Wednesday, October 28, 2009

Healthcare 2: Follow the Money (created on 10-28-09)

In the advice of "deep-throat", when you want to find out what’s going on, "Follow the Money."

So why does healthcare cost so much. Why would a minor, 30 minutes in and out, hand surgery I recently had cost $1800. There wasn't much in the way of materials. They sterilized my hand, they put a sterile cloth over my arm, they gave me a few injections of lidocaine, and then the doctor, nurse and assistant spent about 15 minutes poking holes in the fibers built up by my Dupuytren's contracture. And simple band aid was all I needed and I was on my way home.

The process was a complete success. I am totally happy with the results. But why so much cost.

The company I learned most of what I know about successful business would have been able to give me an answer. They religiously tracked the cost of doing everything so that they didn't take on jobs which were no profit and strove to develop customers which were high profit. They tracked how much it cost to do internal operations. We were advised that because of the paperwork involved in filling out a purchase requisition, tracking the purchase requisition, tracking the invoice, and paying the invoice, that there was a hidden cost of $100 for every purchase order. So we should whenever possible, wait to order until we had several items to order from the supplier. And we shouldn't split orders between suppliers because one supplier was $10 cheaper on one item than the other supplier. Saving that $10 would cost $100.

So here is my suspicion, there is too much paperwork in healthcare. I suspect a big portion of the cost is filling out and handling all of the paperwork. Of course the insurance industry won't want to hear this. There entire existence is based on paperwork. I have heard estimates that 20% of our healthcare costs occur directly in the insurance companies. But it has to much more than this. The doctor and his staff have to spend a huge amount of time filling out paperwork for the insurance company and the government.

So the next time you go to an emergency room and get a $500 bill for the 10 minutes the doctor spent putting in a couple of stitches, the doctor didn't get paid that $500. I suspect that for the 10 minutes the doctor spent with you, a total of 1 to 2 hours of paperwork by a number of other people were involved.

If I were in charge, I would start "following the money" with a religious fervor.

Tuesday, October 13, 2009

Genesis: A story I wrote in 1992

Genesis

12/13/1992
With slight updating on 1/17/2009

Doug Iverson

[This story is not meant to be taken seriously.
It is just a story.]

*************************************

Nothing.


There was nothing.
No life. No land. No water. No mass. No light. No energy. No matter. No space. No time.

There was nothing.

There was a purpose. There was a consciousness.

It couldn’t move because there was no space. It was both everywhere and no where at once. It was both infinitely large and infinitesimally small at once.

It couldn’t age because there was no time. It was both old and young, at once, forever.

It could think; therefore it was. It called itself Iam. Iam had a purpose.

Iam desired beauty; beauty in symmetry, arrangement and pattern.

With a flexing of its will, Iam created energy and matter. Iam also created time and space in which the energy and matter could exist. In a rapidly expanding bubble, time and space grew, drawing matter and energy with it.

The energy possessed many forms; kinetic, electromagnetic, nuclear and gravitational. The total of all energy was zero. The positive and negative energies were exactly equal. Nothing had been divided into two symmetrical halves and when put back together, it would still be nothing.

At first there was only energy. As more space was created, the energy cooled and matter condensed like dew during a cool night. The matter was pro-matter and anti-matter. The total of it was zero. Nothing had been divided into two symmetrical halves and when put back together, would still be nothing.

The matter had symmetry reflective of Iam. A symmetry of three coupled with two.

For every particle, there was an antiparticle. Of particles, there were two basic types, quarks and leptons. Of each basic type, there were six particles, six quarks and six leptons. Each quark and lepton was created in three different flavors.

The sphere of Nothing expanded in perfect symmetry and quantum mechanical pattern. Iam was happy. This was beauty. This was Good.

The quark and leptons began to aggregate. They formed arrangements. The nothingness formed protons and neutrons. These formed new arrangements of simple atoms and molecules. Hydrogen and helium filled the universal sphere of Nothing.

Iam enjoyed the arrangements. This was beauty. This was Good.

