Tag Archives: Affordable Care Act

Monday Assorted Links

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1. Students’ grades determine where they eat lunch at Florida schools. While trying to process this, I was overcome by a strong desire to excise the peninsula along the Alabama-Georgia borders. Let it drift away I say.

2. Olympic marathon champ Jemima Sumgong banned four years for EPO. This is so common place, why doesn’t the Olympic Organizing Committee wait four years and distribute the awards right before the next game’s Opening Ceremony. And while we’re at it, let’s all agree to wait ten years to give wedding gifts. Make sure the relationship sticks before springing for that state-of-the-art toaster oven.

3. How to Get Entirely Tax-Free Retirement Income. An excellent explanation of why Health Savings Accounts rock.

4. When Your Shitty Health Insurance Doubles in Price.

“Remember, health insurance is not really health insurance. It’s just “large medical bill insurance” – a shaky precaution against having to pay for expensive procedures, so you can keep your investments instead of using them to pay the bills, perhaps eventually becoming poor enough that you are covered by public health insurance (Medicaid). A better name for it might be wealth insurance.”

5. Here’s why you may want to stop judging your emotions.

“. . . research from the University of California, Berkeley found that the pressure to feel upbeat can make you feel downbeat, while embracing your darker moods can actually make you feel better in the long run.

“We found that people who habitually accept their negative emotions experience fewer negative emotions, which adds up to better psychological health,” said senior author Iris Mauss.

At this point, researchers can only speculate on why accepting your joyless emotions can defuse them, like dark clouds passing swiftly in front of the sun and out of sight.

“Maybe if you have an accepting attitude toward negative emotions, you’re not giving them as much attention,” Mauss said. “And perhaps, if you’re constantly judging your emotions, the negativity can pile up.”

What the Affordable Care Act Gets Wrong

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Poor form to be contrarian following a week liberals can’t stop celebrating, but count your blessings I’m done writing about golf. For now at least. I always reserve my right to tap my inner Alan Shipnuck.

Thursday night near the end of another spirited training ride. Soft spinning on North Street, two friends and I head for home. One is a well-to-do 59 year old who just retired. His very nice lake home is paid for and he and his wife just returned from another trip to Europe. Euro vacations aside, as his threadbare cycling gloves illustrate, he’s actually on the frugal side. He says he can afford the vacations because of the gloves. Decades of having made very good money no doubt help too.

“You’ll never guess what medical plan I’ve signed up for,” he says. “No clue,” I replied. “Medicaid!” “Wait, you’re 65?!” “No, I’m 59, that’s Medicare. I was surprised to learn I qualify for Medicaid because I have no income now.”

Quick google search. Medicaid is “a U.S. government program, financed by federal, state, and local funds, of hospitalization and medical insurance for persons of all ages within certain income limits.”

I was stunned. He told me a person can make about $20k/year and still qualify for Medicaid. He hardly has any capital gains because he hasn’t sold any assets for a long time. Apart from his international vacations, I’m guessing his expenses are minimal and he’s living off of savings that he previously set aside. I’m not sure how he’s sheltered his wife’s income.

Then he tells me the adult son of a mutual cycling friend is also getting “free” Medicaid despite the fact that he has a very large trust fund that must consist of tax-free municipal bonds.

Undoubtedly, if my friends are doing this, so are other high wealth/low income people. Especially those whose income stems largely from tax-free municipal bonds. Why isn’t anyone writing about this gigantic loophole and what we should do to close it?

More generally, why does the Affordable Care Act (ACA) use income as it’s sole reference point instead of some combination of income and wealth? The same can be asked about the IRS and college financial aid offices. When it comes to health care premiums, college financial aid, and taxes more generally, it’s far better to be wealthy than to have lots of income. Just ask Mitt Romney. My guess is, and I’d love a more tax savvy reader to enlighten us on this, IRS agents, ACA bureaucrats, and college financial aid officials are unable to determine people’s total wealth with any certainty.

