08/17/09 05:07 - 88ºF - ID#49558
good health care plan?
But I'd love to hear other opinions... DCoffee? Larsons?
Sounds a lot better than an Obamacare card to me...
Permalink: good_health_care_plan_.html
Words: 35
Location: Buffalo, NY
08/16/09 08:37 - 70ºF - ID#49548
Rebirth!!
But I have to say- I'm sure the band kept thinking "wow, we are not in new orleans". These guys are a fixture down there. Everyone knows and loves them. Then they come here and get a bunch of white people, all sitting down- haha. They kept saying "come on people, MOVE!"
Heh. Eventually people got into it and were dancing. But so fun.
I don't know how people can listen to this music and NOT 1: instantly feel happy and 2: shake that ass!
Gotta love those horns!!
Permalink: Rebirth_.html
Words: 120
Location: Buffalo, NY
08/13/09 01:57 - 81ºF - ID#49525
WTF????!!!!!!!!!!
That's a little frightening. Because I can't tell who it's from (just comes up as one of those 5 digit codes).
But it was some text message telling me to go to some dating website.
I do NOT like this. How the fuck did they get my cell phone number? Who are they? I don't like that I can't respond/block them.
This is not cool. Spam email is one thing. But spam texts??!!
Has anyone else had this happen??
Permalink: WTF_.html
Words: 87
Location: Buffalo, NY
08/13/09 01:24 - 81ºF - ID#49523
more healthcare stuff, blah blah blah
I just finished taking my general surgery boards. Fingers crossed that I passed- because it's not something I'd like to do again.
So now I am catching up with email- got this from the American College of Surgeons the other day.
Now, when I don't have my facts straight, I try to stay out of a conversation- or at least admit that I may well be talking out of my ass. Apparently our president does not do the same thing?
This is distressing, if you ask me...
Statement from the American College of Surgeons Regarding Recent Comments from President Obama
CHICAGO--The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.
Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.
Three weeks ago, the President suggested that a surgeon's decision to remove a child's tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what's right for the patient.
We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President's remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.
We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.
Permalink: more_healthcare_stuff_blah_blah_blah.html
Words: 444
Location: Buffalo, NY
08/04/09 07:00 - 76ºF - ID#49459
grave oversight
But realized that I left out the other bit- that I had a FIRST date this weekend, which was great. :)
Wheee.
He's super adorable. Both in looks, and actions.
After he dropped me off, he texted me that he had a great time and hoped I did too- and that I looked gorgeous.
Aww, he got big points for that.
But he was embarrassed that I was more dressed up than he was- but he was in those ultra-preppy 'nantucket red' shorts.
And I have to say- I am a sucker for a preppy boy.
so anyway.
Yay.
Permalink: grave_oversight.html
Words: 115
Location: Buffalo, NY
07/30/09 01:23 - 67ºF - ID#49411
NY, NY
But, whatever, it's fine. And the room has a little mini-kitchen. So today I on my way home I bought a box of granola bars to have for breakfast. And I ate a bag of popcorn on my way home. And threw the bag in my trash can.
Which in retrospect, was a stupid idea. But I figured if there's a kitchen, there's meant to be food. But I should have known.
Yesterday, I saw a big roach scurry under the bed. Awesome. But, having lived with cat-sized roaches in New Orleans, I didn't care too much.
But the reason I am awake now is because I was just AWAKENED FROM A DEAD SLEEP by the sound of a MOUSE in my popcorn bag. Awesome.
May have to bring this to someone's attention. Too bad the 'office' is only open from 10-2, and I am gone from 8-5.
Oh well. Otherwise NY is good. Have had the chance to see some friends, and make some others, and on top of it all it's Restaurant Week, so I've been eating way too much.
But, I kind of can't wait to go home on Sat, because I have my date that night. :) He's been super adorably cute. Calling just enough to make me feel important, and not enough to make me feel smothered.
So I want to hurry up and have this date and get to know him better... because I feel like it's not right to be all excited about someone I barely know.
