Following the flight to safety and sell off in the risk assets on Thursday and Friday of last week, markets today showed a return to stability with equity markets closing up in Asia and marginally down in Europe. Abu Dhabi and Dubai, whose markets opened today for the first time since the news of Dubai World’s warning on debt repayment, witnessed a record drop in their indices; falling 8.3% and 7.3% respectively. Fears that the delay in debt repayments by Dubai World may signal new strain of systemic risk have largely abated. The United Arab Emirates central bank’s announcement that it would stand behind domestic and foreign banks has reassured investors and has stemmed a potentially larger capital flight. Nevertheless, the news from Dubai is a sharp reminder that the financial crisis that began two years ago and almost destroyed the global economy a year ago is still with us. Pimco’s Mohamed El-Erian believes Dubai is a reminder that we still need to deal with the repercussions of massive credit expansion to unjustifiable projects earlier this decade.
Despite the emirate’s astonishing level of self-aggrandisement, Dubai’s debt is not enough to rock financial world. Of the $123bn of UAE foreign obligations, US banks account for $10.6bn, Japanese banks for $9bn and EU banks $40bn. The UK appears to be uniquely vulnerable to a potential Dubai default as British banks account for $50bn of the debt. The Foreign Exchange markets have reflected this, with Sterling being the only currency to fall against the USD at the start of the trading week. The US Dollar had strengthened significantly against all currencies, bar the CHF and JPY. The resumption of a weakness reflects a modest return to risk. However, the news from Dubai has had a broader impact on sentiment towards sovereign debt. Given the sharp increase in debt to GDP over the last two years, no end in sight for emergency monetary policy and, unlike Euro area countries such as Greece and Ireland, an ability to put off difficult political decisions by devaluation, Sterling may be the biggest loser from the Dubai debacle.
Dog Catcher’s thoughts: It is a bit strange that we are just now debating the war’s cost after 8 years of being in Afghanistan. Not only is it expensive but this is the highest year on record for casualties. Our troops are tired and it is also the highest year on record for military suicides.
The Bush Administration named its doctrine the Long War (DoD PowerPoint explaining the doctrine), and expectations were that we would be fighting it 10 years, 15 years or perhaps even indefinitely. Someone should have done a cost estimate. Someone should have leveled with the American people that the mission may never be accomplished, but that once you start a shooting war it isn’t over until someone loses or someone quits.
If I were a Democrat or America First kind of person: I would say no to delaying the health care debate. No to delaying the things that we never find time to discuss or get around to deciding on domestic issues. For the first time in 100 years we are actually close to having a health care vote in Congress. Theodore Roosevelt started the health care debate in 1909 and now in 2009 we want to delay due to national security costs? I would not trust Republicans to ever get around to revisiting the health care debate. Not some. Not at all. I would propose that we discuss national security costs instead.
If I were a Republican or national security before all else person: I would make the argument that America is essentially bankrupt and unfortunately we are not in a position to just walk away. And the status quo is not working either. So we need to get serious about pay-as-we-go; not only for the war but for everything. In Afghanistan we need to either totally change our game plan or step up our current game plan, which unfortunately will be expensive: about $1 million per every soldier we send to surge in Afghanistan.
As for Senator Bernie Sanders’ (I-VT) idea that we should get the rest of the world in on paying for the war: great idea but each of the nations in Afghanistan is already paying their own way. And European taxpayers are already paying for a “NATO” war that many of them find hard to understand. Won’t happen. But there is always the chance that we could make a case for it: the Pentagon reports that foreign countries paid for 97% of 1990’s Gulf War.
Hmmm? What would you do?
Fox News reports:
President Obama on Tuesday is expected to outline his plan to send around 30,000-35,000 more U.S. troops to Afghanistan over the next 12-18 months. The prime time speech comes as the Senate begins debate this week on expanding coverage of health insurance to 30 million Americans for six years at a cost of $848 billion.
The cost of the war surge is being estimated at $1 million per soldier for one year on the ground — or $30 billion to $35 billion additional dollars next year based on the president’s expected announcement.
Opponents of the war say America can’t afford that cost.
“What’s happening now is not only a $12 trillion national debt, we’re in the midst of the worst economic recession since the Great Depression of the 1930s. The middle class is collapsing. The gap between the rich and the poor is growing wider,” said Sen. Bernie Sanders, I-Vt. “So I’ve got a real problem about expanding this war where the rest of the world is sitting around and saying, ‘Isn’t it a nice thing that the taxpayers of the United States and the U.S. military are doing the work that the rest of the world should be doing?’”
BEIJING (Reuters) – Meng Ni and Fan Zhiqing said "I do" to each other in the same month that they said "we do" to their real estate agent.
China is in the midst of a golden age of weddings, a boon for businesses from photo studios to global platinum miners. Yet nowhere is the economic impact so potentially profound as in the housing market.
A flood of newlyweds such as Meng and Fan buying their first homes could help power China's property sales for years, even as some investors fear that prices are already in dangerous bubble territory.
"My husband and I preferred to have our own home rather than rent one as before, because marriage stands for a new start and we are building a family now," Meng said, sitting in their tidy, studio apartment.
Their story may seem perfectly normal, even universal, at first glance. What makes it more powerful is that Meng and Fan are part of a demographic bulge of people in their twenties who will be of prime marrying age between now and 2015.
As these newlyweds shell out for their first homes, the property market will enjoy a fount of solid demand. Analysts estimate such couples could mop up as much as 450 million square meters of housing every year, or roughly 16 percent of all that is under construction at present.
BABY-BOOMERS' BABIES
Looking west from Meng and Fan's window, clusters of new apartment buildings fill the skyline. To the east lies a flat, gray landscape of single-storey dwellings that is slowly being swallowed by high-rises.
"The apartments here are fairly small. They're a perfect fit for young couples," Meng said, estimating that three-quarters of her neighbors were around the age of 30.
These are the children of China's baby-boomers, a demographic ripple effect of the country's population surge in the 1950s and 1960s.
They would have been even more numerous had Beijing not launched its one-child policy in the late 1970s to cap family size, but they are still a bigger group than those immediately younger and older than them.
As it turns out, the controversial population controls have shaped their consumption habits. Showered with attention and gifts all their lives, this generation of only children keep their purse strings loose, unlike their parents.
"They have all grown up since 1980, during 30 years of fast-paced growth, so they don't feel the same need for precautionary savings as their parents," Xing Ziqiang, an economist with China International Capital Corp, said.
Nuptials give them a ready outlet for spending.
Not only are more people getting married, more of those getting married are choosing to have weddings — and lavish ones at that. The wedding industry is worth about 400 billion yuan a year, roughly a 2.5 percent contribution to gross domestic product, according to official estimates.
BIG BUSINESS
The Xidan Wedding Mall in the heart of Beijing offers three floors of dress makers, jeweler merchants and photo studios.
"A bride usually buys two gowns: a white one in the Western style, used for the procession and vows, and a traditional Chinese one in red for the banquet," said Ying Zi, a saleswoman at Modern Bazaar, a dress shop in the mall.
A few years ago, brides often rented their clothes. Ying said almost all of her customers were now buying the dresses, which cost at least 2,000 yuan ($293) each.
Diamonds are also hot. Chen Yin's family began crafting diamond rings at home for a niche market a decade ago. Now they run a shop, Bling Jewelry, selling hundreds a month.
"There are some people who originally bought small diamond rings, but are now looking to upgrade to bigger ones," she said.
And brides have taken to platinum jewelry, because the white metal matches their white gowns. Its place in Chinese weddings has helped double global demand for platinum this year despite a sharp fall in use by the hobbled auto industry, according to precious metals refiner Johnson Matthey.
The choice of white is, in itself, an indication of the social change sweeping over China, where white was traditionally the color of funerals.
Then there are the wedding photos, shot against elaborate, if fake, backgrounds: a couple in 1920s attire on a French boulevard or in cowboy gear with a rugged Wild West landscape behind them.
The wedding boom has not escaped the government's notice. The state-run China Association of Social Workers established the Wedding Industry Committee in 2003 to gather data and set standards.
The number of weddings, about 10 million in 2008, is increasing by 10 percent a year, while spending is rising 20 percent, according to Shi Kanning, the committee chief.
NO CRISIS
"The global financial crisis hit a lot of industries: exporters, banks, insurance. But not only was the wedding industry not affected, it has had even stronger growth over the past year," Shi said.
This resilience, he said, spilled over to the property market, with newlyweds buying homes when other business dried up. He pointed to surveys by the China Index Research Institute, which show that three-quarters of first-time home buyers are below the age of 35.
But a surge in housing sales — up 79 percent by value in the year to October — is clearly about more than just newlyweds.
The economy is awash in cash after banks issued an unprecedented flood of loans to help combat the financial crisis. With few investment channels in China, property is alluring.
"Property prices are largely dictated by investors," Zou Linhua, an economist at the Chinese Academy of Social Sciences. "Wedding-related home buying is only a part of the demand."
Yet it is an essential part, Xing of CICC argues, so much so that the demographic implications need closer analysis.
In smaller towns, for example, where men outnumber women by a wide margin, families try to help make their sons more attractive by promising larger homes to potential brides.
The government needs to give serious thought to how to cushion a potential fall-off in housing demand at the end of the wedding boom, sometime around 2015, Xing said.
