mattp

If you suffer insomnia, you'll pay the doctor ten times as much for repeat visits and new treatments and stuff that doesn't work as opposed to if you actually got the right diagnosis and a simple cure on the first visit. Along the way, you might try a bunch of "alternative" therapies that on any objective scale show no signs of benefit, and much of this will be based on payment rather than outcome. How sensible is that?

Jay, While you have for a second time criticized me for not reading your article all the way to the end I believe you have not read my reply all the way through either - or at least not stopped to think about what I said rather than look for an angle to criticize it. In a nutshell, what I said was that you raise a point that I agree with, but I don't agree with your conclusion. I agree with the idea that our current system distorts any rational analysis of outcomes vs. cost, and that the proposed "reforms" being discussed in Congress do not directly address that. I believe a public option has potential to do so, but only if it is widely subscribed to and only if the government bureaucracy that you decry actually does its job (I'd give you 3 to one they'll do a better job than private insurance, though). And, lest I simply give you an opportunity to jab more and discuss less, I'll concede that I did slightly overstate my case on the "for-profit" thing. Obviously, it is legal in France for a doctor to make a profit on a hernia operation. It is systemic profiteering that is illegal. blog New America Foundation I'll give you 3 to 1 odds that a government agency won't be as motivated by profit as private insurance, too. Here's a little light reading on this topic though it is not, as you might request, based on peer reviewed studies. It also acknowledges that a government-paid system can support profiteering and, at the end, the author concludes that government funded health care is not "the" answer to expensive health care. I find this persuasive, and this is one reason why I find your original link, at the start of this discussion, interesting. I don't subscribe to the idea that you may think some on the left do that all we need is single payor. I think we need a different reimbursement scale as well. NewYorker "

I participate in medicaid hearings on a regular basis. Today I had a hearing concerning the costs, benefits, and risks associated with a particular course of action. I have also been making my own healthcare decisions for decades and am familiar with the decisions made by friends and families over the years. I have also had a lot of experience with private paid services and private paid insurance coverage. I don't know if you are an expert or not, but I must certainly have had a different set of experiences than you.

There’s definitely something to that article, Jay. To be sure, healthcare reform as presently proposed is merely going to put more people into the existing system and fix little of its ills. To the extent that you believe health care should be a for-profit enterprise at all (something that is illegal in many civilized nations), we should find a way to link profit with outcomes, not with procedures. The article suggests that day-to-day expenses would be linked in this fashion if they were not covered by insurance but I think the same problem – that of providers profiting from procedures and not from outcomes – exists with respect major medical services. Personally, I think the idea that the solution lies in having everybody make “market-based” decisions about their own care priorities and efficiencies is folly. I don’t think you, I or anybody else is really in any position to say to their doctor “no thanks. I don’t need that procedure.” Certainly not based on any rational analysis. And I don’t think competition, if it is based on simply being able to advertise wart removal or flu shots for less than the shop next door, is really the answer. It’s nice to see something other than the argument “government isn’t the answer,” though. But wait: that is really the thesis, isn’t it?

I've done a lot of extended trips in cold but not really cold weather (winter and spring in Cascades and Sierra) where body heat was all it took to dry things. If you sleep under a tarp or can leave the tent open so moisture can escape, you can dry completely sodden clothing by wearing it or taking it to bed (if taking things to bed, thought, you have to take relatively small items like socks or mittens, and put them on your belly). In colder weather, and if you are using a tent, (particularly a gortex tent), it is not so easy. You can have some success if you take a stove into the tent and dry out things with that external heat source, but you will really only dry the morning frost and little more.

$9,730.00 raised tonight. Thank you all.

It was chilly in Darrington yesterday but the shoes sure worked well! I think it made things a half-grade easier.

There are some good books listed here. Here are a few more: "Upon that Mountain," by Eric Shipton (1943) is a classic that has some real precious passages. There were many things I did not like about climbing, and there were brief periods of bitter disillusionment: being waken at 1 a.m. form a deep sleep of real physical fatigue, and having to turn out into a cold hard world of stale bread and boots and cracking lips – it was many years before I became resigned that grim business of the midnight start … Thomas Hornbein's "The West Ridge" (1965) is pretty good and the pictures are excellent. At four the oxygen ran out, a most effective alarm clock. Two well incubated butane stoves were fished from inside our sleeping bags and soon bouillon was brewing in the kitchen. Climbing into boots was a breathless challenge to balance in our close quarters. Then overboots, and crampons. ‘Crampons in the tent?’ ‘Sure,’ I replied. ‘It’s a hell of a lot colder out there.’ "Mount Analogue" (1952) by Rene Daumal, is another classic. You cannot stay on the summit forever; you have to come down again. So why bother in the first place? Just this: What is above knows what is below, but what is below does not know what is above. One climbs, one sees. One descends, one sees no longer, but one has seen. There is an art of conducting oneself in the lower regions by the memory of what one saw higher up. When one can no longer see, one can at least still know Slightly more modern (still dated but very much irreverent) "Downward Bound" (1975) by Warren Harding is definitely worth a read. 'Good Evening! What can we do for you.' 'We've come to rescue you.!' 'Really? Come now, get hold of yourselves - have some wine In the book Ascent, published by Sierra Club in 1980 and edited by Steck and Roper, is a good story written by Mark Twain: The conquest of Riffelberg. …we roped ourselves together and went at that rock. For some time we tried the hook-rope and other means of scaling it, but without success – that is, without perfect success. The hook caught once and Harris started up it hand over hand, but he hold broke and if there had not happened to be a chaplain sitting underneath at the time, Harris would certainly have been crippled. As it was, it was the Chaplain. …

