“Insurance” Costs

My Medicare-aged wife broke her wrist, which necessitated surgery, and our health plan provider sent us an accounting of the costs involved.  Following are the high points of those costs.  It’s necessary to emphasize that the surgery is relatively routine following a wrist “fracture,” since the wrist is little different from a sack of pig’s knuckles, and where the arm bones, the ulna and radius join the wrist is more of an abutment than a joining.  The “fracture” was more of a slight jumbling of those pig’s knuckles and small breaks of the ends of the ulna and radius; the surgery was to rearrange the knuckles and repair the fractures with a plate and some bolts.  Really quite routine and minor (save the post-op pain and the long recovery time and discomfort); that emphasizes the nature of the costs.

Spotify and Crony Capitalism

Spotify AB wants to do an initial stock offering, an IPO, on the New York Stock Exchange, and the company wants to do it without benefit of bank underwriters.  Oddly, the NYSE has to ask the SEC for permission to amend its own rules to allow this.  Even more strange, the SEC is dithering over granting that permission—to allow the private enterprise, the NYSE, to conduct its own business as it sees fit, and more proximately, to allow the private enterprise, Spotify, to conduct its business as it sees fit.  The SEC is claiming, with a straight face, that it has until the middle of February to make up its mind.

The Question is a Non Sequitur

John McKinnon and Brent Kendall, in their Wall Street Journal piece, asked Is FTC Up to the Task of Internet Regulation?

His piece is about the split between what the FCC (the erstwhile “regulator” of the Internet, courtesy of the Obama administration) and the FTC are qualified to regulate.

The question is a bit of a non sequitur, though. The Internet is merely a transport medium, and it needs very little regulation. The FTC is fully up to the task of regulating (ideally with a similarly light touch) trade, which is independent of the medium—highway, railroad, snail mail, or electronic—over which the traded products are transported.

“major distortive impact on international trade”

That’s the claim of European nations–Germany, France, Italy, Spain, and the UK—as they worry about the drop in corporate tax rates that the House and Senate bills propose.

Well, of course.  They also don’t like the highly competitive tax rates applied by Ireland and Luxembourg and routinely excoriate those nations for having the temerity of competing via tax treatment for business.  While the nations bleat about double taxation and how European businesses operating in the US would be at a tax disadvantage compared to US companies operating in the US, here’s the nub of the thing:

Individual Mandate and Risk Pools

Louise Radnofsky and Stephanie Armour had a piece in The Wall Street Journal that looked at the small and shrinking impact of removing the Individual Mandate (or more accurately, removing the penalty Supreme Court-created tax imposed for not satisfying the IM) on the health coverage providing industry.  The piece is worth the read, but there was one remark quoted at the end that wants a particular look.

“Making the risk pool stable is a vital part” of keeping individual insurance premiums in line with the overall cost to cover a person insured through a larger group or employer, said Andy Slavitt, a top health official in the Obama administration.

Another Reason

…to push for lowered State tax rates, empirically observed.

There are signs home buyers in metropolitan New York are pausing to consider the effects of proposed federal tax law changes, setting the stage for a possible chill in the market, brokers say.

The changes, in versions of bills in both the House and the Senate, likely would increase the cost of home ownership and reduce after-tax discretionary income for many mostly affluent home buyers in New York and other states with high state and local income and property taxes, brokers and analysts say.

Death Panels?

The Affordable Care Act required Medicare to penalize hospitals with high numbers of heart failure patients who returned for treatment shortly after discharge. New research shows that penalty was associated with fewer readmissions, but also higher rates of death among that patient group.

Because sometimes readmission is necessary for quality care—whether that readmission was driven by later complications, by too-soon original discharge in the Medicare (which is to say Government) pressure to hold down costs first, or by some other factor—but that Government pressure to push the patient out the door also pushes against the patient’s return.  Even when necessary.

Tax Havens

Christian Reierman, writing for Spiegel Online, thinks tax havens are bad.

He began with the usual false premise, itself as usual unspoken: that Government is owed the money earned by private citizens or their privately owned enterprises, or that Government is somehow otherwise entitled to it.  His proximate vehicle is the Paradise Papers and their exposure of how widespread is the use of tax havens—entirely legal tax havens, mind you—by international businesses.

The German newspaper Süddeutsche Zeitung leaked a vasty number of documents—the so-called Paradise Papers—that exposed

Obamacare Subsidies

Recall that under Obamacare, health coverage plan providers are required to subsidize low-income Americans (who, under Obamacare, are required to buy the plans regardless of need for the plans on offer or ability to pay the vig for them) for their costs in buying those health coverage plans.  Recall further that the Obama administration paid those plan providers monies to reimburse them for those government-mandated subsidy payouts.  Recall also that Congress never appropriated any funds for the purpose of making those payments to the plan providers.  Finally, recall that a DC District court ruled those payments to the health plan providers illegal—because Congress had not appropriated any funds for the purpose.  Then the Trump administration ceased those payments to the health plan providers.

Health Plan Providers Are Concerned

These providers, which surprisingly The Wall Street Journal misapprehends as insurers, are bracing for a drop in enrollment in the ongoing health plan provision program “turmoil.”  There’s this key passage in the article at the link:

[M]any firms say they expect to lose consumers who will bear the full brunt of the rate increases—those who aren’t eligible for the health law’s premium subsidies, which help enrollees with annual incomes of less than around $48,000.