Archive for the “Dangerous Thoughts” Category

Just a random thought I had...

polygamy = many legs

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It only takes a dollar to win a 300 million dollar lotto jackpot, but it takes 1.5 billion dollars that didn't win to get the lotto jackpot that high.

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Photo of mansion by patishka - sxc.hu"Warning: This episode of 'MTV Cribs' is known to create unrealistic expectations in teens about what it takes to succeed in America. Your odds of becoming a multi-millionaire athlete, musician, actor, or person who is famous for being famous are about the same as your chance of being hit by lightning."

"Furthermore, most of these people became millionaires through a relentless drive for self improvement and success, making sacrifices, and not taking the easy road."

"If you want to be on 'Cribs' get off your ass, and start *working* toward a goal. You may not ever reach it, but you'll get more of what you want by working for it than by watching it on TV and wishing for it."

Wanna suggest another warning label? E-mail burgerguy@gmail.com

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Pills & Bottl - Photo by Tom Varco via Wikimedia CommonsSlate had an interesting article last week on the overuse of prescription heartburn drugs like Prilosec. If you read through it, the author links the overuse of these drugs to doctors being too quick to write a prescription instead of getting a better understanding of the problem or doing lifestyle counseling instead. The author then takes the next step to say that paying for all these prescriptions is a major part of why our healthcare costs are skyrocketing.

Now, the fact that doctors are prescribing a new prescription medicine when a generic cousin is available is a problem that increases costs, especially in the light that the new medicine is not significantly better than the old one in any particular way. But the practice of dashing off a prescription and moving on cannot be blamed entirely on the doctors. It can be blamed to a certain extent on the way our healthcare system is structured.

Insurance companies do not have billing codes for 15-minute blocks of time. They have billing codes for office visits and patient assessments. Your doctor gets the same amount of money if they spend half an hour with you or 5 minutes with you. If they want to make enough to pay their mortgage, car payment, health insurance (you'd be surprised how expensive insurance is for doctors), they have to see a certain number of patients per day. Sometimes they work on salary for a clinic or HMO, but then they have to go through performance reviews which count how many patients they're seeing in a day.

Talk may be cheap, but not when you're talking to a lawyer, doctor, or other professional who expects a certain hourly rate far in excess of what you and I make. And insurers seem to have done the math and decided that they're paying less for prescriptions than they would for longer office visits.

But it's not just the insurance system that promotes overprescribing. We're Americans, goddamnit. If we go to the doctor and complain that hitting ourselves in the head with hammers is giving us headaches, we don't want our doctor to tell us to stop doing that. We want our doctor to prescribe the medicine we saw on TV that stops the headaches associated with hitting yourself in the head with a hammer. We don't feel better unless we walk out of there with a prescription in our hot little hands.

We already know "bed rest, fluids, Tylenol, and time" are what you do for a cold, and if we know that, we don't want to hear that from a doctor. We came to the doctor for expert advice, not common horse sense. And thus the doctor feels pressured to prescribe something. And that's likely a big contributor to the study showing nearly half of kids getting prescribed antibiotics for colds that won't even respond to antibiotics. I'm sure many doctors tried to put up a fight when they were young and idealistic, but got beat over the head so often by stupid parents who wanted a feel better pill, even if there wasn't one, they started handing out antibiotics just to avoid the argument.

High-priced prescriptions do add to the health care overhead. But so does procedure-based payment that encourages doctors to tag 'em and bag 'em. So do people who don't feel like they've been treated unless they get a prescription. So do people who would rather use pills to relieve the discomfort caused by bad lifestyle choices than suffer the self-denial of making good lifestyle choices. We're all to blame for our overmedication and the associated costs, and it won't get better until attitudes change in a number of camps.

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