At the risk of being over the top, things change when the only hospital within 30 miles of the home of a hypothetical state Rep. Bond has closed, and leadership responds with, "No, Mr. Bond, I expect your children to die!" Based on geography, such closures are more likely to occur where the state capital is west of about 100° longitude, where by my informal (and sloppy) tracking the red/redish states are moving towards adoption in some form. Much more so than in the Midwest and South.
It may take a few more years, but I expect all states will eventually accept the Medicaid expansion -- their hospitals, particularly their rural hospitals, will demand it. The ACA changed the way funds are supposed to flow to hospitals with relatively more indigent patients, with more of the money coming through Medicaid rather than as direct payments to the hospitals. IIRC this change is being challenged in the courts, but it seems unlikely to me that the SCOTUS will rewrite any more of the law at this point in time.
The cynic in me says that CJ Roberts had this in mind specifically when he tossed conservatives the bone of "voluntary" Medicaid expansion.
One of the interesting things about Idaho is that the Republican governor's staff analysis said that the Medicaid expansion would be cheaper than the state's current state- and county-funded indigent care programs. My interpretation of the legislature's reason for not doing the expansion -- and reasonable people can disagree with this -- is "At the national level, our party may screw the states."
If you really follow regular order and allow bills that pass out of committee of record to reach the floor, you lose the ability to enforce the Hastart Rule unless all your committee chairs are willing to follow orders all the time and block votes there. Two-three years ago, a Senate immigration bill passed out of the House committee with a number of Republican votes and would almost certainly have passed on the House floor (Democrats plus the same moderate Republicans represented on the committee). Instead, it was bottled up in the Rules Committee until the end of the session.
The Speaker can also avoid the embarrassment of looking weak. IIRC, some of the budget bills passed out of Rep. Ryan's committee were left to die in the Rules Committee after a number of more moderate Republicans came back from a recess and told the Speaker that they would lose their seats if they passed a budget that included the severe social services cuts included in the bill, so would be voting against them. There was nothing "nutty" about those cuts -- they were just at the level that had been called for in the House budget resolution. It's easy to vote for social welfare cuts in the abstract, but rather more difficult when you have to vote for specific real cuts.
The Windows version of Excel is the standard computing platform across a disturbingly wide range of disciplines. VBA is sometimes part of the Mac version, sometimes not. As the source trees for those two versions are distinct, it is unclear whether the two VBAs are bug-for-bug consistent. None of the other spreadsheets, including the Mac version of Excel, have the equivalent of Solver, a nonlinear generalized reduced gradient (GRG) optimization tool. GRG solvers have their own set of strengths and weaknesses. When I was in graduate school the first time I worked on the code that eventually became solver (although I didn't find that out for some years). I ran some of the old test cases through Solver, and it failed in the same ways that the code I worked on occasionally failed.
While not particularly relevant to the circumstances he will face as Speaker, it does seem worth mentioning that his chairmanships of two very powerful committees -- Budget and then Ways & Means -- have resulted in a lot of posturing but very little tangible. If that's part of Part 2, feel free to delete this.
I say "cell phones" but really mean "ongoing evolution of smart phones", which is me being less than clear. The LTE networks that are the future are pure IP and require hybrid fiber-wireless networks to function well. Despite claims by the hardware companies, you can only push the wireless part so far and get acceptable service. East of about 100° W and along the Pacific Coast the rural areas are dense enough to justify fiber if you plan well. The western Great Plains and Mountain West are largely unprofitable to serve at high bit rates outside of the few metro areas.
Sprint's 4G LTE map is interesting. There are sizable dead spots within walking distance of my house, even though we're a reasonably dense suburb.
These days, I argue internet access more than anything.
A bit over fifteen years ago, the State of Colorado paid (indirectly, through some odd accounting) to have one of the big telcos run fiber to every county seat. Absent that subsidy, half of those towns would never have gotten fiber links to an internet backbone -- there simply isn't enough revenue potential for a private company to justify plowing in 50 or more miles of fiber. With the fiber in place, though, Damon's (1), (3), and (4) subsidies that apply to the local aspects of service become useful. Eg, useful telemedicine requires end-to-end broadband. As it turned out, such links were also necessary to implement the statewide voter registration system required by HAVA.