FUELED BY PARENTS
In the meantime, it is frugal parents, not the young couple and not banks, who often foot much of the bill for new homes. Armed with a lifetime of savings and with just one child because of the government's population controls, parents are only too willing to lend a hand — and sometimes twice.
Wang Dajian and Niu Xiaoxia said they recently purchased a second Beijing apartment for their 29-year-old son and his wife after the first one they had bought failed to entice the young couple out of the parents' home.
The newlyweds found the first apartment "inconvenient" for their jobs, their parents said, because it required a 30-minute commute from their offices.
"They should be independent. They should be responsible for their own lives," lamented Niu, who noted that when she and Wang married they had to wait more than two years after marrying before their work unit arranged for a tiny one-room apartment.
"I want to push them out, to make them suffer a little like we had to," Wang said with a wave of determination that quickly melted.
"But the problem is, when we see him suffer, we feel bad. I don't blame them, because all this resulted from us. We are responsible because we spoiled them."
(Additional reporting by Ken Wills; Editing by Megan Goldin)
* You can listen to a segment of the Slavoj Žižek essay on contemporary apocalypticism that will appear in our upcoming issue of Polygraph here. (via Verso)
* The headline reads, Cigar-Shaped “Mothership” Plunges Argentinian Town Into A Blackout.
* 15 Toys Not to Buy Your Child This Christmas. Of course, science proves you shouldn’t buy anyone gifts at all. (Both links via Neil.)
* Is the public option now too watered-down to fight for? Matt Yglesias and Steve Benen join Josh Marshall in thinking this over. I feel exactly how I did on Monday: the point is to pass anything so it can be improved without a filibuster.
* North Carolina in the news! Kay Hagan is the Senate’s 17th wealthiest senator (via), while Blue Cross/Blue Shield of North Carolina has gotten itself in big trouble for improper issue advocacy against the public option.
* Other politics quick hits: HIV travel ban finally lifted. The national GOP has money problems. They’re talking about a war tax. Despite what you may hear in the press, Obama is pretty good at this whole international diplomacy thing. And Dubai is collapsing; couldn’t have happened to a nicer country.
* The New York Times “100 Notable Books of 2009″ list is already out.
* ‘Are Fake Academic Conferences the New Nigerian Prince Scam?’
* Little-used geek measurements.
Sheppey (distance)
I have to include Douglas Adams’ co-creation (with John Lloyd) here — It’s from The Meaning of Liff, their dictionary of things there aren’t any words for yet. All the words in the dictionary are British place names (the Isle of Sheppey is off the Kent coast). One sheppey is the closest distance at which sheep are still picturesque, and is about seven-eighths of a mile.
* Thor, a Marvel comics character I’m still pretty sure has to be an elaborate joke, will redefine what a superhero movie can be.
* Black Friday LEGO nostalgia.
* Ah, that explains it: that badly timed Dollhouse ARG turns out to be the work of overzealous fans.
“Nature rewards producers and punishes consumers.”
When I stated this sentence to a Christian gentleman, he immediately got the point. Even though we were coming from different perspectives, we were able to reach the same conclusion about humanity and economic development. He even stated that if one were to study the Old Testament teachings, one would conclude that the “job” concept as we know it was not meant for humanity.
When the children of Israel were in the desert, the Universe had to destroy the slave psychology of the people in order for them to be “right” to enter the Promised Land. It took 2 generations to eradicate the behavior. Once they became truly free, they had to enter and conquer the present inhabitants to establish themselves. Then, the Universe taught them skill sets that made them producers of their daily bread, milk and honey.
As we witness what Alan Greenspan calls “The Age of Turbulence“, we must prepare for the world to come. We must be prepared to produce for ourselves again. How should we interpret this “age of turbulence”? Is this our opportunity to cross the Red Sea while Pharaoh’s armies are drowned? Are we ready for “life without Pharaoh”?
Part of the reason why I’ve pushed for the aggressive pursuit of entrepreneurship (especially children) is to become masters of our own economic fate. The fatal concept of the “job psychology” reminds me of the child that refuses to evolve into adulthood. When the mother eagle begins kicking her eaglets out of the nest, she knows that they will have to learn to “do for self” or die in the wilderness. Animals use game theory to teach their children life lessons and skill sets that will serve them as adults in the wild. In the human world, we have violated those laws by conditioning ourselves and our children to look for some “sugar daddy” (corporation) to take care of them for 30-40 years and pay for our medical assistance in our “golden years” (which doesn’t even provide a lot of gold to make our elderly feel social or secure).
If you are working now, begin to treat it as an apprenticeship. You should NEVER look to stay on someone’s plantation for ALL your adult years. Most apprenticeships usually last 4-5 years. Once that learning experience is completed, the apprentice should be equipped with everything s/he needs to go and do for self and take on her own apprentice. That is how certain skill sets are kept within families and societies. If I’m a master woodworker, I should take on an apprentice or small group of students to teach them not only the woodworking craft, but the business side of woodworking as well. This is the natural order of creating “producers” as opposed to the modern “consumer conditioning” that is taught in the “American FOOL System“.
So, as we witness the economic changing of the guard on this planet, let us focus on enhancing our business and financial literacy. When we seek an education, let it be one that will teach us how to produce our own daily bread, milk and honey. Instead of trying to make the world play checkers, we should focus on learning chess and join the ranks of those business and financial grandmasters that create opportunities for others.
Let Nature reward your production as you bring products and services of value to the marketplace and let Nature continue to punish those who choose to consume like swine and offer little to nothing in return.
When I reached Jonathan Gruber on Thursday, he was working his way, page by laborious page, through the mammoth health care bill Senate Majority Leader Harry Reid had unveiled just a few hours earlier. Gruber is a leading health economist at the Massachusetts Institute of Technology who is consulted by politicians in both parties. He was one of almost two dozen top economists who sent President Obama a letter earlier this month insisting that reform won’t succeed unless it “bends the curve” in the long-term growth of health care costs. And, on that front, Gruber likes what he sees in the Reid proposal. Actually he likes it a lot.
“I’m sort of a known skeptic on this stuff,” Gruber told me. “My summary is it’s really hard to figure out how to bend the cost curve, but I can’t think of a thing to try that they didn’t try. They really make the best effort anyone has ever made. Everything is in here….I can’t think of anything I’d do that they are not doing in the bill. You couldn’t have done better than they are doing.”
Gruber may be especially effusive. But the Senate blueprint, which faces its first votes tonight, also is winning praise from other leading health reformers like Mark McClellan, the former director of the Center for Medicare and Medicaid Services under George W. Bush and Len Nichols, health policy director at the centrist New America Foundation. “The bottom line,” Nichols says, “is the legislation is sending a signal that business as usual [in the medical system] is going to end.”
Both the Senate bill’s priority on controlling long-term health care costs, and its strategy for doing so, represents a validation for Senate Finance Committee chairman Max Baucus (D-MT). When Baucus released his health reform proposal last September, after finally terminating months of fruitless negotiations with committee Republicans, Democratic liberals excoriated his plan as a dead end. And on several important fronts–such as subsidies for the uninsured, the role of a public competitor to private insurance companies, and the contribution required from employers who don’t insure their workers–Reid moved his product away from Baucus toward approaches preferred by liberals.
But the Reid bill’s fiscal strategy, and its vision of how to “bend the curve,” almost completely follows Baucus’ path from September. Baucus’ bill was the first to establish the principle that Congress could expand coverage while reducing the federal deficit; now that’s the standard not only for the Senate but also the House reform legislation. And, perhaps even more importantly, the Reid bill maintains virtually all of Baucus ideas’ for shifting the medical payment system away from today’s fee-for-service model toward an approach that more closely links compensation for providers to results for patients. In the Reid bill, there is some backtracking from Baucus’ most aggressive reform proposals, but not much.
Almost everything Baucus proposed to control long-term costs have survived into the final bill. And, with only a few exceptions, that’s just about all the systemic reforms analysts from the center to the left have identified as the most promising strategies for changing the economic incentives in the medical system. (The public competitor to private insurance companies championed by the Left would affect who writes the checks in the medical system, but not what the checks are written to pay for.) Most of the other big ideas for controlling costs (such as medical malpractice reform) tend to draw support primarily among Republicans. And since virtually, if not literally, none of them plan to support the final health care bill under any circumstances, the package isn’t likely to reflect much of their thinking.
In their November 17 letter to Obama, the group of economists led by Dr. Alan Garber of Stanford University, identified four pillars of fiscally-responsible health care reform. They maintained that the bill needed to include a tax on high-end “Cadillac” insurance plans; to pursue “aggressive” tests of payment reforms that will “provide incentives for physicians and hospitals to focus on quality” and provide “care that is better coordinated”; and establish an independent Medicare commission that can continuously develop and implement “new efforts to improve quality and contain costs.” Finally, they said the Congressional Budget Office “must project the bill to be at least deficit neutral over the 10-year budget window and deficit reducing thereafter.”
As OMB Director Peter Orszag noted in an interview, the Reid bill met all those tests. The CBO projected that the bill would reduce the federal deficit by $130 billion over its first decade and by as much as $650 billion in its second. (Conservatives, of course, consider those projections unrealistic, but CBO is the only umpire in the game, and Republicans have been happy to trumpet its analyses critical of the Democratic plans.) “Let’s use the metric of that letter,” said Orszag, who helped shape the health reform debate for years from his earlier posts at CBO and the Brookings Institution. “Deficit neutral; got that. Deficit-reducing second decade, got that. Excise tax: That was retained. Third is the Medicare commission: has that. Fourth is delivery system reforms, bundling payments, hospital acquired infections, readmission rates. It has that. If you go down the checklist of what they said was necessary for a fiscally responsible bill that will move us towards the health care system of the future, this passes the bar.”
