Sunday, July 29, 2007

Hipparchia's cat

The original Hipparchia is famous for having sex on her front porch. Or maybe it was somebody else's front porch. I couldn't say for sure, I wasn't there.

What I can tell you is that if you're going to try this at home on your own front porch, either you'll want sturdier furniture [that's not my lawn chair, but it sure could have been], or you'll want to be the one on top.

Given this heritage to live up to, it shouldn't be a surprise when I tell you that almost exactly two months ago, just days before luring all the porch cats into the house, I came home one afternoon to find mom cat entertaining gentleman callers on the front porch.

I started a post about it, but decided to wait and see what developed before reporting on the event. I mean, breast-feeding is supposed to be an effective form of birth control, right? The kittens you've been reading about were still heartily bellying up to the milk bar every day at the time. It should have worked.

Well, if you were paying attention in biology class you know what developed. More kittens. Born just about 48 hours ago. At least four of them, maybe five, but I can't tell for sure. They're under the bed, surrounded by the dog's blanket. It's unclear whether mom cat dragged the blanket under the bed, or the dog, self-appointed kitten guardian that he is, donated it and pushed it under there. Both are equally likely.

It's not true that one cat will produce 400,000 420,000 kittens in her lifetime, or whatever the scare tactics number is that feral-cat haters use, but this one sure seems to be trying to. Sigh. I seem to be harboring an unabashed patriarchy enabler.

Those Fantastique French & Their Flying Machines

In my previous post, I got interested in that fighter jet's location, but didn't get very far on its raison d'être.

But a Francophonic friend generously donated a few minutes to co-googling, in which we discovered that the Université de Paris X Nanterre has sites at Ville d'Avray and Saint-Cloud, and the IUT de Ville d'Avray, 1 chemin Desvallières, 92410 Ville d'Avray, France) has an Aeronautiques program and publishes research of the applied physics variety. Call me fanciful, but I'm thinking that aeronautiques = aeronautics. Seems like a reasonable spot for a fighter jet to come to rest.



A couple of Google-y side trips along the way:

  • Nicolas Sarkozy attended the University of Paris X Nanterre.

  • If you tire of Google maps for some reason, there's always mappy.com. Am I the only person who thinks of Austin Powers when confronted with MappyMe?

  • I like the computer-geek-y job that I have now and I work with a congenial group of of folks, but I'd love to join any of the women doing robotics.

Saturday, July 28, 2007

I almost hate to do this.

I was only skimming down this list of interesting stuff but I just had to check out Why is a fighter jet parked (Google Earth coordinates 48.825183,2.1985795) in what looks to be a residential neighborhood lot near Paris?

First things first, plug those coordinates into Google Maps, turn on the satellite view, and zoom way in. Yep, there it is.


Hmmm... Certainly looks like it could be a fighter jet, but maybe it's just a mockup of some kind for some reason. Googling fighter jet france leads to a list of what else? Fighter jets developed or used by France. Checking out the links... looks like a Mirage III. More on the Mirage III here.

Zooming in as far as possible, you can just see, down in the lower left corner, that the object of interest appears to be about the same size as that scale bar that says 50 ft, so maybe it's for real.


Panning around from those coordinates in satellite view, you can see that the surrounding neighborhood does look sort of residential, but right here things look a tad industrial to my eye. And those lanes painted diagonally across the parking lot? Doesn't look very residential to me. Wassup widdat?

Well, the Paris Air Show is kind of a big deal, something to do with that maybe? Doesn't seem real likely, given that Le Bourget, site of the Paris Air Show, is 26 km down the road:


Turn on the hybrid view, pan around a bit, and look for some street names.


Googling Chemin Desvallières brings up a list of links:

  • Theoretical and numerical study of strain localization under high ...

  • Dissociating the effect of different disturbances on the band gap ...

  • Optimal Location of Actuators and Sensors in Active Vibration ...

  • Threshold Region Determination of ML Estimation in Known Phase ...

  • Welcome to IEEE Xplore 2.0: Music and Model-Order Selection for ...

  • Energy Citations Database (ECD) - - Document #20685984

  • EXPERIMENTAL DEMONSTRATION OF THE DEPENDENCY OF THE NEGATIVE ...


Looks like Laboratoire de Mécanique de Paris X, 1 Chemin Desvallières, 92410 Ville d’Avray, France turns up in an awful lot of those links. I'm thinking that something that looks like "Laboratory of Mechanics" is suggestive, but I didn't find an actual website for a laboratory of mechanics. Google did, however, map out directions for me from 1 Chemin Desvallières, 92410 Ville d’Avray to 48.825183 N, 2.1985795 E, a distance of 50 whole meters.


Not that I've actually figured out yet why they've got a jet fighter parked in their parking lot, but the hunt's been fun so far.

New Favorite Blogs

Thursday, July 26, 2007

"A President is impeachable

if he attempts to subvert the Constitution."

Barbara Jordan, quoting James Madison, here.



thanks

Webbery



I was reading about the high price of free credit reports the other day, and decided to look up the text of the Fair Credit Reporting Act, since I think as highly of credit bureaus as I do of for-profit health insurance.

