Thursday, January 12, 2017

There Will Be No Obamacare Replacement [feedly]


....really, Prof Krugman, only Comey and Putin?

There Will Be No Obamacare Replacement
http://economistsview.typepad.com/economistsview/2017/01/there-will-be-no-obamacare-replacement.html

Paul Krugman:

There Will Be No Obamacare Replacement: You may be surprised at the evident panic now seizing Republicans, who finally — thanks to James Comey and Vladimir Putin — are in a position to do what they always wanted, and kill Obamacare. How can it be that they're not ready with a replacement plan?
That is, you may be surprised if you spent the entire Obama era paying no attention to the substantive policy issues — which is a pretty good description of the Republicans, now that you think about it.
From the beginning, those of us who did think it through realized that anything like universal coverage could only be achieved in one of two ways: single payer, which was not going to be politically possible, or a three-legged stool of regulation, mandates, and subsidies. Here's how I put it exactly 7 years ago...
It's actually amazing how thoroughly the right turned a blind eye to this logic, and some — maybe even a majority — are still in denial. But this is as ironclad a policy argument as I've ever seen; and it means that you can't tamper with the basic structure without throwing tens of millions of people out of coverage. You can't even scale back the spending very much — Obamacare is somewhat underfunded as is.
Will they decide to go ahead anyway, and risk opening the eyes of working-class voters to the way they've been scammed? I have no idea. But if Republicans do end up paying a big political price for their willful policy ignorance, it couldn't happen to more deserving people.

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Eastern Panhandle Independent Community (EPIC) Radio:How to get a raise, on Labor Beat Radio

John Case has sent you a link to a blog:



Blog: Eastern Panhandle Independent Community (EPIC) Radio
Post: How to get a raise, on Labor Beat Radio
Link: http://www.enlightenradio.org/2017/01/how-to-get-raise-on-labor-beat-radio.html

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Links for 01-12-17 [feedly]

Links for 01-12-17
http://economistsview.typepad.com/economistsview/2017/01/links-for-01-12-17.html


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Congestion on the Last Mile [feedly]

Congestion on the Last Mile
http://www.digitopoly.org/2017/01/11/congestion-on-the-last-mile/

It has long been recognized that networked services contain weak-link vulnerabilities. That is, the performance of any frontier device depends on the performance of every contributing component and service. This column focuses on one such phenomenon, which goes by the label "congestion." No, this is not a new type of allergy, but, as with a bacteria, many users want to avoid it, especially advanced users of frontier network services.

Congestion arises when network capacity does not provide adequate service during heavy use. Congestion slows down data delivery and erodes application performance, especially for time-sensitive apps such as movies, online videos, and interactive gaming.

Concerns about congestion are pervasive. Embarrassing reports about broadband networks with slow speeds highlight the role of congestion. Regulatory disputes about data caps and pricing tiers question whether these programs limit the use of data in a useful way. Investment analysts focus on the frequency of congestion as a measure of a broadband network's quality.

What economic factors produce congestion? Let's examine the root economic causes.

The Basics

Congestion arises when demand for data exceeds supply in a very specific sense.

Start with demand. To make this digestible, let's confine our attention to US households in an urban or suburban area, which produces the majority of data traffic.

No simple generalization can characterize all users and uses. The typical household today uses data for a wide variety of purposes—email, video, passive browsing, music videos, streaming of movies, and e-commerce. Networks also interact with a wide variety of end devices—PCs, tablets, smartphones on local Wi-Fi, streaming to television, home video alarm systems, remote temperature control systems, and plenty more.

It is complicated, but two facts should be foremost in this discussion. First, a high fraction of traffic is video—anywhere from 60 to 80 percent, depending on the estimate. Second, demand peaks at night. Most users want to do more things after dinner, far more than any other time during the day.

Every network operator knows that demand for data will peak (predictably) between approximately 7 p.m. and 11 p.m. Yes, it is predictable. Every day of the week looks like every other, albeit with steady growth over time and with some occasional fluctuations for holidays and weather. The weekends don't look any different, by the way, except that the daytime has a bit more demand than during the week.

The bottom line: evenings require far greater capacity than other times of the day. If capacity is not adequate, it can manifest as a bottleneck at many different points in a network—in its backbone, in its interconnection points, or in its last mile nodes.

