Thursday, March 29, 2012

AT&T Lost It's Chance to Bury the Internet Future

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The system of communications that Baran attacked in the early 1960s at RAND was the imperial establishment of AT&T. As Baran explains, "While AT&T did have digital transmission under examination, it was in the context of fitting directly into the plant by replacing existing units on a one-for-one basis. A digital repeater unit would replace an analog loading coil. A digital multiplexer would replace an analog channel bankalways a one-for-one conceptual replacement, never a drastic change of basic architecture. I think that AT&T's views on digital networks were most honestly summarized by AT&T's Joern Ostermann after an exasperating session with me: 'First, it can't possibly work, and if it did, damned if we are going to allow the creation of a competitor to ourselves.'"

In 1972 the company sealed its fate by turning down an opportunity to buy the entire Arpanet. As Larry Roberts explained in Where Wizards Stay Up Late, "They finally concluded that the packet technology was incompatible with the AT&T network." So it was and so it still is. The existing phone system remains the chief obstacle to the final triumph of the Net. But the logic of digital communications is inexorable. It will displace all the existing establishments of television and telephony.  


read much much more at www.discovery.org/a/20

Wednesday, March 28, 2012

Your 1 Minute, 4 Year Degree in Social Sciences

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The root cause of society's ills is simple: "Make it as cheaply as you can (pollution controls be damned), paying as little as you can, importing illegals to do so, reducing taxes via lobbyists, and then let the society as a whole take care of the resulting mess, while you hoard the profits every which way, including stashing them offshore." 

This explains healthcare, budget deficits, prison problems, family discords, drugs, slums, etc. You've just had Keachie's 4 year degree in the Social Sciences distilled into one brief paragraph.

If employers paid more by hoarding less, all the boats would rise. Better home life with healthcare = better educated kids = less drug use = fewer unplanned pregnancies = happier families, = fewer folks in prisons = more productive GDP.  Republicans fail to understand the situation, and fail join in to solve it, and instead aggravate the situation even more,  with the laws and candidates they push. WHY???

Monday, March 26, 2012

Sierra Nevada Memorial Hospital Karma

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Deferred karma? Yup. I always heard the middle class pays for the ER care the poor get regardless. Wasn’t sure just how this happened, until an accident required a quick visit to check out shoulder. Checked with United Health Care, “is ER covered?” “Yes it is, but you pay 15%. I guesstimated 500 to $1000, my cost thus 75 – $150.

Clever people in accounting had big surprise for me. Intake clerk and initial RN interview take place in ER. Then they call the doc, on the phone. He says: “x-rays!” Through one door and another 50 steps and into x-ray room.

” You are now leaving ER, warning Will Robinson, you are leaving ER” unfortunately was not piped into my head. Three x-rays later, on to Area 2, where the doctor is, deep in the basement of Sierra Memorial Hospital. Sat there for well over an hour. Finally called, and as I go through the door, notice sign that says doctors are all independent contractors, not employed by hospital. First question out of my mouth were, “are you “in-network” for UHC?” Answer, “NO!”

I told him that it stopped there, and we then had a chat about how broken the system was. I said I would offer $100 to find out the results of the x-rays, but that was ALL I would pay. He eventually told me that I hadn’t actually broken anything.

End result? Initial bill from SNMH for ER (AKA, intake person, RN interview, roof over head for doctor and x-rays) $823. Most likely covered. Not covered and not received yet, x-rays and doctors, all cash, pay now, not covered, not in network, etc., God knows how much?

So, yes, selected members of the middle class are indeed and very much up front and in person, footing the write-off bills of the hospitals, the sluicing of the middle class managed by clever labeling and bookkeeping. I will be driving all the way to UC Davis Med Center for all additional medical needs, or via CALSTAR helicopter. My health care is accepted there. Not buying local anymore. Not one, but two local doctors dropped “out of network” and never told me, and racked up big bills on what I thought were covered visits. There ought to be a law.

Monday, March 19, 2012

Privacy and Facebook, Saving Yours.

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How to share stuff on Facebook without giving the entity it came from complete access to your information: Just capture the web address (highlight address bar, and hold down CTRL and tap the "c" key) and then CTRL-V it at the end of your comment, as I will do now: http://www.pbs.org/arts/gallery/idea-channel-s1e1-super-mario-surrealism/idea-channel-s1e1-supermario/

Thursday, March 15, 2012

EMTALA, the Ebola of Modern Health Care

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Well, at least for the middle class it is the equivalent of the ebola virus.

