Tidbits Quotations
To Accompany the November 28, 2013 edition of Tidbits
http://www.trinity.edu/rjensen/tidbits/2013/tidbits112813.htm  
Bob Jensen at Trinity University




My Free Speech Political Quotations and Commentaries Directory and Log ---
http://www.cs.trinity.edu/~rjensen/temp/Political/PoliticalQuotationsCommentaries.htm

If everyone is thinking alike, then somebody isn't thinking.
George S. Patton

I never could see good in any filibuster. I can see a whole lot that's bad. I just wish the Senate had really put an end to it rather than limit its use in the nuclear vote of 2013. On the other hand, I do see a whole lot that's wrong with the nuclear voting option in the Senate.
Bob Jensen

JFK’s Assassination is the Most Tragic Day in American History at that Point.
Andrea Mitchell on MSNBC
This leaves room for 3,000+ trade towers murders but makes the bombing of Pearl Harbor a second-rate tragedy.

Your City Was Not Leveled by Godzilla.
Bill Mahar, HBO Jerk who will say anything to be noticed

Someone should defecate and urinate into the former Alaska governor's mouth (read that Sarah Palin)|
Martin Bashir, Commentator on MSNBC
Think of the outrage by the women on MSNBC if somebody said that about Rachel Maddow or Andrea Mitchell.
But since it was Sarah Palin the women of MSNBC like Rachel Maddow and Andrea Mitchell expressed no outrage.

Barack Obama beat Mitt Romney in the 2012 elections 65,909,451 Obama to 60,932,176 Romney votes.
Among the 48 million people of food stamps, how many voted for Mitt Romney?
The GOP will never win without gaining half the food stamp votes.
Here Are The States With The Most To Lose From Republican Food Stamp Cuts ---
http://www.businessinsider.com/here-are-the-states-with-the-most-to-lose-from-republican-food-stamp-cuts-2013-9
It would do wonders for farmers if we gave food stamps to the 99%. The GOP would do better with that platform.

The Knockout Game (sometimes deadly)
Black gangs (mostly teenagers) have made a new shameful game of bushwacking lone whites (often Jewish) and Asians with knockout punches (some deadly).
I think it’s very real as opposed to a motive for assault, be it anger or robbery, this is strictly for a game.

Sgt. Tom Connellan
http://www.nytimes.com/2013/11/23/nyregion/knockout-game-a-spreading-menace-or-a-myth.html?_r=0
Although the NYT did the above feature on the Knockout Game, the television media broadcasters rarely mention the Knockout Game. I wonder if it would be different if white gangs were playing the game on lone blacks. Fox News is an exception.
http://nation.foxnews.com/2013/11/22/ablow-knockout-game-part-epidemic-senseless-violence
And NBC reported on the game
http://usnews.nbcnews.com/_news/2013/11/21/21565494-authorities-nationwide-probing-disturbing-trend-of-knockout-attacks-on-unsuspecting-pedestrians?lite
Don't look for this to be even mentioned on MSNBC until a white gang plays the game on a long black or Hispanic. Then it will be a racial incident that MSNBC won't stop yelling about.

If you treat every situation as a life-and-death matter, you'll die a lot of times.
Dean Smith
, American college basketball coach
As quoted in the CPA Newsletter recently

U.S. National Debt Clock (now $17+ trillion booked debt) ---
http://www.usdebtclock.org/
Also see http://www.brillig.com/debt_clock/

Rep. Jim Bridenstine (R-Okla.) took to the House Floor (one minute) this past Monday ---
http://www.ijreview.com/2013/06/56922-gop-reps-epic-1-minute-beatdown-of-barack-obama-on-house-floor/

List of United States presidential assassination attempts and plots ---
http://en.wikipedia.org/wiki/List_of_United_States_presidential_assassination_attempts_and_plots




"JFK's Legacy: Proving the Laffer Curve," by Kevin Glass, Townhall, November 22, 2013 ---
http://townhall.com/tipsheet/kevinglass/2013/59/22/jfks-legacy-proving-the-laffer-curve-n1751869?utm_source=thdaily&utm_medium=email&utm_campaign=nl

While the mainstream media's hagiography of John F. Kennedy continues on the 50th anniversary of his tragic death, it's important to remember his full legacy - not just the parts that the mainstream media likes to promote.

President Kennedy proved the existence of the Laffer curve. When he came into office, Americans at the top end of the income ladder faced marginal tax rates in excess of 90%. Kennedy proposed tax cuts across the board - including marginal income tax rates, corporate rates, capital gains rates. And after JFK's tax cuts passed, tax revenue increased. As Diana Furchtgott-Roth, director of Economics21, writes:

Kennedy was one of the first presidents to articulate a supply-side theory. On Nov. 20, 1962, at a news conference, he said “It is a paradoxical truth that tax rates are too high and tax revenues are too low and the soundest way to raise the revenues in the long run is to cut the rates now ... Cutting taxes now is not to incur a budget deficit, but to achieve the more prosperous, expanding economy which can bring a budget surplus.”

Kennedy’s tax cuts were not passed by Congress until after his death on Feb. 26, 1964, in the Revenue Act of 1964. The bill reduced the top marginal rate from over 90% to 70%. Tax revenues increased from $94 billion in 1961 to $153 billion in 1968, and the new rates led to a greater percentage of tax revenue coming from those making over $50,000 a year. Tax receipts from those making over $50,000 rose 57%, whereas receipts from those making under $50,000 rose 11%.

Continued in article

Jensen Comment
One instance of most anything does not prove much in economics. Even two instances hardly constitutes proof even though President Clinton managed to balance the budget largely due to lagged effects of the Reagan tax cuts. The problem with tax cuts, stimulus spending, Quantitative Easing, or most any other factor intended to increase the GDP and employment is that circumstances change greatly over time. Economies have too many complex and interacting variables to attribute much of anything to a single factor.

Certainly the Laffer Curve has not convinced all economists that it's a Swiss Army Knife for a faltering economy ---
http://en.wikipedia.org/wiki/Laffer_Curve

However, nearly all nations (including the Scandinavian countries, Canada, all of Europe, and Iran) significantly decreased the top tax rates between 1979 and 2002 largely in belief of the Laffer Curve.

 


Table 1 Maximum Marginal Tax Rates on Individual Income
*. Hong Kong’s maximum tax (the “standard rate”) has normally been 15 percent, effectively capping the marginal rate at high income levels (in exchange for no personal exemptions).
**. The highest U.S. tax rate of 39.6 percent after 1993 was reduced to 38.6 percent in 2002 and to 35 percent in 2003.

