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Best of the West College Football Top 25: If CSU Rams fans want another reason to dig Jay Norvell, check out his division record in Mountain West

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Best of the West College Football Top 25: If CSU Rams fans want another reason to dig Jay Norvell, check out his division record in Mountain West

Steve Addazio talked a good game, but only really backed it up once.

Hey, we’ll always have CSU 34, Wyoming 24, on Nov. 5, 2020, under the lights, played in front of nobody. A scrappy tilt that ended with the Bronze Boot raised by a joyous Toby McBride to the stars and ghosts above.

The rest of the last two years in FoCo will be remembered as a fever dream of disaster. The off-field accusations in the summer of 2020. The investigations. The news conferences that sometimes doubled as scream therapy. The ejection that ended his reign. A stubborn refusal — look up “stubborn” and “refusal” in the dictionary and you’ll probably find Daz’s mug shot next to both entries — to hire a full-time special teams coordinator.

Followed, of course, by a special-teams calamity at Boise State in 2020. And an even worse one, a national embarrassment, at Utah State in 2021.

So, yes, Jay Norvell is a fine addition, one helped by an even better, and necessary, subtraction that preceded him. There’s a lot to like about Monday’s hire, and there’ll be more to like, no doubt, after the new Rams coach’s introductory news conference Tuesday at Canvas Stadium.

And there’s a small nugget that’ll probably get buried once the back-slapping starts: Norvell’s record in Mountain West tilts while at Nevada. The new CSU boss is 12-8 (.600) since 2018 against West division foes. He’s 6-4 (.600, again) against the Mountain division, where his new annual dance partners reside.

If that last number doesn’t blow you away, consider this: CSU is a hair-pulling 4-13 (.235) in Mountain division games since 2018.

And it gets worse: Take out a 3-0 mark against New Mexico, and the Rams are 1-13 (.071) against Wyoming (1-3), Air Force (0-3), Boise State (0-4) and Utah State (0-3) over the last four autumns.

If CSU had posted a Norvell-esque .600 winning percentage in those 17 division games since 2018, they’d be 10-7, with six more victories. That’s roughly two more per season.

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Ross Douthat: How being sick changed my health care views

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Ross Douthat: How being sick changed my health care views

Often around the turn of the year I perform an act of pundit accountability, looking back on the previous year’s columns to assess the things that I got wrong. For this January’s edition, though, I’m going to take a different kind of backward glance, and try to answer one of the frequent questions I received when I wrote, last fall, about my experience with chronic illness: Namely, has being sick altered any of my views on health care policy?

It’s a good question; the answer, like health policy itself, is complicated.

For an example of my pre-illness views, consider a column I wrote in 2013, in the midst of the endless Obamacare debates. Titled “What Health Insurance Doesn’t Do,” it looked at evidence from an Oregon study tracing the effects of a Medicaid expansion that happened via lottery, creating a genuine randomization in the population that had the chance to enroll.

The results, after a couple of years, showed that access to Medicaid helped people avoid “catastrophic expenditures” and reduced their depression rates. The program did not, however, seem to have much impact on recipients’ physical health. This was a counterintuitive finding but not necessarily a surprising one: From a famous RAND experiment in the 1970s and early 1980s down to a recent National Bureau of Economic Research paper looking at the effects of insurance in India, it’s common to get results suggesting that the relationship between health insurance spending and physical health is relatively weak.

With these findings in mind, my 2013 self warned against health insurance profligacy, on the grounds that if we try to provision everyone with comprehensive coverage, we’ll probably end up encouraging overspending on unnecessary care. Instead, the ideal insurance system would cover genuinely catastrophic expenses, helping people avoid bankruptcy and the worst kind of mental stress — but avoiding the overtreatment and cost inflation that you get when you earmark too many public dollars for health and health alone.

I was healthy then; two years later I began my strange descent. And one part of the experience took those pre-illness views — I’d call them center-right with a libertarian flavor — and pushed them to the left.

This was the part of the experience where I was sick and had absolutely no idea what was wrong with me — which meant that I went from doctor to doctor, specialist to specialist, submitting to tests that succeeded only in ruling out various plausible diagnoses, without actually pinning down the source of all my blazing pain.

