Links 12/22/13

The Origin of Flowers: DNA of Storied Plant Provides Insight Into the Evolution of Flowering Plants Science Daily

Twin U.S. studies unlock mystery of how HIV causes AIDS Reuters

The corporation invasion Lori Wallach, Le Monde Diplomatique. MAI (not TPP).

Investors’ Story Left Out of Wall St. ‘Wolf’ Movie Times (RS). Wall Street crime pays.

WEIRD IS NORMAL Francis Coppola, Piera

We still need to learn the real lessons of the crisis Martin Wolf, FT

Getting qualitative with monetary policy FT Alphaville

All-Cash Home Sales Hit Record 42% of Sales Global Economic Trend Analysis

Where in the United States is median income growing? Marginal Revolution. Answer: Where there’s fracking. And only there.

Boeing machinists to vote on company’s revised offer, union says Reuters

Temporary Work, Lasting Harm Truthout

Why I want Bitcoin to die in a fire Charlie’s Diary. Must read.

Bitcoin, Magical Thinking, and Political Ideology Alex Payne

ObamaCare Launch

Obama On Obamacare Rollout: ‘We Screwed It Up’ TPM. So Obama had bi-weekly meetings where he never thought to ask about problems?

Latest ACA problem: New Medicaid enrollees may find their coverage is limited NJ Business. A different kind of narrow network.

‘Tis the season for health and taxes Politico 

Miami-Dade Public Schools and WLRN Make Serious Cuts, Supposedly Because of Obamacare Miami New Times (SM). Really, or just the excuse. Either way…

I never thought I’d be an outlaw, but the Affordable Care Act might make me one PNHP. “Even with all the work that went into the Affordable Care Act, it remains a game of chance.”

New health law frustrates many in middle class Times. Citizens who “just miss” the income cutoffs and get thrown into the “no subsidy for you” bucket. Another view; and another.

Federal ACA spokesman Anton Gunn leaving HHS for private sector Charleston City Paper. “I am looking forward to taking this next step in my personal and professional journey as a Healthprenuer!” Spot the Flexian!

FBI DISRUPTS SHOOTINGS THROUGH INTERVENTIONS The Big Story. Behavioral threat assessments.

Drivers: Officers profiling specific cars for searches WTEV 

California police department gets $650,000 37,000lb armored military truck Daily Mail

Wyoming to fight U.S. over Indian reservation land grant Reuters

Big Brother Is Watching You Watch

U.S. reasserts need to keep domestic surveillance secret WaPo. Yes, Bush putatively authorized collecting Americans’ data.

White House Tries to Prevent Judge From Ruling on Surveillance Efforts Times

Review Group Falsly Claims No NSA Backdoors in U.S. Software Moon of Alabama

NSA review panel stops short of concrete surveillance reforms Spencer Ackerman, Guardian

Mr. Obama’s Disappointing Response Editorial, Times

Conning the Record, Conning the Courts, Defrauding the People Emptywheel. Big document dump.

Obama Pursues “Occupation-Lite” in Afghanistan Truthout

Navy Secretary Predicts Contracting Scandal Will Expand Bloomberg

What Really Happened in Ukraine Counterpunch. Even if this is Putin hagiography, Putin did have a good year.

Coming Election Widens Rift in Thailand’s Political Crisis Times

Heart of the slums The Age

Semi-live blog : Anti-government protests of December 22 Bangkok Pundit

Lunch with the FT: Peter Thiel FT. Just another nutbar squillionaire.

The Most Memorable Words of 2013 Nooners, Online WSJ. At the end.

Grassroots politics: The voter registration list and why it is essential Corrente. Nuts and bolt of electoral politics.

The Vast Majority of Raw Data From Old Scientific Studies May Now Be Missing Smithsonian

Chart Junk: A Magnet for Misguided Research Visual Business Intelligence. A bit stale but good.

Rome: Sex & Freedom NYRB

The Perfect Solution to Obnoxiously Loud Public Cellphone Conversations Gawker

Antidote du jour:

monkeys

Bonus antidote du jour, How to gift wrap your cat:

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

74 comments

  1. skippy

    Filed under as if you didn’t know…

    The climate change countermovement is a well-funded and organized effort to undermine public faith in climate science and block action by the U.S. government to regulate emissions. This countermovement involves a large number of organizations, including conservative think tanks, advocacy groups, trade associations and conservative foundations, with strong links to sympathetic media outlets and conservative politicians.

    “The climate change countermovement has had a real political and ecological impact on the failure of the world to act on the issue of global warming,” said Brulle. “Like a play on Broadway, the countermovement has stars in the spotlight – often prominent contrarian scientists or conservative politicians – but behind the stars is an organizational structure of directors, script writers and producers, in the form of conservative foundations. If you want to understand what’s driving this movement, you have to look at what’s going on behind the scenes.”

    To uncover how the countermovement was built and maintained, Brulle developed a listing of 118 important climate denial organizations in the U.S. He then coded data on philanthropic funding for each organization, combining information from the Foundation Center with financial data submitted by organizations to the Internal Revenue Service. The final sample for analysis consisted of 140 foundations making 5,299 grants totaling $558 million to 91 organizations from 2003 to 2010.

    Key findings include:

    Conservative foundations have bank-rolled denial. The largest and most consistent funders of organizations orchestrating climate change denial are a number of well-known conservative foundations, such as the Searle Freedom Trust, the John William Pope Foundation, the Howard Charitable Foundation and the Sarah Scaife Foundation. These foundations promote ultra-free-market ideas in many realms.
    Koch and ExxonMobil have recently pulled back from publicly visible funding. From 2003 to 2007, the Koch Affiliated Foundations and the ExxonMobil Foundation were heavily involved in funding climate-change denial organizations. But since 2008, they are no longer making publicly traceable contributions.
    Funding has shifted to pass through untraceable sources. Coinciding with the decline in traceable funding, the amount of funding given to denial organizations by the Donors Trust has risen dramatically. Donors Trust is a donor-directed foundation whose funders cannot be traced. This one foundation now provides about 25% of all traceable foundation funding used by organizations engaged in promoting systematic denial of climate change.
    Most funding for denial efforts is untraceable. Despite extensive data compilation and analyses, only a fraction of the hundreds of millions in contributions to climate change denying organizations can be specifically accounted for from public records. Approximately 75% of the income of these organizations comes from unidentifiable sources.