So, while I was composing a post in my head on the FCRA, I was also surfing some of my favorite blogs, which lead me to the EFF's FOIA Litigation: Abuse of National Security Letters (NSLs).

They've gone to some trouble to get this information, and will be putting a lot more effort into the project it looks like:
EFF received these documents as the result of a FOIA request made through our FLAG project. We ask that you please mention EFF if you use these documents in any way. We're a nonprofit organization, and our funding for this project depends on showing that our work is important and relevant. For more information about these documents or EFF's FLAG project, please contact EFF Staff Attorney Marcia Hofmann at marcia(at)eff.org.


I'm a fan of EFF, and not a fan of being spied on, so I thought I'd take a crack at some small portion of the project. I'm on page 45 [of 199] of the very first background documaent, A Review of the Frderal Bureau of Investigation's Use of National Security Letters, so I may not get around to actually contributing much.

A couple of years ago, I was reading in one of the magazines that only a geek could love about the FBI's antiquated computer system and their buggy database, and I remember thinking even I could do better than that. 45 pages into it and I'm glad they can't get their act together. I think.

via

Wednesday, July 25, 2007

Lions and snapping turtles and pit bulls, oh my!


Some years ago [ok, a lot], I worked my way through high school and part of college as a veterinary assistant. Mostly the job entails mopping up quantities of poop and restraining the business end [usually but not always the end armed with teeth] of whatever animal the vet is administering unpleasantness to [shots, heartworm sampling, temperature taking...].

We always rejoiced when a pit bull was brought into the clinic. Robust, agile, strong, stoic, and ridiculously friendly dogs, the main danger in treating them was that they'd slime you with kisses, even as you were cleaning and suturing small wounds.

Sure, it was an open secret that dogfighting happened and that pit bulls were the dog of choice, but the ones that people cared enough about to bring to the vet were mostly pets. The fighting dogs generally just lived or died, there were always more where that one came from, and the lucky ones were taken out in the woods shot if they weren't going to make it.

The pets were usually farm and ranch dogs: gentle enough to babysit toddlers, rough-and-tumble enough to play with older kids, authoritative enough to handle unruly livestock, and tough enough to hunt feral pigs. And with a short, smooth coat that didn't collect mud or burrs or hold in the heat, they were ideally suited to life in the South.

Plus, they come in lots of cool colors.

How did this paragon of dogdom become the devil dog du jour? [I stole that phrase from I-don't-remember-where-on-the-web.]

Blood sports
have been and still are popular the world over: dogfighting, cockfighting, and baiting of all kinds of animals. Bear baiting was a popular spectacle, much enjoyed by Queen Elizabeth I, but bears were expensive to obtain and keep. Bulls were relatively plentiful and cheap though, and bull baiting could be enjoyed by rich and poor alike.

Bull baiting. Fans on bleachers, surrounding a high-walled pit, in the center of which was tethered a bull, to be set upon by dogs. Thus was born the bulldog, not really a breed so much as a type of dog, heavy and slow and tenacious. Somewhere along the line people got the idea of kicking it up a notch, and infused the agility and ferocity of the terrier breeds into their bull-baiting dogs. Thus was born the bull-and-terrier, which developed into several breeds over the years, the most infamous of which, thanks in no small part to Michael Vick, is the American Pit Bull Terrier.

In spite of their acknowledged prowess as fighting animals [when specifically raised and trained for it], many of the other myths about pit bulls are overblown or downright untrue. They attack and kill smaller dogs. Their jaws have more crushing power than Superman has superpowers [check out those snapping turtles!]. They're just plain vicious [better temperaments than Snoopy, actually].

I leave you with some further links about pit bulls:
A Popular History of the Pit Bull in America
Pit Bull Rescue Central
Understand-a-bull

Monday, July 23, 2007

Farmers pushing up daisies... and corn... and soybeans...












Sure, this was an excuse to add another lolcat to my blog, but here, have some farm bill reading:


CNN gets it right.

Good job on the format.
Excellent choice of viewer questions from YouTube.
Anderson Cooper for President.


Transcript of the entire thing:
Part 1
Part 2

I watched two whole hours of television in one sitting. Did you feel the earth shift on its axis?

Update:
Recap of all the videos and the candidates responses.

Jane Bryant Quinn gets it mostly right

in Yes, We Can All Be Insured. Nice to see some MSM writers for the masses telling it like it is. Finally.

One thing I'd like to see: on those waiting times that we're so much better at than everybody else, is anybody figuring in those of us, the uninsured, who are just going to have to wait forever?

That's what I thought.


Interesting article in that same issue on Express-Lane Medicine.

Some doctors are complaining that walk-in clinics at grocery stores -- I [heart] HEB -- will, among other evils, fragment health care. Ha!

And the free-marketeers are going to go batshit happy over the fact that market forces are solving a pressing problem here [they are]. What those people aren't going tell you [or themselves] is that dispensing antibiotics for sinus infections is easy, quick, and cheap, but this model isn't going to be expadable to the big stuff, cancer, heart transplants, the like, unless everyone has upfront all the dollars they'll need before they walk in. The only way to do that of course is some version of Medicare-for-All.