This is where engineering and economics can become tricky to explain (and to manage). Consider this metaphor (with apologies to network engineers): Metaphorically speaking, network congestion can resemble a bathtub backed up with water. The water might fail to drain because something is interfering with the mouth of the drain or there is a clog far down the pipes. So, too, congestion in a data network can arise from inadequate capacity close to the household or inadequate capacity somewhere in the infrastructure supporting delivery of data.

Numerous features inside a network can be responsible for congestion, and that shapes which set of households experience congestion most severely. Accordingly, numerous different investments can alleviate the congestion in specific places. A network could require a "splitting of nodes" or a "larger pipe" to support a content delivery network (CDN) or could require "more ports at the point of interconnection" between a particular backbone provider and the network.

As it turns out, despite that complexity, we live in an era in which bottlenecks arise most often in the last mile, which ISPs build and operate. That simplifies the economics: Once an ISP builds and optimizes a network to meet maximum local demand at peak hours, then that same capacity will be able to meet lower demand the rest of the day. Similarly, high capacity can also address lower levels of peak demand on any other day.

Think of the economics this way. An awesome network, with extraordinary capacity optimized to its users, will alleviate congestion at most households on virtually every day of the week, except the most extraordinary. Accordingly, as the network becomes less than awesome with less capacity, it will generate a number of (predictable) days of peak demand with severe congestion throughout the entire peak time period at more households. The logic carries through: the less awesome the network, the greater the number of households who experience those moments of severe congestion, and the greater the frequency.

That provides a way to translate many network engineering benchmarks—such as the percentage of packet loss. More packet loss correlates with more congestion, and that corresponds with a larger number of moments when some household experiences poor service.

Tradeoffs and Externalities

Not all market participants react to congestion in the same way. Let's first focus on the gazillion Web firms that supply the content. They watch this situation with a wary eye, and it's no wonder. Many third-party services, such as those streaming video, deliver a higher-quality experience to users whose network suffers less congestion.

Many content providers invest to alleviate congestion. Some invest in compression software and superior webpage design, which loads in ways that speeds up the user experience. Some buy CDN services to speed delivery of their data. Some of the largest content firms, such as YouTube, Google, Netflix, and Facebook, build their own CDN services to improve delivery.

Next, focus on ISPs. They react with various investment and pricing strategies. At one extreme, some ISPs have chosen to save money by investing conservatively, and they suffer the complaints of users. At the other extreme, some ISPs build a premium network, then charge premium prices for the best services.

There are two good reasons for that variety. First, ISPs differ in their rates of capital investment. Partly this is due to investment costs, which vary greatly with density, topography, and local government relations. Rates of investment tend to be inherited from long histories, sometimes as a product of decisions made many years ago, which accumulated over time. These commitments can change, but generally don't, because investors watch capital commitments and react strongly to any departure from history.

The second reason is more subtle. ISPs take different approaches to raising revenue per household, and this results in (effectively) different relationships with banks and stockholders, and, de facto, different budgets for investment. Where does the difference in revenue come from? For one, competitive conditions and market power differ across neighborhoods. In addition, ISPs use different pricing strategies, taking substantially different approaches to discounts, tiered pricing structures, data cap policies, bundled contract offerings, and nuisance fees.

The use of tiers tends to grab attention in public discussion. ISPs segment their users. Higher tiers bring more bandwidth to a household. All else equal, households with higher tiers experience less congestion at peak moments.

Investors like tiers because they don't obligate ISPs to offer unlimited service and, in the long run, raise revenue without additional costs. Users have a more mixed reaction. Light users like the lower prices of lower tiers, and appreciate saving money for doing little other than email and static browsing. In contrast, heavy users perceive that they pay extra to receive the bandwidth that the ISP used to supply as a default.

ISPs cannot win for losing. The archetypical conservative ISP invests adequately to relieve congestion some of the time, but not all of the time. Its management then must face the occasional phone calls of its users, which they stymie with phone trees that make service calls last 45 minutes. Even if users like the low prices, they find the service and reliability quite irritating.

The archetypical aggressive ISP, in contrast, achieves a high-quality network, which relieves severe congestion much of the time. Yet, such firms (typically) find clever ways to pile on fees, and know how to stymie user complaints with a different type of phone tree that makes calls last 45 minutes. Even when users like the quality, the aggressive pricing practices tend to be quite irritating.

