Wednesday, June 29, 2011

Health insurers could save money by buying hospitals -- but will they pass savings on to patients?

A recent merger between non-profit Highmark (BCBS) health insurer and West Penn, a hospital and health care provider, sounds innovative. Although in other businesses this might violate anti-trust laws, in health care it gives a private carrier the incentive to negotiate salaries with physicians and pay for maintenance of wellness rather than “fee for service”. On the other hand, it breaks a contract with UPMC (University of Pittsburgh) which could lead to out-of-network charges for many patients.

The story broke today in the Wall Street Journal, with Q&A here A paywall subscription may be required.  
The lead story, “Insurer’s Cost-Cut Plan: Buy Hospitals”, by Anna Wilde Mathews, also appeared on the Marketplace page in print June 29.

Also, a federal appeals court in Cincinnati, Ohio has ruled that the individual mandate in Obamacare is constitutional (CNN story).  The case is likely to be headed for the Supreme Court next term.

Friday, June 24, 2011

GOP cuts Biden out of debt ceiling negotiations

This week, a financial advisor called, and in the conversation he did say that a failure to extend the debt ceiling would be a catastrophe, so a deal will get done.

The GOP bolted out of budget negotiations run by VP Joseph Biden, so the Vice President seems out of the picture. No one will comment on the golf session Saturday between Obama and Boehner.  This sort of behavior sounds familiar. We hear about it with labor union negotiations. Remember that "Ford to City Drop Dead" headline in 1975, regarding an impending default by New York City? (The teachers' union caved in at the last minute on that one.) 

The GOP seems to be walking out on the administration’s insistence of tax increases, or closing of loopholes. 
All this while at the same time Obama releases some oil from the Strategic Petroleum Reserve., although XOM more or less remained stable.

The moral scuttlebutt is that America and the West are living beyond their means, and “sacrifice” is in order. Back in 1992, H. Ross Perot had talked about “shared sacrifice”. But the GOP wants the strong (and the wealthy) to “keep that” but be held personally responsible, through the “natural family” for the less fortunate, less talented, or less able. It sounds like the Parable of the Talents.

The most vulnerable in the current budget mess, if it isn’t settled by Aug. 2, are retirees. After all, they’ve already lived, right?  It should be up to their families, right?  That’s what the GOP wants.  But retirement portfolios could collapse without a deal, and the irony is that creditors might have the legal basis to force the government to “means test” current retirees now, but the “means” will be much less.

This is dangerous stuff. It’s grown-ups playing with matches. 

Here's a ten minute PBS clip on the debt ceiling debate and why it matters:

Tuesday, June 21, 2011

Solar flares could knock out power grid: concern grows with increase in Sun's "coronal mass ejections"

Here we go again, on call for “coronal mass ejections”.  The “Health & Science” Section E of the Washington Post on Tuesday June 21 with the story “Sunburst could be a big blow; experts say power grids and communications are vulnerable to ‘space weather’”, link here. The online title is more telling: “As the sun awakens, the power grid stands vulnerable.”

The sun is re-entering a period of more sunspot activity, to maximize from 2012-2014.  There may be a long term trend for less activity after 2021, but we have to get through a potentially dangerous period. It appears that major power transformers need big time “Faraday-type” shielding, as would be recommended for defense against terrorist-originating EMP attacks.  There are mechanisms to shut down transformers about a half-hour before a plasma cloud hits the Earth.

There a flare on June 7, the cloud from which enveloped some of Earth by June 9, but there was no direct hit.  The position of the Earth in its orbit would also affect the severity of the hit.

A solar storm or coronal mass ejection would not affect unplugged personal electronics or cars; but an EMP event would. 

Because the electromagnetic field is weaker at the poles, northern regions are more vulnerable. There have been dire predictions (even from a 2008 National Academy of Sciences Report) that parts of northern US, Canada and Europe could go without power for years. The utility industry tends to discredit those fears.  There was a flare about 1/10 tenth the size of the 1859 Carrington Event back in March 1989, that shut down part of Quebec for about a day.  Exposure risk for a region may be greatest near the time of its hemispheric solstice.

