Rough Book

random musings of just another computer nerd

Category: Politics and Law

The Rand Paul Healthcare Bill

The house withdrew the AHCA today. After seven years of screaming about repealing the ACA, it looks like they can wait longer. I had made some criticisms of Ryan’s plan and so a friend asked me what I thought of Rand Paul’s healthcare bill. There are some good ideas in there, but also some bad ones, and some ones that I’m not so convinced would work out, even though they sound good. So here are my thoughts on it in no particular order.

I liked the Charity and Bad Debt deduction for physicians. Basically, physicians can deduct up to 10% of their gross income for amounts they would have otherwise charged for charitable care or for those with bad debt. I think this may help drive down some healthcare costs, while also helping out people who aren’t able to afford healthcare. But I think this whole issue of healthcare costs itself needs to be looked at more (for example, drug costs).

Paul’s plan is pretty bad for poor or unemployed people in general. It brings back the HIPAA protection for pre-existing conditions, but that is tied to the time you were employed. So if you haven’t been able to get a job for a while, you’re screwed. It also takes away the ACA’s essential health-benefits requirements, community rating restrictions, rating reviews, medical-loss ratio, and other mandates. I think these mandates are necessary because otherwise the system is setup so that it is more profitable for companies to deny coverage than provide it. Not only that, without the individual mandate, healthy or younger people don’t really have any incentive to sign up (not that the individual mandate was doing much in that regard). This means that the individual market is not that profitable for insurance companies, and most Americans get their insurance through employers anyway. So I don’t see how market forces will drive prices down, enough to where younger or healthy people don’t feel like it is such a burden to get insurance, or even to where it is affordable for poor people.

One of Paul’s other proposals is to open competition across state lines. I think that may help drives the prices down a bit, but since purchasing individual-coverage is still largely disincentivized, I still don’t see much change happening. This is also not going to happen immediately, so in the meantime, it will be more profitable for insurance companies to deny coverage to risky (in the sense of costs to the insurer) individuals. This will stress out an already expensive market, because these people will inevitably get sick enough to where they need care. They won’t be able to afford it, and will go bankrupt, causing someone to eat the costs, which forces prices to go up even more as they try to offset the difference. He also mentions expanding the Medicaid Waiver program, which lets states change their Medicaid plans without approval by the HHS. This can allow states to experiment with different coverage-rules, but my admittedly-cynical expectation is that they will change rules in an effort to save costs and not expand coverage, which I think will make the problem I mentioned earlier even worse.

He does propose a tax-related benefit; basically you are allowed to deduct your premiums from your taxable income. But I don’t know if that really would be an incentive. Note that you will end up saving more money if you didn’t get insurance and held onto what you would have paid in premiums, than you would by getting insurance, and then claiming the premium as a tax deduction. To encourage participation in the individual market, there’s stuff in there about Individual Health Pools and Association Health Pools, where a bunch of people can get together and pool their money. It sounds like a good idea in theory, but without more details I can’t say whether it would help or not.

There’s a bunch of stuff related to HSAs, but HSAs are only useful for people with steady income, and most definitely not for people making minimum-wage. He does also propose removing limits, but that won’t help someone making minimum wage either. There’s a funny bit where you can use your HSA to pay for insurance premiums I guess, but why not just pay for it directly if you’re going to be putting money into an HSA? I don’t think HSAs in general work; at least not for a healthcare market with the kinds of costs we see today. People don’t have the information to predict what kind of healthcare they would need. Not only that, people have no idea how much such care would even cost. So how does it really help if you’ve been putting away $200 a month for a year, only to get surgery in December that costs $6000? This is not outside the realm of possibility.

Overall, I think Rand Paul’s plan is worse than the ACA, because it will effectively start off by denying coverage to a bunch of people. Some of the ideas sound good in theory, but I am not convinced they will work out. Some of the ones that may work out, will take too long to do so, which means that a lot of people are going to be without coverage in the meantime; it seems unethical to write them off simply because the market needs time to “correct”. However, I think there are some good ideas in there that could be rolled into ACA — some of the tax-related ideas are good, although I would much prefer a refundable tax-credit for premiums compared to a deduction. The tax benefits for physicians that provide charitable care is also good, and I think it would be helpful to expand those to apply to all sorts of healthcare providers.

