Weekly Roundup, Friday 15 March 2019

Stones (in both foreground and background) and sheep (everywhere) – we’ll see these in Kilmartin Glen, on our Scotland’s Highland Highlights Tour this September.

Good morning

Wow, what a wild and crazy week this one has been, with the added dimension, for me personally but I trust not for you, of (hopefully just) experiencing another kidney stone event.  These seem to be occurring with increasing frequency.

The extraordinarily dysfunctional nature of Obamacare was driven home to me.  When it became apparent that I needed some sort of medical assistance, I had three choices.  I could go to see my normal doctor ($50 copay), I could go to an “Urgent Care” service ($60 copay), or I could go to an Emergency Room ($250 copay and everything costs two to ten times as much while you’re there).  The “doctor” I use (actually a company with many doctors over multiple locations) had all three options in the same building in Redmond, so I called to make an appointment with a regular doctor, only to find that it would be many days before I could see anyone.  However, I could make an Urgent Care appointment for later that day, and so I did, being pleased that, unlike last time, I now knew enough to avoid the ER costs.

The doctor at the Urgent Care said that the urinalysis had some surprising results, and he’d like to send me to the “machine” (I forget exactly what – CT Scanner or something) on the next floor, but he was unable to arrange that, even though he worked for the same company that also owned and operated the machine.  He didn’t completely understand why, but thought it was something to do with insurance.  He said if I wanted that, I’d have to go down a floor and check in to the ER instead. With something like a $6850 deductible this year, and knowing from my last time in an ER how less than half a day’s stay with no surgery or anything much at all could rapidly exceed $5000, I declined his invitation.  He went to leave, his very brief consult now being at an end, but I asked him to stay long enough to write me a prescription for the same meds I was given last time by the ER.  He kindly agreed to do so.

I truly don’t understand how a company that provides three levels of patient service provision, and owns equipment that costs the same to operate, no matter where the patient comes from, and which makes no money when not being used as much as possible, sets up things that way.  Are they not in the business of providing the most and best healthcare and getting efficient use out of their assets?  Or is it indeed a requirement of standard Obamacare insurance that means some types of pathways through the healthcare maze include more or fewer features than others?

I am hoping all is back to normal now, and even more I hope will remain that way for another few more years.  But between starting to type this a couple of hours ago and now, things are going a bit haywire again, and I’m going to cut the newsletter short.

Of more general importance has been the second 737 MAX crash, just 4 1/4 months after the other one, and seeming to be very similar in nature.  I write about the issue from the point of view of “how safe is safe enough” in the attached article.  We know that there have been two plane crashes, and a number of “near misses”, but we also know there are about 350 of the planes out there, flying every day.  When does a plane transition from being an acceptably safe plane to an unacceptably dangerous one?

I also have some further thoughts on the matter in the item below.

Lost in all the clamor over the 737 MAX was a preliminary report from the NTSB into the crash of the Atlas Air 767 a couple of weeks ago.  More “cryptic clues” and some strange editing of the report’s language – discussed below as well.

The good news in all of this?  Something like 300,000 or more flights operated perfectly this last week, and most other weeks too.  Planes are still safe to fly.

What else for the week?  Please keep reading for :

  • Travel Insider Touring Update
  • 737 MAX Crash and Confusion
  • Atlas Air Crash Update
  • Travel Insurance
  • Another Crazy SSSS Selectee
  • Tesla Model Y Reveal
  • Bargain Priced Noise Cancelling Headphones
  • And Lastly This Week….

Travel Insider Touring Update

We’ve had another six people express interest in our Scotland tour this week, and another couple affirm their participation in the Loire Valley landcruise.  So good news on both fronts.

If you’ve nothing yet planned for mid/late September this year, why not consider joining either or both tours.  Our Scotland’s Highland Highlights Tour is a great way to see some of the unexplored and less explored parts of Scotland, and our Loire Valley Landcruise is a lovely way to enjoy a relaxing week in the French countryside.

The Loire Valley tour follows on from the Scotland tour, so if you wish, you could be like me and do both.

737 MAX Crash and Confusion

When the Ethiopian Airlines 737 MAX plane crashed on Sunday, it didn’t take long for the world to respond.  It is often easy to dismiss plane crashes in Africa as not relating to us in the west, but when the plane is nearly new, and the crash is similar to another crash of the same type of new plane, it starts to sound alarm bells.

