Primary Care Physician Welcome Letter

health policy

Saturday, 31 March 2007

discount contracts with health insurance from April 1
Significant changes for the insured!

million of insured persons must be prepared to get soon prescribed only affordable medicines very specific manufacturer. Thus, the cost of medicines for health insurance will drop. This view of health care reform before new regulations that are to take effect April 1, 2007. This is the first time allows health insurance exclusive discount agreements with certain drug manufacturers abzuschließen.Die General Local Health Insurance had been in early February, the legislative process was still running, announced that they have completed for 43 active ingredients discount agreements. From this, they hope to tens of millions in savings. Why should the doctors AOK insured possible only prescribe the discount means. For the chronically ill, in many cases this will mean a big change, as they increasingly take their familiar will get a new agent, which is mentioned in the discount contracts. Affected are those compounds for which patents have expired and are therefore taken from several manufacturers on the market, the so- called generic drugs.
The AOK has completed nationwide and regional discount agreements at the country level, which ergänzen.Die AOK Baden-Württemberg, for example, negotiated a regional contract discount, will also benefit from the doctors. 30 percent of the savings will by prescription discount drugs leave the AOK get the doctors, the rest will keep it themselves. Save patients the legal supplement of five to ten euro.

The AOK has played a pioneering role

at the conclusion of discount contracts

The AOK has made relatively minor producer in Germany under contract, representing only the market shares of not more than 4%. This supply problem is almost inevitable. AOK insured is therefore quite possible soon have no other choice than two times to go to the pharmacy because the drugs must be ordered only for them. Also also waiting longer to be expected then.
The pharmacist can then help the patient, barely, because of the health reform, new regulations enter into force, leaving only little room for maneuver. With the tightening of the so-called "no substitution scheme (exchange control) the pharmacists are forced to leave only the drugs for which the cash register of the patient has signed a rebate agreement. This applies even if the doctor does not discount drugs, such as that which has received the patient had always been prescribed on the prescription. There is one exception only if the doctor explicitly "aut idem" rule out the recipe by making it there a cross.

with a cross at "aut idem" nor may the specialist's prescription proven

drug be given, if it does not discount contract is

If pharmacies adhere to these rules do not, or about the customer's request, the prescribed date ever, but do not give the discount agreements included drug, they get no money from health insurance and thus remain sitting on their costs.
Is not that the discount agreement provided for drug available, it may be made, replacement with another same type drug only under certain conditions. The non-deliverable manufacturer has a pharmacy to supply shortage in writing. Only if such written confirmation to the recipe submitted each accompanied by, the pharmacy receives from the health insurance you Geld.Die new rules on the discount contracts will also affect patients of other funds: company health insurance, health insurance funds and the Federal Miners have also signed discount agreements for key ingredients, as well as from the 1st April should apply.


comment

The revisions in the even more controversial health reform, which will now enter into force should, according to its proponents, cut costs, but take little account of a quick and proper care of patients with drugs. The exclusive contract with some very small manufacturers supply problem is difficult to avoid because, as they should within the shortest Time to expand their capacities so that they can keep supplying the whole market. The expansion or even construction of new manufacturing facilities will cost much time and money. Other producers, often those with the largest market shares to be pushed through the discount contracts from the market, regardless of how much they will demand in future for their drugs. This does not necessarily mean more free market economy with freedom of choice for the customer or patient. Many patients are forced in the future of their best means by which they are doing fine, for them to transfer to a new unknown drug which can tolerate, perhaps worse, because although the same active ingredient, but contains other additives. We express regret
the future, not our intended inconvenience that will face many of you. We will continue to do everything in our power to ensure you are served in the future with good drugs without long waiting times. But unfortunately this is becoming increasingly difficult by the legislature.

We are all therefore called upon to stand up against the path in the cheap medicine, where the welfare of the patients no longer counts a lot. Yet it is perhaps not too late!

