Tag: Premium

McArdle worries that Obamacare is entering a “death spiral,” where young and healthy individuals don’t buy coverage and thereby drive up premiums:

[W]hat we have now is a situation where only the extremely persistent can successfully complete an application. And who is likely to be extremely persistent?

1. Very sick people.
2. People between 55 and 65, the age band at which insurance is quite expensive. (I was surprised to find out that turning 40 doesn’t increase your premiums that much; the big boosts are in the 50s and 60s.)
3. Very poor people, who will be shunted to Medicaid (if their state has expanded it) or will probably go without insurance.

Insurance that is only sold to these groups is going to be very, very expensive. Not the first year — President Barack Obama was in the Rose Garden just this morning, touting the fantastic cost savings available to the old and sick people whom Obamacare was already helping. But if those are the only people who sign up, insurers will lose a bunch of money on these policies. And then next year, they’ll ask for a lot more money.

Adrianna McIntyre, on the other hand, argues “delaying the individual mandate for a year wouldn’t provoke a full death spiral” because “there are deep-in-the-weeds protections baked into the Affordable Care Act” that “aid insurers if they wind up enrolling a population that is sicker and more expensive than projected” during Obamacare’s first few years:

Basically, today’s worst-case scenario is that HealthCare.gov takes months to fix and the mandate is delayed until 2015, resulting in widespread adverse selection. Insurers wouldn’t recoup all losses, but the risk corridor program provides their bottom line with a substantial buffer. Importantly, it doesn’t need to be budget neutral; if the math demands it, the government can pay out more than it collects through the program. This could be expensive—the CBO scored the health law as though risk corridors were budget neutral—but it could also be offset by foregone subsidies.

Insurers have a stake in Obamacare’s success; that doesn’t magically disappear if 2014 enrollment is rockier than anticipated. The the risk corridor program continues through 2016, which would allow plans to weather 2014′s uncertainty and probably keep the following year’s premiums relatively unchanged as the risk pool normalizes.

The real risk of delaying the individual mandate is long-term political fallout from Obamacare being labeled a “fiasco”, not the dreaded insurance death spiral.

Barro agrees that insurers will do everything in their power to avoid a death spiral:

Health insurers are eager to add tens of millions of new customers and have every reason to work to prevent a death spiral. Even if website problems that drag into 2014 cause the participant pool to be disproportionately sick, and insurers take a bath for one year, they will be motivated to price in a way that draws healthy participants in for 2015, so long as the website is working well by fall 2014, when 2015 enrollment starts. Still, it would be best to avoid the problem altogether.

That’s Kevin Drum’s reaction to Gallup’s latest:

I have a rule of thumb that favorability ratings need to reach about 65 percent before you hit a tipping point where a major social change starts getting codified into law nationwide. There’s nothing magic about this threshold. It’s just a general sense based on previous issues similar to this.

And as you can see, public opinion isn’t merely rising on marijuana legalization, it’s accelerating. The rate of increase has gone from about 0.5 points per year in the 90s to 1.5 points in the aughts to 4 points so far in the teens. If this keeps up, we’ll pass the 65 percent threshold by 2016 or so.

Mark Kleiman agrees that, unless the polling trend reverses, that federal legalization will happen in the near future:

If the question of whether to legalize now seems largely settled, that makes the much-less-debated question of how to legalize even more topical. Some of the smarter opponents of cannabis have figured this out, and are now looking for ways of limiting the increase in drug abuse likely to follow legal availability. However, career and ideological interests and group ties are likely to lead the majority of the active drug warriors to keep fighting what now seems like an unwinnable battle, telling one another that legalization is sure to be such a disaster that the public will demand re-prohibition. By doing so, the warriors will help to ensure that the legal system that eventually arises will be over-commercialized, under-regulated, and under-taxed.

This would simply repeat the mistake they made in opposing the medical use of cannabis. While the warriors kept chanting “Cheech and Chong medicine,” the pot advocates rolled right over them.

