Slightly More Traditional Morning Report

Slightly more Traditional Morning Report

Last Change Percent
S&P Futures 1305.6 3.4 0.26%
Eurostoxx Index 2413 27 1.12%
Oil (WTI) 101.95 .02 –%
LIBOR .561 -0.001 -0.20%
US Dollar Index (DXY) 80.323 -0.311 -0.38%
10 Year Govt Bond Yield 1.9% 0.0007%

On the 10 Year Govt Bond Yield, Brent reported 1.85% yesterday, Bloomberg is the source for the “Change” report.-  Via Mark with an assist from ashot

Thanks, Ashot!  CPI is reported “unchanged” which means some stuff went up and some went down: http://www.bls.gov/news.release/cpi.nr0.htm

Housing starts are way below anticipated:  http://www.bloomberg.com/news/2012-01-19/u-s-housing-starts-fell-more-than-forecast-on-drop-in-multifamily-units.html

BUT:  Jobless claims are the lowest in four years!

http://www.bloomberg.com/news/2012-01-19/jobless-claims-in-u-s-plunge-to-lowest-in-almost-four-years.html

– Mark

Health Care Headlines

I wanted to put this post up last week, but got distracted by work and my one month old son (he’s great by the way). So some of this is a week or two old and I don’t have much time to add a bunch of analysis, but I thought some of these may provoke some discussion or just be informative to those who are interested.

The American College of Physicians encourages physicians to take into account the cost-effectiveness of their treatment decisions. In their ethics manual (which you can access for free), the ACP does more than just argue that physicians should take into cost effectiveness with regard to exposing patients to excessive, unnecessary or potentially harmful treatments. The manual encourages physicians to think about how cost effective care can increase the availability of health care to more people. Now I’m all for more cost-effective health care, but I’m not sure I want my physicians worrying about how a treatment they are ordering for me may somehow reduce health care resources available to the community as a whole.

USA Today recaps some of the provisions of the ACA that have already had an impact. It’s not exactly a critical look at the law (OK, it’s pretty much a puff piece), but the government’s success in fighting fraud has gotten more attention lately and the article leads with that aspect of the ACA. While the Obama Administration deserves some credit for the crackdown on fraud, I would also point to the increased use of electronic medical records as a reason for the increase in fraud prosecutions.

The Washington Post has a depressingly humorous article about doctors complaining that the Medicare “doc fix” was closer to becoming a reality than ever. So they’re complaining that the perpetually scheduled reimbursement cut that they know Congress will never pass was closer to passing this time than in the past. Boo-freaking-hoo. The refusal of Congress to pass the cut in physician reimbursement under Medicare is of great amusement to me and NoVa, but it’s emblematic of why we need to fundamentally change our health care system.

The Detroit Free Pressdiscusses all the merger activity between solo hospitals and larger health systems. One of the criticisms of the ACA and programs like ACOs was that they would lead to mergers which would lead to less competition and higher prices. To a large extent mergers were occurring before the ACA so it’s a bit difficult to determine to what extent the ACA increased that activity. It’s also difficult to determine whether or not the mergers will lead to higher prices. The argument that they won’t is that consolidation will lead to increased efficiency which will lower health care spending. It remains to be seen whether or not one or both of those theories will be true.

Lastly, here’s a link to the government’s anti-trust complaint against Blue Cross Blue Shield of Michigan (BCBS). It provides an interesting (albeit one-sided) read. As a brief summary, BCBS entered into most favored nation (MFN) agreements with hospitals throughout Michigan that required the hospitals to charge other insurers as much or more than they charged BCBS. Since BCBS has such a large share of the insurance market here in Michigan that made it hard, if not impossible, for some insurers to compete. And obviously it drove prices up for everyone, including BCBS. Both Michigan and the Feds are in on the suit and several private insurers have filed similar suits.

Bits and Piece: New Year’s Eve Edition

There aren’t nearly enough songs out there where whistling is used effectively or at all. Both of these always make me smile.

Taj Mahal: Ain’t Gwin to Whistle Dixie Anymo’

and Edward Sharpe and the Magnetic Zeroes singing Home

As we head into 2012 a look back at 2011 seems like a logical activity.

Reuters has some compelling images and videos.

Somehow the creation of this blog was left out of all the videos. But thanks to Scott, Kevin, lmsinca and whoever else I am missing that worked to create this place.

On a personal note, I will miss 2011. It was the year I bought my first home and, more importantly, the year my son was born. Here’s to an even better 2012.

GOP Security and Foreign Policy Debate

So apparently there was another Republican debate last night and the candidates discusseed Security and Foreign Policy…again.

For those, like myself, who were too busy gauging their eyes out or refuse to watch another debate until jets fly across the screen again, here are a handful of articles discussing the debate:

The NY Times has a good summary of the goings on. And I enjoyed this live blogging of the debate from the WSJ. My personal favorite was Gingrich (who apparently is the new front runner) defending the Patriot Act by noting “All of us will be in danger for the rest of our lives.” Good times. I’ll be sure to pass that heart warming nugget on to my son if he ever decides to leave the womb.