Sunday, July 22, 2007

3 out of 4 kittens agree:



  • Whataburger makes the best chicken fajitas and picante sauce.

  • Hard-boiled eggs are edible, but you have to play with them first.

  • Liverwurst tastes better if you smush it into the linoleum before you lick it up.



The one food all eight of us have agreed on so far: canned Bumble Bee Prime Fillet Atlantic Salmon.

An update in the battle to win over their fuzzy little hearts and minds:

Tiger kitten, ever the seeker after truth, eschews such mundane activities as trying out new canapes and prefers to reach for the stars. This is the one who interacts the least with other species, giving curmudgeon cat a wide berth, only occasionally taking a swipe at the dog's fluffy wagging tail, and running out of the room every time I get up from the computer. I did trick this one into taking some of that yummy salmon right from my hand once. Once.

Patches kitten sits off to the side and observes. And takes notes. I still can't touch this one either, except to get my fingers licked if they taste good enough, but like the two blues, this one runs expectantly to the kitchen at food time, and follows me around the place if I'm carrying a plate of something.

Blue kitten 1 is the half-cuddler, going so far as to jump up in the chair with me, so long as I keep both hands on the keyboard, or snuggling briefly when I'm lying on the sofa or the bed, but only if I'm reading a book. This one likes being brushed but bare hands are still suspect [unless they're holding food].

Blue kitten 2 has crossed over to the Dark Side and become a pest, snuggling up to me, to the dog, to curmudgeon cat, even when we want to be left alone. This one purrs non-stop, loves sitting in laps, being carried, being brushed, helping with the blogging. Which is all very funny, because blue kitten 2 is the one who wouldn't be taken alive a few short weeks ago.

All four of them still attack feet [and dirty socks and catnip toys] and all four have discovered the joys of racing across the bed at 3am [humans are so entertaining when you wake them up like that].

Also, all four of the kittens find strange humans fascinating... so long as said humans stay on the outside of the front windows. Once they come into the house, the only thing any prospective adopters ever get to see are some furry streaks leaving the room. And my neighbors are all getting a little tired of being pressed into service as kitten desensitizers, especially when I try to smear them with canned salmon.

My New Love

Average Conservative [in comments].

Today is the last day

to submit your question. Not that I expect CNN to pick any questions that the candidates [or CNN] might find bothersome, but all the same I'm going to be inviting myself over to someone's house tomorrow night to view the results [seeing as how I'm too cheap to buy my own TV].

Harry Chapin meets Ookie

stolen from WF


I wasn't planning to revisit Michael Vick this soon, but I've been a BradyFan83 fan ever since he put Randy up.

Friday, July 20, 2007

the time is: five forty-six pm

the temperature is: one hundred five degrees

That's what the time-and-temperature announcement told me when I called. Hellish conditions notwithstanding, we went to Gallery Night anyway. Rode the air-conditioned trolley around parts of downtown and historic districts, dropped into some favorite art galleries [not all of them air-conditioned], and then ended the evening sitting in the park, drinking wine, soaking up the breeze, watching the far-off lightning, and listening to the Pensacola Youth Steel Orchestra.

Thursday, July 19, 2007

Poster Boy





**** WARNING: NSFW NSFK ****

Michael Vick, handsome dude with cute puppy, has a reserved spot in the 10th level of Hell.




nsfw = not safe for work
nsfk = not safe for kids


update: found the photo here

Wednesday, July 18, 2007

What a difference a Friedman unit makes

One of my New Years Resolutions for 2007 was to lobby Congress [okay, send them e-mails] about the farm bill, health care, the Mideast [just for starters]. It's not something I kept up with, but I got a few replies. Form letters to be sure, but replies nonetheless. Six months ago the good [and not so good] people of Congress didn't exactly see it my way. Now, though, they're singing a different tune.

We'll see what happens.

FYI

The White House on Strengthening Health Care

Tuesday, July 17, 2007

Another useful thing I learned in school

If you know your report isn't going to be substantive, be sure to dress it up with a pretty cover, and pad it with graphics that are almost certainly only remotely relevant to your paltry analysis.

Block Ice & Propane

As much as I loved stuffing my head full of new stuff when I was a kid, I spent an awful lot of my school career figuring out ways to get out of going to class. When the Suzuki method made it to one of the four or five elementary schools I went to, I jumped at the chance to take violin lessons.

Small problem. Not only am I musically klutzy, but most of my family is musically gifted. Not only did I hate them for setting the bar impossibly high, but they hated me for inflicting unbearable pain on their eardrums. Even the family cat, whenever I opened my violin case getting ready for the day's practice, would jump off the furniture and put her head under the sofa. Just her head, the rest of her body was visible. The implication was clear: I refuse to leave the room because I was here first, but have you ever, just once, considered the possibility that you have all the musicality of a jackhammer?

This was all right down traumatic for a 10 year old, but I stuck with it for a year or two, or however long I was at that particular school. Mostly to get out of class for an hour once a week for violin lessons in the school auditorium. Plus, I loved the rosin. I loved the crumbliness, the stickiness, the smell [I think I want this job]. To this day, every time I hear Johnny you rosin up your bow, it brings back intensely pleasurable memories.

