Wikipedia:Reference desk/Archives/Miscellaneous/2014 April 24

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April 24

Thieves Carnival by Jean Anouilh

In the Thieves Carnival by Jean Anouilh can anyone fill in the word in this line:

"I am so _____. How long must I remain _______?" — Preceding unsigned comment added by 70.192.4.83 (talk) 01:56, 24 April 2014 (UTC)

In the French edition there is this passage spoken by Juliette (in a sudden burst of joy): "Oh! Je suis trop heureuse! Je n'ai pas le courage de rester près de toi qui es triste."—"Oh! I am so happy! I don't dare remain with those who are sad." That is the most similar passage I could find, but it's not the same word in the blanks so it could be another line. --Canley (talk) 02:16, 24 April 2014 (UTC)

"... remain near you who are sad." —Tamfang (talk) 05:00, 24 April 2014 (UTC)

And that, everyone, is a homework question. Evan ^{(talk|contribs)} 03:41, 25 April 2014 (UTC)

Biofuels, compatibility

In the UK, E5 petrol will be phased out in 2017. [1] After that, you can only buy E10 (ie, 10% is biofuel), which isn't compatible with older cars (8% of UK cars). I have a 2007 motorcycle (NT650V [2]) with carburettors. Does this chart [3] mean I'll only need to change the carbs? 81.145.165.2 (talk) 08:37, 24 April 2014 (UTC)

You might have more luck at a specialist motorbike forum, such as UK Bike Forum. Alansplodge (talk) 17:14, 25 April 2014 (UTC)

The problems with ethanol are many. Your bike will certainly run on E10 - the question is what damage it'll do to it, and how fast that'll happen. The biggest problem with older vehicles is that they have rubber seals and/or hoses. Ethanol gradually dissolves rubber so eventually, you'd get fuel system leaks. However, natural rubber has a limited life in those applications anyway - so if the vehicle is really old, then you probably should consider replacing them anyway. Replacing those seals and hoses with modern plastics will fix 99% of your potential problems with E10. The other 1% is mostly due to the fact that ethanol absorbs water more than regular gasoline. This is actually a good thing if you run your vehicle a lot. But if you let it sit (particularly outdoors where the temperature changes quite a bit) you can get some kind of separation between the gasoline and the water+ethanol and that can make for problems. In a bike that you run often, I wouldn't expect to see problems - but if you intend to let it sit for months out in the open, you might want to consider draining the tanks when you're not using the bike. E10 is said to dissolve some of the 'varnish' that can accumulate in old engines - which is kindof a good thing! But the resulting goo can get into fuel filters and places like that - so you should keep an eye on those for the first few months after the switch-over. Some people claim that their vehicles need the gunk and varnish to maintain a good fit between piston rings and cylinder and that removing the varnish will make them burn oil. That's complete nonsense.

Bike manufacturers have been aware that E10 was coming for much more than 7 years (our article on the subject says "As of 2006, mandates for blending bio-ethanol into vehicle fuels had been enacted in at least 36 states/provinces and 17 countries at the national level, with most mandates requiring a blend of 10 to 15% ethanol with gasoline" - so I'd be really surprised if your engine wasn't already set up for E10. E15 fuel is sold with a warning label that says that you shouldn't use it in vehicles made before 2001 - which suggests that your bike should be fine. Vehicles that are 20 or more years old are far more vulnerable.

That said, E10 and even E15 is no big deal - and you've been living with E5 that has many of the same issues for years without problems! The real problems come with higher blends like E85 which really are a major problem for older engines. Here in the US, we've been using E10 for a couple of years now and classic car owners aren't seeing massive problems as a result. I don't think you should worry too much. SteveBaker (talk) 14:27, 26 April 2014 (UTC)

Desert Storm

In Orange is the New Black, they talk about how she isn't supposed to eat the pudding since it went to Desert Storm. What does that mean and what is Desert Storm? La Alquimista 10:33, 24 April 2014 (UTC)