McClellan, the former Bush official and current director of the Engleberg Center for Health Care Reform at the Brookings Institution, was one of the economists who signed the November letter. McClellan has some very practical ideas for improving the Reid bill (more on those below), but generally he echoes Orszag’s assessment of it. “It has got all four of those elements in it,” McClellan said in an interview. “They kept a lot of the key elements of the Finance bill that I like. It would be good if more could be done, but this is the right direction to go.”
Reid gave ground on one Baucus proposal that the economists identified as a priority-taxing high-end insurance plans. Like many health reformers, the economists who wrote Obama argue that such a tax “will help curtail the growth of private health insurance premiums by creating incentives to limit the costs of plans to a tax-free amount.” Amid intense opposition from unions, Reid raised the thresholds at which family plans would face that excise tax from $21,000 to $23,000. But given all the pressure from labor, the more striking thing may have been that Reid didn’t increase the thresholds even more; the CBO calculated the proposal, which the House excluded from its bill, would still raise $35 billion annually by 2019. “They held pretty strong,” said one administration health care expert. “It’s not like unions haven’t been making the case that it shouldn’t have been a much higher number.”
On delivery reform, Reid stayed even closer to the Baucus blueprint. The Finance bill laid out a series of measures to change the way providers are paid for delivering care to Medicare recipients; the hope was that once Medicare instituted these reforms, private insurers would also adopt many of them. “The goal here is that the things we do in Medicare will translate over into the private sector, and there is quite a bit of historical precedence for that,” said one Democratic aide involved in drafting the package.
The Baucus delivery reform ideas revolved around two central aims. One was to reward Medicare providers who deliver care more efficiently and penalize those that don’t. The Reid bill upholds the major proposals Baucus offered to advance that goal. For instance, hospitals under current law must report on their performance in treating patients for common conditions like heart problems and pneumonia; under the bill, their Medicare payments, for the first time, would be affected by their ranking on those reports. Hospitals would also be penalized if they readmit too many patients after surgery or allow too many to acquire infections while in the hospital itself. Another provision would begin the process of applying such “value-based purchasing” toward other providers like hospice providers and inpatient rehabilitation facilities.
With physicians, the Reid plan takes a step back from the Finance Committee bill but still a long step beyond current law. The Finance Bill proposed automatic reimbursement reductions for doctors who order up the most care for Medicare recipients with similar medical and demographic characteristics. That was meant to respond to the research showing big disparities in spending on medical services for similarly-situated patients in different communities. But, Democratic sources say, that proposal ran into charges that it would promote rationing-and even function as “a death panel by proxy”-by compelling doctors to arbitrarily reduce care. So the final bill takes a less direct route toward a similar end. It requires Medicare to begin studying the utilization patterns of doctors participating in the program. And then it establishes a “values based payment modifier” that would, in a budget-neutral manner, increase reimbursements for physicians found to deliver high-quality care at lower cost, and reduce them for physicians at the other end of that spectrum. “It will, we believe, have the same net effect [as the original proposal],” said the Democratic aide. “It should change behavior around that threshold.”
The other set of Baucus proposals were intended to promote more coordination among providers. These have survived almost verbatim into the final bill. The bill encourages groups of providers to establish doctor-led “accountable care organizations” to more comprehensively manage patients’ care by allowing them to share in any savings for Medicare they produce. It also establishes a voluntary national pilot of “bundled” payments that would encourage hospitals, doctors and other providers to work more closely together. Another pilot program would test coordinated home-based care for chronically ill seniors.
Finally, the Reid bill maintains the two powerful institutions the Finance legislation proposed to promote these reforms and develop new ones. The one that’s attracted the most attention is an independent “Medicare Advisory Board.” Under the Senate bill, that board would be required to offer cost-saving proposals when Medicare spending rises too fast; Congress could not reject its proposals without substituting equivalent savings. Since the board would be prohibited from offering changes that raise taxes or “ration care,” and since the legislation initially exempts hospitals from its recommendations, it could choose to promote the sort of payment reforms the bill establishes. (More prosaically it might also clear away some of the expensive coverage mandates that Congress imposes on Medicare under pressure from different elements of the medical industry). Given the limitations imposed on the commission, an equally important means to expand these reforms might be a second institution the legislation creates: a Center for Medicare and Medicaid Innovation in the Health and Human Services Department. Though this center has received much less attention than the Medicare Commission, it could have a comparable effect. It would receive $1 billion annually to test payment reforms; in a little known provision, the bill authorizes the HHS Secretary to implement nationwide, without any congressional action, any reform that department actuaries certify will reduce long-term spending. While the House bill omitted the Medicare Commission (a top priority for Obama) it included the innovation center.
No one can say for certain that these initiatives will improve efficiency enough to slow the growth in health care spending. Some are only pilots; others would affect only a small portion of providers’ revenue from Medicare. CBO typically evaluates them skeptically: it generally scores little or no savings from most of them. Former CBO director Robert Reischauer, who signed the November 17 letter, says that’s not surprising. “CBO is there to score savings for which we have a high degree of confidence that they will materialize,” says Reischauer, now president of the Urban Institute. “There are many promising approaches [in these reform ideas] but you…can’t deposit them in the bank.” In the long run, Reischauer says, it’s likely “that maybe half of them, or a third of them, will prove to be successful. But that would be very important.”
While generally supportive of Reid’s approach, McClellan, the former Medicare administrator under Bush, offered several specific ideas for strengthening it. He says the Senate should improve the capacity of HHS to more quickly evaluate whether the payment reforms are working, and also to provide data and technical assistance to new physician groups like the accountable care organizations that will be attempting to better coordinate care. “Ideally you’d both be able to tell the organizations involved and Congress what is working or not, and give the organizations the feedback and data they need to know whether they are doing a good job,” he says. McClellan also believes that the plan needs sharper sticks-tougher penalties on providers who don’t provide efficient and effective care. “There are a lot of carrots and not so many sticks,” he maintains. Of course, tougher penalties might provoke more opposition from provider groups like hospitals and physicians now tenuously supporting the legislation.
[[McClellan stands at the forefront of centrist Republican thinking on health. Even the more ideologically conservative health care thinkers to his right generally don’t oppose long-term reform ideas like bundling payments (John McCain promoted that during his presidential campaign). But they tend to view them as insufficient or tangential to the real problem. Their view highlights a fundamental difference between the parties’ on health care. To save costs, Democrats mostly want to change the incentives for providers. Republicans mostly want to change the incentives for patients by shifting toward a model where insurance covers only catastrophic expenses and people pay for more routine care from tax-favored health savings accounts. In essence, the Republican view is that the best way to hold down long-term costs is to directly expose patients to more of them. Few Democrats accept that logic though and it has little influence on either chamber’s legislation.
Another Republican cost-containment priority missing from the bill is meaningful medical malpractice reform. (The bill only encourages states to think about it.) Nichols, of the centrist New America Foundation, would like to see that included as well. Its omission is one reason he says he gives the plan a “b” rather than an “a”; the other is he’d like to see mechanisms to more quickly diffuse into the private insurance system reforms that show promise in Medicare. Democratic sources say a group of centrist Democrats led by Virginia Senator Mark Warner is trying to devise a package designed to do just that, perhaps by expanding the role of the independent Medicare advisory commission.
The attempt in all these ideas to nudge the medical system away from fee-for-service medicine toward an approach that ties compensation more closely to results captures how much the health care debate has shifted toward cost-control. So far, the rise in health care spending has proven almost invulnerable to every previous attempt to tame it, like the managed care revolution in the 1990s. Even if Obama signs into law a final bill embodying all these reform proposals, many skeptics wonder if they can bend, much less break, the seemingly inexorable increase in health care spending. Reischauer understands that skepticism, but isn’t able to entirely suppress a kernel of optimism that this latest reform agenda may prove more effective than its predecessors. “One never knows whether we’re turning the corner or if this is just playing the same old game for another inning,” he says. “But I sense there’s something different out there. I think the medical profession and its leaders have read the handwriting on the wall and are trying to evolve.” If so, the ideas the Senate will begin voting on tonight could mark a milestone in that journey.
While you are enjoying your Thanksgiving, do take the time to act upon this.
Daniel Simmons writes:
Great work with Watts Up With That (RWL Note: WUWT is where I first found this – here) on the CRU email scandal. Hopefully this scandal will lead to increased openness in climate science.
With all of the noise about those emails I wanted to bring your attention to an EPA comment period that closes this Friday. As you previously covered on Watts Up With That, EPA is working on declaring that CO2 and GHGs greenhouse gases endanger human health and welfare under the Clean Air Act.
That endangerment finding is the first step to regulating GHGs and the second is to develop the actual regulations to regulate GHGs for cars and light trucks. On Friday, the comment period for EPA’s proposed regulations on cars and light trucks closes. It would be very helpful to push back on the proposed endangerment finding by pushing back on the proposed regulations on cars and light trucks and sending EPA as many comments as possible on the proposed GHG regulations for cars.
