Michigan Hullabaloo

Posted on December 11, 2012 by ashot

Things have been a bit crazy up here in Michigan as Republicans are attempting to pass some right to work legislation. Obviously, Michigan has a long history with unions so this topic is even more contentious here than in many other states. The manner in which the bill is being passed (no committee meeting, public banned at one point, in the lame duck session) only fans the flames. Here are the basics and here is an article from Michigan State Senator Gretchen Whitmer. Keep an eye on her. I would not be surprised to see her run for Governor. Governor Snyder signing this bill has given her significant publicity and will motivate the Democratic base for the next election.

Getting less attention than the right to work legislation is piece of education legislation also being considered in the lame duck session. We have had several discussion at this blog regarding public schools, private schools, and the role of the government in education. Fortunately we have a diverse view on the subject and people, I’m thinking Kevin in particular, with some great knowledge in the subject area. With that said, I am interested in people’s thoughts on quite the hullaboloo that has arisen here in Michigan over a couple of laws being considered by the lame duck state legislature.

In short, the legislation would expand the Education Achievement Authority (EAA) to become a super-disctrict of underachieving schools (the bottom 5%). The two primary criticisms relate to the lack of oversight, the head of the EAA is not elected and reports only to the governor, and the absence of much evidence that the EAA improves things.

One of the interesing aspects of the debate is that the superintendents from some rather wealthy and successful districts are strongly opposed to the proposals. A couple have drated letters and various PTA organizations had a letter published in The Washington Post

Work is pretty busy, but I’ll try to keep an eye on comments to answer any Michigan specific questions.

Filed under: 2012, education | 2 Comments »

A Couple of Articles That May Be of Interest

Posted on November 12, 2012 by ashot

I’m wading a bit into rocky waters with these two articles, but perhaps we can have a good discussion on this topic. I’m particularly interested in Michi and Okie’s thoughts on an article in The Atlantic discussing rape exceptions for abortions. Given our past difficulties in discussing abortion maybe Michi and Okie can send me their thoughts via email, but even if there is no discussion, I thought it was an interesting take on the subject.

For those who are not inclined to read the article, the author argues that were abortion to be made illegal, a rape exception would not really provide women with control over their bodies. She argues that any reproductive freedom from a rape exception would only by illusory because eventually some bureaucrat (possibly, if not probably, male) would likely have ultimate say over whether a particular woman qualified for the exception.

I must admit that I found the argument compelling with respect to its take on the fact that a rape exception would probably only make it seem like women still had some control. However, the article does ignore the more practical aspect of the rape exception, namely that a woman may not have to carry a rapist’s baby to term. Even if the decision is not entirely her own, there is obviously a benefit to the woman. The other thing the article ignores is what were to happen if there were no exception. What if the woman went on a hunger strike? What if she tried to hurt herself and/or the baby? Would the government intervene and force her to eat and deliver the baby? Would a jury convict a woman of murder if she killed the baby? Would physicians be required to report a miscarriage that they thought was a self-induced abortion? So many troubling questions.

This article, also from The Atlantic, talks about where racists tweets came from following Obama’s re-election. The results are both not at all surprising and surprising.

Filed under: racism | Tagged: | 24 Comments »

The AL MVP Debate

Posted on October 5, 2012 by ashot

It’s Friday, so how about something on the light side?

We’ve discussed some weighty topics here at ATiM and, with the exceptions of Scott and QB, we’ve all managed to be right once or twice. But we have yet to tackle a topic as important or divisive as: Who should win this year’s American League Most Valuable Player award?

Like the Presidential race, there are two candidates: Mike Trout of the Anaheim Angels and Miguel Cabrera of the Detroit Tigers.

As in the Presidential race, the sides have dug in and the mud-slinging has begun. There are many other similarities as well, but let’s just get to the arguments.

Mike Trout:

.326 BA, 30 HR, 83 RBI, 49 SB, 10.4 WAR (via Fangraphs)

Pros:He’s one of the best center fielders in baseball and is a rookie! He’s having one of the best rookie seasons in the history of baseball.

Cons: His team didn’t make the playoffs and he faded the last month of the season.

Miguel Cabrera:

.330 BA, 44 HR, 139 RBI, 4 SB, 7.2 WAR (via Fangraphs)

Pros: He just won the Triple Crown, meaning he led the American League in Batting Average, RBIs and Home Runs. He is the first player to do so since 1967. He played his best in August and September with the Tigers trying to make the Playoffs.

Cons: He’s not a good defender and he is not a good runner. His team had a worse record than Mike Trout’s team.

