Sunday, March 28. 2010
The major media has neglected to examine one of the major sections of ObamaCare, its long term care program CLASS, the Community Living Assistance Services and Supports Act.
The New York Times’ chosen "New Old Age" guru, wrote on March 24 that,
I’ve read so little about the Class Act in recent weeks that when President Obama signed the health care bill yesterday, surrounded by a gaggle of happy Democrats, I had to call the National Council on Aging to reassure myself that yes, this often overlooked but potentially transformational program remained part of the package.
Of course, the Wall Street Journal did manage an op-ed, last December, “Congress’s Long Term Care Bomb,” written by a professor of health-care management and insurance and risk management at the University of Pennsylvania's Wharton School.
But CBO and the Centers for Medicare & Medicaid Services (CMS) have identified parts of the program that will subject it to considerable financial risk.
First, those who enroll would likely be more apt to need care and will be more expensive to cover than those who buy private insurance. To cover its costs, the program would have to charge more than private insurers.
The best objective and factual summary and analysis of CLASS I’ve found is that by one of the preeminent global consulting firms on benefits, Towers Perrin.
The Senate version is projected to bring in $72 billion, with an average monthly premium of $123. The initial positive cash flows come, of course, from the five-year period before participants vest, when premiums are paid but benefits are not. Tens of billions are foreseen to flow into the trust fund during those five years. In later decades, however, the flows would turn negative and increase the federal deficit.
(Note that $72-billion is over half of the highly doubtful supposed first 10-year federal budget deficit reduction of ObamaCare, which itself ignores the tens of $billions of mandates in Medicaid imposed on the states from the majority of ObamaCare’s increased coverage of the uninsured and the tens of $billions of extra costs imposed on private firms that continue retiree prescription benefits.)
Let’s look closer at that estimated 2011 average premium of $123 per month, or $1476 per year.
I checked the standard risk premiums charged in most states by one of the largest top-rated long term care insurers for an individual to have a lifetime benefit period, as in CLASS.
Insurers cover working and non-working applicants. CLASS will only enroll working participants, who are more likely to be of reasonable health if working. As the CBO points out, non-working spouses are more likely to have impaired health and are more likely to enroll than are workers, which increases the actuarially required premiums. Insurers will cover seriously impaired risks at about a 50% higher premium than standard risks, and only for a 6-year benefit period versus the lifetime benefit period in CLASS (average benefits actually needed by all insurer claimants is about 3-years), while insurers reject some applicants with severely impaired health. The CBO did not reveal the details of its analysis, but one may expect that these factors and others were considered.
To get at an apples-to apples comparison of a $50 dollar a day benefit, I further adjusted the insurer rates downward by 30%, as would be charged for a joint policy with spouse from that insurer, to estimate efficiencies of marketing and administration to a larger pool mostly garnered via the workplace in CLASS. Further, CLASS will not be paying commissions to agents as does insurers, so I subtract another 5% from the adjusted insurer premiums below, for a total reduction of 35%. The elimination period, or time to have the qualifying inabilities to manage activities of daily living, by the insurer is 30-days. In parentheses I include the insurer’s annual premium for a preferred risk. CLASS has substantially more liberal reinstatement provisions for non-payment of premiums than this or any insurer, for example, along with other provisions which increase the cost of the program. CLASS subsidizes those of low income, but claws back part of their benefit if qualified for Medicaid, which private insurers don’t.
CBO estimate of average premium for CLASS in the Senate version enacted: $1476
Adjusted Insurer Premium: Age 25 $373.93 ($317.84); Age 40 $483.91 ($411.33); Age 60 $978.82 ($832.00).
Unadjusted Insurer Premium: Age 25 $575.28 ($488.99); Age 40 $744.48 (632.81); Age 60 $1505.88 ($1280)
An $80/day benefit insurer premium is higher, but still below the CLASS initial estimated premium, which includes a $75/day benefit for nursing home care which is much less preferred or used by claimants than the $50/day for home health care.
The House version of CLASS included non-working spouses, according to the CBO more likely to have impaired health and more likely to enroll than are workers, at the following estimated annual premiums: Age 18-39 $1632, Age 40-49 $1728, Age 50-59 $1824, Age 60-69 $2772. The actuaries estimate anticipates that those older are much more likely to enroll than those younger. One may expect political pressure in coming years to open CLASS to non-working spouses.
So, first of all, it does seem that CBO and actuaries did a reasonable job of estimating initial CLASS premiums, though the Medicare chief actuary did warn that, as the WSJ op-ed indicates,
[P]remiums would be set so high they would discourage healthier people from buying in. As the healthy stayed on the sidelines, the program would have to charge more to those who did enroll. This in turn would price more people out of the program, risking what the memo called an "insurance death spiral."