We want to make sure as many people as possible know about this proposed rule and generate as many comments as possible. To facilitate people sending comments to EPA on the proposed rule, we put up a page that contains a model comment to send to EPA. The model comment is completely modifiable (RWL Note: I myself sent a heavily modified version – see below).
Also, here is EPA’s Proposed Rule: and a direct link to the Docket to submit comments to EPA is here:
People can also send email on this rule directly to EPA at a-and-r-Docket@epa.gov.
It would be very helpful if you would let your readers know about this comment period. Because of Thanksgiving and the cap-and-trade bills, this proposed rule hasn’t gotten very much attention and yet it relies on the same science as EPA’s other regulations and will help trigger a regulatory cascade of EPA inserting itself into many areas of life because those activities emit GHGs.
Here’s more background: To address climate change (and relying on the standards sources of climate science–the IPCC, NCDC, GISS, etc.) EPA is proposing to use the Clean Air Act to require 35 mpg fleetwide fuel economy standards by 2016—four years faster than Congress’ plan in the Energy Independence and Security Act of 2007. Not only will this rule drive up car and truck prices and limit consumer choice, it will start a regulatory cascade with EPA regulating GHGs using a number of sections of the Clean Air Act.
But EPA’s data show that the rule is all cost and no benefit. According to EPA, the proposed rule will increase car and truck prices an average $1,100. (74 Fed. Reg. 49460) As a result of less CO2 in the air, the rule will lead to decrease in global mean temperature by 16 thousandths of a degree Celsius (0.016°C) in 2100 and a decrease in mean sea level rise by 1.5 mm. (74 Fed. Reg. 49589) That’s not a joke—that’s what the rule says. Obviously 16 thousandths of a degree Celsius, 90 years down the road will not affect the climate in any way.
It would be bad enough if the rule only imposed exorbitant costs and with no benefits. But this will start the regulatory cascade that many of us have written about. To finalize this rule, EPA would also finalize their “endangerment finding” (in other words, EPA would find that GHGs from motor vehicles harm public health and welfare). CO2 and GHGs will become subject to National Ambient Air Quality Standards, New Sour Performance Standards, Hazardous Air Quality Standards, among other regulatory schemes.
If EPA makes an endangerment finding for GHGs, that action would make two permitting programs apply to GHGs—prevention of significant deterioration (PSD) and Title V. PSD applies to stationary sources which emit more than 250 tons a year and Title V applies to stationary sources which emit 250 tons per year. According to EPA, this would force as many as 6 million buildings (school, churches, hospitals, office buildings, farms, etc.) to comply with the Clean Air Act’s permitting provisions. To try to address this problem, EPA has proposed a “tailoring rule.” The point of the tailoring rule is that 250 tons per year of emissions can be read to mean 25,000 tons per year. Again, that’s not a joke.
I know, I know, we’re two days out, and Thanksgiving is one of those days, but it took me less than five minutes to hit the IFE’s page and put together my “model” – which, for anyone who wants it, is as follows:
Attn: Docket ID No. EPA-HQ-OAR-2009-0472
RE: Proposed Rulemaking to Establish Light-Duty Vehicle Greenhouse Gas Emission Standards and Corporate Average Fuel Economy Standards
The Environmental Protection Agency (EPA) is not justified in regulating carbon dioxide emissions from vehicles. Not only will these regulations will only increase the cost of our cars, harm our economy, and limit our transportation options, but they are also based on a scientific theory (man-made global warming) that has come into serious question with the release of the East Anglia University files. We need efficient, affordable transportation to rebuild our economy and create American jobs, not regulations derived from questionable theories.
According to the proposed regulations, EPA wants to regulate carbon dioxide emissions from cars and trucks, “because of the critical need to address global climate change.” (74 Fed. Reg. 49454).This regulation does not achieve EPA’s stated goal because, according to EPA data, it does not reduce global warming or sea level rise in a meaningful way. The regulation states that the carbon dioxide reductions “are projected to reduce global mean temperature by approximately 0.007–0.016°C by 2100, and global mean sea level rise is projected to be reduced by approximately 0.06–0.15 cm by 2100.”
To be clear, EPA is proposing to increase the price of automobiles by $1,100 per car (74 Fed. Reg. 49460) in exchange for (according to EPA) a global temperature decrease of 16 thousandths of a degree Celsius in 90 years. Also, according to EPA, sea level won’t rise by an extra 1.5 millimeters. These tiny amounts are so inconsequential that they will not affect global climate at all nor will they affect “public health and welfare” (See Clean Air Act Sec. 202).
The proposed regulations will, however, have dramatic and harmful consequences for our economy. To make matters worse, these regulations would start a regulatory cascade. EPA would start regulating emissions from millions of sources, including large buildings, churches, sports arenas, office buildings, farms, schools, hospitals, etc. EPA will be empowered to regulate greenhouse gases with many sections of the Clean Air Act, including sections 108, 111, and 112. This will further harm our economy, reduce American jobs, and worsen unemployment.
EPA should not regulate carbon dioxide or greenhouse gas emissions under the Clean Air Act. These regulations will make our high unemployment even worse. It does not make sense for EPA to reduce American jobs, increase the price of cars and trucks, and make America less economically competitive in exchange for an immeasurable and meaningless reduction in global temperature. These costs far outweigh a minimal reduction in carbon dioxide for a scientific hypothesis that remains unproven and has relied on extraordinary deviations from the scientific method in order to avoid scrutiny.
See? That’s not so hard, is it?
So please, go to the IFE or the EPA, and make your voice heard.
Hello Friends here we come up with the Latest Agri Commodities updates from various parts of the country.
'Futures trading in rice, sugar and pulses should be banned'
‘Futures trading in rice, sugar and pulses should be banned’:
A parliamentary panel today suggested that futures trading should be banned in case of wheat, rice, sugar and some pulses till the country becomes self sufficient in these food items.
The Estimates Committee asked the government to bring a new legislation to control the retail prices of essential commodities like rice,wheat, pulses, edible oils, sugar, milk and vegetables.
On futures trading, the report said: “Since food security of the country is at the stake, the Committee recommends that futures trading in wheat, rice, tur dal, urad dal and sugar should be banned till the country achieves self-sufficiency in the production of these items on a continuous basis”.
In Other major Commodities Updates we can see exports of Spice declining and on the other hand price of pulses rising up 80% in a year time.
Spice exports decline 1.3% in April-October:
Exports of spices fell 1.3 per cent in volume and 1.6 per cent in value during the April-October period of the current financial year.
According to the latest estimates of Spices Board, total exports in the period were 280,885 tonnes valued at Rs 3,031.59 crore against 284,560 tonnes valued at 3,080.25 crore in the same period last year.
Pepper exports suffered a serious setback as the figures dropped to 11,500 tonnes valued at Rs 179.16 crore as against 14,750 tonnes valued at Rs 246. 70 crore in the same period last year.
Export of chilli also declined to 100,500 tonnes valued at Rs 706.50 crore as against 121,500 tonnes valued at Rs 660.17 crore.
Coriander exports had a better performance at 25,250 tonnes valued at Rs 128.12 crore against 17,100 tonnes valued at Rs 116.80 crore.
Pulse prices rise up to 80 per cent in one year:
The government today said prices of pulses have surged by up to 80 per cent in the national capital over the last one year.
While prices of tur have gone up by 80 per cent in the last one year to Rs 90 a kg, that of moong dal surged 74 per cent to Rs 82, according to the data presented by Food and Agriculture Minister Sharad Pawar in a written reply to the Lok Sabha.
Even import of about 16 lakh tonnes of pulses between April and October has not eased pressure on the prices, the data showed.
Not just pulses, prices of sugar have almost doubled to Rs 38 a kg.
Note : For More Latest Industry, Stock Market and Economy News and Updates, please Click Here
A though occurred to me while I was shopping at Whole Foods with The Girlfriend: in the vegetarian utopia where humans finally give up eating meat altogether, what will happen to the species we’ve domesticated? Presumably some of them, like the genetically-modified pigs that are specially engineered to live in a single stall and be fattened up, will just die out. But what about the more durable ones? Are we picturing cows just wandering around, eating grass? And presumably even though we’re not killing them to eat them, they’ll still die — what would be done with the meat? Would it just be left to rot?
I’m sure that some thought has been given to these questions, specifically by people with some proximity to this blog. (I hope those people will read this post as a genuine question instead of me swooping into their territory making completely uninformed claims to have found a massive blind spot in their thought, etc.)
“The [email] correspondence between dozens of climate-change researchers, including many in the U.S., illustrates bitter feelings among those who believe human activities cause global warming toward rivals who argue that the link between humans and climate change remains uncertain. Some emails also refer to efforts by scientists who believe man is causing global warming to exclude contrary views from important scientific publications.” Read the full article below. Also available for download are the emails and documents in question.
Climate Emails Stroke Debate | Wall Street Journal | November 23, 2009
(Economic concepts and application on public health economics, pattern of health services by using economic plan. The relationship between public health service and national economic development plan.)
The Oak Ridge Institute for Science and Education (ORISE) is soliciting applications for the Summer Undergraduate Research Experience (SURE). The research opportunity is part of the Department of Energy’s Global Change Education Program. Opportunities are available in Atmospheric Science and Biometeorology, Earth Systems Modeling, Atmospheric Boundary Layer Modeling, Atmospheric Radiation Measurement, Atmospheric Science, Terrestrial Carbon Studies and Ecosystem Research, and Social, Behavioral, and Economic Sciences.
