If Obamacare Doesn't Kill Small Medical Practices, Bureaucratic ICD-10 Coding Requirements Might

ICD-10News headlines have focused on
the
bureaucratic mandates
,
financial looniness
, and
unlikely assumptions
that seem designed to drive medical
providers away from the Affordable Care Act or out of business
entirely. But this year, a non-Obamacare bureaucratic car bomb is
set to explode in the medical world in the form of
ICD-10
—a new coding system for patient diagnoses and inpatient
procedures. Mandated by the Centers for Medicare & Medicaid
Servives, the coding system standardizes communications among
providers and insurers. Well, it standardizes them more,
since ICD-9 has been in place for 30 years. Uncertainty over
hitches in replacing the old coding system with a brand new one has
industry experts advising practices to keep several months
worth of cash on hand to cover lags in reimbursement. Practices
lacking that much liquidity under the mattress may be truly
screwed.

Theoretically, the new coding system covers inpatient care
involving Medicare, Medicaid, and “everyone covered by the Health
Insurance Portability Accountability Act.” The government says up
and down that the new codes aren’t really necessary for private
practices providing outpatient care. A handy FAQ insists:

Will ICD-10 replace Current Procedural Terminology (CPT)
procedure coding?

No. The switch to ICD-10 does not affect CPT coding for
outpatient procedures. Like ICD-9 procedure codes, ICD-10-PCS codes
are for hospital inpatient procedures only.

But as EHRIntelligence
points out
, “While it’s true that CPT/HCPCS codes will continue
to be the gold standard for outpatient
procedures, providers will be required to include ICD-10
diagnostic codes with their claims in order to receive
reimbursements from payers.”

So, if doctors want to be compensated by anybody other than
cash-only patients, they need to adopt the new codes, too.

The problem is that glitches are anticipated in switchover to
the new coding system, since nobody is allowed to use it before
October 1, 2014, and everybody is required to use it after
that day. That’s right, another government-mandated healthcare
industry hard launch, exactly one year after Healthcare.gov
debuted.

Actually, ICD-10 and Healthcare.goc were originally scheduled to
launch on the same day in 2013.

The Healthcare Billing & Management Association
warns
that “it is possible that not all payors will be ready
for ICD-10 on October 1, 2014,” so “it will be important that you
are able to submit in both ICD-9 and ICD-10 formats.” The group
further recommends that practices “establish a line of credit to
tide the office over during the first months following the
implementation of ICD-10” to acommodate reimbursement delays.

The CMS itself notes in its
Implementation Guide for Small and Medium
Practices
:

The transition to ICD-10 will result in changes to physician
reimbursements. … [C]hallenges with billing productivity combined
with potential payer claim processing challenges may result in
signicant impact to cash flow. This may require the need for
reserve funds or lines of credit to offset cash flow
challenges.

According to
HealthcareITNews
:

Healthcare providers may face disruptions in their payments even
if they are on target to operate using ICD-10 codes on Oct. 1,
2014. 

Since providers will, and indeed need, to be able to
pay rent and staff salaries if the transition does not flow as
smoothly as testing has indicated, experts advise having up to
several months’ cash reserves or access to cash through a loan or
line of credit to avoid potential headaches.

“Just figure that with the transition to ICD-10 there will be
delays in reimbursement,” said April Arzate, vice president of
client services at MediGain, a Dallas-based revenue cycle and
healthcare analytics company.

Arzate recommends keeping enough cash on hand to cover medical
supplies, payroll, rent, and the rest of a medical practice’s
overhead for three to six months.

In a
separate document on risk-mitigation strategies
for
implementing IDC-10, the CMS specifies a “minimum of six months of
cash reserves to mitigate revenue impacts over the ICD-10
transformation period.”

Lines of credit might step in where available cash is
short, but banks issue lines of credit to good risks—not medical
practices already struggling in an uncertain regulatory
environment.

If you’re a doctor, now is a good time to look at your cash
flow, or your retirement options. If you’re a patient, you might
just consider buying your favorite doc a good-bye drink.

from Hit & Run http://ift.tt/1mZBGXR
via IFTTT

If Obamacare Doesn’t Kill Small Medical Practices, Bureaucratic ICD-10 Coding Requirements Might

ICD-10News headlines have focused on
the
bureaucratic mandates
,
financial looniness
, and
unlikely assumptions
that seem designed to drive medical
providers away from the Affordable Care Act or out of business
entirely. But this year, a non-Obamacare bureaucratic car bomb is
set to explode in the medical world in the form of
ICD-10
—a new coding system for patient diagnoses and inpatient
procedures. Mandated by the Centers for Medicare & Medicaid
Servives, the coding system standardizes communications among
providers and insurers. Well, it standardizes them more,
since ICD-9 has been in place for 30 years. Uncertainty over
hitches in replacing the old coding system with a brand new one has
industry experts advising practices to keep several months
worth of cash on hand to cover lags in reimbursement. Practices
lacking that much liquidity under the mattress may be truly
screwed.

Theoretically, the new coding system covers inpatient care
involving Medicare, Medicaid, and “everyone covered by the Health
Insurance Portability Accountability Act.” The government says up
and down that the new codes aren’t really necessary for private
practices providing outpatient care. A handy FAQ insists:

Will ICD-10 replace Current Procedural Terminology (CPT)
procedure coding?

