Precedent has problems, but it has benefits as well. If your case resembles a previous one, you can be fairly certain of the outcome - which means, e.g., that in the US it's nearly impossible to be sued successfully for libel.
As for the court deciding how long is too long, they are mindful of the fact that they count on the good will of the executive and legislative branches. The Supreme Court can't actually enforce its own decisions. So they have a certain bias toward letting Congress decide things like the exact permissible length of copyright, even if they know that the terms proposed are mockeries of original intent - the courts should defer to the elected representatives on such political questions.
Fine. Subtract physician and nurse. Still have to pay the pharmacist and pharmacy tech. My point is that while prices are inflated, it's still really expensive to deliver in a hospital.
Also, the Joint Commission says you can't let patients keep their own meds in their room, as a "safety" issue. They can bring their own meds, but they must be kept in a locked drawer at the nurses' station and dispensed by the nurse. Now, that is a racket.
1. $14.05 for one 600mg Ibuprofen (people, bring your own bottle of 200mg Advil and take three)
This is sound advice, but consider what went into providing that one pill: You requested it. Your nurse (who is a college-educated professional that can have only one or two patients at a time on labor and delivery) called the physician. Said physician said, OK, and wrote an order for it. This was then faxed down to the pharmacy, where a pharmacist (six years of post-secondary education) confirmed the order, verified it against your allergies and med list looking for interactions, and put the pill onto your wife's drug profile. The nurse then had to go to the machine, have it dispense the individually-wrapped pill, and take it to your wife with a sip of water. The pill was cheap; the labor was expensive.
Re:A false choice, of course...
on
Health Care Reform
·
· Score: 4, Insightful
And when social security was being debated, Republicans screamed up and down that this was government socialism, and will be the ruin of everything good and democratic.
The baby boomers are about to test that proposition rather thoroughly.
And if gov't does shitty job, one can always vote for opposition/independent - you rarely if ever have much choice when dealing with health insurers.
Well, this is sort of backwards to the US situation. While individuals have fairly limited choices in who to get their health insurance from, employers can choose any company they like - and companies can and do get fired by employers for not doing right by their employees. The government in the US, OTOH, is much less like what you see in the rest of the world. We don't have a parliamentary system, and terms are staggered - so replacing the government takes a long time. And even once you do that, the bureaucrats have gone nowhere.
Pharma definitely plays a role, but there's a lot more than that. We do a LOT of stuff that doesn't prolong life (quality-of-life surgeries, cosmetic, Lasik, etc.). And while recission is awful, it's also fairly rare - they do take care of most people with very expensive diseases.
And I think most people in other countries are a lot more accepting of "well, we're just not going to do that."
Can't speak for DVMs, but MDs mostly do not consider themselves scientists and will freely admit it. (Those that do, generally are - they have a PhD, or a research-heavy background.) It's biological engineering.
Med schools hire statisticians for this. Read the thank-yous. Even small studies will thank the biostatistician. The biostatistician will be an author on a major study.
Not being able to define it with the same precision as someone who works daily in the field is not the same as having no clue what it is, but enjoy your word games, and next time hire a statistician to analyze your blood sugar. He'll be able to tell you all about your statistics, but unless he's diabetic himself, probably won't have a clue what to do about it.
I've read your downthread comments, and FWIW biostats in medical school is usually a course involving 36 hours, tops, of instruction. Most physicians do not need to understand statistics in order to do their jobs, any more than they need to understand how lab equipment generates its results. I get statistics better than 90% of physicians, and I'd wilt like a flower in front of a first-year PhD student of the subject. Why? Because I don't do it all day. You can, and do, forget over time.
The ignorance of physicians on statistics is mostly rational ignorance - they've realized that most studies are crap, so they ignore anything that doesn't have lots of patients. It's only indefensible when they go around trying to spout off like they know what they're talking about - and that is, mercifully, rare.
I live in Mississippi; have my whole life. I have a noticeable if not particularly strong Southern accent. And Mississippians still ask me - on a weekly basis - where I'm originally from.
