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Politics : Just the Facts, Ma'am: A Compendium of Liberal Fiction -- Ignore unavailable to you. Want to Upgrade?

To: Orcastraiter who wrote (16156)	9/10/2004 7:37:42 PM
From: Lazarus_Long	Read Replies (1) \| Respond to of 90947

Seems like I read somewhere that the death of a child leads the list of stressful human disasters. More than death of a spouse. Serious illness requiring urgent surgical intervention has to be right up there in the top ten. I guess it's time for some observations on the health care system in the USA through the eyes of a user rather than provider. When it became apparent that we had a sick kid, our first action was to contact the pediatrician who ordered an outpatient MRI the following day. This was accomplished with no delay and the film was read by the radiologist and duly transmitted to the pediatrician who asked my wife if she had a preference for a neurosurgeon. I knew who to talk to and the office was called same day. As it turned out an appointment was made the following afternoon. That was Friday of the Labor Day weekend. On examining Devon and looking at the MRI, the neurosurgeon felt this was an urgency and bumped a case previously scheduled for the following Tuesday (after labor Day). That patient was postponed to be the second case. I don't know that you get much better efficiency than that for a non-emergency. Did this case get speeded up because I was who I am? The usual wait to see a neurosurgeon is about a month. I don't think that was a serious consideration as the surgeon was a pediatric surgeon in a different hospital and didn't have a clue who I was till the residents told him. I think the process got speeded up because there were aspects of it that leapt out as more urgent than usual. There's a big billboard around town that says something like: "If you have childrenŠ.be glad you have Children's (Hospital). I wholeheartedly agree. Kids are different. Pediatricians are definitely different. You don't deal with a kid, you get a mother-kid amalgam, some say akin to various two headed monsters of mythical yore. No everyone can deal with peds. i don't do it well. The particular crew rotating through Ped NS does it exceedingly well, to their eternal credit. The surgery was performed with world-class players, Pediatric Neurosurgeon, pediatric anesthesiologist and went well. Postoperatively, she was immediately put on patient controlled analgesia and a physician from the "Pain Team" visited every day to insure the setup was titrated properly. They changed the settings several times. She was quickly weaned off to ketorolac and small amounts of diazepam. When the attending surgeon arrives for rounds, with a gaggle of residents, everyone in the room leaps to attention. God-like isn't the right word, just definitely in charge. "Commanding" is a better word. When he speaks everything stops. The pediatric nursing staff was superb. When the call button was pushed, someone actually showed up to deal with it. The sofa chair next to the bed folded into a bed for her mother to sleep in. All aspects of her care were superb. Seems like a perfect healthcare system. Once a need is recognized, the patient enters the system quickly, evaluations are performed efficiently, a diagnosis is made and the problem is rectified in short order. So what's the big fuss about health care in America? I suspect the fuss is because the care for my daughter, world class in every respect is going to cost someone a whole lot of money. A heart-stopping sum. But I won't be paying for any of it out of pocket. It would be physically impossible to put a dent in it if I paid the rest of my life. I am essentially an employee of the University of Pittsburgh Medical Center (UPMC), which provides a Practice Plan for physicians. We have negotiated salary and benefits, which are very generous I think. One of those benefits is health insurance through a UPMC Health Maintenance Organization (HMO). There are several plans to chose from, some with more flashing lights and bells than others. I can't remember exactly how much I pay out of pocket a month to subsidize the health care plan but I think it's somewhere around US$300.00 a month. If I or any of my family requires health care, the only caveat is that a UPMC provider must render it at a UPMC hosptial and, unless I get sick or injured out of town. Of course I have absolutely no problem with that, as I believe UPMC is as world class a center as it gets. It would never cross my mind to go elsewhere. But let me tell you, a neurosurgical procedure and anesthesia by a double Boarded ped anesthesiologist and (probably) four days in the hospital is going to cost a LOT of money. If I ever see a bill, I'll try to give you some idea what it all costs. What if I was not who I am? What if I was a small business owner struggling to sell used video tapes, DVDs and rock memorabilia in a small shop on the strip on Liberty Avenue. Obviously no extra money to purchase phenomenally expensive private health insurance. Going bare and praying for no illnesses in the family. What if that man's daughter came up with the exact same scenario as mine? Would that child enter into the system with the rapidity