    “The real issue here is one of democracy. Without a free flow of accurate information, democratic politics and government accountability become impossible,” said Brulle. “Money amplifies certain voices above others and, in effect, gives them a megaphone in the public square. Powerful funders are supporting the campaign to deny scientific findings about global warming and raise public doubts about the roots and remedies of this massive global threat. At the very least, American voters deserve to know who is behind these efforts.”

    http://phys.org/news/2013-12-koch-brothers-reveals-funders-climate.html

    Skippy… Conservative just might be the biggest oxymoron ever concocted…

    1. ex-PFC Chuck

      Merchants of Doubt by Naomi Oreskes and Erik Conway (http://amzn.to/1dwgzsm) is a good source of information on the early years of this “Doubt Science” movement and their original funding from the Tobacco industry. (Big surprise.) A number of its founders were lower-tier people from the Manhattan project.

    2. Ed

      I’m curious, for historical interest, what the motivation is for this disinformation campaign.

      Do the owners and managers of these polluting industries view themselves as having an ethical obligation (as has been taught for decades) to boost the prices of the shares of their companies, and if the atmosphere gets too poisonous to support human life, well that is not their problem?

      Or do they genuinely believe that the warnings about climate change are incorrect and they are exaggerating a little to prevent public policy being based on bad science? Antebellium slaveholders tended to be genuinely convinced that they were acting in their slaves’ best interests.

      If the climate change science was not on point, you wouldn’t really need to plough this money into a disinformation campaign. You could just give more prominence to the normal genuine dissident scientists that arise. This is a topic that is very controversial and that lots of people are interested in, and crosses many disciplines, so the chances of groupthink are lower than normal.

      1. afisher

        Follow the money. The CCCR are following the Tobacco Industry protocol – each day of delay is money in their pocket. These folks are playing a zero sum game. Read any of the processes set up by ALEC ( as the known players all subsidize this group) – if there is any process that they are against, then they set up the game to fail – as any standard that they select must be met with 100% certainty – which in the world of Science is essentially never.

    3. TimR

      Okay, but what about the funders on the other side? I want to know where everyone’s chips are. As much as I’m suspicious of the conservative groups he listed, suppose they’re only “second-tier” tyrants? Suppose the top of the pyramid is funding the AGW believer agenda, with designs of manipulating the public further into neofeudalism.

  2. dearieme

    “Even with all the work that went into the Affordable Care Act, it remains a game of chance.”

    Shouldn’t that “even” be “because”?

    1. Antifa

      “Game of chance” in the same way Las Vegas casinos are — there is a built-in 5% odds advantage to the house that is the reason for the irrefutable law of averages that says, “The House always wins.”

      The health insurance game is just as carefully rigged. To begin with, rates are set not to provide payment for your healthcare costs but to provide partial payment PLUS a minimum 15% revenue portion to the insurer. That’s like the dealer at a blackjack table taking a little off the top of each of your stack with every hand.

      Then there’s the special rules you learn about when you try to use your health insurance. Ruling certain doctors, hospitals, procedures, tests “out of network” means you either pay for them or have to drive hundreds of miles to find one “in network.” And then there’s the rule about whether you were actually “admitted” to a hospital for your 2-week stay or were just there for “observation.” You pay for observation, not the health insurer, but you won’t ever find out about your status until after your release.

      What Americans are just beginning to discover is that what ACA offers is less coverage at higher prices, and the coverage is rife with little levers and rules and unmentioned quirks that make the patient the payee.

      It’s the same game for physicians, who are now going to be receiving less for Medicaid and Medicare patients, and more “consultation” on approved medicines and procedures.

      Arching over all of this is the specter of international trade agreements that will make it impossible to buy inexpensive generic drugs from overseas, so that lifesaving avenue — a vital one to millions of elderly Americans — will be closed as well.

      If the ACA ever gets Americans back to the “number of covered” citizens that existed before its rocky launch this fall, it will be the most unworkable and unpopular government program out there. It’s just theft from the top to bottom.

      1. kareninca

        “And then there’s the rule about whether you were actually “admitted” to a hospital for your 2-week stay or were just there for “observation.” You pay for observation, not the health insurer, but you won’t ever find out about your status until after your release.”

        Ugh. Didn’t know about that one. Thanks, I guess.

        1. LucyLulu

          No, this is not how it works. You will not spend two weeks in the hospital and then have insurers decide after the fact they will not pay. Prior to admission, the hospital obtains a pre-cert from the insurer. This pre-cert is an agreement that the insurer will pay for a certain number of days of hospitalization. Either you meet the criteria for a need for hospitalization, with care in a less acute setting being determined to be insufficient, or you don’t. For example, a child who fell and hit his head but looks fine, can be observed for vomiting and changes in behavior at home by his parents. A child with a head injury, alterations in consciousness and intracranial bleeding on CT scan, may also require “observation”, with regular neurological assessments and direct measurements of intracranial pressures, whether with or without medication to reduce the volume of intracranial fluids, in an ongoing assessment of need for surgical intervention, until the child is out of the woods. This “observation” requires a hospital setting and would be covered.

          So, within 24 hours of the expiration of the original number of days of coverage granted, a renewed cert is obtained by the hospital for continuing payment for another specified number of days. Rinse and repeat until certification is terminated, at which point the doctor will order you to be discharged…… absent the rare case of the medical team deeming release to be clearly medically inappropriate and a serious threat to health and well-being. IME, the majority of the time, insurers and docs are on the same page, and when not, any disagreements are minor.

          The hospital will do all they can to avoid incurring costs that are non-payable by insurers. Costs billed to patients have a high risk of being written off as non-collectible. Non-authorized, denied claims end up being a headache to insurers as well. This is why insurance cards invariably contain clear statements about pre-authorizations being required. It also provides patients a means of protection against providers encouraging frivolous/inappropriate use of resources in order to game profits (as patients are notoriously poor watchdogs when it comes to their own care). Inappropriate use of medical care also carries with it increases in health risks, as few interventions are risk-free (and hospitalization is definitely high risk). When the system works as designed, which is usually the case, all parties see their interests protected. One of course has the option of extending one’s stay if wanting to pay out-of-pocket (and probably up front). However, most would find that checking in at the Ritz with ultra liberal use of room service would be more economical, healthier, and far more comfortable. And much better food.

