Sunday, April 7, 2013

Miscellaneous KL

Medicare reimbursement rates.

The Central Management Services office of the Federal government is supposed to set national rates for procedures and tests. Unfortunately, they have declined to do this for medical diagnostics used to "effectively customize treaatment" (molecular tests). These tests look at specific regions of DNA or protein sequences, typically in cancer cells. In some cases they do it by looking at each discrete step, but without looking at the value of the test. However, since the Central management services has not done what it should do, the "contractors" that cover each region of the country have the option of how much to pay each provider of diagnostic services. Some of them have not set rates and are not paying at all.

Of course, the other approach is to allocate a certain amount of money to molecular diagnostics or diagnostics in general. Each company then does the best job it can providing useful tests. They are reimbursed based upon how well their tests actually lead to better case. As judged by panels of sortition juries aided by the appropriate biomedical experts.

REferences

  1. http://www.forbes.com/sites/scottgottlieb/2013/03/27/medicare-has-stopped-paying-bills-for-medical-diagnostic-tests-patients-will-feel-the-effects/
  2. Jill Dombraukas, Ph.D. "What is Molecular Diagnostics?" ehow.com facts 5615341
  3. National Cancer Inststitute, Slide four, Molecular Diagnostics, http://www.cancer.gov/cancertopics/understandingcancer/moleculardiagnostics/page4

Medicare reimbursement

Medicare pays more for the same service when a doctor is an employee of the hospital than when they have their own practice. For example, it pays a hospital $400.00 for an echocardiogram as compared to $150.00 if the same thing is done by a private pysician. Predictably, physicians are selling their practices to hospitals and becoming employees.

"The High Price of Nickel-And-Diming Doctors, Bloomberg Business Week November 25 to December 2 2012, page 39 and 40.

Craft Brewers want a cut in excise taxA

They are lobbying to decrease the excise tax rate per gallon of bear and 116 members of a caucus introduced legislation to do just that. The badness tax I proposed in the first few weeks of this blog. would handle this problem and allow the taxpayers to give a discount to small brewers and other businesses that are truly investing in good things.

http://www.nytimes.com/2013/03/29/business/riding-wave-of-popularity-craft-brewers-ask-congress-for-a-tax-cut.html?pagewanted=all&_r=0

Referendum Voting Age

An Taiwan online survey showed that 90 percent favored lowering the referendum voting age from 20 to 18. Half of the respondents showed that the schools should discuss nuclear energy. However as the survey was conducted by the Taiwan Alliance for the Advancement of Youth Rights and Welfare--I wonder about the quality of the survey.

http://www.taipeitimes.com/News/taiwan/archives/2013/03/29/2003558278 Tapei Times, "Group Urges Lowering Referndum Voting Age" Hsieh Wen-hua and Jason Pan.

Participatory budgeting

Relates experiments with participatory budgeting in New York City to the United States.

"http://www.salon.com/2013/03/27/lets_decide_the_budget_ourselves_partner/Next New Deal" The Blog of the Roosevelt Institute.

The Cynic Kids

The new generation, those in College now, in response to the financial crisis and the problems after entering Iraq and Afghanistan:

"'don't like the system == however, they are wary of other alternatives as well as dismissive of their ability the desired modifications....Broadly speaking, Cynic Kids distrust the link between action and result.'

"the Occupy movement, 'launched more traffic jams than legislation'"

And the Arab Spring has not given the desired results.

Perhaps, noteworthy, that there is a desire for experimental and empirical evidence. We are unable to appraise multiple options, so we stick with the known evil. Perhaps, experiments with the online Constitution construction Kit and other techniques can give some empirical evidence that participatory democracy could work.

the New York Times

Paulson, an example of the Hedge function going crazy

John Paulson's Very Bad Year by Sheelah Kolhatkar,

John Paulson, no relation to Hank Paulson, former Secretary of the Treasury, earned four billion dollars as a hedge fund operator. Howe ha made his money:

  1. merger arbitrage, after a merger is announced, short the acquirer, buy the target company's share and pocket the difference whent he merger goes through. However, there is a big risk of large losses if the merger falls apart (e. g. because of regulatory snafu).
  2. But his real venture was, in 203 to 2007. Before the housing bust, shorting housing. He did this with the famous "credit default swaps" betting that the mortgage bunds would go bust.
  3. Buying debt of financial companies in 2008, in other words betting on the bailout.
  4. Goldman Sach marked a collaterized debt obligsgtion called Abacus. Mr. Paulson put these together as designed to decline and that he would make a profit if they did. Goldman Sach did not tell the purchasers of the bond fund that was what Paulson was doing.
But Paulson made some big plays in 2011 that screwed up:
  1. A Chinese forest company product stock where the company was accused of fraud
  2. buying bank stocks
  3. buying high-yield and distreswed bonds
  4. a gold mining stock called AngloGold Ashanti
Although Paulson's hedge fund lost 13.2 billion dollars, however, over its life time, gain was the third highest in history. And Mr. Paulson's net worth declined from sixteen billion to twelve billion.

To Be Blogged Later

Sebasian Mallaby More Money than God: Hedge Funds and the Making of a new Elite

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