Linking health insurance and employment: does the saga ever end?

This is Joseph

Yesterday, I wrote about Matt Reed talking about unions.  He had an earlier post on how an aging work force was doing bad things to the health insurance costs at his institution.  His solution is pretty obvious from a policy perspective -- linking health insurance to employment is looking like less and less of a good idea over time.  Among other things, it reduces job mobility and insulates customers from directly seeing the relevant costs (a second payer causes problems).  But it also reduces the quality of life for older adults.

One of the commentators on the post had an excellent point about how it discourages things like early retirement for burnt out staff:

Here is how we think Matt: Retiring before 65 is economic suicide. Even if you have a decent pension and some serious savings, a quick look at the private health insurance market will dissuade you from even thinking about it. This is doubly the case if you have any known health problems. Those $2,000 a month premiums, $5,000 deductibles and $7,500 out-of-pocket maximums mean you are $30,000-some a year in the hole the day you walk out the door. If you become disabled and don't have private disability insurance that you bought when you were 20 it is even worse. I have known people who have been fired before age 65, but I don't know any that went out the door on their own. (Oh, and your chances of finding another job? Zero! Unless you like driving Uber.)

It's astonishing that costs of health insurance exceed that of many people's pensions.   It is also likely that we've long since hit the point of diminishing returns on trying to get people to pay more in deductibles.

Now I am not unaware of the risks and costs of transitioning to a single payer style of system, especially when health care costs are already high.  But it isn't absolutely clear to me that these high costs are necessarily helping improve health, overall, which is an issue.  But it is also clear that suddenly radically reducing compensation for a huge segment of the economy is likely to cause . . . disruption.

But it is a problem worth thinking about and it would likely pay large dividends to have a good policy plan for improvement.  I mean it isn't like there are nearby functional models that work in decentralized and diverse English speaking countries with a large immigrant population that manage to have a decent life expectancy.  Right?

Colleges and unions

This is Joseph

Matt Reed is worried about unions in discussions of the financial stability of colleges:

Internally, for instance, many public colleges (including my own) are unionized. Collective bargaining agreements, and sometimes state laws, can greatly narrow the strike zone for any prospective downsizing. When you have to do layoffs by seniority, and your salaries are mostly determined by seniority, the most expensive employees are the most protected. That makes the math harder.

While I get that this creates problems, there are bigger issues that everyone wants to ignore.  I want to talk later about health insurance costs, and how that creates a relatively large crisis.

But the idea that job security is a problem suggests that there is already an assumption of neoliberal ideals of a lack of security in life.  Keep in mind that wealth provides options and people with lots of money have an implicit security -- you have options if working is optional or if you can cover a gap without problems. Why have we evolved from seeing people as resources to liabilities?  Why would you not want to keep your most experienced employees?

It is also worth noting that institutional loyalty is much harder to develop if senior managers are constantly worried about high seniority employees.  How can you be loyal to a place that sees you as a barrier to efficient lay-offs.

Now I do get the main point -- that colleges are meant to be grown and shrunk in slow and organic ways.  It is not a style of organization that works well with either fast growth or fast shrinking.  This suggests that maybe stabilization of finding (both directions) should be a piece of the conversation.  After all, doesn't it make sense to be able to plan?

It took Coke a while to escape its patent medicine origins

As this July 6, 1907 issue of Scientific American demonstrates.

Self-driving cars would be wonderful

This is Joseph

Another new year topic seems to be that of self driving cars.  This is a nice piece on the subject, with a smart take on the problems of having a human driver ready to take over: 

First, as one might infer, the human who is suddenly asked to intervene is going to have to quickly asses the situation. The handoff delay means a slower response than if a human had been driving the entire time. Second, and even worse, the human suddenly asked to take control might not even see what the emergency need is. Third, the car itself might not recognize that it is about to get into trouble. Recall that Uber tried to blame a car accident when its self driving car was making a left turn on the oncoming driver, when if you parsed the story carefully, it was the Uber car that was in the wrong.

This is exactly correct.  Problems that can be foreseen well in advance really don't typically need a human driver.  It is the moment that things go wrong that you need a sense of judgment.  And I can't think of a more boring thing to be doing than constantly watching the car drive.  I would much rather either check out and do something else (e.g. read) or be accumulating information on issues like road surface slipperiness. 

Remotely located drivers are even worse (imagine a bad cellular connection during the driving emergency). 

If we have a way to make a self-driving vehicle work than I am an enthusiast, but I want to make sure that the new option is better than the current technology.  We might get there, but it is during an emergency that I want the enhanced reflexes of a computer the most. 

