A Few Beers, a Moustache and A Cause Is Born–Where in the World Did Movember Come From…

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Have you seen that world floating around the web and wonders where in the world did this word come from?  Well Adam Garone is here to tell you the story.  This was one of the TED featured videos this month which I try to catch a few of them and this has humor and he talks about how a charity process came about.  He didn’t really have a cause and a person affected which is how most charities get started.  He talks to the Prostate Cancer Foundation and this is what they said on their first meeting…they have “hairy ribbons” too..he says..
"We're an ultraconservative organization and we can't have anything to do with you... but if you happen to raise on money with this, we'll gladly take it", he heard it twice…very well done and a change from the normal routine.  BD 



http://www.ted.com/talks/adam_garone_healthier_men_one_moustache_at_a_time.html?utm_campaign=&utm_content=awesm-publisher&awesm=on.ted.com_movember&utm_medium=on.ted.com-static&utm_source=t.co

Jon Stewart and Steven Colbert Are Back and Recapping “Sandy” and Give Out Some Well Deserved Recognition–Namely the NYU Nurses for One

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These are great videos and done well with recognition and humor.  We have seen the images all week on the two cities and the Daily Show shows the difference pretty well with humor.   It’s like the north side hasn’t missed a step while rats crawl over those on the south side.

The Daily Show with Jon Stewart
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Steven Colbert and his comments…. Everyone is here to charge their cell phones and shower in the sink..but he does a very serious introduction with credit and tells all to donate.  The nurses the first to be recognized.

The Colbert Report
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American Hospital Association Files Suit Against HHS and CMS Over 3rd Party Audits Disputing Inpatient and Outpatient Documentation Parameters–Maybe Tired of Swapping Spit Over Payment Algorithms

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When you read this, what’s the first thought I think of, attorneys and legal interpretations.  You reach a point to where you can go back and forth and back and forth on the audits.  This makes it hard for hospitals to budget and I have written about this before and really there should be some statute of limitations here and a look at reality. This could go on forever when you run analytics and you might spend a couple million on the project to get back a half a million so does that make sense?  Last month we had this statement and again it is due to the election for the most part as costs went up and let’s don’t mention that more doctors and hospitals are using electronic medical records that connect to coding systems so they get it right according to the rules established by the doctors and hospitals. 

HHS and DOJ Send Letters to Hospital Trade Associations Warning of Gaming Billing System Via Use of Electronic Medical Records–Hospitals Just Learned How to Bill Better & Hired Consultants–Case of Being Algo Duped With Numbers?

This was weak and again an emotional kind of witch hunt as someone felt compelled to find a goat here as there were no specifics mentioned.  In a lot of instances 3rd party consultants are used by hospitals as well to help them, and remember part of their sales pitch is “saving money”.  Everybody has a focus and the analytics don’t see the entire “human side” of this either, just dollars and parameters set in software configurations. 

Bad Algorithms in Healthcare Payment Systems and Risk Assessments–Did the Hospital Bill Fraudulently or Were They Sold Formulas That Did Not Conform

Next week we could be back to the re-admissions algorithms, again formulas that keep the money shifting, so if the government were a business what do you think they would do?  A business if it was not profitable and poured too big of an expense and hassle on their clients would probably move on.  Hospitalists go through this re-admissions documentation all the time and shoot even the hospitals and doctors have trouble understanding what insurers want and don’t get straight answers either, because of complexities.

Medicare Re-Admissions Penalties–Algorithms Keep Money Shifting and Make It Difficult for Realistic Budgets to be Met Along With Good Patient Care–Algos Keep the Money Moving In One Direction or Another

If this were to really be pursued, get the 3rd party consultants who advise hospitals and see what they have going and what they are advising hospitals.  So many of these consultants work right on the floors of the hospital any more so they can see and advise and few are subsidiaries of insurance companies. 

The Medicare Contractors are subsidiaries of insurance companies so if it was their auditors doing the work, what’s up with that?  I’m not talking about the obvious “fraud” cases where business intelligence software can nail those down because they exist too but the “billing” audits on some of this can go on for lifetimes.  Here’s an example with Mayo clinic.  Upon discovering a billing error in 2007, Mayo promptly corrected it and voluntarily refunded $262,975 to the government.  This case looks like the needed more money to pay the whistleblowers and it settled up with Mayo paying $1 million on top of what they originally paid.  You just have to ask since this began in 2007 was all this time and effort and paperwork to get $1 million worth it?  It was a billing error.  This is what I mean by shifting money back and forth and it went on for 5 years.  Mayo sent money, take it and settle the case and move on.   