          1. kareinca

            Thanks. That makes sense. It would be pretty rare that the hospital would be able to get the money for a two-week stay, out of a patient. They would have every motive to make sure they can get it from the insurer. As you say: “The hospital will do all they can to avoid incurring costs that are non-payable by insurers. Costs billed to patients have a high risk of being written off as non-collectible.”

      2. LucyLulu

        Who is reporting cuts to physicians? I would like to see sources, please. It isn’t what I’m seeing reported or consistent with my understanding of the ACA.

        Medicaid reimbursement rates for physicians see substantial increases, to essentially the same as Medicare rates. Medicare just saw the “doc fix” renewed by Congress this month, sparing physicians reductions in reimbursements. Individual physicians could potentially see Medicare reimbursements beginning in 2015 be affected by the data they must report r/t cost and quality of the care they’re providing. It’s part of a new reporting requirement for physicians. It’s more paperwork (and as such, loathsome and guaranteed to result in meaningless data), and is only a potential reduction in the future. Because physicians will retain a strong measure of control over the payments, either cost and quality goals will be achieved or the system successfully manipulated to maintain the necessary rates. Though the field isn’t as lucrative as it was a generation ago, the docs will still be doing fine, don’t worry. Compared to other providers, docs were spared the knife. The AMA still has clout.

        The fiscal cliff deal and sequestration have both imposed cuts on the programs however. And hospitals agreed to Medicare reimbursement reductions in anticipation of a drop in the number of uninsured requiring uncompensated hospital care. This agreement was made prior to governors refusing the Medicaid expansion. Also, long prior to the ACA, states have conducted audits of Medicaid providers and made clawbacks of payments when every ‘i’ wasn’t dotted and ‘t’ crossed.

  3. Butch In Waukegan

    A McClatchy article offers a fuller analysis of the forced second vote on the Boeing contract.

    The national leadership of the International Association of Machinists has forced an unprecedented second vote on the Boeing contract, and scheduled it for January 3rd. Earlier this month the workers rejected the contract by a 2 to 1 margin. A high percentage of Boeing workers will be on holiday on the day of the vote. Has there ever been a clearer example of union leaders in the pockets of the bosses?

    Some Boeing workers see what’s going on.

    Some cynically accuse the International of seeking nothing more than securing their union dues for the next decade. Last year, the 751 district paid $25.5 million in dues to the International.

    “We are dealing with a corrupt International,” said Evans. “All they are interested in is getting their $25 million.”

    Who’s cynical, the union leadership, or the Boeing workers fighting a management / union tag team?

  4. DakotabornKansan

    For cats, putting a tree in your living room is like setting out a plate of heroin in front of an addict. They simply can’t help but climb that sucker:

    http://www.buzzfeed.com/katienotopoulos/guilty-faces-of-cats-climbing-christmas-trees

    My cat Snickers was also a Christmas tree “addict” and proud of her wanton ornament destruction. While it was aggravating at times, I now smile because it happened. She died this past year of feline dysautonomia.

    1. Antifa

      Our Christmas nemesis for 13 years was a coal black demon who formerly worked for Beelzebub before taking feline form. We named it something cute at first but that was all lost in the trauma of living with the creature we called Breaker. We couldn’t leave anything out on countertops or tables, whether soft or hard, dishtowels, glasses, once even a hot teapot cooling on the burner. Boxes of cereal were a favorite, salads washed and ready to carry to table, condiments, cutlery — scotch and soda infuriated Breaker. He would try to pull it from our hands. He had no use for lamps, CD’s, car keys, the mail, magazines, nothing. It all needed to be bitten, scratched and wrestled to the floor. It made us very neat housekeepers.

      But Christmas was when his inner demons truly came forth. After the first year, our tree was always wound with a thin steel cable and hung from a ceiling hook, so it barely touched the carpet in the corner by the front window, and couldn’t be knocked over by any assault Breaker mounted. And assaults were constant. His days and nights were spent chewing branches off the tree, making them sag or fall off. He gagged from the pitch and pine oil he tasted, but he slowly reduced our tree to a sagging wreck of its former glory. He knocked off ornaments so constantly that we took to using only wooden ones that he could merely leave teeth marks in to show his hate.

      To our shame, we never did stop putting a bit of tinsel on the tree. Not because it was pretty, but because Breaker would eat it, and it would move through his system unchanged, emerging in a scintillating second tail that followed him around the house, making him stop and do somersaults every few feet to attack it. It kept him so distracted from his work on the Christmas tree that it looked like our little Scotch Pine could possibly go the distance, and still be standing on Christmas morning. Our vet said a bit of tinsel was harmless as long as it came out the other end, and to give him a laxative if it didn’t. We enjoyed doing that on several occasions, wrapping him in a quilt to cover his claws, and squirting it into his mouth. His curse eternal rests upon our souls for such disrespect. We don’t care.

      Breaker passed away while asleep on his favorite pillow on 10/2/2008, the night before George Bush signed the original TARP bailout. We think he was recalled to active duty in the infernal regions to help with destruction of not just one home, one family, and one Christmas tree, but of an entire nation ripe for looting.

      Or maybe there’s a black cat at Jamie Dimon’s house.

    2. Elliot

      My condolences on Snickers’ death. I lost a beloved cat to the same horror.

      My cats didn’t climb Christmas trees, they slept under them, and once the presents were opened, returned the ribbons and wrapping paper to whence they had come.

  5. Foppe

    Lunch with the FT: Peter Thiel FT. Just another nutbar squillionaire.

    Isn’t that the chap who’s now bankrolling Mark Ames and friends? ;)

    1. bob

      I’m not here to defend Thiel, or Pando, but this is just a smear. Bankrolling implies ongoing support. Have you any evidence of that? Thiel invested 200k in pando a few years before Ames showed up.

      On the other hand, Omidyar has pledged to invest 250 million into a monopoly on GG’s cache of Snowden docs.