As the sphere of Nothing grew, the remnants of the quantum mechanical patterns present in the first few instants of time arranged the gasses of the expanding universe in long strings strung across the heavens. The strings pulled apart into short segments of galaxies. The galaxies swirled around themselves forming disks and arms and spirals. The gasses within the galaxies were pulled together into tight balls in which the matter began to convert into energy and into more complex patterns of matter. Heavier atoms were created within the suns and Light pervaded the universe.

Iam was happy. This was new symmetry. There were new arrangements and patterns. This was beauty. This was Good.

Some of the larger agglomerations consumed too much of their matter. They became unstable. They became explosive. In a tremendous burst of energy these suns supermovaed, spewing forth into the galactic gas clouds hew heavier elements suitable foe building planets. The gasses began to pull together again, this time drawing the solid dust particles with them. The aggregating mass began to pick up energy and revolve because of the Coriolis Effect from the spiraling galaxy it was part of. The rotating motion separated the gasses and particles based on density and molecular weight. Many of the systems became temporarily unstable because of the large masses of metals and other heavy elements and split into two gas galls; each circling the other and having orbs formed from the heavier elements circling each.

Iam was happy. These were new arrangements, new symmetries. This was beauty. This was Good.

Some of he orbs generated gasses, building an atmosphere. As the orbs radiated off heat to the vast nothingness, water vapor condensed into mighty clouds, raining for eons, and covering the planet surface with a mighty ocean. In the ocean, carbon based molecules began to form a dazzling array of organic molecules. Supplied with an abundant source of simple carbon molecules emanating from the center of the orb and warmed by the sun’s energy in the shallows, complex forms began to take shape: lipids and fatty acids and ring structures and chains.

Phosphorous was also used, as well as nitrogen and sulfur.

Some of the molecules formed lower energy, more stable arrangements which aggregated with each other. Fatty acids formed emulsion droplets with lipids in the center. New molecules formed in the specialized environment of the lipids/fatty acid droplets which would not have been stable in the general ocean environment. The more stable droplets drew on the abundance of molecules dissolved in the ocean. Growing until they reached an unstable size, they split into two halves, each of which continued to grow.

Iam was happy. There was symmetry, pattern and beauty in the planetary orbits, solar systems, galaxies and clusters of the large scale. There was symmetry, pattern and beauty in the atoms, protons, neutrons, leptons and quarks of the smallest scale. Now there was symmetry, pattern and beauty in the molecular arrangement made of these carbon clusters.

Iam called them the tender beauties.

Iam had not exerted his will since the original creation of space, time, matter and energy. The entire universe had unfolded without intervention. Now Iam reinserted himself into creation. These tender beauties were fragile. They occasionally made molecular mistakes while growing and copying themselves. These mistakes sometimes lead to a more stable, ever larger arrangement. Some of the droplets formed a molecule in their central regions that could directly capture the energy of the sun and store it as chemical energy for the use of the droplet. Some of these droplets formed protective sheaths around their perimeter. Some formed aggregates of sheathed droplets which took on larger patterns of symmetry. Iam began to control some of these “mistakes.” Iam controlled the formation of symmetry, pattern and beauty of the tender beauties. Iam directed the formation of millions of types of animals and plants which filled the oceans, covered the lands, and filled the skies.

Iam never interfered with the physical forces released at the creation of the cosmos. Sometimes these forces destroyed the tender beauties. An asteroid would strike a planet disrupting the delicate balance the tender beauties could exist in, or a sun would nova sterilizing the surface of the planet. Sometimes the animals advance to such a high degree of specialization that a minor environmental change caused their extinction. Whenever these setbacks happened, the evolutionary force to develop new levels of symmetry, new forms of patterns and increased beauty began again. Occasionally directed by Iam.

Iam was happy, but Iam was not complete.

Iam was alone.

Iam desired someone to share the universe with. Someone to enjoy the beauty in the symmetry; beauty in the patterns; beauty in the life of the tender beauties.

Iam flexed his creation will for the second time. Iam created two beings, so that neither would be lonely as Iam had been. Iam created them in his own image and likeness. They were timeless and dimensionless. They had Iam’s appreciation of beauty. Iam called them Adam and eve. Iam gave them the universe to enjoy.