Mayo Clinic Agrees to Settle DOJ Legal Suit Dating Back to 2007 Under Whistleblower Provisions–One More Example of Algorithms Shifting Money in Healthcare As Cost of the Lawsuit Had to Far Exceed the End Results With Time and Money–A Waste

How important is it that we have “perfect claims” going back how far and how much time is going to be spent I think is a good question to ask.  By the time you audit all the hospitals in the US this can go on for years and years.  Again I understand that auditors are paid to do a job and that’s what they do under someone else's direction so somebody has to make this call on the parameters of the audits.  BD

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The American Hospital Association sued the agency that oversees Medicare, saying an audit program aimed at trimming improper payments is unfairly depriving hospitals of reimbursement for care they provide. 

The suit, filed Thursday in U.S. District Court for the District of Columbia, targets the federal Department of Health and Human Services, the parent agency of the Centers for Medicare and Medicaid Services. In addition to the association, the plaintiffs include hospital operators in Michigan, Missouri and Pennsylvania.

The suit focuses on the Recovery Audit Contractors program, which involves third-party contractors that review Medicare payments to hospitals. According to the suit, many hospitals have faced rulings by the auditors that care provided and billed on an inpatient basis should have been performed in an outpatient setting. Hospitals are then forced to return the money paid for the services.

http://online.wsj.com/article/SB10001424052970203707604578093550273882508.html?mod=googlenews_wsj

City of Houston New Health Insurance Plan Not Saving Money, Costing More–It’s Going to be Hard To Save Money With Health Insurance As Economics Change and Financial Algorithms Continue to Shift Money

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This is just one example and there will be more and yes there are obvious areas where savings can be had, but we’re getting down close to the end of the barrel and the only way to save money beyond that is to cut services for patients.  They did make a change to a “self insured” model and you can listen to the video and that didn’t have any impact. 

They are a year and half into their new contract and have about the same to go, so they will look at it again soon I am guessing.  Certain elements have rising costs and everybody has those and drugs and devices go up in price as well.  So after all the administrative changes and time, no money being saved.  They moved from Blue Cross To Cigna on a self insured model.  One item they did note though is the higher cost for preventive care.  We know that always costs a little more but hopefully keeps some of the big bills away with care before it gets to that point. 



Last year in 2011 at the TED conference Bill Gates made a few statements in looking over municipality budgets and said “where did you get those numbers” and not this case here.  He identified 3 points that need to be addressed in healthcare that we need now…and here they are..


I think we are gathering a lot of tools but the second one might be next to impossible as we are all duped from the banks, insurers on down with complex business models designed for profit and the 3rd one..well we might be getting closer on a few of those.  BD 

Bill Gates–TED-Talks About States Budgets (Where Are You Getting Those Algorithms) and Educational Needs (Update)(Video)

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It was a big fight a year and half ago for the city to switch from health insurance policy to another. But now that they've actually made the switch, they're not sure it actually saved anyone money.

Eighteen months ago, the city switched from a Blue Cross Blue Shield insurance plan to a Cigna managed self insurance plan. It was supposed to save the city money and improve service.

"It went up about $30," James-Davis said.

But more than a year later, it turns out not only are employees paying more, but the city isn't saving nearly as much. In fact, they're bringing in $17 million less than what they budgeted for.

http://abclocal.go.com/ktrk/story?section=news/local&id=8868845

Excise Taxing the Data Sellers–Nobody’s Supporting the US IT Infrastructure, Especially In Times of Disaster-Companies Have Probably Made Money Off Selling Scraped Data of Those Hurt in the Wake of “Sandy”

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Nobody likes taxes but it’s a topic up for discussion all the time. Mining and selling of consumer data is so engrained in the current world of business and it’s the companies that benefit.  Right now some need power in New York for one example and as mentioned in the title many of the consumers affected by the hurricane have already been products that have been bought and sold.  As we have seen the economy depends largely on IT infrastructure in New York and that dependence exists in other places as well, and who benefits the most, companies, banks, other businesses.  Is there a way for them to pay for their use of modern day technologies..nope. 

