Tag: insurance

A Very Successful Failure

While the Government was having it’s temper tantrum and existential crisis, the very bill the Republicans claimed to have been fighting quietly started working. Of course, we’ve all heard about how the official Federal website hasn’t been running as well as we expect well-established online services like Google to run. Because it’s totally reasonable to expect rock solid performance from what is in many respects a Beta Test. Stick with that story.

In the meantime, a system that was supposed to deal with a half million people over the course of this month racked up 476,000 users in the first 19 days of the month. They could conceivably hit the half-million mark by the time the weekend is over, and more like 750,000 by Halloween. So two little things here. First, this system is racking up 50% more traffic than anybody thought it would. Second, so much for the idea that nobody wants affordable health insurance. Not bad for a failure!

I am still not a fan of the mandatory insurance aspect of Obamacare, particularly since there is no public option. However, I don’t think it’s fair to call it a failure.

In Closing: Modern bridge replacement; PSA; I’m not sure where the Obama Administration gets off telling the Supreme Court what they can and cannot hear (right of Americans to receive redress of grievances, baybee, it’s in the FIRST Amendment); there but for the grace of god; CEO pay; middle path; maybe schools make kids fat?; and I think Drew is on to something here. I wonder what he would have thought about that Wonder Woman outfit from a few weeks ago.

No Shortie Lives

Ok, just so you know, air quality in Vegas is absolutely awful today because of the massive fire on Mount Charleston. This also means that Vegas’s favorite get-out-of-the-heat spot is closed. So on with the Shorties.

A Few Words on Abortion: Don’t want one? Don’t have one. Don’t think others should have them? Support birth control or admit that what you’re really against is sluts having sex.

Insurance Companies Fixing Things: Heh, Kansas’s plan to let teachers carry guns has effectively been nixed by the insurance company. It makes me wonder if SWAT team tactics might not be fixed by enough insurance claims. Turns out Allstate and those guys have lots of lawyers on the payroll….

Always Low Wages: Walmart threatens to leave DC if they are forced to pay a living wage. Don’t let the door hit you on the way out.

Speaking of Wages and the Mood of the American People: liberty vs security, where’s the outrage, I’m not sure it’s capitalism to blame.

On Health Insurance Reform: “The politicians’ consensus is that health care reform shouldn’t alter or disrupt the way the majority of Americans get their insurance today…. The policy consensus, though, is that the status quo is actually the problem and that it deserves to be threatened, undermined and replaced as expeditiously as possible.” Further, it turns out that when real people are forced to hold their noses and select coverage, they choose the plan that costs the least every paycheck and still pray they don’t get sick because the coverage sucks. I concede that means I was wrong about where cash-pay clinics are headed; we’re gonna need more, not less.

How about Lowering the Danger, then?: Pentagon wants to cut danger pay.

On the Millenials: Matt Bors. Thank heaven we have a better name for them than “Generation Y”.

Miscellany: Banks, Choirs, Sinners, Poor Little Pageant Queen, Cats, Planes, and freakin hipsters.

 

Open Letter to Los Angeles

Hi L.A., How are you?

This is a little awkward. See, the thing is that I do like you. I don’t mind your sprawl. I love your museums. How many cities have their very own tar pit?  You have a cute little Chinatown.

The thing is, I don’t think you are safe anymore. The problem isn’t you. It’s that police force of yours. I think he’s bad for you and I wish you could dump him for somebody better.

It isn’t just the thing with Chris Dorner — even though it’s obvious that LAPD never intended to bring him in alive for a trial. I mean really, they shot up two different pickup trucks, not one of which met the description of Dorner’s truck, and not one of whose occupants was even the same race as Dorner.

Unfortunately, this is just part of a trend for LAPD. I know there’s more to the story, but shooting somebody in the back as they run away from you isn’t exactly the textbook definition of “self defense.” And do you know what happens if you search Youtube for “LAPD Shoots”? Over 300 videos at the moment: shooting carjackers, shooting murder suspects, shooting those pickup trucks, shooting a deaf mute man, shooting a young Muslim man 90 times. Sure, there are films of the shooting range, and about cops being shot, commentary about people being shot, and of course some multiple-camera-angles-of-same-incident. An alarming number of these clips are recent.

