Saturday, December 28, 2013
Saturday, December 7, 2013
Street-parking near the Hollywood location is already at capacity, it's extremely rare to see open spots. And because of the configuration of the highway and Sandy Blvd there are no nearby neighborhoods that would absorb parking by new residents. Given that, what difference could new residents make? There's no such thing as negative parking spaces, street parking can't be more full than it is now. I get the distinct impression neighborhood concerns are not about parking, but about other things.
A recent letter from the Hollywood Neighborhood Association Board printed in the Hollywood Star reinforces that impression, emphasis mine:
Imagine the effects on your neighborhood if small, single-family homes on standard 50-by-100-foot lots were replaced by 64-foot tall apartment buildings that housed 70 or more people stuffed into 56 dormitory-like units with no parking. Imagine further that the buildings' tenants were temporary with no connection to each other despite its so-called "group living" designation. Imagine no dorm proctor to keep things from getting out of hand. It is easy to anticipate noise problems, even worse parking problems than we've already experienced from no-parking apartments…
Look instead at the concerns: The residents will be noisy and temporary, they won't have a proctor. Those concerns have nothing to do with parking, and everything to do with fears and preconceptions about potential new residents.
If residents of the new buildings create noise problems or "get out of hand," whatever that means, then it should be addressed via law enforcement just as it would be if they lived in a single family home. And yeah, people in single family homes do get out of hand and we find a way to cope and the world goes on. But do we prohibit construction of new single family homes because their residents might be criminals? How is that any more rational with apartments?
People should be judged on what they do, not on where they live. It is shameful when we do otherwise.
Saturday, November 30, 2013
Friday, November 29, 2013
Thursday, November 21, 2013
- Go to a food fair where there will be other chefs to prepare a meal
- Hire your own chef
- Do your own cooking and buy direct from grocers.
Tuesday, November 5, 2013
1) It's another example of someone going after providers for what the medical world considers business as usual, but which the rest of the world considers fraud. Oregon's justice department did this when they went after a pair of doctors for not disclosing they were paid by device manufacturers.
2) It shows the importance of pricing. Getting providers to disclose pricing isn't just about empowering patients to shop, it's about exposing hospital charges to scrutiny. Nasty things breed in the dark, like $5,000 "anesthesia" charges for materials and service that cost the hospital $250.
3) It's worth reading the allegations to get a sense of how messy the billing for a surgical procedure is, and how abusive Sutter's pricing was. They are contained in a filing by the CA Department of Insurance which supported the suit, it starts on page 18 of the pdf.
4) It's also worth thinking about the limitations of using lawsuits to control hospitals. This suit caught one service out of many the hospital bills. There is nothing stopping hospitals from simply shuffling costs to a different service code. Or they might not even do that, the basis of the fraud claim was that the hospital was charging a time-based fee for a one-time service that had no time component. The suit alleged the hospital was either trying to trick people into thinking it was the anesthesiologist's bill (that is billed separately by the anesthesiologist, see what I mean about messy billing) or they were charging for services they didn't deliver. Hospitals could fix that by just charging a fixed cost that wasn't time based but was no less inflated, and that's essentially what they're saying they will do.
Lawsuits are better than nothing, but they are no substitute for regulation.
Sunday, October 13, 2013
Special sessions are a poor way to run a government.The recent special session was the embodiment of "quick and dirty" solutions. It valued short term results- a short term boost and in revenue, a short term boost in school funding- in return for long term, unknown liabilities. How much of the PERS reform will survive court challenge? What impact will the tax cut on S corporations have if businesses reorganize so as to take maximum advantage of it? And in the mix of that short term thinking was pure pork: a GMO bill that had nothing to do with taxes, nothing to do with education, and that in no way was an emergency requiring immediate intervention.Oregon may well face an extended period of relative scarcity, where tough decisions that cross traditional interests become routine. But that makes it more urgent to make such decisions carefully, with full consideration of costs and benefits and long term outcomes. There are times when leaping before you look may be a good thing. The management of long term contingent liabilities is not one of them.Deliberation not only allows for better decisions, it allows the public through its legislative representatives to take ownership of those decisions. That matters if one believes in democracy and self-government. What good is a compromise reached only because legislators didn't vote their conscience? Plus it improves the chances of continuity, and that efforts at reform will be sustained until the underlying problem is solved. The governor now says PERS reform is off the table. Is PERS no longer a problem? Is school funding no longer a problem?Instead of careful deliberation backed by citizen support what we got in the special session was a plate of spaghetti thrown at the wall. We can and should do better.