This is the last post, completely rewritten

Locally on the Medicare and Health Plan front I learned something the other night after falling into an unmarked and uncovered culvert drainage basin, and slamming my right shoulder full force of my body weight in a drop of four feet, onto a solid rock face.. This was after the tow truck had carted my now destroyed vehicle up on to the platform, and I was asked to get into the passenger side of the truck. Rock falls happen, right before your very eyes and too late to stop. 2/10th of a mile up towrds NSJ from SYR Bridge. Only uncovered such basin, less than 4 feet from the fog line.
Suffice it to say, shoulder was damn good and sore, hardly movable, and so a trip to Sierra Nevada Hospital was in order. I checked with United Health Care, my primary provider, and ask specifically if the ER at SNMH was “in network.” They assured me it was.
I arrived and went through the intake process, with only one other mother daughter with a fever in the waiting room. I was initially identified via computer (I’d been there some years before) and pronounced fiscally fit. Even so I inquired to make doublke triple sure that I wanted this whole visit on my UHC account, with me paying a 15% co-pay. I was told they would only discuss it at the “end of the visit” I then went to a nurse who summarized my problems and called a doctor to see what should happen next.
Xrays, 1, 2, and 3. Off to the xray area, click click click, very modern digital xrays, fast results, cool. Nice technician as well. She now walks me quite a ways through the maze that’s under SNMH, to an area called: “area 2″ and marked Urgent Care. I spent quite a long time sitting there, I had arrived at 6:30. I may have even gone to sleep. The lady again has me sign some more papers, which I assume are the standard liability releases.
Then finally the doctor calls me in to the back area of area 2, and as I pass through the door I notice a sign stating that the physicians here are all independent contractors, and separate from the hospital, financially.
All the alarm bells go off in my head.
I ask point blank if this means that he is NOT part of the ER, even though he is the first doctor I get to see “in ER?”? And will I get a separate bill, ? Yes.
So we haggled. And I learned that the xrays were also “not part of ER.” As the doctor put it, the system is totally broken. I have to agree. I got out at 9:30, the waiting room was packed.
As for not stating the costs up front, there’s a crazy set of laws abbreviated as EMTALA. Buried in the middle of this is a prohibition about telling the patients anything about costs until the patient’s condition is “stabilized.” This is so they won’t go away untreated, supposedly. In my case I couldn’t be considered “stabilized” until after the xrays had been taken, and I too had been taken, but in this case by the hospital having to live up to the law. EMTALA was total news to me, to be discovered as outlined below, and I suspect total news to my daughter as well, a newly minted MD in a large university teaching hospital.
For further information on this ghastly addition to “kill the middle class” laws, check out:
http://www.carefirst.com/pages/mdmedicare/provider_relations/pdf/emtala.pdf
and
from Wikipedia. see http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act: for a whole lot more information:

My recommendation is that SNMH post the fact that they are bound by the terms of EMTALA, in the ER waiting room.  That way those of us with electronic communicators could check it out and get a heads up.

Now for the entertainment, compliments of a crazed world. 

http://crasspollination.blogspot.com/2011/10/neighborhood-rapscallions-and-emtala.html

There is no longer a place to put in tags?

Wednesday, March 14, 2012

Sierra Memorial Hospital, and EMTALA,

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EMTALA is a real problem, for those of us who pay for our health insurance, and have the wherewithal to pay for all "extras."

What is EMTALA?

Basically speaking, ER is not allowed to do anything that would make you think twice about getting care, like reminding you that certain costs that most people would think are part of ER, are not.

Thus if you call your insurance provider, and ask the simple question, "is ER covered at Sierra Memorial Hospital as an 'in network provider' (cheapest possible cost to insured consumer) ? "  you may get a simple answer, "YES!"  However much common sense would tell you that, that would mean that everything that is needed to make an ER worthwhile, is included, this is not the case.  Let's see how this works locally:

Sierra Memorial Hospital ER is covered for ER according to our United Health Services rep. Go there, and you are nicely processed, and if you asked about cost, they say it will all be explained in the end. Now comes the big Federally mandated switch. you go off to xray for what ever. Then they move you to a waiting room marked Urgent Care. On the wall just before you go off to see the doctor is a cute sign that blends in well with the decor that basically states that all the doctor here are “independent contractors. Guess what? You been transitioned from the ER to a zone in which everybody is out of network for independent health care, and you are about to get charged with full boat rates for everything. The Federal law probably might even prevent that sign as well, but since that clinic is marked "Urgent Care," and might possibly get referrals from elsewhere other than ER, it is probably legal.That xray tech? Possibly also out of network, but Sierra Memorial has just assured me that most likely they are in network.. She gives a preliminary reading which the doctor seeing you uses to go forward.  Guess what ? Next they might even send that xray out to be read by a full attending doctor, also possibly out of network.  At Sierra Memorial, regardless of how many radioogists look at it, just one charge, and most likely in network. And then recommend that you have followup xrays to see if any cracks develop later on. This situation needs to be posted in the first waiting room.

