The only people that are interested in making a stand against the jury's decision in this particular case would be those opposed to the death penalty in all cases, basically those that do not believe that the State should kill people.
No. I can accept the death penalty under 3 conditions: (1) The defendant must actually be guilty (2) The defendant must have a fair trial (3) People who commit the same crimes must all be executed.
I would contend that less than the death penalty here would be to de-value the lives of those he killed. Taking another's life is too serious of a crime to punish by any lesser measure.
You might recall that we have a justice system, and that justice is generally defined by punishments meted out in proprotion to their crime. What punishment would be more just than death for one who has killed many?
The Greek philosopher Thrasymacus told Socrates, "Justice is the interest of the strong." That's the kind of justice system we have.
Punishments (and prosecutions in the first place), are determined by the political support that the accused gets. In our system, we avoid punishment for even the worst crimes committed by our military or cops.
And as each group kills members of the other group, they're both encouraged to continue killing in retribution. The mentality is the same for common street gangs and for nations.
tldr: Human groups have always killed each other. But they've also reconciled with each other.
The model is South Africa, where some of the worst criminals were pardoned in order to get a resolution.
No dipshit.. If you kill someone, we will kill you.
That worked when people were fighting with bows and arrows. Once modern weapons came along, that attitude wound up in wars in which both sides were massacred.
It is OK for Dzhokar to target a crowd of spectators because the U.S. military kills more people than it should with drone strikes?
There are similarities between Dzhokar killing civilian spectators and the U.S. military killing civilian spectators at a wedding.
The main difference is that the U.S. military will say, "We only intended to kill bad guys. We didn't intend to kill civilians."
This is subject to a just war analysis. A war is justified when the aggressor has tried every other reasonable approach, when the goal is justified, and the aggressor tries to minimize damages. I'm not convinced this is true for the drone attacks.
I'm not absolutely against the death penalty. I could accept it under 3 conditions: (1) The defendant must actually be guilty (2) The defendant must have had a fair trial (3) Other defendants who committed similar crimes must have gotten the same penalty.
I would compare the Boston Marathon killings to the Nusoor Square killings, where Blackwater private security contractors killed 17 people. My interpretation of the evidence is that the killings were unjustified and indiscriminate, and part of a pattern of such killings by Blackwater. One Blackwater contractor was sentenced to life in prison, and 3 others were sentenced to 30 years.
Dzhokar's death sentence fails my third condition. If we didn't sentence any of the Blackwater contractors to death, then we can't sentence Dzhokar to death.
Actually the federal government's National Vaccine Injury Compensation Program has a reasonable basis.
There are 2 kinds of vaccine injuries:
(1) The avoidable injuries that come from the manufacturer clearly violating the good manufacturing procedures, like improperly filtering the vaccine preparation or letting it get infected.
(2) The inevitable injuries that come even when the manufacturer does everything right, meets the good manufacturing procedures. That's because the immune system is complicated, and we don't understand everything about it. (Furthermore, they sometimes have to make tradeoffs between a vaccine that protects you better from the infectious disease, but has more adverse effects, and a vaccine that has fewer adverse effects, but doesn't protect you from the infectious disease as well.)
I think the inevitable serious injuries occur at the rate of 1 in a million vaccinations. These are the kids who just drew an unlucky lottery ticket. Nobody's wrong.
There were a lot of problems with the vaccine program, and manufacturers stopped making a lot of vaccines, because they were getting hit with big-dollar product liability lawsuits. Some of them were justified, some of them weren't, and some of them, nobody knows, because the immune system is complicated, and we don't understand everything about it.
In order to encourage manufacturers to make vaccines, and parents to vaccinate their kids, the federal government set up what amounts to a no-fault program. https://en.wikipedia.org/wiki/...
They listed a lot of known serious complications that everybody agreed were caused by vaccines. Kids with those complications were automatically compensated, and it was fairly generous compensation, designed to match what they would get if they went to court and won. That's worked pretty well.
The idea is, if a kid gets vaccinated, in order to protect society as a whole, and draws the unlucky lottery ticket, then society ought to insure him for that bad luck. That's the proper role of insurance.
Then along come the parents whose kids have serious complications where people don't agree it was caused by vaccines. Sometimes they are, sometimes they aren't, and sometimes (usually) nobody knows. Those go to a special vaccine court. From the occasional articles I've read about it, they seem to be pretty generous in giving the injured child the benefit of the doubt. I can accept that. It's better to err on the side of compensating people who don't deserve it, than err on the side of not compensating people who do deserve it. But they held the line at the vaccine-autism connection, and rejected those cases.
