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Illegal Immigrants and Healthcare: One Story

Published by
Demosthenes
at September 25, 2009 in General and Rants & Raves. 1 Comment

Immigrants Cling to Fragile Lifeline at Safety-Net Hospital
Source: New York Times

Hospital officials estimate that two-thirds of the outpatient clinic??s roughly 90 patients are illegal immigrants. They do not qualify for Medicare, which covers dialysis regardless of a patient??s age, and they are excluded in Georgia from Medicaid and other government insurance programs. Legal immigrants face a five-year waiting period before becoming eligible. That leaves Grady to absorb costs of up to $50,000 a year per dialysis patient, some of whom have availed themselves of the thrice-weekly treatments for years.

This outpatient dialysis clinic at Grady Memorial Hospital is closing because it has bled money year after year. Essentially 60 out of the 90 patients are illegal immigrants and cost the United States an annual $50,000 per patient which equals $3,000,000. Lets compare that to the 30 legal patients’ cost of $1,500,000. Assuming, just for a second, that these numbers have been roughly the same over the past 5 years, the cost to treat just illegal immigrants would have been $15,000,000 compared to $7,500,000 for legal patients. In other words, the dialysis clinic could have stayed open approximately 10 more years to treat America’s own even if none of the patients were capable of paying a cent — based on what has already been spent.

However, legal patients can qualify for state and federal programs which defray the costs to a facility. Sure, it may take five years, but some percentage of the existing dialysis patients at this clinic probably had state or federal funding. Taking this fact into consideration, this dialysis clinic may have lasted considerably longer than ten more years if it had not taken on the challenge of treating illegal immigrants. In this case, as in many other cases, the policy to treat everyone failed the legal patients of this country by short changing them and their communities. This is not to say that all people don’t deserve healthcare. However, resources are scarce for even America’s own poor and uninsured. I cannot fathom why we, as a country, attempt to care for the citizens of every sovereign country in the world. Why do we welcome, with open arms, every foreign visitor who, legal or illegal, lands on our soil and beelines to our emergency rooms in the pursuit of free or subsidized health care?

Lastly, as any primary care physician or nephrologist will tell you, it is the rare patient on dialysis who didn’t do it to themselves either through ignorance of their disease or wanton disregard. There are far more out-of-control type II diabetics with end stage renal disease on dialysis than people who just happen to be born with failed kidneys. Too often, “being sick is not my fault” is utter nonsense. All the alcoholics with cirrhosis and upper GI bleeds, all the smokers with cancer and COPD, all the gluttons with heart disease, all the blind diabetics on hemodialysis. Who is to blame? The healthcare system? God? That’s all bull. There is no manual for life. At the end of the day, whether you knew it or not, you did it to yourselves.






Medical Truisms #1

Published by
Demosthenes
at July 30, 2009 in General and Rants & Raves. 0 Comments

The more surgical crap you where outside of the OR, the less likely you are to be a surgeon:

1. The surgeons usually wear nothing but their scrubs and white coats.
2. The anesthesiologists usually wear scrubs and flaming caps. Nowadays, add iPhones too.
3. The ob/gyns love to wear scrubs, booties, and those silly gowns. Look at me! I think I’m a surgeon. All the other doctors know that they’re kidding though.
4. Scrub techs, nurses, and other miscellaneous staff love to wear just about everything they can to say, “Look at me! I work in an OR. Please confuse me with a doctor!” Their attire, as seen in the cafeteria, includes scrubs, a paper skull cap, paper booties, gown, etc.

Relax people, its just medical humor except for #4.

That’s My Brother

Published by
Demosthenes
at June 23, 2009 in General. 1 Comment

Attending physician, John Lee. Go easy on them poor MS3’s, brother.






How to Survive A Professional Services Firm: Rule #1 - Never work under a single or divorced woman

Published by
Demosthenes
at June 19, 2009 in How To's and Rants & Raves. 2 Comments

Lets think about all the professional services partners who are single or divorced women. First, my apologies if you are one of the 0.1% of women partners who are the exception to my following rant. Returning to the population in question, I posit that these women are single or divorced for a reason. They prefer their careers to their personal lives. Simple. Say what they will about feminism, they will be depressed spinsters in their later years who dote on their nieces and nephews with repressed regret for not having a family of their own and who lose themselves in travel to exotic locations and dining at fancy restaurants with other spinsters to fill the undeniable void in their lives.

