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In response to:

Dr. Emanuel's Death Wish

Dot462 Wrote: Oct 07, 2014 2:03 PM
We have to remember that old Ezekiel wrote the Lancet article in 2009 that outlined the Complete Lives System, a method of applying cost/benefit analysis to health care rationing. The N.I.C.E. system in the U.K. applies cost/benefit analysis to decide whether to pay for certain procedures/treatments for persons who are not going to be able to contribute to society. Old Ezekiel has been a main advisor to Obama in development of the ACA. Obama pushed off by a year implementation of the Independent Payment Advisory Board, which probably will be using cost/benefit analysis to decide with greater specificity what treatments/procedures are appropriate for Medicare/Medicaid to pay for. I am looking forward to the day when Old Ezekiel decides he's lived long enough and he goes out in the snow without clothes on and waits to freeze to death. They say you just go to sleep.
In response to:

Ebola and Obama

Dot462 Wrote: Oct 07, 2014 1:40 PM
Thank you, Dr. Sowell. Looks to me like the reason many people no longer trust what govt officials have to say stems from the many lies that have been told by agency officials like the ones from the IRS, the State dept on Benghazi, etc. When Dr. Frieden tells us he's "100% sure" that nobody can get Ebola from sitting next to someone on an airplane he is flying in the face of infection control measures. Who would trust such a doctor? Nobody knows how the NBC photographer got it; he wasn't engaging in direct patient care, was he? Even the CDC website says that Ebola can live on surfaces for hours and even days. Letting people fly in here from Liberia and Sierra Leone is bad infection control. Airlines are also at fault because they are putting their passengers at risk when they allow people to fly on their planes who have been in west Africa within 21 days. People will lie in order to get out of west Africa and come to the U.S. where medical treatment is better. This epidemic may approach 10,000 cases by the end of October; it is hard to control if people can fly in here with west Africa stamps on their passports.
The trouble is that there is no really effective treatment for Ebola other than supportive care. We don't have a vaccine. I'm sure that is being worked on, but vaccines don't just hop on the market overnight. I read there's a shortage of IV fluids, which is the main supportive care because of the fluid losses experienced by victims. Pain control is also a factor as a thrashing patient can spread droplets all around them. I guess it's time to buy stock in companies that make PPE and other companies that make IV fluids and morphine.
What has to happen if what you desire can come to pass is that the airlines decide on their own to screen passengers, not depending on natives of the countries involved. I've read that some of these so-called screeners can't even read a digital scanning thermometer. What'll probably happen is that airlines (to protect themselves) will stop picking up passengers in those countries. That might happen if the epidemic spreads to tens of thousands, which WHO said could happen in a worse-case scenario. Passengers need to be screened out prior to boarding in those countries. By the time people get to the U.S., it's too late.
It might be airborne, but what we do know for sure is that it lives for hours or even days on surfaces (It says so on the CDC website). It obviously is transmitted by even infinitesimal contact with bodily fluids of a victim. It can enter the human through a cut or through contact with mucous membranes (like cleaning up after somebody who is sick and, even though wearing PPE, touching eyes or mouth). You do not have to have direct contact with the victim, but you do have to have direct contact with the droplets. Masks don't help with viruses as they are too small to be filtered. That's why the PPE of people working with Ebola victims is head-to-toe plastic suits with self-contained air. That's why Ebola victims who have come to the U.S. are put in negative-pressure rooms and treated like a Level 4 biohazard. But, we only have a limited number of isolation rooms with negative pressure so if an epidemic ever really got going here there wouldn't be enough rooms to treat the victims.
Wait...only a crazy person would infect themselves with Ebola and then travel to the U.S. to spread it. Wait...there are crazy people who want to do harm to the U.S. and are suicidal. Is it too farfetched to think somebody might do that? How many people could such a person infect? Nobody knows. Fortunately, Ebola is quick to incapacitate its victims, making it difficult for them to walk around spreading it. Dr. Freidan of the CDC says he's "100% sure" that you can't get Ebola from sitting next to somebody on an airplane. Really! 100% sure! It's tough to be 100% sure of anything but one thing we do know is that politicians (even politicians who are incidentally doctors) don't want to scare people. But, maybe people need to be scared. I recommend reading Clancy's book Executive Orders (although it's a biowar scenario, not a straight epidemic). The Hot Zone is a true story of Ebola Reston (an airborne form of Ebola) which infected monkeys from the Philippines which were brought to Reston, Virginia, for research. The more people become infected with Ebola Zaire, the more opportunity for it to mutate.
In response to:

Harry Reid: Public Enemy No. 1

Dot462 Wrote: Oct 05, 2014 3:46 PM
But, a large part of the Nevada populace is on some sort of govt dole and they don't bite the hand that feeds. Another large part are union members (although they ought to know better) that reflexively vote Dem. Another part is some big business owners and operators who want their own kind of handouts from D.C. They were afraid that if Reid was ousted they would lose their power position in the Senate. There are also quite a few RINOs here, unfortunately. Some voters in the state are libertine, but there are a lot of others who don't use the services of the prostitutes or participate in the gambling halls.
In response to:

Harry Reid: Public Enemy No. 1

Dot462 Wrote: Oct 05, 2014 3:41 PM
Unfortunately, the Repub party here is so fractured that they'll be lucky to be able to elect any Repubs. The fight has been going on well before the old guard Repubs refused to support Sharron Angle (who would have been a better Senator by far than Reid). But, he enjoys strong union support and big business interests don't want to give up his power in the Senate. But, I will vote for Repubs (even though I don't agree with a lot of what some say) because Dems are worse. It's sad to be in a position like that, voting for the lesser of evils, but right now that's where it is.
In response to:

Harry Reid: Public Enemy No. 1

Dot462 Wrote: Oct 05, 2014 3:36 PM
I can't second what is said in this commentary often enough. If voters don't elect enough Repubs in the Senate to kick Reid out of the majority leader position they will consign this country to further inability to take any action in the Senate. Of course, gridlock is not entirely a bad thing considering who's in the White House, since even if both houses become Repub Obama will just veto anything he doesn't want and there probably won't be enough votes for an override. Unfortunately, Reid enjoys union support and has a lot of clout in Nevada to get people to give him and his PAC money which he uses to support the election of Dems. My most favorite scene I would like to see is a Repub Senate after November. Not that the Repubs are really good, but anything is better than having Reid as majority leader.
In response to:

Must We Loose This Mortal Coil at 75?

Dot462 Wrote: Sep 30, 2014 12:16 PM
There's a difference between "loose" and "lose." I don't know how that headline passed through the author, editors, writers... Oh, well. As to the sentence about old Zeke probably authoring the provision that doctors should get paid for "end-of-life counseling," they already are. Doctors (and nurses and physicians' assistants) ask patients whether they have a Living Will or a Durable Power of Attorney for Health Care, which are forms asking patients to consider what they want done in case they are medically incapacitated. The "end-of-life counseling" isn't just a session limited to that topic, but a part of an office visit or consultation. Now, there's a code for it. It has nothing to do with knocking off old people when they are "too old." The main issue to consider is that when the decisions for what to pay for is vested in a govt entity with a limited budget, then decisions will be made on reimbursement based on SOMETHING. Old Zeke has put forth a method -- cost/benefit analysis. If people could pay for their own health care and not rely on the govt, they would be able to make the decisions about expensive treatments based on their ability to afford it. There's inequality in every system and many people don't like deciding health treatments based on money, but the hard reality is that medical treatment isn't free, whether govt (taxpayers) pay for it or people do. Our system of DRG reimbursement puts the burden on providers to treat people with less and less pay (for Medicare/Medicaid patients). The main thing is that the system should be voluntary. Once the IPAB comes into existence next year, decisions will be made (as they have been under N.I.C.E. in the U.K.) to not fund certain treatments (expensive ones) in people over a certain age (like, no coronary artery bypass surgeries if over 65). Rationing exists now -- rationing by lowered provider reimbursement, which has forced many providers out of business, or into not taking Medicare/Medicaid. But, since the costs continue to rise, the govt may use the IPAB to decide whether to deny payments for people over a certain age, or preemie babies (that commonly run up a million dollars), or terminal illnesses which are treated palliatively with expensive drugs. Can't avoid rationing unless we want unlimited payments for every treatment which has to be financed by increased debt.
In response to:

Saving California One Republican At A Time

Dot462 Wrote: Sep 29, 2014 12:33 PM
Unfortunately, the big cities control how the votes go in CA. The only way the voters there will wake up is to see big problems that cost them a lot of money and have been implemented by a Dem-controlled legislature. Maybe this author isn't giving up on CA, but back in 1995 I did and I've never regretted moving to Nevada. Unfortunately, there are a lot of refugees from CA over here and some of them don't understand that what they voted for over there will ruin Nevada if they vote that way here. I saved 20 years of state income tax, lowered my property taxes by 2/3 and saved lots of money with not commuting, enjoyed no "rush hour" and a nice four-season climate here close to Tahoe. Tesla saw the advantages. Now, all we have to do is defeat the proposal for a margins tax. I hope the voters are smart enough to understand that taxing the GROSS RECEIPTS of a business means a business can owe the tax even if they lost money. A stupid proposal -- but understandable since it came from the teacher's union.
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