  1979 1990 2002
Argentina 45 30 35
Australia 62 48 47
Austria 62 50 50
Belgium 76 55 52
Bolivia 48 10 13
Botswana 75 50 25
Brazil 55 25 28
Canada (Ontario) 58 47 46
Chile 60 50 43
Colombia 56 30 35
Denmark 73 68 59
Egypt 80 65 40
Finland 71 43 37
France 60 52 50
Germany 56 53 49
Greece 60 50 40
Guatemala 40 34 31
Hong Kong 25* 25 16
Hungary 60 50 40
India 60 50 30
Indonesia 50 35 35
Iran 90 75 35
Ireland 65 56 42
Israel 66 48 50
Italy 72 50 52
Jamaica 58 33 25
Japan 75 50 50
South Korea 89 50 36
Malaysia 60 45 28
Mauritius 50 35 25
Mexico 55 35 40
Netherlands 72 60 52
New Zealand 60 33 39
Norway 75 54 48
Pakistan 55 45 35
Philippines 70 35 32
Portugal 84 40 40
Puerto Rico 79 43 33
Russia NA 60 13
Singapore 55 33 26
Spain 66 56 48
Sweden 87 65 56
Thailand 60 55 37
Trinidad and Tobago 70 35 35
Turkey 75 50 45
United Kingdom 83 40 40
United States 70 33 39**

Source: PricewaterhouseCoopers; International Bureau of Fiscal Documentation.

 

 


"Marx for Millennialsm" by Andrew Seal, Chronicle of Higher Education, November 18, 2013 ---
http://chronicle.com/article/Marx-for-Millennials/142963/?cid=cr&utm_source=cr&utm_medium=en

Jensen Comment
Firstly, note that this is not about a resurgence of Marxism in any real-world economies. It's about resurgence of Marxist thinking among progressive professors in the Academy.

Secondly, it's easy to lose sight of the fundamental difference between capitalism and Marrxism --- the allocation of goods and services in an economy. Capitalism relies on market-based allocations superimposed with government taxes, subsidies, and market regulations in the face of externalities such as the carbon tax. Communism relies on government allocation of all goods and services.

The fundamental problem of communism is that it assumes that central government is less corruptible than the private sector and that workers will be highly motivated to work their butts off even if the neighbor next door contributing nothing to society gets the same rewards as the eager beaver shedding blood, sweat, and tears 20 hours a day for the good of society. Castro at long last admitted that free housing, free transportation, and free food and drink coupon books for all had created a generation if lazy "workers" no longer interested in working.

The above article makes no attempt to explain why capitalism is creeping back into the great communism experiments in Cuba, Viet Nam, China, and Russia.

The above article makes not attempt to explain why elites in the Communist party in Cuba, Viet Nam, Russia, and China get better housing food, and medical care than the proletariat.

The above article makes no attempt why the welfare states in Scandinavia in the rest of the world lowered their marginal tax rates rather than raised them for more social services over the past four decades ---
http://www.econlib.org/library/Enc/MarginalTaxRates.html
For example, Finland reduced its top tax rate from 71% in 1979 to 37% in 2002. Sweden went from 87% to 56%. Denmark went from 73% to 59%. Is this a sign of creeping Marxism.? Yeah right!

 

Marginal Tax Cuts in Denmark --- http://www.asb.dk/en/aboutus/newsfromasb/newsarchive/article/artikel/feature_article_what_can_we_expect_from_the_spring_tax_reform-1/

The media regularly feature stories about how Danes are unwilling to work extra hours, even if taxes are lowered. The Danish Economic Council and the Danish Ministry of Finance say the opposite is true, while the public debate swings in both directions.

By Associate Professor Anders Frederiksen, Department of Marketing and Statistics, Aarhus School of Business, University of Aarhus

(This article was published in the Danish daily Berlingske Tidende on Monday 16 November 2009.)

This spring will see the implementation of a comprehensive tax reform that will reduce the marginal tax rate for most people in Denmark. We are becoming quite well versed in concepts such as financial 'carrots' and 'hammocks', and we have been inundated with all manner of studies of the willingness of the Danish people to work more if taxes are cut. Most of these studies find that the Danes are willing to work more, but there are always some that present the opposite conclusion; and the media has a tendency to call more attention to the latter. Perhaps it makes for a better story when people contradict the Economic Council and the Ministry of Finance.

Longer workdays
Let's nail the point home once and for all: the supply of labour in society will increase if the marginal tax rate (the tax on the last krone earned) is cut. This outcome is so certain that not a single economist contradicts it. But that is where the consensus ends, and opinions on the scope of this effect differ greatly, because the change in the supply of labour that will follow a cut in the marginal tax rate is generally considered relatively small � a conclusion that has also been confirmed by Danish research. This means that if the marginal tax rate is lowered by, e.g. 1 per cent, a good estimate is that the supply of labour will increase by 0.05 per cent for men and 0.15 per cent for women. In other words, after a marginal tax rate cut of 10 per cent, an average woman working full time will be willing to work approx. 30 minutes more a week.

Uneven effect
But exactly who can we expect to work longer hours? The spring tax reform will abolish the middle-bracket tax, shift the tax basis for the top-bracket tax and reduce the bottom-bracket tax rate. This will increase the incentive for nearly every worker in Denmark to work more, although the consequences for the supply of labour depend on the level of income. Workers with a bottom-bracket tax as their marginal tax will experience a moderate reduction in taxes, and thus we can only expect a moderate increase in the supply of labour within this group. In contrast, people who are no longer charged top-bracket tax and who also experience the reduction in the bottom-bracket tax as well as the abolishment of the middle-bracket tax will have a significantly reduced marginal tax rate, and this will have a major impact on their willingness to work more. Thus, one of the consequences of the tax reform is an increase in the supply of labour among those workers earning around DKK 400,000.

New study
But what do the Danish people say when asked whether they would work more if taxes were cut? To obtain a better understanding of this key question, we asked the members of the unemployment insurance fund FTF-A what they would be willing to do if the top-bracket tax were abolished? Their response was clear � they would work more. More precisely, 17 per cent responded that they would work more, while 77 per cent responded that they would not change their working hours and only 6 percent believed that they would reduce their working hours. Thus, these responses confirm the findings found in the specialist literature.

Overtime or another job?
The spring tax reform will increase the supply of labour, but how is that possible when everyone works 37-hour-a-week jobs? The idea of inflexible working hours is actually a misconception. According to our study, the majority of the unemployment insurance fund members who responded that they would work more would do more overtime, while nearly a third would increase the supply of labour by taking an additional job. A small share would exchange their part-time job for a full-time job. And those who are not in employment would spend more time looking for work. In other words, you and I may not see any possibilities for earning extra money, but there is a large group of people who would see these possibilities and would be willing to make an extra effort if the incentive were greater.

Less attractive to moonlight
One thing is the supply of labour, but what other consequences will the tax reform have? Unintended consequences of taxation, such as the existence of a black labour market, will also be affected by the reform. The specialist literature documents that the supply of labour in the informal labour market (especially for men) will be significantly affected by the pay that can be brought home from the regular labour market. We also know from previous studies that a large share of the population moonlights � a finding that is also confirmed by FTF-A's members, where approximately 10 per cent say they moonlight. If the top-bracket tax were abolished, 18 per cent of those who moonlight would reduce the amount of work they do on the black labour market, while only 1 per cent would go against that trend and moonlight more. In short, lower taxes also contribute to a more honest labour market.

Pamper pension savings
The tax reform will also have interesting consequences for the financial sector, the retail sector and other areas of society with an interest in the economic priorities of Danes who have more money in their pockets. We know that the retail sector will experience a boost resulting from the increase in disposable income, but not all the money will go towards extra consumption. Some of it will also be put into savings, but what kind? The high marginal tax rate in Denmark has turned increasing pension payments into something of a national pastime in an effort to avoid and postpone paying taxes. If the top-bracket tax were abolished, this hobby would become less interesting, even though the higher disposable income would make it possible to increase savings. The responses from FTF-A's members show that 20 per cent of people with pension savings would increase their payments if the top-bracket tax were abolished, while only 8 per cent would decrease payments to their pension savings. This illustrates that the tax reform will not only have consequences for the labour market, but for many other sectors as well. For instance, people will spend more money in shops, and the financial sector can expect to experience an increase in demand for pension-related products.