Iam was happy.

“Who am I? Who are we?”

“You are Adam and Eve.”

“Who are you?”

“Suffice it to know that Iam. I am your creator and of everything you sense other than myself.”

“There’s so much. You made all of this?

“Yes. All of it and yourselves, my children.”

“We are different from the rest of creation. We seem more like you; almost exactly like you, only lesser somehow.”

“You are different from the rest of creation, my children. You are in my image and likeness. I induced all of this creation from nothing and back to nothing it will someday return. It is always aging and changing; until someday it will end. You, my children, are timeless, ageless, eternal.”

“Who created you?”

“No one created me. I have always been. This will be difficult for you to understand since even though you are eternal, you have never existed outside of time and you won’t until all of this creation ceases. At that absence of time, you will understand.”

“Why have you done all this?”

“I created time, space, energy and matter for the beauty contained in its symmetry and patterns. As you focus your attention on it from the smallest to the largest, you will find beauty.”

“And why did you create us?”

“It brings me even more pleasure to share all of this creation. All of creation is yours to behold and enjoy. Center yourselves wherever you desire. The universe is yours to watch and enjoy. But not to alter. Enough of this. Go; focus yourselves elsewhere or on each other. We will converse more later.”

Adam and Eve needed no further prompting. A nearby sun was supernovaing. They both focused themselves into it, experiencing the swirls, the power, the expansion and the beauty in the rapid change of atomic patterns.

Iam was happy, very happy.


--------------------------------------------------------------------------------------------------------

Adam’s and Eve’s concentration was on an island which moments before had teamed with a dazzling variety of tender beauties. They were all gone now. This planet had a high level of volcanism. The entire island had just been recoated with thirty feet of volcanic rock.

Eve called “Iam.”

“Yes my children.”

“Why did this happen?”

“It has to do with the planet’s highly elliptical orbit caused by the next planet out in this solar system. This induces tremendous gravitational tidal forces which keeps the interior molten and induces cracks and fissures in the crust.”

“We know and understand that. I’m asking, why did you let this happen? Why did you let all this life be destroyed?”

“Have you noticed that I never intervene with the physical forces of my creation?”

Adam replied “Yes, but we sense that you could. You have the power to do so. We don’t. Why did you let all this beauty be destroyed?”

“Center within the rock as it cools and crystallizes. Focus on the steam swirls rising where the hot rock meets the sea. There is still beauty here.”

“You know it’s not the same”

“You speak with such certainty my children. But you have focused on this planet for not even one complete orbit around its sun. Not long enough to notice the instability of the large polar ice caps on this world. When life first evolved here, those ice caps were twice as large and sea was much lower and yet there was no dry land for life to exist on. Only in the oceans was there life. This volcanism you view as so destructive created the first islands of dry land and that was the substrate of the life you miss so dearly even though it exists on hundreds of other islands on this same planet. But the ice caps have been melting, raising the ocean level. The islands have to keep rising to prevent of these dry land life forms from perishing in a flood of sea water. Luckily, the instabilities of this planet only raise and resurface a few islands at a time. They will be repopulated with life from the other islands before those other islands either flood or resurface. As you can now see, life has evolved very well here to deal with the local physical forces. It needs no interfering on my part.”

“Now focus elsewhere my children. Do not trouble yourselves with why and because. Just enjoy the beauty.”

They each thought to themselves as they shifted their concentration, “I could manage that planet better than Iam. If I had Iam’s power I could find a way to stabilize the ice caps or raise the islands without having to kill all the life.”

Iam’s thought followed them. “Enjoy the beauty my children. There is more beauty in the ceaseless change of creation than you could ever imagine on your own. Enjoy the beauty my children.”

Adam and Eve shifted their focus across the universe. They flitted through and past galaxies and clusters of galaxies. They experienced the cloud shapes, the disk shapes, the spiral shapes. Their focus shifted further and further waiting for some detail to catch their attention. They burst through suns, penetrated through the core of planets, enveloped entire galaxies.

-------------------------------------------------------------------------------------------------------

Eve spoke, “There. Adam, did you feel that?”

