Winter Break

I've been on vacation from work since the 21st. I didn't make plans to travel anywhere this year since I just wanted some time to relax in CT. I've used the past week to establish a regular routine at the gym, read, shop, and basically just relax.

I recently finished a very good book about the fast food industry and I am reading another somewhat interesting book about our ineffective tax code. Both books are reinforcing my liberal political views and my general contempt for our political system and how it caters to the minority that provide them with the funds needed to get elected as opposed to the best interests of our nation. I'll try to put up a short review of each book later this week.

I should clarify some comments from my last post. I think I was a little steamed about that story when I made my post. After thinking the situation over some more, I do not believe that an insurance company should ever have final say in approving high cost treatments for patients such as an organ transplant. It's clearly a conflict of interest, regardless of whether the intentions of the insurance company are pure. However, I don't think that these expensive procedures should be solely at the discretion of the physicians directly involved with the case either. If an independent organization that delegates and approves organ assignments to a specific patient on a centralized list after considering the details of their case, that should be considered tacit improvement for the procedure and the insurance company must comply (unless the insurance policy explicitly excludes transplants...but that is an unrelated issue). That's not necessarily consistent with what I wrote last week, but I think it's a more reasonable perspective after stepping back and trying to be as unbiased as possible.

U.S. Health Care System

There's a tragic news story in southern California that has me very conflicted about how to improve the U.S. Health Care system. For those of you smart enough to find the story on the Internet, you'll understand in part why I am conflicted about the story and whether I should even make this post.

The highlight of the story is that a teenage girl with leukemia received a bone marrow transplant, developed complications, her liver failed, and she sadly passed away. A tragic step within this story is that on December 14th, six days before the girl died, a liver was available for a transplant. However, the girl's insurance refused to cover the cost of the liver, though I am not exactly sure why the insurance company made this decision. Obviously, I'm no expert here regarding why this treatment is too experimental, but perhaps the girl would be alive today if she had received that liver transplant.

After a series of public protests and appeals by the hospital, nurses, and the girl's family, the insurance company had a change of heart and made a one-time exception five days after the initial denial. Unfortunately, the original liver had already been given to a different patient and the girl died before another liver was available.

The one-year survival rate for liver transplants in the U.S. is a strong 85%, but that figure is probably much lower for someone also suffering from leukemia since the drugs needed after a transplant to suppress the immune system would not help the battle the body is already fighting against leukemia. The insurance company had already paid several hundred thousand dollars for other treatment, but balked at the >$250k tab for a liver transplant that was not guaranteed to be successful. The hospital also declined to perform the procedure and appeal for reimbursement at a later time or do it for free.

Understandably, the insurance company that denied the cost of the claim is getting a bunch of bad press. Much of it is probably deserved. The girl's family has already sued and also wants criminal charges pressed, though I have no idea how you can charge a corporation with murder.

We can all sit here and point the finger of blame squarely at the insurance company in question, but this issue is far more complex. We can also make a lame effort to defend the insurance company and argue that the hospital could have done the transplant anyway when there was opportunity. Furthermore, we could argue that it was irresponsible for doctors to try and put a teenage girl with leukemia through a liver transplant when there are other patients in need of a liver with a much better hope of survival. However, all of the arguments miss the point here.

In defense of insurance companies, these decisions are not made based solely on dollars and cents. Insurance companies employ doctors and nurses to evaluate cases like this. They have to. Insurance companies would be deservedly sued into bankruptcy if accountants had veto power over the doctors who are treating the patients. Unfortunately, some cases are considered 'experimental' because they simply have not been performed enough to assess their effectiveness. It's hard to innovate without practical application of new techniques, and allowing insurance companies a voice in this decision is dubious, regardless of whether the insurance companies are deferring these decisions to doctors and nurses not directly involved with the patient. It's a huge conflict of interest unless the insurance company refers these decisions to an independent and accepted third party!!

