Messages

1

General Chat / Re: What Games are you playing 2015?

« on: January 04, 2016, 05:03:51 AM »

So I played Nier when it first came out a couple of years ago and enjoyed it's off-the-wall plot (and the music, oh yes, the awesome music).  Gameplay was a bit meh, but entertaining enough with the boss fights (mobs were boring...jump with two-handed sword, drop attack, dodge-roll and animation cancel into another jump).

Now that I finally got unpacked and my TV and old PS2 back, I decided to give Drakengard 1 & 2 a spin, since Nier was an off-shoot continuum game.

Drakengard 1 was a thoroughly terrible game as far as gameplay goes, but the bizarre plot was interstingly enough to convince me to knock out all five endings.  All the characters were awful people, but they also all had wierd and interesting flaws that mad them interesting (except maybe Verdelet, who would go from a mad prophet crying "DOOOOM" to a fanatical, genocidal racist "Caim, make sure you kill all the subhuman scum!").  Plus Drakengard had Chapters 12 and 13 (for endings D and E).  Those two Chapters may be the greatest "what the hell is going on here!?" scenarios in video game history.  Didn't really find the Ending E boss as bad as has been hyped...took me about 4 tries (not the 30+ that some have warned of).  I died way more times to the Ending B boss, although that's because I sped through Aerial missions and never really bothered learning how to actually use the Dragon until that boss...If I had to rate...probably 5/10, all points because of the insane characters and completely original and entertaining mind-fuck plot.

Drakengard 2 I didn't even bother finishing.  This is what happens when your creative genius (Taro Yoko) leaves and the publisher (Square Enix) decides to heavily get in the executive meddling department.  There is nothing redeeming about this game at all.  Terrible gameplay (supposedly it's better than Drakengard's...all I noticed was a slightly smoother camera and you could mix up the Triangles with the Squares in the combos, instead of just a bunch of Squared followed by a Triangle finisher); terrible characters (Drakengard 1 had terrible characters, but they were entertainingly quirky); terrible plot (driven by the terrible hero, Nowe, who is possibly the most mentally challenged protagonist in any medium of fiction, ever)...I suppose the music "terrible" but it is completely forgettable.  I may finish this some day.  Given what I've played so far, easily a 0/10 game (solidly the worst PS2 game I've played, right now I'm thinking only some hot NES trash may compete with it.  This is Hydlide level bad).  No redeeming qualities.  Period.

Now to finally get around to Xenosaga 3 (yes, yes, I'm behind the times).  I'm sure Super broke out cackling upon reading this.

2

General Chat / Re: Good morning 2015: Creative topic title goes here.

« on: October 24, 2015, 08:41:48 PM »

My household goods finally arrived the other day after being in storage for a year (3 years for one shipment).  Surprisingly, there was little damage.  The movers, however, apparently did not know how a cam works, so they just ripped my desk apart rather than loosen the cams...so new desk is needed sometime in the future (I have enough screws and brackets to make the desk work for the time being).  Also, they somehow managed to keep track of about 2/3s the nuts and washers needed for my dining room table, but decided to toss the rest.  Yay for a trip to Lowe's sometime this weekend.

...and now I'll be spending the next few weeks putting crap away...probably will end up tossing/donating a huge chunk of my random stuff I haven't seen, or needed, for years now.

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General Chat / Re: What Games are you playing 2015?

« on: October 24, 2015, 08:35:18 PM »

Hey, ID, this is neither here nor there, but do you play League of Legends under your usual call sign? I only ask because my roommate was paired up with an Infinity Dragon the other day and then you magically reappeared shortly thereafter.

I haven't played LoL in a while now, and that was never my tag.

4

General Chat / Re: What Games are you playing 2015?

« on: October 21, 2015, 04:54:17 AM »

All three of the points feel relatively useful? Admin are the best of the three but yeah, you can always develop your provinces. I also like how you got to Japan, you didn't waste time on taking/coring nonneeded provinces.

You playing Common Sense EU4?

All three have their uses...Admin just have the most general utility, since they are needed for everything important (keeping Stability at 0 or better; keeping inflation below 5; expansion via conquest; etc...).  That said, having a lack of Military hurts you more than a lack of Admin (even a 0.25 Tactics difference can make a huge difference, likewise with a Morale advantage).  So I'll definitely national focus Military if my ruler rolls a garbage Military score.  Falling behind in Military Tech is a bad, bad, thing.  Diplo points are just, meh (I guess you can develop your Silk/Spice/Ivory/Gold producing provinces).  Ever since they nerfed Diplo-Annexing, I just seem to run a stockpile of them except every 15 years when I tech up.

And, yeah, I'm running all DLC on 1.13.1. 

