Anatomy of a Tragedy | The Texas Observer

August 30, 2013

But the real tragedy of the Christopher Duntsch story is how preventable it was. Over the course of 2012 and 2013, even as the Texas Medical Board and the hospitals he worked with received repeated complaints from a half-dozen doctors and lawyers begging them to take action, Duntsch continued to practice medicine. Doctors brought in to clean up his surgeries decried his “surgical misadventures,” according to hospital records. His mistakes were obvious and well-documented. And still it took the Texas Medical Board more than a year to stop Duntsch—a year in which he kept bringing into the operating room patients who ended up seriously injured or dead.

via Anatomy of a Tragedy | The Texas Observer.

Behavioral Economics, Consumer Choice, and Regulatory Agencies | Mercatus

August 30, 2013

Regulatory agencies have traditionally focused on mitigating the harm imposed on individuals by market failures, that is, harm caused by such things as pollution, misleading advertising, and unsafe products. These regulatory theories were built upon the neoclassical economic theory that individuals are rational actors who act to maximize their own welfare. The purpose of regulation was to mitigate the effect of “external” forces that would reduce consumer welfare.

In the mid-1970s behavioral economics began to challenge the neoclassical rational actor model by fusing the insights of psychology and economics. Over the course of the next 40 years, a prescriptive framework built around these insights shifted focus toward attempting to mitigate the harm individuals cause themselves as a result of what the agencies view as “irrational” behavior.

Agencies increasingly began to intervene to “nudge” consumers toward “better” choices through regulation, arguing this improves consumer welfare. The restriction of consumer choices is then counted as a benefit rather than a cost of regulation. As much of the research highlighted in this paper shows, this approach is dubious.

This paper begins with a brief overview of behavioral economics as well as the derivative field of behavioral law and economics. This sets up a discussion of several studies that demonstrate how limiting consumer choice is a cost, not a benefit, to consumers. Many of these choice-constraining regulations disproportionately burden lower-income households. To help preserve consumer choice, we offer some suggestions for protecting consumers from these heavy-handed regulations.

via Behavioral Economics, Consumer Choice, and Regulatory Agencies | Mercatus.

Strassel: A Test of GOP Resolve on ObamaCare –

August 30, 2013

Republicans are busy debating what gives them the most “leverage” in their fight to get rid of ObamaCare. One powerful tool, it happens, is an issue that few of them so far have wanted to talk about.

The issue is the White House’s recent ObamaCare bailout for members of Congress and their staffs. The GOP has been largely mute on this blatant self-dealing. The party might use what’s left of its summer recess to consider just how politically potent this handout is, and what—were they to show a bit of principle—might be earned from opposing it.

via Strassel: A Test of GOP Resolve on ObamaCare –

Obama’s Affordable Care Act Looking a Bit Unaffordable –

August 29, 2013

Republicans have long blamed President Obama’s signature health care initiative for increasing insurance costs, dubbing it the “Unaffordable Care Act.”

Turns out, they might be right.

For the vast majority of Americans, premium prices will be higher in the individual exchange than what they’re currently paying for employer-sponsored benefits, according to a National Journal analysis of new coverage and cost data. Adding even more out-of-pocket expenses to consumers’ monthly insurance bills is a swell in deductibles under the Affordable Care Act.

via Obama’s Affordable Care Act Looking a Bit Unaffordable –

MAP: Americas low-income uninsured.

August 29, 2013

Jeff Young tweeted these Census Bureau maps showing where Americas low-income uninsured live, using the cutoffs for Medicaid expansion eligibility and for Obamacare exchange subsidy eligibility.

via MAP: Americas low-income uninsured..

Genomic Research Ethics: Special Rules for HeLa Cells

August 29, 2013

In her 2010 book The Immortal Life of Henrietta Lacks, Rebecca Skloot told the story of Henrietta Lacks and the cell lines derived from her cervical tumor biospecimen (cell lines known to scientists simply as “HeLa cells”). To make a long story short, in 1951 physicians at Johns Hopkins Hospital took a biopsy from a patient, Henrietta Lacks, and from that biospecimen developed the first human cancer cell line. The biospecimen was taken without Lacks’ knowledge or informed consent. No laws were broken in the creation of the HeLa cell lines that are now recognized (pdf) as “the most widely used human cell line in the world.” She died in 1951, and it was reportedly not until 1973 that her family learned about the HeLa cells (two years after Henrietta Lacks’ name was published as the source of HeLa cells in a scientific journal). As the table below shows, this incident occurred long before the adoption of regulations and ethical guidelines for biomedical research that, today, generally require researchers to obtain voluntary, informed consent from individuals before performing biomedical experiments.

via Genomic Research Ethics: Special Rules for HeLa Cells.

Report: If New Hampshire Expands Medicaid, State Hospitals Will Lose Hundreds Of Millions Of Dollars – Forbes

August 28, 2013

In states that remain undecided about whether or not to expand Medicaid, as Obamacare prescribes, hospitals have lobbied furiously in expansion’s favor. That’s not surprising, on its face; hospital executives’ eyes widen at the possibility of hundreds of billions in additional taxpayer subsidies under the law. But an analysis from the Lewin Group, a prominent health care consulting firm, finds that if New Hampshire expands Medicaid, Granite State hospitals will actually lose $228 million in revenue over the next seven years. How is that possible? Read on.

via Report: If New Hampshire Expands Medicaid, State Hospitals Will Lose Hundreds Of Millions Of Dollars – Forbes.

White House Publishes Final Regulations For Obamacare’s Individual Mandate — Seven Things You Need To Know – Forbes

August 28, 2013

Here are seven things you need to know about the mandate, what the law calls your “Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage.”

via White House Publishes Final Regulations For Obamacare’s Individual Mandate — Seven Things You Need To Know – Forbes.

Obamacare’s Fraud Prevention Program Plagued with Implementation Problems | Washington Free Beacon

August 27, 2013

The IRS’s new fraud prevention program, planned for use with Obamacare, has been plagued with implementation problems, according to a Treasury Inspector General for Tax Administration report.

via Obamacare’s Fraud Prevention Program Plagued with Implementation Problems | Washington Free Beacon.

Inside the last-minute scramble to stand-up Obamacare

August 26, 2013

I’ve spent the past few days talking with state marketplace directors, alongside a few Medicaid officials, about what they expect to happen when the marketplaces go live.

What I heard back was this: We’ll be ready to launch, and good chunks of our technology testing are done. But there’s a lot of work left until we flip the switch – and the product we launch won’t be what was initially envisioned.

“The IT folks are doing nights and weekends right now,” says Jon Hager, executive director of the Silver State Health Insurance Exchange in Nevada. “They’re working seven days a week and getting very little sleep.”

via Inside the last-minute scramble to stand-up Obamacare.