No. The switch to ICD-10 does not affect CPT coding for
outpatient procedures. Like ICD-9 procedure codes, ICD-10-PCS codes
are for hospital inpatient procedures only.

But as EHRIntelligence
points out
, “While it’s true that CPT/HCPCS codes will continue
to be the gold standard for outpatient
procedures, providers will be required to include ICD-10
diagnostic codes with their claims in order to receive
reimbursements from payers.”

So, if doctors want to be compensated by anybody other than
cash-only patients, they need to adopt the new codes, too.

The problem is that glitches are anticipated in switchover to
the new coding system, since nobody is allowed to use it before
October 1, 2014, and everybody is required to use it after
that day. That’s right, another government-mandated healthcare
industry hard launch, exactly one year after Healthcare.gov
debuted.

Actually, ICD-10 and Healthcare.goc were originally scheduled to
launch on the same day in 2013.

The Healthcare Billing & Management Association
warns
that “it is possible that not all payors will be ready
for ICD-10 on October 1, 2014,” so “it will be important that you
are able to submit in both ICD-9 and ICD-10 formats.” The group
further recommends that practices “establish a line of credit to
tide the office over during the first months following the
implementation of ICD-10” to acommodate reimbursement delays.

The CMS itself notes in its
Implementation Guide for Small and Medium
Practices
:

The transition to ICD-10 will result in changes to physician
reimbursements. … [C]hallenges with billing productivity combined
with potential payer claim processing challenges may result in
signicant impact to cash flow. This may require the need for
reserve funds or lines of credit to offset cash flow
challenges.

According to
HealthcareITNews
:

Healthcare providers may face disruptions in their payments even
if they are on target to operate using ICD-10 codes on Oct. 1,
2014. 

Since providers will, and indeed need, to be able to
pay rent and staff salaries if the transition does not flow as
smoothly as testing has indicated, experts advise having up to
several months’ cash reserves or access to cash through a loan or
line of credit to avoid potential headaches.

“Just figure that with the transition to ICD-10 there will be
delays in reimbursement,” said April Arzate, vice president of
client services at MediGain, a Dallas-based revenue cycle and
healthcare analytics company.

Arzate recommends keeping enough cash on hand to cover medical
supplies, payroll, rent, and the rest of a medical practice’s
overhead for three to six months.

In a
separate document on risk-mitigation strategies
for
implementing IDC-10, the CMS specifies a “minimum of six months of
cash reserves to mitigate revenue impacts over the ICD-10
transformation period.”

Lines of credit might step in where available cash is
short, but banks issue lines of credit to good risks—not medical
practices already struggling in an uncertain regulatory
environment.

If you’re a doctor, now is a good time to look at your cash
flow, or your retirement options. If you’re a patient, you might
just consider buying your favorite doc a good-bye drink.

from Hit & Run http://ift.tt/1mZBGXR
via IFTTT

City, county offices to reopen tomorrow (Thurs.)

Local government offices will be getting back to business tomorrow (Thursday).

Fayette County and Fayetteville offices will open at 10 a.m. and Peachtree City offices will open at 10:30 a.m. Tyrone town offices will open for business at noon.

read more

via The Citizen http://ift.tt/1fxXzuP

The Emerging Market Collapse Through The Eyes Of Don Corleone

Submitted by Ben Hunt of Epsilon Theory

It Was Barzini All Along

Tattaglia is a pimp. He never could have outfought Santino. But I didn’t know until this day that it was Barzini all along.

      — Don Vito Corleone

Like many in the investments business, I am a big fan of the Godfather movies, or at least those that don’t have Sofia Coppola in a supporting role. The strategic crux of the first movie is the realization by Don Corleone at a peace-making meeting of the Five Families that the garden variety gangland war he thought he was fighting with the Tattaglia Family was actually part of an existential war being waged by the nominal head of the Families, Don Barzini. Vito warns his son Michael, who becomes the new head of the Corleone Family, and the two of them plot a strategy of revenge and survival to be put into motion after Vito’s death. The movie concludes with Michael successfully murdering Barzini and his various supporters, a plot arc that depends entirely on Vito’s earlier recognition of the underlying cause of the Tattaglia conflict. Once Vito understood WHY Philip Tattaglia was coming after him, that he was just a stooge for Emilio Barzini, everything changed for the Corleone Family’s strategy.

Now imagine that Don Corleone wasn’t a gangster at all, but was a macro fund portfolio manager or, really, any investor or allocator who views the label of “Emerging Market” as a useful differentiation … maybe not as a separate asset class per se, but as a meaningful way of thinking about one broad set of securities versus another. With the expansion of investment options and liquid securities that reflect this differentiation — from Emerging Market ETF’s to Emerging Market mutual funds — anyone can be a macro investor today, and most of us are to some extent.