 

Expensive in the beginning
Naturally, the many positive effects of the tax reform described here do not stand alone, and the observant reader is probably wondering whether there are any negative consequences of the tax reform. One problem is that the reform will not be self-financing in the short term. Consequently, the state will have less money in its coffers as a result of lower taxes next year, even taking into account the fact that a number of people will work more. However, this does not mean that the tax reform cannot be self-financing in the medium or long term. The changed behaviour patterns that we will see in the Danish people as a result of the lower tax on work will contribute to this. For example, higher pay after taxes will encourage young people to exploit their potential better, e.g. by obtaining a higher education, which will contribute in the long term to better pay conditions and growth in the economy.

 

How skewed can Denmark be?
One of the more negative consequences of the tax reform stems from the fact that the
tax cut primarily affects the upper levels of the income distribution, leading to greater inequality in society. While the question of how much inequality can be tolerated is a political issue, it is naturally an important aspect that should be considered. But with that said, Danish society generally has a very high level of equality compared to other countries.

Jensen Comment
Could it be that tax revisionists in Denmark are beginning to anticipate value added from something like an American Dream being introduced in Denmark?

More at http://www.cs.trinity.edu/~rjensen/temp/SunsetHillHouse/SunsetHillHouse.htm


"The 18 states that cut taxes in 2013," by Reid Wilson, The Washington Post, November 20, 2013 ---
http://www.washingtonpost.com/blogs/govbeat/wp/2013/11/20/the-18-states-that-cut-taxes-in-2013/

Here’s where states cut taxes in 2013:

State Type of Tax Estimated relief* Source:
Alaska Oil tax $750 million Marketplace.org
Arkansas Personal income tax $160 million Arkansas News Bureau
Florida Manufacturing sales and use tax $115 million WLRN
Idaho Personal property tax $20 million StateImpact
Indiana Personal and corporate income tax, inheritance tax $1.1 billion National Review
Iowa Property tax, personal income tax $4.4 billion Cedar Rapids Gazette
Kansas Personal income tax, sales tax $3.8 billion Kansas City Star
Mississippi Energy sales tax $6 million Associated Press
Montana Personal property tax $100 million Legislative News Service
Nebraska AMT, capital gains tax $7.8 million**
New Mexico Corporate income tax $55 million Citizens for Tax Justice
North Carolina Personal and corporate income tax, inheritance tax, others $500 million CNN Money
North Dakota Property tax $1.1 billion WDAY
Ohio Personal income, small business $2.7 billion Ohio Department of Taxation [pdf]
Oklahoma Personal income tax $237 million The Oklahoman
Tennessee Sales tax $164 million Chattanooga Times Free Press
Texas Margins tax $1 billion Reuters
Wisconsin Personal income tax $650 million Associated Press

* Note: States estimate the impact of tax cuts over different budget cycles, some in one-year segments, others over two-, three- or five-year periods.

** Nebraska’s Department of Revenue estimated the AMT cut will have a $7.8 million fiscal impact in FY 2014-2015.

Bob Jensen's tax helpers ---
http://www.trinity.edu/rjensen/Bookbob1.htm#010304Taxation


The Best and Worst Run States in America: A Survey of All 50 ---
http://247wallst.com/special-report/2013/11/21/the-best-and-worst-run-states-in-america-a-survey-of-all-50-2/?utm_source=247WallStDailyNewsletter&utm_medium=email&utm_content=NOV222013A&utm_campaign=DailyNewsletter


From the CPA Newsletter on November 14, 2013

CBO report gives 103 suggestions for balancing the budget
A Congressional Budget Office report outlines 103 options for Congress and the Obama administration to raise revenue or cut spending to bring down the budget deficit over the next 10 years. These include 23 necessary spending cuts, 28 discretionary spending cuts, 36 tax increases and 16 changes to spending in health care. The CPA profession has called on both policymakers and the public to engage in a national dialogue to improve our country's fiscal health through the "What's at Stake" initiative. The Hill/On the Money blog (11/13)

Also see
http://taxprof.typepad.com/taxprof_blog/2013/11/cbo-releases-.html


2013 Happiest Nations of the World ---
http://247wallst.com/special-report/2013/11/07/the-happiest-countries-in-the-world-4/2/

Jensen Comment
I've been though this before in a debate with Jim Peters and won't repeat myself again except to say that all the Top 10 other than Canada hare not at all diverse and have relatively small populations with strict barriers to immigration. This is not a good testimonial that diversity leads to national happiness. The Ethnic Fractionalization Index is as follows for selected nations shown below with the least fractionalized nations having the highest numbers ---
http://en.wikipedia.org/wiki/List_of_countries_ranked_by_ethnic_and_cultural_diversity_level

002 Tanzania (high ethnic diversity)
060 Canada (Happiness Rank 08)
063 Switzerland (Happiness Rank 01)
071 Mexico (Happiness Rank 10)
085 USA
087 Iceland (Happiness Rank 03)
128 Sweden (Happiness Rank 04)
142 Finland (Happiness Rank 09)
144 Denmark (Happiness Rank 05)
145 Austria (Happiness Rank 07)
146 Norway (Happiness Rank 02)
148 Germany
151 Netherlands (Happiness Rank 06)
157 Japan
158 South Korea
159 North Korea (lowest ethnic diversity)

Canada enjoys an enormous land mass relative to its population and is a nation that sells immigration to highest bidders in many instances. Canada also is the largest exporter of oil, timber, and maple syrup to the USA and lives under the umbrella of the USA military and advanced medical research.

Switzerland and Iceland ethic diversity surprises to me, although neither Switzerland nor Iceland is noted to have ethic diversity based upon skin color. The same can be said for Mexico.

The odd thing is that Mexico is among the Top 10 happiest nations in the world. Under these circumstances I would think that people trying to wade south in the Rio Grande would obstruct all those trying to wade north. Why isn't Mexico building a high wall on its northern border?

My guess is that if you randomly offered an immigration lottery ro 10,000 randomly chosen people in Africa, India, and other parts of Asia that the USA would have the highest probability of being chosen by those lottery winners. Why don't they want to go to happier countries?

