Tag Archives: edinburgh

Quote of the Day: How Do You Solve a Problem Like Obamacare?

by LesterMcGrowdie Posted on April 8, 2014

Mother Jones

From a Republican congressional health aide who was “granted anonymity to speak candidly,” on the difficulties of creating a Republican plan to replace Obamacare:

The problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act. … To make something like that work, you have to move in the direction of the ACA. You have to have a participating mechanism, you have to have a mechanism to fund it, you have to have a mechanism to fix parts of the market.

That’s a problem, all right. If you actually want to cover people, you have to pay for it. End of story. Republicans are steadfastly not willing to pay for it, so they aren’t going to cover anyone with whatever plan they dream up. No matter what kind of smoke and mirrors they throw up to disguise this, that’s the bottom line. No money, no coverage.

Really, though, all this GOP aide is saying is that Obamacare is fundamentally a pretty conservative plan. Liberals nearly all prefer a simpler, cheaper, more comprehensive riff on single-payer of some kind. But that couldn’t pass in 2009—even moderate Democrats wouldn’t have supported it—so instead we had to cobble together a bunch of conservative ideas into a kind of Rube Goldberg edifice that was at least better than nothing. It only works moderately well, but that’s because the conservative take on healthcare is fundamentally incoherent. The more conservative your health care plan, the worse it works.

So Republicans have a choice. They can:

  1. Introduce a more liberal plan that’s cheaper and works better.
  2. Introduce an even more conservative plan that’s more expensive and works even worse than Obamacare
  3. Toss out a few of the usual pet rocks and just pretend it’s a plan.

My money is on Option 3.

This article: 

Quote of the Day: How Do You Solve a Problem Like Obamacare?

Posted in FF, GE, LG, ONA, Uncategorized, Venta | Tagged , , , , , , , , | Comments Off on Quote of the Day: How Do You Solve a Problem Like Obamacare?

My Kinda Sorta Non-Review of Thomas Piketty’s “Capital in the 21st Century”

by LYZPhiltyouwwfc Posted on April 8, 2014

Mother Jones

I’m having a hard time finishing Thomas Piketty’s Capital in the 21st Century. Is this because it’s a long, dense tome? Not really, though that doesn’t help. Is it because he has nothing interesting to say? Not at all. Capital presents a very provocative thesis. Nevertheless, I started it once, put it down, finally picked it up again, and still haven’t finished it.

So what’s the problem? It’s pretty simple: Piketty’s provocative thesis is extremely elementary and he makes it right in the introduction. Here it is in a nutshell:

Over the long run, ordinary labor income grows at about the same rate as the broader economy. That’s about 2-3 percent per year these days. Capital, however, tends to produce real returns of 4-5 percent. This means that over the course of, say, 50 years, labor income will increase about 3x while capital stocks will increase about 9x. That in turn means that income from capital will also increase 9x. And since rich people have by far the bulk of all capital income, income inequality inevitably grows forever unless something stops it.

The shorthand for this is r > g. That is, r (the return on capital) is historically greater than g (economic growth), which means that rich people with capital will always see their incomes grow faster than ordinary wage slaves. The rest of the book is a lengthy succession of charts and tables demonstrating that, historically, r really is greater than g. Since I was pretty easily persuaded of this, I had a hard time slogging through all the details.

In any case, the historical data isn’t really why anyone other than specialists cares about this book. After all, the world has been ticking along for centuries, and somehow the rich have not, in fact, accumulated 99.9 percent of the world’s income despite more than a thousand years of r being greater than g. Why? The simple answer, I gather, is war. This is the great leveler. The rich get richer for a while, but then they lose it all during periods of war, and the cycle starts all over. That’s what happened in the 20th century: The rich were obscenely wealthy early on, and then came World War I, the Great Depression, and World War II. That wiped out lots of wealth, and the postwar rebuilding era was one of those rare eras when r was actually greater than g. (See chart on right.) So labor did relatively well for a few decades. This ended in the 80s, when the old historical pattern reasserted itself.

This brings us to the question we really care about: Now that we’ve reverted to a more ordinary r > g world, will this continue? I started skipping through the book to find Piketty’s answer, and I was disappointed at what I found. After some preliminary throat clearing to get clear on some details (the nature of private savings, what components should be counted in capital accounts, etc.), we get….nothing.

Basically, Piketty says that historically r has been greater than g, and there’s no reason to think this won’t be true in the future. That’s really about it. Oh, he addresses some technical issues, like the fact that a glut of capital should reduce the return on capital, but basically that’s his argument. In the past r has almost always been greater than g, and we’d be foolish to think that’s likely to change.

Don’t get me wrong: Piketty may be right. Hell, he probably is right. But while the details are of keen interest to specialists and practitioners, the gist of his argument is simply that the future will probably look like the past. That’s certainly plausible, but I’m frankly having a hard time plowing through a ton of background material in support of such a simple thesis.

I’m not sure why I’m fessing up to all this. I’m really doing nothing except admitting that I’m not sure what everyone else sees that I don’t. As a data-gathering exercise, this book is unquestionably a tour de force, and I’m truly not trying to slight Piketty’s seminal achievement here. But as a layman’s guide to the future (and it’s explicitly written for a lay audience), Capital has little to say except that current trends will probably continue. It might be unreasonable to expect more, since obviously no one can predict the future, but I guess I expected more anyway. Is r > g really a monocausal explanation for the evolution of the entire world economy? Is it possible that r might decline for structural reasons in the future? Or that g might increase thanks to automation? Or that other factors might come into play? That seems at least worth addressing in some depth.