I am referring to the frequent claim, repeated here, that you can donate your used cell phone to an organization that will redistribute it to a battered woman who can't afford a cell phone herself, so that she can use it to only call 911 in an emergency.
First, none of the organizations I contacted had a program like that. They accept old cell phones, but they don't redistribute them. They give out cheap new cell phones, with full service, including 911.
But you don't need an organization for that. Anybody who can't afford a cell phone is likely to meet the very flexible requirements for Assurance or Safelink and get a free phone directly, with full service, including 911. Assurance now has unlimited calling and texting.
Yes, if you're right, you could go to Radio Shack or its successors, and buy a cell phone for $15, and use it to call 911 in an emergency, which might be useful in some scenarios.
But you can't donate your phone to an organization that will give it to a battered woman.
I don't believe that you can donate your old cell phones to be used as 911-only phones by victims of domestic violence, etc. It's an urban myth.
I checked it out once because of a 90-year-old neighbor. He had a stroke, and he was lying in the bathroom for 24 hours, unable to call for help, until one of his children came over for their daily check-in.
I tried to find out where in New York City I could get one of those 911-only reconditioned cell phones, that he could carry with him and use if something similar happened again. I researched the Internet, made several calls, and couldn't find one.
But who needs one? Low-income people can get a free Assurance or Safelink phone, that they can use to call 911 and everything else (like doctors and relatives). So why would anybody want a phone that could do nothing but call 911?
I just called another nationwide service (which I am not identifying because I don't want everybody calling them), and the woman answering the phone told me that they really don't provide people with reconditioned 911-only cell phones. They collect the old phones, turn them into Verizon, and Verizon gives them "Help" phones which are cheap cell phones with free minutes on them.
Try it yourself. Call one of those services and ask them whether they can give you a reconditioned phone. They can't.
Think about it. You can buy a low-end wireless phone new for $15 retail (and probably $5 wholesale). In order to "recondition" them, you'd need a technician to check it out, to make sure it's working. People would be using them for life-threatening emergencies, so they have to work reliably. You'd have to repackage and distribute them. It's cheaper for a phone company or any agency to just buy new phones in bulk. But why bother? Why not just let people get a phone directly from Assurance or Safelink?
Sometimes they want to rename diseases because of the association with a bad person. I have Reuter's, but he experimented on Jews during the war. Also, the new name, reactive arthritis, is much more descriptive and I don't have to immediately say I have arthritis afterwards. Even doctors tend not to know what it is unless they are specialists.
The problem is that all autoimmune diseases are reactive, and most of them involve arthritis.
As a compromise, it would have been better to hang Reiter at Nuremberg and keep his name on the disease.
The organization suggests researchers, health officials, and journalists should use more neutral, generic terms, such as severe respiratory disease or novel neurologic syndrome instead. “It will certainly lead to boring names and a lot of confusion,” predicts Linfa Wang
WHO thought this was a good idea? It's all fun and games until someone confuses two different severe respiratory diseases, or a novel neurologic syndrome for an older neurologic syndrome.
It's really simple:
Neurologic syndrome
New neurologic syndrome
Newer neurologic syndrome
Even newer neurologic syndrome
Really new neurologic syndrome
Really new neurologic syndrome with strawberry rash
“Confusing” Brand, Generic Drug Name System To Be Replaced Full scientific nomenclature will soon be mandatory November 1, 2002
WASHINGTON, DC--In an effort to decrease prescription errors, The American Pharmaceutical Association announced today that a new naming system will be enforced by pharmacies nationwide beginning in January.
Instead of the current system of brand and generic names, clinicians will be required to use full scientific nomenclature on all prescriptions, and are urged to use the new names when discussing medications with patients and with other providers.
"There's mounting evidence that having both a brand and a generic name causes a lot of unnecessary confusion," said APhA spokesman Noreen Marzette. "You get patients taking both Lasix and furosemide, not knowing they're the same thing."
"Now in the new system, they're on 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid. It just doesn't get much more unambiguous than that."
According to the APhA, responses to the planned implementation have been mixed. At a trial implementation in Baltimore, MD, some patients were reportedly unable to obtain (3b, 5b, 12b)-3-[(O-2,6-dideoxy-b-D-ribo-hexopyranosyl-(1“4)-O-2,6-dideoxy-b-D-ribo-hexopyranosyl-(1“4)-2,6-dideoxy-b-D-ribo-hexopyranosyl)oxy]-12,14-dihydroxy-card-20(22)-enolide (formerly known as digoxin) when a computer glitch caused the third hexopyranosyl to be omitted.
