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Thursday, December 05, 2019

Bobby Jenks: Scar Tissue

When I woke up that morning in Fort Myers, Florida, I was sitting all alone in my underwear.

No shoes. No shirt. No pants. Just underwear.

Also, I was somehow behind the wheel of a parked car that didn’t belong to me.

And there was broken glass everywhere.

What the hell is this?

I rubbed my face and scratched the back of my head, and then I looked to my left and noticed that the driver’s-side window had been smashed in.

What the ####?

Beyond what I could see with my own two eyes in that moment, I had no clue what was going on. Or what had happened. All I could remember was taking a bunch of pills the night before, and then it’s just … me sitting there in my underwear in the parking lot of an apartment complex.

So almost everything that I tell you from here on is what the cops told me.

RoyalsRetro (AG#1F) Posted: December 05, 2019 at 10:39 AM | 80 comment(s) Login to Bookmark
  Tags: bobby jenks

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   1. filihok Posted: December 05, 2019 at 12:32 PM (#5905922)
Woah
   2. Jose Is Absurdly Chatty Posted: December 05, 2019 at 12:39 PM (#5905930)
This is just a terrific piece. Highly recommend it. Jenks has always been a punchline for me as the guy who got busted in the parking lot at "Babes" in Fort Myers. This piece really gives a lot of insight into what he went through and is well written. Highly recommend it.

And this...I mean this is a thing? WTF?

In short, there’s this thing now going on at some hospitals that’s referred to as concurrent surgeries, and it’s straight up evil. It’s basically one doctor overseeing two surgeries … at the same time.

Yes … you read that right. One doctor. Doing two surgeries. Simultaneously.

And get this: They don’t even tell you it’s happening, or ask you whether you’re O.K. with it. They just go ahead and do both surgeries at the same time without the two patients ever knowing.

This is really happening. Every day. In 2019. At legit, reputable hospitals.
   3. the Centaur Nipple Paradox (CoB). Posted: December 05, 2019 at 12:48 PM (#5905934)
Jebus.

That was tough to read.

But worth it.

   4. What did Billy Ripken have against ElRoy Face? Posted: December 05, 2019 at 12:55 PM (#5905938)
Yeah, read this. It's a great window into the very human struggles that players have, exacerbated by the physically risky nature of their jobs.
   5. . Posted: December 05, 2019 at 01:01 PM (#5905944)
I had a pretty significant struggle with sinusitis not so long ago that wound up with surgery; my experience without question led me to the opinion that the side effects of a number of mainstream prescription medications are vastly understated. And even though every time you go to a doctor, the forms ask you what medications you're currently taking, the doctors never actually pay attention to them, or consider them.

Totally eye-opening. There has to be something broken in the incentive structure as far as when and how to medicate. America seems to specialize in dodgy incentive structures that wind up in excess.
   6. salvomania Posted: December 05, 2019 at 01:06 PM (#5905948)
This is really happening. Every day. In 2019. At legit, reputable hospitals.

There's a big story in my neck of the woods about a doctor who raised a stink about Mass General double-booking surgeries, and he was fired after he blew the whistle.

He sued, and was just awarded $13 million.

From the Boston Globe:
Though many surgeons at teaching hospitals schedule operations to overlap by a few minutes — letting trainees close the surgical wound of the first operation while the surgeon moves on to the second — the debate at Mass. General focused on surgeries, mostly in orthopedics, that overlapped for much longer, sometimes for hours.

Burke and other critics of the practice, including several anesthesiologists who act as the eyes and ears of sleeping patients, said that it was dangerous and that patients hadn’t consented beforehand to share their surgeon.
   7. . Posted: December 05, 2019 at 01:12 PM (#5905952)
So I guess the lesson is that you have to ask in advance whether the surgeon is actually going to be focused on you and you alone -- something a patient should be able to take for granted because the alternative is so ####### gobsmackingly stupid. I'd be livid beyond words if I found out my two surgeons were multitasking with someone else. It's absurd that such a thing would even be permitted by the medical licensing authorities. These kind of gatekeepers are failing us badly.
   8. Der-K: at 10% emotional investment Posted: December 05, 2019 at 01:20 PM (#5905957)
good read
   9. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 05, 2019 at 01:39 PM (#5905962)
Clear liquid pouring out of your spine is definitely an "oh ####!" moment.
   10. snapper (history's 42nd greatest monster) Posted: December 05, 2019 at 01:47 PM (#5905965)
So I guess the lesson is that you have to ask in advance whether the surgeon is actually going to be focused on you and you alone -- something a patient should be able to take for granted because the alternative is so ####### gobsmackingly stupid. I'd be livid beyond words if I found out my two surgeons were multitasking with someone else. It's absurd that such a thing would even be permitted by the medical licensing authorities. These kind of gatekeepers are failing us badly.

