In response to my friend @Mr Poltroon's grammatically-questionable-but-nevertheless-generous patronage, I've decided to utilize my artistic skills and produce a drawing that does justice to his favorite character, Kilometers Edgeworth.
In short, I labored to reproduce the following piece that I found on an insider artists' hub known as Google Images:
(I forgot to replace the transparency in his eyes with whiteness, so please don't use a dark skin or he'll look scary and deformed.)
While the final cause of my chronic insomnia has been a subject of much consternation on my part, the answer was none too subtle last night. Indeed, something weighed heavily on my heart, compounding the recurring problem of Arby's-induced arterial blockage.
If I were to own a cat, would it ever catch on to my laser-pointing diversions? As any former or current participant in this activity can attest, it is very entertaining, such that one should enjoy it in the absence of concerns that it may someday become infeasible. I ruminated on this question after recalling this gif that tangentially addresses the matter.
In other words, may I consider the feline mind analogous to that of a dog who, in a like manner, readily fetches the stick only to endure the same Sisyphean struggle moments later and without cessation?
Today I'll be going through this new visual novel "Noble Works." Some call it a moege, some call it a charage, and people who aren't pretentious call it an eroge.
The story begins from the perspective of our male protagonist, Noble Works. Noble Works is in a real pickle.
You see, Noble Works works a lot of part-time jobs in order to pull himself through high school. He lives alone because he doesn't want his parents around when he inevitably does the sexorz with cute girls. Unfortunately, various circumstances have left him unemployed, and he now wonders how he'll pay the month's rent.
Suddenly, Noble Works is approached by his cute kouhai.
She and Noble Works attend Hatsushiba Academy together. But apparently you don't have to remember that, because the name of the school appears only twice in the damn game.
After she contributes jack shizzle to our protagonist's plight, we move on and meet a guy who looks suspiciously similar.
This guy looks exactly like the protagonist! Having determined that there's been some sort of glitch in the matrix, they decide to battle in order to decide who's the true Noble Works. However, this battle goes a step too far.
Our protagonist has killed the imposter Noble Works. In a panic, he rushes the body to his apartment.
Soon thereafter, a group of suspicious people and a cute Chinese girl break in. Despite Noble Works's best attempts, he cannot explain away the corpse at his side.
The situation gets complex at this point, but it all comes down to this: In order to atone for his sins, Noble Works must attend a prestigious high school academy in the dead guy's place. It's kind of like The Prince and the Pauper, or Princess Evangelion.
Anyway, we soon meet Bigtittymaid-san.
I know what you're thinking: That's an awfully short tie she's wearing. In actuality, that's a perfectly normal tie. It's just that her knockers project so greatly that it looks short from this perspective.
While at school, Noble Works meets the next heroin. Well, first we meet her grampa, this guy:
Then we see the confused, alien-looking chick.
Later on, Zoltron Glocknork approaches Noble Works to ask for help.
Basically, she doesn't know how to play shogi, so she asks our protagonist for help. You can think of shogi as the Japanese version of 52 Pickup.
The common route gets complicated around this time, so without spoiling too much, I'll skip ahead to alien girl's route. I soon found that this route was a whole lot of plot, a whole of lot shogi, and then a whole lot of "plot." The thing I liked most was how much pee there was.
The following images aren't NSFW, but they're as close as one can get to NSFW without being NSFW.
Indeed, by my count, they didn't technically have the sexorz until the fourth H-scene. But urine for a treat, because there's plenty of pee to sustain you until then.
And when it's finally time for them to do the sexorz, they get into this super-advanced position. Noble Works knows what his girl wants.
Oh, and then there's pee.
I'll stop here, where the plot gets pretty intense. The "plot" also gets pretty intense.
I'd like to finish the whole game before giving it a proper score. I wonder how long it is? Let's see, it's got 57,690 lines, and at >10 words per line, that adds up to at least 576,900 words.
Gee, that's longer than Infinite Jest, one of the longest novels ever written. I wonder what it says about our society when some degenerates will dedicate more time to a game about pee fetishes than David Foster Wallace's classics.