The approximately ten-week SURE program generally begins in early June through mid-August. Fellows attend a one-week orientation and focus session that includes a series of lectures to provide a detailed overview of all research areas within the BER global change mission. Fellows also receive more focused information on the specific areas in which they expect to conduct research. Following the orientation and focus sessions, SURE fellows travel to their nine-week research assignments at national laboratories or universities (or other participating DOE funded contractors) to conduct BER-supported global change research. Each Fellow has a mentor who directs and monitors his/her summer research experience.
The deadline for the submission of applications is December 31, 2009; transcripts and Letters of Reference will be accepted via U.S. Mail, email or fax through 11 January 2010
BENEFITS: $475 weekly, plus travel. Fellows are responsible for their housing arrangements and costs, food and transportation while at their research facility.
First, from Walter Williams, A Minority View: Excused Horrors.
Nazis were responsible for the deaths of 20 million of their own people and those in nations they conquered. Between 1917 and 1983, Stalin and his successors murdered, or were otherwise responsible for the deaths of, 62 million of their own people. Between 1949 and 1987, Mao Tsetung and his successors were responsible for the deaths of 76 million Chinese.
For decades after World War II, people have hunted down and sought punishment for Nazi murderers. How much hunting down and seeking punishment for Stalinist and Maoist murderers?
…the reason why the world’s leftists give the world’s most horrible murderers a pass is because they sympathize with their socioeconomic goals, which include government ownership and/or control over the means of production. In the U.S., the call is for government control, through regulations, as opposed to ownership. Unfortunately, it matters little whether there is a Democratically or Republican-controlled Congress and White House; the march toward greater government control continues. It just happens at a quicker pace with Democrats in charge.
In Worse Than Taxes, John Stossel makes the point that while taxes are bad enough, what’s worse – and gets little attention – is government spending.
[California and New York] would have big surpluses had they just grown their governments in pace with inflation. But of course they didn’t. Now the politicians act like their current deficits are something imposed on them by the recession.
Had the government of New York state grown at the rate of population and inflation over the past 10 years, it would have a $14 billion surplus today. Instead, spending grew at twice the rate of inflation (http://tinyurl.com/yguvfpm). So New York has a $3 billion deficit.
Stossel quotes Walter Williams:
It reminds me of Walter Williams’ riff: “Politicians are worse than thieves. At least when thieves take your money, they don’t expect you to thank them for it.”
And Milton Friedman:
The true burden of government, the late Milton Friedman said, is the spending level. Taxation is just one way government gets money. The other ways — borrowing and inflation — are equally burdens on the people. (State governments can’t inflate, but they sure can borrow.)
I’m terrible, I’m sorry. I don’t really have any good excuse!! And the thing is, I actually kind of do have stuff to talk about!
Well #1 is: last week I was at this surprisingly great workshop at the Bahamas National Trust, entitled “Understanding and Using Economic Tools in Protected Area Research and Management”. It was given by 3 people from the Conservation Strategy Fund, which, as I understand it, is a non-profit organisation which uses economics to help developing countries.
Anyway, I learned an absolute ton! It was like a refresher of the Environmental Economics class I took in college (twice, cuz I failed the first time, lol). And I also made some great contacts! One of the lecturers is at Duke University in North Carolina, and he encouraged me to check out the Nicholas School at Duke for my Masters, and even said he would write me a recommendation! So, I’ve been research Duke the last couple days, and it really looks like a great programme! Master of Environmental Management (MEM). There’s even a joint MEM/JD in Environmental Law programme (that takes 4 years, butttttt), so I’m considered that as well! Gaahhhh! So much to do!
First thing I’d have to do is study for & sit the GRE! Soooo, today I ordered my GRE study books online, and hopefully I’ll have that by next week or so…anddddd the application deadline is Feb 1st, so that means I’ll have to sit the exam sometime in January. Gahhh!!
Consumer prices were up 0.3% for October despite the fact that hundreds of thousands of jobs are lost each week under Obama’s economic policies. Is this the start of the inflation that many including Warren Buffet have predicted will come as the result of the massive spending, debt and debasement of the US$ that are the cornerstones of Obama’s economic policies? Does Obama friend and campaign supporter, anti-American and socialist George Sorros know something?
Housing building permits fell 4% and construction dropped more than 10% in October.
What great indicators that the socialist policies of Barack Obama are working so well for individual Americans.
Our wise guy and absolutely marvelous U.S. Treasury Secretary Timmy The G. told us this morning the economy needs more time to rebound. No Kidding. The last time we went through this mess it lasted from 1929 to 1954 for the stock market recovery. This time it’s infinitely worse times ten. We might all die of old age before the next recovery in mainstream shares. The stocks today (excluding precious metals and a few others) are just where they were in the year 2000. Consequently those holding from there to here had a wonderful exercise in brain damage and futility. So much for buy and hold forever.
Key Points To Ponder On Our Conclusions.
Bond markets are overbought.
Junk bonds and municipal bonds are going very scary.
Japan’s bond pile is so enormous it simply cannot go on much longer.
Since U.S. bond markets are 70 times larger than the shares, when this baby pops it could be financial Armageddon.
Equities have gained nothing for a decade. They gave it all back.
Gold has tripled in less than ten years and is rising even faster.
Consumer confidence is at new lows.
Real estate foreclosures were reported up 18% this morning. It’s getting worse.
Billionaire Wilbur Ross posted an extreme warning on commercial real estate. We said the same thing many months ago. Insurance companies holding this paper are going down, too.
Moody’s is going to report stuff ever faster; each month instead of intermittently. They do not intend to take more extreme criticisms on all of these bank and corporate failures.
The stimulus in the U.S. has stopped having any effects. Now the political manipulation idiots want another one. More paper printing and dilution with inflation and hyper-inflation results.
One of the last remaining sources of investment bank income, trading, is being capped by a federal dolt restricting pay. The good traders are going overseas. Adios bank income. All they need is Glass-Stegal and reasonable SEC enforcement. They won’t do it.
China has five big bubbles in progress. Watch for them to pop individually or collectively-credit, shares, housing, banks and real estate.
Financial stocks are headed south again after the bear market dead cat bounce and free taxpayer cash.
Bank credit is as scarce as hen’s teeth. These guys are working the spread on free government cash and not lending. New loans are pure fiction.
Borrowers qualified to borrow are cutting back credit lines and hunkering down with cash. Smart ones are shunning debt for liquidity. They know what’s coming.
GE is having a fire sale to off-load as many divisions and assets as possible to raise cash. Being a big bank (not in name but as GE Capital) they are in deep you know what. We think they could potentially fail and we give it one out of three. That would really dump ALL the markets.
CIT, the premier lender for medium and small businesses went bankrupt. Yes, they will reorganize but with what tiny previous percentage of loans being originated? Small business is credit dry as CIT funded receivables.
Dollars are oversold and will bounce a little. For the longer pull they get cut in half again.
The Canadian Dollar is rising on commodities and a government with a much better balance sheet. For the shorter term it could correct mildly but then should rise in value beyond the US dollar. Canada is best situated to weather the storm in our view.
The Swiss Franc is another fiat currency. However, it is sounder than the others and is still perceived as being a “safe and secure currency”…a place to park some cash for a rainy day.
The Euro is overbought and should be selling back to some place lower. Recently it’s been an inverse dollar trade in rallies.
Barter has begun in earnest with crude oil. Producers are finally skipping the interim paper cash or bond route as currency. China can buy oil with trade goods and so can others. Look for barter to spread rapidly.
In summary
Since USA consumers are 70% of the American economy and this economy is the world’s fiscal driver with our failing dollar covering 80% of the world’s reserves; think about this nasty combo.
U.S. consumers are saving not spending.
Consumers are unemployed to the tune of 20% in USA. It’s going to 30-35%.
Since credit is terribly expensive (29.99% on credit cards) and not available for the most part, the American economy is stalled and frozen.
Stocks are flat to down and have earned nothing for a decade.
Where is the engine of growth? Who has credit? Who has money to spend?
U.S. Dollars are sliding in value as shares are peaking and selling-off.
We are toast and the worse hits in 2010-2012; then comes World War III.
U.S. Dollar index supports at 75.00. After a return to 78.50 selling resumes.
We are expecting a mild markets’ move on technical signals at this date. Could it become more extreme? Yes, it could but it increasingly appears we get a mild correction followed by a new shares rally in precious metals and mainstream shares. We would be PM shares buyers on our technical confirmation.
Financials crashed in fall, 2008 with Lehman. Recovery began with TARP in May, 2009: During November, 2009, we’re ending a dead cat bounce with mild toppy selling this month. Precious metals and their shares are still peaking on this November 11, 2009; for the shorter term. This week most trends are in reverse and then later move to rallies. Between now and then some selling and corrections should appear. We are at a turning point in most markets with lots of choppy, sideways trading.
Keep in mind, if you own paid for stuff it will most likely remain in your hands; not in somebody else’s. That includes gold and silver. Do not get tangled-up in daily noise. Keep studying the larger view and buy precious metals after each profit-taking correction. Headwinds are building into an economic hurricane. Take care of business right now.
My dire prediction might surprise us and arrive at any time. Selling is mild now. But next summer could be the large crash. In the coming middle, look for more buying on most everything. Our personal trading year to date is up nearly 100%. Markets are giving.
