tshile

Do you recall what point levels were required for the three jersey levels? I don't really buy redskins stuff anymore. I would maybe consider this for the jersey but i think my current card gives me such better regards i could use the cash back from that to buy the jersey and come out ahead. Assuming I even wanted to buy another jersey... Otherwise, thanks.

so they send you this offer for a credit card with rewards. You can get 100$ off if you put your tickets on it because you'll get enough points for that reward. I start looking at the other rewards, because I love credit card rewards. If you can pay off your card every month you get something for simply changing how you pay for things, with no interest/fees or anything attached. http://www.nflextrapoints.com/nfl-extra-points-credit-card/nfl-credit-card/rewards but it looks like all the rewards are only for buying NFL stuff. seems like a joke. you get 1 point for every 1$. you have to put 12k on your card to get a free jersey (or 6k if every purchase is an NFL product because you get double the points, how generous of them...) it doesn't specify what kind of jersey either, i'm willing to be it's the cheapest of the options. what a joke. does anyone use this and have good feedback? is there something i'm missing here?

I'm not saying it's anything to cheer about. It's just not as bad. If anything it's indication of how terrible the other side is...

Yes, either side foaming at the mouth about how the current day's temperature/weather patterns supports either argument is ignorant. But at least the ones you're talking about have their ignorance in a better place. They may not understand the issue as well as they think they do, but at least the foundation of their opinion isn't "LOL SCIENTISTS ARE SO STUPID"

There's probably no better way to show ignorance on what scientists have been reporting on the topic over the last decade than to make some sort of "It's cold outside, therefore global warming must not be true" statement.

well played

When a cornerstone of someone's argument, at any given time, is that a report doesn't explain something that said report explains... yeah, ignorance is an issue.

The right seems to be stuck in that rut right now, though I think you're being a little over the top in describing them What's shocking is things like the IPCC are freely available to read, but almost no one bothers. Which would be fine, except the sheer number of people that comment on the issue without reading. Then you have media sites that get away with pushing absurd narratives because they know the vast majority of people will not read the report, so they can just make up whatever they want about the report because those people will never know any better, in fact they will write off any news that runs counter to their preferred news provider's narrative as just biased reporting... After the report there were "legit conservative news" (as proclaimed by conservatives I talk to) saying things like they avoid the issue of a decline in average temperatures over the last decade... except that's in the report, if you read it you would know that not only do they address the concern but they provide a reasonable explanation that creates an interesting conversation itself. Or they say things about ice at the poles, without understanding the difference between land and sea ice, salt and fresh water, and the arguments around the entire conversation of ice. If they bothered to read these reports, they'd understand that stuff. The list is endless. If you read the reports, you see these arguments immediately identify them as ignorant because you cannot say the things these people are saying if you read the reports. You can take issue with their findings, but you cannot make the statements people are making (like: they didn't address the issue when they absolutely did.) And then you get their audience running around parroting what's being said, completely oblivious to the fact that anyone who's read the report immediately identifies them as a partisan hack ignorant of the actual subject. And when you try to show them all you get is "Yeah but who wrote that report?!?!?", "What data are they using?!?", and "And what does the other side have to say?!" (even though the reports authors are on the front page, they data is open to critique, and you can read the peer reviews if you put forth any effort) and other idiotic questions, as if they're enlightened or profound questions, when in reality they're just intended to change the topic or attack the idealism of certain people instead of addressing the actual research and its findings. It's really like a plot from a terrible movie... majority of the scientists on the issue have come together to write numerous reports and hold numerous press conferences warning us of the potential dangers of an issue, and half of our society is like "lol scientists i know more than them because google"

It's the mentality we have. Nothing can be addressed until it is a crisis. We can't even agree on what the facts are... much less a solution. This subject is hardly unique in this regard. People in this country are too easily manipulated by arguments that sound good. Critical and logical thinking are too much to ask for. All you need is money to fund an ad campaign and put in politicians pockets and all the sudden you have overwhelming support for an idea that has little factual backing. It's maddening/tiring to watch.

Yeah, that's what some people call conjecture. It doesn't take much looking into the issue to be able to identify when people are and are not doing this.