Consumers pay for highways every time we buy a tire or go to the gas pumps so it’s about time we look at IT infrastructure an creating a source of revenue to maintain as well.  It’s the same thing and the economy doesn’t work without it.  This is a topic I have blogged about frequently here with tapping into this area as it is so profitable for companies to mine and sell data and as consumers we are finding their error rates climbing and we, as consumers and on our own dime have to fix everything banks,corporations, etc. foul up and it’s been going on a long time and with flawed data on the rise with some less than credible data services being sold at times, it’s an expense that is dumped on the consumer, even though we are earning less money today and holding more than one job to just exist. 

It’s not fair and equitable to even dump more responsibility on the consumer for corporate America data flaws and to deny services and credit for one example.  Setting up a quarterly tax and license is not a difficult model as we can pretty much base it on the model used for sales tax and being it would be brand new and not have to be built from existing technologies, the up and running time could be pretty fast. You can’t help but think about this when you see the likes (and this is just one example, link below) of stingy little companies like this that have found a way to operate outside the regulation of the federal government and make millions.  As a consumer you can’t even see what they send out about you.  Is this fair..no.  These folks were Chapter 42 of my Attack of the Killer Algorithm series and there’s more like them out there. 

E-Scoring Credit Algorithms Invisible To Consumers Used to Market and Evaluate, Does Not Fall Under Federal Law And Such Are Used by Insurance Companies - How Will This Work With Exchanges –Attack of the Killer Algorithms Chapter 42

This topic was also Chapter 17 of the Killer Algorithm series.  When you read in the news about companies being more profitable than ever, well this is a big chunk of it, banks too. 

^{Start Licensing and Taxing the Data Sellers of the Internet Making Billions of Profit Dollars Mining “Free Taxpayer Data”–Attack of the Killer Algorithms Chapter 17 - “Occupy Algorithms”– Help Stop Inequality in the US}

 

Behavioral analytics is huge area for abuse and that’s not to say it’s all bad because it’s not but people abuse it like anything else, they write some code, write a study to substantiate their math and off they go.  Do we know they are gaining any “real” value here?  So much of it is information from the web and people lie their asses off on this part of the data, so credible in all area..nope and in some areas you have been “duped” and it goes something like this…

”Hey dude let’s crunch some numbers and see if we can come up with some analytics to sell”

I read a lot of the comments on the web from various sources and it’s even out there with people commenting on the fact that they are tired of reading predictions as they don’t work and this make being an economist a very tough job today for sure, as things change with the drop of an algorithm.  It’s really time to start separating some of garbage out there from what does have value and by licensing and taxing them we will not only gain revenue but it will put the “slick data willies” on alert. 

I keep giving the public example of Walgreens making short of $800 million in 2010 from just selling data only and that example alone can demonstrate how much available money there is to tax..billions and billions.  It would algo give the consumer a break to have a federal page where companies, banks, etc. were required to disclose what kind of data they sell and to who.  Think all these formulas you see out there today are credible..wake up.  In healthcare Cuomo proved it with the algorithms United Healthcare used for 15 years to short pay doctors and hospitals, remember that one and the class action suit finally settled and I think payments were made but again most took the amount United figured they owed them as this situation went so far back neither the doctors or the hospitals had the time and money to pull up and generate all the records for a larger claim, so they won again with the algorithms.  Watch this video and see gullible we are.  I have used it many times here as it applies. 

Big Data, Flawed Data, Business Intelligence, Where’s The Future and What Has Been Our Past…A World With ”Algo Duping” of Society and Consumers

We talk about the algos on the stock market, well they get you in every day life as well and the accuracy is getting worse, again that non credible data that gets sold as a Pandora’s box for knowledge.  There’s 4 videos on this blog on the left hand side, watch them and get educated as to why this data selling tax should exist.  In the wake of the hurricane damage in New York, one more great example to have this as who benefits, banks and companies.  Should we plan for funds to cover disasters, I think so and those who mine and sell the data off our backs  are making millions off the free data sounds like a good place for me and read through the series on the Attacks of the Killer Algorithms if you will to understand how this works behind the scenes, you do not see it, hear it but go try to buy a car, a house or get any loan and the potentially flawed information is there having you guilty of data you never created that is potentially full of flaws. 