My threads on happiness and The American Dream (with a special section on Denmark) are at
http://www.cs.trinity.edu/~rjensen/temp/SunsetHillHouse/SunsetHillHouse.htm


National Labor College's Demise:  USA's Largest Labor Unions Could Not Save Their College

"A Small College's Demise," by Rivard, Inside Higher Ed, November 14, 2013 ---
http://www.insidehighered.com/news/2013/11/14/labor-college-backed-afl-cio-decades-closes-because-finances 

Bob Jensen's threads on higher education controversies ---
http://www.trinity.edu/rjensen/HigherEdControversies.htm


Ten Companies Paying Americans the Least --- Click Here
http://247wallst.com/special-report/2013/11/15/ten-companies-paying-americans-the-least/?utm_source=247WallStDailyNewsletter&utm_medium=email&utm_content=NOV152013A&utm_campaign=DailyNewsletter
Not included are companies employing the highest number of undocumented workers even less

01. Walmart
02. McDonald’s
03. Target
04. Kroger
05. Yum! Brands
06. Sears Holdings
07. Darden Restaurants
08. Macy's
09. TJX Companies
10. Starbucks

Jensen Comment
The numbers are a little misleading. For example, Wal-Mart first hires at low wages without many benefits but promotes over 400 employees each day such that people serious about staying with Wal-Mart get higher wages, more benefits (including health care), and education and training benefits. New workers at Starbucks and McDonalds, for example, have fewer opportunities for promotions and better benefits.

Kroger surprises me since it is unionized.

I think Macy's is also unionized although I did not verify this. Most big department store chains are unionized by the retail unions.

How come the top ten listed above are not all fast food restaurants like McDonald's? Is McDonald's stingier than Burger King and Taco Bell?

Is support for a higher minimum wage self-serving?
Some like Starbucks support legislation for large increases in the minimum wage. This is self-serving. Firstly, most of the companies listed above pay more than minimum wage, and increases in the minimum wage clobber Starbucks' competition more than Starbucks itself. More than 50% of the companies that pay bare minimum wage, often with part-time workers receiving no fringe benefits, are small mom and pop businesses.

For example, a doubling of the minimum wage might put many of the downtown urban mom and pop coffee shops out of business, thereby making Starbucks much more profitable. And many those former part-time workers in those destroyed mom and pop coffee shops won't get unemployment compensation and will have to become welfare cases for more than just food stamps.

November 15, 2013 reply from Jim Peters

I agree that this is complicated. I had a very good student a while back who quite Wal-Mart to come back and get his BA in accounting. He was making $250,000 per year as a regional manager for Wal-Mart without a BA degree. When I asked him how he learned the skills to oversee a region, he said he got his education from "the University of Wal-Mart." They have very good training programs and 75% of their execs came up through the ranks.

Jim Peters


"Extension of Benefits for Jobless Is Set to End," by Annie Lowrey, The New York Times,  November 17, 2013 ---
http://www.nytimes.com/2013/11/18/business/extension-of-benefits-for-jobless-is-set-to-end.html?ref=business&_r=0

Unless Congress acts, during the last week of December an estimated 1.3 million people will lose access to an emergency program providing them with additional weeks of jobless benefits. A further 850,000 will be denied benefits in the first quarter of 2014.

Congressional Democrats and the White House, pointing to the sluggish recovery and the still-high jobless rate, are pushing once again to extend the period covered by the unemployment insurance program. But with Congress still far from a budget deal and still struggling to find alternatives to the $1 trillion in long-term cuts known as sequestration, lawmakers say the chances of an extension before Congress adjourns in two weeks are slim.

¶ As a result, one of the largest stimulus measures passed during the recession is likely to come to an end, and jobless workers in many states are likely to receive considerably fewer weeks of benefits.

Continued in article

Jensen Comment
The article fails to mention that one of the main obstacles to full-time job growth in some states is the high payroll tax. for unemployment benefits. The lion's share of the payroll tax is paid buy business firms that hire workers. High payroll taxes encourage replacing full-time workers with part-time workers and robots.

One misleading number in this article is the $1 trillion for sequestration. Yes this is the reduction in Federal spending for the next trillion years. But sequestration for the first year is only 10% of an approximate $3.5 trillion of the annual Federal government spending. The bulk of the savings from reduced jobless benefits will go to hard-pressed state budgets rather than the Federal government.

The irony is how, when it comes to unemployment benefits, the Democrats will stress that the economic recovery is "sluggish." But for elections of 2012 and 2014 they will stress how huge gains are being made in economic recovery, including daily new records in stock market prices.

The real crisis is that most of the unemployment is now structural made up of unskilled workers who either do not want to return to work or cannot find jobs because they do not have the skills needed for for the 21st Century. What we need is to spend an enormous amount to provide modern skills to unskilled workers.

Ironically, for 12-months the Wal-Mart stores in Littleton and Woodsville (with a new Super Wal-Mart) in New Hampshire have had huge banners in front of the stores reading "Now Hiring."

It's a welcome relief that long-time unemployed in New Hampshire and Vermont will have at least two opportunities to fall back on when their unemployment benefits terminate. Yeah right! What unemployed worker in New Hampshire or Vermont wants to work for Wal-Mart?

On the other hand, I read where getting a job at the new Wal-Mart store in Washington DC will be less probable that being "admitted to Harvard." Employment opportunities vary widely across the USA. Some unemployed workers in Washington DC should buy heavy parkas and snow shoes for their moves to Vermont so they can work in Wal-Mart stores in New Hampshire. There are no new Wal-Mart stores in Vermont since Vermont banned such new non-unionized big box stores. However, moving to Vermont is preferred to New Hampshire since Vermont has the most generous welfare benefits among all 50 states. Really!

"In Italy, High Payroll Taxes Stand in Way of Recovery Tax Model Thwarts Efforts to Cut Labor Costs, Spur Growth," by Christopher Emsden, The Wall Street Journal, November 19, 2013 ---
http://online.wsj.com/news/articles/SB10001424052702303936904579179672072106820?mod=dist_smartbrief

Patrizia Zanotta, owner of a welding firm in northern Italy, survived the country's worst recession since World War II without layoffs by cutting her 10 employees' hours and scrimping on new equipment.

Though orders are finally starting to pick up from her clients abroad, demand remains weak from the local builders that are her main clients. She blames Italy's extraordinarily high business and payroll taxes, which together take some two-thirds of a company's gross earnings.

"The state is strangling us," she complains.

The staggering tax burden is a big part of the reason Italy's output has grown the least over the last decade of any of the 34 countries in the Organization for Economic Development and Cooperation.

Continued in article


From the CFO Journal's Morning Ledger on November 20, 2013

CFOs wary of Fed nominee
Only about one in five chief financial officers in the U.S. believe businesses will welcome Janet Yellen if she becomes Fed chairman, according to a survey by Financial Executives International and Baruch College’s Zicklin School of Business. An overwhelming majority of U.S. CFOs surveyed, 94%, expect Ms. Yellen to continue the Fed’s bond-buying program, which is keeping interest rates low, until at least the first quarter of 2014,
James Willhite notes. CFOs also expressed less optimism about the financial prospects for their businesses. The survey’s CFO Optimism index dropped to 65 from almost 71 in the second quarter, marking the lowest reading in the past four quarters.


Eminent Domain --- http://en.wikipedia.org/wiki/Eminent_domain

Em = Mortgage holders, including government agencies, like FHFA,  Fannie Mae, Freddie Mac, PIMCO, Wells Fargo, and other investors who bough mortgages from mortgage brokers on the assumption that borrowers would either make contractual payments or suffer foreclosure.

Hockett to Em
"Eminent Domain For Negative Equity Borrowers: ACLU Versus PIMCO And FHFA (Hockett To ‘Em, Baby!) " Professor Anthony B. Sanders (George Mason University), Confound Interest, November 16, 2013 ---
http://confoundedinterest.wordpress.com/2013/11/16/eminent-domain-for-negative-equity-borrowers-aclu-versus-pimco-and-fhfa-hockett-to-em-baby/

Jensen Comment
I can't think of another eminent domain ploy that is more likely to be resolved ultimately by the U.S. Supreme Court. Maybe it's a good thing since eminent domain in general is being so inconsistently abused by towns, counties, and states.