Why did they come to such a sad state? Because they consciously or unconsciously chose to make their careers their number one priority. After all, when people are young and ambitious, they think they can have it all. Partnership is just a hop, skip, and a jump away, right? However, with maturity, most adults come to realize the truth of the world. Very few women make partnership. Fewer actually make partnership and have it all. Most of these “successful” partners will pair up with comparably ambitious men and have a dysfunctional family involving in vitro fertilization, live-in nannies, and boarding schools. However, the vast majority of female partners are single or divorced with no children.

Now, what does this mean for you as the associate, consultant, analyst, or other cog being managed by this sort of woman?

First, the idea of management suggests that one can balance multiple tasks or goals by correcting assigning priorities. Single or divorced women are often poor managers because they obviously do not comprehend true priorities. Please spare me the values conversation. I’ll redirect your attention to the lonely but successful spinsters and ask you to have a heart to heart with them. Still arguing? Then you’re the outlier and not really significant to this discussion. And, once again, apologies if you think you are the rare exception. Who is that going nuts again the night before a contract or deliverable is due? Yep, its her again. Forty emails today and wants a lunch time teleconference because she eats yogurt and granola and doesn’t understand why people need to ingest solid food. Don’t forget the teleconference at 7 pm because if she isn’t going home to an empty house, you’re not going home to your family. You know it and I know it.

If you’re a man, you’ll suck it up because this woman made it to the top and sacrificed her soul. She will expect no different from you lest she call you pussy. Moreover, don’t expect any of the topics of conversation (i.e. sports), alcohol-driven events, or activities that help mitigate the stresses of working under a slave driving male partner. You won’t get any of that.

If you’re a woman, its only human nature to want you to suffer just as she did, to sacrifice what she has sacrificed. Your pleas of pediatric appointments and PTA meetings will fall on deafened years. Each whisper of husband and child will merely stir that subconscious cauldron of angst and remorse and, in turn, you will be made more miserable. Don’t you want to make partner too? If the woman partner has a child, consider it a slightly mitigating circumstance. Perhaps she will nostalgically indulge you in a little bit of empathy every once in a while. But, still, if she can manage, why shouldn’t you? Misery loves company. All bets are off if she used a sperm donor.

Its a sad fact that you’re better off working for a male partner. He is more likely to have a stay-at-home wife and children. He be in a better position to empathize with your situation, male or female.

Essentially, having one of the aforementioned women managing your project or deliverables is going to be absolute nightmare, which segues into my #1 rule of surviving a professional services firm:

#1. Never work under a single or divorced woman, particularly with no children.

Review: Park Place Apartments, Mountain View, CA 94041

Published by
Demosthenes
at June 15, 2009 in Rants & Raves. 0 Comments

Prometheus Real Estate Group: Park Place Apartments

Downtown Mountain View via Castro Street is a wonderful community. Lined with Asian restaurants, boba shops and gelato stores on either side of the street, the main thoroughfare is beautiful and idyllic. Ensconced right at the beginning of downtown is a rental community called Park Place which is touted to have won a number of industry awards. The website beckons with the words: “Ever wondered what it was like to actually live on Park Place when you played Monopoly as a kid?”

Four apartment complexes each take a quadrant of the block with a fountain surrounded by green lawns at the center. Neighbors walk their dogs in this pet-friendly community and mothers push their baby carriages as the birds chirp above in the towering foliage. Contiguous to the community is a Starbucks, Amici’s Pizza, a Le Boulanger. A large park is situated a block away where people play Ultimate frisbee on the weekends and kids swing in the play area. Sounds beautiful, doesn’t it?

The truth of the matter is a little more complicated. You see, what surrounds you is secondary to where you actually dwell. On the surface, the units themselves are nice and clean. But, after one night, the foibles of this community become readily apparent…

Construction

Peruse the awards carefully. None of them are for the quality of the actual construction. Landscape Contractors Association Trophy Awards. Exceptional Mixed-Use Office and Residential Project. Outstanding Infill Architecture. Best Residential Product Level Site Plan. Essentially, all the awards tell you that the place looks nice and mixes well with the businesses on the same block. What they don’t tell you is that you can hear the upstairs neighbors walking around, and open and close their closet doors or that you can hear your own thumps as you walk about in your unit. You don’t even have to be obese. Be prepared to hear you upstairs AND downstairs neighbors watch tv and play video games. Our first night, the downstairs neighbor decided to bounce some sort of ball against the wall starting 3 in the morning. Bastard. He doesn’t want to get me started.