Recent events have compelled me to contemplate the Oxford comma to an even greater extent than usual, so let me share a story to convince you that, in addition to using the Oxford comma in writing, you should enunciate it in your speech.
I was getting pizza some time ago. But I must note that it was one of those pizza places where they make little quadrilateral pizzas for a single person ("single" having two meanings, probably). I normally wouldn't concede to the expenses associated with such a bourgeois establishment, but the meal is quite cheap when one orders a full-sized square pizza―probably because they aren't meant to be eaten in one sitting―and, most notably, the meal comes with a free side order.
As such, the cashier asked which side I would like, and I will transcribe this in such a manner as to accurately represent her enunciation: "You want bread chips or carrots?"
I cannot think of how to tell this anecdote without now giving away the catch, which the keenest among you may have already ascertained: The sentence was actually, "You want bread, chips, or carrots?"
But I am not the keenest among us, and the fact that there was no pause between the "chips" and "or" suggested, in my mind rightfully accustomed to the Oxford comma, that there were only two items: bread chips and carrots. I sought to confirm this, asking, "Bread chips?"
And she, wielding the apathy of an employee who unwittingly tempts the manager into automating all the cashiers, recited the items with the selfsame cadence or lack thereof―"Bread chips or carrots?"
This corroborated my confusion, and I thought to myself, I have no idea what bread chips are, but I know I don't want carrots. So I said, "BREAD CHIPS."
She replied, "Chips?" And then I might have said "BREAD CHIPS" again―I forget―but apparently I conceded to chips eventually, and went to await the production of my comestibles thereafter. Not even at this point had I come to realize the situation, as my friend labored for some time to explain it to me.
The Oxford comma was not the instigator in this story; it was a reluctant spectator, a single tear running down its cheek. I implore you to take this experience to heart.
So I have one of those coffee machines that uses the little cups of coffee shizzle to, like, brew coffee, and the first brew or so yields a legit cup of high-concentration coffee (to be defiled by excessive sums of creamer et al.), but each cup thereafter is extremely watery. This Interwebs how-to thing says, "Lift the top handle to remove the K-cup after it is done brewing, and dispose of it in a trash can." Does that mean you're supposed to dispose of the entire cup after one use? But the coffee machine asks which size coffee I want for each cup, so if I were to pick a larger cup rather than a smaller one, and we assume that one K-cup is indeed to be used for each cup of coffee, then wouldn't the different sizes vary in concentration? If the largest size were worth one of the little cups, then the smallest size would be worth, like, one half, but I don't see those specifications anywhere in any guide. Besides, there's so much coffee shizzle still in there after one cup. It's literally like 95% full. Unless there's some sort of magical coffee-resin-extraction capabilities being utilized, they're wasting a whole lot of shizzle. Is there some sort of coffee industrial complex in which coffee distributors are made to deliberately expend large amounts of coffee in their products in order to keep the inflation of coffee supply in check? This is exactly the sort of capitalist-oligarchic society that Sanford Dole and his ultra-rich friends had in mind during their imperialist conquest of the Hawaiian kingdom. Well no more, hoalohas! We shall regain our sovereignty!
But seriously, is something wrong with my coffee machine?
You'd expect them to be of a size adequate to fulfill the role of spread on a particular food, but I can't think of any widely consumed product that would require this little butter. This is inconvenient especially because I don't know how many butter packets to take when I need to use them in the future, which is exactly their intended purpose. How am I supposed to know how much butter something warrants when the amount of butter in the packet isn't set to any standard? If it were set to cover a regular-sized slice of bread, then I'd say "I'll just take two" when I intend to apply the butter to a bagel. But no, I cannot fathom any metric justification by which the mass of butter abides. The size of these packets serves no righteous ends. By that I mean that they may be convenient for those who have power over their specifications, because some companies profit liberally by excessive packaging and other iniquitous forms of mass production. But viewing the situation from a zero-sum perspective, this obviously isn't beneficial to the general population. That extra packaging probably costs small companies an additional marginal sum, which adds up to a lot across the board. And it certainly doesn't help myself and other consumers who want larger package sizes.
