(from The Incidental Economist)
This is simply the best! Cheerful, energetic presentation of lots of things that are going right!
|(from Nancy LeTourneau - "2013 Most Memorable Moments")|
|(Rembrandt, Adoration of the Shepherds)|
On Saturday, Ross Douthat (a writer with whom I rarely agree) put up a splendid column in the New York Times titled "Ideas from a Manger". I will quote from it at length:
PAUSE for a moment, in the last leg of your holiday shopping, to glance at one of the manger scenes you pass along the way. Cast your eyes across the shepherds and animals, the infant and the kings. Then try to see the scene this way: not just as a pious set-piece, but as a complete world picture — intimate, miniature and comprehensive.
Because that’s what the Christmas story really is — an entire worldview in a compact narrative, a depiction of how human beings relate to the universe and to one another. It’s about the vertical link between God and man — the angels, the star, the creator stooping to enter his creation. But it’s also about the horizontal relationships of society, because it locates transcendence in the ordinary, the commonplace, the low.
Many Americans still take everything: They accept the New Testament as factual, believe God came in the flesh, and endorse the creeds that explain how and why that happened. And then alongside traditional Christians, there are observant Jews and Muslims who believe the same God revealed himself directly in some other historical and binding form.
But this biblical world picture is increasingly losing market share to what you might call the spiritual world picture, which keeps the theological outlines suggested by the manger scene — the divine is active in human affairs, every person is precious in God’s sight — but doesn’t sweat the details.
Then, finally, there’s the secular world picture, relatively rare among the general public but dominant within the intelligentsia. This worldview keeps the horizontal message of the Christmas story but eliminates the vertical entirely. The stars and angels disappear: There is no God, no miracles, no incarnation. But the egalitarian message — the common person as the center of creation’s drama — remains intact, and with it the doctrines of liberty, fraternity and human rights.
Accelerating progress. If you go to obamacaresignups.net, you can click back to prior forecasts, so you can get a sense of the acceleration factor. With 43.4% of the time between October 1 and March 31 elapsed, some states (with their own Exchanges and reporting systems) are just behind, right on, or ahead of pace for private insurance enrollments:
My forecast has been: 5MM private, 7.5MM Medicaid. If the current pace continues, I could be low on both.
So what enrollment numbers would be generally acceptable to a broad range of the media? My guess is that any number below the 7MM private enrollment CBO forecast will be flagged as a miss by many in the media; though it's possible a "big win" in the Medicaid number would offset the miss narrative for all but the most conservative media. 9MM was the original Medicaid target, but that included all states: the 25 states not accepting the Medicaid expansion accounted for about half that forecast. So if Medicaid hits 8MM, which it might, that might offset a private forecast miss. Minimum private enrollment needed to record ACA a success in most major media? My guess: 5MM. And I think we'll hit that.
And how about the possibility of a premium "death spiral", caused by too few "young invincibles" signing up? This is the core conservative argument as to why Obamacare will "collapse of its own weight": the ACA, according to this argument, is based on a faulty model - the mandate penalties are too low to compel performance by the young, so they will not sign up and the program will eventually break down. The "death spiral" argument is, I am certain, groundless:
And finally, what about the employer-sponsored insurance market? Any chance of a wholesale dumping of people into the Exchanges to avoid ACA-related problems? The Right is pushing this meme big time, saying we will see this as we approach the July 1 date when the delayed employer mandate kicks in. My response: Quite simply, it won't happen. Providing quality benefits is too important to employers to just give it up.
The ACA is reaching solid ground. It will not be derailed. Will the strengths of the program emerge before the November, 2014 elections? They might, and they might not. To some extent it will depend on how effectively Democratic candidates present the evidence. By 2016, I am confident the benefits of this bill will be understood and this will contribute to what I am certain will be a Republican shellacking.
|(Obama and Clinton just post-Benghazi)|
|(from Gerald Seib at The Wall Street Journal)|
Gerald Seib put these numbers up in his column this morning at the WSJ. He dug into the cross tabs from the most recent WSJ/NBC poll. True, this is just a one shot/one moment in time look, but the differences between the men and women is remarkable.