In that same free market, many rural people wouldn't be able to get cell-phone or internet-access service. The "fees" that Verizon collects almost all go to fund various government subsidy programs with roots going back to the 1930s.
I am a net neutrality advocate, and was 20 years ago when I was involved in the business.
That said, I also understand Comcast's (and the other cable companies') position that they invested tens of billions of dollars in their distribution networks under a set of rules that said they could generate revenue from it pretty much any way they wanted, and are unhappy that one of the potential revenue streams is being taken away from them.
Back in the early days of the web comic Girl Genius, one of the characters set a pistol down on the mantle. Months later (in readers' time), the action returned to that room and a different character picked up the pistol and used it. This in a comic where it would be perfectly normal for any number of the characters to assemble an exotic weapon out of the odd parts laying about...
The Chekhov's Gun principle says that if you make a point of there being a gun on the fireplace mantle in Act 1, then you darned well better make sure the gun gets used in Act 2. I'm asking about the opposite. Is there a name for the principle -- or even a principle -- that says if a gun gets used in Act 2, you've taken pains to establish that gun in Act 1.
Eg, when I dabble in fiction, and the sorcerer needs a particular artifact in Act 2, I take pains to place the artifact in a reasonable place in Act 1. No Agatha Christie bits, with a long-lost cousin that gets introduced in the next-to-last chapter being behind the whole thing.
Spielberg is generally pretty good about Chekhov's Gun: if he gives you something as obvious as the somewhat odd way the Nazi bad guy grabs the medallion, he's going to use it.
We have theater people here; is there a formal name for that kind of thing from the opposite direction? Eg, if there's a gun on the fireplace mantel at a critical point, taking pains to put it there earlier?
Most of the developed world practices one or the other or both. Small ISPs that are limited to dial-up and DSL complain bitterly to whoever will listen how much they are disadvantaged by not having access to the cable companies' last mile. Telcos complain about the playing field being unequal. And the cable companies themselves are not shy about saying what a disaster unbundling in any form would be for them. Google put further fiber expansion on hold until the Commission announced there would be no unbundling.
I suspect the sector security analysts thought what I did -- if the FCC is willing to open the huge can of worms that will eventually have to be dealt with by putting internet access service under Title II, there's a possibility the Commission will consider any number of things.
Stock prices went up on the Commission's announcement that there would be no price regulation, and no last-mile unbundling. When I worked as a technologist for some big cable companies, the latter was a potential break-the-business concern.
One of the interesting things about being on the staff for the state legislature's budget committee -- for certain "take me out back of the building and beat me with a baseball bat because it will be less painful" values of interesting -- was figuring out what was excess revenue that had to be refunded and the proper form of the refund.
One summer I had to read a bunch of the state supreme court decisions in cases where counties had sued the state over this or that. I'm fairly sure that the court said the no-respect thing explicitly in at least one of them.
The neighbor raised them. It was a bad winter and everyone's livestock was wandering in search of better forage. The Texan hired hunters who killed 32 buffalo, mostly pregnant cows, some of them on US Forest Service and BLM land. The carcasses were left to rot. Even if they had all been on the Texan's land, under Colorado law -- dating back to the 1880s -- you can't kill loose livestock.
Part of the problem was that the Texan got bad legal advice. He was an Austin IT millionaire, and used a Denver attorney who specialized in securities litigation and arbitration. Probably not the lawyer I would have chosen to consult on open-range statutes and case law.
I sympathize. Earlier this year I spent $800 or so that I had saved up on a specialist. I have low bone density, and every GP on Earth thinks they're the one who can figure out why. All of the evidence across 15+ years is that it's just the way I am, it's not progressive, and absent some other change in my health, not something that anyone should worry about. The world-class research specialist and the tests he wanted resulted in a letter that said "It's just the way he is, it's not progressive, it's not anything to worry about."
Since I have to go through at least one more change in health insurance in the next few years -- I'll reach Medicare age -- which may mean a change in care provider, I wanted something I could hold up and say, "No. No more exotic blood tests. No more upper or lower GI examinations. No more pressure to try bizarre drug combinations. Smarter people than you say that those are a waste of time and money."
