Tidbits Quotations
To Accompany the April 26, 2015 edition of Tidbits
http://www.trinity.edu/rjensen/tidbits/2015/tidbits032615.htm  
Bob Jensen at Trinity University

Only those who will risk going too far can possibly find out how far one can go.
T.S. Eliot

Be brave enough to start a conversation that matters.
 Margaret Wheatley,

We must be willing to get rid of the life we've planned, so as to have the life that is waiting for us.
Joseph Campbell

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

Happiness is like a butterfly: the more you chase it, the more it will elude you, but if you turn your attention to other things, it will come and sit softly on your shoulder.
 Henry David Thoreau

Heads are going to role
ISIS --- http://www.businessinsider.com/r-islamic-state-shot-and-beheaded-30-people-in-libya-video-2015-4

(Indiana) School District Excludes All White (and Asian) Students From Third-Grade Field Trips To Local Colleges ---
http://dailycaller.com/2015/04/17/school-district-excludes-white-students-from-third-grade-field-trips-to-local-colleges/
Is this kind of racial policy in the public sector legal? Would it be legal in a private school?

Let me tell you that government creates jobs, not business
Hillary Clinton --- http://guardianlv.com/2014/10/hillary-clinton-backs-away-from-businesses-do-not-create-jobs-remark/
Jensen Comment
I was listening to her on television when she first made this assertion. Let me tell you that it is the most ignorant assertion that I've heard in my entire life.

The Unsustainable Eurozone ---
http://economia.icaew.com/finance/april-2015/sustaining-the-unsustainable-eurozone

What do the USA and North Korea Have in Common?
North Korea bills itself as a collectivist state, but the country has plenty of black and grey markets. A survey of North Korean defectors found 62 percent reported working outside their official occupations. “Private trade has become so prevalent in recent years that it permeates all levels of society, from the poorest through to the Communist Party and military elites.”
James Pearson and Daniel Tudor, Reuters ---
http://blogs.reuters.com/great-debate/2015/04/13/years-after-the-famine-heres-how-north-koreans-really-get-by/

The Politics Of Christie’s Social Security Plan Are Atrocious ---
Harry Enten --- http://fivethirtyeight.com/datalab/the-politics-of-christies-bold-social-security-plan-are-atrocious/ 

If only Obama had paid attention to Iraq ... But his only interest in Iraq was in ending the war.
Emma Sky, former White House aide to the top US commander in Iraq
http://www.businessinsider.com/obamas-iraq-policy-and-criticism-2015-4#ixzz3XNBUxho4

. . .

Emma Sky is no warmonger. She is a British, Oxford-educated political analyst who served as a humanitarian worker in the Middle East for a decade before helping the US rebuild Iraq.

And her new book, "The Unraveling: High Hopes and Missed Opportunities in Iraq," is not kind to the Obama administration's handling of Iraq.


Read more: http://www.businessinsider.com/obamas-iraq-policy-and-criticism-2015-4#ixzz3XNC3JwOl
 

 

Global Warming Is Already Clobbering the Amazon ---
http://www.wired.com/2015/04/global-warming-already-clobbering-amazon/

 

We'd rather be obese on benefits than thin and working.
Janice and Amber Manzur
http://www.telegraph.co.uk/news/uknews/11347454/Mother-and-daughter-weigh-a-total-of-43-stone-and-get-34k-a-year-handouts-but-refuse-to-diet.html 

Moocher Hall of Fame --- https://danieljmitchell.wordpress.com/the-moocher-hall-of-fame/

Bob Jensen's Fraud Updates --- http://www.trinity.edu/rjensen/FraudUpdates.htm

Jensen Comment
The problem is that we've made the USA Presidency unattainable by honest, truthful, self-sacrificing, bipartisan, and skilled world leaders. To become president these days requires selling your soul to corruption, money, and power.

Where are the clowns?
Don't bother they're here?
https://www.youtube.com/watch?v=HqcKDmjFfNI

Yes, "The Clintons Have Been Disorganized and Greedy," But the Republicans Are Still "the Stupid Party" ---
http://reason.com/blog/2015/04/24/yes-the-clintons-have-been-disorganized#.03jwkv:bWBa

You Know, It Sure Looks Like Hillary Was Bribed at State ---
Mitt Romney

NYT, WSJ Editorial Boards Hit Clinton Over Foundation Dealings
Matt Vespa  --- http://townhall.com/tipsheet/mattvespa/

"The Clinton Scandal Manual," by Kimberly A. Strassel, The Wall Street Journal, April 23, 2015 ---
http://www.wsj.com/articles/the-clinton-scandal-manual-1429831783?tesla=y

. . .

The standard operating procedure never changes, however. It is as if the Clintons have—filed within easy reach on a shelf—a book titled “Clinton Scandals for Dummies.”

Chapter One: “Pick Your Spots.” The Clintons flourish in that hazy interface between legal and lawless. Their dealings always stink, but are rarely blatantly or provably (or traceably) corrupt. Consider this week’s news. Yes, tons of donor cash flowed to the Clinton Foundation at the same time Mrs. Clinton’s State Department was greenlighting deals helping those donors. But prove there was a quid pro quo! The Clintons dare you.

They know you likely can’t, since Chapter Two is “Limit Those Paper Trails.” Remember those “misplaced” 1990s documents, but also reread the 2000 report from the House Committee on Government Reform titled “The Failure to Produce [Clinton] White House E-Mails: Threats, Obstruction and Unanswered Questions.” The Clintons learned it took effort to keep documents secret. These days, they make sure there are no documents at all. (Mrs. Clinton, which emails would you like us to delete? Just search for key words “yoga,” “wedding” and “uranium.”)

Chapter Three: “Remember, the Press Has ADD.” Pixar’s “Up” features Dug, a cute dog with a serious attention problem (“squirrel!!!”). This is how the Clintons view the media. Pettable. Unfocused. When caught, the Clinton communications team will issue lofty dismissals—calling charges baseless or old news—and wait for the press to believe it. If it doesn’t, Team Clinton will hold one press conference—a la Mrs. Clinton’s email event—and wait for the media to call the case closed. If it doesn’t, they will change the subject (Hillary is running for president! Squirrel!!!) and wait for the press to lose interest. It often does.

Still, if all else fails, there is Chapter Four: “Vast Right-Wing Conspiracy”—or VRWC. Mrs. Clinton’s conspiracy shtick is today a bit of a joke, but it doesn’t make it any less effective. It works to cast any serious investigation of Clinton behavior as a partisan witch hunt, and therefore illegitimate. And it does work. Former Virginia Gov. Bob McDonnell is going to jail on dubious claims of trading favors for money. Could an enterprising prosecutor cobble together a similar case against Hillary? Undoubtedly. But no one will for fear of being accused of doing a Republican hit job on the Clintons.

