Interview/Podcast With Runners Connect

I’ve found what I am sure is the best podcast on running. The podcast is put on by Runnersconnect  and hosted by excellent and ever improving, elite marathoner Tina Muir.

Tina is knowledgeable, ever prepared, sounds great, and conducts a wonderful interview each week. Runners Connect has interviewed many fascinating people from the running community. Among those I’ve listened to are Dan Lieberman, Chris McDougall, Tim Noakes, and Jack Daniels. Each week there is another interview with someone who has a special take on running and from which you can learn.

This week a podcast in which I was interviewed has gone online. RunnersConnect Podcast Interview with Dr. PributThe interview covered a lot of ground. We did not review the questions in advance. Instead we did wing it. Free range always sounds best to me. Tina was well prepared and asked questions that led to many different areas.

I hope you find the podcast interesting. It is likely to contain information you haven’t heard before and likely not quite what you’d expect. If what you wanted wasn’t included, there are so many other great podcasts, I have no doubt you’ll discover a good number that you’ll enjoy.

http://runnersconnect.net/running-interviews/steve-pribut-injuries/

Artificial Intelligence And Intelligence

AI has made tremendous strides in the past 15 to 20 years. In going from a constraints and rules based system in which “expert systems” were hailed as the future, to today’s probabilistic and stochastic systems we’ve come a long way. There are many current and future uses for AI and they are far too many to list.

Some recent work has been done in gait simulations in which everything from dinosaurs to people walking with osteoarthritis or cerebral palsy (crouch gait) has been modeled. Strategies have been proposed to lessen the load on the knee using one model. But the strategy was difficult to adapt and I believe only the author of the study was able to successfully and readily use his “intoe” strategy. (Note: Lateral wedging on orthotics has also been found to lessen medial compartment forces in the knee. And that does not need you to study at Monty Python’s Ministry of Silly Walks, to walk like Young Frankenstein or to sing “Walk This Way” while you move about.)

Biorobotics, a new field of robotics, has been used to model a variety of animal methods of locomotion. Snakes, cats, fish, and human like robots have been created for this purpose.

The October 7th edition of Science Magazine features an interesting article which suggested that artificial intelligence products were needed to make connections and correlations for novel ideas on research projects. (Gill, Y et. al. 2014; 346:171-172). This is an excellent idea.

An intelligent system should be at the core of many systems. It should be at the core of all EHR (electronic health records). Some of the advocates, designers, and marketers of these products seem to be first interested in market penetration and are proud of achieving a government defined Level 2 of “meaningful use”. However meaningful use is losing its cachet since it doesn’t add intelligence, thought, or many things that are helpful to a medical record. Insted it adds more data points but not meaning. (ICD 10 coming to a healthcare provider near you next year will also add an incredible amount of not very useful datapoints and has been precicted to cause many physicians to leave private practice.)

AI could be helpful. AI could have assisted by creating a red flag notice on the Electronic Health Record that the patient with a headache and severe stomach pain had just arrived from Liberia. It was entered into the medical record of the hospital but set off no alarms.

Of course the final failure was a human one. The doctors, nurses, and residents should have made connections. It really doesn’t take a computer to put information like that together. The close partner of the patient who brought him to the hospital is said to have informed 3 people that he had come from Liberia, Africa. He did not have a Texas accent. He had more than one classical sign of Ebola or other serious illness. He rated his GI upset at 8/10, he had a fever and a headache and did not have signs that he had a sinus infection as some articles stated.

In this case an intelligent system could have made up for the unwise human conclusions and actions. But there are a few simple lessons:

1) We need to be intelligent and make connections. A diverse knowlege base is helpful.
2) We need to exclude data points that don’t make sense and are suspicious and not likely.
3) We need to have an intelligent core to our EHRs. One in which probabilty and hidden Markov Processes are used will be far better than just using Natural Language Processing (NLP) but it will be harder to implement.
4) The humans are the final arbiters of the decision making process and need to think and understand their own thinking process to produce optimal decision making and to determine the optimal next step in treating their patients.

