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grantcart's Journal
grantcart's Journal
December 19, 2017

Adverse Selection and how the Republicans just killed the ACA

The whole idea of insurance is to spread the risk among the largest population. Let's say that we want to help people who get Multiple Sclerosis a terrible condition that attacks people at random. If everyone is covered by MS insurance we can amortize it over 300 million and have a per capita charge of $ 1.00 per person.

If the number of people who buy the insurance is reduced the per capita charge increases.

If we force the insurance company to provide care for all of the MS but don't require a mandate this creates a situation of "ADVERSE SELECTION";

here is how adverse selection is explained with life insurance and smokers/non smokers

The term "adverse selection" was originally used in insurance. It describes a situation where an individual's demand for insurance is positively correlated with the individual's risk of loss.

This can be illustrated by the link between smoking status and mortality. Non-smokers typically live longer than smokers. If a life insurance company does not vary prices according to smoking status, its life insurance will be more valuable for smokers than for non-smokers. Smokers will have greater incentives to buy insurance from that company and will purchase insurance in larger amounts than non-smokers. As smokers are at higher risk of early death due to their smoking status, and more smokers than non smokers will purchase life insurance, the average mortality rate increases. This increase means the insurer will spend more on policy payments, leading to losses.

In response, the company may increase premiums. However, higher prices cause rational non-smoking customers to cancel their insurance. The higher prices combined with their lower risk of mortality make life insurance uneconomic for non-smokers. This can exacerbate the adverse selection problem. As more smokers take out life insurance policies and increase the insurer's mortality rate, its prices will continue to rise, which in turn will mean fewer non-smokers will purchase insurance. Eventually, the higher prices will push out all non-smokers and the insurer will also be unwilling to sell to smokers. No more interactions will take place, and the life insurance market will collapse.

Legislative Adverse Selection occurs when legislation destabilizes the natural selection then it creates a death spiral for the insurance plan. When you mandate that the insurance company must accept everyone regardless of pre existing conditions BUT then takes away the individual mandate they are creating Legislative Adverse Selection.

If we require Health Insurance companies to cover people with pre-existing conditions but don't have an individual mandate we will set up a death spiral for the ACA.


Susan Blumenthal, M.D., Contributor

Public Health Editor, The Huffington Post; Former U.S. Assistant Surgeon General

Repealing the Individual Mandate would not only create an influx of adverse-selection by depleting the Marketplace of many young and healthy individuals who abandon the Marketplace while seeking “skimpy” insurance plans, but might also result in the Marketplace becoming victim to an exodus of individuals abandoning purchasing health insurance altogether. On November 26, 2017, the CBO reported that repealing the ACA’s Individual Mandate might increase the number of uninsured Americans by 4 million by 2019 and by 13 million by 2027 while reducing the federal budget deficit by less than originally forecast. Sick and older Americans, some of the most vulnerable individuals needing insurance coverage, would likely remain in the Marketplace and be subject to higher premium prices — projected to increase an additional 10 percent over the next decade — resulting from instability caused by adverse-selection.

Unable to kill the ACA by guillotine the Republican Senators killed by slow strangulation.

Senator Collins, Senator Murkowski and all of the others who said that they would protect the ACA and healthcare for the middle class and poor lied.

The ACA is now a dead health plan walking. It will take a couple of years but without the mandate it will be a plan that will end up only with those who have current conditions signing up for it and others opting out as premiums will start to radically increase.

This is the most cynical move possible. Keep the popular requirement mandating insurance companies must take everyone and then take away the individual mandate so that the plan becomes unsustainable.
December 11, 2017

In Trumpism epistomology was the first casualty, and why there is still hope.

At some time in the 5th century BC Aeschylus enumerated a truth that has been repeatedly confirmed in our lifetime, "In war, truth is the first casualty."

We can now update that with “In neo fascism, epistemology is the first casualty”

Systemic philosophical or theological discussion doesn’t start with what you know but the more important question “how do you know what you think you know”. Up until Copernicus knowledge was thought to be the recitation of the obvious: God made us, we live by simple rules and noting that which can be easily observed.

