Ryan, Debi, and Toren Cragun's Blog

I caught this story a couple of days ago about a wealthy chiropractor trying to change Florida legislation on childhood vaccines.  I was so annoyed by it that I wrote a letter to the editor of the St. Petersburg Times. They called yesterday to let me know they were going to publish it. Found it today:

Thank you for bringing this piece of disturbing legislation to my attention. I wrote my state senator, Arthenia L. Joyner, and my state representative, Michael Scionti, to encourage them to vote against this piece of legislation. I would not have known about it if not for you story. So, thank you.

But I’m also writing with a bit of criticism. In that story, Gary Kompothecras’ claims were basically left unchallenged. A recent study in the journal Pediatrics found no link between thimerosal and autism. By not mentioning this you are doing your readers a huge disservice. To date, there is no scientific evidence to suggest vaccines cause autism.

If people like Kompothecras get their way, the result won’t be a reduction in autism (autism rates are going up while thimerosal has been removed from childhood vaccines), but outbreaks of measles, as has already happened in the United States. Please do a good, scientific story on this topic. Educate the public, don’t spread fear.

Dr. Ryan T. Cragun, Tampa

On the agenda for tomorrow – posting footage of Toren.  Stay tuned!

I’ve had this post sitting around for a while as a draft and finally have a few minutes to develop it into a full post.  So, here goes…

Periodically you hear about how scientifically illiterate Americans are.  A recent Harris Poll found the following:

• Only 53% of adults know how long it takes for the Earth to revolve around the Sun.
• Only 59% of adults know that the earliest humans and dinosaurs did not live at the same time.
• Only 47% of adults can roughly approximate the percent of the Earth’s surface that is covered with water.
• Only 21% of adults answered all three questions correctly. (correct answers at the bottom)

So, we have scientific literacy problems in the US.  This was confirmed as I was flying into Hartford, CT over my winter break.  As we began our descent to land in Hartford, a kid across the aisle from me, probably 10 years old, began to whine about how his ears were not popping.  Now, the kid was whining the whole flight to begin with (and there may have been an organic problem with the kid, not just poor behavior; he was a bit dysmorphic), but what happened next shocked me.

The parents, rather than give the kid some gum or have him yawn or swallow something (all known to help ears pop) pushed the button for help from the flight attendants.  The flight attendant, a young woman, showed up and asked what the problem was.  The parents requested some cups to put over the kids ears.  I almost said, “Are you retarded?  How is that going to help?” but I held back and just watched.

The flight attendant returned with two styrofoam cups and proceeded to explain to the parents that she had put damp tissues in the cups to help his ears pop.  Apparently the damp tissues would help balance the pressure in his ears through some magical means of water evaporation in an enclosed space (a.k.a. “I’m totally making this shit up as I go.”).  The kid was whining quite loudly at this point, but put the cups over his ears.  He did quiet down a bit, probably due to the placebo effect (someone was doing something for him, so it must help in some way!).  His ears didn’t clear right away, but they did before we landed.  Even so, the kid kept complaining.  After we landed, they took the cups off and thanked the flight attendant on the way out.

I’m pretty sure what I watched was a very unfortunate incident of confirmation bias.  There were very high odds that the kid’s ears would pop if he did nothing, just because ears will do that.  But because the parents did “something” (despite that something being utterly retarded and useless), that “something” (styrofoam cups filled with damp tissues over the ears), they will now believe that this is a solution to pop ears.  I’m still shaking my head as I write this.

So, here’s the question: Should I have said something to the parents and the flight attendant?  Or was I right to let them continue in their bias confirming ignorance?

*correct answers:

• 365 days; ergo, the length of a year (technically 365.25 days)
• yeah, um, no humans when there were dinosaurs (unless you include extent bird species, which is a bit misleading)
• correct answer is 70%, but the researchers would accept anything between 65% and 75%

Not sure if anyone will be interested in this, but I occasionally talk about this issue in my classes and finally found a document to illustrate my point.

Our health care system in the US makes little to no sense, in large part due to health insurance companies.  From what I understand, health insurance companies negotiate prices with health insurance providers for pretty much every service they cover (when they cover services).  Thus, the health care provider (your doctor) charges some price for a service but the insurance company pays a different price.

So, an example:  Let’s say you go to a doctor for a visit.  The doctor charges you $100 for the visit.  The bill goes to your insurance provider, who has negotiated ahead of time to only pay $50 for a doctor’s visit.  So, your insurance company pays it’s percent of the negotiated amount – 80% or $40 -  and you pay your percent – 20% or $10.

Here’s the kicker: If you don’t have health insurance, you still get charged the full amount by your doctor – $100, no discount applied (some times they do, but often they don’t).  Now, this may not be a big deal if you’re only talking about a doctor’s visit for $100.  But what if it’s a $1000 charge, or $10,000?  Now it’s an issue of really screwing over the uninsured.