Attack of the Killer Algorithms–Digest & Links for All Chapters–on How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You

How do you feel as a consumer knowing that corporations are all getting richer and with this and nobody pays attention and the government certainly is not a getting a share to have funding to help with disasters nor to help fund the NIH and FDA.  The GOP in Congress doesn’t seem to have a clue and even in my area the representative’s office seems to be more concerned about their tomatoes they grow n the patio.  Some of these businesses can’t wait to get up and running with the disaster in New York, they are not making money not having access to mine and sell your data.  Here’s where I commented on relief to the FDA and NIH with such a tax. 

One More Good Reason to Tax the Data Sellers– Create Additional Funding for the NIH and FDA From Sources That Otherwise Are Too Greedy to Share & Contribute

Long and short of all of this, we’ve been Algo Duped and where the money in a time of disaster that could help those who have been hurt…data miners have already made money off their backs and time for a tax for this benefit it is stand continue, which it will as you can’t stop it as Congress seems to think but you and certainly get smart and use some current day methodologies to tax and get some revenue.  Fight fire with fire.  You never know who reads your stuff on the web at times but I had some nice comments on this one from Nielsen.  They would tune in here as they are rating game folks. 

Big Data, Flawed Data, Business Intelligence, Where’s The Future and What Has Been Our Past…A World With ”Algo Duping” of Society and Consumers

Yesterday, a study about “math”making you hurt…a little write up on it and from I see just from writing this blog, consumers, the media, everyone runs from this topic so maybe they are on to something.  The media today chases the OMG and the drama queen stories like crazy and if you look hard enough you will find a few that don’t and they are valuable reporters that investigate issues and still work on “reality” stories and I’m glad some of those folks are still around.  The OMG journalists at times get old and too many of the articles reported lack facts and just serve as a distraction with nonsense that stirs you up but gives you no direction to go.

“Algo Duping” – PLOS One Journal Publication Explains Why The Fear of Math Plays a Big Role As One Underlying Reason We All Get Duped And Those Who Don’t Fear Math Take All the Money, Gradually, Using “Mathematical Formulas & Algorithms”

Time to excise tax the data sellers who get their data for nothing (off the taxpayer’s backs) and their profits for free. It’s time they pay their share so we have funds for disasters, for the NIH and the FDA as we need this and some are not paying their share but are rather greedily profiting.  One more shade of greed that maybe is finally coming to light once you realize what goes on with servers operating 24/7 with mining and working your data and dumping out flawed data created by the Killer Algorithms.  You almost can’t find another tax resource area that is as big as this and sits under everyone’s nose because its invisible, but it does exist.  Take some aspirin for for the pain and let’s gets smart and put the responsibility where it belong and help the companies who make tangibles expand and create jobs so they can compete the stingy billionaire data selling data mining businesses.  BD

New link between high-fat 'Western' diet and atherosclerosis identified

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A diet high in omega-3 polyunsaturated fat lowers levels of problem enzyme

Columbia University Medical Center (CUMC) researchers have found that a diet high in saturated fat raises levels of endothelial lipase (EL), an enzyme associated with the development of atherosclerosis, and, conversely, that a diet high in omega-3 polyunsaturated fat lowers levels of this enzyme. The findings establish a "new" link between diet and atherosclerosis and suggest a novel way to prevent cardiovascular heart disease. In addition, the research may help to explain why the type 2 diabetes drug rosiglitazone (Avandia) has been linked to heart problems.

The study, conducted in mice, was published in the October 4 online edition of Atherosclerosis, Thrombosis, and Vascular Biology.

Like other lipases, EL plays a role in the metabolism of blood lipoproteins, which are complexes of lipids (fats) and proteins. EL, which is secreted by macrophages (a type of white blood cell) and other cells in arteries, was discovered in 1999. Studies have shown that elevated EL is associated with atherosclerosis and inflammation. Until now, however, little was known about how dietary fats might affect this enzyme, said study leader Richard Deckelbaum, MD, the Robert R. Williams Professor of Nutrition professor of pediatrics and of epidemiology and director of the Institute of Human Nutrition at CUMC.