Umm, it's actually best practice in some cases. In things like heart bypass operations there's like 15-30 minutes of tricky surgery in a 6 hour operation. Opening, closing, getting the veins from the legs are routine.

But you absolutely want the top guy doing the 15-30 minutes of hard work while your heart is stopped. So, the lead surgeon will have 6 or 8 surgeries lined up back to back, doing only the most critical bit.

When my grandmother had her bypass, the lead surgeon was the head of the heart transplant team at Columbia University. He had a bunch of surgeries back to back, but when they had trouble restarting her heart, he came back in.

It's much better for the patients collectively to have the best surgeon do 8, 30-minute stints, for each of 8 patients, than have him stay for the whole operation for one guy, and some other poor schlub have to have the 8th best surgeon do the hard part.
   11. bunyon Posted: December 05, 2019 at 01:48 PM (#5905966)
Definitely, Vlad, but I wonder how many people know that? I mean, it's clear, it's probably just water or something, right? I can imagine a lot of people have no idea how dangerous that is.

Co-sign what everyone else says.
   12. . Posted: December 05, 2019 at 01:50 PM (#5905968)
But you absolutely want the top guy doing the 15-30 minutes of hard work while your heart is stopped. So, the lead surgeon will have 6 or 8 surgeries lined up back to back, doing only the most critical bit.


Sure, that works. If that's actually what's going on, I'm good. I doubt it is though.
   13. snapper (history's 42nd greatest monster) Posted: December 05, 2019 at 01:56 PM (#5905973)
Sure, that works. If that's actually what's going on, I'm good. I doubt it is though.

It is a thing that goes on. That doesn't mean there aren't abuses too. But an less experienced surgeon being allowed to open and close, while the main guy does the hard part, is not an abuse.
   14. salvomania Posted: December 05, 2019 at 01:58 PM (#5905974)
More from the Globe article:
Some of those records were available in the public court docket and reviewed by the Globe. In court filings, records showed that a crisis-management consultant retained by the hospital e-mailed a hospital spokeswoman in 2015 suggesting the Stern report found problems with surgeons performing simultaneous surgeries in two operating rooms.

Those court filings also contained a 2012 e-mail from Dr. Keith Lillemoe, the hospital’s head of surgery, to MGH officials about a recent spine surgery case that Burke had complained about. A Westwood financial analyst, Tony Meng, had become a quadriplegic a few weeks earlier after his surgeon, Wood, overlapped his operation with another spine patient’s for more than five hours.

MGH faces a separate whistle-blower lawsuit in federal court in Boston by a former MGH anesthesiologist, Dr. Lisa Wollman, who alleged that a handful of orthopedic surgeons repeatedly kept patients waiting under anesthesia longer than was medically necessary or safe as they juggled simultaneous operations.
   15. What did Billy Ripken have against ElRoy Face? Posted: December 05, 2019 at 02:30 PM (#5905983)
I deduct some points from my previous positive review because the headline has gotten a Red Hot Chili Peppers song stuck in my head.
   16. gef, talking mongoose & vexatious litigant Posted: December 05, 2019 at 02:35 PM (#5905986)
I deduct some points from my previous positive review because the headline has gotten a Red Hot Chili Peppers song stuck in my head.


Very possibly the only song of theirs I like, as it happens.
   17. What did Billy Ripken have against ElRoy Face? Posted: December 05, 2019 at 02:50 PM (#5905991)
Very possibly the only song of theirs I like, as it happens.
That is interesting, because to my ears every single they released from that album and the two after it sound exactly like it.
   18. gef, talking mongoose & vexatious litigant Posted: December 05, 2019 at 03:03 PM (#5905997)
My exposure to them around that time was limited to whatever happened to show up on the so-called alternative station in Little Rock, which means I'd never have heard anything after Californication, given when I moved to Montgomery (11/01).

Never a fan. When their headlining set in Dallas at the 2nd Lollapalooza started, my gf & I left. (Did the same the previous year when Jane's Addiction began playing.)
   19. What did Billy Ripken have against ElRoy Face? Posted: December 05, 2019 at 03:14 PM (#5905999)
I was in high school circa BloodSugarSexMagic, which was of course huge at the time - I liked that and Mother's Milk quite a bit, mostly because John Frusciante was great on those albums (and highly underrated because of Flea's scenery-chewing). After that...meh. They kept trotting out the same-sounding midtempo singles, and Kiedis got progressively more annoying. Saw them live at an outdoor shed some point in the late '90s, I think, and I remember thinking they were pretty terrible.

