Wednesday, October 19, 2011

Could someone please 'splain to me

Why the hell the Department of Agriculture thinks it can regulate school lunches? Via Drudge, we see that
The Senate threw its support behind the potato Tuesday, voting to block an Obama administration proposal to limit the vegetable on school lunch lines.(source)
Ok, statists think they should keep kids from eating too many potatoes at school, so they don't get so fat. A stupid idea, a further intrusion in matters that should be kept local, but far from the worst thing the administration has tried to pull. 

Reading deeper into the article, we see that:

Agriculture Department rules proposed earlier this year aimed to reduce the amount of french fries in schools, limiting lunchrooms to two servings a week of potatoes and other starchy vegetables.

Umm, WTF? How the hell is this the business of the USDA? Do they really think they have the power to regulate anything that was ever grown on a farm? That's almost as far-reaching a power as Congress's post-Wickard v. Filburn Commerce Clause usurpations.

Thursday, September 22, 2011

The brilliance of bureaucrats amazes me

Gary Alexander, secretary of public welfare for the commonwealth of Pennsylvania, has come up with a great idea on how to save money on Medicaid. He wants to steer Medicaid recipients to specific, lower-cost hospitals. How does he plan to do that, you ask? By handing them piles of taxpayer cash.
“We are looking at a model to save hundreds of millions of dollars by steering Medicaid beneficiaries to the most cost effective settings,” Alexander told about 300 health insurance executives last week at a meeting in Washington. “To reward beneficiaries we would give them some incentive… so if the state saves $1,000 on a medical procedure we may give the beneficiary $100 or $200 as a reward.”

"Advocates for the poor", of course, hate the idea:
“People on Medicaid should be able to go to the doctor or medical provider of their choice,”  said Michael Froehlich, an attorney with Community Legal Services in Philadelphia. “We are all in favor of better quality health services but if it comes at the expense of restricted access to neighborhood doctors then I think we would want to take a closer look at it.”
All very nice, high-minded liberal buffoonery. Why don't these fine, upstanding idiots have any understanding of human nature? Have they never met the poor?

Ok, libs, here's how it works: If you subsidize something, you get more of it. Demand creates supply, and, by offering people a coupla hundred buck to go to a hospital, they're going to do it. $200 is a lot of cash to some people -- me included! -- and they'll be lining up to go to the hospital now.

As Whitecoat points out:
If Pennsylvania begins paying people to go to “better” hospitals, the cab voucher fiasco will occur in Pennsylvania, only on a much grander scale. Once Pennsylvania Medicaid recipients learn that they will be paid to go to a certain hospital for medical care, those hospitals will be deluged with patients. To those receiving public medical assistance, the medical care is free, the medical testing is free, and the medical procedures are free. Now, with a monetary incentive to have a procedure done at a given facility, what do you expect will happen? Patients get $200 if they get a cardiac catheterization at one hospital versus another? Twelve year olds will go to those emergency departments complaining of crushing chest pain. Patients get $50 if they go to one emergency department that provides “higher quality”? There will be lines out the door.

Tuesday, September 20, 2011

The science, it doesn't work the way you think it works.

They're quite concerned
Italian Scientists Go On Trial For Failing To Predict L'Aquila Earthquake

L'AQUILA, Italy - A group of Italian scientists went on trial Tuesday for failing to predict an earthquake that killed more than 300 people in central Italy in 2009 despite signs of increased seismic activity in the area.

The seven defendants -- six scientists and one government official -- are accused of manslaughter in a case that some see as an unfair indictment of science. (source)

Man, and I thought my job was stressful! So it's technically impossible (with current science) to predict an earthquake with any certainty -- but these poor bastards are on trial for frikkin' manslaughter?? Idiocy. If I were a geologist in Italy, I'd be publishing an earthquake warning every hour of every day, just to avoid prison.