For years afterwards, I had this love/hate relationship with the music of string instruments, dominated mostly by hate, I hate to say. But one afternoon spent with Erik Friedlander on my computer has changed all that. My list of CDs that I have to buy isn't as long as my list of Books that I have to read, but I've just added Block Ice & Propane to it.



ErikFriedlander.com [great photos]
cello lessons

Sunday, July 15, 2007

Who was that masked man?

[ok, so the title of this post is an inside joke, and a bad one, plz to ignore that part]

Krugman's latest column, The Waiting Game [that link's broken, try this one], takes on that bugaboo of Socialized Medicine [TM], the loooooong waits for elective surgery in those other countries. You have to wait, like forevah dude, for a hip replacement in Canada, but you can get one right quick here in The Good Ol USofA.

Here's why we're quicker:
On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it.

PBMs

Peanut butter and molasses sandwiches it ain't.





Are you thinking what I'm thinking? With a single-payer system, we could have one PBM for the entire country and all 300 million of us could participate.




That second column, "Utilization," it should more properly be labelled "Rationing of Care." Here's the Wisconsin Medicaid protocol for DURs [drug utilization reviews], which is supposed to limit waste, fraud, and abuse, but they look more like ways to abuse poor people's privacy and limit their medical care. Patient profiling and physician profiling are just what they sound like, tracking which drugs patients take too much of and which drugs doctors prescribe too much of.

Just an aside, the same people who profile patients and physicians will audit your PBM for you too. How many layers of bureaucracy do you need?

Fourth column. Formularies are lists of "preferred drugs" which surprise! surprise! turn out to be the drugs that the PBM negotiates the best prices on. If the best drug for what ails you isn't in the formulary, it'll cost ya. Disease management programs are a bit of a HIPAA nightmare [HIPAA being a nightmare in its own right too].




A finger in every pie...


How PBMs get paid: administrative fees and sharing in manufacturer rebates. Switching to a single-payer system would cut out this particular layer of administrative costs and secure the manufacturer rebates/discounts directly for the consumer, not one of the many middlepersons.


Political tensions have resulted. That should improve health care, when the pharmacy benefits manager causes tensions at the pharmacy.


If you think a 25% rebate is high, California Health Care Foundation says it may be as high as 35%.

Increased scrutiny by the Inspector General for Medicaid participation? The headline at the bottom right reads Medicaid AMPs: PBMs out, mail order in.

The Pink Sheet website, if you have $1775 to spare.




Sure, you and your doctor together make the decisions on which drugs you get, but with significant interference from people whose interest in their wallets is greater than their interest in your health.




Potential legal, political, and resulting PR threats. I'm doing what I can to give them bad PR.



Competition in the Healthcare Marketplace Hearings, 2003

Thursday, July 12, 2007

Safety and Ethics




cowboydog blog





















The Ethics of Modern Things
free e-book [PDF]

Health care just wants to be free!

The anti-dePresidential candidates, with the exception of Kucinich, are all pushing for some market-based solution to the current health care problem, either relying totally on the market [competition good!] with subsidies for the poor [maybe] to buy insurance, or insinuating Medicare into the market and waiting for the people to flock to the socialized solution.

Bryan lays it out for you in words of one syllable.

Force everyone to buy insurance!
The reality is when states started requiring automobile insurance, they had to create an auto insurance company to handle people that insurance companies refused to cover. Florida has had to do the same thing with homeowners’ insurance, create a state insurance company to cover people the insurance companies refuse to cover. The Federal government operates a life insurance company for the military, because the insurance companies don’t want to sell insurance to the military.


Markets just want to be free!
The market cannot work unless it is free. When the government or reality make it imperative that you buy something, the market loses its freedom and becomes distorted. The insurance companies are controlling the market and the healthcare industry, they aren’t free. The insurance companies are the problem, not the solution. The cost of healthcare is rising primarily as a result of the cost of insurance, not the salaries of doctors.


That last sentence got me wondering: if we had truly socialized medicine, where doctors are salaried employees of the state [as in the UK], wage slaves just like the rest of us [some of us], what would we pay them? From USAJOBS, the federal governments website for all federal civil service jobs, some current openings for physicians:

  • PHYSICIAN (FAMILY PRACTICE)
    Salary: From 86,445.00 to 175,000.00 USD per year

  • Physician (Interventional Radiologist)
    Salary: From 90,000.00 to 255,000.00 USD per year

  • Physician (Urgent Care)
    Salary: From 90,000.00 to 200,000.00 USD per year

  • Physician
    Salary: From 130,577.00 to 175,000.00 USD per year

  • PHYSICIAN (GENERAL PRACTICE)
    Salary: From 86,445.00 to 175,000.00 USD per year

  • Physician (MRI Radiologist)
    Salary: From 91,531.00 to 255,000.00 USD per year

  • Physician (Internal Medicine)
    Salary: From 100,000.00 to 200,000.00 USD per year



Not the princely sums that a few high-demand specialists might be making under our present system, but respectable salaries nonetheless.