Personally, I can see unbelievable opportunities to trade that we would never see again for many years. Turn these problems into opportunities. Those on the right side of the trade might get rich. Those on the other side are just victims. Stay Alert
….trying to figure out why the stuff “they” taught or tell us and what happens doesn’t correspond.
I am not a young person, and I have the same problem.
Fantasy
I believed what seemingly authoritative, intelligent and educated people used to say. Do this and you will achieve that. The ever present carrot in front of the ass, and in this scenario, I am the ass and I keep going for the carrot in an endless scene.
Still Believable?
No more.
I have learned enough in my life to trust my own instincts, and if it no longer sounds “right”, I won’t even consider it.
There is too much garbage fed to the people for it pays to keep the masses ignorant. They are more easily directed this way.
SEBI’s has planned to remove the cap price for the follow-on public offerings and this idea seems to be impressing market players.
SEBI has said that it would introduce “pure auction as an additional book building mechanism for institutional investors for follow-on public offerings (FPOs).”
Analysts and market men feel that this is going to generate loads of excitement and fun for market players, as those investors who are convinced about a particular issue will invest at a higher price to seek allotment and those not-so-convinced can invest at a lower price.
Merchant bankers said it will be interesting to see how this will work as there are a few PSU FPOs likely to hit the market soon.
PSUs likely to come out with FPOs include NMDC, MMTC, Neyveli Lignite Corporation, Rashtriya Chemicals and Fertilizers, National Fertilizers, Coal India and Engineers India
As of now, the IPO price is determined through a price band (which has a lower and upper level).
An auction or floor price is the minimum price at which bids can be made for an IPO.
Meanwhile, merchant bankers welcomed SEBI’s announcement on Monday that exchanges could have a separate platform for Small and Medium Enterprises (SME).
As the primary market size grows, the smaller companies are getting lost amid the big ticket IPOs.
Having such exclusive guidelines for SMEs is definitely a good idea, said merchant bankers.
SME platform SEBI on the lines of the AIM on the London Stock Exchange will be better.
Those SMEs with a paid-up capital of between Rs 10 crore and Rs 25 crore have an option of either being on the SME exchange or the main bourses.
According to the new guidelines, SMEs should have a maximum paid up capital of Rs 25 crore for listing.
For an investor the minimum application size in an SME IPO will now be Rs 1 lakh.
Though such a limit might seem like it will prevent the retail investor of small means from investing in SME IPOs, merchant bankers said that it is a good move.
“This will allow retail investors to take more informed decisions. It will protect these investors as the chances of manipulation with respect to smaller companies are much higher. Those investors with the right amount of knowledge and liquidity will be the ones investing in these IPOs,” said Mr Jagannadham Thunuguntla, Head of Equity at SMC Capital.
Having the merchant bankers underwriting the IPO will make sure that they price the issue properly and also provide proper valuations.
Merchant bankers are also happy that for an SME issue the minimum number of investors is only 50 for a particular issue.
“For an issue, as of now, there has to be a minimum of 1,000 investors,” said Mr Thunuguntla.
I recall twice during my time at Creekside Community Church in Gainesville (FL), Pastor Parker polled the congregation seeing how many people had been at the church 4 years or less. Both times, at least 50% of the congregation raised their hands indicating being there less than 4 years. If you are in a college town or a city that has a University or has major office parks, you may notice the revolving door of a good percentage of your church. Globalization, the abundance of English, the ease of travel, and electronic communications have shrunk our world and have increased mobility within countries and across countries. Lets define our terms:
Globality is the the theoretical end-state of globalization – a world and economy without national borders.
Mobility is the idea of population migration or population turnover.
Much of this blog post is inspired by a speech that Stephen Um delivered at the Gospel Coalition ‘09 entitled, “On Ministry and Revolving Doors: Practical Challenges and Ideas for Ministry in a Mobile Society,” (audio). In his speech, he likens the issues that the early Christians faced in Acts, to the complexities of doing ministry in the 21st century – namely, mobility, globality, urbanality, and pluralism.
The 2st century is becoming a globalized, urbanized, and post-secular world again. I say ‘again’ because this means that the 21st century will be more like the 1st century AD than has been any of the centuries in between. -Tim Keller, Theology and Practice of Church Ministry: Ministry and Leadership in the City (Unpublished private notes, 2004), pp. 90-93.
Evangelical churches, particularly the ones in more urban areas, near employment hubs, or near Universities, are going to have to learn how to train up people who will be sent out elsewhere. Churches will need to be able to take people who are under their care for 2-4 years, promote spiritual maturity, promote community, and connect them to mission at-hand. Churches will need to invest in these people and not seen them as a poor ROI (return on investment) because some other church in some other place will benefit from your hard labor. Before you say that this is impossible, recall that Jesus only spent three years in his public ministry and under three years training up His disciples. These men went on to make huge kingdom differences as they were sent out and spread out following the Ascension and persecutions. Consider also, if every church had the attitude of stewarding the migratory transplants in their flock, then when someone came from another church, they come to you already heavily invested.
Moving forward, the evangelical church is going to have to rediscover the art of disciple-making. From my experience, most churches just hope that discipleship happens and have no real plan for doing it. They could learn from organizations like Campus Crusade for Christ, who routinely take some of the most spiritually immature young people and turn them into passionate multiplying disciples in under four years. Urbanization, globalization, globality, and mobility present incredible opportunity for the church. The more mobile people are the higher the velocity of interaction in the world. In The Rise of Christianity and Cities of God, Rodney Stark points out that one of the reasons that Christianity spread so quickly was because it was an urban religion and even though 98% of the population was rural, culture was created in the cities. We must be investing in individual people following the discipleship model of our Lord. If we do not, we will be further lost in the increasing complex web of interconnectedness and paradigm shifts.
Up next we will look at some of the false assumptions of the culture in evangelicalism’s game plan at reaching America.
Neoclassical economists don’t focus on inequality, in their teaching and research. But they’ve been forced to confront the problem because of the data compiled by Thomas Piketty and Emmanuel Saez documenting a persistent and growing inequality in the distribution of income in the United States (not to mention the general discontent about CEO salaries, government bail-outs of banks that are “too big to fail,” the problems of health care coverage, and much else).
The response of neoclassical economists has been to deny the existence of a problem, by arguing:
inequality doesn’t exist (Alan Reynolds)
inequality hasn’t increased by as much as people think (Scott Winship)
even if inequality has been growing, it’s not the real problem (Will Wilkinson)
Still, the problem of inequality is not going away, nor are its consequences. . .
“Americans may be settling into spending less,” we are told. We spent about the same last month as we did during the two months prior, and this is supposed to reflect a new low-spending habit? What are they teaching in journalism school these days?
Americans spent about the same amount in October as in August and September, according to figures released Thursday by a key data service, and they may be settling into new low-spending habits.
Including everything from toys to food, but not cars or gasoline, U.S. retail sales rose slightly in October — 1.5 percent — from a year earlier even as consumers grappled with rising unemployment and tight credit.
Americans may be settling into spending less – Yahoo! News
11 November 2009. Rhodium prices continue to rally on the EIB market, opening today at US$2,100/toz. The economic downturn of 2008/2009 lead to a dramatic collapse in rhodium prices. Rhodium crested at US$10,100/toz in June of 2008, only to fall to below US$1,000/toz by early December of that year. By early October of 2009, prices began to show signs of buoyancy.
Rhodium demand is strongly tied to the health of the automobile industry, with ~85 % of production going towards automotive use. Approximately 84 % of rhodium production comes from South Africa where a handful of mining companies operate in the amazing Bushveld Igneous Complex near Johannesburg.
Let me tell you what happened to me on this last Monday. My blog was very late that day because I was at an Urgent Care center. I got there at 11am.
I was taken into exam room at 1pm.
Doctor came in at 1:45pm
I was out the door by 2:30pm because it was a lot serious in the end that I thought it was.
But what I am focusing on is that an “Urgent Care” facility had this long wait because they were short staffed for doctors I heard. They only had 2.
And waiting room full of people.
Then I started to hear about doctor shortages and the Health Care reforms that will short Doctors on their payments and making no less bureaucratic than it is now. Probably even more so.
I have already said one of the real reforms need is Tort Reform, where the doctor doesn’t run unnecessary and expensive test just to be pararnoid that if they don’t run it somewhere down the line they’ll be sued for not running them
This drives up the costs.
Then I ran across this article about Canada’s health care and the long wait times due to doctor-patient ratios.
The Hill: After more than a decade of public healthcare with mandatory coverage, so many Canadian doctors have left the practice and so many young people have entered other fields that Canada ranks 26th of 28 developed nations in its ratio of physicians to population. Once, Canada ranked among the leaders in the number of physicians, but that was before government health care drove doctors out of the practice in droves.
The fundamental fact is that we cannot cover 36 million new patients without more doctors and nurses, much less with the declining census of medical professionals the Canadian experience points to. A recent survey of doctors by the Pew Institute found that 45 percent of all practicing doctors would consider retiring or closing their practices if the Obama healthcare bill passes. This scarcity of medical personnel heightens the likelihood of draconian rationing, lengthy waiting lists and lower-quality medical care for all of us, particularly for the elderly.
This physician shortage leads to massive and never-ending waiting lists. In 1993, for example, there was an average wait of 9.3 weeks from the time a patient got a referral from a general practitioner to the time he could see a specialist. By 1997, the wait was up to 11.7 weeks. Now it’s 17.3 weeks — over four months just to see a specialist!