Thursday, September 15, 2011

Yep, another Marine is a frikkin' liar

Dakota Meyer, Marine Medal of Honor Recipient, Says He’s No Hero

At a White House ceremony later today, Dakota Meyer will become the first living Marine to receive the Medal of Honor for heroism in the wars in Afghanistan and Iraq.   Meyer becomes the tenth recipient of the nation’s highest award for valor in those conflicts; all but two have been presented posthumously.  Army soldiers Staff Sgt. Salvatore Giunta and Sgt. First Class Leroy Petry are the only other living recipients of the award.
The former Marine sergeant  insists he is not a hero for repeatedly rushing into heavy enemy fire in an attempt to rescue four missing U.S. servicemembers pinned down in an intense hours-long ambush in eastern Afghanistan.

from the Medal of Honor citation:
When the forward element of his combat team began to be hit by intense fire from roughly 50 Taliban insurgents dug-in and concealed on the slopes above Ganjgal village, Corporal Meyer mounted a gun-truck, enlisted a fellow Marine to drive, and raced to attack the ambushers and aid the trapped Marines and Afghan soldiers. During a six hour fire fight, Corporal Meyer single-handedly turned the tide of the battle, saved 36 Marines and soldiers and recovered the bodies of his fallen brothers. Four separate times he fought the kilometer up into the heart of a deadly U-shaped ambush. During the fight he killed at least eight Taliban, personally evacuated 12 friendly wounded, and provided cover for another 24 Marines and soldiers to escape likely death at the hands of a numerically superior and determined foe. On his first foray his lone vehicle drew machine gun, mortar, rocket grenade and small arms fire while he rescued five wounded soldiers. His second attack disrupted the enemy’s ambush and he evacuated four more wounded Marines. Switching to another gun-truck because his was too damaged they again sped in for a third time, and as turret gunner killed several Taliban attackers at point blank range and suppressed enemy fire so 24 Marines and soldiers could break-out. Despite being wounded, he made a fourth attack with three others to search for missing team members. Nearly surrounded and under heavy fire he dismounted the vehicle and searched house to house to recover the bodies of his fallen team members.  

Disragarding your own safety and rushing into danger to save the lives of your brothers-in-arms? That's the very definition of being a hero, you frikkin' jarhead. HUAH!

Wednesday, September 14, 2011

At last, Aeschylus is vindicated!

How can a rock-head get hurt like this?
It was a terrible tragedy. Aeschylus, first of the ancient Greek playwrights  was out bebopping along, and his buddy Euripides was like, "Hey! Look out!", and Sophacles said, "Yo! Is that a turtle?", and whammo! A  frikkin' turtle landed on his head (Aeschylus', not the turtle's).  History doesn't record the fate of the turtle, but we can assume it didn't do well. They rushed Aeschylus off to the local emergency room, conveniently next to the Parthenon.

The real tragedy, of course, was that once they got there the doctors had no concise way to document the diagnosis of turtlecrainiotomy, and while they were looking for one, Aeschylus assumed room temperature. You see, those ancient physicians were stuck using ICD-9 diagnosis codes to document patient problems. Those 18000-odd codes aren't granular enough to describe Aeschylus' injury, so they didn't know if his injury was 854.10 (Intracranial injury of other and unspecified nature, brain NOS, with open intracranial wound) or 934.19 (imbalance of humors, black bile, unspecified).

Well, believe it or not, but it took 2500 years or so before humankind could fix this problem. The kind-hearted bureaucrats at Medicare have decided that the country needs to switch to the newfangled ICD-10 codes. Now those 18000 inadequate diagnosis codes have been replaced with 155,000 codes that cover everything from L89000 (Pressure ulcer of unspecified elbow, unstageable) to Y92250 (Art Gallery as the place of occurrence of the external cause). And, thank God, there's not 1, but *9* separate codes that deal with turtles -- everything from bites to strikes to "other contact" (Gormogons, I'm sure you know what that means, wink wink). If only they had this in 500 BC Aeschylus could have survived!

This is all quite silly, of course, except for one minor issue: what good does it do, and what does it cost? The bureaucrats claim this is a cost-savings measure, of course, as if changing a few codes on a billing sheet will save money. Someone sat down and calculated how much this cost-savings would cost, and it's a doozy:

The total estimated cost for a 10-physician practice to move to ICD-10 would be more than $285,000. These expenses include:
  • Training expenditures are estimated to total $4,745
  • New claim form (superbill) software $9,990
  • Business process analysis $12,000
  • Practice management and billing system software upgrades $15,000
  • Increases in claim inquiries and reduction in cash flow of $65,000
  • Increased documentation costs $178,500
For a small, three-physician practice, the total cost to implement ICD-10 is estimated to be $83,290, for a large, 100-physician practice the estimated costs to implement ICD-10 is more than $2.7 million.