Much better marks for Obama among women. Pro-gun control. Pro-minimum wage increase. Eager for Dems to retake control of the House. More supportive of the ACA. Angry at Republicans for the shutdown. Wow!
What might move men in a positive direction?
It's possible they all could happen. If so, the GOP will lose the House.
Ron Fournier is out with another sweeping hit on President Obama at The National Journal titled "This is the End of the Presidency", where he compares Obama's evolving second term to Bush II's. I will let Andrew Sullivan at The Dish do the rebuttal for me. Listen to Sullivan at his hard-hitting best:
|(Obama's Cairo Speech, January, 2009)|
We have looked at some key characteristics of the integral leader:
Today I want to add one more quality of the integral leader - the ability to plant "seeds of possibility" and the patience to wait for what may emerge.
That's what Obama did in Cairo, in January 2009: he planted "seeds of possibility" that are beginning to grow and bear fruit. Let me give some highlights, which will include other "seed planting" fruit growing; in other words, Obama planted seeds in many places, not only in Cairo:
In some ways, Obama's work in the international domain doesn't fit quite as neatly into the Deep Currents, Surface Storms metaphor and analysis. But key elements are there. And for certain, the media is essentially blind to the deep currents beyond our borders. They are endlessly distracted by our distractions. I will close this piece by saying I feel the world is becoming a safer place: the big, powerful countries are less and less likely to go to war with each other; and weapons of mass destruction have a reasonable to good chance of being curbed in the coming year.
One more note from the past and pointer towards a possible future: have you noticed that the Global War on Terror is over - we have specific adversaries but no existential threat; and what would you say if Israel and the Palestinians made peace before 2016?
Hopeful - that's the stance I am taking in the world. And much of the source of it for me is the extraordinary integral leadership our President is offering us. Bravo, Sir. And our gratitude.
I'll stick with my December 2 forecast:
Can't wait until April, when we will know these numbers. We'll also have a better feel for the numbers of folks who feel they ended up losers. For example, if 5.0 million policies get cancelled, how many of that number, at the end of the day, feel they were, in some way, ripped off? I'm guessing only 20%, still a lot of people, but way less than 12.5 million.
Also want to know how many under 35s' will have signed up for private insurance, and whether folks are saying the pool appears balanced. I'm pretty confident it will be.
By April, millions upon millions of Americans will know Obamacare is here to stay! The Right won't acknowledge it. But the next job for Progressives will not be to bad mouth the Right; rather it will be the important job of making the big case for the cost curve being bent, and how this solidifies the country's fiscal sustainability.
|(CBO Monthly Budget Report)|
The above chart presents some great news: combined Medicare/Medicaid spending for the first two months of F2014 (October-November) is down 2% from F2013 levels. This continues the trend pointed to in this chart from the Council of Economic Advisers' recent report on how the ACA is helping to moderate healthcare costs.
Medicare and Medicaid costs are flatlining. As the chart above shows, costs per capita are flat for Medicare and down for Medicaid since 2010, when the ACA was launched. In point of fact, on a gross basis (overall year to year spending comparisons), they are flat as well, meaning that the cost slowdown thus far has been able to absorb the demographic increase in enrollees, due to the retiring of the Baby Boomers, without increasing spending. The October-November F2014 numbers above show this trend is continuing.
It's your light
that lights the world.
This idea is very hard for those of us raised in the West. The sin/sinner idea is hard to shake. But Jesus did say:
"If thine eye be single, thy whole body shall be full of light."
Matthew 6 (22)
and He said:
"Ye are the light of the world. A city that is set on a hill cannot be hid."
Matthew 5 (14)
Am I that tree in full flower under the stars?
