Monday, January 06, 2003

A Perfect Storm For Health Care Reform?

Unless the war with Iraq interferes this could be the year for major health care actions at both the national and state level. Why? According to the December 23, 2002 Managed Care Week (not available online) these factors are coming together:

(1) A continued rise in health care premiums. For several years now, industry analysts and pundits have predicted an end to the double-digit premium hikes that restored many health insurers to profitability in the late 1990s. But 2003 looks to be another good year for insurers, with average premium hikes easily outpacing medical cost increases of 15%.

(2) Increasing ranks of the uninsured. Lately, it has seemed that a good year for health plans means a bad year for those teetering on the brink of losing coverage. Already, small employers in a few areas of the country have reported discontinuing workers' health insurance because of skyrocketing premiums

Far more common are workers who have been priced out of the market, as employers pass on a larger share of premiums and raise workers' copays and deductibles. In fact, the number of uninsured is on track to reach 45 million in 2003, representing a "political albatross that must at some point exact its revenge," says Standard & Poor's.

"It seems like a lot of people are suffering for the benefit of a few," says Robert Booz, vice president, health and managed care at Hartford, Conn.-based Conning Research and Consulting.

(3) Stable profitability. Most insurers have enjoyed improved profitability, although analysts aren't sure how much longer the good times would last. The nation's HMOs collectively reported a 162% increase in profits for the first three months of 2002, compared with the same period in 2001, according to Weiss Ratings, Inc. What's more, those profits were more evenly spread across managed care companies, with 73% of HMOs reporting a profit during the first quarter of 2002, compared with 60% during the 2001 period.

But insurers could see a public backlash against their financial health. "The managed care industry is doing remarkably well financially," Booz says. "Wall Street numbers are very strong. The issue is how much is too much, from a profit point of view?"


This could result in local regulators seeking to limit new premium increases:

The three factors described above--continued premium increases, stable profitability among many health insurers and the corresponding rise in the number of people without insurance --are conspiring to create a "perfect storm," predicts Booz.

"You're going to see more cases where plans come in saying we need 15% to 18% [rate increases], and regulators are going to say, 'Gee, is that so you can increase earnings by 25%?'" he says.


And even action on the federal level:

Although Republicans soon will be in control, the Senate still will be ruled by a slim majority. "It may give insurers more latitude in the short term, but I doubt it's going to prevent more government intervention down the road," says Standard & Poor's analyst Joe Marinucci.

The threat of war in Iraq could temper lawmakers' itch for regulation, though. "Were we not in a situation of uncertainty on the world stage," Booz says federal proposals to reduce the number of uninsured would be more likely. "What I do see is the legislature looking at affordability and accessibility and the tremendous number of uninsured."

The past few years have been good for many health insurers, says Standard & Poor's. But downward pressure on pricing from employers and regulators and upward pressure on health care costs could combine to squeeze health insurers' margins in the years to come.

It's A Fine Line Between Clever and Stupid

After watching with joy as the Packers stumbled badly in their playoff game and then watching with consternation as a brutal penalty call late in the game for cost the Gopher hockey team a chance for a win against St. Cloud State (the game ended in a 3-3 tie), I was surfing through the multitude of channels when I came across something on Oxygen that caught my eye. Believe it or not I am not a regular viewer of Oxygen. Something about being the channel that Oprah built just doesn't appeal to members of my demographic group.

What did catch my eye was a program called Bliss described on Oxygen's web page thusly:

Acclaimed women screenwriters and directors have adapted the best of women's erotic fiction to create diverse, edgy and provocative drama that honestly explores women's sexuality.

I don't know about how honest the show is but edgy and provocative are certainly apt descriptors particularly for a non-premium cable channel like Oxygen. The plot of this particular episode concerned a fetching young woman who had fantasies about rough, animalistic sex. Her wussie, yuppie boyfriend refused to fulfill her wishes in this area because he didn't feel like it was a proper way to "make love" (too much Alan Alda and Donahue growing up I'm afraid).

