Is It in My Head?

The RAND Health Insurance Experiment demonstrated that health care use was reduced by 30 percent in patients with cost sharing as compared to first dollar coverage, supposedly without resulting in harm (though low-income people were harmed). But that study was limited to healthy workers and their young healthy families during a few healthy years of their lives. It does not apply to the relatively unhealthy 20 percent of people who use 80 percent of our health care dollars – care that is not influenced by deductibles. Reducing spending by 30 percent on healthy people who use very little care – perhaps an office visit or two – is not going to reduce our national health expenditures significantly.

Many other nations have first dollar coverage with no deductibles, yet spend far less than we do, and with no evidence of significant overuse of medical services. There are far more effective and much more patient-friendly methods of controlling spending than the use of deductibles and other cost sharing, as these nations have demonstrated.

The Affordable Care Act is not providing us the framework that would ensure affordable care for everyone. Trying to modify the Act to make it work better won’t help because the financing infrastructure is so fundamentally flawed that legislative tweaking cannot repair it. Though getting rid of deductibles would be an improvement, it wouldn’t reduce our high costs, but would merely shift them, making insurance premiums even less affordable.

…one particular pro-business group exercises what seems to be a huge amount of influence over pro-business lawmakers. (Of course, if we ever spot any “anti-busi­ness” lawmakers out there — something that hasn’t been located since the beginning of the republic — we’ll be sure to let you know.) The American Legislative Exchange Council (ALEC) is generally described by its members as “pro-business” and “free-market.” And lawmakers who support their priorities, it turns out, also can be ALEC members — and no less than 115 cur­rent or former state lawmak­ers have such ties, according to the study. In fact, akin to the revolving door of con­gressmen­turned-highly­paid lobbyists in Washing­ton, ALEC leaders in Virginia have been known to go on to legislative leadership posts in Richmond, and vice versa. They may be totally different jobs, but they in­volve all the same group of people.

Although the uninsured would be expected to have problems paying medical bills, we should be very concerned that one-fifth of insured individuals under age 65 also face significant medical debt.

Most of these individuals are insured through their work. Since the state insurance exchange subsidies for purchase of insurance and for out-of-pocket expenses will not apply to employer-sponsored plans, it can be anticipated that the Affordable Care Act will not reduce medical bill problems for a majority of our workforce.

When we know that the Affordable Care Act will fall far short of what we need to ensure financial security in the face of medical need, why aren’t we as a nation busy with efforts to enact a program that actually would work?

Because Barack Obama has adopted so many core Republican beliefs, the US opposition race is a shambles.

PITTSBURGH (AP) — An 18-year-old Pittsburgh man is accused of burglarizing a market with three teens, then posted pictures on his Facebook page showing the suspects mugging with some of the loot.

Isaiah Cutler who has been jailed since Friday in the Dec. 12 burglary. Online court records don’t list an attorney for him.

Police say Cutler, a 17-year-old and two 14-year-olds stole more than $8,000 worth of cash, cigarettes, candy and checks from the business. About an hour later, police say, Cutler posted pictures of the teens posing with the loot on his page on the social networking site.

He seems highly qualified to compose these masterpieces.

…in July, the movement hopes to mobilize thousands as the American Legislative Exchange Council — an organization Fruhwirth called “the epitome of corporate control of our government” — holds its 29th annual meeting in Utah.

First of all Governor, why would anyone foreigner want to visit Phoenix when you have the most investigated Sheriff in the country harassing immigrants? Why would they want to subject themselves and their families to your illegal immigration policies?

Second, why aren’t you helping the most needful people of this state first? You could have taken the money and invested in our own people, but you choose another path. You could have used the surplus to fund education or to build our state’s infrastructure, but you decided to fund an advertising campaign to lure people into Sheriff Arpaio’s web of harassment.

While I was watching MSNBC talking heads (goddamn straight, Rachel Maddow, too) do victory laps around the studios yesterday, something got stuck in my head: that bill that the House majority caved in and signed did have a provision to support the creation of the Keystone XL pipeline.

I knew that I had to double check that this morning…somehow, it got stuck in my head. It’s no surprise that I didn’t hear much about it with my eyes open because MSNBC runs a hell of a lot of advertising from the petroleum industry. All cable news is Fair and Balanced^©, don’t you know.

or Dalit boy Makes Good

A new report finds evidence of forced child labor in Burkina Faso.

As Victoria’s Secret’s partner, [fair trade leader Georges] Guebre’s organization, the National Federation of Burkina Cotton Producers, is responsible for running all aspects of the organic and fair-trade program across Burkina Faso. Known by its French initials, the UNPCB in 2008 co-sponsored a study suggesting hundreds, if not thousands, of children like [13-year-old laborer] Clarisse could be vulnerable to exploitation on organic and fair-trade farms. The study was commissioned by the growers and Helvetas. Victoria’s Secret says it never saw the report.

Did you know that Limited Brands is the parent company of Victoria’s Secret?