One last note: It is a complicated situation where ISPs interconnect with content providers. Multiple parties must invest, and the situations involve many supplier interests and strategic contingencies.

Some observers have alleged that the biggest ISPs have created congestion issues at interconnection points for purposes of gaining negotiating leverage. These are serious charges, and a certain amount of skepticism is warranted for any broad charge that lacks specifics.

Somebody ought to do a sober and detailed investigation to confront those theories with evidence. (I am just saying.)

 

What does basic economics tell us about congestion? Congestion is inevitable in a network with interlocking interests. When one part of the network has congestion, the rest of it catches a cold.

More to the point, growth in demand for data should continue to stress network capacity into the foreseeable future. Since not all ISPs will invest aggressively in the presence of congestion, some amount of congestion is inevitable. So, too, is a certain amount of irritation.

Copyright held by IEEE. To view the printed essay, click here.


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Wednesday, January 11, 2017

Eastern Panhandle Independent Community (EPIC) Radio:The Are You Crazy Show Goes Crazy, Then Straight

John Case has sent you a link to a blog:



Blog: Eastern Panhandle Independent Community (EPIC) Radio
Post: The Are You Crazy Show Goes Crazy, Then Straight
Link: http://www.enlightenradio.org/2017/01/the-are-you-crazy-show-goes-crazy-then.html

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Tuesday, January 10, 2017

30 Percent Of W.Va. Families On Medicaid [feedly]

30 Percent Of W.Va. Families On Medicaid
http://www.wvpolicy.org/30-percent-of-w-va-families-on-medicaid/

WHEELING — Only six states have a higher percentage of residents on Medicaid than West Virginia, according to a national nonprofit health policy group.

More than 554,000 Mountain State residents — more than three of every 10 — are enrolled in the program, according to the Henry J. Kaiser Family Foundation. That's well above the national average of 23.4 percent — meaning a potential repeal of the federal Affordable Care Act under which West Virginia's Medicaid program was expanded could have a disproportionate impact on the state's residents.

The percentage of West Virginians on Medicaid comes as little surprise to incoming state Senate Majority Leader Ryan Ferns, R-Ohio.

"What it says about our state is we have the lowest workforce participation rate in the country and the highest number of people on welfare," Ferns said. "Over half our population is receiving financial assistance, and that is not sustainable."

New Mexico has the nation's highest percentage of residents covered by Medicaid, at 40.4 percent. Next is Arkansas, at 39.6 percent, followed by California, 34 percent; New York, 33.7 percent; Vermont, 33.2 percent; Louisiana, 31.2 percent; and West Virginia, 30.2 percent. Rounding out the top 10 are Massachusetts, at 29.9 percent; Kentucky, at 28.9 percent; and Oregon, at 27.2 percent.

The District of Columbia also has a higher rate than West Virginia, with 36.6 percent of residents enrolled in the program.

Under the Affordable Care Act, the federal government currently is paying 95 percent of the cost of the Medicaid expansion. But if the GOP-led Congress is successful in repealing the Affordable Care Act under a Donald Trump presidency, the 32 states — including West Virginia and Ohio — that opted to expand Medicaid under the health care law could be forced to bear the entire cost of the expansion or revert back to pre-Affordable Care Act eligibility requirements for the program.

Jeremiah Samples, deputy secretary for public health and insurance with the West Virginia Department of Health and Human Resources, acknowledged Mountain State residents have seen "significantly varying" impacts from the Affordable Care Act — but he pointed out the state has reduced its uninsured rate from 17 percent to 5 percent due to coverage expansions under the law.

"There are more than 175,000 citizens on the Medicaid expansion and more than 35,000 who have received coverage on the health insurance exchange. The vast majority of these individuals are working or are transitioning between jobs," Samples said. "It would be devastating for families, the state's workforce and the state's economy if these West Virginians lost their health insurance."

Although the Kaiser Family Foundation report points out any loss of Medicaid coverage would "depend on the specifics of the repeal and any replacement plan as well as actions by individual states," Ferns said there's no way West Virginia can afford to pay for all the new enrollees made possible by the 2014 expansion.

"It likely would go back to the way it was before Obamacare," Ferns said of West Virginia's Medicaid program if the Affordable Care Act is repealed.