Sunday, September 29, 2013
Last year, a few weeks before Christmas you called the legislature into special session to provide a tax perk to Nike. Reporting in the Oregonian shows that you were in active discussions with Nike several months prior to December. You had ample time to advise the legislature of Nike's request and to allow a more deliberate and public discussion of the costs and benefits of Nike's proposal. You chose to call a special session not out of need but out of convenience. After being called, the legislature faced a fait accompli. There was no time to consider alternative mechanisms that could accommodate Nike and other businesses, the legislature's choice was to accept the demand or risk driving the underlying investment out of state.
The resulting legislation had immediate negative consequences as other large employers wondered why they hadn't received similar consideration. And the long term consequences of the Nike deal- a 30 year dispensation from state tax law backed by an insurance contract underwritten by the state- are utterly unknowable. No one knows what state tax law will look like 30 years from now or what liability this created for Oregon. Fortunately, the legislature was wise enough to include a sunset provision that voided this power without additional legislation. In the 2013 session there was not even a proposal from either party to renew this power unaltered. That strongly suggests that when the legislature had time to think about it they found the "Nike Bill" to be a bad idea.
The current special session, called for September 30th, is only marginally better grounded. The "grand bargain" of PERS reform and tax changes was actively considered in the 2013 regular session. But that just shows that the use of an emergency session is even less justified. Neither PERS nor taxes are new. Neither PERS nor taxes is going away. So why can't a grand bargain wait until next year?
The nominal reason, to provide immediate funds for the current school year, is poorly considered. It is well known that public employee unions will challenge any changes to PERS in court, including those already passed in 2013. What happens when the court, as is quite possible based on past experience, overturns some portion of the reforms? What happens to schools which spend money this year that they don't actually have? It has been a longstanding complaint of districts that their budgets are unstable, leading to constant cycles of hiring and firing teachers. Your use of the special session here ensures that problem will continue.
The short term education dollars bought with a special session may prove more costly in the long term. In my school district, it is estimated that the grand bargain would provide an additional 40 teachers this year. That's nice, but there are 78 schools. Given ludicrously high class sizes, an extra half-teacher per school isn't an adequate remedy. Getting class sizes down to something reasonable will require a larger conversation with teachers about the connections between compensation, class sizes, work environment, and ultimately their work output. Even great teachers become bad teachers when classes are too big. Having that conversation requires a great deal of trust and respect, it requires that the public and teachers speak and hear each other. Rushing PERS changes through the legislature and depriving unions of input makes that conversation less likely.
Emergency legislation should address what is truly an emergency and nothing more. That is not how you've used your power to call special sessions, and in my view your use of that power has hurt the state more than it helped. I urge you to use greater discretion, and have more respect for the legislative process.
Tuesday, September 24, 2013
But you would think insurers would welcome those providers who could keep costs down with arms wide open. So I was surprised to read this:
Now maybe that's just jawboning, seeking political pressure to force insurers to pay more, but maybe it isn't. Insurers are very good at underwriting, at classifying things and figuring out what they cost. They can't underwrite patients based on their medical profile, but what's to say they aren't underwriting providers based not on cost but on the expected profile of their patients? Helping people who want cheap insurance find cheap providers is a good thing, helping people who want cheap insurance find providers with cheap patients is not.Daniel R. Hawkins Jr., a senior vice president of the National Association of Community Health Centers, which represents 9,000 clinics around the country, said: “We serve the very population that will gain coverage — low-income, working class uninsured people. But insurers have shown little interest in including us in their provider networks.”Dr. Bruce Siegel, the president of America’s Essential Hospitals, formerly known as the National Association of Public Hospitals and Health Systems, said insurers were telling his members: “We don’t want you in our network. We are worried about having your patients, who are sick and have complicated conditions.”
It strikes me that the competitive nature of exchanges might change the market a lot more than people bargained for. We've been so worried that rates would go up that we may have overlooked what might happen if they go down, and in particular that they might go down for reasons at cross purposes to reform efforts (such as finding new ways to exclude the sick).
Whether it's jawboning or something else, it will be interesting to see how states react.