That's great, John. I've looked at that line every time I've driven highway 2 eastbound for literally decades. Thanks for posting this. Nice colors this year, huh? Is that related to the fact that we had a dry summer, or a sudden cold snap in the Fall, or what?

I'm not really a mushroom guy, but I think aminita muscaria is most known for psychedelic properties and has widely been publicized as deadly poisonous, but if braised or steamed I think it is supposed to be relatively safe to eat. I've never tried it and I don't think I will, though. Better to stick with something that doesn't have so much potential to hurt you! Nice pictures, by the way. They cause me to think about past trips to the Olympics as well.

I don't know about the video, but whenever I use a Meunter (or is it "Munter") I find that I get absolutely no rope twist if I am using it to lower or belay from a fixed anchor at or above my stance. The key is that it only works this way when the load and control ends of the rope are both hanging down. If I rappel on a Meunter, I get a twisted rope. It is actually an excellent knot for lowering somebody. I used it in a rescue situation once, very much to the astonishment of one of the accident victims who expected some use of their gris gris. As to the original inquiry? I have minimal problems with my ATC guide. Given my experience with the Meunter, though, I suspect that a minimal re-orientation of the brake hand, or maybe the addition or subraction of an extra leg twist (changing the way the rope feeds into the brake), or maybe the addition of an extra 'biner or different attachment point for the brake biner (changing the way the rope feeds out of the brake) or something similar to that may be the cause of "sometimes I get the twisty's and sometimes not."

Looks like some kind of granite or similar rock to me. Hmmm.

A lot has changed in a week. Check out the colors: High on Jacob's Ladder, four routes left of Westward Ho. Chilly! Clear Creek valley from the base of the Dome.

Tvash had a point, or a couple of points. Good ones. But is his view of the book or movie the only "right" one? No. Part of what makes the story so compelling is that it has so many layers to it. Armchair analysis from beginning or experienced climbers alike, literary criticism, and just plain "wow" are all perfectly appropriate topics for discussion.

The Kone is pictured on a topo on my website: website Topo: Great Arch Area Topo

I agree with the Heather Ridge and Mount Rainier Park recommendations. I believe the feature that most of us call "Heather Ridge" is in fact "Skyline Ridge" if you check the topo maps, but it is accross the street from Stevens Pass ski area and it is a good place for an intro overnight tour. Another Highway 2 destination is the Lichtenwasser Lake on Lichtenburg Mtn., approached from the Smith Brook trailhead with a tour that is largely flat road, a bit through the woods, and a couple hundred feet where you'll probably take the skis off and doggie crawl. The result is that you will reach a remote-feeling lake that is not likely to see other visitors and is actually close to the road. A very do-able summit climb lies above, though it can be hazardous in avalanche conditions. At Snoqualmie Pass you can head up from Gold Creek snopark to get to Kendall Lakes and you'll get a mountain lake that is pretty close to logging-road skiing. You might also park closer to the pass and head up into Commonwealth Basin, from where there are some pretty good peak climbs. Source Lake is not a bad choice but it is a popular area so this may be a deterrent depending on your taste. At Paradise, or really just about as accessible from the Narada Falls parking lot below, is the road to Reflection Lakes. From Paradise, ski out the back end and follow the road that drops downhill; from Narada do the doggie crawl up through woods left of an avalanche slope to reach a road that heads right. Either appraoch will lead to Reflections Lakes, and you can camp "roadside" ( 2 miles from the car in winter) or head up toward Pinnacle and Castle peaks on the right or onto the ridge to the left. In good weather this will offer great views but will also have other visitors. At Chrystal Mountain, you can head up behind what I think is called Chair 4 (Quicksilver?) into a backcountry basin that is pretty damn scenic and close to "development" as well as probably avalanche controlled. White Pass also offers some possibilities. I think to the North is "Cramer Lake" or "Dumbell Lake" that are off the highway, remote enough to feel isolated, and really only a few miles from the road but requiring a climb of one steep but fairly modest hill. From there you could tour as far as you want on a high plateau with some small hilltops, all safe from an avalanche perspective. At Mt. Baker you can head out toward or beyond Table Mountain but I don't know the area well enough to suggest any particular destination and I think most of what you will encounter there is avalanche prone during high hazard conditions.

