Choosing Hospitals

Choosing hospitals, like choosing insurance, seems like a super daunting task. Sure you can look at the newsmagazine "Best of..." lists but they are at best quasi-scientific and probably have little to do with the experience that one individual will actually have. You can also visit the Medicare Hospital Compare website but again it is a bunch of statistics that may or may not be relevant. A couple questions come to mind as I look at the stats on their site:
- Since these stats/surveys are about/from Medicare patients, who are generally older, sicker, and less well educated than I am how do I translate them for my own use?
- When I am wading through the stats how do I know what is a significant difference. Look at this graph about how well nurses communicated with patients. Does a 5% difference really mean that one is better than another? I assume that the sample size is large enough that these numbers are meaningful but they could be skewed by the department that most of the patients were in.

Ok so I haven't solved anything but at least I made a note that there is a place where you can get survey results that provide statistics about hospitals and that you can use these in an attempt to compare one hospital to another.

Legislative language

In musing about how Congress should stay on topic I found govtrack.us (which seems to be a very useful site). (No comments on how my first sentence is not related to the rest of my post).

As a result of finding govtrack and the full text of the bill I skimmed through the Credit CARD Act of 2009 and read the section allowing guns in National Parks and National Wildlife Refuges. The thing that struck me was the language used. I did student congress in high school and I know that the law has its own language. But some parts of this section read more like PowerPoint slides than legal language. The sentence that really got me:

Congress needs to weigh in on the new regulations to ensure that unelected bureaucrats and judges cannot again override the Second Amendment rights of law-abiding citizens on 83,600,000 acres of National Park System land and 90,790,000 acres of land under the jurisdiction of the United States Fish and Wildlife Service.

Weigh in? Next thing you know Congress is going to leverage the synergy of the new process to produce outstanding results in all that they do.

Why doesn't congress stay on topic?

I've been thinking about this for a long time but the recent passage of the Credit CARD Act of 2009 prompted me to write it down. Would our government be better or worse if members of Congress were compelled to deal with issues one at a time? Or maybe not even that--members of Congress do need to multi-task and deal with many issues in a day. Would public policy/legislation be better if it were always limited to a single topic? We would end up with more bills certainly but would they be better?

Regardless of how one feels about credit card regulation or carrying guns in National Parks these topics are not in any way related. I know that there is a good deal of horse trading that goes on to get legislation passed. And I have heard the old saw about laws being like sausage. But even if the deal making includes unrelated topics it seems like the legislation itself should be on a single or closely related set of topics. Maybe there are big advantages to doing it this way that I just don't see but it seems ludicrous that such muddled thinking and writing are the norm and that everyone accepts it.

HealthCare could be better...

As a Kaiser patient ordering from their mail order pharmacy involved logging in to the website and entering some information about the prescription I wanted filled and my credit card number. Since their docs enter the prescriptions in their system the pharmacy fills it and sends it to me.

Now that I have Aetna I have to go to my doctor, give them a form, which they fax to Aetna, and then I send Aetna a payment, and then Aetna sends me the medicine. The Chipotle add that says "1984 called and they want their fax machine back" comes to mind.

Thankfully our health care system gives me "choices" and since my employer dropped Kaiser I got to choose Aetna. I think Aetna is typical and Kaiser is the exception with regards to computerized records and I find this amazing (in a bad way).

audi a4 dome light rattle

As it turns out it isn't the dome light that rattles so bad--it is the piece of plastic right behind it that covers the built in microphones (for the bluetooth that I don't have).
It's not actually that hard to take the whole thing apart but the steps at audiworld helped. I took the whole assembly apart which made it easy to snap the rattling mic cover off. I then stuck some double-sided tape (the puffy stuff for mounting pictures to frames) on the inside and re-assembled. Hopefully this fix will last longer than the dealer's did.

competition for government contracts

Competition for services is different that competition for goods
After hearing about that no government contract should be awarded sole source and that no contract should be cost-plus I have been thinking about what that might look like. The problem is competition for government contracts is not like competition in a normal marketplace. Most contracts aren't for widgets that are being built and the government is trying to buy a few--it is for a service. So it should be thought of more like hiring a home contractor or a doctor. Have you ever tried to get a fixed price contract with your doctor? Do you shop for a different doctor every time you feel sick?

I am not saying that all contracts should be sole source or that fixed price contracts are bad. I do find the lack of depth in the public conversation to be frustrating.

My wife is way smart (programmable thermostats)

A while back my wife and I were discussing how a programmable thermostat can save energy (money). I fell into the trap of thinking that it took just as much energy to heat back up as was saved while the house was cooling. She pointed out that savings is not while cooling down or heating up but while the house is sitting at the cooler temperature. In almost exactly the same words the Department of Energy says the same thing. She claims she's not a physicist--just that she studied physics--but I don't think I believe her, she thinks like a scientist, a super smart one.

I love you T.