Mark also takes me to task for downplaying marijuana’s downsides:

Andrew Sullivan strikes a triumphal note. Hard to fault him for that. But goddammit, “less harmful than alcohol” and “not harmful to most of its users” do not add up to “harmless.” Adolescents spin out on cannabis and wreck their academic careers. People of all ages do stupid things while stoned, including driving their cars into trees and other cars. Cannabis now follows only alcohol as the primary drug of abuse reported by people voluntarily entering drug treatment.

Why take the perfectly reasonable case that cannabis should not be illegal and ruin it with the silly claim that the stuff is harmless?

Well, I was perhaps a bit too giddy last night to avoid stupid, simplistic adjectives. In The Cannabis Closet and this blog, we’ve long aired the harms that can attach to the plant. I think it should be kept from teenagers the same way we restrict alcohol (perhaps more so). What I was getting at is that there is no fatal overdose for marijuana – unlike alcohol and so many other drugs; and that almost everything is harmful in certain contexts and degrees: driving sober, for example; or skiing; or sex; or porn. My point is that in this broader context, pot is pretty harmless as these things go. But nuance eluded me last night, for which I apologize.

A new paper does just that. George Dvorsky summarizes:

The specific virus used for the new study, which was conducted by Curtis Brandt and Aaron Kolb of UW-Madison, is the herpes simplex virus type 1 (HSV-1) which typically causes nothing more than cold sores around the mouth. It’s not lethal, but it’s incredibly virulent. It tends to run in families owing to the manner of infection, which can include simple contact like kissing or through saliva. It’s been such a part of the human story that Brandt refers to herpes as “a kind of external genome.”

For the study, the researchers compared 31 strains of HSV-1 collected in Africa, Europe, Asia, and North America. Then, by mapping the mutation patterns of the virus, they were able to reconstruct the way herpes hitchhiked on humans as they traversed around the globe. By using high-capacity genetic sequencing and advanced bioinformatics, the researchers were able to parse through the massive amount of data embedded within the 31 discrete genomic strains.

Joshua Keating adds:

In general, the paper suggests that the data “supports the “out of Africa model” of human migration with HSV-1 traveling and diversifying with its human host”. There was one North American derived strain which they found was related to the East Asian family of the virus. They estimated the “divergence time” between this strain and its relatives as around 15,000 years which corresponds “with the estimated time period in which the North American continent was populated from Asia, approximately 15,000 years BP.”

In other words, the first arrivals on the North American continent may have brought their cold sores with them.

Lindy West praises the short film Meet My Rapist (seen above) as an effective comedic take on rape, especially from a victim’s perspective:

It’s a brilliant, troubling example of how “rape jokes” can be cathartic and complex and difficult and empowering—for victims and allies, not for the predatory and indifferent. As I’ve said many times before, I don’t want to ban rape jokes; I want to see more rape jokes, everywhere, targeting rape culture instead of perpetuating it. Because nothing punctures and deflates hypocrisy like humor. Nobody speaks truth to power like a sharp-toothed goofball.

The filmmaker, Jessie Kahnweiler, describes how she translated her own experience of rape into comedy:

I think the distance between making the film and the actual rape (which occurred eight years ago) and the frustration came with this feeling, like, “what the fuck, it’s been eight years and I’m STILL not over this? what the hell, man?!” The film deals a lot with my frustration and trying to reconcile being a “strong/ badass feminist” with a “hurting victim,” and being a sexual being as well. There is such a certain amount of guilt and shame around my own body with this experience, and the film was a chance to confront all these lurking fears.

My immediate reaction was just that: a reaction. I was formulating my feelings around my rape based on what other people felt and thought about it. Does that make sense? Like, I was so busy making sure my friends and family knew that I was “OK” that I forgot to ask myself if I actually was “OK.” Perhaps I used humor to skip over the pain and move straight to the hero rape victim, but obviously that shit caught up with me.