The rest of the book falls under the heading “Stockholm Syndrome,” and consists of tactics for convincing fellow Democrats that the Clinton machine is inevitable. The Democratic Party has for so long been held psychologically hostage to the Clinton scandal factory, a part of it—albeit an aging part—has forgotten there is happy, normal life. So (for now at least) it sticks with its captors.

The question is whether this model, perfected in an earlier age, can hold—especially under the cascade of scandals. Times have changed. There’s more competition in the media these days (blogs, cable, podcasts) and that’s kept pressure on traditional outlets to keep digging into the Clinton Foundation money story. So much so that this week Mrs. Clinton had to escalate to VRWC.

The Democratic Party has changed. It’s now more Obama than Clinton, its left dominated by progressives who didn’t grow up under Hillary, and don’t much like her. They want Elizabeth Warren, and what surely terrifies the Clintons is the potential party explosion were the Massachusetts senator to jump in at this moment of vulnerability. Would it take much to send the party bolting to a fresher female firebrand—without the baggage?

Maybe not, because Mrs. Clinton isn’t putting on the best show. She never had Bill’s political charm, and her years out of elected politics are showing. She looks grim. She looks cautious—hedging her bets, refusing to take positions. She looks out of touch, in the Scooby-Doo van. Mrs. Warren doesn’t have any of these problems.

The most likely scenario is still that the Clintons prevail—the media lets go the stories, the party sticks with the $2.5 billion woman. But as the Clintons replay the scandal script, and keep adding liabilities to Hillary’s campaign, you have to imagine a growing number of Democrats are wondering: what if? The Clintons might, at the very least, want to consider updating that manual.

Clinton Greed ---
 http://townhall.com/columnists/lindachavez/2015/04/24/clinton-greed-n1989794?utm_source=thdaily&utm_medium=email&utm_campaign=nl&newsletterad=

Clinton Foundation Spending: ONLY 15% ON CHARITY?

The Federalist (via Drudge) ^ | March 2, 2015 | Sean Davis
When anyone contributes to the Clinton Foundation, it actually goes toward fat salaries, administrative bloat, and lavish travel. Between 2009 and 2012, the Clinton Foundation raised over $500 million dollars according to a review of IRS documents by The Federalist (2012, 2011, 2010, 2009, 2008). A measly 15 percent of that, or $75 million, went towards programmatic grants. More than $25 million went to fund travel expenses. Nearly $110 million went toward employee salaries and benefits. And a whopping $290 million during that period — nearly 60 percent of all money raised — was classified merely as “other expenses.” ...

Hillary Clinton's Campaign Isn't Answering Questions About Sketchy Clinton Foundation Donations ---
http://reason.com/blog/2015/04/23/hillary-clinton-campaign-isnt-answering

New York Times reporter has accused Bill Clinton of trying to deny meeting linked to 'Clinton Cash' scandals ---
http://www.businessinsider.com/nyt-reporter-clinton-lied-about-meeting-2015-4#ixzz3YAo9KwaQ

Yes, "The Clintons Have Been Disorganized and Greedy," But the Republicans Are Still "the Stupid Party" ---
http://reason.com/blog/2015/04/24/yes-the-clintons-have-been-disorganized#.03jwkv:bWBa

Jensen Comment
The problem is that we've made the USA Presidency unattainable by honest, truthful, self-sacrificing, bipartisan, and skilled world leaders. To become president these days requires selling you soul to corruption, money, and power.

Where are the clowns?
Don't bother they're here?
https://www.youtube.com/watch?v=HqcKDmjFfNI

I'm glad I'm not young anymore!

Bob Jensen's Fraud Updates --- http://www.trinity.edu/rjensen/FraudUpdates.htm

 

 

Wealth Tax --- http://en.wikipedia.org/wiki/Wealth_tax

. . .

In the United States, depending upon how Article 1, Sections 2 and 9 of the United States Constitution would be interpreted, the implementation of a wealth tax not apportioned by the populations of the States would require a Constitutional amendment in order to be passed into law. The United States Constitution prohibits any federal direct tax on asset holdings (as opposed to income tax or capital gains tax) unless the revenue collected is apportioned among the states on the basis of their population.[40][41][42] Although a federal wealth tax is prohibited unless the receipts are collected from the States by their populations, state and local government property tax amount to a wealth tax on real estate.[43] There is sufficient question about its Constitutionality that the issue is debatable.

Hillary Clinton called for 'toppling' the 1% ---
http://finance.yahoo.com/news/report-hillary-clinton-called-toppling-140603537.html
Also see
http://hotair.com/archives/2015/04/21/hillary-at-meeting-with-economists-we-need-to-topple-the-wealthiest-one-percent/

Clinton pointed at the top category and said the economy required a 'toppling' of the wealthiest 1 percent, according to several people," writes The Times' Amy Chozick.

Continued in article

Jensen Comment
The Devil is in the details. The interesting thing is that She and Bill will be toppled as well along with her wealthiest friends donating the enormous contributions to her campaign, including the donations from celebrities like Barbara Streisand and George Clooney. 

Here are some of the disadvantages of toppling the wealthiest people in a nation ---
http://en.wikipedia.org/wiki/Wealth_tax#Disadvantages
Scroll up to see some of the alleged advantages.

Of course economics is not Ms. Clinton's strong suit.

Let me tell you that government creates jobs, not business
Hillary Clinton --- http://guardianlv.com/2014/10/hillary-clinton-backs-away-from-businesses-do-not-create-jobs-remark/
Jensen Comment
I was listening to her on television when she first made this assertion. "Let me tell you" that it is the most ignorant assertion that I've heard in my entire life.

She's Ready (Hillary Dances) --- Click here: 2008

What countries do when migrants show up in droves by boat ---
 http://www.businessinsider.com/heres-how-countries-cope-with-migrants-arriving-by-boat-in-droves-2015-4#ixzz3XxFoD25u

Jensen Comment
Undocumented people crossing into the USA from Mexico find it much easier to bypass the border patrol and move undetected into other parts of the USA. These are the rights of those that are detained by authorities in the USA ---
http://www.nilc.org/to_do_if_arrested_2007-08.html
Those that are deported are often back in the USA in a matter of weeks. Those arrested for felonies who are deported face greater risks when re-entering the USA.