I am starting to think that the real gun control needs to involve taking guns away from your officers.

Sorry Los Angeles. I’ll keep in touch, I promise. But don’t expect my tourist dollars any time soon.

In Closing: break the silence; broadband; nosy neighbors confuse maple syrup rig for meth lab; apparently, some cops think a car sticker is “probable cause”; not just at airports; glad Joe Biden cleared that up!; mainstream nutrition; Dave Johnson uses this thing called logic; have no fear, your homeowner’s policy covers meteor crashes; on Elizabeth Warren; please notice the very careful wording about 2/3 down; on consumer education; I guess she’s hoping no future employers Google her; and pot.

Kitchen Tasks that Sound Hard but Aren’t

When I got out of college, I wasn’t much of a cook. Most of what I made wasn’t awful, but much of it wasn’t good either. Still, I never bought those Hamburger Helper type products, and I have gradually stopped using most processed foods. Over the years, I’ve learned a lot. Here are some things that trust me, you really can do at home.

Whip Butter: Put some softened — not melted! — butter and some milk (or half-and-half) in the mixer. If it’s unsalted butter, add a teaspoon of salt. Start your mixer fairly while everything mixes up or you’ll spray milk everywhere. Keep turning it up gradually until it’s set to the highest setting. Keep going until that stuff is light and fluffy! Put it in a container in the fridge and enjoy for a week or two. Oh, whatever shall you enjoy that butter on? How about some homemade sourdough bread?

Sourdough Starter: Until recently, I kept a starter in the fridge. Let’s start with a film:

The short version is mix whole wheat flour with bottled or filtered water (chlorine in tap water kills microorganisms that would make you sick, but it will also kill yeasts). Put it out someplace covered with cheesecloth to keep bugs out. Once it’s going, you can use a folded paper towel and rubber band instead. Add some more water/flour mix every day until it gets foamy. Feed daily if you leave it out, weekly if you put it in the fridge.

Caesar Dressing: Ok, there are two intimidating parts to making this at home. First is called “coddling the egg.” Put a small pot of water on the stove. Use a pin to poke a small hole in the big end of the egg. Put it in boiling water for a minute. The other “hard” part is the emulsion. More on that in a minute. Toss a clove of garlic, a couple tablespoons of lemon juice, your choice of a total of 2 teaspoons of anchovy paste/Worchestershire/both (I use both), fresh ground pepper, and everything you can scrape out of 2 coddled eggs into a blender. Turn it on, and keep blending even after it looks blended. Now comes the “tricky” part: very slowly add a half cup of olive oil. Seriously, very slowly. That’s the key to the emulsion. Once you’re done, toss that stuff with some romaine hearts and parmesan and call it done.

Devein Shrimp: Ok, I admit this one is a little gross. Recently, my partner got “a great deal” on a box of frozen shrimp, and we discovered that they were whole. Get some water running because you’re going to need it. If they still have heads, you’ll need to twist their little heads off. Then follow these easy tips. By the time dinner is ready, you will have forgotten the shrimp heads.

Seasonings: I am mystified by those little packets of things like “taco seasoning” or “Italian seasoning” sold in every grocery store. Come on folks! I know it seems more expensive to buy things like garlic powder, chili powder, cumin, oregano, and basil, but a bottle of each will last quite a while through many meals. And you’ll probably get a lot less salt and preservatives too.

And don’t even get me started on canned soup as an “ingredient.” Expensive, loaded with crap you don’t need, and not nearly as good as making your own sauces.

In Closing: more Facebook; income inequality and job creation; honestly in the so-called pro-life movement; just change how we grade the test so more people pass; and crash.

ShortWoman’s Musings on Travel

Last week, I was out of town. Having grand adventures. You know, the usual. I’m home, and things are back to normal, so let me tell you what I think about travel.

On Packing: Pick your battles when it comes to your quart zip-top bag of liquids. Would it kill you to use the shampoo you’ll find in the hotel? Don’t forget to pack sunscreen. Really.

