I'm currently reading the book "Pinched: How the Great Recession has Narrowed Our Futures and What We Can Do About It". I'm hoping to give more details of this book as I go along, but one thing the author does that I found fascinating was to describe the short and long term effects of our previous significant recessions in hopes of gleaning lessons from those down terms and applying those to what we're finding today.
"Long, deep slumps are foreign to many Americans alive today, but of course they are not unknown in the nation's history. The final two decades of the nineteenth century saw steady deflation, hard times for typical workers, and great tumult. The Great Depression and the 1930s are now nearly synonymous. Most recently, from 1972 through the early 1980s, the United States endured economic stagnation, wage erosion, and a serious of painful economic shocks; in some respects, the weakness lingered until the mid-1990s. If we align shocks of those periods - the panic of 1893, the crash of 1929, the oil shock of 1973 - then we'd be sitting today in 1896 or 1932 or 1976."
and it's affects:
"The longer society stews in a deep slump, the more it is altered. Changes to community character, generational ambition, and social harmony that are nearly imperceptible early in a downturn become suddenly overwhelming later. What follows is a pocket of history of these three long downturns, with a focus on the enduring marks they left on America. Each delineates a major turn in the country's economic, political, and cultural history. And each holds lessons for us in the present day."
One thing is certain to me, that this recovery is going to take a while. I don't care what anti-Obama people think. You could elect Ron Paul as president, and the recovery will take a devastatingly long time. Well, in the absence of something cataclysmic and unseen, that is. I'm speaking based on my perceptions of our current trajectories.
The problem is that a long downturn is going to change our cultural landscape in ways that are impossible to predict.
Two high-level lessons garnered from the book so far. The Great Depression changed the political landscape heavily toward liberalism. This persisted through the 1960's no matter which party controlled the presidency.
All of this ended in the 1970's when we experienced another economic cataclysm precipitated by massive government spending combined with a significant oil shock. We were also, not coincidentally, coming off a massively wasteful war in Vietnam and the Nixon presidential scandal. All of this shook our country and left it open for Ronald Reagan to take over and begin a period of conservatism that has persisted for 3 decades.
Our current recession is much more similar to the recession of the 1930's than the 1970's. I'm not at all sure, where it will lead us, but one thing seems certain, it will probably last a while and there will be a lot of painful, long lasting bumps a long the road.
Showing posts with label recession. Show all posts
Showing posts with label recession. Show all posts
Sunday, August 14, 2011
Saturday, June 13, 2009
Proposed Cuts in Medicaid will Threaten Coverage of Diabetes Pumps
We just received this e-mail:
"Dear JDRF Families:
The state's Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS) recently announced their Benefit Re-Design Proposal in an effort to address Arizona 's significant fiscal challenges and a substantial growth in the Medicaid population. One coverage cut that has been proposed is the elimination of Insulin Pumps for Adults (age 21+) living with diabetes.
This is a grave disservice to the diabetes community and we are asking for your help in fighting this proposed cut. AHCCCS is accepting public comment on this issue until June 26th via email. There is a public hearing scheduled for this Monday, June 15th at the AHCCCS Administration building in Phoenix from 3:00 to 4:30 p.m. We urge you to email Theresa.gonzales@azahcccs.gov with why coverage of insulin pumps is important for adults living with diabetes.
AHCCCS is recommending that coverage for pumps be eliminated for ADULTS ONLY, and though this may not apply to you or your loved one, it is still important that we fight this recommendation. Whether this directly affects you and your family, or whether or not you or a loved one utilizes the pump, allowing AHCCCS to eliminate this coverage will negatively the diabetes community and places access to quality care in jeopardy. When drafting your email, please include specific examples of how insulin pumps have helped your family manage their diabetes. If you or your loved one does not use the pump, please keep in mind the pump has been proven in a number of case studies to 1.) help patients better controlled blood glucose levels, 2.) benefit those suffering hypoglycemia unawareness and 3.) benefit those who are pregnant. Also remember, currently AHCCCS does not cover Diabetes Self Management Training, and that with this cut; AHCCCS will be even greater limiting access to quality care for those living with diabetes.
