A friend is on a California organ transplant surgical team, which apparently means long weekends in Tahoe every weekend. She posted the following on Facebook:
[stream of updates with pictures of snow in the Sierra and continued skiing]
Snowboard accident. Hit some little jumps, that I’ve gone over and landed fine. Bad landing/tumble today.
Shouldn’t think I can jump like Millenials
Guessing it’s tendon/ligament… when I took my SB boots off, pressed everything 1-5″ above medial malleous, didn’t feel like bone pain. Didn’t feel anything crunch. And my dexa was 2.5 SD above now for my age. Was suppose to hit Squaw next weekend and was hoping another mammoth visit in July
Thank God for Arctica race shorts… they won’t need to cut off any clothing
Wtf!!!? Been here almost 3 hrs!! If it weren’t for the painful hobbling to fuel, I woulda just waited til tomorrow. But I was a tad concerned if I wouldn’t be able to stand/drive in am. Guess next time (fingers crossed never again), unless I have a bone protrusion, bullet wound, knife wound, or CP…. not going to the ED. This is such a waste of time!
[response to comment blaming Donald Trump for the long wait times] I swear- no bone protrusion = no ED! This is a joke!
(“ED” = “Emergency Room”; see Medical School 2020)
Related:
- “Seriously!!?? 73 minute commute for 23 miles??? So over the Bay Area!” (same friend; May 31 status)
I’ve had ER visits vary widely. On the few visits I’ve made to the Really Famous University hospital ED down the street, I’ve waited hours (usually 4-6) for sloppy, indifferent treatment.
When a family member had a cut needing stitches late at night, we decided to skip RFU hospital and drive an extra 20 minutes to a generic facility the next city over. Seen by the doctor in under half a hour, back out the door in less than two.
My wife and I have found ER departments at most hospitals are slow and difficult and not that competent at best. Only go if you must. I arrived once with a badly broken arm. I got seen right away but the surgeon used me as a training opportunity. They had to do things multiple times in the OR to get it fixed. They woke me up to sign stuff in the middle, twice. Then I had to find a third doctor to fix it again 2 days later. Another time they tried to set the wrong hand when I broke a pinkie finger. Another time they made my wife wait 4 hours for a broken elbow with no pain meds. Another time they told me it was “probably a kidney stone” but they were not sure as their MRI was broken. So unless you are having a heart attack or have a badly broken arm/foot stay away…….
Typical entitled Bay Area whiner.
I am not in the medical field, but I am familiar with the triage process.
If driving herself home was an option, then waiting three hours should be no issue.
She doesn’t know what ails the other people in front of her, but she is convinced of her own importance.
–Ed
One consolation — if she is in Truckee hospital they have more experience with ski injuries than any other hospital for hundreds of miles. Because that is most of their business…
My experience with slope-side emergency room was positive, very prompt service. Luckily I had only a dislocation. The only thing doctor could do was to fix my leg rigidly. Instead I opted driving with my left leg about 100 miles back home.
I would recommend Barton in south lake Tahoe. I went there when I broke my leg skiing and they were excellent. The orthopedic group also in south lake Tahoe is wonderful.
Note to self: don’t take up skiing.
“Seriously!!?? 73 minute commute for 23 miles??? So over the Bay Area!” – That’s why I won’t go back (even though I might be able to double my income)
A tale from “socialized medicine” – spent midnight Christmas Eve 2016 in the ER of an NHS hospital in London (eye injury). Clean, prompt, courteous, competent MD, and no charge. I guess that puts me in “Facebook Friend” territory.
Donald: You can get into Facebook friend territory with this story if you infer from “British government can do X” that “U.S. government can do X.” (The U.S. government has already shown what it can do when it runs health care and the examples are Medicare, Medicaid, and the VA! Part of this seems to be asking the doctors’ trade union to tell the central planners how much it should cost for a procedure: https://www.washingtonpost.com/business/economy/how-a-secretive-panel-uses-data-that-distorts-doctors-pay/2013/07/20/ee134e3a-eda8-11e2-9008-61e94a7ea20d_story.html?utm_term=.176f3ea1ddcc )
Donald: Also, the big fight in the U.S. is how to pay for the 18 percent of GDP that is consumed by health care. Your story that you didn’t have to pay for your own care and you were happy about not having to pay suggests that we would still be having an intense fight with any system that consumed anywhere near 18% of GDP. Each group of voters would be seeking to have some other group pay their bills.
I’ll start… I would be happier with my own health care if Silicon Valley billionaires who profess to be concerned about inequality and health care would pay my Obamacare bill! (About $8,500 per year plus it would have been a $700 deductible for the hospital visit that you described. See http://philip.greenspun.com/blog/2017/03/02/adventures-in-obamacare/ )
(Also see http://philip.greenspun.com/blog/2016/05/09/eisenhower-biography-suggests-that-we-should-avoid-war/ for the differences in military performance during World War II for the same troops under British versus American leadership.)
