I went to an outpatient clinic yesterday to get an impacted tooth removed. Handling my case yesterday were: one doctor, one anesthesiologist, two receptionists and five nurses. As for space, there was one lobby, a room where a nurse looked through the forms I filled out, the operating theater and a room that led to a loading ramp. The total cost of the 30-minute operation was $800. There are only two surgeons in Norman who are covered under my insurance plan, so I'm sure the other place is quite similar.
Why is it that expensive? It's not that the surgeon himself makes that much money. Take away the cost of the clinic rent, receptionist salary, nurses, materials, liability insurance, and I would estimate that his take from the operation may have been less than $200. Yet, the operation cost my insurance company $800.
I think that the reason is that there is no economy of scale in healthcare. In a country where retailing is dominated by big box stores, medical practices are run like boutiques.
Tornado warnings: failed dissemination mechanism
The mailing lists are abuzz with indignant meteorologists. This is about the tornado that struck the Georgia Dome where the University of Georgia was playing Mississippi State. Announcers on sports radios state that people in the stadium had no warning. They're probably using the words "no warning" in a generic context. But to a meteorologist, a "warning" is a technical term. And there was a tornado warning issued for the event about 10 minutes before the tornado struck the Dome. And even earlier, there were warnings for severe weather and for hail. Hence all the indignation.
Nevertheless, it appears that the warning never made it to the hordes of basketball fans in the stadium. The folks at Georgia Dome seem to not have made the announcement. It was fortunate that the game went to overtime, otherwise basketball fans would have been in the parking lot when the tornado stuck. In other words, the problem is not that a warning was not issued but that the dissemination mechanism failed.
We need to have warning applications that will automatically send weather warnings to mobile phones. A while ago, a colleague and I did a proof of concept using a web service and Android's cell-phone-tower triangulation capability. Somehow, though, I don't have much hope that it will see the light of day any time soon. Dissemination is a private sector responsibility and government agencies like the National Weather Service are afraid to tread there for fear of being slapped down by Congress. And since few people are willing to pay for weather information, the private sector seems uninterested in the mass market. Besides there seem to be liability issues that are far above my pay grade to sort out.
The sad thing is that we're probably one disaster away from resolving this. Close calls like the Georgia Dome incident are not going to do it.
Disclaimer: My opinions, not my employer's.
Nevertheless, it appears that the warning never made it to the hordes of basketball fans in the stadium. The folks at Georgia Dome seem to not have made the announcement. It was fortunate that the game went to overtime, otherwise basketball fans would have been in the parking lot when the tornado stuck. In other words, the problem is not that a warning was not issued but that the dissemination mechanism failed.
We need to have warning applications that will automatically send weather warnings to mobile phones. A while ago, a colleague and I did a proof of concept using a web service and Android's cell-phone-tower triangulation capability. Somehow, though, I don't have much hope that it will see the light of day any time soon. Dissemination is a private sector responsibility and government agencies like the National Weather Service are afraid to tread there for fear of being slapped down by Congress. And since few people are willing to pay for weather information, the private sector seems uninterested in the mass market. Besides there seem to be liability issues that are far above my pay grade to sort out.
The sad thing is that we're probably one disaster away from resolving this. Close calls like the Georgia Dome incident are not going to do it.
Disclaimer: My opinions, not my employer's.
Matchpoints vs. IMPs: It does make a difference
I played my first bridge tournament over the weekend. This was with C., a new partner with whom I'd played exactly once before.
We first played an open pairs event on Saturday night. We came in fourth overall, and second in our division. Pretty good going.
Considering how well we were doing, we teamed up with another pair to play in a Swiss team event on Sunday. Eric, our club's resident expert, warned us that the scoring was different. The open pairs event was scored using match points, the same system that we use at our club games. The team event, on the other hand, would be scored using IMPs.
"What's the difference?," we asked him.
"Bid aggressively," he advised.
We shrugged it off. What on earth does bidding aggressively mean?
We paid for our indifference by getting our heads handed to us. Placing dead last after playing 48 boards over 7 hours is no fun.
"Does the scoring system really matter so much?," asked the wife when I told her that we came in last.
I tried to explain to her and as usual, in the process of explaining it to somebody, I really understand the impact of the scoring system now.
In matchpoints, which is how the open pairs event and club games are scored, you are essentially competing against everybody in the room. And what matters is your rank within the group, not the actual scores. So, there is no point in trying to make wild bids. Conversely, you play very carefully, trying to make as many overtricks as you can.
In IMPs, which is how the Swiss teams event was scored, you are competing against just one team. And what matters is the difference in the scores between yours and theirs. The upshot is that you do make wild bids, because the bonus for a game can easily swamp what you lose by not achieving a part score. To be exact about this: you make bids that have only a 30% chance of making whereas at matchpoints you make bids that have a 50% chance of making.
We played the Swiss teams event carefully and conservatively and got slaughtered. Even though Eric told us not to.