Of course her urges must be met and so she ends up hooking up with a guy from her karate class for a little one on one full contact match in a secluded area of a public garden. I was a bit surprised by the rather liberal doses of nudity and graphic language of the show. After the boyfriend turned down her requests to turn it up a notch in the bedroom the young woman was seeking solace from a girlfriend who advised her to quit complaining since "he doesn't blow his load early or screw your friends". We're not watching Lifetime anymore are we Dorothy?

I don't have HBO and so don't know what the episodes of Sex In the City are like. But as far as "regular" cable networks go this one appears to be pushing the envelope. Not that there's anything wrong with that. I just wonder what the reaction would be if USA started airing a similar type of show geared to and produced by men. Maybe that's the difference between sexy and sexist.

Oh yeah. Saturdays at 11:00pm CST and Sundays at 12:00pm CST.

Echoes of Nelson Munce Still In My Head

In case you missed it: Atlanta 27 Green Bay 7. At Lambeau. In the playoffs. With the temperature below 34 degrees. The best part? The stunned looks on the faces of the Packer faithful as they watched their green and gold heroes be eliminated in humiliating fashion. Haw haw.

Sunday, January 05, 2003

The Good, The Bad, & The Ugly All In The Morning Paper

Today's Minneapolis Star Tribune was chock full of interesting nuggets.

First the good news. Despite the efforts of the Strib and most of the media in Minnesota (summed up nicely by Power Line) a Minnesota Poll in today's paper shows that an overwhelming majority (76%) of Minnesotans favor spending cuts to solve the state's 4.5 billion dollar budget deficit. And even more encouraging only 37% favor raising taxes. Of course when the Strib adds a personal touch to the story by inserting the comments of a couple of the respondents they include one who favors spending cuts and one who favors raising taxes despite the disproportionate results of the poll in regard to those two positions.

The bad was a plethora of editorials pining for the days when there was a "consensus" in Minnesota politics. This "consensus" as described by Jim Boyd (who probably had the most honest look at it by acknowledging that it ain't coming back) went something like this:

The late, lamented Minnesota consensus was quintessentially one of moderation, centered on moderate Republicans and moderate Democrats, influenced by a strong strain of community-minded Scandinavian Lutheranism. There was agreement to bear relatively heavy tax burdens to finance schools, highways, parks and the other amenities that made the community function well.

In other words it was a pretty much an unquestioning acceptance of the need for government in most areas of life and a belief that government could best solve the problems faced by the state.

Lori Sturdevant writes about the "fractured state" that Minnesota has become and includes this gem:

The election was portrayed not only as a victory of Republicans over DFLers, but also of the suburbs over the core cities, of rich over poor, of conservatives over liberals.

Portrayed by whom? The Star Tribune? Activists on the Left? It's interesting that while she's lamenting the division of the state she certainly doesn't help matters by giving credence to such imaginary divisions as "rich versus poor" or "suburbs versus urban core". Does a Republican victory necessarily mean that the poor and the inner cities will now suffer?

Only if you accept a sort of zero sum game view of politics which is exactly what Dave Hage's piece does (in fact it's called Zero-sum politics asks, 'What's in it for me?'). According to this view politics is all about getting your piece of the pie:

It says that the first question of government is "What do I get out of it?" and it asserts that one side wins only by making the other side lose.

He then makes a fairly typical liberal swipe against talk radio insinuating that most callers are just a bunch of cranks:

It's the familiar logic of talk radio, where every caller seems to have a grudge against the government.

And then lays out his personal views on how we ought to view government:

Consider the following thought experiment. I seldom drive on freeways, but I support freeway construction because a big city needs efficient roads. My kids want to go somewhere far-off and exotic for college, but I still support the "U" because a prosperous, educated state needs a fine public university. I rarely go to Twins games, but I'll help pay for a new ballpark because I think it would add to the Twin Cities' cultural mix. This isn't boasting -- it's the way most Minnesotans think about their state and its public assets. It's certainly the way our parents and grandparents thought.