Nevertheless, the new system will be universally adopted by pharmacies, hospitals, and medical centers throughout the nation in January 2003. Prescriptions not written in scientific notation after that time will be sent back to the prescribing clinician for revision.
I believe the triggering incident here was swine flu, where pigs (owned mainly by christians, since muslims don't eat pork) were slaughtered because of fears of swine flu
So Muslims once again are behaving like ignorant savages. And for that the rest of us should dumb down and obfuscate our language. No. They need to drag themselves out of the seventh century and grow up.
The absence of world-spanning aurorae in historical records and of anomalous extinctions in the geological record indicates that our Sun likely does not suffer superflares.
Now what do I do with the 30 years worth of survival food bars in my fallout shelter?
The issue is whether the American health care system is second to none, as you said.
You're wrong. In other systems, the quality of care is as good (or better), and access is better. A system that only treats people who can afford to pay is second to a system that treats all people.
The medical journals regularly compare different systems. I've read them, and talked to experts on international comparisons. There are many systems that are better than the American health care system, even in quality.
The outcomes in an academic hospital in Sweden or Canada is as good as (or better than) the outcomes in any similar American hospital (and far better than a typical American community hospital). Patients with cancer survive just as well at the University of Gottingen hospital as they do at Memorial Sloan-Kettering. In some ways, the care at Gottingen is better, because the Swedes have medical databases for their entire population to monitor how effective different treatments are, so they can stop using ineffective or dangerous drugs. We don't have information like that. We're second to Scandinavia in managing patient information.
The access in every other country at our income level is better than ours. Since low-income Americans can't even get essential health care that would save their lives, our system is second to those systems where everyone can get essential care.
You can find health care systems that are worse than ours in Russia, China, India, Greece, or third-world countries. But if you include access and population-level criteria like infant mortality, the US is second to most (or all) industrial countries with similar income.
For anyone who cares about those less well off, the World is not a comfortable place. America is a good place to be poor, compared to most of the world.
Compared to Africa, America is a good place to be poor.
Compared to the rest of the developed world, like Germany, France, and certainly Scandinavia, America is not a good place to be poor.
In America, people with cancer can be kicked out of a hospital and left to die because they can't pay the bill. http://www.wsj.com/articles/SB... That doesn't happen in France or other developed countries.
Well, I guess it is preferable that in third world countries they will go ahead and admit you without insurance, but not know how to do anything about it. This is assuming you live in a large city that has a hospital, as most of the rural areas have nothing, or might have a nurse or a midwife, but no medicine or tools.
You might be worse off in parts of Africa, but a typical resident of the South Bronx could get better health care in Cuba.
Like a lot of New York Times reporters, Elisabeth Rosenthal is an MD (Harvard '86).
Of course for each (expensive) new test there's a big debate about whether it contributes anything to a better outcome.
I think the broader point is that there are people like Steve Brill who say that we can significantly reduce health care costs if everybody knew the benefits of each treatment, and could shop around for the best price, the way we buy a refrigerator. Rosenthal seems to be tempted by that philosophy.
I don't think it's going to work. Kenneth Arrow, the Nobel laureate in economics, write an article years ago about why health care isn't a free market like other markets. The consumer doesn't have enough information to make an informed decision.
Even doctors can't make informed decisions about their own treatment. Eugene Braunwald, the cardiologist, said that when he needs a doctor, he doesn't want to be a medical consumer. He wants to go to a doctor he trusts, and let his doctor make the decisions. I don't think you can improve on that. If you don't have a doctor you can trust, you're doomed.
If you're a patient, I think NICE does a pretty good job of making your decisions for you. If NICE thinks I need an EM and IF, I'll get it.
Since you can't legally share a lot of patient information with "unknown third parties", a consequence is that bills are going to be decidedly lacking in specific information. Even if you want to ascribe that to malice, it isn't necessarily the hospital that you should point the finger at first.
Under HIPAA, doctors and hospitals can share patient information for operational purposes, which is pretty broadly defined to include certainly the insurance companies, any doctor who's treating the patient, the pharmacy, and a poorly-defined group of hospital personnel and hangers-on.