The North American Electric Reliability Corporation is authorized by Congress to supervise the readiness of electric utilities, and here is their page on the potential impact of electromagnetic pulse (EMP) events or geomagnetic storms, here. Note the sublinks dealing specifically with EMP and solar flare (coronal mass ejection or geomagnetic storm) events on the second page, right side.

After Hurricane Isabel in 2003, some areas in northern Virginia were without power for nine days because of the time it took Dominion Power to locate transformers, an observation that highlights the need for substation protection.

In August 2003 parts of the Northeast were without power for up to four days after an unusual cascading failure.  Failures had occurred in New York City in 1977 and 1965.

Unlike the climate change debate, the solar flare problem is totally "nature made".  But warfare or terrorism could lead to EMP incidents. 

Monday, June 20, 2011

Washington DC will require candidate teachers to "audition live" for jobs

Perhaps as part of the legacy of  "the departed" Michelle Rhee,  the Washington DC public school system is now requiring that prospective teacher candidates “audition” for jobs with “tryouts” in classrooms that are videotaped. The Washington Post news story, by Bill Turque, appeared Sunday June 19 in the Metro section, here

I do recall having one student teacher in high school, for US government, in 12th grade.  Her January mid-term (1961) was one question: "Compare democracy and communism". 

The story gives a specific example of a middle school algebra class “audition”.   There is the old adage from my old days at the University of Kansas in the 1960s as a graduate assistant instructor (with a “remedial” algebra class), “if the students didn’t learn, the teacher didn’t teach.”

Picture: Me, around 1946

Saturday, June 18, 2011

"Tree Law": If my neightbor's tree is about to fall on my house with the next breeze, can I have it cut down?

Here’s a wrinkle that homeowners, particularly in densely packed wooded suburbs can note. In 2007, the Virginia Supreme Court ruled that a homeowner can sue to force a neighbor’s tree to be removed if it poses a threat of imminent harm. The story goes back to September 15, 2007 in a Washington Post story by Brigid Schulte, link here.

The law has changed in a number of states, reversing a long held trend that homeowners are absolutely responsible for insuring any damage to their own property.

The tree issue is particularly troubling in many eastern metropolitan areas with heavy suburban forestation, as trees get older and grow weaker while housing gets denser. And storms seem to increase in intensity; although I suspect that when I was growing up there were a lot more severe storms than we heard about. But the reports of damage and power outages seem to be getting worse.

Tree trimming has to be done carefully, though, or it can actually make a tree weaker and more likely to “liontail” and fall completely. It is not always a good idea to trim branches overhanging your property.

Generally, in most states, neighbors owning trees are not responsible for “acts of God” (extreme storms, tornadoes, etc) but might be responsible if they were negligent and knew that a tree was particularly weak or dying. But this whole idea gets harder to decide as storms get stronger and trees age.

Here’s a Tree Law video from “The House Detective”:

Friday, June 17, 2011

ABC shows how Treasury auctions debt; this all stops Aug. 2 iff...

Daniel Arnall of ABC News provides a report on the “Auction Room” belonging to the US Treasury Department, somewhere in an undisclosed office building in Washington.

The US Treasury sells T-bills to investors to keep the government running another two or three days at a time.
The chief said this stops cold on Aug. 2 if Congress doesn’t extend the debt ceiling.

Conceivably, if the US defaults, investors could turn to the courts to force immediate cuts in entitlements.
John Boehner (R-OH) is said to be preparing to discuss the debt ceiling issue with president Obama over golf on Saturday. Biden and the Republican governor of Ohio will join in.  Some sort of agreement, maybe?  No cigarette smoking, please. 

Senator Sanders of Vermont asks, “what happened to ‘shared sacrifice’ that HR Perot had talked about in 1992? That means taxes on the rich. But it could mean immediate means testing, too. The Yahoo! interview of  Sanders is here.

Picture: Little me (1946) at a farm in Boehner's state. 

Thursday, June 16, 2011

Should community service be "almost" compulsory?

Conservative columnist Deborah Simmons admitted in the Washington Times today, that Washington DC’s mayor Vincent Gray “is on to something.” That refers to an Americorps appropriation when in DC will be used in part for summer mentoring opportunities for older high school students 17-24 (does sound older).

This doesn’t count as part of the 100 hour community service requirement demanded for graduation from Washington DC high schools (did this come from Michelle Rhee?), an idea not conceived of in my high school days when boys lived under the threat of military conscription if their grades weren’t good enough.