What’s amazing in all three of these pieces that long for a day when “we” could all just agree to pay higher taxes and spend more on government is that none of them acknowledge the abject failures of the increased state spending in the last twenty years to solve the most critical problems that the state faces. Education, poverty, urban development, and crime are problems that the state has poured billions of dollars into with scant results to show for it. Meanwhile the personal and business taxes required to support such spending has limited people’s abilities to achieve their goals and created a most unfriendly business environment. If people are looking out for their own self interests more than in the 60’s or 70’s it’s because they are forced to by the fact that government has by in large failed them. And is that really such a bad thing?

Finally, the ugly. The Star Tribune has been publishing a continuing series of “Arguments Through the Ages” which they describe as “Samples of Great Rhetoric From the Past”. Today they featured an Arguments Through the Ages: John Reed who was described as:

John Reed (1887-1920), best known as the author of "Ten Days That Shook the World," his account of the Russian Revolution, was a Harvard-educated journalist and activist who worked for the Masses, a radical journal. His Marxist sympathies led him to work both as a propagandist and as a diplomat for the Soviet government, and after his death in Moscow he was buried in the Kremlin.

In the past this series has included such notables as Mao, Ho Chi Minh, and Lenin men responsible for the deaths of millions of people in the 20th century. I’m still waiting for a reprint of a speech by Mussolini or Hitler. And you know that Goebbels had a way with words too...

Saturday, January 04, 2003

Five Things That Real Hockey Players Hate

1. Excessive protective equipment: Facemasks are acceptable but unless you're a goalie I don't want to see you wearing a fargin' throat protector.

2. Stick bags: It ain't a violin, it's a hockey stick. Used to smack pucks around, and slash, spear, and hook opposing players. Are you afraid that's it going to break if you drop it on the way to the rink?

3. Valuable ice used for purposes other than hockey: This would include figure skating, ice dancing, ringette, and ESPECIALLY broomball. Broomball is to hockey what softball is to baseball. A dumbed down, easy to play sport designed to allow uncoordinated oafs to participate and drink beer.

4. Guys who want to play boot hockey when the ice outside is good: Just because you can't skate don't drag me down to your level of incompetence on the ice. If the ice is crappy then we can play boot but if it's halfway decent we're lacing em' up.

5. People who live in Minnesota and think rainy thirty five degree weather in January is "nice": I'm glad that the three minute walk to your car at work is easier on you but weather like this is good for NOTHING. Give me twenty degrees and clear sunshine any day. That's winter. If you don't like it move to Missoura.

Dad, do you know what Schadenfreude is?

Falcons 27 Packers 7. How very sweet it is.

Friday, January 03, 2003

The Only Man Who Could Ever Reach Me

I received an interesting e-mail the other day that began: Dear Preacher. While most of the spamvertisemets I get make promises along the lines of "finally get that college degree", "refinance your home with the lowest possible interest rates", or "enhance your manhood with this guaranteed product" (always forwarded on to Saint Paul) this one offered "hundreds of free sermons". Now I'm not in the business of delivering sermons (unless you count those late night diatribes at bar closing time that usually begin with a slurred "Let me tell ya how things outta be...") but since I do attend church on a fairly regular basis I am a consumer of sermons or more specifically homilies since I'm of the Catholic persuasion. And it's been my experience that for the most part priests, ministers, pastors, or whatever you wanna call them fail miserably to deliver decent ones.

I realize that it's not an easy task to come up with a compelling message every week. But think about it. If you're a cleric you've got hundreds if not thousands of people willing to give you the pulpit (literally) for ten to fifteen minutes to speak to them on some of the most important topics in their lives. And yet how many times do you actually hear a homily or sermon that really delivers? Not often enough in my view.

