Thursday, September 11, 2008
The Wheel turns your bike into a moped
This idea has been around for a couple of years and may be making its' debut any time now. It is a really cool idea. Cozy Beehive is wondering what has happened to it. Most of it is the speed reducer. Something like this would need some careful engineering and plenty of field trials to make it consumer friendly.
H/T to Mike
Blue Man Group
Slut-gate
The GOP has a candidate whose daughter is an underage, unwed -- um, pregnant teenage slut. If you had asked me even a month ago, I would have said the GOP frowns on this kind of behavior. Yet they seem to be embracing it, they're saying they're "super proud" of this person, and perhaps they'll put underage pregnancy into their campaign platform. I don't get it.
Candidates spend SO much time on obscure nuances in an effort to "swing voters." But apparently voters aren't even swayed when their own candidates do a complete 180 on their own ideals and pee in their own punch bowl.
What gives?
Reply:
"We embrace the utter failure of our hypocrisy, and hope all underage
unwed mothers and their soon to be responsible partners will join us
in promoting family values that will carry us into the 21st century
and beyond."
Sounds pretty good when you put it like that.
Politics: The Poision Flower
It's kind of like the NFL: they set up this totally contrived structure for competition, promote the heck out of it, and people line up to pay big money to align themselves with one team or another -- to the point where it's really costing them in terms of dollars, emotional investment, stress, time wasted, etc.
This is how I view politics. Nobody is so concerned about improving things so much as they are about scoring points and beating the other team.
The way I see it, I just happened to be born here, I pay good money to live here, and I'm a realtively excellent citizen. Why should I have to drink the political Kool-Aid as well?
And yet, I cannot turn away from TV coverage...
Iraq Strategy 204.1
It's 12:40 and my mood is philosophical. Reviewing the situation objectively, and from the current standpoint, disregarding past (charitably phrased) mistakes.....
[NB: I find it helps your objectivity if you consider the situation in terms of "the US," rather "us."]
It is very compelling to want to withdraw from Iraq and staunch the wasteful flow of lives and money. Nevertheless, the US created this mess, and you can argue that therefore it is their responsibility to clean it up. As someone once said about Iraq, "You break it, you buy it." I therefore submit that one course of action is to stay in Iraq and continue policing for several years, until some kind of semi-stable arrangement is attained, if possible.
The drawbacks to this policy, with responses, are:
-More lost lives -- well, the US killed 10's if not 100's of thousands of people already; losses are part of the cost and the US can't expect not to lose soldiers. Remedy: don't join the army.
-More trillions of dollars spent, with commensurate burden on the deficit, taxes, the domestic economy, etc. -- well, it's the penalty countries pay for waging war; many countries have warred themselves into insolvency; US went through this with Viet Nam not 40 years ago. One would think people would exercise common sense or learn lessons, but they haven't throughout history so why should people be any wiser today? One could argue that ignorance has earned a more severe lesson in the consequences of adventurism. Remedy: try to discern the money flow and minimize your exposure, or even profit.
-US insistence on unrealistic solutions may draw out the adventure for decades. US is only likely to approve solutions with an obvious pro-US benefit; thus many otherwise promising independent or nationalist solutions will probably be stymied. Remedy: none. Prepare that this may go one for decades.
One sub-strategy is, under guise of US police presence, to make Iraq a de facto colony, and take over the hydrocarbons -- at least that could defray the cost or maybe turn a profit. Downside: criticisms of US imperialism, but so what? Governments can be remarkably free of shame.
Wednesday, September 10, 2008
From Someone I Usually Think Is A Jerk
Why Should Anyone ::.
ANYWHERE IN THE WORLD think America should care what they think about us, our politics, commerce, or culture?
Oh, I dunno... Envy? Ignorance? Hubris? Stupidity?
... all of the above...?
But serially, folks.
I mean... I mean... what the fardles has the world done better than we have that the advice they have to give us should be given any credence whatsoever? Economy? Science? Invention? Individual liberty? General prosperity? Military and political power? The strength of our culture -- meaning people actually (you know) want it, as opposed to being told by their (scorn quotes) "betters" the should appreciate it? Our absolute dominance in any sport any thinking, self-aware person could possibly find interesting (i.e., not scoccer or cricket)?
The lesser beings of this world really should stop embarrassing themselves and, instead of presuming to lecture Americans about how inferior and stupid and provincial they are, should instead buy a frelling clue.
Mark Philip Alger
Monday, September 8, 2008
Sunday, September 7, 2008
Hellfire
I found this explanation for the text on the "bumper sticker" in a comment by ed foster:
The greek reads "Molon Labe" in English. When the Persians offered to let the Spartans at Thermopolae walk away alive, the only requirement was that they lay down their weapons.