What really made this incident surprising was a rush by the Chinese to ground all 737 MAX planes, pending an understanding of what caused the crash(es) and a resolution thereof.  I’m not aware of the Chinese being in the vanguard of such moves in the past, and some people wondered if this was done with an eye to strengthening interest in their 737 competitor, the Comac C919.  Others wondered if this was provoked by the Huawei and other trade disputes, while some people said there’s no way that the Chinese government would inconvenience its own citizens (because Chinese airlines already own something like 96 of the 737 MAX planes) and so any grounding decision would only be for bona fide reasons.

I’ll simply observe that the decision was made with almost indecent haste, early on Monday after the Sunday crash.  On the other hand, China said that its decision followed months of unhappiness at the lack of response to the Lion Air crash and a loss of confidence that it could rely on the FAA to fairly evaluate issues to do with Boeing.

China’s move was the catalyst for other national air safety authorities to follow suit, and slowly, one by one, more and more countries grounded their 737 MAXes.  When the UK and then European authorities did the same, it seemed almost impossible for Canada and the US to continue to hold out, and then after Canada grounded the 737 MAX, eventually the FAA did too.

I’m still not sure if this was necessary or not, but I do know that the reluctance on the part of the FAA, and the steady issuing of expressions of confidence in the plane and its safety, sure didn’t look good and made it even harder to then do a 180° shift and to contradict their comments of just the previous day and two and three, and also issue a grounding.

How long will the planes be grounded for?  We’re not certain.  We’d guess somewhere between two weeks and two months (assuming both crashes are due to the same causes).  The FAA expects that Boeing’s software fix to the known problem will be deployed by the end of this month.  Southwest, American and United are the three US airlines with 737 MAX planes in their fleet and their schedules will be a bit messed up by this for a while.  Air Canada has 23 of the planes, too.

The two black boxes retrieved from the crashed plane have been sent to France, not the US, for analysis.  This is slightly surprising and seems like a rather public expression of unhappiness by Ethiopia with the US response to the crash.  It is thought data might start to be read and analyzed from Friday this week.

Atlas Air Crash Update

I’d mentioned last week the strangely worded comment from the NTSB that 18 seconds prior to the end of the voice recording there were “crew communications consistent with a loss of control of the aircraft”.  What does that mean?  And, also, why is this described so cryptically?

You also have to wonder, if you’re on a plane that is in the process of seriously misbehaving, wouldn’t one of the three people in the cockpit have the presence of mind to recite any relevant things for the benefit of the voice recorder and subsequent crash analysis.  Especially in this case, because as well as the two pilots there was a third pilot passenger who was merely enjoying his pilot privileges and traveling in the jump seat for free.

But all the NTSB would tell us was this enigmatic phrase.

They’ve now released an “investigative update“.  Initially it said something to the effect of engines being increased to maximum power and then the control column being pushed forward, with the plane going into a dive.  But shortly after commentators, including myself, started to wonder what that meant, they changed the wording – not to make it clearer, but to make it less clear!  It now says

Shortly after [entering some turbulence], when the airplane’s indicated airspeed was steady about 230 knots, the engines increased to maximum thrust, and the airplane pitch increased to about 4° nose up. The airplane then pitched nose down over the next 18 seconds to about 49° in response to nose-down elevator deflection. The stall warning (stick shaker) did not activate.

To explain, it is not obvious what caused the engines to increase in power to their maximum.  A slight increase could be explained by many reasons, but going to maximum power, for a plane that was generally descending and approaching its destination airport, is surprising and unexpected.

The slight pitch up in plane angle is due to the engine power increase.  The comment about no stall warning (and the steady airspeed prior) is meant to confirm the obvious – this was not a maladroit attempt to stop a stall.

The NTSB are no longer saying what caused the elevators to command the plane to go nose down so steeply to a 49° angle, having deleted the earlier reference to the control column originating the action.

During the course of the plane’s descent, its angle of descent moderated to about 20°, but that’s still massively more than you’d ever see a plane doing normally.  The NTSB doesn’t explain the reason for this at all.  There is also no mention of the engines being throttled back from full power.

So, was this a pilot suicide?  A massive mess up of the control systems?  When will the NTSB tell us more of what it already undoubtedly knows?  When can we listen to the voice recording, ourselves?

Travel Insurance

Two things this week reminded me of the benefit of, and for many, the need for, travel insurance. My own passing (quite literally!) kidney stone ailment, and the 737 MAX grounding and the wide-ranging disruptions that passengers otherwise scheduled to take 737 MAX flights are now suffering.

You never know when something might not happen to you or to some other element of your travels and cause inconvenient problems.  Sure, travel insurance is costly, and I suspect somewhat overpriced, but its cost also reflects the frequency of the payouts it makes.

