Jonathan Golob
Stranger Staff
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Feb 20, 2015 Jonathan Golob commented on Seattle's Three Biggest Earthquake Hazards, Reviewed.
@2:
The current consensus seems to be an Subduction earthquake caused the mudslide.

@4:
For the region, the subduction zone quake is worse. For the city of Seattle, the blind thrust fault is felt to be the bigger risk, for a few reasons:
- While the subduction zone quake would be stronger (about 100x stronger), it will also be much farther away (energy drops off very quickly with distance).

- The Kobe and Northridge earthquakes (both blind thrust) revealed that the way the energy is concentrated in these sorts of quakes tends to be more destructive to city buildings. Construction practices that are modestly protective against the shaking from a deep or subduction zone quake seem to be less effective against the shaking and liquefaction caused by the blind thrust quakes. Seattle (by mathematical modeling) seems particularly vulnerable to amplification of the forces caused by blind thrust faults.

- There will be almost no warning from the blind thrust quake (as it would happen essentially in the city.
The early warning systems work via two basic techniques, neither of which would apply well to the Seattle Fault.
i) Detect the leading p-wave, which travels faster than the more destructive s-waves.
ii) Have a network of automated seismographs, to detect the earthquake far away, and transmit a warning via radio (much faster than the earthquake waves travel through the ground).
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Oct 3, 2014 Jonathan Golob commented on Ebola Thrives on Poverty and Disparity.
@8 Emergency medicine as a culture?



The stated mission of the ER is to stabilize and triage patients. Most ERs are better at the former than the latter. A few thousand words could be written on that subject alone.
Jul 28, 2013 Jonathan Golob commented on A Needle in a Needlestack.
@delirian

Agreed, overall. Hence why I quoted David Simon and not, say, Michelle Bachman. David was overheated and condescending in the post I quoted.

Even there, he acknowledges the fatal flaws in his argument--the weakness of the oversight by the secretive FISA court.
May 8, 2013 Jonathan Golob commented on The American Health Care Market.
@2: It's, sadly, more complicated than that. (While reading this, I suggest humming the Canadian National Anthem to keep calm.)

For a given diagnosis (classified into a DRG), Medicare has a base payment rate they will pay a hospital. This payment is modified based on physical location, patient factors (housing, other medical problems), if doctors-in-training are helping in the care, and other factors. The amount is supposed to, on average, have the hospital break even or make a slight profit.

After all this, the payment is what the payment is. The hospital can bill whatever it wants; the amount Medicare will pay is already set by CMS.

Physicians are paid by a completely separate system, based on CPT coding and fee-for-service.

Hence, a hospitalization in the US involves at least TWO bills and TWO separate billing systems: one for the hospital (capitated and based on DRGs), and one for the physicians (based on CPT codes and fee-for-service).
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