The real question is how can the U.S. identify ways to control medical costs, provide universal access to health care, provide incentive to develop new technologies, and operate an efficient system? Other countries have tried to tackle some of these issues, but no one seems capable of addressing all of these issues successfully. The U.S. system relies on private insurance companies to tackle all four issues, but it's clearly imperfect since there are always puts and takes across those four major goals, especially when you add that private insurance carriers ultimately answer to their shareholders. A private system cannot possibly succeed if forced to insure everyone at an affordable price. However, if the government tried to develop an affordable approach to provide universal access to health care, there would likely be significant rationing of health care and ultimately less innovation and efficiency and deterioration relative to the current system (i.e. Canada). Also, does anyone actually think that the government can administer anything efficiently?

Unfortunately, that leaves us in a very precarious situation today. The more that private insurance companies are controlled via regulations that take away their decision making ability (i.e., controlling the rates they can charge), the more everyone will suffer through higher costs. However, treatment decisions should be left between the doctor and patient. When the costs and stakes are so high, it's hard for the private health care system to satisfy all parties (how does one set a $ value on a human life??).

Obviously I have no answer to this problem, and I am somewhat biased since I have a personal stake in this topic. I understand how/why the private sector can add value here with the help of commonly accepted information and tools, but the private sector will ultimately fail to provide access to all Americans, regardless of how well they can control costs, spur innovation, and operate efficiently.

The 2008 election has the potential to result in drastic changes to the current system, regardless of which political party takes the White House. The major difference is whether the current private system will be a focal point or a casualty of a solution.

In the meantime, we'll probably be hearing a lot of references the girl that died from leukemia and the flaws of the current health care system.

Snow Day!

We had a bad snowstorm this afternoon. It started snowing around 10 and by noon, the snow was heavy and the visibility was low.

Around 11AM, my manager told me that me and my team were excused to leave whenever we felt it was necessary (though I was supposed to log in and work from if at all possible). He left shortly after passing along that information.

I decided that I would stick it out for a while. I had some meetings that I did not want to cancel and I have a car that handles the snow very well. Unfortunately, I forgot about how difficult it is to be in the office on a "snow day" when that majority of my peers have already gone home. Productivity is completely shot. By 2PM, about 80% of the office had already left, e-mails were sent from the division president telling all CT employees to go home, and no one who was left was very focused (including myself).

I decided around 2PM that I needed to go home. I had no more meetings on the calendar, and I thought I'd be more productive working 2-3 more hours in the comfort of my own place.

I chose poorly. Traffic all over the state of CT was horrid from about 1-5PM. I thought it might take me an hour to get home (normal driving time in rush hour is 25-30 minutes). It took me an hour to get to an interstate, and I ultimately tried a different route that took me to downtown Hartford because my normal driving route was full of parked cars. I left work at 2PM. I got home at 4:15.(!?!?!?!?!) I still worked for a little over an hour, but I still had the lingering effects of road rage and couldn't work too long.

I should have just worked from home all day. If only I didn't feel guilty about having staff without laptops and my obligation to be there with them on days like today. In my last role when my entire team was in Philadelphia, I would have stayed home today and not had to deal with the road rage that is a 135 minute drive to go 15 miles. Seriously, I almost could have walked/run home from work and made it back quicker.

Good thing I have a Subaru with all-wheel drive or I might still be stuck on the highway now!

Ranking the FOX Cartoon Options

I love The Simpsons. That show will forever hold a special place in my heart. It's the television show of my generation. The subtle pop culture references that are embedded throughout the series allow people to enjoy a joke on so many levels. That said, I rarely watch new episodes anymore. Something about the subtlety and staleness of The Simpsons has caused be to divert my attention elsewhere.

Consider Family Guy. This show walks that fine line between sheer brilliance and pure crap. Sometimes, it can accomplish both in the same scene. Sometimes the show can take a fantastic joke to new levels by sticking with it for a few extra seconds, and sometimes you wonder if the show's writers are so uncreative that they drag out a joke for 30+ seconds because they can't come up with any more jokes. Sometimes, they are both brilliant and crappy in the same scene. Take this scene from last week's episode. 5+ freakin' minutes on a running joke. I was laughing hysterically and bored silly multiple times in the same scene. This show is probably in its prime right now and airs in a different era where indecency on television is more accepted, so it's somewhat difficult to really understand which show is better.