Some of you may be asking…what in the world is WAR? WAR is a “new” statistic that stands for Wins Above Replacement and has become somewhat of a dividing line between the Pro-Cabrera and Pro-Trout camps. From Fangraphs: WAR basically looks at a player and asks the question, “If this player got injured and their team had to replace them with a minor leaguer or someone from their bench, how much value would the team be losing?”

So, according to WAR, if Cabrera was replaced with a minor league player, the Tigers would win 7 fewer games while the Angels would win 10 fewer games. Now I could go on and on about these arguments and am happy to do so in the comments, but the bottom line is I’d be voting for Trout. He’s nearly as good of a hitter as Cabrera and he adds a lot more value with his running ability and defense. Who’s got your vote?

Filed under: 2012, fun stuff | Tagged: | 27 Comments »

Amazing video

Posted on March 21, 2012 by ashot

Total drive by post. I am swamped at work, but this video was too cool not to share.  For whatever reason it would not let me put the video in the post, but if someone else can, please do so.

Filed under: fun stuff | 2 Comments »

Something to Talk About

Posted on March 15, 2012 by ashot

Posts have been a bit down over the last week (I’ve been sick and swamped at work), so here’s a bit of a random collection of stories.

“[F]our Republican senators will unveil a plan Thursday that would transition Medicare enrollees into the same health care program offered to federal employees while gradually increasing the eligibility age and requiring wealthier seniors to pay more.” The article notes that “the measure would phase out the existing Medicare program over an unspecified period of time.”

I can’t access the link that came with the above blurb, but maybe nova can help us out.

The CBO says the ACA will costs less but cover fewer people than first expected. Since the law’s primary goal is arguably to increase coverage, that seems like a bad thing.

It looks like the IPAB is going to be repealed as democrats run from the death panel as fast as they can. One of the criticisms offered up by at least one politician was that it takes these decisions away from Congress. Ummm…wasn’t that the point?

And just so it isn’t all health care, here is an amusing review of the movie version of Atlas Shrugged Part 1. The reviewer is assigned to watch random instantly available movies on Netflix and mostly he just makes fun of the movies.

And as we start the NCAA tournament….Go Green!!

Filed under: aca | 26 Comments »

Cigarette Companies Breathe Easier on Package Warning Requirements

Posted on March 1, 2012 by ashot

A Federal Judge blocked the FDA’s requirement that cigarette companies put graphic pictures of disease lungs, bodies on autopsy tables and other images on packs of cigarettes. He held that it violated the tobacco companies’ First Amendment Rights.

I like this quote from this NY Times article:

Paul G. Billings, vice president for national policy and advocacy at the American Lung Association. “This industry has been marketing its products to children for years in ways that have enticed them to use them — the Marlboro cowboy and Joe Camel — and what Congress said was fight back with all the same tools.”

That isn’t exactly a compelling First Amendment argument for upholding the FDA requirements, but I thought it was a good point. The real reason I like the quote is because the guy is the VP of advocacy at the American Lung Association. Is there an Anti-Lung Association? Who exactly is opposing the American Lung Association that they need a VP of policy and advocacy?

Here’s the opinion.

Filed under: Uncategorized | 10 Comments »

Romney Wins??

Posted on February 29, 2012 by ashot

It will be interesting to see how the press covers Romney’s win in Michigan last night.

An article on Yahoo Calls it an important win.

Meanwhile, Dan Balz has a more measured take on the win. He questions whether a frontrunner should really have such a hard time winning a state where a grew up, where his dad was governor and where he won 4 years ago. A fair question in my opinion.

On a slightly more wonkish note, Romney’s Michigan win netted him only 14 delegates while Santorum got 12. This is because Michigan broke GOP rules by moving their primary up a week and lost a few delegates and also because the race was very close.

It will be interesting to see if Romney can turn the two wins into some real momentum heading into Super Tuesday and whether Santorum can successfully counter the perception that Romney had two big wins on Tuesday. Then again momentum may be red herring if the real reason for Romney’s wins were that he has more money and is better organized. Scott, care to opine?

Filed under: Uncategorized | 24 Comments »

How do you solve a problem like Santorum?

Posted on February 28, 2012 by ashot

jnc posted these links in the open thread last night, but in light of today’s primary in Michigan, I thought they were worthy of their own post.

