Jan 022014
 

A new study in Science finds that expanding Medicaid increases emergency room visits, undercutting previous claims from lawmakers and policy wonks that expanding Medicaid would decrease ER use. these findings shouldn’t be a complete surprise to those who are familiar with the program and the people it serves. Many of those who are newly eligible for Medicaid likely have medical conditions that have gone unadressed for long periods of time. They also didn’t have an existing relationship with a physician, which probably explains why they turn to the ER as soon as they have coverage.

These findings shouldn’t be interpreted as a reason to not expand Medicaid. Access to Medicaid results in better mental health and increased financial stability, which are no small things. But as health economist Jonathan Gruber notes, making people healthy shouldn’t be framed as a cost-saver. States should expand Medicaid because it’s the right thing to do. And perhaps state Medicaid programs can do a better job of connecting new enrollees with primary care physicians.

Dec 312013
 

Where’d You Go, Bernadette was the best book I read this year. I can’t remember the last novel that elicited so much laughter from me; a remarkable accomplishment considering its dearth of sympathetic characters. This story of an affluent Seattle family who comes undone pokes fun at a rich array of upper-middle-class foibles, but it never crosses the line into pure satire. Even though we may not like the people we meet in the book, author Maria Semple makes us care about what happens to them.

And the runners-up: Stephen King’s Joyland and Lauren Beukes’ The Shining Girls. Joyland is a bittersweet ghost story that shows King writes best when he writes short. The Shining Girls is a time-travel story crossbred with a serial killer thriller and the result is pure narrative adrenaline.

Dec 302013
 

Gravity was that rare film that reminded me why movies must still be watched on a big screen in a darkened theater. Its straightforward story of a marooned astronaut is, on its own, nothing spectacular. The presentation of that story is what makes Gravity so memorable. The first ten minutes alone are a revelation, particularly when viewed in 3D. This is no glitzy, brash science fiction spectacle. It’s a movie grounded in realism (a few nitpicks notwithstanding) that still has a graceful dreamlike quality. I’ll probably be a little disappointed when I watch it again at home, but I’ll always have that memory of the breathless vertigo I experienced when I saw it the first time.

Dec 252013
 

Breaking Bad concluded its remarkable run with a final season that saw Walter White meet the end that fans (and most likely, Walter) knew was coming. We had spent the past few years watching Walt’s greed and anger devour his humanity, but the final episode gave him some measure of the redemption that he had sought. The show’s writers and cast leave us with one of television’s most finely polished gems while setting a lofty new standard for episodic storytelling to which many successors will aspire, but few will reach. I expect Breaking Bad to represent a healthy portion of Netfllix’s streaming business for years to come.

Meanwhile, Game of Thrones became a truly formidable pop culture force, propelled by the strength of a particularly riveting and brutal episode. And Hannibal schooled everyone else in the art of finding beauty in the most horrible things. It was a remarkable year for TV and I’m eager to see what fills up my TiVo in 2014.

Dec 232013
 

I didn’t get to play many new games in 2013; I kept returning to old favorites like FTL and Planescape. But I did manage to play Bioshock Infinite and it left me amazed. While it follows many of the standard first-person shooter conventions, the setting and story make the game a truly unique experience. The floating city of Columbia is both fantastical and fully realized, providing a brightly lit backdrop for a narrative that grows increasingly dark. I finally finished it yesterday and I’m still thinking about that incredible ending that has so much to say about science, fate, and even how we play games. Bioshock Infinite is ushering in a new era of games that mesh artistry and adrenaline and I can’t wait to see where the industry goes next.

Dec 202013
 

I have some vacation coming up next week, which may allow for more frequent blogging. Assorted MNsure-related issues have come to dominate my corner of the bureaucracy, leaving me more inclined to park myself in front of the television rather than attempt to compose a blog entry when I get home. Lazy, I know. But I’m hoping to post a few Year in Awesome entries over the next week that will highlight my various pop culture obsessions of 2013. I may even share some thoughts on the recent whirlwind events surrounding MNsure.

In the meantime, perhaps one of my UK readers might like to send me this Union Jack Dalek as a Christmas present. Or I could just pay you for it. It would be a nice addition to my geek shrine.

Dec 172013
 

It’s certainly good news that a former Microsoft executive will assume leadership of the ongoing repairs to healthcare.gov. The website’s functionality has already improved significantly and an experienced tech manager is sure to push further enhancements. But I’m still frustrated that the White House didn’t hire someone in this capacity three years ago, thus avoiding a huge self-inflicted clusterfuck. As Ezra Klein observes, somebody really needs to be fired at some point to demonstrate that this administration holds people accountable. It can wait until the open enrollment period ends in March, but Obama can’t afford to stay his hand indefinitely. The public may have an unfairly dim view of government employees, but surely a few people at CMS have earned their contempt.

Dec 122013
 

Megyn Kelly of Fox News wants to make damned sure that the children of America know that Santa Claus is a white man. Any suggestion that this mythical figure, who defies the laws of physics and spacetime once every year, could not be white is both silly and quite possibly subversive. Santa was, is, and always will be a white man, just like his pal Jesus.

You really must watch the video; it’s priceless. These are actual adults who are, presumably, paid to be on national television:

Dec 102013
 

Iowa may be the latest Republican controlled state to expand its Medicaid program. The federal government is poised to approve a waiver that will allow Iowa to use federal funds to purchase private insurance for individuals eligible for the expansion while charging some a premium for their coverage. I’m not thrilled with the idea of requiring people who live near the poverty line to pay a premium for Medicaid. But if this is the kind shell game conservatives need to play to convince themselves that they’re remaining true to their skewed free-market principles, then fine. It’s a better option than completely denying health coverage to people for no other reason than geography. And perhaps the feds’ flexibility on the mechanics of the expansion will encourage other red states to follow suit and do the right thing for their citizens.