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There’s More to "Improper Payments" Than Meets the Eye

Mother Jones

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Here’s an interesting thing. I was browsing over at The Corner and came across a post from Veronique de Rugy, who was unhappy about the federal government’s rate of improper payments, which totaled $137 billion last year. That’s fair enough. Here are the six worst programs:

This is the kind of thing that liberals should care about too—in fact, we should care about it more than conservatives if we want people to trust government to handle their tax dollars competently. Still, it got me curious. What exactly does this mean? $137 billion in waste and fraud last year? As it turns out, no. Here’s one interesting methodological tidbit:

Another prevalent misunderstanding is that all improper payments are a loss to the government, but that is not always the case. For example, although most of the $137 billion in improper payments was caused by overpayments (payments that are higher than they should have been), a significant chunk of that total amount was caused by underpayments (payments that are lower than they should have been). The difference between these two amounts (that is, overpayments minus underpayments) equals the net amount of payments that improperly went out the door.

Huh. So if the feds overpay Joe $10 and underpay Jane $10, that counts as $20 in improper payments. This is a reasonable thing to track, since we’d like all the payments to be correct, but it doesn’t give us much insight into how much money we’re losing to improper payments. My guess based on a bit of googling is that underpayments are a smallish part of the whole number, but for some reason there’s no official tally of this. Roughly speaking, though, you can probably shave 10-20 percent off the top and get pretty close.

What else? There’s this:

Also, many of the overpayments are payments that may have been proper, but were labeled improper due to a lack of documentation confirming payment accuracy. We believe that if agencies had this documentation, it would show that many of these overpayments were actually proper and the amount of improper payments actually lost by the government would be even lower than the estimated net loss discussed above.

An entire payment is labeled improper if complete documentation is not available. This appears to account for somewhere in the neighborhood of 50-60 percent of all improper payments. Most likely, though, once the documentation is in place, the vast majority of these payments turn out to be correct.

Put this all together, and the net value of genuinely improper payments is probably about $50 billion or so. Still high, but not quite as outrageous as it seems at first glance.

Something about this whole exercise seems kind of weird to me, though. We’re only a few months into 2016 and we already have numbers for FY2015. That’s fast work—too fast to be anything but a preliminary cut at flagging payments that might be incorrect. But how many of them really are incorrect? Nobody knows. For that, you’d have to wait a year or two and then re-analyze all the payments in the sample.

I’d be a whole lot more interested in that. $137 billion makes for a fine, scary headline—especially when the headline leaves the vague impression that this is all due to fraud and waste—but why don’t we ever get a follow-up number that tells us how much the feds ended up paying improperly once all the documentation is rounded up and the final audits are done? Wouldn’t that be a better number to care about?

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There’s More to "Improper Payments" Than Meets the Eye

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Quote of the Day: Donald Trump Doesn’t Need No Stinkin’ Policy Experts

Mother Jones

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Politico interviewed “nearly five dozen Republicans” recently and heard a consistent message: nobody with even a trace of policy cred wants to work in a Donald Trump administration. “The A-level people, and there are not that many of them to begin with, mostly don’t want to work for Trump,” said a former Bush official. “He will cut the A-level bench of available policy talent at least in half, if not more.”

But not to worry. This is all part of the plan:

A source familiar with Trump’s thinking explained that the billionaire businessman was reluctant to add new layers of policy experts now, feeling it would only muddy his populist message that has been hyperfocused on illegal immigration, trade and fighting Islamic extremists.

“He doesn’t want to waste time on policy and thinks it would make him less effective on the stump,” the Trump source said. “It won’t be until after he is elected but before he’s inaugurated that he will figure out exactly what he is going to do and who he is going to try to hire.”

That’s a confidence booster, isn’t it? We’ll all have to wait until after the election for Trump to tell us what he actually plans to do. In the meantime, he’s just going to keep tossing out anti-Muslim, anti-Mexican, and anti-Chinese bombs because that seems to appeal to his fans. But once he wins, he’ll be the most presidential president in the history of presidenting.

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Quote of the Day: Donald Trump Doesn’t Need No Stinkin’ Policy Experts

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Here’s An Idea For Urban Living

Mother Jones

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A couple of days ago I read a post at New York magazine about a new kind of apartment:

This weekend, residents will begin moving into New York’s newest experiment in communal living: a blocky red-and-white building in Williamsburg, nestled snugly against the BQE. It’s run by the company Common, which sells “co-living,” a relatively new product that’s a start-up version of rental roommate shares.

Click the link for the full story, but it brought to mind a random thought that’s been on my mind for a long time. I’ve never mentioned it since it’s light years outside my wheelhouse of knowledge, but it’s Monday, so why not?