Simmons mentions the idea that, if government compels “volunteering”, then it isn’t volunteering any more.  
Perhaps it’s more like servitude or at least internship (see my Book Review blog June 8).

But she also appropriately points out that the alternative to people’s do more to help one another personally could be much more government paternalism. She could have also mentioned that this sort of idea of social responsibility or cohesion transcends the way we look at most choices, like whether to have children. 

The link for her op-ed is here.

Wednesday, June 15, 2011

"D.C. Flag Tattoo Day": does political home rule deserve personal "disfigurement"? They call it "body art"

Washington DC celebrated Flag Day with renewed demands for political independence and home rule, specifically with a “D.C. Flag Tattoo Day” at Dupont Circle around 6 PM on Tuesday, June 14.
ABC station WJLA has an account on its TBD website here. 

Some people really did have real tattoos chiseled into their shoulders or elsewhere with the needles.  Others just used temporary paint-ons.

Speaking for myself, I can’t see being disfigured more or less permanently for a political cause. But it happens “in the Navy” all the time.  Okay, I’m too sensitive about my body (maybe other people’s bodies) to see this as a good thing.  There are other examples: how about Westover Market’s annual “Be Brave and Shave” in the fall.

The group adjourned to the Eighteenth Street Lounge afterward (about a block from most of the 17th street gay clubs, and a block in the other direction from where Electronic Frontier Foundation had its DV party).
I was going to head for the demo for photo blogging and got sidetracked at home (again), and wound up going to see “Midnight in Paris” in Arlington later instead (after trying Beckett’s).  I’ve got to be on time getting to things.

There was also a Flag Day celebration at the National Building Museum, which will soon start charging admission. 

When I grew up in Arlington VA in the 50s, home rule was discussed askance. No question, it (preventing home rule) was about race then; now it is about GOP partisanship. 

Monday, June 13, 2011

Mortgage industry "gets away" with pregnancy discrimination, but not for much longer

Discrimination in mortgage lending against pregnant mothers seems to happen a lot despite court rulings that it is illegal, the Washington Post reported Saturday, in a piece by Kenneth R. Harney here

Two specific cases, one in Seattle with Cornerstone and another in Pennsylvania are discussed.  Sometimes lenders don’t want to consider income paid while on maternity leave, but generally it must be considered if the mother is going to return to work.

The story also suggests that Fannie Mae and Freddie Mac need more guidance on how to handle the situations.   It would appear to be more testy for single mothers.  Of course, it would generally amount to illegal gender discrimination, since women are much more likely to use parental leave than men in the real world (if you allow disparate impact analysis).

There is another detailed story on Mortgage Orb here.  Cornerstone was required to set up a discrimination victims fund.

All that social conservative talk of the “family wage” doesn’t get very far in the law, much to the chagrin of the “natural family” crowd warning us about “demographic winter”. 
Update: June 14.  In a distantly reported story, the ACLU reports on the Supreme Court's allowing a law that makes it more difficult for fathers to transmit US citizenship to their kids than for mothers, link here.

Thursday, June 09, 2011

Some airplanes at risk if passengers leave cell phones on; my own incident with the TSA

There are a couple of stories about airline safety this morning.

Brian Ross is reporting  on ABC GMA that leaving cell phones (and Blackberries) on during takeoff and landing in flights could disrupt navigation devices in older planes (not the newer ones that allow WiFi and have more shielding).  Even one cell phone left on could cause an issue. John Nance questioned the findings.

On Monday morning, at the MSP airport, I noticed that I did not have to go through the new cat-scan-like device, just the old metal detector. The newer devices, which essentially show Xrays and no images of any possible erotic interest, would show a screener that my surgical plate in my pelvis is just that. I was surprised I wasn’t stopped.  Then I noticed I had left my MiFi card in my suit rather than putting it on the tray. 

I asked the TSA personnel if it could have been harmed, and they thanked me for honesty and ran the MiFi card back through security in the tray according to regulations. No, I wasn’t trying to see what holes there were, but they did miss this.  

The Verizon MiFi Secure card did continue to work just fine in the airport in giving a connection with moderate-speed Internet access, good enough for the road.  (Hotel WiFi’s seem to be pretty good.)