If it’s big enough or heavy enough to need wheels, it is by definition not a carry-on.

Rolling pants and most other garments takes up less room and means fewer wrinkles.

Think carefully about how long you’ll be gone and what you’ll really need. After all, you’re going to have to carry it.

On Airports and Airlines: Do everyone a favor and have your ID and boarding pass ready to go when you get in the security line. Already be prepared to go through the probe-u-later. Be polite as long as feasible. And seriously, don’t even joke about terrorism or bombs.

No, U.S. Air, I am not paying for your overpriced food.

The Airbus A321 has the worst overhead storage I have ever seen. Somebody decided that it’s more important for a 6′ tall man to be able to stand than for anybody to have a carry-on bag. The more I travel, the more I like Boeing.

The only thing I like about Phoenix Sky Harbor is that it’s called “Sky Harbor.”

Cancun, on the other hand, has a very nice airport. Clean, well laid out, plenty of room near the gates, huge duty free shop, decent food. Oh yeah, and a Margaritaville.

On Mexico: I understood Montezuma’s Revenge before I even made it through customs. The sink in the airport bathroom was labeled “NON-POTABLE WATER. DO NOT DRINK.” In English, I might add. If a sink is not labeled “POTABLE,” don’t drink that water. It’s simple.

I’ve come to the conclusion that if you are willing to stick to areas frequented by English speaking tourists, you will need very little Spanish. This may hold up in other countries as well.

The Cancun Hotel District looks a lot like the Las Vegas Strip: lots of luxury resorts, lots of palm trees, high end malls, the occasional convenience store that looks like it’s been there for decades. However, the big difference is that Cancun has more pyramids.

Lots of shopping, yes. I think the only things I could have bought there that I can’t get here are Cuban cigars and Cuban rum (which is yummy stuff). And since I can’t bring either one home, not worth bothering.

Going out to Isla Mujeres was much more like visiting a foreign country. Be aware, the shopkeepers will see you getting off the boat.

Step out of your comfort zone and eat what the locals do. You’ll be glad you did.

Tip well around your resort and you will be remembered for it.

And one last thing: You never know who you will run into when you travel. Be aware of opportunities to meet people, or at least say hello to people you know.

In Closing: hilarious; small Mercedes coming soon; must read explanation of “not in the labor force”; Occupy Ports; a battle that was lost by 1978; and Jesus approves this message.

The T Is Not Silent

If you watch a Japanese news broadcast about the tsunami, every time you hear a word that ends in “ken,” they are talking about a prefecture. That’s kind of like a state or province.

Fukushima — where they are having the nuclear issue — is the Capitol of Fukushima Prefecture, number 7 on that map. For reference, Tokyo Prefecture is number 13. Thanks to Jill, we now know that if the reactor does blow the fallout will reach all the way to Colorado, Montana, Wyoming, and New Mexico: Update: there seems to be a lot of debate over this map. It’s true that I should have said fallout may reach, rather than will reach. As someone who lives in the yellow zone, it is still my duty to prepare myself and my family for the worst but hope for the best.

Speaking of which, I don’t know how anybody with any understanding of geology can look at the mountains just west of Vegas and possibly think Yucca Mountain is a good idea.

If you were to lay Japan down next to the East Coast of the United States, it would look something like this:

As you can see, Hokkaido is as far north as Maine, but Kyuushu is as far south as Florida. Okinawa extends quite a bit further south. The tsunami was by any standard a big deal.

Speaking of the United States, thanks to TYWKIWDI for pointing out this graphic:

For the record, that’s 12 events in the 80s, and 38 events in the 90s, 47 from 2000 to 2009, and an additional 3 events in 2010. I think I’ve said before that actuaries believe in global warming.

First hand accounts of the quake are starting to be heard. For those of you trying to contact someone in Japan to make sure they are safe, the State Department says “We understand also that some telephone landlines there are disrupted. We are recommending that people try contacting loved ones in Japan by email, text, SMS message, or social media.”