      1. Foppe

        To be honest, I can’t say I like Omidyar very much, if what Carr/Ames are writing about him and his operations is anywhere close to accurate. And I find it fairly disturbing that GG is willing to say very little about the methodology behind “vetting documents to see if publication is in the PI”, and that he is so reluctant to name & shame individual companies. What I don’t get, however, is why Ames & co have made this into such a personal thing; everything is about “exposing” Greenwald as a toady/sellout, while they are utterly unwilling to concede that the power of the American State is indeed something you have to worry about as someone with comparatively limited means. That, coupled with the case of the retracted nation “expose”, makes it rather difficult for me to trust their journalism implicitly.

      1. hunkerdown

        So? For all we know they kissed and made up. Power as an ethos trumps any other ethos, and that’s why the proles are encouraged to be partisan.

        1. bob

          So? For all we know you are looking for a job with pierre as his lap dog.
          Evidence might be of some use here.

  6. Yata

    The Le Monde Diplomatique article definitely leaves an impression with the reader.
    It’s my guess that popular financial legislation and regulation can’t be overtly defeated in the direct view of the public so, it requires the creation of superseding international agreements.

    “But the most determined enemy of regulation is the financial sector. Five years after the global financial crisis, the US and EU negotiators have agreed that regulation has had its day. The framework they want to put in place would remove all safeguards on high-risk investments and prevent governments from controlling the volume, nature or origin of financial products on the market. Basically, the word “regulation” would be removed from the dictionary.”

    And it’s not just the financial sector, it’s the ascendancy of a race of crappy corporate minions with failing business models not satisfied with what they’ve leeched from the world.
    I’m somehow reminded of the tales of the Winchester house and the flight from confronting spectres, real or imagined.

    1. from Mexico

      Yata said:

      “It’s my guess that popular financial legislation and regulation can’t be overtly defeated in the direct view of the public so, it requires the creation of superseding international agreements.”

      Yep. Neo-imperialism is a real b*tch when it comes home to roost.

      My message from Latin America is this: Suck it up, you hijos de la chingada. You have no idea what the lords of capital have in store for you.

      1. Yata

        Listo amigo

        No soy un Gringaderas,Primo.

        “You have no idea what the lords of capital have in store for you.”

        I can make a pretty good guess at what happens when the wealth transfer hits a wall.

      2. ambrit

        Sr. deMexico;
        Si, yo lo puede.
        Remember when Ross Perot mentioned “that sucking sound” and described it as all ‘our’ (Nortenos) jobs going south of the border with NAFTA? He was not quite right. It was really the new jobs we got fellating the Patrones!

  7. Ned Ludd

    “Cantor [director of the Center for State Health Policy] cited a paper published earlier this year in Health Affairs that found more than half of New Jersey primary care doctors did not accept new Medicaid patients in 2011 and 2012, compared to about 33 percent nationwide.”

    Noted New Jersey economist Paul Krugman wants Medicaid to be the future. He concedes that “sometimes” people have trouble finding doctors, but dismisses this is “a greatly exaggerated issue”. Medicaid is the key to health care austerity for the rest of us.

    “Medicaid does it far better than private insurance, and better than Medicare too. It does it by being willing to say no, which lets it extract lower prices and refuse some low-payoff medical procedures. […]

    “So, I’m not proposing that we turn the whole system into Medicaid any time soon. But what I take from the data is that if and when we feel the need to make tough choices — really, really make tough choices, not use the rhetoric of tough choices to justify what conservatives wanted to do in any case, namely privatize everything in sight — health cost control won’t turn out to be that hard after all.”

    Krugman doesn’t want Medicaid to subsume “the whole system”; I would guess that he wants something better for Princeton professors and wealthy economists. Medicaid-for-everyone-else benefits elites by forcing the riff raff into a cheaper system, while guaranteeing that the best doctors serve the rich. The low reimbursement rates of Medicaid – the reason that “fewer doctors take Medicaid in New Jersey than accept Medicare and commercial insurance” – creates an incentive for the best doctors to work only for those who can pay high rates. The wealthy get the best physicians, and the rest of us get the chaff.

    1. Ned Ludd

      The <blockquote> tag is not affecting the text. The tag is there, in the source of the published comment, but the text is neither indented nor italicized. It looks the same as a typical paragraph.

      For example, this paragraph is surrounded by <blockquote> and </blockquote> tags. You can see the tags in the source, but this paragraph does not look any different from the first paragraph.

      Tested on Chrome 31 on Windows 7, Internet Explorer 11 on Windows 7, Firefox 25 on Linux Mint, and Firefox 24 on Ubuntu.

        1. Ned Ludd

          In markup, the slash appears in the end tag, before the element name. So, for example:

          <b>bold</b> and <i>italics</i>

    2. Liz Mabry

      ok I am a long term nurse 36 yrs and have had illness myself as well as my immediate family and friends. You get what you pay for is not so the case with physician and medical care in general. Think about it. Would you rather go to a DR that worked for more than just the almighty $. Like she/he might really care about the well being of their patients? I have had myself and inner circle misdiagnosed , treated incompetently by those most highly recommended physicians. The bottom line is picking a DR is like finding a good auto mechanic/handyman. You need to do your own research then find someone who will listen to the symptoms and what you know and get to the bottom of the problem together. They need to have a good office staff and be able to communicate well with you whether it be the DR or ancillary staff; NP/PA/nurse. Do not settle for any less. And above all take the best care of yourself as possible in order to avoid medical problems to begin with. Eat right, exercise[ brisk walks weight bearing 3x week 30 min is fine after you get in good health] keep a healthy weight and DO NOT SMOKE , consume excessive alcohol, illegal drugs. Practice preventive care which all ACA plans provide for free. Especially as you grow older. I love people that abuse their bodies to the hilt, never go to the DR/ or if they do don’t follow up properly and then show up at the ER with some huge crisis and plead to “be fixed”. I am sorry if that sounds harsh but it happens probably thousands a time a day in this country and it is a large reason why our healthcare is so expensive and it is totally irresponsible

      1. Ned Ludd

        “The bottom line is picking a DR is like finding a good auto mechanic/handyman.”

        An expensive mechanic can still be lousy. However, a good mechanic who is in demand is not going to work for peanuts. Good doctors will refuse Medicaid if they feel that they are not being compensated well.

        “Practice preventive care which all ACA plans provide for free.”