There's actual reasons for it. But one side just likes to wave their arms around and scream. It makes it easier to argue when you just make up everything about the topic. Yup. Failure to understand the issue. It's a real problem with the one side. I've said it a few times - the conversation the actual researchers are having is a different conversation that what political junkies are having. We seem to be the only 'western' country that has this denial problem though. I was in Europe when the IPCC's report was released in September of 2013. The way it was covered there (maturely, with adults, that actually understand science/research) made me quite embarrassed of us

My favorite is when we have a historic/record cold period for an area in a given week/month, and certain people trot it out and make snide remarks about current climate change theory. They have no idea the remarks they're making, which their tone suggests they think are clever, only go to show their lack of a grasp on both statistics and the actual theory which they purport to be arguing against...

It's not normal, or at least it's not ethical/honest. It's also not normal/ethical/honest to completely discount peer review and go out of your way to avoid peer review of your own work. I was agreeing with you

It's so tiring. It's a shame how many people don't even understand how research works. It allows for one side to just wave their arms all over the place and appeal to a group of people.

You're excused No seriously, I get it. I already admitted its anecdotal - it's from a few systems in the same geographical area. I'm less trying to to argue with you here, more just trying to add to the conversation. I knew that ACA dinged reimbursements based on readmission numbers and cold call surveys of patients. I didn't know that was because readmission was such a huge issue. So I never thought to ask - what would you do to lower readmission. So I just asked my wife - her only real comment was: the problem is that we get penalized for any readmission within 30 days of discharge, even if it's unrelated to the original cause for being in the hospital. She's watching a movie so I didn't get any more out of her I'll try again later. I really need to dig up a link of the GOP talking about ACA (or "socialized healthcare" in general) resulting in more patients, overworked and under compensated doctors and nurses, leading to doctors running out of the field? Because for a good 2-3 months it was a huge talking point of the left to make fun of the right for saying those things. At least 2-3 months. (to answer your question - i don't really want to put int he effort to find a link, but if you're going to call me stupid or a liar or something because i'm being lazy then sure, i'll go find one... ) Hmm, I don't really know enough to comment either way other than to say it's something I'll look out for in my news feed WrongDirection - I would love for what you say to be true, I hope it is. I'm probably blinded by the circus show and not looking behind the scenes, like you say.

Again, PeterMP, we're in 99% agreement and I think we're both picking at nits in each others posts I'm certainly not suggesting all the positive news is because of cooked books The impression I get is that there is concern that patient care isn't being kept high. In addition nurses are more stressed out, more concerned, more overworked, and are afraid they are not being allowed to do their job (all of which were GOP talking points on ACA pre-implementation, btw.) This is what i hear them saying. These are concerns they voice, openly, to anyone willing to listen. You can keep pointing to statistical numbers, I'm telling you what people I know in the field are telling me. And I'm not a "Repeal Obamacare" person... But I'm only talking to people in a limited number of settings. These issues could be isolated, I realize that. But to me it seems like, nationally, we have two sets of hospitals: Those that have figured out how to adapt in a successful manner, and all the other ones still trying (of which some terrible decisions have been made.) None of that is to imply we're doomed - just that there are very real issues going on and that we shouldn't gloss over them. I'm not saying that. What I am saying is that I haven't see either side propose any changes. I've seen one side constantly propose repeal, and another only fight against repeal. The system still needs changes. It's not where it needs to be. There are still problems. The job is not done. Yet no one seems to be talking about the next round of changes... no one. (maybe i'm just not paying attention, always a possibility )