I was pleased to see that Poul Anderson's The Broken Sword made that list, but disappointed that his Three Hearts and Three Lions didn't. Three Hearts was the first adult fantasy that I ever read, and hooked me.
This is one of the reasons that I am outraged by how medical records are handled. Even with the ACA's push to electronic records, the intent is to facilitate transfer from one practice to another. No provider is as interested as I am in maintaining my history of test results and treatments. But getting such is difficult and/or expensive.
What the hospital initially bills you has as much relation to what you actually pay as the sticker price on a car has to how much money the dealer actually gets.
Only more so. My friend who works in a hospital business office says that the proper procedure, if you can manage it, is to take the bill to the hospital and speak to the office manager (not anyone lower). Offer to pay one third the amount on the bill in cash or equivalent. She says in almost all cases, the hospital will take the cash and stamp the bill "Paid in Full". She says that what they want is not the amount on the bill, but rather what a bill collector will pay them for the debt.
It's been a while since I had my eyes measured for my reading glasses. I do recall that before I was out of the exam chair the optometrist was handing me the prescription form with the information. As I read the regulation, that would be the end of his obligation under this part of the code. Technically, it would appear that if I lost the prescription, I'd be out of luck.
My recollection of the fine print at the big chain glasses places is that the optometrists are individuals in private practice, renting the office space and test gear from the chain. I assume that if they get a better gig a couple of months down the road, they just "disappear" without any forwarding address. My wife's eyes are both worse and more volatile than mine; she sees an optometrist with an established practice so that she has a longer-term relationship.
*Comment archive for non-registered commenters assembled by email address as provided.
On “Paul Ryan & The Blood of the Tiger”
At the risk of being over the top, things change when the only hospital within 30 miles of the home of a hypothetical state Rep. Bond has closed, and leadership responds with, "No, Mr. Bond, I expect your children to die!" Based on geography, such closures are more likely to occur where the state capital is west of about 100° longitude, where by my informal (and sloppy) tracking the red/redish states are moving towards adoption in some form. Much more so than in the Midwest and South.
"
It may take a few more years, but I expect all states will eventually accept the Medicaid expansion -- their hospitals, particularly their rural hospitals, will demand it. The ACA changed the way funds are supposed to flow to hospitals with relatively more indigent patients, with more of the money coming through Medicaid rather than as direct payments to the hospitals. IIRC this change is being challenged in the courts, but it seems unlikely to me that the SCOTUS will rewrite any more of the law at this point in time.
The cynic in me says that CJ Roberts had this in mind specifically when he tossed conservatives the bone of "voluntary" Medicaid expansion.
"
One of the interesting things about Idaho is that the Republican governor's staff analysis said that the Medicaid expansion would be cheaper than the state's current state- and county-funded indigent care programs. My interpretation of the legislature's reason for not doing the expansion -- and reasonable people can disagree with this -- is "At the national level, our party may screw the states."
"
If you really follow regular order and allow bills that pass out of committee of record to reach the floor, you lose the ability to enforce the Hastart Rule unless all your committee chairs are willing to follow orders all the time and block votes there. Two-three years ago, a Senate immigration bill passed out of the House committee with a number of Republican votes and would almost certainly have passed on the House floor (Democrats plus the same moderate Republicans represented on the committee). Instead, it was bottled up in the Rules Committee until the end of the session.
The Speaker can also avoid the embarrassment of looking weak. IIRC, some of the budget bills passed out of Rep. Ryan's committee were left to die in the Rules Committee after a number of more moderate Republicans came back from a recess and told the Speaker that they would lose their seats if they passed a budget that included the severe social services cuts included in the bill, so would be voting against them. There was nothing "nutty" about those cuts -- they were just at the level that had been called for in the House budget resolution. It's easy to vote for social welfare cuts in the abstract, but rather more difficult when you have to vote for specific real cuts.
On “Why Alphabet?”