When Copernicus established that the most obvious known fact, that the Sun “rose in the East and set in the West” was not a fact and that we were instead a sphere rotating through space, human reasoning went through a crises of epistemology. How should we know anything? Are we even human beings or could we be (in the absurd) a butterfly dreaming that we are humans. Descartes established a new foundation with “I think therefore I am”, that knowledge can be certain on the basis of rational discourse and the use of the scientific method.

In 1970 Alvin Toffler observed in “Future Shock” that technological change would continue to speed up until it would happen at a rate that was faster than the psychological ability of society to absorb it. It would create pockets of fear. That is exactly what we are witnessing.

Please take a minute and read this disturbing article by The Guardian. It documents that farmers in the US are committing suicide at a rate much higher than not just the population but higher than other high risk groups, like veterans.



Last year, a study by the Centers for Disease Control and Prevention (CDC) found that people working in agriculture – including farmers, farm laborers, ranchers, fishers, and lumber harvesters – take their lives at a rate higher than any other occupation. The data suggested that the suicide rate for agricultural workers in 17 states was nearly five times higher compared with that in the general population.

After the study was released, Newsweek reported that the suicide death rate for farmers was more than double that of military veterans. This, however, could be an underestimate, as the data collected skipped several major agricultural states, including Iowa. Rosmann and other experts add that the farmer suicide rate might be higher, because an unknown number of farmers disguise their suicides as farm accidents.

The US farmer suicide crisis echoes a much larger farmer suicide crisis happening globally: an Australian farmer dies by suicide every four days; in the UK, one farmer a week takes his or her own life; in France, one farmer dies by suicide every two days; in India, more than 270,000 farmers have died by suicide since 1995.

When we look at the irrational embrace of neo fascism in Trump and scratch our heads why rural parts of the country (and other countries), even those that are located close to normal urban and progressive communities, embrace policies of tribalism, we can see the reason, they are filled with fear. Fear is the fuel that has empowered fascism for a hundred years. In their fear they cling to their guns, their bibles and the false memory of a simpler time when society could be ordered by the simple observation in known truths; The sun rises and sets and human society was based on families that had a simple formula – a man, a women and children, that all you needed to succeed in the work place was to show up and work hard.

We need to face that what we are seeing is in fact a new branch of fascism. It is a world view that is not based on reason or fact but the Nietzsche like birth of the “strong man” who intends to reorder society not by reason but as an extension of their personality camouflaged democratic institutions. In this way Trump is like other “strong men” of fascism like Mussolini.

Truth, for people like Trump, is simple; it is not in a fact but in bellicose repetition of a lie where the truth of a thing is established not by reason but by the forceful assertion of a phrase. In the New York media and property world Trump was able to establish a win by simply wearing down critics by an obstinate repetition of a lie and that is the game that he is playing now.

Where the News Media went wrong with Trump is when they allowed him to state a known lie and after a few attempts at questioning “went on” to the next object. When Trump entered the absurd world of “birtherism” the news media should have never asked him another question, never moved on. They should have repeatedly asked him to explain how he arrived at that lie. Until he conceded that lie then they should have not let him make any other point. He won by his persistence.

We must now re-establish reason as the currency of public conversation. We should never again let one of our courageous leaders be targeted by absurd allegations that parallel Trump’s tactics of bellicosity and repetition as a substitute for fact and reason.

We should also understand that for many in the rural areas of our country the embracement of Trump is a cry for help. The are afraid of the future that takes their children to live in urban areas far away and eliminates jobs that have provided stability for families for generations.

How can we take the higher road, understand the pain that has mobilized our political enemies into an eruption of fascist irrationality and find a path forward that unites our common interest based on shared values? I would suggest we could accomplish this by simply recalling the wise leadership of the man who spent 8 years doing it day in and day out. The strange reality we live in is the country that has tens of millions that support Trump is the same country that elected and re-elected President Obama.