“The world faces deep problems that challenge traditional methodologies and ideologies. These challenges will require the best brains on our planet. In the modern world, the best brains are a combination of humans and intelligent computers, able to surpass the capabilities of either one alone.” Well stated by Gill (2014).

AI-ScienceMag-small
AI Connections via the Hanalyzer.

 

References:

Gill, Y et. al. Amplify scientific discovery with artificial intelligence.  Science Magazine 20 14; 346:171-172

Ijspeert, Auke. Using robots to emulate and investigate agile locomotionScience 10 October 2014: Vol. 346 no. 6206 pp. 196-203.

Exercise is good for the mind and the soul

Another study has demonstrated that those who exercise regularly have a decreased incidence of depression.

The new study titled “Depressive Symptoms and Physical Activity During 3 Decades in Adult Life” appeared in JAMA Psychiatry in the issue published Oct 15, 2014.

At each age group, those who exercised had a lower incidence of depression than those who did not. Those who took up exercise were doing better 5 years later than those who continued to not exercise.

This is one more reason to exercise regularly. Exercise is good for ails you or for what might ail you in a few years!

Unknown-3-small

 

 

 

 

 

Moving is Exercise (Competing Tunes below)

Examine Your Models and Theories Often

I’ve been spending far too much time doing 140 character mini blogs or actually enjoying MOOCs (massive open online courses). My favorite MOOCS may be found at EdX.org and Coursera.org. If you are not currently involved in a formal course of study, there probably is no better way to spend time learning than these. But it is time for at least a short blog.

So, off we go to theory. We see many theories proposed and many adopted with little study. We may see a study of 13 people or 20 people that some purport to change all thinking on a long standing medical problem. This is not the proper way to approach a poorly designed and implemented study or even a well designed but entirely all to preliminary study.

We would not change the treatment of heart disease, any type of cancer, or try to prevent Alzheimer’s disease on evidence as weak as this, but somehow it is deemed worthy of a sea change for running injuries. A shower and a change into clean clothes is likely a better use of your time.

But allowing models and theories to last for far too long can be an equally troubling problem. But this is why models and theories must be thoroughly examined. There is no need to adopt an untested theory. And there is no value in making a theory about how to treat a clinical entity and proposing that is how all such entities should be treated without testing clinical results.

Now on to yesterday, in the hope of having a better tomorrow, today!

 

Quinta_Essentia_(Thurneisse)_illustration_Alchemic_approach_to_four_humors_in_relation_to_the_four_elements_and_zodiacal_signs-small

 

Examine your theories and models often.

The model of “humors” as the cause of diseases persisted for over 2,000 years. The Greeks refined this concept in about 400 BC and it persisted for far too long.

Aristotle’s scientific publications also lasted for far too long as unquestioned dogma. And there is even recent praise in both film and print for the wonders of his study of biology. While Aristotle may have been the first to take a systematic approach to science, it is even more important to know your failings and where your knowledge is lacking. A recent book and a documentary by evolutionary biologist Armand Leroi called “Aristotle’s Lagoon” have interesting points to bring forward about Aristotle and his study of Biology. But I’m in the camp of believing that he may have done more harm than good by not successfully encouraging others to better study and verify or disprove his theories. He certainly was a busy thinking man for his time. But unexamined, he dominated western thinking for far too long.

Old knowledge isn’t necessarily knowledge at all. It is more likely a historical artifact or relic. Most medical studies from 100 years ago would not past muster today. So using them to justify someone’s completely unscientific theories is absurd. And I, like many, will even have questions about studies performed last week.

And below we have David Attenborough describing (via Louis Armstrong’s words) what a wonderful world is and Otis Redding performing Sam Cook’s song of that name. (And via the wonders of Youtube you can also find Sam Cook, Dr. John, and even Joey Ramone doing one or the other of these songs.)

