Brief Primer on Health Law Compliance

Ralph J Williamson MD” (alias?) seems to be confused about how health law enforcement actually works (in my thankfully limited experience.)

… 30,000 physicians can’t be wrong. If practice fusion was an illegal product, or an unethical product, it would have already been shut down. Put your money where your mouth is and challenge them, Mr. Yates. Report them to the feds, call the police, call your politician, tell the press, sue them. … So I would like you to bring them down before I make the move.

First, I don’t think I’ve been ambiguous about “putting my money where my mouth and challenging them.” I do publish on a public website under my own name, and I do file reports with the appropriate agencies when it’s my business to do so (for whatever that is worth, which is zero), but I don’t know what you’re expecting… a bazooka? The Men in Black? Harvey Birdman, Attorney at Law?

Second, you know what the big problem in healthcare is right now? Medicare in Connecticut stopped all payment this month. Yah, oops! the government healthcare payers missed a payment. “Immediate Financial Catastrophe” is probably higher on the checklist of things for “the government” to “fix” right now over some snipity Blueshirt MD super douche throwdown over a blog comment about some new Website! …dot com run by 10 people in California.

Third, every big provider in region that I know about is currently being audited for “compliance.” “Big” means “hospitals” and “nursing homes the size of hospitals.” “Compliance?” You know how that works? Here’s how: Government Auditors: “We’ll get back to you.” You know what that means? Doesn’t matter! Do you think that the government is in the “Free Audits for Fun” business? “Hey guys, um, we couldn’t find anything wrong even though we don’t audit you without knowing that you’re already guilty of something largely because we are the sole arbitors of what and who is guilty whenever when and why, but could you, like, please try harder to not bill medicare now? Cause, we don’t have any money to pay you, and you’re probably guilty as hell anyways? Is that cool? Thanks guys.”

Yah, they’re fucked.

But the good news for idiot medical students who think that a free and easy Practice Fusion account and a fresh MD makes them a “threat” to the “establishment” is: “No, you’re not. Please continue to avoid regular employment despite your expensive educations by the grace of there actual problems real adults have to solve now. We are not worried that sometimes you smoke pot and may own a Che Guevara t-shirt because he is dead and because buying t-shirts can be positive consumer activity which we as Americans endorse and appreciate. Thank you.”

Fourth, selling patient data is wrong, even if you don’t get caught or get in trouble. It’s also stupid if you don’t even get paid for it in cash.

Fifth, even a single lawsuit is expensive. Very expensive. And one lawsuit means you’re on the Law Menu. If you lose, it’s feeding season. Would you take a bet to earn an extra $1k per month if, in exchange, you had to pilot an explosion on wheels while half asleep twice a day at speeds which would instantly kill you over several miles also swarming with other explosions on wheels also piloted by other half asleep people whom you’d recognize at the DMV? Yes. So… never mind.

Six, law is slow. Even if God told George W. Bush right now that everybody at Practice Fusion had to be assassinated immediately, practicefusion.com would still probably accept your new user registration. In practice, the law is going to be even slower than that. So, I think I’m not going to be able to “save” you this time from big bad Practice Fusion, Dr. Ralph. Sorry.

Aside: I have no idea what motivated this comment, but if “Ralph” were a sock puppet, I am struggling to fathom the poor judgement of engaging me in some blog comment defense of Practice Fusion. My motive is usually provoked adolescent rage. It’s not complicated or dishonest. If I don’t have any new reason to like something I hated before, why would I change my mind later given that same information? In fact, the only new information I have is that somebody thinks that by repeating the same information is itself veiled threat. Like, if this was a clever attempt to get me to post more about Practice Fusion, it worked, but I don’t see how me not liking Practice Fusion and saying so changes the law I cited, the moral hazards of medical privacy I described, and the fact that other companies including Google already offer better, similar services for similar prices with more honest terms. For example, mdon-line.com is OK, and they’ll process your billing, and they seem to be doing OK, even though I’ve never been pestered by their blueshirts or blog spam. Like, it’s not that hard. Just ignore me. Then, I do other things. Problem solved.

Gas cooler

I have a PM on a gas cooler motor first i isolate the drawer When i measure the winding resistance of the motor i found that the value varies and the avometer don,t indicate a certain value?

SA10: Commercial RLV Technology Roadmap update

[The first in a series of posts from the Space Access ’10 conference this week in Phoenix.]

Dan Rasky of NASA Ames presented on the status of their Commercial RLV Technology Roadmap Study, seeking to identify what technologies needed for such vehicles (both suborbital and orbital) are of most interest to industry. The full details of the effort are in his slide presentation, posted here by popular request. The goal, he said, is to have an interim roadmap ready to present at the NewSpace 2010 conference in July at NASA Ames; the final version will be out in September.

One interesting note from the presentation: Rasky said that NASA Dryden recently acquired the two airframes from the canceled X-34 program. They had been in storage since the program’s cancellation when a Dryden employee bought them for $1 each from Orbital Sciences, but when he retired the airframes were dragged out to the bombing range at Edwards AFB. Fortunately the airframes were recovered intact, although several crates of other X-34 parts were lost. Rasky said his office is trying to get some funding to study the airframes and determine their potential viability for future integrated flight tests, something the roadmapping study has found considerable interest for so far.