Nate Silver --- http://en.wikipedia.org/wiki/Nate_Silver

From Nate Silver's 5:38 Blog on April 17, 2015 --- http://fivethirtyeight.com/

Whether you get a tax bonus by being married or end up paying the marriage penalty depends on how much income you and your partner make and how it’s divided between you
Should You Get Married (Or Divorced) For Tax Reasons? (by Ritchie King) ---
http://fivethirtyeight.com/interactives/marriage-penalty/

She Got the Gold Mine and You Got the Shaft ---
https://www.youtube.com/watch?v=U-p0zn3PijY
With Dolly
https://www.youtube.com/watch?v=lLA3NdXDRIw

Chat With Nate Silver And Harry Enten About 2016!  ---
http://fivethirtyeight.com/datalab/chat-with-nate-silver-and-harry-enten-about-2016/

"Is Bush Doomed In The General? (Or: A Lesson In Conditional Probability)," by Nate Silver, 5:38 Blog, April 17, 2015 ---
http://fivethirtyeight.com/datalab/is-bush-doomed-in-the-general-or-a-lesson-in-conditional-probability/ 

Significant Digits For Friday, April 17, 2015  ---
http://fivethirtyeight.com/datalab/significant-digits-for-friday-april-17-2015/

If Republicans hang on to the a Majority in both the House and the Senate in November 2016 it will be the end of the world
Nancy Pelosi (who certainly does not look like she turned 75 years of age on March 26, 2015)

Boston College Subpoena --- https://bostoncollegesubpoena.wordpress.com/

Farmers Bear Brunt of Climate Impacts ---
http://newsroom.unfccc.int/action-to-adapt/fao-famers-bear-brunt-of-climate-impacts/

Northeast Has Snowiest Winter Since 1717 ---
http://www.thepiratescove.us/2015/04/13/northeast-has-snowiest-winter-since-1717/
It was cold as well.

A Different Kind of Red States Versus Blue States:  Divisional Average Temperature Ranks---
http://www.ritholtz.com/blog/wp-content/uploads/2015/03/record-temp.jpg

"The Dirty Secret of Obama’s Carbon Plan," by Warner Baxter," The Wall Street Journal, April 12, 2015 ---
http://www.wsj.com/articles/the-dirty-secret-of-obamas-carbon-plan-1428875418?tesla=y

Americans don’t give much thought to whether their electricity will be there when they need it. You flip a switch, the lights go on. Your phone charges up. The medical equipment in the emergency room does its job. Yet electric reliability, long a bedrock of this country’s prosperity and high standard of living, does not come as easily as its steady presence might suggest.

The Environmental Protection Agency’s Clean Power Plan, a proposed regulation limiting carbon emissions from existing coal-fired plants, threatens to jeopardize the reliability that Americans and businesses have come to depend upon. The EPA proposal calls for states to cut emissions by 30% from 2005 levels by 2030. It also imposes aggressive interim targets starting in 2020 that will test states’ ability to meet these standards without disrupting service. For example, 39 states must achieve more than 50% of their final target by 2020.

Reliable power requires decades of careful planning. The appropriate amount and type of round-the-clock generation capacity, transmission and distribution lines must be finely balanced in advance to ensure the lights go on when a switch is flipped anywhere in the U.S. The EPA plan will significantly impair that planning process.

The EPA’s proposal is causing concern among those who provide electricity for a living. The Federal Energy Regulatory Commission held an event in St. Louis on March 31, the last in a series of conferences on the implications of the plan. The North American Electric Reliability Corp., a nonprofit oversight group, has said the EPA plan could constitute “a significant reliability challenge, given the constrained time period for implementation.”

These concerns are driven in large part by the planned retirement, mostly thanks to the EPA’s carbon plan, of about one-third of America’s coal-fired power plants by 2020. This represents enough generating capacity to supply the residential electricity of about 57 million Americans. That’s a lot of power being taken off the grid in a very short period.

It takes years to site, permit and construct replacement power plants, and EPA’s compliance timeline does not account for this reality. For example, if a new gas-fired power plant must be built to meet the EPA’s 2020 interim target, all permitting and development would need to be completed by 2017. But that is impossible because state compliance plans might not even be submitted to the EPA until 2017 or 2018, and the agency has said it may take up to a year to approve them.

Beyond that, opening new natural-gas plants, as well as operating existing plants at higher levels, will require new pipeline infrastructure, and building natural-gas pipelines often takes five years or longer. More transmission lines will likely be needed to connect the new capacity to the grid. These projects can take 5-15 years. The point is that the 2020 interim targets are simply not achievable.

Like many utilities, my company, Ameren, has spent years developing a plan that achieves substantial carbon reductions without straining the grid or needlessly raising rates. With millions of people in Missouri and Illinois relying on us for safe, reliable and reasonably priced energy, we have to find responsible, practical ways to transition to a cleaner and more diverse portfolio. Our 20-year plan involves adopting a mix of coal, nuclear, natural gas and renewables, while improving energy efficiency, and reaches the EPA goal only five years later than the current plan—and at a staggering cost savings of $4 billion for our Missouri customers, according to company estimates.

A few solutions would significantly reduce the reliability and cost risks of the EPA’s proposed plan. A critical first step is that the EPA must replace its aggressive interim targets with a process that allows states to set their own paths toward the final goals. Each state should be allowed to tailor its compliance plan to local circumstances, balancing unique factors such as cost, fuel diversity and environmental benefits. In exchange for this flexibility, enhanced interim reporting requirements would help the EPA monitor the progress while providing a more accurate idea of the work under way—and challenges involved—in achieving the targets.

Beyond that, two safeguards should be added to the plan. First, it should include a mechanism to deal with reliability issues before a state’s plan is implemented. Such a mechanism would require the Federal Energy Regulatory Commission to examine the effects of state-submitted plans on regional reliability. If issues are identified, the state should be allowed to resubmit a revised plan and potentially adjust its targets to maintain reliability.

Continued in article

Also see
http://www.wsj.com/articles/washingtons-beyond-coal-blackout-1428706365?tesla=y

The Worst Tax Breaks According to the New York Times ---
http://www.nytimes.com/roomfordebate/2015/04/14/the-worst-tax-breaks

No mention is made of the most popular way that wealthy people avoid taxation by investing in bonds of towns, cities, counties, cities, school districts, and qualified economic development zones. There is a strong argument for this break that significantly lowers the cost of capital of those worthy borrowers. No mention is made of significantly increasing the penalties for participating in the $2 trillion underground economy.

What about lower rates on capital gains? What about tax deferrals for foreign investments? Now these are breaks for the rich.

What about the tax breaks in the underground economy? Millions of people on welfare supplement their incomes tax free while receiving Medicaid, food stamps, subsidized housing, etc. Oops these are tax breaks for the poor. The NYT would never criticize tax breaks for the poor.

 

The IRS Budget Cuts:  Administration Versus Tax Handouts ---
http://taxprof.typepad.com/taxprof_blog/2015/04/irs-budget-cuts-.html

Chris Edwards (Cato Institute), IRS Budget Cuts and Tax Filing:

For taxpayers needing IRS help, this year’s filing season could be a nightmare. The Washington Post today reports on the long lines at IRS offices. The newspaper suggests that five years of Republican budget cuts are to blame, even though Democrats control the White House and, until recently, the Senate. But, whoever is at fault, the IRS commissioner is correct that his agency’s service is “abysmal.”

