Later On

A blog written for those whose interests more or less match mine.

Archive for April 13th, 2009

Cost containment for healthcare

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From a post by Ezra Klein:

Theodore Marmor, Jonathan Oberlander, and Joseph White are pretty big names in health care policy, and they have a depressingly realistic editorial in the latest Annals of Internal Medicine.

Claims of savings from health information technology, prevention, P4P, and comparative effectiveness research are politically attractive. Their political appeal lies largely in the embrace of widely supported goals, including better health and improved quality of medical care. In theory, these reforms—more research, more preventive screenings, and better organized patient data—sound like benign devices to moderate medical spending. For many purposes, such reforms are substantively very desirable. But these reforms are ineffective as cost-control measures. If the United States is to control health care costs, it will have to follow the lead of other industrialized nations and embrace price restraint, spending targets, and insurance regulation. Such credible cost controls are, in the language of politics, a tough sell because they threaten the medical industry’s income. The illusion of painless savings, however, confuses our national debate on health reform and makes the acceptance of cost control’s realities all the more difficult.

Full paper here.

Also read Klein’s comment on the paper.

Written by LeisureGuy

13 April 2009 at 12:22 pm

Interesting article on taxation

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The article by David Leonhardt in the NY Times Sunday Magazine observes that Obama is being extremely timid about the marginal tax rate for the wealthiest Americans:

… It’s well known that tax rates on top incomes used to be far higher than they are today. The top marginal rate hovered around 90 percent in the 1940s, ’50s and early ’60s. Reagan ultimately reduced it to 28 percent, and it is now 35 percent. Obama would raise it to 39.6 percent, where it was under Bill Clinton.

What’s much less known is that those old confiscatory rates were not as sweeping as they sound. They applied to only the richest of the rich, because yesterday’s tax code, unlike today’s, had separate marginal tax rates for the truly wealthy and the merely affluent. For a married couple in 1960, for example, the 38 percent tax bracket started at $20,000, which is about $145,000 in today’s terms. The top bracket of 91 percent began at $400,000, which is the equivalent of nearly $3 million now. Some of the old brackets are truly stunning: in 1935, Franklin D. Roosevelt raised the top rate to 79 percent, from 63 percent, and raised the income level that qualified for that rate to $5 million (about $75 million today) from $1 million. As the economist Bruce Bartlett has noted, that 79 percent rate apparently applied to only one person in the entire country, John D. Rockefeller.

Today, by contrast, the very well off and the superwealthy are lumped together. The top bracket last year started at $357,700. Any income above that — whether it was the 400,000th dollar earned by a surgeon or the 40 millionth earned by a Wall Street titan — was taxed the same, at 35 percent. This change is especially striking, because there is so much more income at the top of the distribution now than there was in the past. Today a tax rate for the very top earners would apply to a far larger portion of the nation’s income than it would have years ago…

Read the entire article—very interesting.

Written by LeisureGuy

13 April 2009 at 12:13 pm

Posted in Daily life, Government

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The ROI on lobbying

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The Washington Post’s Dan Eggen:

In a remarkable illustration of the power of lobbying in Washington, a study released last week found that a single tax break in 2004 earned companies $220 for every dollar they spent on the issue — a 22,000 percent rate of return on their investment.

The study by researchers at the University of Kansas underscores the central reason that lobbying has become a $3 billion-a-year industry in Washington: It pays. The $787 billion stimulus act and major spending proposals have ratcheted up the lobbying frenzy further this year, even as President Obama and public-interest groups press for sharper restrictions on the practice.

The paper by three Kansas professors examined the impact of a one-time tax break approved by Congress in 2004 that allowed multinational corporations to “repatriate” profits earned overseas, effectively reducing their tax rate on the money from 35 percent to 5.25 percent. More than 800 companies took advantage of the legislation, saving an estimated $100 billion in the process, according to the study.

The largest recipients of tax breaks were concentrated in the pharmaceutical and technology fields, including Pfizer, Merck, Hewlett Packard, Johnson & Johnson and IBM. Pfizer alone repatriated $37 billion, representing 70 percent of its revenue in 2004, the study found. The now-beleaguered financial industry also benefited from the provision, including Citigroup, J.P. Morgan Chase, Morgan Stanley and Merrill Lynch, all of which have since received tens of billions of dollars in federal bailout money.

The researchers calculated an average rate of return of 22,000 percent for those companies that helped lobby for the tax break. Eli Lilly, for example, reported in disclosure documents that it spent $8.5 million in 2003 and 2004 to lobby for the provision — and eventually gained tax savings of more than $2 billion…

Continue reading. Via Kevin Drum, you can download a PDF of the study report at the link (which is to a Web page).

Written by LeisureGuy

13 April 2009 at 11:58 am

The world’s most interesting bookstores

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Take a look.

Written by LeisureGuy

13 April 2009 at 11:40 am

Posted in Books, Business, Daily life

Jared Diamond on the evolution of religion

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From the YouTube "more info:

Jared Diamond, professor of geography at UCLA, received the Pulitzer Prize for non-fiction in 1998 for Guns, Germs and Steel: The Fates of Human Societies. In 1999, he received the National Medal of Science. His most recent book is Collapse: How Societies Choose to Fail or Succeed (2004).

Professor Diamond argues that religion has encompassed at least four independent components that have arisen or disappeared at different stages of development of human societies over the last 10,000 years.

Written by LeisureGuy

13 April 2009 at 11:36 am

Five excellent To-Do apps for Linux

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I know I have some Linux fans among my readers. They should check out this post.

Written by LeisureGuy

13 April 2009 at 11:27 am

Posted in Software

Extremely cool stove for camping

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This little guy looks great. Uses only wood, and not much of that. Click and read.

Written by LeisureGuy

13 April 2009 at 11:04 am

Posted in Daily life, Technology

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