Aetna pulls out, Obamacare frustrated

The defenders may continue to say it ‘works’ as a function of the program enabling coverage to some previously uninsured people.  But its ability to do that was tied to the assumption that a large pool of healthy rate payers would enroll as a function of statute, and that these people would fund the system with its new mandates and expensive to insure enrollees.

http://www.vox.com/2016/8/16/12499920/aetna-obamacare-marketplaces

https://www.bloomberg.com/view/articles/2016-08-16/aetna-s-retreat-from-obamacare-is-more-than-it-seems

Healthy rate payers for exchange policies have been elusive, and mainline, mass subscriber companies – like Aetna and UHC – have found the business impossible.  You do have some boutique companies who seem to be making a profit after claims provided they can manage pools of high premium paying subscribers who do that because their income allows for generous Obamacare tax credits.

The anecdotal expertise I speak from around here is young under 50 middle age suburban strivers right…..  I had my roof done this summer by a local contractor.  So I encounter this guy, and I’m like I always am, do what I always do…. Give him the Studs Terkel / Working analysis.  And knee jerk is ooh, contracting, what a great business to be into, look at the multiple well kept 2 ton trucks in the office parking lot, prolly makes loads of money, why didn’t I become a contractor…..The guy shows up at my house on tear off morning and he’s got a huge stitched gash on his forehead.  Work boo-boo …. he tells me that at the ER the doc wanted to do an MRI and he declined cuz it seemed a clean cut, the MRI was in the low multiple thousands, and he doesn’t have insurance….

I was kind of floored.  Guy is organized, guy is middle age, guy is not superficially ‘fast and loose’, and he was going w/out health insurance.  Well, it’s explainable.  He’s no doubt past the $89k subsidy cutoff and the premiums were too high, like $3k a month for him and his wife, for a policy that would / would not have have meaningfully insured him from ongoing medical expenses given his age and care consumption…  And ya know, you can’t get blood from a stone.  He may not have the money to write a $3k + check every month even if he’s grossing $150k a year.

That’s your anecdote, that’s ACA’s problem, the one that makes it ‘not work’.  Healthy people with jobs but without group insurance aren’t buying in given the high premiums and deductibles, so there’s no mitigation of the actuarials of people who can buy in with subsidies.  Actuarial death spiral, it’s no longer a potentiality, it happened.

So no, Obamacare doesn’t work such that it became ‘subsidized risk pools’, and too expensive for normal middle class people….that’s not what it was supposed to do.

I’m not a nihilist anymore right, so I don’t expect repeal, don’t desire it as a positive good.  The coverage that was extended needs to stay, PPACA has to be fixed…needs to be fixed as a function of it NOT WORKING, alright.

Such that you got a Democrat POTUS and Senate coming up, ya know, the paranoid righty thing is to believe we get single payer shoved down our throats.  No, that’s not going to happen.  Now, something will happen, because with the expiration of risk corridors and the absence of funding authorizations, stuff crashes.  It’s just employer insurance doesn’t go away at this point, its stronger as an institution with the Obama admin having fucked up the individual market.  And I think HRC goes for a pragmatic, middle ground solution out of wisdom and the necessities of practical politics.  IE, I don’t think the Democrats are going to want to give up those seats they just won in 2018.

I could buy one of my favorite, antique sixguns for the price of Epipens

I’m working up an Obamacare rant what with Aetna pulling out of the exchanges.  Ya know, it’s ‘working’.  But I’m confronted by this Epipen / allergies thing that is newsworthy last couple days.

People have allergies right, allergies are a thing.   Not uncommon.  But I didn’t have any, and there were none in my family as a kid, we didn’t have to manage that stuff.  I think my wife can say the same for the most part.

Well kid2004 had an allergic reaction a couple years ago at a restaurant where he broke out in hives and had the superficial appearance of going vaguely cardiac.  But he didn’t, right, it was mild as far as things go.  He had an ambulance ride and he pulled out of it at the ER.

He had the battery of allergy tests then and they were inconclusive.  Couldn’t figure out if it was say shellfish or peppers or peanut butter.  And it hasn’t happened since.  But the health guidance conventional wisdom is we’re to keep Epipens around.  And the cash price of these things is $500 for a two pack.

http://nymag.com/thecut/2016/08/price-of-epipens-has-shot-up-by-400-percent.html

I saw that the other day and went…. No way, do I have a $1500 Epipen outlay on the agenda for September (need 3 two packs of em, so they say…)?  That would make daddy kind of pissed.