Single-Payer FAQ

Here's question 1:
Is national health insurance “socialized medicine”?

No. Socialized medicine is a system in which doctors and hospitals work for the government and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. Examples also exist in Great Britain and Spain. But in most European countries, Canada, Australia and Japan they have socialized financing, or socialized health insurance, not socialized medicine. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in this country. Doctors are in private practice and are paid on a fee-for-service basis from government funds. The government does not own or manage their medical practices or hospitals.

The term socialized medicine is often used to conjure images of government bureaucratic interference in medical care. That does not describe what happens in countries with national health insurance. It does describe the interference by insurance company bureaucrats in our health system.


Read the rest here.

Road trip

I haven't been to the Grand Canyon since I was a kid, and while I seem to have missed out on the falling mules, I can clearly remember my Dad yelling [from way back at the parking lot, practically] to my Mom: Erma! Get those kids away from there!! every time my brother and I tried to look over the edge.

So now I've got a trip planned for Christmas vacation 2007 to AZ: the Grand Canyon, coupla other spots, and maybe a side trip to Sedona [which somehow I've also missed]. If I spend my money wisely and well, and get lost on the way home, maybe I can even end up homeless and destitute on the streets of Denver.

Speaking of the Commonwealth Fund [I like that: common wealth], they've also put this report out recently: Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care [warning: 40-page PDF] comparing the health care systems of the United Kingdom [leading the pack], Germany [2], Australia and New Zealand [tied for 3.5], Canada [5], and the US [dead last].

Consolation prize: We're first in spending.

The Brits want their NHS back.

This article in The Guardian had me worried at first:
The NHS is on the brink of collapse and cannot be saved unless Gordon Brown intervenes when he becomes prime minister to give doctors the authority to organise a recovery, the leader of Britain's 33,000 hospital consultants will claim today.


Oh dear. I've been trumpeting the merits of both socialized medicine and "socialized medicine" for some time now. The UK health care system on the brink of collapse?! Say it ain't so! They drag out the suspense with the following paragraph [I'd like to point out that bit about best piece of social capital].
Jonathan Fielden, chairman of the British Medical Association's consultants committee, will tell Mr Brown: "Political meddling has brought the NHS to its knees. Unshackle the profession, give us back the health service, and we will rebuild it. Fail to do so and you will rightly be condemned for destroying the best piece of social capital the country has ever had."


If you've seen some of the reports and tables and graphs I've linked to here in this blog, you may have noticed that the UK doesn't spend a whole lot of money per person on health care. One could easily be misled into thinking it's because they don't have a whole lot of money to spend on health care. Not so, apparently:
Dr Fielden will make his plea as Patricia Hewitt, the health secretary, announces the NHS's financial results for the year to March. She is expected to confirm a report in the Guardian last week that it made a surplus of about £500m.


Finally! Down at the very end of the article, comes this quote:
"The excessive use of private firms to provide NHS services has been costly, disruptive and has fragmented care. The independent sector should only be used where the NHS needs it, not thrust into its midst like a carelessly placed hand grenade.

....

"We will not stand by and see the Trojan horse of the independent sector rolled in to take over the health service from within."

Wednesday, July 11, 2007

Manifesto

The fine print at the bottom says: "We expect this one movie to lead the revolution and take down the greedy health insurance industry." If you want to print out the PDF of the above prescription and mail it to like everybody in the government, all the newspapers in the country, and every single candidate, anti-depresidential or not, and paper your cubicle walls while you're at it, I won't stop you.



I saw CNN's Sanjay Gupta try to refute Sicko, and had planned to rail against it, but tartuffe has already done the heavy lifting:

Moore fact-checks CNN's Sicko "reality check"
by tartuffe
07-10-2007, 1:01 PM #


Result: Moore/Sicko -- 2, CNN -- 0

CNN's distorted, biased "Reality Check"

Moore confronts Blitzer (live, on-air) over distortions and falsehoods in "Reality Check" (and other matters!); suggests apology warranted

Moore fact-checks CNN's Sicko "Reality Check"

And a good time was had by all (well, except perhaps Wolf Blitzer and Dr. Sanjay Gupta . . . and maybe top CNN management!).

What would Mohammed drive?

Doug Marlette, creator of the gently wacky Kudzu comic strip, and wickedly pointed editorial cartoonist, would probably appreciate the very black humor of his dying when the pickup truck he was riding in ran off the road on a rainy night in Mississippi. I didn't read Kudzu regularly, but I'm going to miss his editorial cartoons something fierce.

Tuesday, July 10, 2007

oh noes...


EHRs, I can has antidepressants?

The news has been making the rounds. Electronic health records don't aid patient care. Not all of the Presidential candidates are going to be happy to hear this.

But enough about the candidates. I was originally going to rant about the MSM and the paucity of information they always give out on important topics in science and medicine. Fortunately, before I could go too far off into the deep end, I thought to look for the press release. Silly me, I should have remembered that press releases are usually full of fluff. So, just this once, I'll give the corporate-owned media bobos a get-out-jail-free card.