I'll probably revert back down to 1.9 if/when I go for Three Mountains.  With changes to coring range, all good openings are now gone.  No more No-CB on Champa to full Annex--they are now too far away to claim any provinces in the Peace deal (I suppose you could vassalize, then hope like hell they fabricate claims, then war on their behalf for 10 years).  I think the only targets in direct coring range are Japan (haha, no, not with one stupid port to build up the needed Galley navy to win) and Ming (uh, yeah).

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General Chat / Re: What Games are you playing 2015?

« on: October 20, 2015, 04:22:31 AM »

Europa Universalis IV - Meissner Porcelain Achievement Run

Completed the main achievement in 1720.  Last guy to have the Chinaware I needed was some random Korean island you can barely see.  Silly Korea, trying to hide that from me...enjoy your full annexation.

State of the world as it stands at the end of the achievement:  https://imgur.com/VlAwz5i (revel in those spiderweb borders!)

Now, I had noticed earlier that I had forgotten to click the final HRE reform button during my Austria game (because going full Greyskin sucks compared to having 50+ vassals) and that save is no longer compatible.  Sooo, as soon as I grabbed that last piece of Chinaware for Meissner Porcelain, I also clicked the button and went full Greyskin for the "A Kaiser Not Just in Name" achievement.  Yay, two for the price of one.  Even more cool: I'm standing at exactly 50% of the EUIV achievements unlocked.

My total firepower went down significantly (not that it matters at this point, I still have a standing army equal to my force limit of 640K...well enough to DoW the world and win...oh, and now I make 120 ducats a month), but oh well.  Looking at what I can do in another 110 years or so, I think I'll keep playing a bit before shelving this particular save file.  A quick glance at stuff I can still unlock pretty easy with this save:

Master of India - Own and have cores on all of India as a European Nation.
At Every Continent - Own one province on each continent (why do I not have this yet!?)
The Rising Sun - Own and have cores on all of Japan as a European Nation.
City of Cities - Own a core province with at least 60 development (I have the points to burn, and some of my Chinese provinces are already in the mid-40s for development)
Subsidize my Love - Subsidize at least 3 allies with at least 50% of their income (Got the money to burn).
A Decent Reserve - Have a maximum manpower reserve of at least 1 million (currently at about 600K...easy enough to get by taking Quantity Ideas).

We'll see how many of those I manage to plow through!

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General Chat / Re: What Games are you playing 2015?

« on: October 18, 2015, 05:11:03 PM »

*Stare* You went more than a little warmongery in that case, holy hell. That is an obscene amount of gold as well, you can buy a navy  (Or anything) with that much money. I'm guessing you're playing more wide than tall (IE not spending points on upgrading your provinces) as well.

My income is off the charts, thanks to revoking the privilege.  50+ some odd vassals pay me a total of about 70 ducats a month.  I don't need mercenaries, since my vassals provide all the extra warm bodies I need, so most of that money sits around doing nothing.  I could buy buildings, but eh,

And while it's mostly been building wide, I've dumped my share of monarch points into development.  Basically, if I'm still ahead of time on tech, and my monarch point pool is approaching the cap (around 950 is when I start paying attention), I'll spend on development to buy my pool back down to 850 or so.  This happens mostly with Military and Diplomatic points.  Military points are useless beyond buying Tech upgrades (and the occasional general)...with all my ideas and traditions, I roll a God-Tier general on first try, so 50-100 points every few years is nothing.  Diplo points are just weak in the current version of the game.  Buying down war exhaustion is not needed, ever, when I have Defender of the Faith (and am the suzerain overlord of every Protestant nation, so I don't get DoF Call to Arms).

Given how smooth this run went, it may be time to shoot for Raja of the Rajput Reich achievement next...

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General Chat / Re: What Games are you playing 2015?

« on: October 18, 2015, 06:00:52 AM »

Pft, Hitler has nothing on Ehrenfried Walther von Tschirnhaus and his desire to conquer the porcelain market.  He only wishes his domain extended this far (and in 1674 no less!).



Then again, he didn't have the advantage of a fully unified Holy Roman Empire at his beck and call, either, given how Napoleon smashed--then disbanded--a less unified coalition instead. 

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General Chat / Re: What Games are you playing 2015?

« on: October 18, 2015, 03:10:16 AM »

Don't really do much game playing these days other than fiddle around with grand strategy games.  That said, those games still manage to be a fantastic time sink!

Europa Universalis IV - Meissner Porcelain Achievement Run - It's the very early 1700s, playing as Saxony, and I'm currently smashing the Ming and "Japan" (for some reason the AI-controlled Daimyo of Ouchi conquered all of Japan, yet declined to take the Japanese throne).  The goal of the campaign is to control every province that produces Chinaware, which is found only in China, Southeast Asia, Indonesia, and Japan...as Saxony (which starts smack dab in the middle of Germany).