Nobody would locate a general-purpose call center here.
As for how it will work, the answer is simple: they are going to go after in-state scammers. Once you start crossing state lines, the feds get interested in your frauds.
Frankly, I find that number very hard to believe. Maybe 14% of prostate surgeries in hospitals with a DaVinci took place without one, but there are less than 1400 machines nationwide according to TFA. That's less than one per 200 000 people.
If anything, they perhaps meant they have 86% of the market for radical prostatectomies. Most prostate surgery is done via the urethra because it's done for benign prostatic hypertrophy that impedes urine flow, not for cancer.
Go read comments to the original article, where it is explained that "reasonable expectation of privacy" is a term of art, and it does not mean "what a reasonable person would expect to be private". E.g., you do not have a privacy interest in what numbers you dial with your phone, because you willingly told the phone company who you wanted them to connect you to. The contents of the conversation, OTOH, do have a reasonable expectation of privacy. You even have REOP if you make your call from inside a closed pay phone booth.
Again, IANAL, but I've had several of them explain this to me in enough detail that I'm almost certain I didn't make a mistake in what I've said here.
Your snail mail enjoys no protection if, as on a postcard, there is no attempt to shield its contents from public view. Encrypt your email and things may change (IANAL, don't know for sure if they do - e.g., would it then be permissible to brute-force any encryption without a warrant, or does the mere act of encryption indicate an intent that something should be private?)
pretty much kills the rest of your argument. Do you think that nurses all have God complexes too? Or is it perhaps that people who don't do critical care can't make rational judgments, because nobody can possibly be rational about whether or not to keep trying on a family member? I'm an anesthesiologist. I trained in critical care units. I work daily with nurse anesthetists, every single one of whom is a former critical care nurse. I don't ever - ever - go against my nurses unless I have a very, very good reason to do so. Have you ever suggested it was time to give up on a trauma case? I have. I've polled the room - me, the surgeon, my residents, his residents, the nurses - everybody. And if someone says they think we have a chance, we keep going. I'm sorry that your mom never told you about that. And I'm even sorrier that there are physicians out there who ignore nurses as a general rule (FWIW, some nurses are shitty, too. It's not just physicians.) But we are the experts, and we deal with it all the time, and it's routine to us.
I don't know any details about Hagman, but Jobs got a transplant because he registered on a bunch of lists. The catch was that he could afford a private jet to get to the transplant center within the requisite time frame (several hours). This is outside the reach of average people, but you don't have to be Jobs rich to afford it - $100k should get you a chartered private jet to anywhere in the country.
I am a professor of anesthesiology at a transplant center. During residency, I trained in ICUs and pronounced death by brain death. Both during residency and in practice, I have provided anesthetic management for organ donors. It's also a level one trauma center with a catchment area of perhaps 150 miles' radius. Which is to say: I know a lot about trauma, and am more than passingly familiar with the organ donation process. Consider this your reward for posting this while logged in.
Here's how it works: person has trauma. They are brought to our hospital either directly, or as a transfer (usually via helicopter) from a smaller hospital that can't handle the case. When they arrive, they are brought into the emergency room and evaluated by the ER docs, the trauma surgery team, and possibly one of the on-call anesthesiologists (depending on how bad it looks). The patient then is brought to the OR, the ICU, or a regular room depending on how ill he or she is.
The only path that leads to organ donation is the one that takes you to the neuro ICU due to head trauma. If you've had low blood pressure due to injury/bleeding, you're not going to be eligible to donate. So, you go to the neuro ICU. Up there, the neurosurgeons evaluate you constantly, and treat as best as they are able. If it turns out that you have an immense injury that is probably not going to be survivable, the organ donation agency is called. They draw blood samples to try to match your tissue to potential recipients. If the potential donor does actually die (brain death), the organ donation agency only then notifies the possible recipient transplant surgeons that organs are available. Our transplant surgeons get first pick, but anything that doesn't match anyone on our list gets shopped around to nearby transplant centers.