You might think that the ease with which anyone can be an Emerging Markets investor today would make the investment behavior around these securities more complex from a game theory perspective as more and more players enter the game, but actually just the opposite is true. The old Emerging Markets investment game had very high informational and institutional barriers to entry, which meant that the players relied heavily on their private information and relatively little on public signals and Common Knowledge. There may be far more players in the new Emerging Markets investment game, but they are essentially one type of player with a very heavy reliance on Common Knowledge and public Narratives. Also, these new players are not (necessarily) retail investors, but are (mostly) institutional investors that see Emerging Markets or sub-classifications of Emerging Markets as an asset class with certain attractive characteristics as part of a broad portfolio. Because these institutional investors have so much money that must be put to work and because their portfolio preference functions are so uniform, there is a very powerful and very predictable game dynamic in play here.

Since the 2008 Crisis the Corleone Family has had a pretty good run with their Emerging Markets investments, and even more importantly Vito believes that he understands WHY those investments have worked. In the words of Olivier Blanchard, Chief Economist for the IMF:

In emerging market countries by contrast, the crisis has not left lasting wounds. Their fiscal and financial positions were typically stronger to start, and adverse effects of the crisis have been more muted. High underlying growth and low interest rates are making fiscal adjustment much easier. Exports have largely recovered, and whatever shortfall in external demand they experienced has typically been made up through an increase in domestic demand. Capital outflows have turned into capital inflows, due to both better growth prospects and higher interest rates than in advanced countries. … The challenge for most emerging countries is quite different from that of advanced countries, namely how to avoid overheating in the face of closing output gaps and higher capital flows. — April 11, 2011

As late as January 23rd of this year, Blanchard wrote that “we forecast that both emerging market and developing economies will sustain strong growth“.

Now we all know what actually happened in 2013. Growth has been disappointing around the world, particularly in Emerging Markets, and most of these local stock and bond markets have been hit really hard. But if you’re Vito Corleone, macro investor extraordinaire, that’s not necessarily a terrible thing. Sure, you don’t like to see any of your investments go down, but Emerging Markets are notably volatile and maybe this is a great buying opportunity across the board. In fact, so long as the core growth STORY is intact, it almost certainly is a buying opportunity.

But then you wake up on July 9th to read in the WSJ that Olivier Blanchard has changed his tune. He now says “It’s clear that these countries [China, Russia, India, Brazil, South Africa] are not going to grow at the same rate as they did before the crisis.” Huh? Or rather, WTF? How did the Chief Economist of the IMF go from predicting “strong growth” to declaring that the party is over and the story has fundamentally changed in six months?

It’s important to point out that Blanchard is not some inconsequential opinion leader, but is one of the most influential economists in the world today. His position at the IMF is a temporary gig from his permanent position as the Robert M. Solow Professor of Economics at MIT, where he has taught since 1983. He also received his Ph.D. in economics from MIT (1977), where his fellow graduate students were Ben Bernanke (1979), Mario Draghi (1976), and Paul Krugman (1977), among other modern-day luminaries; Stanley Fischer, current Governor of the Bank of Israel, was the dissertation advisor for both Blanchard and Bernanke; Mervyn King and Larry Summers (and many, many more) were Blanchard’s contemporaries or colleagues at MIT at one point or another. The centrality of MIT to the core orthodoxy of modern economic theory in general and monetary policy in particular has been well documented by Jon Hilsenrath and others and it’s not a stretch to say that MIT provided a personal bond and a formative intellectual experience for a group of people that by and large rule the world today. Suffice it to say that Blanchard is smack in the middle of that orthodoxy and that group. I’m not saying that anything Blanchard says is amazingly influential in and of itself, certainly not to the degree of a Bernanke or a Draghi (or even a Krugman), but I believe it is highly representative of the shared beliefs and opinions that exist among these enormously influential policy makers and policy advisors. Two years ago the global economic intelligentsia believed that Emerging Markets had emerged from the 2008 crisis essentially unscathed, but today they believe that EM growth rates are permanently diminished from pre-crisis levels. That’s a big deal, and anyone who invests or allocates to “Emerging Markets” as a differentiated group of securities had better take notice.

Here’s what I think happened.

First, an error pattern has emerged over the past few years from global growth data and IMF prediction models that forced a re-evaluation of those models and the prevailing Narrative of “unscathed” Emerging Markets. Below is a chart showing actual Emerging Market growth rates for each year listed, as well as the IMF prediction at the mid-year mark within that year and the mid-year mark within the prior year (generating an 18-month forward estimate).

Pre-crisis the IMF systematically under-estimated growth in Emerging Markets. Post-crisis the IMF has systematically over-estimated growth in Emerging Markets. Now to be sure, this IMF over-estimation of growth exists for Developed Markets, too, but between the EuroZone sovereign debt crisis and the US fiscal cliff drama there’s a “reason” for the unexpected weakness in Developed Markets. There’s no obvious reason for the persistent Emerging Market weakness given the party line that “whatever shortfall in external demand they experienced has typically been made up through an increase in domestic demand.” Trust me, IMF economists know full well that their models under-estimated EM growth pre-crisis and have now flipped their bias to over-estimate growth today. Nothing freaks out a statistician more than this sort of flipped sign. It means that a set of historical correlations has “gone perverse” by remaining predictive, but in the opposite manner that it used to be predictive. This should never happen if your underlying theory of how the world works is correct. So now the IMF (and every other mainstream macroeconomic analysis effort in the world) has a big problem. They know that their models are perversely over-estimating growth, which given the current projections means that we’re probably looking at three straight years of sub-5% growth in Emerging Markets (!!) more than three years after the 2008 crisis ended, and — worse — they have no plausible explanation for what’s going on.

