Saturday, December 22, 2012

Day 189 - reading recs

It's a good thing I've been reading lots of interesting things because my life has been beautifully dull today. Terry and I did our pre-leukemia normal thing to do on Saturday morning which is to visit the Beach Pea, then his studio. I spent most of the day doing crossword puzzles, reading and weaving. You can see the tea towel starting to look like something that could be a present rather than a snarly mess. Hopefully, I'll finish it in time!

A couple of days ago, the NYT ran a huge story with all kinds of cool graphics about a free-skiing episode (free-skiing, for the horribly out of touch, like me, is skiing on the ungroomed, unmaintained sides of mountains). This happened in the Cascades and 16 experienced skiers started at the top and three of them died in an avalanche by the time they got to the bottom. What was interesting to me about it besides how fast an avalanche can go--this one topped out at 65 mph!--was to think about how this could happen to a bunch of experts in free-skiing. As you read the article, you think about how it sure sounded like the avalanche conditions were too unstable to make skiing safe, but they go out anyway. Then there are sixteen people at the top of a huge mountain and no one says, "Gosh, the conditions are ripe for an avalanche and the more of us that ski, the more likely we are to trigger one. Maybe we should think about plan B." I can imagine being in a similar situation (not an extreme sports situation because that is not my bag), but a situation where there is a group of people and we've planned to do something that may not be a great idea, but I think "Well, everyone here knows so much and if it were a bad idea, surely some one else would have said something." So, I don't say anything and everyone else is probably thinking exactly the same thing so we do something that is a less than stellar idea. It's interesting how groups of people do not act like individual people multiplied by N.

The other interesting thing I have been reading is this week's NEJM. I may have more to say about the rest of the journal, but I was astonished to learn that currently, for uncompensated care, NH gets reimbursed an average of $629 per patient-day. The next closest state is Louisiana at $400, then Maine at $308. Whoa! I wonder what the formula is that favors NH so much and I wonder how it was established so or maybe our uninsured people are just that much sicker than they are anywhere else in the country. The article was actually about how if states do not opt in to expand Medicaid, their hospitals that serve the uninsured (who would have been insured if the state had expanded Medicaid) are really going to be squeezed. The internet says that NH is in the states "leaning toward" expanding Medicaid. I don't know if this is a reliable site or not. I am surprised that whether we are expanding or not is not more widely known, but it seems to be an issue flying completely under the news radar.

I was perfectly happy with a non-newsworthy day for me and will wish to have a second relaxing, quiet day tomorrow. How about you? I hope you are not making yourself crazy with holiday frenzy and will hope for relaxation for you, too.

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