Paying through the nose for emergency room visits so that Americans can proclaim they have freedom of choice when it comes to health care insurance!

Last weekend, I had a wonderful discussion with one of my hard-core republican neighbors about health care insurance and Obama care. She was very much opposed to socialized health care because it was socialism. Eeeuuuwwwwww..... No, you should take care of that yourself, and if you are not working, tough luck, because everybody who can work can have healthcare insurance. Right...... (That's a blog post on its own, I leave that for another time)

Anyway, she was very much surprised when I told here that the socialized health care in the Netherlands was cheaper per capita than in the capitalized US health care 'system'. Of course she didn't believe me. O well.

But the most interesting part was the discussion about why the costs for health care per capita in the US are larger than any other country. There are of course a whole slew of reasons for that, but one that I like to discuss here is the use of Emergency Rooms as last ditch primary care. People without health care insurance often wait with going to the doctor when they are sick in the hope that it will go away with home remedies, over the counter medication, or that the body deals with it by itself. But when that does not happen, people end up in the room when the situation worsens and they need urgent care. That is were the costs come in, because a 100 dollar visit to a primary care physician has now multiplied itself to a 1,000+ dollar bill. A bill they cannot pay anyways.

Here is the crux. My neighbor, who vehemently opposed ObamaCare because it was ugly socialism, really really agreed with the statement that we could not let people die. At the same time, she really really didn't want to have socialized health care because it is evil socialist yuckyness.... This dual choice results in lack of primary care (which is cheap) for many people and racked up emergency room bills (which is really expensive) for those waiting too long in order to avoid large health care bills. So, who is paying those emergency room bills? Well, not the people who tried to avoid using the health care system in the first place because they don't have the money to pay for it. They are more likely to go bankrupt because of it. Wna when that happens, who pays the bill? Exactly, the taxpayer.

In short, her choice to have 'freedom' in whether to have health care insurance resulted in higher costs for society because we were not consistent with our mantra that everybody should take care of themselves. Because when it comes to the point of letting someone die, society at large has decided that letting someone die of a curabvle medical issue is not accaptable, hence we allow gthem to flock the increadible expensive emergeny rooms, but we refuse to provide them with a cheaper option because it infringes on the perceived 'freedom' of choosing yourself whether you want to have health care or not. This inconsitency results in far mo0re tax payer dollars to go to health care then when we would be consistent in our choice. Either we choose to have the freedom to be insurced or not buit we let people die who do not have health care insurance, or we provide a meaningful option so that everybody can have affordable health care. This hybrid system of denying health care when you are not yet almost dead but allowing to use the emergency room as a last ditch effort to prevent someone from becoming a carcass is the most expensive compromise you can imagine. But try to tell that to someone who listen only to the republican propaganda channel to Fox News.

Pedophilia whitewash at Wikipedia

As some of you know, I regularly edit wikipedia articles. Just for fun. Occasionally, I get dragged into articles far outside my own field. In the recent weeks, while being incapacitated with a replaced hip, I ended up in the discussions related to pedophilia. The Wikipedia article about pedophilia is pretty much a wet dream for lawyers. It is so unilaterally focused on the medical operationalization used by the DSM IV of the term, which by definition will leave out many cases that I would consider pedophile's. For example, if a person has many sexual explicit fantasies about how he has sex with a 11 year old, but those fantasies do not cause him either distress of interpersonal difficulty, guess what, he is not a pedophile.

But it gets better. If you have to believe the people of the Clarke Institute, he would not have been a pedophile even when it had caused him distress, because the child is too old. James Cantor, an active wikipedia editor who not always knows the limits of self-promotion as in this edit where he links to an interview with himself related to the topic, regularly comments on the talk page of the article. In and by itself, that is a good thing. Wikipedia needs expert editors. The reason you want expert editors is that they often know the field much better than the lay editors that are the bulk of the workforce at wikipedia. When you have such an expert editor, you see it in the width of the sources they use, the nuances they can express, and the skill with which they put in words the controversies, differences of opinion, and unresolved issues in the field. So, when someone added a so-so source, James proposes to replace it with....... You guessed it, an article of himself. A primary source as well. if that had been the ONLY article available, o well, than I understand, but when there are multiple second and tertiary sources available, this is not acceptable.

This provides us with some idea why this article is so biased towards the medical operationalization of the term as used in the DSM IV, and not towards the more general usage of the term which generally is defined as something like:

"sexual perversion in which children are the preferred sexual object" Merrian Webster online

"a person, especially a man, who is sexually interested in children", Cambridge Dictionary online

or how many more examples can be given.