Fortunately for all concerned, a Narrative of Central Bank Omnipotence has emerged over the past nine months, where it has become Common Knowledge that US monetary policy is responsible for everything that happens in global markets, for good and for ill (see “How Gold Lost Its Luster”). This Narrative is incredibly useful to the Olivier Blanchard’s of the world, as it provides a STORY for why their prediction models have collapsed. And maybe it really does rescue their models. I have no idea. All I’m saying is that whether the Narrative is “true” or not, it will be adopted and proselytized by those whose interests — bureaucratic, economic, political, etc. — are served by that Narrative. That’s not evil, it’s just human nature.

Nor is the usefulness of the Narrative of Central Bank Omnipotence limited to IMF economists. To listen to Emerging Market central bankers at Jackson Hole two weeks ago or to Emerging Market politicians at the G-20 meeting last week you would think that a great revelation had been delivered from on high. Agustin Carstens, Mexico’s equivalent to Ben Bernanke, gave a speech on the “massive carry trade strategies” caused by ZIRP and pleaded for more Fed sensitivity to their capital flow risks. Interesting how the Fed is to blame now that the cash is flowing out, but it was Mexico’s wonderful growth profile to credit when the cash was flowing in. South Africa’s finance minister, Pravin Gordhan, gave an interview to the FT from Jackson Hole where he bemoaned the “inability to find coherent and cohesive responses across the globe to ensure that we reduce the volatility in currencies in particular, but also in sentiment” now that the Fed is talking about a Taper. Christine Lagarde got into the act, of course, calling on the world to build “further lines of defense” even as she noted that the IMF would (gulp) have to stand in the breach as the Fed left the field. To paraphrase Job: the Fed gave, and the Fed hath taken away; blessed be the name of the Fed.

The problem, though, is that once you embrace the Narrative of Central Bank Omnipotence to “explain” recent events, you can’t compartmentalize it there. If the pattern of post-crisis Emerging Market growth rates is largely explained by US monetary accommodation or lack thereof … well, the same must be true for pre-crisis Emerging Market growth rates. The inexorable conclusion is that Emerging Market growth rates are a function of Developed Market central bank liquidity measures and monetary policy, and that all Emerging Markets are, to one degree or another, Greece-like in their creation of unsustainable growth rates on the back of 20 years of The Great Moderation (as Bernanke referred to the decline in macroeconomic volatility from accommodative monetary policy) and the last 4 years of ZIRP. It was Barzini all along!

This shift in the Narrative around Emerging Markets — that the Fed is the “true” engine of global growth — is a new thing. As evidence of its novelty, I would point you to another bastion of modern economic orthodoxy, the National Bureau of Economic Research (NBER), in particular their repository of working papers. Pretty much every US economist of note in the past 40 years has published an NBER working paper, and I only say “pretty much every” because I want to be careful; my real estimate is that there are zero mainstream US economists who don’t have a working paper here.

If you search the NBER working paper database for “emerging market crises”, you see 16 papers. Again, the author list reads like a who’s who of famous economists: Martin Feldstein, Jeffrey Sachs, Rudi Dornbusch, Fredric Mishkin, Barry Eichengreen, Nouriel Roubini, etc. Of these 16 papers, only 2 — Frankel and Roubini (2001) and Arellano and Mendoza (2002) — even mention the words “Federal Reserve” in the context of an analysis of these crises, and in both cases the primary point is that some Emerging Market crises, like the 1998 Russian default, force the Fed to cut interest rates. They see a causal relationship here, but in the opposite direction of today’s Narrative! Now to be fair, several of the papers point to rising Developed Market interest rates as a “shock” or contributing factor to Emerging Market crises, and Eichengreen and Rose (1998) make this their central claim. But even here the argument is that “a one percent increase in Northern interest rates is associated with an increase in the probability of Southern banking crises of around three percent” … not exactly an earth-shattering causal relationship. More fundamentally, none of these authors ever raise the possibility that low Developed Market interest rates are the core engine of Emerging Market growth rates. It’s just not even contemplated as an explanation.

Today, though, this new Narrative is everywhere. It pervades both the popular media and the academic “media”, such as the prominent Jackson Hole paper by Helene Rey of the London Business School, where the nutshell argument is that global financial cycles are creatures of Fed policy … period, end of story. Not only is every other country just along for the ride, but Emerging Markets are kidding themselves if they think that their plight matters one whit to the US and the Fed.

Market participants today see Barzini/Bernanke everywhere, behind every news announcement and every market tick. They may be right. They may be reading the situation as smartly as Vito Corleone did. I doubt it, but it really doesn’t matter. Whether or not I privately believe that Barzini/Bernanke is behind everything that happens in the world, I am constantly told that this is WHY market events happen the way they do. And because I know that everyone else is seeing the same media explanations of WHY that I am seeing … because I know that everyone else is going through the same tortured decision process that I’m going through … because I know that everyone else is thinking about me in the same way that I am thinking about them … because I know that if everyone else acts as if he or she believes the Narrative then I should act as if I believe the Narrative … then the only rational conclusion is that I should act as if I believe it. That’s the Common Knowledge game in action. This is what people mean when they say that a market behavior of any sort “takes on a life of its own.”