As people that grew up in The Simpsons era and watched Family Guy take the FOX cartoon to a new level by testing the limits of decency, what show do you think was better in its prime?

Happy Hanukkah

After over a decade of cuts and close calls, it's finally time for me to get with modern times. Thanks to DrT, I have myself a wonderful new electric razor. Today was the first time I have ever taken advantage of this wonderful thing called technology when shaving!! I never really bothered to try to shave the easy way in the past, but DrT gave me a very thoughtful Hanukkah gift this year. Now I don't have to fear shaving while half awake at 6:30AM every day! :)

I also have some yummy Hanukkah gelt. Mmm...chocolate money.

Holy Crap

I think the Tigers gave up 5 of their top 6 or 7 prospects in their minor league organization to make this trade happen, but holy crap!!! Talk about playing to win NOW.

The Tigers will have a stacked lineup and rotation in 2008 and also likely in 2009. Now they need to draft and develop very well over the next couple years because the cupboard is bare behind the parent club. If Cabrera and Willis leave via free agency in 2009, the Tigers are likely F-ed.

I am not all that sold on Willis as a pitcher that can will live up to the potential of the three strong pitching prospects Detroit gave up, but a starting rotation of Rogers, Willis, Verlander, Bonderman, and Robertson seems stellar to me for at least one year. Add a batting order where Pudge Rodriguez will likely bat 9th, and the Tigers will be roaring in 2008!!

Still. HOLY CRAP!

A Friendly Mechanic

I finally sucked it up and took my car to the dealership to have some ongoing problems looked at. I always tried to take my car to other places instead of the dealership, partly because it was so far away when I used to live in Bloomfield and partly because I am cheap (blame my upbringing if you must).

Well, as it turns out, the ongoing cooling systems issues were due to a leaking headgasket that needed to be replaced. This is not a cheap repair since it takes a significant amount of time for a mechanic to get to the engine.

Amazingly, there was an extended warranty that covered this part because of the known problem with the headgasket on my particular car. If I had known about this sooner, I could have saved about $500 in expenses at other places chasing this problem. I never was notified since there was no recall on the part.

The ~$3k repair was covered by my warranty, so I did not have to pay a dime. Furthermore, since Subaru was covering the labor costs, they recommended that I replace the timing belt and water pump. These are two repairs typically required after ~70k miles. Even though I was ~15k miles away from that, they were offering to do the repairs for $350 instead of the normal cost of $1k.

Then, to top things off, they knocked 10% off the cost as part of their toys for tots program. Although they completely forgot to ask me to bring in a toy when I picked up my car, they gave me the discount anyway.

Moral of the story? Get your car serviced at the dealership. They may charge a little more than the Midas or Jiffy Lube around the corner, but they know the inside of your car much better than anyone else and they have an incentive to provide excellent service (get you to buy another car from their dealership).

Too bad I have no plans to buy another Subaru, but I am grateful for their service and will continue to take my car there for work until I part with my car.

A Hy-po-the-ti-cal

I want to qualify the following hypothetical situation by stating that this does not at all relate to me. Seriously.

Let's say that there is this guy. We'll call him 'Lou'. Lou has been dating Leslie for three years. Leslie is sweet, smart, and completely in love with Lou. Lou also has strong feelings for Leslie. There is definitely potential for these two lovebirds to take their relationship to the next level.

Unfortunately, there is one problem. Lou is still infatuated with Michelle, a girl that he has been crazy about since high school. Lou and Michelle never dated in the past, but they have always been close. Lou always wanted to date Michelle, but Michelle was never single. She has gone through a couple long-term relationships since those high school years.

About three years ago, shortly before Lou met Leslie, Michelle and boyfriend Boyd were on the rocks. Boyd was ready for a change in his life and just didn't seem to have the commitment and passion for Michelle that she deserved from her boyfriend. Lou sensed a potential opportunity. Even though Lou was dating someone else at the time, he started asking some of Michelle's friends about her relationship with Boyd and whether there was a chance she would leave Boyd for Lou. Sensing opportunity, Lou started spreading false rumors about Boyd to common friends. Needless to say, Boyd thought Lou was a slimy bastard.