But in Elisabeth Rosenthal's example, they claimed that for privacy reasons they couldn't share billing information with the patient herself. In the course of a day's work, a big part of a clerk's work is to just make up bullshit to get rid of people.
>> "The software industry has pretty much decided what information patients should receive, and to my knowledge, they have not had any stakeholder input..."
Um...yeah. I'm sure it was a bunch of developers who decided one night to pound a bunch of Mountain Dew and then set up a billing system for a bunch of multi-billion dollar hospital groups that contained hundreds of thousands of items that magically skirt around insurance limits and pre-negotiated fees, then tack on expensive and low-value items, and follow it all up by adding on mysterious charges from other providers months after the original procedures happened.
Actually I used to write about medical software for the medical magazines, when they were first installing it. It was indeed pretty haphazard. They started out as billing systems, for which it worked pretty well, and tacked on other modules, like prescription drug ordering, for which it was not all that successful.
One of the major medical office systems was written by a chiropractor, who designed it after a general accounting program that was used for hardware stores or restaurants and modified for each customer. It worked great for everything that a medical office had in common with hardware stores, but not for the unique stuff that doctors had to do, like saving medical records and reminding patients to come in for followups.
The main thing that medical software did well was meet the billing needs of the insurance companies. They didn't meet the needs of doctors too well. If the doctor didn't repeat every fucking thing he did into a record field, the insurance company wouldn't pay for it. They wound up with enormous billing records, with field after field of data that the insurance companies decided it would be "nice to have," but were useless for doctors (is this prescription a pill or a capsule?). Even today, doctors complain that they have to spend an additional hour a day filling in EMR forms.
What they don't have, and still don't have, is a short narrative that would take 4 handwritten lines in an old medical record, explaining concisely what the fucking problem is with this patient and what the doctor thinks is the best way to manage it. Instead they wind up with a 100-page record that literally no one ever reads, most of which is for the irrational requirements of the insurance company, most of which is transmitted unread to the insurance company's computer.
So the insurance companies are basically spamming the doctor's medical records with billing trivia.
The great thing Wachter did was go to Boeing and talk to the engineers who designed jet cockpits about human factors design. The EMRs, which peoples' lives depend on, were designed and pushed on doctors without the basic usability testing that an auto company would use for a cup holder.
Dude, we are the only first-world country with a third world healthcare system. Wake up
Anybody who thinks that our healthcare system is third world has obviously never been to the third world. I have been to several third world countries and I can tell you that our system is hundreds of times more functional then theirs.
If you think that, you have obviously never been to low-income places in the US like the South Bronx or rural Louisiana or Mississippi, where the infant mortality rates and life expectancy are lower than Cuba.
In the US, you can have cancer and be kicked out of a hospital because you can't afford to pay for the treatment. http://www.wsj.com/articles/SB...
Slashdot Mirror
The only people that are interested in making a stand against the jury's decision in this particular case would be those opposed to the death penalty in all cases, basically those that do not believe that the State should kill people.
No. I can accept the death penalty under 3 conditions: (1) The defendant must actually be guilty (2) The defendant must have a fair trial (3) People who commit the same crimes must all be executed.
American combatants committed worse crimes in Iraq and Afghanistan, and were not given the death penalty. https://en.wikipedia.org/wiki/... https://en.wikipedia.org/wiki/... https://en.wikipedia.org/wiki/...
Therefore, it doesn't meet my third condition. If Dzhokhar Tsarnaev is executed, it will demonstrate the unfairness of our justice system.
I would contend that less than the death penalty here would be to de-value the lives of those he killed. Taking another's life is too serious of a crime to punish by any lesser measure.
You might recall that we have a justice system, and that justice is generally defined by punishments meted out in proprotion to their crime. What punishment would be more just than death for one who has killed many?
The Greek philosopher Thrasymacus told Socrates, "Justice is the interest of the strong." That's the kind of justice system we have.
Punishments (and prosecutions in the first place), are determined by the political support that the accused gets. In our system, we avoid punishment for even the worst crimes committed by our military or cops.
For example, consider the https://en.wikipedia.org/wiki/... the https://en.wikipedia.org/wiki/... or https://en.wikipedia.org/wiki/... The Nisour Square massacres and the rape and murder of Abeer Qassim Hamza al-Janabi were worse than the Boston Massacre, and yet none of those involved got the death penalty. Those responsible for the death of Dilawar didn't even serve jail terms.
Do you also think the death penalty was appropriate for those American murderers?