PeterMP: My contention was with your use of the word avoidable, and saying that's how they get their reimbursements. There are other things that affect their reimbursements. Furthermore not every readmission are avoidable. The only way to make them all avoidable is to keep the patient until they are 100% healthy, which is not feasible because of costs (and people wouldn't stay in the hospital that long.) So, you're at the mercy of the patient doing what they're supposed to do. I don't know if you have experience with the medicare/medicaid crowd, but if not - they're not exactly a population of people known for taking care of themselves/following direction... they're just not. Lowering readmission saves us money? Sure, it sounds good, but I don't know. Again, numbers are being fudged. There's a cost associated with that fudging. I don't think it can accurately be measured due to various limitations. I would like to believe it's saving us money, but absent an adequate way to ACTUALLY measure readmission I don't honestly know. I don't know about penalties balancing out of bonuses... I don't even understand what your claim there is. But as for this: "But realistically, we need to bring some sort of quality measures and consequences back into health care. Is there any reason why the government should pay equally for good care as bad care?" I agree with you. My argument is that they're doing it wrong; or maybe to put it better - they're not doing it the best/most productive way. They are getting some of the results they want, and they'll surely tout that. And you're not going to catch hospital CEO's saying "Well, we just found ways around the new rules", they're obviously going to run around saying they have a renewed focus on patient care... let's not be naive here I don't have a problem with what you're saying. I just don't think the results are what you seem to think they are, and I don't think the rule is having the impact you seem to think it's having, and I think this because people that work in the field are telling me the changes they've made because of this rule and why... and it's to get around it in various ways. Here's some changes I know about: Patient load has been increased # of nurses on a floor at any given time has been decreased acuity levels a nurse maxes out at has been raised the follow up process has been completely redone and is a huge focus - part because they want to make sure they don't have a readmission from the patient, part is to transfer the patient to their doctor like I said earlier middle management has been drastically cut and you very well may be appalled at the number of people any given manager is now responsible for. I'm not quite sure how any of them get any proactive work done. There are still fundamental issues with the system. There are still changes that need to be made. The sooner both parties realize that and start working on it the better. As of right now, form where I sit, the Administration seems to think everything is all roses now and the GOP seems to think it's doom and gloom and repeal is the only option. Both are wrong and you and I and everyone else are screwed until they figure that out. (screwed in the sense that we're stuck with a system that won't be improved and needs to be improved)

I think you're assuming that numerical change in how it's measured was caused by the results that the rule change was meant to create... I, for a fact, know that's not (entirely) the case. For example - Part of the rules apparently say that the hospital can go through a process which transitions the patient back to the primary care doctor. When this is done there is no "readmission" for this patient. The hospital is considered to have done its job, and it is now in the hands of the doctor. So if the patient winds up back in the hospital, for the same issue, it doesn't count as a readmission because of a procedural issue. This is done so the hospital doesn't get its rates cut. The "stats" reflect it. Any reasonable person can look at the situation and say - this is a readmission. They're skirting around the rule, the problem hasn't been fixed. I'm sure some of the reasons the numbers have gone down is because people are making more of an effort to guard against it. But to attribute the entire decline to that is... well, I know it's just not true. You can turn around and blame the hospitals, but I (and many that work in the field that I've talked to) would argue it was a stupid rule, based on numbers that don't capture the actual issue, that punished hospitals for something they had no control over to begin with, created by people that don't actually understand the system, and so there should be no surprise, shock, or outrage that they are trying to get around it (and being successful in some cases.) The biggest problem with ACA (in my opinion) is that it put the ENTIRE onus of cost control on the hospitals. It's a flawed approach, and this is just one that shows it. Lots of people have lost their jobs because of this. Hospitals have gone through complete restructures centered around reimbursements being cut for ridiculous reasons. edit: I don't work in the field, and everything I'm posting is based on conversations I've had with people that do and (for the most part) I trust/value their opinions. I very well may have butchered a few things in the explanation because I'm regurgitating something I don't have a lot of experience with. I'm also only familiar with how things are working in my area.

Kind of. First off - they're not avoidable. Not entirely. If you release a patient with medicine and instructions on how to get better, and they don't take their medicine or follow the instructions and wind up back in the hospital, is that an avoidable readmission? I wouldn't think so. This is a problem that exists right now. A big problem. The idea that readmissions are a completely avoidable thing (from the care-provider's side) is something that sounds good but just isn't true. People do not have the desire, or capacity, to follow directions even when their health is on the line. Just a sad fact of life. Second - they're also tied to patient satisfaction scores which has a lot of issues itself. I'm not quite sure what else their reimbursements are tied to, but I will ask my wife as she's up to her eye brows in this crap right now

hey - now is not the time to highlight the negative. there will be plenty of time for that later this year.

which is a problem a lot of things have had to overcome

depends on the specific field. in this case, due to the grip the oil industry has on the world and the subsidies the government gives them, initial is probably going to be a while.

have you seen how apples data travels?

Apple has the cash reserves to make a bold move like that. I'm kind eh about what I expect from them. They have some very, very strong traits as a company when it comes to products, but they have some equally weak ones as well. Some of their weaker areas give me concern over something like.... a moving vehicle at 60 miles an hour. I hope it's the most hipster car ever just so I can have a good laugh.

we can, but we shouldn't. unless the goal is to destroy competition in the energy market. like many technologies we enjoy, the government must fund the initial start up. it isn't new and it shouldn't even be controversial.