A quick summary of events to this point:

Loaded the game up as Saxony (kind of required for the achievement) in the 1444 start date and immediately started internal Holy Roman Empire politics!  Allied France (because it's the unstoppable baguette of doom), Poland, and 2 of the Electors.  Spent the first few years eating territory from the bigger HRE princes, without full annexing anyone, while waiting for the first election.  Austrian Emperor dies and Saxony becomes Emperor.  Yay.  Spend the next several DECADES squashing internal HRE wars and force-releasing any HRE prince that was vassalized, expanding into Bohemia and Austria (to get access to the non-HRE countries of Hungary and Poland), and just generally passing Imperial Reforms and increasing my own territory (again without annexing anyone).  Somewhere in this time period I picked up Offensive ideas (can't go wrong with early god-tier Generals and stupidly good Policies that Offensive unlocks).

Start eating into Hungary by the late 1400s, just before the horrible Reformation hits.  The Reformation fired around 1510, and I made the stupid mistake of switching to Protestantism right away.  This caused me to lose the Imperial throne (to lowly one-province minor Anhalt, of all things).  To get my revenge, I take Religious ideas, and immediately start Holy Wars with just about everyone.  This lets me eat more land for cheap plus force convert all those heretical Catholics.  In the meantime, I continue annexing land to the East, eating most of Hungary and the Balkans until I'm bordering the Ottoman Empire.

Around 1560 or so, the Religious Leagues unlock.  I immediately join the Protestant League, wait for my allies (i.e. France) to join on my side, and declare war on poor little Anhalt.  The 30 Years War lasts more like 5, and I force convert every HRE prince that dared join the Catholic League.  With Protestantism entrenched, I am again crowned Emperor.  I continue the HRE politics and eventually pass Revoke the Privilege.  This is why keeping as many princes around as possible pays off: by passing this reform, I now have 54 vassal princes, each with an army of about 10,000.  With my Zerg swarm, it is time to eat the Kebab.

I Holy War the Ottomans and watch as my horde completely obliterates and full occupies the Ottoman Empire within a span of 2-3 years.  Too bad peace deals cap at 100% warscore.  I eat territory  all the way to the Timurids (somehow they haven't imploded) and spend the rest of my warscore releasing minor nations to keep Kebab busy.  From here, its a succession of fast, easy Holy Wars to crunch through the Timurids (releasing Afghanistan along the way), Yarkand, and Mongolia to make a beeline to the Orient.  I reach the western edges of the Ming in the mid-late 1600s (about 1670).

Ming is huge, but stupidly fragile.  I've taken multiple Military Ideas by this point (Offensive, Defensive, and Quality); I have Western Technology versus their Chinese Technology, so they are consistently about 4-5 Military Tech levels behind (which usually leads to about a 0.5 Tactics advantage, or roughly 50% military effectiveness advantage; and I have a vassal swarm of 500,000 troops or so (Ming can field an army of about 70,000).  Despite that, Ming has enough provinces to equal around 500% warscore, so it'll take several wars (with a 15 year truce between each war) to fully devour them.

The first war goes easy enough, as expected, and I take provinces that lead to Chinaware, and end up bisecting Ming.  I then notice during the truce period that Ming starts to collapse to rebels, releasing the nations of Shu and Wu.  They also lose some of their southern territory to Spain (two of which contain Chinaware, so Spain is going to be a future enemy).  I Holy War Shu and Wu and take what Chinaware provinces I can from them. 

My truce with Ming expires and I eat all their provinces bordering Spain (preventing Spain from expanding further) and reach a border with Dai Viet.  My truces with Shu and Wu also then expire, so I Holy War them again and take more of their land.  At this point, I have all the Chinaware provinces in China proper, minus the ones Spain holds.  This leaves about three

Next steps:  Holy War on Dai Viet to start the conquest of southeast Asia (which will also get me closer to Malacca/Indonesia).  I will also Holy War Japan, but that will require a navy (of which I do not have, having started as a landlocked German prince and not having much access to the water until just recently).  Given that it's still the early 1700s,  I should easily knock out the achievement requirements before the game ends in about 120 years.

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General Chat / Re: What music are you listening to 2015?

« on: October 10, 2015, 06:58:04 AM »

If Eternity Should Fail - Iron Maiden

Creepiest Intro/Outro ever?  Also, The Book of Souls is probably the best Maiden album since Somewhere Out in Time.  It's still in the prog metal vein as the post Brave New World albums, but also brings back some of their raw 80s edge.  Makes for good balance overall.

