Jan 23 2013
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Insurance

on Dental Insurance

After visiting the dentist a few weeks ago and for some reason not getting berated for doing something wrong (I credit my electric tooth brush) I wondered why exactly do people who take excellent care of their teeth have to visit the dentist on the same schedule as those who do not? My first thought is that they do not have to, but also that the way in which a dentist receives payment incentivizes more checkups rather than less.

Why are insurers not incentivizing less care? Why wouldn’t an insurer pay dentists to see their customers less? I’m sure there is a scheme out there in which the insurer shells out less money for costs (billable hours and equipment cost), the dentist still gets paid a sizable amount of what he was billing the insurer for (probably his fee and not equipment or hygienist costs) and there might even be a small amount left over for a “Good Teeth” dividend for the patient in order to encourage good dental hygiene  I’m sure the insurers could easily identify likely candidates by finding those in their database who have gone a reasonable amount of time without anything more than a normal cleaning (no cavities, special work and the like). They could then set parameters for when to check in on those patients and reevaluate their status around key ages where work is generally done (see age).

The end result is more money for the insurer, similar profit margins for the dentist (probably more, even much more at the expense of bad dentists, because the fewer bookings lead to space to pursue new business) and a rebate for those of us who take care of our teeth. I think the new business aspect for successful dentists is the real gain here. For example, my dentist is consistently rated #1 in the Somerville/Cambridge area but as a result if I ever have to reschedule the options are very very limited. I would assume those scheduling limitations hurt the business, and growth will eventually plateau short of taking on a partner or opening a second location (alternatively the dentist could push the boundaries by charging more for his time but I don’t know how that works with insurance to really speak on it). If the scheme I outlined here were to be implemented, a highly regarded dentist could increase his client book without doing anything other than a good job. This would not only be great for great for dentist but also the consumer, it makes desirable dentists more accessible as well as affordable.

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Nov 26 2012
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Food, Links

on Coca Cola

For 70 years Coca Cola was 5 cents. 70 freaking years! Apparently inflation was relatively non-existant until the 1940′s and had something to do with the price never moving (also early vending machines, a great ad campaign, and a horrible bottling contract).

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Nov 26 2012
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Books

on The Finish

Mark Bowden – The Finish

 

The Finish by Mark Bowden is exactly what I expected it to be, a great behind the scenes look at the lead up and eventual killing of Osama bin Laden. It is complete with insights of all the main principles, their relationship to the President and in some cases their level of respect of the President. One thing I would like to point out is there is not a bad word said about anyone in this book so if you are looking for dirt I would try elsewhere.

Striking was the odd personal code that bin Laden clung to. He was known to boast of actions that led to the mass murder of thousands (including children) but decried the death of any innocent Muslim. He had had no qualms in asking men to die for his cause but he took great care to ensure the survival of his family and the families of his followers.

The most baffling to me was his dismay at the Time Square bomber for breaking his oath to protect America:

“[Shahzad] was asked about the oath that he took when he obtained American citizenship,” he wrote to al-Rahman. “And he responded by saying that he lied. You should know that it is not permissible in Islam to betray trust and break a covenant. Perhaps the brother was not aware of this. Please ask the brothers in Taliban Pakistan to explain this point to their members. In one of the pictures, brother Faisal Shahzad was with the commander Mehsud [Hakimullah Mehsud, who would be killed by a drone strike in 2012]; please find out if Mehsud knows that getting the American citizenship requires taking an oath to not harm America. This is a very important matter because we do not want mujahidin to be accused of breaking a covenant.”

Out of everything he worked for and was looking to accomplish he would get hung up on a car bomber crossing his fingers while taking his citizenship test?

Another fascinating thread was the internal struggle bin Laden had trying to reconcile the role of  Al Qaeda (or lack there of) in regards to the Arab Spring. He saw the overthrow of autocratic governments throughout the Arab world as only “half measures”. He felt it was the duty of Al Qaeda to shepherd these movements to their obvious conclusion, an Islamic Caliphate. In letters bin Laden is found fretting about not being prepared for this moment, that he wished Al Qaeda had more scholars to advise in this transition. All the while fearful of Western secularism and democracy.

For in the end that is what this book is about, a profile of bin Laden’s waning days, the franchising of his brand against his will and his inability to stop it (and him) from becoming irrelevant.  All as the American noose tightened. It’s humanizing, or as humanizing as a portrait of an aging mass murdering hermit can be. He was a dedicated husband and father (in the patriarchal conservative Muslim kind of way) and a loyal leader of his followers. But like most individuals on the FBI’s most wanted list, there was a fatal flaw.