And who knows, maybe if this works out I can cancel my match.com, which seems to be hitting an all time low. I seriously can't believe some of the people on there. Especially when they email me about how much we have in common. I'm like "really? fat bald divorced high school dropout guy with no job in a football jersey? You think we have a lot in common?" But then the other day I actually, for the first time in months, saw someone that might be interesting... so I sent him a message. No reply. After a week, I wrote back "wow, I don't even get a hello? Well, good luck to you." To which he sent back an apology... Said he was sorry to be rude but he thinks it's best not to answer. That while he respects doctors, "Being a doctor is a massive time commitment and for that reason I didn't feel it was a good fit. I am sure many would be estatic [sic] to be involved with someone that would so greatly assist on the financial side of life in addition to the general relationship. For me, time is more important."
Dumbass. The 'financial side' comment is super obnoxious, if you ask me. I also noticed that the only place I didn't match his criteria was "body type". I have listed myself as "average"- he only wants "slender" or "athletic and toned." Again, oh really dude? You're not that hot. You posted 12 pictures that prove that fact. I wrote b/c he was witty and seemed to like the same things as me. Guess not. He also wrote "reguardless" and "defensce". We're clearly not meant to be.
So, I couldn't let it go and sent him back a message that said that I agree- I don't respond to people I'm not interested in. But that usually those people aren't cute doctors. But that if he is willing to write off a whole profession without knowing more [my hours as a hand surgeon will not be a problem]- then maybe we're not a good match. Then for good measure I tacked on "and I have to ask- are you really that hot that merely "average" girls need not apply?"
Somehow i'm not expecting a response to that one.
And just now I got "Your smile light up my screen.. If think.. We can be friends let me know.. I am DOMINIC. If want please sent me mail.. Thanks." DOMINIC, you are 46 but don't seem to have mastered fundamental reading/writing, so I think I'll pass.
God I'm a bitch. Ugh.
Last comment-
Jim/James- you guys ok? :(
later peeps. Now I will try to fall back asleep and hope the mouse doesn't wake me up going through the garbage I moved out to the hallway.
Permalink: NY_NY.html
Words: 812
Location: Buffalo, NY
07/26/09 03:15 - 76ºF - ID#49383
cupcake weekend
So this weekend a girlfriend of mine came into town, and I ventured out 'on the town' for the first time. We had a great time. On saturday night, we went out for dinner and then were getting some drinks... Now, she works with a woman in Rochester who was like "omg you need to meet my son! He lives in CT!" and gave him her number. Well, since she was in CT, she called him. So he rounded up a buddy, and they drove an hour from New Haven to Hartford, to come hang out with these two girls they'd never even met. heh. But it was a lot of fun. They were, as she says, cupcakes. 'sweet and warm and impressionable, with a short half life.'
But even better was friday.
We went out, and then this friend of mine met us.... I knew him when I lived in DC, but hadn't seen or talked to him in >10 years. But then one day he popped up as a 'friend suggestion' on facebook, and lo and behold- he lives in hartford.
So, he met us out.
And- he's still totally cute.
And single.
And fun.
So we had a great night.
And he texted me the next say "that was really fun! Let's go out this week. Let me know what day is good for you."
And I'm so dumb that at first I didn't even realize- I think I was just asked out!
I told him I'd be in NY this week, but am coming back Sat. Then my friend took my phone and texted him "would a boy like you be interested in seeing a girl like me on, say, next saturday?" (which is way more boldly flirtatious than I could ever be) and he responded "a boy like me would DEFINITELY be interested in spending next saturday with you."
Aww.
Way too early to make anything of it.
But, exciting nonetheless. I can barely even remember the last time I went on a date.
Permalink: cupcake_weekend.html
Words: 347
Location: Buffalo, NY
07/23/09 04:37 - 72ºF - ID#49364
a few random thoughts
It pissed me off way more than I expected. I really wanted to roll down my window and yell at him to pick up his fucking garbage, but he looked like the type of guy who may well pull out a gun and shoot me right there for saying that.