Not surprisingly and hardly unique to Republican politicians, there were some factual inaccuracies made by the candidates.
Not to be outdone, the WaPo fact checker points out 15 statements that weren’t entirely consistent with reality.

What’s a debate if we can’t instantly declare winners and losers (anyone who watched the debate falls, I suspect, into the later category)CBS News takes a Little League approach and names virtually everyone a winner. Apparently Cain called Wolf Blitzer, Blitz, which is cute. And in breaking news Jon Huntsman and Ron Paul are apparently running for the Republican nomination.Cillizza sees Ron Paul as a loser in the debate mostly because the rest of the Republicans were hawkish and Ron Paul is decidedly not.

Last, but not least, no news on the baby front. We’ve tried every remedy known to man and if the baby is not here by Tuesday we’re headed to the hospital for induction. Thanks for all the well wishes and an early Happy Thanksgiving to everyone.

Michigan Miscellanea….Illiteration is Lame

This item is a week or so old, but Michigan’s Senate recently passed an Anti-Bullying law that requires schools to pass rules and policies to protect students from bullying….well most bullying at least.

Democrats have been trying to pass an anti-bullying bill for years but were always thwarted by Republicans, leaving Michigan as one of 3 states without such a laws. Why would Michigan Republicans oppose such a bill? Government intrusion perhaps? Nope, it was fear of the big, bad homosexual agenda that fueled opposition. In the decade Republicans have opposed the anti-bullying bill, at least 10 homosexual students committed suicide.

The controversial portion of the bill is the following: “This section does not prohibit a statement of a sincerely held religious belief or moral conviction of a school employee, school volunteer, pupil, or a pupil & parent or guardian.”

I suppose one could argue that the exception created by this language was aimed at making sure the bill complied with the First Amendment, but if that was the reason for the exclusion I would think political belief would have been added rather than just addressing religious beliefs and moral convictions.

The bill has been heavily criticized by the media and Democrats in Michigan. Stephen Colbert had a pretty funny and on point take on the bill, too.
By the way, keep an eye on Gretchen Whitmer who appears in the video in the second link. She is the Senate Minority Leader here in Michigan and will probaby be making a run at Governor or Congress in the next few years. She was also named one of the World’s Hottest Politicians a few years ago by Maxim.


The other big controversy in Michigan surrounds a bill which would change Michigan’s No Fault Car insurance law. To summarize, the bill would put a cap on how much insurance companies could end up paying at which point payment would come from Medicaid, Medicare or private insurance. I had also heard that the reimbursement amounts paid by insurers would also become tied to Medicaid amounts, but I can’t find a good article discussing that aspect of the bill at the moment. Anyway, assuming that is part of the bill, it would reduce revenue for hospitals and physicians while increasing profits for insurance companies. If catastrophically injured payments exceeded the cap, the government would likely end up on the hook for the medical care through Medicare or Medicaid.

One of the problems with the proposed reform (which has stalled) is that insurers are already protected from having to pay millions of dollars in medical benefits to injured victims since after $500,000, benefits are paid by a catastrophic claims fund. The money for that fund comes from, at least in part, assessments on consumers. If the insurers also contribute to that fund, then I can see how the cap would save them money, if not I don’t see where their costs are reduced. Obviously, their profits would be increased if they continued to charge the assessment. I also wonder what would happen with the $12.9 billion dollar fund if this law passes? Would I get a check?

Aligning payment with Medicaid payment would definitely save the insurers. This brings us to people’s biggest problem with the bill. There is no guarantee the insruance companies would pass this savings on to consumers nor is their a guarantee that they would end the assessment that has thus far funded the catastophic injury fund. Absent such a promise, this would simply be a giant giveaway to the insurance company while pushing costs to the Medicare and Medicaid and further reducing income to hospitals and doctors. Elections matter, people.

More On Penn State

I have been largely baffled and appalled by the reaction to the unspeakable child molestation incidents that have been connected to Penn State, its coaches and administrators. I’m a big sports fan and my first child is due to appear on Saturday so I guess that helps explain my interest in the story. I have traded comments with many bloggers over at ESPN in the last week or so attempting to disabuse people of their inclination to defend Paterno. I have also read lots of columns addressing the issue, but the majority of them lack any semblence of perspective. This weekend I occasionally switched over to the Penn State v. Nebraska game only to hear announcers, coaches and players lament the empty seat on the Penn State bus usually occupied by Joe Paterno or to praise the focus of the players despite all the distractions (I get angry even typing that). I eventually just had to stop watching the game. I was also slightly disappointed in how Obama addressed the issue when asked about it during another sporting event, the Carrier Classic. While he made the point to focus on the children, he should have more forcefully condemned the attitudes that got Penn State to the point it is now. Finally I think I have found a column that strikes the appropriate tone.

