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Comment Re:just use virtual machines (Score 1) 464

Who solves social problems? Hint: It's not the techies. We techies generally have no power to solve social problems. The evidence is all around us. It is how the world works. That power goes to the socialisers with their ass-kissing, smooth talk, pointless speeches, and the riches and charisma to reach positions of influence.

I really resent your implication that I am not a socializer with ass-kissing smooth talk and pointless speeches.

Comment Re:Why is McAfee's affair on Slashdot? (Score 1) 148

Further: If you're a rich American and left (and renounced US citizenship) to avoid paying taxes, you'd leave for Switzerland or somewhere like that, not corrupt and poor Belize. Any money he makes now is almost assuredly capital gains, which is taxed at one tenth or one twentieth of the US rate in Switzerland (depending on long-term vs short-term, tax bracket, etc.).

Comment Re:Lucky bastards (Score 2) 296

IMHO chrome has become too much of a behemoth. I'd migrate them to Firefox.

What? My experience is that Firefox is slower, uses more RAM, and has other problems Chrome does not. I switched from Opera to FF because Opera stopped handling Japanese input correctly. Then I switched from FF to Chrome because FF was so slow compared to Opera and Chrome was not.

Comment Re:Here I come. (Score 1) 732

Here is an example of what is wrong. My son got hurt and didn't have any money, so he called a hospital to find out what it would cost to xray his ankle to see if it was broken. Because he knew if it was just sprained, there was very little anyone could do other than tell him to 'stay off it'. They hospital refused to quote a price, because there was no way they knew how much it could cost because they didn't know what was wrong. In other words, if all he wanted to get was an xray and have a doctor tell him if the ankle was broken, they wouldn't do it.

There are several reasons this is the case:

  1. 1) Hospitals that are subject to EMTALA (a.k.a. all except the VA) are prevented from telling you the cost of possible services prior to a medical screening exam (MSE) by a physician or a mid-level like an NP or PA. This is to ensure that hospitals don't use cost to dissuade people from seeking care. If a hospital answers that question they can be subject to a fuckton of fines. I am surprised they called back.
  2. 2) The real reason that a MSE is important (other than to avoid fines for violating EMTALA) is that not every sprain needs an X-Ray. The Ottowa Ankle Rules are very useful to eliminate the need for XRay in about 30% of people presenting with acute traumatic ankle pain.
  3. 3) The FDA and states regulate medical treatments and tests for a good reason. If you made medical test/treatments like a vending machine, you would harm way more people than you help. Full body CTs are a good example (though these still required a physician's order, they were essentially provided to anyone with the $ to pay for it.) The brochures showed you the father of 4 who had a stage 1 kidney cancer diagnosed and treated, but not the ten other people who had incidental findings that once discovered had to be followed up... landing people in the hospital, with invasive procedures, and sometimes disabling complications from these unnecessary investigations. If you look at the cost-benefit for tests like this, the cost weigh outweighs the benefit, but that doesn't stop people who have no concept of basic math, much less Bayes Theorem, from getting the test. That's the reason that lotteries are so so popular: tax on those who can't do math.
  4. 4) Without an exam the diagnostic value of an ankle Xray is diminished (also a Bayesian deal). The pre-test probability of disease effects the performance of the test. As an example, think of a test for HIV that has a 1% false positive rate (but for simplicity assume no false negatives). If you do that test in an individual in a population with 0.1% incidence of HIV, and it is positive, 90% of the time the person with the positive result doesn't have HIV. In a population with a 20% incidence, 95% of the time they really do have HIV. So there is an additional negative of testing not directed by history/exam in that its less accurate. (Which is why I am surprised that the Radiologist who volunteered to read it did... the malpractice vulnerability increases with decreased accuracy.)

Finally, if your son wants a cheaper option next time, try a NP staffed clinic. In some states you even will find them in big box stores or pharmacies. They are a better value especially if you have something simple like an ankle injury.

Comment Re:Here I come. (Score 1) 732

Your 10% figure is correct but misleading. It is correct in that insurance companies take 10% from the total figure we spend on health care in the US. It is misleading in that the total health care spending is a combination of private insurance AND public insurance.

If you look at the percentage that insurers add to the cost of health care FOR INSURED PEOPLE only, the figure is more than double that. In fact, part of Obamacare is limiting the percentage that private insurers take off the top for “profit and administration” to ONLY 15%. If you look at the percentage taken off for administration (obviously 0 profit) taken off VA healthcare, government employee care, straight Medicare (i.e. not Medicare that is administered through private insurers), etc that percentage is in the low single digits (varies between programs a little – the VA is the best bet and most efficient of all dollar for dollar).