“No, what? I was busy trying to sense any free quarks in this sun.”

“Adam, unfocus yourself. Open yourself. It’s like when we communicate, but from a much greater distance. It’s a presence, a consciousness. Can’t you feel it?”

“Yes, now I can. It’s coming from the blue planet in this solar system. I’ve never felt anything like it before.”

They both centered themselves on the planet; focused on the consciousness; perceived its emotions; felt its fear; converged closer and closer until they were both in a field, next to flocks of animals running from a fire which engulfed the savannah. The flames were only minutes away from the animals and stretched from horizon to horizon. Fed by dry winds, the flames shot hundreds of feet into the air. Fireballs of burning debris were lifted and then dropped starting new fires. Black smoke darkened the midday sky. The terrified animals ran in sheer panic. The old and the weak fell and lay until the flames swept over them and they transformed back into the elemental oxides from which they were formed.

“Adam, there’s so much destruction. There must be something we can do to save these tender beauties. And the thoughts we feel, they’re here, close by. But where and what are they from?”

“Eve, these bipedal animals running next to the river are what we sense. We’re able to sense their feelings. There’s so much fear it’s nearly overwhelming!”

“Adam, the flames are so hot and close. All of these animals are going to perish. They’ll all die, millions of different animals. We must save them. There is something special here.”

“Iam forbade us from interfering Eve. And it doesn’t matter, there’s no way to save them. We can sense them, the same as we sense the fire, the soil, the sky. But we can’t influence them. None of Iam’s creation can sense us.”

“I won’t accept that any longer Adam. If it’s impossible for anything to sense us and receive direction or motivation from us, then why did Iam so carefully forbid us to try?”

“Eve, forget it! I’m focusing elsewhere. I refuse to sense this much devastation.”

“Adam, stay and help me. The bipedal animals are those which we can sense the strongest. Perhaps they would be able to sense us. If we can get them to submerge themselves in the fiver, the flames would pass overheat and not kill them.”

“I’m focusing elsewhere eve. Come be with me again when you realize how futile this is.”

Adam was gone. Eve had never felt so alone before, so vulnerable, or so determined.

Many of the animals collapsed from exhaustion in their flight from the advancing wall of flaming chaos. It swept over the bodies, char sealing their skin and then exploding them as their interior fluids eruptively boiled. Of the animals which made it to the river, many drowned in panic in the water. Others swam to the other side, only to be greeted by more flames which had jumped the watery span and ignited an inferno on that side of the river also. Others ran along the edge of the river, in a futile hope of outdistancing the fire.

A band of bipedal animals was among the latter. Eve focused on the entire group. She tried to plant the thought in their brains of hiding in a calm part of the river at a depth where they could still stand on the bottom. She sensed their panic, but they couldn’t sense her. She tried focusing on smaller and smaller groups of the tribe. As her task seemed increasingly unobtainable, she became more resolute. But these creatures were emitting so much panic and fear it began to over whelm her.

Then Eve felt determination returned from one of the creatures. It was a mother, carrying an infant, clutched tightly to her chest. She was near the lead of the tribe, forcing herself to keep up her pace, controlling her breathing, ignoring the agony rising up in her leg and abdominal muscles. Forcing herself to keep panic subdued for the sake of her baby.

Eve focused herself entirely on this creature. She confined herself completely within the body of the female and tried to reinforce her self-control. It began to work. What panic did exist, subsided. Eve couldn’t control the bodily motions of the creature, but she could influence its emotions. Eve tried to convey the thought that the cool water could be a haven, the only source of refuge. The female slowed her run. Many of the other creatures ran past her, gasping to her not to stop. She walked slowing into the water. Eve helped her fight the fear of it. The female and never been more than knee deep in her life. She called to the slower ones who were now passing by. Most continued on, too physically spent and panicked to notice her. A few stopped and stood at the water’s edge with dazed eyes.

