Recission should simply be made criminal except when actual fraud was perpetrated upon the insurance company. But it's rare, and so it's not really the problem.
Perhaps I can give you a bit more insight into how the system works from a slightly more insider perspective: insurance in the US is a complete dog's breakfast because there are 50 different state regulatory agencies telling companies what to do. My state places very few requirements on what the companies must cover, and premiums are fairly low - I can join the "high-risk pool" run by the state, with immediate coverage and no preexisting conditions disallowed, for $450/mo (which has a $1000 medical deductible and $250 pharmacy deductible; rates go down to $170/mo for $10000/$1000). This isn't cheap, but it's affordable for anyone who doesn't qualify for Medicaid, which is the state-provided coverage for the poor. There are all sorts of things that state insurance boards can do to run up the cost, though, like requiring that birth control pills be covered, or having "community rating" in which everyone in an area generally pays the same amount regardless of preexisting conditions, or "shall issue" in which they can't turn you down. (The combination of the last two works to make costs much, much higher.)
So when we say we don't trust our government, there's more than one government at work. State governments generally regard Federal money as a delightful windfall to be used and abused as long as it's there, so they don't work to keep costs down. Insurance companies may try to screw you, but at least you can go to another one. If you have group health insurance via your employer, you can even get your preexistings covered if your employer switches plans.
Medicaid alone goes a long way to explaining American indifference to the uninsured. The presence of programs that exist solely to provide for the poor gives the very clear impression (whether or not it is correct) that someone who doesn't have insurance isn't poor, but has chosen not to buy insurance. And that makes people a lot less sympathetic - why worry about the 25-year-old guy who'd rather have a fancy car than health insurance? Furthermore, it presents a rather immediate solution to the problem of the uninsured - provide it for everyone in the state who wants it, and set up a sliding scale of payments required based on income. Medicaid is a sufficiently unpleasant coverage to have that people will happily pay to have something better.
And this gets right to the heart of it. Medicaid and Medicare were sold to our parents and grandparents as a way to provide coverage for everyone. Given that they've screwed that up, why is chucking the whole system (which, on balance, works pretty well for the vast majority of people) and starting all over the best way to do it? The issue has been complicated by the fact that quite a few people in the liberal wing of the Democratic Party have all but openly acknowledged that any "public option" would be a first step toward a fully socialized health care system (which nearly always ends up sounding just like Canada's system, as if we can't do better than that). It doesn't take too many tales of patients waiting a few months for a hip replacement, or not being able to get a doctor's appointment when away from home, or not being able to see the doctor they want, for the relatively well-to-do elderly to kill something off (and there is no voting bloc like the over-65s - they are politically savvy, they are wealthier than any other group, and they always have free time to go vote).
Oh, and to answer something you mentioned earlier - EMS that has a contract for an area can't refuse to pick you up, but they can send you a bill afterward, and it's extremely common for the Coast Guard and other rescue agencies to send bills to people who do dumb stuff.
It's not 83 degrees, that's why. If you immerse yourself in 110 degree water, you will trend inexorably toward 110 degrees yourself. When you get there, you will find that your biochemistry no longer works - this is why fevers over 103 are worrying and over 106 are usually fatal.
Now, if you like a hot bath, and you get out before your body cooks, that's fine. But you can't take 110 forever, like you could (say) 95.
Well, knives are used all the time for cutting up things other than live people. What's the distribution of smashed windows for burglary vs escaping a sinking car?
Remarkably simple, actually. Just needs a sharp point impact. Check out the devices sold for breaking car windows "in case your car falls into the water".
Don't be so sure. If they have a PhD in something, they will most assuredly introduce themselves as "Doctor". Why else do you think there's a push for a new nurse practitioner degree called "Doctor of Nursing Practice"?
Hint: long white coats are sold at uniform stores, and the embroidery people don't check credentials. If someone introduces themselves as "Doctor so-and-so", ask them what their doctorate is in. If the answer is something other than "Medicine", then know that you're dealing with someone who's trading on your ignorance. That's why my coats say "Demon Lapin, MD" and not "Dr. Demon Lapin".