Whether you choose to purchase travel insurance or not, you owe it to yourself to at least review your options and make an informed decision each time you travel somewhere.  I’ve a three-part series on the topic of whether or not you should buy travel insurance; included are links to “shopping services” that will instantly create quotes from many different insurers so you can see exactly what it would cost and cover.

There’s one more thing to be sure to understand about travel insurance.  Of course, the insurance companies don’t want you waiting until you know you have a need to file a claim before you buy the insurance.  So the best policies with the most inclusions require you to buy your insurance within a week or so of making your first deposit payments on the trip you’re insuring.

Another Crazy SSSS Selectee

I heard from a friend who was given the dreaded SSSS designation on his boarding pass for his flight from London to Chicago a week ago.

I’d expressed amazement at how I had earned that similar distinction a few months back on a flight from Vancouver to Seattle, something I felt undeserved because it was the last of a series of six flights, others of which I’d been allowed my usual PRE checking privilege, and also because I had a NEXUS pass for expedited low/no hassle travel between Canada and the US.

My friend, who was traveling with his wife, and both are former United Global Services members (the ultra level creme de la creme of United’s elite frequent/commercial travelers) and with Global Entry and PRE privileges, was surprised to be given this, particularly because his wife was not also selected.  You’d think in such a case, a real terrorist would pass the things he was trying to smuggle onto the plane to his partner.

Note to TSA – if you’re selecting someone as a SSSS selectee, select all the other people traveling with them too.

He proudly went up to security at Heathrow and said “Hi, I’m your designated terrorist today and need to be screened”. This earned a laugh, and a quick whisk through security little slower than normal.

We both marveled however at the logic behind his selection.  Here’s a retired gentleman, very frequent flier, solid and stable by every possible measure, being designated as a possible terrorist.  Sure, the Brits didn’t take that as seriously with him as the Canadians did with me, but the fact remains that this was a bad choice and in choosing him, resources were misallocated to micro-check him, instead of people who truly could qualify for some uncertainty and ambiguity about their probity.

Why, TSA, do you choose people who couldn’t be less likely to be terrorists for extra security screening?  Can’t you find anyone more likely to be suspicious?

Tesla Model Y Reveal

Thursday evening saw Tesla officially reveal their new Model Y vehicle.  Just like the Model 3 is a smaller less expensive version of the Model S, so too is the Model Y a smaller less expensive version of the Model X.

The presentation was very low key, and started 20 minutes late.  Musk spoke on a casual and largely unscripted basis, and spent 30 minutes of boasting about the company’s history and progress to date (although in very vague terms), and then spent less than ten minutes talking about the new Model Y, during the course of which he was again very light on specifics.

The Model Y will be available in four models, with 230 – 300 miles of range, and prices from $39,000 to $60,000 (plus options of course).  The expensive three models will appear in Fall 2020, the entry level model in Spring 2021.

One thing I’d not realized.  Musk pronounces the name of his company and its cars as Tez-la rather than Tess-la.

Bargain Priced Noise Cancelling Headphones

I’d mentioned this to our Supporters last week, and now this week it seems Amazon has decided to “go wide” with its sale on the Bose QC25 noise cancelling headphones.  So I too should share this more broadly.

These are, to my mind, the very best there are, and happily free of all the Bluetooth complications.  Best of all, they are on sale for a limited time at only $159 instead of their regular $279 list, which makes them less than half the $349 price of the Bose QC35 II or the Sony WH-1000X M3 headphones that I reviewed last week.

And Lastly This Week….

Scary news.  Some states are looking to add sales tax to travel purchases.  This would be very harmful to travel agencies in such states, because what resident would pay a sales tax in their home state when they could avoid it by booking through an agency or direct with a supplier in another state?

It also brings up an issue of double taxation – you would pay a tax in your home state for, eg, a hotel stay, and then you would pay a second tax, on the same hotel stay, in the state (or country) the hotel is located in.  The only piece of good news in this is that probably air fares would be exempted.

Just when you thought the Heathrow expansion was finally resolved, here’s news of more challenges.  When will this ever end?

Talking about the Brits, their last Prime Minister forgot his 8-year-old daughter, leaving her alone in a pub one night.  So we understand – barely – how it is possible to forget one’s child, as was the case with this woman who remembered leaving her baby in the boarding area – but only once the plane was airborne.

And now truly lastly this week, we know the Italians are very stylish and fashion conscious.  But fining tourists for wearing inappropriate footwear in the Cinque Terra area?