For those who haven’t seen this, it’s worth a read:

“Goodbye to Goldwater
Rick Santorum’s Republican crusade for big government.”
Jonathan Rauch from the December 2005 issue

The rise of Rick Santorum does not make a whole lot of sense to me and the article makes it even more baffling. My only theory is that he seems to speak honestly and people recognize and appreciate it (either that or Republicans really just don’t think much of Romney). While I disagree with a whole lot of what Santorum says, I do appreciate that he generally just says what he thinks and avoids non-answers that we here from most other candidates, Republican and Democrat alike. I’ll admit I have not watched the Republican primaries all that closely, so maybe my perception is incorrect. However, even having said the above, as a Democrat I am at a bit of a loss to understand Santorum’s rise, any insight from our conservative brethren would be appreciated.

Filed under: Uncategorized | 43 Comments »

Health Care Report

Posted on February 16, 2012 by ashot

Here is the first of what I hope to be a weekly post on Health Care.  This will be largely oriented towards the legal side of the health care world because that is the information I get on a daily basis.  But if anyone, especially, NoVa, wants to add links, please do so.

This is sort of not news because everyone knew it was going to to happen, but the scheduled 27% cut in Medicare fees for doctors is not going to happen. The “Doc Fix”, as it’s commonly known, is going to be part of the payroll tax deal. Maybe NoVa has heard differently, but I think hosptials and physicians know this dance can’t go on forever and that eventually reimbursement rates will be cut.

The administration was bragging about its success in fighting fraud. The DOJ attributes the success to city specific anti-fraud teams. As I’ve said before, a lot of the success is due to the spread of electronic health records.

This is a bit “inside baseball”, but CMS just issued a proposed rule regarding a provision in the ACA that requires providers to report overpayments within 60 days of “identifying” those overpayments. I don’t recommend reading the actual propose rule (unless you have trouble sleeping), but I mention this for several reason. First, it is a big deal for providers. Second, it’s an example of the (slow) legislative process. The ACA was passed 2 years ago and we are just now getting regulations on this aspect of the law. This is just the proposed rule after which people submit comments. After reviewing the comments, a final rule will be published. Lastly, it is an example of something posters have talked about here, where an unelected body (CMS) is, to a large extent, legislating. I don’t necessarily agree with some of the viewpoints expressed on that topic, but I think it can lead to an interesting discussion.  [Also of note is the look-back period.  CMS wants it to be 10 years, which is unheard of.  Currently, CMS can reopen a claim within 1 year of payment for for any reason and within 4 years is “good cause” is shown – NoVA]

According to CMS and HHS 86 million Americans took advantage of the “free” preventative services required by the ACA. The quotes around free are mine since I’m pretty sure we’re paying for these one way or another. As NoVa has pointed out several times, there is also a question as to the efficacy of these preventative treatments.

Speaking of preventative care, at least one insurer is increasing reimbursement for primary care doctors. According to the article, the plan is supposed to pay for itself through decreased ER visits and hospital admissions.

This focus on preventative care is part of a broader trend towards ephasizing wellness. In addition to cheaper and more efficient treatment of chronic and acute conditions, hospitals and doctors are going to try and keep people healthy. Why? Because under payment models like Accountable Care Organizations, hospitals well earn money if they get you out of the hospital faster or prevent complications from arising once you are in the hospital. But they will earn even more money if you never come to the hospital or doctor. While it’s nice to see the current incentives (more care = more money) turned on their head, there still seems to be incentives (other than good health) for health care consumers to buy into this. As things stand, providers will laregely be held responsible for patient non-compliance. Needless to say, that is a concern for hospitals and doctors.

A couple more random links: The Washington Times demagogues the daylights out of ACOs. I could spend a long time pointing out the errors in that article. Meanwhile, Forbes talks about how private insurers are adopting some of the payment models in the ACA.
____________________________

An article from the New England Journal of Medicine about the new American College of Physicians ethics manual guidelines of “parsimonious care” and how that relates to health care costs.
— Mike
________________________________________

Here’s a link to the WSJ editorial QB referenced in his comment. I am familiar with the Center for Medicare and Medicaid Innovation, but not at all familiar with this task force. While I’m unlikely to see it as the menace QB does, I do appreciate being made aware of it.

Filed under: Uncategorized | 30 Comments »

A little flavor of Michigan politics

Posted on February 7, 2012 by ashot

All of Michigan talk radio is a buzz with praise and criticism of Senate candidate Pete Hoekstra’s Super Bowl ad.  He’s running against long time incumbant Debbie Stabenow and well…

To summarize, we have an asian woman…riding a bike…. through a rice paddy… and speaking in less than ideal english…with “asian” music playing in the background. 

 Effective?? Racist??  Offensive?? Politically Corageous?? I report…you decide.

Filed under: Uncategorized | 12 Comments »

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