Miscellaneous And Off Topic Subjects

[Jeff Buchanan]

Hack, never thought of that .......

To add to your list on your brain, I recently worked for an MD who had maintained the autonomy of his private practice by not converting to Electronic Medical records (foregoing a $75K bonus paid for by the Feds for doing so) and keeping his complete staff at less than 10 employees.

He unendingly bitched about the administrative costs of the ACA and was and remains an ardent supporter of Trump who is reasonably certain is going to not enforce many of the mandates that create these administrative cost increases which he quotes a figure in the neighborhood of $500M.

When the ACA was rolled out, private contractors bid on (well, maybe just given contracts depending on who they knew) and some of these new administrators are pulling town 6 figure salaries for administrating.

He was pissed about that as the amount of money he is paying himself every year from his practice has probably dropped over 40% in the last 5y due to the huge decrease in reimbursement he suffers.

His claim is that administrative costs of the ACA are directly eating into his reimbursements stating the money came from somewhere to hire these clowns. I don't think he is too far off base.

[hack]

Good posts, last two. Another way to determine what effective government would be could be bang-for-your-buck. Health care spending as a percentage of GDP posited against actual health-care outcomes is tops worldwide: http://data.worldbank.org/indicator/...high_desc=true. Are we getting our money's worth? Is government a problem here or a solution?

[Jeff Buchanan]

............ when we begin to make value judgments as to what is important (like Maslow's) we run into trouble. Take "Personal Security". Does that mean a person should be required to have a handgun, the better to fend off danger? Or does it mean a person should be prohibited a handgun, so the police don't have to worry about it? Does "financial security" mean we should promote greatly similar salaries (and mediocrity) or should we nurture the brightest and most aggressive among us, tax those folks, and give the rest some sort of guaranteed (but lower) income?

In general, I think Jefferson's advice "...that government is best which governs least" remains the touchstone of good governance.

I'm in agreement with you on value judgments but I made it clear in my post that when you get to the point beyond Maslow's low down on the needs chart (security) it gets complicated ...... I believe you and I see value judgments differently

Air Pollution and Handguns ..... not talking about that kind of detail and it clouds the discussion.

I'm talking about Security in its broadest sense as it is defined in the Constitution (".....insure domestic Tranquility, provide for the common defense, promote the general Welfare....."). If you agree that the US Government has a role in doing that, and I think you do, then the next question to ask is to what extent which then begs the question how much does it cost? ..... or what is the value to you of having Government assure that outcome.

..... and I absolutely agree with you that the question of how much does it cost does come down to how much money or what portion of my earned income am I willing to give the Government to do those things.

At this level of thinking, it is a value judgement, you can't escape that.

Moving on, when you say, Does "financial security" mean we should promote greatly similar salaries (and mediocrity) or should we nurture the brightest and most aggressive among us, tax those folks, and give the rest some sort of guaranteed (but lower) income?

Again, there is point at which you make a value judgement about this sort of question as well. As for me, I'm not ready to leave the handicapped, in every meaning of that word, in the gutter. I don't think you are either and I don't mean to imply that. I just may be willing to pay more in taxes to help the poor than you might be and I'll vote for elected officials who have similar ethical viewpoints to mine.

Geezer quotes ....... In general, I think Jefferson's advice "...that government is best which governs least" remains the touchstone of good governance.

Agree, but that's a meaningless platitude albeit a good one.

[AlabamAlum]

The ACA was/is sloppy. The medical center I managed spent $67 million on the EHR and becoming compliant.

It was a real case of "we must do something even if what we do doesn't work well."

[Da Geezer]

Hack. First, a really good post from Cato. Thanks.

Second, you should be able to get a human to explain to you what is required if you call the IRS helpline. The advice you receive on the helpline has been found to be correct about 20% of the time. Good luck with that. Larger taxpayers, corporations and the like, can indeed get an Advance Pricing Agreement, but the cost is in many ways prohibitive. Reality is that the larger the taxpayer, the more likely he has retained lawyers and accountants to help him comply with the IRS Code. This cost is in addition to and far in excess of any cost to the government for those bureaucrats issuing an APA.

I must again address your concern with "corporations" and commercial interests as opposed to "individual" interests. In the eyes of the law, corporations are individuals. Corporations may be owned by many owners, or they can be owned by few or even one. What makes corporations relatively unique is the concept of Limited Liability (now we have LLCs and SubS corps., and limited partnerships, but all are based on limited liability). Limited Liability means investors can only lose the amount invested in the entity. This makes a great deal of sense when raising funding for a risky project.