In a 1982 review from TNR’s archives, Samuel Hynes evaluated a biography of P.G. Wodehouse, the British humorist behind Jeeves and Wooster.  He zeroed in on Wodehouse’s lowest moment, when he provided broadcasts for German radio after being captured during WWII.  But Hynes wrote that “as Fascist propaganda [the broadcasts] were surely no more useful than [Ezra] Pound’s were”:

Still, it’s not surprising that the British took a harsher view, and considered that Wodehouse had given comfort to the enemy. He was never tried, but the incident darkened his life, and made him an exile until his death. Even long after the war he could get no assurance from the British government that he would not be prosecuted if he returned to England, and so he ended his days at Remsenburg, on Long Island, though at the last moment the British did relent enough to offer him a knighthood (the Queen Mother’s work, no doubt).

The whole episode is a sad one, reflecting only discredit on everyone connected with it. It is interesting, though, for what it suggests about Wodehouse the man, and also about the kind of writing of which he was so much a master. Throughout the German years, and for long afterward, Wodehouse behaved like one of his own characters—like the imbecile Bertie, or Lord Emsworth, that “vague and woolen-headed” peer whom he admitted he resembled. He never really did understand what he had done that was wrong, and though he regretted having broadcast, it was only because it had offended his readers. The moral issues of the war seem never to have penetrated his woolen head.

Update from a reader:

As is often the case, Orwell got there first. In his wonderful essay “In Defence of P.G. Wodehouse” (July, 1945), he makes the argument that Wodehouse was really only guilty of stupidity and to charge him with treason, etc. was “untenable and even ridiculous.” Orwell believed the that fascism was a distinctly modern (i.e. interwar) phenomenon. Orwell’s contention is that Wodehouse’s mind never moved beyond 1914 (nor did the mental universe of any of his characters, including the knee loving “fascist” Roderick Spode). To Orwell’s mind, Wodehouse was a Victorian who couldn’t even comprehend fascism and Nazi tyranny, let alone be complicit in it. It’s interesting that this is also his argument for why Kipling, that “good bad poet,” was also innocent of fascism – his mental universe never grew beyond the summer of 1914. 

(Video: “P.G.Wodehouse faces the music from his wife, Ethel, following the reception of his broadcasts on German radio during WWII.”)

A reader writes:

I think one of the things that is being missed by most of the contributors to this thread is that male-on-female rape is rarely about sex.  Typically, it’s an assertion of power on the part of the male, not a desire to get off sexually without seeking the consent of the other.  But in most of the stories sent in by your male readers about non-consensual sex, the dynamic seems different.  In none of those stories does it seem like the female is trying to exert power over the male; it seems like the females just want to get off.  Maybe that’s why the guys respond so differently to being “violated.”

Another reader:

Interesting conversation you’ve been having about the many forms of rape and how we as a society perceive them. I actually think language is posing an obstacle here. Look at “killing”. All killings end with the same result: death. But look at how many legal names we have for it. There’s murder (and even murder one and murder two), manslaughter and involuntary manslaughter. There’s also justifiable homocide, killing in self-defense, suicide, euthanasia, assassination, killing during war – all these distinctions and definitions to describe a variety of traumatic acts that end in the same exact result: death.

And yet we use the word rape to describe a widening range of actions with a vast range of outcomes.

We use rape to describe a man hiding in the bushes, pouncing on a woman in the dark and penetrating her while holding a knife to her throat. And we now also use it to describe a man buying a woman too many drinks at a bar and having sex with her while she’s conscious but inebriated. Both acts are wrong, but do they really deserve to be described with the same word?

Yes, we do sometimes distinguish between rape and statutory rape, but even there, when a male authority figure coerces a young child into sex, is that the same thing as a high school senior smoking a joint with his sophomore girlfriend and engaging in sex that is seemingly consensual, even if the law doesn’t recognize it as such?

