Friday, September 24, 2010

First Cold, Car Seats & Health Care Reform

From BambiniPt2


Most babies get their first cold before their first birthday, and it seems our boys are no exception. Thankfully it does not seem to be too bad. They are ok during the day, but at night they are blocked up and wake up every hour crying. After three nights of this I have given up trying to keep them from waking Barbara, and just give her one of them so I can get the other back to sleep.

I rushed out and bought another humidifier as the moist air makes it easier for them to breath. Babies don't know how to breath through their mouths so they get very freaked out when their noses don't work. This is our second humidifier. The last one smells bad and probably has mould growth in it. They are virtually impossible to clean properly and all the water additives and silver anodes don't seem to do the trick. The only solution is to use distilled water which is totally impractical.

We have been having a big debate about PJs for the babies and this week we are trying out two flavors, both with long sleeves. One his a long tube and the other completely encloses their feet and zips up. They always seem to have cold arms or legs in the morning and any blankies just get thrown aside as they toss and turn.

Nico is getting heavy and he is quite strong. Luca has a vice like grip and can case pain if he grabs the skin on your forearm for example. They are growing so rapidly we are afraid they will no longer fit in the car seats, so this week we worked on buying them new seats.

The Britax model has been on the market for many years with excellent reviews. Luckily there are many families in the bay area selling car seats so we started looking for one used seat to see if Luca would like it.

It seems that car seat manufacturers have colluded to propagate the myth that a car seat has a shelf life of only six years. The carseat "lifespan" was touted as being ten years, but I guess someone realized that a few extra billion dollars could be extracted from the market by changing this to six years supported by "fear of death" marketing with "official" statements that the seat is "not safe" after six years.

This is complete nonsense of course. Just to check, I thought it might be amusing to start a thread on an engineering forum to see what people in the industry had to say. Generally speaking polypropylene has some very long lasting durable qualities, which is why they made the car seat out of it in the first place!

One of the major advantages of polypropylene is its complete resistance to attack by environmental stress cracking (which causes other plastic to become brittle and crack). The principal problem is solar radiation (UV) from sunlight (p133). The surface deteriorates by crazing to a chalky friable material of very low strength. In mouldings, the surface can be scratched away and bleaching is visible.

This is all good news for car seats because they are mostly completely shaded from sunlight. They sit with their back against the seat and the front is completely covered with a fabric seat cover. Some small unimportant areas of the base may be exposed, but if they were effected it would be immediately obvious.

Now why am I bothering to explain all this? Because people believe this industry BS, and when you mention car seats they get this intense stare as they repeat the same thing every time: "We bought new car seats. Our babies safety is worth it." This is exactly what the manufacturers want the public to think.

In fact, the statistics show that this scaremongering has nothing to do with the reasons infants are killed in cars every year.

"In the United States, more than 2,000 children under 14 years of age die each year in vehicle crashes. Most of the fatalities happen because the children aren't secured in specially designed car seats. Instead, they are strapped in the wrong kinds of seats...or they aren't wearing any restraints at all. Child seats are also often incorrectly placed rear-facing in front of air bags. In 1997, six out of 10 children who were killed in vehicle crashes were unbelted."



Notice nowhere is deterioration of plastic leading to failure mentioned. This is because it is JUST NOT AN ISSUE. In fact you could place the child in a bucket so long as it was secured properly in the car and he would probably survive just fine. Car seats do not go flying down the tarmac and impact solid objects. The just provide a seat to restrain the child in for goodness sake.

Fortunately for those of us that are able to discerne these simple truths, this leads to a large supply of perfectly good car seats that nobody wants. Since people believe that a car seat is useless after six years, and junior is going to need it for about four years, they all look for a 2yo seats. Seats that are four or five years old are virtually worthless in the market.

Just about every website now quotes the shelf life number of six years so it has become a self perpetuating "truth". About the best they can offer as a reason is the the belts and buckles wear out. This is even more insulting to the intelligence than the plastic degradation (which I have not seen mentioned).

Safety belts and buckles have to be about the most rigorously manufactured items in any vehicle. They have triple stitching everywhere and are made from materials that are designed to never fail. They are not affected by UV or heat or freezing or water or any elemental force. I have actually used these belts to tow vehicles. I could probably tow city buses when they break down for the next twenty years with any child car seat safety belt, and this is what they allege is going to wear out? Its absurd.

Wear on this kind of belt is visually evident. There is obvious fraying. Buckles are engineered very well in the first place. How are they going to wear out? Is the metal going to be worn away by the friction or something. It's just ludicrous rubbish.


So anyway, we picked up two very nice examples of these "worthless" car seats this week for $40 (they retail for $280 + tax). We actually paid more for two brand new seat covers that we did the seats. When the original covers were removed, a perfect car seat was lurking underneath. It will probably be just as good in 60 years.





