Dec 172010
 

If all goes as planned, I’ll be greeting you on Monday with an upgraded computer. For the geeks, here are the specs:

  • Asus M488TD-V motherboard
  • 4 gigs of DDR3 1600 memory
  • Radeon 5770 video card
  • AMD Phenom X4 955 CPU
  • 1TB Western Digital Caviar Black hard drive
  • Windows 7 64 bit

Sexy, huh? It will do pretty much everything except give me a massage. But don’t worry; I’ve got that covered as well. My new rig should be sufficient to handle the gaming goodness that will be forthcoming in the next few years. And I’ll finally have enough storage for my massive collection of…nature photography.

Dec 162010
 

I had a lot of respect for Peter Orszag when he served as Obama’s budget director. He’s a smart, wonkish type who strongly advocated for the health care reform law and financial reform. But I’m not sure what to make of his latest Times arguing for a rethink of Social Security Disability Insurance. Like a lot of other policymakers, Orszag thinks that too many people have become dependent on SSDI and are thus forever severed from the workforce. I don’t disagree on that point, but Orzsag seems to think that the solution is to require employers to offer private disability insurance. It’s an interesting idea, but it seems that it could be susceptible to the same troubles that have plagued employer-based health insurance. Large employers might be able to afford such insurance without much trouble ,but small businesses could be in a weaker position. The quality of such insurance could also very greatly, with some insurers offering a variety of supports to help workers with disabilities stay on the job while others might do little more than write a check. I’d like to see more energy focused on reforming SSDI to make it more responsive to workers who, with the right training and accommodations, could continue working.

Then again, Orszag just accepted a multimillion dollar gig with Citigroup while I’m a lowly government bureaucrat, so what do I know?

Dec 152010
 

We’re still digging out from the massive snowstorm that hit the Twin Cities over the weekend. I’m guessing that a significant number of people with disabilities and the elderly have become homebound since then. If not for the skyways and my van, I probably wouldn’t be going anywhere. Many of the sidewalks are still impassable or the cut-offs are blocked by huge piles of snow. The storm’s aftermath is making it difficult for everyone to get around and I know cities are struggling to clear the streets, but it might help to remind their workers that not everyone can climb over the mountains of snow and ice left behind by the plows.

Dec 142010
 

Jeopardy! plans on airing a couple matches featuring two of its most dominant ubergeek contestants of the past and Watson, an artificial intelligence developed by IBM. Oh, sure, the idea seems cute now. I’m sure our robotic overseers will play it on a loop in the dismal rec rooms of the lunar labor camps, giving us ample opportunity to curse our oh-so-clever scientists. Perhaps I’m just being an alarmist and this is a harmless publicity stunt. But don’t come crying to me if Watson suddenly vaporizes its human opponents and declares itself Master of Humanity.

Dec 132010
 

All the health policy wonks are talking about the news of a federal judge ruling that the Affordable Care Act’s insurance mandate is unconstitutional. For those keeping score, two federal judges (appointed by Democrats) have ruled in favor of the mandate’s constitutionality while one judge (appointed by a Republican) has ruled against it. The latest ruling isn’t a surprise and the issue will ultimately be decided by Justice Kennedy (the other Supreme Court justices will simply cancel out each other’s votes). What is interesting about the judge’s decision is that he refused to strike down the entire law or stop its implementation.

This will create an interesting set of circumstance for the Court. States and insurers will continue to prepare for a post-2013 world of insurance exchanges and Medicaid expansions. If this ruling stands, those things wouldn’t go away, but it could create a lot of confusion and uncertainty for policymakers. Without a mandate, insurers will scream bloody murder about having to make insurance available to anyone who wants it. State exchanges might be made irrelevant after millions of dollars are spent on their planning and creation. How the Court does or doesn’t respond to these facts on the ground will give us wonks plenty to speculate about over the next couple years.

Dec 102010
 

The Twin Cities is scheduled to get hit with an epic blizzard this weekend, so I’m making a list of things to do in between glances out the window:

  • Hit the Schlocky Science Fiction portion of my Netflix streaming queue (think Enemy Mine or Starship Troopers).
  • Make a dent in my book club reading.
  • Make a dent in my other reading
  • Download Cataclysm and get started on my worgen hunter named Mortimer. 
  • Eat way too many Pringles and Andes mints. 

