�鶹Ů��

Some conservatives can’t find anything to like these days, crying betrayal at every turn. Witness the bad acid trip over the planks in the omnibus spending bill that undermine ObamaCare. The latest charge is that Republican leaders were dumb to delay three major Affordable Care Act taxes, and they may even have doomed the cause of repeal in 2017. (12/17)

After dozens of futile votes to repeal Obamacare, Republicans in Congress may have finally found a winning strategy: Delay or suspend the taxes that pay for the program, and enfold the provisions in a larger spending bill that has to pass. Even congressional Democrats are on board with the plan -- at least this year. But these taxes are crucial to the success of health-care reform, and Democrats need to ensure the delays and hiatuses remain temporary. (12/17)

Basically, there are two ways to think about the tax package. One is to focus strictly on the merits, or lack of merits, for the most well-known provisions. ... The new tax agreement also suspends or postpones introduction of several levies that became law as part of the Affordable Care Act. That includes a tax on health insurers and a tax on device-makers. ... But the device industry has howled about its contribution from the get-go, claiming that it would stifle innovation and destroy jobs. The innovation argument is shaky at best and, for all of the whining about the tax, which took effect two years ago, the industry appears to be making comfortable profits. But Congress is about to suspend the tax for two years anyway. ... More significant, perhaps, the tax package will delay by two years introduction of the “Cadillac tax” -- a levy on the most expensive health plans that, most economists believe, would help to reduce health costs. Key architects of the law, including former Budget Director Peter Orszag, consider it a pillar of the law’s architecture. ... To be clear, Greenstein doesn't believe the tax agreement represents smart policymaking. Neither would most experts. But the question is whether, given how Congress typically behaves, this agreement represents a better alternative. It might. (Jonathan Cohn, 12/17)

You’ve probably read about huge disparities in regional Medicare spending, without equivalently huge disparities in health outcomes. You’ve probably read that quite a few times. It is one of the most favorite data points for people writing about health-care costs, because it suggests there’s a magic pot of money that can be neatly drained out of the system without making anyone worse off. Unfortunately, like the other magic pots of money that people thought they’d found in the health-care system, this one turns out to be underwhelming. A new study looks at hospital spending not just by Medicare, but by private insurers. And it turns out that areas where Medicare spending is low often have high private spending, and vice versa. (Megan McArdle, 12/17)

Whatever Obamacare's shortcomings, a new paper shows one place where the law has been a clear success: narrowing the race gap in health insurance. So why aren't more Democrats shouting that from the rooftops? In 2013, the year before most of the law's provisions for subsidized insurance took effect, non-elderly blacks were 47 percent more likely than whites to be uninsured. For American Indians, that figure was 93 percent; for Hispanics, 120 percent. (Chris Flavelle, 12/17)

Still, I can't shake my sense of amazement that Shkreli seems to have gambled on redemption and won. If you believe the allegations in today's indictment, he lost (or stole) all of his investors' money, then lied to them to string them along, Ponzied it up by raising new money to keep them happy, and then finally found an investment that allowed him to pay off his earlier investors, with profits all around. He wasn't caught because his scheme, like most such schemes, eventually crashed under its own weight. His scheme worked! He was caught, as far as I can tell, for being so abrasive about everything. How could shareholders not complain; how could prosecutors not go after him? Still, it is quite an accomplishment. If he is a securities fraudster, he should be an inspiration to securities fraudsters everywhere. (Matt Levine, 12/17)

There is good news in the fight against obesity: Rates are finally falling in young children. The bad news? They’re continuing to rise to new heights in adults. The decline in childhood obesity rates is one achievement within a larger failure. By focusing so much attention on the young, in the hopes that avoiding unhealthy weight gain in childhood would prevent adult obesity, we made the same mistake health advocates made in the battle against smoking 25 years ago. (Thomas A. Farley, 12/18)

The technology for altering defects in the human genome has progressed so rapidly in the last three years that it has outstripped the ability of scientists and ethicists to understand and cope with the consequences. An international panel of experts has wisely called for a pause in using the technique to produce genetic changes that could be inherited by future generations. That would allow time to assess risks and benefits, they said, and develop a “broad societal consensus” on the work. (Editorial Board, 12/18)