Two Words One Doesn't Want To See In Same Sentence -- But Absolutely Predictable -- November 4, 2014

The two words: ObamaCare, soaring.

Again, thank goodness Mr Boehner did not defund this debacle. This debacle belongs completely to its namesake. A more accurate name for the program would be PORCare -- Pelosi, Obama, Reid-care. Or even OPRAHCare -- Obama, Pelosi, Reid, Anti-Health Care. Yeah, that's a stretch.

Reuters headline: Cost of Cheapest Obamacare Plans Is Soaring.

Even Congressmen -- who run for election every two years -- can read that short headline.

Some excerpts from the article:

Subsidies are probably the biggest thing keeping the markets from sliding into the dreaded adverse-selection “death spiral,” in which sick people are more likely to buy insurance, so the pool is sicker and more costly, so prices go up, so the healthiest folks decide the insurance isn’t worth it, so the pool gets sicker and more costly….

Contrary to expectations, the mandate really doesn’t seem to be doing much to get people to buy insurance, at least yet (the penalty is set to go up again this year, and that may get people to pay attention). The subsidies, on the other hand, clearly have a large effect, which is why the customer base for the exchanges is so disproportionately composed of folks who are getting large amounts of taxpayer assistance to buy insurance. Anything that increases the gap between the cost of the insurance and the subsidy they are getting is therefore worrisome, if you want the exchanges to get and stay healthy.

More:

The whole bottom of the market is undergoing a fairly massive repricing. In most states, the cost of the cheapest Silver plan, relative to the cheapest one last year, rose even more than the benchmark rate. And in most states, the cost of the cheapest Bronze plan went up by more than the cost of the cheapest Silver plan.

(The average increase was 13 percent, but it looks as if it's unweighted, while the government used a weighted average. As I noted last week, the weighted average is usually the most meaningful national metric, but the unweighted can be revealing as well.)

That still doesn’t tell us what happened at the top of the market, with the carriage trade splurging on policies that cover nearly everything. But I think there’s one thing we can say for certain: Insurers significantly underestimated how much people would spend on health care, even if they chose stripped-down plans that have narrow provider networks and require consumers to cover a significant portion of their own costs.

Yada, yada, yada, soaring premiums, yada, yada, yada.

**************************

The Train Wreck In Slow Motion

Speaking of the TrainWreck, Business Insider also has a story with this headline: One of Obamacare's biggest success stories is suddenly under serious threat.

One of the Affordable Care Act's biggest success stories since its implementation came in an unexpected place.

That would be in Kentucky, the deep-red Southern state that has drifted further and further away from the policies of national Democrats and President Barack Obama.

The Bluegrass State's Democratic governor, Steve Beshear, embraced the law colloquially known as Obamacare — though he wouldn't dare call it that. The state set up an exchange, called Kynect, that thrived in 2013, as the federal government's website was mired in disaster.

And Kentucky expanded the federal Medicaid program, signing up more than 375,000 people over the first year of the expansion. One study found that the expansion could inject as much as $30 billion into the state's economy through 2021, in the form of tens of thousands of new jobs.

But most of Obamacare's success in the state is under significant threat after Republican Matt Bevin won Tuesday night's election for the governorship.

Bevin's surprisingly dominant win served as at least an implicit rebuke of the law in the state, and it cemented the trend of Southern states' continued shift to align more with the policies of the national Republican Party. Just on Tuesday, Beshear was touting Obamacare as a political winner in the state.

*********************************

Reading

A few weeks ago there was a lot of chatter on a new book, fiction, City On Fire. It was about NYC during the 70's, during the great blackout. I was intrigued. And then I read at Amazon that it was a 994-page book and everyone said that by page 250 it was already too long; one reader had gotten to 750 pages, and realized there were still 200 pages to go. It sounded like no one read the entire book. Everyone said the author -- who did not live in NYC in the 70s -- captured NYC perfectly. He had done his homework; lots of research. I couldn't wait to see the book. I spent some time with a copy at Barnes and Noble the day it was released. I skimmed through a fair amount of it, but in the end, it held no interest for me. I recognized some passages that had been used by critics or book reviewers. Interestingly, these passages were at the very beginning of the book, suggesting the critics and the book reviewers had not read very much of the book either, though they all raved about the writing.

The New Yorker published a collection of stories published during the decade of the 1940's. It was extremely good. It was my impression The New Yorker planned to follow up with a similar book from other decades. Collections of New Yorker short stories should capture the city of New York also.

I say that because as good as The Great Gatsby was, chapter 4, "The Princess with the Golden Hair" in Edmund Wilson's Memoirs of Hecate County is absolutely superb at describing the city in the 20's, the crash, and immediately following the crash. The book was copyright as early as 1942 and again in 1943, and 1946, by Edmund Wilson. It was banned in the US at the time, and it took a number of years before it was finally allowed to be published/sold in the US. Certainly chapter 4 was the reason the book was banned, although I've yet to complete chapter 4 or any of the following chapters.

The first three chapters were excellent but would not have bothered the censors.

Chapter 4 starts on page 82. I am on page 146 and can only read a few pages at a time. It is very, very dense. I see chapter 5, "The Milhollands and Their Damned Soul" doesn't start until page 240. It's going to take a long time to finish "The Princess with the Golden Hair." I'm not even sure there is a plot, but it sure is interesting reading, on so many levels.

See this 2011 review of Memoirs of Hecate County.