And by law, it cannot. EMTALA RULES!

And what, mighten you ask is EMTALA?

from Wikipedia. see http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act: for a whole lot more information:

Hospital obligations

Hospitals have three obligations under EMTALA:
  1. Individuals requesting emergency care, or those for whom a representative has made a request if the patient is unable, must receive a medical screening examination to determine whether an emergency medical condition (EMC) exists. The participating hospital cannot delay examination and treatment to inquire about methods of payment or insurance coverage, or a patient's citizenship or legal status. The hospital may only start the process of payment inquiry and billing once they have stabilized the patient to a degree that the process will not interfere with or otherwise compromise patient care.
  2. The emergency room (or other better equipped units within the hospital) must treat an individual with an EMC until the condition is resolved or stabilized and the patient is able to provide self-care following discharge, or if unable, can receive needed continual care. Inpatient care provided must be at an equal level for all patients, regardless of ability to pay. Hospitals may not discharge a patient prior to stabilization if the patient's insurance is canceled or otherwise discontinues payment during course of stay.
  3. If the hospital does not have the capability to treat the condition, the hospital must make an "appropriate" transfer of the patient to another hospital with such capability. This includes a long-term care or rehabilitation facilities for patients unable to provide self-care. Hospitals with specialized capabilities must accept such transfers and may not discharge a patient until the condition is resolved and the patient is able to provide self-care or is transferred to another facility.

Here is a site that discusses what doctors can and can't dicuss, in detail,

http://www.carefirst.com/pages/mdmedicare/provider_relations/pdf/emtala.pdf

Tuesday, March 13, 2012

Misc. Privacy Issues. Local Adverts on Rush

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  • What is the purpose of the new "Timeline?" Look at what happens as you use it. You look first in one column, and then in the second column, and then back to the first, and so on. What is the logic here? Seems to me, as I finally explored it, that my normal, ignore the right hand crap at all times, was interrupted, and that my eyes were put into an unnatural roaming mode. I think the purpose was simple, to get us to look at more ads. Timelines are straight, not bouncy crooked, and most of them are horizontal, not vertical. Nice try at hiding the real motive, no cigar. Wonder if this will be deleted? Screen shot time!
    · · · 29 minutes ago

  • Verizonwireless just added a new "feature" that lists your four top dialable people in boxes across your screen. A great way to generate more "pocket" or "butt" dials, and determine who you really like. I am getting very annoyed with FB and other companies attempting to find out who likes who, in hopes of selling more goods. You can dump this feature, or anything else you don't want, by holding down on it for 4 - 8 seconds, until the trash can shows up.
    · · · 44 minutes ago

  • KNCO now has a "feature" called "Restaurant Review" which was a Baskins Robbins adn IHOP local ad, thinly disguised, during Rush Limbaugh, at 9:48 am this morning.
    · · · 2 hours ago

    Baskin Robbins is also supporting Rush.  If you wish to picket, try this: Ahha, the perfect sign for picketing: "This establishment supports the Rush Diet. Is that the one you are on?"


  • Douglas Keachie Dokimos Pharmacy ad at 9:56.
    2 hours ago ·

  • Douglas Keachie Maule Windows at 9:57
    2 hours ago ·

  • Douglas Keachie Rush is claiming victory. Tofanellis is advertising at 9:58
    2 hours ago ·

  • Kris Wilson
    I thought Rush's "bosses" suspended advertisement for 2 weeks?

    This is a sneaky way to save advertisers from jumping ship because the "bosses" think people wont boycott if they think there is no advertisement and in 2 weeks they also probably think the public will forget everything. It is all about saving advertisers from pulling out. Rush is losing money for his show. To some extent this will work because Americans do have a short attention span.

    2 hours ago · · 1

  • Shelley Watten Hanan Nothing changed.
    about an hour ago · · 1

  • Katherine Brousse Porebski Has SPD pulled their ads???

  • Douglas Keachie I am only spot checking, too much Rush destroys my mental happyness.