Still, it would be nice if somebody who [1] understands this stuff, [2] has access to the literature, and [3] can write would report on it. I've found the abstract of the journal article, but if I paid $15 each time I wanted to read an article, I'd never be able to feed kittens. And look, down at the bottom of the press release, you see that this research was funded by the U.S. Agency for Healthcare Research and Quality. I'm thinking that .gov in the URL means that my tax dollars paid for this research. I don't think I should have to pay extra to read the results.

So, anyway, just looking at the abstract---
Results Electronic health records were used in 18% (95% confidence interval [CI], 15%-22%) of the estimated 1.8 billion ambulatory visits (95% CI, 1.7-2.0 billion) in the United States in 2003 and 2004. For 14 of the 17 quality indicators, there was no significant difference in performance between visits with vs without EHR use. Categories of these indicators included medical management of common diseases, recommended antibiotic prescribing, preventive counseling, screening tests, and avoiding potentially inappropriate medication prescribing in elderly patients. For 2 quality indicators, visits to medical practices using EHRs had significantly better performance: avoiding benzodiazepine use for patients with depression (91% vs 84%; P = .01) and avoiding routine urinalysis during general medical examinations (94% vs 91%; P = .003). For 1 quality indicator, visits to practices using EHRs had significantly worse quality: statin prescribing to patients with hypercholesterolemia (33% vs 47%; P = .01).


Statins aren't properly prescribed for patients with high cholesterol if their doctors use EHRs. I'm too lazy to go look for it, but hasn't there been some question about when it's best to use or not use statins for high cholesterol?

Apparently urinalysis is over-utilized in routine physicals if your doctor hasn't got EHRs. I can't get excited about this, urinalysis is cheap, and if you accidentally find a few cases of diabetes or kidney failure or whatever a bit earlier than you would have otherwise, how is this bad? It's not like they measured the over- or under-utilization of MRIs.

If you're taking antidepressants, you'll be safer if your doctor uses EHRs, but probably any good pharmacy would note that drug interaction problem too.



Only tangentially related... on the topic of antidepressants and their new-found popularity, I just thought I'd mention some of the reasons [that I know about] that antidepressants are prescribed. They're given to people to help them quit smoking. They're given to cancer patients. They're used in conjunction with pain relievers in pain management. Just in case you were curious.

Monday, July 09, 2007

Why Beautiful People Have More Daughters

Echidne, bless her heart, tackles the Evil Psychos.

[oh, wait. that didn't come out quite right. or maybe it did.]

Part 1
Part 2
Part 3
Part 4


Also, Echidne asks, in part 3, whether suicide bombers really are all single. I did a quick googling, but all I could come up with was this:

The early years of suicide terrorism were a simpler time, the officers explained. Suicide bombers were—at least in theory—easier to spot then. They tended to carry their bombs in nylon backpacks or duffel bags rather than in belts or vests concealed beneath their clothing, as they do now. They were also typically male, aged seventeen to twenty-three, and unmarried. Armed with these data, the authorities could simply deny work permits to Palestinians most likely to be suicide bombers, thus restricting their ability to cross the Green Line (Israel's pre-1967 border) into Israel proper from the West Bank or the Gaza Strip.

Today, though, suicide bombers are middle-aged and young, married and unmarried, and some of them have children. Some of them, too, are women, and word has it that even children are being trained for martyrdom. "There is no clear profile anymore—not for terrorists and especially not for suicide bombers," an exasperated senior officer in the Israel Defense Forces told [the author] last year.


from:
The Atlantic Monthly | June 2003
The Logic of Suicide Terrorism
by Bruce Hoffman

I was going to post it as a comment over there, but haloscan is being unfriendly. I'll try again later.

Sunday, July 08, 2007

Why not go to war for oil? We need oil.


Hey, Ann Coulter said it, not me. You can look it up. But she's right, you know.

How much of your life is dependent on oil? Drive a car? Wear shoes? Take pills? Have a computer? Have furniture? Clean your windows? Eat food? Wash dishes? Take a shower? I used to know a thing or two about black gold, and even I was surprised at the list.

Here's the technical version of what crude oil gets made into. White mineral oil and petrolatum are just a couple of the many items from that list. Here's a list of uses [several lists, actually] for just those two products. Want a list of ordinary everyday household products? Here ya go. You should take a couple of minutes to watch that video, it's the only levity you're going to find in this post.

Sure, we can grow corn and soybeans and algae and some exotic plants, use their oils and sugars and so forth to make fuels and plastics, but then where do we grow our food? Move everybody to Manhattan? Mow down the forests and level off the mountains? We've come a long way since the days of scooping that black stuff up out of pools in the ground and now we go through about 21 million barrels of the stuff each and every day. At 42 gallons per barrel, that's a lot of milkjugfuls of anything.

That's okay, we've got a lot of it in the ANWR, the Alberta Tar Sands, the North Sea, friendly places like that. Sure we do, but for the near future, we're still mostly going to be using the stuff from the Middle East.