This knocks me over. Strong. Clear. Fully grounded. Inspiring. Full of Light. Generative.
If these are qualities you admire and are touched by, be sure to visit theobamadiary.com every day! TOD's site reminds me of a favorite quote, from a book I read 50 years ago:
"The lover of beauty finds it everywhere around him. The vein of gold in the basest of ores. And he takes the collector's joy in finding the fragmentary masterpiece that is commonly passed by."
Memoirs of Hadrian
by Marguerite Yourcenar
TOD is a lover of beauty. And she has deeply enriched my life by finding a great many fragmentary masterpieces I would never have found or seen.
|(from Council of Economic Advisers Analysis of ACA)|
Conservatives attack Obamacare for creating a large group of injured parties - those people whose policies are being cancelled; who are being told they have to buy an ACA-approved Essential Benefits policy (even though they don't personally need all the benefits offered); and who have to pay more than before, so they can be counted as part of a large and balanced risk pool that will benefit the sick and the elderly. Many hurt; few helped - this seems to be the argument.
What few realize is that the cost curve-bending effects of the ACA is having a dramatic effect on two programs (Medicare and Medicaid) that benefit 100 million Americans, a much larger group than the 5 million or so who may be losing their current policies.
The above chart shows how the Medicare/Medicaid spending projection line has moved down and to the right in the last three years. The above graph lines were put together by the CBO in their four most recent 10 year budget forecasts. The "gap" between the August 2010 and the May 2013 lines represents reductions in estimates of what the Medicare/Medicaid programs will cost going forward. The next chart (CBO/Doug Elmendorf ACA Cost Control Presentation) shows the magnitude of the savings.
|(from Council of Economic Advisers Report)|
I'm a real bear about healthcare costs. I read whatever I can find. You will find me blogging about this repeatedly. Why am I so obsessed? Quite simply: almost no one gets the full implications of what's happening. Here's a Tuesday New York Times article that talks about the cost slowdown and how it will lower ACA's total cost; but the explanation for the slowdown is primarily the impact of the recession, slowing down demand for medical services. And the article quotes a conservative source saying there is no cost slowdown, and talk of such is just another piece of the Administration's misinformation campaign.
So I was really happy when the Council of Economic Advisers put out the above report, doing a thorough presentation of the academic research on the healthcare cost slowdown, showing that one group (The Kaiser Family Foundation) argues that the recession is the primary cause; but other researchers have concluded that structural factors are at play, representing a possible seismic shift in how healthcare is delivered, moving from payment only for quantity of service, to more payment for quality delivered (see particularly CBO Working Paper, August, 2013).
|(from CBO Enrollment Forecast)|
The above chart is the "holy grail" CBO forecast for Obamacare. Key points:
Points to highlight:
So what's your guess? Here's mine:
Considering the horrible start, not too bad. Am convinced there will be a big surge at the end that will be handled mostly well by the website's front end and pretty well by the backend (the part that links to the insurance companies). The system will be seen to be working, to be self-correcting, and most experts will be predicting a smooth open enrollment, when October 2014 comes around. Further: employers will not be planning a wholesale dumping of employees into the Exchanges for 2015 and 2015 premiums will be coming in with only small increases over 2014.
If this is the picture next summer, what will the GOP argument be? Mostly unchanged. They will focus on whatever problems are present; they will argue that employers will begin dumping next year, and that premiums will surely start skyrocketing soon, etc.
Will the public begin to see the true picture? I think so, but I'm not sure. It's possible the MSM will start holding the GOP accountable for making predictions that don't pan out, but I won't count on it.
The sleeper might be healthcare costs overall. If they stay moderate for another full year, and more research analysis points to the ACA as a key factor in the cost slowdown, this could tip the analysis towards a conclusion that the ACA is a strong net plus, and that GOP resistance has been political, not based on sound policy estimates. If this is the tenor of the public conversation, the House will be in play.