We must insist on a return to compassion and reason. Exhaustion, lassitude and defeat are not options.
December 3, 2017

Russian Roulette Republicans

It is entirely possible that all 51 Republican Senators want to pass a terrible tax bill.

However there is, I believe, a much simpler explanation for the Senate vote.

They passed a terrible bill that will not get past the debt hawks in the House and the House Republicans will make substantial changes and return it to the Senate where it will lose at least two more Senators and fail.

Why would the Republican Senators who are seriously against this legislation (and there may be more than those that telegraphed a problem with it) vote for it?

They are tired of being blamed by the radicals in the Republican House and getting challenged in primaries by Tea Party. The House can pass the Senate bill without any changes and send it to the President. If they make any changes the Senate Republicans can say "we did what we had to do but it is the purists in the House that sabotaged it".

Of course if the House Republicans pass the Senate bill then it will hurt the Republican Senators in the General Election but not in the primaries and that is their greatest concern. Senator Lugar, Bennet and Murkowski all lost in the primary and would have easily won in the GE. Murkowski won on an independent ticket.

The Senate Republicans have put a bullet in the chamber and dared the House to pass it knowing that if it goes back to the Senate it will not pass, especially if they lose on Tuesday and the responsibility will be 100% on the House Republicans.

December 3, 2017

Stupid on stupid: "The lawyer ate my tweet homework"

Woke up to this

John Dowd, President Trump's personal lawyer, tells me that a Trump tweet that caused an eruption yesterday was "my mistake," made in a tweet he had drafted and passed to White House social media director Dan Scavino.

It is a stupid excuse of course but the question who drafted it is of no consequence. The point is that Trump tweeted it out and found nothing untruthful with it.

However this is just more lies on other lies. No attorney is drafting tweets for Trump to send out. All attorneys are telling Trump to stop talking about the case, stop tweeting about the case and refer all questions to a single attorney that represents the entire defense team. If that attorney says anything more than "We have no comment" he will be sacked.

Have Dowd and Savino explain minute by minute before FBI agents what happened and maybe we can get these asses understand that they have to stop lying but more likely we are going to get more guilty verdicts.

Evidence of a cover up (lawyer ate the tweet) about a cover up (the actual tweet) of a felony obstruction claim(Flynn lying to the FBI) about the conspiracy (conspiring with the Russians to modify the sanctions) of sedition (not treason).


Congress has passed laws creating related offenses that punish conduct that undermines the government or the national security, such as sedition in the 1798 Alien and Sedition Acts, or espionage and sedition in the Espionage Act of 1917, which do not require the testimony of two witnesses and have a much broader definition than Article Three treason. Some of these laws are still in effect. Some well-known spies have been convicted of espionage rather than treason.

We are literally watching people commit felonies before our eyes in slow motion. If the lawyer states before FBI agents that he drafted the tweet and did not, its another level of obstruction. Whether he drafted it or not it has been tweeted out and Trump hasn't disowned it. Who "drafted" the tweet is of zero relevance.
November 6, 2017

The Paradise Tsunami: 13.4 million pages 1.4 Terabytes 100 media outlets

We are all about to become experts in the Paradise Papers, a follow up on the Panama Papers.

It consists of 13.4 million pages, 1.4 Terabytes of Data all of which has been sent to 100 media outlets.

It has already showed that Ross and Kushner have DIRECT ties to Russian government entities. It includes offshore transactions for Tillerson, Mnuchin, Huntsman, as well as the Queen of England and Prime Minister Trudeau. We are going to see a nightly revelation as all of the media outlets start wading through 13 million pages of transactions.

Here is a good summary of what we know as of today:



A massive leak of financial documents appears to reveal that many of US President Donald Trump's advisors, members of his cabinet, and donors hold accounts in offshore tax havens. Those individuals include US secretary of state Rex Tillerson, Treasury Secretary Steve Mnuchin and Trump's ambassador to Russia Jon Huntsman, among others, according to reports.