Desert Storm was the battle against Saddam Hussein in the early 90s. Is there any reference to the military or to the Gulf Wars in that series? ←Baseball Bugs ^{What's up, Doc?} carrots→ 11:38, 24 April 2014 (UTC)

Could be an insinuation that the pudding is carrying whatever caused Gulf War syndrome. InedibleHulk (talk) 11:59, 24 April 2014 (UTC)

See Orange Is the New Black if, like me, you've never heard of it. Alansplodge (talk) 12:12, 24 April 2014 (UTC)

Thanks. That helped me find this quote. Seems the pudding was in cans marked for Desert Storm. So in 2013, it's old and moldy. Still may contain traces of depleted uranium, but that's not implied. Not implied it ever went to Iraq, either. If it had, it'd probably have been eaten while tasty. InedibleHulk (talk) 12:20, 24 April 2014 (UTC)

Aha. So the bottom line would be that it's old and not palatable, like old C-rations or something. ←Baseball Bugs ^{What's up, Doc?} carrots→ 12:25, 24 April 2014 (UTC)

If it was powdered or frozen, it'd probably be fine. But according to the Pittsburgh Food Bank, that pudding should have been tossed well before the war ended. In general, don't eat anything from prior decades. Even non-deadly old spice will lose its zing. InedibleHulk (talk) 12:33, 24 April 2014 (UTC)

Even fresh Old Spice isn't all that palatable. --Jayron32 14:42, 24 April 2014 (UTC)

Yea, maybe it would stink less with age. StuRat (talk) 17:13, 24 April 2014 (UTC)

As for old spices, if they are less potent, then use more, don't toss them out. "Season to taste". StuRat (talk) 17:13, 24 April 2014 (UTC)

But powdered pudding? Thanks, but I'll pass. -- Jack of Oz ^{[pleasantries]} 18:19, 24 April 2014 (UTC)

Jello (and Royal) have been making powdered pudding for generations. Presumably a higher grade than C-rations style. See Pudding#Creamy puddings for further general info. ←Baseball Bugs ^{What's up, Doc?} carrots→ 18:37, 24 April 2014 (UTC)

Is this one of those things where "pudding" means something else on your continent? InedibleHulk (talk) 18:59, 24 April 2014 (UTC)

For a UK example (not sure about other ENGVARs), see Angel Delight. Which I now have a craving for even though I'm sure it's not as good as I remember. MChesterMC (talk) 08:28, 25 April 2014 (UTC)

Probably. In the US, "pudding" is a sweet dessert, like what in the UK would be called custard although often without the eggs. In the UK "pudding" is a savory dish (or perhaps unsavory, as in the case of black pudding). StuRat (talk) 17:23, 25 April 2014 (UTC)

Most British puddings are sweet, hence the use of the word "pudding" to describe the sweet course at the end of a meal. DuncanHill (talk) 17:50, 25 April 2014 (UTC)

I believe "pudding" originally referred to the gelatinous consistency of the dish, not the level of sweetness. StuRat (talk) 16:40, 29 April 2014 (UTC)

In any case, here's an example of a powdered and (partially) frozen pudding snack, published by a man named Dick Johnson at midnight. Even that wouldn't be good nine years later, but it would definitely outlast a red pudding. InedibleHulk (talk) 19:14, 24 April 2014 (UTC)

Fun Fact: This is the only mention of Sundae Toppers on Wikipedia. InedibleHulk (talk) 19:26, 24 April 2014 (UTC)

Powdered pudding can be perfectly good, so long as you only start with powdered gelatin, sugar, and natural flavors which dehydrate well, such as vanilla and cocoa. In this case you need to add milk, or better yet cream, and maybe eggs. It's only when they try to make a "just add water" version that they need to use some creative chemistry to fake the cream, eggs, etc., and that's when it starts tasting like a chemistry experiment. Also, many natural fruit flavors don't dehydrate well, such as grape and cherry, so you get some horrible artificial flavors there, instead. Artificial banana, on the other hand, seems to taste like the real thing. StuRat (talk) 17:32, 25 April 2014 (UTC)

