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Comment Re:I call BS (Score 1) 157

Oh, and I left out rx, and payments to (and clawbacks from) providers. We can also discuss vision and dental, but again, what is the point???

The American medical insurance is so broken there is no believable reason another nation would wish to copy it.

Why not adopt a more believable (and simpler) hypothesis that the reason medical insurance claims data was of interest was because of mental illness and sexual disease claims?

Comment I call BS (Score 1) 157

I offer my services to the Chinese. For a mere $300K I will elucidate in greater detail if required. Medical insurance is not exactly rocket science (and you've already launched something to the moon! Congrats!)

Let's break it down. There are a few components:

Plans - but in a Communist country I'd expect everyone has the same insurance plan, right? Or is one animal great than another?

Member Information - things like name, gender, age, tobacco user, dependents, etc. Again, though, given it is a Communist country, are there really dependents, or is everyone a participant?

Provider information - things like provider name, address, tax ID. I hate to sound tedious, but in a Communist country I don't think you'd have PPO networks, right? Aren't all providers equal?

Premiums - this ties the member to a plan. In a capitalistic society this gets pretty complicated, as there are a vast number of plans, and different rates based on member age/smoker status/gender, etc. As I have now stated ad nauseum, I expect under a Communist system everyone pays the same, so maybe this becomes a trivial issue?

Claims processing - in a Capitalistic system one would take the billing codes, procedure codes, diagnostic codes, etc., match them against the date of service, connect this to the member and the plan, and adjudicate to determine if 1) the claim falls under the plan, 2) who gets paid what, 3) a bunch of other stuff (like lifetime deductibles). Now, if we were operating under a Communist plan, wouldn't all claims be covered?

When I started writing my response, I sympathized w/ the Chinese, as I've been involved with a few claims processing systems, and there's a ton of institutional knowledge. However, under a Communist system, what really is there?

Ps - Honestly, as an American who thinks theAmerican insurance & medical business is a complete scam, I'd love to hear what Sweden and other civilized countries need in the way of medical insurance software.

Comment The stupid, it burns! (Score 2) 246

I worked for seven years in the medical insurance business (so glad to have left the field!) and the ignorance seen in many high-rated posts here is astounding.

1. GAO report, so no fraud
2. Even if someone wanted to fraudulently create an applicant, I don't see the problem, as long as they don't submit a claim. What's wrong w/ additional premium? (I will ignore the geeky underwriters, as I understand their position, but haven't seen any relevant objections so far about messing up the statistics.)
3. You cannot begin to appreciate the stupidity of pretty much everyone in the insurance business - so the inability to do very basic SSN validity checking comes as no surprise at all.

I left the year ACA came into effect, so got to experience the fun as we tried to implement insurance plans that Congress had not defined. See, ACA went into effect 2014, but we (that is, insurance companies) didn't have black letter law or even Federally-defined policies established (on many different fronts) until way past Jan 2014. How can you determine policies if underwriters don't know what the rules are???

Biut what continues to be under-reported is what a complete disaster/fail the back-office procedures are. Are we finally able to determine if someone is eligible? When I left, there was no way to tell if an applicant was qualfied for subsidies under the various arcane income rules.

If I were dictator, I'd immediately force hospitals and pharmaceutical companies to fall under the anti trust laws that everyone else has to follow. The high-deductible plans were created under the assumption that consumers would be motivited to shop around for the cheapest deal. But, it is impossible to get an actual quote for a procedure. If you require hospitals to produce a rate sheet that applies to all, and permitted people to import drugs from anywhere in the world, a massive amount of money could be saved.

But this cuts into rx profits, and we can't have that.

Comment No surprise - I work in the industry (Score 4, Informative) 122

Incompetence abounds in the health care industry:

1. Legacy mainframe systems that have no data integrity - dates like 99/99/9999 are considered valid

2. Legacy mainframe systems that have no data integrity - tabs present in names & addresses, so a tab-delimited extract then proves challenging

3. IT Staff who refuse to block China and the -stans (despite having only US coverage), saying that it is not a complete solution.

4. On the database side, passwords stored in cleartext. Surprisingly, this apparently isn't a violation of PCI rules.

My advice? If you have a sensitive claim, pay cash and don't involve the insurance company. This is difficult, and may require you to use a different doctor when going this route. Bonus points if you can use fake ID. You would be absolutely astonished at where the claims data goes. Third parties get all sorts of data. HIPAA exclusions are enormous. If you think only your doctor knows about your embarassing drug addiction/sexual disease/mental health problem you are grossly mistaken.