That's why Wheeling Health Right Executive Director Kathie Brown, even though she believes the Affordable Care Act has serious flaws, doesn't want to see the law repealed without a workable replacement. The free clinic on 29th Street began accepting Medicaid patients in 2014.

"What it will mean for free clinics across the country is we will be slammed with patients who don't have any other access," Brown said of a potential Affordable Care Act repeal. "I pray there's enough intelligent people working on this to see that you can't just completely throw it out without something else in place. … We need to fix it, but I certainly hope we don't throw the baby out with the bath water."

Brown said she's grateful for the support Health Right receives from the community, but with the decline of state funding for free clinics she isn't sure her facility would be able to handle the influx of patients she'd expect to see if the health care law is repealed and not replaced.

"All we can do is the best we can do. … The people who can't get in here or other free clinics in the state will go to the (emergency room), and it will get back to episodic care rather than primary care," she said.

Although the federal government to this point has paid most of the tab for the Medicaid expansion, West Virginia still has seen its costs under the program increase by almost 25 percent since 2012. The state spent $809.7 million on Medicaid in fiscal year 2012; $901.2 million in 2013; $932 million in 2014; $961 million in 2015; and $985.9 million in 2016, according to a joint report from the West Virginia Center on Budget and Policy and West Virginians for Affordable Health Care.

While the total figure continues increasing, Samples said the state has reduced its per-capita Medicaid costs over the last three years, from $8,914 to $7,154.

Still, as the federal share of the Medicaid expansion cost under the health care law decreases each year, Mountain State lawmakers who will grapple with a potential $400 million fiscal 2018 budget deficit during their upcoming session will have to find an estimated $40.8 million in additional funding for Medicaid.

The report from the West Virginia Center on Budget and Policy and West Virginians for Affordable Health Care suggests ways to increase revenue to fund Medicaid, including additional increases to the tobacco tax, or increasing taxes on beer, wine and distilled spirits and "sugar sweetened beverages."

But Governor-elect Jim Justice has said he plans to propose a fiscal 2018 budget with no tax increases, something incoming Senate President Mitch Carmichael said he supports.

"The people of West Virginia are struggling financially and cannot endure additional tax burdens to prop up government. Just as each family is faced with difficult financial choices when money is scarce, our state government must do the same," Carmichael, R-Jackson, said in a press release.

Although the U.S. Department of Health and Human Services says more than 20 million Americans have gained health insurance because of the Affordable Care Act, Ferns said he doesn't believe the health care law accomplished what it was intended to accomplish. That, he said, is because many people who have purchased coverage through the marketplace have annual deductibles as high as $7,000.

"Now you've got all these people who are supposedly insured who have deductibles they can't afford. … They have an insurance card, but do they have access to health care? In my view, they certainly don't," said Ferns, a licensed physical therapist who owns a business in Benwood.

Ferns said the state needs to turn its economy around to reduce the number of people who need Medicaid, and he believes the best way to do that is for lawmakers to create an environment in which businesses can thrive.

Samples agrees that the best solution to reducing the state's Medicaid enrollment is to focus on the economy and "empower individuals to obtain higher paying jobs."

"As the West Virginia economy improves, less citizens will need Medicaid services as they buy insurance on their own or it is provided through their employer. That said, there will always be some individuals who need support from the Medicaid program," Samples said. "The DHHR is committed to ensuring that these individuals are provided quality care in the most efficient manner possible."


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Bernstein: Paul Krugman goes all “crowd out” on us. Is he right? [feedly]

Paul Krugman goes all "crowd out" on us. Is he right?
http://jaredbernsteinblog.com/paul-krugman-goes-all-crowd-out-on-us-is-he-right/

Progressives' Keynesian economist in chief, Paul Krugman, has been second to none in calling out policymakers' focus on reducing budget deficits when economies were still weak (also known as "austerity"). Given that record, his oped in today's NYT may surprise some readers. He argued that, as the economy closes in on full employment, fiscal budget deficits could crowd out private borrowing, pushing up interest rates and slowing growth.

Paul's argument in the oped shouldn't actually be surprising; he has long depended on a very simple and, as the record shows, very insightful, application of the ISLM model, a diagram of how interest rates and output interact in key markets in the macroeconomy. See here for his useful discussion of how the model ticks.