The center of the community, where the fountain exists and the lawns are dog toilets, is not access controlled. Anyone from the area can walk right in. Moreover, ground level units facing the community center or sidewalks have balconies with steps that descend down into this public area. How alarming is that? A stranger could step right up to your living room and peep in. Fortunately, the 4 complexes are access controlled, though your idiot neighbors or constant furniture rental companies are prone to prop the door open and allow miscreants into this little “paradise.” Tiff was recently browbeat into buying a newspaper subscription by some punk black kid with the same bullshit “sell papers to graduate” nonsense I’ve heard countless times. The unit across from us just installed another lock on the door and left a sign up for whoever just robbed them.

Landscape

Green grass and trees everywhere! A verdant paradise? No. An utter mess. I’m not sure which moron architect or landscape designer selected the trees in this community, but they are essentially the bane of all tenants. There are a few species of trees which contribute to the overall mess. The trees in the central, public area of the community constantly shed allergens/particles (I don’t remember anything from plant biology) like an all day long rain of floating crap — for lack of a better word — just begging to land in your eye or get inhaled into your lungs and exacerbate your allergies. As you walk into your access controlled complex, there is another species of tree which freaking sheds like a dog does hairs — I kid you not. From the stairs down to the underground garage to the front door of every unit — and I mean every unit — there is a profuse clumping of this wretched plant shedding which eventually transforms into dust. It gets absolutely everywhere. People don’t open their windows. Why? Because all the floating crap outside our complex and the tree shedding inside the complex. Walk down to the garage and you’ll also notice that there is a fine layer of plant-derived dust/crap on every car. I feel sorry for the poor sucker with his pride and joy black M3 parked down there. All that yellow crap probably drives him nuts… BMW drivers are like that.

Next, all these god damn trees block the sun for every unit that doesn’t face west. Its the middle of summer and our apartment is like a cavern. We often turn the lights on in the afternoon. Why? Because the landscapers wanted to win their “We Frakked the Tenants and Got Away With It” trophy awards. However, this isn’t the sole reason either. The units facing each other across the center of the community are so freaking close, I can look across and see what they’re having for dinner. So, tenants in such units keep their blinds either fully or partially closed throughout the day and night.

Gym

Forget about it. Tiff went to take a look at their treadmill and came right back. We moved our gym-grade treadmill up from Los Angeles, but until I can figure out how to dampen the vibrations and noise levels so as to not drive our neighbors insane in the evenings, we are limited to jogging during the day on weekends. Unfortunately, we prefer to be out in the sun than jogging in the dark at that time. I’m sure things will change with the onset of the rainy season.

Positives

Despite it all, there are a few positives. I think the community appears to be well managed managed. Payment and repair requests are all submitted online. The maintenance team is very prompt. The leasing office accepts packages and either emails you upon arrival or delivers them, with the tenant’s consent, into the residence. And, downtown Mountain View really is within a very short walking distance.

Quirks

The online leasing application is an utter failure. Here is a good example. Tiff is a fifth year attorney and I am a new medical intern. We didn’t pass. Nevermind that we’re pulling in a quarter million a year. To pass, I was instructed by another idiot to say I made no income rather than my meager intern salary. Afterwards, the office asked me for a pay stub when we arrived and signed. I said no. You can’t have one since I can’t have a salary.

Unit prices change daily for no apparent reason and the automatons in the leasing office don’t have the brains to think independently. Whatever the computer says is whatever the computer says. When I submitted our online application on a Friday, the rent was $1990 for our unit. After it failed, the rent went up to $2011. I asked for the $1990. Denied. I asked to speak with someone who could think independently. Denied. Why the frak should I pay twenty bucks more because your retarded program thinks our total income minus my salary is better than our total income? Because that’s what the computer says.

The week we moved in, there was a notice tucked into every door frame. Apparently, the police department had “misplaced” a police car and it was found in the garage of one our the community’s complexes. Any information would be greatly appreciated. I’m not sure what that says about the Mountain View Police Department or about the neighbors.

Conclusions

We won’t renew our lease because we’re only here for one year. We wouldn’t renew our lease even if we were here longer.

Recommendations for Prometheus Real Estate Group

Cut down the frakking trees, consult an ecologist, and replace them with more appropriate species. Tear up the carpet and sound proof the god damn floors. Access control the center of the community. Fix your online application system. This place is a far cry from a true Park Place.

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