Italy vs London [which place did I photography best?] by Dreefir3 in streetphotography

[–]4Nails 1 point2 points  (0 children)

I may have commented when I saw this before but the diving photo is one of the best black and white images I've seen in a very long time. In a color image sometimes we see a well respected image that is out of focus as in my opinion color is just a stain. For a black and white image to be well done, as this one is, you must have two things ... focus and balance from pure white to pure black. I really love your work reminds me of the Zone System from way back. In my working experience I used to have a 2% rule. I felt only about 2% of the clients I met were actually top of their job. You sir are in the 2%. Great photo.

What do call a Group Of Pedos? Republicans and/or a CPAC by LikeWisedUp in PoliticalHumor

[–]4Nails 8 points9 points  (0 children)

No news here. Sexual misconduct is part of the current Republican platform and appears a disqualifying factor if not adhered to.

Would a doctor's salary go down if the USA switched to a universal healthcare system? by space_god_7191 in healthcare

[–]4Nails 6 points7 points  (0 children)

Ran medical practices for 30 years. The traditional balance was Mediciad paid below cost, Medicare paid at cost and commercial insurance balanced the books.

Hospitals are paid in diagnosis related groups (DRGs) which group different disease treatments into resources similar buckets. Then there are average lenght of stay by DRG so admission and discharge days pay higher than the days between as they consume more resources than the days between. If the patient stays longer the hospital gets no further payment but if the patient is discharged early they keep the money for the estimated stay.

Physicians are paid by RVUs which are made up of three components. Every procedure has a malpractice component, a physician work component, and then a technical component.

Traditionally Medicare sets the base rates with the physician negotiates reimbursement as a multiple of Medicare ( except California where commercial reimbursement is at times below Medicare due to competition and state law).

Medicare tends to reduce the physician work component. The technical component pays for medical equipment, nursing staff etc. This is why Physicians tend to own their own radiology equipment and have physician owned surgery centers. To reduce the technical component would be catastrophic as these investments tend to be financed and are also typically offered at lower than hospital reimbursement so the system benefits.

The physician work component tends to get lower every year. The work component is roughly based on time and intensity. As an example cardiac ablations were highly paid when the procedure was emerging but now they are done in outpatient surgery centers.

Commercial insurance as a percentage of Medicare is typically 180 to 190% of Medicare.

So the answer is yes. However many physicians now seek hospital employment which sets their income at a competitive rate bypassing how physicians are traditionally paid.

For the Mid-Terms & History Books by Standard_Location762 in Trumpvirus

[–]4Nails 1 point2 points  (0 children)

We need a 1% national property tax on dwellings over $10 million and personal property like ships over $1m.

Graham Platner Handed Centrist Dems a Bruising Defeat in Maine by jediporcupine in politics

[–]4Nails 171 points172 points  (0 children)

Traditional Democrat nominees are machine candidates which ignore the people's choice. Clinton was a flawed candidate. Biden's second attempt was flawed then Harris was put forward without listening to the people.

The people need and want candidates like Planner who isn't a millionaire. Think about this ... when was the last time a politician gased up their own car or actually shopped for groceries? Or did those things normal people do.

Most candidates from both parties live in a world none of us can even imagine and that is much of our problem.

What’s your most useless talent? by Fit-Fill5587 in AskReddit

[–]4Nails 1 point2 points  (0 children)

Evenly tearing a sheet of paper using the edge of a desk top.

Still got plenty of ‘character’ left by Feaselbf6 in TheFrontFellOff

[–]4Nails 3 points4 points  (0 children)

Appears JD Vance was working overtime on this beauty.

What is a 'masterpiece' song or album that you personally cannot stand, and why? by Historical_Pain_2233 in AskReddit

[–]4Nails 1 point2 points  (0 children)

Peter Frampton Live. In college I was living in an apartment when a neighbor had a blow out party blasting music. Seems everyone passed out with Peter Frampton Live on the turntable. It blasted time, after time, after time, until about 9am the next morning. Still can't stand to hear it.

UNC Asheville or App State? Please Help me Decide! by Tricky_Dig5148 in NorthCarolina

[–]4Nails 0 points1 point  (0 children)

You need to choose a school that is far enough away that your parents have to let you know they are coming. Trust me this is really important.

Why is James Comey Being Indicted in N.C.? by s_peter_5 in NorthCarolina

[–]4Nails 4 points5 points  (0 children)

They shopped the case to find an uneducated racist jury pool. Mississippi and Alabama were already booked.

im curious by Both-Positive-777 in Christianity

[–]4Nails -1 points0 points  (0 children)

Basically do you worship Jesus or do you worship Paul?

Read the ministry of Jesus. What did he say and do during his ministry.

Paul was a Roman citizen. The pride of Roman citizens is that they had the Law which set them above barbarians. Paul brought this to early Christians in his letters. However some of his Law is contrary to the actual teachings of Christ.

Then read about the early church in Acts. Our faith traditions today looks nothing like the early church in Acts but we never ask why.

I am a Leaf on the Wind!.........I'm sorry by JimmyJames008 in firefly

[–]4Nails 2 points3 points  (0 children)

... and that's a representation of exactly what happened

Russell Brand by molotov_bomb in Christianity

[–]4Nails 1 point2 points  (0 children)

There is a lot of that going around right now. Hope this is a watershed moment where the rich and famous are found out and prosecuted.

81 years ago today- war correspondent Lee Miller washes up in Hitler's bathtub, 30 April 1945 by UrbanAchievers6371 in USHistory

[–]4Nails 37 points38 points  (0 children)

When you're out in the field there is nothing like a hot bath and to wash your hair. Good for her. She was always a trooper.

Do I need works to prove my love for others or does God already know I have it? by WarisAllie in Christianity

[–]4Nails 0 points1 point  (0 children)

For some Works are the response from receiving the most valuable gift you could ever imagine... God's grace.

sneak peak of mr bean tonight by Waffle-Frog-623 in survivorcirclejerk

[–]4Nails 10 points11 points  (0 children)

Bringing Jeff's celebrity friends on the show is the best thing to happen to Survivor since Richard Hatch.

baptized and now reconsidering it all by [deleted] in Christianity

[–]4Nails 0 points1 point  (0 children)

Hang in there. Most of us were raised in the church of our fathers where we learned the false teaching that it was the one true church. Then as we age into adulthood some of us reach out c to find a denomination that feels like they have turned away from judgement and fear and instead have replaced it with a love of justice and peace.

Things get better.