Health care: "I guess that's right..."

Health care today operates with QA (quality assurance) equivalent to that of American and Japanese manufacturing in the 1950's, before formal QA techniques and analysis were introduced.

Yes, our system is incredibly improved over the past 60 years, it is now better.

'Better' is not necessarily even 'poor.' (If I cut smoking from 2 packs a day to 1 ½ packs per day, I am now 'better' but the prognosis is still 'bad.')

As a systems analyst and a patient, reviewing my personal experiences with the health care industry I find myself appalled at the level of QA which the industry finds acceptable.

No major manufacturer could stay in business with QA at this level.

Policy is irrelevant if not followed and properly executed, and there appears to be little effective QA information gathering, verification or analysis.

I realize that my experience isn’t scientific evidence, but as it covers 35 years and several clinics & hospitals located around the country, I do believe it is indicative (if only because only a single error elicited any real response from the physician who discovered it.)

I’m not a Dr. (though I was an EMT for a time,) I’m an analyst. For two decades my work has been to examine operations of companies and locate extraneous, faulty, duplicative, obsolete and other costly interruptions of the work which exist in the work flow. I then make recommendations based upon my findings. My intent is always the same: reduce error, reduce cost, increase safety, increase processing speed, and generally improve the overall efficiency, effectiveness and profitability of the entire organization.

In my experience with health care I have had; diagnostics performed multiple times when even I as a layman knew that previous procedures would render the results useless, improper IV treatment, deadly medications prescribed, unnecessary surgery, symptoms ignored, expected organ failure go unnoticed, over-prescription of drugs, been consulted on my treatment by a Dr. while I was under the influence of narcotics he had just prescribed, instructions given w/o followup and other systems failures. I’ve been given complex instructions w/o verification that I truly understood them--with no followup.

I’ve been asked questions which weren’t properly designed to elicit necessary information, given vaguely worded information, been mis-heard, misunderstood and had these errors entered into my record.

Thankfully, none of these killed me, but I have lost years of my life to some of these simple errors--of which no action or recognition of the error seemed to be taken where other than to revise treatment.

The single, simplest, cheapest option to improve health care is to bring QA out of the dark ages and provide a system with transparency, system failure identification and correction, and solid metrics by which success can be determined.

I know that there are problems, I know the type of problems I've personally encountered in my limited contact with various parts of the system.

Obviously, I have had contact with only the tiniest bit of the system, but the number of errors convinces me that my case is not unique.

A full-scale analysis will reveal numerous places in which the system fails both the patient and the caregivers at unthinkable expense. Many of these will be easy and inexpensive to repair.

Perhaps the industry is awaiting a huge class-action suit charging thousands of facilities and individuals with incompetency. Win or lose, such a suit would waste billions which could be used not only to repair the system faults, but provide better facilities and infinitely better levels of care.

The Closing Cage?

The phone tapping problem is indeed global:

http://eolake.blogspot.com/2011/11/secret-software-on-millions-of-phones.html

Besides the security concerns for your own property and information this offers another, considerably more disturbing possibility.

What's more disturbing than having your identity and everything you own stolen?

News media are at best, unreliable, at worst, fabrications and fantasies.

The only reliable news from many places comes in tweets, sms/txt & such.

If you can intercept those, you can rewrite or block them:

"There's rioting in the streets, and the police

have opened up with automatic weapons fire on the crowd."

Sent from China, or Malaysia or London, anywhere--

Becomes:

"Hey! Having a great time. Getting ploshed & laid. Glad you're not here. :)"

Combine this with an unstable global economy, potable water shortages tottering governments, rapidly changing weather patterns (10-20xfaster than is being reported,) whatever the current threats of the day happen to be--the knowledge about them can be contained, if not forever, for several days.

Most, if not all governments (and probably corporations) monitor internet and phone traffic already. With only a slight change in programming, this traffic can be edited or blocked almost in real-time and that includes revising voice messages.

That leaves radio amateurs (who are registered to their governments,) and travelers for news sources--news then travels at the speed of transport. All vehicular traffic, air, ground & water is monitored at the boarders—and elsewhere in most places those traffic and stoplight cameras everywhere. If the government where you are, shuts down travel, anything moving becomes a readily seen target--day or night.