As near as I can tell, the Common approach is a building full of bedrooms of various sizes and prices. There are common bathrooms and dining areas in various places, and the rent ranges from $2,250 to $3,190. But if you’re going to go the dorm route, why not do it better? Take a look at the floor plan below:

I chose the bedroom size because it’s the size of my master bedroom. It’s plenty large and comfy, with room for two, lots of closet space, and a nice private bathroom. Five of these bedrooms enclose a 1,100 square foot common area, which is about the size of the entire downstairs of my house. In real life it would be divided into various areas, either via walls or potted plants or what have you. There’s plenty of space for a large kitchen in the center and various dining, seating, and TV rooms around it. The entire thing is 3,162 square feet, and every bedroom has two doors: one into the common area and a private door to the outside. The building would presumably have the usual amenities depending on how upscale it is: fitness center, laundry facilities, storage areas, etc.

So I’m curious: why doesn’t anyone do this? Are there regulatory issues? Has it been tried and failed? It seems like a decent idea that provides a lot of space for the money, and plenty of privacy too if you build the bedrooms right (i.e., good soundproofing). If five roommates are just too many, you could do the same thing with three bedrooms at a somewhat higher cost.

Obviously this isn’t ideal for everyone, but especially in high-cost urban areas it seems like a decent compromise between commune and private apartment that could be rented out for a reasonable price. Has this been done? If so, is there something I’m not thinking of that kept it from catching on?

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Here’s An Idea For Urban Living

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That Profile of Ben Rhodes? You Need to Read It Very Carefully.

Mother Jones

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I honestly don’t care much about Ben Rhodes, but reaction to David Samuels’ profile of him is getting out of hand:

Everyone is circling the wagons around Laura Rozen, and that’s fine. She’s a very good reporter. But once again, let’s take a look at what the Times profile actually says:

The person whom Kreikemeier credits with running the digital side of the campaign was Tanya Somanader, 31, the director of digital response for the White House Office of Digital Strategy, who became known in the war room and on Twitter as @TheIranDeal. Early on, Rhodes asked her to create a rapid-response account that fact-checked everything related to the Iran deal.

….For those in need of more traditional-seeming forms of validation, handpicked Beltway insiders like Jeffrey Goldberg of The Atlantic and Laura Rozen of Al-Monitor helped retail the administration’s narrative. “Laura Rozen was my RSS feed,” Somanader offered. “She would just find everything and retweet it.”

A few points:

This quote comes from Somanader, not Rhodes.
An RSS feed is something you read. Somanader seems to be saying only that she relied on Rozen to keep her up to speed on who was saying what in the Twitterverse.
The idea that Rozen was a “handpicked Beltway insider” comes solely from Samuels’ framing of the quote, not from what Somanader actually said.

It’s common in profiles for authors to intersperse their own impressions with actual quotes. There’s nothing wrong with that. But in this profile, Samuels goes overboard. It’s possible that every quote is well framed, but he’d have to produce far more context to demonstrate that. As it stands, he seems to be a little desperate to spin quotes to make points he wants to make.

This is why I said in my previous post that you have to read Samuels’ profile very carefully. Take a look at what people actually said vs. what Samuels says in his own voice. The quotes themselves are more anodyne than they seem.

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That Profile of Ben Rhodes? You Need to Read It Very Carefully.

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A Vote For Not-Trump Is a Vote For Hillary

Mother Jones

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Jay Nordlinger is confused at the idea that if he doesn’t vote for Donald Trump, he’s effectively voting for Hillary Clinton:

People tell me that, if I don’t vote for either Trump or Hillary, I’m voting for Hillary. My first response is, “So?” My second response is, “What are you smoking?” If it’s true that, if I don’t vote for either Trump or Hillary, I’m voting for Hillary, why isn’t it equally true that I’m voting for Trump? You see what I mean? How come Trump doesn’t get my non-vote? Why does just Hillary get it?

Am I missing something?

Perhaps it’s this: Perhaps people think that Trump has some kind of claim on my vote, because I’m a conservative (and, until earlier this week, I was a Republican)….

Let’s stop right here. I think I see the problem. If not-Trump voters are distributed randomly, the effect would indeed be small. That’s what happened with Ross Perot in 1992. But if millions of people who otherwise would have voted for the Republican nominee are defecting, then the effect is large and decidedly non-random. You really are effectively voting for Hillary since there’s no plausible third-party candidate to take votes away from her.

And it doesn’t even take millions. Ralph Nader effectively elected George W. Bush in 2000 with only a few thousand votes in Florida. It wasn’t his intent, and the odds against it were high, but nonetheless that’s how it worked out.