These recommendations will have to pass through the legislative process and once we have more information on exactly how the recommendations will move forward we will be reaching out again to you for your help in defeating the legislation before it has a chance to go to the Governor for her signature."
This irritates me to no end. We have massive waste in our health care system. But diabetes management is not one of them...
By the way here is the complete list:
Elimination:
- Emergency Dental Services
- Medically Necessary Dentures
- Genetic Testing
- Orthotics
- Insulin Pumps
- Services by a Podiatrist
- Percussive Vests
- Gastric Bypass Surgery
- Allergic Immunotherapy
- Well exams for adults
- Bone-Anchored Hearing Aids
- Cochlear Implants
Limitation:
- Non Emergency Medical Transportation (not available for waiver groups in Maricopa
and Pima counties)
- Negative Pressure Wound Therapy
- Somnography (limit to 1 study/year)
- Physical Therapy (limit to 6 visits/year)
- Durable Medical Equipment (limit to Medicare covered items only)
- Prosthetics (limit non-implantable items to $12,500/year)
- Transplants (selected limitations)
"Dear JDRF Families:
The state's Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS) recently announced their Benefit Re-Design Proposal in an effort to address Arizona 's significant fiscal challenges and a substantial growth in the Medicaid population. One coverage cut that has been proposed is the elimination of Insulin Pumps for Adults (age 21+) living with diabetes.
This is a grave disservice to the diabetes community and we are asking for your help in fighting this proposed cut. AHCCCS is accepting public comment on this issue until June 26th via email. There is a public hearing scheduled for this Monday, June 15th at the AHCCCS Administration building in Phoenix from 3:00 to 4:30 p.m. We urge you to email Theresa.gonzales@azahcccs.gov with why coverage of insulin pumps is important for adults living with diabetes.
AHCCCS is recommending that coverage for pumps be eliminated for ADULTS ONLY, and though this may not apply to you or your loved one, it is still important that we fight this recommendation. Whether this directly affects you and your family, or whether or not you or a loved one utilizes the pump, allowing AHCCCS to eliminate this coverage will negatively the diabetes community and places access to quality care in jeopardy. When drafting your email, please include specific examples of how insulin pumps have helped your family manage their diabetes. If you or your loved one does not use the pump, please keep in mind the pump has been proven in a number of case studies to 1.) help patients better controlled blood glucose levels, 2.) benefit those suffering hypoglycemia unawareness and 3.) benefit those who are pregnant. Also remember, currently AHCCCS does not cover Diabetes Self Management Training, and that with this cut; AHCCCS will be even greater limiting access to quality care for those living with diabetes.
These recommendations will have to pass through the legislative process and once we have more information on exactly how the recommendations will move forward we will be reaching out again to you for your help in defeating the legislation before it has a chance to go to the Governor for her signature."
This irritates me to no end. We have massive waste in our health care system. But diabetes management is not one of them...
By the way here is the complete list:
Elimination:
- Emergency Dental Services
- Medically Necessary Dentures
- Genetic Testing
- Orthotics
- Insulin Pumps
- Services by a Podiatrist
- Percussive Vests
- Gastric Bypass Surgery
- Allergic Immunotherapy
- Well exams for adults
- Bone-Anchored Hearing Aids
- Cochlear Implants
Limitation:
- Non Emergency Medical Transportation (not available for waiver groups in Maricopa
and Pima counties)
- Negative Pressure Wound Therapy
- Somnography (limit to 1 study/year)
- Physical Therapy (limit to 6 visits/year)
- Durable Medical Equipment (limit to Medicare covered items only)
- Prosthetics (limit non-implantable items to $12,500/year)
- Transplants (selected limitations)
Monday, December 1, 2008
On houses, On the Recession
Guess what folks, it looks like we're officially in a recession, as of December of last year, and by all accounts, we may be in this one a long time.
