Month: September 2014

Last year I
wrote that Obamacare could leave doctors holding the bag for
claims for patients who don’t pay their insurance premiums. That’s
because the law includes a three-month grace period during which
health insurers must continue to cover patients who sign up, but
don’t pay the price of their insurance. If the patients eventually
make good, there’s no problem. But if patients don’t pay the owed
premiums, the insurance company has to cover the cost of claims
filed during the first month. Providers are stuck with the tab for
any claims filed during months two and three.

The piece I wrote last July was theoretical. The notification
letter I’m holding in my hand, addressed to my wife’s pediatric
practice, is reality. And reality costs, in this case, over $600.
That’s the outstanding balance owed the practice by a patient
insured by BlueCross BlueShield of Arizona. It’s a balance that my
wife might have to eat, or else try to collect herself.

Here’s the letter, from which my wife redacted all identifying
information before showing it to me.

Dear Practitioner:

Under the Patient Protection and Affordable Care Act (PPACA), if
an individual purchases health insurance through the Individual
Marketplace and receives a subsidy to assist with premiums, there
is a three month grace period in which the individual can make
premium payments. During this period, insurance companies may not
disenroll members, issuers must notify providers as soon as
practicable when an enrollee enters the grace period and, during
the second and third months of the grace period, they are required
to notify providers that claims incurred in the second and third
months may deny if the premium is not paid.

The member referenced above purchased health insurance through
the Marketplace and currently receives a subsidy to assist with
premiums. This letter is a courtesy notification to make you aware
that this member and any covered dependents are currently in the
3rd month of their grace period.

What this means to you

• This claim was incurred during the second or third month of the
  member’s grace period and was pended. All individual claims under
  this contract are also in the second or third month of their grace
  period.
• Any additional claims incurred during the second and third
  month of the grace period may be pended until the full premium due
  is paid by the member.
• If the premium is paid in full by the end of the grace period,
  and pended claims will be processed in accordance with the terms of
  the contract.
• If premium is not paid in full by the end of the grace period,
  any claims incurred in the second and third months may be denied.
  If claims incurred in the second and third month are denied due to
  non-payment of premium, you may seek reimbursement directly from
  the member.

The American Medical Association (AMA) has more information
about the grace period
here, though the letter above covers the high points. Given the
potentially high costs providers can face when the insurance
coverage they process for patient care turns out to be more of a
conditional suggestion than a firm guarantee, the AMA also offers

physicians guidance, and urges them to
enter into financial agreements with patients who receive
subsidized care. The idea is to get them to promise to pay their
own bills if they stiff the insurance company.

Of course, those patients promised to pay their insurance
companies, too.

With much fanfare, Ukraine is
pushing forward in its fight for economic integration with the
European Union. But, quietly, the government is also granting
autonomy to the eastern regions occupied by Russian-backed
forces.

The Ukrainian Parliament adopted a law that will
“for the period of three years” allow “local self-government as
well as activity of local bodies of self-government in separate
regions of Donetsk and Luhansk Oblasts.” Local elections will take
place in November. The parliament adopted another measure to grant
some separatists (“except
those who have committed serious crimes“) amnesty.

As the BBC notes, these
deals were “laid out” as part of the September 5 ceasefire
agreement, which was
devised by Russia’s Vladimir Putin.

Ukrainian President Petro Poroshenko
assures that this laws respect the “sovereignty, territorial
integrity, and independence” of Ukraine.”

The concession were made during “a closed-door session — an
anomaly in Ukrainian parliament,” reports the Associated Press.

By contrast, the Ukrainian Parliament loudly ratified a
long-awaited deal to “deepen economic and political ties with the
European Union” through
freer trade. Last year, then-President Viktor Yanukovych, who
has been denounced as a “Kremlin
puppet,” refused to sign this agreement. His corrupt,
pro-Russian administrative actions led to widespread pro-Western
protests against him, and ultimately a revolution.