Combine this with remote or automated piloted armed drone aircraft (their abilities only limited by their programmers abilities and the powers-that-be desires.)

If it moves. Kill it.

That this can be done should scare the pants off everyone who's not the powers-that-be. That it hasn't happened isn't any real comfort.

The only thing makin the 1984 style tyranny impossible in the past was that you eventually end up having everyone watch everyone else, nothing gets done--and people are unreliable. In the US we have successfully trained the children for the past 30 years to report suspicious activities (mom & dad = terrorist/drug dealer|user?)

Wireless phone dependence is nearly universal in many countries--the only communications in some--in the developed countries nearly every child who can dial a phone--which means: push a button—has a phone. One button with speed dial (how often do you get butt calls? If people can dial their phone with their butt, which has no intelligence, it's reasonable to assume that most humans from about age 3 on up can do so.

The most successful tyrannies are, like the best cons, those in which the victims beg for it. It's how Hitler and Peron did it, and it's how the USA has effectively lost all rights for individuals. For those elsewhere, the USA's vowed to go anywhere to fight the "War on Terror" and the "War on Drugs"--which even the US government admits have only made the problems worse.

Even before the current threat in the Senate was written--as far back as 2001, it has been possible for the US government to 'legally' abduct and--whatever--anyone they decide is a 'terrorist.' And few governments have ever bothered to get permission to abduct whoever they're after, wherever they are, in a covert operation.

It's really only about 1% of the population that is an active threat capable of leading others and seriously thinking about situations.

Most governments already track such people--they tend to be visible.

Most governments in the developed world could 'disappear' the majority of these people overnight.

In the morning, a few journalists, teachers, lawyers and other professionals aren't to be seen at work--and no one knows anything about it.

Krystallnacht was, by comparison, a larger operation, more difficult to coordinate.

I'll admit, that this sounds like the ravings of mad-man--until you verify and examine what technology and laws are in place. Am I crazy? Is this just in my head? I certainly hope I am just crazy.

If you control information, laws become irrelevant.

People are conditioned to believe that 'conspiracy theories' are all just wackos. Part of this is that if the government explanation is conspiracy, they never call it that...it's aways “ organization” responsible.

A conspiracy exists any time a group plans an illegal act. Whether they call themselves "Al Qaeda," the Senate, or have no name at all, they exist. And most world-shaking human events have involved one or more conspiracies: From the murder of Caesar, to the founding of governments of the USA, France, Argentina, Egypt, Germany and many more, conspirators have succeeded and changed the world.

History is written by the winners.

Every monarchy in Europe has it's origination in a few men grabbing control of a group. Legitimacy is made up afterwards.

Sitting Duck with Broken Wing

Health Care: The One Required Change

There is one change to America’s Health Care system which is required in order to actually improve the care and reduce costs.

It’s the change that HMO’s were supposed to make, but failed.

Currently, healthcare workers and companies from insurors to orderlies are paid based upon the number of treatments.

Insurers make a percentage of the insurance premiums--so the higher the premium, the more the insurance company makes.

Hospitals and clinics are paid based upon the number and kind of treatments given. And Healthcare workers are paid either by the hour or by the year or by the treatment.

Currently, nobody in the system except the patient has any real incentive to actually keep peo[le healthy--financially it is best for them if the patients stay ill enough to require services, but not so ill that they die.

We need to design the system to give those involved a financial advantage for a healthier people.

While complicated in detail (what multi-trillion-dollar industry isn’t complex?) the concept itself is quite simple:

First, insurance premiums are only paid when you are healthy--illness/injury stops the premium payments.

This provides the insurance industry an incentive to make certain that treatments are effective AND cost-effective.

As it is considerably cheaper to keep people healthy than it is to attempt to repair them when they are sick or injured, maintaining premiums at a stable rate causes the insurance companies to make higher profits from healthy policy holders on the same premiums.

Providers could concentrate on getting, keeping and training the best possible workers if their income depended upon the cure rate rather than the treatment rate (again, there are lots of details.)

Like a well run modern manufacturing plant, you would be able to tell by looking at how busy people were treating patients to determine how well things are going--the nost profitable days are those where the staff spends their time learning and teaching instead of treating.

Fewer patients would permit us to eliminate some of the least safe practices of our system: workers would no longer be over-worked and short of sleep--both of which are major contributors to the accident rate in treatment..