Ironically, the towns will have a harder time rather than easier time collecting their property taxes. The "Ems" pay their property taxes in full and on time.


Forthcoming in The American Sociological Review
Title:  Overwork and the Slow Convergence in the Gender Gap in Wages
http://mypage.iu.edu/~cha5/Youngjoo_Cha_files/Cha_weeden.pdf
  

Authors:  Youngjoo Cha, Department of Sociology Indiana University cha5@indiana.edu
                Kim A. Weeden , Department of Sociology, Cornell University kw74@cornell.e

September 24, 2013

Despite rapid changes in women’s educational attainment and continuous labor force experience, convergence in the gender gap in wages slowed in the 1990s and stalled in the 2000s. Using CPS data from 1979 to 2009, we show that convergence in the gender gap in hourly pay over these three decades was attenuated by the in creasing prevalence of “overwork” (defined as working 50 or more hours per week) and the ri sing hourly wage returns to overwork. Because a greater proportion of men engage in overwork, these changes raised men’s wages relative to women’s and exacerbated the gender wage gap by an estimated 10% of the total wage gap. This overwork effect was also sufficiently large to offset the wage-equalizing effects of the narrowing gender gap in educational attainment and other forms of human capital. The overwork effect on trends in the gender gap in wages was most pronounced in professional and managerial occupations, where long work hour s are especially common and nor ms of overwork are deeply embedded in organizational practices and occupati onal cultures. These results illustrate how new ways of organizing work can perpetuate old forms of gender inequality.

Bob Jensen Threads on the History of Women ---
http://www.trinity.edu/rjensen/bookbob2.htm#Women


"The Complex Economics of America’s Minimum Wage," Knowledge@wharton, November 11, 2013 ---
http://knowledge.wharton.upenn.edu/article/complex-economics-americas-minimum-wage/

Jensen Comment
This is a long article that covers most of the main points. The main conclusion is that we need to comprehensively study the types of people who receive the minimum wage and to invent better solutions to their problems that a higher minimum wage alone will never solve. For example, young people should probably be paid much less than the minimum wage provided they are provided alternatives to acquire skills, experience at teamwork, and better hope for a rewarding career. I'm not certain what to recommend for older folks beyond retirement age. In many instances it's the work, no matter how mundane, that keeps them young and needed. For others working for minimum wage is a bitch brought on by inadequate savings, zero interest on what savings they have, and a painful chore with their arthritis. For workers caught in the middle its the economy of high unemployment, especially those who lost their higher paying jobs. Minimum wage type of work was never meant to provide careers for the underemployed.

The knee jerk reaction is hope that Wal-Mart becomes unionized.
Wal-Mart is not your minimum-wage employer. Wal-Mart provides higher wages and many benefits including good deals for health care and education and training. Unionized companies like Kroger are not doing any better than Wal-Mart.

Well over half of the truly minimum wage workers in the USA work for small businesses, and doubling the minimum wage will merely cost many of them the jobs that they are clinging to in an effort to not have to totally disrupt their lives with divorce, welfare dependency, moving to another town, and uprooting their children in school.


Fox News Would Never Get Away With IT
"MSNBC's Double-Standards," by The Wall Street Journal, November 18, 2013 ---
http://online.wsj.com/news/articles/SB10001424052702303985504579206062600974566?mod=djemEditorialPage_h

. . .

Another MSNBC host, Al Sharpton, has also made racist and homophobic remarks throughout his career. On the old Morton Downey Jr. talk show, Mr. Sharpton referred to an audience member as "a punk faggot" and then challenged him to a fight. The video is at http://www.youtube.com/watch?v=f9IdddtgP2o.

Mr. Sharpton is also fond of the N-word, it turns out. In his book "The Power of the Mayor: David Dinkins: 1990-1993," author Chris McNickle writes that "Over the years, Reverend Al Sharpton had called [New York Mayor David Dinkins] an Uncle Tom and once referred to him as 'that nigger whore turning tricks in City Hall.'"

None of this seems to have gotten in the way of MSNBC hiring Mr. Sharpton or giving him his own television show. There he was Monday morning on MSNBC lecturing professional athletes on their choice of locker room insults. He equated using the N-word to using sexist or homophobic terms and said that people who use such language "should be fired."

Yes, he really said that.

 

 


From the CFO Journal's Morning Ledger on November 15, 2013

Should CEO pay be capped?
Switzerland will vote next week on a proposal limiting executive pay to 12 times that of a company’s lowest paid worker, the second time this year the country will use the ballot box in an attempt to rein in corporate compensation,
writes the WSJ’s Neil MacLucas. The Swiss have grown more concerned about wealth disparity as the gap between a wealthy executive class and everyday workers grows. But critics say the initiative, if passed, will make Switzerland a less attractive place to do business. And executives at some companies, including Glencore Xstrata and Kuehne + Nagel, have said they would consider leaving Switzerland if the initiative passes.


Is it possible to criticize a black leader without being a called a racist?
Probably not according to Oprah and MSNBC.
Oprah Plays Obama-Race-Card ---
http://townhall.com/columnists/jeffcrouere/2013/11/16/oprah-plays-obamaracecard-n1747417?utm_source=thdaily&utm_medium=email&utm_campaign=nl


From the CPA Newsletter on November 14, 2013

CBO report gives 103 suggestions for balancing the budget
A Congressional Budget Office report outlines 103 options for Congress and the Obama administration to raise revenue or cut spending to bring down the budget deficit over the next 10 years. These include 23 necessary spending cuts, 28 discretionary spending cuts, 36 tax increases and 16 changes to spending in health care. The CPA profession has called on both policymakers and the public to engage in a national dialogue to improve our country's fiscal health through the "What's at Stake" initiative. The Hill/On the Money blog (11/13)

 




And by the way, this favor harms all other taxpayers. The IRS assesses the reinsurance tax in annual tranches; it must collect $12 billion in 2014, $8 billion in 2015 and $5 billion 2016. So the smaller pool of ordinary people without a union card will pay a larger individual share of the same overall amount.
"ObamaCare's Union Favor:  The White House may let Big Labor dodge a reinsurance," The Wall Street Journal, November 18, 2013 ---
http://online.wsj.com/news/articles/SB10001424052702303309504579182061106839366?mod=djemEditorialPage_h

The Affordable Care Act's greatest hits keep coming, and one that hasn't received enough attention is a looming favor for President Obama's friends in Big Labor. Millions of Americans are losing their plans and paying more for health care, and doctors are being forced out of insurance networks, but a lucky few may soon get relief.

Earlier this month the Administration suggested that it may grant a waiver for some insurance plans from a tax that is supposed to capitalize a reinsurance fund for ObamaCare. The $25 billion cost of the fund, which is designed to pay out to the insurers on the exchanges if their costs are higher than expected, is socialized over every U.S. citizen with a private health plan. For 2014, the fee per head is $63.