Jens Christian Heuer

Sources:

AOK Bundesverband http://www.aok-gesundheitspartner.de/bundesverband/index.html

Financial Times Germany http://www.ftd.de/

Maria Conchita Alonso Moscow Hudson

Miscellaneous Astronomy

Wednesday, Mar 28, 2007

strange structure on the north pole of Saturn

The discovery

at the North Pole of the ringed planet Saturn There is a huge, exactly hexagonal structure, which is rotating on itself (rotated). This structure appears on infrared images of the American Saturn probe Cassini, which investigated the north pole of Saturn in detail. It is ruled by polar night, because the north pole points to the time away from the sun and is therefore in Dunklen.Der Saturn is the sixth of 95 Earth masses and the second largest planet in our solar system. It is visible to the naked eye. Of the other planets in our solar system stands out from the Saturn by its visible in small telescopes ring, which consists largely of water ice. Saturn is running on a nearly circular orbit at a distance 90-10 AU around the Sun (1 AU = 1 astronomical unit = 150 million kilometer is, the mean distance between Earth and sun). For one orbit around the Sun (1 Saturn year) Saturn requires over 29 earth years. A day on Saturn takes less than 11 hours. The Saturn rotates so, compared with the earth, much more quickly around its own axis. The rotation axis of Saturn is similar to the Earth, tilted not perpendicular to the orbital plane, but something so that it also gibt.Saturn seasons there is one of the so-called gas giants. Its atmosphere consists mainly of hydrogen, helium, it follows by some distance and then again in organic considerably lesser amount of ammonia, methane, water and various Compounds. Although he is only slightly smaller than Jupiter, the largest planet in our solar system, with 318 Earth masses, a gas giant, but it weighs less than a third, which is due to its very low density, even lower than that of water. If there were an ocean full of water that is large enough, Saturn would float like a cork out. The weather is happening on Saturn, as on other gas giants also determined not only by the sun, but to a great extent by the internal heat of the planet. The strong internal heat generation could be based on a gravity-induced contraction process of the entire planet. The clouds of Saturn are formed by condensation of water, ammonia and condense Methandämpfen.Sie but from different heights. Deep down and form water clouds above at much lower temperatures ammonia and at the top, in extreme cold and methane clouds. With increasing depth of the atmosphere, this, on account of the high pressure from the gaseous state to liquid state. There is perhaps an ocean of highly compressed water, ammonia and methane. At even greater depths, there is an ocean of liquid hydrogen. Ultimately, the hydrogen is then in very extremely high pressures into a metallic form. Below this layer, a metallic rock is the core estimated to be about 16 Earth masses is. The interior of the rock core is red hot and aufgeschmolzen.Saturn has many moons, the largest, the titan even has its own atmosphere.

The long journey of the Cassini probe to the ringed planet Saturn (NASA)

The giant hexagon on the north pole of Saturn (diameter 25000 km !) was already over 20 years ago discovered by the American, interplanetary probes, Voyager 1 and 2 were, who have now left our solar system.


Rotating hexagonal structure at the north pole of Saturn (infrared image from Cassini, NASA)

The first recordings of the hexagon by interplanetary Voyager probes (NASA)

The infrared images from Cassini show that the six-corner structure of several hundred kilometers deep reach into the Saturn atmosphere. Within the hexagon is a cloud system, which also rotiert.Die NASA scientists are still baffled when it comes to explaining the phenomenon really is. At the south pole of Saturn, where it is, according to recent temperature measurements are particularly warm, Cassini had already discovered some time ago a large stationary hurricane that seems to have a certain similarity to the structure to the North Pole.

