Bicyclist Fatalities in AZ 2009

On 12/1/2010 8:03 AM, Duane Hébert wrote:
On 11/30/2010 9:37 PM, Tºm Shermªn™ °_° wrote:
On 11/30/2010 9:04 AM, Duane Hébert wrote:
[...]
One of the joys of socialism is that there is not usually enough money
to go around for things like education and health care.[...]

When did Canada become socialist?


That was mostly tongue in cheek. Canada is actually a parliamentary
democracy (see Douglas Adams' comments on that idea)

But there is a federal party with seats in parliament called the NDP
(New Democratic Party) that profess to be social democrats. And of
course we have the actual Socialist Party and the Marxist Lenninist
party but these are about as popular as the Green Party.

http://en.wikipedia.org/wiki/Sociali...racy_in_Canada

Of course the Communist Party is banned in the US, which is undemocratic.

--
Tºm Shermªn - 42.435731,-83.985007
I am a vehicular cyclist.

On 12/1/2010 8:33 PM, Tim McNamara wrote:
Obamacare (much mis-named since as far as I can tell he had almost
nothing to do with shaping the actual legislation (as in providing
little or no leadership) is weak reform that is little more than a
giveaway to the insurance industry in return for too little benefit.
The public knew it, too- when the public option was on the table about
65-70% of the population supported health care reform; when the public
option was taken off the table, public support was taken off the table
too. Tone deaf, the Democrats plunged ahead- leading the charge without
checking to see if anyone was behind them.

I disagree on the Democrats being tone deaf - the Democrats were
supporting their real base, that base being large donation campaign
contributors and lobbyists.

--
Tºm Shermªn - 42.435731,-83.985007
I am a vehicular cyclist.

In article ,
Simon Lewis wrote:

"(PeteCresswell)" writes:

Per Tim McNamara:
I have to deal with a half dozen EMR systems in my consulting
practice. They range from bad to execrable. A pen and a piece of
paper- or a typewriter- remains faster, simpler, easier and more
reliable than any computer system. I spend twice as much time on
documentation now as I did 10 years ago, with the advent of
computerization.

The physician that helped me out over last weekend took the
opportunity to cry on my shoulder a little too. His estimate is
that coping with electronic records has increased one portion of
his workday from one hour to over four hours - and he gave me
examples that made perfect sense.

And for each of these there are 1000x examples where people have
their systems running well. Cross referencing, at a press record
retrieval, readable, cross referenced, easy to print/email etc.

Paper charts are easier to read and faster to find information. They
don;t need to be printed, as they already are (the downside being
handwriting, which can be a significant downside). As for e-mailing of
identifiable patient data, that is in violation of current law unless
done with encryption; thus far none of the systems I deal with have
encrypted e-mail (the funny thing is that unencrypted e-mail is more
secure than snail mail and fax machines).

There will always be incompetents.

If you're referring to the people who write EMS software, I have to
agree. They are routinely badly organized, counterintuitive, have
cluttered interfaces complicated by the various stupidities of the
Windows platform on which most of these run. Of the half-dozen I've
dealt with, one (Matrix) is halfway decent, one (PointClick) is just
mediocre and the rest range from execrable to horrific. My experience
and observation is that (at least in most of the settings where I work)
EMRs have reduced productivity by 25%. Used to be that I had to look
for the nurses because they were off doing patient care; now I just look
for the computers and the nurse is sure to be sitting in front of it.

--
Gotta make it somehow on the dreams you still believe.

On 12/1/2010 9:29 PM, DirtRoadie wrote:
On Dec 1, 7:19 pm, Tºm Shermªn™ °_°""twshermanREMOVE\"@THI
$southslope.net" wrote:
On 12/1/2010 11:04 AM, Phil W Lee wrote:





Radey considered Wed, 01 Dec 2010
02:53:42 -0500 the perfect time to write:

Tim writes:

In ,
Radey wrote:

Did the plumber give you an estimate?

Yes.

What would you have done if his bill were ten, or a hundred times the
estimate?

Turned him down and learned to do it myself. It's plumbing, not rocket
science. Whether I could learn to do it cheaper than paying him is an
open question; I generally find it more cost-effective to pay someone
with expertise to do something rather than learning to do it myself
(unless, of course, it's something I want to learn to do for its own
sake).

The premise of the question was that the plumbing was done, but the bill
was many times the estimate. I would think your options would be to pay
the bill (and maybe learn plumbing for next time), negotiate, take the
plumber to court ...

I'm not sure about your legal system there, but over here I'd pay him
the sum agreed on the estimate, and invite him to take me to court if
he thought he could increase it.
If he then tried, I'd produce the original estimate as proof of the
agreed price, and invite him to pay for my costs in defending the
claim, along with his own in bringing it.

That is how it would work here also.

I assume you expertise comes from your having been sued a BUNCH or
from trying to collect on unjustified billings.

DR

I would assume "DirtRoadie" is full of excrement, and I would be correct.

--
Tºm Shermªn - 42.435731,-83.985007
I am a vehicular cyclist.