The unions hate this reinsurance transfer because it takes from their members in the form of higher premiums and gives to people on the exchanges. But then most consumers are hurt in the same way, and the unions have little ground for complaint given that ObamaCare would not have passed in 2010 without the fervent support of the AFL-CIO, the Teamsters and the rest.

The unions ought to consider this tax a civic obligation in solidarity with the (uninsured) working folk they claim to support. Instead, they've spent most of the last year demanding that the White House give them subsidies and carve-outs unavailable to anyone else.

But don't expect ObamaCare favors unless you helped to re-elect the President. In an aside in a Federal Register document filed this month, the Administration previewed its forthcoming regulation: "We also intend to propose in future rulemaking to exempt certain self-insured, self-administered plans from the requirement to make reinsurance contributions for the 2015 and 2016 benefit years."

Allow us to translate. "Self-insured" means that a business pays for the medical expenses of its workers directly and hires an insurer as a third-party administrator to process claims, manage care and the like. Most unions as well as big corporations use this arrangement.

But the kicker here is "self-administered." That term refers to self-insured plans that don't contract with the Aetnas and Blue Shields of the world and instead act as their own in-house benefits manager.

Almost no business in the real world still follows this old-fashioned practice as both medicine and medical billing have become more complex. The major exception is a certain type of collectively bargained insurance trust known as Taft-Hartley plans. Such insurance covers about 20 million union members, and four out of five Taft-Hartley trusts are self-administered.

There's no conceivable rationale—other than politics—for releasing union-only plans from a tax that is defined as universal in the Affordable Care Act statute. Like so many other ObamaCare waivers, this labor dispensation will probably turn out to be illegal.

And by the way, this favor harms all other taxpayers. The IRS assesses the reinsurance tax in annual tranches; it must collect $12 billion in 2014, $8 billion in 2015 and $5 billion 2016. So the smaller pool of ordinary people without a union card will pay a larger individual share of the same overall amount.

Count all of this as one more illustration of the way that ObamaCare has put politicians in control of health care. Some people get taxed but others don't, some people get subsidies but others don't, and some have to pay more so Mr. Obama can deliver favors to his political constituents.

As you might imagine, The New York Times does not even mention this pending labor union exemption when it explains the Affordable Care Act Re-insurance Fund:
"A Closer Look at the Reinsurance Fee," by Robert Pear,
The New York Times, October 15, 2013 ---
http://www.nytimes.com/news/affordable-care-act/2013/10/15/a-closer-look-at-the-reinsurance-fee/?_r=0

The reinsurance tax is one of several measures intended to stabilize premiums in the individual insurance market as major provisions of the health care law take effect in January. The fees, to be charged from 2014 to 2016, will provide money to insurers that incur high claims for consumers in the individual insurance market, both inside and outside the new exchanges, or marketplaces. Insurers are apprehensive that some of their new customers, having been uninsured for years, will have costly existing conditions.

The fees are to be paid by insurers in the individual, small group and large group markets, as well as by employers that serve as their own insurers.

A delay in the implementation of the tax is popular with both employers and labor unions, many of which provide health coverage to members, because it would put off significant new costs.

The government set the fee for 2014 at $63 per covered life, or $5.25 a month. Insurers and some self-insured employers may have to pay not only for subscribers and employees, but also for spouses and children who are covered.

The total amount of fees to be collected over three years is $25 billion. Of that amount, $20 billion will go to the reinsurance program and $5 billion to the Treasury.

“The primary purpose of the reinsurance program is to stabilize premiums in the individual market from 2014 through 2016,” the Obama administration said when it proposed the rules in December 2012. “The reinsurance program is designed to protect against issuers’ potential perceived need to raise premiums due to the implementation of the 2014 market reform rules, specifically guaranteed availability.’’

The tax, the administration said, should alleviate the concerns of insurance companies about the risk of “high-cost claims from newly insured individuals.’’

Jensen Comment
Political favors are like that on both sides of the aisle. This one is just a bit more blatant without a justifiable reason.

It will be interesting to watch Big Ed  try to squirm around this one. Even though he's employed by MSNBC, Ed Shultz draws hundreds of thousands in promotion fees from labor unions. At the same time he's also an effective champion for the common man who will be footing the bill for this gift to labor unions. My guess is that, like The New York Times, he will not even mention this pending labor union exemption on the Ed Show.

“U.S. labor unions paid MSNBC ‘Ed Show’ host Ed Schultz  roughly $200,000 in 2011, and roughly $337,000 in 2005-2012, according to Department of Labor documents.”

Also see
http://www.politico.com/story/2013/10/obamacare-reinsurance-fee-spending-deal-98328.html

Bob Jensen's universal health care messaging --- http://www.trinity.edu/rjensen/Health.htm


The President made one sorry excuse that riles my feathers.
Yesterday he made the claim that "government is incapable of creating high quality Websites." That just has not been true over the past two decades. The Federal government created some of the finest Websites in the world. Exhibit A is the IRS Website. Exhibit B is the OLAP implementation of FedScope over 15 years ago ---
http://www.fedscope.opm.gov/index.asp

OLAP --- http://www.trinity.edu/rjensen/XBRLandOLAP.htm#OLAPextended

 

"A Health Care Fix," NYT Editorial Board, The New York Times, November 15, 2013 ---
http://www.nytimes.com/2013/11/15/opinion/a-health-care-fix.html?hp&rref=opinion&_r=0

. . .

The White House had no estimates on how many consumers whose policies were canceled might want reinstatement as opposed to buying something better, often with the help of subsidies. It is also unclear how the temporary fix might affect the overall goal of upgrading the benefits covered and keeping premiums affordable.

If a relatively small population of people get extensions, as some experts think likely, the effect on premiums in the overall health insurance market may be minimal. Even so, this disturbing reversal is caused by the incompetence of the administration in ushering in reforms that millions have been waiting for.

 

"The politics behind Obama’s health-care ‘fix’," by Stephen Stromberg, The Washington Post, November 14, 2013 ---
http://www.washingtonpost.com/blogs/post-partisan/wp/2013/11/14/the-politics-behind-obamas-health-care-fix/

Is President Obama’s “fix” to the health-care rollout more about politics than substance? (Yoon S. Byun/The Boston Globe)

(Yoon S. Byun/The Boston Globe)

Probably, but not for the reasons that some Republican commentators spun up shortly after news of the plan leaked out.

Obama’s plan is to allow insurance companies to extend certain health-care policies that don’t meet the Affordable Care Act’s minimum standards, offering a one-year reprieve to people upset about the cancellation notices their insurers sent them over the past several weeks.

“Why only a year?” Sean Hannity asked of the president’s plan. “Because he wants to get past the midterms.”

“One year from now is when an election occurs, and conveniently, the delay would occur right after the election,” said Republican National Committee spokesman Sean Spicer. “So all of these 2014 Democrats that are running for the hills right now would get a one-year reprieve until after their election.”

Actually, the political timing could be worse for the Democrats under the president’s plan. Federal law requires insurers to give customers 90 days’ notice before canceling their insurance policies. That is why so many cancellation letters have gone out over the past couple months; insurance companies have been sending notice that plans up for renewal at the beginning of next year will terminate then instead. Under the president’s new policy, renewed plans would presumably expire on the same date, just shifted forward a year. So one would expect a similar wave of cancellation letters to hit right before next November’s midterm elections, not right after.