I posted this picture 4 years ago. It’s a sign warning people of tsunami risk. Of course, the current crop of Republicans thinks that tsunami warnings — and other weather warnings — are a waste of time. I’ve got news for you, that’s not going to play well in Iowa.

Susie Madrak had this up, and I think it’s a good sentiment:

In Closing: leave your laptop home; old fashioned boycott causes old fashioned bank run; Bill Maher; on oil; No Depositor Left Behind; long but interesting; and after all that I sure do need a good laugh.

Mulholland Shorties

Was I Wrong About Rahm?: He’s not even sworn in yet, and he’s announced that something he wants to do is enlarge a good old-fashioned public works project! Granted, it’s just bike lanes, but it will put people to work and help other people get around when it’s done.

Food Insecurity is just a fancy word for Going Hungry: Here’s a viewpoint from somebody who once had to endure it. It turns out there are a lot of issues in play.

So You Want to be a Revolutionary: This man wrote a book about non-violent revolution. There’s a link to the PDF, which is credited with change around the world.

Income Inequality: When people in other nations notice it, it’s bad. If that has too many words, this one has lots of pretty pictures. Here’s more.

Release the Hounds: An Indiana Deputy Attorney General suggested using live ammunition on protesters in Wisconsin. Thankfully, he didn’t have the authority to order such a thing. But sanity did prevail: he is now unemployed on the grounds that a man in his position must demonstrate civility.

Speaking of Shafting the People who Teach Your Kids: Providence just sent lay-off notices to each and every teacher. They will decide later who actually gets the axe. Way to promote morale! And just a reminder, the average teacher in Wisconsin makes less than the Wisconsin median income.

Your Insurance Company Believes in Global Climate Change: Because 2010 was one of the worst years for climate disasters ever! That would include things like storms. Oh, and I sure hope those of you in San Francisco enjoy the expected snow.

Too Big to Fail is Too Big to Exist: Seriously, even people from the Fed say so.

Making the Situation Worse: Banks are moving branches from poor neighborhoods to wealthy ones — despite laws requiring them to serve the entire community. In this vacuum, payday lenders and check cashing businesses spring up out of need. And did you know that one in nine banks is in danger of collapse?

Some People Have Never Heard of the First Amendment: Some people think you can outlaw “shariah.”

Who Knew: It turns out Americans like having clean air and water.

Priceless: It turns out you can download sheet music of the classics for free. Mozart’s copyright rights are long since expired.

Truth in Comics: Drew and Bors.

Can we Stop Calling it the Party of Lincoln?: It turns out President Lincoln would disagree with almost everything the current Republican party stands for.

They Really Would Prefer All Women were Pregnant: No word on whether they think we should be allowed to wear shoes.

Plastic Tubes and Pots and Pans, Bits and Pieces: Kids need to do more science.

Batshit Crazy: Qaddafi.

The Only Evidence that I am “Moderate”: I’m clearly somewhere between these two crazy extremes. Honestly, I think of myself as left of center. You know I think that the banks are the root cause of much of our current economic woes, but it would be childish to assert that “Wall Street causes all bad things.”

Placebo: Dogs just want to please their masters. That’s why drug sniffing dogs only have an accuracy rate of 44%. That rate drops to 27% when the person in question is Hispanic.

Lily the Pink: Or, Who Knew Moldovans Drank So Much?

Advice for Democrats: Stop using the Republican’s terminology! I want to scream every time i hear one of you talk about the “death tax” or “tax reform” or “Obamacare” or “Social Security reform.” For pity sake, all these things have names that don’t admit that their way of looking at it is correct!

What Happens When This One Pops?: College textbook price bubble.

Why Your Medical Bills Go Up Next Year

And, Why Your Doctor Won’t Get a Penny of That Money

Maybe some of you recall my posting a picture taken from the 3rd floor of the Clark County Courthouse. Perhaps you wondered why I was there. I had been called to jury duty. Now that the trial that I was in the jury pool for is over — except for appeals, of course — I think I can safely comment on the case.