Russia itself is on the brink of recession due to its war,

says a former Kremlin finance minister. Crediting sanctions
from the U.S. and E.U., The Christian Science Monitor

reports that today “Russia’s currency dropped to an
all-time low against the dollar.”

Russian state-owned media has made a “drastic change” lately by
softening its anti-Ukrainian rhetoric,
according to the independent Moscow Times. This may be
a positive sign of Russia winding down its war.

For its part, the U.S. is also speaking somewhat more softly
about Russia. President Barack Obama admitted that Crimea “is
gone,” and Secretary of State John Kerry last week
called upon Moscow to help America fight the Islamic State,
which has personally threatened Putin. 

In our
August/September 2013 edition,
Reason named the “45 Enemies of Freedom: People who have
been trying to control your life since reason was founded in 1968.”
Included on that list of villains was Robert Moses, the shadowy
government official who spent nearly half a century exercising
unprecedented power over the city and state of New York. Here’s why
Moses
made the cut:

The most authoritarian city planner in New York history, Moses
wielded eminent domain and many other government powers, unleashing
his bulldozers and wrecking balls on the homes, businesses, and
churches of as many as half a million powerless citizens, many of
them black, brown, or poor.

Forty years ago today, a young journalist named Robert Caro
published
The Power Broker: Robert Moses and the Fall of New
York. Thanks to this extraordinary book, the world came to
learn in detail about Moses and his many crimes. The book soon won
both the Pulitzer Prize and the Francis Parkman Prize and it still
remains the definitive work on Moses and his legacy. In my own
view, The Power Broker is one of the greatest cautionary
tales about political power ever written.

At The Daily Beast, Scott Porch offers a detailed and
fascinating account of how The Power Broker came to life.
It was “a seven-year ordeal,”
Porch writes, “that took the book through three publishers and
two editors and nearly bankrupted Caro.” As for the book’s enduring
appeal, Porch rightly credits both Caro’s masterful writing and the
strength of his research:

One thing that had made a strong impression on [Caro] in the
course of his research was the human cost of the massive
construction that Robert Moses had wrought in and around New York
City. Moses’ major highway projects had destroyed entire
neighborhoods and uprooted the lives of thousands of New Yorkers.
For a chapter called “One Mile,” Caro decided to trace the impact
of a mile of one of Moses’ expressways on hundreds of displaced
families. “This is such a human tragedy, and no one writes about
these things,” Caro said, “and I want to show what one mile of a
highway through a congested city can mean.” That single chapter,
the most visceral and moving part of The Power Broker, took Caro
six months to research and write….

On August 26, 1974, three weeks before The Power Broker
was published, Robert Moses, then 86 years old, released a
3,500-word rebuttal that said the book was “full of mistakes,
unsupported charges, nasty, baseless personalities and random
haymakers thrown at just about everybody in public life.” But Moses
had already lost. His reputation as a power-hungry bully preceded
the book, and the rapturous reviews praised Caro’s prodigious
research and his fair treatment of Moses.

Read the whole story
here.

Related: In 2011, Reason TV spoke with Robert
Caro about “The Tragedy of Urban Renewal: The destruction and
survival of a New York City neighborhood.”

In our
August/September 2013 edition,
Reason named the “45 Enemies of Freedom: People who have
been trying to control your life since reason was founded in 1968.”
Included on that list of villains was Robert Moses, the shadowy
government official who spent nearly half a century exercising
unprecedented power over the city and state of New York. Here’s why
Moses
made the cut:

The most authoritarian city planner in New York history, Moses
wielded eminent domain and many other government powers, unleashing
his bulldozers and wrecking balls on the homes, businesses, and
churches of as many as half a million powerless citizens, many of
them black, brown, or poor.

Forty years ago today, a young journalist named Robert Caro
published
The Power Broker: Robert Moses and the Fall of New
York. Thanks to this extraordinary book, the world came to
learn in detail about Moses and his many crimes. The book soon won
both the Pulitzer Prize and the Francis Parkman Prize and it still
remains the definitive work on Moses and his legacy. In my own
view, The Power Broker is one of the greatest cautionary
tales about political power ever written.