        Great, you can find out what is wrong, then go bankrupt trying to treat it.

        “I love people that abuse their bodies to the hilt, never go to the DR/ or if they do don’t follow up properly and then show up at the ER with some huge crisis and plead to ‘be fixed’. I am sorry if that sounds harsh but it happens probably thousands a time a day in this country and it is a large reason why our healthcare is so expensive and it is totally irresponsible.”

        When you are poor in an urban area, you have to deal with no car, multiple jobs, long commutes with lousy bus service, changing work schedules, no nearby grocery stores, rotting produce in the corner store, and a complete lack of time to see a doctor.

    3. kareninca

      Even those doctors who “accept new Medicaid patients,” may not take very many of them. I have read that they lose money on each one*, so they see them as charity cases (charity with complex costly paperwork attached), so they take a certain number and no more. So even if every doctor in the country said in a survey that they “accepted new Medicaid patients”, including every specialist, it doesn’t really tell us how many patient slots there are for Medicaid clients.

      * yes, I know that reimbursements have been upped for some period, but it is not permanent and doctor’s don’t trust these temporary increases

      If Paul Krugman were required to make do with the shit insurance that he wishes to inflict on most of the population, it would make me very, very happy.

  8. Bill the Psychologist

    “So Obama had bi-weekly meetings where he never thought to ask about problems?”

    I’ve come to the conclusion that much of his behavior is aimed at his being seen as a “good guy” –therefore does not threaten others or is rude to them, like asking embarassing questions — and remaining popular with his peers.

    Unfortunately, the American people are not his peers, only his cronies are. And he’s not going to ruin that good guy rep by something like actually firing somebody or asking harsh questions.

    Very sad for us, and for him actually, for the first African American President to be afraid to kick ass to get things done.

    1. neo-realist

      Re firing, he makes exceptions for the progressive window dressing hires who offend powerful people inside or outside his administration, or if they stray from or oppose neocon policies, e.g., Van Jones and Christina Romer.

    2. Jackrabbit

      . . . much of his behavior is aimed at his being seen as a “good guy”

      Teasing out Obama’s psychological make-up is not easy because:
      – the Office of the Presidency has largely become one of figurehead;
      – his political advisors do not want him to appear antagonistic as this might alienate many white voters;
      – he wants/needs to hide his pro-corporate agenda;
      – he has a the typically weak, pilable character of a “sell-out”.

      I saw his news conference after the Obamacare launch. Some past Presidents might have bristled when reporters criticize his performance on his ‘signature initiative.’ Not Obama. Just another day in the Office.

      A similar thing occurred after the Sandy Hook shootings. He wiped away tears, seemingly deeply affected by the tragedy, but just a few weeks later he forgot to mention gun control when talking about his second term agenda. Matt Lauer had to remind him about it.

    1. XO

      Maybe just naturally mellow. Behaviorally (that is to say, personality-wise), cats have a very wide gamut. Sometimes, I think breed has something to do with it. Mellow: Maine Coon. Rip your face off: Cross-eyed Siamese.

    2. Shutter

      More likely he got the cat when it was young, has treated it kindly and with love and respect ever since and doesn’t allow anybody in the household to abuse it. You know, just like people? Treat ’em right and see what happens.

  9. zephyrum

    From Nooner’s WSJ column:
    A billionaire of New York, in conversation: “I hate it when the market goes up. Every time I hear the stock market went up I know the guillotines are coming closer.” This was interesting in part because the speaker has a lot of money in the market. But he meant it. He is self-made, broadly accomplished, a thinker on politics, and for a moment he was sharing the innards of his mind.

    Seems to be a need to rethink the term “self-made”. I’m sure society provided him nothing.

    His biggest concern is the great and growing distance between the economically successful and those who have not or cannot begin to climb. The division has become too extreme, too dramatic, and static. He fears it will eventually tear the country apart and give rise to policies that are bitter and punishing, not helpful and broadening.

    It would be interesting to hear what policies the man believes could possibly be “helpful and broadening” while still, by necessity, impacting his wealth.

    This year I came to understand, at meetings and symposia, that this has become an ongoing preoccupation of the wealthy. They are not oblivious, they are concerned. And though they give away hundreds of millions of dollars to charities, schools and scholarships, they don’t know what can be done to turn the overall economic picture around. Globalization isn’t leaving, industrial manufacturing isn’t coming back as it was, technology will continue to give jobs to the educated, and the ever-evolving mischief of men and markets won’t change.

    The “ever-evolving mischief” waxes and wanes through history; it is ever-changing. Corruption is the ultimate bubble, spawning more, larger, and more frequent bubbles until it reaches its grim conclusion. When corruption itself collapses the cycle starts anew. The roaring 20s ended with bankruptcy for many, a rather civilized end. Current policies close that door and leave open a far more sinister one. Those who refuse to let go a collapsing system will follow it into oblivion.

    They are worried. They are right to be. They are trying to think it through, trying to find any realistic solutions, and words.

    I sincerely sympathize with the majority of the wealthy, who are not sociopaths. The only way they know to improve their lives is by increasing their wealth, yet that path is marching them off a cliff. And they see it coming. They try to give away chunks of money but it’s not working. Generosity does not consist of stealing $100 and giving away $10, even if you didn’t personally steal the money. Even if you worked hard to get that $100 away from the original thieves. There is no method to purify ill-gotten gains.

    There really are no good choices for the wealthy. They can give away all their wealth, but that’s like pouring water into the desert sand; it dissipates without effect. All that hard work amassing a fortune, squandered. They can attempt societal change, but it’s hard to make a difference even with a lot of money, and it’s very hard work. They can hope that matters come to a head after they die, which is the default choice.

    In the end I know of no greater purpose in life than to do small kindnesses for others. The wealthy can do more of these than most, but it’s hard work–as hard as making the money in the first place. The ultimate irony of wealth is that one is imprisoned by either too little, or too much.

    1. MyLessThanPrimeBeef

      ‘They can attempt societal change, but it’s hard to make a difference even with a lot of money, and it’s very hard work.’

      But change happens all the time. How? I guess when change happens, it is brought into being, not through one billionaire, but through the hard work of many.

      So, it’s always about teamwork, through teamwork, we accomplish, socially, politically and economically.