The leaked documents also show that Trump's commerce secretary, Wilbur Ross, retained business investments with a Russian shipping company with ties to a Russian oligarch subject to US sanctions, and Vladimir Putin's son-in-law, according to the New York Times.

The massive leak of 13.4 million financial documents also paints of a picture of how the world's most powerful individuals and companies — from the Queen of England to Apple — use and benefit from offshore tax havens.

The documents, obtained by the German newspaper Süddeutsche Zeitung, come a year after the Panama Papers similarly revealed the inner workings of offshore tax havens. As with the Panama Papers, Süddeutsche Zeitung handed over the 1.4 terabytes of data to the International Consortium of Investigative Journalists (ICIJ), which then distributed the documents to around 100 media outlets around the world.

"Many of the stories focus on how politicians, multinationals, celebrities and high-net-worth individuals use complex structures of trusts, foundations and shell companies to protect their cash from tax officials or hide their dealings behind a veil of secrecy," wrote the BBC, one of the media outlets that received documents from the ICIJ.

The BBC, The Guardian, The NYT and 97 other media outlets competing for the Pulitzer Prize. We are going to need bigger federal prisons.
October 2, 2017

Senator Corker is a rare Republican. On 3 big issues he has put country above party.

Senator Corker has put country before party and before ambition three times this year.

1) After working with President Obama to get the deal passed he affirmed this year that the Iranians are in compliance with a good agreement.


“After more than a year of bipartisan work and a veto threat from the White House, I am pleased to see this bill become law so that any final nuclear agreement with Iran will have to go through Congress where the American people will have a say and lawmakers will have a vote,” said Corker. “I appreciate the strong bipartisan support for this effort that demonstrates Congress’s determination to prevent Iran from getting a nuclear weapon. With the role of Congress now guaranteed, the administration must address the many significant concerns raised by Congress, and our negotiators should take advantage of the added leverage to force further concessions from the Iranians so that any agreement reached is verifiable, enforceable and can assure the American people Iran will not be able to develop a nuclear weapon.”


The Iranian agreement requires that the President certifies their compliance every 120 days. The ONLY reason that Trump hasn't decertified is because that Corker keeps saying "they are in compliance:

So you look at where we are, there’s some nuance to this certification. What it actually says is that they are implementing the deal. Iran is implementing the deal. They do have technical violations that take place. Most of them have not been what I would—it’s like a loan covenant. This is the way I’ve talked to the president, “Mr. President, we’re in loan covenant.” There’s a technical issue and then there are material breaches that matter, right? Well, right now, they’ve had some technical non-compliance but they get back into compliance from time-to-time.

Senator Corker, more than any other single person, is the obstacle keeping Trump from ripping up the Iranian Nuclear Agreement.

2) Senator Corker has openly question Trump's competence. The removal of a President cannot be done with a partisan brush. There must be independents and Republicans who agree to the basic premise of competence and that Trump is a danger. Corker took the first shot.


"The President has not yet been able to demonstrate the stability nor some of the competence that he needs to demonstrate in order to be successful," Corker said, according to a video posted by local news website Nooga.com.
"He has not demonstrated that he understands what has made this nation great and what it is today, and he's got to demonstrate the characteristics of a president who understands that," Corker added.

3) Today Corker killed the Tax Cut Bill


In an exclusive interview on Meet the Press, Sen. Bob Corker (R-Tenn.) tells Chuck Todd that if the GOP’s new tax reform plan adds a penny to the deficit he won’t support it.

This will give the Republican debt hawks enough of a spine stiffening that it will kill the Tax cut insanity of the Goldman Sachs clique. It will doom their "Tax Reform" con.

The reason that I am a debt hawk (besides stimulus and other similar legislation) is that Republicans use debt to give away big ticket items to the business establishment and leaves the budget strangling to find money for the poor and middle class. If we didn't have to pay interest on the current debt we would have sufficient revenues to fund most of a single payer health care system.