In article ,
"(PeteCresswell)" wrote:

I guess this means that Steve Jobs' job is safe,

Steve isn't selling EMRs. Maybe he should- the iDoc with integrated
wireless connectivity between servers, laptops and iPod Touches.

but I cannot imagine anything that could equal the ease and speed of
the physician's just spreading and eyeballing the paper - except for
having the aforementioned hourly employee print out the relevant
material and put it in a folder as before.

What happens at most of the places I consult is that someone prints out
the records for me, because all the computers are in use by their
employees and for me to access the computer means that someone else
can't get their job done for that time. I then type the relevant
information into my report on my laptop, use the back side of their
printouts for taking notes during my interviews and consultations, type
that information into the report, print it to give to them to be filed
and shred the stuff they gave me unless there is specific reason to keep
it.

EMRs are generally not designed to accommodate outside consultants,
unfortunately. And, even if they were, the law requires me to have a
copy in my files at my clinic as well as a copy in the chart at the
medical facility... so I'd still have to print.

--
Gotta make it somehow on the dreams you still believe.

On Dec 1, 4:58*pm, Tim McNamara wrote:
In article
,
*Tom Ace wrote:









On Nov 30, 7:00 pm, Tim McNamara wrote:

Did you have to pay premiums to a plumbing insurance company for
several years in order to get a reasonable rate?

Another goofy question. But it does demonstrate my point nicely,
which is that somehow we expect health care to operate as a
different sort of economy than other business sectors.

Tha's not a goofy question at all. *It goes to the heart of one of
the suckier aspects of health care in the USA.

And it doesn't illustrate anything about wanting health care to be
different. *If anything, it's about asking why it is an exception. *
Pharmacies charge more money for the same prescription from an
uninsured customer than they do from someone with insurance. *Same
product, and in the case of the uninsured guy the transaction is
simpler (cash and carry). *This is not like most other businesses.

The people who pumped my septic tank were more professional and
ethical than many of the businesses I've dealt with for medical
needs.

Here again you are talking about health care finance rather than health
care.

Huh? I responded in a thread where, a few postings ago
(see above), you'd said your point was about the "economy"
of health care.

Pharmaceutical companies charge X for their products (say, $170 for an
Advair Diskus inhaler product which lasts a month). *That's the price. *
Insurance companies get to negotiate a discount* because they are in
effect making a large volume purchase. *It's like Trek ordering 10,000
bottom brackets from Shimano- they get a better price than my LBS who
orders 5 bottom brackets. *Indeed, just like component manufacturers
compete for Trek's business, pharmaceutical makers compete to be on the
formularies of insurance companies.

Yeah I know. Screw the references to other industries;
this is medicine, not bike parts. You tell me if you think
it's a decent state of affairs that uninsured customers are
charged more for prescriptions.

Tom Ace

On Dec 1, 4:03 pm, Frank Krygowski wrote:
On Dec 1, 8:50 am, Peter Cole wrote:



On 11/30/2010 10:31 PM, Frank Krygowski wrote:

On Nov 30, 10:02 pm, wrote:
On Dec 1, 1:21 pm, T m Sherm n _ ""twshermanREMOVE\"@THI

$southslope.net" wrote:
On 11/30/2010 3:24 PM, James Steward wrote:
[...]

Anyone riding on the road with motor traffic is in constant mortal
danger.[...]

Anyone alive is in constant mortal danger.

I thought I mentioned that already.

Then James, try mentioning it more often regarding other activities,
would you?

I don't know if you can get Time magazine in Australia. But the
December 4, 2006 American issue has, on page 68, an excellent graphic
and table discussing mortal dangers, i.e. causes of death in the US.
Maybe they did one for Australia, as well?

US deaths for 2003 are shown as a great 3 dimensional pyramid, divided
into horizontal slices by causes of death. The largest volume slice,
at the pyramid bottom, is heart disease. 685,089 of those. The slice
for "other diseases" not otherwise mentioned has 681,150. For cancer,
556,902. For stroke, 157,689. Certain respiratory diseases,
126,382. Diabetes, 74,219.

_All_ accidents combined cause only 4% of US fatalities, or 109,277.
Of those, the biggest sub-category by far is motor vehicle accidents,
_not_ including bike deaths, at 44,757.

Working our way down, we eventually get to choking on food (875) and
falling out of bed (594). In between that are biking deaths, at 762.

762 out of 2.5 million annual deaths. 762 out of 109,277 annual
accidental deaths. Somewhere between falling out of bed and choking
on food. And you're afraid of dying while bicycling??

For someone who's critical of other's statistical thinking, that one is
a whopper.

Since it didn't make bicycling sound horribly dangerous, I knew there
would be objections. Some people simply can't stand the idea that
riding a bike is beneficial, not detrimental.


Who?

As far as I know, virtually 100% of people get out of bed at least once
a day, and eat many times more frequently than that -- compared to how
often they ride a bicycle?

There are many ways of talking about danger. "Safety!" fanatics often
talk about cost to society...