For the short term, at least, the smart play is probably just to go along with the Barzini/Bernanke Narrative, just like the Corleone family went along with the idea that Barzini was running them out of New York (and yes, I understand that at this point I’m probably taking this Godfather analogy too far). By going along I mean thinking of the current market dynamic in terms of risk management, understanding that the overall information structure of this market is remarkably unstable. Risk-On / Risk-Off behavior is likely to increase significantly in the months ahead, and there’s really no predicting when Bernanke will open his mouth or what he’ll say, or who will be appointed to take his place, or what he or she will say. It’s hard to justify any large exposure to public securities in this environment, long or short, because all public securities will be dominated by this Narrative so long as everyone thinks that everyone thinks they will be dominated. This the sort of game can go on for a long time, particularly when the Narrative serves the interests of incredibly powerful institutions around the world.

But what ultimately saved the Corleone family wasn’t just the observation of Barzini’s underlying causal influence, it was the strategy that adjusted to the new reality of WHY. What’s necessary here is not just a gnashing of teeth or tsk-tsk’ing about how awful it is that monetary policy has achieved such behavioral dominance over markets, but a recognition that it IS, that there are investment opportunities created by its existence, and that the greatest danger is to continue on as if nothing has changed.

I believe that there are two important investment implications that stem from this sea change in the Narrative around Emerging Markets, which I’ll introduce today and develop at length in subsequent notes.

First, I think it’s necessary for active investors to recalibrate their analysis towards individual securities that happen to be found in Emerging Markets, not aggregations of securities with an “Emerging Markets” label. I say this because in the aggregate, Emerging Market securities (ETF’s, broad-based funds, etc.) are now the equivalent of a growth stock with a broken story, and that’s a very difficult row to hoe. Take note, though, the language you will have to speak in this analytic recalibration of Emerging Market securities is Value, not Growth, and the critical attribute of a successful investment will have little to do with the security’s inherent qualities (particularly growth qualities) but a great deal to do with whether a critical mass of Value-speaking investors take an interest in the security.

Second, there’s a Big Trade here related to the predictable behaviors and preference functions of the giant institutional investors or advisors that — by size and by strategy — are locked into a perception of Emerging Market meaning that can only be expressed through aggregations of securities or related fungible asset classes (foreign exchange and commodities). These mega-allocators do not “see” Emerging Markets as an opportunity set of individual securities, but as an asset class with useful diversification qualities within an overall portfolio. So long as market behaviors around Emerging Markets in the aggregate are driven by the Barzini/Bernanke Narrative, that diversification quality will decline, as the same Fed-speak engine is driving behaviors in both Emerging Markets and Developed Markets. Mega-allocators care more about diversification and correlations than they do about price, which means that the selling pressure will continue/increase so long as the old models aren’t working and the Barzini/Bernanke Narrative diminishes what made Emerging Markets as an asset class useful to these institutions in the first place. But when that selling pressure dissipates — either because the Barzini/Bernanke Narrative wanes or the mega-portfolios are balanced for the new correlation models that take the Barzini/Bernanke market effect into account — that’s when Emerging Market securities in the aggregate will work again. You will never identify that turning point in Emerging Market security prices by staring at a price chart. To use a poker analogy you must play the player — in this case the mega-allocators who care a lot about correlation and little about price — not the cards in order to know when to place a big bet.

In future weeks I’ll be expanding on each of these investment themes, as well as taking them into the realm of foreign exchange and commodities. Also, there’s a lot still to be said about Fed communication policy and the Frankenstein’s Monster it has become. I hope you will join me for the journey, and if you’d like to be on the direct distribution list for these free weekly notes please sign up at Follow Epsilon Theory.


    



via Zero Hedge http://ift.tt/MhJ9pJ Tyler Durden

Jeff Sessions: Marijuana Can't Be Safer Than Alcohol Because 'Lady Gaga Says She's Addicted to It'

Sen. Jeff Sessions (R-Ala.)
looks back proudly at his efforts, alongside Nancy Reagan, to
“create a hostility to drug use” in the 1980s. Not surprisingly,
Sessions was not pleased by President Obama’s
recent comments
about the relative hazards of marijuana and
alcohol, as he explained to Attorney General Eric Holder during a
Senate Judiciary Committee
hearing
today:

I have to tell you, I’m heartbroken to see what the president
said just a few days ago. It’s stunning to me. I find it beyond
comprehension….This is just difficult for me to conceive how the
president of the United States could make such a statement as
that….Did the president conduct any medical or scientific survey
before he waltzed into The New Yorker and opined contrary
to the positions of attorneys general and presidents universally
prior to that? 

Sessions, by contrast, clearly did his homework. He rebutted
Obama’s observation that marijuana is safer than alcohol by citing
a renowned expert on substance abuse:

Lady Gaga says she’s addicted to it and it is not
harmless.