Though even if you take your 10% figure at face value, that means that insurance companies are funneling off 1.7% of the total US GDP for doing work slightly less valuable than a wet kleenex. That amounts to 250 BILLION dollars a year.

Lets however compare that to the administrative cost for traditional Medicare plans (the CBO calls it 2% for traditional MediCare plans and 11% for those run through private insurance companies.) Lets even round that 2% up to 5% to account for arguments about whether its really 2% or 4.6 or whatever.

Then lets take your figure of 255 billion – but we will use the correct denominator. Forty-five percent of US expenditures are (prior to Obamacare) are from public programs. So 255billion/(GDP * percent of GDP spent on health care *percent of private insurance) = 255billion/(15trillion * 0.17 *0.55) = 18%. This 18% is (shockingly) quite similar to the percentages quoted by people not wanting to obfuscate the data. Its actually a bit of a low ball figure for that, but again to give you the benefit of the doubt. In addition, that's the reason why the limit on profits/admin of 15% that is part of Obamacare was fought by health insurers. If 15% is less than what they were taking off the top already, why did they fight it?

So lets say the entire US expenditure on health insurance were administered through a MediCare for all plan versus an average private plan. Fifteen trillion*17% of GDP*18% admin/profit = 459 billion is the cost for private companies administering it. Fifteen trillion*17% of GDP*5% admin = 127 billion is the cost for private companies administering it.

That's a lot of zeroes in between those numbers. 332,000,000,000 to be exact. Plus, Medicare is good insurance. Most seniors on Medicare LIKE their insurance – whether or not its traditional Medicare or more expensive Medicare Advantage plans.

So why not just offer that plan to everyone? Its a simple solution: if you like your insurance that you have, fine. If you don't have insurance and make too much for the Medicaid programs, you have a choice: any one of many insurance plans on the exchange, or to buy into Medicare for the average cost of traditional Medicare for existing Medicare recipients. So if Medicare costs $7,000 per person per year, anyone could buy into it for $7,000 per year.

Why do you think the insurers fought that – the Public Option – tooth an nail? Because they knew they could not compete unless they brought their margins down to match Medicare. Its the simplest math in the fucking universe: If you only spend $0.82 for every dollar you take in, you will spend less than if you paid $0.95 for every dollar you take in. And that expenditure – whether 82 or 95 cents is the actual payment for doctors, medicines, hospitals, etc. If you can't understand that, go refresh your algebra on the Kahn Academy.

Comment Re:It's okay (Score 2) 1469

One of many reasons why I am a devout evangelical atheist is because of all the Ten Commandments int he Bible, God chose not to outlaw rape.

Depending on the marital/betrothal status of the woman, rape violates either the proscription of adultery or theft in the Ten Commandments. Not revisionism. The Bible says raping a married woman carries the death penalty, and raping an unmarried, unbetrothed woman carries a substantial fine.

A couple caveats:

1. Rape was considered an offense against the owner of the woman (rape a married woman, you've offended the husband, and you die; rape an unmarried woman, you've offended the father, pay him a fine).

2. There is nothing in the Bible against raping your own wife.

The lack of understanding about the Bible is something I would expect from an atheist, so no harm no foul. Just amend your complaint next time. :)

Comment Re:VBA? (Score 1) 285

Isn't that partly (wholly?) because Iceland has a language academy that regulates the Icelandic language (Like the Real Academia Española or L'Académie française) and it insists on coining proper Icelandic terms instead of using loan words? Sort of like how anyone born in Iceland is required to be given a name that must be approved before being introduced into the language (if it's not already an existing Icelandic name)?

Comment Re:Nah... (Score 1) 193

I'm general counsel for a consulting firm involved in the public sector. What you say is true based on my understanding, especially with so many troops returning home. A ton of things are being re-insourced, for lack of a better word. I just attended a talk given by contract officers in the military; they said there are going to be fewer opportunities for outside firms going forward because the military is taking over many functions again (combined with the current stress on the economy making budgets tighter).

And to respond to GP's point about how the Army should build missiles and such, the answer is similar to why companies operate on credit. Work needed is not flat and consistent; things fluctuate. It is SOP in business (and has been for decades) to outsource non-core functions of your business to take advantage of economies of scale and comparative advantage. Manufacturing missiles is no more a core function of the military than manufacturing radios or gunpowder is.

The military is not in the manufacturing business. It's in the de-manufacturing business (and defense, obviously).

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