getting cold

it's cold outside, which means that the ED is pretty quiet (and i finally have some time to blog).
starting a long string of nights for the next 5 days before our california vacation. we'll be going to hanging out in the city, going for a hike in the marin headlands, and checking out  japan town (with a visit to kabuki springs planned). after a few days in the city, we're going to hit the yoga farm for a little yoga retreat.

in medical news, this website has rocked my world. it presents the data for several common medical interventions in a straightforward fashion. as a friend of mine and i have been saying for years, we should be smarter about what therapies we use. it might save us a few lives as well as money.

in health policy news the ACA was challenged successfully in federal district court in VA. the justice dept has already said that it will appeal this decision. so what does this mean?

the recent court decision wasn't a ruling on the entire ACA. rather, it specifically addressed the question of the individual mandate to purchase health insurance. the problem is that repealing the individual mandate spells disaster for many of the big (moneyed) players in healthcare, when you consider that insurance companies now are forbidden from excluding individuals with pre-existing conditions or  dropping subscribers when they get sick. trying to muck with these provisions of the ACA would be politically disasterous. if insurers aren't happy about the idea of having to cover sick folks while healthy people aren't required to purchase insurance.

for this reason, it seems as if the individual mandate is here to stay.

in other ridiculousness, try out this toilet. one of our hospitalists has one in his house. as you approach the toilet, the seat rises, anticipating your arrival. upon sitting upon this thrown, you are greeted by a pre-warmed cushion, pre-programmed by remote control, to your exact temperature specification. as you take care of business, a fan propels air aftward, bypassing your nose and keeping the room air fresh. (ordinary fans direct air upward, which causes foul air to pass by one's nose) after your mission is complete, an oscilator comes out spraying you with cleansing water applied in either a direct or oscilating fashion, followed by blow dry. lastly, the lid closes automatically after you stand up.