An insurance death-spiral occurs as due to adverse selection, when the healthier don’t join or leave the program, and the costs of the remaining less healthy escalate future premiums, leading even more of the healthier to leave or find other alternatives. The death-spiral leads to the program’s costs rising to bankruptcy, otherwise. Although CLASS says they won’t have to, one may expect a future Congress to bail it out with taxpayer funds rather than abandon this new entitlement.
Private long term care insurers have not opposed CLASS. Of course, they expect that the added consciousness of the need for long term care insurance prompted by CLASS marketing at workplaces will, together with insurers’ lower premiums, increase their own sales. Similarly, life and annuity insurers may expect increased sales of their products that contain a long term care component.
That just leaves taxpayers on the future financial hook for CLASS, and disappointed ObamaCare supporters on the hook for letdown.
As Ed Morrissey points out from the latest Washington Post poll on ObamaCare, opposition continues to mount. Relatively few are aware of the details of the CLASS failure, so more should be expected to become disappointed in the non-classy failure of Democrats to be responsible.
Jamie Oliver's Ministry of Food Control.
Governments love controlling people, don't they? It's a mental disease. Power is a drug for those susceptible to its perverse appeal.
Deresiewicz begins his 2008 essay The Disadvantages of an Elite Education thus:
It didn’t dawn on me that there might be a few holes in my education until I was about 35. I’d just bought a house, the pipes needed fixing, and the plumber was standing in my kitchen. There he was, a short, beefy guy with a goatee and a Red Sox cap and a thick Boston accent, and I suddenly learned that I didn’t have the slightest idea what to say to someone like him. So alien was his experience to me, so unguessable his values, so mysterious his very language, that I couldn’t succeed in engaging him in a few minutes of small talk before he got down to work. Fourteen years of higher education and a handful of Ivy League degrees, and there I was, stiff and stupid, struck dumb by my own dumbness. “Ivy retardation,” a friend of mine calls this. I could carry on conversations with people from other countries, in other languages, but I couldn’t talk to the man who was standing in my own house.
It’s not surprising that it took me so long to discover the extent of my miseducation, because the last thing an elite education will teach you is its own inadequacy.
Luke 19: 29-40
29When he had come near Bethphage and Bethany, at the place called the Mount of Olives, he sent two of the disciples,
30saying, “Go into the village ahead of you, and as you enter it you will find tied there a colt that has never been ridden. Untie it and bring it here.
31If anyone asks you, ‘Why are you untying it?’ just say this, ‘The Lord needs it.’”
32So those who were sent departed and found it as he had told them.
33As they were untying the colt, its owners asked them, “Why are you untying the colt?”
34They said, “The Lord needs it.”
35Then they brought it to Jesus; and after throwing their cloaks on the colt, they set Jesus on it.
36As he rode along, people kept spreading their cloaks on the road.
37As he was now approaching the path down from the Mount of Olives, the whole multitude of the disciples began to praise God joyfully with a loud voice for all the deeds of power that they had seen,
38saying, “Blessed is the king who comes in the name of the Lord! Peace in heaven, and glory in the highest heaven!”
39Some of the Pharisees in the crowd said to him, “Teacher, order your disciples to stop.”
40He answered, “I tell you, if these were silent, the stones would shout out.”
Saturday, March 27. 2010
Arizona getting tough on illegals. I guess it feels to them like an unarmed invasion and, in a sense, it is. Armed too, in many cases.
Why Mexico cannot make their beautiful warm country a place where people want to live, or even to immigrate to, is beyond me. I do not know why they make it so difficult, if not impossible, for people to move or work there either. They would benefit immensely from 100,000 genius techies, finance wonks, and engineers from India and China and Singapore.
Mrs. BD is now considering this idea for an August trip: barging through Provence on the Rhone and the canals.
I told her the choice was between that trip and finishing getting my teeth fixed. It's called Fun With Implants. (Of course, if Obama would pay for my teeth then I could do both. Maybe I should write a note and cc Reid and Pelosi and tell them I'm ready for my new choppers right now.)
My Mom and Dad took one of these trips a few years ago. She said their plump Chef decided to try the balloon ride one time, got about 10" in the air and leaned out to tell the Sous-chef some last minute cooking detail and fell out of the basket into the canal. Hilarity ensued.