The rest of the mass is pretty much the same thing week in or week out. Sure the readings are different each week but if you grew up attending church and Catholic school you've heard every one of them many times over. The Gospel is where the real meaningful message can be found and it's the homily that should explain the Gospel and give it context.

I am very fortunate in that the priest at the church I now attend usually offers up good homilies and has even delivered a few that I considered excellent. It was these killer homilies that I found myself thinking about and discussing long after I had left church for the day that made me realize how rare they were and how many crappy homilies I had endured in my life.

And so in the spirit of self-improvement (for the clergy) I offer up a few tips for a successful homily:

1. Make it relevant to today: Many of the Gospel readings have rather vague or unclear messages that need to be explained in the homily and we need to know how to apply these lessons to our lives now. And sometimes the message can seem so overwhelming or unattainable that people tend to turn off completely. Explain to us how we can incorporate it into our lives on a scale that is realistic. Don’t be afraid to talk about events of the day, September 11th, sexual abuse scandals in the church, the economy, etc., which impact our lives and how we should view these events as Christians.

2. Keep it simple: One of the big problems that I have noticed is that priests start on one topic and fifteen minutes later have taken us through a contorted manic reasoning process which covers so many other issues that by the time they’re done your head is spinning and you have no idea where it began. Focus on a message and stay on it.

3. Along with number 2 heed the advice that Steve Martin offered in Planes, Trains and Automobiles “Have a point. It makes it so much more interesting to the listener.” I don’t know how many times I’ve reached the end of a homily just to find myself scratching my head wondering what the heck that was all about. Put some forethought into your message. Start with a introduction that previews your main point and wrap it up by summarizing it. The kind of thing that you should learn in Speech 101.

I come to church waiting and hoping for a good homily each and every week and I think I have a right to expect one. Challenge me. Make me think. I’m ready and I’m listening. Let her rip padre.

Thursday, January 02, 2003

Getting Ahead of Myself

Dr. Keith Poole at the University of Houston has come out with a statistical ranking of all members of the 107th Senate. It attempts to rank Senators on a liberal-conservative continuum, based on their voting behavior on bills which came before the Senate in 2002.

To compile this ranking, Dr. Poole uses the Optimal Classification algorithm and based on my understanding of it (which is none, the methodology reads like a tax form written in Sanskrit) his procedures seem to be in good order. If my qualified endorsement doesn’t convince you of the accuracy of this statistical exercise, perhaps you'll have more confidence knowing that Dr. Poole holds the prestigious Kenneth L. Lay chair of Political Science at the University of Houston. (Really, check out Poole’s profile). It makes me wonder whether the bestowing of this honor will be featured in the upcoming Enron movie on CBS. Considering the level of talent cast in the starring roles of this production, I imagine a scene with Mike Farrel as Ken Lay presenting this honor to Dr. Poole, as played by Dr. Demento.

Assuming the statistical model is accurate (and in all seriousness, it appears to be well considered and executed), it’s interesting to note who comes out where. At the extremes, Russ Feingold of Wisconsin is at number 1, meaning most liberal. And at number 102 (there were extenuating circumstances that caused more than 100 Senators to be ranked this year), the most conservative Senator is John Kyl of Arizona. Of local interest, coming in at Number 2 was Mark Dayton. That Mark Dayton would fall on the liberal side of the continuum is not a surprise. But the fact that he had the second most liberal voting record in the entire Senate is surprising. As measured by his voting behavior, Dayton was more liberal than Paul Wellstone (#6 - who admittedly was running for election, which may have tempered his impulses ever so slightly), and more liberal than the likes of Ted Kennedy (#8), Robert Byrd (#12.5), and Hillary Clinton (#22).