Do you now conclude that our system has devalued the lives of Iraqis and Afghanis? (I would agree.)
Are you willing to execute Dzhokar, when people who committed equal or worse crimes aren't executed?
I could accept the death penalty if it were applied fairly and consistently. But it's not.
And as each group kills members of the other group, they're both encouraged to continue killing in retribution. The mentality is the same for common street gangs and for nations.
Science magazine had a special issue on human conflict. http://www.sciencemag.org/site...
tldr: Human groups have always killed each other. But they've also reconciled with each other.
The model is South Africa, where some of the worst criminals were pardoned in order to get a resolution.
No dipshit.. If you kill someone, we will kill you.
That worked when people were fighting with bows and arrows. Once modern weapons came along, that attitude wound up in wars in which both sides were massacred.
Those who deserve to lead do so by example -- not by saying "do as we say, not as we do".
The USA does have a hypocrisy problem.
Or, as we prefer to say, "Several factors go into our decisions."
Just to make sure I understand you here:
It is OK for Dzhokar to target a crowd of spectators because the U.S. military kills more people than it should with drone strikes?
There are similarities between Dzhokar killing civilian spectators and the U.S. military killing civilian spectators at a wedding.
The main difference is that the U.S. military will say, "We only intended to kill bad guys. We didn't intend to kill civilians."
This is subject to a just war analysis. A war is justified when the aggressor has tried every other reasonable approach, when the goal is justified, and the aggressor tries to minimize damages. I'm not convinced this is true for the drone attacks.
I'm not absolutely against the death penalty. I could accept it under 3 conditions: (1) The defendant must actually be guilty (2) The defendant must have had a fair trial (3) Other defendants who committed similar crimes must have gotten the same penalty.
I would compare the Boston Marathon killings to the Nusoor Square killings, where Blackwater private security contractors killed 17 people. My interpretation of the evidence is that the killings were unjustified and indiscriminate, and part of a pattern of such killings by Blackwater. One Blackwater contractor was sentenced to life in prison, and 3 others were sentenced to 30 years.
Dzhokar's death sentence fails my third condition. If we didn't sentence any of the Blackwater contractors to death, then we can't sentence Dzhokar to death.
Actually the federal government's National Vaccine Injury Compensation Program has a reasonable basis.
There are 2 kinds of vaccine injuries:
(1) The avoidable injuries that come from the manufacturer clearly violating the good manufacturing procedures, like improperly filtering the vaccine preparation or letting it get infected.
(2) The inevitable injuries that come even when the manufacturer does everything right, meets the good manufacturing procedures. That's because the immune system is complicated, and we don't understand everything about it. (Furthermore, they sometimes have to make tradeoffs between a vaccine that protects you better from the infectious disease, but has more adverse effects, and a vaccine that has fewer adverse effects, but doesn't protect you from the infectious disease as well.)
I think the inevitable serious injuries occur at the rate of 1 in a million vaccinations. These are the kids who just drew an unlucky lottery ticket. Nobody's wrong.
There were a lot of problems with the vaccine program, and manufacturers stopped making a lot of vaccines, because they were getting hit with big-dollar product liability lawsuits. Some of them were justified, some of them weren't, and some of them, nobody knows, because the immune system is complicated, and we don't understand everything about it.
In order to encourage manufacturers to make vaccines, and parents to vaccinate their kids, the federal government set up what amounts to a no-fault program. https://en.wikipedia.org/wiki/...
They listed a lot of known serious complications that everybody agreed were caused by vaccines. Kids with those complications were automatically compensated, and it was fairly generous compensation, designed to match what they would get if they went to court and won. That's worked pretty well.
The idea is, if a kid gets vaccinated, in order to protect society as a whole, and draws the unlucky lottery ticket, then society ought to insure him for that bad luck. That's the proper role of insurance.
Then along come the parents whose kids have serious complications where people don't agree it was caused by vaccines. Sometimes they are, sometimes they aren't, and sometimes (usually) nobody knows. Those go to a special vaccine court. From the occasional articles I've read about it, they seem to be pretty generous in giving the injured child the benefit of the doubt. I can accept that. It's better to err on the side of compensating people who don't deserve it, than err on the side of not compensating people who do deserve it. But they held the line at the vaccine-autism connection, and rejected those cases.
I am referring to the frequent claim, repeated here, that you can donate your used cell phone to an organization that will redistribute it to a battered woman who can't afford a cell phone herself, so that she can use it to only call 911 in an emergency.