So much about this recession is both predictable and irritating. Predictable because the core of its cause came because too many of us thought we could get rich simply by buying a house. Now, that thought is not so crazy, many people have gotten rich off of real estate, but everyone cannot get rich off of real estate, and you certainly cannot get rich off a house you are living in. Why? Because you have to live in it. It's draining money from you every single month in maintenance costs in mortgage payments. It's not a cash cow, its a money pit.
But that's not how people were looking at houses. They would put a little (or no) money down, get into the house, watch it appreciate, take out an home equity loan and Wa La, free money. It's easy to say now, but this makes no sense in so many levels. The home equity loan is not free money at all, its a loan that you'll have to pay back on top of the mortgage you already took out. But assuming the house won't depreciate (which of course it now has), you can always sell the house, and pay back the mortgage, right? Sure, but now where do you live????? You have basically put yourself back to where you began before you bought the house but now house prices are more expensive.
This made sense to me then and it makes sense to me now, but I understand why many people did what they did, because everyone else was doing it. I was bucking the trend set by so many other people (getting a fixed 30 year mortgage rather than an ARM, getting into a mortgage well below the amount I qualified for, buying an older home in a area closer to my work, refusing to get a home equity loan, trying to stay out of debt generally so I wouldn't have to get a home equity loan). I'm really glad I did all of those things now, but at the time, I felt out of date, not with it, and rather foolish as I kept pleading with people to not buy crappy cookie cutters at edge of the universe...
But the whole thing is very irritating to me because a lot of bad behavior affects me. Too many people were making money off of a phony economy and I wasn't. Peddling subprime mortgages to whomever and whoever, making bank off of commissions. All of this real estate effort was doing nothing for the real economy. But it was inflating our perception of how large our economy was, and that perception was born out in an inflated stock price which is now in process of a free fall, and that free fall effects me. Now house prices and stock prices are sinking below their true values, the values they should be at if people just remained calm. The value of my house will bottom out I am sure below where it should be, the value of my 401K is below what it should be. None of this matters too much, as long as I don't sell my stocks or sell my house, my losses aren't realized. And even if I did sell my house, sure I sold in a buyer's market, but I would be buying another house in that same market, so I'm not too worried. As long as the economy stays healthy enough for me and for you to remain productive and employed.
But the fake economy can and is affecting the real economy. It affects our psyche, it scares us out of the stores. We stop spending, we stop investing, we begin hoarding, and that is a recipe for a prolonged recession.
But it doesn't have to be. Our government needs to spend money where we the general public pulls back. Ideally, we would have a healthy symbiotic relationship between government spending and personal spending. I want to live in a community where my government spends money on nice parks, light rail, free ways.
I drive around my part of Tempe, some of the oldest neighborhoods every single day and I wonder how we could more beautify the city. I love what's been done in downtown Tempe. I love the light rail that is opening soon that will connect me to downtown Phoenix in a more personal way than a freeway will.
I love the Tempe Center for the Arts, Tempe Town lake, the Botanical gardens, the Zoo. Scottsdale's Museum of Contemporary Art has an exhibit exploring innovative ways to renovate and gentrify the ugly strip malls that litter our community. I personally live right next to three, with their expansive parking lots, ugly 1970's cheap no-design architecture. They are ugly and decaying. Granted, one corner was refreshed slightly by a fresh coat of paint, but that ghetto-Fry's strip mall needs much more than a coat of paint. I would love to see something happen there, and yes I'm willing to pay for it.
At the same time, I want my neighbors to spend money on their houses, to landscape and beautify. Living next to their beautiful homes makes my life more beautiful, living next to their blight makes my life more blighted. Investing in my home makes my life more beautiful, failure to do so, makes my life more blighted.