At The Daily Beast, Scott Porch offers a detailed and
fascinating account of how The Power Broker came to life.
It was “a seven-year ordeal,”
Porch writes, “that took the book through three publishers and
two editors and nearly bankrupted Caro.” As for the book’s enduring
appeal, Porch rightly credits both Caro’s masterful writing and the
strength of his research:

One thing that had made a strong impression on [Caro] in the
course of his research was the human cost of the massive
construction that Robert Moses had wrought in and around New York
City. Moses’ major highway projects had destroyed entire
neighborhoods and uprooted the lives of thousands of New Yorkers.
For a chapter called “One Mile,” Caro decided to trace the impact
of a mile of one of Moses’ expressways on hundreds of displaced
families. “This is such a human tragedy, and no one writes about
these things,” Caro said, “and I want to show what one mile of a
highway through a congested city can mean.” That single chapter,
the most visceral and moving part of The Power Broker, took Caro
six months to research and write….

On August 26, 1974, three weeks before The Power Broker
was published, Robert Moses, then 86 years old, released a
3,500-word rebuttal that said the book was “full of mistakes,
unsupported charges, nasty, baseless personalities and random
haymakers thrown at just about everybody in public life.” But Moses
had already lost. His reputation as a power-hungry bully preceded
the book, and the rapturous reviews praised Caro’s prodigious
research and his fair treatment of Moses.

Read the whole story
here.

Related: In 2011, Reason TV spoke with Robert
Caro about “The Tragedy of Urban Renewal: The destruction and
survival of a New York City neighborhood.”

One of the supposed selling points of
the Common Core standards is that they are “internationally
benchmarked” in order to make the U.S. education system more
competitive with better systems in other countries. Implement
Common Core, and U.S. students will catch up to Chinese students in
no time—or so proponents of national standards claim.

Even if that’s true, it may not be a good
thing. The
New York Times recently published a fascinating
interview with Yong Zhao, a professor of education at the
University of Oregon. Zhao was born in China; unlike many American
intellectuals, he does not think U.S. schools should try to emulate
China.

“If the United States and the rest of the West are concerned
about being overtaken by China, the best solution is to avoid
becoming China,” he said.

Chinese schools stamp out individuality and make kids spend all
their time preparing for exams that are focused on “narrow
intelligence.” This produces fewer creative and entrepreneurial
people, which is precisely what the authoritarian national
government of China wants, according to Zhao.

Zhao warned that the kind of standardization offered by Common
Core is a danger to a free culture and a free economy. Relevant
excerpts from the interview below:

Q. You have said that traditional Chinese
education actively “harms” children. How?

A. It basically ignores children’s uniqueness,
interests and passion, which results in homogenization. It forces
them to spend almost all the time preparing for tests, leaving
little time for social and physical activities. It also places them
under tremendous stress through intense competition, which can
damage their confidence and lowers their self-esteem.

Q. Is the United States becoming like China in
education? How?

A. The U.S. has certainly become more like
China in recent years. The No Child Left Behind Act has increased
the stakes and usage of standardized testing. President Obama’s
Race to the Top and other initiatives continue to push testing into
schools and classrooms by associating test scores with teacher
evaluation. The Common Core State Standards Initiative has been
pushed to many states, creating de facto national standards in math
and English language arts. So American education today has become
more centralized, standardized and test-driven, with an
increasingly narrow educational experience, which characterizes
Chinese education.

Q. Will this damage America?

A. I believe so. Because a narrow education
experience that is centrally dictated, uniformly programmed and
constantly monitored by standardized tests is unlikely to value
individual talents, respect students’ interest and passion,
cultivate creativity or entrepreneurial thinking, or foster the
development of noncognitive capacities. But it is the diversity of
talents, passion-driven creativity and entrepreneurship, and
social-emotional well-being of individuals that are needed for the
future economy.