FWIW, LOTR is easy to read if you skip the songs, the chants, and the history lessons. It's a relatively small part of the bulk, but nearly 100% of the purple prose.
Actually, you were the one using spelling that is correct in neither country (as I pointed out in another post, the correct spelling for a subject of Queen Elizabeth II is MANOEUVRE).
The only reason for [sic] on the Internet is to be a dick - we know that you just used cut and paste, so accuracy in quotation is a given.
Learn something every day. When I read about it - twenty years ago, and not in actual classwork - I came away with the strong impression that it stood between Chaucer and Shakespeare, being basically complete by 1550 or so. Glad to know the right details.
If you know that U and V were the vowel and consonant pronunciations of the same letter - so that either one might actually be pronounced as the other - this is trivial to understand, if you try to render it phonetically. If you read a few of Shakespeare's works - let's say 5, over the course of a dozen weeks - you'll find that the quirks are fairly minimal, the diction is not terribly strange to modern English speakers, and it's quite easy to immerse yourself in the language and understand it very clearly.
Furthermore, that's on the other side of a large dividing line of standardization. Many writings from the early 1700s are archaic in style but easily, eminently readable.
My take on it is that they should teach elementary students how to write in block print like drafters, and then give them keyboards. Then again, I'm a lot happier with a keyboard than a pen.
I'd never tell you, specifically, how to raise your children, specifically, unless I knew a hell of a lot about both of you and you specifically asked me for advice, because people are extraordinarily touchy about parenting style, and every child is different. But the fact that you felt the need to jump down his throat over a very general comment that cell phones are great no matter your age, on the grounds that a six-month-old has no use for one, suggests that you're on the touchier end of things. Probably too much so.
I don't have kids, but I'm old enough that almost all of my friends do, and I frequently have to deal with them (all ages) in my job. I can detail all the major mistakes that my parents made in raising me, and I'm adult enough to understand why they made them and forgive them for it. Am I a parenting expert? Of course not. I did once meet a man who had ten children, all of whom went to medical school. THAT is a parenting expert. I'm not even an amateur, but saying that mobiles are great for kids - it's a pretty benign statement. He's not telling you how to discipline Johnny.
You guys had strange parents. Mine didn't care how late I stayed up so long as I didn't make any noise. (And it was an old house with hardwood floors, so rolling over in bed made noise. You had to be still.)
Some Brits have a real problem with the fact that we call our language English and then don't spell it (or, for that matter, speak it) as they do. Personally, I generally go with American spellings, since I'm an American, but I do really prefer "travelling" to "traveling" and "grey" to "gray". And I prefer British-style quotation syntax, with all punctuation that isn't in the original located outside the marks.
But the best part? He's misspelling it. It's MANOEUVRE and MANOEUVRABILITY (at least according to Cambridge University Press, which kindly puts a free dictionary online - unlike Oxford).
It's pretty routine to be given IV induction agents - to go out - but IV maintenance was a real bear before propofol came along unless you used some gas to supplement.
A nuclear sub can do a lot of damage to ships, but can't take land. Carrier battle groups can - they have aircraft and Marines. You may think that a CBG is a ridiculous expense, but it is indeed a far more capable beast than a nuclear-powered submarine. As for other nuclear ships, Wikipedia says only the Russians have anything but carriers with reactors on board (certainly the US does not). The entire rest of the US Navy runs on oil - that's the cruisers, destroyers, patrol boats, troop transports, and tankers. A nuclear aircraft carrier can cruise for a long, long time without refueling itself, but eventually you run out of ordnance, food, and jet fuel if you don't resupply. You can resupply back at home if you don't have somewhere closer, but that just cuts into your time on station and increases the number of ships and crews necessary to keep a vessel there at all times.
OTOH, if you have access to nice places like Diego Garcia, well... it's a lot closer than Pearl Harbor or Guam. Nuclear subs are great devices, and they suited the Soviet and Russian strategic aims extremely well. After all, the Soviets had all the oil and gas they needed, and can easily get it back if they want it - with a land war. The US gets its supplies of materials not available locally - oil is only one example - over water, so we need a larger sea presence.