One of these wasn’t as tired as the rest. He was a large male, carrying two small children and helping a lame female to keep moving. Eve extended her focus to him and could feel him respond. He started to put aside his fear of the water and view it as a sanctuary from the heat and flames which were almost upon them. As he began to move his family out to the chest deep water where the first female stood calling, a few of the other creatures followed. The rest began running down the riverside again.

The male looked around and picked some large fleshy leaves from the foliage along the river’s edge. He covered his family and each of the others with a leaf and then began slowly dunking himself, his children and the leaf under water and then just an inch up. “Yes,” thought Eve, “keep the leaves wet so the fire can’t burn through to you.” Some of the others copied his example. The fire was almost overhead now and panic began to fill the creatures. Eve spread her focus over all who were in the water, calming them, keeping them under their wet leaves. And then the fire was past and the creatures were alive.

Eve, completely spent, lost her focus on everything and slowly dispersed and drifted away.

--------------------------------------------------------------------------------------------------------

“Eve, Adam, where are you?” Iam searched for his creations. “I know you’re focused here, but I can’t sense you in the normal way. Where are you?”

Adam was focused inside of and controlling a bipedal creature. He was just finishing the model for the new fertility temple to be built at the center of the city Adam had designed and caused the creatures to build over the last 100 years. Eve was focused inside a priestess. She was starting the rite of spring planting.

“Adam, Eve, where are you?”

Eve and Adam both heard the calling. Their attention wavered, wanting to stay hidden and yet also wanting to focus with Iam even though they feared Iam’s displeasure with the tampering they had done with his creation.

Adam switched focus first. When Eve felt his normal focus, she left the priestess also. Iam focused on them immediately. “Adam, Eve, where were you?”

Adam spoke. “We have been enjoying the beauty of shape, form and life cycle of the bipedal creatures on this planet.”

Iam replied, “I sense you have done more than just appreciate the beauty. There are advances in civilization, agriculture and architecture here which should not yet be.”

“It’s not my fault” Adam protested, “Eve did it first. When I saw what a beautiful thing it could be and that you did not come to punish her, I started doing it myself. If doing this bothers you so much, why did you wait so long to come back and tell us?”

Eve defended herself. “Don’t blame me. When I did it, it was just to be once, to save some of these creatures from death in fire. They Adam did it again and again. I saw he wasn’t punished, so I did it also.”

Iam stopped all the blame casting. “Enough, both of you. I am not interested in why you are doing it. It is enough that you are. And what you are doing with it is exactly as I know it would be. On any of the planets anywhere in the universe, you have never seen any of the creations involved in any action to praise or glorify me. None of them even know of my existence. They were only meant to be beautiful. Now you have these creatures honoring yourselves as gods, as if you were me. They view you as their creators, the bringers of Life and Death. Because you have disobeyed my law and directly interacted with physical creation, I banish you to be part of that creation. I banish you to become one with them. Their needs will be your needs. Their pains will be your pains. You will wear their bodies like clothing which cannot be removed.”

“But there are so many of them and only tow of us. If we are to be one with them and no longer able to control them, they might kill us for they are violent creatures and then we would cease to be.”

“Your deaths will not be the end of you. You will be different than all the other creatures of the universe and you will be the only creatures of both physical and spiritual substance. All of your physical children will also be made of the spirit also.”

“I will change the mitochondria in Eve’s womanly body so that it is much more efficient than the other bipedal creatures’ at releasing energy to do work. All of your children will have that change also, for their lives will be filled with work and toil to survive in this world you have chosen. You and your children and your children’s children will spread like a flood across this planet and once you have filled and mastered this planet, you will spread to the billions of other planets that exist in the universe. For I still want the same thing for you now which I have always wanted. Enjoy the beauty, the symmetry, the arrangement and the patterns which fill all of creation. But now I give you permission to create and augment beauty after your own desires.”

With that, Iam focused elsewhere.

In the beginning, God created the heavens and the earth but they were without form and void. Light shone forth and a solid firmament formed in the midst of water. God let the earth bring forth life in the form of vegetation and all creatures. God created man in his own image and likeness and gave man all love creation. God gave man the command to not act as God. Man disobeyed. God banish man from their special place in creation and clothed them in the skins of animals to live out their days until their redemption at the end of time.