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Comment: Freight Forwarding experience. (Score 1) 206

by unkiereamus (#45296207) Attached to: Ask Slashdot: Package Redirection Service For Shipping to Australia?
I know nothing for about them specifically for Aussielandia, but from my experience with forwarders when I was living in Honduras: First, you might actually want two different forwarders, one who does air service and one who does ship service. Generally, air service for small light things you want fast, and sea service for everything else, usually you're paying a nominal monthly fee, then a per item fee for packages, the per package fee can be quite high for air, and is usually almost a (low) flat rate for sea.

Second, you are almost certainly going to be paying import duties, but the forwarder should take care of all that and roll the price into the price for the package itself.

Third, there's going to be breakage, it should be relatively rare, but it will happen, I had no choices for insurance on the forwarder, you might. It's probably pretty exorbitant, though. When it comes to moving something delicate and expensive your options basically boil down to hand carry it in your carryon when flying back, or go ahead and pay the extra money to buy it there and let the retailer deal with the possible breakage.

Finally, just spitballing here, and I have no idea how practical it might be, but you might want to look to japan for your cutting edge electronics, I've always had the impression that they're more available and cheaper there than almost anywhere else.

Comment: Re: What is an ACA Exchange? (Score 1) 333

by unkiereamus (#45273911) Attached to: How Kentucky Built the Country's Best ACA Exchange
And that is almost exactly how that works. Although I'll note that 1) the basic minimum amount of time for a call is more like an hour, once you factor in dropping off the pt,restocking, cleaning and most of all, paperwork. 2) the supplies can be exhorbitant. Especially some of the drugs. It's not out of the question that I could use 3,000 dollars worth of supplies and drugs for a single pt, and that's at our resupply cost.

Comment: Re:What is an ACA Exchange? (Score 1) 333

by unkiereamus (#45269835) Attached to: How Kentucky Built the Country's Best ACA Exchange
Okay, you've got a couple of problems here. First:

Healthcare is full of fake non-profits. They're NP because they "donate" care to the needy - though in reality they are required to treat everybody by law,

What you're thinking of is EMTALA (Emergency Medical Treatment and Labor Act). It's the big dog in the "you have to provide medical care" laws (in the US). It basically boils down to "If you want to be eligible to be paid by Medicare, and you have an emergency room, you have to evaluate anyone who shows up at your emergency room to determine if they have a life-threatening condition, and stabilize them if they do, as well as providing obstetrics services to anyone in imminent labor." If you show up to the ER with a cold, they don't have to treat you, they just have to evaluate you to be sure you're not gonna croak, then they can kick you loose. Now, the reality is, the evaluation is basically the hardest, and most expensive, part of an ER visit, so they tend to tack on treatment, but they're not required to. (Also, the prevailing attitude in emergency medical workers is that we SHOULD treat everyone, billing can worry about whether or not we get paid for it.)

Nearly every NP hospital has a team of lawyers which clog the judicial system chasing payments from non-paying patients.

Here, I can only speak anecdotally, First, my experience as a patient: I recently broke my leg badly enough that I required surgery, and I have no insurance. I could have gone to the university hospital, which receives funding from the state and the county to take care of people with no insurance, but for various reasons, I preferred to go to the local non-profit hospital. I went to one of their financial counselors, explained my financial situation, provided them with a copy of my most recent w2 and my last two paystubs, and they qualified me for 100% charity care, which means they're not going to charge me for anything, which by the time I'm done with everything is going to be around 35k USD that they'll be picking up. (As an aside, I have a job I had to go to college for, work 48 hours a week at, and am open to massive liability every day I work, and I make little enough money that I qualify for charity care, thus the pay scales in EMS.)

Next from a professional perspective: I work for a company that does a lot of inter-facility transfers, both taking people back to nursing homes, and what I personally tend to do the most of, since I'm a paramedic, is taking people from the local small community hospital (which is a non-profit), down to the university hospital, the big non-profit I went to, or a big for-profit, basically because the patient needs better medical care than the community hospital can provide. It's all done on a case by case basis, but if for whatever reason it's determined that the pt's insurance won't pay for our services, because they don't have any, because the pt has reached their cap, whatever, the small non-profit hospital will pay us. In fact, to take it a step further, I know of at least one patient recently who needed to go into a nursing home, but he is 42, so he doesn't qualify for medicare, and he didn't have any insurance, so in the interim time while they were working on getting him qualified for medicaid (about 3 months that I know of), the hospital was paying for the nursing home, as well.

As a final anecdote, and somewhat off the topic, but I've always worked for for-profit private companies, and every last one of them writes off bills all the time. In fact, the general rule of thumb is that for 911 services, you're going to write off 80% of your bills.

Comment: Re:Wow. (Score 4, Interesting) 333

by unkiereamus (#45269369) Attached to: How Kentucky Built the Country's Best ACA Exchange
I really probably shouldn't do this, since it's far too close to arguing politics on /., which everyone knows is a no-no, but...