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General Chat / Re: Good morning 2015: Creative topic title goes here.

« on: October 10, 2015, 06:29:47 AM »

NotMiki:  Good work getting through law school and the bar exams.  Unfortunately bad bosses are everywhere...they just happen to be worse when in an already higher-stress occupation (I am firmly convinced that my boss for the last 6 months of my tour to Afghanistan suffered from disassociative identity disorder and had damage to his temporal lobe, leaving only the ability to swear and speak in tongues).  What type of tax work do you get to work on?  Purely personal income tax, or do you get to dabble in partnership and corporate tax areas as well?  I loved tax law...probably because it was almost entirely rules driven and not patchwork random judicial opinions.

Seconding the "independence is nice" for Snow.  Just make sure you learn some life skills (like....laundry!) first!  I say that half jokingly: after seeing countless people away from home for the first time living in a clueless manner, you can no longer assume people just know basic skills like laundering their clothes, or taking trash out of the home into a trash bin.  Yeah.  You don't want to be that guy.

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General Chat / Re: Good morning 2015: Creative topic title goes here.

« on: October 08, 2015, 07:59:25 PM »

Greetings everyone!

So I popped in once about 2 years ago, said hey, and promptly disappeared.  Such was life, courtesy of the U.S. Air Force...let's see if I can do better this time!

A quick recap of the last...oh...seven or so years (I think I popped smoke around the summer of '08?  Time flies.):

Graduated law school in May '08 and took the bar that July.  In that time period, I was conditionally accepted in the U.S. Air Force JAG Corps (pending bar results and a medical exam).  After taking the bar is about when I disappeared and moved back to Illinois to wait out the inprocessing.  Bar results came out in Oct '08 (I passed, yay) and the Air Force was able to schedule my physical exam in...Feburary '09.  Took the physical, then went back to the waiting game.  Started doing construction work in March '09 to keep from going insane, and in June finally recieved word that my Officer Training date would be in August. 

Attended Commissioned Officer Training in August...in central Alabama (it was...sad...really, mostly a "here's how you wear your uniform and salute and not look like a clown" for lawyers and docs).  First assignment was to Wright-Patterson Air Force Base, near Dayton, Ohio.  Got to Ohio in September, then went back to Alabama for lawyer-specific training until December.  I spent the next two years living near Dayton, Ohio.  Most of the legal work I did involved addressing government ethics, client services and legal assistance (e.g. wills and powers of attorney for military members along with legal advice regarding areas like divorce or consumer affairs), and military personnel law (stuff like discharges for bad behavior).  Also got to try a few criminal cases (a coke user, a pot brownie eater, and some white-collar fraud).  During this time I also pretty much stopped with the video games and picked up board games instead; let's face it, board games look more awesome on a shelf! 

Around June of '11, my supervisor gave me the "good" news that she had two really great opportunies, and I could choose one.  I could either spend a year in Afghanistan doing government contract work, or I could spend a year in Afghanistan doing general legal practice work (and if I choose neither, I was still hot to deploy and would go to Afghanistan anyways and without any input into the office I'd end up in).  I chose the government contract option (turned out to be the perfect choice, I'd later find out!).  I spent the next 6 months training up, capped by a two week expeditionary course at Fort Dix-MacGuire, New Jersey...in early January

I started my deployment to United States Force-Afghanistan in late January '12.  Since mine was a year-long billet (most were 6 months), my duties evolved from contracts and fiscal law to...just about everything, since I had the continuity.  All said, I got to spend time in Doha, Qatar; Mazar-e Sharif, Afghanistan; and Kabul, Afghanistan (twice!).  Oh, and a two week paid vacation to Australia courtesy of the Army (awesome!) for spending a year in the suck.  In about December '12, I found out I wouldn't be returning to Ohio; rather, I was being assigned to Ramstein Air Base, Germany as a "reward" for deploying.

Finished up my time in the Middle East, returned to the states for two weeks to outprocess, then flew to Germany in Feb '13.  Ramstein is anything but a reward.  Living in Europe was fantastic, but the workload is crushing (take 18 year olds away from home for the first time, who are legally allowed to drink copious amounts of cheap wine and beer, and you have a recipe for disaster).  Legal work there started with doing discharges, and later working as the General Law division chief when our GS-14 senior civilian attorney quit.  At least I had the chance to visit parts of Germany, France, Austria, Hungary, Poland, and the U.K.!