WHAT IS THIS MADNESS? STOP OPPRESSING THE LOWER CLASSES, YOU DESPICABLE AUTOCRATS. I want to make a title that's two characters or fewer in length, and Big Brother restricts my due FREEDOM? Is this the kind of institution you proudly lead? Do you quell the voices of the public with pleasure!? CLEARLY somebody isn't familiar with the timeless proclamations of Voltaire. It seems liberty has declined over the ages, the result of the moral decadence manifest in those who so carelessly control us. Freedom of speech is my RIGHT, my PRIVILEGE, and I have no intention to live under YOUR TYRANNY.
Oh, wait, two-letter titles are still allowed, even though it says "longer than 2 characters." Somebody should fix that.
Anyway, I wanted to say that I've taken a liking to the color yellow recently.
Punching Doctors to Reduce Healthcare Spending in the United States
Abstract
Healthcare costs in the United States are the highest of any country in the world, even when adjusting for relative wealth1 (Figure 1). In spite of this, life expectancy in the United States falls behind that of other OECD countries2, as demonstrated in Figure 2. Considering the disparity in life expectancy by income quintile3―a disparity that is not nearly as pronounced in other countries4―it is presumable that the overall life expectancy in the United States would increase significantly if universal coverage were achieved5, thereby granting the poor, who are disproportionately represented by uninsurance and underinsurance6, access to basic preventative services.
Figure 1: Healthcare spending (public + private) per capita in several OECD countries.
Source: The Kaiser Family Foundation
Figure 2: Life Expectancy at Birth of OECD Countries, 2011.
Opinions regarding the manner in which universal coverage can be achieved, or should be achieved, vary widely by partisan affiliation7. However, in consideration of the fact that Medicaid, the United States federal program that seeks to alleviate uninsurance among the poor, yields high returns on investment8, bipartisan support should exist for a proposal in which funds accrued from an agreeable health-related policy change were earmarked to expand coverage under Medicaid.
In particular, Republican politicians widely favor tort reform9, whereby legislation is enacted to minimize malpractice lawsuits against doctors. These costly lawsuits, it is reasoned, not only waste time and money where the cause for litigation is often trivial, but also incentivize medical practitioners to order unnecessary and expensive testing.
This investigation proposes an alternative to tort reform: Violence against doctors.
Theory
The phenomenon of violence against doctors and other medical practitioners exists primarily in China, where, accordingly, malpractice lawsuits are less common than in other countries10. As patients find it difficult to successfully sue practitioners who provide inadequate care or order unnecessary tests (often at the expense of the patient in the form of co-pays and deductibles), they instead retaliate by violence against those practitioners. While the patient may make this decision out of personal emotions, this phenomenon theoretically works to the benefit of the healthcare system at large, because this incentivization against malpractice is much less expensive than lawsuits.
The conservative think tank American Action Forum estimates that tort reform enacted nation-wide could save $15 billion11. This figure will serve as the minimum amount of savings required for this "Violence Against Doctors" system to be considered successful. (In fact, this system will likely have additional benefits not shared with tort reform; for example, tort reform enacted in Texas simply capped the plaintiff's allowed expenditure of medical malpractice lawsuits12, which does not necessarily disincentivize the doctor from committing malpractice or ordering excessive testing.)
In 2008, there were 63,370 medical malpractice lawsuits costing a total $55.6 billion across the system, meaning that the mean lawsuit costs approximately $877,387. In order to save $15 billion, therefore, 17,096 lawsuits (or roughly 27% of all medical malpractice lawsuits) would have to be avoided by violence-induced disincentivization.
In order to standardize the amount of violence against doctors, we will use "punches" by the patient against the practitioner as the unit of measurement. Figure 3 demonstrates the theoretical relationship between each punch and the amount of averted medical malpractice lawsuits.
Figure 3: Relationship between punches and resultant averted lawsuits.
Because 0 punches should result in 0 averted lawsuits, the regression does not have a y-intercept. Therefore, the relationship between the two variables is y = mx, where "m" represents the amount of lawsuits averted per punch. For example, if a patient punching a practitioner results in two fewer lawsuits, then m = (1 punch)/(2 averted lawsuits) = 0.5 punches per averted lawsuit.