Also on my bucket list: Sailing cruise down the coast of Turkey. Yes, I do want to visit Turkey again - with digital camera this time. I like the people, the food, the landscape, the markets, the history, the ruins, and their fruit and wines.
Carpe diem. Cave canem. Gnothi sauton, too.
I don't want you to bail out my mistakes, America, and I don't want to bail out yours. Take your lumps! It's the free market; prices have to find their real level. I'm underwater in my stocks, and nobody cares. It will come out OK in the end.
Paraphrased from Larry Kudlow, on the radio this morning re government support of artificially high housing prices.
Why believe in a conspiracy when stupidity is explanation enough? With that at the front of my mind as a major caveat to my and others’ conjecture, aside from not knowing what is going on in the privacy of White House meetings, there may actually be a secret purposeful plan behind President Obama’s public undermining of Israel.
Stupidity isn’t enough of an explanation:
First off, there’s every reason to believe Obama’s pledge to be a “transformative” president. Nearly every policy, law and appointment from him and his allies have been distinctly left of those from previous Democrat and Republican administrations.
Second, there’s every reason to believe that Obama and his counsels are aware, how can they not be, of the past refusals by Palestinian leaders to accept offerings, to obstruct negotiations, to foment violence, to foster corruption, to be divided between the violently hostile and the very violently hostile, and that repeated and continuous Israeli concessions and withdrawals have encouraged more of the same from the Palestinians.
Third, there’s every reason to believe that Obama and his advisors are aware of Iran’s impending nuclear status (even the IAEA has finally publicly woken up) and that other MidEast nations are accommodating themselves to Iran, they seeing little likelihood that the US will push for severe enough sanctions in the face of Russian and Chinese opposition and European profits or the US striking Iran’s nuclear installations.
Fourth, there’s every reason to believe that the US has more influence upon Israel, given that Israel has heavily depended upon the US as a bulwark of support, than upon the Palestinians, MidEast nations, Russia, China or even Europe.
Fifth, there’s every reason to believe that President Obama and advisors, some of whom are Jewish, depend upon the Democrat’s base supporters, some of whom are Jewish, to at worst weakly react to the Obama administration undermining Israel. (See this post.)
Sixth, there’s a big difference between occasional ignorance or mistakes and a consistent pattern of such, particularly when the facts and errors are so well known.
Secret Plan:
Yesterday, I had a brief conversation with a very liberal, very smart friend who visits Israel several times a year to study. I shared my conjecture in an email to another very knowledgeable MSM friend:
My theory is that the O master plan, if there is one, is to force Israel to bomb Iran, then disavow Israel and further isolate it, and maybe even let it be overwhelmed.
It very well may not be true, but it does explain a lot.
This morning, Glenn Reynolds similarly conjectured:
WHY HAS BARACK OBAMA TREATED NETANYAHU SO RUDELY? “Obama would never treat the president of Equatorial Guinea that way.”
Possibly Obama just hates Israel and hates Jews. That’s plausible — certainly nothing in his actions suggests otherwise, really.
But it’s also possible — I’d say likely — that there’s something else going on. I think Obama expects Israel to strike Iran, and wants to put distance between the United States and Israel in advance of that happening. (Perhaps he even thinks that treating Israel rudely will provoke such a response, saving him the trouble of doing anything about Iran himself, and avoiding the risk that things might go wrong if he does). On the most optimistic level, maybe this whole thing is a sham, and the U.S. is really helping Israel strike Iran, with this as distraction. The question for readers is which of these — not necessarily mutually exclusive — explanations is most plausible.
I’d add to the above that President Obama may also, not mutually exclusive, be currying favor with the Moslem states in continuation of his seeming belief that rewarding enemies will somehow make them less hostile, particularly in a new world order in which the US is no longer and doesn’t act to be preeminent in its power or actions, regardless of the consequences domestically or abroad.
Name at least one thing you think is right about the Dem healthcare-insurance bill which, I remind you, is far less radical than it could have been. (Yes, I do know that the Dems regard it as one step towards complete nationalization.)
 Well, it finally happened.
I was impressed with a video program.
And, let me assure you, for me to be impressed with a video program takes a lot. I have in my tool bag all of the latest, hottest goodies, and I know all the video tricks. Hell, I invented half the tricks. I've been a leader in the field of digital video for a decade.
Nevertheless, I'm impressed with AVS Video Converter. And the $59 they're asking is fairly cheap for a quality conversion program. To keep it in perspective, Adobe Premiere lists for $799. The whys and wherefores will only be of interest to us videophiles (budding and otherwise), so I'll lay it all out below the fold. This is truly a remarkable program in at least three ways.
