ER Visits Up with the Advent of Obamacare

Stephanie Armour and Louise Radnofsky pointed this out earlier in the week in The Wall Street Journal.

Among other things, they mentioned

The median ER charge was more than $1,200 for the most frequent outpatient diagnoses in a study of over 8,000 ER visits in 2006-08….

This is right before Obamacare was enacted.

Notice that ER charge. A significant fraction of the deductibles on Obamacare health coverage plans is larger than that—ranging from $2,000 to above $10,000, depending on family size, the specific plan selected, and so on.

Since the ER charge is less than the deductible, even if these ER patients had an Obamacare plan, where is their incentive to see a doctor in his office? He’s still paying those $1,200 out of his pocket. The proud possession of a health plan is irrelevant to that.

Not the Best Move

According to Spiegel Online International, the European Central Bank intends to introduce a negative rate on cash deposits member banks make into their ECB accounts—a rate of -0.1%. This means that banks would be paying the ECB to deposit their money with the central bank: if a member deposited €100 million with the ECB, the latter would take a €100,000 fee.

The central bank’s motive is to stimulate more lending by those private and commercial banks, to get more money flowing in the EU’s economy. But with loan rates already at historic lows (the ECB itself is only charging 0.25% and intends to reduce that to 0.15%), it hardly seems likely that loan demand is the only impediment to lending—loan quality, borrower quality also are major factors.

Further, with loan rates so low—there’s no room, for instance, for a premium for poor credit risk—the cost to the lender of defaults goes up a lot: only those enormously low rates are there to absorb default losses.

This is a move that can only end badly for the ECB, and at best end indifferently for the banks and the EU’s overall economy. Banks look to make money, not just to let cash sit around twiddling its thumbs. If the ECB is going to charge a fee for making a deposit, look for the member banks to deposit their cash, instead, with each other.

Signs of this will include an increase in the markets for seven-day repurchase agreements, and variations on these. Repurchase agreements are mechanisms whereby banks will lend each other short-term (typically, seven days…) to cover momentary—and expected, even planned—cash flow shortfalls. Repos will make suitable substitutes for deposit accounts in the ECB.

Look, also, for increases in the markets for interest rate swaps—mechanisms whereby banks will trade future interest income streams with each other, typically with one exchanging a variable rate stream for the other’s fixed rate stream. These swaps generally are used to get (slightly) lower interest rates, or because the bank trading for the one stream finds that more useful to it than the stream it’s trading away. But these will make adequate “deposit” arrangements, also.

Look, among other places, for an increase in riskier “deposit” arrangements, too, with the member banks looking again to such instruments as credit default swaps and mortgage-backed securities. These devices aren’t much riskier, if they’re properly constructed and monitored, their negative press during the Panic of 2008 notwithstanding.

All of these, though, will make borrowing at least slightly more expensive, when (if?) borrowing picks up—hence the “at best indifferent” aspect of the ECB’s move from the private market’s perspective. On the other hand, deposits with the ECB are a major source of the funds the ECB loans out. To the extent CDS and MBS (and/or other financial instruments) do go bad, and to the extent the ECB (or its governmental masters) feels constrained to bailout, again, financial instrument market participants, it’ll be hard-pressed to do so. It won’t have the deposited funds to lend on.

Rule of Law

Earlier I wrote about government and free speech regarding a Wall Street Journal op-ed about the FCC’s proposed interference with the business of the Internet.

Buried near the end of the op-ed, though, was a remark that needs greater notice than was present in the piece.

Mr Wheeler’s FCC claims “there are no rules on the books to prevent broadband providers from limiting Internet openness by blocking content or discriminating against consumers and entrepreneurs online.”

The WSJ denied the charge,

But this is false. …the Federal Trade Commission already has ample authority to go after businesses that mistreat customers, online or off[]

but that’s beside the point.

We’re not Europeans. Neither are we, generally, Progressives. We have no need of a government’s rule to tell us every jot or tittle of what we are permitted or not permitted to do. We are American citizens; we are fully capable of deciding for ourselves, in the absence of the “guidance” of our Betters, what we might do or not do.

Ukraine and Energy

America’s booming natural gas production could help Ukraine keep the heat and lights on amid Russia’s latest threat to cut off supplies, if the US cuts through troublesome red tape, lawmakers said. … The U.S. has port facilities that turn natural gas into liquid for export and more are under construction, but shipping to any country not bound by a free trade agreement with the US requires a federal permit. Since 2011, DOE has approved six [count ’em] applications for permits to export natural gas to non-free trade agreement nations, but Ukraine is not one of them. … [The] “Domestic Freedom and Global Prosperity Act”…would grant immediate approval of the 24 pending applications currently filed with the Department of Energy…. “This would send the clear signal that we are serious about enlarging the scope of natural gas exports, and immediately undercut Russia’s dominance,” [Congressman Fred (R, MI)] Upton said. “Russia has chosen to wield its energy resources as a geopolitical weapon to inflict harm on others. As the world’s emerging energy superpower, America has a newfound responsibility to help our allies.”

There are a lot of logistics problems along this path to work out, but that puts a premium on getting started; these problems cannot be allowed to serve as excuses for not bothering. Again.

On top of that, we also need to stop sending signals and start sending stuff—like oil and gas, like weapons, like intel, like…—to Ukraine, as well as sending oil and gas to Germany and the rest of the EU.

Government and Free Speech

This time in the milieu of the Internet. And it’s not good, if the FCC’s latest “rule” proposal is allowed to stand.

Federal Communications Commission Chairman Tom Wheeler went ahead with his proposal on Thursday to give his agency the power to decide whether the terms and prices of broadband Internet services are “reasonable.” That’s bad enough as political discretion, but according to dissenting Commissioner Ajit Pai, regulators from every state will also be able to get into the act.

Government, once again, is deciding that it’s better suited to determine what a proper business arrangement is than the participants in the business. Only this time, since it’s the Internet that’s at stake, and the Internet plays such an enormous role, not only in business per se, but in speech of all forms—political, business, communication of innovations, the list goes on—the FCC is plainly inserting itself into the business of government determiner of what appropriate speech is.

If this rule stands, government will be able to pass on the Internet-based “business arrangements” regarding, oh let’s say, a documentary called Hillary: The Movie. Worse, it’ll be able to do this, not overtly because it objects to the politics of the movie, but more sotto voce, under the guise of objecting to the appropriateness of the business arrangements surrounding its Internet distribution. And by allowing the States to get in on the censorship, the FCC is looking to broaden government…management…of permissible speech.

The Wall Street Journal‘s op-ed points out a myriad of other objections to this harebrained scheme of the FCC, but this will do for this post.