I have been covering drug policy for about 25 years, and I am
still sometimes startled by
what passes for an argument
among prohibitionists. What should
we conclude from this sample of one about the hazards posed by
marijuana? That it can be taken to excess, like every other fun
thing on the face of the planet? That some people say they have
trouble consuming it in moderation? Didn’t we know both of those
things before Dr. Gaga’s earthshaking
discovery
?

More to the point, what does the possibility of addiction tell
us about the truth of the statement Obama made—i.e., that marijuana
is less dangerous than alcohol? After all, “less dangerous” does
not mean “harmless.” As Holder observed, “any drug used in an
inappropriate way can be harmful,” and “alcohol is among those
drugs.” To evaluate relative hazards, we have to dig a little
deeper.

According to one widely cited
study
, based on data from the National Comorbidity Survey,
“dependence” is nearly 70 percent more common among drinkers than
it is among pot smokers. So even by this measure, marijuana looks
less dangerous. That’s without considering differences in acute
toxicity, driving impairment, and the long-term effects of heavy
consumption, all of which
weigh strongly
in marijuana’s favor.

Gaga was not the only authority cited by Sessions. He also
mentioned former Rhode Island congressman Patrick Kennedy, chairman
of the anti-pot group Project SAM, who according to the senator
“says the president is wrong on this subject.” Yet here is what
Kennedy
said
during a recent debate on CNN with my colleague Nick
Gillespie:

I agree with the president. Alcohol is more dangerous.

Sessions was on firmer ground when he pressed Holder to admit
that “if marijuana is legalized for adults, it makes it more
available for young people.” As I’ve
said
before, it is likely that legalization in Colorado and
Washington will be accompanied by an increase in underage
consumption. While the newly legal marijuana stores are not allowed
to serve anyone younger than 21, there will be a certain amount of
leakage from adults to “minors” (who in this case include a bunch
of people who in most other respects are considered adults), as
there is with alcohol. Buying marijuana may
become more difficult for people younger than 21 (assuming the
black market eventually withers away), but that does not mean
obtaining marijuana will be more difficult. Some
teenagers and young adults will get pot by swiping it from parents
or older siblings, and some legal buyers will have no qualms about
sharing with older teenagers or 20-year-olds (although that will
remain illegal). Given this reality, Holder’s response to Sessions’
concern about underage access is a bit troubling:

One of our eight priorities is the prevention of distribution of
marijuana to minors. If there’s an indication that marijuana is
being distributed to minors, that would require federal
involvement….

Young people find ways to get alcohol because adults can have
access to it. I’m not sure that we’ll see the same thing here given
what we have said with regard to our enforcement priorities.

Holder is referring to the eight issues the Justice Department

expects
Colorado and Washington to address as the price of
federal forbearance, one of which is “preventing the distribution
of marijuana to minors.” If that means stopping state-licensed
stores from selling marijuana to people younger than 21, it can be
accomplished through strict enforcement of the states’ age limits.
But if it means preventing 21-year-olds from sharing marijuana with
their 19-year-old friends or brothers, it is not a realistic
expecation. It is more like an excuse to crack down whenever
the president gets tired of sniping by diehard drug warriors like
Sessions.

[Thanks to Richard Cowan for the tip.]

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Jeff Sessions: Marijuana Can’t Be Safer Than Alcohol Because ‘Lady Gaga Says She’s Addicted to It’

Sen. Jeff Sessions (R-Ala.)
looks back proudly at his efforts, alongside Nancy Reagan, to
“create a hostility to drug use” in the 1980s. Not surprisingly,
Sessions was not pleased by President Obama’s
recent comments
about the relative hazards of marijuana and
alcohol, as he explained to Attorney General Eric Holder during a
Senate Judiciary Committee
hearing
today:

I have to tell you, I’m heartbroken to see what the president
said just a few days ago. It’s stunning to me. I find it beyond
comprehension….This is just difficult for me to conceive how the
president of the United States could make such a statement as
that….Did the president conduct any medical or scientific survey
before he waltzed into The New Yorker and opined contrary
to the positions of attorneys general and presidents universally
prior to that? 

Sessions, by contrast, clearly did his homework. He rebutted
Obama’s observation that marijuana is safer than alcohol by citing
a renowned expert on substance abuse:

Lady Gaga says she’s addicted to it and it is not
harmless.

I have been covering drug policy for about 25 years, and I am
still sometimes startled by
what passes for an argument
among prohibitionists. What should
we conclude from this sample of one about the hazards posed by
marijuana? That it can be taken to excess, like every other fun
thing on the face of the planet? That some people say they have
trouble consuming it in moderation? Didn’t we know both of those
things before Dr. Gaga’s earthshaking
discovery
?

More to the point, what does the possibility of addiction tell
us about the truth of the statement Obama made—i.e., that marijuana
is less dangerous than alcohol? After all, “less dangerous” does
not mean “harmless.” As Holder observed, “any drug used in an
inappropriate way can be harmful,” and “alcohol is among those
drugs.” To evaluate relative hazards, we have to dig a little
deeper.

According to one widely cited
study
, based on data from the National Comorbidity Survey,
“dependence” is nearly 70 percent more common among drinkers than
it is among pot smokers. So even by this measure, marijuana looks
less dangerous. That’s without considering differences in acute
toxicity, driving impairment, and the long-term effects of heavy
consumption, all of which
weigh strongly
in marijuana’s favor.

