DC Tom Posted April 1, 2014 Share Posted April 1, 2014 Oh and B-man and DC_Tom here is something about ICD-* that you might hate/like. It's long, and I don't care if you don't read it. It's just something I wrote out while listening to a dopey call today. The problem with ICD-* is actually quite simple. Origin of the problem: Mumps. Mumps was widely spread(like manure) in health care, and remains widely spread to this day. Mumps has informed the thinking of practically every health care person(and yeah, most don't know it). Mumps is a hierarchical database, a B-tree, etc. Hierarchical approaches are crap. Largely because they don't allow for multi-node properties, and, nothing can be transitive. Hence, if I want to describe a pizza in ICD-9, I have: 1. Pizza 1.1 Dough 1.2 Cheese 1.2.1 Mozarella 1.2.2 Ricotta 1.3 Pepperoni This is great if you are moron, and work at a pizza place that buys everything from SYSCO, has 2 employees, and is a cash business. The real, not "it's 1979 and Mumps is the best!", world needs to look at pizza in more than a "what do i do first" way. It may look at pizza in terms of "toppings", but, it could also look at pizza in terms of "things I buy from company X". ( I use 2 different doughs, one from company X, one from company Y, and also 3 different cheeses from 3 different suppliers, etc.). But instead of being able to attach that info, I have to make a subnode, just like I did to show different kinds of cheeses. The effect of the problem: if you notice above the way I've laid out my data means I only get the, moronic, "what do I do first" look. ICD-* dopiness is that in order to add the classifications, or properties that I need in order to supply the other looks, the answer always is: add a new code. This is an inifinitely stupid thing for health care, as the classification of different diseases NEVER breaks down in a single, uniform manner, however, the premise of a hierarchical data structure requires that. We need to be able to look at diseases in more than 1 way. In one case, because one disease/condition can cause another. The only way to represent the exact same disease, one "free standing", one caused by another? 2 different ICD-* codes. Clearly that is patently ridiculous. It's the same damn disease. Ask yourself: do we treat that disease differently? You say "sometimes"? Yeah, and what is the solution there? More ICD-* codes! Most importantly, we need to be able to look at diseases in terms of "WTF are we going to do about it, given that there may/not be other diseases present", and ICD-* fails miserably in terms of functional thought/care/whatever. There are a lot more examples, but, I say again: ICD-* is what happens when you let the unqualified do my job. The only reason ICD is the way it is? Mumps thinking, left over from the late 70s early 80s, and there's really no reason to keep it around. I knew most of that already, from dicking around with the ICD codes and exclaiming "Who wrote this bull ****?" to my doctor. NOTE: This is not an endorsement for doing this in a relational model either, so sorry Tom, your 3rd normal form, MS_Access experience is useless here as well. Diseases do not lend themselves SQL structure, and nobody wants to put up with doing the joins/many to many tables required to make that happen either. This is probably part of the excuse as to why ICD is still in the horrible state that it is. Solution to the problem: Look at HL7. THEY have got something going on...finally. They think in terms of objects/properties. ICD could easily be fixed if they used HL7's approach. However, HL7 also has many design flaws. We have a better design for all of it. But, we have to do other stuff first. Meaningful use is our first exploit.... I work for the government. I am required to write databases in Excel, and contractually forbidden to acknowledge that anything exists beyond first normal form. I can use Access for gantt charts, though. Link to comment Share on other sites More sharing options...
boyst Posted April 1, 2014 Share Posted April 1, 2014 I called BCBS last night and had to leave a message. I called the number the ACA provided and the prompt said it would be at least 24 hrs for a return call. I logged in...sorry, attempted to log in this morning before work and could not. It kept saying that it could not verify server or something After work I called BCBS and still got no one. I successfully logged in but cannot pay for my coverage to start. I get all the way to the "pay now" option and just like last night it shows the same message. I have no insurance coverage at this time and it is less then 45 minutes to the deadline. But I guess that is ok because Obama would consider me "enrolled" though my start date now says it will not be available now until April 10th. It scares me shirtless to think I have no medical coverage right now. With a farm and active lifestyle it is a big risk. Thank Allah I am a bachelor with out kids. Link to comment Share on other sites More sharing options...