Bitcoin skepticism

This is Joseph

This is a very good critique of bitcoin and blockchain approaches in general.  It pairs with some recent work by Megan McArdle, who is also skeptical.  It's got to be a great solution for something if this part is even close to correct:

Plus, it’s not actually that good a payment system — Visa can handle sixty thousand transactions per second, while Bitcoin historically taps out at seven. There are technical modifications going on to improve Bitcoin’s efficiency, but as a starting point, you have something that’s about 0.01% as good at clearing transactions. (And, worth noting, for those seven transactions a second Bitcoin is already estimated to use 35 times as much energy as Visa. If you brought Bitcoin’s transaction volume up to Visa’s it would be using as much electricity as the rest of the world put together.)

I value privacy in my transactions but I also value fast and cheap, as well.  I am not sure what problem this solves that cash or gold can't solve, given that they also have the slow transaction problem.  Cash has the added advantage that things are priced in it, making it a bit easier to come to agreements about the cost of things (a volatile currency is a bad store of value).

So I suspect that this is one more case of a market showing irrational exuberance.  Which should get us to wonder about what other price discovery mistakes could be embedded in markets, and why it is key to think about how and why a market can fail.  Bitcoin is a small issue, but health care is a much bigger one and it is quite possible that we have similar issues of market failure there as well.  

So food for thought.  

All of Ryan's speeches sound better in the original Newspeak

For years, Joseph and I have been arguing over the use of terms like “Orwellian.” His position was that certain comparisons (such as those to Hitler and the Nazis) were so emotionally charged and carried so much baggage that you could seldom productively employ them in a rational argument. My counterargument was that if the similarities were both fundamental and specific and the relationships were truly analogous, you should use the most apt comparison.

At the time I think he got the better of me in the debate, but conditions have changed and I am feeling stronger about my arguments. Certainly a reference to Orwell wouldn't be out of place in this excellent column by Michael Hiltzik.

One expects politicians to conceal their intentions behind a obfuscating scrim. The problem is that news organizations become complicit in their underhanded efforts to cut social program benefits by employing the benefit-cutters' terminology.

Just after Christmas, for example, Politico achieved a multi-fecta in an article about disagreements between House Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.) over Medicaid and Medicare.

Reading from the top down, the article referred to "overhauling" the programs, to "reform," "welfare and entitlement changes" and "policy modifications." These are Republican terms for benefit cuts. There's no excuse for journalists repeating them without defining them. But one has to drill pretty deeply into the Politico piece to find the first mention of benefit "cuts" (to paragraph 12, actually).
Politicians aiming to cut Social Security and Medicare use weasel words to hide their plans. Let's call them on it.


Other weasel words often found creeping into what purport to be objective reports about social programs are "reshape," "revamp," "modernize" and especially "fix." As we've observed in the past, Republican plans for Medicaid, Medicare, food stamps and other such programs are "fixes" in the same sense that one "fixes" a cat or the Mafia "fixes" an informer.

I've mentioned (in another context) the warning delivered in a 1965 speech by the late Sen. Daniel Patrick Moynihan (D-N.Y.) about what he called "semantic infiltration" in policy debates: "If the other fellow can get you to use his words, he wins."

Retirement and the issue of social security

This is Joseph

Every once in a while I hear about how social security is a monster that will destroy the federal budget if it is not reigned in.  Seriously, just google about the social security trust fund and you will be amazed.  So I was curious as to what the average benefit looks like.

According to Social Security, itself, the average benefit in November 2017 for retired workers was $1,375.29.  It was less for people living on disability.  That averages out to about sixteen thousand dollars per year.  The poverty line, for one person, is twelve thousand dollars per year as of January 2017.

What this actually means is that there isn't actually a lot of room for cuts here. Remember, that is the average and many participants will end up with even less.  Even in low cost environments, this suggests that social security is mostly a hedge against actual starvation and homeless, more than a real plan to retire.

So keep this in mind when there is a discussion of the need to cut entitlement programs to handle the new deficit crisis.  There isn't really a lot here to cut without having very profound economic impacts on vulnerable senior citizens.  And it is not really a driver of increased costs:

According to the Congressional Budget Office, Social Security’s share of gross domestic product will rise by about 1.5 percentage points over the next three decades, to 6.4%. The share going to Medicare, Medicaid and the Childrens Health Insurance Program (if Congress ever gets around to reauthorizing CHIP) will rise by 3.3 percentage points, to 8.8%.

Now there is a looming problem with medical costs, but these apply to all forms of medical insurance and not just public programs. 

It's inexpensive and bare bones now.  Reform, other than maybe increasing pay-outs to recipients who end up below the poverty line is likely to do real harm for surprisingly small savings (and keep in mind that we recently enacted a huge tax cut that suggests that deficits are not an immediate concern).  Finally, undermining this program undermines the justification for the quite regressive payroll tax, which is a key piece of revenue now that we keep cutting income taxes.

