Archive for January, 2010

A market solution to health care pricing

There are no silver bullets for fixing health care, but few things come as close to the mark as price transparency.

A great health market failure is a lack of clear pricing that patients can use to compare providers. The tax code’s unequal treatment of health spending doesn’t help. But so many ills flow from our byzantine pricing method: fee schedules under which doctors charge different prices to different patients, flat co-pays that discourage rational decision-making.

Big companies buy most of the private health insurance in this country. But, unlike with most other purchases they make, they don’t really know whether they’re getting a good deal. They are in part buying an assurance that the insurer has negotiated the best prices from the best network of doctors.

But even the insurers themselves aren’t quite sure about the value they offer; they can’t compare fee schedules with their competitors without colluding. Ditto for the providers.

The result is a system that not only …

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A little birther-ism about, not by, Nathan Deal

Heh:

During an online chat in November, Rep. Deal wrote “I am joining several of my colleagues in the House in writing a letter to the President asking that he release a copy of his birth certificate.”

(snip)

Of course, Deal’s concerns about the President are nonsense….But Nathan Deal nonetheless exposes another politician whose eligibility is hardly as settled as President Obama’s. And that person is Nathan Deal.

Deal is currently running for Georgia Governor. Per the Georgia Constitution, the Governor must have been a U.S. citizen for at least 15 years.

I have never seen any proof that Nathan Deal is a U.S. citizen. Unlike President Obama, he has never released any records of his birth. The documentation that is publicly available leaves many things to be desired. Extensive online research turns up only an alleged birthdate and birthplace of Millen, Georgia. Who were his parents? What was the hospital? Who was the delivering doctor? These are questions that need answers.

You …

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Which Obama do you believe?

From President Obama’s State of the Union speech last night:

But what frustrates the American people is a Washington where every day is Election Day. We can’t wage a perpetual campaign where the only goal is to see who can get the most embarrassing headlines about the other side -– a belief that if you lose, I win.

(snip)

So, no, I will not give up on trying to change the tone of our politics. I know it’s an election year. And after last week, it’s clear that campaign fever has come even earlier than usual. But we still need to govern. (emphasis added)

From Obama’s Organizing for America Web site, updated just after midnight:

I just finished delivering my first State of the Union address.

I set out an urgent plan for restoring economic security for struggling middle class families. This is my top priority, but I cannot do it alone — and that’s why I’m writing to you now.

(snip)

So tonight, I’m asking you to join me in the work ahead. I need your voice. I need your …

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Let’s try a smaller approach to the big problems

From 1991 to 2005, the Atlanta Braves won every division title but just a single World Series. A common refrain then was that, in baseball, you build a team one way for the 162-game regular season and another way for the shorter playoff rounds. The Braves, built perfectly for April to September, had flaws come October.

We may have reached a comparable point in politics.

Since 2000, Americans have elected two men as president who were very talented at campaigning and connecting with voters but far less effective at selling their biggest ideas once in office.

George W. Bush’s proposals to transform Social Security died quickly and rather quietly, and he managed only to expand the spiraling Medicare. Barack Obama got further with his health care plan, but that proposal appears ready for burial beside labor-union “card check” and cap and trade.

Personality, it turns out, helps only so much once it’s time to govern. More than that, the decision between Candidate A and Candidate B …

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Live blogging the State of the Union

Final UPDATE for tonight: A perfectly fine speech by the president, as long as you weren’t looking for evidence that he’s taken some lessons from the public reaction to his agenda. He is going to give it — and by “it” I mean everything he’s put on the table over the past year — one more try. He is either doubling down on the idea that Americans in their heart of hearts want what he’s offering, or he’s serious about being willing to be a one-term president if that’s what it takes to get his agenda passed.

He basically told Democrats to fall in line behind him and be ready for a fight. The next few months, or even weeks, will determine whether they really have his back.

Bob McDonnell also did a good job in his response. No one will be starting a “Draft McDonnell” movement for 2012, but it’s a good move by the Republicans to put some fresh talent on TV screens.

UPDATE at 10:46 p.m. — McDonnell is smart to talk about common ground, about not wanting the status quo but not …

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Oregon passes tax boost on consumers

Elsewhere, the headline from yesterday’s referendum results reads “Oregon passes tax boost on wealthy, corporations.” But there’s no such thing as a tax on corporations, and states that pass taxes on the wealthy soon find themselves with fewer wealthy people.

