Friday, April 23, 2010

Will HCR Reduce Costs? [Updated]

A new report from the Medicare's Office of the Actuary says no. Coverage will expand to 34 million more people - but overall medical spending will increase about 0.9% in the first decade to achieve that goal. A couple of notes:

1. Even if this report turns out to be accurate, I'd argue (as the White House does) that HCR is still a bargain.

2. This is a rather pessimistic analysis (that's not to suggest it's flawed; in fact, pessimism is helpful in these sorts of matters). That's just a way of saying that it's extremely difficult to predict the costs of such a sweeping bill (and besides, it's way beyond my expertise). It should also be noted that this report concerns total medical spending, not the deficit specifically. But on the question of the deficit and costs more generally, I would point you to the arguments and analyses of some leading economists and health care experts* who would disagree with this report's finding. Bottom line: it's a tough question! The consensus seems to be that the bill either lowers costs or - in the new report's more pessimistic prediction - comes really close. For a bill that extends insurance to 32-34 million Americans, that's pretty impressive.

3. The fact that I came across this article on the Huffington Post says something about epistemic closure: namely, that it is largely a right-wing phenomenon with no liberal analogue (at least not right now).

*The Commonwealth Fund study I linked to dates from December 2009; for a more updated look at the bill's costs from David Cutler, a Harvard health care economist and one of the study's authors, see this WSJ editorial. He concludes that the bill will cut costs and gives most of its saving measures "passing" grades (Subscription required.)

UPDATE: Some helpful analysis from Jon Chait here. He points out that the Medicare Actuaries are extremely reluctant to factor behavioral changes into their analyses, meaning that their findings sometimes underestimate savings that are created by changing incentives. (This was one of the reasons that the office overestimated the cost of the Medicare prescription drug bill by 37%.) And this bill is chock full of programs aimed at changing behavior and incentives - at least some of which will produce major savings, just not savings which can easily be predicted.

Thursday, April 15, 2010

Keep This in Mind

Next time you hear somebody cite First Things as a home for intelligent Catholic conservatism, just respond with this. Joshua Keating is good-natured enough to poke some fun.

It shouldn't shock me anymore, but somehow it still does: this is the opposition.

Tuesday, April 13, 2010

Maybe I'm Just Being a Puritan, But...

...I think it's really beneath the dignity of the President and the presidency to hawk a t-shirt, especially this one, to commemorate a legislative achievement.* First of all: this is health care reform, not the Stanley Cup. It doesn't need a t-shirt.

More importantly: the DNC and Organizing for America should know better than to stick the Obama brand on something that refers to a major political achievement as a "BFD." (Frankly, I find a lot of the official Obama marketing and media outreach to be cheesy and distasteful. But whatever.) It's not that I disagree with the shirt - getting health care done was a big effing deal, and I'm glad it happened. But can we show a little more respect for the office than this?**

*Yes, I realize this is technically the work of the DNC and Organizing for America, not the White House. But still.

**Also, if you're going to comment that there are other, more serious offenses that harm the dignity of the presidency (like lying about torture), don't bother: I realize this, and I agree with you. But this one is beneath Obama, and it should have been a no-brainer to whatever bozo was running the shirt design contest.

Monday, April 12, 2010

In Which I Write About Television

Or something. Actually, I'm not going to say much, since (as you may have noticed from the lack of posting) I'm incredibly busy right now. But I wanted to say that I find something a little odd about the pieces I keep reading by people who take 30 Rock personally. Or, to put a finer point on it, by people who seem to be reading way too much into the show. I don't think Tina Fey is out to mock single women in order to feel better about the dullness of her real-life marriage, or that we're actually supposed to think Liz Lemon isn't attractive (that's part of the joke!), or that deep-down the show promotes conservative politics.

The most bizarre example of this trend was Feministing's take on 30 Rock a few months back, in which the writer came so close to getting the joke:
The most frustrating thing about 30 Rock, an otherwise excellent show, are the constant references to the fact that Tina Fey's character Liz Lemon is ugly. The thing is, Tina Fey fits conventional standards of female beauty almost to a T.
That's why it's funny! The entire Liz-Jenna dynamic set up by the show is one big joke: Liz, who is constantly referred to as plain or homely, is naturally beautiful. But Jenna, the heavily made-up blonde TV star who always talks about her good looks, has that faded-beauty look to her: you can tell that she was attractive when she was younger, but her refusal to deal with her age gracefully means she always looks like she's grasping (unsuccessfully) for some of her past glory. Hence her absurd dismissals of Lemon's looks: that she could never be an actress "because of her neck" and so on. It's a joke. Maybe we should just laugh - and refrain from suffocating the show's humor with forced political readings of our favorite episodes. (Unless I'm doing a political reading. Then it's OK.)