So, there is a ton of work to do. Really, the amount of work to be done is limitless. And guess what? We have more than enough people who can do the work. We have talent, the US has the most educated work force in our earth's history. More people are graduating with college degrees. The internet provides information to each of us at our finger tips. We can mingle, share ideas, innovate together, help each other find more opportunities, learn from each other's mistakes. Technological advancements allow us to do more with exponential efficiencies. We have no excuses for a recession really. Let's get to work.
The problem is that we have been working for the past decade on completely idiotic activities. We had Harvard grads go to work for financial institutions to discover ways to make money by dividing up and moving around securities and credit default swaps in ways to maximize their profits. I'm sure some of this work is necessary, it creates greater efficiencies in money transfers, providing industry access to funds. But I am also sure that much of this work was a complete and total rip off and a complete waste of some of the best minds of our country. And that is nauseating to me.
Changing the color of the collar, I'm also thinking of all of the labor that went into building cookie cutter McMansions in the most remote locations of our dear desert just so people could have the illusion of money. They could feel rich in their pillored-stucco houses miles away the city center where they pile into their SUV's to commute each day across miles of dessert.
Now, places like Maricopa and Anthem are completely over-developed, glutted with foreclosures. A lot of hard work and sweat went into building a lot of cheaply constructed homes in far away places that now nobody wants to live in. I made some pretty persuasive arguments to friends who were buying out in the far reaches of our cities, predicting that the slums of the near future will be in exactly those neighborhoods.
So, we're in a recession. But it does not have to be prolonged. I believe we have elected the right president to pull us out of this one. I believe he will care more about spending then about deficits. He will invest in health care, in education, in infrastructure. We need improvements in all of those things. In the short term, it will get people working, in the long term we will benefit from the innovation and the infrastructure that will result from the efforts.
We can worry about the debt later when the recession is history. Let us hope that in the meantime we can take away a few lessons from the financial mistakes at the heart of this recession.
Let us learn the ultimate lesson of all: we can get rich, but its better, more sustainable and more globally available if we get rich off of work producing goods and services that actually help people. That kind of work is more enjoyable and more sustainable.
So much about this recession is both predictable and irritating. Predictable because the core of its cause came because too many of us thought we could get rich simply by buying a house. Now, that thought is not so crazy, many people have gotten rich off of real estate, but everyone cannot get rich off of real estate, and you certainly cannot get rich off a house you are living in. Why? Because you have to live in it. It's draining money from you every single month in maintenance costs in mortgage payments. It's not a cash cow, its a money pit.
But that's not how people were looking at houses. They would put a little (or no) money down, get into the house, watch it appreciate, take out an home equity loan and Wa La, free money. It's easy to say now, but this makes no sense in so many levels. The home equity loan is not free money at all, its a loan that you'll have to pay back on top of the mortgage you already took out. But assuming the house won't depreciate (which of course it now has), you can always sell the house, and pay back the mortgage, right? Sure, but now where do you live????? You have basically put yourself back to where you began before you bought the house but now house prices are more expensive.
This made sense to me then and it makes sense to me now, but I understand why many people did what they did, because everyone else was doing it. I was bucking the trend set by so many other people (getting a fixed 30 year mortgage rather than an ARM, getting into a mortgage well below the amount I qualified for, buying an older home in a area closer to my work, refusing to get a home equity loan, trying to stay out of debt generally so I wouldn't have to get a home equity loan). I'm really glad I did all of those things now, but at the time, I felt out of date, not with it, and rather foolish as I kept pleading with people to not buy crappy cookie cutters at edge of the universe...
But the whole thing is very irritating to me because a lot of bad behavior affects me. Too many people were making money off of a phony economy and I wasn't. Peddling subprime mortgages to whomever and whoever, making bank off of commissions. All of this real estate effort was doing nothing for the real economy. But it was inflating our perception of how large our economy was, and that perception was born out in an inflated stock price which is now in process of a free fall, and that free fall effects me. Now house prices and stock prices are sinking below their true values, the values they should be at if people just remained calm. The value of my house will bottom out I am sure below where it should be, the value of my 401K is below what it should be. None of this matters too much, as long as I don't sell my stocks or sell my house, my losses aren't realized. And even if I did sell my house, sure I sold in a buyer's market, but I would be buying another house in that same market, so I'm not too worried. As long as the economy stays healthy enough for me and for you to remain productive and employed.