Here's the thing, per the wikipedia page, which is as much research as I care to do about this, he got the board certification from the ABoO, then formed the NBoO because he and about 200 other ophthalmologists got their knickers in a twist about having to recertify, let that fall apart, then reformed it right before his original certification ran out. As of now the NBoO isn't recognized by anyone. That's problematic.

Certification is incredibly important in medical fields. If the chef at a restaurant doesn't know his stuff, you're gonna eat a steak that's overdone, if your ophthalmologist doesn't know his stuff, then you're blind for life. Someone's gotta be making sure that our doctors actually know what they're on about, the price of them screwing up is too high.

If you genuinely disagree with that, then let me know the next time you need surgery, with three days notice I can be board certified by the National Board of AreYouFuckingInsane Surgery, and I'll beat anyone else's price for your surgery by 25%. Don't worry dude, I"m like, totally qualified. I saw it on TV once.

Oh, and real quick before anyone brings up the whole recertification thing, Even if you're the best damn ophthalmologist in the world, if you don't keep up with the current science, you'll fall behind in much less than 10 years. The big bad secret about medicine is that we still don't really know how the human body works, we've just got a pretty good set of guesses, but we figure out ways that we're wrong all the time. Hell, I'm a paramedic, I deal with disease processes that we understand pretty well, and I have to recertify every 2 years, including proving I've done a whole bunch of continuing education.

Comment: Re:Good. (Score 2) 699

by unkiereamus (#45117919) Attached to: UK Court Orders Two Sisters Must Receive MMR Vaccine
There's a statistic I've run into multiple times throughout my education. It's there to make us feel better about delivering a child, something we do infrequently at best. (In fact, in 8 years I've still never done it, I'm hoping to keep up that record.)

99% of neonates will not require resuscitation.

The flip side of that is, of course, that 1 out of every 100 births will require extraordinary measures. So let's just go ahead and say that we're 99% accurate in spotting the high risk OB pts (which is quite generous, believe me.), that means that 1 out of every 10,000 "normal" births will require resuscitation.

Per the CIA Factbook, the global birthrate per minute right now is about 252, which means that once every 40 minutes or so, a birth we thought would be no problem results in a child requiring extensive, trained care.

Comment: Re:Good. (Score 4, Interesting) 699

by unkiereamus (#45117819) Attached to: UK Court Orders Two Sisters Must Receive MMR Vaccine
I've got a theory about hating needles, or being afraid of them.

The reason that most kids and later adults who are afraid of needles is because they were lied to when they got their first injection/venipuncture. If they're told "Don't worry, this won't hurt." in the misguided belief that they'll relax so it'll hurt less, then the surprise becomes a lifelong aversion. If however the provider was honest and says "This will hurt, but only for a little bit" and ideally bribes them with candy after, then you're golden.

I have absolutely no proof for this theory, it's purely anecdotal, but it seems sound, and at any rate, I always tell a kid something will hurt if it MIGHT, let alone will. I never lie to a pediatric patient.

Comment: Re:Buying without driving? (Score 2) 182

by unkiereamus (#44963729) Attached to: Big Box? Nissan Note the First-Ever Car You Can 'Buy' On Amazon

Really, there's very little that matters that you can learn from a test drive.

I rather disagree.

First, I'm 6'8, I can find out whether I fit in the car. Second, I can find out whether the build quality meets MY definitions of acceptable. Finally, I can find out if I like to drive it, for some people a half second turbolag is no big deal, for some it's a huge deal, and still others they have no idea, since they've never driven a car with a turbolag.

There are some things that are very specific to people. True story: I once went out to test drive a truck, turns out the exhaust note was smack dab on the resonant frequency of my sinuses. Despite it not being that loud in any sort of absolute sense, driving for 5 minutes gave me a splitting headache. And yet the vast majority of people had absolutely no problem with it.

Comment: Re:No (Score 1) 128

Except that it is replacing work I would do on a PC.

First, let's get rid of the notion that laptops are inferior species spec wise, compared to a server, they are, compared to a high end desktop they are, but my primary computer is a laptop, this is because I spend 48 to 96 hours straight at work, so it just makes sense for me to have a computer I can take with me. In fact, I would go so far as to say that my laptop, which is a higher end model, but certainly not the highest end, is superior, spec wise, to at least 80%, and probably 90% of the desktops that are in use today. And you know what I get when I put my laptop on a desk rather than my lap? A somewhat odd form factor desktop.

Second, You know what services that can't afford toughbooks do these days? The answer isn't "don't use EMR" because that's really not an option any more. They have the field employees fill out paper while they're in the truck, then when they get back to base, they have to duplicate all that information into a desktop using a variety of services (imagetrend being the 800lbs gorilla in the field).

I dunno, I had a beautiful woman asking me why I wasn't drinking with her as I finished typing up the last comment, and now I'm in the after effects of having a beautiful woman demanding that I drink with her, I'm not sure I'm making sense, but I'm pretty convinced that I'm right...but my etoh level suggests I might be full of shit.