Additionally, insurance companies increasingly want all expenses to go through them – you don’t even pay co-pays anymore.  This makes it so individuals have no idea how much their health care actually costs.  I don’t remember the last time I went to a doctor’s office and the doctor actually told me the up front cost of a procedure or visit.  This way, the insurance companies are like a big black box – health care providers submit charges, the insurance companies pay whatever they pay, and they pass on a certain percent to the consumer.  This puts the insurance companies in almost complete control of health care in the US.  Consider what life would be like if all of your purchases worked this way:

You walk into Best Buy to buy a TV.  When you walk in, you have to sit down and fill out a form that asks about your purchasing history to make sure you will have no complications purchasing anything at Best Buy.  There are no prices on any TVs, but you talk to someone in the store who tells you that you “need” the 46 inch flat panel TV.  You agree and tell him you’ll take it.  You pull out your “merchandise insurance card” and hand it over.  He photocopies it, tells you to sign a piece of paper, then sets up a follow up visit to consider universal remotes.  They load the TV into your vehicle and you drive it home.  Several weeks later your “merchandise insurance company” sends you a bill.  Best Buy charged them $10,000 for the TV, but they have a discount negotiated with them of $8,000, so the TV is only $2,000.  You pay 20%, so you owe $400.  Of course, to use this “merchandise insurance company” you also pay them about $500 per month for a family plan and your employer pays an additional $1,000 per month.  So, your insurance company makes $1,500 per month and doesn’t pay full price for services.  If you don’t have “merchandise insurance,” you pay the full price at Best Buy.  Who would buy anything this way if you have no idea how much it will eventually cost you?

So, I was getting rid of 2007′s financial records when I came across a bunch of notices from our old health insurance company.  The one I scanned is great.  I won’t say what it is for, but the charge from the health care service provider was $965.  The discount for the insurance provider: $885.  That’s a 92% discount.  That leaves $80 to be paid.  Our co-pay at the time was $15.  Which means the health insurance company paid $65 out of $965 charged to it, or 7% of what it was charged.

How many times have you heard someone say, “Thank god we have insurance”?  Are we really lucky to have health insurance? Health insurance seems like a good idea when it is used to spread out the cost of major healthcare expenses.  But today it is generally used just to enrich people: catostrophic health care is passed on to the government because the health care companies either drop them or won’t take them for pre-existing conditions.  They also try to find as many things as possible to not cover.  That leaves health insurance companies providing insurance just for the healthy, who have lower costs.  Then they get discounts and pass some of the cost on to you.  You pay for the privilege to not know how much you have to pay.  It’s time for a new system…

A friend gave us a gift card to Carrabba’s Italian Grill a little while back.  We used it on November 10th (it took me almost a month to remember to get the picture off my phone).  We had never been to Carrabba’s, so we were excited to try it out.  But, we’re also cheap.  So, we tried to make sure we could cover our entire meal with the gift card (that’s how we roll!).  Also, we know servings at most restaurants are big enough for the two of us, so we usually split one, especially when we are on vacation.

With all this in mind, we decided on the following: I would order an entree we would both like – the Manicotti.  Debi would order a bowl of soup.  The entree came with a cup of soup or salad.  We’d split the entree; I’d get the cup of soup, and Debi would get the bowl of soup and we would be good to go.  The soup of the day was an awesome tomato soup.  We thought this would fill us up, so we went ahead and ordered it, oblivious to what we had just done…

A few minutes later out comes the waitress carrying these:

I actually said as she delivered these “bowls” to our table, “You have to be kidding.  That’s not a bowl, it’s a pot of soup!”  The waitress seemed surprised by our surprise.

I know the picture isn’t great quality (taken with my phone), but hopefully you get the point.  The small bowl fathest away from Debi was the “cup” of soup.  That “cup” is as big as the bowls we have at home.  It was easily a bowl of soup.  The enormous vat closest to Debi is what qualifies as a bowl at Carrabba’s.  I know it’s a little difficult to get a good reference to illustrate the size of this bowl, but think about it this way: Debi is 5’4″.  While her waist is quite narrow and she’s very thin, the “bowl” of soup was actually larger than her waist.  There was enough soup in the “bowl” to feed a family of 4.

They served both the “cup” and the “bowl” with a side of bread.  They also brought us half a loaf of bread with olive oil and pesto dipping sauce.

I ate my bowl and bread and was pretty full.  Debi ate about half her bowl and her bread and was stuffed.  I finished off her bowl and was ready to pop.  When the waitress brought out the entree we just laughed.  We told her to just put it into a to-go box. I skipped breakfast the next morning – too full from the night before.

Certainly you don’t have to eat what they bring you at Carrabba’s.  And, just so I’m clear, I thought the soup was great.  But I don’t really wonder why 34% of Americans are obese… If people don’t bat an eye at a vat of soup that is called a “bowl,” people have a serious issue understanding portion sizes.  We estimated that we were served somewhere between 14 and 16 servings of food (1 cup of soup is usually a serving).  We were easily served 8 servings of soup alone.  Add the half loaf of bread, the other bread, and the entree, and we were served enough calories for three people for one day (about 6,000).  I’m sure Carrabba’s is just catering to customer wants, but when will the over-sizing end?