First, none of the organizations I contacted had a program like that. They accept old cell phones, but they don't redistribute them. They give out cheap new cell phones, with full service, including 911.
But you don't need an organization for that. Anybody who can't afford a cell phone is likely to meet the very flexible requirements for Assurance or Safelink and get a free phone directly, with full service, including 911. Assurance now has unlimited calling and texting.
Yes, if you're right, you could go to Radio Shack or its successors, and buy a cell phone for $15, and use it to call 911 in an emergency, which might be useful in some scenarios.
But you can't donate your phone to an organization that will give it to a battered woman.
I don't believe that you can donate your old cell phones to be used as 911-only phones by victims of domestic violence, etc. It's an urban myth.
I checked it out once because of a 90-year-old neighbor. He had a stroke, and he was lying in the bathroom for 24 hours, unable to call for help, until one of his children came over for their daily check-in.
I tried to find out where in New York City I could get one of those 911-only reconditioned cell phones, that he could carry with him and use if something similar happened again. I researched the Internet, made several calls, and couldn't find one.
But who needs one? Low-income people can get a free Assurance or Safelink phone, that they can use to call 911 and everything else (like doctors and relatives). So why would anybody want a phone that could do nothing but call 911?
I just called another nationwide service (which I am not identifying because I don't want everybody calling them), and the woman answering the phone told me that they really don't provide people with reconditioned 911-only cell phones. They collect the old phones, turn them into Verizon, and Verizon gives them "Help" phones which are cheap cell phones with free minutes on them.
Try it yourself. Call one of those services and ask them whether they can give you a reconditioned phone. They can't.
Think about it. You can buy a low-end wireless phone new for $15 retail (and probably $5 wholesale). In order to "recondition" them, you'd need a technician to check it out, to make sure it's working. People would be using them for life-threatening emergencies, so they have to work reliably. You'd have to repackage and distribute them. It's cheaper for a phone company or any agency to just buy new phones in bulk. But why bother? Why not just let people get a phone directly from Assurance or Safelink?
Sometimes they want to rename diseases because of the association with a bad person. I have Reuter's, but he experimented on Jews during the war. Also, the new name, reactive arthritis, is much more descriptive and I don't have to immediately say I have arthritis afterwards. Even doctors tend not to know what it is unless they are specialists.
The problem is that all autoimmune diseases are reactive, and most of them involve arthritis.
As a compromise, it would have been better to hang Reiter at Nuremberg and keep his name on the disease.
The organization suggests researchers, health officials, and journalists should use more neutral, generic terms, such as severe respiratory disease or novel neurologic syndrome instead. “It will certainly lead to boring names and a lot of confusion,” predicts Linfa Wang
WHO thought this was a good idea? It's all fun and games until someone confuses two different severe respiratory diseases, or a novel neurologic syndrome for an older neurologic syndrome.
It's really simple:
Neurologic syndrome
New neurologic syndrome
Newer neurologic syndrome
Even newer neurologic syndrome
Really new neurologic syndrome
Really new neurologic syndrome with strawberry rash
Suggestions like this have gone nowhere in the past.
http://www.qfever.com/2002/11/...
“Confusing” Brand, Generic Drug Name System To Be Replaced
Full scientific nomenclature will soon be mandatory
November 1, 2002
WASHINGTON, DC--In an effort to decrease prescription errors, The American Pharmaceutical Association announced today that a new naming system will be enforced by pharmacies nationwide beginning in January.
Instead of the current system of brand and generic names, clinicians will be required to use full scientific nomenclature on all prescriptions, and are urged to use the new names when discussing medications with patients and with other providers.
"There's mounting evidence that having both a brand and a generic name causes a lot of unnecessary confusion," said APhA spokesman Noreen Marzette. "You get patients taking both Lasix and furosemide, not knowing they're the same thing."
"Now in the new system, they're on 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid. It just doesn't get much more unambiguous than that."
According to the APhA, responses to the planned implementation have been mixed. At a trial implementation in Baltimore, MD, some patients were reportedly unable to obtain (3b, 5b, 12b)-3-[(O-2,6-dideoxy-b-D-ribo-hexopyranosyl-(1“4)-O-2,6-dideoxy-b-D-ribo-hexopyranosyl-(1“4)-2,6-dideoxy-b-D-ribo-hexopyranosyl)oxy]-12,14-dihydroxy-card-20(22)-enolide (formerly known as digoxin) when a computer glitch caused the third hexopyranosyl to be omitted.
