Annals of insane medical service pricing

I recently had back surgery for a herniated disk. The procedure was pretty high-tech - insertion of a series of ever-larger tubes to create a roughly 1/2" hole, through which the surgeon could get in to my spinal area to clean up the bits of disk and disk gel that were pressing on my sciatic nerve. Time from walking in the front door of the surgery center to getting in the car to go home: under 7 hours. The results have been great - no pain at all for the first three weeks, then some minor nerve irritation as the steroids have worn off. The doc promises that this will go away, which it's already started to do.

As to the title of this post: the outpatient facility (Sam Ramon Surgery Center) is out-of-network. Lucky for me, I have great medical coverage through my employer. But being out of network means that we get billed at the full rate - not a contracted or negotiated rate. The "facility fee" for those 7 hours? Guess, then scroll down.

















$85,000.

I don't know what to say about this except that it's insane. It's obviously completely unrelated to the actual cost of providing the facility to do the procedure or to the skill of the people involved. (Note that the surgeon's fee was separate.) The usual explanation for insane hospital charges is that they have to cover unreimbursed ER and medicaid care. That doesn't apply to an outpatient clinic. They get paid for everything.

This is not the fault of any "greedy insurer". It's the greedy medical-industrial complex...

The only way to make politics tolerable is to watch it unfold on Comedy Central

That is all...

Smedley Butler for President (in 2016)

From Wikipedia

"I spent 33 years and four months in active military service and during that period I spent most of my time as a high class thug for Big Business, for Wall Street and the bankers. In short, I was a racketeer, a gangster for capitalism. I helped make Mexico and especially Tampico safe for American oil interests in 1914. I helped make Haiti and Cuba a decent place for the National City Bank boys to collect revenues in. I helped in the raping of half a dozen Central American republics for the benefit of Wall Street. I helped purify Nicaragua for the International Banking House of Brown Brothers in 1902–1912. I brought light to the Dominican Republic for the American sugar interests in 1916. I helped make Honduras right for the American fruit companies in 1903. In China in 1927 I helped see to it that Standard Oil went on its way unmolested. Looking back on it, I might have given Al Capone a few hints. The best he could do was to operate his racket in three districts. I operated on three continents."
...
He became widely-known for his outspoken lectures against war profiteering, U.S. military adventurism and what he viewed as nascent fascism in the United States. In addition to his speeches to pacifist groups, from 1935 to 1937 he served as a spokesman for the American League Against War and Fascism.[49][50] In 1935 he wrote the exposé War Is a Racket, a trenchant condemnation of the profit motive behind warfare. [ Smedley_Butler]

Cutest Name for a Bail Bondsman

Seen near Broadway and 19th in Oakland.

US Chamber of Commerce makes clear where it stands

The headline yesterday said "Chamber's Donohue Says Obama's Rules Suffocating U.S.".

It's an interesting word choice, since one of the highlighted regulations is a tightening of the ground level ozone standard. High in the stratosphere, ozone is our main natural UV protection. At ground level it causes asthma and other respiratory problems. From the EPA's summary: "The proposal to strengthen the primary standard places more weight on key scientific and technical information, including epidemiological studies, human clinical studies showing effects in healthy adults at 0.060 ppm, and results of EPA’s exposure and risk assessment."

Another highlighted Chamber complaint is about tighter regulation of cement plants. Here's the EPA's news release on the regulation: "The U.S. Environmental Protection Agency (EPA) is issuing final rules that will protect Americans’ health by cutting emissions of mercury, particle pollution and other harmful pollutants from Portland cement manufacturing, the third-largest source of mercury air emissions in the United States. The rules are expected to yield $7 to $19 in public health benefits for every dollar in costs. Mercury can damage children’s developing brains, and particle pollution is linked to a wide variety of serious health effects, including aggravated asthma, irregular heartbeat, heart attacks, and premature death in people with heart and lung disease."

So there's your US Chamber of Commerce: fighting the good fight for more asthma, heart attacks and brain damage.

Matt Taibbi in Rolling Stone

[T]he fact that we're even sitting here two years after Bush talking about a GOP comeback is a profound testament to two things: One, the American voter's unmatched ability to forget what happened to him 10 seconds ago, and two, the Republican Party's incredible recuperative skill... This is a party that in 2008 was not just beaten but obliterated, with nearly every one of its recognizable leaders reduced to historical-footnote status and pinned with blame for some ghastly political catastrophe. There were literally no healthy bodies left on the bench, but the Republicans managed to get back in the game anyway by plucking an assortment of nativist freaks, village idiots and internet Hitlers out of thin air and training them into a giant ball of incoherent resentment just in time for the 2010 midterms.

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Weekend in Inverness

Pt. Reyes, not Scotland. We rented a friend's house high up on the ridge overlooking Tomales Bay. I woke up on Saturday morning at 5:30 - it usually takes a day to adjust to a more normal schedule. So I sat in the hot tub on the deck and watched the dawn across the bay. I felt Californian.

Fog over Alcatraz

The view from my window. The slight rise of Alcatraz in the breeze is enough to make the fog quite a bit denser.

Visit from Tycho

Tycho is visiting from NY for a meeting and hanging out with us for the weekend. He's as entertaining as ever. He's decided that everything we do must be documented, so we've now got lots of photos from the last two days.

1. A mouse somehow has moved into our kitchen. It looks more like a pet mouse than a pest. We can't catch it, but Tycho did snap some photos of the critter.
2. Another mouse, being eaten by a snake, seen on trail between Muir and Tennessee Valley beaches.
3. A lizard.
4. Tycho
5. Us


UPDATE: House mouse caught & released into the wild around 9 pm last night. We caught it fairly easily in the end, then put it in a box. It was more curious than fearful, making me think again that it was a lost pet. But it seemed unlikely that we'd find the owner if there is one, and no one in our house was particularly interested in taking care of it. Anna's rat cage was long gone, so we had to let it go.

Nature red in tooth & claw.



On the bluffs between Muir beach and Tennessee Valley.

The trip to Angel's Landing

We climbed up to Angel's Landing in Zion NP today. It's 2 1/2 miles with 1500' of ascent. Quite a hike - a switchback up the cliff base followed by a walk through a slot canyon and a steep climb up Walter's Wiggles to the staging area. (OK, I was having Everest fantasies). The day was gorgeous - cool hiking weather, sunny and not too much wind.
The last half mile is along a rock fin jutting out over the Zion Canyon valley. In several places the trail is no more than a few feet wide and sometimes runs along the side of the cliff, with chains set into the rock for handholds. Two of the five of us decided to skip the last stage. Catherine, Anna and I headed out to the tip.

"White knuckles" doesn't do it full justice. And on the way back, Anna slipped and fell headfirst on one of the cliffside segments. She managed to arrest her slide with inches to go before the edge. I was right behind her and grabbed her leg, as did a guy coming up the other way (who may have been partly responsible for her slip, by refusing to give way on the chain), but she had already stopped by then. So the good news is that I still have a daughter. The bad news is that I'll have that image stuck in my head forever.