and efficiency as that of an attending physician in the system? I'd like to think so but I don't know. I honestly don't know. We have binding laws that facilitate entrance into the health care system for all comers regardless of their ability to pay. We treat all patients equally as far as their care goes, but I'm not sure we continue to treat them the same after the care is rendered. There are no laws that I know of that prohibit dunning patients for billable charges due and payable. I will never see this hospital bill. I don't know if a penuric father of a similar child as mine would be presented with a multi hundred thousand bill and told to pay up according to a court ordered monthly schedule for the rest of his life. A high risk, high stakes crap game in which none of the rolls bring you riches but some of the rolls might break your bank forever. I think that would qualify as a BIG problem with our system. Wouldn't you? Currently we are only insuring about 80% of our population, but many of them are dramatically underinsured. Being "insured" is not the same as having all your medical bills paid. The real number of patients that can access the kind of care my child received this week is probably closer to 60%. Can we afford to suddenly indemnify every single family in the USA for phenomenally expensive catastrophic illness? No one knows the answer to that since we have not tried it. What we have done is dance around it, or worse let Hillary tinker with it. If we choose to try, it is arguable that we can provide the exact same care my daughter received on demand for everyone that needs it. First of all, we probably don't have the personnel or facilities to serve the increased demand. Secondly, it will require a stunning increase in taxes and employee co-pay to afford it. Everyone wants "good" health care but these are the same taxpayers that vote down tax referendums that benefit their own kids. Thirdly, and perhaps most important, we will need to cut back on expensive services we now render that serve no useful purpose other than to expend huge amounts of money maintaining life-in-death for moribund end of life patients. That last one means we'll have to tell medical ethicists supporting unlimited patient autonomy as a right of living in civilized society to go stick their nose in a book. Go to the families of patients at end of life and tell them if they want to continue maintaining open ended vital signs with no hope of any other than delaying death, they'll have to pony up for it themselves Go see the cashier and make the same deal they currently make for the father of the child with an urgent operative disease similar to mine. We can probably finance one, but not both. It's our choice. - -From Crippen's List pitt.edu

To: Orcastraiter who wrote (16156)	9/10/2004 7:41:09 PM
From: Alan Smithee	Read Replies (1) \| Respond to of 90947

Hugh Hewitt Another very big nail in CBS' coffin from RedState. The swarm continues to skin CBS of the last shreds of its credibility. One example of the process underway: Yetserday and today I received a series of e-mails from a Professor of Computer Science at Rice University. E-mail #1: Hi Hugh, I am a Professor of Computer Science at Rice University who has followed the evolution of word processing technology over the past 30 years. A cursory glance at the "Killian documents" shows that they are forgeries, the product of a modern word processing system. Even the most powerful word processing systems available in the early 70's were not designed to produce propotionally spaced documents. Moreover, no mechanical typewriter, even with variable letter widths like the IBM Executive typewriter, could produce precise propotional spacing comparable to a modern word processor. Precise proportional type-setting is a very demanding computational problem. Since modern PC's are more powerful than supercomputers from the 70's, we take this form of computation for granted. Let me take a moment to recount the state-of-the-art in word-processing in the 1970's. I used a state-of-the-art word processing system to write my undergraduate thesis at Harvard in the spring of 1971. I was one of a handful of Harvard students who were given access to a PDP-10 time-sharing system to conduct my thesis research. I used the same machine to prepare my thesis using a word processing program called "runoff". The output device for "runoff" on the Harvard PDP-10 was a flexowriter, a typewriter-like device driven by punched paper tape. I had to write in the superscripts and subscripts by hand because the flexowriter could not perform fractional line spacing much less proportional font spacing. The runoff program did not support any output devices with proportional spacing. Neither did any other word processing of that era to my knowledge. In the late 1970's, researchers at Bell Laboratories developed a new version of runoff, called troff, to support proportional typesetting on a photo-typesetter; troff is still available today on standard Unix distributions. So in 1971, even the most powerful available computer systems were not equipped to produce documents like the Killian documents. In Fall 1971, I entered graduate school in Computer Science at Stanford. I soon