Let’s take a closer look at those alleged budget cuts. Using data from the OMB budget database, I split total IRS outlays into two activities: administration and handouts. Administration includes tax return processing, taxpayer help, enforcement, and other bureaucratic functions. Handouts are mainly refundable tax credits, particularly the earned income tax credit, child credit, and Obamacare exchange subsidies, which began in 2014.

Continued in article

 

 

PREPARED REMARKS OFJOHN A. KOSKINEN COMMISSIONER, INTERNAL REVENUE SERVICE, BEFORE THE NATIONAL PRESS CLUB
March 31, 2015
http://www.irs.gov/uac/Newsroom/Commissioner-Koskinen-Speech-before-the-National-Press-Club

Thank you for that warm welcome. I’m delighted to be back here at the National Press Club.

The IRS Commissioner isn’t always the hottest ticket in town, because everyone knows the subject is going to be taxes. So I want to thank the Press Club for allowing me a return engagement, and I promise to stifle the impulse to remind everyone, as a public service announcement, that April 15th is just around the corner – although it is. I hope everyone is doing well with their taxes, and would remind you that the complexity of the tax code is not my fault.

I’ve now been leading the IRS for 15 months. It has certainly been in an interesting time, to say the least – and has led me to conclude that, next time, I should pay more attention to the fine print of the contract. Especially the part about long hearings running into the night with no breaks. Today, I want to share with you some observations and some insights about the IRS, on the past, the present and the future.

First, I’d like to talk a little bit about what I’ve learned about the IRS.

When people hear “IRS,” they usually think of tax enforcement, a letter in the mail or a knock on the door. While we are the nation’s tax collector, that’s not the whole picture. Besides enforcement, another big part of our job is to help taxpayers fulfill their tax obligations as quickly and easily as possible.

When I arrived at the IRS, it surprised me to learn that more than a third of our employees work in taxpayer service. For example, we run one of the world’s largest customer service phone operations. But after seeing everything they do to keep the tax system running and help taxpayers, I’m no longer surprised. Let me give you a few numbers to show you what I mean, courtesy of our excellent research division. The leader of that group, Rosemary Marcuss, is here on the dais today. She will be retiring shortly, and I want to thank her for more than three decades of wonderful public service, at the IRS, the Bureau of Economic Analysis, and the Congressional Budget Office.

So consider some of these breath-taking numbers.

This year, the IRS has already received about 92 million tax returns from individual taxpayers, on the way to an expected total of 150 million. We have issued more than 71 million refunds to individuals so far.

Last year, the refunds we processed topped $330 billion. Put another way, that’s more than the GDP of entire nations, such as Chile, Portugal, Ireland, and my own personal favorite, Finland. I should note, in passing, that given my Finnish ancestry, I get better press in Finland than I sometimes get here. But that’s another story.

This year, through March 20th, the average refund check issued by the IRS was nearly $2,900. That’s real money going into people’s wallets and back into the economy. In a way, I suppose you can blame the IRS at this time of year for the annual surge in loud commercials selling furniture, flooring and cars – all in pursuit of the biggest check many people see all year.

Also, thus far in 2015, the IRS has assisted more than 24.2 million taxpayers who called our telephone help lines. We’ve helped more than 1.3 million people who visited one of our 350 Taxpayer Assistance Centers around the country. Our website, IRS.gov, continues to grow, with more than 231 million visits. Our electronic tracking tool, “Where’s My Refund, is even more popular than ever, with more than 173 million hits already this year.

But there’s more. We also routinely provide help to people who are victimized by identity theft, dispute a tax liability or face some form of hardship. In 2014, our Appeals officers assisted more than 100,000 taxpayers, while the Taxpayer Advocate Service provided help to more than 200,000. Our employees with special identity-theft training worked with victims to resolve about 825,000 cases of tax-related identity theft.

And our tax collection continued as well. As the economy improved in 2014, the IRS collected a total of $3.1 trillion in federal revenue. And yes, that’s $3.1 trillion – not billion. We’ve been working hard to improve our operations. One interesting figure that comes out of this is the cost of collecting this revenue. According to statistics gathered by the OECD, the IRS spends less than half the amount to collect a dollar of revenue than do the tax administrations of Germany, France, England, Canada and Australia.

I could go on. If there’s any place that has numbers, it’s the IRS. But we only have an hour, so I won’t. But I hope this gives you a better idea of what the IRS does year-in and year-out.

I also want to mention the people behind these numbers. None of the work I just described could happen without the dedication, professionalism and expertise of our employees, and my admiration for them continues to grow. I’ve never seen such a dedicated workforce in my entire career. The smooth filing season we’re experiencing is a great testimonial to our employees. They have achieved an amazing degree of success, when you consider that the challenge this filing season was to build into our system the back end of the Affordable Care Act, the front end of the Foreign Account Tax Compliance Act and the tax extenders passed in December. We often only hear from people only when things go wrong so I thought it would be helpful to remind you of something significant that’s going right.

A great exemplar of the caliber of our work force is sitting up here on the dais with us: Eric Smith, who has spent nearly four decades at the IRS working with reporters, helping them put the complexities of the tax code into plain English. And he shows no signs of slowing down. His dedication to public service is what you find with employees in locations all across the country.

I wanted to give you this picture of the IRS today because I think it has been obscured by the intense focus on the problems of the past. For a while now, you’ve heard a lot about these problems: overspending on conferences, making some ill-advised videos and, of course, inappropriate scrutiny of applications from groups seeking social welfare status and others. The criticism of these areas is absolutely deserved. But what gets lost is that these mistakes occurred several years ago, and we have taken concrete steps to address them.

In the tax-exempt area, we acted on all of the Inspector General’s recommendations to fix the management problems they identified nearly two years ago. These problems should not have happened, and we continue to work to make improvements to insure that they never happen again. As for conferences, spending has been reduced by 80 percent since 2010. Not only that, but we require all conferences costing above $20,000 to get prior approval from the IRS Commissioner, otherwise known as me. And, for any expense over $50,000, planners have to get my approval and that of the Treasury Department.

And as for videos, many of the ones we’re making these days are aimed at helping taxpayers. The IRS channels on YouTube now have more than 100 videos, with nearly 9 million views to date. Make no mistake – we’ll never compete with Taylor Swift, Jimmy Fallon or funny animal videos. But our videos do offer help on some tough tax topics. Their subjects run the gamut from understanding how to claim various tax credits to protecting yourself from identity theft and avoiding tax scams. What’s more, the much-criticized videos from years ago could not be made today. Any IRS division seeking to make a video must receive prior approval from an executive review board the agency created more than two years ago.