      Thus, we say, we must share our GDP.

    2. Shutter

      They’re ‘concerned’. Breaks my heart. First step, public funding for elections. All elections. Second step, a cap on maximum *total* compensation enforced thru onerous taxation. Three — estate tax that will break up the big family fortunes.

      They’re ‘concerned’. They have reason to be scared stiff, not ‘concerned’. Money addicts, every last one of ’em. Break ’em.

    3. MikeNY

      Thanks for this post. It’s refreshing to hear of a billionaire who isn’t thinking about savoring his next $100,000 bottle of wine while stroking plutocrat poodle Ben Bernanke.

      However, IMHO, there really ARE a few things your average billionaire might do to try to stay the guillotines:

      1. Actively champion a liveable minimum wage;
      2. Actively champion the ordinary taxation of dividends, cap gains and carried interest;
      3. Rail against the infinite, wasteful gluttony of the US military;
      4. Publicly espouse (and fund) the effort for single-payer healthcare;
      5. Publicly advocate a guaranteed jobs program for all un- and under-employed Americans (including those displaced from the military and healthcare). Green energy, a decent passenger rail system and environmental remediation could be a start… I am open to other ideas.

      Otherwise, I fear he is right: ultimately, it will be heads on pikes and guillotines.

    4. Glenn Condell

      ‘they don’t know what can be done to turn the overall economic picture around’

      Everyone knows what to do, especially them, but they don’t want or feel the need to. Yet.

      Not enough of them anyway, and that will only happen when it is clear to them that their ownership of politics, the law, media, policing, military and intelligence can no longer protect them.

      That’s one scenario. The other is that this totality of power does work for them, forever.

  10. Eureka Springs

    Kudos to the NYT article which says:

    “The panel’s experts concluded that “there has been no instance in which N.S.A. could say with confidence that the outcome would have been different” in a terror investigation without the collection of the telephone data.”

    However it fails terribly by quoting Clapper authoritatively without mentioning he lied to congress… even though he knew ahead of time what the questions would be. Senator Wyden sent the questions a day early, which we know Clapper lied when answering.

    And as bmaz stated so well (although I would go much further than him) in the emptywheel article Conning the Record, Conning the Courts, Defrauding the People – linked today.

    “The one common theme that I can discern from a scan of a couple of note is that there is no reason in the world minimally redacted versions such as these could not have been made public from the outset. No reason save for the conclusion that to do so would have been embarrassing to the Article II Executive Branch and would have lent credence to American citizens properly trying to exercise and protect their rights in the face of a lawless and constitutionally infirm assault by their own government. The declarations by Mike McConnell, James Clapper, Keith Alexander, Dennis Blair, Frances Fleisch and Deborah Bonanni display a level of too cute by a half duplicity that ought be grounds for sanctions.”

    All of this circling the wagons of and by liars, sycophants and investigative committees built of the same… layers upon layers of liars protecting liars…. Many tens of billion of dollars, countless thousands of people operating in secret. Who the hell would hire people, give them insane amounts of info and money and power to operate in such secrecy, all while they don’t know what those they/we hired are actually doing? If on a governmental level that’s not a perfect definition of treason, set up for a coup, enemy within, totalitarianism I don’t know what could be.

    State secrets are not worth the risk when time and again we know those who operate under secrecy, lie, steal, murder, all around fail miserably at their supposed purpose (so clearly noted if one simply looks at everything from the end of the cold war which they failed to detect, to Iran Contra, 9-11 and all the claims of terror since then) and do so as long as we let them.

    Courts must reject State secrecy of any kind. Or like the politicians who condone this they must be replaced/overthrown. Whatever it takes. Never assume someone works for you/your nation when they don’t want to tell you what they do. Or a court that allows it.

  11. XO

    Why I want Bitcoin to die in a fire
    ______________________________
    Wow! “Die in a fire . . .” That’s some strong shit, there.

    The thing I like about bitcoin is that it can’t simply be pulled out of a banker’s ass — it takes effort, time, and energy to create one. It isn’t called mining, for nothing. Bitcoin is a threat to the bankers simply because they can’t sequester it. It might be a failed, or soon-to-be-failed threat, but it’s a warning shot.

    The author of this article suggests that bitcoin will serve to enable child pornographers and tax evaders. As if the current system does not already enable them.

    Bitcoin might have a carbon footprint, but so does everything else.

    Other than that, I’m certain that, like any other currency, bitcoin has both its advantages and disadvantages.

    1. Jamie Dimon

      Try pulling anything out of my ass. I’ll have you and your whole family killed.
      Although, I do like the framing of your argument. “effort, time, and energy” to make pols compliant. I’m mining politicians!

  12. Institutionalized

    Under the TPP, if I get an injunction stopping a foreign subsidiary from fracking directly through my house, how much would I owe? And who determines the ‘expected profits’ damages, the foreign subsidiary? Also, why would a company ever do business in the US as a US company? After TPP, I suspect we would see all business in the US done through ‘foreign subsidiaries’. Say hello to massive outsourcing.

  13. MyLessThanPrimeBeef

    The most memorable word for me – share.

    Shareholder – you hold a share in the endeavor.

    We are all shareholders of this corporate nation whose only business is business… a lot of people don’t realize this.

    That’s is to say, GDP sharing.

  14. MyLessThanPrimeBeef

    New health law frustrates…’just miss the income cutoffs…

    Thus we lower the Medicare eligibility to zero.

    A basic income law will frustrate many who just miss the income cutoffs too.

    Thus we go to GDP sharing.

    We simply say no to all these partial schemes that is not ‘one for all, all for one.’

  15. MyLessThanPrimeBeef

    ‘Occupation Lite’ in Afghanistan.

    It’s hard to Pivot to Asia without some bases in Kazakhstan, Uzbekistan, and Afghanistan to listen in on China and be within a few minutes flight to her nuclear facilities in western China.

    1. Ed

      You are looking too much at large scale maps. A couple of air bases thousands of miles from where Chinese population and GDP is concentrated does absolutely nothing. To the extent that there is some sort of strategic rationale for these bases, its to contain Russia, not China. But really they are there because having lots of bases around means lots of government contracts.

  16. MyLessThanPrimeBeef

    On the Relativistic Nature of Money.