The Soviet Union had a dearth of warm-water ports from which to operate, and the Atlantic-facing ports were in the Baltic - necessitating a run through the straits at Denmark. A real two-ocean navy wasn't an option for them, and in any case would have been a bad way to spend their resources given their strategic situation - land enemies to worry about, particularly China.
The US had no real risk of invasion and warm-water ports on two oceans. It therefore could become a real two-ocean navy (and, with the use of British and Australian ports, a global one) and built accordingly.
The US doesn't have a better military because we're smarter or cooler. We have a better military because we can afford it.
Propofol is used primarily as an agent for the induction of general anesthesia rather than for maintenance. There are several reasons why this is so:
Propofol is expensive. A 20mL vial - i.e., an induction dose - costs my hospital about $15. A typical 2-hour surgery would require 150 mL or so. $120 for propofol, vs. $10 (at most) for gas anesthesia.
Propofol is bacteria food. To solubilize it requires a lipid emulsion. For safety, it cannot be used after 6 hr and thus cannot be cheaply provided from bulk containers (as the gases can).
We cannot measure blood propofol concentrations on the fly; we can easily measure exhaled anesthetic gases. This gives some degree of certainty with gas anesthetics that the patient is, in fact, unconscious.
It takes forever to wear off if done as an infusion.
Having said all that, it is a superior induction agent due to the rapid recovery from single-dose injection and its anti-nausea properties. So it's used for induction, but not to keep you out. (Why don't we just give you gas to go to sleep? Because there's Stage II anesthesia - a disinhibition, in which people routinely go wild. Propofol skips that step by knocking you flat out.)
And to answer others who mentioned the spread of the gas: it's not ventilated into the OR, due to the closed breathing circuit, but it is evacuated by the hospital vacuum system and ejected into the atmosphere.
Slashdot Mirror
Buffalo lacks the lively atmosphere, and it's a lot farther from Windsor. Also, there's no White Castle in Buffalo.
Well...
Recission should simply be made criminal except when actual fraud was perpetrated upon the insurance company. But it's rare, and so it's not really the problem.
Perhaps I can give you a bit more insight into how the system works from a slightly more insider perspective: insurance in the US is a complete dog's breakfast because there are 50 different state regulatory agencies telling companies what to do. My state places very few requirements on what the companies must cover, and premiums are fairly low - I can join the "high-risk pool" run by the state, with immediate coverage and no preexisting conditions disallowed, for $450/mo (which has a $1000 medical deductible and $250 pharmacy deductible; rates go down to $170/mo for $10000/$1000). This isn't cheap, but it's affordable for anyone who doesn't qualify for Medicaid, which is the state-provided coverage for the poor. There are all sorts of things that state insurance boards can do to run up the cost, though, like requiring that birth control pills be covered, or having "community rating" in which everyone in an area generally pays the same amount regardless of preexisting conditions, or "shall issue" in which they can't turn you down. (The combination of the last two works to make costs much, much higher.)
So when we say we don't trust our government, there's more than one government at work. State governments generally regard Federal money as a delightful windfall to be used and abused as long as it's there, so they don't work to keep costs down. Insurance companies may try to screw you, but at least you can go to another one. If you have group health insurance via your employer, you can even get your preexistings covered if your employer switches plans.
Medicaid alone goes a long way to explaining American indifference to the uninsured. The presence of programs that exist solely to provide for the poor gives the very clear impression (whether or not it is correct) that someone who doesn't have insurance isn't poor, but has chosen not to buy insurance. And that makes people a lot less sympathetic - why worry about the 25-year-old guy who'd rather have a fancy car than health insurance? Furthermore, it presents a rather immediate solution to the problem of the uninsured - provide it for everyone in the state who wants it, and set up a sliding scale of payments required based on income. Medicaid is a sufficiently unpleasant coverage to have that people will happily pay to have something better.