We could all switch to electric cars tomorrow, that'd cut our oil usage in half. But electric plants are powered by coal and natural gas, and these are finite resources too. We could build more nuclear power plants, but that's a decade or so into the future at the very soonest. Longer if we do it right and make real and workable plans for both security and storing the radioactive waste.

So, now that you know how much oil we need, and for how much longer, and where we're going to be getting it from, why couldn't we just have used diplomacy and sweet-talked the Arabs into selling all their oil to us?

Saddam Hussein was getting old, 69 when he was hanged. How much longer could he have ruled over the festering mess that was and is Iraq? And Qusay and Uday, his two psychopathic sons [remember them? yeah right], they weren't going to be of any use in international negotiations. If they were, we'd have already seen them doing more in the outside world than caning the soles of the feet of losing Olympic soccer players.

There's always Iran. We've done business with them before, and if you look at the "business cycles" we were about due to switch from Iraq back to Iran as our "business partner" in oil production. But Ahmadinejad, President of Iran, while he looks like us and dresses like us, doesn't actually like us. There have been [might still be] more moderate factions in Iranian government, who might have been willing to deal with us, but they wear turbans and robes, and we would have had to work around [or wait out] that firebrand Ahmadinejad.

Meanwhile, India [where our high-tech jobs are going] and China [where our manufacturing jobs are going] have huge, growing populations, billions of them to our paltry 300 million, and they all want cheap energy too. Now that they're becoming world players in matters financial, they can afford to go after it. China has been particularly aggressive in their quest, and Iran wants to do business with them.

We've had 30 years to work on alternate energy sources: wind, solar, geothermal, hydroelectric, biofuels, electric vehicles, you name it. Longer than that really, but the 1970s saw the first big crunch, the first peek at what life without petroleum might be like. What did we ultimately do? Made tax concessions so that more people could drive Humvees.

Now we're bang up against the wall, and we don't have time to go a-courting, carefully and gently wooing Iranians and Iraqis over to our side, to sell us all of their black gold. By creating strife and chaos in the region, we can perhaps bludgeon them into giving up their riches, but even if that doesn't work, at least the Chinese won't be able to get their hands on the oil either.

Egg ... Chicken ... Chicken ... Egg

I was just reading my favorite columnist over at my favorite subversive blog, Krugman, expressing contempt of Bush's "taking care of" Libby, when I noticed a couple of things.

First off, Krugman refers to the Where Are They Now? wrap-up that Think Progress has done on the architects of the invasion of Iraq. The link he provides is to Think Progress' front page, rather than to the article in question. I did a little detective work and found it for you: THE ARCHITECTS OF WAR: WHERE ARE THEY NOW?

Secondly, I couldn't help noticing something else, as I skimmed down the list of those architects. A question: does being ugly make you a warmonger, or does being a warmonger make you ugly?

Saturday, July 07, 2007

Friday, July 06, 2007

All the Strange Hours



Curmudgeon cat, ignoring my words in favor of somebody else's, Loren Eiseley's this time.

Thursday, July 05, 2007

Shorter [and more colorful] Austan Goolsbee



I had orginally planned to whine, at length, in a post titled Austan Goolsbee and the Dog Collar Buick, in repsonse to this article over at Slate: Michael Moore and the Beige Bomber. Fortunately, the blogging birdman stepped in and has saved me the trouble [and likely saved my sanity too] by posting a link to this says-it-all Tom Tomorrow cartoon. Thanks, Arch.

Life is short. Play with your food.

Tonight: Vegemite on toast.


I love faces. I love portraits. I could spend all day in galleries studying them. I like to draw them. I like to paint them. I like to watch other artists drawing and painting them. My latest unholy obsession is speed painting and speed drawing over at You Tube. Artists [and a few wankers] make time-lapse videos of themselves drawing or painting a subject, and set the videos to music.

My very favorite is Eclectic Asylum Art, followed closely by Monster by Mail.

Eclectic Asylum Art has finally started those long-awaited portrait drawing lessons. The first three are all lecture, no lab, but he's promised that these are the only ones like that. Links:
Lesson 1
Lesson 2a
Lesson 2b

Bonus: One of my favorite videos, the chocolate syrup drawing, won Third Place in the New Numa Contest.

Why the surge is working. Or not.

Iraq's cabinet has approved changes to a draft oil law and sent it to parliament in a step seen as vital to curbing sectarian violence.

Nuri al-Maliki, Iraq's prime minister, said it was the "most important" law in the country.

"The law was approved unanimously ... it was referred to the parliament which will discuss it tomorrow," he said.

"I call on all our partners in the political process and in this national unity government to respect this deal."


A couple of years ago, I wasn't entirely convinced that our invasion of Iraq was entirely about OIL. These days I'm not so sure of that.

They've toned down the language a bit, made some concessions on some percentages, and shortened some timeframes for leases, but the Iraq Oil Law is still all about production sharing agreements, and a few troublesome folks aren't buying off on it.

Followers of Shiite cleric Moqtada al-Sadr on Thursday joined a growing chorus of Sunni, Kurdish and Shiite opposition to a draft oil law approved by Iraq's cabinet and backed by the US government.