The Windows version of Excel is the standard computing platform across a disturbingly wide range of disciplines. VBA is sometimes part of the Mac version, sometimes not. As the source trees for those two versions are distinct, it is unclear whether the two VBAs are bug-for-bug consistent. None of the other spreadsheets, including the Mac version of Excel, have the equivalent of Solver, a nonlinear generalized reduced gradient (GRG) optimization tool. GRG solvers have their own set of strengths and weaknesses. When I was in graduate school the first time I worked on the code that eventually became solver (although I didn't find that out for some years). I ran some of the old test cases through Solver, and it failed in the same ways that the code I worked on occasionally failed.
On “Election Time in the Rockies”
No regulars from Ohio? They're deciding on recreational marijuana this year...
On “John Boehner & The Rock of Sisyphus”
While not particularly relevant to the circumstances he will face as Speaker, it does seem worth mentioning that his chairmanships of two very powerful committees -- Budget and then Ways & Means -- have resulted in a lot of posturing but very little tangible. If that's part of Part 2, feel free to delete this.
On “There but for some humility go neo-liberals”
I say "cell phones" but really mean "ongoing evolution of smart phones", which is me being less than clear. The LTE networks that are the future are pure IP and require hybrid fiber-wireless networks to function well. Despite claims by the hardware companies, you can only push the wireless part so far and get acceptable service. East of about 100° W and along the Pacific Coast the rural areas are dense enough to justify fiber if you plan well. The western Great Plains and Mountain West are largely unprofitable to serve at high bit rates outside of the few metro areas.
Sprint's 4G LTE map is interesting. There are sizable dead spots within walking distance of my house, even though we're a reasonably dense suburb.
"
These days, I argue internet access more than anything.
A bit over fifteen years ago, the State of Colorado paid (indirectly, through some odd accounting) to have one of the big telcos run fiber to every county seat. Absent that subsidy, half of those towns would never have gotten fiber links to an internet backbone -- there simply isn't enough revenue potential for a private company to justify plowing in 50 or more miles of fiber. With the fiber in place, though, Damon's (1), (3), and (4) subsidies that apply to the local aspects of service become useful. Eg, useful telemedicine requires end-to-end broadband. As it turned out, such links were also necessary to implement the statewide voter registration system required by HAVA.
"
In that same free market, many rural people wouldn't be able to get cell-phone or internet-access service. The "fees" that Verizon collects almost all go to fund various government subsidy programs with roots going back to the 1930s.
"
I am a net neutrality advocate, and was 20 years ago when I was involved in the business.
That said, I also understand Comcast's (and the other cable companies') position that they invested tens of billions of dollars in their distribution networks under a set of rules that said they could generate revenue from it pretty much any way they wanted, and are unhappy that one of the potential revenue streams is being taken away from them.
On “In Which I Am Impossibly Dense: Hellraiser Edition”
Back in the early days of the web comic Girl Genius, one of the characters set a pistol down on the mantle. Months later (in readers' time), the action returned to that room and a different character picked up the pistol and used it. This in a comic where it would be perfectly normal for any number of the characters to assemble an exotic weapon out of the odd parts laying about...
"
The Chekhov's Gun principle says that if you make a point of there being a gun on the fireplace mantle in Act 1, then you darned well better make sure the gun gets used in Act 2. I'm asking about the opposite. Is there a name for the principle -- or even a principle -- that says if a gun gets used in Act 2, you've taken pains to establish that gun in Act 1.
Eg, when I dabble in fiction, and the sorcerer needs a particular artifact in Act 2, I take pains to place the artifact in a reasonable place in Act 1. No Agatha Christie bits, with a long-lost cousin that gets introduced in the next-to-last chapter being behind the whole thing.
"
Spielberg is generally pretty good about Chekhov's Gun: if he gives you something as obvious as the somewhat odd way the Nazi bad guy grabs the medallion, he's going to use it.
We have theater people here; is there a formal name for that kind of thing from the opposite direction? Eg, if there's a gun on the fireplace mantel at a critical point, taking pains to put it there earlier?
On “There but for some humility go neo-liberals”
Most of the developed world practices one or the other or both. Small ISPs that are limited to dial-up and DSL complain bitterly to whoever will listen how much they are disadvantaged by not having access to the cable companies' last mile. Telcos complain about the playing field being unequal. And the cable companies themselves are not shy about saying what a disaster unbundling in any form would be for them. Google put further fiber expansion on hold until the Commission announced there would be no unbundling.