Ended up deciding to separate from the Air Force in the later summer of '14.  I had been holding out for a chance at being selected to go back to school for an LLM in International Law, but they decided to instead give that school slot to someone who never deployed, had never been overseas, and had never worked with another government agency (let alone a foreign agency).  That was all the incentive I had to get out.  Finished out my service in October.  For one last hurrah, I stayed in Europe and went to Athens, Greece in November and ran the 'original' Athens Marathon (from Marathon to Athens).

From December '14 until about May '15 was spent doing the job search (grad school courtesy the G.I. Bill was also on the table, if the job search had failed).  Initially, I had good prospects for a GS-14 attorney position with the Federal Transit Authority in Chicago, IL, but that didn't pan out when they indicated they wanted the attorney to also have environmental litigation experience (would have been nice to have known that before they called me in for the second-round interview!).  In May, I went to our family vacation home in Door County, WI to work as the night manager for a local hotel.  Finally, in June the U.S. Army called about a position at White Sands Missile Range, NM I had applied to in February and interviewed for in May.  The position I applied to was for client services, but they also had an unexpected opening for a contracts attorney position they needed to fill and I had the requisite contracts experience for it (yay for that time doing contracts in Afghanistan!).  I accepted that job offer and was given a start date of 13 July 2015. 

So, in July I moved to Las Cruces (back to my old stomping grounds of NM!) and started a GS-13 (roughly equivalent to a senior associate attorney or junior partner position at a law firm) contracts attorney position.  Did some house hunting and just closed on a nice home that was intended to be a vacation home, but was never actually used.  Perfect.  So here I am today. 

That should about catch me up on 7 years of absenteeism!

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General Chat / Re: G'morning, 2013! - Post-Kopocalypse Sunshine Frolics

« on: April 23, 2013, 11:01:29 PM »

Hello all...it's been a while!

I just recently got back from the Arabian Peninsula and Afghanistan...fun times...

I'm now in Germany, where I'll be for at least the next two years. Must say...it's good to have some spare time again!

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General Chat / Re: Idiot of the Day

« on: January 13, 2010, 11:36:09 PM »

Discussion on Paleolithic/Caveman diets

As far as what is eaten in the general paleo diet, you can't do much better.  You eat lean meats, vegetables, fruit, and dairy if you aren't lactose intolerant; nothing more. All you're doing is replacing grains and processed food with the above types of food.  This gives you all the benefits of grains without all the negative effects they can have on you.

Now stuff like the fasting is just silly.  There's a point where you take the lifestyle too far.  Just because cavemen had to go 24 hours at a time without food doesn't mean its healthy.  What you need to do is take the good points of what they did (eat very basic, very healthy food) and mix it with the good points of modern diets (easily available food at the grocery store).

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General Chat / Re: Sunshine, lollipops and rainbows: G'morning, 2009!

« on: October 04, 2009, 05:45:41 AM »

Found a 1200 square-foot townhouse with an attached garage for $800/month rent and no deposit; water, trash, recycling, and sewage are included.

Now I just need to wait until Dec. to move in...at least I get paid extra for going TDY, even if its for required training!

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General Chat / Re: Sunshine, lollipops and rainbows: G'morning, 2009!

« on: September 30, 2009, 07:24:20 PM »

Finished Commissioned Officer Training School down in lovely Alabama and graduated in the top 10%.

Now its back to Alabama to attend Judge Advocate Staff Officer Course on Oct 10.

It'll be nice not living out of a suitcase come late December.

16

RPGDL Discussion / Re: Season 54 nom pools

« on: August 23, 2009, 03:21:15 AM »

Rashidi (OB), Cidolfas Orlandu (FFT), Claude Kenni (SO2), Ramirez (SoA), Avalon (LoL2), Ryu3 (BoF3)
Marsillo (SO2), Kaus Debonair (OB), Richard (S5), Cristo (DQ4), Nina5 (BoF5), Erim (Lufias)
Grobyc (CC), Nergal (FE7), Yukiko Amagi (P4), Anna Lemouri (MK), LC Chan (S2), Bruiser Khang (ToD)
Garcia (FE8), Beecham (S3), Nara (DQ4), Yushis (OB), Cid (FF4), Melville (S3)

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General Chat / Re: Sunshine, lollipops and rainbows: G'morning, 2009!

« on: August 19, 2009, 09:59:26 PM »

and fine, fine, you guys got me:

...but I see no beautiful and accented calves! I see midriff and upper thighs; even a panty shot that would put MOMO to shame, but where are the beautiful calves!?

18

Discussion / Re: Politics 09: Fire Reid and Steele.

« on: August 19, 2009, 09:56:18 PM »

For a little levity regarding the health care, here's Barney Frank's town hall meeting.

As much as I hate most of Frank's policies, I have to admit I like his style of insult. Much more clever than Pelosi's and Reid's unimaginative, bland, and overused "zomg u r teh un-american" crap.

