You Can Have the Red States

I think some national framework should be set up to allow every American one free health maintenance exam every year. Just a chance to go in to see a doctor, get a thorough exam, discuss any concerns and discuss problems that put the individual at any risk. Like i mentioned, small problems can be warning signs of trouble on the way; and if it can be prevented, at least we're saving our citizens money and keeping more people healthy and happy and productive. This is good for the country.

If we can give all Americans a free credit report every year for their financial health, I'm sure this could be worked out to help people out with their physical health.

How this would work financially, is over my head. I don't do politics and I don't do any budgeting outside our own monthly bills... but I'm sure it could be done seeing the other foolish amounts of money being spent by the government...

 

Fred:

Well, just using the *very* simplified points I raised, I rather doubt there is any single "solution" to this complex problem. I'm honest enough to recognize and admit this too.

A larger problem - at least in the same general context - is that we as a society have somehow become dumbed-down to the point where we routinely expect simple "solutions" ( that have no repercussions to any particular group ) to very complex problems.

If you have any knowledge of advanced statistics (FMECA, ANOVA, Monte Carlo, Weibull, F&T, etc) , or any engineering field/science, then you know that a simple "solution" is almost impossible. What is a "solution" to one group becomes a "problem" to another and v-v.

The issue of how to treat those who especially seem to cause their own health problems - in particular those who use drugs - is especially complex. Obviously I believe they shouldn't get a free ride on my back, but I'm also not advocating rounding them up and shooting them either.

No easy answer at all, a huge can of worms. It's very hard for me to conceptualize this problem or at the very least provide a similar concept without knowing your background. At the end of the day we're both likely to give each other that "deer in the headlights" look and say "huh?"

I'll try though with something I'm very familiar with: try to design an embedded controller - say a control loop for a heat exchanger feed valve or VFD input to a pump - that uses PID (Proportional deadband, Integral, and Derivative) as a Cascade or back Cascade control loop strategy.

Your inputs are input process temperature, HX outlet temperature, process cooling water temperature, VFD motor speed, and process tank level (To determine how quickly to ramp the HX OP). Many variables to deal with here.

Now you also have to "anticipate" something like a batch seed volume that may already be in the batch reactor. So you will need the inputs of level, temp, and conductivity from the seed batch and apply a complex equation that will effect the HX OP loop.

You will also have to accept diagnostic inputs from the RTD's, and the LV and conductivity sensors. This way, you will have early warning of critical fail points (Single point fail) and if possible you will also design the cascade PID loop to continue to function on either manual input OP or the last known "good" value while the RTD or other sensor is replaced.

You will have to decide if additional memory and processing is required if you want to consider that device as the most critical in that part of the process. If it is, then you will want to designate it as a Backup LAS (Link Active Scheduler).

You will also have to accept diagnostic input from the VFD controller (Single phasing, thermistor temp from motor windings, stall, jam, cavitate, etc) so you will get early warning of a motor problem or a pump problem, and do a preventative shutdown before you cook the controller or the drive motor.

Don't forget you will have to tie in to the Allen Bradley IntelliCenter MCC networked system, so the MCC will know if you have anticipated an early failure and will also shut down pre and post stream systems.

And you will also have to generate suitable messaging using something like a messaging broker interface so the Emerson Plantweb DeltaV process control system will understand how to talk to the device in question, and how to deal with things like predictive maintenance and predictive failure analysis.

It will take at least 3 weeks to design such a system, another 2 weeks to prove-in, and a month to carefully monitor in the field to ensure the PID algorithm is well tuned. The final design will be the size of a medium dictionary with network ports (Foundation FieldBus, ControlNet, etc) and have some blinking LED's to indicate power and network comms.

That sort of work isn't cheap by any measure, but the end product will appear to be deceptively simple and cheap. The end product may also cause future expansion headaches if say a new RTD or ORP is inserted downstream that doesn't play well with other Backup LAS-capable devices. So your "solution" will have to come with known caveats and you will have to do compatibility testing with newly released devices to ensure reliable performance.

I typically do 4-5 such major designs a year, and many more "routine" process updates and compatibility testing. Most of these devices are embedded devices, so I never have to worry about something like the Microsoft Windows (Insert newest flavor of their OS).

I consider the above exercise remarkably simple in contrast to figuring out how to "fix" health care in the United States and Canada. It will require the same boring, grinding attention to detail at the micro and macro level.

Unfortunately, from what I've seen from both sides of the border, people want some magic black box with lights that go blinky blinky, and they (The people and especially the politicians) don't want to strain their brains worrying about the complexities involved.

I know that isn't the answer you were expecting, but I just wanted to illustrate the only way I knew how to just how complex I consider the health care problem to be. And just how difficult to derive whatever "solution" will be.