As of sixty years ago, women also (apparently) didn't feel like real cooks when just adding water to cake mix. Flavour aside, the egg was worth more whole. Times have changed as far as women and instant food go, but we're all still generally cracking our own eggs. InedibleHulk (talk) 01:32, 26 April 2014 (UTC)

That helped. Thank you for your answers everyone. ^_^ La Alquimista 06:20, 25 April 2014 (UTC)

See also Meal, Ready-to-Eat or MRE (Americans love TLAs), which has been the standard US Army ration pack since 1986. Apparently, the earliest versions were so unpleasant that they were referred to as "Meals Rejected by Ethiopians" or "it's not a Meal, it's not Ready, and you can't Eat it".[4] Alansplodge (talk) 17:06, 25 April 2014 (UTC)

Legality and availability of totally anonymous healthcare

Is totally anonymous healthcare legal and available in the United States? That is, is it legal under Federal and various State laws for a physician to provide service in exchange for cash payment from a patient who provides no identifying information? Even if legal, would it be difficult to find physicians willing to do so? Might this be more accepted by dentists than physicians? (While I am primarily interest in the status in the US, particularly given the recent health care reform, I'd be happy to hear about other countries. I assume that it would not be legal for citizens in countries with significant social welfare support, but that it would likely be legal for foreigners visiting countries with a medical tourism industry.) -- 94.198.176.23 (talk) 20:31, 24 April 2014 (UTC)

In such a scenario, who would pay for the office visit? ←Baseball Bugs ^{What's up, Doc?} carrots→ 20:56, 24 April 2014 (UTC)

The anonymous patient would pay the fee in cash (possibly in advance) for service to be rendered. -- 94.198.176.23 (talk) 22:39, 24 April 2014 (UTC)

Googling "emergency room john doe" indicates that at least some emergency rooms will treat a patient without an ID. ←Baseball Bugs ^{What's up, Doc?} carrots→ 21:10, 24 April 2014 (UTC)

It can't be illegal in Canada or the U.S., because there are laws against emergency rooms turning people away. (Also, there are those extremely rare cases of people with total amnesia being admitted to hospitals, obviously with no ID.) It probably wouldn't be easy, or advisable, under most circumstances, though. Doctors prefer to keep medical records on patients for good reason. It's difficult to treat someone if you don't know their medical history, whether or not they have pre-existing conditions, anything that would interfere with treatment, and so on. They can have legal/professional obligations to at least try to obtain that information whenever possible. OttawaAC (talk) 22:23, 24 April 20

I've fortunately never had to go to hospital in the US. How are the laws requiring ERs take people in reconciled with the practice of charging for medical treatment at the point of use? AlexTiefling (talk) 22:41, 24 April 2014 (UTC)

The ER certainly will try to charge the patient - but if he just can't pay, they're not allowed to deny him emergency treatment. 87.114.34.30 (talk) 23:07, 24 April 2014 (UTC)

So an unconscious person can wake up in a strange hospital to a bill they never consented to, that could ruin them if they are technically able to pay it? That seems highly unjust. AlexTiefling (talk) 23:10, 24 April 2014 (UTC)

just winds up being an unpaid bill. This is why some US patients wind up in debt, or worse, bankrupt. Some ERs in the US inner cities have shut down in part, I take it, from the costs they have to assume as a result of the law (Emergency Medical Treatment and Active Labor Act). The Act is unfunded. OttawaAC (talk) 23:15, 24 April 2014 (UTC)

(edit conflict)Per 87.114.34.30, the patient still gets billed, and incurs a real debt for the services rendered. It's just that the hospital cannot deny his treatment because of his financial status. He'll just keep incurring bills for the services, which, if he can't pay, won't get paid. Two things happen: 1) the patient's credit gets destroyed (assuming it isn't already; most in this situation don't have credit to begin with) and the normal processes of debt recovery (including wage garnishment, bankruptcy proceedings, liens on real property, etc.) are started against the patient and 2) the hospital basically eats the cost, because most patients that use the ER as their "primary" care have no insurance, cash, or means to get health care otherwise. That then causes the hospital to pass those costs on to other patients who do have the ability to pay, usually through insurance, which drives up premiums, deductables, etc. and thus passes on those costs to everyone else. That's at least one of the primary arguments for a single-payer, government run health care system: it can only cost less than it does now, because we're still paying for healthcare for the uninsured, except we're paying more than we should because of the inefficient way it works. --Jayron32 23:16, 24 April 2014 (UTC)

