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In response to:

The Most Boring California Election Ever

Dot462 Wrote: Oct 23, 2014 12:08 PM
They don't need elections in CA. We know who dominates the politics in the People's Republic -- coastal cities control and other areas of the state are not represented. That's why there was a push to cut the state into pieces (won't happen, but it might be nice). Might as well just recognize that CA is a dictatorship of one party and just get on with life, pay your confiscatory taxes and be thankful that you can deduct your state income tax from your Federal.
In response to:

Rebuilding Gaza for the Next Attack

Dot462 Wrote: Oct 15, 2014 1:26 PM
It is interesting to me that Kerry can promise money to rebuild Gaza without an appropriation from Congress. Is he pledging his own money, or ours? If I could cast a vote on this, I wouldn't send a dime to Gaza until they recognized Israel's existence as a legitimate govt, renounced terrorism, got rid of Hamas. But, of course, that won't happen. In that case, no money should go to them.
I like Ron Paul, but saying that Ebola is not easy to transmit may be an error. Dr. Chan of the WHO says if it gets started in some of the huge cities in such countries as India, the Philippines and Malaysia, it would be an incalculable disaster. Now, we have two Ebola cases in workers who were exposed to Duncan. The CDC seems to be treating Ebola as though it is a Level 4 biohazard when they treated the two patients at Emory, but their guidelines don't advocate Level 4 protection in hospitals outside of the Level 4 facilities (of which we only have four here). When hazmat people suit up completely to remove Duncan's stuff from his apartment, it leads me to think that it's much easier to transmit than the CDC says. But, the main thing is confusion with CDC guidelines plus the lack of uniformity in how PPE is handled and provided for in hospitals.
The attack ads proliferate in Nevada. I try to mute them, but it's hard to avoid. Seems to me most of the attack ads are put up by Dems and I make it a policy to vote for the other candidate if I see an attack ad. The Miller-Laxalt campaign is pretty nasty. But, it extends down to the city council level as I received a robocall from candidate Cafferata attacking candidate Duerr, which makes me instantly want to vote for Duerr (this is a nonpartisan race). I check them out on their websites and elsewhere to see if either of them are worth voting for. We have None Of The Above here in Nevada and I sometimes exercise that option. In the primary for governor, there were a couple of Dems and they both lost to NOTA. Flores was the second best in that primary, but has no chance against Sandoval, but it was interesting that NOTA won.
But we have the International Classification of Disease (ICD-9, soon to be ICD-10) which lists many "diseases." It breaks down subtitles under the "diseases" into minutiae. It classifies "substance abuse" as a disease and under that it includes "alcohol abuse" and "drug abuse," which is further broken down into what drug. It codifies accidents and injuries and includes how the person was injured such as falling off a swing in a playground or being kicked by a horse. So, the reason the CDC takes on "diseases" such as obesity, smoking and gun injuries is that they are classified as "diseases." So, "public health" has been expanded to include anything that can happen to somebody indoors or outdoors. The CDC, then, thinks that it is the nanny state and can advocate, by spending money on TV advertising, that we stop smoking, stop drinking sugary beverages, etc. It then doesn't spend money on such things as research into a vaccine (or vaccines) for hemorrhagic fevers (of which there are several besides Ebola). When ICD-10 comes out next year, CDC will have even more minutiae to be concerned about that will be classified as a disease.
It's your tax dollar at work. The hospital will collect from Medicaid.
You are able to add a correction to your records if you find an inaccuracy, although I'm not sure who will read it since some records are voluminous and more cumbersome to handle and locate data than in a paper record. That's why you should have a copy of pertinent records that you keep with you.
You're absolutely right, Dr. Zinj. Think of how the IPAB will use the expanded data under ICD-10 to keep track of more minutiae in medical records and decide whether to pay based on cost/benefit analysis. I'm sure you have read Dr. Ezekiel Emanuel's Lancet article in 2009 about the Complete Lives System.
It is so important for you, as a patient, to have copies of your medical records (at least, the pertinent parts) which you keep in your possession. I've been in hospitals a lot both for myself and for my family members and have used the record that I have to point out to the doctor what was there before, particularly because I have not always gone to the same hospital. For example, I had an EKG done in southern California when I had chest pain and when I followed up back at home I had a copy of it which the doctor was glad to have and copied it for their own records. Don't rely on the electronic record. Know what is in it. You have the right to read your record (for a fee).
Travel data was not considered a high priority until now, so most likely Epic (and other EMR systems) didn't automatically put a red flag on it. People who program the system have to be told what the providers want. Right now, travel data is a high priority so the programmers jumped in there and changed the screens to grab that data and put it in a priority setting, or flag it in red, or put it in capital letters. The trouble is, there's only so much room on a page and you can't make the typeface so small that nobody can read it, so sometimes important data is on a second page and the doctor or nurse has to actually scroll to read the whole thing, which is something that sometimes doesn't happen. Now that travel data has been flagged, maybe the providers will look at it, although we all know that patients lie so just because travel data is priority doesn't mean what the providers read is true. A patient might lie if he thinks he won't get treated if he tells the triage nurse the truth.
Sure. You're absolutely right. And they haven't even instituted the minutiae of ICD-10 with 140,000 codes detailing practically everything and making it possible to assign a value to those codes (they do it now with ICD-9, but there's only 40,000 codes there) and have some criteria for deciding whether to pay for that code under Medicare/Medicaid. ICD-10 has been postponed for a year. Coincidentally (or not), the IPAB (new board under ACA that will assign values and decide the cost/benefit of payments) has also been postponed for a year. Maybe there's an election to get past first?
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