I agree with the post above noting that "fast and light" has become stylish and speed climbing is not always necessary or even a good idea but on most mountain rock routes over grade III you are going to have to do some simulclimbing or simply "moving together" or you will end up overnighting it.

For Mt. Washington in January, I would guess it will not be warm. You will want to be able to layer your clothing so that you can "strip down" if you are hiking and it is not windy, but wet weather is probably not likely to be an issue. Assuming you don't go when some kind of warm weather event is predicted, I would take a light weight base layer that includes some kind of wool or synthetic long underwear, a wind shell for both top and bottom, and full on down for the top half. Maybe some kind of sweater garment would be good as well and if it were me it would be a thin wool sweater with a low or v-cut neck. You might also want some kind of pile pants or similar garment for your legs, but I bet you'd get away without. I'd also bring a scarf, and a serious balaclava type hat and ski goggles. Serious mittens, too, should not be overlooked. You want some light weight gloves, some real insulating mittens (I like wool), and some shells. You don't need expensive gear: army surplus or discount long underwear and a jogging suit, combined with the cheapest down coat you can find are sufficient. But it better be thick. A down "sweater" will probably not cut it. Good luck. Mt. Washington can be tough!

Pilchuck, I'm not sure what you have been trying to do. To link a photo you have to use the URL with the actual .jpg file name. Here is one of your recent photo's: I clicked the "photopost" icon, the one with a little picture of a picture, and "pasted" the URL.

Yes, nearly all Darrington routes require a 2nd rope for rappels. You can rap from at least one or two Three O'Clock Rock routes without two ropes, Dreamer was for years treated as a walk-off-the-back-side outing and, from the looks of it, I think folks are rapping the West Slabs route on Blueberry Hill with a single rope (but it means rapping from single bolts on Westward Ho). You need a 2nd rope but do they have to be "doubles?" No.

Good luck with Regence. My wife and I have had coverage with Regence for a few years and as soon as we developed significant health issues that threatened to be ongoing we found out our coverage was not at all what we thought we had purchased and what do you know: our premiums went up substantially as well. The co-pays and limits to what services they covered became very significant when we started useing the coverage and on medications our coverage was particularly poor even though my wife had shopped very carefully and thought we had good coverage. On one very expensive medication that my doctor inquired in advance to learn it would be covererd they covered 10% of a year's expense. On another, slightly better but still low. With a recent antibiotic they covered 25% of the cost of inexpensive medicines and then they denied coverage because they said my doctor was recommending a "non-preferred medicine" when my doctor said that, based on lab tests, I should switch to something else that just happened to be about 10 x more expensive. I got it anyway and it did the trick, though. Regence is probably better than some companies and worse than others but, in general, individual insurance plans may take care of broken legs and stuff just fine. Be sure not to become chronically ill.

Fairweather, I believe it was YOUR argument that first suggested a Constitutional amendment would be necessary or appropriate if Congress wanted to enact health care. Tvash, as I read his argument, simply stated that all other so-called advanced nations DO consider having access to health care to be a fundamental right. I'm not entirely sure, but I think Thomas Jefferson might have agreed had he been alive today: Healthcare was not an issue of the day when they wrote the Constitution, but they did include the 9th amendment in the bill of rights: Joseph Healy is right: we're talking about taking care of people here and we will be more competitive if we have affordable healthcare for all our citizens. Arguments that those who seek decent healthcare in this country are trying to turn us into a communist nation or that Congress must amend the Constitution if they want to enact healthcare legislation are absurd.

Tvash: I'm an attorney and he's right. The U.S. Constitution allows the government to build Interstate highways, clean up toxic waste dumps, and regulate safety in the workplace but they have no business getting involved in health care. The Supreme Court resolved this question in the 1896 case of what's-wrong-with-these-people vs. say-what. Get a clue.

I'm not sure what you are recommending there, Tvash. I agree that insurance companies lie. My wife spent a lot of time comparing insurance offerings and selected a plan that was not cheap but which offered strong coverage of prescription drugs and then, when we later turned out to actually HAVE prescription drug needs, denied coverage. But I would not suggest anybody lie on an insurance application. You would only be giving them a free pass to deny coverage.

I think there is an old church camp site (or something like that) across the Creek and upstream of the Bridge Creek bridge that may be available as a group site but I don't know much about it. Perhaps because it is not a campground it is subject to different rules. As I understand it, this is the turn-off immediately across the bridge that is normally gated on the right - not the dirt baggers campsite up the hill a little way and left.