To illustrate how US biased the article is, lets look at the World Health Organizations definition in the ICD10:

"A sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age", ICD 10 F65.4

Lets see, if we use this definition, our pedophile friend example in the beginning would be properly diagnosed as a pedophile, even when his interest was in somewhat older children. As it should be.

The pedophilia article at wikipedia makes a classic error. It goes completely overboard by focusing on the medical operationalization of the term at the cost of common sense and general definitions that are far more generally used. A good article would start with the general term, and then work towards the more specialized definitions. Wikipedia does it the other way round. When you start reading the wikipedia article, you might think that most people we normally would label a pedophile are just not that. And that is wrong. Medical operationalizations are necessary for research, but they should not eclipse the more general used term and basically free many pedophiles of the label they despise and would like to get rid of. Thanks to wikipedia, an ever increasing primary source of information, they are no longer pedophiles. Good job!

Disclaimer: I tried to change some things for the better, but one editor specific, and several more in general pretty much block any improvement of the article that is not in line with the medical operationalization of the term.

Moving on.....

I am amazed. Six days ago, I splintered the head of my left hip by falling of a horse. Due to the severity of the fracture, the doc advised to not even try to fix it, and replace the hip joint immediately. After the surgery, he told me that if he had tried to fix it, I probably in two months time would be back for a replacement anyway. Carolyn saw my X-rays when they were made, and she could even see it was just over with the joint.

This makes me wonder, what the heck did people do in my situation before hip-replacement?

In the meanwhile, I am enjoying the modern wonders of the medical technology that will make it possible for me to basically do the same things again as before the fracture. Like horseback riding. Or climbing.

The day-by-day drill is getting better. Which means, doing the exercises of the physical therapist, drinking enough, taking my blood-thinner shot in time, and give it enough rest so it heals quickly enough.

The day after the surgery, I was already taken out of the bed by the physical therapist to walk a few paces and sit in a somewhat reclining chair. I was very dizzy and sitting up made me nauseous. Nausea turned out to be my biggest issue the next day, because it prevented me from actually doing my walking exercises. After cutting the narcotics, and going on only Tylenol, this problem was solved, but it was not enough because my muscles would cramp up a bit. First a muscle relaxant was added, and now I am on Vicodin, a somewhat stronger painkiller than Tylenol (Paracetamol), but substantially weaker than the Hydromorphone they had me previous on.

Wednesday, 4 days after the surgery, I was discharged from the hospital because I had mastered all the things I needed to know before I could go home. Most people who's hip is replaced go home later, but keep in mind that that most hip replacements are in elder people who break a hip after a low energy fall in combination with osteoporosis. I am the minority, in which high energy trauma results in such a replacement. And I am in excellent physical condition as well as reasonably strong. So, being ahead is somewhat expected.

Now I am planning when to go back to work (part-time!), when I can drive a car again, etc. Longer term recovery includes getting back on the horse's back (I might have to learn to get up at the other side) and eventually, hopefully, rock climbing.....

Snap said the bone......

Yesterday morning, I broke my leg at the hip joined. It happened around 11:00 (am). and by 416:00 (4 pm), I was wheeled into surgery for a hit replacement. The hip joined was demolished and the changes of healing were close to zero, so they recommended to replace the hip joint. My legs are now strapped down in a specific position, to keep the artificial joint in place. Not pleasant, but heck, if that means I heal faster or better, I take it.

Yesterday morning, after I had my morning work done (collecting virgins, committing mass murder), I went out to Havana to ride Pate, the favorite horse. After first playing with him a bit using new exciting Natural Horsemanship techniques, I tagged him up. After lunging his a bot, I got on him and while I was adjusting the stirrups, he wandered over to a shady spot with low hanging branches. To late, I noticed we had gotten into them and I tried to turn him around because the low hanging branches was really dense. When I turned him around, I had to bent forward substantially to avoid to many branches. That was not an issue, but what I could not avoid was that Pate got the branches in a nasty way in his face and he responded to that my jumping somewhat away. Or something like that, because I do not recall exactly. Next thing I know is that I am flying of the horse and I land exactly on my left hip joint.

There is immediately a LOT of pain. I manage to role myself on my side in the first aid position but there is no way I could put any weight in that leg. I managed to get Pate close to me so I can take his bridle off. After about ten minutes, The people who live there came home and found me. They were so kind to bring me to patients first where they X-rayed me, Well, the verdict was clear, no more moving and they got an ambulance to move to the first aid of the local hospital.

At the hospital, they made a few more x-rays, and the verdict was rather clear. The neck of the femur leading to the hip joint had snapped of, and if I am correct, the ball of the joint was split. The doc didn't fuss about it, when he said: "This will never heal. The only option is a hip-replacement." With a hip replacement, I had two options, femur part only or both sides. The first option often result in increased arthritis on the cup of the joint, which basically means that you have to fix that part in a year or ten. Benefit, you heal faster. The latter option is more permanent and you are not getting into arthritis issues, but the time to heal is longer. As I do not feel like having major pain and surgery in 10 years time, I opted to take the longer healing time and have the whole thing fixed.