And this gets right to the heart of it. Medicaid and Medicare were sold to our parents and grandparents as a way to provide coverage for everyone. Given that they've screwed that up, why is chucking the whole system (which, on balance, works pretty well for the vast majority of people) and starting all over the best way to do it? The issue has been complicated by the fact that quite a few people in the liberal wing of the Democratic Party have all but openly acknowledged that any "public option" would be a first step toward a fully socialized health care system (which nearly always ends up sounding just like Canada's system, as if we can't do better than that). It doesn't take too many tales of patients waiting a few months for a hip replacement, or not being able to get a doctor's appointment when away from home, or not being able to see the doctor they want, for the relatively well-to-do elderly to kill something off (and there is no voting bloc like the over-65s - they are politically savvy, they are wealthier than any other group, and they always have free time to go vote).
Oh, and to answer something you mentioned earlier - EMS that has a contract for an area can't refuse to pick you up, but they can send you a bill afterward, and it's extremely common for the Coast Guard and other rescue agencies to send bills to people who do dumb stuff.
It's not 83 degrees, that's why. If you immerse yourself in 110 degree water, you will trend inexorably toward 110 degrees yourself. When you get there, you will find that your biochemistry no longer works - this is why fevers over 103 are worrying and over 106 are usually fatal. Now, if you like a hot bath, and you get out before your body cooks, that's fine. But you can't take 110 forever, like you could (say) 95.
Well, knives are used all the time for cutting up things other than live people. What's the distribution of smashed windows for burglary vs escaping a sinking car?
Anytime, HTH. I make a great straight man, even when I'm not trying to be.
Remarkably simple, actually. Just needs a sharp point impact. Check out the devices sold for breaking car windows "in case your car falls into the water".
He mentioned bath, not shower. In that context, he's correct.
Don't be so sure. If they have a PhD in something, they will most assuredly introduce themselves as "Doctor". Why else do you think there's a push for a new nurse practitioner degree called "Doctor of Nursing Practice"?
Hint: long white coats are sold at uniform stores, and the embroidery people don't check credentials. If someone introduces themselves as "Doctor so-and-so", ask them what their doctorate is in. If the answer is something other than "Medicine", then know that you're dealing with someone who's trading on your ignorance. That's why my coats say "Demon Lapin, MD" and not "Dr. Demon Lapin".
FWIW, LOTR is easy to read if you skip the songs, the chants, and the history lessons. It's a relatively small part of the bulk, but nearly 100% of the purple prose.
I take off my hat and pedants' cloak...
Is that like putting on your robe and wizard hat?
Actually, you were the one using spelling that is correct in neither country (as I pointed out in another post, the correct spelling for a subject of Queen Elizabeth II is MANOEUVRE).
The only reason for [sic] on the Internet is to be a dick - we know that you just used cut and paste, so accuracy in quotation is a given.
Learn something every day. When I read about it - twenty years ago, and not in actual classwork - I came away with the strong impression that it stood between Chaucer and Shakespeare, being basically complete by 1550 or so. Glad to know the right details.
If you know that U and V were the vowel and consonant pronunciations of the same letter - so that either one might actually be pronounced as the other - this is trivial to understand, if you try to render it phonetically. If you read a few of Shakespeare's works - let's say 5, over the course of a dozen weeks - you'll find that the quirks are fairly minimal, the diction is not terribly strange to modern English speakers, and it's quite easy to immerse yourself in the language and understand it very clearly.
Furthermore, that's on the other side of a large dividing line of standardization. Many writings from the early 1700s are archaic in style but easily, eminently readable.
300-year-old text is actually pretty easily readable, once you adjust yourself to the slang of the time and the German-inspired capitalization rules.
I'm pretty sure that Shakespeare came after the Great Vowel Shift.
My take on it is that they should teach elementary students how to write in block print like drafters, and then give them keyboards. Then again, I'm a lot happier with a keyboard than a pen.
