500 Million Lines of Code

[Turdacious]

On Friday afternoon, a district court in Pennsylvania enjoined the Trump administration’s new rules on contraception coverage from taking effect. The court’s ruling was not unexpected: I’d argued earlier that the rules were vulnerable on both procedural and substantive grounds, and the court’s analysis largely tracks my own.

Procedurally, the Trump administration had no good explanation for why it skipped notice and comment:

There was no deadline, much less an urgent one, to implement new rules. The [rules] did not resolve any uncertainty and … have not prevented ongoing litigation. And the blizzard of prior comments that [HHS has] received in past rounds of notice and comment rulemaking actually demonstrates that further comments are necessary given the public interest in this matter.

The sloppiness here is striking. HHS could have run through the notice-and-comment period on an expedited timeframe. Doing so would have delayed the rules by a few months, but probably no more than that. Instead, the Trump administration practically begged the courts to step in.

Barring a successful appeal, the Trump administration will now have to start all over. And appealing is risky. HHS apparently thinks that time is of the essence here. Yet, if the agency appeals and loses, it will have wasted another year before even starting notice and comment. At best, HHS might issue final rules sometime in the middle of 2019. At worst, the timeline could slip to 2020.

https://theincidentaleconomist.com/word ... ion-rules/
Those of you who like this ruling shouldn't get too excited-- nobody's clarified whether or not this applies nationally or just in Pennsylvania.

[Turdacious]

The final report on Obamacare's performance during Obama's administration is out. Mortality stats got worse for the second year in a row.
https://www.cdc.gov/nchs/products/databriefs/db293.htm

[nafod]

The final report on Obamacare's performance during Obama's administration is out. Mortality stats got worse for the second year in a row.
https://www.cdc.gov/nchs/products/databriefs/db293.htm

Not sure how the steady rise in unintentional injuries speaks at all to Obamacare.

[Turdacious]

The final report on Obamacare's performance during Obama's administration is out. Mortality stats got worse for the second year in a row.
https://www.cdc.gov/nchs/products/databriefs/db293.htm

Not sure how the steady rise in unintentional injuries speaks at all to Obamacare.

For the most part, unintentional injuries are fatal drug overdoses. The mismanagement of the opioid crisis is one of the biggest public health failures of the Obama years.

Even setting that aside, if Obamacare had worked the way it was supposed to, we should have seen a significant improvement in other mortality and longevity stats over the last two years-- other than an improvement in cancer, we haven't. In most of the major medical mortality categories, it got worse.

[nafod]

The final report on Obamacare's performance during Obama's administration is out. Mortality stats got worse for the second year in a row.
https://www.cdc.gov/nchs/products/databriefs/db293.htm

Not sure how the steady rise in unintentional injuries speaks at all to Obamacare.

For the most part, unintentional injuries are fatal drug overdoses. The mismanagement of the opioid crisis is one of the biggest public health failures of the Obama years.

What should have been done? Is it being done now?

Even setting that aside, if Obamacare had worked the way it was supposed to, we should have seen a significant improvement in other mortality and longevity stats over the last two years-- other than an improvement in cancer, we haven't. In most of the major medical mortality categories, it got worse.

Wonder why that is, when more people gained access to health insurance.

Complicated problem.

[Turdacious]

The final report on Obamacare's performance during Obama's administration is out. Mortality stats got worse for the second year in a row.
https://www.cdc.gov/nchs/products/databriefs/db293.htm

Not sure how the steady rise in unintentional injuries speaks at all to Obamacare.

For the most part, unintentional injuries are fatal drug overdoses. The mismanagement of the opioid crisis is one of the biggest public health failures of the Obama years.

What should have been done? Is it being done now?

What should have been done was a much faster recognition of the connection between legit opioid prescriptions and opioid abuse, more focus on diagnosing and treating opioid use disorder, and better prescription guidance for providers. We still have only a limited idea, and government programs have been notoriously awful in their prescription policies (Medicare, Medicaid, military medical system, the VHA, etc).

The VHA has cleaned up its prescription policies somewhat but hasn't done a good job of funding and managing its addiction treatment programs; the military has improved their prescription policies somewhat, but still uses bad paper discharges inappropriately; and the feds punished manufacturer Insys for their aggressive promotion policies of fentanyl containing drug Subsys (all without taking accountability for paying for prescriptions they never should have paid for of coarse)

Other than that, most everything good is being done at the state and local level. States are taking the lead on implementing improved opioid prescription policies (Medicaid and Medicare are following their lead instead of taking it); states and municipalities are funding better toxicology in mortality reports (one of the reasons the opioid death rate is going up-- we didn't know how high it was before); and states and municipalities are providing first responders better training and Narcan.

There's also a big focus on addiction treatment through Medicaid but this is a problem-- states are struggling to expand capacity when budgets are tight and pension liabilities are exploding, there's a ton of fraud, HHS guidance and oversight is poor, and there's always the threat that HHS will do a clawback years after the money was spent.

HHS was a mess when Obama left office; other than not hiring Jeanne Lambrew, the orange one hasn't done anything to help.

Wonder why that is, when more people gained access to health insurance.

Complicated problem.

The opioid crisis is a part of it, but bigger factors are probably rising deductibles, rising drug prices, out-of-network billing for in-network care, the rise of aggressive coding for medical bills, and inadequate oversight over preventative doctor visits (some providers find ways to charge you during free visits)-- people are skipping or postponing beneficial medical treatment because of cost.