My original impetus for this came from wondering why insurance companies woudn’t cover drugs and treatment to help people stop smoking--but instead seem to prefer treating lung cancer and other diseases which often result from smoking.  It doesn’t take genius to realize that paying $100 to help someone quit is cheaper than spending 10’s of thousands to attempt to repair them after they have a disease!

But if cancer rates drop, the amount spent on treating it drops and everyone in the system loses money--including insurance companies who base their premiums upon actuarial statistics and compete on having the lowest premium or ‘best’ coverage.

Currently, it is far more profitable for a patient to come frequently to the provider for expensive (profitable) treatments which never actually cure them!

Without this change, no change to the system will result in improved health care at lower costs.

The healthcare industry, like defense contractors on “cost plus” contracts, have far more incentive to raise costs than to lower costs.

Charles Barnard

Water Alert! The North American Water War Begins

Waukesha, Wisconsin has fired the first shot in the water war in the Great Lakes.

They have filed a request to divert water from the Lake Michigan watershed.

I won't bother to argue their reasons--they're irrelevant to the actual problem.

If this request is permitted, it will set a precedent which we will regret.

The Great Lakes are one of if not the largest masses of fresh water on the planet.

There is an international agreement between Canada and the US prohibiting the movement of water outside the Great Lakes Watershed.  This request will either violate the treaty, and/or set a precedent for permitting the export of Great Lakes water.

Waukesha won't take much--but the precedent will permit places like Los Angeles, Phoenix & many others to put in their requests.

The treat exists for good reasons, and so far, there have been no life/death issues raised to justify the request--and it probably shouldn't be honored anyway.

As is, many people living in the desert SW already believe that when they run through their own water, they can simply take the Great Lakes.

This request, if honored, opens the door legally for the government to remove what is likely to be the next extremely scarce resource on the planet--taking it 'elsewhere.'

This water and the ecosystems in and around it, are vital to the entire continent merely in their influence on weather. But removing water will eventually destroy the current situation and create a new, scarce water ecology. Incidentally putting the people who live around the lakes in a position similar to that which the SW put itself into by overpopulation and poor water management.

There are thousands of ways in which Waukesha's request is different in character and result from what will happen when we pipe it to SoCal. none of which matter, for it is not their needs or use which is the problem, it is the potential problem that it creates in easing the ability of others to steal this resource.

Like the little Dutch Boy with his finger in the dike, the drain may be unnoticeable at first, but will extend inevitably until the Lakes run dry.

Please note my NEW blog!

my new blog xrystlbali is a bit more focused than this one...check it out!

On Games

Life's a game.
Life's not a game.

Let's begin where most discussions ought, and define what a game is.

Dictionary says:

...oh my! Long, confusing and in places contradictory!

That simply won't do. It's amazing that people even think that they communicate.

Games have rules.
Often the rules themselves have rules, including rules about how to create new rules.

Games can be played simultaneously--rules between simultaneous games can conflict or reinforce each other.

Hmmmm. It looks really messy from here.

As I sit, the children in my neighborhood, who range from 5-15, are playing across the street.

One of them just said, "Let's have a rule like...."

Some rules are assumed, unspoken--and some of those may be secret until someone initiates you into the local game by popping one of these rules on you--and it is often permitted to attempt to foist a 'new' rule upon a noob.

It appears that whatever humans do, they are likely to turn into a game or a competition. "Just to make things interesting."


The question becomes not: "Is life a game?" But; "Which rules and games will I play?"


Without humans, the rules of the game become the rules of physics as translated into matter/energy interfaces. Humans can choose, and in choosing change the universe.

Rules are limits which we set upon ourselves. Nature doesn't care.

Except that the fact that many lifeforms appear to create games. From cat's playing predator-prey to tigers sliding down hillsides in the snow to dogs chasing each other, games exist or are created. Often, they are quite obvious practice for 'grown-up' existence, but many appear to satisfy some itch deep down.

Beneath it all like the real world--a game for high stakes in which luck has a large role.

This just in....

I have a question….

Nagasaki 1945, after the atomic bomb

Nagasaki 2011, after the Tsunami.

What the (&^$ is that arch made of? And why didn't we build the World Trades Center out of THAT!!