Nevertheless, the new system will be universally adopted by pharmacies, hospitals, and medical centers throughout the nation in January 2003. Prescriptions not written in scientific notation after that time will be sent back to the prescribing clinician for revision.
Old New
Prozac (fluoxetine) (±)-N-methyl-3-phenyl-3-[(a,a,a-trifluoro-p-tolyl)-oxy]propylamine hydrochloride
Viagra (sildafenil) 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl]-4-methylpiperazine citrate
Tagamet (cimetidine) guanidine, N''- cyano-N-methyl-N- [2-[[(5-methyl-1H-imidazol-4-yl)methyl]thio]-ethyl]-monohydrochloride
Valium (diazepam) 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one
Norvasc (amlodipine) (R.S.) 3-ethyl-5-methyl-2-(2-aminoethoxymethyl)-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5-pyridinedicarboxylate benzenesulphonate
Zithromax (azithro-mycin) (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-dideoxy-3-C-methyl-3-O-methyl-a-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[[3,4,6-trideoxy-3-(dimethylamino)-b-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentadecan-15-one
Worst case scenario, they have to change their name.
That is a bit much too. Nobody wants to be 'Mr. & Mrs. Alzheimer' .
My high school science teacher told us that the worse the disease, the greater the honor it is to have your name on it.
If the Alzheimers don't want it named after them, there are loads of researchers who would be happy to have the honor.
I am proud to say that acinetobacter baumanii has a mortality of over 50% and is resistant to every major antibiotic.
I believe the triggering incident here was swine flu, where pigs (owned mainly by christians, since muslims don't eat pork) were slaughtered because of fears of swine flu
So Muslims once again are behaving like ignorant savages. And for that the rest of us should dumb down and obfuscate our language. No. They need to drag themselves out of the seventh century and grow up.
Pamela Geller derangement syndrome.
The absence of world-spanning aurorae in historical records and of anomalous extinctions in the geological record indicates that our Sun likely does not suffer superflares.
Now what do I do with the 30 years worth of survival food bars in my fallout shelter?
Good thing I saved my vacuum tubes.
So every 10,000 years, a superflare destroys human civilization?
The issue is whether the American health care system is second to none, as you said.
You're wrong. In other systems, the quality of care is as good (or better), and access is better. A system that only treats people who can afford to pay is second to a system that treats all people.
The medical journals regularly compare different systems. I've read them, and talked to experts on international comparisons. There are many systems that are better than the American health care system, even in quality.
The outcomes in an academic hospital in Sweden or Canada is as good as (or better than) the outcomes in any similar American hospital (and far better than a typical American community hospital). Patients with cancer survive just as well at the University of Gottingen hospital as they do at Memorial Sloan-Kettering. In some ways, the care at Gottingen is better, because the Swedes have medical databases for their entire population to monitor how effective different treatments are, so they can stop using ineffective or dangerous drugs. We don't have information like that. We're second to Scandinavia in managing patient information.
The access in every other country at our income level is better than ours. Since low-income Americans can't even get essential health care that would save their lives, our system is second to those systems where everyone can get essential care.
You can find health care systems that are worse than ours in Russia, China, India, Greece, or third-world countries. But if you include access and population-level criteria like infant mortality, the US is second to most (or all) industrial countries with similar income.
For anyone who cares about those less well off, the World is not a comfortable place. America is a good place to be poor, compared to most of the world.
Compared to Africa, America is a good place to be poor.
Compared to the rest of the developed world, like Germany, France, and certainly Scandinavia, America is not a good place to be poor.
In America, people with cancer can be kicked out of a hospital and left to die because they can't pay the bill. http://www.wsj.com/articles/SB... That doesn't happen in France or other developed countries.
And those with a family income of at least $100,000 a year and do care about those worse off?
For anyone who cares about the worse off, America is not a comfortable place.
Well, I guess it is preferable that in third world countries they will go ahead and admit you without insurance, but not know how to do anything about it. This is assuming you live in a large city that has a hospital, as most of the rural areas have nothing, or might have a nurse or a midwife, but no medicine or tools.
You might be worse off in parts of Africa, but a typical resident of the South Bronx could get better health care in Cuba.
Darn. I didn't factor for race.
And economic status. http://www.wsj.com/articles/SB...
I admit it, America is a great place if you have a family income of at least $100,000 a year (and don't care about the people who are worse off).
Like a lot of New York Times reporters, Elisabeth Rosenthal is an MD (Harvard '86).