I'd never tell you, specifically, how to raise your children, specifically, unless I knew a hell of a lot about both of you and you specifically asked me for advice, because people are extraordinarily touchy about parenting style, and every child is different. But the fact that you felt the need to jump down his throat over a very general comment that cell phones are great no matter your age, on the grounds that a six-month-old has no use for one, suggests that you're on the touchier end of things. Probably too much so.
I don't have kids, but I'm old enough that almost all of my friends do, and I frequently have to deal with them (all ages) in my job. I can detail all the major mistakes that my parents made in raising me, and I'm adult enough to understand why they made them and forgive them for it. Am I a parenting expert? Of course not. I did once meet a man who had ten children, all of whom went to medical school. THAT is a parenting expert. I'm not even an amateur, but saying that mobiles are great for kids - it's a pretty benign statement. He's not telling you how to discipline Johnny.
You guys had strange parents. Mine didn't care how late I stayed up so long as I didn't make any noise. (And it was an old house with hardwood floors, so rolling over in bed made noise. You had to be still.)
Some Brits have a real problem with the fact that we call our language English and then don't spell it (or, for that matter, speak it) as they do. Personally, I generally go with American spellings, since I'm an American, but I do really prefer "travelling" to "traveling" and "grey" to "gray". And I prefer British-style quotation syntax, with all punctuation that isn't in the original located outside the marks.
But the best part? He's misspelling it. It's MANOEUVRE and MANOEUVRABILITY (at least according to Cambridge University Press, which kindly puts a free dictionary online - unlike Oxford).
It's pretty routine to be given IV induction agents - to go out - but IV maintenance was a real bear before propofol came along unless you used some gas to supplement.
A nuclear sub can do a lot of damage to ships, but can't take land. Carrier battle groups can - they have aircraft and Marines. You may think that a CBG is a ridiculous expense, but it is indeed a far more capable beast than a nuclear-powered submarine. As for other nuclear ships, Wikipedia says only the Russians have anything but carriers with reactors on board (certainly the US does not). The entire rest of the US Navy runs on oil - that's the cruisers, destroyers, patrol boats, troop transports, and tankers. A nuclear aircraft carrier can cruise for a long, long time without refueling itself, but eventually you run out of ordnance, food, and jet fuel if you don't resupply. You can resupply back at home if you don't have somewhere closer, but that just cuts into your time on station and increases the number of ships and crews necessary to keep a vessel there at all times.
OTOH, if you have access to nice places like Diego Garcia, well... it's a lot closer than Pearl Harbor or Guam. Nuclear subs are great devices, and they suited the Soviet and Russian strategic aims extremely well. After all, the Soviets had all the oil and gas they needed, and can easily get it back if they want it - with a land war. The US gets its supplies of materials not available locally - oil is only one example - over water, so we need a larger sea presence.
The Soviet Union had a dearth of warm-water ports from which to operate, and the Atlantic-facing ports were in the Baltic - necessitating a run through the straits at Denmark. A real two-ocean navy wasn't an option for them, and in any case would have been a bad way to spend their resources given their strategic situation - land enemies to worry about, particularly China.
The US had no real risk of invasion and warm-water ports on two oceans. It therefore could become a real two-ocean navy (and, with the use of British and Australian ports, a global one) and built accordingly.
The US doesn't have a better military because we're smarter or cooler. We have a better military because we can afford it.
British vs US spellings.
Don't forget halothane and enflurane. (Although it's hard to figure out if anyone is still selling enflurane.)
Propofol is used primarily as an agent for the induction of general anesthesia rather than for maintenance. There are several reasons why this is so:
Having said all that, it is a superior induction agent due to the rapid recovery from single-dose injection and its anti-nausea properties. So it's used for induction, but not to keep you out. (Why don't we just give you gas to go to sleep? Because there's Stage II anesthesia - a disinhibition, in which people routinely go wild. Propofol skips that step by knocking you flat out.)
And to answer others who mentioned the spread of the gas: it's not ventilated into the OR, due to the closed breathing circuit, but it is evacuated by the hospital vacuum system and ejected into the atmosphere.