Fucker. I hate that guy.
Next thought:
I like my co-fellow. I liked him when I met him during interviews, and was looking forward to working with him. Was actually hoping he would be single and would be my soulmate. Alas, he is neither. He is dating some country singer with a kid, and he talks a LOT (almost exclusively?) about bodybuilding, and strippers. (apparently he used to be a semi-pro bodybuilder). He's from new jersey and shaves his arms. I think that says it all. ;) No but really, he's a decent guy and we get along fine and I think working together all year will be good- but we're not soulmates.
But so my dilemma is-
he has AWFUL breath. Like always. Maybe it's because all he eats is "muscle milk"- who knows.
but what do I do about this?
I offer him gum like constantly. To the point that I am running out of gum. But he doesn't seem to have gotten the hint.
Help! Any suggestions?
And final comment-
I'm going to NYC on sunday, and will be there til Sat. Any NY peeps (jess?) going to be around?
Permalink: a_few_random_thoughts.html
Words: 281
Location: Buffalo, NY
07/18/09 10:06 - 65ºF - ID#49328
etc etc
Looking/reading about italian fest etc is making me jealous. Looks like everyone is having so much fun!
I finally got in touch with the kid I knew back when I lived in DC... And then I also saw the girl I lived with when I was there... It's been 11 years since I saw him. And probably 5 since I've seen her. So she invited me over for dinner last night, and said to bring him along. I was kind of excited 1- to actually leave the house and be social, 2- to catch up with old friends, 3- to spend some time with someone who actually lives here and might be able to give me some hints on where to go, etc and 4- to see this guy again. For all I know he's married with kids now, but, eh, so what. He was really cute ten years ago. ;)
But, at the last second he called and cancelled. Bummer. But said we'll have to hang out this week.
So I went to dinner alone. And we had a nice time, but it was super chill... burgers with her, her husband, and their son. Then we chatted until it was his bedtime, then I left. I thought about going to the bar near my house alone afterwards... but then decided to skip the calories and go to bed.
Today tried to do some errands, only to learn that this city is a GHOST TOWN on weekends. I tried to go to CVS... a major pharmacy, only to learn it's only open til 12 on saturday, and not at all on sunday. WTF?! What the hell kind of place is this?
But tomorrow I'm going to Ikea. woohoo, can't wait. Then maybe I can finally finish my last bits of unpacking.
I finally talked to my girlfriend K, for the first time since I moved, so now I'm not mad at her anymore. AND, she's going to come visit me next weekend. wheee.
Work is good. I printed up a report this AM... it's been 2.5 weeks, and I have done 58 cases already. For comparison- I did 168 during my whole final year of residency. Granted, these cases are, for the most part, much quicker cases, but still. It's good. :)
Oh, and on thursday at work I had a super hottie patient. 33 and a cop- busted his hand catching a 'bad guy'. So I took my time putting his cast back on so we could chat. ;) Too bad it's totally unethical to date a patient. But, at least it was fun for the day. And, I know I'll see him again in 2-3 weeks to take the cast off.
What else. My boards are in like 3 weeks. SHIT. I really need to go into super hermit mode and study non-stop. But, it's not happening. And then I have to go to NYC for the last week of July, to take a course for work. Which normally would be awesome, but it's just about the worst possible timing. Ugh.
And what else... I think Dan is going to marry his new GF. He told me she's moved in with him and they're 'very very serious'. The only catch- she's still married. Oops. Minor detail. I like her fine... she's... nice, sweet. Vanilla. I mean there's nothing BAD about her, but nothing amazing either. So I'm not exactly sure what he sees in her, but... whatever, guess it's none of my business.
But the thing that pisses me off, is that now he won't even talk to me. I mean yes, I'm not stupid, I understand that we can't be super tight. But I finally said to him "you know, she is a better friend to me these days than you are." And he said "well, sometimes it's hard to be your friend when I know you want so so much more."