 

Comprehension note: If you do plan on reading this I highly suggest giving the short eBook The Command  by Marc Ambinder a read, it’s a great primer on JSOC.

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Nov 23 2012
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Economy

on Natural Gas

I’ve been dwelling on this subject for a while now, with the widening spread between oil and natural gas continuing to widen, and advertisements from local gas companies imploring one to switch from oil to gas at home (gas here), it’s hard not to wonder why we are not seeing a push to make more of a switch from the government. I was talking to my Uncle yesterday about how he would love to make the switch from Oil to Natural Gas to heat his New England home but lacking a gas line on his street he just can not. If the federal government thinks Natural Gas is the wave of the future why aren’t they paying for residential piping to every American home? Not only would it lower the cost curve for home energy bills going forward it would also free up home heating oil to be used for other purposes, lowering the cost curve for petroleum goods as well. Smaller energy bills mean more disposable income, which means a stronger economy (not to mention the stimulus effects from the infrastructure construction). Sounds like a large federal matching fund program is called for.

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Nov 20 2012
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Books

on Unfamiliar Fishes

Unfamiliar Fishes by Sarah Vowell

As someone who grew up almost as far east in the US as you can get the state of Hawaii was not much more than Hula Girls and Pearl Harbor based WWII movies. Needless to say I knew absolutely nothing about Hawaii. Coupled with a viewing of The Descendants, that ignorance is what led me to pick up a book on Hawaii. I chose Unfamiliar Fishes in particular due to Sarah Vowell’s work on the the radio program This American Life.

Now, going into this I did not expect a feel good story, most conquests of native populations by white men (and women) tend to not go well. Hawaii is no exception. In short, God is a helluva drug and Teddy Roosevelt is not as cool as I once thought he was.

The bit longer version is as follows: On the heals of New England missionaries, we (read Americans) screwed Hawaiians only slightly less than we did Native Americans. And by slightly I mean we took their paradise but neglected to move them to Oklahoma. To be fair it was not all the invading white man’s (and woman’s) fault, the nobility of Hawaii clearly fell prey to what the salesmen were saying. They bought into the religion and the vices without adequately hedging themselves for the impending rub that was certain to come along. Simply, while Hawaiians got screwed with their pants on the inbreeding at the top did not help very much.

All in all it is an enlightening yet sad history. I still have very little desire to got to Hawaii but now the long flight is not the reason. Part of it is the guilt and part of it is the “you don’t belong here” feeling that townies/islanders tend to have when they live in a nice place.

My parting thought is to the Hawaiians in the book who say they are not American. To them I say that’s fine but just be thankful you were annexed by America and not the Russian Empire.

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Jun 13 2012
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Books

on Paul Krugman’s End This Depression Now!

To begin, I need to say that I love Paul Krugman and I am a fervent Keynesian. There, I got that out of the way.

“Some three years ago, when I realized how the profession was failing in its moment of truth, I coined a phrase for what I was seeding: a ‘dark age of macroeconomics.’ My point was that this was different from what happened in the 1930s, when nobody knew how to think about a depression and it took pathbreaking economic thinking to find a way forward. That era was, if you like, the Stone Age of economics, when the arts of civilization had yet to be discovered. But by 2009 the arts of civilization had been discovered-and then lost. A new barbarism had descended on the field”

That quote, from Paul Krugman’s bookEnd This Depression Now!, sums up his thesis quite well; we have been here before, we know how to fix this, but we’re not doing anything for some inexplicable explicable reason. The barbarians of our time insist that in order for the economy to recover we as a people must suffer the pain of deleveraging. We need to tighten our belts and power through it. Besides being wrong, these Visigoths are advocating that we should all willingly allow our souls to be crushed. That’s wrong. Krugman puts it as such:

“[...] there’s only one economics-driven thing that matters enormously to human well being: having a job. People who want to work but can’t find work suffer greatly, not just from loss of income but from a diminished sense of self-worth. And that’s a major reason why mass unemployment-which has now been going on in America for four years-is such a tragedy.”