Monday, September 23, 2013
Lawsuits allow select individuals to recover some damages, but they also encourage providers to take a pre-emptive "defensive" stance when adverse events occur. Instead of analyzing errors and broadly distributing lessons learned providers have incentive to clam up and hope no one notices. The consequences are visible in statistics. The IOM estimated at least 44,000 deaths per year are caused by preventable medical errors but fewer than 5,000 payments per year for fatalities are logged in the National Practitioner Data Bank, a registry of medical malpractice payments. I think the community would be better served by encouraging processes that reduce errors, even if that alters the way individuals seek recovery. Oregon's new malpractice reform is a modest step towards that goal.
Having said that, there are times when individual interests do trump community interests. The constitution enshrines the principal that people cannot be arbitrarily punished or have property seized without due process. Even if the community overwhelmingly supports such an action and even if the community would overwhelmingly benefit from it, in the absence of due process such a taking violates the core individual rights that we grant ourselves.
I don't see how those rights can be honored by the current tort cap which limits recoveries even for specific economic damages. It imposes arbitrary and unlimited costs on individuals without process or appeal. I say it with a grimace, but I think Mr. Pope is right.
Friday, September 20, 2013
Reversing that, for every medical malpractice prompted by an injury caused by substandard care during a hospitalization, there are 50 injuries caused by substandard care that didn't prompt a claim plus another 100 - 150 injuries caused by standard care.
Public Citizen worries about the information lost by decreasing the number of claims entering the little green slice that represents the medical malpractice system. In a world where that reporting could be maintained cost-free, sure we'd be better off with it. But is maintaining current reporting so important that it's worth discouraging reforms that would increase reporting and scrutiny of the vast world now outside the medical malpractice system?
Wednesday, September 11, 2013
The story is about how Public Citizen is critical of a Disclose and Compensate tort reform program Oregon enacted earlier this year. The question asked how to weigh the potential loss of reporting of some incidents to the
But I'll speculate that how those reports get used is on second hand decisions: Should we renew so and so's credentials? Should we revoke them? Should we hire or grant privileges? Except for the case where a facility is reviewing an incident which happened on their premises (and in that case they shouldn't need an NPDB report to tell them what happened) none of those decisions can influence the process that lead to error, assuming there was one. They are go / no-go decisions about a specific person and they only effect errors to the extent those individuals are personally responsible for them.
There are really bad doctors and having a process that can get rid of them is a good thing. But most doctors aren't really bad and most adverse events aren't attributable to a single individual. Keying off Merwin's comment below most doctors are neither superheroes nor super villains, they're regular people typically working in complicated, interdependent systems. A malpractice monitoring system that only catches super villains isn't that helpful.
Consider some statistics. Over the last 10 years there were on average 14,787 medical malpractice payments reported to the NPDB each year. For the sake of argument let's suppose each and every one of those involved a death. Well, the IOM estimates there are 44,000 preventable deaths caused by medical errors each year, just in hospitals. So even using charitable assumptions there are two preventable deaths outside the NPDB system for every one that makes it in. And when you use less favorable assumptions- fewer than a third of NPBD med mal payments involve a fatality and estimates of preventable deaths due to error go much higher- it's clear that the world outside the NPBD system is a lot bigger and no less consequential than the world inside it.
Oregon's reform is an acknowledgment of that reality, and intended to encourage institutions to dig deeper into adverse events to better understand why they happened and prevent their recurrence. It's meant to impact the broad middle ground where most practice is, not the narrow extreme. And where a provider is at the extreme you have to consider the chance they wouldn't resolve in mediation and they'd get reported to the NPDB anyway.
Opinions will vary, but to me the NPDB issue looks like a small cost for a potentially large gain in patient safety. I'm surprised and disappointed Public Citizen objects to that.
Sunday, September 1, 2013
First, nothing encourages lying like war. Since war is a matter of survival, successful prosecution of war is a moral imperative that overrules prohibitions against lying. Plus, the government takes risks and has consequential screwups in war more often than in any other venture. There are fewer penalties for lying in war and much more to lie about.
Second, lying has bad consequences for democracies.
- It impairs the ability of voters to act on their interests at the ballot box. Informed choices are impossible without good information.
- It impairs the ability of government itself to function as agencies learn to distrust each other. Everyone has to devote extra resources to verification and they won't always get it right, either missing a lie or assuming something true is false. As with voters informed decisions requires good information.
- Lying undermines the rule of law. When it becomes commonplace it's hard to hold anyone accountable, the excuse that "so-and-so got away with it so why shouldn't I" looms larger and larger. Plus, frictional costs weigh down the system. IL governor George Ryan banned the death penalty not because it was wrong but because lying was so prevalent in prosecutions that it could not be fairly applied.