Rethinking crossownership

[Warning, I'm pretty much shooting from the hip here. This is not an area where I am knowledgeable and I do not have the time to research the subject properly. As a result, this is very much written to the good-enough-for-blogging standard, so it would be wise to double check any of the following assertions before passing them on.]

As a general rule, I tend to be skeptical of "we need this to be competitive" arguments against regulation and antitrust enforcement. Usually these claims come down to an excuse for gouging the customer or an attempt by incompetent managers to survive by gaming the system. If you can't make a go of a business without monopoly/monopsony power, then you probably aren't very good at your job.

There are, of course, exceptions, cases where technological and economic changes really have made it difficult for even the best run companies to survive, even when those companies serve a real and necessary social good. Local journalism is a perfect case in point. Some of the best reporting I've seen over the past few years has come out of newspapers, and yes, television stations outside of the major markets of New York and LA. I particularly want to single out the TV reporters because, though we all tend to mock them, they've been responsible for some remarkably good work on stories that, though important, are often ignored by institutions like the New York Times.

John Oliver hit many of these same points in his excellent piece on Sinclair broadcasting.



.

Anything we can do to encourage more and better local journalism is worth pursuing. There are considerable synergies and cost savings from combining a newspaper and a television (and possibly even a radio) station. Furthermore, in an age of cable and the Internet, I am much less concerned with the potential abuses from having this kind of cross ownership.

The key word here (and it is absolutely essential) is "local." As soon as you start to scale up, the social benefits start to drop off while the potential for abuse increases exponentially. As the experience with Sinclair has shown us, ownership across many markets actually tends to decrease the amount of local journalism and, perhaps more importantly, the amount of local editorial control.

Put simply, the standard I have in mind is that crossownership is acceptable, perhaps even desirable, if you're talking about relatively small players in relatively constrained regions. If, on the other hand, you're talking about big players (particularly those like Sinclair with a history of stifling local journalistic autonomy), the tighter the ownership restrictions the better.

Happy New Year from Winsor McCay.

Should we care that the congestion tax is regressive?

This is Joseph

Over at Vox, Matt Ygelsias very nicely hits on one of my pet peeves about people calling congestion taxes (and similarly gas taxes) regressive:

Again and again, one hears the objection that congestion fees are regressive, but I think this is doubly mistaken. Analytically, it's true that congestion fees let the rich off relatively easy, but it's also the case that it's poor people who are disproportionately likely to not own cars and to benefit from faster buses.

But more to the point, it's easy to alter your overall tax system to make a congestion charge clearly progressive. The two main options are either to use the revenue to finance a sales tax cut (sales taxes are extremely regressive) or to pay out a "congestion dividend" to all the city's residents.

 I think that the current conversation about taxes has poisoned people's ability to be objective about these things.  Every time there is a new source of revenue, there is a push to cut progressive taxes (like the income tax).  The recent cut of the top income tax bracket is a case in point.

But raising revenue can be used to provide income support and social services.  It is a two step process, although I can understand the confusion about this given how we seem to focus only on a "taxes are bad meme".

But Matt is completely correct that poor people don't always have cars.  And if good (i.e. fast and reliable) bus service made it possible for more families to live car-free then that would be a big win, both for road safety and pollution.  Or maybe safer roads make bicycles work (even greener and cheaper).  Now this requires a commitment to good public transit services (or bike lanes), but I remain puzzled as to why this is remotely controversial.

I also want to note that the people making this argument seem to have no trouble with regressive taxation in other contexts.  The payroll tax is more regressive than the income tax.  Want to bet which one we just cut? Sales taxes are regressive, but they show no signs of being targeted in favor of an increased capital gains tax (which is progressive).  I am not saying that there are not other considerations, but I always find it puzzling how regressive is brought out in this context and not any other.

I will become much more sympathetic to the "regressive" objection when it is applied more broadly.  At the margin a congestion tax can finish a family financially.  But so too can sales taxes, which could make the difference between sufficient and insufficient income.  So if we are going to discuss regressive taxes, can we start with the elephant in the room. It's really an astonishing example of details are just not thought through.  If this is the standard then I don't see regressive as a serious problem with a tax that can be a) remedied with the right spending decisions and b) has positive social consequences.  So can we drop this point? 

Please?

The Last Jedi and narrative risks *major spoilers*

This is Joseph

The last Jedi is visually amazing and has some great character moments.  The plot is not the best, although that has rarely been a strength of Star Wars movies.  But I did want to comment on how the plot was, in a very odd way, just as safe and conservation as the Force Awakens. 

Needless to say: SPOILERS

REALLY, no kidding, SPOILERS




The Force awakens was basically the plot of a New Hope rehashed for a new group of heroes.  It is not necessarily the wrong artistic choice -- bringing a series back to the basics can create a fertile ground for exploring new paths forward.  Unfortunately, the Last Jedi seems to have managed to mangle the plot. 