3rdnlng Posted April 1, 2014 Share Posted April 1, 2014 I called BCBS last night and had to leave a message. I called the number the ACA provided and the prompt said it would be at least 24 hrs for a return call. I logged in...sorry, attempted to log in this morning before work and could not. It kept saying that it could not verify server or something After work I called BCBS and still got no one. I successfully logged in but cannot pay for my coverage to start. I get all the way to the "pay now" option and just like last night it shows the same message. I have no insurance coverage at this time and it is less then 45 minutes to the deadline. But I guess that is ok because Obama would consider me "enrolled" though my start date now says it will not be available now until April 10th. It scares me shirtless to think I have no medical coverage right now. With a farm and active lifestyle it is a big risk. Thank Allah I am a bachelor with out kids. Not a problem Farmboy, did the members of "Little House On The Prairie" have health insurance? Just eat an apple a day and you'll keep the doctor away. Link to comment Share on other sites More sharing options...
boyst Posted April 1, 2014 Share Posted April 1, 2014 (edited) Not a problem Farmboy, did the members of "Little House On The Prairie" have health insurance? Just eat an apple a day and you'll keep the doctor away. I prefer lavender Edit, and actually, I eat a grapefruit a day. Edited April 1, 2014 by jboyst62 Link to comment Share on other sites More sharing options...
3rdnlng Posted April 1, 2014 Share Posted April 1, 2014 I prefer lavender Edit, and actually, I eat a grapefruit a day. Grapefruit---good. Link to comment Share on other sites More sharing options...
DC Tom Posted April 1, 2014 Share Posted April 1, 2014 I called BCBS last night and had to leave a message. I called the number the ACA provided and the prompt said it would be at least 24 hrs for a return call. I logged in...sorry, attempted to log in this morning before work and could not. It kept saying that it could not verify server or something After work I called BCBS and still got no one. I successfully logged in but cannot pay for my coverage to start. I get all the way to the "pay now" option and just like last night it shows the same message. I have no insurance coverage at this time and it is less then 45 minutes to the deadline. But I guess that is ok because Obama would consider me "enrolled" though my start date now says it will not be available now until April 10th. It scares me shirtless to think I have no medical coverage right now. With a farm and active lifestyle it is a big risk. Thank Allah I am a bachelor with out kids. Fortunately for you, you now qualify for the "unable to get health insurance through the ACA web site" hardship exemption under the ACA, so your coverage is 100% subsidized. Your doctors, of course, aren't in your plan. Link to comment Share on other sites More sharing options...
Nanker Posted April 1, 2014 Share Posted April 1, 2014 I prefer lavender Edit, and actually, I eat a grapefruit a day. Grapefruit---good. Not if he's taking a statin. Fortunately for you, you now qualify for the "unable to get health insurance through the ACA web site" hardship exemption under the ACA, so your coverage is 100% subsidized. Your doctors, of course, aren't in your plan. Neither are the hospitals, but at least he's covered - and for free, at least for now. Link to comment Share on other sites More sharing options...
boyst Posted April 1, 2014 Share Posted April 1, 2014 How the !@#$ am I covered for something I haven't paid for, have no proof of purchase and even more scary is a service from the government? I don't believe it. Link to comment Share on other sites More sharing options...
3rdnlng Posted April 1, 2014 Share Posted April 1, 2014 How the !@#$ am I covered for something I haven't paid for, have no proof of purchase and even more scary is a service from the government? I don't believe it. Are you a member of the Tea Party? Link to comment Share on other sites More sharing options...
IDBillzFan Posted April 1, 2014 Share Posted April 1, 2014 How the !@#$ am I covered for something I haven't paid for, have no proof of purchase and even more scary is a service from the government? I don't believe it. It's absolutely true. You see, it works like this: if you had coverage, but lost coverage, but were able to log into ACA and put in all your important information, that means you're enrolled. I mean, you're not enrolled in that you have proof of coverage. You're enrolled in that you gave them information. So you can go to any doctor or hospital and explain this to them, and they will take care of you. I mean, yes, they'll make you pay for the services, but if you hold onto your receipt, the government will reimburse you once they see that you couldn't sign up. They'll probably send you a check right away. Usually in 24 hours. In fact, I think they recommend you just float a check, call the ACA number, and the government will wire money directly to your account to cover the check. If for any reason the money doesn't make it, the doctor will be charged a penalty, and that penalty will be deducted from the amount you owe. And every day the check doesn't clear, the doctor gets dinged and you owe less. And that's how ACA works, Charlie Brown. Link to comment Share on other sites More sharing options...