Gaga was not the only authority cited by Sessions. He also
mentioned former Rhode Island congressman Patrick Kennedy, chairman
of the anti-pot group Project SAM, who according to the senator
“says the president is wrong on this subject.” Yet here is what
Kennedy
said
during a recent debate on CNN with my colleague Nick
Gillespie:

I agree with the president. Alcohol is more dangerous.

Sessions was on firmer ground when he pressed Holder to admit
that “if marijuana is legalized for adults, it makes it more
available for young people.” As I’ve
said
before, it is likely that legalization in Colorado and
Washington will be accompanied by an increase in underage
consumption. While the newly legal marijuana stores are not allowed
to serve anyone younger than 21, there will be a certain amount of
leakage from adults to “minors” (who in this case include a bunch
of people who in most other respects are considered adults), as
there is with alcohol. Buying marijuana may
become more difficult for people younger than 21 (assuming the
black market eventually withers away), but that does not mean
obtaining marijuana will be more difficult. Some
teenagers and young adults will get pot by swiping it from parents
or older siblings, and some legal buyers will have no qualms about
sharing with older teenagers or 20-year-olds (although that will
remain illegal). Given this reality, Holder’s response to Sessions’
concern about underage access is a bit troubling:

One of our eight priorities is the prevention of distribution of
marijuana to minors. If there’s an indication that marijuana is
being distributed to minors, that would require federal
involvement….

Young people find ways to get alcohol because adults can have
access to it. I’m not sure that we’ll see the same thing here given
what we have said with regard to our enforcement priorities.

Holder is referring to the eight issues the Justice Department

expects
Colorado and Washington to address as the price of
federal forbearance, one of which is “preventing the distribution
of marijuana to minors.” If that means stopping state-licensed
stores from selling marijuana to people younger than 21, it can be
accomplished through strict enforcement of the states’ age limits.
But if it means preventing 21-year-olds from sharing marijuana with
their 19-year-old friends or brothers, it is not a realistic
expecation. It is more like an excuse to crack down whenever
the president gets tired of sniping by diehard drug warriors like
Sessions.

[Thanks to Richard Cowan for the tip.]

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Edward Snowden Nominated For Nobel Peace Prize

Just five years after President Obama was awarded the Nobel Peace prize (to much global amazement), Norwegian politicians have nominated none other than Edward Snowden for this year’s award for contributing to transparency and global stability by exposing a U.S. surveillance program. As Reuters reports, Snowden’s “actions have in effect led to the reintroduction of trust and transparency as a leading principle in global security policies.”  


 

Via Reuters,

The public debate and changes in policy that have followed in the wake of Snowden’s whistleblowing have contributed to a more stable and peaceful world order,” Norwegian parliamentarians Snorre Valen and Baard Vegar Solhjell said in the nomination letter obtained by Bloomberg.

 

 

There’s no doubt that the actions of Edward Snowden may have damaged the security interests of several nations in the short term,” said Valen and Solhjell, who was environment minister in the former Labor-led government. Snowden’s “actions have in effect led to the reintroduction of trust and transparency as a leading principle in global security policies.”

 

 

Valen and Solhjell, who represent the Socialist Left Party in the Norwegian parliament, also said that they “don’t necessarily condone or support all of his disclosures.”

 

The Nobel Committee accepts nominations from members of national assemblies, governments, international courts, professors and previous laureates. It received a record 259 nominations for last year’s prize. While the nominees are kept secret for 50 years, names are sometimes disclosed by the nominators. The prize winner will be announced in October.

 

Is this the Nobel’s last best effort to regain some credibility?


    



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RBS £8 Billion Loss Shows Risk In UK Banking System

Today’s AM fix was USD 1,254.75, EUR 917.89 and GBP 756.42 per ounce.
Yesterday’s AM fix was USD 1,253.50, EUR 919.12 and GBP 757.04 per ounce.

Gold fell $1.00 or 0.08% yesterday to $1,254.10/oz. Silver slipped $0.05 or 0.25% to $19.58/oz.

Find out why Singapore is now one of the safest places in the world to store gold in our latest gold guide –The Essential Guide To Storing Gold In Singapore

Traders eagerly await news from the Fed’s policy announcement on Wednesday. The recent tapering of the central bank’s bond-buying program by $10 billion to $75 billion a month is already largely priced into the market.

Most physical buyers will ignore the noise and focus on the fact that the Fed’s monetary policies, along with most central banks in the world, remain extraordinarily accommodative even after the recent $10 billion taper. They are likely to continue accumulating until they see an actual, real tightening in monetary policies and an actual end to quantitative easing.

Royal Bank of Scotland (RBS) is heading for an £8 billion loss for 2013, rewarding senior executives massive bonuses despite losses, having to lay aside nearly $5 billion to cover potential litigation claims related to mortgage-backed securities and other high risk products sold before the financial crisis, gouging some of their business clients and now allegations of currency price fixing.

RBS is to stop providing dozens of currency benchmarks, as regulatory rate rigging probes raise doubts about the integrity of daily price fixings in the global foreign exchange and gold markets.