This is all predicated on the fact that Nordlinger almost certainly votes for Republicans most of the time and for Republican presidential candidates all the time. I’m pretty sure that’s true. And if millions of formerly loyal Republicans stay away from the polls or vote for Gary Johnson or just leave their ballots blank, then Hillary is a shoo-in. I kinda hate to be the one making this case, but there’s really no way around this.

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A Vote For Not-Trump Is a Vote For Hillary

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Heroic Passenger Recognizes Quantitative Economics as True Threat to America

Mother Jones

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Forget ethnic profiling. The real danger facing America these days is economists and their differential equations:

On Thursday evening, a 40-year-old man — with dark, curly hair, olive-skinned and an exotic foreign accent — boarded a plane. It was a regional jet making a short, uneventful hop from Philadelphia to nearby Syracuse.

….The curly-haired man tried to keep to himself, intently if inscrutably scribbling on a notepad he’d brought aboard His seatmate, a blond-haired, 30-something woman sporting flip-flops and a red tote bag, looked him over….He appeared laser-focused — perhaps too laser-focused — on the task at hand, those strange scribblings.

….Then, for unknown reasons, the plane turned around and headed back to the gate….Finally the pilot came by, locking eyes on the real culprit behind the delay: that darkly-complected foreign man….The curly-haired man was, the agent informed him politely, suspected of terrorism.

The curly-haired man laughed. He laughed because those scribbles weren’t Arabic, or some other terrorist code. They were math. Yes, math. A differential equation, to be exact.

It’s about goddam time, I say. Personally, I’d say that economists and their math have done a lot more damage to the world recently than terrorists and their bombs. We owe this flip-flop-wearing woman our thanks.

On a more serious note, can it really be true that no one recognized what decorated young Italian economist Guido Menzio was doing? Sure, maybe his seatmate didn’t recognize math. But neither the flight attendant nor the pilot recognized math-ish scribblings when they came back to take a look at things? “What might prevent an epidemic of paranoia?” Menzio wrote on Facebook. “It is hard not to recognize in this incident, the ethos of Donald Trump’s voting base.” And that’s quite true: Donald Trump is notoriously an idiot at math. I suppose his followers are too.

POSTSCRIPT: You know what’s missing from this story? The actual page of math Menzio was working on in the plane. Admit it: you want to see it too. You’re all such a bunch of nerds.

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Heroic Passenger Recognizes Quantitative Economics as True Threat to America

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Quote of the Day: Debt? What Debt?

Mother Jones

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From Donald Trump, on his plans to run up the deficit in order to rebuild infrastructure:

I’ve borrowed knowing that you can pay back with discounts. I’ve done very well with debt….Now we’re in a different situation with the country, but I would borrow knowing that if the economy crashed, you could make a deal. And if the economy was good it was good, so therefore, you can’t lose.

There you have it. If Trump crashes the economy, he’ll just default on our sovereign debt. Easy peasy. Why is everyone so worried?

POSTSCRIPT: This is a pretty good example of the Trump Dilemma™. Do you ignore this kind of desperate plea for attention? Or do you write a long, earnest piece about just why it’s a very bad idea indeed? You can hardly ignore it since it’s now coming from the Republican Party’s presidential nominee. But giving it oxygen just gives Trump the free media he was angling for in the first place. In this case, I’m semi-ignoring it. Josh Marshall takes the opposite tack here. Decisions, decisions.

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Quote of the Day: Debt? What Debt?

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Americans Aren’t Really Very Angry — Except Toward Uncle Sam

Mother Jones

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Are voters really angry this year? The Associated Press says no:

All that talk of an angry America?

An Associated Press-GfK poll finds that most Americans are happy with their friends and family, feel good about their finances and are more or less content at work. It’s government, particularly the federal government, that’s making them see red.

Hmmm. People are generally pretty happy with their finances and their personal lives, but they’re really pissed off at the federal government. We’ve seen this dynamic before. Here’s a long-term look at polling data from the Washington Post:

Anger toward the federal government has been on a steady upward trend ever since 2003 (though voters in 2016 are less angry than they were in 2014). And this trend is notably unaffected by economic conditions. Anger didn’t spike during the 2000 dotcom bust and it didn’t spike during the 2008 crash. So what’s going on? The obvious culprits are:

Fox News and the rest of the conservative outrage machine
The Iraq war, which explains why anger started to rise in 2003
The tea party, which explains the spike in 2010
The election of Barack Obama, which would explain a spike beginning around 2008 (there’s no data between 2004-2010)

Take your pick. Maybe it’s a combination of things. But the bottom line seems fairly simple: there’s voluminous data suggesting that, in general, Americans are fairly happy with their personal finances and fairly happy with their lives in general. As happy as they’ve ever been, anyway. But they’re pretty pissed off at the federal government. If there’s anything interesting to be said about voter anger, this is the puzzle to focus on.