    Money is a dimension, just like space and time.

    We used to think that space and time did not change, they were just there in the background as references.

    But we know otherwise now.

    Similarly, money contracts when the we print it too fast, at the same, the ego dilates or expands, as ego is also a dimension in the Money-Ego Continuum.

  17. Andrew Watts

    RE: Review Group Falsly Claims No NSA Backdoors in U.S. Software

    The NSA has some of the best computers, mathematicians, and various other resources at their disposal. They can break any commercial encryption with enough time and effort. It’s strictly a matter of computing power, money, and the amount of time it would take to decipher the encryption. The NSA’s decryption procedure will simply take significantly fewer resources to break. That’s not the same thing as having a backdoor into the BSafe software.

    The other intelligence agencies without such a similar insight into this encryption scheme will still be at a loss vis-a-vis their own efforts at decryption. Though that doesn’t mean that they couldn’t break the software’s encryption. Overall the software is generally safe for private use assuming you’re not a specific target of the NSA or any other intelligence agency. Personally, I wouldn’t trust any commercial software if I was worried about that.

    For more information about code breaking, encryption, and the NSA/GCHQ refer to David Kahn’s book “The Codebreakers: The Story of Secret Writing”.

  18. Andrew Watts

    RE: Mr. Obama’s Disappointing Response

    The last few presidents who’ve tried to reform the intelligence agencies from top to bottom without congressional involvement and widespread public support was President Kennedy followed by Nixon. Kennedy began this after the Bay of Pigs and when the CIA was running it’s own foreign policy with regards to Egypt/Nasser. Nixon after the assassination of Kennedy.

    Seriously, draw your own conclusions.

  19. jrs

    Where I suspect all that QE money is really going, hoping to lock in monopoly rentier profits:

    http://www.bloomberg.com/news/2013-12-20/wall-street-unlocks-profits-from-distress-with-rental-revolution.html

    The banks will lend to the rentiers in a way they won’t lend to the people (people are too risky), and housing prices were not allowed to fall to the point where more individuals could reasonably qualify for a loan, because that would be bad see, whereas institutional investors trying to monopolize the rental market isn’t.

  20. Hugh

    We always knew the NSA review panel was going to be a propaganda exercise. Obama had said at the outset that he saw the controversy as nothing more than a PR problem. The NSA wasn’t broken, he backed its spying programs, there was nothing to fix.

    The naming of a “panel” is a tried and true Washington stall. The NSA panel was stacked with intelligence insiders and Obama loyalists. Its mission was cirumscribed to principally the telephone mass surveillance program, not all the internet stuff. And the panel was directed to release its “recommendations” the week before Christmas when the public’s attention was almost completely elsewhere.

    Predictably when the panel released its report, the media ballyhooed its reforms. First impressions count. The conventional wisdom is that most people will continue to believe the initial story even if it is later refuted. They were aided this time around by the likes of the EFF and Glenn Greenwald who dutifully pointed out the positive aspects of the panel’s report and recommendations.

    Much attention was paid to the remark by one of the panelists that the NSA telephone spying program had never prevented a single act of terror, its supposed raison d’être. But we largely knew that already. Alexander’s protestations that it had been instrumental in dozens of cases had been debunked a couple of months ago.

    More importantly, on second look, we are now getting the stories that the panel’s reforms are a lot less than meet the eye. They do not stop the telephone spying program. They just redistribute some of its functions. Oh yes, and Obama has already signalled that he likely won’t accept any recommendation that significantly changes the program. Again because he saw this as a PR problem, this was entirely expectable.

    What we are not getting is a debate on the question of why our political classes are building massive spying programs aimed not against terrorists but against us and spending tens of billions on them every year. If these programs do not serve their stated purpose in any way, shape, or form, if they are enormously expensive, why are our elites so hellbent on keeping and even expanding them?

    1. Chauncey Gardiner

      Yes, what a marvelous Centennial of Gross Mismanagement and policy sponsorship of criminal behavior.

      Unsurprised this is passing without a great deal of public fanfare.

      1. psychohistorian

        When you control the media, you control what folks under that influence think about…..or not in this case.

        The FED, the first 100 years of living the lie of sovereign money have passed. It is an institutionalized lie now.

  21. LucyLulu

    Further wasteful military spending reports as of late include a $5.6M incinerator facility at Sharana in Afghanistan. The two incinerators were to replace burning the waste in open air pits which has been shown to have adverse health effects, however open air waste burning continues while the incinerators remain unused. The pads upon which they were placed are insufficient to withstand the stress/weight of transport of the waste to and from the incinerators, and the incinerators are believed to have been dismantled and sold for scrap by local Afghans.
    http://www.usatoday.com/story/nation/2013/12/16/afghanistan-wasted-money-on-incinerators/4038793/

    There is also a monstrosity of a command center in SW Afghanistan, a $36M and 36,000 s.f. structure that has been described as the most lavishly appointed marine operations complex in the world, undergoing completion at Camp Leatherneck in Afghanistan. The camp is due to close soon, with no or few troops remaining in the region. Senior officers at the base had requested in 2010 that construction be cancelled, stating the facility would not be needed, but found their requests denied by the deputy commander, a two-star general, at command headquarters. Today there is debate if more money should be spent on conversion into a gymnasium/movie theatre that would get some use. Meanwhile, the two star general that insisted construction be undertaken as planned?

    “Vangjel has since been promoted to a three-star general. He is now the Army’s top inspector general, responsible for identifying waste, fraud and abuse in the service.”

    How come similar spendthrift-minded sorts never seem to show up on, let’s say, the Board of Trustees for Social Security or Medicare?
    http://www.stripes.com/news/middle-east/army-sees-use-for-36m-afghan-building-despite-marines-objections-1.255816

  22. affinis

    I do have a quibble – issues with source credibility – with the use of material from Israel Shamir (link “What Really Happened in Ukraine”).