>I would be happier with my own
>health care if Silicon Valley billionaires
>who profess to be concerned about
>inequality and health care
>would pay my Obamacare bill!
So single payer with progressive taxes.
Exactly, Neal! I propose that tax rates be 0% for income under a threshold and 100% for income over that threshold. Also there will be property and wealth taxes at the same 0/100 rates with an annually-adjusted threshold.
[For 2017, the income tax threshold will be $1 over our family’s income level. And the wealth tax threshold will be $1 over our family’s wealth level.]
Great philg 12, alternative history is a new and promising field. The key is to get enough eyeballs on it and everyone forgets what happened in real life! CNN it. Only tiny majority will have a chance to review archived documents and real artifacts.
@philg: Your proposal would work fine for me too, but we may need to compromise a bit to make the overall numbers work. I doubt your proposed tax plan would raise enough money, even without taking into account adaptive behaviors which might reduce revenues after implementation (in the past you have claimed these behaviors occur at much lower tax rates than those you have proposed). Plus, this is a democracy and others might find your proposal unfair. Thus, we may need to compromise to accommodate different proposals from our fellow citizens. Even if the people who would be taxed under your plan are small in number, the reality is that they are powerful minority and can definitely make their voices heard. It would be great if you and I could escape taxation, but it seems unlikely (even without single payer health care).
Neal: “Adaptive behaviors”? Hillary, Obama, and many other brave politicians have assured me that Americans will not change their behavior in response to higher tax rates (just as employers won’t change their hiring decisions in response to higher minimum wages). Why wouldn’t people want to pay their fair share?
I hope that you’re not becoming a Mankiw-style heretic (see http://www.nytimes.com/2010/10/10/business/economy/10view.html )
@philg: I don’t claim (and I don’t think the politicians you reference don’t claim) “that Americans will not change their behavior in response to higher tax rates (just as employers won’t change their hiring decisions in response to higher minimum wages).” It’s just that these effects are only one of the factors to be considered when setting policy which (like engineering) always involves balancing trade offs. Plus, these effects are likely to be much smaller at the tax rates actually under consideration by said politicians than at the 100% rate you have proposed.
>Why wouldn’t people want to pay their fair share?
As I said in my post, in a democracy, the definition of “fair” is a compromise. People who don’t accept your proposed tax structure might accept a different, but still progressive, tax structure.
>I hope that you’re not becoming a Mankiw-style heretic
I must certainly take Mankiw at his word when he describes what his response to changes in tax rates would be. However, there are at least two factors which limit the applicability of Mankiw’s argument to tax policy. (1) Many people don’t really have the capability to fine tune their income in response to to tax policy as Mankiw apparently does, and (2) For a person who needs a minimum take home income to maintain a lifestyle, their response to an increase in effective tax rates would be the opposite of Mankiw’s if their take home income is near that level. Many people do maintain a lifestyle near that supported by their take home income so it is not clear which effect would predominate.
I am very surprised the corporations (who supposedly own all the pols) have not demanded single payer in some form. Wrangling with sickcare providers has become a huge distraction from managing a business. The GOP is about to learn that there is no place to hide while continuing to pay everybody retail and pre-ordaining the services to be provided.
Neal:
Everyone can finetune their income down and majority does, especially given that lower paid workers get back larger return than they put in dollar wise! It is a democratic compromise and you need to your adaptive models adaptive and recursive. When you think about it looks like what philg says. Income tax in the USA was originally created as 0% for majority + some small percentage for super reach. philg is pulling our leg here, not exactly inventing anything new, just ‘optimizes’ it to 100%
@dean: Of course most people can change their income and easily change their income to zero, but not everyone can easily fine tune it.
I could fine tune my salary down to 25%-20% of my current with 10K decrements, taking less stressful jobs in closer proximity. All software developers and IT workers can.
There’s an obvious issue with that Mankiw column. He says that he would like to have more money to help his kids. If he gives his kids money so that “they won’t have to struggle to find down payments to buy their own homes or to send their kids to college” that would have to provide incentives to his kids similar to welfare, causing them to work less because Dad is providing income. If Uncle Sam reduces the amount of money Professor Mankiw has to provide gifts to his kids, that should cause to work more and harder.
Also, do you have a link for this assertion?
Hillary, Obama, and many other brave politicians have assured me that Americans will not change their behavior in response to higher tax rates
I don’t recall Hillary or Obama making any such claim.
@dean: I am very happy for you, but your statement does not contradict or invalidate mine.
73 minutes for 23 miles? Going West from San Jose to Sunnyvale in the afternoon, I hear 2 hours for 11 miles is not uncommon before major holidays or the odd Friday.
73 minutes for 23 miles? &3 minutes would be very good for many NYC outer boroughs dwellers who work in Manhattan and take subway.. And 73 minutes is about how long 9 miles morning drive towards lower Manhattan lasts.