Continue reading "Doc's Computin' Tips: The Amazing AVS Video Converter"
Our pal Sipp is moving to Maine. All of us at Maggie's wish him and his wonderful family an enjoyable "moving experience."
But who moves to Maine? Maybe Texas, but Maine? I recall that Abe Lincoln's dad always believed that you should move on whenever you could see the smoke from another settler's fireplace. (Not sure I believe that story about Thomas Lincoln, however.)
Speaking of presidents, Who's U.S. Grant minus John Quincy Adams?
 Photo of a Cuban hospital from SDA's Fidel praises Obama's healthcare.
Dr. Sanity: THE PROGRESSIVE LEFT GOOSE STEPS INTO HISTORY
Frum's fall from grace. I tend to agree with Rick on this.
Gov. Christie: Saving NJ from its government. h/t, Insty.
Welcome to the Machine: Cultural Marxism in Education
Krauthammer: Watch out for the coming VAT
Timeline of the major provisions of the Dem healthcare bill
Krugman needs to get out more. The guy is a sneaky, dishonest putz in my opinion. And that is not because I often disagree - it's because he is. I'm sure he knows it, too.
Pelosi in Neverland:
The bill, she said, would lead to "healthier lives, more liberty to pursue hopes and dreams and happiness."
Is that a promise? Oh Boy! Sign me up! as a member of FCA (Future Curmudgeons of America), I want that free happiness.
Now It Can Be Told: Health Care Is About Wealth Redistribution
In totalitarian North Korea, every hour is Earth Hour
Jeff Goldstein tried to talk to one of his old writing profs. One quote:
It is an Orwellian world in which we live when fucking novelists want to distance themselves from those who criticize the government.
Yeah, we thought dissent was a high form of patriotism...oh, never mind. It's just not worth the effort.
Bottled Piety from VDH. Good term. Almost as good as "bully state."
Culture matters. Check out the link to the photos of Labrador.
The coming black market in medical care
Hutzpah of the day, via Surber:
COMPOSED DURING A STORM (1819)
Written in Rydal Woods, by the side of a torrent.
One who was suffering tumult in his soul,
Yet failed to seek the sure relief of prayer,
Went forth - his course surrendering to the care
Of the fierce wind, while mid-day lightnings prowl
Insidiously, untimely thunders growl;
While trees, dim-seen, in frenzied numbers, tear
The lingering remnant of their yellow hair,
And shivering wolves, surprised with darkness, howl
As if the sun were not. He raised his eye
Soul-smitten; for, that instant, did appear
Large space ('mid dreadful clouds) of purest sky,
An azure disc-shield of Tranquillity;
Invisible, unlooked-for, minister
Of providential goodness ever nigh!
Friday, March 26. 2010
On medical care (I refuse to term it "health" care. Health requires no care.), from AVI:
Health care costs are rising, not because of inefficiency or heartless business practices or stunning malpractice claims – though these all deserve significant attention – but because the products and services provided simply are very expensive. And they are going to get more expensive - much, much more expensive – for the foreseeable future. We can do magical things we were never able to do. We can keep people alive (such as a family friend with CF) far longer than we could. We can save people who simply died not very long ago. And it costs a fortune.
The first comment there is good, too, about how government interventions increase costs.
Cell phone photos: A pal visited NASDAQ HQ yesterday:
As VDH observed on the John Bachelor show the other night, the O administration offers succor and submission to our enemies and enmity and insults to our friends. Obama Refuses to Dine With Jewish Leader.
According to this plan, we end up with emboldened, unrespectful enemies - and no friends. Brilliant...if you dislike America.
VDH, via Vandy: (link fixed)
Some people screw up or are unlucky. We're here to ensure they end up the same as you who don't screw up or are luckier. We can't say they are in any way culpable, so we blame either the system or you who are better off. The best way to level the playing field is to tax all we can, take our percentage, and redistribute the rest. Lots get hired to administer to even more. The rules don't apply to ourselves, who are wealthy but not the targeted culpable. We know privately all this is not sustainable, but assume the better off will find a way to save themselves and thus us, before we bankrupt ourselves - after we are gone. And we don't care really whether this is always legal, or fair, or workable, because we know it is moral and we are far more moral people than you.
The Jewish holiday of Passover begins this year next Monday night with the first Seder. (Translation = Order or sequence and content of the prayers, symbolic foods, and retelling of the Exodus, with emphasis on educating the children.) Many Christians also celebrate the Passover Seder, which was their Last Supper.
