The One Change Required to Repair Health Care in the USA.

There is one change to America’s Healthcare 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 most 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 wouldn’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.

Holiday Driving Tip

Everyone knows that they shouldn't drive after drinking (or while drinking,) but how often do you drive when you're sick?

Over half of my moving violations occurred when I was sick or heavily medicated--yet not once has an officer asked me if I was feeling o.k. or if I were ill.

Anything that affects your ability to move or to think properly is a sign that you should either cancel your trip or turn the driving over to someone else.

This includes: prescription and other drugs, alcohol, nausea, severe headaches or other pain, lack of sleep--anything which affects your ability to move or think clearly.

If you are under the influence of any of these--get a second opinion from someone who's not under influence...and if they say you're not in condition, it's best to avoid the driving.

Do NOT trust your own opinion! Anything which affects you enough to make you an unsafe  driver probably affects your opinions adversely too.

If you drive while affected, you may take a life, and you will never be able to forget that. Dying is easy, living with having killed an innocent person is much, much harder.

Ask yourself: "Is this trip important enough to kill?"

The Enslavement of a People

What structural changes in society led American from a wealthy nation to a nation in debt?

The main change consists of the banking industry convincing people that a mortgaged home was the same as 'owning their own home.' I believe that the so-calle American Dream of home ownership was also a put-up job. After this, they were convinced that they owned consumer items when paid for with debt. Of course, in most cases all of these consumables (even houses are consumables and not really assets) have a cash value which is only 20% or less of the debt created to purchase them--so if you cannot pay, you end up losing 'your' things AND still in debt.

These changes ensure that your support group (ultimately family/clan) consists of as few people as possible--the less support you have and the more debt you carry, the tighter you are tied to your job, regardless of pay rate. In a quick calc, a 3 generation family with 2 elders 2 couples and 4 children would own their house as an  extended family, free and clear, saves on all routine expenditures, requires fewer vehicles and will likely raise more balanced children and more durable relationships while having surplus income to invest. They can also survive on one working adult's income rather than at least 3 if they occupied 4 separate dwellings. Effectively, 1-3 adults can be working and having their entire take-home pay invested.

Along with this housing scam, the offered abilities to mortgage the farm led inevitably to huge corporate farms and families dependent upon them for food...no one can afford to stay home and watch kids and garden with everyone mortgaged and in debt for everything from cars to baby toys.

In a great many places in the US the 'neighborhood agreements' specify that vegetable gardens are either confined or banned--while mowed grass is required for at least the front yard--taking productive land out of production and making it an expense instead if an asset.

Today we're reaching the end, and end in which the vast majority own nothing, including a place to stand, air to breath and water to drink while the bankers hold all the real property, the rest are left with worthless paper or nothing at all except debts.

If I need $2,000 every month to pay my mortgage and debts, I am far less likely to tell my boss to shove it when turned down for a deserved raise.

The "War on Drugs" as it is played, is primarily a way to keep people in their current job--most people are tested only when hired, not while they are employed...you have to "get clean" to find a new job. At the same time, debt levels make survival "in the manner to which TV has accustomed us" impossible on a single income--adding stress, which is one of the main reasons people use any recreational drug.

Over the past 2 decades the US tax law has made being self-employed harder and harder, requiring more paperwork and fees at the same time eliminating things like averaged income for tax purposes (any creative independent has a very lumpy cash-flow...as do most other small businesses. Few businesses generate steady income streams--with the exception of lending money.

Effectively, money today is created out of thin air only when debt is created. It's backed by the faith that it can actually be used to purchase things, but the fact is that today the average American HAS NO MONEY only debt, and that debt exceeds the value of the assets that it is backed by...effective slavery.

With a negative savings rate, every penny an American spends is borrowed money worth more for debt payment than for the purchased items.

The kids I know roaming the world living off the land and the dumpsters with nothing in their pockets except maybe a couple of dollars, have more money than most people living in $500,000 homes.