Anyway...back to the topic at hand.
   20. Tin Angel Posted: December 05, 2019 at 03:33 PM (#5906009)
Kiedis was always the problem with that band. The first three Frusciante solo albums done at home on a four track are actually pretty great.
   21. Walt Davis Posted: December 05, 2019 at 03:43 PM (#5906013)
When my grandmother had her bypass, the lead surgeon was the head of the heart transplant team at Columbia University. He had a bunch of surgeries back to back, but when they had trouble restarting her heart, he came back in.

But this is surely where things start to go wrong. What if two surgeries get unexpectedly complicated at the same time and the lead surgeon can only work on one. Even in a case like your grandmother's where thankfully everything worked out OK, presumably one of the other patients was under anaesthesia longer than originally planned, may have had their critical bit pushed back by 20-30 minutes (meaning other patients had theirs moved back as well) which while maybe not critical can't be a good thing.

I am confident there are ways to address some of these dangers. Something like the lead surgeon's time has to have leeway built in -- a tricky 20 minutes is given a 40-minute block -- if it only takes 20 minutes, then the surgeon can get a rest or move onto the next patient early. As somebody implied above, the concern is that insurance company bean-counters are in there making sure there's as little downtime as possible.

Of course this happened all the time on MASH and they almost never lost a patient. :-) It got to the point you expected them to say "Klinger, you can close." (Yes, obviously field hospital surgery is a whole different ballgame.)
   22. snapper (history's 42nd greatest monster) Posted: December 05, 2019 at 04:08 PM (#5906025)
But this is surely where things start to go wrong. What if two surgeries get unexpectedly complicated at the same time and the lead surgeon can only work on one. Even in a case like your grandmother's where thankfully everything worked out OK, presumably one of the other patients was under anaesthesia longer than originally planned, may have had their critical bit pushed back by 20-30 minutes (meaning other patients had theirs moved back as well) which while maybe not critical can't be a good thing.

I am confident there are ways to address some of these dangers. Something like the lead surgeon's time has to have leeway built in -- a tricky 20 minutes is given a 40-minute block -- if it only takes 20 minutes, then the surgeon can get a rest or move onto the next patient early. As somebody implied above, the concern is that insurance company bean-counters are in there making sure there's as little downtime as possible.


Sure, things can go wrong, but things can also go wrong when you have far less qualified surgeons doing the important parts of the surgery. It's a trade-off.

Say the best 100 heart surgeons in the U.S. are doing 8 surgeries a day by only doing 30 minutes of a 4 hour surgery of the actual surgery. If you make them do the whole 4 hour surgery, now they can do 2 a day, and you need to introduce 600 less qualified surgeons to doing the hardest part. That seems way more risky.
   23. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 05, 2019 at 04:14 PM (#5906028)
the headline has gotten a Red Hot Chili Peppers song stuck in my head


Californication, right?
   24. What did Billy Ripken have against ElRoy Face? Posted: December 05, 2019 at 04:25 PM (#5906036)
Under the Bridge. Because the narrator in that song is obviously quite scarred.
   25. jacksone (AKA It's OK...) Posted: December 05, 2019 at 05:07 PM (#5906068)
It is a thing that goes on. That doesn't mean there aren't abuses too. But an less experienced surgeon being allowed to open and close, while the main guy does the hard part, is not an abuse.


Opening and closing around the spinal column should most definitely not be doled out to less experienced surgeons as a matter of expedience. There's just as much of a chance at doing major damage then as during the 'hard part'.
   26. JRVJ Posted: December 05, 2019 at 07:09 PM (#5906094)
I can't say that I thought much of Bobby Jenks when he was a player, but after reading this, much, much respect to him as man.

He has gone through a tremendous ordeal as a person, and one would hope he has a nice life from here on out.
   27. Jose Is Absurdly Chatty Posted: December 05, 2019 at 07:24 PM (#5906095)
I recently learned (like this week) that the Lush song “Ladykillers” was inspired by Kiedis.
   28. snapper (history's 42nd greatest monster) Posted: December 05, 2019 at 07:31 PM (#5906098)
Opening and closing around the spinal column should most definitely not be doled out to less experienced surgeons as a matter of expedience. There's just as much of a chance at doing major damage then as during the 'hard part'.

Again, if you make the most experienced surgeon do everything they do far fewer surgeries, and other surgeons never learn.

Also, there's no way opening and closing are nearly as difficult/dangerous as operating on the actual spine.

In Jenks' case, the screwup happened in the hard part;

My surgeon back on the East Coast was supposed to decompress two levels of my spine, and my insurance company had been charged for both elements of the procedure. But now I was being told by this new doctor that only one level had been decompressed, and that the second part of the surgery was never fully completed. To make matters worse, he said that the surgeon in Boston, in using the tool that shaves bone spurs, had left a jagged point, a bony spike, in my body. And that was what had ended up puncturing the membrane around my spinal cord — something called the dural sac — in two different places. The doctor in Arizona told me that while he had been in there doing this new procedure, he’d found a spike that was actually still embedded in my dural sac — that a week earlier I’d been sewn up with this thing still inside me.