Dayton has kept a low profile since being elected in 2000, which is perhaps appropriate for the Senator who had the least seniority in the 107th Senate. But perhaps his Claude Raines-like stature was for his own good, since I don’t think most Minnesotans would have guessed he was at the extreme Left of his party. Of course, as the DFL endorsed candidate, no one would expect Dayton to be conservative in any way. But the 2000 campaign had very little to do with a broader ideological debate. Dayton was never challenged on his core beliefs, rather he ran primarily on the canard issue of prescription drug benefits and on the fact that he wasn’t the paternally beleaguered and personality paralyzed Rod Grams. This, combined with his high name recognition and his ability to personally finance and outspend his opponent by almost 2-to-1, lead to a 49%-43% margin of victory. This is extremely close when you consider another 6% of the vote was received by moderate to conservative leaning Independent candidate Jim Gibson.

Dayton himself can rightly be described as deeply frozen in the personality department. He’s a lousy campaigner who seems ill at ease in public speaking appearances, especially when they’re not scripted. You can see his discomfort ratchet up even further when he attempts to mouth the class warrior rhetoric which is the foundation of the Democratic platform. Granted, as a dilettante heir to the Dayton-Hudson fortune, one who has embraced the life of extreme luxury and privilege his whole life, it must be difficult to capriciously condemn the rich and extoll the virtues of being poor and needy. But, to his consistency discredit, Dayton does attempt to play this game whenever he’s called to do so.

However rhetoric of that nature only plays to the base of the DFL party, which recent elections in Minnesota seem to indicate comprise no more than about 33% of the electorate. Meaning, the next Senate election in Minnesota may hinge once again on the so called swing voters, the exact types of voters that may not be inclined to support someone who is among the most liberal members of a very liberal party. If the Republicans can field a candidate in 2006 who presents legitimately middle class credentials combined with the proper appeals to sound economic policy and a strong national defense and who has a proven record of accomplishment under trying circumstances, it could be a walkover for the GOP. Can anybody say Pawlenty in 2006? Maybe I should wait until that “proven record of accomplishment” thing comes together before I start printing up any t-shirts.

Don't Expect Any Gray Area (or matter) Here

I'm going to go out on a limb and predict that if you're looking for an insightful, well made account of the causes and results of last year's Enron collapse you're not going to see it in this Sunday's made for TV CBS Movie on the matter. Starring noted geopolitical scholar Mike Farrell among others the movie will likely be a very dumbed down look at the accounting chicanery and corporate malfeasance that made Ken Lay and Jeff Skilling household names. The good guys (whistleblowers, average Joe employees) will be very good and the bad guys (Lay, Skilling, Arthur Anderson accountants) will be very bad with a strong undercurrent of corporate bashing throughout the two-hour movie.

Guess Who?

Check out who made web site of the day at Right Wing News.

Realizing the Dream

Yesterday was a day for watching hours of television, most of it mind numbingly simple which was perfect for the state I was in after celebrating the arrival of the New Year a bit too heartily the night before. Between episodes of the addictive I Love The 80's on VH-1 (what the hell was the embarrassing Hands Across America all about anyway?) and meaningless college football bowl games I did catch something worthwhile on Sixty Minutes II. They had a segment on the Lost Boys Foundation which has brought young Sudanese refugees from a camp in Kenya to the United States.

These refugees are mostly Christians who have been driven from their country by Islamists in the brutal civil war in Sudan. When they arrive in the United States they are assitsted by volunteers who help them get accustomed to a new lifestyle in America. Within a few months they need to get jobs to pay for their apartments and repay the government for the cost of their relocation. The boys (more like young men) featured in the story were working (sometimes more than one job) shortly after their arrival and planning on pursuing education to better themselves. They were grateful for the opportunity to change their lives and all planned on becoming American citizens.

What was really moving was that after September 11th the boys wanted to help out and offered to donate blood to the victims in New York. Doctors determined that they would not be good donors since many were still not in great physical condition because of the hardships they endured in Sudan and Kenya. So instead they started a collection of funds among themselves and raised $400. Not a lot of money by most standards but considering that they basically had nothing it was an extraordinary achievement.