And not to miss anything that people might have listed to justify cuts to our budget, we no longer pay performance awards to employees who have willfully failed to pay their taxes. But I would note that the tax compliance rate of IRS employees is over 99 percent, by far the highest compliance rate of any government agency. And we are working to insure that no former employee with a serious performance problem is rehired.

I would stress that, while these problems are important, and deserved our attention and the remedies we have applied, they are from a prior era. We have addressed them so they will not happen again. That really does make it a new day at the IRS. It’s not the IRS of 2010, 2011 or even 2012.

I can’t guarantee that we won’t have problems in the future. No one could, since we have 87,000 employees who deal with 150 million individual taxpayers and administer the world’s most complicated tax code. But I can assure you that our commitment is to find problems quickly, fix them promptly and be transparent in the process.

So how are we doing that?

In the past, problems sometimes were not found fast enough or corrected right away. We are now building a culture within the IRS that is focused on risk management, that encourages the flow of information up from the front lines through the organization, and that encourages every employee to think of themselves as a risk manager, responsible for reporting problems as soon as they see them. Employees are beginning to believe that I mean it when I say that bad news is good news, we don’t shoot the messenger, we reward him or her, and the only problem we can’t fix is the one we don’t know about.

In trying to build for the future, one of the challenges we’re facing involves our workforce, which has changed dramatically over the years. The workforce issues facing the IRS are similar to the challenges facing many other government agencies. For years, we’ve heard concerns about the “brain drain” confronting the federal workforce as large numbers of workers head toward retirement. The IRS has been dealing first-hand with that issue.

The problem is aggravated by our steadily declining employee numbers, which in turn are driven by our budget cuts. The high-water mark of the agency’s workforce in terms of size was in 1992. Since then we have lost more than 30,000 full-time employees, and are at our lowest level since the early 1980s.

The drop has been accelerating. Between 2010 and 2014, the IRS lost over 13,000 employees. These aren’t just positions in Washington or one or two other cities. Every state in the country now has fewer IRS employees than they did a few years ago – meaning fewer people to help with taxpayer service and enforcement. We expect to lose through attrition another 3,000 people – possibly more – by October 1st of this year.

The resulting composition of the IRS workforce also presents a challenge. The problem is simple. Given my own age, I think I can diplomatically say our workforce is maturing at a rapid rate. As highly skilled employees retire, we need to replace them with the next generation of talented, dedicated people. But that is becoming harder and harder to do, in large part as the result of the hiring freeze we have been forced to maintain for the last several years to absorb the significant cuts to our budget since 2010. More than 70 percent of our budget is devoted to employee costs, so we have had no choice but to constrain our hiring of new employees.

As a result, the portion of our workforce over 50 years of age has been growing steadily during the last several years. Today more than half of our employees are in that age group. And we estimate that by next year, more than 25 percent of the IRS workforce will be eligible to retire. By 2019, that number will be over 40 percent. Meanwhile, the number of IRS employees under 30 has been steadily declining, and is now less than 3 percent of our workforce. We only have about 1,900 employees under age 30 – and about half of those are only part-time. And we have only 650 employees who are 25 or younger. Essentially, the IRS is facing its own version of the Baby Bust.

This situation makes it extremely difficult, if not impossible, for the IRS to properly develop its next generation of leaders. We estimate that by next year 41 percent of our front-line managers and 61 percent of our executives will be eligible to retire.

With so many departures go knowledge and expertise that we will find difficult or impossible to replace, especially if our severe underfunding continues.

For anyone who questions whether it really is a new day at the IRS, let me share another piece of information with you about our workforce. Since October, 2011, 101 IRS executives, or 46 percent of the leaders of our agency, have left. The turnover for our top tier of leaders on our senior team is even higher: nearly two-thirds since 2011. Some of our business divisions have experienced a still higher rate of turnover. A good example is our Small Business/Self-Employed Division, where about 80 percent of the current leadership team is new since the end of 2010. The changes are so significant throughout the agency that you could hang a sign on our headquarters saying “Under New Management.”

Tax issues aren’t simple, and neither are the core skills we need to run the IRS. For our technical positions, it’s not like hiring people for a fast-food restaurant or a grocery store. When we hire a tax auditor, it takes years for them to reach full productivity. And it can take even longer for those auditing the largest, toughest corporate cases that involve complex issues spanning industries and national boundaries. That’s one of the reasons we have decided, even in this budget environment, that we have to continue to train our employees to insure that they are as prepared as possible to deal effectively with taxpayers and their questions and problems.

These negative impacts of our budget situation on our workforce are generally overlooked in our funding discussions. And yet these issues are critical to the future of the agency and will only grow in importance in the months and years ahead. As I have noted along the way, my term will end before the true magnitude of this problem is visible to outsiders. But it would be irresponsible to just slide along without beginning to address the situation.

We have a number of initiatives underway to deal with this specific challenge. With regard to the loss of insights and experience when employees retire, we have initiated an agency-wide knowledge management program designed to capture, to the extent that we can, the lessons learned along the way by employees at all levels of the organization. Our Large Business and International Division is leading the way in this area, and our Human Capital Organization is coordinating similar activities in other areas.

The Office of Personnel Management has approved a phased-retirement program designed to have retirees spend time transferring their experiences to ongoing employees. We are still studying how to fit that program into operations that don’t have the resources to support that activity.

With regard to our lack of younger employees in the work force, I have advised our senior leadership that this is the last year that we will deal with budget constraints by freezing or severely limiting new hires into the agency. We have interesting and exciting career opportunities to offer to young people beginning their careers, and we need to encourage more of them to join the agency.

In days gone by, the IRS had a reputation of being a great place to start your career, because of everything you learned that made you attractive to accounting firms, businesses and law firms. Many of those who started with the IRS, and assumed they would move on after what sometimes was viewed as a post graduate education, discovered the challenge and satisfaction of the work here, and stayed throughout their careers. We need to restore our reputation in that regard.

But I’m not here today just to talk about problems we face. We are also working to move the agency forward with new ideas and new initiatives, especially new ways of helping taxpayers. Even with our budget constraints, many good things have been happening at the agency recently that people may not be aware of. Let me give you just a couple of examples.

One is our adoption last summer of a Taxpayer Bill of Rights. We believe this is a cornerstone document that will provide clearer help to taxpayers. The Taxpayer Bill of Rights contains 10 fundamental rights that every taxpayer should be aware of, such as the right to receive quality service from the IRS, the right to pay no more than the correct amount of tax, and the right to retain representation when a taxpayer has a disagreement with the Service. Our employees believe in these rights and are doing their best to advise taxpayers about them and to support them in their day-to-day activities.

