Friday, May 08, 2015

Explaining Hilary

Megan McCardle goes a long way in explaining Hilary for me. One of the things I object to is academic high mindedness about the relationship of pharmaceutical companies to doctors. In part this is, for me, about profitable interchange of ideas that may occur at dinners to promote a product. For instance I learned more about the physiology of pain at a talk on Neurontin. Or it may just be about things that make life a little easier or more fun. For instance I weigh patient's on an Equetro branded scale. I didn't know about the type of scale it is an example of. These things are now not apparently permissible. Many politicians know this but there are obviously strains of 'reform' that oppose their existence, similarly in campaign finance and across the spectrum of social interaction. These reforms are to keep the big players from influencing what happens to the 'little people.' Now Hilary is in the camp that is for the little people and so she speaks as a lawyer for that point of view. She however knows otherwise and doesn't apply it to herself, think cattle futures, think Bill's sexual affairs, think debt forgiveness in Whitewater, emails. De nada as a new constituency would say but it doesn't mean not being a lawyer for 'reform,' 'transparency,' FOIA requests requests, all things important to a part of her base.

Tuesday, May 05, 2015

Greg Mankiw, Chairman of Harvard's Economics Department, Favors the Abolition of the Estate Tax

Here. My own view of it is that it is a burden on high middle earners and their offspring. Given that you have enough funds, you can engage in estate planing and work to avoid the tax like people used to avoid income taxes, not so inclined or having the time, the estate gets taxed. That would tend to fall on people who are not primarily significant financiers.

Saturday, May 02, 2015

Baltimore

I think the facts of The Freddie Gray case, the false arrest, the brutal ride in the paddy wagon are a surprise to most white Americans. The fact that police authority in this case has been subject to a flanking attack by a Pennsylvania state attorney will open up more hope to black people and together these events are the most positive for interracial comity in many years. We love you, poor Freddie.

Sunday, March 22, 2015

The Oklahoma University Conteoversy

Having graduated from Jesuit High School and seen my children graduate from Highland Park High School, even my limited experience assures me that there is no more a right wing group wanting to lynch black people than there is a left wing conspiracy to outlaw the NFL in favor of a national scrabble tournament. What we have is youths saying ‘bad words’ in response to the chanting of evidently ‘bad facts’ by others. The limited experience of the white youths did not let them see that the chanting of ‘bad facts’ was related to experiences which may have been true enough(1). But the privileged graduates also were not talking about a true behavior, lynching, that they wanted to engage in, only celebrating having equal time in saying ‘bad words.’

1. TNC article in the Atlantic

Thursday, March 19, 2015

Thoughts on Leaving Private Practice (Equipment and Business Methods)

The most surprising outrageous thing involved a Brother printer. We had trouble with a network connection; so someone called the helpline. They in turn were referred to someone else who did solve the problem but 'noticed some intrusions in our computer' and scared this HIPAA sensitive staff person who asked for authorizations of $600 and $300 to clear the matter up and 'have something placed on the computer to monitor.' A complete fraud from some outfit in India as it turned out. In printers I have appreciated the speed of the HP Officejet Pro 8600 which has some good HP support tools. The Samsung basic small rectangular box has been a reliable printer of patient notes. RxNT is an excellent eprescribing solution and has helped with qualifying for the associated 'meaningful use' parameters involving computers. The ability to link to LabCorps and Quest Laboratories for your patient results is very nice. Billing we did with Lytec and is a subject which is rewarded by reflection on possible deviations from expected. In retrospect one of the most amusing related to Medicaid. I relocated my office. Part of the process of that was informing the state office of the change of address. We continued to have Medicaid patients and to get EOBs telling us what we would get paid from Medicaid. About 2 years after we moved though the billing person noticed a footnote saying that a payment had not been sent, we had electronic funds transfer, for lack of an address. 'The left hand didn't know what the right hand was doing,' so to speak. Medicaid knew my address well enough to send us mail explaining what we would be paid but not well enough to electronically send us money for services which for proper arrival didn't depend on my office address anyway. A few polite letters and phone calls did resolve the matter. As far as I know the back pay was accounted for. One more device I found awesome is the Black & Decker shredder model BD AF7500. For my office it was heavy duty, very convenient to use. Checkmark Payroll has been a useful software for payroll, 940s, and 941s. I use QuickBooks, but, in this context it would be useful to have just a check writing software.

Saturday, December 06, 2014

The Season of the Witch

During the VN era, there was a song with the line, 'Must be the Season of the Witch,' a haunting rock song. Now we have the Michael Brown shooting, and riots, the misfired UVA rape allegations, and the Garner death; and injustices in some parts real and in other parts projected out of the preexisting anger of the accuser are played out in the reactions of victim identification. During VN we had the 'specter' of communism, and now I see the 'Season of the Witch' and see this time similarly. I wish we had let the Vietnamese vote to decide their country's status in 1956 but my feelings about the war have further thoughts, and I will leave it at reflecting on this Season.

Saturday, October 25, 2014

Exorcism and Nonepileptic or Pseudosiezures

The discussion of the painting (1) The Miracles of St Ignatius Loyola might seem to disparage religion. My consultation experience and that of others (2) with ‘pseudoseizures’ or nonepileptic seizures and conversion disorders , the syndromes of the discussion, suggests that the syndromes may be variants of panic disorder and successfully biologically treated as such. Hypothetically the syndromes might be induced by the anxiogenic methods of sodium lactate infusion (3) or high dose caffeine ingestion (4). In reference to the painting and its discussion, if religious experience restructures the psychodynamic and psychophysiology of the sufferer, then indeed religious experience might be helpful.

1. Harris JC. Exorcism: The Miracles of St Ignatius Loyola: Peter Paul Rubens. JAMA Psychiatry. 2014;71(8):866 2. Snyder SL, Rosenbaum DH, Rowan AJ, Strain JJ. SCID diagnosis of panic disorder in psychogenic seizure patients. J Neuropsychiatry Clin Neurosci. 1994 Summer;6(3):261-266. 3. Liebowitz MR, Fyer AJ, Gorman JM, Dillon D, Appleby IL, Levy G, Anderson S, Levitt M, Palij M, Davies SO, et al. Lactate provocation of panic attacks. I. Clinical and behavioral findings. Arch Gen Psychiatry. 1984;41(8):764-770. 4. Charney DS, Heninger GR, Jatlow PI. Increased anxiogenic effects of caffeine in panic disorders. Arch Gen Psychiatry, 1985;42(3):233-243.

Tuesday, October 21, 2014

Ebola and Politics

Socialism or family life is like an MC Esher print. It has areas or blocks of equal properties which fit together and then there is an edge in which the properties of the spaces change. The unseen disharmony of the same spaces can be covered over in an unseen way by some of the spaces until an edge. The failure of the CDC or simply its lack of effectiveness represents Obama's inability to cover an unseen disharmony. The U.S. is at risk from West African travelers. To allow the CDC to acknowledge this risk suggests that steps which disproportionately affect black people might be appropriate. That contradicts the internal domestic policy that something that 'disproportionately affects black people' is per se racist so would open a can of worms.

Saturday, September 20, 2014

Books noted: Eichmann Before Jerusalem: The Unexamined Life of a Mass Murderer. Also Dying Unneeded: The Cultural Context of the Russian Mortality Crisis Also Max Hastings on the Marne and WWI more generally and Fromkin on 'Europe's Last Summer' (before WWI), the Prussian plan for war, and Fromkin on the war outcome 'The Peace to End All Peace.' DeLong also highlighted the classic book on the Marne recently, that by Sewll Tyng.