It's easy to be cynical and jaded at times but seeing a story like this was a reminder of the power of the American dream and what it can mean for people who only ask for a chance to realize it. Check out the Lost Boys Foundation web site if you're interested in lending a hand.

Wednesday, January 01, 2003

Are They Making Ice Yet?

Growing up as a boy in the 70's in Minnesota playing hockey outside was a part of my life. It usually wasn't "pond hockey," although if we had an early freeze with no snow we might skate on nearby Lake Minnetonka, but rather at the local outdoor rink and warming house next to city hall. It was probably about a half a mile from home by car but if you took the railroad tracks on foot it was only half that long. Every year there was an anticipation to the start of the outdoor ice season and we'd be checking the status of the ice constantly once the weather cooperated and they started flooding the rink.

My brother and I used to tramp down to the rink almost daily once it opened carrying our sticks and skates over our shoulders like a couple of hobos. On Saturdays we sometimes would also be toting bag lunches that Mom packed for us since we'd often spend the whole day skating. We always wanted to play hockey at the rink but it wasn't always possible. If there weren't enough guys for a game we'd spend hours ripping "slappers", often until our sticks broke. If there was snow on the ice and we couldn’t shovel it off we'd take off our skates and play "boots" with a tennis ball.

When you were younger you always wanted to play with the "big kids" on the hockey rink and took every opportunity to hone your skills and prove that you were good enough to skate with them. Then one day you were a big kid and you got to make the rules. Like no lifting of the puck. Or a goalie has to stay in the net. And throwing your sticks in the middle and having somebody--with their hat pulled over their eyes to avoid favoritism--throw sticks to each side to pick teams.

We played for hours at a time stopping only when we were exhausted or it was time for the rink to close. Sometimes when the weather was really cold they wouldn't open the warming house. We'd go down there anyway and lace up our skates in the elements trying to get them on as quickly as possible to avoid the bitter cold that stung your bare hands as you tugged on the laces.

We didn't learn breakouts or how to play a neutral zone trap but we did learn how to skate and stick handle as that was what the game was all about. We played for the sure joy of hockey and the camaraderie that we experienced with our fellow rink rats.

Inevitably the weather would warm and the ice would be gone. We usually would make at least one more trek down to the rink in the look for pucks that had been shot over the boards and lost in the snow during the winter. The spring thaw left them exposed and some years we would find thirty or forty of these black rubber treasures. We'd bring em' home and store em' in the garage to wait for the next season.

Today, I live less than a block from an outdoor rink in a suburb of Minneapolis. And just like when I was a kid once December rolls around I start checking almost daily to see if they've started flooding it. The season seems much shorter now. I suppose that's the influence of me getting older. Everything seems to go by much faster. But I still try to get out and skate as much as I can every winter.

I can't go to the local rink anymore and expect to find a game. It seems as if few kids skate outdoors these days and most of the time I'm the only one down there. I lace up my skates anyway and can spend hours skating and shooting on a quiet winter's night. The sounds of the game are much more noticeable outside. The puck slams off the boards and echoes into the darkness. You actually hear your stick as it hits the ice on a shot or when your skates cut up the crisp ice as you turn and glide across it.

On Saturday mornings, I set off early in quest of a game. There's a rink at Lewis Park in the nearby suburb of Edina with immaculately groomed ice where a good game can usually be found. Fifteen to twenty guys, ranging anywhere in age from twenty to fifty, gather there on Saturday mornings and we can play for two to three hours before the ice gets too chewed up to carry on. There's nothing better than playing outside on a sunny day with temps in the twenties. After a short time you're down to a sweatshirt and jeans or sweatpants but you're not cold at all. In fact you're working up quite a sweat skating up and down the ice, stick handling and passing around eight or nine guys trying to stop you, all the while trying to remember if the guy in the red hooded jacket is on your team or not. Just like being a kid again.

Are they making ice yet?