 

 

 

 

 

Art And Dissent

Art And Dissent

Recently a Miami, self-styled artist, feeling neglected, went to an exhibition, picked up an ancient Han Vase which was the subject of another artists work, and dropped and broke it.

This was not cool. And it wasn’t even original. Been there and done that was the artist whose work it was. In fact the dude broke the million dollar vase in front of a picture of Ai Weiwei doing it himself. So, this derivative artist created nothing new. The act had no meaning and it was not original. In fact it was done in ignorance and not out of creative feeling, impulse or thought. It was at the level of a monkey flinging shiz. The artist did not know the value of the vase and clearly didn’t understand the nature of Ai Weiwei’s work or the purpose of art and museums which display art. (In a sense, it is like blowing up the Army Mathematics Research Center (AMRC) at the University of Wisconsin in Madison and declaring that this act was to call attention to the new math.)

He claimed that he felt “inspired and a feeling of solidarity” with Ai Weiwei. But the feeling of solidarity and empowerment I felt from Ai Weiwei was that Ai Weiwei allowed visitors to photograph his exhibit. Photography is generally forbidden at visiting exhibits at most museums. But while here in DC at the Hirshorn Museum all photography was allowed and I was allowed to bring in any camera I desired.

What is never allowed is touching the art objects. So, no matter what one thinks of any art or any modern art, if you visit museums regularly or if you produce art, you know not to touch the art work. Picking up and destroying a piece of art that is owned and produced by another is not art and is not protest. It is vandalism. What was done was the equivalent of taking a hammer and knocking the nose off of a Michelangelo statue. It is like slashing a Rembrandt or the Mona Lisa.

In fact Wikipedia has a whole entry on “Vandalism of Art“. The article states “Restorations were costly and time consuming and in many cases were followed by shielding the artwork from future attacks”. I don’t know about you, but I like to see my art up close and personal. I don’t like to see it behind a screen, glass or other barrier. Looking at Michelangelo’s La Pietà through a thick glass plate was not a moment of aesthetics. The glass plate was covered with dirt, grime and finger prints. The statue was hardly visible. It was a moment of consternation. Why did some person have to damage this work of art so that no one visiting the Vatican would ever be able to see it properly again. Michelangelo’s David was also damaged by a fruitcake with a hammer and the result was some broken toes.

Ai Weiwei had clearly stated in many places that the artwork he himself dropped and photographed and the ones he painted were Han vases. Some of us may have doubted that was true, but no one doubted that it was Ai Weiwei’s artwork. Whether it was a $25 model or a $1 million vase, the artwork was that of Ai Weiwei and not for some random person to destroy.

The lesson is be you crazy, misguided or whatever “don’t break other people’s stuff in museums”. It will ruin it for the rest of us. As I mentioned, I can’t see the Pieta up close and personal. In fact I found it hardly visible at all behind the thick and dirty glass. There was no longer an art experience there. I haven’t been to the Louvre, but I’m not sure I want to bother looking at the Mona Lisa behind a thick piece of glass from several feet away. The intricate detail can only be seen up close. Vandals have made this a necessity. Will all art one day be viewed only online or through protective glass?

It is laudable that Caminero’s friends are having an auction to help with his legal costs. But hopefully they will also learn the lesson that others art has value, as they value their own. Busting up, defacing, and damaging artwork in a museum is not a creative it is destructive of all artwork, past, present, and future. It is not helpful to those who want to view artwork, have a relationship with the art, artwork, and artist though experiencing the exhibits. From the article in the NY Times it seems they do know the lesson and while they support the friend, understand his motivation, they do not support his act. While I don’t think he needs to spend 5 years in jail, restitution and acts of penance are in order.

Ai Weiwei’s art of dissent is legitimate. Caminero’s act is ill advised, ill considered, and illegitimate.