But corporations behave in almost all ways that matter precisely as individuals might act in a similar situation. That's because they are run by humans. To blame the organizational structure of a venture for its flaws is just not logically accurate. $ 700 hammers exist because humans do what humans do, not because they are produced by a corporation.

[Jeff Buchanan]

http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?year_high_desc=true[/url]. Are we getting our money's worth? Is government a problem here or a solution?

I just saw a great piece on the topic of US Health Care costs but I'll have to find it. Essentially it says that when you remove certain costs that do not involve direct patient care, there are five countries that spend more than the US does per capita. France and the Nordic countries - whihc one's I can't recall - are among those countries paying substantially more per person than the US does.

[Da Geezer]

Geezer quotes ....... In general, I think Jefferson's advice "...that government is best which governs least" remains the touchstone of good governance.

Agree, but that's a meaningless platitude albeit a good one.

I'm not at all certain it is a platitude anymore. Maybe you are right. My hope is that Trump's cabinet appointees will ask the question "is this a valid use of government power?" when issuing edicts allegedly enforcing laws. If you look at the Clean Water Act, and then look at the regulations promulgated under that act, you can clearly see the overreach. Are plowed fields actually "little mountain ranges" as the EPA contends? Do puddles that last an hour actually justify the federal government calling all surrounding areas "wetlands"? At another level, do we really need to license persons who braid hair for a living?

I believe the first question should be "How does this improve the health, safety, and welfare of the country/state/locality". If there is not a real nexus, then government should stay out. It will be interesting to see how these matters are handled in the coming months.

[hack]

In the eyes of the law, corporations are individuals.

I guess there's no good time to bring this up, but I do have something to tell you guys and I cannot keep it a secret any longer. I've felt feelings inside me for a long time. A yearning to unshackle myself from liabilities and take reckless risks without suffering any consequences. In order to be true to my real self I am attempting to become the first male-to-LLC transgender person. I hope you all will support me, even as my body undergoes awkward changes from male physiology to organizational flowchart.

Also I expect my own fucking bathroom wherever I go, with a throne-style paper shredder.

[Whitley]

I guess there's no good time to bring this up, but I do have something to tell you guys and I cannot keep it a secret any longer. I've felt feelings inside me for a long time. A yearning to unshackle myself from liabilities and take reckless risks without suffering any consequences. In order to be true to my real self I am attempting to become the first male-to-LLC transgender person. I hope you all will support me, even as my body undergoes awkward changes from male physiology to organizational flowchart.

Also I expect my own fucking bathroom wherever I go, with a throne-style paper shredder.

ooooooo.... are you springing extra for the gold tinged lanyard and dont forget that sexy three hole punch.

[Whitley]

Acting AG Sally Yates tell the DOJ lawyers not to defend Trump's EO regarding the 7 countries ban.

"My responsibility is to ensure that the position of the Department of Justice is not only legally defensible, but is informed by our best view of what the law is after consideration of all the facts," she said in a letter. "In addition, I am responsible for ensuring that the positions we take in court remain consistent with this institution's solemn obligation to always seek justice and stand for what is right."

President Trump has just fired Sally Yates for refusing to carry out his orders.

Jeff Sessions, Trump's choice for AG, is up for a confirmation vote on Tuesday.

[Whitley]

Statement from Trump White House on firing Acting AG Sally Yates:

A statement from the White House said that Yates ?has betrayed the Department of Justice by refusing to enforce a legal order designed to protect the citizens of the United States.?

?Ms. Yates is an Obama Administration appointee who is weak on borders and very weak on illegal immigration,? the statement said. ?It is time to get serious about protecting our country. Calling for tougher vetting for individuals travelling from seven dangerous places is not extreme. It is reasonable and necessary to protect our country.?

[Dr. Strangelove]

Are Republican leaders of Congress really okay with their staffers working for Trump behind their backs?? Is it even legal to force congressional staffers to sign non-disclosure agreements so they won't inform their actual bosses?

http://www.politico.com/story/2017/01/trump-immigration-congress-order-234392

[iam416]

Yates took her lititle stand and was properly fired.

[Jeff Buchanan]

A stand that, BTW, had little cost. She probably had 3 or 4 more days on the job with Session's nomination vote in the Senate looming and a likely 51 votes needed for confirmation assured.

[iam416]

Correct.