- Finally, it breeds cynicism in the public and dissolves respect for democracy. A nation with a cultural of lying is vulnerable to authoritarianism.
Putting those two ideas together you have to wonder, what happens to a democracy that embraces permanent war?
Saturday, August 10, 2013
The Wall Street Journal ran an op-ed this week critical of Oregon's Health Evidence Review Commission (HERC).
parts of it were misleading and some outright false*, but on a
fundamental level the concern it expresses is correct. To the extent
we turn over health insurance to government we have to live with what
government gives us.
What government gives us isn't arbitrary, it's a
product of a public process which because we're a democracy is ours to
control. But it's for all of us to control, and what we collectively
decide may not coincide with what some of us individually might prefer.
That's the case with education, the law, and everything else achieved
through a political process. Health care is no exception.
If that sounds scary, chew on the alternative. How effectively could we act on our preferences in the pre-ACA system?
WSJ: On Thursday a state board could change Oregon's Medicaid program to deny costly care to poor patients who need it most...
That's why HERC, for example, proposed in May that Medicaid should not cover "treatment with intent to prolong survival" for cancer patients who likely have fewer than two years left to live.
Reality: The current guideline, adopted in 2009, restricts coverage of certain treatments for cancer patients expected to live 24 months or less. The policy WSJ claims was proposed in May was four years old, and was preceded by even tighter restrictions. Whatever changes HERC adopts, these kinds of coverage restrictions aren't new.
As for "costly care to poor patients who need it most," HERC is considering changing the guideline so that restrictions aren't based on expected life but instead on clinical circumstances (such as multi-system organ failure). Such restrictions are sought precisely because those treatments are unlikely to help anyone in those circumstances. The guideline isn't about denying care to patients who need it most, it's about avoiding care that isn't needed. Ignoring the probability of benefit as the WSJ does is like claiming buying a lottery ticket is the same thing as getting rich.
Sunday, July 28, 2013
This calculates annualized growth in housing units based on the change between the 2000 and 2010 census, and compares that to the price change from Jan 2000 to Jan 2010 based on the S&P/Case-Shiller Index.
How many households in Portland were earning 47% more in 2010 than they were in 2000? That's what they'd need to have the same home-buying power over that time.
It begs the question of what's a bigger driver of gentrification: A housing policy that encourages construction, pushing the city down and to the right along that curve, or a policy that discourages new construction which leaves housing unchanged but ensures that only an ever wealthier class of people can afford it?
Monday, May 27, 2013
If we want a less complicated system the solution is obvious: Reform property taxes, and allow them to pay for the things we want them to pay for. What purpose has been served by doing otherwise?
Saturday, May 25, 2013
On taking office Mayor Hales took control of all city bureaus. In effect Portland has not had a commission form of government in that time, it's had a strong mayor system.
The problems with implementing the arts tax can't be put on the commission form of government, they belong solely to Hales. By changing deadlines, monkeying with the definition of who was subject to the tax and generally badmouthing it he's given Portlanders every indication they should ignore the tax. That so many have paid anyway is a testament to how popular the idea of putting art teachers in schools is.
The "kinks" in the arts tax demonstrate the weakness of a strong mayor system, wherein a city's priorities can be totally re-written by the election of a single office. It encourages short term thinking and a focus on what one person can do in a four year term, rather than thinking about what a city should do in the long term. And it's impossible to adequately vet candidates. The arts tax drew more votes than did Charlie Hales, is it likely that people supported him knowing he'd undermine the tax?
Portland's problem isn't with the commission form of government, the problem is that we've abandoned it.
Saturday, May 18, 2013
The Oregonian published a modest story highlighting the economic diversity of the Pearl District, a well known urban renewal project. I was surprised at how many negative comments the story drew. Apparently it tweaked some people's noses to learn that poor people can live in the Pearl.
There are a lot of reasons to like or dislike urban renewal, but let's look at the most basic consequence. Urban renewal added housing. Between 2000 and 2010 the two census tracts which most match the Pearl added more than 5,000 units of housing. And it didn't add it willy-nilly, it was concentrated within an area of 0.72 square miles, most of it reclaimed from industrial and commercial use.