After all of that, the (now legally dead) person is brought to the OR for the organ harvest. All in all, it takes at least 24 hours to put together, and it's intermediated by the organ donation agencies. Frankly, until someone has been declared dead, we don't even know if we have a match. Our great success in not having organs rejected comes from not transplanting organs into people who aren't very, very good tissue matches.
So no, despite your desire for it to be otherwise, we don't actually bump people off for organs. After all, if even one nurse, tech, therapist, or anyone else in the entire process thought that something wrong was happening and reported the physician to the state medical board, the physician would face license revocation, criminal prosecution for murder, and civil suit for wrongful death. Do you really think we care that much about money?
The military is a prerequisite of a state ("A language is a dialect with an army and navy"). It cannot be socialist, no matter its extent. A public library is, by the strict criteria, probably socialist, but it's so inexpensive that I just can't get too worked up about it. Fair enough?
If you're talking about the government providing non-essential services directly, you're talking about socialist goals. That doesn't make them communist goals, or fascist goals, or even (necessarily) bad ideas. It doesn't mean that you're trying to go back to pre-Thatcher Britain.
As for the one sixth, it may be a bit of an exaggeration for now, apparently. According to the WHO tables US healthcare spending was 15.3% of GDP in 2006, while 1/6 would be 16.67%. However, it has been rising as a percentage, so it's a good rough estimate. It's certainly more than 1/7.
Books are already cheaper on Kindle than paper, often by a fair amount. The problem is that right now e-Ink screens are really good only for continuous text streams without graphics. Now, for that one purpose, they're fantastic. I love my Kindle. But I would have had a lot of trouble justifying the cost if I were a casual reader (5-6 books/year).
Slashdot Mirror
Probably an 8250 in that thing.
Presumably, the 5-digit SSID is a cue that the person hasn't changed anything from default, and so it's still using 64-bit WEP.
Precedent has problems, but it has benefits as well. If your case resembles a previous one, you can be fairly certain of the outcome - which means, e.g., that in the US it's nearly impossible to be sued successfully for libel.
As for the court deciding how long is too long, they are mindful of the fact that they count on the good will of the executive and legislative branches. The Supreme Court can't actually enforce its own decisions. So they have a certain bias toward letting Congress decide things like the exact permissible length of copyright, even if they know that the terms proposed are mockeries of original intent - the courts should defer to the elected representatives on such political questions.
Fine. Subtract physician and nurse. Still have to pay the pharmacist and pharmacy tech. My point is that while prices are inflated, it's still really expensive to deliver in a hospital.
Also, the Joint Commission says you can't let patients keep their own meds in their room, as a "safety" issue. They can bring their own meds, but they must be kept in a locked drawer at the nurses' station and dispensed by the nurse. Now, that is a racket.
1. $14.05 for one 600mg Ibuprofen (people, bring your own bottle of 200mg Advil and take three)
This is sound advice, but consider what went into providing that one pill: You requested it. Your nurse (who is a college-educated professional that can have only one or two patients at a time on labor and delivery) called the physician. Said physician said, OK, and wrote an order for it. This was then faxed down to the pharmacy, where a pharmacist (six years of post-secondary education) confirmed the order, verified it against your allergies and med list looking for interactions, and put the pill onto your wife's drug profile. The nurse then had to go to the machine, have it dispense the individually-wrapped pill, and take it to your wife with a sip of water. The pill was cheap; the labor was expensive.
And when social security was being debated, Republicans screamed up and down that this was government socialism, and will be the ruin of everything good and democratic.
The baby boomers are about to test that proposition rather thoroughly.
And if gov't does shitty job, one can always vote for opposition/independent - you rarely if ever have much choice when dealing with health insurers.
Well, this is sort of backwards to the US situation. While individuals have fairly limited choices in who to get their health insurance from, employers can choose any company they like - and companies can and do get fired by employers for not doing right by their employees. The government in the US, OTOH, is much less like what you see in the rest of the world. We don't have a parliamentary system, and terms are staggered - so replacing the government takes a long time. And even once you do that, the bureaucrats have gone nowhere.