You are welcome to make your own art, give it away, blow it up (where legal), or let others deface it for you. But leave the stuff in the museums alone. You are now welcome to done one old and badly fit pair of “No Excuses” Jeans. You may rip and patch them to your heart’s content.

Behind The Smashing Of A Vase

Artists Friends Auction for Defense Funds

Evolution, Tolerance, Humaness and Humaneness

As our brain expanded in evolution, we became more and more adaptable. Social structure became more complex, cultural and symbolic phenomena began and refined communication became possible.

Contemplation We developed many types of adaptability: physical, spiritual, cultural and emotional adaptability are among the hallmarks of human evolution. To say that we have evolved to run in one way, and that way must be that we should always land on our forefoot in shoes dictated by any authority is absurd. But the discussion that has taken place in the past few years demonstrates the impact of culture and society on thought and how memes are generated and circulate in traditional and new media.

To say that evolution has mandated that we are designed to wear no shoes or minimal shoes would have precluded our explorations of much of our own planet, let alone our exploration of the moon’s surface. And the movie Gravity just wouldn’t look right with Sandra Bullock wearing a white suit with no shoes while floating around in space.

Have our minds evolved faster than our bodies? Does peer pressure play a major role in our social development? Are we justified in wearing shoes in hostile environments or during particular sports activity? Or should we all take feet as a special evolutionary case in that they are meant to be set free from the encumbrance of all shoes?

Do some intelligent people cherry pick literature for one reason or another and are they knowingly intellectually dishonest? It is possible that some may not even be totally aware of what and why they are taking a particular approach on this topic. A recent study reported in Nature demonstrated that social ideas on climate change are influenced at the subconscious level by those around you. The media can have a tremendous impact. The trend in which the new needs to be continuously highlighted (and yes the new is often good, but not everything new is going to work well or last long – or we wouldn’t need to see so many new shoes every year. ) to the point where what has recently been new and highly touted is suddenly set upon and put down.

Should someone not agreeing with our particular choice engender hate, disrespect and a virtual piling on? That seems to perhaps be a hallmark of humanness but not humaneness. Historically and culturally we often seek the similar and the like and avoid or abhor the different. When cultures merge and converge though, some of the differences no longer matter. Often, those outside of the mainstream or lagging behind the trend line are disparaged. Sometimes quite strongly disparaged. It is clear in politics and global affairs that unfortunately this often guides our approach to life and society.

For the runners among us, I’ve emphasized that we are all runners. That is our commonality and what should bond us together. Politics, shoes, feet, none of that really matters and there is room for all kinds of runners among the running community. There are sprinters, milers, marathoners and ultra-marathoners. There are barefoot runners, minimalist shoe runners, runners in structured cushioned shoes, runners in neutral shoes, and runners who run comfortably in motion control shoes ( a few anyway, but not a good choice for most people). We all run or if we are injured or otherwise unable to run, we all think about running. My belief about shoes is that you should run in what is comfortable and works for you. A recent book on evolution and running insists, in spite of an absence of evidence that comfort is a bad indicator of success. However Benno Nigg and others have done research that indicated that comfort was a relatively good predictor of fewer injuries among military recruits. With all of the research that has been done we still have essentially no studies that tell us how to avoid running injuries. One budding guru said on a national television program “throw away your high tech running shoes and you will never have another running injury”. Unfortunately, that was patently false and misleading. There are a number of new studies showing injury trends with different shoes – the first study which comes to mind is one that concluded a recommendation to wear a motion control shoe just based on a low arch foot type does not work well and seems to lead to more injuries than the choice of another shoe type.

George Sheehan said that “we are all an experiment of one.” We do have to discover what works well for us as individuals and follow that path. There is much to read on the Internet that can be helpful, but the correct answer for one individual may be hard to find. Sometimes guidance and the advice of a professional is helpful when one of us becomes injured, or has repeated injuries.