But is Paul right? Despite the fact that he invariably turns out to be so–i.e., correct–I'm not nearly so worried about interest-rate crowd-out resulting from the big, wasteful tax cut team  Trump and his Congressional allies will pass, I fear, sometime later this year. What I'm worried out is what their raid on the coffers of the US Treasury will do to the programs we increasingly need to meet the many challenges we face.

Let me explain.

Here at OTE, we maintain that all economic models are wrong but some are sometimes useful. For years, at the end of the ISLM section of economics courses, there's been this little section that shows how the model changes in a particular type of recession when two things happen: demand significantly contracts and interest rates fall to around zero (the dreaded liquidity trap). At that point you get the diagram Paul put in his link above (ignore for a moment the "IS Now" line, which I plugged in there, as did Paul in a post today).

Source: Paul Krugman

The point of the ISLM-in-recession model is that policy makers can do a lot to boost demand without worrying about crowding out private investment, inflation, or push-back from the Fed. So let the fiscal stimulus rip. The question in such moments shifts from "is the deficit too large?" to "is the deficit large enough?!"

But according to the model, you should only let it rip up until the point when the IS curve shifts enough to the right ("IS Now") that the economy is back in a place where increased demand will invoke those negative outcomes just noted.

One implication Paul draws from these dynamics is that Republicans, motivated not by improving the economy but by bashing Obama and the D's, inveighed against deficits when we needed them and are about to shift to not caring about them when deficits – again, according to the model – could actually do some harm.

But how reliable is this crowd-out hypothesis? It's actually pretty hard to find a correlation between larger budget deficits and higher interest rates in the data.

There are some obvious reasons why that's the case. Oftentimes, like in the Great Recession, a large budget deficit corresponds with demand contraction and very low rates, so that messes up the predicted correlation. The budget deficit got to -10% of GDP in 2009 and interest rates were stuck around zero. That also implies rates can't fall as deficits have become less negative.

To see if anything jumps out, the figure plots real rates on the 10-year bond against the deficit from 1990 to 2007, years chosen because the deficit moved around a lot in those years, including into surplus at the end of the 1990s, and the Fed wasn't nearly as much in the interest-rate setting mix as they've been since then. But it's just pretty much a random plot (if you plot changes in the variables, it still looks random; same with nominal rates; same with corp bonds, etc.).

Source: BEA, Fed

The raw data miss a potentially important expectations component often in play regarding movements in rates. Very recently, investors' expectations of Trump-induced fiscal expansion, along with the Fed's plans to hike rates, have pushed up inflation and interest rate expectations. But it's not at all clear how much of that relates to the expectation that deficits will crowd out private borrowing.

So is Paul making a mistake to continue to depend on the model that has heretofore served him—and anyone else willing to listen—so well? My guess is that deficit crowd-out is not likely to be a big problem, as in posing a measurable threat to growth, anytime soon, even if deficits, which are headed up anyway according to CBO, were to rise more than expected.

The global supply of loanable funds is robust and, in recent years, rising rates have drawn in more capital (pushing out the LM curve). Larger firms have enjoyed many years of profitability without a ton of investment so they could use retained earnings (the fact of unimpressive investment at very low rates presents another challenge to this broad model). And most importantly, while we're surely closer to full employment, there are still a lot of prime-age workers who could be drawn in to the job market if demand really did accelerate.

(This, by the way, is the only part of Paul's rap today that I found a bit confusing. He's a strong advocate of the secular stagnation hypothesis, wherein secular forces suppress demand and hold rates down, even in mature recoveries. His prediction today seems at odds with that view.)

And yet, I'm still really worried—profoundly so—about crowd-out, just not the interest-rate type that Paul's worried about. What keeps me up at night is that if Republicans are able to waste a bunch of money on deficit-inducing tax cuts that go mostly to rich people, there will be too few resources to support the safety net, public goods, health care, and possibly even social insurance.

This, I've long maintained, is the true target of trickle-down tax cuts: force the government to shrink by cutting off its revenue oxygen. And this is a particularly damaging time to be cutting revenues; our demographics alone mean we're going to need more, not less, revenues in coming years. And I'm not even talking about what we'll need to address the challenges posed by climate change, inequality, poverty, our infrastructure needs, geopolitics, and Buddha-knows what else.

So I stand firmly against big, dumb wasteful tax cuts. Not because I think they're going to raise interest rates that much (though I could be wrong and PK is typically right), but because they're going to shut down the federal government's ability to do what needs to be done.


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