In a memo to clients, the bank said that it would limit its offering of foreign exchange benchmarks to a handful of price fixings, and that it would wind down its internal benchmark, called RBS Fix.

Nearly six years after the financial crisis and its massive bailout, it looks like business as usual by the bankers in RBS and in the City of London and Wall Street.

Find out why Singapore is now one of the safest places in the world to store gold in our latest gold guide –The Essential Guide To Storing Gold In Singapore


    



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Nothing Lasts Forever; World Bank Ex-Chief Economist Calls For End To Dollar As Reserve Currency

In the past we have discussed at length the inevitable demise of the USD as the world's reserve currency noting that nothing lasts forever. However, when former World Bank chief economist Justin Yifu Lin warns that "the dominance of the greenback is the root cause of global financial and economic crises," we suspect the world will begin to listen (especially the Chinese. Lin, now – notably – an adviser to the Chinese government, concludes that internationalizing the Chinese currency is not the answer (preferring a basket approach) but ominously concludes, "the solution to this is to replace the national currency with a global currency," as it will create more stable global financial system.

 

The infamous chart that shows nothing lasts forever…

Nothing lasts forever… (especially in light of China's earlier comments [21])

 

Via China Daily,

The World Bank's former chief economist wants to replace the US dollar with a single global super-currency, saying it will create a more stable global financial system.

"The dominance of the greenback is the root cause of global financial and economic crises," Justin Yifu Lin told Bruegel, a Brussels-based policy-research think tank. "The solution to this is to replace the national currency with a global currency."

 

Lin, now a professor at Peking University and a leading adviser to the Chinese government, said expanding the basket of major reserve currencies — the dollar, the euro, the Japanese yen and pound sterling — will not address the consequences of a financial crisis. Internationalizing the Chinese currency is not the answer, either, he said.

 

 

"China can only play a supporting role in realizing the plans," Lin said. "The urgent thing is for the US and Europe to endorse these plans. And I think the G20 is an ideal platform to discuss the ideas," he said, referring to the group of finance ministers and central bank governors from 20 major economies.

 

The concept of a global "super currency" tied to a basket of currencies has been periodically discussed by world leaders as well as endorsed by 2001 Nobel Memorial Prize-winner Joseph Stiglitz. A super currency could also be tied to a single currency, but the interconnectedness of world financial markets and concerns about the volatility that can occur as a result of the system being tied to one currency have made this idea less popular.

 

Arguments in favor of a global currency resurfaced during October's US budget impasse, which forced the government to shut down (as we noted here).

"It is perhaps a good time for the befuddled world to start considering building a de-Americanized world," a Xinhua News Agency commentary said on Oct 14. The piece argued that creating a new international reserve currency to replace reliance on the greenback, would prevent government gridlock in Washington from affecting the rest of the world.

 

In March 2009, China's central bank governor, Zhou Xiaochuan, called for the creation of a new "super-sovereign reserve currency" to replace the dollar. In a paper published on the People's Bank of China's website, Zhou said an international reserve currency "disconnected from individual nations" and "able to remain stable in the long run" would benefit the global financial system more than current reliance on the dollar.

Of course, as we are seeing now, it's not just the Chinese that are concerned…

On that note, David Bloom, global head of FX research at HSBC, said US monetary policy change "will bring fluctuations for emerging countries' currencies and lead to financial instability".

 

Chen Wenling, chief economist at the China Center for International Economic Exchanges, a government think-tank, said, "A supranational currency may be a new direction for development of the global financial system. It also requires different countries to cooperate in coordinating macroeconomic policies."

 

Bloom and Chen both said China needs to play a more important role in global financial governance. But Bloom said it is difficult for international financial organizations to reach a consistent conclusion on how to improve the foreign exchange system.

 

He said the renminbi is predicted to be stronger this year, even against an appreciating US dollar, and internationalization of China's currency will accelerate when the government decides to further open the capital market.

Of course implementation will be painful…

Pierre Defraigne, executive director of the Madariaga College of Europe Foundation in Brussels, said of Lin's infrastructure proposal, "It is excellent, but the problem is how to implement these plans to link those countries that need such infrastructural construction and those with enough foreign reserves, by using an effective global mechanism."

As we noted previously, the muddle-through is over and there is no painless solution left…

Michal Krol, a researcher at the Brussels-based European Center for International Political Economy, said …

 

"I don't think that the largest economies and their currencies are at this moment ready for the introduction of a supranational currency," Krol said. "Neither the EU nor China have financial markets and monetary systems yet that are sound, solid, predictable and well functioning to be the cornerstone for a global system. But, indeed, it is time to formulate the fundamentals for global monetary governance."
 


    



via Zero Hedge http://ift.tt/1bzeNoB Tyler Durden

Coweta schools closed on Thursday; Coweta EMA chief to drivers – 'stay off roadways'

The continued effects of the winter storm on roadways has led to Coweta County schools remaining closed on Thursday for students and staff, according to school system spokesman Dean Jackson.

Coweta County Emergency Management Agency Director Jay Jones on Wednesday morning said the 911 center through Tuesday and into Wednesday received 100-200 calls, with many of those being accident-related.

read more

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