Today the first part of the US health care reform took effect and.... the insurance industry completely ignored it. This is an industry that takes real money from millions of people and promises services that they employ an army of people to deny you when you need. This is true of car insurance as much as for health insurance. It is the business of scam artists in suits that spend more time and money lobbying congress to make .living without their "products" illegal than they do providing the service they claim to sell.

The original concept of insurance, was as a general fund for securing provisions to widows, sisters and other females related to soldiers during the Napoleonic war. It was started in March 1812 by a number of "eminent Scotsmen" gathered in the well established Royal Exchange Coffee Rooms, and called; Scottish Widows Fund and Lif Assurance Society.

Since then, this concept has been twisted, manipulated and distorted into the joke that passes for insurance "industry" today. This is a place where teams of Harvard MBA's spend the bulk of their careers working on "products" designed to separate people from their money with the promise of "coverage" that to actually benefit from, requires hours and hours of reading fine print to determine how to get a simple referral.

Then when you actually make a claim, whole departments of employees spend their days finding ways to deny the benefits you paid for and desperately need. Instead, your premiums have essentially paid the salaries of the people who are working to deny you the coverage you thought you were paying for.

This situation is not new, or limited to the US. This country just happens to have the most egregious examples of desperate people being denied life saving treatments, coupled with blatant industry wide predatory practices.

Today we were supposed to be able to change insurance plans. The US government wrote legislation that mandated change. The insurance industry has done nothing except spend our money trying to fight the change, spreading misinformation and hiking the rates by as much as 30% in a political move to blame the administration for the hike!

In fact a misbegotten last-minute bill using exactly the insurance industry's language on actuarial justification passed on the last day of the session. And an effective bill to regulate health insurance didn't. You could almost predict the votes by how much each legislator got from the $800,000 the insurance industry recently contributed in the state Senate.

I have called many insurance agents trying to find someone that can write us a policy. Not only do they have NO IDEA if this is possible, they say there is "confusion" in the industry right now.


Contacting people in hospitals is hard. It took a week to get the Dallas administrator to respond and the news was not what we expected. I had asked her to confirm the rates that the Doctor told us. Somehow the facility fee was double. When I asked about this, they said they were trying to negotiate this with the hospital.


Meanwhile, since it may make sense to go to San Francisco, I have been attempting to find out how UCSF has the gall to charge $5500 per hour for an operating room that the insurance industry "negotiates" for somewhere around 10% of that. The answer it seems is a national disgrace recently highlighted in a recent 60 minutes story.

I called the billing department and after being transferred to Siberia and back, got a monotoned Asian woman that was obviously the designated bearer of bad news for the faceless hospital administration. She told me that this rate was in fact 40% off the actual rate (which would make the actual rate $18,333.33, an improbable
number if every I there was one).

I asked her if she could give us the "MediCAL rate". This would be a fair
price negotiated by the industry. She said she could not. So I asked her why this rate was so high? She had no answer. I explained that other facilities around the country charge self pay patients between less than 1/4 this rate. She simply said that this was "real rate" that other people had paid.

Next I asked if this was an example of price gouging reported in the 60 Minutes show and read her the quote: "Basically, hospitals charge uninsured people four or five times more than what they would accept as payment in full from an insurance company. Simply put, it's price-gouging,". There was no response.

Finally I asked her why a hospital would impose such a hardship on the uninsured?
you would think they would be the group that was offered a lower rate than
the insurance industry. No answer. I pointed out that people that
come into the emergency room and cannot pay inflated bills are often offered
steeply discounted prices. I asked her if this was possible. You can guess what the answer was.

After I got off the phone with her I wrote to the Doctor again and asked him if there was anything that could be done or if we could perhaps use a different facility? I got the customary one line answer with no preamble whatsoever: "you can check with Children's hospital of Oakland". You would think this man has a tooth extracted for every word he uses in an email. I have never seen anyone this economical with words. So I called Oakland.

I had along conversation with the pediatric urology administrator who loosened up after a few minutes and told me things that "I didn't get from her". First she pointed out that Oakland sends its billing through UCSF and so their rate is whole $1000 cheaper. Some grey little administrator probably finds that amusing. After that she revealed that this practice is common and many people suffer from it... except of course other doctors dentists and hospital employees and their friends and families.

She then revealed that the Doctor is the one that sets this pricing and he has the power to set it at some other level as a "professional courtesy" for another doctor for example. I could appeal to this Doctor again and beg for a courtesy, but I don't know why he would extend this to us.

So I asked her if she thought our state senators office might be able to apply enough pressure to the hospital administration. They can write letters asking for explanations and apply the scrutiny of a US senator. She applauded this idea (but she didn't say that) and said anything like that would help everyone.

So next I contacted Barbara Boxers office. A very eager young man responded immediately and sounded like this was just the kind of thing he would like to sink the teeth of her office into. He wanted me to fax him release forms so that he could begin gathering information and get to work.

Since I don't think any of this is going to resolve itself in the next four weeks, it looks like we are going to have to scrub his operation for now.

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