Well, you come to find that the way it works is you get a prescription, which the doc will write, and at that point it’s like everything else….  everything but the copay should be covered.  And then Mylan, maker of Epipens, has a coupon to pay for the out of pocket, and they distribute this coupon profligately just  so that everyone understands they are trying to screw the insurance company, not Joe and Jane Officeparkworker.

https://www.epipen.com/copay-offer/

So, no biggieFair to say if Mylan was trying to get $1500 a pop out of ‘people’, then ‘people’ would have lawmakers put a stop to it.  And at that point you’re not getting $1500 a pop for a sixpack of these things at all

Omar’s ‘discrepancy’

I’ve been watching this Ilhan Omar thing the last couple days, where Omar’s marriage is observed for an apparent ‘discrepancy’.

http://www.startribune.com/marriage-discrepancy-clouds-ilhan-omar-s-historic-primary-victory/390247381/

Interesting word choice… how can a marriage have a ‘discrepancy’?  Well in Omar’s case her marriage is ‘discrepant’ in its conformity to western assumptions of monogamy.  Bigamy was an implication, though it turns out she’s married to just one man… it’s just not the one she’s lived with steadily and had 3 children with in these last 12 or so years….

So this is a screwball situation…. with a pretty obvious explanation.  A reasonably worldly person knowing the superficial details and not choosing to be obtuse as a form of virtue can discern it, you just got to be willing to. Omar has been complicit in an immigration fraud gambit that used paperwork marriage.

Its all there, alight, like I say, obvious if one chooses not to be obtuse as a form of virtue.  And plenty in these parts are (say David Brauer on Twitter).  But there is a lefty reality discerner out there, a guy not being obtuse as a form of virtue.  That man is Lambo:

https://www.minnpost.com/politics-policy/2016/08/what-ilhan-omar-story-says-about-media-and-political-reporting-2016

I’m kinda shocked, I think cuz he managed to get past being able to call Powerline a bunch of racists to actually weigh the qualitative merits of the observations / question.  But then he does go on a journalism jag now and then.

Fing biceps tendon

I am so not into politics right now.  Funny that.

I’m throwing like a 19 year old again this year. With regular playing, can throw at full speed and decelerate without feeling like my arm is going to explode.

This is new .  I think most ballplayers shoulders go bad.  Mine went balky in 1997.  I quit playing for a couple years, then started again.  By I think it was end of 2003 I couldn’t throw, at all.  Couldn’t make the throw from 2nd to 1st.  I was whatever I was, 34 or 35.

Went in, had a mild arthroscopy…. They call it an acromioplasty.  Acromion is the end of a clavicle that will impinge your ‘rotator cuff’ in places.  Thing is, I suspect its ability to impinge heightens as you age and acquire thick adult guy muscles.  As well, Ortho doc discerned my ‘acromion’ was a type 3, which is a somewhat scarce genetic feature such that it was curvy and hooked.  And that it was cutting off my supraspinatus, big muscle band / tendon going into the rotator cuff from the arm.  This was a known phenomenon for people with the type 3 genetic acromion.

So, he relieved the bone there in his little Dremel arthroscopy operation.  And it worked, to a point.  Came back the next spring throwing, though it was not free and easy like when I was a kid / young man.  Always felt like I had to pull back so as to not tear my  …. bicep…. Which you don’t really throw with.

http://www.cleveland.com/tribe/index.ssf/2016/08/cleveland_indians_michael_bran_34.html

https://www.verywell.com/biceps-tendon-problems-2549799

Baseball fans and players get educated to various facets of orthopedics as time goes on and advancements are made.  Ya know, we know ‘labrums’ real well now as a function of sports medicine’s progress.  I don’t think we’ve had much notion of this biceps thing though, which seems somewhat simpler and I bet actually extraordinarily common.

But they do have a biceps tendon procedure now it appears.  I don’t need any work on mine.  I’ve thrown a lot this year, and an adhesion in there broke or it got the blood flow it needed and the biceps tendonitis I think I had since 1997 went away.  It’s the damndest thing.

Trump inciting his sad sack 2A fan boys to revolt. Or not.

In the broader pundisphere there’s some discussion of a class of white people that is getting let’s say culturally / economically ‘left behind’ (to mix metaphors).  And they support Trump, right, because he addresses their concerns in a way establishment politics does not, or it’s because he affirms what they feel about their loss of white privilege, yada yada, trope trope.

There are both lefty and righty flavored riffs on said analysis, and one thing they share is a qualitative observation that this class of white people is kind of… pathetic.  And that this is borne out by their income / age / work demographics intersecting with what is a curious epidemiological blip of rising morbidity among some white people (numerous references.  Among others:  Kevin Williamson at NRO, Lambo yesterday over at WWP)

I happen to agree or be sympathetic to all those notions, and even the assessment of patheticness.  Now, I haven’t observed it to be true first hand….  I got 3 Trumpsters with no self awareness for what they say in my 200+ FB feed.  One’s a woman cop, my age.  One is one of my wife’s cousins, who has done 6 figure well as a commercial roofing contractor, pretty affluent.  One’s a small business owner, has a personal services practice of sorts….  They’re not pathetic, not at all.  But ya know there is a sample size / assortatative problem with where I can look for evidence….  I run with a crowd of suburbanites who work…. How many of them are going to be pathetic and then make the house payment?   Anyway, I’m a Republican disgusted with the Trump nomination and the people who nominated him.  Those people must have a deficiency that explains what they did right.  Patheticness of sorts would explain it, and I can see the truth there though I don’t know anyone like that…

You get to this ‘2A people’ thing from Trump yesterday, I do want to speak to some things here with the truths and realities that I know.