It's wasn't the closing guy that screwed up, it was the guy doing the main part of the surgery.
   29. reech Posted: December 05, 2019 at 09:43 PM (#5906117)

'I'm forever near a stereo saying, 'What the f#ck is this garbage?' And the answer is always the Red Hot Chili Peppers.'
- Nick Cave
   30. PreservedFish Posted: December 05, 2019 at 09:59 PM (#5906125)
I was in high school circa BloodSugarSexMagic, which was of course huge at the time - I liked that and Mother's Milk quite a bit, mostly because John Frusciante was great on those albums (and highly underrated because of Flea's scenery-chewing). After that...meh. They kept trotting out the same-sounding midtempo singles, and Kiedis got progressively more annoying. Saw them live at an outdoor shed some point in the late '90s, I think, and I remember thinking they were pretty terrible.


Me too.

I really loved BloodSugarSexMagic and while I don't listen to it much, I bet that I would still love it. I don't care that much for Kiedis' sing-rapping but I love the aggressive punk/funk and the drums, bass and guitar. When "Scar Tissue" and other songs of that era came out, I figured they were done as a band, because that stuff sucked, and I keep being surprised at their popularity. I also saw them at a show in the late 90s, and I remember thinking that the new material - which they played note for note - was obviously lifeless in comparison to the old stuff, which they jammed on enthusiastically.
   31. frannyzoo Posted: December 05, 2019 at 10:20 PM (#5906130)
Amazing memoir. Must admit the high ratio of RHCP-related responses irks, but both appreciate the number elaborating on the surgery, etc. and kinda see the RHCP stuff as emblematic of the problem. Thanks for the link/posting.
   32. puck Posted: December 05, 2019 at 10:37 PM (#5906134)
Oh crap, I somehow missed this was posted and submitted it. I hope someone catches that.

It is worth the read. Hard to imagine all that happened to him. It's like a country western song, all that's missing is the dog getting hit by a car.
   33. base ball chick Posted: December 05, 2019 at 11:06 PM (#5906139)
bobby's story is telling how a whole lot of people get addicted to narcotics. they didn't originally take them to get high

bobby's story is telling how a whole lot of people self medicate for depression and other mental illnesses with narcotics (and other illegal drugs) instead of seeing a psychiatrist - even when they can easily afford it

bobby's story is telling how a whole lot of marriages go to pieces when one of the partners gets addicted or refuses to treat a mental illness such as depression

bobby's story is telling how men too often define them self as what they do and not who they are, or insist they are the same thing

bobby's story is telling how even the rich get in trouble from the american medical system. you can't do 2 surgeries at the same time. people should not be a treated like a metal piece in a factory line. we should train a lot more doctors. anyone ever notice how these days at least half of doctors are not from america?

why are people bringing up some really lousy band from 30 years ago?
   34. JimMusComp likes Billy Eppler.... Posted: December 05, 2019 at 11:30 PM (#5906142)
Just read this - I followed Jenks since he was an Angel farmhand. He had addiction issues then, too - and character issues that precluded him from getting a real shot in LAA. So sad to see him relapse with his injury issues. Sadder still is the horrible combination of events that got him to that point.

   35. Misirlou gave her his Vincent to ride Posted: December 05, 2019 at 11:36 PM (#5906144)
That was one hell of a story
   36. Misirlou gave her his Vincent to ride Posted: December 05, 2019 at 11:39 PM (#5906145)
I had hernia surgery a month ago. I don't think there was concurrent surgery, because I don;'t think my local little hospital has more than one operating room. But the bills are starting to come in, and the total will likely top $100,000. For a simple hernia surgery with no complications and a one night stay.
   37. JimMusComp likes Billy Eppler.... Posted: December 06, 2019 at 12:33 AM (#5906149)
Jesus, Miserlou. Any insurance? Or is that what insurance is paying?

My wife and I are both in education and were double covered when we had our triplets in 2005. They were born premature (32 weeks) and were in the NICU for 4 weeks, and then some. They had one surgery, etc. Their bill was about $250,000 per kid. Wife had complications - was in hospital for 3 weeks before birth and 1 week after. Her bill was $400,000. We paid about $2,000. This country needs Universal HC something fierce. Hope you don't have to cover the 100K....
   38. Misirlou gave her his Vincent to ride Posted: December 06, 2019 at 12:46 AM (#5906151)
Insurance. I am out $8K
   39. JimMusComp likes Billy Eppler.... Posted: December 06, 2019 at 12:58 AM (#5906152)
Wow. Still a big payment. Sorry man. That's not nothing. Bernie2020.
   40. bunyon Posted: December 06, 2019 at 09:36 AM (#5906174)
We also need more doctors. And nurses and PAs etc.

