh! Unfortunately, our solons in Washington seemed to ignore the importance of incentives when crafting Obamacare.
Marron’s theory is especially relevant when it comes to Obamacare, which drastically changed incentives for workers and employers throughout the country. Because of the requirements that companies of a certain size offer health care coverage to full-time employees or face stiff government fines, many employers have started to either drop coverage altogether (the fines are cheaper) or reduce the amount of full-time employees to avoid the mandates.
You ready for more joys of divided government? Now it is the turn of the House Congressional committees to start investigating what the blankety-blank was going on at HHS to lead to the fiasco of the launch of Obamacare. This should be interesting.

Perhaps this is why the system is crashing.
A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)
Read the rest. Short summary: the technical problems are a feature, not a bug.

Remember all that malarkey Obama fed the public about being the "purple" candidate who move beyond the partisan divide. Well, according the Boston Globe, it has turned out the exact reverse.
Obama’s talk of uniting the nation often has not translated into, to use military parlance, “boots on the ground.” He has visited Democrat-leaning “blue” states six times more often than he has visited Republican “red” states. He has staffed much of his administration with people who grew up in blue states. None of his major legislative accomplishments — the stimulus, health care, and financial reforms — received more than six Republican votes.

In sum, one of the biggest failures of Obama’s presidency is that, five years after he took office vowing to close the partisan divide, the capital he now oversees and the country he represents are far more divided than they were before he came.

Washington is as poisonous — and, to use Obama’s words, petty and immature — as ever. Obama has not turned the United States into 50 purple states, where compromise is desired and citizens agree there are two sides to each coin. It is indisputable, longtime observers says, that the red states are redder, and the blue states are bluer....

As president, Obama has taken more trips to South Korea (three) than he has to South Carolina (zero). He’s been to Ghana but never to Utah. He’s visited the citizens of Denmark (twice) more frequently than the residents of Kentucky (once).

Overall during his presidency, Obama has spent an average of less than four days in each of the red states he lost in 2012, while he has spent an average of 23 days in each of the blue states he won, according to an analysis of data compiled by Mark Knoller of CBS News. He’s made 428 visits to blue states and 75 visits to red states.

He’s never been to Arkansas as president, nor has he visited Republican-dominated North Dakota, South Dakota, or Idaho. He’s been once to Kansas, Kentucky, Mississippi, Montana, Nebraska, and Wyoming.

Obama, who often vacations on Martha’s Vineyard, has visited Massachusetts 13 times, for all or part of 42 days.

George H.W. Bush visited all 50 states during his four-year term; Bill Clinton visited all 50 by the end of his eight years in office; George W. Bush visited every state except Vermont, which passed legislation calling for his impeachment.

The itinerary is seen as bolstering Republicans’ frequent criticism of Obama: while he talks about bipartisanship, he has done little to act it out.

Only 18 percent of top Obama administration officials grew up in a state that voted for Mitt Romney, according to a National Journal review of the backgrounds of 250 staffers. Only four staffers grew up in Texas, the second most populous state, compared with nine who grew up abroad and 40 who grew up in New York.
He just hasn't met much at all with Republican leaders, famously not meeting once with John Boehner for the first two years of his presidency. He can blame the partisan atmosphere on Republican intransigence, but the truth is that he hasn't done much at all to cross that divide he campaigned on bridging.

I meant to post this last week, but it got lost in my links. Jonah Goldberg noted that President Obama came out and admitted that he is continuing the government shutdown as a political ploy.
On October 8, Obama was asked by Mark Knoller of CBS if he was “tempted” to sign the numerous funding bills passed by the GOP-controlled House that would greatly alleviate the pain of the shutdown. Republicans have voted to reopen parks, fund cancer trials for children at the NIH, and to keep FEMA and the FDA going through this partial shutdown. But Obama has threatened to veto any such efforts, effectively keeping the Senate from considering the legislation.

“Of course I’m tempted” to sign those bills, Obama explained. “But here’s the problem. What you’ve seen are bills that come up wherever Republicans are feeling political pressure, they put a bill forward. And if there’s no political heat, if there’s no television story on it, then nothing happens.”