Pharma definitely plays a role, but there's a lot more than that. We do a LOT of stuff that doesn't prolong life (quality-of-life surgeries, cosmetic, Lasik, etc.). And while recission is awful, it's also fairly rare - they do take care of most people with very expensive diseases.
And I think most people in other countries are a lot more accepting of "well, we're just not going to do that."
Si hoc legere scis nimium eruditionis habes.
Has it been too long, or shouldn't that be potes instead of scis?
Can't speak for DVMs, but MDs mostly do not consider themselves scientists and will freely admit it. (Those that do, generally are - they have a PhD, or a research-heavy background.) It's biological engineering.
Med schools hire statisticians for this. Read the thank-yous. Even small studies will thank the biostatistician. The biostatistician will be an author on a major study.
Not being able to define it with the same precision as someone who works daily in the field is not the same as having no clue what it is, but enjoy your word games, and next time hire a statistician to analyze your blood sugar. He'll be able to tell you all about your statistics, but unless he's diabetic himself, probably won't have a clue what to do about it.
I've read your downthread comments, and FWIW biostats in medical school is usually a course involving 36 hours, tops, of instruction. Most physicians do not need to understand statistics in order to do their jobs, any more than they need to understand how lab equipment generates its results. I get statistics better than 90% of physicians, and I'd wilt like a flower in front of a first-year PhD student of the subject. Why? Because I don't do it all day. You can, and do, forget over time.
The ignorance of physicians on statistics is mostly rational ignorance - they've realized that most studies are crap, so they ignore anything that doesn't have lots of patients. It's only indefensible when they go around trying to spout off like they know what they're talking about - and that is, mercifully, rare.
I live in Mississippi; have my whole life. I have a noticeable if not particularly strong Southern accent. And Mississippians still ask me - on a weekly basis - where I'm originally from.
Nobody would locate a general-purpose call center here.
As for how it will work, the answer is simple: they are going to go after in-state scammers. Once you start crossing state lines, the feds get interested in your frauds.
Under this law, it's not illegal to do that. Read the bill; it's very short.
If you're not in Mississippi, you can still commit a crime there, but they may have some difficulty enforcing the law against you.
Thanks, I was hoping someone who knew the answer might post on this.
Choles and Nissens? Really? You take a 15-20 minute, three-port procedure and do it with a non-feedback mega-port device? Why?
Frankly, I find that number very hard to believe. Maybe 14% of prostate surgeries in hospitals with a DaVinci took place without one, but there are less than 1400 machines nationwide according to TFA. That's less than one per 200 000 people.
If anything, they perhaps meant they have 86% of the market for radical prostatectomies. Most prostate surgery is done via the urethra because it's done for benign prostatic hypertrophy that impedes urine flow, not for cancer.
Go read comments to the original article, where it is explained that "reasonable expectation of privacy" is a term of art, and it does not mean "what a reasonable person would expect to be private". E.g., you do not have a privacy interest in what numbers you dial with your phone, because you willingly told the phone company who you wanted them to connect you to. The contents of the conversation, OTOH, do have a reasonable expectation of privacy. You even have REOP if you make your call from inside a closed pay phone booth.
Again, IANAL, but I've had several of them explain this to me in enough detail that I'm almost certain I didn't make a mistake in what I've said here.
Your snail mail enjoys no protection if, as on a postcard, there is no attempt to shield its contents from public view. Encrypt your email and things may change (IANAL, don't know for sure if they do - e.g., would it then be permissible to brute-force any encryption without a warrant, or does the mere act of encryption indicate an intent that something should be private?)
if anyone besides the docs and nurses knew
pretty much kills the rest of your argument. Do you think that nurses all have God complexes too? Or is it perhaps that people who don't do critical care can't make rational judgments, because nobody can possibly be rational about whether or not to keep trying on a family member? I'm an anesthesiologist. I trained in critical care units. I work daily with nurse anesthetists, every single one of whom is a former critical care nurse. I don't ever - ever - go against my nurses unless I have a very, very good reason to do so. Have you ever suggested it was time to give up on a trauma case? I have. I've polled the room - me, the surgeon, my residents, his residents, the nurses - everybody. And if someone says they think we have a chance, we keep going. I'm sorry that your mom never told you about that. And I'm even sorrier that there are physicians out there who ignore nurses as a general rule (FWIW, some nurses are shitty, too. It's not just physicians.) But we are the experts, and we deal with it all the time, and it's routine to us.