One of the major disadvantages of nuclear families is that the generational wisdom is unavailable--when you have 3 generations, at least one has lived through a recession and knows in their gut that it happens. It is around the dinner table that people learn about (or fail to learn about) money. Since the nuclear family dates back to the mid-40's, we have 3 generations raised with the idea that debt is normal and desirable. Prior to that, people avoided debt like plague, properly understanding that unless the borrowed money was going to generate MORE in income than it cost, it was evil.

The high divorce rate and bankruptcy rates devolve from the idea that you own something paid for with borrowed money and the nuclear family.

Humans are social animals which thrive in groups which help each other. Individual humans are weak and helpless.

Divide, conquer and own everything produced has worked quite well, while the slaves feel that they are 'free' because the chains are intangible.

The development of Kindergarten from the failures of the Germany mercenary efforts of the 1800's--created precisely to indoctrinate the population into following orders--when adopted in America was also used to provide purchasing demand. Lack of school uniforms is one of the mechanisms used, since this allows everyone to compare their 'stuff' to everyone else--encouraging class distinction and decreasing egalitarianism. Some inevitably become 'more equal' than others.

At the same time, while not as strongly as uniformed schools, early education in age cohorts promotes "me to"edness and group identification. In our current society, children are separated into cohorts in infancy and kept with their cohort until they become nearly fully-developed humans. They learn little or nothing from other age groups, develop a much smaller age spread of friends and in general are isolated from most of their society.

Today, I'd estimate that the 'average American' works 3 month for necessities, 3 months of the year for the government (about the same percentage as always) and the other 6 to pay the banks, ending each year just a bit further in debt.

Privacy? Is it possible?

Ubiquitous cameras and global communications combined with ultra-fast computers will shortly be able to pull up everything you've said or done that wasn't hidden perfectly.

Most public space in the civilized world has not only stationary cameras but thousands of phone cameras. Hidden cameras with battery and recorder for video hidden in a cigarette lighter can be purchased from China by anyone with enoughh money to eat a meal at a fast-food restaurant--not top-of-the-line ultra-miniature stuff by any means--consider that this is consumer equipment and you know that gov'ts have equipment at least 3 orders of magnitude smaller 40mm > 0,4mm length.

What stopped Big Brother 60 years ago was the need to have humans to monitor each other--which leads to an unafordable cost.

Cheap computing makes it possible to handle, evaluate, store all data and send only the things that evaluated as 'of interest.'

Privacy is nearly impossible outside your own head.

The big question boils down to: Do we turn access to all of this off to some centralized authority(ies)? Or do we allow everyone access to it all.

The biggest problems with privacy come not with individual rights, but with the ability of some to know all and keep others ignorant--tyranny is the usual result of secrecy (privacy.)

We have literally millions of laws on this planet, most of which are ignored or written to be circumvented. This happens away from the public eye. Open the public eye and society will be forced to determine which rules are important and enforceable and which are not.

The risk is in allowing those in control to continue to hide their activities is far greater than the risk that those in power will use that power to cement their own power.

Note that a society in which everyone agrees not to perform certain acts never creates laws against them. Such laws only arise in places where those acts do occur, and which some power block finds unacceptable.

Honest men seldom brag about their honesty--it never occurs to them that others aren't like themselves.

Dishonesty becomes profitable only when being detected has only a local effect which can be negated by changing location.

If you live in a small village, everyone knows who is trustworthy and to what degree--get out of line too far and people will refuse to deal with you. Within a huge population base, the news won't get to everyone (though the Net is changing that.) Since only a minuscule percentage of any huge population need be cheated (or a huge population cheated to a tiny degree each,) in order to thrive, criminal operators don't need to worry about reputation.

Robbing only one small bank of everything will support you for many years--and can be done in minutes via Net (though as with most large operations, preparation may take considerably longer.)

While the only observations over much of the planet are space-based and interested in only a tiny subset of activity, nothing precludes their use for other purposes...you can find private spaces. but guaranteeing that they are private is much, much harder. In cities, where the bulk of the population with the ability to effect major changes live, it is much, much harder to even find a place--and with the eyes watching, and recording, it is not difficult to find out where you are meeting after the fact. With current equipment "persons of interest" can be tracked and recorded quite easily unless stringent measures are taken.