Obama’s answer dragged on, as all of Obama’s answers do. But the point was made. For the first time in American history, a president confessed to deliberately hurting his country to score points against his enemies.
Given this admission, is it any wonder that some believe the administration deliberately played politics with denying death benefits to families who suffered a loss from a loved one serving in Afghanistan.
White House press secretary Jay Carney insists, with operatic righteousness, that Obama never intended for the 26 families of the fallen to be denied this aid or to be hindered from retrieving their beloveds’ remains from Dover Air Force Base.

But Carney is surely lying — and the evidence isn’t simply that his lips are moving.

Carney defends the administration by noting that the Pentagon warned Congress in late September that the shutdown would prevent the payments from going out.

But Congress passed the Pay Our Military Act to fund the military through the shutdown. Administration officials first stonewalled Congress’s efforts for clarity on the issue, then the lawyers eventually determined that because the act didn’t specifically include the word “benefits,” they couldn’t err on the side of helping grieving families.

In other words, when asked to make a judgment call, and knowing that Congress wanted the benefits paid, this administration still claimed its hands were tied by the fine print. Given how often the White House routinely ignores the plain meaning of the law — and the will of Congress — when it suits its political agenda, logic dictates that it denied the benefits on purpose.

Moreover, by its own account, the White House says it knew for weeks this would happen. During all the back-and-forth, the White House did nothing to remedy the situation. It only sprang into outraged action when suddenly faced with a PR nightmare.
Leon Panetta, who knows something about what a president should do during a government shutdown, is not impressed with President Obama's leadership.

The Chicago Tribune editorializes in favor of a delay in Obamcare as they note the problems that are becoming so apparent to Illinois residents.
Those who have managed to browse the marketplace have often been hit by sticker shock. Take Adam Weldzius, a nurse practitioner and single father from Carpentersville. He sought the same level of coverage on the exchange as he and his 7-year-old daughter have now, with the same insurer and the same network of doctors and hospitals. At best, Weldzius found, his monthly premium of $233 would more than double. If he chose a plan priced at the same level, the annual deductible would be $12,700, more than three times his current $3,500 deductible.

"I believe everybody should be able to have health insurance, but at the same time, I'm being penalized. And for what?" Weldzius told the Tribune's Peter Frost. "For someone who's always had insurance, who's always taken care of myself, now I have to change my plan?"

Last spring, President Barack Obama said "there will still be, you know, glitches and bumps" in the rollout of the new system. But what we're seeing now is no glitch or bump. There is a growing mountain of evidence that Obamacare has fundamental problems in design and implementation.
Ya think? Ed Morrissey raises another question.
Bear in mind that Democrats claimed that the ObamaCare exchanges would make insurers treat individuals better in relation to group insurance plans. Instead, they’ve made the markets for individuals even worse than before, thanks to the deluge of costly mandates imposed on insurers, who must pass the cost of risk pools to the consumers.

The higher deductibles are the result of attempting to tamp down the premium hikes, but this raises a big question about the structure of the reform itself. If consumers end up with $4000 deductibles, how are these costs different than the alternate reform model of hospitalization insurance, health-savings accounts (HSAs), and emphasis on the cash/retail system for routine medical care? What we’ve ended up with is the same deductible costs — no one will use $4000 in routine medical care a year — without the cash-market reforms that would drive costs downward through price-signal clarity and competition, while incentivizing providers to get back into routine medical care by wiping out third-party payer red tape and costs.
Megan McArdle has a typically well-argued column arguing that there should be some absolute date by which the government decides if we need to delay Obamacare for a year while they work on improving the exchanges and computer programs. First she goes through the reasons why the computer site isn't working and refutes the argument that the problems are due to requirements for federal contracting code. And she refutes the argument that it's all the Republicans' fault. The truth is that the administration knew that the site wasn't ready, yet refused to delay the launch because they didn't want to give the Republicans any sort of victory. But, as she argues, it is very dangerous to go forth with a shoddily written launch that will discourage young, healthy people from signing up.
The administration estimates that it needs 2.7 million young healthy people on the exchange, out of the 7 million total expected to apply in the first year. If the pool is too skewed -- if it’s mostly old and sick people on the exchanges -- then insurers will lose money, and next year, they’ll sharply increase premiums. The healthiest people will drop out, because insurance is no longer such a good deal for them. Rinse and repeat and you have effectively destroyed the market for individual insurance policies. It’s called the “death spiral,” and the exchanges, like the mandate, were designed to keep it from happening.
Without the exchanges, the death spiral seems almost assured. The amount of work required to find a policy, figure out your subsidy, buy coverage and file the paperwork will be very high. And it’s unlikely that folks who can’t even be bothered to go to ehealthinsurance.com right now will do it. The Affordable Care Act made the task of signing up young healthy people on the exchanges even harder with its much-loved requirement that companies allow kids to stay on their parents’ policies until they’re 26, which took millions of potential buyers out of the pool. The ones who are left are going to be disproportionately poorer and less well educated than the middle-class offspring who can get cheap insurance through mom and dad. There’s a reason that virtually every person you’ve seen written up in an article as they tried to get insurance at a community center or clinic is some combination of over 55, retired or afflicted with a serious chronic condition.
Bret Stephens sees a new measure of a nation's greatness - how many Nobel Prizes a nation wins. By that standard the United States is truly great.
The secret of America's Nobel sauce isn't hard to understand: an immigration culture that welcomed everyone from Ronald Coase (from the U.K.) to Subrahmanyan Chandrasekhar (from India) to Martin Kaplus (from Nazi-era Austria) to Elizabeth Blackburn (from Australia). A mostly private, highly competitive, lavishly endowed university system, juiced by federal funding for fundamental research. A culture of individualism and an ingrained respect for against-the-grain thinking.