But the fake economy can and is affecting the real economy. It affects our psyche, it scares us out of the stores. We stop spending, we stop investing, we begin hoarding, and that is a recipe for a prolonged recession.
But it doesn't have to be. Our government needs to spend money where we the general public pulls back. Ideally, we would have a healthy symbiotic relationship between government spending and personal spending. I want to live in a community where my government spends money on nice parks, light rail, free ways.
I drive around my part of Tempe, some of the oldest neighborhoods every single day and I wonder how we could more beautify the city. I love what's been done in downtown Tempe. I love the light rail that is opening soon that will connect me to downtown Phoenix in a more personal way than a freeway will.
I love the Tempe Center for the Arts, Tempe Town lake, the Botanical gardens, the Zoo. Scottsdale's Museum of Contemporary Art has an exhibit exploring innovative ways to renovate and gentrify the ugly strip malls that litter our community. I personally live right next to three, with their expansive parking lots, ugly 1970's cheap no-design architecture. They are ugly and decaying. Granted, one corner was refreshed slightly by a fresh coat of paint, but that ghetto-Fry's strip mall needs much more than a coat of paint. I would love to see something happen there, and yes I'm willing to pay for it.
At the same time, I want my neighbors to spend money on their houses, to landscape and beautify. Living next to their beautiful homes makes my life more beautiful, living next to their blight makes my life more blighted. Investing in my home makes my life more beautiful, failure to do so, makes my life more blighted.
So, there is a ton of work to do. Really, the amount of work to be done is limitless. And guess what? We have more than enough people who can do the work. We have talent, the US has the most educated work force in our earth's history. More people are graduating with college degrees. The internet provides information to each of us at our finger tips. We can mingle, share ideas, innovate together, help each other find more opportunities, learn from each other's mistakes. Technological advancements allow us to do more with exponential efficiencies. We have no excuses for a recession really. Let's get to work.
The problem is that we have been working for the past decade on completely idiotic activities. We had Harvard grads go to work for financial institutions to discover ways to make money by dividing up and moving around securities and credit default swaps in ways to maximize their profits. I'm sure some of this work is necessary, it creates greater efficiencies in money transfers, providing industry access to funds. But I am also sure that much of this work was a complete and total rip off and a complete waste of some of the best minds of our country. And that is nauseating to me.
Changing the color of the collar, I'm also thinking of all of the labor that went into building cookie cutter McMansions in the most remote locations of our dear desert just so people could have the illusion of money. They could feel rich in their pillored-stucco houses miles away the city center where they pile into their SUV's to commute each day across miles of dessert.
Now, places like Maricopa and Anthem are completely over-developed, glutted with foreclosures. A lot of hard work and sweat went into building a lot of cheaply constructed homes in far away places that now nobody wants to live in. I made some pretty persuasive arguments to friends who were buying out in the far reaches of our cities, predicting that the slums of the near future will be in exactly those neighborhoods.
So, we're in a recession. But it does not have to be prolonged. I believe we have elected the right president to pull us out of this one. I believe he will care more about spending then about deficits. He will invest in health care, in education, in infrastructure. We need improvements in all of those things. In the short term, it will get people working, in the long term we will benefit from the innovation and the infrastructure that will result from the efforts.
We can worry about the debt later when the recession is history. Let us hope that in the meantime we can take away a few lessons from the financial mistakes at the heart of this recession.
Let us learn the ultimate lesson of all: we can get rich, but its better, more sustainable and more globally available if we get rich off of work producing goods and services that actually help people. That kind of work is more enjoyable and more sustainable.
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