We keep getting more finance guys to manage the system.
   41. PreservedFish Posted: December 06, 2019 at 09:56 AM (#5906181)
Feeling chastened by frannyzoo's comment, I did read the article and, holy ####, what a nightmare. I do like that Tim Wakefield shows up as the only person that properly diagnoses Jenks' mysterious arm pain.
   42. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 09:57 AM (#5906182)
Makes me appreciate the heck out of the insurance my employer provides. My hernia operation 14 months ago, which included a stay of 2 nights rather than 1, wound up costing me $200, I'm pretty sure, compared to an itemized hospital bill that memory tells me was in the $30,000 neighborhood. (Presumably, that doesn't include the anesthetist, etc.)

I'm also pretty sure they said I was my surgeon's only patient that day, so the concurrent procedures business wasn't involved.
   43. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 10:11 AM (#5906185)
Hope you don't have to cover the 100K....

No one will actually pay the $100K. Medical billing is a huge shell game. The insurer has negotiated rates with the hospital that bear no resemblance to the "headline rates".

It's like the "rack rate" you sometimes see posted on the door of hotel rooms, which is often $600 on a $150 hotel room. Nobody ever pays the full price unless you're a wealthy foreigner.
   44. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 10:14 AM (#5906188)
My wife and I are both in education and were double covered when we had our triplets in 2005. They were born premature (32 weeks) and were in the NICU for 4 weeks, and then some. They had one surgery, etc. Their bill was about $250,000 per kid. Wife had complications - was in hospital for 3 weeks before birth and 1 week after. Her bill was $400,000. We paid about $2,000. This country needs Universal HC something fierce. Hope you don't have to cover the 100K....

Sorry your kids and wife had those issues, but this is like the best advertisement for private health insurance ever. You paid $2000 on a notional bill over $1M. That's absolutely awesome.

A national health care systems may very well have denied your kids care.
   45. Lassus Posted: December 06, 2019 at 10:29 AM (#5906202)
may very well have

What is this based on?
   46. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 10:40 AM (#5906208)
What is this based on?

There has been press coverage out of the U.K. of the NHS denying advanced treatments to premature babies. Here's the first case that popped up in Google.

Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care

Every treatment in the NHS is subject to a cost/benefit analysis. Honestly, they may be right to deny a lot of the care we allow in the U.S., but no parent wants to hear that about their child.

If you want to have a National Health system that covers everyone, and spends less than we do today, pretty much any treatments that cost millions of dollars should be off the table.
   47. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 06, 2019 at 10:45 AM (#5906210)
why are people bringing up some really lousy band from 30 years ago?


Because it's a lot easier to crack jokes about an old band than it is to have a conversation about serious #### like addiction and mental health problems and near-death experiences.
   48. cookiedabookie Posted: December 06, 2019 at 10:48 AM (#5906213)
A national health care systems may very well have denied your kids care.

Yeah, because there's tons of stories of premature babies being left to die in Canada, England, Sweden, etc.
   49. What did Billy Ripken have against ElRoy Face? Posted: December 06, 2019 at 10:49 AM (#5906214)
Because it's a lot easier to crack jokes about an old band than it is to have a conversation about serious #### like addiction and mental health problems and near-death experiences.
Oh, FFS. Because conversations sometimes diverge. We beg your forbearance.
   50. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 10:52 AM (#5906216)

Yeah, because there's tons of stories of premature babies being left to die in Canada, England, Sweden, etc.


I found one in 5 seconds.

If it costs $2M to save a premature baby, no public system should logically pay for that.

   51. PreservedFish Posted: December 06, 2019 at 11:06 AM (#5906224)
While I did really like RHCP, I also feel fairly sure that if I hadn't grown up at that correct age to enjoy them, I would've hated them, the same way that just a decade later I saw zero appeal in, say, Linkin Park or Incubus. That 90's funk-punk thing was really a moment that doesn't seem like it ought to have much lasting appeal, and their occasional acoustic ballad side must have seemed pretty cynical to an older listener.
   52. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 11:18 AM (#5906228)
why are people bringing up some really lousy band from 30 years ago?


Ahem. The period being discussed is more like 15-20 years ago.

/pedant
   53. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 11:21 AM (#5906232)
That 90's funk-punk thing was really a moment that doesn't seem like it ought to have much lasting appeal,


I paid them no attention whatsoever until Give It Away started polluting MTV in '91. What a vile piece of crap -- the song, too.
   54. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 06, 2019 at 11:25 AM (#5906234)
Oh, FFS. Because conversations sometimes diverge. We beg your forbearance.