I don't know any details about Hagman, but Jobs got a transplant because he registered on a bunch of lists. The catch was that he could afford a private jet to get to the transplant center within the requisite time frame (several hours). This is outside the reach of average people, but you don't have to be Jobs rich to afford it - $100k should get you a chartered private jet to anywhere in the country.
I am a professor of anesthesiology at a transplant center. During residency, I trained in ICUs and pronounced death by brain death. Both during residency and in practice, I have provided anesthetic management for organ donors. It's also a level one trauma center with a catchment area of perhaps 150 miles' radius. Which is to say: I know a lot about trauma, and am more than passingly familiar with the organ donation process. Consider this your reward for posting this while logged in.
Here's how it works: person has trauma. They are brought to our hospital either directly, or as a transfer (usually via helicopter) from a smaller hospital that can't handle the case. When they arrive, they are brought into the emergency room and evaluated by the ER docs, the trauma surgery team, and possibly one of the on-call anesthesiologists (depending on how bad it looks). The patient then is brought to the OR, the ICU, or a regular room depending on how ill he or she is.
The only path that leads to organ donation is the one that takes you to the neuro ICU due to head trauma. If you've had low blood pressure due to injury/bleeding, you're not going to be eligible to donate. So, you go to the neuro ICU. Up there, the neurosurgeons evaluate you constantly, and treat as best as they are able. If it turns out that you have an immense injury that is probably not going to be survivable, the organ donation agency is called. They draw blood samples to try to match your tissue to potential recipients. If the potential donor does actually die (brain death), the organ donation agency only then notifies the possible recipient transplant surgeons that organs are available. Our transplant surgeons get first pick, but anything that doesn't match anyone on our list gets shopped around to nearby transplant centers.
After all of that, the (now legally dead) person is brought to the OR for the organ harvest. All in all, it takes at least 24 hours to put together, and it's intermediated by the organ donation agencies. Frankly, until someone has been declared dead, we don't even know if we have a match. Our great success in not having organs rejected comes from not transplanting organs into people who aren't very, very good tissue matches.
So no, despite your desire for it to be otherwise, we don't actually bump people off for organs. After all, if even one nurse, tech, therapist, or anyone else in the entire process thought that something wrong was happening and reported the physician to the state medical board, the physician would face license revocation, criminal prosecution for murder, and civil suit for wrongful death. Do you really think we care that much about money?
Are you a Jesuit, a trial lawyer, or both? ;)
The military is a prerequisite of a state ("A language is a dialect with an army and navy"). It cannot be socialist, no matter its extent. A public library is, by the strict criteria, probably socialist, but it's so inexpensive that I just can't get too worked up about it. Fair enough?
If you're talking about the government providing non-essential services directly, you're talking about socialist goals. That doesn't make them communist goals, or fascist goals, or even (necessarily) bad ideas. It doesn't mean that you're trying to go back to pre-Thatcher Britain.
As for the one sixth, it may be a bit of an exaggeration for now, apparently. According to the WHO tables US healthcare spending was 15.3% of GDP in 2006, while 1/6 would be 16.67%. However, it has been rising as a percentage, so it's a good rough estimate. It's certainly more than 1/7.
Yep. I'm thinking that the iPad is going to become a compelling product around v3-v4.
Books are already cheaper on Kindle than paper, often by a fair amount. The problem is that right now e-Ink screens are really good only for continuous text streams without graphics. Now, for that one purpose, they're fantastic. I love my Kindle. But I would have had a lot of trouble justifying the cost if I were a casual reader (5-6 books/year).