Less known is that the Exodus was central to the minds of the new United States' Founding Fathers. The first committee of the Continental Congress assigned to design our Great Seal, the symbol of our sovereignty, was comprised of three of the five men who drafted the Declaration of Independence: Thomas Jefferson, Benjamin Franklin and John Adams. Franklin chose a design of "Moses standing on the Shore, and extending his Hand over the Sea, thereby causing the same to overwhelm Pharaoh who is sitting in an open Chariot, a Crown on his Head and a Sword in his Hand. Rays from a Pillar of Fire in the Clouds reaching to Moses, to express that he acts by Command of the Deity." The motto: "Rebellion To Tyrants Is Obedience To God," which was later adopted by Jefferson as his personal motto.
The above is drawn from this website about the US' Great Seal. Click around the site. It is fascinating.
Here's a relevant quote:
"All the armies of Europe, Asia and Africa combined could not by force take a drink from the Ohio or make a track on the Blue Ridge, in a trial of a thousand years. At what point then is the approach of danger to be expected? I answer, if it ever reaches us, it must spring up amongst us. If destruction be our lot, we must ourselves be its author and finisher." – Abraham Lincoln
 Canada opts for nice state-enforced conformity. Be nice, or we'll kill you hateful bastards.
Bully State insanity du jour: EU wants to regulate bread. These people clearly have nothing to do. Let them eat cake.
Change: Personal Income Drops Across the Country
Krauthammer: The bureaucrats will decide your fate. I have a better idea: Save some $ and pay a private doc or private clinic for your care, and avoid the government plantation.
MA rebellion against Obamacare medical device tax. Is that, like, a Boston Tea Party?
Fidel Castro Praises Obama & Dems on Nationalizing Health Care
MSNBC: It's time for socialism. Groovy, dude. It has worked so well everywhere else. Let's begin by making profits for MSNBC illegal. For the Greater Good.
Pajamas: Is Anthropogenic Global Warming the New Intelligent Design?
Related: Add to the list - global warming causes street brawls. Everybody knows that. When it's nice out, everybody wants to go out and start a fight. Who doesn't?
PBS' Jim Lehrer gets it totally wrong. WTH? Wasn't he alive then? Or is he spinning lying? It was the Repubs who made it possible to pass the civil rights legislation in Congress. Also, Lincoln was a Repub, remember?
Health care and the Bully State. h/t Q&O's When Nanny Becomes Bully
Related: Big Baloney fans fear of conservatives
Re-posting: Milton Friedman on Solzhenitsyn on government health care
John takes on the AP's insanity over Jerusalem
Thursday, March 25. 2010
The subject is Real Estate in the New York Times, and the treatment of it in this article is architecture. This short filmette from the article is well done, but (more below)
that was my high school, the largest in the country. The NYT misses the more important backstory.
Winners of the most Westinghouse and National Merit Scholarships were from Erasmus Hall High School. (My favorite alumnus was Moe Howard.) With changing demographics and theories of education, the city has shut it down as unmanageable. The building on the corner was a Yeshiva in my time. The grade school (P.S.6 for public school #6, in NYC parlance) sits on what was a parking lot in my time, for people who flocked to the then excellent shopping, now mostly gone and replaced with Carribbean shops, and three palace like movie theaters on Flatbush Avenue, now shuttered. What's now called the Flatbush Town Hall, built in 1875, was a police station, and we knew all the beat cops who looked out for us. Down the block on Church Avenue was Holy Cross, church and school, now closed. If you look in the upper right corner of the shot above you'll see the steeple of the Dutch Reform Church, built in 1654.
In my time, one out of every seven families in the US traced its family to Brooklyn, a major settling spot from the 1600s to 1900s for immigrants who went on to build America. The bones that made Flatbush, at the heart of Brooklyn, famous are still there. The spirit and lifeblood isn't.
About half of those touted by the Democrats to gain more medical care coverage will be in Medicaid.
In California, per the Los Angeles Times, that's estimated to add $3-billion to its budget spending, already $20-billion in deficit. Former Governor Moonbeam, now Attorney General, Jerry Brown, now running for an encore as governor, has not joined other states' attorney generals in challenging ObamaCare.
In South Carolina, it is estimated to add 10% to its budget spending, reports its capital's newspaper The State.
In my small California town, the PTA is urgently asking parents to kick in an extra $25-thousand to support non-core but valuable instruction slated for state funded cuts. No mention of cutting teachers' rich benefits, or the staff protected by unions from being cut by being slotted into useless holding posts. I wonder how long it'll be before my neighborhood's very involved Moms and Pops, and those elsewhere, will connect the dots.
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The brave escape of Curious George