First is, its crazy talk, and it ought to disqualify Trump from the ballot.  I wish it would.

As a matter of it being ‘scary’ and ‘inciting’ among the pathetic Trumpsters who are apparently to be understood as some sort of social powderkeg ready to go off….I think that’s wrong or lacks for a confluence of the right Venn bubbles.  Which is to say, there’s not a danger of incitement here.

You can’t really mobilize the pathetic for right wing revolution, right… they’re all broke 4 days after their monthly EFT from uncle sugar and waiting for the next one.  And then there’s a matter of decorum, we just don’t see right wing social protests in the streets like we do left wing ones.  Marxism is big on street revolution.  Whatever righty-ism is, it’s about law and order…..  And you can’t get a lumpen RW mob to the streets in the age of the welfare state.  The things / ingredients / catalysts you need never come together for a volatile dynamic there.

The ‘2A people’ and their ‘2A solution’ thing…. yeah, this is kind of a sub-culture touchstone among the gunnies.  But ya know, see above comment and think again how a populist, RW revolution actually comes about.  It does not come about, this is not a volatile, revolutionary group.  They work for a living.  Other thing, such that the gunnies say they reserve their right to revolt, the fantasy is one of defense rather than offense…. Say kind of Alamo last stand-ish, firing away as the hordes coming over the walls or the jack-booted thugs coming in the door.  Which is to say, it’s not an ‘offensive’ fantasy, it’s a defensive one.  And this is compatible with the notion of ‘Molon Labe’, as the gunnies like to say.  Which means ‘come and take it’.  I’m not a guy who cocks off about Molon Labe but that’s its context.  Defiance rather than say revolution and assassination.  In their apocalyptic, paranoid dreams / nightmares, yeah the gunnies think of themselves fighting off the government…. but it’s a defensive / defiant fantasy, not a revolutionary one.

Whatever.  Lambo over there at WWP says “It is also beyond obvious that this same, large, despairing group has a pathological relationship to guns, their precious Second Amendment rights being one of the very few means left to them to exert dominance in their lives. For all intents and purposes it is their primary religion.”

I don’t think that’s without some kind of truth in this age, but I don’t actually see the gunnie people as very substantial actors in the repugnant phenomena of Trumpism this year.  Seems like there are quite a few conductors more prominent than the gunnie people on the Trump train.

So, the suggestion / worry is Trump is going to motivate one / some of the gunnies to political violence.  It’s possible, of course it is… But I don’t think it’s likely, for reasons I’ve stated.  And what I think is likelier to happen before that is say a dozen more Islamic mass shootings within this country’s borders.  I am not trying to end this column with the dull thud of ham-fisted irony.  I’m just saying  whats reality is the gunny people are largely normal people whose lives preclude them from acts of fanaticism in contrast to other groups who actually do produce practicing fanatics.

Story lead for the reporters and reporterettes: Delta and the mail

I don’t think there’s any US mail currently outgoing from the Eagan distribution center because of this Delta computer grounded flight thing.  I got a package tracking there that’s getting way overdue to make its way to Seattle.

I had a gig interview with Delta maybe 3, 4 years ago.  I didn’t get the gig, and the feedback that came back was about my ‘attitude.’ This was constructive, just one more nudge that moved me down the path of peace / love / harmony in the last couple years.  But the other thing was, it was a COBOL project.  Ya know, green screens, 70’s / 80’s technology…. So my disdain was righteous.

They are still doing a lot of green screen stuff over there at Delta.

Truth discerner: “The 2A people”

Truth discerner answers the relevant questions.

Is Trump referring to mobilizing at the ballot box or shooting judges / politicians:  he’s talking about the 2nd amendment solution, ie, shooting the politicians, which is a fanciful discussion in the relevant sub-culture.

Is Trump “joking”: hard to know.  No one should be properly convinced of Trump’s grasp for topical knowledge, normative behavior, and its potential intersection with ‘humor’.

Should this be disqualifying: Sure, and this ought to be what his removal is hung on, such that if he runs, he loses, and if someone else runs, maybe this someone else does not lose.  WTF is going on w/ Republicanism man, it’s a bunch of mass psychosis I swear.  I blame Hannity in a lot of respects, seriously.

As an aside, I like this analysis of said incident:

http://www.slate.com/articles/news_and_politics/politics/2016/08/trump_s_joke_about_second_amendment_people_was_targeting_gun_owners_too.html