Maybe if he focused on and stuck to advocating one thing (say...gay rights, where he can put in personal perspective?) instead of trying to defend his miserable economic stances, he'd be more worthy of respect!

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Discussion / Re: A law question.

« on: August 19, 2009, 05:44:14 AM »

So my question is, what can we do? He's obviously just completely robbing us of our money and not doing anything to help us like he said he would.

First step. If they haven't done so, have your parents fire the attorney. Clients have a right to fire their attorneys at any time for any reason. Hire a new lawyer to work on your dad's jail/bond issues.

Second step. Report him to the State Supreme Court by having your parents file a complaint to the Attorney Regulation Consul, or the equivalent department, of the state the attorney is practicing in. Since he failed to perform a fairly routine procedure and deliver what was promised, you have a valid complaint against him, which can lead to the disciplinary action by the supreme court.

Assuming this has all happened in Oklahoma:

http://www.okbar.org/members/gencounsel/grievance.htm

Go there, have them fill out the form linked near the top of the page. The complaint and investigation will likely be a fairly long process, so you'll have to bear with it.

Third step. If you want to try to recover the money the first attorney took, you'll have to hire another lawyer (probably a different lawyer than the one you'll have hired to represent your dad in the criminal proceeding). I don't know enough about Oklahoma state law to say whether you have a good claim or not (people can get away with crazy shit if they know what they're doing, sadly), but an Oklahoma attorney should be able to give you a good indication after a preliminary consultation whether or not you should proceed with filing a suit.

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General Chat / Re: Sunshine, lollipops and rainbows: G'morning, 2009!

« on: August 19, 2009, 05:17:39 AM »

I didn't whore it up, but I wore skinny pants that accented my beautiful calves well enough to get plenty of looks from guys.

pics nao

Or it didn't happen.

21

Discussion / Re: Politics 09: Fire Reid and Steele.

« on: August 18, 2009, 08:38:39 AM »

While it wouldn't shock me if this were true, this doesn't seem like the aim of a country, and certainly what wasn't I was getting at.

It's just a matter of definitions. People who claim that the US has the best quality of health care, and base their definition of quality health care on the quality of services rendered, are correct. Likewise, people who criticize the current system and define quality of health care as the benefit society as a whole derives from the health care system are also correct.

If you assign personal preference to one definition over another, that's fine, but it doesn't make the opposing definition incorrect, it simply means you value the net benefit of the preferred definition more.

I'm assuming that homicides have a fairly negligible effect on life expectancy as a whole given their rarity and, also, relatively small variance in rate among developped nations (much higher in developping nations though... wow. Didn't realise how large the spike was there). Accidental deaths I am again going to assume is negligible across borders.

Those aren't the only two forms of "premature death," for lack of a better term. If you take every form of premature death and aggregate the total, its going to have a non-negligible impact on life expectancy. Do keep in mind that accidental deaths would include traffic accident (~40,000 deaths per year certainly isn't a small chunk) and construction/mining/manufacturing accident fatalities.

Lifestyle, though, is to some extent a reflection of health care. You mention the US' high obesity rate. It's worth noting that this rate is highest in low socioeconomic brackets... aka the same people who are less likely to regularly visit a doctor (because they can't afford to).

True, but at some point personal responsibility kicks in. If someone has been given the opportunity to learn and develop healthy habits and declines the opportunity, I would not consider the resulting premature death as being indicative of poor health care quality but of poor personal choices made by the individual.

Also, the relationship between obesity and socioeconomic status is for the most part spurious. The more accurate relationship is between obesity and education level (which in turn gives us the correlation between obesity and socioeconomic status, since most poor people are also less educated). People who are highly educated but work in low income public jobs still tend to be in far better shape than average. If somebody drops out of high school and misses out on learning the skills needed to make wise personal choices, then I consider this a fault of personal responsibility more than anything else (except, perhaps, poor parenting) and not something that health care should be concerned with.

Part of education is developing common sense and critical thinking skills, which are important in making critical decisions about personal health habits. Another problem in low education areas is poor parenting, which leads to the development of poor health and eating habits in children.

Giving people education and access to resources that help them overcome unhealthy lifestyles is something doctors definitely do, and something that has been definitely shown to help.

The problem is that educational programs have met only mixed success. Giving people access to health information, such as calorie counts on menus, does have a positive effect. Programs that actually try to motivate the personal to change their lifestyle once bad habits have been formed aren't nearly as cost effective.

If I were to reform health care from the education side, I'd first try to make as much information public as possible. This would be cost-effective and beneficial. Second, I'd want to develop good health habits in people at a young age, which unfortunately, means taking the matter out of the hands of irresponsible parents as much as possible. This means making health education and physical fitness a much more prominent facet of secondary school, along with actual reinforcement by providing school meals that are actually healthy. All fairly cheap and cost effective measures.