There were 150 of us asked to fill out a 30+ page juror questionnaire, and when I saw it I immediately thought “Oh no, they do not want me on that jury!” When I got out and called my partner to let him know I was on the way home, he asked me about what had happened. I said “I can’t comment on the case, but I think I can safely say there’s a doctor who’s a witness, it involves propofol, and it doesn’t involve Michael Jackson.” He replied “Oh no, they do not want you on that jury!”

Sure enough I was called by the court and asked not to return.

Here are the facts of the story. Dipak Desai was a doctor who came to Vegas and built an “empire” on quickie colonoscopies. It all came tumbling down a couple of years ago when a cluster of Hepatitis cases was traced to his clinic. While hepatitis is a known possible complication of colonoscopy, this was an unusual number of cases. Six cases rapidly expanded to 114 cases (and counting), with tens of thousands of people needlessly exposed to disease while getting a screening exam in the name of staying healthy. Desai himself eventually declared bankruptcy, but not before a stroke, trying to flee the country (thwarted by the local Mercedes dealership!), and much handwringing over Nevada’s malpractice insurance “reform” and the fact that he only carried the $1,000,000 per incident and $3,000,000 per year coverage required by law. A small number of cases have been settled, but there are many more cases and not enough money to go around.

Now make no mistake: there are a lot of people who are very sick because of the actions of Dr. Desai, his colleagues, and his staff. But sometimes it is just not possible to make things right. So since you can’t get blood form a turnip, some very sick people and their lawyers started looking for the deepest available pockets.

The media has made much of the fact that the clinics used “single use vials” of medication more than once and may have re-used some syringes. If that’s how the Hepatitis was transmitted, then USA Today and the CDC are right that it’s the tip of the iceberg. Except that’s not how it happened; if it were, there would be clusters of blood-borne disease around every surgical center, vaccine clinic, and med-spa in the nation.

Enter the sad but true case of Henry Chanin, who at the time he was infected worked for the Mayor’s wife at the posh Meadows School. It’s the kind of place with multi-million dollar facilities, a waiting list as long as your arm, and a near 100% college admissions rate. His lawyers alleged that it was the fault of the drug companies that made the medication in the single use vials that was to blame for his hepatitis. And, since the drug companies were specifically not allowed to blame the doctors for “misusing” the product, the jury I narrowly missed being on found in Mr. Chanin’s favor and awarded him and his wife over $5,000,000.

Here’s the problem; it wasn’t the meds. My partner put it very well back in 2008 when this was a new story:

Consider that if a clinic’s management is so cheap and careless as to cut corners over a $.05 syringe which is essentially the accusation leveled at this clinic, how much risk are they willing to put patients at? Endoscopes require cleaning and disinfection. That takes time. In a busy center, there have to be enough scopes to do the procedures and still have the downtime for the devices to allow them to be properly cleaned and disinfected.

The scopes cost thousands of dollars which is a very likely place to cut corners if it’s all about the bottom line and patient care never really enters the equation. Couple that with a high volume clinic and violations of the cleaning guidelines for the endoscopes are certain to happen.

It was very likely the endoscope, not contaminated propofol.

Using “single use vials” multiple times is almost standard for many medications, and research has been done to clear a number of drugs for use in this manner. You could clog journals with thousands of studies like this and that. Re-using the syringe is not a good idea, but the drug companies didn’t tell clinic staff to do that. I think the one biggest thing in my questionnaire that got me off that jury was the fact that Allergan send representatives to my office to teach me how to sell Botox from vials that should theoretically have been single use. Well guess what, for what those vials cost, nobody is only using them only once. And strangely enough, not a single case of hepatitis or AIDS has ever been traced to a Botox party. Disclaimer: my partner used to work for the guy who filed this suit, who also happens to be quoted extensively in the link on Dipak Desai above. Yeah, sometimes it feels like the medical community in Vegas traces back to a very small number of people who all know each other.

While nobody can give Mr. Chanin his health back, blaming a drug company for a clinic that didn’t follow the instructions and according to many sources didn’t even properly clean the apparatus they put up people’s butts will only drive up everybody’s costs: drugmaker’s costs, malpractice insurance costs, liability insurance costs, doctor’s costs for drugs and insurance both. Your insurance company? They will raise your premiums. And your doctor? His costs will go up but he won’t make an extra dime.