Sadr's supporters said they would not support any law that would allow firms 'whose governments are occupying Iraq' -- a reference to the US, Britain and their coalition allies -- to sign Iraqi oil deals.


My guess is that the surge was all about stabilizing just enough of Baghdad and buying just enough time to get the infamous oil law signed, and not about anything else.

Presentation of the draft to parliament after the cabinet approved it on Tuesday was a big step towards meeting a key political target set by the US.


Please prove me wrong.

France ... Italy ... Italy ... France ... I dunno.

It's a toss-up.

Italy. I like Italian food better [lots], and I speak slightly more Italian than I do French [I speak this || much French]. On the other hand, they let the Pope live there. You'd think that someone with snakehandlers in their family tree wouldn't be afraid of the Pope, but I am.

France. I've long wanted to visit Brittany. I could take day trips to London. I'm a fan of Inspector Maigret [and Clouseau too]. I've always wanted to learn to speak French, and I'm a believer in the immersion method.

Greece. Maybe I'll skip them both and just escape to the land of retsina and stuffed grape leaves. Besides, it's close to Turkey.

Tuesday, July 03, 2007

B-b-b-but, the taxes!

It'll cost a fortune to provide free health care for everybody!

Well, no, not really. We're already spending a fortune on lousy health care for only part of our population, as numerous people have pointed out. And now here's a blogger who tackles the thorny question I'd been avoiding: just exactly where are those other countries getting the money?

[via]

Green Goddess




Curmudgeon cat is in his last week [one hopes] of pills and shots for flea allergy. I've never really had any trouble giving pills to cats, in part because I use the Yummy Food technique.



So, what is this magic procedure? you ask. It's very simple, I say.


  1. Announce that it is pill time. What? Your cats don't come running when you tell them that you are about to shove horse pills down their throats? You're doing it wrong.


  2. Get the can of Yummy Food out of the refigerator and set it next to the cat's food bowl.


  3. Grab the cat's head, pull back gently [just until the lower jaw drops open], put the pill on the back of the tongue [far enough back that the cat can't spit it out, but not so far that you shove the pill down the airway].


  4. Immediately plop a spoonful of Yummy Food into the cat's food bowl.


  5. Go around the house, distributing Yummy Food into all the other pets' bowls too. This is an important step. Leaving it out creates resentment in the household.


  6. Put the food and pills away until next time.



This works best if your cat is a Glutton Cat, but will work for almost all cats [dogs, horses, gerbils, goldfish... ]

So what constitutes Yummy Food? Only your cat [dog, hamster, goldfish, horse... ] can tell you, but for best results it should be something that your animal companion doesn't get as a regular part of its diet. Gotta be something special. Around here, that usually means the smellier the better. Last week it was Kozy Kitten canned fish dinner. This week it's Green Cow canned beef tripe.

Green Cow is everybody's very favorite around here [not me, but I don't count], and they all, even the little wild heathens who won't let me touch me them at any other time, follow me through the house like I'm the Pied Piper, the cat's whiskers, the Goddess of Yummy Food, when I bring out this stuff.

That's me, Goddess of Tripe.

Monday, July 02, 2007

Administrative costs, here and in Canada

from Costs of Health Care Administration in the United States and Canada by Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D.

In Table 1, the authors [admitting that the numbers are imprecise] attempt to break out the various administrative costs in the two health care systems. Ours costs more. No surprise there.


Table 2 is a bit more interesting. The percentage of health care employees [doctors offices, hospitals, clinics, etc] in the US who are administrative or clerical has grown over the years. This isn't proof that the insurance industry is the cause of this growth, but if you've ever had a lengthy, complicated, expensive illness, you've dealt with more than your share of these people. >Bryan has some related info.


My apologies if Table 3 is unreadable here. If you click on it, a larger version should appear.

How many insurance company employees does it take to screw you out of your hard-earned dollars, and try to deny you decent health care? In Canada, it takes about 1.5 employees to deliver Canadian Medicare to 10,000 enrollees [patients, or potential patients]. In the US, it takes 23.5 employees to deliver for-profit health insurance to the same 10,000 enrollees.

Forgetting for the moment how to calculate and compare administrative costs between two very different systems, how about if we just assume, and it's a reasonable assumption, that we could dispense with 90% of those employees? This would bring it down to about 2.5 employees per 10,000 users of health care services. Even if the salaries + benefits of those employees only add up to a paltry $20,000 per year per employee, that's roughly $3 billion per year that could be spent on doctors, nurses, orderlies, pharmacists, and other truly useful people.

What are those approximately 150,000 displaced insurance workers going to do? They can do like the rest of us who have lost jobs to re-engineering, right-sizing, down-sizing, out-sourcing, and off-shoring: get another job. I wouldn't mind paying them to mop the floors in the hospitals, or take my blood pressure at the doctor's office, but I'll be damned if they ought to get any money from me for the purposes of denying me the insurance I paid for.

Speaking of denials, I didn't stumble over this until last night, but there's a whole denial managment industry out there. That's right, if we scrap the for-profit insurance industry, we're also going to put a bunch of people out of work whose job it is now to try to get the insurance companies to pay those claims that get filed.