You can not simultaneously ask someone to work harder and then cut his knees out from under him. Life does not work that way. People are not always logical or willing to take the long road. There is a reason why powerful men brazenly cheat on their wives and frequent prostitutes. We as a race react to temptation and urges, and we do so in our own individual ways. You can not tell a man who lost his job six months ago that in order for the economy to heal, he (and many more like him) must endure a few years of pain. In which time he will lose his house, give up on sending his kids to college, possibly get divorced, etc.  All the while refrain from picking up a life of crime, heavy drinking, a drug addiction, violence, etc. No one chooses that path.

You need to give him a reason to get up in the morning or else he’ll wake up and decide to steal your car, or join a radical organization, or maybe commit a hate crime, or vote for a fascist, or possibly a communist. This has happened before, the result was Europe in the 1930′s. Let’s try to avoid that this time.

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Jun 07 2012
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Thought Experiment

on What Makes a State

In the past 100 years the United States has added just 2 states, both of which (Alaska and Hawaii) are not found in what is known as the lower 48. That makes sense, in the last 100 years the US has not laid claim to much in the ways of territory so there has not been any real opportunity. What is fascinating is that no state has split or broken away since Maine did just that from Massachusetts in 1820. Yet since 1900 the population of the US has quadrupled. Yes, we have 4x as many people in this country but yet our internal borders largely remain unchanged. I find it hard to believe that state demographics haven’t changed drastically since then.

Would it not make more sense for the New York Metro area to be a state of it’s own? The same could be said for the Washington and Boston Metro areas. We have cities in this country that are located at the far corners of their respective states and share more in common with people across the border. Why can’t we redraw states like we do Congressional districts?

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Jun 06 2012
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Thought Experiment

on Smaller States and Bigger Municipalities

Ever since I took a local government class in college I have considered myself as someone who is for giving more power to county sized and/or large city size governments. It is my opinion that states (in the American sense) are too large to adequately address localized issues while small towns and cities (not a New York/LA/San Fran) are too small to benefit from economies of scale. That’s why I find Frank Jacobs’ piece in today’s New York Times so fascinating. It’s not that I think the US should be broken up in to seperate countries much like they are in dystopian sci-fi novels (my favorite being Slapstick by Vonnegut), I simply would like to see more mechanisms of government arise in order to facilitate needs that are within and across state borders.

Problems such as Western water rights, transportation along the Northeast corridor, and regionalized public works & emergency services are all things that could benefit from connections and alliances that do not fit into the current borders of the United States. Because what are borders other than arbitrary lines on a piece of paper? Societies are shaped by their borders, hardly do they ever shape the borders themselves. Don’t I, a resident of the Boston Metropolitan area, have more in common with a resident of greater Toronto then I do with a Texas rancher? And doesn’t that same Texas rancher have more in common with an Argentinian rancher or an Australian rancher?

I’ll end with this; I suppose the theme I’m going for is that our way of mapping out society via arbitrary borders is antiquated and more importantly, inferior.

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May 23 2012
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Books

on Monsoon

I recently finished Robert Kaplan’s book Monsoon and can say that if you are looking for a readable primer on the history and future of the Indian Ocean then look no further.

My two cents from a policy stand point would be that as the many nations of the Indian Ocean (China and India in particular) see rises economically there will be an opportunity to build a strong policing coalition  that could alleviate the demands placed on the US Navy thereby making cuts to military funding more palatable.  After all “50% of the world’s merchant fleet capacity is hosted at the Strait of Malacca”  according to Kaplan. With the US being the largest economy in the world it has a heavy interest in the safety of that fleet that plies both the Pacific and the Indian Oceans. If the US could share the costs of policing with nations like China and India it not only could free up resources but could also strengthen ties with those two countries as well as the region as a whole.

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May 09 2012
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Books

on Book Publishers

This pisses me off, much in the same way that this pisses me off. The publishing business model is outdated; rather than integrate into a new model that cuts out a middle man (themselves or, if they had thought about it years ago, the retailer), puts more money in the hands of the authors and gives the consumer more disposable income, they are trying to prolong the inevitable (the inevitable being their demise).  If I told you you could all but eliminate the rent you pay for storage and at the same time produce the exact amount of copies you need of every book you have ever published, on demand, would you not say “YES”? The savings you would be reaping could then be used to diversify your operations through acquisitions and/or product development. Encounter the problem head on, take what positives you can from it and pivot to a new opportunity. Publishers are not doing that, instead they are stifling innovation in hopes that something more favorable to them will appear out of thin air. It will not happen.

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