The author may cast his net a bit too wide on occassion, but even when he does, he raises issues about corporations, religion in general and the Catholic Church in particular. I particularly enjoyed his ending:

Nevertheless, Kenny said:

“Thankfully … this is not Rome. Nor is it industrial school or Magdalene Ireland, where the swish of a soutane smothered conscience and humanity and the swing of a thurible ruled the Irish-Catholic world. This is the Republic of Ireland, 2011. A Republic of laws … of rights and responsibilities … of proper civic order … where the delinquency and arrogance of a particular kind of ‘morality’ will no longer be tolerated or ignored … as taoiseach, I am making it absolutely clear that, when it comes to the protection of the children of this state, the standards of conduct which the Church deems appropriate to itself cannot, and will not, be applied to the workings of democracy and civil society in this Republic.”

He did not drop to his knees. He did not ask for a moment of silence. He did not seek “closure” but, rather, he demanded the hard and bitter truth of it, and he demanded it from men steeped in deceit from their purple carpet slippers to their red beanies. Enda Kenny did not look to bind up wounds before they could be cleansed. And that is the only way to talk about what happens after the raping of children.

Buy Here Pay Here

lmsinca brought this up in the post from last night, but it spawned an interesting discussion, so I thought we should link to all three parts of the series.

Part 1

Part 2

Part 3

Axelrod’s Accusations

This was discussed in the comments to MsJS’s excellent post so I thought I would give it it’s own post.

I’m sure most people are familiar with the story, but in case they aren’t our old buddy Greg has a good summary. This jist is that Axelrod is accusing Republicans of purposefully hurting the economy in order to damage Obama’s reelection prospects.

As several here have already pointed out, this isn’t exactly a new political tactic. However, given the context of the present political situation, I do think it is an interesting development. Nobody in DC is popular right now, but Congress seems to be less popular than Obama. So perhaps placing the blame on the unpopular kid is a decent strategy.

On the other hand (others ponted this out) this move could potentially make Republicans look stronger than they really are and blaming someone else is not generally the kind of leadership people are looking for from their President.

My opinion? Glad you asked. There is some truth to the notion that Republicans want to block anything Obama supports. But I don’t think it’s a nefarious effort to destroy the economy. Given Obama’s general unpopularity, it’s probably not even a bad political strategy (although it doesn’t appear to be making them more popular). Greg frequently cites polls that show Americans support various portions of Obama’s economic and health care plans as evidence of a variety of things ranging from Republicans not listening to Americans to Americans being less conservative and many more. My takeway is that Obama is unpopular and if you put his name next to rainbows, the popularity of rainbows would take a hit. As a result, it makes sense politically for Axelrod to point the finger at Republicans and for Republicans to oppose most anything Obama proposes.

Eye on the Courts

The Sixth Circuit recently heard oral arguments on an interesting “free exercise” case. However, the case also addresses free speech issues and the role of counselor among other thought provoking issues. As a liberal lawyer who was raised in an evangelical home and is now a practicing Catholic (there’s a joke in there somewhere) and since I know one of the lawyers involved in the case, I find the case very interesting. The basic facts are that a student, Julea Ward, enrolled in the counseling program at Eastern Michigan University and subsequently refused to talk with patients about their homosexual feelings. Ms. Ward was dismissed from the program and subsequently sued the University. The District Court granted Summary Judgment to the University, and Ward filed an appeal with the 6th Circuit who heard oral arguments in early October. A decision is expected some time in November.

Not to wade too deeply into the factual weeds, but the University’s program is accredited by the American Counseling Association and must follow the ACA’s Code of Ethics. It is this Code of Ethics that Ms. Ward was accused of violating and which led to her dismissal. There are programs that aren’t accredited by the ACA where Ms. Ward could have attended and possibly avoided this conflict. However, since she hired an attorney 3 years before she was kicked out of the program, it seems that she was probably actively seeking out this fight. To be fair to Ms. Ward, there is literature that supports the notion that it is appropriate to refer clients to another counselor where your personal beliefs may cause a conflict. So it does seem that the ACA and the University’s position on the Code of Ethics is not without it’s holes.

I have a hard time seeing this as a violation of the free exercise clause, or any other Constitutional right for that matter. As the District Court pointed out, this was a narrowly constructed rule that applied only to counseling students and only when they are speaking with a client. It also seems aimed at preventing clients from feeling judged by their counselor.

An interesting side note to this is that the Michigan Attorney General, Bill Schuette, filed a brief in support of Ms. Ward so he took a position contrary to the interests of a State University. On the other hand, the ACLU sided against the little guy and in favor of the big University. If the 6th Circuit upholds the District Court’s ruling, expect Ms. Ward to appeal to the SCOTUS. If the 6th Circuit reverses the District Court, there are several scenarios; appeal en banc, appeal to the SCOTUS, settlement, take a chance at trial.

If you have the time, here are the ACA’s amicus brief, Ms. Ward’s brief, the AG’s brief.

EMU has a site that links to several different briefs and opinions.

I agree with Pat Robertson

That’s right, I said it, I agree with Pat Robertson. He thinks the Republican candidates are being pushed into taking extreme positions that they will later have to step back from in the general election. He says it is a game for losers.

And Captain Obvious apparently visited Perry’s campaign headquarters because Perry now thinks participating in the debates was a mistake.