Given the complexity of our tax code, the majority of taxpayers these days seek professional help with their taxes. Last year, more than half used a professional preparer. The IRS has been taking steps to help taxpayers know where and how to get the help they need. We’ve also been working with the national tax groups, including some of those here in the room, on raising taxpayer awareness about the different types of tax professionals available to help. As part of that effort, we launched a new directory of tax return preparers on IRS.gov earlier this year. For the first time, taxpayers can use this directory to find tax professionals with credentials and qualifications in their local area.

We also are trying new ways of doing business in our Taxpayer Assistance Centers. We remain deeply concerned about helping people at these walk-in sites, given our resource limitations. We are aware of taxpayers lining up outside some of our offices many hours before they open. You would think we were selling the Apple Watch. This isn’t a new story this year, it’s just gotten worse, and we are working to find a better approach for taxpayers.

To help cut down on the long lines, one new approach we’re trying is very simple: Why not let people make appointments in advance rather than wait in line for hours? We began doing this at 10 centers in February, and recently added 34 more. If this works, we’ll consider expanding the approach to all of our Taxpayer Assistance Centers.

We have already discovered one major advantage of this new system. The IRS employee setting the appointment time is often able to determine what the taxpayer’s problem is and, as a result, what information the taxpayer needs to bring with them to their appointment. This saves the taxpayer the aggravation of having to make a return trip later. This pilot program is a great example of a common-sense change that increases the level of customer service we can provide while minimizing needless, pointless burden on taxpayers.

Another good example of a new initiative is in the tax-exempt area, where 15 months ago we had a backlog of applications from groups seeking status as private, nonprofit organizations. These applications come in at a rate of 70,000 a year, and at one point the backlog surpassed 60,000. This kept these groups in limbo for months or years. So our exempt organizations group got to work trying to come up with ways of tackling the problem before it got further out of hand.

Those efforts led to new processes and the development of a simpler application form for small groups, the 1023-EZ. That form debuted last year. The result is that our inventory of applications is now current. That’s a huge accomplishment – and a change that’s helping all applicants, including larger organizations completing the longer, more complicated forms.

Those are just a few of the new innovative initiatives we’ve been working on to help taxpayers and improve tax administration. All of these efforts are important, but we want to do still more.

In the time remaining, I want to talk about the IRS of the future and some of the things we’re looking at. Before we do that, I need to talk for a minute about our current budget and technology challenges.

By now, some of you may wonder why I don’t get tired of talking about this subject. The simple answer is that the underfunding of the agency is the most critical challenge facing the IRS today. As the serious ramifications of five years of budget cuts become increasingly visible, I don’t want anyone to say that we didn’t warn you in advance. Consider this your warning.

In case you missed it, the IRS budget for Fiscal Year 2015 was set at about $10.9 billion, which is $1.2 billion less than five years ago. The IRS is now at its lowest level of funding since 2008. If you adjust for inflation, our budget is now comparable to where we were in 1998. Despite that, we’ve taken on many new additional responsibilities while our taxpayer base continues to grow by millions.

As a result, this year, we reached the point of having to make very critical performance tradeoffs. For enforcement, the budget cut means we will close fewer audit and collection cases. We estimate that the reduced closures this year will translate into a loss for the government of at least $2 billion in revenue that otherwise would have been collected. This is a classic example of being penny wise and pound foolish.

We are also seeing a noticeable negative impact on taxpayer service. This year, we were forced to substantially reduce hiring of extra seasonal help we usually bring in during the filing season. As a result, our phone level of service is now below 40 percent. That means more than six out of every 10 people who call can’t get reach a customer service representative. That is truly an abysmal level of service.

In looking to the future, we believe it is not an option to stay at our current level of funding with our current portfolio, given the extent to which both taxpayer service and enforcement will suffer as a result. Further cuts, with the increasing responsibilities we face, threaten to destroy the ability of the IRS to discharge its fundamental responsibilities.

It’s especially troubling to me that these cuts prevent us from fully improving and modernizing our IT infrastructure and operations support. This situation hurts taxpayers and the entire tax community.

We are operating with antiquated systems that are increasingly at risk, as we continue to fall behind in upgrading both hardware infrastructure and software. Despite more than a decade of upgrades to the agency’s core business systems, we still have very old technology running alongside our more modern systems.

We have many applications that were running when John F. Kennedy was President. About the only good thing you can say about them is that the code they use has been out of date for so long that it has the unintended effect of creating problems for hackers who may be trying to figure out how the system actually operates.

But this ancient technology compromises the stability and reliability of our information systems, and leaves us open to more system failures and potential security breaches. While IRS systems have held up well, it a continuing area of major concern for us in this era of daily headlines of major companies and institutions seeing security breaches.

So there you have it – there’s no doubt the IRS has budget and IT challenges. So where does that leave us? Will simply providing additional funding for the agency solve these problems? While funding will certainly help, I am increasingly convinced the IRS needs to do more and take a different approach – and one that doesn’t just rely on funding.

As I told our Appropriations Committees a few weeks ago, the IRS can’t keep doing business in the old ways. If we get additional money, we are not going to build the IRS back to where it was in 2010. We need to be looking forward to a new, improved way of doing business.

The world is changing, taxpayers are changing and so, too, must the IRS.

We need to look at the future in a more comprehensive way, and consider how we can take advantage of the latest technology to move the entire taxpayer experience to a new level – and do it in a way that’s cost-effective for the government.

That’s what we’re doing. In particular, we are focused on how best to use our limited information technology resources. Our goal is for taxpayers to have a more complete online experience for all their transactions with the IRS.

The online experience should give everyone confidence in knowing they can take care of their tax obligations in a fast, secure and consistent manner. This goal is not unrealistic. We’re not trying to go to the moon. We’re simply saying people should expect the same level of service when dealing with the IRS in the future as they have now from their financial institution, whether it’s a bank, brokerage, or mortgage company.

The idea is that taxpayers would have an account at the IRS where they, or their preparers, can log in securely, get all the information about their account, and interact with the IRS as needed. Most things that taxpayers need to do to fulfill their obligations could be done virtually, and there would be much less need for in-person help, either by waiting in line at an IRS assistance center or calling the IRS.

Improving service to taxpayers in this way can also help us on the compliance side of the equation. We need to be faster and smarter. With a more modern system, the IRS could identify problems in tax returns when a return is filed – rather than coming back to taxpayers years after the fact while the meter is running on potential interest and penalties. We want to interact with taxpayers as soon as possible so that those issues can be corrected without costly follow-up contact or labor-intensive audits. This up-front issue identification effort could also help in other areas as well, such as the ongoing battle over the use of stolen identities to file fraudulent tax returns.