And now we bring in the variety of male-victim rapes, many of which are certainly as traumatic as those of the female variety. However, having a stronger man force himself upon you and penetrate you is not the same thing as waking up to find your girlfriend using your sleep-induced erection for her pleasure without your permission. I was once the “victim” of the latter, some 15 years ago. Prior to that, had you asked me, I would have said that waking up to such a scenario might be fun. But it wasn’t. It was annoying, disturbing and felt like a violation. I expressed my displeasure, she apologized and then I felt a little bad for making her feel bad about it. I forgot about it shortly after and never think about except at the rare times like now, when the topic is brought up.

Had it been reversed, had she woken up with me on top of and inside her, I’m pretty sure she would have been far more upset and far more traumatized. In the instance of my being violated, I think it would have been a gross overreaction for me to call the police and cry rape, but in the reverse scenario, that might be a reasonable reaction.

There is a double standard, or a multiple standard, and one of the key factors is penetration. I think I would have felt differently had there been a digit or object inside me than I felt waking up inside her. And I think the distinction is enough to give the two acts different names. One is rape and the other is… something else, maybe harassment?

As for the story that started this all, that of Chris Brown’s loss of virginity at 8 to a girl of 14, it seems there are so many distinctions that keep it from feeling like rape to my mind, and the fact that he is male is NOT one of them. First, he was underage, but so too was the girl. Second, according to his description, she did not in any way seduce him; rather the desire was mutual. And finally, while there was pressure put upon Brown, it did not seem so much to be from the girl as from his environment. You could blame those around him who applied the pressure, but then who would be the culprits … 11 and 12 year old neighborhood boys?

Did the incident in question shape Brown’s attitude toward sex and later actions? Possibly. Probably. But does that make it rape? I just don’t see it.

One more story:

Ok, you finally have provoked me to respond. I unfortunately have a lot of thoughts on this subject. For one thing, I have unequivocally been “taken advantage of” by a girl before. In my college days, back in the ’90s, I went to a friend’s apartment, and when I arrived, I was invited in by her roommate. Her roommate was extremely attractive, and in the process of waiting for my actual friend, somehow she talked me into taking a pill. Now, I liked pills back then, and this is not about my genuine lack of good judgment at a time when I was totally reckless. Besides, I think this girl could have talked me into just about anything.

Regardless, it was a Rohypnol, the infamous roofie of date rape fame. What ensued that night was a total blur. I remember bits and pieces, like ending up at a party with the girl, but not what happened at the party, or what happened when it was over. What I do remember, however, was waking up the next morning, naked in the bed with her, and then taking a shower with her (we were both late for class), as if it were perfectly normal, and wondering, “what the hell just happened?” I wasn’t upset over the thought of having been with her. I was upset that I couldn’t recall any of it. Not one bit. The most satisfaction I got out of it was seeing her naked, and wondering.

Now, I clearly was culpable in the sense that I freely popped a pill which I didn’t have any experience with. But as other readers have pointed out, had the gender roles been reversed, I would clearly have been the aggressor, and she the victim, and subject to prosecution had she desired it.

The bigger picture here is that we, as a society, are using one term, “rape,” in an overly broad fashion. Rape is a crime of sexual violation, with elements of aggression, violence and/or control. What happened to me, was not a crime of aggression, was not violent, and arguably was not about control, as I more than certainly would have had sex with the girl freely, if my consent had been solicited.

Therefore, it can not be rape. It was a non-violent exploitation, maybe even some violation of me (was the violation sexual? Or was it a violation of trust?), with a sexual component, and it didn’t live up generally accepted ethical standards, but it wasn’t rape. Unfortunately, we don’t have a criminal system that recognizes “ethical lapses” as very real, albeit misdemeanor, classes of sexual misconduct. The lack of such distinction, however, means that many people are wrongly accused and convicted over a minor ethical lapse for the same crime as legitimate menaces to society; conversely, many people are never brought to any kind of justice because (in my case) there is no way I would make an accusation of rape against that girl, even if what she did was “wrong,” and I am sure there are many examples of women who have been wronged that aren’t prepared to make a rape claim for similar reasons. And even worse, the contorted legal standard creates the terrifying reality that men in emotionally abusive relationships have to live in fear of being accused of rape, as at least one of your readers alluded to.

