Medical device tax

I’ve been hearing inklings again that there may be some compromise regarding the medical device tax part of Obamacare.  Of course, that’s not going to happen as that would undoubtedly be the Democrats giving into Republican hostage-taking.  Nonetheless, I decided it was time to brush up on my facts on the matter.  Where better to turn than CBPP which explains that, not surprisingly, repealing this tax is not good policy:

The excise tax is sound, however, and the arguments against the tax don’t withstand scrutiny.

  • The tax does not single out the medical device industry for unfair treatment.  The excise tax is one of several new levies on sectors that will gain business due to health reform.  The expansion of health coverage will increase the demand for medical devices and could offset the effect of the tax.
  • The tax will not cause manufacturers to shift production overseas.  The tax applies equally to imported and domestically produced devices, and devices produced in the United States for export are tax-exempt.
  • The tax will have little effect on innovation in the medical device industry.  To the contrary, health reform may well spur medical device innovation by promoting more cost-effective ways of delivering care.

The industry’s lobbying campaign against the medical device tax is based on misinformation and exaggeration, as a number of industry executives and analysts confirm.  For example, Martin Rothenberg, head of a device manufacturer in upstate New York, calls claims that the tax would cause layoffs and outsourcing “nonsense.”  The tax, he writes, will add little to the price of a new device that his firm is developing.  “If our new device proves effective and we market it effectively, this small increase in cost will have zero effect on sales.  It would surely not lead us to lay off employees or shift to overseas production.”[2]  Michael Boyle, founder of a Massachusetts firm that makes diagnostic equipment, insists that the device tax is “not a job killer.  It would never stop a responsible manager from hiring people when it’s time to grow the business.”[3]

Somehow, I think a 2.3% tax on medical devices will not be the death knell of American health care innovation as we know it.  And it will help people afford health insurance (and thereby use medical devices) who would otherwise not be able to.

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WIC and why (social?) media matter

I wrote yesterday about how NC was the only state to somehow refuse to add new WIC beneficiaries due to the government shutdown.   Why did I write about it?  Because it received extensive coverage from local media, and quite prominently from my perspective, social media.  If not for good old-fashioned reporting, this story would have never gotten off the ground.  But I have to think that the role social media played in amplifying the story far beyond those who otherwise would have heard of it (i.e., people like my wife) was important.  And it was, indeed, important.  Faced with a wave of negative criticism, our state DHHS has already done a 180 and changed the policy.  From our solid local media:

RALEIGH, N.C. — Questions are mounting about the Department of Health and Human Services’ decision to halt the state’s WIC program, which issues food vouchers to 264,000 low-income women and children in North Carolina.

Congressman David Price (D-4) confirmed Thursday night that the U.S. Food and Drug Administration offered contingency funds to all 50 states to keep the program running. But, on Tuesday, North Carolina was the only state to announce it was halting WIC benefits, saying it couldn’t afford to issue any new vouchers.

On Thursday night, DHHS Secretary Aldona Wos made an unexplained reversal, announcing that the department is using lapsing funds from last year, contingency funds from the USDA and product rebates from Nestle Foods, a WIC formula manufacturer, to keep the program running through the end of October.

Score 1 for journalism and social media.  Oh, yeah, and poor women and their children.

Photo of the day

From the Telegraph’s photos of the week:

An Autumn dawn cast a golden glow arcoss the Middleham Gallops
An Autumn dawn cast a golden glow arcoss the Middleham Gallops where racehorses train across the high moorland above Wensleydale in North YorkshirePicture: Paul Kingston / NNP

Apples apples up on top

My “real world” friends can sometimes get a little tired of hearing me talk about apples (somewhat less so on the blog).  But I did love receiving a link to this NPR story on apples from my TA who wrote “this story has your name on it.”  Indeed.  It’s about what it takes to engineer a new apple.  And it’s hard work:

It took her most of her professional career to develop these two fruits. Ruby Frost was a 17-year process, while the SnapDragon required 12 years. That may sound like a long time, but it’s fairly standard — even a little fast — in the world of apple breeding.

“You start by identifying two parents with desirable characteristics,” explains Bill Dodd, president of Midwest Apple Improvement Association, breeders of the recently developed EverCrisp apple. “When the trees are in bloom in the spring, you take the pollen of one and pollinate the other. The apples that the pollinated tree produces will have seeds for the new variety of apple.”

Those seeds are mass planted — about 50,000 were planted to develop the EverCrisp — but it takes four or five years before the resulting trees produce fruit.

No breeding for me, just eating, but I do find this stuff fascinating.  It also caused me to revisit my original apple post where I wrote:

So far, can’t beat the Gala, in my opinion.  Honeycrisp was good and so was the Jazz, but no better than the Gala despite being more gourmet types.  I had one Pink Lady that was totally bland– people love those so I suppose I should try another.  The Cameos I got at the Farmer’s Market were excellent, but I haven’t seen them in any of my stores.