One thing is certain: everything goes better with exercise. We all are built to move. In fact evolution has led us to be in dire need of movement and evolution.

So now that we have arrived at another end of year holiday season, it is a good time for both reflection and movement. Plan your approach to the next year of exercise. Work on tolerance – improve your tolerance to endurance exercise, strength training and speed workouts. Improve your tolerance to your fellow runners and human beings. Work on being humane in addition to being human.That you’ll find is the hardest type of tolerance to develop.

But that animal in us does need exercise even during the holidays. How else will you work off those large meals and party foods and drinks?

Obamacare: Fail?

Wizard-of-Oz
A predictable tsunami of a website disaster, inattention to details by the administration, repeated tossing of wrenches into the works by the republicans, a government shutdown, a defund movement, dozens of worthless votes against Obamacare rather than looking for how to fix it and gross overpricing are some of the problems that have led to the current  disaster in progress.

The Democrats wanted healthcare reform badly. And so it has been done. What would every thinking person want? Affordable insurance, optimal pricing, coverage for important items, reward for healthy lifestyle (good diet, no smoking, low substance abuse including alcohol, exercise), risk sharing over a large population group, no prior existing condition clauses, no drop clauses, and you don’t go bankrupt if you get sick.

That sounds great to most people not brainwashed by the media. It sounds good to republicans, independents and democrats. Many of these are principles historically espoused by people from both major parties.

One would expect that with a large risk pool insurance costs would go down. Most models predict that and it sounds like a reasonable assumption. But having healthy people in the risk pool is especially important according to most republican theorists and the democrats have gone along with that. So, there needs to be an incentive for young healthy and older healthy people to sign up. Right now there is a negative incentive: 1% of your salary as a penalty for not signing up. And the pricing itself is at the rip off level. Young people are told they are priced higher because they are covering old people who can’t be priced at more than 3 times their rate. Healthy older people have it high because they are underwriting pediatric dental care, fertility and obstetrics issues which they will not require.

And today, the insurance companies who like this plan which is a giveaway to them with overpriced insurance being subsidized in many cases by the federal government. While theoretically review boards were set up to keep rates affordable. They failed. In spite of high rates, some insurance carriers decided against participating in even populous states panels. This appears to be more an expression of politics than of finance. Which is the same as the group of red states declining to participate even with the financial incentives for them and for their needy constituents. How one wants “states rights” which used to be a code word for things that weren’t rights for many people, but still throw the responsibility back onto the Federal Government for implementation of a plan that allowed states to fine tune it and have their own individual carriers and plans makes no sense at all.

One of the main things I did not like about Hillarycare was the setting up of 50 different panels, groups, and the increased costs of having so many different insurance plans for so many states. We’ve got that now since the smaller states seemed to desire it. Now they have very few choices in those states and believe the prices are high because of that. Well, everyone who is not going to be subsidized finds the prices high: old people, young people, families, singles and groups. It is high. Do we have any potential remedies?

Single payer is not a possibility and not going to happen. So that is not on the table, and neither this nor any proposal discussed here is a step in that direction. What you have today is not a government takeover of insurance no matter what you’ve heard on cable news or liberal or conservative media. It just isn’t. It is still corporate today, but could use a bit of assistance of a different sort to get some downward pressure on the premiums.

First, get the oldsters out of the pool, so the young people can stop being told their plans are costly because there are so many freeloading old people on their plan. Before the debacle that is ongoing now began, I thought Medicare should be expanded to those 57 and up. But, the price gouging related to age begins at about age 50. So, I’d expand Medicare down to include, (“Medicare-Light” as a form of insurance) those down to age 50 (negotiable age of course). Those between 50 and 65 generally have far fewer health expenditures than those 65 to 80. Their premiums would be higher than Medicare is and would not be subsidized in any way by Medicare savings. Their pricing and cost assistance would be under Obamacare provisions. And voila, the older people are in their own risk pool, will pay money that will likely help underwrite Medicare for those over 65.