The main conceit of the new series is that they reverse expectations at every step, often just to reverse them:

1. Luke is a grumpy old man and not a wise Jedi master
2. The plans that the heroes try cost lives and don't save them (Finn's expedition leads to the death of most of the surviving members of the resistance)
3. Poe's reckless actions make things worse, not better, and being a hot shot ends up being counter-productive
4. Snoke is killed immediately
5. Turning on his master doesn't redeem Kylo Ren
6. Rey falls for Kylo not Finn
7. Heroic self-sacrifice is stopped by another character, with no viable plan to prevent everyone from dying

I could go on, but the trick seems to be to reverse expectations at every turn and try to make it fresh and original as a result.  But what struck me is how they somehow managed to avoid all of the real narrative risks that they could have taken with the story.

And we end up with the status quo.  A resistance against an empire that is overwhelmingly strong and is led by a person strong in the dark side is being led by a small group of heroes.  None of the new people died.  Luke becomes a force ghost, just like Yoda. The situation at the beginning is exactly like the end and we don't really have new plot angles that take us in a new and fascinating direction.

If you are going to invert expectations then you should create new paths forward.  Instead we get the same set up and very little narrative payoff.  Maybe that isn't the main thing in a Star Wars movie, but it definitely detracted from the otherwise very beautiful piece of film.  

Robots reanimating dead musicians

From NPR (May 28, 2007)

Pianist Glenn Gould's classic 1955 recording of Bach's Goldberg Variations has never been out of print. Yet this week, Sony Classical will release a brand-new recording of it.

It’s actually a recording of a "re-performance" of the music, designed by a North Carolina software company called Zenph.

The idea is simple: Old recordings sound old. Decades of amazing musical performances are hidden behind the limits of audio technology at the time they were recorded.

The Zenph "re-performance" process isn't a remastering — that is, trying to fix an existing recording with equalization or noise reduction. Instead, it's a new recording of a performance that scientifically matches the earlier one. Zenph uses a Yamaha Disklavier Pro, an actual acoustic piano that can, with a computer's help, play back with microscopically accurate timing and sensitivity.
...
Zenph will be turning to jazz next, with a recording of “re-performances'” of Art Tatum, including a live concert performance they hope to re-create, with no one at the piano, at Shrine Auditorium in Los Angeles.

And you think we're shrill

Ad running in Scientific American, 1905.

Merry Muskmas to all

[I've been going back and forth as to whether or not some of this is meant to be read as parody. If I missed some subtle wink from the author of the piece, pointed out in the comment section I will amend this post.]

I've been on the Elon Musk beat for quite a while now, and I thought I had a pretty good idea where the upper bound was for hype and journalistic credulity, but this Rolling Stone cover story by Neil Strauss really does set a new standard.

Musk will likely be remembered as one of the most seminal figures of this millennium. Kids on all the terraformed planets of the universe will look forward to Musk Day, when they get the day off to commemorate the birth of the Earthling who single-handedly ushered in the era of space colonization.
...
“Musk is a titan, a visionary, a human-size lever pushing forward massive historical inevitabilities – the kind of person who comes around only a few times in a century”

And that's pretty much the level of critical scrutiny you can expect from the entire piece.  It's not just the lack of skepticism – – we've seen plenty of that – – but the obliviousness to the need for skepticism.  Up until now, most reporters for major publications have at least acknowledged that some level of skepticism would have been appropriate. True, many of the disclaimers are little more than lip service, but the journalist on those stories understood that they should do at least the bare minimum.

Strauss is the first writer I can think of who addresses proposals like the Hyperloop completely without any mention of its critics and the serious questions about its viability.

The article even has a photo caption that reads 'Inspecting the Hyperloop, which will transport people from city to city in record time.' Not "may" or even "will probably," but "will" despite a widely held consensus among transportation and infrastructure experts that this is unlikely to be viable as anything more than a glorified amusement park ride in the foreseeable future.

We may come back to this article. There's a great deal of unintentional journalism here, insights into Musk's real and extraordinary gifts for motivation and promotion, talents that have led to some truly amazing accomplishments. There is also an interesting cautionary tale in the way Strauss lets his subject steer the narrative away from these genuinely important and impressive points and toward unquestioning acceptance of a self mythologizing narrative.

For now, though, I'm just going to let it stand with this. Frankly, reading a puff peace this inflated takes a lot out of me.

Kids and Cars 2

This is Joseph

At some point I thought there was a comment on my last post asking about walking to daycare.  It's actually closer than I thought in terms of time: 3.8 miles which Google maps thinks will take me 79 minutes.  With a jogging stroller this would work if I only did one pick-up or drop off a day. 

But I still wonder why it is such a huge deal to have daycares located near places of employment; does it make me a socialist to wonder why the extra commute works (and I am happy to pay marker rates of mid-twenty thousand per year -- it's the price of a kid).