As usual, thank you for airing such a sensitive topic.

Gallup polled Americans on marijuana and found that “for the first time, a clear majority of Americans (58%) say the drug should be legalized”:

The Dish has waged many campaigns over the years, from ending torture to tackling the long-term debt, but I’m particularly proud of championing two social reforms: the legalization of marijuana and civil marriage for gay couples. They appear very different, but both are about bringing outlaws into the civil mainstream. Being gay went from being a crime to being a citizen in my lifetime. Now, smoking or vaping the harmless, ubiquitous drug, marijuana, is beginning to be thought of as indistinguishable from drinking the much more harmful, ubiquitous drug, alcohol.

What the two reforms also have in common, in my view, is adjusting our social norms to empirical reality. It was always absurd to think of gay people as somehow outside the norms of love, commitment and family. It is empirically insane to treat pot as having no conceivable medical use and classified in the most dangerous category there is. And yet our government proved itself incapable of adjusting to reality on both blindingly obvious questions, until the people long moved past it.

Well, Tocqueville is proven right again, isn’t he?

An experiment in two states with full legalization has revealed the pure fear behind our current criminalization of a plant, just as a single state with marriage equality almost a decade ago began a tidal wave of acceptance. Joshua Tucker sees things the same way:

If anything the public opinion swing on marijuana legalization seems a bit more dramatic … suggesting that policy change could come even faster. Splits based on partisanship are almost the same in both cases — Democrats come in at 65 percent in favor marijuana legalization, 69 percent  in favor of gay marriage, while Republican support is at 35 percent  (marijuana) and 26 percent  (gay marriage) — and in both cases, there is overwhelming support among 18-29 year olds, 67 percent  of whom believe marijuana should be legal and 70 percent  of whom think gay marriage should be legal.

More important: on this issue as with marriage equality, Independents are much closer to Democrats than Republicans, with 62 percent support. The GOP is now effectively the oldest generations’ angry veto of the younger generations’ demography, values and politics. Jacob Sullum looks at other recent polling:

Gallup’s survey asks, “Do you think the use of marijuana should be made legal, or not?” That leaves open the question of whether commercial production and distribution should be legal as well (as in Colorado and Washington). But other national polls that go beyond marijuana consumption also have found majority support for legalization.

In a Reason-Rupe survey last January, for example, 53 percent of respondents said “the government should treat marijuana the same as alcohol.” And last month a Public Policy Polling survey in Texas found that 58 percent of respondents either “somewhat” or “strongly” supported “changing Texas law to regulate and tax marijuana similarly to alcohol, where stores would be licensed to sell marijuana to adults 21 and older.” The latter finding was especially striking given the state’s conservative reputation.

And Josh Barro puts support for marijuana legalization in perspective:

More Americans want to legalize marijuana than think President Obama is doing a good job (44%), want to keep or expand Obamacare (38%), favored attacking Syria (36%), support a 20-cent gas tax increase to pay for infrastructure (29%), or like the Republican Party (28%). And legal marijuana has more than five times as many supporters as Congress does (11%).

The Obama administration is following behind, gingerly. Perhaps it’s because this president was such a hard-core stoner in his youth that he feels a little constrained in even discussing the subject. But his administration could easily revisit the – I repeat – insane classification of marijuana as the most dangerous kind of drug there is. What are they waiting for?

A new Amnesty International report on drone use in Pakistan captures the physical and psychological damage caused by drone strikes. Friedersdorf hightlights troubling findings from it, such as this one:

“When children hear the drones, they get really scared, and they can hear them all the time so they’re always fearful that the drone is going to attack them,” an unidentified man reported. “Because of the noise, we’re psychologically disturbed, women, men, and children. … Twenty-four hours, a person is in stress and there is pain in his head.” A journalists who photographs drone strike craters agreed that children are perpetually terrorized. “If you bang a door,” Noor Behram said, “they’ll scream and drop like something bad is going to happen.”