While we don't agree with Corker on many issues I think we should respect Corker for putting the country above the party on Iran, Trump's competence and the Tax cut for the rich.

When they come to rebuild the Republican Party they will need people like Corker to return it to sanity.
September 30, 2017

It, almost certainly, is about to get worse.

A week ago I had a business meeting and the fellow started with something that was obviously on his mind, "I don't want to get into a partisan thing, and I don't agree with everything that Trump says BUT I do agree with him about athletes standing for the national anthem and not disrespecting the flag".

We talked for a bit and I gave him an alternative way of looking at it but then remarked, "its about to get much worse, much worse." He was curious and I explained that we weren't getting news from PR but when we did the news was going to be much worse than people thought. I explained that in modern society when you wipe out the electrical grid you have wiped out the foundation of society. Not only refrigerated food and drugs but also fresh drinking water, and much worse, sewage. When I told him that we were facing a real cholera epidemic that could effect tens of thousands, very quickly, I couldn't really follow the football drama or the stupid tweets. Cholera in the US affecting thousands should be everyone's first concern.

As the situation in PR allows for more interaction we will start getting the details and the pictures. When the basics have been established then there will be a house by house search for victims and it will take weeks to find all those that didn't survive the hurricane.

It will be a relentless day by day record of pain and suffering, some of which is not the fault of anybody and a lot of how Trump's cluelessness caused unnecessary death, suffering and loss.

At that point it will, almost certainly, get worse, much worse.

Trump has only one out. Trump isn't just a vacuous narcissistic semi-literate superficial performer, he is a vacuous narcissistic semi-literate superficial ONE TRICK performer. He has only one out - escalate the buffoonery to a new and higher level of confrontation, reframing, alarmist, scape goading.

The only way that he will get to out flank the pincer movement of bad Puerto Rico stories, general mismanagement stories, Bannon taking over the Republican Party stories, and the drip drip drip leaks from the Mueller investigation is to engage in a military confrontation.

China's closing of most of North Korean expat businesses has put China in the driver's seat in dealing with the North Koreans, along with almost everyone, including Russian revulsion at Trumps wild gestures.

That leaves Iran. At a time when Iran has swerved to its most rational course and made every effort to respond positively to the international agreement including large purchases of Boeing civilian aircraft Trump will be able to stir anti Iranian hysteria that too many including Senator Schumer have used for cheap and dishonest appeals to their bases.

A simple confrontation that triggers brief firing confrontations that doesn't lead to an actual open ended conflict (that would disrupt too much of Trump's golf and social schedule) could bring him weeks of headlines, threats, bombastic tweets and vitriolic nonsense wiping all of the other news of the front page.

It would also bring other benefits for Trump. Any military activity in the Straits of Hormuz will invalidate the underwriting of insurance for the shippers and disrupt 40% of the worlds freely traded oil. Oil prices would go up and bring immediate relief to Russia, OPEC (especially Saudi Arabia who is having an inconvenient debt crises) and the petroleum base of the Republican Party.

It is bad now but we should prepare ourselves for the possibility that it is about to get much worse.

September 20, 2017

Heartbreak at the UN

For those of us who have had the privilege to work as international civil servants in the UN/Intergovernmental Committee institutions (most UN work is done by stand alone intergovernmental committees, like UNHCR, UNICEF and so on and don't report to either the UN General Assembly or the UN Security Council) watching the buffoonery by Trump at the UN was an additional heartbreak to what we all have had to bear these last 8 months.

There are many countries that make generous contributions to the UN from Denmark, Norway to Australia, and so on. The US however has been the anchor, its membership on the governing committees is the only one that has the 'heft' to keep these agencies pointed at long term humanitarian goals.

Today we saw the US become untethered from its role as sextant to help a complicated world work together to plan a common objective. With the similarly banal abandonment of the voluntary Paris Accords the US has established a new drum beat that will appeal to the darkest natures of the craven and ambitious in every country: Everyone for themselves.