Of course, all this is subject to change if my broadband connection goes out or one of my nurses gets stranded in a snow drift.

Dec 092010
 

NPR continues its series on the ongoing struggle for people with disabilities and the elderly to receive care in the community rather than in nursing homes. Particular attention is given to working-age adults and children who are forced to live in nursing homes because states–many in the South–provide little or nothing in the way of community-based supports to enable them to stay at home. One of the stories quotes Carol Steckel, a former Alabama Medicaid director, who explains states’ continued reluctance to offer home and community-based services:

At a meeting of state Medicaid directors, in a hotel outside Washington, D.C., last month, Steckel noted many reasons states are reluctant to expand home-based care. How do you make sure people get good care at home? It’s easy, she says, to send an inspector into a nursing home. It’s harder to check on hundreds of individuals in their own homes.

And then there’s the money question. It’s a big problem for states facing all-time-high budget deficits.

“We’ve got people asking us to do 24/7 at-home care,” she says, “which means that we’ll be paying $500,000 for one individual. And then you have to debate as a society is that what we want to do versus taking that $500,000 and spending it on prenatal care for 10,000 women. I mean it’s a societal question, it’s a conundrum almost.”

With former bureaucrats like Steckel espousing such paternalistic and alarmist bullshit, it’s little wonder that people are still languishing in nursing homes. States are certainly facing significant budget deficits, but in most cases care can be delivered in the home for much less compared to a nursing home. And plenty of people already receive great care at home. Perhaps Steckel should pay a visit to Minnesota to see how it’s done.

Dec 082010
 

Minnesotans woke up this morning to discover that we have a governor-elect. Republican Tom Emmer graciously conceded this morning and Mark Dayton will become Minnesota’s first Democratic governor in twenty years. Dayton won’t have much time to savor his victory as he’ll soon have to develop a budget proposal that addresses a $6 billion deficit. In the short term, Dayton’s victory is welcome news for health care advocates, providers, and others who have been pushing for the state to take advantage of a federal opportunity to expand Medicaid to low-income adults without children. Dayton has promised to sign an executive order authorizing such an expansion. I’ll be working on some of the policy development related to the expansion, so I suspect the next few months will be busy for me.

Minnesota election officials deserve heaps of kudos for overseeing a smooth and orderly recount process. Emmer deserves kudos for putting the good of the state before his own interests or those of his party. And Dayton earns kudos for mounting one of the unlikeliest political comebacks in recent memory. A lot of people, including me, initially dismissed his run for governor as the last gasp of a fading politician. He proved us wrong. Today, I’m happy to call him my next boss.

Dec 072010
 

I was going to write about how one intriguing element of the new Google bookstore is that books can be read on any web browser without additional software, but then Amazon just announced that its digital books will also be available on the web. Web-based reading isn’t anything revolutionary, but it’s a nice feature for those of us who might like to do a bit of lunchtime reading on office computers that don’t allow the installation of additional software. Both Amazon and Google will also allow independent booksellers to sell digital books through their websites and get a cut of each purchase. I’m hoping Uncle Hugo’s takes advantage of this arrangement so that I don’t have to feel guilty about not buying physical books from them anymore. Now, if only digital versions of the Harry Potter books would be released so that I can figure out what the hell was going on in the last movie.

Dec 062010
 

I neglected to mention that last Friday was the United Nations’ designated International Day of Persons with Disabilities. Fortunately, the BBC was paying attention and ran a whole week’s worth of disability-related stories under the heading of All Access. The stories explore issues such as employment, technology, sports, and civil rights from a disability perspective. I haven’t had a chance to review all of the pieces, but the ones that I have seen were quite good; the reporters treated their subjects without resorting to mawkishness or hero worship. I’ve said this before, but of all the mainstream, global news operations, the BBC is one of the best when it comes to presenting disability issues with nuance and maturity. American media outlets–yes, even NPR–could learn a thing or two from their British colleagues.