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Tuesday links


  1. rochester_veteran
    rochester_veteran December 5, 2017 5:18 am

    No matter what you do, it’s all your fault, especially if you’re affluent or white or heaven forbid, both.

    Closing paragraph of the commentary:

    Well, one thing remains clear, and that is that you are guilty. When you moved to the suburbs you were guilty, and when you moved back to the city you became even more guilty. In fact there is no place you could live that would make you any less guilty. We’ll figure out why you are even more guilty after your next move. Better start groveling and begging for forgiveness!

    I let all of this “blame whitey” stuff slide right off as it’s all Marxist-based Critical Race Theory, made up by black racists and accepted as fact by those who advance Cultural Marxism. It’s all bunk that’s meant to divide and destroy our Western Culture.

  2. MamaLiberty
    MamaLiberty December 5, 2017 5:52 am

    I couldn’t load the Forbes article, but I have to say that home visits by doctors can never be common again. Simple logistics for starters. Far, far too many people wanting to see a doctor, and an ever shrinking supply of the docs. The very rich have always been able to get this service, of course, but that’s not apt to change much in the current state of medicine. In a free market? Who knows.

    What has happened, for more than 30 years, is an increasing number of home visits by advanced practice nurses and other medical professionals. I don’t know how many hospital admissions and doctor’s office visits are eliminated or delayed this way, but it has to be huge – especially with the growing utilization of hospice care.

    Personally, I wouldn’t want a doctor to come to my house. I’d have to clean it first… at least run the vacuum and wash the dishes. And if I was sick enough to need a doctor I wouldn’t be able to do that! 🙂

    In any case, I don’t expect to see a doctor now unless I develop a bad red leak or break something. Then I’d likely go to the city, if possible. We don’t have any doctors in town now, just Nurse Practitioners and a “rent-a-doc” coming from the city to man/woman the ER in our little hospital. I’ve got nothing against an NP as primary care, but so far those in this town have proven to be useless. 🙁

    The whole medical system is broken, long beyond repair. And as we all here know, only the free market can change that.

  3. parabarbarian
    parabarbarian December 5, 2017 7:09 am

    So did the book help you increase your bust size?

  4. Claire
    Claire December 5, 2017 8:14 am

    No, but if a cat ever asks me to dance, I’ll know how to.

  5. Desertrat 1
    Desertrat 1 December 5, 2017 9:20 am

    I gave up guilt for Lent, back, I dunno, about fifty or sixty years ago. Never got it back.

  6. Comrade X
    Comrade X December 5, 2017 9:45 am

    “No, but if a cat ever asks me to dance, I’ll know how to” and I was betting on the one on wolves.

  7. Claire
    Claire December 5, 2017 10:54 am

    No, but now that I know about it I do want to read that one. So you’re close.

  8. Jim Brook
    Jim Brook December 5, 2017 10:59 am

    Mama Liberty, “In a free market, who knows?” I do. I have been doing house calls for years. Not too long ago, I did a house call, about 32 miles round-trip, for a routine thyroid followup for a patient that does not like to go out. The entire charge, lab included, was $133. For comparison, a local family practice doc charges $175 in his office for that same thing, and another charges $192. I work by free market principles. I do not take any confiscated money (Medicare or Medicaid), and I do not take insurance. The patient is my customer. My average house call fee this year was $135. Some of those visits were much more – I recently charged a guy $340, as his issue was quite involved. That included labs and meds supplied (as do all these numbers). One visit was for a family of 6, all sick, for $487. However, my average was skewed downward by a blind guy that I only charge a token $20 or so, who I saw several times. Medicare was the main killer of house calls in the U.S. When you work in a free market, and the patient is your customer, it can be profitable to do house calls. Dollars are, after all, certificates of service. Claire sarcastically said, “It’s Your Fault” that the “poor” are suffering, referring to the affluent. In reality, almost all of the affluent became that way by providing a valuable service. The rich get rich by elevating the situation of the “poor,” providing them goods and services that they can afford.

  9. MamaLiberty
    MamaLiberty December 5, 2017 11:35 am

    No argument, Jim. If a doctor thinks he can cart along all the equipment and supplies he needs to make a house call… and make a living, more power to him. I wish you lived here. I just don’t see it as an efficient way to work. And that’s from an APRN who made house calls for home health and hospice for more than 20 years. I spent long, weary days driving hundreds of miles to see just a few patients. I could have seen them all in a few hours in an office… but efficiency wasn’t the object, especially for hospice patients.

    A great many people here can’t see any kind of doctor unless they travel 80 miles to the nearest city. They are then, of course, put through the sausage grinder and the lucky get well… or at least not worse. The rest of us take care of ourselves and pray we don’t get really sick or hurt. I don’t have Medicare part B, and have never used Medicare either. I don’t have any other “insurance.”

    The last time I saw the NP at the clinic, to have them remove a hearing aid tip that got lodged in my ear… the “up front” charge was $130. and I paid it on the spot. Two months later they sent me a bill for an additional $200. I have refused to pay the extortion and the collection agency is having fun sending me mail and making phone calls. I ignore them all, after explaining the first time why I won’t send them another dime.

    I’ve never been “affluent,” but I don’t begrudge anyone who is… as long as they are not rich on stolen goods, of course. 🙂

  10. Jim Brook
    Jim Brook December 5, 2017 12:15 pm

    I did not figure you would have the attitudes that I was refuting, Mama. It actually is not difficult at all to do the house calls. I have a tool box, about 14″ x 6″ x 8″, for each of about 4 categories of equipment, plus a double decker kit about 28″ tall, that I keep in the trunk of a ’99 Caddy. In my office, I have another 28″ kit wherein I keep my temperature-sensitive things like meds and other things that I do not have duplicated. I grab that on my way out. I put my laptop and a few other things in a backpack on my way out also. Then I take off, and start the clock on my way out of the driveway. I take just a few minutes to gather those things on my way out the door, and I charge $1.80 per minute for my drive time, then $2.70 per minute in their house. It’s a good living, and very easy to haul the equipment. Most people come to my office, where it is much less expensive. It is good to have options, though.

  11. Jim Brook
    Jim Brook December 5, 2017 12:36 pm

    The only difficulty in doing house calls is trying to get paid for them, if your customer is the government or an insurance company.

  12. larryarnold
    larryarnold December 5, 2017 6:00 pm

    IMHO house calls went away with the invention of X-ray machines and such. Back then they took up most of a room, and weighed tons.

    They’re coming back with hand-held scanners and instant communication with other diagnostic tools. Like Jim’s kits.

    Today, most EMS units have more equipment available than whole hospitals did when I was a whippersnapper.

    Back when I worked on construction projects for the VA we were renovating electrical systems for 1950s hospitals. A lot of the rooms had one wall outlet for a floor fan, and one telephone line.

  13. fred
    fred December 6, 2017 2:47 am

    When I tried home health I got 35 dollars a call,and I cant believe the miles i put on.Total disaster,financial joke on the nurses.

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