Monday, July 17, 2017

The Rand Paul Compromise

I wish I knew St. Paul's view on healthcare.  Maybe he thought it was a right.  If so, Rand Paul would certainly be the right guy to propose the solution to the healthcare mess that he has come up with.

Being a complete hypocrite, Sen. Paul does not care whether Obamacare disappears.  He just wants to be able to say he voted to repeal it and did not vote to replace it.  It makes no difference to him what the replacement says or does, so long as he can "keep his promise" to vote for the repeal.  After that, if Republican moderates and Democrats want to destroy the country, at least his pecker tracks won't be on the bills.  He'll be the author of the procedure that made the new law possible, but he'll have voted against it, and that's all he has to do to fool enough of the people enough of the time in Kentucky.

I really like this solution.  By allowing Republicans to vote for what Sen. Paul calls "clean repeal," he gives each of them the ability to go home and shout from the rooftops the wholly irrelevant fact that he or she successfully voted to repeal Obamacare.  That's the promise Republican have been making for eight years, and it's the promise they can claim - substance aside, of course - to have kept.  After that, a compromise bill can be created.

On substance, Dr. Paul doesn't understand the issues.  He has latched onto an important insurance notion - adverse selection - but he has not shown any useful grasp of it.  Adverse selection is the tendency of people with the greatest risk to buy the most insurance.  In other words, the people voluntarily buying health insurance are, in general, sicker than those choosing not to buy it.

Adverse selection is a problem for insurers today because, under Obamacare, people can buy insurance from any carrier with no exclusion for pre-existing conditions.  The mandate that forces people to buy when they are healthy does not help insurers, because the insurer acquiring a sick person does not get the money that that person may have paid under the mandate when healthy.  If the person paid the penalty for declining coverage, or was covered by Medicaid or a parent's group plan, the new insurer must rely on a subsidy (or higher premiums on everyone it covers) to defray the cost of pre-existing conditions.

Senator Paul doesn't like these subsidies because the "health insurance industry" is making $15B annually, and he doesn't see why an industry that is making so much money should get a government bail-out.  This is really a stunningly stupid claim.  The insurance companies are making that much money only because they are not forced to participate in the individual Obamacare market.  They have withdrawn from that market so that they can remain profitable.  If the subsidies under Obamacare were increased to the level necessary to attract private insurers, those insurers would make some more money - they are entitled to profit on every class of business - but no more than is usual under our capitalist system.  That's not a "bail-out," as Sen. Paul likes to call it.  It's just how a free private market works.

What Paul does not seem to see is that he is exposing the thread on which the fans of single-payer are dying to pull: administrative costs.  If the insurance companies are making so much money, maybe it's because they charge more than a public payer - Medicare, say - would charge for covering the same ailments in the same way.   (That is, of course, the case.)  He is laying the groundwork for single payer by attacking the insurance industry.  Is that any way for a guy named Rand to think?

But wait!  There's more!  Sen. Paul's solution to the problem of insurers leaving the individual market is to get rid of that market by letting people form non-employer groups.  There are group policies available in other areas of insurance - life insurance through AARP, say - that are based on affinity of some sort, so why not health insurance?  The answer: all of these other insurance programs do have some underwriting requirements; they are actuarially sound and benefit primarily from the economies of scale.  Health insurance policies without pre-existing exclusions are not actuarially sound (see adverse selection, supra) and, therefore, cannot work that way.

Sen. Paul also argues that these pick-up groups would be viable just like employer groups.  If the large-employer market is profitable without subsidies, he, er, reasons, why wouldn't group plans of random citizens be healthy?  Well, one of the first thing one learns in the group insurance business is that group insurance isn't insurance.  Group insurance is "experience- rated." The employer basically pays the cost of all claims, plus an administrative fee.  The insurance policy simply smooths out the peaks and valleys, but premiums are adjusted to match claims over time.  An employer-based plan is an employee benefit, part of the compensation of the employees, with the added benefit of a healthier workforce for the sponsoring employer.  A random group of people with no interested third-party to pick up the rising costs simply would not be viable.

The employer's backstop for employee plans, and the entanglement of membership in the plan with having a job, make the employer market a wholly different place from the random group market.  Indeed, if these sorts of plans were viable, is there any doubt that insurance companies would have lobbied to make them legal?  If they made any damn sense, they would exist already. Because they don't make sense, they don't exist.  Sadly, the same cannot be said for Rand Paul.


Tuesday, June 13, 2017

What Privilege?