Yeah, that's going to save us a huge amount in healthcare costs. It's almost like Government bureaucrats aren't helping things!

Dr. Wes nails it on the head, as usual:
But lets not fool ourselves. This is exactly what the government wants: more complexity and bureaucracy in the name of lower "costs." One only needs to see how the government calculated their "cost" savings for justifying the massive increase in complexity to the coding scheme:
Benefit Assumption 2: Pended claims will be reduced by 0.28% (minimum) to 0.7% (maximum). Using the research and interviews, it was assumed that the pended claim percentage, currently 14% (Benefit Assumption 1), would be reduced through standardization.

Benefit Assumption 3: Reduced manual intervention will reduce the costs for providers by $3.20 per call and for plans by $1.60 per call. Manual intervention is required to resolve pended claims and both Healthcare providers and Health Plans incur these operational costs.

Benefit Assumption 2: Pended claims will be reduced by 0.28% (minimum) to 0.7% (maximum). Using the research and interviews, it was assumed that the pended claim percentage, currently 14% (Benefit Assumption 1), would be reduced through standardization.
Benefit Assumption 3: Reduced manual intervention will reduce the costs for providers by $3.20 per call and for plans by $1.60 per call. Manual intervention is required to resolve pended claims and both Healthcare providers and Health Plans incur these operational costs.

Benefit Assumption 3: Reduced manual intervention will reduce the costs for providers by $3.20 per call and for plans by $1.60 per call. Manual intervention is required to resolve pended claims and both Healthcare providers and Health Plans incur these operational costs.
Yep, there you have it. CMS has justified the most massive expansion of electronic coding so "providers" and massive health systems can get their money without having to pick up the phone.
Benefit Assumption 1: Based on the data provided in a recent AHIP report the percentage of pended claims was assumed to be 14% of total claims.
My friends, soon we will see that the Beast has won. Independent stand-alone physician practices will soon be a thing of the past, brought to their knees by overbearing electronic billing and prescribing regulatory requirements. In their place will be physician-employees of major health care systems that are capable of purchasing computers, personnel and electronic reimbursement software upgrades annually, while they are subject to data-mining algorithms to assure "efficiencies" and "effectiveness" and "quality," all in the name of cost-savings.

Friday, September 9, 2011

Why doesn't this happen in shall-issue states?

This is an outrage: Longshoremen storm Wash. state port, damage RR
from the article:

LONGVIEW, Wash. (AP) — Hundreds of Longshoremen stormed the Port of Longview early Thursday, overpowered and held security guards, damaged railroad cars, and dumped grain that is the center of a labor dispute, said Longview Police Chief Jim Duscha.
Six guards were held hostage for a couple of hours after 500 or more Longshoremen broke down gates about 4:30 a.m. and smashed windows in the guard shack, he said.
(emphasis mine).

So they invaded the port, damaged property, and frikkin' kidnapped some people -- and nobody was arrested? People were kidnapped -- where was the FBI?

Oh, and this was in defiance of a federal court order. The judge who issued the order was outraged -- OUTRAGED!! -- so he, umm, issued another order. Yay.

Scott Mason, president of the ILWU Local 23 in Tacoma, said some of his members have joined in the Longview effort, but he doesn't believe they were involved in illegal activity. He blamed the company for provoking the response and warned that more activity could be coming.(source)

Isn't this pretty close to open rebellion? Where's the outrage? Where are the cameras?

Thursday, September 8, 2011

"Why bother? We're not going to watch it either!"

Thankfully the caption is no longer correct.
Queen Nancy is peeved that Republicans have opted out of a rebuttal to Obama's speech tonight. I understand their feeling -- it's the same reason my wife doesn't nag me about my drinking too much these days.

From the article:
Sen. Roy Blunt, R-Mo., said there will be "plenty" of response to the president's speech on Friday, but told Fox News he suspects the reason there's no formal response is "the speaker doesn't expect to hear much to respond to." 

In other news, Obama has his worst approval numbers yet. After his first year in office, Obama had 95 percent approval among blacks, 78 percent approval among Hispanics, and 53 percent approval among whites. Since then, his monthly approval has dropped 11 points among blacks, 30 points among Hispanics, and 20 points among whites. Ouch!