Now consider what would happen without such concentrated development. 5,000 units equals 50 100-unit apartment buildings. Given the problems the east side has shown accepting multi-unit housing, how would nimby leaders feel about 50 additional big buildings heading their way? Or you could suppose that demand would have been met with suburban housing. Assuming the same housing density as Beaverton that would require developing over 1,500 acres of land.
There are only so many ways of dealing with a rising population and a corresponding demand for housing. Urban renewal has its flaws, but if you don't allow multi-family housing in existing neighborhoods and you don't want sprawl then reclaiming land from other uses (and the subsidies that go with it) is what is left.
Wednesday, May 15, 2013
On the other hand it isn't plausible or desirable to say that insurers who want to lower their rates and who can bear the risk should be prevented from doing so.
I think the solution is to make such changes expensive. If a company fudges filed rates the "error" should be widely publicized so as to create reputational damage. Who wants to pay higher rates just because? There should also be a financial hit, perhaps by the state contracting out for third party review at the filing company's expense. Not only does it create a penalty to discourage such behavior, it's prudent since where there's one "error" there may be more.
And I have to add, I'm shocked... shocked that Providence had fat rates.
Thursday, May 2, 2013
Flynn wrote this back when George W Bush was still in office and troops were still dying in Iraq, but it is no less meaningful. It might be even more meaningful now, looking at the dual tragedies of the Boston Marathon and the Texas fertilizer explosion, or the destruction wrought by Hurricane Sandy.Coming to grips with perils that can lead to catastrophic consequences is not about living in a perpetual state of fear. We become fearful only when a sense of imminent danger is coupled with a feeling of powerlessness. But there is no reason to doubt our ability to confront and manage these risks. Every American generation has had to confront serious dangers, and they have always passed the test. While we must be prepared to acknowledge that there are dark clouds on the horizon, it is vital that we not lose sight of our most important and endearing trait: our sense of optimism about the future and our conviction that we can change it for the better.
We can quantize information of all types as never before. With that data we can project risk. It isn't something to be afraid of, nor is it something to ignore. I think incorporating knowledge of risk, and deciding what warrants action and what does not, is a critical challenge for self government.
Sunday, March 24, 2013
City Council Members,I'm writing to urge you to reject the proposed increases in parking minimums, or if enacted to allow neighborhoods to waive the requirements in return for alternative design considerations.Parking minimums are terrible social policy. They encourage the supply of premium, high-end housing both because larger units will push unit counts down and because more expensive units will more easily absorb the cost of parking. That has consequences for economic and ethnic diversity. The market for low-cost housing does not look like the market for high-end housing. The minimums will in effect further segregate our city.Parking minimums are terrible environmental policy. They encourage the use of automobiles, both for apartment residents and for homeowners whose street parking is effectively subsidized. Because our roads aren't getting any wider they will increase traffic and congestion, making our air more polluted. Parking minimums discourage people from using alternate transit, rendering our sidewalks less active and less safe. And because more buildings will have ground floor parking rather than retail they render our streetscapes uglier.Finally, parking minimums have consequences for regional policy. Encouraging high density elsewhere, such as urban growth boundary expansion areas, is untenable if we reject density in inner-city Portland. One way or another housing demand will be met. If it isn't met by urban housing it will be met by sprawl.All this, for what purpose? To protect who? How many homes lack off-steet parking? Where are they concentrated? Virtually every home in my neighborhood has off-street parking, what purpose do minimums serve here? That's not an idle question, I live [near an arterial street] and apartment development is not unlikely. Why should those apartments be required to have parking?Where homes do lack off-street parking why should their occupants be entitled to preferential treatment? Why should such residents be protected from the consequences of their decision to live in a home without off-street parking? If they should be protected why should that cost be born exclusively by renters in other buildings? Why should the resident of a 500 square foot apartment pay for parking so that the resident of a three bedroom single family home doesn't have to?As a matter of equity, as a matter of sustainability, and as a matter of basic common sense parking minimums should be rejected.But what should happen and what does happen aren't always the same. With that in mind, if parking minimums are adopted I urge the council to include an amendment that would act as a breath of fresh air. Allow a waiver of parking requirements if the presiding neighborhood association consents to one as part of a broader agreement with developers on project design. This flexibility would allow neighborhoods to determine their own best interest on a case by case basis, and it allows the possibility of creating particular amenities or features to meet a particular location's needs.If a location needs more parking lots, the neighborhood can sit on their hands and get that by default. But for neighborhoods with different aspirations, such as a public plaza or seating area, or a lower building height, or a stoplight to improve pedestrian safety, the ability to grant a waiver on parking requirements creates a powerful incentive for developers to take those aspirations seriously. Maybe a meeting of the minds will happen and maybe it won't. But if a bargain is there to be struck why shouldn't the city bless it?If this measure is passed make it one that strengthens the hand of neighborhoods in pursuing their own interest, not one that binds them.