In Canada, unions control the entire healthcare process. In Manitoba, for example, there is an eight-month wait for colonoscopies, yet the unions do not permit weekend or evening procedures, thereby extending the waiting lists. The unions are doing to health care in Canada what they have done to education in America: stifling creativity, reinforcing bureaucracy and extending waiting times.
Because of these long waits for colonoscopies, there is now a 25 percent higher incidence of colon cancer in Canada than in the United States. And because the leading drugs that we routinely use to treat the malady in the U.S. are banned in Canada because of their high cost, 41 percent of Canadians who get the cancer die of it, compared with only 32 percent in the United States. Overall, the cancer death rate in Canada runs 16 percent higher than in the United States. Cancer does not wait for waiting lists to clear.
The proposed $400 billion cut in Medicare raises the probability that more and more of those doctors who do practice will refuse to accept Medicare patients, aggravating the doctor shortage among the elderly, the population that needs them the most.
Utopia awaits!
UK Telegraph 4/2009: “We’re not producing enough primary care physicians,” Mr. Obama said at one forum. “The costs of medical education are so high that people feel that they’ve got to specialize.” New doctors typically owe more than $140,000 in loans when they graduate.
And paying them less, and leaving malpractice insurance and paranoia of law suits, not to mention a Bureaucrat in Washington making decisions for them, sure sounds like a good career path to me.
Miriam Harmatz, a lawyer in Miami, said: “My longtime primary care doctor left the practice of medicine five years ago because she could not make ends meet. The same thing happened a year later. Since then,many of the doctors I tried to see would not take my insurance because the payments were so low.”
So that where the so-called “doctor fix” comes in. You bribe them with an “off the books” bribe of $250 million dollars so that it’s not counted in the 1 trillion plus accounting legerdemain that both houses of Congress are engaged it.
If we don’t count it, it won’t count. Magically disappearing debt!
Simple, right?
Democrats plan to make ObamaCare “deficit-neutral” by moving nearly a quarter-trillion dollars off the books, one of the great fiscal deceptions of the century.
In January, doctors fees are scheduled to fall by 21.5%, and 40% over the next five years. That would force many doctors to stop seeing Medicare patients, so Congress intervenes every year and temporarily overrides the cuts.
But now they are going to cut as much as $500 million from Medicare to pay for the new Albatross on the block. But to do that means even more cuts, so very likely, less Doctors to treat you.
So we have the fix of the century. And it doesn’t count.
And it’s not their fault.
Self-interest is more important than principles.
Hill: The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs.
WSJ: The American Medical Association’s asking price for supporting ObamaCare is scrapping the SGR (Created in 1997, the SGR slashes Medicare reimbursements if costs rise too steeply, as they always do).
So now Democrats are simply going to “untether” this spending on doctors from ObamaCare, hiding even more of its true costs. At a meeting on the Hill last week, Mr. Reid and White House Chief of Staff Rahm Emanuel made the quid pro quo explicit, telling the AMA and about a dozen specialty societies that in return for this dispensation they expect them to back ObamaCare, no questions asked.
The AMA does support Obama. As does AARP.
The Hill: The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.
Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP — which supposedly represents them — will make more money.
Feel those bus tires on your back yet? Or are the knife wounds getting in the way?
It turns out the AMA is a cheap date. President J. James Rohack now looks ready to embrace whatever else Democrats offer up, even though the new bill only delays the SGR cuts for 10 years instead of doing away with the formula permanently. Never mind that the AMA’s other legislative priority—tort reform—is dead on arrival. ObamaCare is stocked with other provisions that punish doctors, such as a Medicare commission tasked with cutting spending but barred from raising the eligibility age or reducing benefits. In practice, this means it will only be allowed to crank down Medicare’s price controls on providers.
This doctor maneuver is such a cleverly dishonest solution to their many contradictory promises that we’re surprised Democrats didn’t think of it sooner.
So these endorsements are not freely given, but bought and paid for by an administration that is intent on passing its program at any cost.
Evil Capitalism Alert: When the supply goes down and the demand goes up– What happens to the price?
Ironically, just a little more than a decade ago, there was a doctor surplus. In 1996, a committee of the Institute of Medicine warned that the United States had a surfeit of doctors caused by foreign-trained physicians coming here to work and recommended freezing med-school class sizes and limiting first-year residency positions. A year later, Slate ran an article on an alternative strategy for reducing the number of doctors approved by the federal Health Care Financing Administration. Under the Graduate Medical Education Demonstration Project, 41 teaching hospitals received $400 million in exchange for not training between 20 percent and 25 percent of the medical residents they would otherwise have trained over the next six years.
According to some estimates, the demand for doctors will rise to between 1.09 million and 1.17 million by 2020—many tens of thousands more than we’ll actually have.
Banks face a huge hike in financing costs as $2,000,000,000 of funding comes dues in the next three years. From the FT:
Moody’s estimates that a lender wanting to refinance a short-term government-guaranteed bond with 10-year paper could see costs rise nearly 7 percentage points.
This surely of huge concern. The end of QE may be a really fraught experience. Or – central banks see this coming, and don’t have the nerve to end it. On the subject (loosely), how might it be helping London property prices?
The most dramatic improvement has come in London, where 95 per cent of surveyors are reporting rising prices, a level unseen since 1996, including during the whole of the last housing boom. Some properties in London were now back above the 2007 peak prices, according to Simon Rubinsohn, economist at Rics, helped by hopes of big financial sector bonuses.and an influx of foreign investors taking advantage of the weak pound.
So, great for the London market. Great if you got on the train in time. What about if you can’t afford houses? Um . . . affordable home starts drop by a third. Oh dear. No wins for QE on the social justice side. It may be blowing bubbles. Mishkin is not worried. Some are more concerned about the Chinese one.
Not sure it’s been good for the rest. As Tracey Corrigan says, banks make hay, the rest of us pay. It’s becoming the conventional wisdom. Perhaps more fiscal policy would have worked. Of course, Krugman would agree, but here is some major empirical evidence to back him up. “Initial fiscal multipliers of 2 or more, although they shrink over time. Yes, fiscal expansion is expansionary.” As he wisely points out, you have to ask not whether fiscal stimulus has worked in ordinary conditions (think Tony Benn, and go ‘no’), but what about during a liquidity trap?
In anticipation of the Copenhagan (Hopenhagen) Climate Change Conference on December 7th, advocates of mandatory carbon targets are again flogging China as the world’s largest carbon emitting political body. There are those who dismiss China’s efforts to-date and those who demand more action. Perhaps the most disconcerting argument i’ve encountered comes from Steve Forbes of Forbes Magazine:
Last year, China surpassed the U.S. in carbon dioxide production, even though China’s economy is less than one-third the size of ours. By 2020, China’s emissions will be twice ours… Our CO2 emissions increased only 1.3% from 2006 to 2007–proof that we are already more efficiently pursuing economic growth. Even if the U.S. drastically cut back on its CO2 output, its impact on global temperatures would be barely noticeable. It could be three-tenths of a degree Fahrenheit at best.”
If i’m reading this right, Forbes is arguing that high existing economic activity perforce justifies high continued carbon emissions. In other words, those who have managed to get out there early and accumulate wealth, largely by burning carbon, should be allowed to continue to burn the most carbon. What if, for example, the UK had three times more economic activity than the US — would they then be permitted three times the quantity of carbon warrants? Any equitable and democratic assignment of obligation regarding the costs of carbon must first consider per capita emissions. See how long it takes you to find China on this list.
At the same time, it should be comforting to know that the government responsible for the world’s largest population is arguably making the most concerted efforts to develop the most efficient technologies to reduce their economy’s dependence of heavy-carbon productivity. Consider this from The Climate Group:
China ranked second for the absolute Dollar amount invested in renewable energy in 2007 with approximately US$12 billion, trailing the leader Germany which invested US$14 billion.7 The nominal sizes of the Chinese and German economies were almost equal at US$3.3 trillion in 2007,8 meaning that China trails leader Germany only slightly in renewable energy investment as a percentage of GDP.”
The energy intensive economic growth model acutely seen in China and through the Asia Pacific region has brought more people out of poverty than any system in human history. Evidence suggests that global warming is a very real and nasty problem — but as far as I can tell it is not nearly as dangerous as the non-linear pains of poverty and destitution. Despite the doomsday rhetoric, or perhaps because of it, we should take Jim Manzi’s lead and simply rethink the costs and benefits of carbon taxes that could accompany binding carbon targets.
This weekend Republican Representative Anh Cao, a Vietnamese American from Louisiana, voted “yes” for the recently passed health care reform bill; I am proud of Cao and others that realize just because I have health insurance, or they have health insurance… that does not mean that we should not help the many that do not have health insurance. Mr. Cao stated that he represents a poor district in which many of his constituents do not have health insurance. What is impressive is that Cao’s district is largely lower-income blacks — a population that does not vote for a party that traditionally has been anti-poor. However, Cao’s passion for doing what is best and what is right escapes both ideology and political affiliation.