Part of the art of the dodge is in being willfully inarticulate.  Or in willfully not trying very hard to speak as clearly as one thinks.  I won't try to quote A.G. Sessions on the privilege that seems to have the Democrats on the Intelligence Committee so flummoxed.  If he had stated his position clearly, they might have figured out how to deal with the problem.  But, being a skilled obfuscator, the A.G. relied on "policy" - never a legal basis for anything - and forced the poor Dems to ask for a copy.  Yikes.

Here's what A.G. Sessions would have said if he felt obliged to speak clearly:  
All confidential communications between the President and anyone else in the Executive Branch are privileged.  Only the President can waive that privilege.  He does not need to "assert" it; it applies until it doesn't, and the Attorney General has no power to pretend that it doesn't.  Where, however, the President has publicly revealed a communication that would otherwise be covered by the privilege, the action implies that the President does not consider that communication privileged, and so someone privy to that communication can discuss it publicly.  
So, when the President says publicly "I asked Rod Rosenstein and Jeff Sessions for their views on Jim Comey," the communication ceases to be privileged, and the A.G. can properly, i.e., without breaking privilege, tell the Senate that the President "asked him" for his advice on Comey.  That testimony would not, pax, Senator King, amount to "selective" use of the privilege in question, however one frames it.

But Sessions did not expressly rely on Executive Privilege, because the President has not asserted it, as if that were necessary to its application.  Instead, Sessions relied on a policy of the Justice Department, which appears very much to walk like executive privilege and quack like executive privilege.  That's because it is executive privilege.  Otherwise, it would be nothing more than a wish that Congress could rightly ignore.  

This confusion serves Trump very well.  Not one Senator asked Sessions "Could the President authorize you to answer these questions?"  The answer is clearly "yes."  Leading to the follow-up "Will you ask the President to allow you to answer these questions?"  Stonewall that, Mr. Sessions. As things stand, the President can say he didn't "assert" Executive Privilege even has he hides behind it.  All because the Attorney General could get away with invoking the privilege on the President's behalf by reference to a bright, shiny object - the DOJ's policy (of tacitly treating Executive Privilege as asserted until waived) - that the Senators are now all trying to get a copy of.  

Where does that leave Mr. Comey's disclosure of things the President said to him?  The President is free to say that Comey is lying about his conversations with the President and, at the same time, claim Executive Privilege as to what he and Comey talked about.  Comey himself made this clear when he described a newspaper story as false but declined to say in what regard, because that would reveal things that should not be made public.  What is less clear is whether the President can order Comey, now a private citizen, not to disclose his recollections of conversations that arguably have a bearing on his personal status.  Privilege means "You don't have to tell Congress"; that's not the same as "Don't tell Congress."  Or is it?  I'm going to leave that hot potato for another day.

Thursday, June 8, 2017

No Comment

A lot of noise is being made these days about what Jim Comey did and did not say publicly.  Almost all of that noise is logically fallacious.  Comey tried to explain the matter using what he called the "slippery slope" analogy, but no one was listening.  He should have been more forceful.

The answer to the question "Why couldn't he simply say that Trump was not under investigation?" is simply this: "What would he have said if Trump were under investigation?"

If a reporter asks the FBI whether X is under investigation, there is only one suitable answer:  "No comment." Every other answer is wrong, because any other answer means that there are at least two possible answers: "No Comment" and [the other answer].  And, if that other possible answer is "No," "No Comment" must imply "yes"; otherwise, the "No" answer would have no reason to exist.

Already, we are seeing the fall-out of the possibility of "No" being an answer.  Comey testified
(i) that when he last spoke to President Trump, he told Trump that the FBI was not investigating him, and 
(ii) that his statement to Trump was true.  
Items (i) and (ii) are entirely separate things.  Item (i) is an action Comey swears he took in private.  Item (ii) is a public statement about an investigation that Comey swears is true.  It would be practically impossible for Comey to deny item (ii) without raising the possibility that he was lying to Trump, but that's why he should not have added item (ii).  Indeed, if asked whether what he told Trump was true, he should have answered "I can't comment publicly on whether an investigation was ongoing."  That sounds bizarre, and it would likely be treated as bizarre by the bozos who make hay out of things that sound bizarre.  But Comey could logically have said this:
"I can testify publicly to what was said by President Trump and me and to what I have done in connection with the matter.  Neither of those things requires me to make a public statement as to the truth of what I told President Trump, and, because there can be only one such statement - "No comment" - I am making that statement.  You should not infer anything from my statement, as it is the only one I am able to make, and so it carries no information with it, as if I did not hear it being asked.
Information theorists will see the heart of the matter quickly.  Information is anything that reduces the degrees of freedom in a system.  That's a high-sounding, generalized way of saying that if there are two possibilities (yes and no), and a statement about those possibilities causes there to be one possibility ("YES!!"), then that statement carries information.  If the statement does not reduce the number of possibilities ("No comment"), it carries no information, and nothing can be inferred from it.  For that description of things to be valid, however, it is essential that "No Comment" be the only possible answer.  Otherwise, there are more than one possible answers, so giving either one of them reduces the degrees of freedom in the system of answers and carries information.  Thus, there must be only one possible answer to the question if that answer is to deliver no information.