The churlish and juvenile threat to "wipe North Korea off the map" reveals a casual indifference to the loss of tens of millions of lives, not just in North Korea but also South Korea. It will not be long before not only our traditional allies abandon our common cause but we are met with unified opposition by Russia, China and all nations who see the casual tossing of nuclear weapons to be a precedent in no one's interest.

We need to establish a line, not between the factions of the Democratic Party but between Trump and all rational people, a national coalition of all people who oppose his madness, nothing else is of consequence.

The best case scenario is now a bar so low as to be incomprehensible: The best outcome is that the rest of the world responds in disgust at what is promoting. The worst case scenario is an apocalyptic horror initiated by the richest country in the world with a chip on its shoulder.

Trump's message is "The people that support the higher morality of international cooperation, understanding and mutual development are CHUMPS. It is everyone for the themselves between countries and within countries". There are deplorables in every country who will hear this clarion call for tribalism and rip their countries apart trying to advance their personal fortunes and power.

August 6, 2017

Pressure mounts on Israels prime minister as aide agrees to testify

Source: Washington Post

JERUSALEM — Israeli Prime ­Minister Benjamin Netanyahu is known for being a political survivor, but the revelation this past week that a former top aide will testify against him has led to speculation that his indictment in relation to allegations of corruption is increasingly inevitable.

Ari Harow, who served as Netanyahu’s chief of staff, will turn state’s witness in two probes into the premier, Israeli police said Friday. Netanyahu has repeatedly denied any wrongdoing.

The details of the investigations — from the Cuban cigars and other lavish gifts Netanyahu is alleged to have received from prominent business executives to allegations of collusion with Israel’s dominant newspaper for favorable news coverage — have gripped Israel in recent months. Harow’s agreement to testify, though, significantly ramps up pressure on the premier, now serving his fourth term.

The agreement “has one virtually irreversible implication: an indictment against Netanyahu is coming,” an analysis in Israel’s daily Haaretz said Saturday, as the Israeli press mulled whether it could mark the end for his premiership.

Read more: https://www.washingtonpost.com/world/pressure-mounts-on-israels-prime-minister-as-aide-agrees-to-testify/2017/08/05/5bfb6e3e-79d5-11e7-8f39-eeb7d3a2d304_story.html?utm_term=.86e7b0e77b53

I think Trump is aware that Netanyahu is much brighter than he is, and has a much more favourable home field advantage than Trump does, especially now that Trump has started a war with his own party. If Netanyahu is indicted I predict our sleep deprived President is about to have real insomnia.

I think we can now coin a new term, "Trumpesque", as in the 'Netanyahu family is very Trumpesque' as this excerpt from the article shows:

Meanwhile, his eldest son caused a furor as he lashed out at a website that criticized his lavish lifestyle with a Facebook post signed off with emoji of a raised middle finger and a pile of excrement.

August 1, 2017

One thing, and the most important thing, has changed by having Kelly as COS

The leak which had Kelly calling Comey after he was fired (which had to have been leaked by one or both of them) and threatening to resign as Secretary of DHS to express his anger has made one thing clear IMO: Kelly will not sanction a Mueller firing. Interestingly it is reported that Comey urged him not to resign.

If he was upset about Comey getting fired he would be 10 times more angry at being a part of a huge Saturday Night Massacre that would take Mueller out.

Notice that all of the attacks against Sessions and the rumors of appointing a new AG during recess have evaporated since Kelly moved in.

Trump has to realize that Kelly has a hundred ways to block an attack on Mueller beyond resigning in protest.

Kelly could simply leak details and allow key players to be prepared ahead of time. Exposing a move against Mueller would likely get a resolution from the Senate, among intensive public reaction.

It may be that Kelly approved the leak in order to not only show his personal take on the move but that he was prepared to go outside normal channels, that if Trump moves against Mueller he will have to go through Kelly.

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