Leonidas replied "If you want our weapons, Molon Labe". It means "Come and Get Them".
Saturday, September 6, 2008
Prime Numbers Illegal To Possess
Thursday, September 4, 2008
Athens Monitors
Wednesday, September 3, 2008
Monday, September 1, 2008
Medical Problems
Date: Sunday, August 10, 2008
Hello fellow thinkers and ponderers,
I have to say I feel a bit inept and uninformed in conversations with those of you who are well-read and have sophisticated levels of understanding about our world.
That being said, here's my experience:
1. A significant number of physicians seem to have lost interest in his or her skill and hate their lives. They find themselves filled with disdain for not only the entire system, but patients as well.
2. Of course, it wasn't always like that. Medicine used to be fun.
3. Many physicians, myself included, work to keep the fun alive. We're careful about not burning out, and take care to remember the patient is a human being.
I agree that the AMA keeps an artificial shortage of doctors. Emergency rooms are often crowded and waits can be hours and hours. My next available appointment for a new patient is in October sometime, for example. My colleagues up river stopped taking all Medicare and Medicaid patients over a year ago. These patients jam into community health center waiting rooms and are lucky if they get three minutes of a nurse practitioner's or PA's time.
All this begs the question: Why would anyone go looking for homeless patients to run tests on when the whole system is overrun? I can't imagine, but I believe anything I hear nowadays.
My experience is quite opposite. It's now so cumbersome and time-consuming to get an MRI, for example, that some doctors just forget it. Not good ones, but the less ethical ones. Why? Because BC/BS won't pay for an MRI without a litany of questions, forms, proofs and prior imaging studies. Ever wonder what your doctor is doing while you wait in the waiting room for 2 hours?? He is probably on the phone with a high school graduate attempting to explain why he thinks the MRI is necessary. (Well, an exaggeration, but there are secretaries and nurses embroiled in a fax battle with managed care.) Does the doc make money off the MRI? Absolutely not. I think it's a law or something... we can't be paid bonus money on lab tests, etc.
Scrutiny. Constant. "Report cards." Did you get your notes done, chart documented on time, orders signed? No? Well, you will have to be reported to the State Board. Would you like Fraud insurance? Why would I want that? I don't commit fraud. You certainly do! See that progress note with a bill attached by the billing department at the hospital? You have billed for 9 physical points checked, and you only have 8 written down! (This is not a mistake, but actually "fraud.")
Government has guys that travel around reviewing such charts looking for oversights in a crowded, overrun system. Whatever mistakes -- aka fraudulent entries or bills -- they find, they make 25%. One doctor said, "Why doctors? Why healthcare? I mean, why don't they go visit the Pentagon and look for overcharges on hammers or toilet seats?"
The truth is that I am scanning maybe 15 or 20 systems in a patient, not 9 or 8. But I can't take an hour to list my every thought or to "prove" that I really asked all the questions and ruled out all the differential diagnoses I was thinking about.
Finally, probably the biggest shocker of all: Most physicians don't need incentives to do a good job or be careful to "do no harm." We're aware we can kill someone with a pen and prescription pad. We want to help patients get better, that's all.
On the other hand, why do physicians order MRIs, CT scans and unnecessary tests? We all practice defensive medicine. Better get an XYZ test because if you miss that condition you're sunk. It's called "standard of care." Defensive medicine costs some number of billion dollars per year. Some 50% of physicians will be sued.
Answer? Americans need to be incentivized for good health, maintaining healthy weight, not smoking, lifestyle modifications. We need to get money in our pockets every year when we do. BC/BS is like Exxon-Mobil when it comes to making money. Medicaid's administrative costs are only about 5%, while BC/BS's are some 25-30%. See the skyscrapers in New York made of glass and steel?
I'm not against physicians making decent salaries, after dedicating long hours and years to what usually begins as an altruistic pursuit. Most docs will never be rich -- not like basketball players or money market fund managers or CEOs of insurance companies or oil execs.
Well, that's some of my experience. I do not feel "protected," and I don't feel any lack of criticism. I have 900 patients, and I hope they will be OK. Ask Andy how many times I have called in sick. I have excused myself from an exam room to throw up, washed up, then returned to finish treating a patient. I have gone to work the day after sobbing 12 hours over the death of my mother. We can work all night and all day without complaint. Many of us sleep with pagers or phones under our pillows so as not to wake our spouses if we get called. Almost every doctor I know is the same. The only thing that makes us tired, like Andy says, is the paperwork.
Yes, there probably are doctors and hospitals committing fraud, but rarely.
Sorry it's so long. :-( thought you guys deserved a real answer :-) now to enjoy the weekend.