UPDATE: This article explains the difference between matchpoints and IMPs.
We first played an open pairs event on Saturday night. We came in fourth overall, and second in our division. Pretty good going.
Considering how well we were doing, we teamed up with another pair to play in a Swiss team event on Sunday. Eric, our club's resident expert, warned us that the scoring was different. The open pairs event was scored using match points, the same system that we use at our club games. The team event, on the other hand, would be scored using IMPs.
"What's the difference?," we asked him.
"Bid aggressively," he advised.
We shrugged it off. What on earth does bidding aggressively mean?
We paid for our indifference by getting our heads handed to us. Placing dead last after playing 48 boards over 7 hours is no fun.
"Does the scoring system really matter so much?," asked the wife when I told her that we came in last.
I tried to explain to her and as usual, in the process of explaining it to somebody, I really understand the impact of the scoring system now.
In matchpoints, which is how the open pairs event and club games are scored, you are essentially competing against everybody in the room. And what matters is your rank within the group, not the actual scores. So, there is no point in trying to make wild bids. Conversely, you play very carefully, trying to make as many overtricks as you can.
In IMPs, which is how the Swiss teams event was scored, you are competing against just one team. And what matters is the difference in the scores between yours and theirs. The upshot is that you do make wild bids, because the bonus for a game can easily swamp what you lose by not achieving a part score. To be exact about this: you make bids that have only a 30% chance of making whereas at matchpoints you make bids that have a 50% chance of making.
We played the Swiss teams event carefully and conservatively and got slaughtered. Even though Eric told us not to.
UPDATE: This article explains the difference between matchpoints and IMPs.
The coolest birthday ever
My flight is not till 9pm. I'm at a Panera Bread (free Wifi!) where I had a late lunch and started to catch up on a bunch of things that were on the back burner ... one of which was that I'd meant to post a photo from S1's birthday party.
S1 and M. share a birthday. For the last few years, they've had a joint party, invited all their friends and arranged a book swap instead of birthday gifts.
M.'s dad has a student playing on the university's hockey team. The kid introduced us to the team's coach who essentially planned a party around the hockey game. We had an ice-skating session for all the kids before the game, then they got to sit in a box and cheer the hockey team. Being mostly boys, they lived for the fights and the goals. And at half-time, the two birthday boys got to ride the zamboni, waving to the crowd:
Can you imagine anything cooler than that as a six-year old?
S1 and M. share a birthday. For the last few years, they've had a joint party, invited all their friends and arranged a book swap instead of birthday gifts.
M.'s dad has a student playing on the university's hockey team. The kid introduced us to the team's coach who essentially planned a party around the hockey game. We had an ice-skating session for all the kids before the game, then they got to sit in a box and cheer the hockey team. Being mostly boys, they lived for the fights and the goals. And at half-time, the two birthday boys got to ride the zamboni, waving to the crowd:
Can you imagine anything cooler than that as a six-year old?
Amazing Amish Grace
I just finished reading the book "Amish Grace" on the shooting a couple of years ago at an Amish school in Pennsylvania. Since we don't have cable and don't watch much TV news, I missed much of the hoopla beyond the basic facts: a non-Amish neighbor of the school burst into the school, made the boys leave and tried to molest the girls. The police arrived, however, and the gunman shot several of the girls and then shot himself. Within hours of the tragedy, the Amish community said they forgave the killer and extended a lot of help to the killer's family. I also remember the trite columns written in the aftermath of the tragedy: that we should all emulate Amish generosity
, that the Amish had such large families that the death of a few children didn't affect them as much, that the Amish were repressing their anger.
The book, written by three scholars with a long background in research on Amish traditions, goes beyond the triteness. It turns out forgiveness is an integral part of the Amish culture. For example, when children fight, they are taught to say not only "I'm sorry" but to reply "I forgive you." The Amish understand the Lord's prayer differently from most Christians. Many Christians start from Martin Luther's "from Grace alone" to understand the words "Forgive us our debts as we forgive our debtors" to mean that God has forgiven us, so we should forgive those who wrong us. However, the Amish understand the words of the Lord's prayer to mean that "if you don't forgive, God will not forgive you." And because a typical Amish person reflects on or recites the Lord's prayer four or five times a day and because they spend a whole month focusing on Matthew 18 which deals with a parable on forgiveness, forgiveness is an integral part of the Amish makeup. They learn to forgive everyday, and so it was quite easy to know what do in the wake of the shooting at Nickel Mines.
The authors also dismiss much of the trite commentary by pointing out that commentators failed to distinguish between the words "forgiveness", "pardon" and "reconciliation". I didn't realize the difference until they pointed it out. To forgive is to say "I'm hurt (otherwise there is nothing to forgive), I will not forget what you did, however in spite of what you did, I will treat you with love and respect." Thus, after forgiving someone who abuses them, an Amish person may take steps to ensure that the person doesn't get a chance to abuse them again. And that is quite logical. Pardon, on the other hand, is limited to people in authority. An pardoned offense is one that is made to not have happened. Forgiveness is a personal act; pardoning is an official one. Forgiveness may lead to reconciliation (where the offender apologizes and tries to repair the relationship). Forgiveness is necessary for reconciliation, but reconciliation is not necessary.
