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August 22, 2010

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links for 2010-08-21

Posted: 21 Aug 2010 11:01 PM PDT

"As a Doc, I Don't Get How Vouchers are Supposed to Work"

Posted: 21 Aug 2010 10:58 AM PDT

From jrossi in comments on a post about the failure of vouchers to reduce medical costs.:

As a doc, I don't get how vouchers are supposed to work. Are the insurance companies supposed to be induced to play hardball with me and make me settle for less money? That ain't gonna happen because my waiting room is full to the brim with patients with private insurance, which pays more than Medicare in the first place. So if they try to play hardball, I will simply decline their offer politely but firmly. I see Medicare patients only out of the goodness of my heart. I don't see Medicaid patients because I guess my heart isn't that good.

There's a primary doctor shortage going on in most parts of the country. We have the payers by the balls.

The Perils of Prediction

Posted: 21 Aug 2010 09:28 AM PDT

Those of you who said there was no housing bubble, or that the effects would be "contained" if there was bubble and it did pop, may want to stay out of Italy:

Can Seismologists Be Charged with a Crime for Not Predicting Deadly Quakes?, Scientific American: ...Italian ... seismologists, volcanologists, physicists and engineers are being threatened with charges of manslaughter for failing to definitively predict an earthquake of magnitude 6.3 in the city of L'Aquila on April 6, 2009, which took more than 300 lives and injured an additional 1,600 area residents. The scientists find themselves in legal peril even though anything other than a loosely probabilistic assessment of earthquake risk is currently impossible...
The threatened researchers belong to the Major Risks Committee... Major risk number one: membership in the Major Risks Committee.
After a series of tremors in late March, the committee met, after which a government official informed the press that "the scientific community tells us there is no danger, because there is an ongoing discharge of energy," apparently referring to the aforementioned tremors. Unfortunately, that was like concluding, while taking down your house's Christmas lights, that each little slip down the sloped roof somehow protects you from sliding off completely. ... The official then prognosticated that "the situation looks favorable," a remark that perhaps reveals his previous experience with the Magic 8-Ball.
According to reporting in Scientific American's sister publication Nature, minutes of the meeting show that the researchers were in fact much more circumspect, saying things such as "a major earthquake in the area is unlikely but cannot be ruled out"...
Nearly 4,000 scientists from around the world have signed a letter to the president of Italy urging an end to the witch hunt. ... As one of the signatories, University of Oxford earth scientist Barry Parsons, says...: "Scientists are often asked the wrong question, which is 'when will the next earthquake hit?' The right question is 'how do we make sure it won't kill so many people when it hits?'" ...

The last point -- how do we make sure that the next financial crisis does less damage when it hits -- is one I wish policymakers would have taken to heart when constructing the reform bill. Though it was hard to identify a clear underlying principle guiding reform, I think too much effort went into trying to stop the next crisis relative to the effort spent trying to limit the damage that will be done when the next crisis hits, as it inevitably will. No matter what we do, we can't guarantee an end to crises forever, our ability to predict them may not improve much due to the nature of these crises (though we should try, it's not hopeless), but we can and should take steps to insulate ourselves from the damage.

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