There’s no such thing as a tax on corporations because the money has to come out of someone’s pocket: from shareholders in the form of lower returns, from employees in the form of lower wages, or from customers in the form of higher prices. Liberals seem to think it’s OK for shareholders to lose money, ignoring the ripple effects on investment, and to fantasize that employees and customers won’t get stuck with the bill, ignoring reality.

The most egregious part of the new law is that Oregon will now tax companies based on their revenues in the state even if they don’t make a profit. The state will tax residents earning $125,000 a year at rates that even tax-happy California reserves for millionaires.

Oregon already was …

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What can Obama say tonight to change minds?

President Obama’s first State of the Union is tonight (last February’s speech to a joint session of Congress technically wasn’t a SOTU). Coming amid a stinging special election loss and with the opinion polls all moving against the president, the speech will probably be one part pivot and one part hunker-down. But how much of each?

For all the attention the Massachusetts election has gotten, the Democrats (counting Bernie Sanders and Joe Lieberman) still have 59 senators and a large majority in the House. Normally, that would be plenty of votes to pass a Democratic president’s agenda — George Bush didn’t exactly face gridlock despite having smaller majorities in Congress during his administration.

But Obama’s agenda is different, because he ratcheted up the ambition and rhetoric to match his super-majority. The 60 Senate seats may have been a curse in disguise: Now that the super-majority is gone, he can’t meet the expectations that he set — but he also can’t dial things back …

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One way 2010 is different from 1994

The running theme for this year’s midterm elections will be about whether we’ll see a repeat of 1994, when voters wiped out Democrats’ congressional majorities after, among other things, the dud that was HillaryCare. One difference, however, is how voters are engaging with politicians.

Look no further than this Web site by the Tea Party Patriots, which puts an interesting twist on one of 1994’s dominant features. Rather than a “Contract With America” offered by a political party, this group wants to create a “Contract From America” and invite candidates to sign up to it.

Candidate pledges are nothing new. But the Contract From America is novel in its effort to construct a wide-ranging national political platform from the bottom-up. This is grassroots writ broad.

Visitors to the Web site can contribute ideas, vote on them and prioritize them: Voters use a scale of 1-10 to rank the importance of a specific issue, rather than just saying thumbs-up or -down. The resulting priority …

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What (Scott) Brown can do for Georgia, part 2

In response to my post last week about the lack of competition in Georgia House and Senate races, a source who follows state electoral trends emailed me the following facts and observations:

  • “In [the] 2008 general election, 38 of the 56 state senators (21 Republicans and 17 Democrats) had a ‘free ride’ in November (no opposition from the other party). Of the 18 races that saw a Democrat and Republican run against each other (in that chamber), none was close. The ‘closest’ contest was in Senate District 46 (Athens-Monroe), won by Republican Bill Cowsert by a 58-42 percent margin. Only one other incumbent got under 60% (north DeKalb’s Dan Weber, who took 59%). The Senate has been stable politically (party representation) since the 2004 election. In 2004, 34 Republicans and 22 Democrats were elected to the Georgia Senate, a margin which remained unchanged in the 2006 and 2008 cycles.”
  • “In the State House last year, only 6 of the 180 seats changed [party] hands. Democrats …

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Atlanta as Finland: An interesting chart

I’ve spent the morning working on some longer pieces which I’ll post later this week, but in the meantime here’s an interesting chart courtesy of the U.S. Conference of Mayors (you may have read this article about the mayors’ complaints last week to President Obama about the ineffectiveness of the stimulus). The chart below is taken from page 3 of these charts.

economies_citiesThis chart shows the economic size of various American metropolitan statistical areas (MSAs) relative to entire nations. It would also be interesting to see this done on a per capita basis: Finland and Ireland, the two European countries just above and below the Atlanta-Sandy Springs MSA, are in the same population range as metro Atlanta (four million to five million). So, there wouldn’t be much difference. The New York City MSA, on the other hand, has a population of about 19 million [note: this figure corrected from original text] — versus 33 million in Canada and more than 1.1 billion in India.

I’ll expect a cut of …

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