Dude, go blow it out Flea's trumpet. I'm one of the people who made a joke about the band.
   55. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 06, 2019 at 11:29 AM (#5906237)
   56. What did Billy Ripken have against ElRoy Face? Posted: December 06, 2019 at 11:31 AM (#5906239)
Dude, go blow it out Flea's trumpet. I'm one of the people who made a joke about the band.
Sorry about that - there were a couple of other finger-wagging comments before yours, and I just lumped them all together. My mistake.
   57. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 11:33 AM (#5906240)
Whoso hath this world's good, and seeth his brother have need, and shutteth up his bowels of compassion from him, how dwelleth the love of God in him? My little children, let us not love in word, neither in tongue; but in deed and in truth.

Heal the sick, cleanse the lepers, raise the dead, cast out devils: freely ye have received, freely give.


The (alleged) word of God stops where certain people's politics & wallets start.

Besides, don't you have some money-changers to go drive out of the temple or something?
   58. What did Billy Ripken have against ElRoy Face? Posted: December 06, 2019 at 11:33 AM (#5906241)
But whoso hath this world's good, and seeth his brother have need, and shutteth up his bowels of compassion from him, how dwelleth the love of God in him? My little children, let us not love in word, neither in tongue; but in deed and in truth.
Wait.

The Bible really contains the words shutteth up his bowels??
   59. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 11:37 AM (#5906245)
Verily, it doeseth. Sounds like someone might've had an issue with constipation.
   60. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 11:37 AM (#5906246)

The (alleged) word of God stops where certain people's politics & wallets start.

Besides, don't you have some money-changers to go drive out of the temple or something?


I'm opposed to a national health care system, so don't blame me. I'm just saying, a necessary feature of one is denying care that's not viewed as cost effective.

How do you think other countries spend 10% of their GDP on healthcare rather than 20%? Lots of end of life care, and high-end pharmaceuticals that we take for granted in the U.S. are simply not covered.
   61. cookiedabookie Posted: December 06, 2019 at 11:44 AM (#5906248)
How do you think other countries spend 10% of their GDP on healthcare rather than 20%?

It's amazing how much money you can save when you take the profit motive out of equation...
   62. snapper (history's 42nd greatest monster) Posted: December 06, 2019 at 11:52 AM (#5906250)
It's amazing how much money you can save when you take the profit motive out of equation...

Oh what nonsense. The profit motive is the only thing that makes organizations seek efficiency. Look at how cheap LASIK has become. Non-profit hospitals charge every bit as much as for-profit ones.

   63. cookiedabookie Posted: December 06, 2019 at 11:56 AM (#5906252)
I found one in 5 seconds.

You didn't share it. So I searched. I found two stories from the UK, but they were extreme premature babies, 23 weeks or younger, which have a less than 1% chance of survival, and if they do survive it's most often with severe disabilities. Jim posted about 32 week preemies - which have 99% survival rate.

I get you're against national health care, for whatever reason. But don't be comparing 22 week preemies with 32 week preemies, and act like you are making an intellectually honest comparison.

Signed, a father of 34 week twins, delivered by Medicaid
   64. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 11:58 AM (#5906253)
The profit motive is the only thing that makes organizations seek efficiency.


Can't remember -- is that from the Old Testament or the New Testament?
   65. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 06, 2019 at 12:00 PM (#5906254)
   66. PreservedFish Posted: December 06, 2019 at 12:01 PM (#5906255)
Wherefore my bowels shall sound like an harp for Moab, and mine inward parts for Kir-haresh.

This sounds like it would be hilarious if I could understand the references.
   67. What did Billy Ripken have against ElRoy Face? Posted: December 06, 2019 at 12:03 PM (#5906258)
Wherefore my bowels shall sound like an harp for Moab
This sometimes happens to me after I eat cabbage.
   68. PreservedFish Posted: December 06, 2019 at 12:07 PM (#5906260)
What's the difference between bowels and "inward parts"?
   69. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 12:14 PM (#5906264)
What's the difference between bowels and "inward parts"?


I don't envy your, uh, romantic partner.
   70. Bring Me the Head of Alfredo Griffin (Vlad) Posted: December 06, 2019 at 12:18 PM (#5906266)
What's the difference between bowels and "inward parts"?


There's a good explanation here. In that particular passage, they're speaking about metaphorical bowels, rather than literal ones, and in a lot of more modern translations it's written as "heart" to preserve the metaphor (unlike the bowels from the passage from Chronicles II that I quoted above, which is literally about shitting until your intestines prolapse out of your butt - much as supposedly happened to the heretic Arius - because God hates you).
   71. PreservedFish Posted: December 06, 2019 at 12:20 PM (#5906268)
Thank you Vlad, but Gef's response was funnier.
   72. gef, talking mongoose & vexatious litigant Posted: December 06, 2019 at 12:21 PM (#5906269)
shitting until your intestines prolapse out of your butt
This sometimes happens to me after I eat cabbage.
Obligatory juxtaposition. (Note: I like cabbage.)
   73. Fancy Crazy Town Banana Pants Handle Posted: December 06, 2019 at 03:23 PM (#5906335)
It's amazing how much money you can save when you take the profit motive out of equation...