In these months I was given an object lesson in the ambiguities contained in terms like “overtreatment” and “unnecessary care.” Because considering my ultimate diagnosis, all of these visits were a form of overtreatment. What I really had, though I didn’t know it, was a tick-borne illness. Yet here I was undergoing tilt-table tests and going in for a CT scan and an endoscopy, running up a huge tab on my New York Times Co. insurance policy for tests and procedures that did nothing direct or immediate for my health.

Yet from my perspective as a patient it was all reasonable and necessary, because my illness was severe and needed treatment, and there was no way at the time to know which specialist would be the one who helped, which test or scan would be the one that revealed what was really going on. Nor was I in any position to act as a discerning consumer or a good capitalist, to do price comparisons between different neurologists or cardiologists while my legs burned and my chest blazed. Instead, as a patient I was simply too vulnerable and desperate to do anything save throw myself on the medical system’s mercy.

So my desperate self gained a new appreciation for the things that make health care unique among the burdens that the welfare state is intended to alleviate, and the limits of a libertarian vision of the patient as a cost-sensitive consumer. And I also gained a greater appreciation for the thing that, in the Oregon study, Medicaid spending clearly did seem to achieve — the importance of insurance coverage for stable mental health, greater peace of mind, in situations where you’re worried that not only your body might be ravaged but also your finances as well.

But then comes the complicating factor, the part of my experience that turned me more right-wing. Because in the second phase of my illness, once I knew roughly what was wrong with me and the problem was how to treat it, I very quickly entered a world where the official medical consensus had little to offer me. It was only outside that consensus, among Lyme disease doctors whose approach to treatment lacked any CDC or FDA imprimatur, that I found real help and real hope.

And this experience made me more libertarian in various ways, more skeptical not just of our own medical bureaucracy, but of any centralized approach to health care policy and medical treatment.

This was true even though the help I found was often expensive and it generally wasn’t covered by insurance; like many patients with chronic Lyme, I had to pay in cash. But if I couldn’t trust the CDC to recognize the effectiveness of these treatments, why would I trust a more socialized system to cover them? After all, in socialized systems cost control often depends on some centralized authority — like Britain’s National Institute for Health and Care Excellence or the controversial, stillborn Independent Payment Advisory Board envisioned by Obamacare — setting rules or guidelines for the system as a whole. And if you’re seeking a treatment that official expertise does not endorse, I wouldn’t expect such an authority to be particularly flexible and open-minded about paying for it.

Quite the reverse, in fact, given the trade-off that often shows up in health policy, where more free-market systems yield more inequalities but also more experiments, while more socialist systems tend to achieve their egalitarian advantages at some cost to innovation. Thus many European countries have cheaper prescription drugs than we do, but at a meaningful cost to drug development. Americans spend obscene, unnecessary-seeming amounts of money on our system; America also produces an outsize share of medical innovations.

And if being mysteriously sick made me more appreciative of the value of an equalizing floor of health-insurance coverage, it also made me aware of the incredible value of those breakthroughs and discoveries, the importance of having incentives that lead researchers down unexpected paths, even the value of the unusual personality types that become doctors in the first place. (Are American doctors overpaid relative to their developed-world peers? Maybe. Am I glad that American medicine is remunerative enough to attract weird Type A egomaniacs who like to buck consensus? Definitely.)

Whatever everyday health insurance coverage is worth to the sick person, a cure for a heretofore-incurable disease is worth more. The cancer patient has more to gain from a single drug that sends their disease into remission than a single-payer plan that covers a hundred drugs that don’t. Or to take an example from the realm of chronic illness, just last week researchers reported strong evidence that multiple sclerosis, a disease once commonly dismissed as a species of “hysteria,” is caused by the Epstein-Barr virus. If that discovery someday yields an actual cure for MS, it will be worth more to people suffering from the disease than any insurance coverage a government might currently offer them.

So if the weakness of the libertarian perspective on health insurance is its tendency minimize the strange distinctiveness of illness, to treat patients too much like consumers and medical coverage too much like any other benefit, the weakness of the liberal focus on equalizing cost and coverage is the implicit sense that medical care is a fixed pie in need of careful divvying, rather than a zone where vast benefits await outside the realm of what’s already available.

Alas, I don’t have some perfect policy regime that synthesizes these insights — the value of solid coverage that doesn’t require too much of individual patients, the value of decentralization and innovation and experiments. It’s precisely the challenge of synthesizing them that makes health policy so difficult.

But if I was an Obamacare skeptic before I got sick, today I’m relatively comfortable with the uneasy, unfinished place where the 2010 health care reform has ended up.