Saturday, at 16:00 (4 pm), I was wheeled into the operation room and by 20:00 (8 pm), I was the proud owner of a artificial hip joint. Now, I am resting comfortably and the recovery has started. In about three months time, I will be able to ride again, but for the coming months, I just have to take my time so I heal good.

Suzi check Pate the next morning and he had a bunch of scratches over his face, but he was otherwise fine.

You bitch, we did it for the children

"We stayed together for the children". How many people have heard that phrase. Especially, how many children have heard that phrase, wondering why in earth their parents wouldn't get a fucking divorce at the next blow-up between the so-called 'adults'.

if you decide to stay together for a reason, act accordingly. if you stay together 'for the children', act as mature adults and stop fighting. Really, the last thing that children want is fighting parents who stay together because it would be better for the children. really, it isn't better, it is worse. It is an easy cop-out of taking responsibility for their own action. if you are REALLY doing it for the children, what would you think is best for those critters? Another escalated fight about who has to do the grocery shoppings?

It is easy to claim that you do something for a reason. It is far harder to deal responsibly with the consequences of those decisions. But the bottom line, if you cannot live with the consequences, don't invent a bullshit argument like I am doing it for the children. really, the last ones you make happy with those fights, or complaints, or whatever negative comes from it, is the kids.

Cognitive dissonance: Oppose gay-marriage because children of unmarried couples fare less than from married couples....

One of the main arguments against gay marriage that we hear over and over again is that it is bad for the children raised by same-sex couples. Well, opposing same-sex marriage is not going to change that those children are raised by same-sex couples, whether their parents are married or not.

When pressed why it is bad for the children, the argument often is comparatively, namely that children living in unmarried families, like single mothers, unmarried co-habiting parents, step-parents, etc fare less good than children from happy married couples.

Every time I hear this argument, I am stunned by the inane stupidity of the argument. This argument is the prime argument to promote same-sex marriage. Because if their parents would be allowed to marry, the children should be better of? Not?

Well, if you press them on the details, what you find out is that they try to link two arguments. One is the one I just described, the second is that a child needs a father and a mother, and the link they want to make is that same-sex couples can never offer a mother and a father, and thus need to be compared to the unmarried and single parents trying to raise kids.

Unfortunately, the second argument has already been shot down by social science research, which shows that children raised by functional same-sex couples are equally or even better off than children of married heterosexual couples.

if we combine these, allowing same-sex parents to marry is actually going to help their children. Maybe that is where they are afraid for..... Maybe they are afraid to look incompetent because the kids of the gays are actually doing better......

Will the same-sex marriages haters risk a ruling that will affect the whole nation?

Today, the ruling on the prop 8 trial will be announced. The same-sex marriage haters have already filed a motion for a stay of the decision pending appeal if the case is going to be ruled in favor of the plaintiffs. Based on the specifics of the motion wording, you can bet it is a win for US!

So, appeal. The current ruling ONLY affects California, and leaves the rest of the country out of the loop. A loss at the appeal court would widen this to a loss for a whole range of states: Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon and Washington. and of course, if they appeal it to the US supreme court, it would affect the whole nation.

So, if they want to slow down how many states (have to) recognize same-sex marriages, they would be far better of to not appeal and give away California. Why? There case was a disaster. At the appeals court, they cannot bring new arguments. So, the case will be decided pretty much based on what is now on the record. And that record is, well, shitty at least. Maybe better to qualify it as non-existing.

So, what would be the alternative? Let it stand. Throw California under the train and move on. Because this means that if another gay couple in one of the other states of the union finally wants to be treated as a full citizen, they have to start their own case. With their own lawyer, their own witnesses etc. And this gives the haters one MAJOR opportunity. Time to prepare themselves better. To have real experts. And maybe they will be lucky to find a judge who is more activist and willing to impose his own conservative dogma on the case.

Of course, some day, some case will reach the US supreme court. It can be sooner if they appeal now, or maybe later if they take the loss of one state and try to build a more solid case in the next court battle. The later would be a better strategy, because it they get more favorable evidence into the records, they actually will have a higher change of winning when they finally reach the US supreme court.

But rest assured, they won't be this smart. If their performance at the trial is a indicator, they are so convinced they are right that they are willing to risk it all, just to be right! You almost would think they are actually in favor of same-sex marriage.

And because of that, we have to thank them for helping our cause. So, please, file an appeal and help us to finally ride this country of a grave injustice!