Firstly, I no longer take 1/4 zyrtec before an apple, but just take one zyrtec every third day to fend off Oral Allergy Syndrome.  More importantly, I almost never eat Galas.  My apple palate has become much more complex and the gala is basically a boring, sweet apple.  Now, I love a good mix of sweet and tart.  I often come across excellent Braeburns (especially those imported from New Zealand).  And I’m a huge fan of the Jazz.  Farmer’s market-wise, I absolutely love Suncrisp and Goldrush.  They’re both fabulous and I’ve never seen them anywhere but the NC Farmer’s market.  This year, while waiting for ripe Suncrisp, I experimented with both Mcintosh and Empire (closely related NY apples) and found that they are worth tiding me over at the Farmer’s market until my favorites come in.

As for the title of the post, that comes from one of my favorite Dr. Seuss (under a pseudonym) books.

The Fox News shutdown

I pay a bit of attention to Fox News when I’m in the gym and it’s on the big TV’s.  As we know, they really are in their own reality.  It occurred to me the other day, as long as Republicans– including the cloistered legislators– get their information from Fox, they are going to think they are somehow in the right and continue with their crazy and destructive strategy.  Now, if the people who control Fox News were against the shut-down and debt ceiling breach, then we’d really be onto something.  Connor Friedersdorf has a nice piece at the Atlantic on how Fox’s short-term focus creates long-term problems for the GOP.

Unfortunately for movement conservatives, approaching politics one news cycle at a time and never looking any farther forward than the next election all but guarantees an inability to strategize or lay groundwork. Little wonder that Limbaugh and his fans pined after a future where Republicans would run all three branches of government, achieved just that for a time under George W. Bush, and utterly failed to advance the long-term prospects of movement conservatism. Bush was in constant conflict with liberals, and so he retained the support of movement conservatives year after year with little thought of the implications. Even conservatives agree now that Bush got a pass, but that hasn’t affected the trust they put in the entertainers who created the conditions for it.

The amount of conservative hackery broadcast and published every day remains staggering. In private, that fact is widely acknowledged even among movement conservative pundits, who can hardly deny something so glaringly obvious. But I have long been in a tiny minority of observers who regard conservative media as something that must be reformed if the right is to recover. How can an ideological movement succeed if its leaders and its rank and file daily rely on bad information from sources that constantly peddle fiction as fact?

Notice that conservative media became ascendant after the apex of conservative successes during the Reagan Revolution. And ever since, as conservative media has grown more popular and lucrative, conservatism itself has suffered. Coincidence? Think it over, conservatives. You have nothing to lose but your hucksters.

He also links to an excellent Jon Bernstein piece that makes related points:

What all these [Republican] talking points had in common, however, is that they were eagerly snarfed up by the folks at Fox News and other parts of the Republican-aligned press. The truth is that Republicans can pretty much say whatever they want, no matter what the bizarre logic and no matter what connection it has to what they were saying five minutes ago, and Fox News will totally accept it and blast it for hours or days.

The result? Republicans have become incredibly lazy. After all, why bother constructing a coherent argument if you don’t need one.

So why is it a problem? Well, for one thing, it means that it’s easy for Republican politicians to fall deep within an information feedback loop, not even realizing that what everyone within that loop is excited about is unpopular, or perhaps just irrelevant, to the other 80 percent or so of the nation. Or to put it another way: Benghazi!

That’s potentially bad for Republicans if they lose a bit of popularity that way, but it’s worse for the system as a whole, because the system depends on parties and their politicians trying to do things that appeal to voters. The problem here is that Republican politicians deep enough in the loop might not even realize that they are espousing unpopular or irrelevant ideas. After all, everyone they talk to, for example, is certain that Obamacare is widely hated and collapsing anyway; of course shutting down the government to get rid of it is a good idea!

That’s only part of it, however. Perhaps the even more pernicious effect is that even when they realize that they’re taking unpopular positions – even positions which poll badly among Republicans – they are tempted to go ahead anyway because, after all, as long as it’s a position that conservative talk show hosts will get behind then they can count on rank-and-file conservatives to go along…

Lazy spin, poor choices and terrible incentives: That’s what Fox News, Rush Limbaugh and the rest of the partisan media have given the Republican Party. It’s not a pretty sight.

Really, really love that point of Bernstein.  One of the reasons I was not a big fan of my one year of teaching at Oberlin is that I felt that the fact that the student body basically ran from mostly liberal to extremely liberal made one ideologically lazy.  I faced a single conservative student across the five classes I taught there.  That was not good for me and not good for my students.  Everybody was shocked when I told them I preferred teaching at Texas Tech.  Yes, the mean was much further to the right there, but the variance was way larger.  If all you ever face are friendly audiences– as GOP elites do thanks to Fox– it absolutely breeds intellectual laziness.  And if you haven’t witnessed just how amazingly intellectually lazy the GOP has become, you certainly haven’t been paying attention.

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