A decade ago, if you’d told me that the law’s clearest legacy was its Medicaid expansion, and that the attempts to build a thriving individual-insurance market and rein in unnecessary spending had met with less success, I might have looked at its architects’ grand ambitions and called that outcome a failure.

Today, though, I have more appreciation for the reassuring simplicity of the basic Medicaid guarantee, and more skepticism about the patient-as-consumer hopes that undergird Obamacare’s exchanges. And as for all the American-style bloat and unnecessary spending that the Obama technocrats hoped to purge from the system and mostly didn’t — well, I have a little more appreciation for that as well.

Don’t get me wrong: If I had a simple way to take a scalpel to hospital monopolies and their profits I’d still do it. If you presented me with a blueprint to expand means-testing in Medicare and use the savings to fund new research programs, I’d embrace it. If you offered me a plan to reduce prescription-drug costs by reducing regulatory burdens on new treatments, I’d celebrate it.

But once you’ve become part of the American pattern of trying anything, absolutely anything in order to feel better — and found that spirit essential to your own recovery — the idea of medical cost control as a primary policy goal inevitably loses some of its allure, and the American way of medical spending looks a little more defensible. To just try things without counting the cost can absolutely run to excess. But sometimes what seems like waste on the technocrat’s ledger is the lifeline that a desperate patient needs.

Ross Douthat writes a column for the New York Times.

 

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COVID complicated Denver homeless count but new report offers troubling picture

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COVID complicated Denver homeless count but new report offers troubling picture

The number of people in metro Denver who reported experiencing first-time homelessness in 2021 nearly doubled over 2020, according to a new report.

And people of color make up a disproportionately high percentage of the unhoused in the Denver area, the report found.

The Metro Denver Homeless Initiative on Thursday released its second annual State of Homeless report. Going beyond the once annual point-in-time count of people living in emergency shelters or on the streets the organization leads, the report pulls together data from multiple sources to provide a more holistic view of homelessness, according to the officials.

“When COVID hit, really in an effort to keep people safe and know where they are, we had a lot more street outreach, safe outdoor spaces, the safe parking initiative,” Jamie Rife, the initiative’s spokeswoman said Thursday, speaking broadly about service providers across the metro area. “What that allowed us to do was more quickly reconnect people with resources and help to keep them safe but also to understand that population much better. Now we have much better data.”

This year’s report provides three totals for people experiencing homelessness across Denver, Adams, Arapahoe, Boulder, Broomfield, Douglas and Jefferson counties. The seven counties will be doing an in-person count again on Monday night.

Using data from the metro area’s Homeless Management Information System, the shared information collection point used by nearly 75% of shelters and all federally funded service providers, the report counted 32,233 people who accessed services or housing support related to homelessness at least once between July 1 and June 30, 2021.

While the in-person point-in-time count for 2021 was canceled out of concern for COVID-19 safety, using data pulled from the system, the report found that 5,530 people stayed in shelters, transitional housing or safe haven sites on the night of Feb. 26, 2021.

While that’s a decrease from the 6,104 people in the 2020 point-in-time count, the 2021 point-in-time number only included data from roughly 75% of shelters. The 2020 figure also included an in-person count of considered “unsheltered,” those sleeping in tents, cars and other places not meant for human habitation. The 2021 survey did not.

Overall, the initiative’s report found roughly 40% of people experiencing homelessness in metro Denver are unsheltered on any given night.

What the 2021 point-in-time data revealed was major increases in emergency shelter use and the number of people reporting first-time homelessness. There were 2,530 people in shelters on Feb. 26, 2021 that reported being newly homeless, up from 1,273 people during the January 2020 count, a sign of the crushing impact of COVID-19 on housing security in the Denver area, service providers say.

“I anticipated an increase,” said, Rife, who will take over as the Metro Denver Homeless Initiative’s executive director next month. “I don’t know that I fully anticipated that sort of increase.”

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Nuggets signing DeMarcus Cousins to 10-day contract on Friday, source confirms

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Nuggets likely to sign DeMarcus Cousins to 10-day contract but nothing finalized, source says

After nearly two weeks of speculation, the Nuggets are signing DeMarcus Cousins to a standard 10-day contract on Friday, a league source confirmed to The Denver Post.

By signing him Friday, Cousins is expected to be available for the next six games, beginning against the Grizzlies.

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