I suspect the sector security analysts thought what I did -- if the FCC is willing to open the huge can of worms that will eventually have to be dealt with by putting internet access service under Title II, there's a possibility the Commission will consider any number of things.
"
Stock prices went up on the Commission's announcement that there would be no price regulation, and no last-mile unbundling. When I worked as a technologist for some big cable companies, the latter was a potential break-the-business concern.
On “Election Time in the Rockies”
One of the interesting things about being on the staff for the state legislature's budget committee -- for certain "take me out back of the building and beat me with a baseball bat because it will be less painful" values of interesting -- was figuring out what was excess revenue that had to be refunded and the proper form of the refund.
"
Colorado counties get no respect.
One summer I had to read a bunch of the state supreme court decisions in cases where counties had sued the state over this or that. I'm fairly sure that the court said the no-respect thing explicitly in at least one of them.
"
Wasn't there also a large-scale purge at some point over a copyright infringement notice?
"
The neighbor raised them. It was a bad winter and everyone's livestock was wandering in search of better forage. The Texan hired hunters who killed 32 buffalo, mostly pregnant cows, some of them on US Forest Service and BLM land. The carcasses were left to rot. Even if they had all been on the Texan's land, under Colorado law -- dating back to the 1880s -- you can't kill loose livestock.
Part of the problem was that the Texan got bad legal advice. He was an Austin IT millionaire, and used a Denver attorney who specialized in securities litigation and arbitration. Probably not the lawyer I would have chosen to consult on open-range statutes and case law.
On “Chuck Schumer Eyes Glasses”
I sympathize. Earlier this year I spent $800 or so that I had saved up on a specialist. I have low bone density, and every GP on Earth thinks they're the one who can figure out why. All of the evidence across 15+ years is that it's just the way I am, it's not progressive, and absent some other change in my health, not something that anyone should worry about. The world-class research specialist and the tests he wanted resulted in a letter that said "It's just the way he is, it's not progressive, it's not anything to worry about."
Since I have to go through at least one more change in health insurance in the next few years -- I'll reach Medicare age -- which may mean a change in care provider, I wanted something I could hold up and say, "No. No more exotic blood tests. No more upper or lower GI examinations. No more pressure to try bizarre drug combinations. Smarter people than you say that those are a waste of time and money."
On “Sunday!”
I was pleased to see that Poul Anderson's The Broken Sword made that list, but disappointed that his Three Hearts and Three Lions didn't. Three Hearts was the first adult fantasy that I ever read, and hooked me.
On “Chuck Schumer Eyes Glasses”
This is one of the reasons that I am outraged by how medical records are handled. Even with the ACA's push to electronic records, the intent is to facilitate transfer from one practice to another. No provider is as interested as I am in maintaining my history of test results and treatments. But getting such is difficult and/or expensive.
"
What the hospital initially bills you has as much relation to what you actually pay as the sticker price on a car has to how much money the dealer actually gets.
Only more so. My friend who works in a hospital business office says that the proper procedure, if you can manage it, is to take the bill to the hospital and speak to the office manager (not anyone lower). Offer to pay one third the amount on the bill in cash or equivalent. She says in almost all cases, the hospital will take the cash and stamp the bill "Paid in Full". She says that what they want is not the amount on the bill, but rather what a bill collector will pay them for the debt.
"
It's been a while since I had my eyes measured for my reading glasses. I do recall that before I was out of the exam chair the optometrist was handing me the prescription form with the information. As I read the regulation, that would be the end of his obligation under this part of the code. Technically, it would appear that if I lost the prescription, I'd be out of luck.
My recollection of the fine print at the big chain glasses places is that the optometrists are individuals in private practice, renting the office space and test gear from the chain. I assume that if they get a better gig a couple of months down the road, they just "disappear" without any forwarding address. My wife's eyes are both worse and more volatile than mine; she sees an optometrist with an established practice so that she has a longer-term relationship.
*Comment archive for non-registered commenters assembled by email address as provided.