Just a couple weeks ago, Michelle and Boyd broke up. They remain on very good terms, but they agreed that it was time to end their relationship. Not only is Michelle Lou's dream girl, but she is also a dream catch for many other suitors. Michelle is a monogamous girl, but she doesn't like to be single. Ever. Right after Boyd left her, Michelle was looking for other guys.

Lou faced a major dilemma. He has been dating Leslie, a wonderful girl, for a long time. Things are starting to get serious. Unfortunately, Michelle is his dream girl, and he is debating whether to break up with Leslie for a relationship with Michelle.

Sensing opportunity, Lou asks some of his high school friends to talk to Michelle's friends and find out if Michelle would be willing to date him. However, while this is going on, Lou does not want to end things with Leslie, just in case there is no hope with Michelle.

Lou finds out through friends that Michelle is interested in dating him. Michelle's friends think Lou is a great guy and would be a great boyfriend. Unfortunately, Michelle is still close with Boyd despite their breakup, and he constantly reminds Michelle that Lou is slimy, despite his charismatic front. Michelle decides that she wants to go out on one date before she makes up her mind, even though they have already had discussions about buying a house together. Lou decides that this is a fair request, so he makes plans for a date two days after he attends a wedding for Leslie's best friend.

Leslie gets wind of this planned date and is not very pleased. She makes an ultimatum to Lou and tells him that if they are not engaged and he does not cancel his date plans within 24 hours, their relationship is over. Fearing a situation where Lou could lose Leslie and Michelle and end up with nothing, he has his friends call Michelle to find out if this date next week is a formality or if there is a chance she could ultimately choose another guy. Michelle won't make any promises, but says that she might interested in making Lou her new boyfriend. Lou is conflicted. Does he take his current relationship to the next level or does he take a chance and give up what he has today and pursue his dream girl with no promises that it will actually work out?

What would you do if you were Lou? (other than take a shower to clean off the slime)
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Ok, so you probably figured that this is a thinly veiled analogy of the Les Miles-Michigan situation. It looks like he chose his current job over the dream job, and there is nothing wrong with that. However, how he went about playing his dream job to get the biggest pay day possible sits poorly with me. If Miles was truly serious about Michigan as opposed to getting a big fat raise, he would have stopped all back-channel negotiations until he was ready to have more formal discussions (in order to prevent media leaks). Given how this played out (as a money grab by Miles), I don't think Miles would have been a good fit as Michigan's head coach, even if he might have been Bill Martin's favorite. If Miles truly believed he could lose his job at LSU and lose out on the Michigan job if he approached this with more integrity, he would have easily landed on his feet at some other great football school. After all, he is a very highly regarded football coach.


Michael Rosenberg of the Detroit Free Press provided a great breakdown on what most-likely happened, if you couldn't already figure it out through my wonderful analogy above! I'm still not 100% sure that this is completely over, but it looks like Michigan is going to have to move on to other candidates unless something shocking happens this week.

Or Maybe Not

This whole Les Miles to Michigan thing is really screwy. Where ESPN says it will be annoucned Monday, other sources, including the Ann Arbor News, are saying the exact opposite

Wonder if Miles is using the Michigan opportunity to get more $$ from LSU.

Trading up?

Looks like Michigan is about to turn in it's Carr for Les Miles (I know...overplayed pun and not original, but deal with it). While MGoBlog was not entirely sure of whether this was true after Kirk Ferentz rejected an offer for the position, Kirk Herbstreit put himself on the line this morning during College GameDay. I guess that makes the news highly likely to be true.

Herbie also reported that Miles is bringing in a New defensive coordinator that is very well though of (with OSU ties). Not sure how I feel about English getting pushed out, since English is such a great recruiter. Not sure how I feel about this hire, but Miles was the most likely choice according to the national media.

I'm curious how Coach Carr speaks about this situation since it was rumored that Carr has a strong dislike for Miles (Miles left Michigan's coaching staff when Carr became head coach in 1995). He can't possibly avoid these questions over the next month when Michigan prepares for either Florida in the Capital One Bowl or Florida State in the Champs Sports Bowl (hooray Orlando...)