And we must provide greater security in the future. We need to find more ways to protect taxpayers’ private information. At tax time, we need to be sure we are interacting with the right person. Improving identity authentication is a major goal going forward.

We have already taken a number of steps in the identity theft area. The most recent occurred earlier this month, when we held an unprecedented sit-down meeting with the leaders of the software and tax industry and state tax administrators. We agreed to build on our cooperative efforts of the past and find new ways to leverage this public-private partnership to help battle identity theft. We agreed to form three working groups to come up with short-term solutions to help taxpayers in the next tax season, and work on longer-term efforts to protect the integrity of the nation’s tax system.

You could say, of course, that if I find it this exciting to talk about the possibility of taxpayers being able to conduct all of their communications with the IRS electronically, I may need to find a way to put a little more balance into my life.

I do look forward to talking more about the future vision of the IRS in the months ahead. Many of our efforts to improve taxpayer service will take years to fully implement. Our progress will be affected by many factors, including changes in the tax law, the continuing evolution of refund fraud and the demographics of our aging workforce. And of course, how quickly we can deliver on this concept will depend on future levels of agency funding.

But, even with our constrained funding, we are going to continue to find some funds to support these efforts to build toward the future, even at the expense of other areas of our activities. Otherwise, if we just wage a guerilla-style fight every year through the continuing funding challenges, focusing only on the present, we’ll wake up in five years and be no further ahead than where we are today – in fact, we’ll be five years further behind.

So that gives you an idea of where the IRS stands today, how we’ve changed from the past and where we want to go in the future.

I took this job 15 months ago because I understand the critical role the IRS plays in the lives of taxpayers and in the collection of the revenues that fund the government. I know I speak for the thousands of professional, dedicated employees of the IRS when I say that we are committed to continuing to do all we can to build for the future, in the interest of serving the American taxpayer.

I hope all of you who have filed your taxes this year had a smooth experience. For those of you who haven’t filed yet, remember the clock is ticking and you’re now down to 16 days before the deadline. (You’ve now had the benefit of two public service announcements for the price of one.) But at the IRS, we serve all taxpayers, and that includes procrastinators. So if you can’t make the April 15 deadline, remember everyone can file for a six-month extension.

Thank you.

 

Jensen Comment
There is a great deal of food for thought in these excellent prepared remarks.

I would like to repeat one point I made in an earlier AECM message. There is great concern about the enormous underground economy where both criminals such as drug dealers and very hard workers such as maids cleaning houses are accepting cash wages and not reporting those incomes for tax purposes. They are indeed tens of millions of tax evaders.

One estimate for the year 2010 is that there is $305 billion in tax revenue that could be collected by the IRS is tax evasion was eliminated ---
http://en.wikipedia.org/wiki/Tax_evasion_in_the_United_States#Measurement

Suppose that in 2014 the tax evasion was still around $300 billion. This  is less than 1% of the $3.1 trillion collected by the IRS such even if tax evasion was totally eliminated it would would not have such an enormous impact on total net revenues given the billions that would have to be spent to eliminate tax evasion such as collecting taxes from all the drug dealers and cash workers in the underground economy.

In fact the cost of eliminating tax evasion exceed the revenues collected from tax evaders.

I'm not advocating that the IRS does not continue to seek out and punish tax evaders. However, when we are debating all of the really serious issues facing the USA at this moment such as unfunded entitlements (particularly Medicare and Medicaid), climate change, drought, horrid K-12 education in urban centers, increases in crime such as cybercrime, terrorism, etc., spending a $1 trillion to eliminate $300 billion in tax evasion should be put in its proper perspective.

"Teaching Shakespeare Straight Up No ‘Shakespeare and Imperialism’ or ‘Shakespeare and Gender.’ Students like the real thing just fine," by Paula Marantz Cohen, The Wall Street Journal, April 17, 2015 ---
http://www.wsj.com/articles/teaching-shakespeare-straight-up-1429310444?tesla=y

Of all the courses I have taught over my 30 years as an English professor, the one that I enjoy teaching most and that students seem to enjoy taking most is “Shakespeare.”

That’s the title. Not “Shakespeare and the Elizabethan World” or “Shakespeare and Stagecraft”; not “Shakespeare and Imperialism,” “Shakespeare and Gender,” or “Shakespeare and Postmodern Theory.”

I don’t even title the course, as I once did, “Introduction to Shakespeare,” though it is open to all students and has no prerequisites. Appending “introduction to” would admittedly emphasize the fact that Shakespeare is a vast and deep terrain, but it would also suggest that the course leads to “Advanced Shakespeare.”

This is not the case. The Shakespeare course is not the first step in a graded ascent but an immersion in a world. I want it to be Shakespeare without addendum or dilution. My belief is that anyone at any level can derive benefit from this course, not because I teach it so well but because reading a certain number of Shakespeare’s plays with close attention is an end as well as a beginning. It can yield rudimentary insights but it can also yield highly advanced and sophisticated ones.

Continued in article

 

"Harvard’s Les Miserables Labor exploitation becomes a rallying cry in the academic Third World," The Wall Street Journal, April 17, 2015 ---
http://www.wsj.com/articles/harvards-les-miserables-1429311130?tesla=y

. . .

These aren’t the sans-culottes of late 18th-century France. We’re talking about the modern American university. Specifically, Harvard—at least if you believe the complaints by the graduate students trying to unionize there. They have a case, too, even if their solution isn’t the cure they think it is. Even taking into account the value of the tuition relief that grad students receive in exchange for the teaching and research they do, their low pay and limited benefits are all too real.

These grad students (and part-time adjuncts) carry much of the teaching load at universities for one reason: They are cheaper. According to the Chronicle of Higher Education, at Harvard the average professor’s salary is $205,000. Grad students get a fraction of this, and the glut of Ph.D.s means most will never find the professorships they seek.

Public universities are covered by state labor laws, and some have unionized. Private universities come under the National Labor Relations Act. They have been able to resist unionization because the National Labor Relations Board ruled in 2004 in a case involving Brown University that grad students are “primarily students,” not employees.

That may change. President Obama’s NLRB is a wholly owned subsidiary of organized labor. Last month the board agreed to hear a petition by graduate students at Columbia University that challenges the 2004 decision. The Columbia students want to join the United Auto Workers, and they’re seeking an NLRB ruling like the one last year that Northwestern football players can unionize because they’re employees more than student-athletes.

The universities argue that unionization would make the nature of their relationship with students adversarial. They too have a case. Most of America’s top universities aren’t unionized. So the schools have valid concern about elevating union interests over academic merit. Meanwhile, NYU is a rare private university that has voluntarily recognized a grad-student union.