The other aspect is timeliness. There are many places where advance notice of even a minute or less can make millions.

Information often has an associated time frame in which it has value--and may have no value or even reverse value after that time.

Why Perry isn't a threat.

(I had said that it is far too early to worry about Perry because he's a strawman who will be dropped from the race. The response was that Perry is deadly serious about winning.)


     I have no doubt that Perry's plan is to win.

In American politics, what the candidate wants is mostly irrelevant. It's no secret that the major political parties are not controlled by their members, but that their members are controlled by the party leadership--who are, in turn, controlled by private interests.


While it is in their interests to control everything they can, the current system allows them to have control while seeming to be controlled by the people. The people are largely controlled by what they hear and see, nearly all of which comes through conservative-owned 'liberal' media channels.

People do not vote on logic, they vote (and make most other decisions,) based upon their emotions. The advantage of the appeal to the religious conservatives (despite a long record of failing to even attempt to deliver on campaign promises,) is that "God & Country" are extreme buttons for most, if you can convince them emotionally that they are going to "save the Nation and return to Godliness," your actual agenda and actions go unnoticed.

Appeals to sanity and thoughtful deliberation are boring.

This is is why wrapping yourself in the flag and pointing to the sky and screaming keeps people from asking or noticing what you are actually doing. It's good enough that it has often been used to convince people to vote against their own best interests (most notably GE's Nazi party leader Hitler being handed full control of Germany at the insistence of the people.)

Any conman knows that the best con is one in which the victim begs you to take their money.

Slavery works far better when it doesn't look like slavery (though the old-fashioned methods still see wide-spread use here and around the world.

Last I looked, 16% of Americans are either agnostic or atheists--who tend to vote independently. Independent votes are usually the single factor in winning an election. There are smaller numbers of non-Christian religions, but together they add up to a substantial voting block.

If he were to win, well, the best way to eliminate unjust and illegal 'laws' is through tough enforcement. We're way overdue for a revolution anyway.

Voting for the least evil candidates is a guarantee that your gov't will be controlled by evil...we've gotten darn good at it.

The majority have little confidence in their elected representatives and the gov 't in any case, and America has a deeply ingrained streak of anarchy which tends to rise to the top at any sign of tyrannical government (although hiding behind elections has worked far too well.)

Could Perry get elected? Yes--Bush managed it and the new voting system is easier to manipulate than the old.

In my analysis it is extremely unlikely that he will receive any substantial support after next Spring--probably throwing his crazed backers to one of the more 'moderate' GOP candidates.

Elections are a big show put on to distract the people and convince them that they are in control. That way they tend to accept whatever garbage is shoved at them.

The same people rule the world today as throughout history--the most ruthless and amoral, those willing to do anything to be on top. The problem facing them is that the easiest way to raise yourself up when standing on the backs of the people is to raise the people up too.

Conflict between nations has been largely a matter of the business of war rather than ideology for a very long time. Corporate America made huge profits on every war last century--regardless of the outcome. Our heavy debt load is almost entirely money borrowed by the gov't to pay the corporations for war materials (nearly always with a substantial guaranteed profit.)

Of course, things change, and no one has enough information to make a truly accurate prediction--I've been wrong before and certainly will be again in the future.

Our world economic system is falling apart because people have lost faith in the fiat currency. The actual physical resources are being held by the controlling interests. You will note that China has purchased a tremendous pile of hard resources (ore bodies, oil rights, land,) using fiat money. So have global corporations.

The old evils are still with us: disease (which often could be controlled, but isn't;) military war (which gathers resources from general population and distributes them to a few corporations--true war has been economic for many decades if not centuries;) famine (created despite adequate foodstuffs--though that is likely to change in the near future;) slavery (in many different forms.)

This all sounds like a conspiracy, and we've been taught that; conspiracies are only true when the gov't puts them forth, that conspiracys require unattainable secrecy, and that they are very rare.

