Things to Read at Lunchtime on January 3, 2013

Must-Reads:

1. Jay Ackroyd: Eschaton: Beta: “Something that has surprised reporters has been the persistence of people trying to sign up for PPACA coverage via the Federal exchanges, especially people under 40. One reason, of course, is people really want health insurance they can afford. But  another is the permanent beta release state that characterizes internet applications. Google has accustomed users to buggy software that gradually improves, with no ‘release date’ or ‘gold master’. The ‘deadline’ stories the media likes so much don’t really make sense.  There are no deadlines.”

2. Jonathan Cohn: Five Rules for Talking About Obamacare in 2014 | New Republic: “The debate over the law’s merits will continue, at least through the midterm elections and perhaps beyond. And the debate will probably look a lot like it has for the past few months, with proponents and critics arguing not just about priorities but also basic facts…. But if we’re destined to keep having these same fights over and over again, maybe can learn to have them more intelligently. With that in mind, here are five rules…. RULE #1: DON’T IGNORE THE OBVIOUS…. When the NBC News ‘investigations’ unit reported [plan cancellations] as a major scoop, I noted with a little snark that the article’s source was a set of regulations published years before in the Federal Register—in other words, hardly the stuff of Woodward and Bernstein. But rate increases and plan cancellations were news anyway. And journalists like me were wrong not to recognize that…. RULE #2: PAY ATTENTION TO SCALE. There’s nothing wrong with personal anecdotes…. But anecdotes matter a lot more when they tell us about broader trends…. RULE #3: ACCEPT AMBIGUITY…. Our knowledge of insurance coverage comes primarily from surveys and studies—some by private organizations like Gallup, and some from government agencies like the Census. Our knowledge of what people are paying for medical care and what kind of care they get? That comes primarily from studies that take months, if not years. We can make some pretty good guesses, based on what’s happened in the past. But we rarely know as much as we’d like to think. RULE #4: ACKNOWLEDGE COMPLEXITY AND TRADE-OFFS…. Obamacare sets in motion all kinds of changes. They will typically affect different people in different ways—creating winners, losers, and all sorts of people in between…. RULE #5: CONSIDER THE REAL COUNTER-FACTUAL…. Just because something is happening and Obamacare exists doesn’t mean it’s happening because Obamacare exists—even in health care. This is probably the most important rule of all. It will be tempting to judge Obamacare by comparing it to the status quo. But the status quo was changing already. Preserving it was simply not an option…”

3. Paul Krugman: Disinformation on Inequality: “Miles Kimball catches Bret Stephens pulling a fast one on Wall Street Journal readers–but it’s much worse than Kimball says. Kimball take Stephens to task for overstating the economic progress of poorer Americans by presenting nominal figures, without any adjustment for inflation…. Stephens also accuses President Obama of a ‘factual error’ in claiming that the top 10 percent receive half the income; it’s the top 20 percent, says Stephens, and there has been no significant rise since the mid-1990s…. Stephens is citing the Census data, which everyone who knows anything about inequality knows has a problem with very high incomes thanks to ‘top-coding’…. Why doesn’t [the recent] sharp rise [in inequality] show in the Census data? Because almost all of it took place among the top 1 percent–the income range that the Census data, which are survey-based, can’t effectively track. OK, we’re still not done here. Stephens then goes on to suggest not just that there has been no rise in inequality since 1995, but that not much has changed since 1979…. The point here, as on so many other economic issues, is that we are not having anything resembling a good-faith debate. We could have a debate about whether rising inequality is a problem, and whether measures intended to curb it would do more harm than good. But we can’t have that kind of debate if the anti-populist side won’t acknowledge basic facts–and it won’t…. Oh, and just FYI: this is the kind of journalism that the great and the good deem worthy of a Pulitzer Prize.”