Blue dog Democrats and conservative Republicans do not favor this bill. Why should they? This group represents a population of upper middle-class whites that can afford health insurance. I want the wealthy and middle class to set aside the notion of rugged individualism for a second and evaluate the day-to-day fears of driving in a car without health insurance. If one hit another car in a collision, how would that person afford the thousands it will cost them in rehab? Former American president and Constitutional framer James Madison warned against majority factions dictating the way of life for all; in this situation, the majority is made up of those who can afford health care and who are against this bill. In Madison’s Federalist Paper number 10, contends that the Constitution should guard against what he calls majority rule, hence stating that direct democracy is dangerous, thus ruling in favor of representative democracy; still, the fallacy is that a majority still lives in a representative democracy; I suspect we will hear commercials that liberals are evil, un-Christian, immoral, and communist.
But the reality is this: Liberals are not negative adjectives. In essence, we advocate for the working class, the poor, and minorities against big business. Moreover, we are supporters of civil rights for blacks, women, and ethnic minorities against the repression of government and business. Thus we see ourselves as defenders against what Madison might call a ” direct faction.”
Whether you’re alarmed or reassured by this chart, from the National Institute for Esonomic and Social Research, probably depends whether you’re a glass half-full or glass hald empty sort of a person. It shows the comparative paths of five recessions – the red tracks the 1930s, the incomplete black line tracks the present slump.
The first ‘bounce’ in the 1930s was when Britain left the Gold Standard. But despite the billions of pounds pumped into the economy now by the Bank of England, and seventy years of learning about macro-economic management, the fall has been as steep as in the ’30s, even if the small turn in September came after a decline of only six percentage points in GDP, rather than the eight of the 1930s.
If you’re a glass half full person, you’ll be reassured to learn that the economics editor of the FT, Chris Giles, quotes the NIESR as saying that the reseccsion is ‘on track’ to be less severe than the ’30s. But in the coming months output is still as likely to go down as up. Giles also quotes the NIESR’s Director, Martin Weale, as saying: “The end of the recession should not be confused with a return to normal economic conditions.”
A hat tip to Ben Cunningham for pointing toward this column by the great Thomas Sowell. (Rush Limbaugh always says that if he didn’t have his own brain, he would want Antonin Scalia’s. I, on the other hand, would want Thomas Sowell’s.)
1. If we cannot afford to pay for doctors, hospitals and pharmaceutical drugs now, how can we afford to pay for doctors, hospitals and pharmaceutical drugs, in addition to a new federal bureaucracy to administer a government-run medical system?
2. Economics and politics confront the same fundamental problem: What everyone wants adds up to more than there is. Market economies deal with this problem by confronting individuals with the costs of producing what they want, and letting those individuals make their own trade-offs when presented with prices that convey those costs. That leads to self-rationing, in the light of each individual’s own circumstances and preferences.
Politics deals with the same problem by making promises that cannot be kept, or which can be kept only by creating other problems that cannot be acknowledged when the promises are made.
That’s so easy that only a politician couldn’t understand it.
An unimaginative title, but I’m going to make this a quick, to-the-point post; this is partly because I am expanding on a point that has already been made, and partly because I have a ton of work to finish up before the Pakistan-New Zealand clash at 5 am tomorrow.
Ezra Klein is probably the best source for the ongoing healthcare reform process; specifically, on costs, see these two posts. For the sake of convenience, I’ve reproduced a couple of shocking charts below (courtesy the International Federation of Health Plans via Klein):
Source: IFHP
Source: IFHP
I won’t bother summarizing Klein’s points, since the posts are fairly short by themselves. However, I did find this little “gem” on the internet that is worth quoting:
But all folks like Klein ever seem to want to talk about is “price”. This may comes as a surprise to some, but price is determined by cost and competition. It’s not an arbitrary number. In fact, competition keeps both cost and price (and thus profit) at a reasonable level. That’s how a market works, even one as distorted by government intrusion as our health care system.
Um, no. While the Econ 101 “competition drives price down towards the marginal cost level” theory is normally applicable, the folks over at Planet Money do a great job of showing just why we need to move to a more sophisticated analysis when it comes to doctor pay and costs of medical services. They interview Joe Califano, who notes that as part of the disastrous fee-for-service system instituted under President Johnson, the administration actually passed legislation to increase the number of doctors (both primary-care and specialists) in the system; the rationale seems to have been that more doctors ==> more competition ==> lowers prices. Sound familiar? Unfortunately, by 1975, aggregate healthcare costs had ballooned up to $133 billion ($33 billion more than LBJ had forecast) and have been rising ever since. Competition didn’t really do much there.
In the aforementioned podcast, the podcasters (is that a legitimate word?) explain the difference by pointing to a number of different factors. For now, focus on the key presence of an intermediary in the market for healthcare services: insurance providers. Thus, the market mechanism whereby customers would stop purchasing services from overly expensive providers has to mediate through the insurance providers. Now, teasing out the layers in the excellent Planet Money analysis further, there are two things to note here: first, additional intermediaries generally result in higher costs as a general rule of thumb (somebody needs to pay said intermediaries). Fair enough- if it needs to be done, it needs to be done.
Second, how do the insurance providers determine the prices that they should be paying? A fee-for-service system seems reasonable, but it cannot follow the model adopted by LBJ’s administration whereby no negotiation was stipulated and doctors essentially asked for whatever they felt like. The problem with this unregulated fee-for-service system is that while equilibrium will inevitably be reached through a self-regulating market mechanism, it will most likely end up at a higher equilibrium level than is socially optimal. Simply put, if all doctors dictate higher prices than they deserve, an equilibrium will eventually be reached that prevents doctors from demanding even more than this higher level, yet keeps prices at an inefficient level nonetheless.
So, we need a negotiated fee-for-service system, which raises the question: how do we determine these prices? Obviously, given historic trends in the healthcare market, resorting to the “competition keeps prices at a reasonable level” defense is plain wrong (as explicated above). Planet Money interviews Harvard Professor William Hsiao, who was one of the pioneers in determining the relative value of services provided by doctors, by interviewing doctors and asking them a whole host of questions. Naturally, as the healthcare industry caught wind of this, they realized that intervention was needed lest a truly competitive price for their services be arrived at. Hsiao talks about the manner in which consultants and lobby groups galore flexed their muscles, from manipulating his survey respondents’ answers to actually commissioning similar studies of their own. Sound familiar? Again, it should: institutional capture by interest groups is one of the biggest problems plaguing the American system today. One can examine the various reasons why- information asymmetries, political clout exercised by interest groups, private and therefore profit-oriented insurance companies- but ultimately, even Hsiao’s method for determining “fair” prices was destined to fail as well. The proof is right in front of us, as the charts above indicate. In addition, there is the issue of exorbitant drug prices (also covered in the package of charts provided by the IFHP and available here), but I promised to keep this post brief.
Returning to the aforementioned, ignorant critique of Klein, the authors observe:
Additionally, there is the quality of care – what does a $30 doctor’s visit buy in Canada or the UK in comparison with a $72 Medicare visit in the US? We really have no idea. So how then is such a comparison relevant to anything? I can buy a KIA or I can buy a BMW. Few would argue they have the same cost and certainly not the same value. The quality is entirely different. Yet they’re both cars. The chart assumes all care is equal. But we know that isn’t true.
No analysis of qualitative differences in care across countries is provided to back up their claim. Furthermore, even if there are differences in care, they may often be marginal: is a normal delivery in Canada so inferior to one in the US that it justifies a minimum 379% difference in price? As far as I know, the babies are delivered in a remarkably similar manner across the Western world and whatever differences do exist, are negligible for the purposes of this discussion. Even granting that there may be certain services that are superior in the US (a moot point at best), it seems far-fetched to attribute said superiority across the board to every service. Yet, that is the only alternative for those that would justify the prices based on an efficient, competitive markets basis. Try telling the majority of Americans that they receive a quality of healthcare that is significantly superior to the rest of the world and they would scoff…and rightly so. These are imperfect markets with skewed, highly imperfect results.
Finally, in the interests of doing this dismantling job properly, the authors also note:
There’s also another 800 pound gorilla in the room. Actually the gorilla is the bar on the graph disguised as a $72 fee from Medicare. How do you think the difference between those paltry fees and the real cost of the visit are recovered? Look left, young man, look left. That big bar of private insurance subsidizes Medicare by absorbing the cost shifting which goes on from Medicare payments which don’t cover cost. Without the ability to do that fewer and fewer doctors would accept or treat Medicare patients. In fact, why do you think they limit them now? That reality, of course, isn’t reflected at all in the chart.
Right, so if Medicare is only able to keep costs below the real costs of services by virtue of a coexisting, sacrificing private insurance, how does one explain the significantly lower costs in other countries? The “differences in care” argument is laughable and should not be entertained further. Where is the private insurance sector subsidizing healthcare in the UK? I expect the argument here would be that the government keeps prices artificially low, well below the true marginal cost of service provision. If that were so, wouldn’t we witness an exodus of people from healthcare professions, with increasingly fewer people applying to become doctors? As far as I know, other developed countries are not facing a dearth of doctors. On the contrary, skewed prices in the US have changed incentives, resulting in a gravitation of doctors towards specialization- we are headed towards a scary deficit of primary care physicians. Given that Hsiao’s study found their services to have amongst the highest relative values, I find this particularly poignant.
There is a lot of economics underpinning the healthcare debate, some of it complicated, but a lot of it startlingly simple. The least we can do is get the simple parts right.
* You can listen to a segment of the Slavoj Žižek essay on contemporary apocalypticism that will appear in our upcoming issue of Polygraph here. (via Verso)
* Little-used geek measurements.
