Feds get specific on ACA individual mandate rules  : ACEP NEWS

After years of legal wrangling and a showdown in front of the Supreme Court, the federal government has finally begun to implement the Affordable Care Act’s controversial individual insurance mandate.

Starting on Jan. 1, 2014, Americans will have a choice: Buy basic health insurance, qualify for an exemption, or pay a penalty when filing federal income taxes, according to proposed regulations issued Jan. 30 by the Treasury Department and the Health and Human Services Department.

via Feds get specific on ACA individual mandate rules  : ACEP NEWS.

Go and read all the exclusions. For an incredibly intrusive and expensive mandate there sure are a lot of people that still won’t have to be covered.

Siri and the Three Laws of robotics

I’d have been much happier had they just come out straight…

IMG_0826

 

So, our future mechanical overlords will at least have some sense of humor…

Update: And, from Twitter via @whatImeantwas1 :4th Law

BS Study*: Doctors Feel Patients’ Pain | Empathy | LiveScience

Been a while since I pulled out the BS flag, and this seems entirely appropriate:

Good doctors really do feel their patients’ pain.

Hmm. ‘Good’ doctors?

A study, published today (Jan. 29) in the journal Molecular Psychiatry, shows that when doctors see their patients experiencing pain, the pain centers in the physicians’ own brains light up. And when the doctors give treatment to relieve pain, it activates the physicians’ reward centers.

The doctors were then instructed either to use an electronic device that they believed would relieve the patients’ pain, or to withhold the pain relief. In response, the patient-actors either grimaced in pain or maintained a neutral expression to suggest their pain had subsided.

via Doctors Feel Patients’ Pain | Empathy | LiveScience.

Umm, what? These ‘good’ doctors were told that an electronic device would either relieve or not relieve pain, and then they reacted to their patients’ acting with activity in their own pain or reward centers by fMRI.

My first question: did these docs really buy into this magical electronic pain-relieving device, and if so, why? I have to wonder if it was their amusement areas lighting up and not their pleasure centers…

Second, at no time is ‘good’ established in this article. Were there a subset of docs whose fMRI’s didn’t change, and thus they’re ‘bad’?

Not buying it (would buy one of those magical electronic pain relievers, though).

 

*I say this is a BS study based on this writeup. If it’s something else entirely, okay, but this is just awful.

Health Insurance Brokers Prepare Clients For Obamacare Sticker Shock – Forbes

(emphasis added):

By Dr. Scott Gottlieb, M.D.

A California insurance broker, who sells health plans to individuals and small businesses, told me that she’s prepping her clients for a sticker shock. Her local carriers are hinting to her that premiums may triple this fall, when the plans unveil how they’ll billet the full brunt of Obamacare’s new regulations and mandates.

via Health Insurance Brokers Prepare Clients For Obamacare Sticker Shock – Forbes.

You. Don’t. Say.  Thanks, Obamacare!

Bug-a-salt is here!

Got mine today (I was one of their project funders) (of course with it being cool very few targets of opportunity):

Killing bugs. With salt.

Killing bugs. With salt.

 

Bug-a-salt.

 

I’ll let you know how it goes.

Don’t open wide: Annual check-ups are pretty much useless

I suspect this underestimates the problem. I think a lot of ‘chasing incidentalomas’ in medicine start here:

Two doctors in Colorado scanned through 14 randomized, controlled studies involving 182,000 patients. The articles spanned from 1963 to 1999. The doctors looked at whether those who had regular check-ups had higher mortality rates than their counterparts who dodged such visits. They could not find a difference.“General health checks do not improve important outcomes and are unlikely to ever do so based on the pooled results of this meta-analysis spanning decades of experience,” write authors Allan Prochazka and Tanner Caverly. ”There remains a belief in the value of general health checks despite the accumulating evidence. This belief is buoyed by screening advocacy groups and insurance coverage, and they have ramifications for patient welfare and health care costs.”

via Don’t open wide: Annual check-ups are pretty much useless.

They point out that Canada actually stopped paying for ‘routine checkups’ in 1979.