    Most of the personal history Israel Shamir (AKA Jöran Jermas AKA Robert David AKA Vassili Krasevsky AKA Schmerlin AKA….) claims for himself appears to be a fabrication. Though his articles appear in CounterPunch and he serves as a conduit for WikiLeaks material, he also appears to have ties to the British National Front and Russian security services. There are also legitimate questions of antiSemitism, Holocaust denial/revisionism, etc.

    e.g. From an interview with Israel Shamir:
    Interviewer: What if someone said: “I hate Jews and I wish Hitler killed all of them.”
    Shamir: People say such things.
    Interviewer: Would that be labeled anti-Semitic?
    Shamir: Well, you know I’ve heard it very often from Sephardic Jews in Israel. I heard it quite a few times actually. [Laughs.] “Pity you didn’t burn in Auschwitz, a pity all of you didn’t burn in Auschwitz.” I heard it many times.
    Interviewer: That’s awful.
    Shamir: Well, yeah. I don’t think that much about it.
    Interviewer: That’s interesting you said “burn in Auschwitz” because your definition of Auschwitz is that it was a Red Cross internment camp. What is your definition of Auschwitz?
    Shamir: I’m not even interested in Auschwitz, you know? I have no interest in it. What I said there is something different. What I said there was that it was perceived as—internment camp.
    Interviewer: By who?
    Shamir: By everybody. By Jews in Palestine, by Europeans, by English, by Russians, by Americans. You know when the rumors of mass annihilation came to Palestine they were strongly refuted by the Jewish authorities. It was reported by many publications that life was so awful. Things are so bad as it is and people come and bring such horrible stories … that was published in many newspapers in Israel in those times. The Jewish authorities were very strongly against this sort of rumor. And it was universally thought—yes, it was a deportation camp, nothing especially wonderful about it, nobody thought it was a resort, nobody did. People thought it was a deportation camp, quite awful place.
    Interviewer: So, it was a concentration camp?
    Shamir: Yeah, but when I say concentration camp is a word that was used a long time before during the Boer War, when the English fought against the Boers in South Africa. There they built concentration camps; that’s how the word became coined.
    Interviewer: So, Auschwitz as being a place to exterminate Jews …
    Shamir: This idea came to existence only after the war.
    Interviewer: So, it’s a rumor?
    Shamir: No, no, no. I don’t say that at all. No.
    Interviewer: But you said, “the rumor of mass annihilation.”
    Shamir: I can repeat more clear. I am not all that interested in what was in reality. I am interested in perceptions. Something I am dealing with is perceptions. So, perceptions during the war was that it was quite awful deportation camp, where people were deported and kept, worked hard labor, this sort of thing. That’s how it was perceived. Only after the war, different perception came. And that was a perception of mass annihilation, and mass murder, and all that.
    Interviewer: So, it’s not a fact that there was mass annihilation?
    Shamir: That’s, not, I did not say that at all. I didn’t even say that, I didn’t even intend to say this or other way. What I say is that there was no such perception during the war. This perception came after the war.
    Interviewer: But so which one is true?
    Shamir: I am not even interested in this kind of question. That is something that is very much outside of my interest.
    Interviewer: But can you comment about if these concentration camps were for mass murder?
    Shamir: Ah, I have really no knowledge about it at all. I was not interested in it because I reject the idea that it is important, you see?
    ——————————–
    Yet another sample – excerpts from an interview (translated from Swedish):
    Israel Shamir: “I received Christ. I believe that Christ was right….. Judaism is the negation, a negation of Christianity. Jew and Christian ethics are opposites.….I think it’s every Muslim and Christian’s duty to deny the Holocaust, to reject this belief, just as Abraham and Moses rejected the idols. Every person who embraces God should deny the Holocaust.
    ———————————
    Another sample from an Israel Shamir article:
    “Not only is Western Christian civilisation dead, but even its successor, secular European civilisation, has met its demise only a few days after its proud and last celebration by the Danish scribes. It was short-lived: about two hundred years from beginning to the end, the Europeans may once have had the illusion that they can live without an ideological supremacy. Now this illusion is over; and the Jews came in the stead of the old and tired See of St Peter to rule over the minds and souls of Europeans”.
    ———————————–
    Yet another sample – Israel Shamir’s thoughts on the Khmer Rouge:
    Cambodians have no bad memories of that period…… The Pol Pot the Cambodians remember was not a tyrant, but a great patriot and nationalist, a lover of native culture and native way of life….. He felt compassion for the ordinary village people who were ripped off on a daily basis by the city folk, the comprador parasites. He built an army to defend the countryside from these power-wielding robbers. Pol Pot, a monkish man of simple needs, did not seek wealth, fame or power for himself.
    ———————————

    A couple background links:

    Guardian – Andrew Brown’s Blog: WikiLeaks and Israel Shamir
    Socialist Viewpoint: Israel Shamir: Wolf in Sheep’s Clothing

  23. dan

    Obamacare may be even worse in the territories.

    Think your state has Obamacare problems? They’re nothing compared to Guam [or the Northern Mariana Islands].
    http://www.washingtonpost.com/blogs/wonkblog/wp/2013/12/19/think-your-state-has-obamacare-problems-theyre-nothing-compared-to-guam/

    “Because of a quirk in the Affordable Care Act’s drafting, the Northern Mariana Islands [CNMI] and the four other American territories are subject to some parts of the law but not others. This has messed up the individual market in the Northern Mariana Islands so badly that the one plan selling policies there [Aetna] told the territory’s top insurance commissioner it would not sell new plans for 2014.
    In other words: Beginning Jan. 1, regulators expect it will be literally impossible for an individual to buy a new policy in the Northern Mariana Islands, and difficult in other territories. . . .
    The problem, in its simplest form, is this: While the Affordable Care Act requires health insurers in the territories to accept all shoppers no matter how sick, it does not mandate that all territorial residents buy plans nor does it provide subsidies to make coverage more affordable–as it does in the 50 states and the District of Columbia.”

    Worth reading the full article.

    FWIW, Aetna isn’t the only plan available in the CNMI but it is the largest and is/was the insurer for government workers. A couple of other plans operate (e.g. Calvo, and Staywell HMO) but those appear to be the crappy plans intended to be snuffed out or improved by Obamacare.
    Aetna may also be leaving CNMI for other reasons that it isn’t disclosing and the reporters apparently didn’t realize they should ask about. Most notably, the largest group of existing plan members were retirees in the recently dissolved/failed government pension system. Aetna has also been threatening to cancel the policies for the past few years because the local government has been very late to pay its bill on several occasions, and it appears the tax collections may be heading south again.

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