Tuesday, June 07, 2011

Connie Mack's 1% per year cut could affect seniors, others immediately, couldn't it?

Connie Mack (R-FL) proposes cutting all Federal spending by 1% a year for six years, to eventually balance the budget.   This would give Congress some explicit incentives to negotiate timetables for real cuts, especially in entitlements.

That would seem to have the potential to require immediate cuts to benefits to seniors, even now, to the extent that their benefits were not funded by FICA and Medicare taxes that they had paid. And it sounds as if they would go into effect automatically, by law.

But other cuts could go into effect automatically, too, like Medicare.

There used to be a Connie Mack who owned the Philadelphia Athletics back in the 1940s!

Mack appeared on Elliot Spitzer’s show on CNN Monday night June 6. 

Saturday, June 04, 2011

USA Today discusses Census reports on lower birthrates; suburbia showing declines

On Friday June 3, USA Today ran a major story on the Census Bureau’s 2010 analysis of birthrates, titled in print “In many neighborhoods, kids are only a memory; declining birthrates are reshaping suburbia”, link here. The story is by Haya El Nasser and Paul Overberg.

The story focuses on Levittown, PA (near Philadelphia), but the theme of the story applies to most suburban upper middle class (formerly white) neighborhoods in the country.

The findings are attributed to both economic hard times, and cultural influences. People wait longer to have children so that both partners finish educations and get careers going, running out the biological clock, even for men, to its “two minute warning”. But the legal system places enormous responsibilities solely on parents based on the concept that having children is an individual choice that incurs full individual responsibility. That seems true, but it can be deceptive. In past generations, there was considerable cultural pressure on most adults to marry and have children, and that is likely to return as a result of sustainability concerns. Some economists point out that a higher birth rate could help economic recovery, especially in communities losing population, and could lead to more innovation. Even in a legal system predicated on freedom to contract and responsibility for contract (and bringing parenting into this concept), more pressure could be put by the market or various social factors on others to participate in family formation and role modeling than has been evident in the past two or three decades. For example, it may be easier for the insurance industry to work with larger family units than with individuals in the future. (To some extent that has been true already; singles often pay higher auto insurance rates than married.)

Here's a PBS video report on the Census findings a few months ago (published data).

Thursday, June 02, 2011

Climate Change: are we ready for more?

Newsweek hit the stands this week with a blistering article on climate change. It asks, in an article by Sharon Begley, “Are you ready for more?”

Joplin was prepared, and still 138 deaths and counting, at least four in a hospital. 

The rest of us are not prepared. 

Look at Springfield, MA June 1.

Will “big”, long tracking tornadoes increase on the East Coast?
The Montreal Gazette has a piece by Albert Nerenberg, here

Actually Newsweek had warned us before, July 24, 2009, “Why climate change is worse than we feared”, here.

AP video of the Springfield tornado shows it emerging as a waterspout on the Connecticut River. 

Wednesday, June 01, 2011

ABC ties debt ceiling debate to Medicare; also sees HPV virus as a new public health problem

Diane Sawyer, host of ABC Evening News, has a perceptive analysis tonight of how Medicare seems to be shaping up as a wedge issue on extending the debt ceiling, link.

Americans would generally oppose Paul Ryan’s plan. But if the GOP (and the tea-party-like crowd) really does succeed in saying that it’s OK for the US to default on an obligation – then legal consequences could mean immediate cuts in unearned benefits to pay them. That could mean immediate cuts in entitlements, including means testing of Social Security, which is partially but not completely funded by the FICA tax. This is turning into a possible war between generations, and on the concept of “generativity” itself, as a component of sustainability.

There’s no question that there can be a tradeoff between spending on the previous generations and future ones. Let's hope that Vice President Biden gets somewhere with the negotiations before the Aug. 2 "drop dead" date.

Sawyer also made a report about a quasi-new public health problem – HPV virus causing throat cancer in men, when supposedly it had only caused cervical cancer in women. The moralists will oppose public funding for vaccines making non-procreative behavior “safer”, but we’ve seen that debate with HIV. A vaccine for men (they don’t have to be gay to need it) is definitely feasible. 

At the same time, the reporting on the "public health" implications of cell phone use is calming down. Cell phone use while driving will cause a lot more grief than rare brain tumors.