The problem isn't really that complicated, its that our health care bureaucracies and publicly funded health programs are uniquely dysfunctional.

[Turdacious]

Re medical bills and the newly signed tax bill, some of you might want to have a conversation with your accountant.

If you have large medical bills that you’ve been paying off, it may make sense to pay more than you normally would before Jan. 1. Changes in the law mean you could see a benefit on your 2017 taxes (paid next April) thanks to a lower threshold for deducting, applied retroactively to 2017. Put more simply: If you pay 7 percent of your income in medical bills, paying 7.5 percent instead will trigger your ability to take a deduction on this year’s taxes. Before the bill was signed, you’d have to get to 10 percent.

https://www.washingtonpost.com/news/pol ... 92dcac7469

[Turdacious]

The PSLF program, backed in the Senate by Ted Kennedy and signed into law by President George W. Bush in 2007, was the first of its kind, and when people talk about “student loan forgiveness,” they’re usually talking about PSLF. It was implemented to address low salaries in public service jobs, where costly degrees are the price of entry but wages often aren’t high enough to pay down debts...

Several companies, including one called FedLoan Servicing, contracted with the Education Department to handle loan repayment, and until 2012, when the government assigned all PSLF accounts to FedLoan, borrowers had to keep track of their progress toward forgiveness. At the time she began paying into the program, McIlvaine wasn’t too perturbed that there was no official way to confirm her enrollment, no email or letter that said she had been “accepted.” She trusted the Education Department to run the program effectively and followed its parameters, taking care to send in the yearly tax forms that proved her eligibility and always submitting her payments on time...

If not for FedLoan’s errors and delays, McIlvaine estimates, her loans would be eligible for forgiveness as soon as 2020. But instead, in the nine years she’s been participating in PSLF, months of payments haven’t been counted toward her 10-year requirement, ultimately delaying the date of her forgiveness by at least a year. All the while, although she’s been making payments of between $300 and $450 a month, her total debt has not gone down. After nearly 100 payments, she still owes the entire amount she initially borrowed.
A decade after McIlvaine and scores of others began paying into the program, many are only barely closer to their goal of being debt-free. And some are even more in debt than when they started.

FedLoan declined to comment on McIlvaine’s tribulations. But as complaints to the Consumer Financial Protection Bureau and lawsuits against the Education Department and FedLoan pile up, she’s hardly alone. In 2017, the bureau issued a report excoriating FedLoan for mismanaging PSLF, misleading borrowers, and losing track of payments. The previous year, the American Bar Association had filed suit against the Education Department for reneging on its own rules about how the program was supposed to work and who was eligible for forgiveness.

https://www.motherjones.com/politics/20 ... t-fedloan/

Guess what student loans revenues are supposed to pay for? You guessed it... (no, it's not Frank Stallone).

[JimZipCode]

Guess what student loans revenues are supposed to pay for?

What? Space Force?

[Turdacious]

Guess what student loans revenues are supposed to pay for?

What? Space Force?

Obamacare-- and student loans are another government program that isn't working (both in terms of cost/benefit to students and in terms of funding Obamacare).

The outstanding principal balance of the Department’s student loan portfolio of direct and guaranteed loans nearly doubled in the last 7 years, from $687 billion at the end of FY 2009 to $1.209 trillion at the end of FY 2016. As of September 30, 2016, 42 million borrowers had outstanding student loans that were either held or guaranteed by the Department. In FY 016, the Department disbursed about $140.5 billion in Direct Loans to eligible students and their parents. Student loan debt is currently the second largest form of household debt in the nation, behind only home mortgages...

Subsidy costs have increased since FY 2013 because of higher participation in the new IDR plans (PAYE and REPAYE), which are more advantageous to borrowers.

https://www2.ed.gov/about/offices/list/ ... 9q0003.pdf
Failed programs like this is why we will never have the Space Force this country deserves.

[Fat Cat]

Make every one of those deadbeats with women's or ethnic studies degrees pay back every cent they bilked from the American taxpayer and shut down the degree mills that sold them. Schools should have to price their degrees based on real market value.

[Turdacious]

Mortality stats worsened for the third year in a row.


https://www.cdc.gov/nchs/data/databriefs/db328-h.pdf

[Turdacious]

The Total Bill: $96,377 for the surgery was billed by the hospital, Sky Ridge Medical Center in Lone Tree, Colorado, part of HealthONE, a division of the for-profit hospital chain HCA. It accepted a $3,216.60 payment from the insurance company, as well as $357.40 from the Benassos, as payment in full. The surgical assistant billed separately for $1,167.

Service Provider: Eric Griffith, a surgical assistant who works as an independent contractor.

Medical Service: Outpatient arthroscopic meniscus repair surgery.

What Gives: The Benassos had stumbled into a growing trend in health care: third-party surgical assistants who aren’t part of a hospital staff or a surgeon’s practice. They tend to stay out-of-network with health plans, either accepting what a health plan will pay them or billing the patient directly. That, in turn, is leading to many surprise bills.

https://khn.org/news/ever-heard-of-a-su ... cal-bills/
Just your friendly reminder that hospitals will never tire in their search for new and exciting ways to fuck you and your families.