The government shutdown is unfortunate; a default would be a disaster. But anyone who thinks America's best days are behind us should take a close look at the latest Nobel haul. It says something that we take it for granted.

8 comments:

Ron K said...

well when you elect someone to the President with microscopic executive experience what do think you will get, the only person with any of that type of experience was vilified, that would be Sarah Palin, not only that but you ended up with a spoiled little brat in oval office.

Locomotive Breath said...

Do not be misled. The goal is to destroy private health insurance. They implemented exactly the employer (dis)incentives they wanted to. When no one can get health insurance by employment then the gov't will be "forced" to step in.

Of course, the future (dis)incentive they forgot about was that if there's no personal incentive to work (such as better health care) then people will stop working. Without that productivity, who will pay for the gov't run health care.

Locomotive Breath said...

Betsy, BTW the captcha here usually take about 3 tries before I can decipher them.

John A said...

"Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping."

I certainly do not approve of "Obamacare" or the "exchanges" or the online implementation, but this argument against it is a bit on the silly side too. If you want a discount for your mortgage because you will not need the otherwise required flood insurance, it helps to limit you search to mortgagers who will allow you to not have that added expense if your home is more than a hundred feet above the local water table. This may in fact be the only realistic thing about the whole mess, though I can somewhat understand wanting it to be optional as an aid rather than a requirement.

Rick Caird said...

John, I believe you have misunderstood the problem. Presenting policies and costs based on zip code is a very easy programming process.

But, determining eligibility for subsidies is a much more difficult programming process and getting that data is very data intensive requiring calls to remote systems with lots of computer processing time and wait times for the other system. Meanwhile, while the web process is waiting, it is holding a thread, holding memory, and holding other resources making them unavailable to others until everything is returned.

Now, with what is going on with companies dropping insurance but requiring everyone get insurance, the processing load is horrendous.

This was a terribly flawed design based on political considerations. Given the huge amount of damage to ObamaCare from the web site roll out problems, I would bet the political problems from displaying the policies is minor. Never let politicians dictate technical design.

I concur with the problems with the captcha. Did we let the politicians design that, too?

elkh1 said...

Bret Stephens is delusional. Those Nobel winners are immigrants, they do research in American Universities, but they were all educated in their countries of origin. There is nothing for America to preen about except they have the best research establishment money can buy, and a lousy education system from K-college that can't produce American educated Nobel laureates.

Eric said...

Betsy,
love your blog.
Regarding Esquire's quiz, I too ended up at "radio talk head" although that's BS. What are the other possible outcomes? Salt of the earth, progressive leader, middle of the road maverick?

LargeBill said...

"He just hasn't met much at all with Republican leaders, famously not meeting once with John Boehner for the first two years of his presidency. He can blame the partisan atmosphere on Republican intransigence, but the truth is that he hasn't done much at all to cross that divide he campaigned on bridging."

In his defense, after seeing how Bush was treated after trying repeatedly to reach across the aisle can you blame Obama for assuming Republicans would treat him as poorly as he and other Dem's treated Bush.