How would they bill a patient who refuses to present an ID? ←Baseball Bugs ^{What's up, Doc?} carrots→ 23:20, 24 April 2014 (UTC)

The average cost of an ER visit in the US has been put at $1,233 or $1,957 (depends on how someone calculated "average"). A day in ICU costs about $4000, according to the UCLA/RAND study discussed in this article. 60% of US bankruptcies are precipitated by medical debt ([5]); those are mostly from longer illnesses than a single ER visit. 87.114.34.30 (talk) 23:26, 24 April 2014 (UTC)

Do any of those studies differentiate between marginal cost of delivery of the care (that is, the real cost of the materiel, electricity to run machines, rent on facilities, and staff pay) and the additional costs built into those visits which are due to artificial price inflation for various reasons (costs to run the billing infrastructure which exists just to deal with insurance, costs inflation due to recovery of other unpaid bills, etc. etc.) It would be interesting to see the difference between the cost of healthcare and the price of health care in terms of how much is spent on the actual care of that actual visit, versus how much is spent on all the other stuff. --Jayron32 23:30, 24 April 2014 (UTC)

Those are indeed billed prices, and even then that's complicated because large insurers negotiate lower per-procedure prices - so Blue Cross will pay an in-network hospital less (often much less) than the hospital would charge an out-network patient, and particularly an uninsured (cash) patient (who doesn't have the negotiating advantage of buying in bulk). It's hard to know what the cost is, because so much of the hospital's outlay is the fixed costs of premises, equipment, and staff, all of which costs the same whether the facility is quiet or busy. 87.114.34.30 (talk) 23:43, 24 April 2014 (UTC)

Yes, but I'm not concerned with how much of the cost is part of the cost of running the care-delivery system so much (including fixed costs of maintaining the hospital even if no patients are arriving) but rather the important bit is how much of the cost is unrelated to the delivery of care itself. I'd suspect that some non-trivial amount is spent on the inefficient insurance system. I'd not even be surprised if it were the majority of such cost. --Jayron32 23:48, 24 April 2014 (UTC)

I don't think you'll ever be able to dissect the cost of an individual's treatment, but it is possible to make statements about the overall efficiency of the gross performance of a healthcare system. This study (which relates mortality effects to costs) makes the US system seem very inefficient indeed, as does this study. 87.114.34.30 (talk) 00:12, 25 April 2014 (UTC)

In Australia, and I suspect in the USA, doctors are required to formally report their discovery of things like suspected child abuse and certain infectious diseases. Not sure how this would work with anonymous patients. HiLo48 (talk) 23:22, 24 April 2014 (UTC)

Here's an article discussing the obligation to report gunshot wounds in the US. [6] OttawaAC (talk) 23:38, 24 April 2014 (UTC)

The only anonymous healthcare I'm familiar with, both in the US and the UK, is for a few serious events where the option of anonymity is significant for the effectiveness of the delivery of treatment (that is, where patients could be discouraged from seeking healthcare if they could not be anonymous). That's mostly sexual health (HIV/STD testing) and victims of rape. In the UK it is possible to receive emergency contraception anonymously; I don't know about the US for that. 87.114.34.30 (talk) 23:56, 24 April 2014 (UTC)

I'm curious now about John Doe trying to pay for secondary healthcare services... pharmacist, blood test, non-emergency X-ray and so on... I don't think those folks are legally obligated to provide services to anonymous people for cash, but I haven't found any info online yet. OttawaAC (talk) 00:10, 25 April 2014 (UTC)

