Category: health

Implementation woes and ACA

Lisa Schweitzer

I don’t know what to say that hasn’t already been said, other than, for the love of God, you people. Anybody who didn’t know that the Affordable Care Act was going to be difficult to implementat was kidding themselves. I did wonder where the big roll-out was in terms of public education a couple months ago. We did a better job with rolling out mandatory seat-belt laws, but in fairness, that was less ambitious. But still, that means more prep, not less. Perhaps I just missed it, as I was focussed on other things, but right now progressives should be seething. They played chicken with the Tea Party types and forced a shutdown over a program that clearly wasn’t ready for roll out. That’s bad. Ack. ACK.

The problems:

1. The health care industry is unbelievably complicated. Most people have no idea what their insurance really covers–or how expensive charges can really get–until the very worst happens.

2. The ACA is more complicated than it should be. It’s a plan with many moving parts, as we say. There’s not much we can do about it due to the horse-trading nature of most legislatively created programs, but still. That doesn’t help.

3. But no, people, the ‘way it was’ before the us attempted to provide health care wasn’t sunshine and roses, either. Just because things were fine for you doesn’t mean it was fine for society, unless you are Margaret Thatcher, and you plan to live your life in such a way that you die disliked even by your own party and appointees. (I think that’s a fair statement.) Your political and economic community matters even if the only political factors you care about are taxation and liberty.

Housing investors, rentals for whom, and what kills you?

Lisa Schweitzer3 Comments

The International Business Times has a feature this morning on a survey from Move.com that suggests that investors are going to be dominating the housing market for the next 2 years.  Some of the commentary suggests that this is where the speculators have gone:

–Nearly 60 percent of investors say they’re new to real estate investing. About 33 percent are considering their first investment purchase and 8.5 percent are in the process of buying and selling their first investment property. Of those surveyed, only 36.5 percent had experience in more than one property transaction.

via Investors to Dominate Housing Market for Next 2 Years.

I have to tell you: my experience with this in Los Angeles County for my own long-term home search has been irritating.  There are a lot of cash investors swooping in to buy things near the university where I work.  One of my colleagues and I decided that we were going to live within walking distance of the distance. And after 4 failed offers (one property had 20 offers on it in the first week), I am giving up and living farther away. So is he; he and his partner are giving up on walking and moving looking at Silverlake and Echo Park.

In the West Adams  case, who those rentals are for is clear. In other parts of the region, I wonder whom these investors believe are going to rent their houses?  Traditional buyers locked out of new financing because they don’t have enough cash to buy; banks demanding 25 percent on $500+ houses make for a pretty high class barrier to traditional home buying? People who have been foreclosed on?

At least a dozen people have sent me the slate.com hysteria fest about how your commute is killing you.  It causes you to divorce. DOOM.  I’m not linking to it since it already has pages of links, and I refuse to participate in the hysteria.

Why?

Because being unemployed and having no commute is a health issue, too.

Of course you could be spending your time doing better, healthier things than in a commute. Why is this even news? I understand why the original study took the approach that it did, but why the hype? This is like saying every minute you spend eating bacon is a minute you could be spending exercising. Ya think? NO KIDDING? For reals? The opportunity costs of community have always been the issue. That’s why some of us–despite all of the critiques leveled at the civil engineering idea of minimizing travel time,  despite all the flouncing around about how efficiency is an empty goal for planning, despite all the people who want to “slow” cities down–still say that travel time is a key measure of service quality and we should pay attention to it. Travel time isn’t the only measure, for sure, but damn it, time matters. And it matters a lot to people on the lower income scale no matter how many I-bankers swish around and say “my time is money.”

But with all my travails in the California housing market–I have been looking for months–you have to wonder how much discretion anybody other than people with big, big money have on where they live relative to where they work and where their kids go to school.

 

Bad Social Science and Medical Journals

Lisa Schweitzer

You know those times when you think you are the crazy one, and then suddenly you find out you’re not?

So for some time, I’ve been reading public health and medical journals and rolling my eyes at what is getting published, while my senior faculty lecture me on quality of research and impact factors. Well, these medical journals have huge impact factors, and they routinely publish terrible policy research. My attitude has been–hell, I can produce bad policy research as well as these people.

Yesterday, one of my wonderful PhD students directed me to this brilliant blog post from aid watch: shaky research to solid headlines via medical journals:

We could go on and on with examples. The British Medical Journal published a study of mortality of age cohorts in five year bands for both men and women from birth to age 95 for 126 countries—an improbably detailed dataset. (The article was searching through all the age groups to see if any group’s mortality was related to income inequality.). Malaria Journal published a study of nationwide decreases in malaria deaths in Rwanda and Ethiopia, except that the study itself admitted that its methods were not reliable to measure nationwide decreases (a small caveat left out later when Bill and Melinda Gates cited the study as progress of their malaria efforts).

The Lancet published a study that tested an “Intervention with Microfinance for AIDS and Gender Equity (IMAGE)” in order “to assess a structural intervention that combined a microfinance programme with a gender and HIV training curriculum.” The conclusion: “This study provides encouraging evidence that a combined microfinance and training intervention can have health and social benefits.” This was a low bar for “encouraging:” only 3 out of the 31 statistical tests run in the paper demonstrate any effects – when 1 out of every 20 independent tests of this kind show an effect by pure chance. (The Lancet was also the culprit in a couple of the links in the first paragraph.) Economics journals are hardly foolproof, but it’s hard to imagine research like this getting published in them.

Word.

Go read the whole post–it’s worth it for the clever graphic.

I got addicted to reading the blog last night, so I’m signing up for the feed. Really good stuff.