Ben Richmond also reads through the report:

Far from solely blaming the United States, the report also points what its authors perceive as failures on the part of Pakistan—for leaving this region of its jurisdiction under-developed, and creating a vacuum to be filled by armed groups who “have been responsible for unlawful killings and other abuses constituting war crimes and other crimes under international law in Pakistan, Afghanistan and elsewhere.”

Pakistan has a poor record for bringing these perpetrators to justice without resorting to the death penalty, and the country’s neglect of the region has also failed to ensure that its residents enjoy key human rights protections.

But also Pakistan has a duty to independently and impartially investigate all drone strikes in its own country and “ensure access to justice and reparation for victims of violations,” just as the United States is obliged to investigate drone strikes and hold those responsible for innocent lives lost accountable.

Human Rights Watch also has a new report on America’s use of drones but its report focuses on Yemen. Abby Haglage analyzes:

Keating puts both reports in context:

The reports come at a time when the administration is signaling its intention to shift away from the use of drones toward other counterterrorism tactics. However, as the report argues, President Obama’s few statements on the topic indicate that he favors a policy shift away from drones rather than legal guidelines on when and how they can be used.

That’s why Jonathan Bernstein is betting against a weeks-long shutdown in January:

All three extended shutdowns in recent American history—the two Newt Gingrich shutdowns in late 1995, and the Ted Cruz shutdown this month—were deliberately planned. In 1995, Gingrich foolishly believed that Bill Clinton was a weak man who would buckle if faced with the risks of an extended shutdown. This year, at least if you accept the surface explanation, radicals believed that a long fight would spark a wave of anger at Obamacare. It’s possible, of course, that Tea Partiers or some other group will decide another long shutdown is the right plan. But don’t expect prolonged shutdown (more than two or three days) to be the natural result of a normal budget stalemate. It doesn’t seem to happen.

Even if we avoid another shutdown, Collender has low expectations for the budget negotiations:

[W]hy does anyone think that the 2014 sequester that will occur on mid-January unless Congress and the White House agree on a deal to stop it will be enough to get everyone to compromise? Everyone also hated it the first time around but it was the best alternative compared to all of the others. Not only will that still be the case in January 2014, it will be even truer this winter with the primaries and general election being only months rather than years away.

That’s not to say that a budget deal can’t or won’t happen in December and January. But it does say that, if there is a deal, it will be much smaller and far more symbolic than significant. It will be the kind of deal where everyone declares victory and goes home.

Charles Casillo profiles John Rechy, the gay hustler-turned-writer whose groundbreaking debut novel, City of Night, just turned 50:

“I want to be known as a writer with a unique life who has transformed that life into literature,” Rechy says. With City of Night he succeeded. City of Night blends Rechy’s poetic vision with his journalistic eye for detail, and he makes his misfit characters yearnings, burnings, and alienation feel universal. The book documents its time, a time when homosexuality was illegal, and still described in medical books as a mental illness. It is one of the best firsthand accounts of what it was like to be gay in the mid-20th century — ostracized — separate from the mainstream world. It reveals, through its characters, how young men couldn’t admit, even to themselves, that they were what society deemed perverted. Rechy recalls. “I remember on a New York subway I saw a man reading a book; I could recognize it right away as City of Night although he had wrapped a different jacket around it.”

The essay also includes a revealing anecdote about Rechy:

“Theres just two ages anyway,” a character in City of Night observes, “youngman and oldman.” After its publication, Rechy, his age murkily sandwiched somewhere between those two extremes, led a bizarrely divided life. He continued hustling the streets and the parks even as he published a steady stream of books — fifteen to date. Simultaneously he became a respected teacher at UCLA and in private workshop classes he gave from his home. Sometimes his carefully compartmentalized worlds collided, as on the evening he was standing shirtless on Hollywood Boulevard, his muscular torso on full display, when one of his students happened to pass by. “Good evening, Professor Rechy,” the bemused student shouted, “Out for an evening stroll?”

(Image: First edition cover)