Until next week, please enjoy safe travels

 

David.

 

 

8 thoughts on “Weekly Roundup, Friday 15 March 2019”

  1. Your post hit home for me because i had a kidney stone last April in the US. between the “regular doctor” and “surgery scheduler” i had quite the runaround – this was after a night in the emergency room, x-rays, etc.

    The machine to break the stone was only going to be available in August, and i preferred not to wait for another emergency. I happened to be going to Singapore in May so had a friend arrange to show my reports to a urologist there. I landed on a Thursday, met the urologist on Friday, had the procedure on Saturday, and was out of hospital on Sunday. zero fanfare, lower cost, and at one of the top hospitals there (mount Elizabeth).

    Highly recommend going to another country rather than being at the mercy of the american medical system, especially since travel insurance is quite inexpensive.

    1. Thanks for sharing your own experience. I think for most of us though, waiting even a day to have a stone removed/broken down is more than we could manage!

      That’s one of the problems with healthcare, anywhere. You aren’t exactly in a good position to walk away if you don’t like what is happening, and it is hard to negotiate when you can barely concentrate through the veil of pain to say your name correctly. As an extreme example of this, not only could I not focus or comprehend any of the pages of legal fine print I had to sign, but I found myself, yesterday, unable to correctly say my daughter’s date of birth for next of kin reasons. Of course I knew it, I just couldn’t work out how to express the date in English (and no, this wasn’t after any brain-scrambling pain-killers).

  2. Just to highlight your point on SSSS, I was travelling back from Florida to the NE (place of origin and destination deliberately left out) and I was stopped when going through the TSAPreCk for ‘random checks’.

    I was asked to hand over any electronic items. I took my phone out of my bag and handed it over and it was swabbed. By this time my wife had picked up my laptop from the belt and I reached to put it over my shoulder. ‘Is that your laptop, sir?’. Quick as a flash my wife said ‘no, it’s mine’ and it was left at that.

    But it highlights your point.

  3. Blaming the ACA for your dysfunctional medical visit is totally misplaced. Yours was just another in the long line of examples of just how broken the system is—at all levels. The ACA was an incomplete and thwarted effort to bring some sense to a senseless system that is, as you noted, expensive, confusing and a mystery to those who live in lands where getting sick does not result in bankruptcy. So use this experience to get on board with demanding a health care system that works.

    1. Hi – in this case, the doctor did say that the inability to send me to the whatever machine, owned/operated by the same company, in the same building, was due to some arcane insurance rule that he didn’t understand himself.

      Obamacare was passed with no-one having read it – the famous point made was “we’ll see what it is after we have it” (and, of course “If you want your doctor, you can keep him”). I now pay $1000 a month, with a $6850 annual deductible, and massive amounts of other copays and everything else, for I’m not quite sure what in return.

      As for getting on board with demanding a health care system that works, the Democrats have nailed their flag to the Obamacare pole, and the Republicans, while full of rhetoric while safely out of power, lacked the gumption to actually make changes during the recent two years when they had both Houses and the Presidency. The matter is simultaneously so full of political posturing and so complicated that the only solution would be to abandon it entirely, and let the market decide.

      I should add that I have lived in a land (ie New Zealand with healthcare for all) where “getting sick does not result in bankruptcy”. But, in such places, getting sick often results in needless death. As in, both my father and my sister. Unsurprisingly, all who can afford it buy “optional” private healthcare in NZ.

      Here’s an article that was published today in NZ’s major newspaper about the state of healthcare there. I’m sure this isn’t what you’re advocating as an alternative : https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12213059

  4. David, there is no need for you to currently buy an ACA plan. You can buy any insurance you want, or none at all, and not take any sort of ACA financial help with it. I would consider whether the rules you encountered had to do with your insurance company and the way they are choosing to make money, rather than by any government fiat.

    If we had single payer, there wouldn’t have been the nonsense you encountered. And indeed, with my Medicare, payment and movement through the system has been very easy, despite a difficult medical year for me.

    1. Hi, Rick

      I wish what you said were to be true.

      (a) You can buy any insurance you want : I am a single guy, with no employer coverage, and, alas, no choices. If you can find other insurance choices for me in WA state, be my guest.

      (b) Or none at all : That would be grossly imprudent, and would also cause the IRS to fine me.

      (c) If we had single payer : Why don’t you read the article about how well single payer works in New Zealand, immediately prior to your note, before advocating that. There is no reason to believe, in any country, that single payer is better or less expensive, it is merely less directly accountable.

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