Big Brother (Soon Will Be) Watching

 

Buried in the more than 800 pages of the bipartisan legislation (pdf) is language mandating the creation of the innocuously-named “photo tool,” a massive federal database administered by the Department of Homeland Security and containing names, ages, Social Security numbers and photographs of everyone in the country with a driver’s license or other state-issued photo ID.

Employers would be obliged to look up every new hire in the database to verify that they match their photo.

David Kravets from Wired.

What Drug Companies Know About You and Your Doctor

 

The information allows drug makers to know which drugs a doctor is prescribing and how that compares to a colleague across town. They know whether patients are filling their prescriptions — and refilling them on time. They know details of patients’ medical conditions and lab tests, and sometimes even their age, income and ethnic backgrounds. (NYT)

Headlines I Wish I Hadn’t Seen

 

Things don’t go as well when the wife earns more than the husband.

The Internal Revenue Service official in charge of the tax-exempt organizations at the time when the unit targeted tea party groups now runs the IRS office responsible for the health care legislation.

The costliest hospital in the nation is in New Jersey and it was bankrupt only a few years ago.

The IRS has requested funding for 1,954 full-time equivalent employees for its Affordable Care Act office in 2014.

Bill Gates: Is No Government Better Than Lousy Government?

 

I was completely surprised that nobody was funding some of these vaccines. When I first looked at this I thought, well, all the good stuff will have been done. It was mind-blowing me to find things like Rotavirus vaccine were going unfunded. One hundred percent of rich kids were getting it and no poor kids were. So over a quarter million kids a year were dying of Rotavirus-caused diarrhea. You could save those lives for $800 per life. That’s like $20 or $30 per year of life. It’s just ridiculous that an intervention like that isn’t funded.

And I’m really surprised at the variance. Some very poor countries run great vaccination systems and some richer ones run terrible programs. The north of Nigeria has about 30 percent vaccination coverage, and they’re above average in terms of wealth within Africa. You compare that to, say, Somalia, which has absolutely no government at all, and they get about 60 percent vaccine coverage of children. So you have a place literally with no government getting a better vaccine coverage than a place that’s above average wealth.

This is from an interview with Ezra Klein.

The “Burden” of High Deductibles

 

The folks at Harvard really, really hate cost sharing (i.e., deductibles, coinsurance and co-pays) in health care. They are much less concerned about high premiums or taxes. At least that is the conclusion one might draw from a new article in Health Affairs.

The authors examined the fate of 393 families enrolled in high-deductible plans through Massachusetts’ Commonwealth Connector. The families were well off enough to be unsubsidized and enrolled in a Harvard Pilgrim health plan. These were compared to similar families in plans with no deductible. They were looking for –

…respondents’ reports of any financial burden, higher-than-expected out-of-pocket costs, or discussions of costs with doctors. To measure financial burden, we asked enrollees whether, in the prior twelve months in the Connector plan, they or a family member had had problems paying or had been unable to pay medical bills; had had to set up a payment plan with a hospital or doctor’s office; or had had trouble paying for other basic needs such as food, heat, and rent because of medical costs. An affirmative answer to any of these three questions was considered an indication of financial burden.

The Entitlement Society

 

Later this month, the American Psychiatric Association will unveil the fifth edition of its handbook of diagnoses, the Diagnostic and Statistical Manual of Mental Disorders. Fourteen years in the making, the D.S.M.-5 has been the subject of seemingly endless discussion.

But many critics overlook a surprising fact about the new D.S.M.: how little attention practicing psychiatrists will give to it.

This is because psychiatrists tend to treat according to symptoms.

So why the fuss over D.S.M.-5? Because of the unwarranted clout that its diagnoses carry with the rest of society: They are the passports to insurance coverage, the keys to special educational and behavioral services in school and the tickets to disability benefits.

Entire NYT editorial here.

Resolving the Question about Federal Employees, I Think

 

We previously asked whether federal employees could enter the (ObamaCare) exchanges and get tax subsidized contributions from their employer at the same time. Timothy Jost, at the Health Affairs blog, seems to have an answer. According to this Department of Labor notice, employers must notify new employees, as well as current employees no later than March 1, 2013:

  1. Of the existence of the marketplace, the services it offers, and how employees can contact it;
  2. That if the employer’s share of total allowed costs of benefit provided by the benefits plan is less that 60 percent of total costs (that is, it does not meet minimum value requirements), the employee may be eligible for a premium tax credit through the marketplace; and
  3. That if the employee obtains coverage through the marketplace, the employee will lose the employer’s contribution and corresponding tax benefits.

There are Very Few “Deserving Poor” ― Other Than Immigrants, That Is

 

Most reviewers have panned the Heritage Foundation’s new immigration study. (See Keith Hennessey, for example.) Yet, Bryan Caplan notes that Robert Rector (co-author of the study) has done some excellent work demonstrating that there are not very many poor people who are deserving of our charity. For example:

The vast majority of America’s “poor” are rich by world and historic standards. 82% of poor American adults say they were never hungry during the last year because they couldn’t afford food; 96% of poor American parents say their children never went hungry because they couldn’t afford food. Half of poor Americans live in a single-family home, and 41% own their own home. Poor Americans have 60% more living space than the average European. 82% of poor Americans have air conditioning. 64% have cable or satellite T.V. 40% own a dishwasher. 34% have a T.V. that would have made billionaires drool in 1990. Materially speaking, poor Americans are doing just fine.

Furthermore, they could easily be not poor: “Most poor American adults could have avoided their situation with prudent behavior ― especially by delaying childbearing until they marry.”

[O]ver 60 percent of fathers who have children outside of marriage earned enough at the time of their child’s birth to support their potential family with an income above the poverty level even if the mother did not work at all. If the unmarried father and mother married and the mother worked part-time, the typical family would have an income above 150 percent of poverty, or roughly $35,000 per year.

But then Caplan cites Rector for lack of moral consistency. Most poor immigrants are “deserving.” Their poverty is no fault of their own.

Best Analysis of the Oregon Medicaid Experiment I Have Seen

 

In summary, based on statistically insignificant effects of coverage from the Oregon Experiment: (1) The effects that are closest to statistical significance are that coverage would increase the rate of smoking and damage the cardiovascular prognosis of sick people; (2) the best estimated net effect on total population cardiovascular health is extraordinarily tiny; (3) this effect would be achieved by making the sick sicker, while very slightly improving the health of already healthy people; and (4) this effect is almost certainly unattractive on a risk-adjusted basis. This is not a series of effects that makes a very attractive argument for an increase in health from the experiment.

This is Jim Manzi via Megan McArdle. Entire piece is fascinating.

Salt Consumption Isn’t So Bad After All, and Other Links

 

Panel: there’s nothing wrong with salt.

Google Flu Trends uses aggregated Google search data to estimate flu activity. HT: Tyler Cowen.

25 million employees are working in industries where employers are most likely to drop their health insurance.