And finally, forgiveness is not a one-time act. The Amish know that acts of this magnitude will continue to hurt for a long time. They take Jesus' admonishment to forgive "seventy times seven" times. They know they that will have to forgive the gunman in their hearts many, many times.
All in all, an amazing book and well worth your time.
An interesting election
This is what I remember of a conversation that I overheard in a hotel bar ... The details are fuzzy because I'd had a few drinks.
A group of five business men, drinking, at a table. Some one says something that I didn't quite hear.
"Oh, Obama'll fix it.", retorts one. General laughter. Hearing the name made me perk up. Where were these denizens of corporate America saying about Obama?
"I was listening to him the other day," says one, "and he says he'll take all your money and give it away." That is true. What a lot of latte-sipping Obama supporters may fail to realize that he is a liberal. Taxes will go up. Since I paid penalties last year to the IRS because I underestimated my tax bracket, I'm quite aware that if Obama wins, I'll have to start paying more to Uncle Sam. And I would be lying if I said that the prospect doesn't bother me.
"That McCain, he's one hell of a mother fucker," one of them said. And then conversation turned to his accomplishments in Vietnam. His self-effacing stand to being tortured impressed several of the fellows. "He is tough," agreed another fellow, "he's not going to dick around."
This is going to be an interesting election -- both the Democrats and Republicans are nominating their strongest candidates.
As for me, I'm torn. I'm with Obama on a more nuanced foreign policy but with McCain on domestic issues like school choice and earmarks. Obama's pandering on NAFTA turned me off a bit, as did McCain's riffs on bombing Iran and a 100-year occupation of Iraq.
P.S. Am I not jumping the gun thinking it's going be Obama vs. McCain? No ... contrary to innumerate media reports, it's impossible for Hillary Clinton to win the Democratic nomination at this point. Obama leads by 150 delegates and 800,000 in the popular vote. Her "big" win in Ohio netted her 15 delegates and less than a 100,000 vote lead. She needs at least 8 more Ohios. She has just one -- Pennsylvania. The best I can tell, her game plan is to weaken Obama so that he loses to McCain and she can run in 4 years. If Obama were not goody-two-shoes, he'd run advertisements in the general election saying "Vote for me so Hillary doesn't run in 4 years!"
A group of five business men, drinking, at a table. Some one says something that I didn't quite hear.
"Oh, Obama'll fix it.", retorts one. General laughter. Hearing the name made me perk up. Where were these denizens of corporate America saying about Obama?
"I was listening to him the other day," says one, "and he says he'll take all your money and give it away." That is true. What a lot of latte-sipping Obama supporters may fail to realize that he is a liberal. Taxes will go up. Since I paid penalties last year to the IRS because I underestimated my tax bracket, I'm quite aware that if Obama wins, I'll have to start paying more to Uncle Sam. And I would be lying if I said that the prospect doesn't bother me.
"That McCain, he's one hell of a mother fucker," one of them said. And then conversation turned to his accomplishments in Vietnam. His self-effacing stand to being tortured impressed several of the fellows. "He is tough," agreed another fellow, "he's not going to dick around."
This is going to be an interesting election -- both the Democrats and Republicans are nominating their strongest candidates.
As for me, I'm torn. I'm with Obama on a more nuanced foreign policy but with McCain on domestic issues like school choice and earmarks. Obama's pandering on NAFTA turned me off a bit, as did McCain's riffs on bombing Iran and a 100-year occupation of Iraq.
P.S. Am I not jumping the gun thinking it's going be Obama vs. McCain? No ... contrary to innumerate media reports, it's impossible for Hillary Clinton to win the Democratic nomination at this point. Obama leads by 150 delegates and 800,000 in the popular vote. Her "big" win in Ohio netted her 15 delegates and less than a 100,000 vote lead. She needs at least 8 more Ohios. She has just one -- Pennsylvania. The best I can tell, her game plan is to weaken Obama so that he loses to McCain and she can run in 4 years. If Obama were not goody-two-shoes, he'd run advertisements in the general election saying "Vote for me so Hillary doesn't run in 4 years!"
Cuteness and modesty
I was having lunch with a new colleague. She'd just seen photo of our kids that is the background on my laptop.
"Your kids are cute," she said.
"They get their cuteness from their dad," I responded.
"And their modesty from their mother?," she enquired.
Touche.
"Your kids are cute," she said.
"They get their cuteness from their dad," I responded.
"And their modesty from their mother?," she enquired.
Touche.
Subscribe to:
Posts (Atom)