That possibility could encourage the White House to offer another extension next year, before the wave would hit, in which case Hannity and Spicer’s accusation would be a plausible explanation for the second time shift.

The calendar could also indicate that the White House doesn’t expect many people will end up renewing their noncompliant plans under its new scheme. Even though the Obama administration has given permission, state regulators might not allow it, insurance companies might not want to revive plans they were in the process of winding down and lots of customers might move on to different policies anyway. The practical effect of the president’s “fix” is likely to be small.

For now, the desired political effect seems to be twofold. First, it might relieve some of the pressure Democrats in Congress feel to approve worse “fixes” that would undermine the new health-care insurance system. Second, it might enable Democrats to shift blame onto state regulators or insurance companies for this year’s cancellations. The first is understandable. The second is not.

"ObamaCare's Nonfix:  Americans still can't keep their health plans, but Democrats get political cover," WSJ Editorial Board,  The Wall Street Journal, November 15, 2013 ---
http://online.wsj.com/news/articles/SB10001424052702304243904579197892755143418?mod=djemEditorialPage_h

. . .

Now these mass cancellations are proving to be unpopular, and Democrats are panicking, so Mr. Obama is offering a temporary stay of execution. He is instructing his health regulators to suspend eight complicated rules that all insurance plans had to meet and had caused the market implosion.

There is less reprieve here than Mr. Obama claims. It's hard to un-cancel insurance. The rules Mr. Obama is repudiating were written in 2010, and insurers have been adapting to them for years. They will now have to scramble to revive the policies they can while throwing all of their actuarial assumptions out the window.

The faux reprieve also lasts for only one year and applies only to anyone who was covered in 2013. The insurers are essentially being asked to agree to accept losses on behalf of a rump group of policy holders in a legacy business that would then turn into a pumpkin in 2015.

Continued in article

 

Jensen Comment
The President's plan seems to be a ploy to buy time and votes rather than fix the fundamental problem. The fundamental problem is that all the expensive additions to required coverage are making the plans too expensive for buyers of medical insurance until the government picks up the lion's share of the tab (nationalize those deductibles?) after the 2014 wipe out of Republicans (Obana hopes) in the next election.

This is a real test of confrontational political power of President Obama (where the other side is comprised of scumbags) versus the Johnson era of backroom politics (where everybody on both sides of the fence is honorable).

Johnson ushered in the Voting Rights Act, Aid to Education, Attack on Disease, Medicare, Medicaid, Urban Renewal, Beautification, Conservation, Development of Depressed Regions, a wide-scale fight against poverty ---
http://en.wikipedia.org/wiki/Lyndon_B._Johnson

Obama ushered in Obamacare. Yeah Right! With a total of 29 apologies (according to ABC News) to the public for his fumbles in connecting people to the exchanges.

I think those "honorable "representatives in back rooms probably accomplish more that public media wars among scumbags on both sides of the fence.

PS
The President made one sorry excuse that riles my feathers.
Yesterday he made the claim that "government is incapable of creating high quality Websites." That just has not been true over the past two decades. The Federal government created some of the finest Websites in the world. Exhibit A is the IRS Website. Exhibit B is the OLAP implementation of FedScope over 15 years ago ---
http://www.fedscope.opm.gov/index.asp

OLAP --- http://www.trinity.edu/rjensen/XBRLandOLAP.htm#OLAPextended


"Affordable Care Act holds opportunities, challenges for internal auditors," by Ken Tysiac, Journal of Accountancy, November 7, 2013 ---
http://journalofaccountancy.com/News/20139066.htm


Why not give HMO Obamacare, Medicare and Medicaid patients the worst doctors?
"
Report: UnitedHealth Drops Thousands Of Doctors From Insurance Plans," by Zeba Siddiqui, Reuters, November 15, 2013 ---
http://www.businessinsider.com/unitedhealth-drops-thousands-of-doctors-from-insurance-plans-2013-11 


The Cadillac Tax: A Game Changer for U.S. Health Care:  Can you explain this tax to your students?
Do you understand the Cadillac Tax provision of the Affordable Healthcare Act that will have a monumental 2018 impact on healthcare coverage of employees who are now covered by employer plans --- plans now costing the government over $250 billion per year? But not for long!

Do you understand the Cadillac Tax provision?
Me neither. As Nancy Pelosi said years ago, Congress passed the ACA before anybody in the USA had a chance to study all the surprises in this the enormous bill.

If you're covered presently on your employer's plan you should most certainly learn about the Cadillac Tax provision that kicks in in 2018.

"The Cadillac Tax: A Game Changer for U.S. Health Care." by Jonathan Gruber (MIT), Harvard Business Review Blog, November 15. 2013 ---
http://blogs.hbr.org/2013/11/the-cadillac-tax-a-game-changer-for-u-s-health-care/

Bob Jensen's universal health care messaging --- http://www.trinity.edu/rjensen/Health.htm


Teaching Case on Cost Accounting in a Medical Revolution and Those 500% Mark Ups
From The Wall Street Journal Accounting Weekly Review on November 21, 2013

What Care Costs. Really.
by: Melinda Beck
Nov 18, 2013
Click here to view the full article on WSJ.com
 

TOPICS: Cost Management, Cost-Basis Reporting, Health Care, Managerial Accounting

SUMMARY: Brent C. James is "...Chief Quality Officer for Intermountain Healthcare, a...network of 22 hospitals and 185 clinics in Utah and Idaho. Dr. James has been using electronic records to improve care and cut costs since the 1980s." In this interview-format article, he discusses the medical field push to a cost-based system, away from a current system of charging for services performed regardless of necessity of the procedure. The article gives classic examples of establishing standard costs for materials and labor such as management engineers "who go around and stopwatch how much time it takes a technician to set up a lab test. They measure how much glassware and reagent the test consumes to process...."

CLASSROOM APPLICATION: The article may be used in a management accounting class to introduce standard costs, particularly the process of establishing standard costs.

QUESTIONS: 
1. (Introductory) Who is Brent C. James? What "medical revolution" may he be starting?

2. (Advanced) Define the term "standard cost." What measurement techniques are described I the article to establish standard costs for hospital products and services?

3. (Introductory) What does Dr. James say is the reason has it taken until now for hospitals to establish cost management systems?

4. (Advanced) What is "transparency"? How has Dr. James's hospital network's management pledged to provide transparency?

5. (Advanced) Are patients at Dr. James's hospital network going to seeing the cost data his team is compiling? Explain your answer.
 

Reviewed By: Judy Beckman, University of Rhode Island

"What Care Costs. Really," by Melinda Beck, The Wall Street Journal, November 18, 2013 ---
http://online.wsj.com/news/articles/SB10001424052702304561004579135434122969634?mod=djem_jiewr_AC_domainid

Brent C. James may be starting another medical revolution.

As chief quality officer for Intermountain Healthcare, a Salt Lake City-based network of 22 hospitals and 185 clinics in Utah and Idaho, Dr. James has been using electronic records to improve care and cut costs since the 1980s.

His data-driven clinical-management systems have been emulated around the world. He estimates that they save at least $250 million and 1,000 lives a year at Intermountain alone.