Of course for each (expensive) new test there's a big debate about whether it contributes anything to a better outcome.
I think the broader point is that there are people like Steve Brill who say that we can significantly reduce health care costs if everybody knew the benefits of each treatment, and could shop around for the best price, the way we buy a refrigerator. Rosenthal seems to be tempted by that philosophy.
I don't think it's going to work. Kenneth Arrow, the Nobel laureate in economics, write an article years ago about why health care isn't a free market like other markets. The consumer doesn't have enough information to make an informed decision.
Even doctors can't make informed decisions about their own treatment. Eugene Braunwald, the cardiologist, said that when he needs a doctor, he doesn't want to be a medical consumer. He wants to go to a doctor he trusts, and let his doctor make the decisions. I don't think you can improve on that. If you don't have a doctor you can trust, you're doomed.
If you're a patient, I think NICE does a pretty good job of making your decisions for you. If NICE thinks I need an EM and IF, I'll get it.
Since you can't legally share a lot of patient information with "unknown third parties", a consequence is that bills are going to be decidedly lacking in specific information. Even if you want to ascribe that to malice, it isn't necessarily the hospital that you should point the finger at first.
Under HIPAA, doctors and hospitals can share patient information for operational purposes, which is pretty broadly defined to include certainly the insurance companies, any doctor who's treating the patient, the pharmacy, and a poorly-defined group of hospital personnel and hangers-on.
But in Elisabeth Rosenthal's example, they claimed that for privacy reasons they couldn't share billing information with the patient herself. In the course of a day's work, a big part of a clerk's work is to just make up bullshit to get rid of people.
>> "The software industry has pretty much decided what information patients should receive, and to my knowledge, they have not had any stakeholder input..."
Um...yeah. I'm sure it was a bunch of developers who decided one night to pound a bunch of Mountain Dew and then set up a billing system for a bunch of multi-billion dollar hospital groups that contained hundreds of thousands of items that magically skirt around insurance limits and pre-negotiated fees, then tack on expensive and low-value items, and follow it all up by adding on mysterious charges from other providers months after the original procedures happened.
Actually I used to write about medical software for the medical magazines, when they were first installing it. It was indeed pretty haphazard. They started out as billing systems, for which it worked pretty well, and tacked on other modules, like prescription drug ordering, for which it was not all that successful.
One of the major medical office systems was written by a chiropractor, who designed it after a general accounting program that was used for hardware stores or restaurants and modified for each customer. It worked great for everything that a medical office had in common with hardware stores, but not for the unique stuff that doctors had to do, like saving medical records and reminding patients to come in for followups.
The main thing that medical software did well was meet the billing needs of the insurance companies. They didn't meet the needs of doctors too well. If the doctor didn't repeat every fucking thing he did into a record field, the insurance company wouldn't pay for it. They wound up with enormous billing records, with field after field of data that the insurance companies decided it would be "nice to have," but were useless for doctors (is this prescription a pill or a capsule?). Even today, doctors complain that they have to spend an additional hour a day filling in EMR forms.
What they don't have, and still don't have, is a short narrative that would take 4 handwritten lines in an old medical record, explaining concisely what the fucking problem is with this patient and what the doctor thinks is the best way to manage it. Instead they wind up with a 100-page record that literally no one ever reads, most of which is for the irrational requirements of the insurance company, most of which is transmitted unread to the insurance company's computer.
So the insurance companies are basically spamming the doctor's medical records with billing trivia.
I saw a good book on this recently called the Digital Doctor by Robert Wachter http://www.amazon.com/The-Digi... although if you don't want to buy it you can just read his New York Times op-ed http://www.nytimes.com/2015/03...
The great thing Wachter did was go to Boeing and talk to the engineers who designed jet cockpits about human factors design. The EMRs, which peoples' lives depend on, were designed and pushed on doctors without the basic usability testing that an auto company would use for a cup holder.
Dude, we are the only first-world country with a third world healthcare system. Wake up
Anybody who thinks that our healthcare system is third world has obviously never been to the third world. I have been to several third world countries and I can tell you that our system is hundreds of times more functional then theirs.
If you think that, you have obviously never been to low-income places in the US like the South Bronx or rural Louisiana or Mississippi, where the infant mortality rates and life expectancy are lower than Cuba.
In the US, you can have cancer and be kicked out of a hospital because you can't afford to pay for the treatment. http://www.wsj.com/articles/SB...