But conspiracies are common. They can be tacit, rather than direct. Members can be large groups which do not know or even suspect that they are part of a conspiracy. Conspiracy takes many forms from direct control of pricing (2006 DOW chemical announced that "In order to control rising prices of titanium oxide, DOW is raising prices in Asia." Note that this announcement followed by about 1 year, the announcement of an improved process to refine titanium which is expected to reduce costs 90%. Titanium oxide is one of the more abundant materials in the Earth's upper crust--only the expense of refining has prevented titanium metal from wider use in our society.

This of course, follows the proven technique of A. Hitler and many others of 'hiding' a conspiracy by announcing the entire plan publicly.

More bad news...

NASA Research Leads to First Complete Map of Antarctic Ice Flows

First complete map of the speed and direction of ice flow in Antarctica, derived from radar interferometric data from the Japan Aerospace Exploration Agency's ALOS PALSAR, the European Space Agency's Envisat ASAR and ERS-1/2, and the Canadian Space Agency's RADARSAT-2 spacecraft. The color-coded satellite data are overlaid on a mosaic of Antarctica created with data from NASA's Moderate Resolution Imaging Spectroradiometer (MODIS) instrument on NASA's Terra spacecraft. Pixel spacing is 984 feet (300 meters). The thick black lines delineate major ice divides. Subglacial lakes in Antarctica's interior are also outlined in black. Thick black lines along the coast indicate ice sheet grounding lines.

"The map points out something fundamentally new: that ice moves by slipping along the ground it rests on," said Thomas Wagner, NASA's cryospheric program scientist in Washington. "That's critical knowledge for predicting future sea level rise. It means that if we lose ice at the coasts from the warming ocean, we open the tap to massive amounts of ice in the interior."

I asked about the bold text above and was told: "Wagner is referring to deformation, like a tank tread. In fact, the bed is considered frozen in most of Antarctica, so it is a bit surprising." Alan Buis JPL.


Water, it seems, is even stranger than I was taught with many more phases than I knew about until now.

The rest of it merely confirms what I've been saying for the past several years...that warming is a positive feedback process which accelerates each season.

The rates of movement of the ice shelves in Western Antarctica (magenta & blue) indicate that it will not be long before the ice on land is free to move and accelerate.

That ice will cause sea level rise--eventually around 5-10 meters.

There will also be a rebound of the currently depressed land, pushed down by the weight of the ice. How rapidly the land will rebound is unknown, but even a few cm per year will increase the sea level and the rate of ice flow in Eastern Antarctica--the largest block of ice on the planet.

http://www.jpl.nasa.gov/news/news.cfm?release=2011-256&cid=release_2011-256

The new data does not change my pessimistic estimate of 5-20m sea level rise by 2027. Nor does it alter the projection that the rise will be non-linear with acceleration (each year it will rise more than it did the year before.)

Note that the rate of visible rise may stay the same or even drop depending upon the slopes of the areas flooded. Steep coasts will show a greater increase than gentle slopes.


To see this effect, fill a glass of water 1/4 full. Note where the surface is on the glass. Now tip the glass over slowly and watch the level rise, stopping when the surface is 3/4 up the glass.


See how much less water it takes to flood a shallow slope. The trade-off is height for horizontal distance.


A rise of 1m at the Gibraltar cliffs will flood well inland on the Nile and other river deltas....

infomot

infomot (alt. infomote)

[in-faw-moht]

-noun

A generic term for units of information media, which would include text, [txt], video, still images, audio, odor, texture or other sensible unit of information embodied as a coherent unit.

There is no existing term in English which specifies a coherent unit of information regardless of format/media.

Examples: movie, pamphlet, commercial, book, txt, white paper, voice message, song

plural: infomots

From 'information' & [mote]

Synonym: datum

Antonym: null

Related words: data, datum, information

Examples:

I sent him a couple of infomots about the project, including the conceptual drawings and sales video.

The product requires the ability to handle many infomots ranging from viral videos to [tweets] and billboards in order to reach market.