Thursday assorted links

Comments

7. Why does the author assume that "Medicare for more" would be a peculiar combination of more coverage for a lower price? Surely even if such a thing were proposed, it would never pass a Congress similar to the one we have today. It is more likely to me that the proposal would be something like "yes you can buy into Medicare, if you buy a supplement through the exchange, to bring it up to spec."

You have no clue about how little coverage is provided by Bronze plans which are superior to the special catastrophic plans for individuals under age 30.

Part A and Part B provide superior coverage to Bronze plans to a population age 65 to 105, or that has been officially disabled for two years or suffering such chronic illness that their kidneys have failed with no hope of recovery. The deductible is only $148 and then CMS pays 80% of all the benefits Bronze plans are required to pay after $3000 to $5000 deductibles for each individual.

Perhaps the biggest beneficiary of Medicare are doctors and hospitals relative to Bronze and Silver plans - they get paid 80% no matter what, but get only a fraction of the thousands in deductibles for patients that buy Bronze and Silver policies and then have serious illness or injury. They bought the low coverage policies because they spend all their income elsewhere. Given the choice, they would simply prefer free medical care - show up, get treated, don't pay the hospital bills so the Federal government pays the hospital for uncompensated care. The payments for uncompensated care are being phased out.

ACA allows Bronze plans based on the conservative theory that paying out of pocket will lead to individual responsibility of choosing not to get hit by buses or get cancer, plus saving cash for medical emergencies.

If the conservative theory is disproved, then CMS is required to revise Bronze and all other plans so providers are not being stuck with unpaid medical bills.

I think the author is saying that without a cap on out of pocket, Medicare by itself is a worse risk than capped ACA plans, would not be legal as an ACA plan. I am not an expert, just trying to understand the argument.

It would not surprise anyone to learn one approach was good in some ways, the other good in others, but that would not seem to imply that there is only one way to integrate them.

You have a rather different understanding of the value of insurance coverage than I do. I want insurance to protect me against large financial shocks, not to less the impact of small ones. If I get hit by a bus and end up with a $100,000 medical bill, the bronze medal plan will pay $95,000 of it while Medicare would only pay $80,000. The fact that Medicare will pay out a few hundred if I break my finger while while I'd need to cover the whole thing with a bronze plan is small comfort. The bronze plan is much better at covering me for what I want insurance for.

2. Or just on a set of metrics that don't comport with Professor Cowen's.

#2 - Great news! I have never had a bad experience at even a Michelin recommended place in New York.

I went to a 3-star Michelin place in Tokyo and I guess I wouldn't say it was a bad experience, but there were some dishes that I didn't care for or actually had to spit out. Probably a personal failing, but I wouldn't say Michelin rating guarantees you will love the food.

To clarify, the only thing I actually spat out was some seven-pickle thing that I just couldn't chew up and did not like, so I discreetly folded it into my napkin. I don't know what the alternative was, choke to death?

I've been in this situation before. My approach was to abruptly stand up, clasp my throat, mime a severe tracheal blockage, stagger backwards into the next diners' table, then fling myself onto another table. The sommelier would perform the Heimlich maneuver in a most gentlemanly manner (it's in the guidelines) and eject the offending foodstuff. Embarrassment would be spared for the restaurant and chef (discretion is a gentleman's obligation). A bonus is you'll have a ready excuse in perpetuity: "No seven-pickle thing for me, please. It almost killed me, once."

Love it. Next time!

Which restaurant out of curiosity?

Ryugin

To be fair, the pickle dish was compensated for by two endangered owls in the large waiting room which I had to myself for 2 minutes before my meal began, and which I assume they sent me to just so I could experience the owls

Avoid restaurants packed with beautiful owls.

The consistency of Michelin really varies between cities. I've dined at about half of the Michelin restaurants in the US, as well as a sizable count in Europe and Asia. I can say that NYC has by far the laxest standards. There are some really questionable choices, particularly at the 1-star level. Not that there aren't fabulous 1-stars, but I highly recommend cross-referencing with Zagat.

In contrast Chicago is notorious for Michelin blackballing amazing restaurants. Chicago, despite being the best food scene in the country if not the world, has only about a third the stars of NYC or San Francisco. You have places like Les Nomades, Next, and mk not rank. In NYC or SF they'd easily be 2-stars. Michelin only begrudgingly started rating Chicago, because it was getting ridiculous that Alinea (probably the best restaurant in the world) wasn't on the list.

I have zero idea what you are talking about but good on you, let that freak flag fly proudly and loudly

3. Are publishers making a mistake by pursuing scale?

It seems to me that newspaper publishers are pursuing the buggy whip model where they provide an excellent product to an ever more discerning and exclusive, that is to say, small, demographic.