Ugh, that made my blood boil. It was everything I could do to not say "oh get over yourself." I mean that's the problem?! he's afraid to say hello to me b/c he thinks I'm sitting here pining over him?!
Bleh.
I am so over him.
And finally... a picture my cousin sent of my little cousin... the last time I saw him he was maybe 7 or 8 [they live in Italy]. And that was in.... '92 maybe? In any case- he's not a little kid anymore! hubba hubba. Enjoy the eye candy.
Permalink: etc_etc.html
Words: 741
Location: Buffalo, NY
07/13/09 09:16 - 69ºF - ID#49282
random hello
I'm settling in ok... haven't met anyone yet, but then again, I haven't made a single effort either. My boards are a month from today (ACK!), so I feel like I can't really justify doing anything but work/unpack/study for work/study for boards.
Work is going pretty well though. There's so much to learn... but everyone knows that and is super understanding and helpful.
I miss Buffalo though. I miss my friends. I miss knowing where things are... It's been revealing though. People that I thought were my close friends, have disappeared. My one "best friend" doesn't answer the phone, doesn't call me back... She has a new BF... I guess he has replaced me. Which I understand... sorta... except- she and I have been close for like 4 years. She's known him since April. If I ever do manage to talk to her, it's via text, and then it's like 'oh shit gotta go, [BF] is coming." It's almost like he doesn't 'allow' her to talk to me, which is SUPER bullshit and makes me want to kick his ass. She's a super cool girl, and should not be with some dipshit who dictates when she can use her phone.
So, I went home for the weekend. It was nice, except I ate way too much, and did not do any studying. But I did get to see my dad's pix from graduation. 5 years, and we only took like 5 pix. All nearly identical (and not great) of me and my mom... none of my friends/classmates... ah well- guess I should have thought of that at the time.
So here's a random photo dump.
my kitchen. Those boxes are all gone now, thank god, but that kind of sucked.
Sunbathing in my [parents'] front yard. I think it was raining in Buffalo at the time. ;)
5 very similar pictures of me and my mom at graduation. Didn't get any with Dad. :( They did take formal pictures, but I'm not sure how/if I'll ever get to see them.
and I figured I'd temper the vanity of posting 5 pix of myself all dressed up with 2 terrible pictures of me in my apt, thinking about packing. (not actually doing anything about it, just contemplating.)
The one makes me think maybe there IS such a thing as too tan... I look scary.
Permalink: random_hello.html
Words: 437
Location: Buffalo, NY
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I Agree:
What we eat and do with our lives greatly effects our health. But I don't see what the government can do to make tofu and cabbage more appealing than KFC, except maybe taxing unhealthy foods and subsidizing healthy ones to change cost incentives, but I don't think people would go for that. I can't even get into America's insane food culture, but I think it's mostly up to parents to teach good eating habits to their children.
Tort Reform - This is a big issue, I don't think it will save much money, but it cripples private practices. Doctors have to buy some kind of lawsuit insurance, and the cost is going up just as bad as healthcare in general.
Buying Insurance over state lines - the only reason we can't is because Insurance companies don't want competition. Try to change it and you'll see the insurance companies fighting it.
Equalize tax laws so insurance is tax deductible - Hell yea, this is one of the things that bugs me. I spend money out of pocket all year on health bills, weather it's insurance or actual doctors bills to see the dentist or whatever. Add it up, maybe it's $2,500 for the year, take it to the accountant "thanks, but it doesn't matter because it's not more than your standard deductible of $8,000." This standard deductable thing is bullshit, what is it supposed to accomplish? does it just make me think that my accountant is a magician for giving me a big writeoff? All it does is ignore essential expenses that come out of some people's income like mine. These expenses should either be added on top, or get rid of the $8,000 standard deductible and just change the tax brackets.
Tax form donation - like people said, this isn't going to generate much revenue.