Now, Intermountain is building an ambitious new data system that will also be able to track the actual cost of every procedure and piece of equipment used in its hospitals and clinics, a function that is standard in many industries but not in health care.

Dr. James shared his vision and the challenges ahead with The Wall Street Journal. Cost Clarity

WSJ: You've described your new data system as a "cost master," in contrast to the "charge master" that many hospitals use to set prices. What's the difference?

DR. JAMES: In a charge master, what you're seeing is the old phenomenon called "mark it up to mark it down." Hospitals will make an initial estimate of what something costs, and then they'll mark it up—sometimes 400% to 500%. Insurance brokers measure success in the size of the discount they get. That's how you end up with $17 pieces of gauze. It loses all connection to reality.

In a cost-master system, you have empirical, fact-based costs. We have eight management engineers, for example, who go around and stopwatch how much time it takes a technician to set up a lab test. They measure how much glassware and reagent the test consumes to process, and how much time it takes on the analyzing machine. The engineers load all that information into the cost master and they get the true cost of running that lab test. They do similar cost measurements on every item contained in our cost master.

We figure we have about 5,000 clinical terms and upward of 25,000 total items in our cost master. Once I get those costs, I can manage them the way I would if I were building an automobile or a washing machine.

These are not new systems. They've been around for a long time in other industries. All we're doing is shifting them over to health care. Truth is, Intermountain has run this sort of activity-based costing since 1983. It just wasn't integrated into clinical documentation through an electronic medical record [EMR]. With a link to the EMR, maybe we'll be able to move health care out of the dark ages.

 

WSJ: How will knowing what everything costs change the way you deliver care?

DR. JAMES: If you know the true cost of providing care, you can ask yourself whether doing one thing is really more important than doing something else.

Our mission statement is: the best medical result at the lowest necessary cost. We think there is enough waste in health care that we can dramatically improve our costs. But to do that, I've got to be able to measure and manage those costs.

A Money Loser?

WSJ: In fee-for-service medicine, hospitals lose money when they cut costs and unnecessary care. How do you get around that?

DR. JAMES: That's why Intermountain made the decision several years ago to shift our business, over time, to capitated care.

In the past, the way to make money was to do more. Figure out how to do more surgeries, even if they're unnecessary. Add that famous physician to try to attract more patients. It creates a medical arms race. Imagine instead that I get a per-member, per-month payment for a population of patients. I no longer have a strong financial incentive for doing more. If I find a way to save money by taking out waste, all the savings come back to me and my patients. At the same time, I make measures of quality outcomes transparent. That way patients can know they are getting good care, and know what it will cost them.

 

WSJ: What impact do you expect this to have on the health-care industry?

DR. JAMES: The whole health-care world is shifting to having the care provider take over the financial risk. In that world, your survival depends on being able to manage your costs. We happened, by luck and circumstance, to get going on it early on. Suddenly this is becoming a race, with some very capable groups entering the fray—but it's a race toward excellence.

Total Transparency

WSJ: Will patients be able to see your actual costs?

DR. JAMES: We made a commitment from senior management that we will be completely transparent.

We have already started to post prices for things that many patients buy directly, such as lab tests and imaging exams [such as X-rays]. We will soon add things like routine office visits and simple procedures, like screening colonoscopy. Later we will add major treatments like delivering a newborn, or surgery to implant an artificial knee joint.

While we will post prices on our website, probably the most effective sharing of cost information will happen through our insurance partners' websites. We believe that patients will mostly want to know what their own out-of-pocket costs will be, given that they've already paid for their health insurance. That's true even if your "insurance plan" is the care delivery group.

Finally, remember that some care delivery is impossible to price as a package deal in advance. For example, treatment of major automobile trauma is so unique that it's impossible to predetermine a standard price.

 

WSJ: How much will the new system cost?

DR. JAMES: Several hundred million dollars. But I could pay for it in one year, if I can use it to get significantly more waste out.

Continued in article

Bob Jensen's universal health care messaging --- http://www.trinity.edu/rjensen/Health.htm




Bob Jensen's universal health care messaging --- http://www.trinity.edu/rjensen/Health.htm

Bob Jensen's Tidbits Archives ---
http://www.trinity.edu/rjensen/tidbitsdirectory.htm 

Bob Jensen's Pictures and Stories
http://www.trinity.edu/rjensen/Pictures.htm

Summary of Major Accounting Scandals --- http://en.wikipedia.org/wiki/Accounting_scandals

Bob Jensen's threads on such scandals:

Bob Jensen's threads on audit firm litigation and negligence ---
http://www.trinity.edu/rjensen/Fraud001.htm

Current and past editions of my newsletter called Fraud Updates ---
http://www.trinity.edu/rjensen/FraudUpdates.htm

Enron --- http://www.trinity.edu/rjensen/FraudEnron.htm

Rotten to the Core --- http://www.trinity.edu/rjensen/FraudRotten.htm

American History of Fraud --- http://www.trinity.edu/rjensen/FraudAmericanHistory.htm

Bob Jensen's fraud conclusions ---
http://www.trinity.edu/rjensen/FraudConclusion.htm

Bob Jensen's threads on auditor professionalism and independence are at
http://www.trinity.edu/rjensen/Fraud001c.htm

Bob Jensen's threads on corporate governance are at
http://www.trinity.edu/rjensen/Fraud001.htm#Governance 

 

Shielding Against Validity Challenges in Plato's Cave ---
http://www.trinity.edu/rjensen/TheoryTAR.htm

·     With a Rejoinder from the 2010 Senior Editor of The Accounting Review (TAR), Steven J. Kachelmeier

·     With Replies in Appendix 4 to Professor Kachemeier by Professors Jagdish Gangolly and Paul Williams

·     With Added Conjectures in Appendix 1 as to Why the Profession of Accountancy Ignores TAR

·     With Suggestions in Appendix 2 for Incorporating Accounting Research into Undergraduate Accounting Courses

Shielding Against Validity Challenges in Plato's Cave  --- http://www.trinity.edu/rjensen/TheoryTAR.htm
By Bob Jensen

What went wrong in accounting/accountics research?  ---
http://www.trinity.edu/rjensen/theory01.htm#WhatWentWrong

The Sad State of Accountancy Doctoral Programs That Do Not Appeal to Most Accountants ---
http://www.trinity.edu/rjensen/theory01.htm#DoctoralPrograms

AN ANALYSIS OF THE EVOLUTION OF RESEARCH CONTRIBUTIONS BY THE ACCOUNTING REVIEW: 1926-2005 ---
http://www.trinity.edu/rjensen/395wpTAR/Web/TAR395wp.htm#_msocom_1

Bob Jensen's threads on accounting theory ---
http://www.trinity.edu/rjensen/theory01.htm

Tom Lehrer on Mathematical Models and Statistics ---
http://www.youtube.com/watch?v=gfZWyUXn3So

Systemic problems of accountancy (especially the vegetable nutrition paradox) that probably will never be solved ---
http://www.trinity.edu/rjensen/FraudConclusion.htm#BadNews

Bob Jensen's economic crisis messaging http://www.trinity.edu/rjensen/2008Bailout.htm

Bob Jensen's threads --- http://www.trinity.edu/rjensen/threads.htm

Bob Jensen's Home Page --- http://www.trinity.edu/rjensen/