No, profit motive has little to nothing to do with it either way.

The biggest issue, is that the Health Care Market is not a free, open, or fair market, in any way shape or form. But do to ideological "free market" fetishization is being forced to be run as one. That this gives unfair outcomes is a direct consequence of that.

There are of course many factors that lead to the distortion of the market. But by far the biggest is of course that customers have little to no choice in choosing their provider in many cases. The reason the free market largely works, is because customers can shop around and compare, and find the product that provides the best value/quality/features (depending on their own preferences of course). If a product is overpriced, the market will sort it out. But when you have a heart attack, you call an ambulance, and you don't know who will show up, and to what hospital they will take you.

Hospitals effectively have a captive audience. You can see the effects of captive audiences in a lot of other places of course. I am sure most people here are familiar with the cost of a beer at the ballpark. Which is at least an order of magnitude more expensive than outside of the park.

Of course, if the park cranked it to $1000 a beer, you would just go without, which leads to another problem. In many cases of course, you are also in no position to refuse the service, even if you thought you could get a better deal somewhere else. When you combine those two effects, the result is always going to be a drastically inflated price. Why wouldn't it be?

There are other issues which have an effect as well. Information asymmetry between doctor and patient, mean most people cannot reasonably turn down unnecessary tests or procedures. Customers being insulated from the direct cost through insurers (Yes, you pay for your insurance through the nose, but once you are actually at the hospital, there is little reason to not get the most out of the insurance.) And on, and on, and on...

Nationalised health care systems by and large realise the imbalance in this system, and address it by setting rates for procedures by fiat. And by using the bargaining power of a single payer to negotiate reasonable rates for pharmaceuticals.
   74. cookiedabookie Posted: December 06, 2019 at 04:38 PM (#5906364)
Nationalised health care systems by and large realise the imbalance in this system, and address it by setting rates for procedures by fiat. And by using the bargaining power of a single payer to negotiate reasonable rates for pharmaceuticals

Thus eating into the profit motive of the health care industries
   75. drdr Posted: December 06, 2019 at 04:56 PM (#5906372)
UK has strong medical ethics guidelines which advise against procedures that are unlikely to do more than prolong suffering (key part being inducing/prolonging suffering).
In general, universal medical systems do not perform or pay for experimental treatments except in special circumstances, but they don't deny other procedures, subject to implementing a cheaper, still effective procedure and ethical cases like in UK.

As for health care market, and any other industry, if you looked at it logically, there are two important factors to determine how appropriate free market is: what is the elasticity in that market and what is the level of competition in that market. If you have highly inelastic market, like health care or electric energy, free market allows extreme profit for actors, not justified by the benefit they produce to the customers (except the benefit inherent in the industry, not the actors' actions). Similarly, if there is a monopoly or oligopoly, monopolists' profit exceeds benefit for the customers. There is no benefit for the people if private company holds monopoly (or few oligopoly) over government holding the same monopoly.
On the other hand, in industries where competition exists and where the customers are not obliged take the service (usually, not taking medical treatment means death) free market is much more effective than governmental control. Another way to think about it: everywhere where profits are created solely by the effort of the companies, free market works well. Where most of the profit is created just by being there (health care, most monopolies,...), benefit for the population wouldn't be any less if those industries are under the governmental control.
Another way to think about it: in the food market, to earn profit you have to satisfy some need of at least a part of the market - new food, cheap food, exotic food, specially prepared food... Competition is large. On the other hand, cable company that holds the monopoly over an area reaps most from the profit from the monopoly, not from its innovation, so any benefit for the customer would not be lower if that monopoly was being run by the government.
   76. Omineca Greg Posted: December 06, 2019 at 07:04 PM (#5906406)
I recently learned (like this week) that the Lush song “Ladykillers” was inspired by Kiedis.


Just for the record for the casual readers, he inspired one of the verses. I don't think Anthony has ever been to Camden (UK), so that is obviously a different dude. And the third verse, "Blondie was with me for a summer, he flirted like a maniac but I wouldn't bite..." is about some dude from Weezer. And Miki says she feels a little bad, because Kiedis really shouldn't be singled out for being a horndog, and she's met guys way sleazier than him, but she never got around to immortalising them in music.

That's one of my favourite songs from the era.