Disagree:
The high deductable + HSA thing - They just did this at my mom's work, everyone's pissed because all of their copays literally doubled, for surgeries, overnights and emergencies you pay between $150-$1,500, and for a specialist you pay $75. Regular doctor $50. All this says to me is that they want to keep you out of the hospital, $50 for a regular checkup, what ever happened to preventing illness so we're keeping people healthy instead of waiting till someone has a heart attack and trying to save their life?
Does anyone actually like going to the hospital? Personally, I don't really enjoy waiting rooms, or sitting in my undies on a paper sheet waiting for a doctor to surprise me. I don't think there are that many individuals overusing the system. How about hospitals who bill for things they never preform, I'll bet there is a lot more money to be saved there.
Repeal government mandates regarding what insurance companies must cover - ?!?! this is a stupid and dangerous idea, but I'll bet the insurance companies are glad someone suggested it. My insurance company doesn't cover ambulance rides, or if I get hurt in another state. I'm supposed to sift through legal/medical language to find insurance that covers everything I will ever need? This is just legalizing denials.
Go ahead, tell America that that's your solution, you're going to double people's copays, then repeal government mandates so Insurance Companies are allowed to opt out of covering more illnesses and treatments. That's the plan to bring the cost of healthcare down. You think that will fly? hell no. That's probably why the republicans haven't even offered a proposal, cause it would sound something like that.
I still think Medicare for all is the way to go.
link
There's a little extra in that bill, like no copays, includes hearing, vision, dental coverage, but that's how it goes, you compromise throughout the process. You don't start with some complex middleground BS like the president and congress are doing now.
:::link::: (PDF)
I definitely agree that we should be able to buy health insurance from any state. The way I see things, we have a couple of regional choices and that's it. There isn't as much competition for our dollar as there could be. I don't understand why laws are put into place to restrict this.
Agree about equalizing the tax laws.
Government mandates - I don't have a problem philosophically with the government setting rules for the market place. I'm going to read more about the mandates. Mackey doesn't get too much into it. I don't have much to say about this.
I agree with everyone who says that we shouldn't be denied coverage because of pre-existing conditions. As a healthy person I already end up essentially helping to cover the risk of paying for someone who is sick. The healthy pay for the sick and it won't change. I'm okay with this.
Tort reform - this is something that has long been needed. It's so bizarre to me that someone wouldn't want this part of the mix to be cleaned up like the rest. Really, really bizarre. We have to be the most sue-happy nation ever.
Enact Medicare reform - okay. Tell me how. I already know they pay fractions on the dollar for services. I know it's abused. Tell me how it's going to be fixed.
Charity - this isn't going to cover a ton of people, but I don't have a problem with making it easier for people to make a donation. Nothing wrong with it at all. I don't foresee a flood of people taking advantage of this, after all part of the problem people have with the government solution is.....they have to pay for the slackers. Why would they pay now? It's a feel good proposition and that's all.
Regarding the rest, obviously I can't comment on everything. When Mackey talks about the root of the issue, the fact that we are a nation of unhealthy overweight folks, and we need a cultural change, I say HELL YEAH but changing food culture is hard enough in a family home, let alone a country. He's right that people should be responsible for their own health, but a lot of people just want their bills to be paid for and aren't interested. I do believe we need to change the food culture in the United States.
High deductible plan with HSA - I have one of these. You still have to pay for the health care you use, which some people are going to have a problem with. Premiums are lower. Catastrophic stuff is covered. I know that maximum I will spend X dollars on health care if something bad happens to me. I'm not abusing the system or nickel and diming the insurance company for copays for every little sniffle.
It forces you to be smarter about how you use health care, and think about preventative maintenance. $10 copays or $0 copays just invite people to take the easy route. Mackey's company gives 1800 bucks which is very, very generous. Presumably his employees may use that towards the deductible. My company gives nothing close to that amount, but I do get a pittance every 6 months.
If you're healthy at Whole Foods it's great, it's like an 1800 bonus every year that is YOURS and will accumulate interest, and it rolls over. If you aren't healthy...you get to still have your deductible subsidized. The employee also may contribute something out of their pocket towards the HSA. I do I think 500 a year.