Comment law enforcement (Score 1) 727

Your Patreon post states "So, I waste hours documenting this for law enforcement."

Can you enumerate the law enforcement reports you've made? Columbus District Attorney said they had no complaint, and you apparently followed up that it was a communication error.

Given the penalties for filing false reports, have you actually filed a report? Please include jurisdiction and date.

Comment Re:Infinity (Score 1) 1067

I believe this is slighly incorrect. In the very first chapter of many algebra/trig/calculus textbooks there's something to the effect that we study y = f(x), where there is only one solution for f(x). In other words, linear. As a kid I wondered why 1/0 was undefined. I only learned at the end of linear algebra, in college, when it came to inverse functions.

We know that x * 0 = 0, for any value of x. However, if we take the inverse operation of multiplication (that is, division), there is an infinite number of solutions for x / 0. Since we're operating in a linear system where there's only one solution for y = f(x), having more than one solution is undefined.

Clear as mud... This is why Feynman was a genius and I am not.

Comment Re:Socialism is not working (Score 1) 710

Oh, don't worry, the parent poster is probably complaining about how the top tier got bailed out in 2007-2008. Goldman Sachs et al, because acorrding to Secretary Paulson, tanks would be in the streets if the 1% weren't bailed out. Elizabeth Warren disagrees with this position. but you'll never read about that in the mainstream media. Sad to say, Chomsky was right. 20 years ago, I would never have thought I'd say that....

Comment Shoutout for Godel Escher Bach (Score 2) 57

The ridiculous summary suggesting that garbage produced from a computer program could be considered music immediately reminded me of Douglas Hofstadter's Gödel Escher Bach, where music and its relevance to AI form much of the book. The book (unlike the article) has meaningful thoughts on Chopin, Bach and AI.

Anyone seriously interested in music & computers needs to read this book now.

Submission + - Google to Ban Ads for Legal Gun Accessories & "Dangerous" Knives: Threatens ( 1

Mark Sauter writes: This morning we received an email from Google with the following title: "Google AdWords Policy Update — Weapons policy restriction."

The email, from the "Google AdWords Team," announces a new policy starting in September for those who advertise on Google Adwords, a service used to attract traffic to Web sites. It bans Adwords advertising for products such as knives "that can be used to injure an opponent in sport, self-defense, or combat" plus "Any part or component that's necessary to the function of a gun or intended for attachment to a gun
Examples: Gun scopes, ammunition, ammunition clips or belts" [and even bb guns!]
We certainly have no problem with Google prohibiting ads involving weapons such as nail bombs and grenades, as it does. But we see a big difference in banning ads for legal products used by many millions of Americans. The ban specifically includes sport and recreational guns and their components.

And it's not just ads that are being threatened. The email (see excepts below) includes the following: "When we make this change, any ads or sites that are identified as violating our revised policy won't be able to run."

In other words, Google is not just threatening to shut down advertising accounts, but also to disable Web sites with content about legal products (or topics?) that it finds politically incorrect. The email did not provide additional detail on the issue of the Web sites. Presumably, Google would shut down sites running on Google's Blogger service, but one could certainly worry the company might use its dominant search engine to make offending sites "disappear" from search results.

Submission + - CIA rendition jet was waiting in Europe to kidnap Snowden 5

Frosty Piss writes: As Edward Snowden made his dramatic escape to Russia a year ago, a secret US government jet previously employed in CIA 'rendition' flights on which terror suspects disappeared into 'black' imprisonment flew into Europe in a bid to spirit him back to the United States. On the evening of 24 June 2013, an unmarked Gulfstream V business jet took off from a quiet commercial airport 30 miles from a Washington DC. regional airport discreetly offers its clients 'the personal accommodations and amenities you can't find at commercial airports'. On its best-known mission, the jet flew a U.S. marshals into the UK on to collect radical cleric Abu Hamza after the United States won an extradition order against him. Only Vladimir Putin's intransigence saved Snowden from a similar travel package. The jet's activities can be followed on many flight tracking websites such as FlightAware

The shortest distance between two points is under construction. -- Noelie Alito