Continued in article

Jensen Comment
One thing that will make unionization at Harvard easier is that the Boston area and Massachusetts as a whole is controlled by labor unions. For example, Wal-Mart will never be allowed to build new stores in Boston until Wal-Mart workers are unionized. If and when that happens will be a sad day for New Hampshire where folks in Mass. go to shop for cheaper prices (and no sales tax).

Most universities have some type of housing subsidies for graduate students as well as undergraduates. That is very important at Harvard and MIT since the Cambridge housing market is one of the highest priced markets in the USA. Providing housing is even more complicated and expensive for married students and families who cannot live in dormitories.

Nine States Running Out of Water ---
http://247wallst.com/special-report/2015/04/22/9-states-running-out-of-water/?utm_source=247WallStDailyNewsletter&utm_medium=email&utm_content=APRIL222015A&utm_campaign=DailyNewsletter

Jensen Comment
Obviously, the drought problems vary greatly between these states. For example, Texas is an enormous state with greatly varying problems in eastern, central, western, northern and southern regions. West Texas has an enormous problem now and historically compared to eastern parts of the states that get relief whenever a Gulf hurricane blows ashore. Has Nevada ever not had rain shortages that are now exacerbated by the drying up of the Colorado River? Californians are hoping the heated blob moving toward its shores will end the drought. We hope and pray that this is true.

States not mentioned are also in deep trouble such as Nebraska where the huge Ogallala Aquifer is drying up in Nebraska on into Texas. Declining water is a problem in the entire western USA.

 

 

 


Brookings: The Patient Protection and Affordable Care Act (links to hundreds of studies) ---
 http://www.brookings.edu/research/topics/affordable-care-act

"The ObamaCare Effect: " by Marty Makary, The Wall Street Journal, April 19, 2015 --
http://www.wsj.com/articles/the-obamacare-effect-hospital-monopolies-1429480447?tesla=y

. . .

Today’s frenzy of hospital mergers and physician practice acquisitions is giving hospital systems even greater leverage to inflate opaque “charge-master” medical bills that even hospitals are sometimes unable to itemize sensibly. With no mechanism to allow free-market forces to keep prices in check, this translates into higher health-insurance deductibles and copays for insured Americans, and in the case of Medicare and Medicaid, higher taxes.

When you’re the only game in town, you call the shots. That is one reason California Attorney General Kamala Harris is insisting on “strong conditions” before approving Prime Healthcare Services’ $843 million takeover of the six-hospital Daughters of Charity Health System. Prime is a hospital management company operating 34 acute-care hospitals in 10 states.

Ms. Harris required Prime to continue operating four Daughters’ facilities as acute-care hospitals with emergency services over the next 10 years. She also required that all six hospitals remain in the state’s Medi-Cal program, maintain charity care benefits at their historical levels, and continue providing essential health services such as reproductive health care.

Those conditions only begin to address the concerns surrounding such a merger. A San Bernardino, Calif., court recently held a Prime hospital, Chino Valley Medical Center, in contempt for needlessly admitting patients through the emergency room. On a national level, physician groups bought by large hospital systems are often prodded to send patients for ambulatory surgery and diagnostic procedures to the departments of their parent hospital, which may charge more than other outpatient centers the doctor might prefer.

A study of more than 150 hospital-owned and physician-owned organizations published last October in the Journal of the American Medical Association found that patient costs are 19.8% higher for physician groups in multi-hospital systems compared with physician-owned organizations.

The Affordable Care Act did not repeal antitrust laws. The Federal Trade Commission prevailed in three litigated hospital mergers in the last three years, and in 2014 it won its first-ever litigated case challenging a health-system acquisition of a physician group. But these victories are few. The great majority of mergers occur with little if any public debate about how they will effect prices or patients.

U.S. Oncology, for example, boasts more than 1,000 oncologists in its network and serves nearly 20% of all U.S. cancer patients. In 2010 it was acquired by McKesson Corp., one of the largest U.S. drug distributors, in what some called a savvy move to get cancer doctors and the drugs they prescribe under the same roof. Specialty hospitals are also sprouting around the country, even franchising, exemplified by the rapid spread of the MD Anderson Cancer Center, which aims to have a center within three hours of every American. But is it wise to have one corporation in charge of cancer care for an entire state or region?

Advocates say such expansion brings standardized care and clinical trials to more of the population, but it also results in an undeniable homogenization that may limit options for patients. If management decides that its doctors can only use one chemo drug for a particular cancer, or if the central leadership elects to not adopt a new surgical technology system-wide, will patients be told about the other options?

As a busy surgeon, I have serious concerns about the race to consolidate America’s hospitals because of the risk that very large organizations may govern without valuing the wisdom of their front-line employees. Already many doctors are frustrated by the electronic medical records, strategic planning and hospital processes that they feel have marginalized their medical insights into their own patients.

We can encourage the good work of hospitals to create networks of coordinated care, while at the same time insist that hospitals compete on price and quality outcomes. Achieving this balance in the wake of the Affordable Care Act is critical to ensure that one-fifth of the U.S. economy functions in a competitive and competent market.

Dr. Makary is a surgeon at Johns Hopkins Hospital and professor of health policy at the Johns Hopkins Bloomberg School of Public Health. He is the author of “Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care“ (Bloomsbury Press, 2013).

Jensen Comment
The word "frenzy" probably overstates the case. In rural areas, however, local hospitals already monopolize local markets in general care. What I see up here is MDs pulling out of primary care practices either by refusing ACA-insured patients or by returning to medical schools to further specialize. Our very best general surgeon just took a year off to return to medical school to further specialize. Chances of his returning to our hospital are zero.

What I see in primary care up here is much wider use of physicians' assistants and osteopathic privary care providers replacing the departing MD providers. ACA and Medicaid rates are driving MDs out of primary care. The only way to make primary care profitable is to make it more factory-like in efficiency in seeing patients.

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

German government poised to tackle healthcare corruption ---
http://www.euractiv.com/sections/health-consumers/german-government-poised-tackle-corruption-healthcare-313782

Jensen Comment
Remember the early days of Hitler when the cheap Volkswagon was developed for the workers and the Porsche was the car of preference for the wealthy.  The workers did not seem to matter since the VW was preferred to not having any affordable car or van.  The German health care system today is built somewhat upon the same premise. The "free" national health care plan offers affordable health care to everybody. But private-sector supplemental insurance gives the higher income people access to faster service for such things as body parts replacements. In crowded waiting rooms those with supplemental insurance sometimes move to the front of the line for examinations.

Corruption can of course arise in both public sector health insurance and private health insurance. In the USA the public health insurance fraud pinatas are Medicare and Medicaid. Under Obamacare the private sector plans offer increased fraud opportunities such as the way 90% of the private sector billing errors to ACA private-company insurers are in favor of the hospitals and the insurers must pay the price for billings of $25 for each Aspirin tablet.

 

 

 

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/