From another era, we have the immortal Isaac Watts (1674 to 1748). Just another kid from Southampton...except his Dad did a couple of stints in the pokey for heresy. So young Isaac grew into a theologian, logician, hymn writer. You probably know one of the hymns he wrote lyrics to, Joy To the World. Not the one about Jeremiah the Bullfrog, the other one with Heaven and Nature singing. And one of his poems was parodied in Alice in Wonderland, so that's pretty badass. Anyway, he wrote lots of hymns, so it only makes sense that one is about God's colon, rectum and anus. It goes like this...

1...2...and a 1, 2, 3, 4. C'mon! Pick up the tempo, this one is about the Lord's GI tract, so that's work that thang!

Now by the bowels of my God,
His sharp distress, his sore complaints,
By his last groans, his dying blood,
I charge my soul to love the saints.
Clamor, and wrath, and war, begone,
Envy and spite, for ever cease;
Let bitter words no more be known
Amongst the saints, the sons of peace.
The Spirit, like a peaceful dove,
Flies from the realms of noise and strife:
Why should we vex and grieve his love
Who seals our souls to heav'nly life?
Tender and kind be all our thoughts,
Through all our lives let mercy run;
So God forgives our num'rous faults,
For the dear sake of Christ his Son.


Rock on bruddah! This was a popular hymn...in the first decade of the 19th century! By about 1850 it had kinda crapped out, probably because...why glorify God's #######, when he's seen fit to send you a Cholera epidemic? I mean, Vibrio cholerae are one of His creations too (I think they are anyway, they've got a Latin name). All creatures great and small, his eye is on the sparrow. People wrote songs about Jesus and the A-Bomb...so I guess they write what they know.

Everybody's worried 'bout the atomic bomb
But nobody's worried 'bout the day my Lord will come
When he'll hit, great God a-mighty, like an atom bomb
When he comes, when he comes

In nineteen-hundred and forty-five the atom bomb became alive
In nineteen-hundred and forty-nine the USA got very wise
It found a country had crossed the line, had an atom bomb of the very same kind
The people got worried all over the land, just like folks got in Japan

So, I say everybody's worried (yeah) 'bout the atomic bomb
But nobody's worried (no) 'bout the day my Lord will come
When he'll hit, great God a-mighty, like an atom bomb
When he comes, good Lord, when he comes

Everybody's worried 'bout the atomic bomb
But nobody's worried 'bout the day my Lord will come
When he'll hit, great God a-mighty, like an atom bomb
When he comes, when he comes

Well now, God told Elijah, he would send down fire, send down fire from on high
He told the brother Noah by the rainbow sign, there'll be no water, but fire in the sky
Now don't get worried, just bear in mind, seek King Jesus and you shall find
Peace, happiness, and joy divine, with my Jesus in your mind

So, I say everybody's worried (yeah) 'bout the atomic bomb
But nobody's worried (no) 'bout the day my Lord will come
When he'll hit, great God a-mighty, like an atom bomb
When he comes, great God, when he comes

Everybody's worried 'bout the atomic bomb
But nobody's worried 'bout the day my Lord will come
When he'll hit, great God a-mighty, like an atom bomb
When he comes, when he comes


Link

That's a goodie, I like it better than the bowels thing. But different strokes yadda yadda yadda.
   77. It's regretful that PASTE was able to get out Posted: December 06, 2019 at 08:18 PM (#5906408)
Players' Tribune employs some world class ghostwriters. It's too bad they can't get byline credit; I hope at least they're compensated appropriately for their skill.
   78. Hank Gillette Posted: December 08, 2019 at 06:17 AM (#5906744)
Oh what nonsense. The profit motive is the only thing that makes organizations seek efficiency. Look at how cheap LASIK has become. Non-profit hospitals charge every bit as much as for-profit ones.


LASIK surgery is relatively cheap because it is an elective surgery, which means patients can shop around, and it is not covered by most insurance plans, so doctors have no choice but to lower the price to get business. It’s really not relevant to most health care.
   79. Hank Gillette Posted: December 08, 2019 at 06:24 AM (#5906745)
I'm opposed to a national health care system, so don't blame me. I'm just saying, a necessary feature of one is denying care that's not viewed as cost effective.


I find that preferable to denying any care at all to some people, but that is just me.

No matter what kind of system you design, some care is going to be denied to someone. Is it better to spend hundreds of thousands of dollars to extend a dying patient’s life for six weeks, or to allocate that money to give dozens of people basic health care that will extend their lives for years?

People who prefer the former almost always already have health insurance, I notice.
   80. Steve Parris, Je t'aime Posted: December 08, 2019 at 01:29 PM (#5906828)
Players' Tribune employs some world class ghostwriters. It's too bad they can't get byline credit; I hope at least they're compensated appropriately for their skill.

They get lovely gift baskets.

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