Creekside Chatter

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In case you spend a lot of your time thumbing through books or drinking coffee in or around a Barnes & Noble bookstore, you'll be glad to know that B&N is now the proud distributor of free Wi-Fi through AT&T. They've offered Wi-Fi for quite some time, of course, but now you no longer have to pay for it.

Great news! Now I can enjoy last.fm with my Saturday morning coffee and magazines.

Seven degrees south of the equator in the middle of the Indian Ocean lie a sprinkling of islands known as the Chagos Archipelago.

Ever hear of it?

Well, for those who want to reconnect with buddies who were stationed at Diego Garcia, an island that’s part of the archipelago, there’s now Basebook, a Web-based application linked via the popular social networking site Facebook. The site lets members post when and where they’ve served, and search for others.

Basebook is a new Facebook application that helps military service members - and their families - stay connected. If you're a veteran, it's worth a look.

When you talk face-to-face with the people like that travel agency owner -- people whose livelihoods are threatened with annihilation by the economic blundering of President Obama, Secretary Geithner and Federal Reserve Chairman Ben Bernanke -- you realize that poll numbers can't begin to capture the pain and anger many people are now feeling.

No wonder the administration is trying to fire all the IGs. There's just too many inconvenient truths.

So things that I’d like to see happen that I think would curb costs without degrading current or future quality of care would be:

1. Significant tort reform where arbitration is used to weed out frivolous lawsuits and a system where negative outcomes are compensated reasonably, while criminal misbehavior is handled criminally. HMOs should no longer hold their privileged immunity from malpractice relative to physicians.
2. Assigning the cost burden of unnecessary or likely futile services to patients or their families
   Eliminating television and direct to consumer pharmaceutical marketing (which all started only in the late 1990s) (drug company marketing is now about $57.5 billion annually, according to a PLOS study by Gagnon & Lexchin in 2008, which nearly equals the $58.8 billion spent in R&D by the drug industry. This would help reduce costs by allowing physicians breathing room to recommend older yet equally effective medications to their patients.
3. Breaking the oligopolies of health insurance coverage present in many states & regions. 94% of insurance markets are highly concentrated. If ever there was a reason for anti-trust intervention, this is it. Consumer choice is constrained by such circumstances and costs are dramatically increased to patients and physicians. The solution to this is not creating a government monopoly of health care, but using deregulation & anti-trust law to allow cross-state insurer competition, and nurturing novel health care coverage systems through unions, community groups, civic associations, patient co-operatives, and physician-run organizations. Government could do a great service by jumpstarting the infrastructure to create such a true free market but it should not take over such a market.
4. Encouraging charity care: Lawyers can treat pro bono work as a tax deduction; hospitals treat charitable services (which are often overcharged in the first place) as a tax write-off and get income tax exemption for being nonprofits. Physicians currently have no such benefit.
5. Cost Transparency: A friend of mine who is a student in a professional school recently had an appendectomy and got a surgeon’s bill of $~3000 and facility bills of $13000. Insurance paid most of it, but he still paid $5000 out-of-pocket. By contrast, Medicare payment for the surgeon is $561 and for inpatient facility care is about $3000. Patients are charged wildly different amounts, and quite often indigent patients get stuck with full charges while Medicare or large insurance company patients get charged much less due to contractual arrangements. This process is just insane. If the rich or foreigners want to pay for concierge care and first-class service, so be it. But for the system as a whole, doctors should be allowed to set their own fees (which we, alone among professions, cannot – Medicare sets rates which we are obligated to accept), waive standard fees for the poor (remarkably, underbilling is considered fraud), and charges should be transparent and consistent.
6. Encourage innovation: Increasing tax credits for R&D, establishing prizes for translating discovery for big problems, and extending patent protection for new molecular entities while limiting patent extension for me-too drugs maneuvers turning Prozac into Sarafem or Wellbutrin into Zyban, would promote advances in drug and device development and maintain America’s edge in science & technology.

A thoughtful article that makes very good sense.

LAMP is the research arm of the St. Augustine Lighthouse and Museum, and our archaeological investigations are focused on increasing our understanding of the rich maritime history of our Nation's oldest port.

The Keeper's Blog is always a fascinating read, but today's post, with photos of many recovered artifacts, is quite impressive. There's lots of history in the waters around St. Augustine.

Hats - don't you love them!

This is my idea of a choir! The storm is amazing.

Mac OS X only: Back in January Skype released a beta version of the popular VoIP application that added screen sharing tools, integration with Wi-Fi access service Boingo, better audio and video, and several other improvements. Today Skype 2.8 was released, officially rolling these improvements into the stable release of Skype. If you'd been waiting until they left beta to enjoy the new features, now's the time. Skype 2.8 is freeware, Mac OS X only. [Skype 2.8 via ReadWriteWeb]

I've been using the beta version and it's very nice.

I'd love to see the Bishop's Building back downtown - especially if it meant a return of the Neptune Grill!

Great stuff from Historic City News!