Comey's slippery slope argument says that if the FBI says it is not investigating X, it must also say that it is not investigating anyone else about whom it is asked, unless, of course, it is investigating that person.  So, if the answer isn't "no," it will be read as "yes," even if it is spelled "No comment," and there goes the FBI's ability to investigate someone without publicly saying so.

This is a big deal.  It explains everything about why officials don't say things publicly even when it is clear that they know the answer and may even be clear to everyone what the answer is.  Any deviation from "No comment" makes any subsequent "No comment" more meaningful than it needs to be.

Thus, Comey testified that, in connection with the matter of Secy. Clinton's emails, he was permitted to say, to Congress and in press briefings - it's not clear why - that the FBI had opened a "matter," but not an "investigation."  That bothered Comey, who said "We're the Federal Bureau of Investigation," so it makes no sense for us to open anything but and investigation.  But A.G. Lynch's justification for ordering him to call it a matter was that the FBI does not comment on whether it has opened an investigation.  But, by creating an alternative statement to "No comment," A.G. Lynch had made "matter" mean something other than "No comment," and the only reasonable thing it could be made to mean, when opened by the Federal Bureau of Investigation, was, duh, an investigation.  Again, Comey should have been directed not to say anything about the matter, other than "No comment." And now it looks like the A.G. was trying to provide cover for Mrs. Clinton, when, perhaps, she was trying, unsuccessfully, to adhere to a policy without understanding its most important instrument: "No comment."

Sunday, May 28, 2017

Plus ça change

"We, the German Führer and Chancellor, and the British Prime Minister, have had a further meeting today and are agreed in recognizing that the question of Anglo-German relations is of the first importance for our two countries and for Europe. We regard the agreement signed last night and the Anglo-German Naval Agreement as symbolic of the desire of our two peoples never to go to war with one another again. We are resolved that the method of consultation shall be the method adopted to deal with any other questions that may concern our two countries, and we are determined to continue our efforts to remove possible sources of difference, and thus to contribute to assure the peace of Europe."  Neville Chamberlain after Munich.

"This call for driving out terrorism is a message I took to a historic gathering of Arab and Muslim leaders across the region, hosted by Saudi Arabia.  There, I spent much time with King Salman, a wise man who wants to see things get much better rapidly.  The leaders of the Middle East have agreed at this unprecedented meeting to stop funding the radical ideology that leads to this horrible terrorism all over the globe."  Donald Trump after Riyadh.

Friday, May 26, 2017

The Rough Beast is a Piss-Ant

Above all else, Donald Trump  will be remembered for his smallness.  Not the hands nonsense, but the petty, petulant, puerility of his time on the world stage. Send not to know for whom the baby monitor tolls.  We have elected a puling nonentity and sent him out to represent us at the big-boy table.  Shame on us.  Shame on the Republican Party for having so little to offer.  But mostly, shame on us as a nation.

Vladimir Putin is popular in Russia.  People say it's because he suppresses information about his flaws, but I don't believe that's so.  I think he is popular because a classy leader is a luxury that the Russians have not been able to afford, ever.  Gorbachev might have been such a leader, but the fact that he has been supplanted by a fascist thug says something about the kleptocratic soil in which Russia grows its leaders.

Trump is living proof that the US can no longer afford the luxury of a quality President.  The GOP gerrymandered the Congress into a feckless mess with an approval rating of 19%, every missing 81 points of which are the other guys' fault.  They aren't to be pitied - they thought they were putting party over country - but there is a delicious irony to their having hoist themselves on their own petard.  When swing voters don't matter, cooler heads have no reason to prevail.  Instead, morons get elected, Congress becomes a swamp, sixteen Tweedle-dees run for the Presidency, and an abomination slouches toward Washington to be born.

Read some Gibbon.  Read Shakespeare's "Julius Caesar."  And then read Yeats:

Turning and turning in the widening gyre
The party cannot hear the ward leader;
Things fall apart; the centre cannot hold;
The Tea Party is loosed upon the world,
The heartless tide is loosed, and everywhere
The ceremony of compromise is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

Or something like that.  I'm quoting from memory.