However, intuitively, it is much more probable that the value of m exceeds 1, meaning that multiple punches are required to avoid a lawsuit. Therefore, to achieve the desired number of averted lawsuits (17,096), it is necessary to estimate the required number of overall punches, p, multiplied by the inverse of the coefficient m.
Figure 4: Number of punches required to avert desired number of lawsuits.
In the above relationship, the quantity p (punches) × m-1 (averted lawsuits/punch) = averted lawsuits. Randomized control trial(s) will be necessary to yield the values of m and p.
Analysis
The following factors may contribute to uncertainty:
Other units, such as "kicks" and "karate chops" can be utilized in lieu of or in coordination with punches, and separate experiments may need to be conducted in order to measure the coefficient m of these alternative methods.
Less discrete methods, such as "rear naked chokes, "kimuras," and "Batista Bombs," may be utilized by the patient in practice but would be difficult to quantify as a function of m.
The value of m is subject to variation depending on the medical practitioner's income: An identical number of punches administered to two separate practitioners should result in more averted lawsuits from the better-paid practitioner. This effectively makes the legislation progressive in terms of revenue, which should please Democrats.
In many cases, the medical practitioner may retaliate by engaging in combat with the patient; this would result in an increase in the value of m and thus a decrease in the value of p, indicating that more punches will be required to achieve 17,096 averted lawsuits.
The above factor is exacerbated by the fact that the constitution of patients, by definition, is usually inferior to that of the medical practitioner.
Care centers may enact measures to retaliate against potential violence by patients. In China, for example, hospital staff have been taught kung fu13 and security personnel recruited to minimize violence. This problem could be alleviated by outlawing such defensive measures.
Practitioners who receive an excessive amount of punches may end up as patients themselves; subsequently, they may be the victim of malpractice by another practitioner, prompting further violence and possibly resulting in a death spiral.
Conclusions
Depending on the findings of potential experimentation, public healthcare spending may be significantly decreased by implementing at the federal level laws with the following effects:
Patients who perceive malpractice on the part of their medical practitioners may punch those practitioners without personal repercussion.
As the effectiveness of alternative methods of violence are revealed by reliable experimentation, those methods will be permitted (and encouraged) alongside punches.
Immediate family members of the patients who perceive malpractice on the part of their medical practitioners may punch those practitioners without personal repercussion.
Medical practitioners are not allowed to carry weapons within a 2-mile radius of any care center in which they work.
Medical practitioners are not allowed to practice martial arts within a 2-mile radius of any care center in which they work.
Add an exception to this rule when the medical practitioner is administering outpatient care and a robber invades the patient's home.
Improve price transparency.
Yearly analyses by the Congressional Budget Office will be performed in order to determine the increased revenue resulting from these provisions, and this revenue will be earmarked to expand Medicaid.
References
http://kff.org/health-costs/issue-brief/snapshots-health-care-spending-in-the-united-states-selected-oecd-countries/
https://aneconomicsense.org/2013/11/22/us-health-care-high-cost-and-mediocre-results/
https://www.washingtonpost.com/news/wonk/wp/2015/09/18/the-government-is-spending-more-to-help-rich-seniors-than-poor-ones/?utm_term=.b78a869d9c01
https://www.ncbi.nlm.nih.gov/books/NBK62373/
http://keepthemiddleclassalive.com/inequality-and-health/
http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/
http://www.pewresearch.org/fact-tank/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/
http://ccf.georgetown.edu/2015/07/28/medicaid-provides-excellent-long-term-return-investment/
https://www.washingtonpost.com/news/to-your-health/wp/2016/12/30/top-republicans-say-theres-a-medical-malpractice-crisis-experts-say-there-isnt/?utm_term=.7046065be43e
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261607/#CR3
https://www.americanactionforum.org/research/tort-reforms-impact-health-care-costs/
http://www.legalmatch.com/law-library/article/texass-cap-for-medical-malpractice-damages.html
http://world.time.com/2013/11/06/kung-fu-doctors-shanghai-hospitals-train-medical-staff-for-attacks/