In Closing: Natazia?; the tax revenue case for marijuana legalization; no more French Foreign Legion for American Boys if Senator LIEberman gets his blatantly unconstitutional citizenship forfeiture bill passed but you’re still clear to join Israel’s army; corporate America passing the expensive part of health insurance reform on to you (and I said something similar when??); educators can’t count; letting states protect citizens from banks must be part of financial reform along with “too big to fail = too big to exist“; on Social Security; deregulation disaster; all just a little bit of history repeating; 30 photos that that changed the world; employment is increasing, just not nearly enough; on terrorist attacks; Yoko Ono; and Happy I Suck Less Than Yesterday Day.

Twist the Facts

Yesterday morning, I wrote a post over at Age Against the Machine on British research showing that oral contraceptives reduce women’s risk of death from cancer and cardiovascular disease. Those happen to be the top two causes of death for American women, so it’s a big deal. And we aren’t talking about some teeny study, but over 46,000 women in a study that went on for 39 years. I think this is good news for the vast majority of women!

Yet I could not help but think that this news might not be welcomed by all. After all, there is a segment of our society that might think this encourages promiscuity. When I ran this past my partner, he thought that was just nuts.

But unfortunately, we live in a society where parents withhold vaccines that could someday save a woman’s life not because of safety concerns with the vaccine itself, but because they think she might think it’s ok to have sex (because good girls don’t like sex, good girls are never sexually assaulted, and good girls certainly never have cheating husbands). We live in a society where pharmacists who should know better are arbitrarily deciding not to dispense oral contraceptives because of “moral objections” and/or the mistaken belief that they can cause “abortion” of an embryo that has not implanted (never mind the other medical indications for oral contraceptives, and never mind that these pills prevent pregnancy rather than end it; arguably they prevent abortions by preventing unwanted pregnancy). We live in a society where the so-called-pro-life crowd thinks abortion causes breast cancer. We live in a society where some people value the lives of embryos more than the lives of full-grown adult women and their families.

So yes, I expect this study to be either ignored, mis-quoted, or mis-used by the Religious Right. They will focus on the small but unexplained increased risk of death by accident or violence — See? The Pill increases your risk of [violent] death! —  if they acknowledge the research at all.

Mere minutes after posting, I found this article at the Christian Science Monitor — hardly a “liberal media” source — with the headline “High divorce rates and teen pregnancy are worse in conservative states than liberal states.” It turns out that educated women and access to contraceptives lead to greater family stability and fewer unwed or teen mothers than “that old time religion.” Yet the Religious Right  has hamstrung both trends by getting the Feds to go along with “abstinence only” sex ed, which not only doesn’t work, fails to teach about contraceptives and disease control, and outright lies to children, but attempt to reinforce very outdated gender roles.

And then I read about how the Texas State Board of Education has decided to re-write history, decreeing what may and may not appear in textbooks. Sure, the Civil War was about “states rights” — specifically the right of states to say it’s ok to own other human beings! Sadly, Texas is a large enough textbook market that students around the country may be subjected to this ultra-conservative, highly Protestant, reinterpretation of reality.

You can say what you like about reality, but you can’t change it.

In Closing: 30! 30 bank failures this year, ah ha ha ha! (reference); fattiest fast foods; mortgage insurance providers say “sorry, we won’t cover this fraudulent claim“; obligatory health insurance reform items (notice I don’t call it health care reform, or worse yet HCR which always makes me think HRC instead) includes Go Grayson Go! Put them on the spot of either saying yes to a real public option, or going on the record as being against Medicare!; oh sure, let’s make it more complicated; what recovery?; Oh No! Obama’s Liberal base is “disengaged!” Could that be because they’ve kicked it in the butt at every opportunity?; most Americans think Wall Street needs better (i.e., more) regulation; for that matter, most Americans would like to see the Government make some progress on anything; don’t take the battery for granted; median wealth, $5; and Blog Against Theocracy weekend is coming.