gravitated to the Artificial Intelligence Laboratory, which had the most powerful time-sharing system (a PDP-10) on campus. In either 1972 or 1973, Xerox gave the Stanford Artificial Intelligence Laboratory a prototype xerographic printer called a "Xerox Graphics Printer (XGP)". Two similar prototypes were given to the MIT Computer Science Department and the Carnegie-Mellon Computer Science Department. The programming staff at the Stanford AI Laboratory was thrilled with the gift because it was the first opportunity that computer science research community had to develop software to support printer quality type-setting. The three Computer Science Departments cooperated in developing the word processing programs to support the XGP. I wrote my first published research paper and my doctoral disseration using the XGP in Spring 1976. It would take another decade before comparable word processing systems were available to most computer science researchers on minicomputers running Unix. It would take nearly another decade before they were widely used on personal computers. Sincerely, Robert "Corky" Cartwright Professor of Computer Science Rice University" I wrote Professor Carwright back and asked if I could reproduce his e-mail on the blog. Before he answered that, he had sent me a second e-mail, as well as one to the DailyKos, who is mounting a very, very lame defense of the CBS forgeries. Here is the Professor's e-mail to Kos: "Hi Markos, You are tilting at windmills with the IBM Selectric Composer theory. Go to ibmcomposer.org. which is a user's manual showing some sample typed text using this typewriter. The typed text in the "Killian memos" is kerned (check out letter combinations like "fo" and "fe"), but the Composer text is clearly not. Kerning is a computationally complex task beyond the capacity of any mechanical typewriter--even one as expensive and elaborate as the IBM Selectric Composer. Moreover, the proportional spacing in the sample text is rather crude (look at the typesetting of "11" for example) which is the best that a mechanical typewriter--even one as complex as the Composer--can do. Consult someone who understands the typography behind modern word processing. The "Killian memos" are word processed documents. Robert "Corky" Cartwright Professor of Computer Science Rice University ACM Fellow P.S. I would have posted a comment on your site but you have a 24 hour waiting period that prevented it." Here's the third e-mail, from earlier today: "Hi Hugh, I have seen reports that Dan Rather has upped the ante on the authenticity of the Killian documents by insisting that they are authentic. How foolish! In the testimony that I have seen by forensic experts questioning the authenticity of the documents, they have qualified their opinions by stating that no typewriter familiar to them could have produced the documents. Perhaps they are merely being cautious to safeguard their reputations. But I wonder if these typewriter experts appreciate the computational complexity of modern "print-quality" word processing. No mechanical typewriter could implement the complex sequence of rules governing the formatting of text in a word processor like Microsoft Word. The Killian memos could not have been typed on an IBM Executive typewriter with "proportional spacing" or any other typewriter using similar technology. According to product descriptions on the web, the IBM Executive typewriter supports only four different character widths. In contrast, modern proportional spacing involves a far more sophisticated type-setting algorithm. Every type font in Word (or any other modern word processing system) has a custom width for every character. Moreover, the spacing between individual pairs of characters is modified by a process called "kerning" that compensates for the fact that letters have varying shapes that affect our perception of proper spacing. To achieve an aesthetically pleasing result, the type-setting process must take into account the relationship between adjacent character shapes. For example, the letter "T" followed by the letter "o" looks badly spaced if the "o" is not tucked under the overhang provided by the top of the "T". On the other hand, no such adjustment is appropriate if the letter "T" is followed by the letter "H". In the Killian documents, you can clearly see the effects of kerning in pairs of letters such as "fo" and "fe". I am amazed that Dan Rather and his associates at CBS are blind to the overwhelming evidence that these documents are blatant forgeries. Sincerely, Robert "Corky" Cartwright Rice University" Unlike CBS, I did a quick google search on my source, Professor Cartwright, and found him to be who he says he is. Cartwright's contributions to the conversation on the CBS fraud are just three examples of thousands and thousands of e-mails to bloggers working the story of the CBS fraud. This is what The Belmont Club is talking about in his post today, what I called "open source journalism" this morning, and what The American Thinker and Samizdata are referring to as "the wisdom of the many," and "distriibuted intelligence," respectively. No matter what you call it, the old media is now undeniably on notice that whoppers get walloped. hughhewitt.com