A hurricane in the south pole of Saturn (Cassini, NASA)

hurricanes (cyclones) occur on Saturn may be due to large temperature differences in the atmosphere between the lower atmosphere, where it is warm and the upper atmosphere, where it is bitterly cold. The hotter it is down, so the more water, ammonia and methane evaporates, the more energy is available to the hurricane. The formation of clouds at a height-first condensed water, then further above, each in its already much colder, and ammonia in a very high altitude and extreme cold and methane, the energy consumed in the evaporation again released. This energy as heat caused a strong additional impetus, and the air rises into the air. This creates a security-enhancing area of low pressure, the more air from all sides, the cold air sucks in from above. The cloud system is rotating, as it is effective because of the rapid self-rotation of Saturn a strong Coriolis force. The resulting vortex strengthened over the warm layer of the atmosphere on and on and spins faster and faster. In the center there is an almost windless eye. The cyclone in the South Pole appears to be stationary. Other Vortex systems on the other hand, Saturn will sooner or later davongetragen.Ein with the wind steady, almost artificial-looking hexagonal are available at the South Pole, in contrast to the north pole of Saturn, but not. Such a phenomenon was not included on any planet in our solar system, the earth, ever discovered.

An attempt to explain ...

When air is heated from below, so the heat is first transferred by collisions between the molecules of the air while the air is still seen as a whole is at rest. If the Temperature difference between above and below a certain level begins to rise, the heated air (convection). But why does this happen? The molecules move from the bottom of the heated air is faster than the colder air, much more violent encounter each other and need more space accordingly. In a specific volume (volume) of warmer air will fit in less than molecules in an equal volume of colder air is why the lower density of the warmer air. The result is like an unstable stratification, since the lower layers of air rise due to their lower density and decrease the upper layers due to their higher density. The lower atmosphere, however, not heated as a whole but is warming unevenly, so that there appear warmer air parcels with lower density in addition to colder air parcels with higher density side by side. Again and again, warmer air parcels below deflected by minor disruptions to the top. You know then, as they are slightly colder than their surroundings, according to Archimedes' principle, a buoyant force. Thus they are accelerated against gravity to the top. On the other hand, colder air packages above, by small perturbations in the direction of gravity accelerates downward. First, the disturbances have no visible impact, as the stabilizing effects of individual movements Particle counter: first, to overcome the resistance forces in the air associated with the mutual attraction of the weak electric air molecules. On the other cool warm air packages on their way up now and reach the surface on only if a sufficient temperature difference between top and bottom is reached. But then the buoyancy force is large enough to overcome all the stabilizing forces. Minor problems and reinforce such an extent that form ascending and descending air currents. Here sit down, after trying out the various flow movements the most effective forms of exercise, ie those that the heat transport ensure bottom-up best in a selection process through. The result of the selection process depends on the temperature difference between top and bottom, ie the rate of ascent of the heated air. It can also interact more different forms of movement, with hexagonal Strömngsmuster caused so-called Bénardzellen can.

Bénardzellen (plus Strömumg = ascending, descending minus = Strömumg)

The giant structure at the north pole of Saturn in my view, it could actually act to such a Bénardzelle, although the flow pattern with a vortex within the hexagon looks different than usual, where the flow outside verläuft.Doch of the rise zone within the hexagon to the relegation zone that could be accounted for: On the Saturn, which is very fast rotates on its axis, the first straight-running currents are deflected by the Coriolis force strongly, creating a vortex within the hexagon. The question remains, why is there only one Bénardzelle at the North Pole of Saturn, although Bénardzellen typically occur more than once? If the neighboring Bénardzellen outside the polar region might be suppressed somehow?

Jens Christian Heuer

Sources:

Cassini mission
http://saturn.jpl.nasa.gov/home/index.cfm

Much ado about vortex
http://www.philippi-trust.de/hendrik/braunschweig/wirbeldoku/index.html

89 Ski Doo Tundra Tune Up

commentary

The climate of opinion
of Christian Schütte

published on Wednesday, 02/21/2007

in the Financial Times Germany

Last week, the District Court of Mannheim Holocaust denier Ernst Zundel to five charges of incitement years in prison without parole sentenced. Claudia Roth, chairwoman of the Greens, welcomed the verdict usual vehemence.
"Dangerous mental arsonists must be made by means of law every opportunity to spread their false (...) Hetztiraden."
also presented in the past week, American columnist and Pulitzer Prize winner Ellen Goodman in the Boston Globe following steep thesis on: "Let's just say that the deniers of global warming is now on a par with Holocaust deniers are denying Although some the past and the other the present and the future.."
It would be interesting to know whether Claudia Roth sees it that way. If so, then we would not, pretty soon a big problem.