22

Discussion / Re: Political compass: ID used to score like a -7 on the left/right scale.

« on: August 17, 2009, 09:11:51 PM »

Actually, I think my old score was around -3 for left/right and -7 for up/down...not that it matters since that's back when I was an idiot freshman undergrad.

Anyways:

Economic Left/Right: +7.25
Libertarian/Authoritarian: +0.40

About the same as always.

23

Discussion / Re: Politics 09: Fire Reid and Steele.

« on: August 16, 2009, 08:32:35 PM »

My main concern with this debate as concerns misinformation is the contention that the US health care system is one of the best in the world.

There are basically two arguments here, both of which have merit.

First. The United States does have the best health care quality. This should be undisputed. Our treatments have the highest success rates in the world, and people who are treated for heart attacks, cancer, etc...in the United States live longer than those treated elsewhere.

Second. On the flipside, the United States does not have the best coverage, meaning not everyone can take advantage of the premium health services that can be found in the US.

So in other words, if you have health coverage, you receive the best care in the world, if you don't have health coverage you're SOL.

yet in return for this gets a system that by almost all measuring sticks (life expectancy, infant mortality rate, citizen satisfaction, coverage of medical insurance, etc.) is poor by the standards of the developped world.

Another problem is that many of those measuring sticks are tangentially related to health care at best. Take life expectancy. More than just health care factors into life expectancy, including number of accidental deaths per year, number of homicides per year, the lifestyle choices of the average citizen (e.g., morbid obesity rate in the US), among others. Additionally, to call the standards "poor", is a bit of a misnomer. The difference between the privatized insurance system of the US (ranked 30th at 78.07 years) and the NHS of Great Britain (Ranked 26th at 78.7) is barely more than half a year.

Out of curiosity, ID, since you reject so strongly the contention that preventive measures would save money, what measures would you propose to reduce US health care costs? It's clear that such measures should be possible.

I'll preface this by stating that my ideas would step on everyone's toes and be politically impossible to implement, absent a miracle.

I'd start by removing the tax code provisions that create the employer provided health care incentive. While it may have seemed like a good idea at the time, our current situation shows it wasn't. Right now, prices are high in part because there is very little need for competition. Consumers have been detached from the services they are buying, while their employers are making the choices for them. To quote the economist Milton Friedman, "people are least careful about their money when they are using someone else's money on someone else." That is, employers aren't going to be all that frugal about selecting the plans for their employees. Oh, and just to nip this in the bud, just because you are getting health care from your employer doesn't mean that its not your money the employer is spending, because you received a reduced salary in return for that health care coverage (and the employer is happy with this because he gets a bigger tax deduction for paying health care instead of paying standard salary).

This employer based insurance also has the disadvantage of creating over-regulation, which also drives up costs. For plans to qualify, they must have certain coverages and cover certain people, even if some employees would rather not have certain types of coverage (all this additional coverage adds to costs, even if the employees don't want the added benefits).

Basically, I'd return health insurance to a true free-market state, like every other insurance type, and prices are guaranteed to go down. Of course, insurance companies wouldn't like this because they'd have to cut prices to remain competitive (and this is why Republicans will stick with do-nothing plans).

Second, as Super mentioned earlier, you need to discourage overuse of hospital emergency rooms. Allowing access to low cost health clinics for low income families could help. Similarly, raising health awareness might help, though as I said earlier, people are notoriously difficult to change so you'll quickly run into diminishing returns if you try to put to much money into such programs.

There are also miscellaneous steps that could be taken, such as reigning in the costs to the hospitals and doctors have to pay (such as malpractice insurance).

If we disagree with your math, don't whine that we didn't understand it; we probably did.  If we throw alternative calculations back at you, don't accuse us of deliberate obfuscation; it's just math.

Except it adds nothing to the discussion at hand, so why bother bringing it up in the first place? Again, the purpose of the math was to ILLUSTRATE how the general principle works. Attacking the math itself is ass backwards and sloppy.

There really isn't much evidence presented at all in that report.

So...you have more to offer? The specific research studies are fully cited in the assessment. Thus, you have the information to look the raw data up yourself if you so desire. The purpose of the assessment is to summarize the findings of research, not to rehash all of the research projects in their entirety.

The author Nathan Deal is a Republican Congressman.

Dot. Dot. Dot.

The letter is addressed to Nathan Deal, the author is Douglas Elmendorf.