Final thoughts

I need to write this down just to sort it out. Everyone says it’s not a “big deal” and that “life will go on”. I don’t know. In elections prior, I have been disappointed but I never grieved. I thought America was headed, or at least heading (however haphazardly) in a direction where we didn’t care about each others’ race, sex, religion, or sexual orientation. I thought that we were poised and ready to tackle the problems of this new century. Then this election happened. Instead of policies, we were literally debating a candidate’s fitness for being President. Instead of merely deciding the direction of this country, we were deciding its character. I never thought that we would elect a man who categorically stated that he wanted to ban an entire religion from this country. I never thought that we would elect a man who is a bully. I thought that we valued experience, knowledge, and intelligence in this country. I never thought we would elect an inexperienced man, who, based on all we know, is not even a successful businessman. I thought we valued pragmatism, poise, and compromise, if not in Congress, at least in the President. I never thought we would elect an immature, thin-skinned man, who goes into an apoplectic fit just from a mean word.

Growing up, we’re taught things by our parents to help us become productive members of society. We are taught to say “Please”, “Sorry”, and “Thank you”. We are taught to respect each other. We are taught not to bully each other. We are taught not to discriminate against each other. We are taught not to take advantage of each other. We are taught not to lie. We are taught to work hard. We are taught to be good people. This election changed all of that. How can a man who disregards the social contract of a society ever be fit to lead that very society? I think those on the other side think I’m sad or disappointed because my party lost. No; it has nothing to do with being Republican or Democrat. But it has everything to do with deciding who we are as a country. Our principles. Our values. Hillary’s sins are well known. She is a flawed candidate. But I don’t think that she is fundamentally a bad person. Think about anyone you disagree with. Simply because you disagree with them, do you consider them a bad person? This is how I have felt about every candidate I didn’t support. I disagreed with Bush, but I never thought he was a bad person. I disagreed with McCain and Romney, but I never thought that they were bad people. They never did anything that ever made me feel that way. Think about Bush’s statement to Cindy Sheehan, his statement about Muslims after 9/11, or McCain’s response to a woman attacking Obama. They were respectful – that is how the people who want to be leaders of this country should behave. How do you explain something like this to a child? If you voted for a person who does everything you tell your child not to do, how do you explain yourself? A Trump supporter told me that one shouldn’t look to politicians for moral guidance. I’m not sure if they understood my original argument. This is not about having a source of morality; it is about an example. Think back to our earliest lessons in morality – fables – if you do bad things, you get in trouble. If you do good things, good things happen to you. Trump contradicts this most basic axiom. His character contradicts it, and now so does our national character apparently, in that a significant part of the country is not just fine with,but wanted a man like this to be president.

As a rebuttal I often get questions as to how I could support someone shady like Hillary. This usually comes with a gish gallop of numerous conspiracy-theory articles. But in general you can sum it up to the following: she lied about Bengazhi, she is corrupt, and of course, her emails. None of those paint her in a flattering light and in isolation they are all concerning. But it turns into a matter of priority. This is what Trump supporters need to understand: she is flawed. But she isn’t talking about banning a whole religion from the country. She could have and probably did make shady deals. But she isn’t talking about how it is ok to sexually assault a woman. She is establishment, and perhaps she cares more for establishment interests. But she isn’t talking about inciting violence or questioning the foundations of our democracy. She may have accepted donations for favors. But she isn’t talking about using nukes or blowing ships out of the water.

I have never felt scared in this country before. That’s different now. Trump’s senior-most advisers are alt-right fanatics. He has regularly courted the white-nationalist and white-supremacist segments of society. He refuses to disavow them as well. I’m not white and I’m an immigrant. How is that supposed to make me feel?

My opposition to Trump is not simply policy. It has nothing to do with the fact that he was on a Republican ticket. It is something far more fundamental; it is about what it means to be an American and a good human-being. It is about how we treat each other. It is about transcending our differences instead of magnifying them. It is about who we are as a society. It is about staying true to the principles that founded this great nation. It is about the statement that we make to the world about who we are as a country. It’s not just about the next 4 years, but the next 400 and where we need to go as a civilization. I really thought we were there. I really thought we were close this time. I really thought that we could start fixing some of the brain-dead decisions that got us here. I really thought that we could actually tackle climate-change. I really thought that we could do it right this time. The irony of all this, is that Trump supporters will never realize is that they not only voted against my interests, but theirs as well. And that is why this hurts so much.

An alarmist future?

If Trump gets elected, I think humanity as a species has failed. Not to sound dramatic, but the choice should be obvious. It’s like you’re offered two bottles: one labeled water and the other labeled Ebola. Which one do you choose?