In any case, this is Piketty’s story. Capital grows faster than labor income. Rich people have most of the capital. Therefore rich people get richer faster than ordinary wage earners and income inequality inexorably rises. If we don’t like that, we’ll have to do something about it. Piketty thinks the only answer is a global wealth tax, which he admits is a political nonstarter. Dean Baker has some other ideas here. Or maybe war will once again take care of things. Or maybe the rise of smart robots will make things even worse than Piketty ever imagined. I guess we’ll all know in another 50 years or so.

Read article here – 

My Kinda Sorta Non-Review of Thomas Piketty’s “Capital in the 21st Century”

Posted in alo, FF, GE, LG, ONA, Uncategorized, Venta | Tagged , , , , , , , | Comments Off on My Kinda Sorta Non-Review of Thomas Piketty’s “Capital in the 21st Century”

Drug-Company CEO: Top Morning-After Pill May Not Work Over 165 Pounds, Regardless of BMI

by GemmaHornung Posted on November 27, 2013

Mother Jones

<!DOCTYPE html PUBLIC “-//W3C//DTD HTML 4.0 Transitional//EN” “http://www.w3.org/TR/REC-html40/loose.dtd”>

Since Mother Jones broke the news on Monday that a European drugmaker, HRA Pharma, found that its popular morning-after pill may not work in heavier women, many readers have asked why the company chose to update its product labels with a hard weight limit—instead of a limit on BMI, an obesity measurement that relies on a height-to-weight ratio.

HRA Pharma was prompted to rethink its labels after University of Edinburgh Professor Anna Glasier linked emergency contraceptive failures and an obese body mass index (or BMI) in a 2011 analysis. The new label for the drug, Norlevo—a brand of emergency contraceptive pills which uses levonorgestrel to prevent pregnancy, and is identical to several US drugs, including Plan B—says it is not recommended for women who weigh 165 pounds or more, no matter their height.

Glasier, analyzing data from one study sponsored by the US National Institutes of Health and another sponsored by HRA Pharma, found that the risk of pregnancy in women using levonorgestrel pills increased significantly if a woman had a body mass index of 30 or higher—which the US Centers for Disease Control considers obese.

On Tuesday, HRA Pharma CEO Erin Gainer explained the company’s decision further to Mother Jones. When HRA statisticians reviewed the data Glasier used for her analysis, Gainer says, they confirmed Glasier’s findings about BMI—but they also found that their products’ failure correlated even more strongly with weight, regardless of a woman’s height.

“We were surprised,” Gainer says. “But the findings were really quite striking from a statistical point of view.” She adds that weight is easier for health care providers to discuss with their patients. “People don’t walk down the street knowing what their body mass index is,” she says.

HRA Pharma has not made its analysis public. But based on the media uproar after I first revealed Norlevo’s new guidelines, Gainer says, “We’re thinking now about how best to publish these findings.”

A New York Times article highlights another change HRA Pharma will make to the leaflets included with Norlevo: the new leaflets will say that Norlevo “cannot stop a fertilized egg from attaching to the womb.” This is significant because it contradicts assertions made by abortion opponents in their lawsuits against the Affordable Care Act’s birth control mandate—the so-called “Hobby Lobby” cases that the Supreme Court on Tuesday agreed to hear this spring. The Times’ Pam Belluck explains:

The cases coming before the Supreme Court involve corporations that object on religious grounds to the health care law’s requirement that employers provide insurance coverage for contraception, including emergency contraception. The cases are based on the claim that some types of contraception, including Plan B One-Step, prevent fertilized eggs from implanting in the womb, tantamount to an abortion.

While labels of Plan B One-Step and related pills, which contain the drug levonorgestrel, say they work mostly by blocking the release of eggs before fertilization, they also say the drugs may inhibit fertilized eggs from implanting in the uterus.

Last year, the New York Times reported on new evidence that emergency contraceptive pills do not prevent implantation of a fertilized egg and the FDA now tentatively agrees with their assessment. But HRA Pharma appears to be the first drug company to adjust its labels accordingly—a significant data point against the abortion foes appearing before the Supreme Court.

In her research, Glasier did not determine why the effects of levonorgestrel diminished as BMI or weight increased. She published her research in the international peer-reviewed journal Contraception.

The FDA is investigating whether US emergency contraceptives that use levonorgestrel must change their labels.

Diana Blithe, a contraceptive researcher at the National Institute of Child Health and Human Development and an author of one of the studies Glasier analyzed, told NPR on Tuesday that she supports such a change. “I think it is incumbent upon American manufacturers to put that information on the label now that they’re aware of it,” she said.

But Glasier told CNN that she was still skeptical of warning heavier women not to use Norlevo or similar drugs. “You are probably better to take levonorgestrel emergency contraceptive pills after unprotected sex than just to leave it to chance even if you are obese,” she said.

Original article:  

Drug-Company CEO: Top Morning-After Pill May Not Work Over 165 Pounds, Regardless of BMI

Posted in FF, GE, LAI, LG, ONA, Uncategorized, Venta | Tagged , , , , , , , , | Comments Off on Drug-Company CEO: Top Morning-After Pill May Not Work Over 165 Pounds, Regardless of BMI