The problem I DO have is this - why was my 20 minute doctor visit 65 bucks, and even worse, why was my GENERIC prescription 45?? WHY? It was worth 110 for me to get rid of my bronchitis, because I could afford it, but it seems brutally excessive and too expensive, especially for the less fortunate among us. I still have a problem with how expensive things are, and just paying fractions on the dollar to the providers doesn't solve the problem, it shifts ownership of it.
Of course, neither Mackey's ideas nor Obamacare answer one fundamental issue some people have, and that's making sure everyone is covered. We have finite resources and infinite wants. It kills me that some people think there is this infinite pool of dollars available. It's an ugly truth we have to swallow, that not everyone is going to get everything they want or need.
One of the missing items is "pre-existing conditions". Insurance companies should not be allowed to exclude people based on their pre-existing conditions. Health insurance is not like auto insurance.
He says, "Repeal government mandates regarding what insurance companies must cover". I'm sorry, but I don't think this is a good idea. There are a zillion medical conditions, each of them known by a dozen different names in multiple languages. There is no way that a layman can understand a lethal mix of legal and medical terms.
I would suggest an FDIC-like federal insurance agency that comes in in extreme cases, and insures expenses over, say, 100K. All insurance companies pool money into this pot, just like banks put money into FDIC.
I'm all for limits on patient lawsuits. This is a uniquely American phenomenon.
Lastly: donations to cover the millions of uninsured people? Ain't gonna happen.
I firmly believe that any civilized society must have safety nets like decent, affordable healthcare for all; just like we have education, transportation, and other infrastructure. Not to mention Defence, which soaks up a large chunk of the budget anyways.
Totally agree on equal tax treatment of individual and employer-sponsored plans - it should all be pre-tax dollars.
I'm pretty sure I agree on plans being able to cross state lines - it's not particularly rational to have 51 versions of the same thing, but we do the same state-controlled but federally funded thing in so many other fields, it's also probably easy to make an argument in the other direction that is rational and fact-based.
I do have big issues with "Repeal government mandates regarding what insurance companies must cover." Health and illness aren't predictable - what if your plan doesn't cover exactly what happens to you in a car accident? Or you develop a mental illness but your plan doesn't cover it? Stuff needs to be covered and insurance companies cannot be allowed to wiggle out of coverage. I read a case in contract law last semester about a break-in at a warehouse that the insurance company didn't want to cover because there weren't sufficient signs of forceable entry, even though that how the perpetrators had gotten into the building. The insurance company lost, but it shouldn't have been an issue at all - does this policy cover burglaries? Yes. Okay, all burglaries are covered, duh. I'm pretty passionate about this because I have one of those medical issues that insurance companies love to shaft on coverage. I would hate hate hate to see people get shafted by greedy nasty insurance companies crafting policies that no one understands and no one can get coverage for actual problems. Does anyone actually read the policy manuals they get from their employer or health insurance company? How much is the copay on that appendectomy? Oh, it's not covered! Only spleenectomies are covered. The idea that insurance companies can offer some kind of a la carte plan is also silly - if they make a cheaper version that doesn't cover ob/gyn care, it discriminates against women - but that's legal (Gudeldig v. Aiello :::link:::). So fucked up.
"Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year." My tort law class touched on medical malpractice tort law for about 10 minutes, so I don't feel like I have enough data to be emphatic about this, but I'm pretty sure this is an exaggeration propagated by the folks related to other "tort reform" - which is incredibly bogus and pro-biz ideological when you look at the data of who sues, how much they get and why.
I'm all for clarity and truth in fees and billing but the current system is pretty broken. The retail fee schedule is way higher than the fees that are paid by insurance companies or medicare. A rather intense, personal look at that issue in Alaska: Mired in the Health Care Morass :::link:::
"Enact Medicare reform." I don't have the time at the moment to analyze/deconstruct that, hopefully someone else will.
"Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation ..." Laughably naive. We cannot run a health care system on charity.
Didn't we deal with the "rationing" canard last week?