Jay

 

I think that answer is fine, even though I obviously could not envision it.
Let me paraphrase what I hear you saying: That the technicalities of a workable health care system are a complex combination of interconnected factors that could be in a state of flux. Implied may the fact that there are very few people who could devise such an animal and further, that the ones that could would never gain the stage. At least that is what I conclude. Then, let us go forth with the largest hope and the smallest expectation. That means that if we initiate something, we must not think of it as a solution, but as a flawed beginning. A combined public and private system, set in motion with large hopes and small expectations would get something in place that would answer some concerns and be subject to "continual improvement", a Deming concept. To expound more on Deming, the ones who should set this up should be at the bottom of the ladder to cover the most concerns. I realize this is not a solution, but that is my point. I happen to agree with your concept of an elusive solution, but as galaxee points out, we should be in motion. Even if my dreamworld is not at hand, wrong is better than nothing if we have an understanding overview of the process. We can't expect this sort of things from our politicians? Maybe not. But, maybe somehow. When I was teaching the bleak world picture to high school students, I always included hope. I projected that economics would eventually lead us out of our doldrums even though I don't trust corporations. Computers will eventually signal the inevitable and those who don't want to listen will listen anyway. I believe there is hope, but I do not have faith or any expectations that politicians will get us there.

 

Fred:

Yep, that sums up nicely.

I'm sure Hope does have its place, but I'm also sure you understand that given my career I only deal with numbers, equations, and cold hard facts.

For that reason, I do not share your optimism.

It's one thing to have to deal with nasty Calculus with other folks who exactly understand what it means when I scribble an integral on the whiteboard and we all beat our brains for a few days to find a "solution" - but if I had to explain it to Average Joe Q. Citizen or, God Help Me a politician, it would seem so hopeless I wouldn't even try.

Again we not only have to raise general awareness in society but we then have to make what I fear will be very difficult choices. The days of Free Rides are over with. Now we have to pay Premium prices for crap service.

Jay

 

I feel the EXACT SAME way in my area of expertise, Jay.

Trying to explain to politicians the importance of addressing medical problems before they get full blown vs treating an already bad situation would be impossible. Even though it would save tons of money.

Raising general awareness is also incredibly hard when the average person thinks they're below understanding basic concepts of health and doesn't pay attention to a basic explanation of why it's important to see a physician when things don't seem right..

Relating what I do in the first place to the guy standing next to me at the bus stop is bad enough, and I'm referring to Duke Transit bus stops...

There are a ton of barriers to understanding, and not everyone is interested in understanding. That in itself is a huge problem.

 

galaxee: Listen to what I am saying. My hope is not based on politicians, I don't see that happening. I am saying that it will eventually become so obvious that we have no choice and the computers will aid that discovery. I believe it will be gradual and few will notice, but things will blend nicely. I guess both you and jayman consider me a naive optimist, but I don't accept that doom is inevitable. It may just be the nature of your training and jayman's training and my training (MAT) Social Studies.

 

Fred, I don't consider you to be a "naive" optimist. I'm openly a pessimist and express it freely... I have nothing against optimists and certainly don't consider you to be a naive guy.

I hope for the sake of everyone that things do blend nicely and there's not too much of a disruption... but I plan for the worst in all cases.

 

Galaxee- That's a bummer.

 

I have always been realistic., there is no perfect system, pardon the pessimism. You can have a better society, but no perfect system. I am an optimist about this country, and I do think we have more good points then EU society today. There are changes they made that are interesting and should be looked at in this country. Most do not agree with the general direction promulgated here, but in terms of the health care, Ireland along with the British system in general have done some very inovative things. A common thread is the higher level of taxation, but the GOVT did deliver something in return. I think a good mix for both BUSINESS and Society must be reached, and that is the common thread Ireland established.

 

<div class='quotetop'>QUOTE(galaxee\";p=\"106274)</div>

IMHO that is the KEY problem.

Even if you take the time to carefully explain something, what's the use if all the other person hears is a humming sound?

Or a sound like the teacher from those Peanuts shows? Quote:

"Whaaaa whoooo whaaaaa woooooooo wwwwaaaaaaaa wwwwwooooo ...."

 

<div class='quotetop'>QUOTE(Fredatgolf\";p=\"106345)</div>

Fred:

No, of course not. I think it's very nice that you have such hope and optimism and I wish I had it too.

<div class='quotetop'>QUOTE(Fredatgolf\";p=\"106345)</div>

Afraid so. I find this is actually to my benefit as I never get stressed out with worry. Trust me on this some of the folks who hire my services are so dense I'm amazed they can tie their shoelaces and properly knot their tie every morning.

Oh, wait a minute, that's what their WIFE is for!

See, I knew there had to be a reason why I've noticed all these women shopping for mens suits and accessories in the stores I buy my suits from.

It's nice to have hope but I'm such a pragmatic that I always plan for and expect the absolute worst FUBAR possible. It's easier that way.

Jay

 

<div class='quotetop'>QUOTE(IALTMANN\";p=\"106796)</div>

Immanuel:

Exactly, at the very least we should carefully examine what others have done. I do this all the time in my line of work, I especially examine the faults and the mistakes and learn from them.

The best way to learn is from your mistakes. The EASY way to learn is to learn from the mistakes of OTHERS and never make any of your own.

My dad taught me that a long time ago. Smart guy for age 85 and a grade 6 education.

Jay

 

Can you say Hillary for President?

 

Hate to break it to you Marin John...I don't think Hillary would be like she is now when she GETS in, and she is not now like she has been in the PAST.

But if you think she can solve it all, by all means vote for her and donate to her campaign, better yet volunteer too.