  • Douglas Keachie Nevada County citizens, at least 51% of them, are smarter than the average bear, and a lot smarter than the average dittohead.

  • Ryan Mount Why are you listening to this cretin?

  • Douglas Keachie To identify the cretins who are paying to keep him on the air.

  • Douglas Keachie The two week hiatus apparently has allowed the locals to pick up ad spots for next to nothing or free, or even the promise of more ad time elsewhere at a later date, who knows? I'm amazed the local businesses would take the chance.

  • Ryan Mount I guess if you want to take on the mantle of watchdog, more power to you. Frankly I haven't listen to that (except accidentally) since 1994 when he referred to homeless people as "human refuse." I don't want to contribute to his Arbitron ratings by rewarding his bad behavior.

  • Douglas Keachie I would hope that each person who signed that petition would do 10 minutes a week, and post to their FB accounts. That way the general awareness would cause a drop in sales, and the local advertisers would just say "no." I'm not going to do it all alone. If others don't pick up on it, why should I suffer, unless someone wants to pay me. You can bet the Koch Brothers won't.

  • Ryan Mount Go protest out in front of Baskin Robbins, Maule's and Dokimos. Aren't they the real enablers?

  • Douglas Keachie They are, but circulating the information among the two to three hundred GV/NC folks I'm connected to on FB is much more effective, as most lean in favor of boycotting already. If we all did this, I suspect they'd cave immediately.

  • Douglas Keachie ‎"I don't want to contribute to his Arbitron ratings by rewarding his bad behavior." No can do, unless you are one of the chosen who actively monitor their listen habits and report to Arbitron, OR, you use an Internet based radio tuner. I like Audials 9, but am aware that they can and most likely do track like crazy, for extra revenue. It is such a handy way to record both audio and video, and make copies on CD's, DVD's, so I accept the tradeoff.
    3 minutes ago ·

Friday, March 09, 2012

Local Advertisers, Abandon Rush!

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Note to Steele and Todd Juvinal

No need to back off. It is not a free speech issue. The beauty of SuperPacs, Obama has no control over returning donations, and people including Russ Steele have to PAY to listen to Bill Maher, and thus it is NOT a public use of the airwaves. You don't like Maher? Boycott your private tv dish or cable provider. In the meantime plans are afoot to have a trailer that is pulled about town with the names of local advertisers who support Rush on KNCO. Of course it will absolutely up to code for everything, and equipped with front and rear videocams, and obeying the laws religiously. Now that's free speech! I have no desire to have KNCO go silent, I just want them to make better use of those three hours. If reducing local advertising revenue is going to "hurt" them, then consider the following:

If KNCO gets national attention directed at GV/NC for dropping the Rush show, it may bring a lot of interest, new people, moving in, and/or being tourists. In short, more money, and more local advertising. losing Rush could be the start of a whole new and more prosperous world, and I really doubt that the major advertisers dropped him without doing a lot of market research, and realized that he was becoming a liability even before he pushed the slut button. It was a great out for them. "Gee (to loyal ditto-ites) we're so sorry we had to drop him, but you do believe in family values, don't you?"

Speaking of which, should a school teacher EVER even vaguely suggest, even in unintentionally overheard private conversation, that a colleague, an administrator, a parent, or God totally forbid, a student, was a SLUT, Steele and Todd would have their job instantly. So, the moves against Rush are payback for your and Rush's attitudes towards teachers, as seen everywhere. Rush can go to 6th and Mission, and blab all he wants. He has no special entitlement to a nationwide microphone, or an Armed Forces radio network microphone.

Wednesday, March 07, 2012

Why We Are Losing in Afghanistan:

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California and Afghanistan are about equal in size and population.  If we have 160,000 troops over there, that is about the same as the number of LE in California 

QUICK FACTS: CA
    Population1: 37,349,363
    Number of Law Enforcement Agencies2: 509
    Officers per 100,000 Population: 217 

Now imagine that all the CA cops are trying to keep order among a populace that has no qualms about shooting the cops, does not speak the same language as the police, and which fervently believes in a totally different religion.  Good luck keeping order.

Boycotting Rush is NOT Affecting His Right to Free Speech

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Rush has a perfect right to say whatever he wants. I have a perfect right to buy whatever I want. If I and a great many others are exercise our rights, and let manufacturers know our preferences for their products may be linked to the shows they advertise on, those are ALL very American Rights.