Yes, a proportion of ER visits (e.g. moderate trauma) will require one or several followup outpatient appointments for things like woundcare, and there are (as you say) continuing costs incident to an urgent event which persist after the emergency is resolved. Some states (I really only know about California - see Welfare in California) mandate counties to provide indigent persons with some degree of healthcare. In addition, some hospitals are operated by charitable or religious groups (or have their own charitable foundations) which provide some healthcare for the poor without cost. Unsurprisingly, the coverage is low and access is difficult. 87.114.34.30 (talk) 00:25, 25 April 2014 (UTC)

Basically the problem of people who can't pay for their own medical care has only 3 possible solutions, none of which seems all that attractive:

1) Deny them treatment, perhaps causing their deaths. This will include the deaths of children.

2) Have taxpayers pay for their care.

3) Force the care providers to do it "for free", which means they charge every other patient more, to cover it. This is how the US gets to $20 aspirin pills in a hospital. Also, some hospitals have to close, in areas with too high of a proportion of indigent patients, as there aren't enough paying patients to cover the cost. Another unintended consequence is that adding a bus route from a poor area to a hospital bankrupts that hospital. So, you end up with ghettos with no transportation to any health facility, defaulting us back to option 1. StuRat (talk) 13:37, 25 April 2014 (UTC)

Well, I suppose we should also consider:

4) Increase the income levels of those people so that they can pay. (Which, in the US, more or less means increasing the legal minimum wage substantially)

5) Decrease the cost of healthcare so those people can afford to pay for it on their present income levels. (Which is one intended (but not inevitable) consequence of ObamaCare)

In the end, either people don't get treatment, get sick and die - or they get treated and someone else somehow has to pay for it. The ways to avoid that are either to spread the cost to everyone (increased minimum wage) - or just to taxpayers (a UK/Canadian style national health system) - or just to healthy people (by insurance). Pres. Obama has tried to do all three of those things - he's used his powers to impose an increased minimum wage for government employees (with the idea that this will encourage similar increases in the general minimum wage - which would increase the cost to almost all manufacture and service industries - which in turn will increase prices - which is effectively a tax on everyone) - he's expanded medicare and medicaid (which selectively hits taxpayers) and he's making health coverage mandatory to those who can afford it but wouldn't otherwise want it (which selectively hits healthy people). Charging sick people more for their coverage to cater for the people that the hospital has to treat for free is a tax on the sick...and that seems like the very worst way to spread the cost! Also, doing that causes a dangerous feedback loop where increasing costs mean that fewer people can pay - so more people wind up in the emergency room - so the cost of healthcare goes up - and increasing costs mean that fewer people can pay.

There's no such thing as a free lunch though. Even letting people get sick is an expensive one because what happens is that they avoid getting care in the early stages of some disease and only do something about it when it's getting super-expensive to fix. Getting someone a shot of a $5 antibiotic from a nursing orderly in a doctors' office is VASTLY cheaper than amputating an infected limb in an emergency care facility six months later.

Unless you're truly going to let people die in the streets for lack of treatment, a free/cheap healthcare system has strong benefits. SteveBaker (talk) 14:38, 25 April 2014 (UTC)

I don't think 4 or 5 could ever fully fix the problem. That is, there's no way somebody who picks cabbages could be paid enough to cover a heart/lung transplant. To do so would make cabbages completely unaffordable by all, or require lowering the standards for heart/lung transplants to a dangerous level. Now, if you toss in insurance, perhaps cabbage pickers might be able to pay for a small risk that they might need a heart/lung transplant, but then of course they are also paying for everybody else's risk of every possible disease, and, in the US, paying a hefty profit to everyone involved in the health care system, along the way.

Perhaps some type of progressive income-based medical charges would solve the problem, where the poorest pay maybe 0.01% of their actual costs, and the richest pay maybe 500%. This is somewhat similar to the current system in the US, but formalizes it and would have the effect that, since the poor do pay something, preventative care would save them money over using emergency rooms exclusively, and hopefully reduce the overuse of emergency rooms. StuRat (talk) 17:42, 25 April 2014 (UTC)