Everyone should get a cost incentive for regular exercise, no smoking, good health and normal BMI (with exception for athletes who have a high BMI from high muscle mass).

It is possible that this will not go far enough in price reduction. A plan that is somehow set up as a “self-funding” plan by those in it to keep costs low and administered by one or more insurance carriers could work. This would be a “public option” of a sort. Large corporations have done this, and many government plans have done this. With the exception of the state of Illinois which has done a terrible job, most other self funded plans have worked well. I am not an expert on self funded plans, and I do not know their status after January 1, 2014. But I’m sure there are experts who can decide if this or some other solution is viable to have an alternative for a lower priced option for those under 50. I am not necessarily a fan of the “Medicare for all” which for many would be what has been opposed as a government take-over of healthcare. Competition is important and the government as a monopoly holder of insurance plans would not be a good thing.

The current dumping of individuals from their individual insurance plans is the last gasp of cherry picking by the insurers. They could all have made the current plans updated and told the individuals how much the new compliant plans would have cost. But that would have been a reasonable approach. Dumping was quick, effective, and made everyone else look bad.

Yesterday, it was announced that Maryland would not implement the business portion of Obamacare. Somehow this has not made the National news. This has tremendous ramifications. It is an embarrassment for a state that said how wonderful their new plan rollout was going to be and how well prepared they would be. But their Wizard of Oz has been revealed as a fraud. There was nothing behind the curtain except a slow, mostly down, failing web site hiding overpriced plans. But this seems to me to indicate that it is not possible to get this off the ground on a national level right now.

Scrap it and start over is a political motto and a cop out. But I’d scrap the current web designs and vendors and start them all over. I’d fine tune the plan and amend it so that it is an affordable plan for more than just those receiving government assistance. Right now, the burden of pricing is on the federal government and those working Americans who do not need federal assistance. Rework those failing websites, start them over, and get to work on fine tuning and a major reworking of this plan to make it affordable for all.

References:

Maryland Delays Full Healthcare System Rollout (WSJ)

Lou Reed (1942-2013)

lou-reedNo medicine, no science. Just a bit of recognition for Lou Reed. Lou died earlier today from liver disease. He had a liver transplant earlier this year and unfortunately did not get a lot of use out of it. After his transplant he said on Facebook over the summer “”I am a triumph of modern medicine, physics and chemistry. His career was quite long and varied. He was a subject for “American Masters” just a few years ago. And earlier this year he received an award from GQ for “Inspiration of the Year” presented by Ronnie Wood.

Lou was a moving force in Velvet Underground along with John Cale. The Velvets were together from 1967 to 1970. Rolling Stone puts their debut album “The Velvet Underground & Nico” as much a landmark album as the Beatle’s Sergeant Pepper or Dylan’s Blonde on Blonde. Although they never said that within the first few years of the album coming out. In fact they also admit to ignoring the initial releases of Sweet Jane and Rock & Roll. Transformer, released in 1972, was produced by David Bowie and received a significant amount of attention. Cover bands were playing Heroin, Waiting for the Man, and what to me seemed to be a Reed influenced “Memo from Turner” in the movie Performance. And actually, Jagger, has admitted to being influenced by the sound of the Velvet’s “Heroin”.Journalists and fans looked back at the earlier work. “Walk On The Wild Side” became a pop hit.

He was one of the first true “punks” and as such inspired even the grandpa of Punk, Iggy Pop. His influence extended to a good number of bands including: Patty Smith, Iggy & The Stooges, R.E.M. Jesus and Mary Chain, Yeah, Yeah, Yeahs, and even the White Stripes.

Julian Casablancas of the Strokes credits Lou Reed and the Velvet Underground of being early influences on his song writing and the early Strokes sound. Julian mentioned his first meeting with Lou did not go exactly as he had dreamed it might. Lou had not heard of the Strokes. But Lou did give a great review this year to Yeezus and Kanye.