history and hypothesis
The legal prohibition of Holocaust denial is a balancing act in the open society, a special law against freedom of expression, which is to protect the victims of a major crime. Whether it actually prevents agitation, is very questionable. Ignorance normally be fought not by banning them, but by being criticized corrosive. After all, it is
the Holocaust but an undeniable historical fact that is proved by the testimonies and documents.
Future warming on the other hand has nothing to do with not only deliberately organized genocide. It is also - sorry, my good woman Goodman - not a fact but only a scientific hypothesis, which is held increasingly plausible. "Deny" Already the word is so completely out of place. Who is denying himself against a proven truth. Scientific hypotheses and predictions can at best be contested, and critically reviewed. Exactly to do that is by its self but also the central task of science.
Pointe a hysterical American columnist, would not further mention it, if they were not indicative of a broad trend in public opinion here in the U.S.. With the battle cry "Now is the time for action!" is just a radical end to all scientific and political climate of controversy propagated.
The brave new world knows no parties - they know only environmentalists. The film about the campaign will enter the former U.S. Vice President Al Gore this weekend, probably even an Oscar. Appropriately, the poster advertises for his film "An Inconvenient Truth" equally comfortable with a falsehood, namely, a hurricane, which springs from a factory chimney. Hurricane researchers see far at most a small effect of greenhouse gases on the storm activity. They deny collectively, would say some columnists do well.

is no doubt any scientist, politician or journalist who deals with the issue of climate change, before a huge communication problem. The hypothesis of man-made global warming is supported mainly by ever more sophisticated computer models that can really understand except their developers and operators no mortal.
be accepted, however, this Hypothesis, derived from it may from preventive measures that may require enormous efforts and political-economic structural changes. The climate computer requires the Revolution.
Where the gap is so great between complicated evidence of research and the drastic implications for everyday life, there is the simplest solution of the big psychological leap firm belief and aggressive missionary work, exclusion and discredit all skeptics and dissenters; public enlightenment on all cylinders and all channels.
science is more welcome - but only if they hergibt what awaits the drunk from the lantern: support instead enlightenment.
makes Since then everyone with love, who knew the always best, as the neighbors should set up her life: make of car, holiday destinations, furnace technology or raising children - all far too vital to make it easy to let the market and the free decisions of an unexplained mass .

The alarmism trap
In the long run, this policy, however, quite dangerous. They risk not only their credibility, because it is caught up in everyday life in countless contradictions. How it fits approximately the one-against-twelve-rhetoric that both airports are celebrated as a job? The fact that high gas and electricity prices, which, after all, more economical with Power to force these days in the name of the people, the fight is announced? With zealous missionaries
can also develop any rational climate strategy. The greatest danger today is not going more from the skeptics, but out of the alarmists warned recently did a pioneer of climate research, Briton Michael Hulme. He will more often attacked by activists who sounded his remarks not dramatic and pointed enough. Hulme's wish: "We should all take a break sometimes and take a deep breath."
A sensible climate policy does not need shock propaganda and not rehashed anti-capitalism, no end-time preacher and not a mass movement of eco-block waiting. She needs a sober debate about how many resources should be used for loan losses as a mitigation can be organized most efficiently and how best to bring them together with other policy objectives. About the long-term security of energy supply that is as independent as possible of the whims of some oil and Gaspotentaten.
For a start should be on every climate change brochure at least the warning must be printed, which formulated the libertarian American journalist HL Mencken decades ago: "The urge to save the world, is almost always a front for the urge to rule."

Christian Schuette is head of the FTD comment

Reprinted with permission of the author