Piping Fabrication to B31.3

CR4's we are looking at an inquiry for 36" pipe with noozles. The wall thickness is based upon a "W" factor of 1. We want to use A312 pipe (100% xray) as our base material, but if we use this welded pipe can we comply with this "W" factor? Section 4 or 5 of the most recent B31.3 code says if we use

The theme of our ageGene Expression

greenyEzra Klein references the old Shaggy hit “It wasn’t me” to characterize Alan Greenspan’s testimony yesterday. It’s not just Greenspan, Robert Rubin is pulling it too. The point isn’t that these people have plausible deniability, they don’t, the issue is that there’s no real recourse anyone has to hold them accountable. They can lie to your face because there’s no consequence. I noted below that institutional investors demand risk so that they can have an opportunity for high returns. This isn’t necessarily just from on high, pension funds need the high returns to fulfill their obligations, and those obligations were entered into by labor and management. The fact is that we don’t have the economic growth to come through over the long term through a conservative investing strategy, so the managers start rolling the dice. If they fail and it blows up, they’re fired, and if they luck out, they’re heroes for the day.

It wasn’t just the big shots. Unless you’re a prodigy (i.e., you’re a 2 year old reading this weblog) and you’re an American you lived through the real estate bubble of the mid-aughts, and you know people who treated their homes like ATMs. People who bet on a “sure thing” future which never came about. Yes, there were greedy mortgage brokers and shady speculators, but if it wasn’t for the avarice of the average man and woman it wouldn’t have been so widespread. But here’s the difference: the average American has experienced a lot of economic distress or insecurity. There have been real consequences for their bad calls. The unemployment rate is high enough that anyone who isn’t a shut-in knows someone who’s been negatively impacted. Not so for Sirs Greenspan and Rubin. The high & mighty are too big to fail, they may have their reputations tarnished but ultimately their lot is one of comfort and ease. This is of course not atypical, it’s most of human history.

I think the ultimate long term problem for American society is that many Americans now perceive the elites as rent seekers and not engines of productivity. The vision of the expanding pie is starting to recede, and once the spell is broken I fear for the well being of the “virtuous circles” which economists praise.

Anyway, I was referencing Shaggy long before Mr. Klein.

U.N. Climate Talks Resume, EPA News

Climate talks resume, very small chance of 2010 deal

Thousands of acres of forest have been slashed and burned in Rondônia, a state in northwest Brazil, mostly to make room for cattle ranching.

BONN, Germany (Reuters) – Climate negotiators meet in Bonn on Friday for the first time since the fractious Copenhagen summit but with scant hopes of patching together a new legally binding U.N. deal in 2010.

Delegates from 170 nations gathered on Thursday for the April 9-11 meeting that will seek to rebuild trust after the December summit disappointed many by failing to agree a binding U.N. deal at the climax of two years of talks.

Bonn will decide a program for meetings in 2010 and air ideas about the non-binding Copenhagen Accord, backed by more than 110 nations including major emitters China, the United States, Russia and India but opposed by some developing states.

The Accord seeks to limit world temperature rises to below 2 degrees Celsius (3.6 F), but without saying how. (Magic?)

“We need to reassess the situation after Copenhagen,” said Bruno Sekoli of Lesotho, who speaks on behalf of the least developed nations who want far tougher cuts in greenhouse gas emissions to limit temperature rises to less than 1.5 C. . . . .  it is unclear what will happen to the Copenhagen Accord.

The United States is among the strongest backers of the Copenhagen Accord, but many developing nations do not want it to supplant the 1992 Climate Convention which they reckon stresses that the rich have to lead the way.

“I don’t believe that the Copenhagen Accord will become the new legal framework,” Yvo de Boer, head of the U.N. Climate Change Secretariat, told reporters in a briefing about Bonn last week.”

Yvo de Boer has actually resigned, so it’s unclear how involved he is at this point.  And a legal framework of any kind will simply be ignored by the U.S. if right-wingers are ever in power again.  They are already working to ignore any laws passed by Democrats from now on.

READ more here.

Green Groups Fight to Keep EPA’s Power Over Greenhouse Gas Emissions

Good luck, green groups — you’re going to need it, but I hope they are successful.   Senators John Kerry, Joe Lieberman and Lindsey Graham are working hard behind the scenes to chop the EPA off at the knees and render it useless on climate change.  With friends like that . . . . .

Environmental activists this week are stepping up a battle to protect U.S. EPA’s ability to regulate greenhouse gas emissions, staging demonstrations and lobbying lawmakers at their local offices.

Carrying signs with slogans like “Fight Climate Change Now” and “We Can’t Wait for Climate Action,” members of the coalition 1Sky already have rallied outside the regional [...]

NorCal skeptic conference April 24 | Bad Astronomy

There will be a skeptic convention in northern California (specifically Berkeley) on April 24. Called Skeptical, it’s being run by the Bay Area Skeptics and the Sacramento Area Skeptics, both great groups of folks. I wish I could go; speakers include Genie Scott, Kiki Sanford, Brian Dunning, Karen Stollznow, Seth Shostak — all friends and wonderful lecturers — and I hate to miss something like this.

But you should go! It’s a one day event, and the cost is only $40. Not bad. That would only buy you like one minute on the phone with Sylvia Browne, or 0.0007 bomb-sniffing wands, or a Deepak Chopra book — all of which are worth far, far less.

skepticalcon


Overmold material adhering to cable

When overmolding PVC, Polyurethane or other compounds onto a flexible cable, it is very difficult to get the overmolding compound to adhere to the cable jacket. We have tried a couple of pre-mold adhesives with very limited success.

We have seen some product from Europe that uses a PUR over