Tuesday, March 5, 2013
… a deliberate, conscious effort to preserve or recall "those forms of experience which can no longer be had in an authentic way." Conservatism "becomes conscious and reflective when other ways of life and thought appear on the scene, against which it is compelled to take up arms in the ideological struggle." Where the traditionalist can take objects of desire for granted- he can enjoy them as if they are at hand because they are at hand- the conservative cannot. He seeks to enjoy them precisely as they are being- or have been- taken away. If he hopes to enjoy them again, he must contest their divestment in the public realm… As soon as those objects enter the medium of political speech, they cease to be items of lived experience and become incidents of an ideology. They get wrapped in a narrative of loss- in which the revolutionary or reformist plays a necessary part- and presented in a program of recovery. What was tacit becomes articulate, what was fluid becomes formal, what was practice becomes polemic.
Thursday, February 28, 2013
The Medicaid expansion population is people with incomes below 133% of the federal poverty level. Per a KFF Brief this population has a household income distribution as follows (2013 FPL level for a single adult in parenthesis):
Less than half of FPL ($5,745) - 49%
Between half and 100% of FPL ($11,490) - 30%
Between 100% and 133% of FPL ($15,282) - 21%
So Arkansas is telling a population, roughly half of whom make less than $6,000 a year, to go shop for insurance policies on the exchange. Gee, I wonder what could go wrong.
- Are these people literate? It's awful hard to shop for a policy when you can't read.
- Do they have homes? How will they manage all the paperwork that goes with private insurance when they don't have a permanent mailing address?
- Most important, will they understand their policies? Understanding the basic terms and conditions, such as when emergency room use will be covered or which providers are in network or what kind of pre-authorization is required is critical to effectively using an insurance policy. Mess that up and you are functionally uninsured.
Oregon is investing a lot of resources into Coordinated Care, ensuring that the Medicaid population gets the most medically-effective and cost-effective care possible. Arkansas, and states that follow them are embarking on a bold experiment in Anti-Coordination. Instead of the hard work of aligning incentives, resources, and purpose they are closing their eyes and throwing money at the problem. You don't need to be an actuary to guess how that will work out.
Sunday, February 24, 2013
Representative [ ],
I'm writing to express my great disappointment with the news that you will support HB 2800, endorsing construction of the Columbia River Crossing. That highway project will have long term adverse consequences for the district, for the city of Portland and the state of Oregon. The project benefits you cited are of marginal value:
- Light rail to Vancouver benefits Vancouver, not us.
- As a tool for managing demand tolling is inferior to existing capacity constraints. Do you really mean to say you support building a new bridge because it will lead to fewer vehicle trips than occur now? We should embark on the most expensive capital project in Oregon history so that it can provide less than existing service? Can you look at yourself in the mirror and say the CRC will be a disincentive to suburban sprawl?
- The construction industry will indeed benefit from spending 450 million dollars. But what does that have to do with the CRC? $450M would benefit the construction industry just as much if it were spent on seismic upgrades to our schools. Or on building a better tsunami evacuation system. Or on rewiring our electrical system to better integrate renewable energy. Or any number of pressing infrastructure needs that you know better than me. Why not spend that kind of money on something that brightens our future rather than darkens it?
The supposed conditions you cited for your support are small comfort. You claim your support was conditional on tolling I-205, and two paragraphs later admit there will be no tolling on I-205. What stock can we put in those conditions when they don't even last through your email? Why should we believe you will react tomorrow to what is plainly obvious today?
Supporting HB 2800 while hiding behind conditions you won't or can't enforce is passing the buck. It puts us in the position of waiting for someone else to do the right thing and pull the plug on this project. That is not what I sent you to Salem to do.
Friday, February 22, 2013
Sunday, January 13, 2013
Hacker writes one of the best explanations I've seen of what insurance in general, and social insurance and particular can do (emphasis mine):
I don't like all of the policy prescriptions, but this is a great book for understanding the underlying tensions in battles over programs like Social Security and national healthcare reform, and it offers a powerful argument about where our interests lie.