This probably sounds stupid. But ever since I first saw Star Trek, I knew I had found a goal. My goal was to do everything I could as an individual, to make that kind of future a reality. I know that I will never live in such a future, but I wanted to do my part to get us as a species, ever so much closer to that reality. I looked forward to a world where the only label we assign to each other is “Human”.

Trump is the antithesis of all of that. He stands at the polar opposite of such a future. If Trump gets elected I have very little hope for the future. Ronald Reagan saw America as a “shining city upon a hill” (a phrase from John Winthrop, an early Pilgrim) – it was a place where “if there had to be city walls, the walls had doors and the doors were open to anyone with the will and the heart to get here”. Ronald Reagan’s America is inclusive; not exclusive. He described it as a proud city, built on rocks stronger than the ocean; a country built on principles that have sustained it for over two centuries.

I have felt that America, even with its numerous flaws, has largely been a force for good in this world. When America decided to take on the mantle of being the world’s superpower, it also inherited the responsibility to do so wisely. As a nation America has made many missteps in this regard, but has also had many successes. Whether nations may admit it or not, many do look to the United States for direction. Trump’s vision threatens all of that. Europe is seeing the resurgence of extreme right-wing nationalism. There are disaffected people everywhere. Feeding into this is rising xenophobia and the desire to blame circumstances on outsiders. This is driven by a migration crisis, which by the way, will be nothing compared to the future ones we will see once the full effects of climate hit us within the next decade or so. Electing Trump will only legitimize and give further traction to these extreme right-wing movements in Europe. This is not a joke; no one saw Brexit coming, and it was largely driven by the same sentiments that are driving right-wing nationalism in mainland Europe.

In the early 1930’s there were a few fascist groups in United States. One of them was the German-American Bund. It was universally rejected by Americans who were repelled by their first exposure to European fascism. How different would the world be today, if a significant fraction of the nation had accepted it? What if there was someone like Trump at this point in time? Imagine a World War II with the United States on the side of the Axis Powers; imagine the outcome.

I am not trying to be alarmist. I honestly feel that we are at a critical point in the history of our civilization. I don’t want to assume the worst, but it’s hard not to. Is our cultural memory really so short that we are going to repeat the same mistakes from more than seven decades ago?

If Trump gets elected, aliens may one day come upon a dead planet and say “See, here’s actual proof that having intelligence doesn’t make you smart. These guys were intelligent, but they still killed themselves anyway because they were stupid.” I’d rather we find them first to disprove that notion.

A Trump presidency does not seem outside of the realm of possibility. That terrifies me. Even if he is elected, I hope the worst does not come to pass. It’s not just the future of America itself that is at stake; it’s the future of our global civilization.

‘I’m really concerned that “too big to fail” has become “too big to trial”‘ — Sen. Elizabeth Warren

Senator Elizabeth Warren at the Banking Committee Hearing

Senator Elizabeth Warren at the Banking Committee Hearing

The Problem With Patents (Infographic)

How a Wired article sent the price of Bitcoins skyrocketing

Disclaimer: I am not an economist and I do not claim to have more than a freshman level understanding of it either. Economics was not my favorite subject and I often find it perplexing. What follows is only based on observation; I may not have considered all variables (mainly due to my ignorance of them). Either way, I thought what happened was pretty interesting. If there are any errors in my assumptions or observations, please feel free to correct me.

Bitcoins are a digital currency. Bitcoins aren’t issued by a bank or a central authority. Instead they are generated by computers when they solve complex problems (for more details, go here and here). I haven’t really read all the details about bitcoin exchange rates and how the bitcoin economy works, but at the very least I know that it does follow the law of supply and demand. So when demand increases and there is a fixed supply, the price will increase (bitcoins are constantly being generated, but it appears that demand is outstripping the rate of generation).

About two weeks ago is when I first decided I would try and get some bitcoins of my own. I decided I would try to generate them and assumed I would have some pretty soon (but I obviously didn’t know the details; it’s a little bit like winning the lottery). So I joined a mining pool online at bitcoinplus. I’ve around .04 bitcoins right now (not much). This was obviously taking too long so I thought about looking into buying some bitcoins. I checked the price over a period of days, it was hovering around $8/bc. I didn’t buy any and decided to check up on it later. A few days later (on the 3rd), I checked again, and this time the price had jumped to a little over $14/bc! What caused this spike? A day later, the price spiked again. This time to about $19/bc! I wasn’t sure what was causing the spike because the price had been more or less stable for the last few weeks.

That’s when I came across this Wired article that my friend sent me. It’s about an underground website (that is also anonymous) that lets you buy any drug. The drugs are priced in bitcoins. It would seem that there are a lot of people interested in buying these drugs and therefore these people require bitcoins. I’m theorizing that this is what led to the increased demand for bitcoins and hence the spike in bitcoin prices.