He had a history of calling out visitors to his shows including Clive Davis asking where his money was and also in the mid-70’s even Mick Jagger at a show in New York City, letting Mick know where Lou thought current rock and roll was at and who was doing it.

Lou had many irreverent and many thoughtful statements over the year:

On New York City as a place to write about: “Joyce had Dublin, Faulkner had the south, I’ve got New York.”

About composing his song Vicious: He said the idea for the song came from an offhand comment of Andy Warhol’s. Lou said he kept a notebook of quotes and comments for later use. Warhol told Lou, “Maybe you should do a song called ‘Vicious'”. What do you mean?, Lou replied. Andy responded “I don’t know, maybe ‘you’re so vicious, you hit me with a flower”.

Sweet Jane:

 

Perfect Day:

American Masters:

A Night With Lou Reed – At the Bottom Line, NYC 1983

Nobody like you (Letterman 11/17/89):

Dirty Blvd (1989 TV)

Heroin (Acoustic Lou Reed)

Vicious (Hard Rock Cafe, live, 1997)

Vicious (Live 1974, Bruxelles) Bowie inspired blonde hair

Text:

Lou Reed, Velvet Underground Leader and Rock Pioneer, Dead at 71 (Rolling Stone)

Outsider Whose Dark, Lyrical Vision Helped Shape Rock ‘n’ Roll (New York Times Obit)

20 Essential Tracks Selected by Rolling Stone

Illinois and The Future Of Healthcare

lincoln-logs-1An Open Letter to Governor Pat Quinn
Governor of Illinois

Dear Governor Quinn,

The state of Illinois is apparently in a precarious position. There are many ongoing discussions about when Illinois will become completely insolvent. Under current law, states can not declare bankruptcy. States do have many means to stay solvent. They can levy taxes, raise tax rates, create user fees, raise user fees, raise tuition on state schools, increase user fees on state highways and roads, create emergency fees on telephone services (911 fees), sell bonds, and even have a bake sale if they’d like. They can cut back on expenditures by a variety of means. The state can pay their employees less and have their employees take limited furloughs. The state can cut back on future benefits offered. A state may lease less space or lease space in less expensive parts of their state.

Selectively skipping payment on certain bills or types of bills by design and systematically avoiding select bills to one group of service providers should not be an option. In the case of the state of Illinois, a decision was made to not pay medical providers bills for 8 months after they have provided the service. In most states it is a legal offense with penalties for the slow payment of medical services. In many states the penalty is interest for payments that take longer than 30 days. This was set up for accidental slow payments. It was not set up for the deliberate avoidance of payment.

With a democratic legislature and a democratic governor it is surprising that Illinois is working so hard at undermining the healthcare system by not paying physicians for 8 months after they have provided services. The state of Illinois and its insurer maintain that claims are processed promptly but payments are delayed until money is allocated.

The conservatives blame the financial problems of Illinois on unions, pensions and benefits. Whatever it is, this is an untenable solution. You can not have payments and the agreements to pay for services arbitrarily abrogated. This creates many problems both for the patients having services (with their medical savings plans not paying for items in the year in which the services occurred and for the providers who don’t receive payment for months and months).

Since the Affordable Health Care Act (also dubbed Obamacare) is on the way and almost here, perhaps Illinois should just drop their bankrupt and unfunded ERISA healthcare benefit and allow workers to purchase individual plans from the state panels. Illinois can then decide how much they can subsidize the health plan, and allow Obamacare to demonstrate how well it works. It certainly can not work any worse then the current democratic designed, self-funded ERISA plan they are now using to undermine the health care delivery system. If the bills that are unpaid are those of the insurers, I can not see those bills going unpaid for 8 months. You will be booted out of your healthcare insurance.

Respectfully,

Stephen M. Pribut

References:

Insurance Payment Delays Causing Hardships for UIC Employees

Illinois Claims Handler Letter on Delay of Payments