Jules Renard on Culture

Vladimir Nabokov on Loathing

Some of Dr. Dean's Delayed Diagnosis of IPABs

Although  former Vermont Governor and 2004 Presidential Candidate Howard Dean (D-VT) has been out of the practice of medicine for a number of years in lieu of politics, the Doctors delayed diagnosis of IPABs is right on the money.

Recently, Howard Dean wrote an opinion piece for the Wall Street Journal in which he prognosticated:  "The IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them."   For those who did not thoroughly study the 2,700 pages of legislation that comprised the ironically titled "Affordable Care Act", otherwise know as Obamacare, IPABs are the 15 member Independent Payment Advisory Board which the HHS Secretary Sebilus appoints that decides the amount that the government will reimburse physicians for medical procedures. 

This was  supposedly intended as a cost control mechanism for Medicare, but in reality will act as a rationing board.  The IPAB name implies that these opinions are advisory, but those opinions become the reality.

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Instead of cajoling vulnerable senior citizens to just "take a pill", the patient is cut out of the process by "Advisory Boards" which make certain treatments financially unviable, depending upon one's status.  When Sarah Palin labled IPABs as "death panels", she was roundly criticized as a scare monger who was stupid, don't cha know?  

A couple of years later,  Dr. Dean  diagnosed IPABs as rationing boards,  it makes  more sense, right?

Howard Dean suggested that: "Getting rid of the IPAB is something Democrats and Republicans ought to agree on."  Obviously, the former DNC chair has not gotten with the program to think that Obamacare is about improving healthcare in America.  It seems that it more about control.

Unless Tea Party House Republicans are successful in defunding Obamacare from the FY2014 budget, all Americans will be mandated to participate in the program or pay a tax.  Nevertheless, the IRS will be in charge of collections and monitoring all of the health information.  Recent reports have indicated that health records will be vulnerable to hackers and scammers.  In addition, the IRS has shown political partisanship in vetting Tea Party tax exempt applications and for surrepticiously sharing this information.  Why couldn't the Obamacare cost cutting extend to denying treatment to political opponents?

Allow me to dispense a rhetorical palliative to Obamacare opponents– as P.J. O’Rourke put it: “If you thought that health care is too expensive now, wait until you see what it costs when it’s free.”  Alas, the Affordable Care Act is doubling many peoples’ rates and may cost some their hides. 

 SEE MORE at DCBarroco.com 

Late Night POTUS Rimshots

What sort of leader goes on a late night talk show to make his first comments on a supposed terror threat which closed down a score of US diplomatic missions in the Middle East and deny domestic spying programs?

The same one who went on televised gab-feast know as ABC's "The View" to further the lie that an obscure American YouTube video sparked a terror attack in Benghazi, Libya on September 11th 2012 which killed four Americans including Ambassador Chris Stevens.  Afterwards, this Chief Executive spoke at the the United Nations and insisted that: "The future must not belong to those who slander the prophet of Islam."

While live blogging on President Obama's nearly hour long press conference which seemed to have been called to quell murmurs in the media that the President was not taking things seriously by going to Jay Leno for making big news, Hugh Hewitt tweeted:  "Obama is a collection of cliches surrounded by an Oval Office."  It is arguable that based upon his persistent partisan pugnaciousness and predilection towards folly that Mr. Obama is better characterized as a pack of punchlines.

It's a Mad world.  Alas these jokes are not confined to Late Night rim shots or adolescent inspired humor magazines but are entrenched in the center of power in the District of Calamity (sic) for the next 3 1/2 years (at least). 

h/t: Kevin Siers

A Bit On Cell Phone Upgrades-- Next, Edge, Jump

American cellular phone companies originally structured their service to entice new customers with heavily subsidized handsets in exchange for a nearly iron clad two year contract.  If a consumer wanted to ditch their contract early, they faced an Early Termination Fee (EFT) of between $175 to $350.  This EFT sought to recover losses from the subsidized handsets, but also acted as an incentive to stop churning customers.  This practice did not always settle well with consumers stuck with lemon phones or if cellular coverage was wanting so a consumer wanted to stop service

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Cellular service providers got the message that both Uncle Sam and consumers were unhappy, so they figured out other ways to cut their losses.  Recently, T-Mobile tried to co-opt a European approach by not offering subsidized handsets with supposedly lower monthly plan rates.  Not being locked into a contract offers the illusion of freedom, but full freight for a smart phone can be $600 up-front and consumers could walk away with their GSM phones and go to ATT or a Mobile Virtual Network Operator (MVNO) such as Wal-Mart’s Straight Talk to get lower rates.

While many cellular consumers like the notion of not being bound by an iron clad contract, what they really want is to feed their fetish for a constantly current cell phone.  Whether a consumer is locked into a two year contract or paying the full sticker price for a smart phone, there are still ties to a handset which makes a consumer chary to switch. 

Several of the major cellular carriers are accommodating the consumer desire for constantly current cell phones with new programs.  

T-Mobile’s Jump program is a no-contract cellphone customers who pay an extra $10 a month for insurance and Jump plan participation.  T-Mobile typically runs a credit check on prospective new customers in order to determine how much of a down-payment is required for a phone purchase in 20 monthly installments on top of your phone plan (although T-Mobile stresses that everyone eventually pays the same price for the handset). But if you are a Jump plan participant, after six months a consumer can trade in an old handset and purchase another on a 20 month installments, but the consumer is no longer responsible for payments on the old handset. Of course, if a customer wants to keep the handset, he must pay the remainder of the balance of the installments.  

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AT and T Next is a way for an AT and T customer to get a new phone every year. When a customer chooses AT and T Next, the price of their technology is broken into 20 monthly installments (with no finance charges).  At the time of purchase, the customer does not have to make a down-payment but must pay the full sales tax.  After 12 monthly payments, a customer can trade in his device and receive a new one, and no further payments are required on the old device and the customer starts over on a new installment plan with no activation or upgrade fee.  After 20 months, a customer does not need to make more monthly payments and the superannuated telephonic toy is yours to keep. 

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Now Verizon seeks to cut into this anxious upgrade consumer segment with Verizon Edge on August 25th 2013.  The Verizon Early Upgrade Program entails a consumer purchasing a phone on a month to month plan and the full retail price is broken up into 24 installments.  When purchasing the phone, the consumer makes the first equipment payment and presumably pays sales tax on the full retail price of the device. 

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These early upgrade programs are a good compromise which allows service providers to re-coop costs on handsets without EFTs while effectively locking consumers into relationships with cell phone providers without an iron clad handshake.  Consumers who opt into early upgrade programs can get the latest and greatest (at that moment) technology and not be stuck waiting so long for an upgrade. And these plans did not require government mandates or Uncle Sam engineering the marketplace. 

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Personally, I am more worried about having favorable cell phone plan rates and coverage rather than periodically having a shiny new telephony toy.  However, I appreciate that I am in the minority in the marketplace.  As for those who have a phone fetish to always have the latest and greatest, my tongue in cheek advice is : “Next, Edge, Jump”!

SEE MORE at DCBarroco.com