(Please understand I’m not including chronic condition maintenance in this category, like CHF or diabetes visits, as once you’ve got a chronic condition that’s where office visits probably really do help).

Funny apartment complex name – RPR Village

This is in the Medical District here in Fort Worth-

I suppose VDRL Court was taken

I suppose VDRL Court was taken

For those not in on the joke: RPR

Texas Medical Association – Legislature Week 1 update

A blessing to this Great State is that the Legislature meets only every other year, and then for only 90 140* days. It concentrates attention.

This episode introduces the new and returning Physician and Nurse Legislators of this session.

 

*Many thanks to TMA’s Steve Levine for pointing out my error in the comments. Texas History class was a long time ago…

Quantas mechanics have another work hazard

Ten foot pythons in the engine compartments/flap operators:

Snake clings to wing of Qantas plane – video | World news | guardian.co.uk_640x480

Click the link, I didn’t embed it here as I cannot turn off the autoplay.

From The Guardian.

Costa Concordia and its refloating (The Parbuckle Project)

I thought it must be a made-up word, but no (The Free Dictionary):

par·buck·le (pärbkl)
n.
1. A rope sling for rolling cylindrical objects up or down an inclined plane.
2. A sling for raising or lowering an object vertically.
tr.v. par·buck·led, par·buck·ling, par·buck·les
To raise or lower with such a sling.

The Parbuckling Project is a consortium of engineering talent with a truly vast (and challenging) task: remove the sunken Costa Concordia safely and cleanly. I had a look and marvel at the ingenuity.

Now let’s hope it works.

Great Moments in Amazon Kindle tech support

I want to preface this by saying the technical problem I had was of my own doing, and once I talked to someone who had a clue it was fixed in two minutes.
Then, there’s this unintentional comedy! I went to the Amazon Kindle support page, as I’d tried their email support and they couldn’t even be bothered to try, I got ‘please open a chat window’ as their response email.
A chat was begun:
You are now connected to Amazon from Amazon.com.
Me:my kindle fire DH 7″ seems to think it’s in the UK. The .com button in the lower right of the keyboard displays .co.uk, and when searching for websites it always offers the .co.uk ones as the recommended ones.

I’ve checked my country setting under manage my devices (US). Serial Number: ####

Amazon:Hello.. This is Sweety from the Digital Team.
Welcome to Amazon Digital Chat.
I am glad to help you.
I am very sorry to hear about this.
[pause]
Let me look into this.
[pause]
Since your query is regarding the Kindle, let me help you by transferring you to our Kindle Specialist. Please be on hold.
A Customer Service Associate will be with you in a moment.
[this is after telling the Amazon support page my problem is with a Kindle to start the chat...]
You are now connected to S*** from Amazon.com.
[I have changed this persons' name so they won't get abused like they should be]
S***: Hello, my name is S***. I’ll be happy to help you.
Me:hi
[long, long pause]
?
S***:I checked and see that your Kindle has been registered under Amazon.com.
Me:Good.
S***:Is there anything else I can do for you today ?
Me:Yes. Fix the problem, or even pretend you understand what it is.
S***:I’m sorry.
Could you please rephrase the above sentence?
Me:Here is my problem:
my kindle fire DH 7″ seems to think it’s in the UK. The .com button in the lower tright of the keyboard displays .co.uk, and when searching for websites it always offers the .co.uk ones as the recommended ones.
I’ve checked my country setting under manage my devices (US). Serial Number: ####
I want my kindle to understand its keyboard, and it itself aren’t in the UK, and to stop behaving that way.
S***:I can confirm that your Kindle is registered under Amazon.com. Your Kindle with serial #### is Kindle Fire HD.
Me:Would you be so kind as to transfer me to the next level or technical support please?
S***:Sure, [me].
Could you please provide me the best possible phone number to connect you right now?
Me:[a phone number]
S***:When your phone rings, please answer it.
You may hear ringing while we connect you to Customer Service.

Your call is now connected.

 

Yep. That happened.

I then spent 10 minutes on the phone with a first level tech person, and an escalation got me to ‘Todd’, who was sharp, and had my problem fixed in about 2 minutes.

Still. Comedy support gold.