Tiberius Posted April 1, 2014 Share Posted April 1, 2014 The first open enrollment season of Obamacare ended at midnight Monday, a day that saw millions of Americans click onto Obamacare sign-up portals, dial into call centers and stand in long lines at assistance sites nationwide. The huge surge made it increasingly likely that enrollment would hit 7 million, the finish line that seemed out of reach during much of the often rocky six-month period. Shortly after 10 p.m., the Associated Press cited two sources that said sign-ups were “on track” to hit 7 million. Administration officials wouldn’t confirm the number but said that signs were pointing in that direction. Read more: http://www.politico.com/story/2014/03/healthcaregov-website-down-obamacare-deadline-105197.html#ixzz2xe3SSc82 Cool! And with the first seven million will come the next seven million. Is it working? Link to comment Share on other sites More sharing options...
DC Tom Posted April 1, 2014 Share Posted April 1, 2014 Read more: http://www.politico....l#ixzz2xe3SSc82 Cool! And with the first seven million will come the next seven million. Is it working? And when are the next seven million signing up? Link to comment Share on other sites More sharing options...
Doc Posted April 1, 2014 Share Posted April 1, 2014 Read more: http://www.politico....l#ixzz2xe3SSc82 Cool! And with the first seven million will come the next seven million. Is it working? Depends on: a) how many of the 7 million actually have paid (estimates are 20% haven't, meaning the number is closer to 5.6M)? b) how many are young and healthy, to keep costs from skyrocketing (they're expected to anyway in 2015)? c) how many were previously uninsured (covering just a fraction of the alleged 50M who were uninsured/mostly people who lost their plans because of Obamacaid would be a massive failure)? d) what kind of care will these people get (assuming they can get care)? When will we find out these things? If they're unfavorable to Barry, probably never. But we'll see the premium hikes and complaints from people. Link to comment Share on other sites More sharing options...
Tiberius Posted April 1, 2014 Share Posted April 1, 2014 And when are the next seven million signing up? In a place called the future Link to comment Share on other sites More sharing options...
DC Tom Posted April 1, 2014 Share Posted April 1, 2014 In a place called the future In other words, you don't know. Link to comment Share on other sites More sharing options...
Tiberius Posted April 1, 2014 Share Posted April 1, 2014 Depends on: a) how many of the 7 million actually have paid (estimates are 20% haven't, meaning the number is closer to 5.6M)? b) how many are young and healthy, to keep costs from skyrocketing (they're expected to anyway in 2015)? c) how many were previously uninsured (covering just a fraction of the alleged 50M who were uninsured/mostly people who lost their plans because of Obamacaid would be a massive failure)? d) what kind of care will these people get (assuming they can get care)? When will we find out these things? If they're unfavorable to Barry, probably never. But we'll see the premium hikes and complaints from people. It's just beginning, moving forward it will cover even more people In other words, you don't know. It's a stupid question, as usual. The next seven million will sign up at different times and no I don't know, no one does, when the goal of 7 million will be reached Link to comment Share on other sites More sharing options...
DC Tom Posted April 1, 2014 Share Posted April 1, 2014 It's a stupid question, as usual. The next seven million will sign up at different times and no I don't know, no one does, when the goal of 7 million will be reached No, it's not. You just don't understand the question. When? Link to comment Share on other sites More sharing options...
boyst Posted April 1, 2014 Share Posted April 1, 2014 It's absolutely true. You see, it works like this: if you had coverage, but lost coverage, but were able to log into ACA and put in all your important information, that means you're enrolled. I mean, you're not enrolled in that you have proof of coverage. You're enrolled in that you gave them information. So you can go to any doctor or hospital and explain this to them, and they will take care of you. I mean, yes, they'll make you pay for the services, but if you hold onto your receipt, the government will reimburse you once they see that you couldn't sign up. They'll probably send you a check right away. Usually in 24 hours. In fact, I think they recommend you just float a check, call the ACA number, and the government will wire money directly to your account to cover the check. If for any reason the money doesn't make it, the doctor will be charged a penalty, and that penalty will be deducted from the amount you owe. And every day the check doesn't clear, the doctor gets dinged and you owe less. And that's how ACA works, Charlie Brown. oh. I get it. I just think that's a pretty fugged up way to do it. Call me old fashioned but I don't want anything I did not earn. Call me old fashioned but I am not going to take the word of someone as good enough in a situation where my health depends on it and most importantly not the word of the government. Ans call me old fashioned but I just believe that things of such magnitude should work correctly. Link to comment Share on other sites More sharing options...
Azalin Posted April 1, 2014 Share Posted April 1, 2014 When? I'll take 'never' for 500, Alex...... Link to comment Share on other sites More sharing options...
boyst Posted April 1, 2014 Share Posted April 1, 2014 Are you a member of the Tea Party? no. But I played one on TV. 100% registered Sagittarius. Link to comment Share on other sites More sharing options...
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