Why not ballpark it though I wonder. If the government knew my friend owned his home outright, would it compromise his Second Amendment rights to privacy? How do we balance well-to-do people’s right to privacy with public policies that, through subsidies, take from those of modest wealth and give to those with considerably more?

Expanding Minimalism’s Reach

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If our government’s closed, why are politicians still appearing on my television? I guess once you get in the habit of working really hard for what’s in the best interest of the people, you just can’t stop.

On Fox News I learned the shutdown’s Obama’s fault. Their refrain is “the American people don’t wan’t ObamaCare.” Guess I don’t count. At times like this, all you can do is watch Saturday Night Live.

My vote for most interesting Affordable Care Act article of the recent past, “An Overlooked Obamacare Flaw: Too Many Choices“. The gist of it:

. .  .the typical family will be able to choose from 53 health plans, on average, with a few states, including Florida and Arizona, offering more than 100. “There’s no way people are going to be able to make optimal decisions, except by luck,” says Barry Schwartz, a psychology professor at Swarthmore University and author of The Paradox of Choice: Why More Is Less. “If you have 40 or 50 insurance possibilities, there will be less uptake and people will make bad decisions.”

The seminal study of excessive choice was a 2000 paper recounting an experiment at a California grocery store in which two tasting tables were set up side-by-side: one offering samples of six jams, the other offering samples of 24. The “extensive” selection of jams attracted more shoppers than the “limited” selection. But only 3% of the extensive samplers made a purchase after tasting. Of those who sampled from the limited selection, 30% made a purchase.

“An extensive array of options can at first seem highly appealing to consumers,” the researchers concluded, “yet can reduce their subsequent motivation to purchase the product.” Too much choice, they found, can be “demotivating” and leave shoppers confused.

The same dynamic applies to decisions in which a lot more is at stake than deciding what to spread on your toast. After the government passed the Medicare Part D prescription drug benefit in 2003, seniors suddenly could choose from dozens of plans that would help lower their prescription drug costs. But many found the offerings so confusing they didn’t sign up, while others mistakenly chose a plan that didn’t lower their costs nearly as much as it could have.

“Decision quality deteriorates as the number of plans increases,” one study reported.

Minimalists focus almost exclusively on decluttering tangible items that often overwhelm—clothes in closets, papers in file cabinets, everything in garages—while ignoring the less tangible, but equally cluttered areas of our lives.

We’re not just overwhelmed by our mindless consumerism and the trail of material possessions that results from it, we’re overwhelmed by a steady torrent of stimuli—whether it’s hundreds of insurance plans, emails, interpersonal interactions, television channels, or advertisements.

Advanced minimalism is the art of narrowing one’s focus and decluttering one’s mind by consciously setting limits. For example, I allow myself to read ten blogs at any given time. That means if you send me a link to your mind blowing blog, I’ll have to decide whether it deserves more of my limited attention than one of my current ten. In the same spirit, I recently deleted some television channels that were more popular with the birdies before they flew the coup.

Social science suggests that if consumers had ten insurance plans to choose among, they’d be much better off. Less is almost always more. This was, in large part, Steve Jobs’ genius—off-the-charts focus. Once he shrunk Apple’s product line, customers weren’t confused, sales caught fire, and the company quickly rebounded.

Another way to impose limits is to lean on others for help. Some of the most popular websites on-line help citizens and consumers narrow their choices to a more manageable level. For example, for bibliophiles, there’s FiveBooks. And for people who want to manage their time better and be more productive there’s Lifehacker. And for consumers overwhelmed by Amazon.com, there’s The Sweethome and The Wirecutter.

My aim is different than the people who write for Lifehacker. They want to help readers get more done. My question to them is, for what purposes? Set limits on stimuli that tend to overwhelm to think about larger life purposes. If we just let any and all email, media images, and the cacophony of modern life wash over us, we’ll live day-to-day without any sense of purpose.

Minimalism must be about more than cleaning out garages. Our goal should be to create silent spaces in our lives, and from them, purpose.