In the current study, a strain of mice susceptible to atherosclerosis was fed a normal diet enriched with either palmitic acid (a common saturated fat) or eicosapentaenoic acid (an omega-3 fatty acid, or polyunsaturated fat, found in fish oil, among other foods). After 12 weeks, the mice's aortas were examined for changes in the expression of EL and inflammatory factors. Aortas of mice fed the saturated fat diet showed a significant increase in EL and detrimental changes in inflammatory factors, while those of mice fed the polyunsaturated fat diet showed a significant decrease in EL and beneficial changes in inflammatory factors. Studies in cultured macrophages showed similar results.

"Our study identifies a new way in which the high-saturated-fat Western diet could lead to the development of atherosclerosis, though, of course, these results need to be confirmed in human studies," said Dr. Deckelbaum. "The findings might also explain some of the cardiovascular benefits that have been attributed to omega-3 fatty acids."

The researchers also found, in cell culture studies, that macrophages fed saturated fat showed increased expression of PPAR-gamma, a cell signaling molecule that plays a role in regulating lipid metabolism and inflammatory responses. This increase was blocked when the cells were fed an omega-3 fatty acid.

"These findings are intriguing, because we know that the diabetes drug rosiglitazone (sold under the brand name Avandia) is a strong PPAR-gamma activator and that it has been associated with an increased risk of heart disease," said Dr. Deckelbaum. "So we hypothesized that if rosiglitazone activates ppar-gamma, it might also activate EL, which would explain its effects on the heart."

In fact, when the macrophages were given rosiglitazone, the expression of EL increased markedly. The addition of omega-3 fatty acids to the cells blocked this increase. "This would suggest that besides raising LDL cholesterol levels, rosiglitazone can raise the risk of cardiovascular disease by increasing EL," said Dr. Deckelbaum. "In addition to its potential role in increasing arterial inflammatory responses, EL increases the anchoring of LDL to cell surfaces, which could be associated with increased LDL accumulation in coronary arteries."

Use of Avandia was severely restricted in 2010, when the drug was linked to the development of heart disease.

Caffeine may block inflammation linked to mild cognitive impairment

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Recent studies have linked caffeine consumption to a reduced risk of Alzheimer's disease, and a new University of Illinois study may be able to explain how this happens.

"We have discovered a novel signal that activates the brain-based inflammation associated with neurodegenerative diseases, and caffeine appears to block its activity. This discovery may eventually lead to drugs that could reverse or inhibit mild cognitive impairment," said Gregory Freund, a professor in the U of I's College of Medicine and a member of the U of I's Division of Nutritional Sciences.

Freund's team examined the effects of caffeine on memory formation in two groups of mice—one group given caffeine, the other receiving none. The two groups were then exposed to hypoxia, simulating what happens in the brain during an interruption of breathing or blood flow, and then allowed to recover.

The caffeine-treated mice recovered their ability to form a new memory 33 percent faster than the non-caffeine-treated mice. In fact, caffeine had the same anti-inflammatory effect as blocking IL-1 signaling. IL-1 is a critical player in the inflammation associated with many neurodegenerative diseases, he said.

"It's not surprising that the insult to the brain that the mice experienced would cause learning memory to be impaired. But how does that occur?" he wondered.

The scientists noted that the hypoxic episode triggered the release of adenosine by brain cells.

"Your cells are little powerhouses, and they run on a fuel called ATP that's made up of molecules of adenosine. When there's damage to a cell, adenosine is released," he said.

Just as gasoline leaking out of a tank poses a danger to everything around it, adenosine leaking out of a cell poses a danger to its environment, he noted.

The extracellular adenosine activates the enzyme caspase-1, which triggers production of the cytokine IL-1β, a critical player in inflammation, he said.

"But caffeine blocks all the activity of adenosine and inhibits caspase-1 and the inflammation that comes with it, limiting damage to the brain and protecting it from further injury," he added.

Caffeine's ability to block adenosine receptors has been linked to cognitive improvement in certain neurodegenerative diseases and as a protectant against Alzheimer's disease, he said.

"We feel that our foot is in the door now, and this research may lead to a way to reverse early cognitive impairment in the brain. We already have drugs that target certain adenosine receptors. Our work now is to determine which receptor is the most important and use a specific antagonist to that receptor," he said.