All that being said, look at his conclusion: "However, government funding for some specific types of preventive care might lower total spending. In its estimates, CBO seeks to capture the likely future effects on the budget on a case-by-case basis."  Funny, that was exactly my conclusion and suggested policy as well.

One, there's a keyword there: "might." Might does not mean definitively. Especially when the specifics of such a program are, at this point, totally non-existent.

Two, the CBO makes no policy recommendation at all; it states the effects of a policy. A case-by-case preventive care policy MIGHT save money, but we don't know with certainty because no such policy was put before the CBO for analysis.

Three, you missed this part:

"In sum, expanded governmental support for preventive medical care would probably improve people’s health but would not generally reduce total spending
on health care."

and how it relates to my original assertion that politicians who claim that preventive care is a magic bullet are lying.

1. We can still make estimates, the same way a first-year physics student can still get some OK pendulum calculations.
2. The principle of "check if it costs less, done", is still the basic strategy for determining if a preventative measure will save money.

So...you still don't have any plan of implementation other than extremely broad generalizations. How are you going to implement the "check if it costs less, done" paradigm? What methods of valuation are you going to apply? Again, to say its as simple as "done" is naive.

24

Discussion / Re: Politics 09: Fire Reid and Steele.

« on: August 16, 2009, 10:09:42 AM »

Umm...no, no I didn't.

Seriously, I know to multiply by "occurs in 2% of the population".  Please don't insult my intelligence.

What I was questioning was not your point, but your numbers.  Let's stick with the "occurs in 2% of the population" number.  If cure costs 10x preventative as you suggest diabetes does, then yes, cure is 5x cheaper for the government; stick with cure for these maladies.  If cure costs 100x preventative, then cure is 2x more expensive for the government.  If cure costs 1000x preventative, then cure is 20x more expensive for the government.

Okay, so instead of missing the point you either willfully ignored or carelessly missed that the numbers I put up were for illustrative purposes to explain the general principle. Bravo. If you're questioning the general principle, then you could have simply asked "according to what research/what's your proof?" rather than trying to create your own, just as equally inapplicable, data set which just obfuscates everything.

Speaking of proof; you have yet to comment on the CBO assessment I linked to that supports my position and undermines yours. If you want to play with real numbers, here's your chance. CBO cites research that only 20% of preventive procedures save money, and that preventive costs in the field of cardiovascular disease are 10 times higher than their total savings. Would you like to cite some research that says otherwise?

So...grab the cases where preventative is 100x-1000x cheaper than cure.  Done.  Seems likely such cases exist since some operations hit seven figures, and the highest cost for preventative I've seen is 3 figures (and I have an endocrinologist who is hyper about preventative, so I've seen quite a lot of preventative figures).

Uh huh...and just how are you going to implement this? Do remember that you need to factor in patient lifestyle choices, cost of preventive care over life expectancy at the individual level, regional variations in pricing, regional variations in preventive care success rates, and patient choice in choosing doctors and preventive medical procedures...at the very least. To simply say "done" is more than just a bit naive and arrogant.

25

Discussion / Re: Politics 09: Fire Reid and Steele.

« on: August 15, 2009, 11:36:00 PM »

If you do what the dutch do, and have a nurse give people regular checkups (sending them to the doctor if she finds something out of place) you save a lot of money on personnel costs--a 15 minute checkup by a nurse should run about $10 in actual costs given nursing salaries.

There's far more to preventive care than just regular check ups. You need medications if you have uncontrolled high blood pressure or high cholesterol (to prevent that costly heart attack or stroke), that adds to costs. To screen for threatening illnesses (I'm looking at you, cancer), you need to administer tests to everyone, this also adds to costs.

Even super simple common procedures like hip replacement ($35,000) and broken arm ($12,000) cost a decent amount.

Except those have absolutely nothing to do with preventive care creating a net savings in health care expenditures. Preventive care will do absolutely nothing to reduce the likelihood of a broken arm or hip. Thus, you still have costs associated with broken bones. Thus, you are now paying for preventive care (costs money) *and* the medical procedure (costs money). There is no cost savings here at all. Not everything is preventable.

But by contrast, given the numbers I googled/looked at hospital bills for above, a 1000:1 ratio for some cure:prevention ratios seems likely, which very easily saves money.

And herein lies the problem; you've missed the point I've made two times now. Yes, at the INDIVIDUAL LEVEL there is a savings...but not everyone will need quadruple bypass surgery or long term cancer treatment. At the POPULATION LEVEL there is a cost increase because you're paying for everyone to get preventive care to screen out and treat diseases that only a fraction of the population will ever have to worry about.

Don't believe me? Why not read the CBO's assessment instead: http://www.cbo.gov/ftpdocs/104xx/doc10492/08-07-Prevention.pdf