I'm mostly concerned with my own noggin.

snip


Also, given that we all must die of something, strokes, heart disease
and cancers are frequently diseases of old age, it's very misleading to
compare accidental death with inevitable death.

Except that the prime medical causes of death - i.e. heart disease,
cancer, strokes and pulmonary diseases - are all made significantly
less likely by regular, moderate exercise. You know, exercise like
riding a bike as part of your normal transportation, instead of riding
in a car. It would take very little cycling to reduce the 1.5 million
annual deaths due to those causes.

Yet you want the dangers, not the benefits, of cycling to be
emphasized. Why? Is the idea to NOT improve the 1.5 million deaths,
but instead to scare down cycling so as to slightly reduce the 762
bike deaths?


Uh-oh - he's on to us :-)

If you want to reduce the 762 bike deaths, enforce headlights at
night. Enforce riding on the correct side of the road. Keep cyclists
out of door zones. Educate drivers about our right to ALL roads, and
punish drivers who screw up. Don't yell that biking is terribly
dangerous.

Ok.

That's counterproductive.


"Kind of depends on the circumstances, Ed" ;-)



Again, maybe things really are different in Australia - but then,
there's yet more data that I found. The Australian Transport Safety
Bureau discussion paper, "Cross Modal Safety
Comparisons" (unfortunately, undated) claims 4.24 bicycling fatalities
per 100 million kilometers. Oh, and for pedestrians? 16.12
pedestrian fatalities per 100 million kilometers - nearly four times
as high. Once again, cycling is safer per km (or per mile) than
walking down the street.

For those used to thinking in miles, that's 14.6 million miles ridden
per bike fatality.

Maybe things are really different in your personal town. Or maybe
_all_ Australia's bike deaths occur in your own neighborhood.

But if those remote possibilities are not true, you are certainly
overstating cycling's dangers. Give it a rest. You're not doing us
any good.

That number is 7x higher than the US auto rate.

Check the US auto rate for driving on country roads. IOW, omit the
freeway miles (since bicycles can't access the much safer freeways in
most areas). You'll find they are much closer.


I can access freeways easier than cars can access sidewalks. It's
even legal here. I never have availed myslef of the "much safer"
freeways, though ;-)

Speaking of those freeways: Do you think they're acceptably safe?

Many people consider the
latter to be unacceptably high, and billions are spent to lower it. Just
more silliness, I suppose.

I approve of lowering the auto death toll. I suggest doing that by
lowering non-freeway speed limits, and by getting people to drive
less. I suggest doing the latter by educating them that cycling IS
acceptably safe...


If it weren't acceptably safe, we wouldn't be doing it, would we. I
will not sugar coat it, though.

... right now, and even safer if done properly.

.... according to Krygowski ;-)

On Dec 1, 6:21 pm, Tim McNamara wrote:
In article ,



"(PeteCresswell)" wrote:
How long do you think a plumbing company would last if it
systematically charged five or ten times the normal rate to those
too poor to pay?

And you think that health care providers do this? Let me discuss
the reality of billing practices....

Try comparing the amounts that one's insurance actually pays for a
given service to the amounts that some poor schlemiel has to pay if
they don't have insurance.

For me, it's a 20%+ diff just for an office visit to a GP.

For a visit back on 8/25, the GP wanted $90. Insurance paid
$71.28... ((90-71)/90) * 100 = 20%+

For a certain recent test, the medical corp performing it tendered
$4,810.00.

Insurance company paid them a grand total of $280.18 - completely
satisfying their claim - as opposed to abovementioned poor schlemiel,
who would be on the hook for $4,180.

((4,180-280)/280)*100 = 1,390%+. If my 2nd-grade arithmetic is
correct (not a "given", by any means....) that's a beeeeeeg
percent....

Sure, two profit-making enterprises have a perfect right to negotiate
terms between themselves - but the bottom line is...

All of which is part of why I believe in a universal public health care
finance for all Americans.


+1

On Dec 1, 9:08*pm, Tom Ace wrote:

Yeah I know. *Screw the references to other industries;
this is medicine, not bike parts. *You tell me if you think
it's a decent state of affairs that uninsured customers are
charged more for prescriptions.

One reason why an analogy to bike parts is not apt:
if Shimano sold parts much cheaper in Mexico,
a gray (but legal) market of parallel imports
would result. Not so with pharmaceuticals.

Tom Ace

"Duane Hebert" wrote in message
...

"Tºm Shermªn™ °_°" " wrote in
message ...
[...]
If you kill-file a person, you have forfeited your privilege to comment
on them.

Oddly enough I agree with that.

There is nothing odd about it. It is simply fair play. I once had an asshole
by the name of Cletus Lee from Texas on ARBR who had kill-filed me but
continued to wage war on me. All he was ever reading was what others had
included of my message in their posts. Is that fair?

If you are going to comment on a person, then you have to read all of his
posts in full, at least in that particular thread. Not to do so marks you as
a scoundrel and a cad.

Regards,

Ed Dolan the Great - Minnesota
aka
Saint Edward the Great - Order of the Perpetual Sorrows - Minnesota