Comment: Re:No (Score 2) 128

The PC is the correct form factor for getting work done by humans. Mobile devices are not.

I'd say, instead, that the desktop and laptop PC are the correct form factors for getting done the sort of work that you do when seated for a long time. There are probably people whose work is sometimes done while on the move and for which a desktop PC is obviously not going to work and for whom a laptop PC might not work very well; consider, for example, somebody managing a construction project who might need to look things up, enter data, do some calculations, etc. while on site. I suspect that a mobile phone would be the wrong form factor for them, but a tablet might be the right form factor.

I'll actually give you a primary source, real life example.

I'm a paramedic, every single patient for whom I have responsibility of care for, I have to generate documentation for. Up until about 2008, that meant actual paperwork, about then, the industry as a whole being phasing in electronic medical records. To the business office, they're great, because billing the patients, and keeping the records is much easier, and for me, the end user of the system, it's great because, especially when you're using a touch screen and a properly designed program, the computer is much faster and easier to use than a pen (especially for me, my handwriting sucks balls.)

Up until this point, and I imagine for a while into the future, the solution of choice has been to use the Panasonic toughbooks that will convert to a tablet form factor (CF-18s,-19 etc). The touchscreen is necessary, because we actually use it to collect signatures (quite aside from the fact that stabbing at options on the screen can easily cover 99.5% of the use cases), the portability was of course necessary, because I start my paperwork in the pt's house and finish in the ER, the keyboard was necessary because I have to type up a narrative for each pt, and the ruggedness was necessary because we beat the hell out of our machines. e problem is, even the older machines are WAY more powerful than we need, not to mention being heavy as hell (remember, I have to hand these to 96 yo pts to get a signature.)

These EMR suites are starting to be developed for tablets, both iOS and android, and the market is starting to come up with workable ruggedized tablets. nce we get over the industrial inertia we have (which is surprisingly significant, given how agile we're supposed to be), we're going to move to tablets with some sort of external keyboard (at a guess, at odds with the ruggedized tablet, the preference will be for keyboards cheap enough to be effectively disposable), and it will be the right solution for us.

No, my biller and office manager will still be using a full blown PC, but in the field, not so much.

Comment: Re:It's all good until (Cost Benefit Analysis) (Score 1) 245

This isn't about power, it's about finding excuses to build rockets.

Not quite.

This is about pushing the boundaries of what we can do. This is about shooting so high we're staring into the sun.

There was no reason for us to go to the moon. In and of itself, it accomplished nothing to improve the lot of humanity, but it was a hell of a thing. It made people dream, it inspired an untold amount of people to go into STEM fields, and on a more direct note, it advanced electronics tremendously.

As a race, we need to do big, audacious things. This is one of them, It should be done. It's not as big a thing as going to the Moon, but it's bigger than getting a cup of coffee.

I'm willing to bet that even if it is just as much a flop as you think it will be, (And you seem to know what you're on about, so I'm willing to concede that if it were done with the current technology, you're probably right.), inside of 20 years, it'll pay for itself in many ways, the least of which might be the power beamed back down to Earth.

Comment: Re:Dominican Republic, Iran and Thailand stats (Score 1) 322

by unkiereamus (#44648005) Attached to: Open Source Mapping Software Shows Every Traffic Death On Earth
Not to detract from your point, but if you need to lower a wheel by dropping it into a pothole in order to leg down comfortably, you really should be riding a shorter bike. You ought to be able to comfortably flat foot both legs at any given stop. Your ability to quickly pull away should some asshole just not see you as they come speeding up behind is greatly enhanced by being at a good balance when you're stopped.

Comment: Re:Practical (Score 1) 127

by unkiereamus (#44560111) Attached to: The First 'Practical' Jetpack May Be On Sale In Two Years

First, a motorcycle rider isn't in the same category as a "Thrill seeker". Maybe the people that ride around in Ninjas and crotch rockets... but the rest of us who ride have a term for those people: Organ donors. Most people ride motorcycles because they're liberating, they're fuel efficient, and because they have fast reflexes. Mostly that's because of people who drive cars stupidly... motorcyclists are amongst the most safety-conscious people on the road. Okay, rant done.

I take some objection to that notion. Possibly thrill seeker is a little extreme, but motorcycle riders can certainly be be categorized at least as being non-risk adverse. There is no doubt that riding a motorcycle is vastly more dangerous than driving a car, is you're someone who categorizes that as important, and especially if you're not going to counterbalance that fact in the decision making process that motorcycles are vastly more fun than cars (or as you call it, liberating), then you're not going to ride one.

I understand your desire not to be lumped in with squids, which is perhaps what GP was thinking, but motorcycle riders are thrill seekers.

Right now, btw, I have the credentials to talk about this, given that I'm currently bed confined s/p surgery to fix the leg I broke after my front tire blew out (a week and a half after I replaced both tires!)...and I'm anxious because I expect to get my bike back tomorrow so I can find out what I'm going to need to do to it to get it running by the time I'm healed.

"Life is a garment we continuously alter, but which never seems to fit." -- David McCord

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