Should Reads:

1. Kevin Drum: If You Think the NSA Debate Has Been Valuable, You Have Edward Snowden to Thank: “Ruth Marcus thinks Edward Snowden is ‘insufferable’, and I guess that’s fine…. But then there’s this: ‘Personality would not matter–at least it would not be so grating–if Snowden’s behavior were more upstanding and his actions more justified. On behavior, if Snowden is such a believer in the Constitution, why didn’t he stick around to test the system the Constitution created and deal with the consequences of his actions?’… On Marcus’s first question: come on. If it were a matter of sticking around and facing the possibility of a few years in prison, that would be one thing. Maybe we should feel that Snowden should have been willing to accept the consequences of his actions. But that was never in the cards, and surely Marcus knows it. In reality, Snowden was facing the near certainty of decades or more in Supermax solitary confinement. There’s just no way you can pretend that an unwillingness to surrender to torture of that magnitude says anything about how upstanding you are or how strongly you believe in the Constitution. Marcus’s second point is even more peculiar. Why does she say that ‘perhaps’ there would have been no debate without Snowden? Is that even an arguable position?”

2. Ryan Cooper: The “wingnut hole” measured: 5 million without insurance thanks to GOP refusal: “Because of the decision on Obamacare by the Supreme Court, which left the decision to expand Medicaid (a key part of Obamacare) up to the individual states, most Republican-controlled states refused said expansion, leaving substantial portions of the citizenry in the lurch. Ed Kilgore has been calling this the ‘wingnut hole’…. How many Americans will go without health insurance simply because the GOP dislikes the president? Well, happy 2014, dear readers: initial estimates are in, and we have 5 million lucky winners!… The Supreme Court decision was doubly unfortunate, because Republican states tend to be poorer than average and contain a disproportionate number of potential beneficiaries who are losing out. Obamacare, by virtue of distributing benefits downward, was aimed at those very people; it never occurred to the law’s architects that the vagaries of politics and law might give states a way out, and so they didn’t design a backup coverage mechanism.”

3. Josh Marshall: As Obamacare Sign-Ups Surge, So Does Conservative Rage

And:

• Owen Zidar: Who benefits from corporate tax cuts?
• Danny Yagan: Moving to Opportunity? Migratory Insurance over the Great Recession

Should Be Aware of:

1. Adam Ozimek: Helping Inflation Reflect Housing Bubbles: “The consumer price index doesn’t use house prices to measure inflation in owner-occupied housing, and instead they impute inflation using housing rents…. The current practice is to survey households about their current rent expenditures, but most of these expenditures are based on leases that reflect prices which are set in the past…. A measurement based on market rents… would therefore better reflect current housing market conditions…. The drop in prices when the bubble burst would have been reflected in the CPI sooner if market rents were being used.”

2. Uwe Reinhardt: Medicare Advantage and the ‘Theft’ of $156 Billion: “In a Dec. 27 lead editorial, ‘Government Advantage’, the editorial writers of The Wall Street Journal wrote: ‘Amid the larger ObamaCare meltdown, seniors are discovering their choices are fewer, costs higher and coverage poorer too. Liberals fear the increasing popularity of Medicare Advantage, and they’re starting to gut this market alternative to their original health care entitlement before the sand runs out on President Obama’s second term. About 14 million people or 28 percent of Medicare beneficiaries choose Advantage over the government option, which is why the Affordable Care Act steals about $156 billion from the program…’ A theft of $156 billion should catch one’s attention, especially if government is the thief. It warrants a closer look…. The drafters of the Affordable Care Act introduced the following changes in the payment formula for Medicare Advantage: (a) Gradually moving the overall average (risk-adjusted) payments per beneficiary to the Medicare Advantage plans toward neutrality with traditional Medicare; (b) Gradually reducing payments to the plans in counties with high per-beneficiary costs under traditional Medicare (on the theory that economies there should be more easily achievable for the private plans), but lifting the payments above per-beneficiary costs under traditional Medicare in low-cost counties; (c) Within those constraints, rewarding the plans explicitly with higher payments for higher, measured quality.

   “Now, one can easily understand why The Wall Street Journal editorial writers, given their ideological predilections and the point they sought to make, would not mention the extra payments hitherto made to Medicare Advantage plans and simply portray the payment change under the Affordable Care Act as theft. On the other hand, one can also easily see why designers of the Affordable Care Act saw in their new payment formula… a leveling of the playing field in that competitive market.

   “I share that view.”

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