Watching President Trump lecture the NATO chiefs on their obligations to the US was really, really painful.  The US has every right to pressure its allies into paying their "fair share" toward the defense of their own soil, but the idea of hectoring them in public should make any American's skin crawl.  With so much going on in the world, so many points to make in a public speech, our guy wants to know who ordered the lobster.  And yet, an astounding and sobering number of self-styled "Americans" actually think this bozo is a better leader than Hillary Clinton.  Or John Kasich or JEB Bush.

Like Willie Loman, when this many voters talk, attention must be paid.  We must take another look at Germany in the late 1920's and see why Hitler's, er, quirks, were overlooked.  If stupid people are empowered to vote, they don't suddenly become smart.  Rather, they just vote for stupid things - solutions that sound good fast, because no one else is offering any solutions at all.  So, no, Mr. Eliot, the way the world ends is not with a bang or a whimper.  It's with a snivel.

Tuesday, May 16, 2017

Or, in the alternative, I had every right to...

To paraphrase Voltaire, if the high-five did not exist, the Russians would have to invent it.

The famous (among lawyers) example of arguing "in the alternative" goes like this:
My dog doesn't bite. Or, in the alternative, my dog was tied up that night. Or, in the alternative, you were not bitten. Or, in the alternative, my dog was provoked.  Or, in the alternative, I don't have a dog. 

That's pretty much how the Trump administration addresses the Orange Peril's blunders.  Why was Comey fired? Because he was unfair to Hillary. Or, in the alternative, because this thing about Trump and Russia is a Hillary-sponsored hoax.  Did Trump leak classified information to the Russians last night?  Well, the formerly respected H.R. McMaster says he was in the room where it happened, and it didn't happen.  Or, tweets the leader of the free world, in the alternative, I had every right to do it.

The Russians have won the Powerball, and they've taken their winnings as an annuity payable over the political life of Donald Trump.  One can only pray that it is short, and that it ends non-violently.  I'll stop typing now, as this is probably already old news...

Sunday, May 7, 2017

It's Only Money (Healthcare Edition)

Is there anything seriously wrong with either Obamacare or the GOP House bill that money couldn't cure?  What are the gripes about Obamacare?  It forces you to buy insurance you don't want.  Would a sufficient subsidy not cure that?  Insurance companies can't make money, so they withdraw from state exchanges.  Would a sufficient subsidy not cure that?

And the GOP bill that lets states set up high-risk pools for people who are very sick.  The Dems' only objection is that such funds have historically been underfunded.  Would a sufficient subsidy not cure that?

Topology fans - yes, there are topology fans - there must be - are fond of pointing to the torus - a solid object with a hole in it.  Like a bagel, or a teacup.  To the topologist, these are the same thing.  (How different is a meatball pizza from a cheeseburger, really?)  Well, any healthcare system that covers the poor and covers sick people after they get sick - when else would they be covered? - is going to be like any other at heart.  The risk has already been socialized, and the only question is whether there will be enough money delivered to providers to get them to deliver enough care.  Everything else is a detail.

Socialized benefits are paid for by taxes, broadly understood as an economic hit imposed to cover the cost of mutual benefits bought by the collective.  Buying insurance you don't want is a tax (just ask Justice Roberts), and inflation is a tax.  Price controls act as a tax.  Export tariffs on drugs sold at a higher price here than abroad impose a tax.  And, of course, explicit taxation is a tax.  But it's all the same to us topologists.  Everyone is getting healthcare, and, as a consequence, we are taxing whomever should be taxed, and in whatever way, as our politics determines.

I have my preferences regarding tax policy, but that's for another day.  For now, it's sufficient to note that any politically acceptable U.S. healthcare system post-Obama will require a lot of public money to pay for people who cannot afford the care they need.  Any legislative scheme that does not come up with that money will fail.  The murderers in Congress killed Obamacare by underfunding it.  The House Bill grossly underfunds the state pools without creating large enough subsidies to entice private companies.  Governors are in a bind: their constituents won't be able to buy coverage from insurers who are not there or afford coverage from pools that are underfunded.

No, the House Bill is not law, nor will it be.  But no new law will work unless it adequately subsidizes the cost of care.  Of course, that gives the government a big stake in cost control - e.g., the aforementioned export tariff on drugs sold to public health systems abroad - but that is a detail to be worked out.  The important thing is that no system that is underfunded can work.  Unfortunately, our pols don't much care whether a plan works; they just care who will get credit if it does, or - what may be a more valuable prize - blame if it doesn't.