Rush Limbaugh still has the right to spout off just as much as he wants to. Whether or not advertisers will pay for him to have a microphone to the entire USA on loan from God, well, it is their American right to decide, as they own the stations. Rush can join the folks down at 6th and Mission. He'll fit right in. Nobody is stopping his free speech. Or do you believe that Rush alone is entitled to a nationwide audience? If he is, we all are. Curiously enough, the broadcasters hold a different view.

So, is there a "Rush Entitlement" in the Constitution? If so, please show me where?

Tuesday, March 06, 2012

S.O.S. Save Our Rush Bucket!

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At Rebane's a frantic distraction effort is going on.  My comment is:

"Steven F, I don't see a lot of Rush Limbaugh defending on this thread."

It's a case of forest and trees, Mr. T.  The fact that the thread exists in it's present form, which is to go chasing only after gov paid or unpaid contraception, and I have been warned to stay "on topic," very clearly shows it is a destroyer, along with many other such blogs and Fox commentators, circling the stricken aircraft carrier, sending up smoke, hoping to screen off the view, and prevent any more damage. By framing the topic, the Right attempts to salvage the argument, even as the bilge pumps fail, and Rush capsizes, on the way to the bottom.  R.L Crabb, where are you?

Thursday, March 01, 2012

Bill Maher "On Being Poor."

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If you grow up in America, it's pretty rare if you don't love money. One of the first things I ever remember being punished for was stealing money. Five dollars, off my father's dresser. I was so little, I don't think I even knew it was wrong to take something that wasn't specifically mine -- I recall this being my introduction to the concept of "larceny is bad." But somehow, I knew it was good to have cash.

After I left my middle class household at 18, standard of living took a real tumble for a while. At Cornell, I had no money, and boy did I look it. They called where I lived the last three years Collegetown, but Collegetown was really slums in a rural setting. Landlords did not have to work that hard in Ithaca, N.Y. -- every year, there was fresh supply of eager tenants among the students who didn't want to live in a sorority or fraternity. It was a sweet market for a slumlord.

But even that looked good compared to what was waiting for me as I began my illustrious career as a standup comedian in New York City in 1979. First year I lived on 99th Street in Spanish Harlem, a five-floor walk up, toilet down the hall. No shower -- a tub that sat in the kitchen with a snake-like attachment that hooked up to the kitchen sink. Walked home every night from the comedy clubs on the tony Upper East Side, watching the neighborhoods become poorer and scarier as I made my way north, and I'm sure the only reason I was never robbed was, they took one look at me and knew it wasn't worth the trouble. Sometimes, freedom really is just another word for nothing left to lose.

And yet, in a short 33 years, things had turned around enough so that I was able to give a million dollars to the super PAC of a certain mixed-race president who, I would like to remind all my overconfident progressive friends, does NOT have this election in the bag. And a lot of people this last week have said the same thing to me: "You're not picking up the drinks tonight?"

The great thing about having been poor is how liberated it makes you if you eventually become rich. There's nothing like the knowledge that you don't need money to survive. That the money cushion you lie on every night doesn't have to be three feet thick, and you can still get to sleep.

Other people seemed surprised I had a million dollars, which amused me. I've had a television show since 1993; television pays well -- I may even have another million lying around somewhere. Every year when I visit my accountant in December to see how the year went, he always says I'm the best saver of all his clients, which amazes me, because I feel like I deprive myself of absolutely nothing. I once asked him, what do your other clients spend their money on? Because I know who some of his other clients are, and I know they make WAY more than I do. He said that what they spend their money on is always changing, and that's not even the point -- the point is, however much money they make that year, they always spend all of it! That's how they think: have money, spend it, because the real tragedy would be to die and have money left over.

Me? I just don't have expensive tastes I guess -- I don't collect cars or paintings or jewelry, and I gave up my heroin habit years ago. But I also know that, as I said when I presented that giant check to Priorities USA Action last Thursday at the end of my stand up special on Yahoo!, "This hurts!" I was trying to make the point that if I could do it, a lot of other people could do it a lot more easily than me. You know, the only place in America where the millionaires and billionaires are predominantly liberal is here in Hollywood -- with the possible exception of Silicon Valley and Ben & Jerry's ice cream. There's a reason that of the 16 billionaires that have contributed to super PACs this year, 14 have given to Republicans. It is generally the party of the rich. And in a post-Citizens United world, the party of the rich has an advantage like they've never had before. In 2008, the most you could give to a candidate was $2,300. Now it's Infinity. No, the election is not in the bag.

http://www.huffingtonpost.com/bill-maher/being-poor-huffpost-money_b_1310162.html