Wednesday, January 28, 2015

They didn't know

As they disembarked from the trains that had carried them to this place some 37 miles to the West of Krakow, the passengers didn't know that many of them had only half-an-hour to live.  They were taken from the trains, forced to march into rooms where they were stripped of their clothing and all their valuables.  They were then told they were going to the showers, ostensibly to be disinfected.

But the showers didn't dispense water.  Instead they filled the locked rooms with Zyklon B, a pesticide containing hydrogen cyanide.  The victims struggled greatly for a few seconds, trying desperately to breathe and failing.  Death came rapidly, after that brief period of intense suffering.

Such was the end of life for many of those who were taken to the concentration camp at Auschwitz.  Today marks the 70th anniversary of the liberation of Auschwitz, which was done by the Soviet Union's Red Army.  No, President Obama's great-uncle wasn't in the Red Army, he was present at the liberation of Buchenwald.

Auschwitz was actually a number of camps and not all were in the business of exterminating their prisoners.  Monowitz was a slave labor camp, designed to provide prisoners to work at a factory owned and run by I. G. Farben, who manufactured Buna (a synthetic rubber) there.  There's no point in delving much further into the details of Auschwitz.

But since we will almost certainly lose the few people still alive who survived their time in that horrific place, we must continue to mark these anniversaries.  We must prevent this type of genocide from happening again on this planet.

* * *

Fee for service is a simple healthcare model.  Providers are paid fees for their services.  This is the model in use by Preferred Provider Organization (PPO) health plans.  HMOs are a different model entirely.  The HMO provides all medical care required by the person they are providing coverage to, with only nominal co-payments.

Then there is the capitation plan.  Under this type of plan an insurance carrier will pay a Primary Care Physician a flat fee for each person that chooses him or her as his PCP.  The monthly fee doesn't change based on the amount of care provided by the PCP.  So healthy patients cost less and the rest drive costs up.

The concept is based on the idea that if there is an incentive for the PCP to keep the cost of care low, they will do so.  The question is, does this provide a reason for "less" healthcare to be provided.  I'm not sure of the answer.

PPO plans can provide the same cost reductions, or at least close to the same level of savings, through reviewing for medical necessity.  If your doctor wants to give you an expensive test, all they have to do is justify the need for the test through submission of paperwork and copies of medical records.  It is true that this type of review system is less than perfect, and because of the litigious nature of our society, some doctors will err on the side of caution in ordering more tests than may be needed; in order to reduce their potential legal exposure.

As long as we are going to provide emergency treatment to anyone in this nation without regard to whether or not they have insurance and/or the ability to pay for care (and we need to keep dong that), then we need a solution to our healthcare mess.  Obamacare is an imperfect execution of the right idea.  Let's fix the execution and follow the lead of the rest of the world.  Healthcare SHOULD be a right.

* * *

Random Ponderings:

No matter how angry you are at the Franchise Tax Board, sending them a box of dog feces is a really dumb idea.  Worthy of a momentary chuckle, but not worth the backlash that is going to hit the person who did this.

I wonder if Tom Cruise ever licked the floors or the toilets at the Sea Org base during his stays there.

I will continue to go and see the annual WrestleMania but there's no chance I'll ever subscribe to the WWE Network.  Not unless they're going to pay me to watch.

Some actor has been arrested for installing hidden cameras in a condo he owns and rents out.  Will a picture be worth 1,000 days in Jail?

Maybe the feature of the Waze app that allows the public to know where police officers are operating isn't such a great idea.

The only people who really care if Bruce Jenner is going to transition from male to female are his ex-wife Kris, and a few nervous LPGA golfers worried that Bruce might join their tour.

Digital footprints will never replace tombstones and cemeteries but the comfort of a friend's FB page seems less comforting than visiting the site where they are "at rest."

Joel Gray decided to come out which takes guts.  Then again, we know he's a brave man, having been willing to take on the role of "Chiun" in "Remo Williams: The Adventure Begins."  Fortunately for all involved, the adventure began and ended with this film disaster.

I'm glad Sly Stone will be made financially whole through the outcome of a lawsuit, but I must admit being surprised at the decision.  I would never have thought the Jerry Goldstein I knew would screw over a client to that extent.