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Americans Aren’t Really Very Angry — Except Toward Uncle Sam

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Here’s Why OxyContin Is So Damn Addictive

Mother Jones

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Why has OxyContin become the poster child for opioid abuse? The LA Times has a long investigative piece today which suggests that a big part of the blame should be laid at the feet of Purdue Pharma, the makers of the drug. When OxyContin was launched, it was billed as a painkiller that would last 12 hours—longer than morphine and other opioids. That 12-hour dosing schedule was critical to its success. Without it, Oxy didn’t have much benefit. Unfortunately, it turned out that it wore off sooner for a lot of people:

Experts said that when there are gaps in the effect of a narcotic like OxyContin, patients can suffer body aches, nausea, anxiety and other symptoms of withdrawal. When the agony is relieved by the next dose, it creates a cycle of pain and euphoria that fosters addiction, they said.

OxyContin taken at 12-hour intervals could be “the perfect recipe for addiction,” said Theodore J. Cicero, a neuropharmacologist at the Washington University School of Medicine in St. Louis and a leading researcher on how opioids affect the brain.

Patients in whom the drug doesn’t last 12 hours can suffer both a return of their underlying pain and “the beginning stages of acute withdrawal,” Cicero said. “That becomes a very powerful motivator for people to take more drugs.”

But Purdue refused to accept shorter dosing schedules, since that would eliminate its strongest competitive advantage. Instead, they launched a blitz aimed at doctors, telling them to stick with the 12-hour dosing but to prescribe larger amounts. Sometimes this worked and sometimes it didn’t, and when it didn’t it increased the chances of addiction:

In the real world practice of medicine, some doctors turned away from OxyContin entirely. San Francisco public health clinics stopped dispensing the painkiller in 2005, based in part on feedback from patients who said it wore off after eight hours. The clinics switched to generic morphine, which has a similar duration and costs a lot less.

“What I had come to see was the lack of evidence that it was any better than morphine,” Dr. Mitchell Katz, then head of the San Francisco public health department, said in an interview.

The whole piece is worth a read. Purdue has known from the start that 12-hour dosing didn’t work for a significant number of patients, but they relentlessly focused their marketing in that direction anyway. Why? Because without it, Oxy wouldn’t be a moneymaker. As for the danger this posed, that was mostly suppressed by keeping documents under seal in court cases “in order to protect trade secrets.” Welcome to the American pharmaceutical industry.

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Here’s Why OxyContin Is So Damn Addictive

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Premium Increases Under Obamacare Have Stayed Really Low

Mother Jones

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The Department of Health and Human Services has issued a report on 2016 premium increases under Obamacare. This is useful information if you want to answer the following question:

How much do actual Obamacare users have to pay for coverage?

Of course, if this is the question you’re interested in then you have to take into account all the data. You can’t cherry pick just one or two providers; you can’t focus on just the states with the highest increases; you can’t ignore the fact that lots of people shop around for the best price each year; and you can’t pretend the federal subsidies don’t exist. You have to take a look at the nationwide average of what users actually paid. When you do, it turns out that premiums increased about 4 percent this year in the federal marketplace.

But that’s not the only question you might want to ask. There’s also this one:

How has Obamacare affected the cost of health coverage more generally?

You can’t answer this by looking only at Obamacare because there’s nothing to compare it to. You can’t compare Obamacare premiums to premiums in the individual market prior to 2013, because the individual market excluded sick people. Naturally premiums used to be lower. Nor can you compare Obamacare premiums to premiums for employer health care. The coverage is completely different. It’s apples to oranges.

But there are other things you can look at. For example, you can look at the cost of employer coverage over the past decade or so. If Obamacare has devastated the insurance market or jacked up the cost of health care, it will show up here. And this is a nice, clean series for the entire period that provides an apples-to-apples comparison. You can see it on the right.

Long story short, nothing much has happened. The annual increase in premiums declined to about 5 percent in the mid-aughts, and since Obamacare passed it’s been about 3 percent. Nothing to see here.

Now, we only have two years of data since Obamacare passed, so this is still pretty tentative. And you might also be interested in how coverage has changed and what kind of out-of-pocket costs workers are bearing these days. Those are all worthwhile things to look at depending on what questions you’re asking.

But if you want to know about the cost of health care coverage, the answer is pretty simple. Since Obamacare has gone into effect, its users have seen modest premium increases. This year it’s around 4 percent in the federal marketplace. And employer premiums have stayed steady too. Over the past couple of years, they’ve increased about 3 percent annually.

Maybe this will change as time goes by. But for now, Obamacare doesn’t look like it’s done any damage at all to the price of health insurance. In fact, it might have helped. That’s what you see if you take a fair look at all the data.

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Premium Increases Under Obamacare Have Stayed Really Low

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