It is more likely that they have been hit with a new technology that has created a new model of news consumption and they simply have no idea, literally no idea, how to make money out of it.

I think the article was trying to avoid the obvious truth that the publishing and distribution end of traditional newspapers is being undermined by web content. Most major newspapers aren't economic any longer and they only exist do to the fact that their older readers still habitually buy the paper. They'll die off as their habitual readers age and die off.

#1 is pretty much nonsense. Economics is useless if people don't have perfect knowledge? I really am kind of tired of people saying things like this. Most economists would have thought that adult coloring books would be a failure? So what? There are many things right now that are competing to be the next trend or next big thing. Most will fail Given a preview of any one of them, and I'd predict that one thing will fail. In this context saying "you are stupid because you did not see this coming" isn't really valid.

Interesting to see that Turkish tourists are considered to be Europeans. I wonder what map the authors of the tourist survey were looking at.

I wouldn't be surprised if the majority of Turkish tourists were from Istanbul, which is in Europe.

6. So if I understand the abstract, the Fed staff is ethical, but media employees are not? Not surprising that bankers are more ethical than reporters, but you can substitute almost any noun for "bankers" in that sentence.

#1- what's his point? So?

And does Gans ever make a statement without referencing his own work?

"7. How would “Medicare for more” interact with the ACA? "

I have to agree with the article that removing those 55+ from the Obamacare market would tend to decrease the price of Obamacare plan. The current maximum age differential artificially lowers the cost of policies for the eldest buyers and raises the cost of policies for the youngest.

Of course, how to pay for any expanded Medicare is the important question. Particularly, since Medicare's dedicated income will be covering less than 60% of it's expected outlays in the next few decades. Expanding a program that's already approaching financial distress seems to be foolhardy.

Medicare buy in costs about $900 a month for coverage superior to a $900 private individual policy for those age 60-65. I speak from experience buying private individual coverage from age 55 to 65.

In 2003 I could have bought private coverage equivalent to Medicare for ~$700 a month at age 55, but I bought one with $5000 deductible because it cost ~$75 a month to lower the deductible by $1000. My premiums increased 10% every year except the year ACA required insurers pay 80% of premiums in medical bills, and that year my premium was 20% lower than it would have been under "free market competition". But that was three years before individual insurance coverage and pricing requirements kicked in - pricing for age 60 was probably 6-8 times that of age 25.

The reason Medicare costs so much out of the general fund is that while Reagan was president, the Part B premium was reduced in perpetuity from 50% to 25% of actual costs. Means testing raises the premium to 50% and 75% for about 5% of those covered. Ie, Warren Buffett pays 75% of Part B cost in premium, plus about three million dollars in taxes.

"The reason Medicare costs so much out of the general fund is that while Reagan was president, the Part B premium was reduced in perpetuity from 50% to 25% of actual costs."

You should really take a moment and check if your facts are even remotely correct.

The Part B co-insurance premium has been 20% since 1966.

https://www.ssa.gov/policy/docs/statcomps/supplement/2011/2b-2c.html#table2.c1

Of course, how to pay for any expanded Medicare is the important question. Particularly, since Medicare’s dedicated income will be covering less than 60% of it’s expected outlays in the next few decades. Expanding a program that’s already approaching financial distress seems to be foolhardy. -

Step 1. Add up costs of those 55-67 on Medicare.

Step 2. Divide #1 by the # of people enrolled.

Step 3. That's the premium if you want to 'buy into' Medicare or if your boss wants to buy you in. If it's too high you're free to get insurance from the exchanges, your boss, or whatnot.

1. I imagined something entirely different.

#6) Why not just auction off the right to receive pre-release access to the information instead of limiting it to accredited news agencies? That way, no one would be able to derive profits (net of auction proceeds) from trading off the early information. Instead, any (expected) insider trading profits would just flow to the government through the auction.

Principal/agent problem. If the access were auctioned off, the auction proceeds would go to the government. With embargoed access, government officials capture some of the benefit personally (i.e., in the form of favorable press coverage).

#2 - Damn--epicurean Tyler is sassy Tyler! I've never had the misfortunate of dining in DC but every person I've known or read who has seems to agree that disdain is merited.

The abundance of Michelin star-rated restaurants in Japan fascinates me, as does Japan's world-class French-pastry chefs. If you want something preserved for posterity, export it to Japan before it's lost domestically.

1) Funny that this simple piece has haters.

Related: "Nobody has ever figured out a perfect technique for dealing with uncertainty."

4) I have not been to South Korea, but when I visit Korean restaurants in California, the staff is extremely polite. Perhaps the Koreans hit a culture shock with indifferent wait staff overseas. Of course they are all bad!

1. I was in a major airport yesterday. Boarding my plane were two individuals in their 20s - one white, one black; one male, one female - both wearing shirts that said "I can't even adult today."

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