The Wired article was posted on the 1st of June. You can clearly see from the following charts how the price of bitcoins jumped on that one day (it’s about a jump of 30% on the 1st). The biggest spike was on the 4th; essentially a price increase of approximately 350% in just four days! Since the 4th, the price seems to be slowly coming down. Currently it’s sitting at around a little over $18/bc. I’ll probably keep a watch on the price of bitcoins over the next few days to see what happens. I’m assuming that the demand will die down and therefore the prices should eventually come down as well. Looking into this has actually ignited some interest in me to learn a little bit more about bitcoins and the bitcoin economy.

Price: USD/Bitcoin from the MtGox Exchange from 05/01/11 to 06/07/11

Price: USD/Bitcoin from the MtGox Exchange from 05/01/11 to 06/07/11

Price as percent-changes. USD/Bitcoin from the MtGox Exchange from 05/01/11 to 06/07/11

Price as percent-changes. USD/Bitcoin from the MtGox Exchange from 05/01/11 to 06/07/11

Normally you hear of currency values and stock prices rising on falling based on events in the world (positive or negative). It’s amazing to see how one little thing can change the prices of commodities. In particular, I found this (bitcoin) example particularly interesting because it’s a relatively insulated economy (i.e., it doesn’t seem to be affected by factors in the traditional market).

tl;dr version: Bitcoin prices were hovering around $8/bc. They jumped to $19/bc when Wired magazine posted an article about an underground market where you can buy illegal drugs using bitcoins.

Update: I was looking at closing prices and so it was showing only prices from the end-of-day. Here’s a chart that includes yesterday’s data. The closing price was a little over $30/bc. That’s an almost 700% increase since the 1st!

Closing prices USD/bc from 5/1/11 to 6/9/11 from the MtGox exchange as a line graph

Closing prices USD/bc from 5/1/11 to 6/9/11 from the MtGox exchange as a line graph

Closing prices USD/bc from 5/1/11 to 6/9/11 from the MtGox exchange as a line graph

Closing prices USD/bc from 5/1/11 to 6/9/11 from the MtGox exchange as a line graph

I made a pretty picture…

… with some numbers I found on the Internet.

A pretty picture

A pretty picture

President Andrew Jackson on Central Banks (or why the Fed is bad)

I came across a few quotes that illustrate why Central Banks (like the Fed) are bad. I think they accurately describe the economic situation that Americans face today. These are from president Andrew Jackson; the only president to abolish the Central Bank and the only president who got rid of the national debt (all emphasis is mine):

The bold effort the present (central) bank had made to control the government … are but premonitions of the fate that await the American people should they be deluded into a perpetuation of this institution or the establishment of another like it. —Andrew Jackson

I am one of those who do not believe that a national debt is a national blessing, but rather a curse to a republic; inasmuch as it is calculated to raise around the administration a moneyed aristocracy dangerous to the liberties of the country. —Andrew Jackson

Gentlemen, I have had men watching you for a long time and I am convinced that you have used the funds of the bank to speculate in the breadstuffs of the country. When you won, you divided the profits amongst you, and when you lost, you charged it to the bank. You tell me that if I take the deposits from the bank and annul its charter, I shall ruin ten thousand families. That may be true, gentlemen, but that is your sin! Should I let you go on, you will ruin fifty thousand families, and that would be my sin! You are a den of vipers and thieves. —Andrew Jackson

It is to be regretted that the rich and powerful too often bend the acts of government to their selfish purposes. —Andrew Jackson

Why I prefer the BBC

This side-by-side comparison of the front pages of the BBC and CNN, says it all:

Comparison of BBC and CNN front pages (23rd November, 2010)

BBC vs CNN

Zen Magnets vs. Buckyballs or Buckyballs, meet the Streisand Effect

Buckyballs and Zen Magnets make nearly identical magnetic toys. Zen Magnets started a campaign where they sold both sets on eBay and asked customers to compare. Buckyballs CEO responded with a legal threat, and Zen Magnets posted a video on YouTube responding to their threat, showing how to compare the quality of both the toys. Buckyballs sent a DMCA takedown notice (a completely frivolous one) to YouTube and YouTube removed the video. Zen Magnets sent a counter take-down notice, but the video still hasn’t come back up.

But no need to fear. Buckyballs is quickly going to be educated on the Streisand Effect. Here is a mirrored video:

Also, here is an mp4 for download.

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