Which is more life threatening?

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Bill Glasheen
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Which is more life threatening?

Post by Bill Glasheen »

As a former rider (who still keeps his license to be on a bike), I found this interesting.

I had a few wrecks when I was a young lad. What saved me is riding every day. It was my sole means of transportation. It was also partly my problem, as I twice dumped the bike on a patch of ice. Ice and two wheels just don't mix.

The worst was when someone pulled in front of me when I was going at a high rate of speed. My training and instincts saved me. I walked away from what could have been a fatal accident by using the bike to take the punishment.

I did have problems getting out of bed the next day... 8O
Marine motorcycle deaths top their Iraq combat fatalities

From Larry Shaughnessy

QUANTICO, Virginia (CNN) -- Motorcycle accidents have killed more Marines in the past 12 months than enemy fire in Iraq, a rate that's so alarming, it has prompted top brass to call a meeting to address the issue, officials say.
Despite crashes, Gunnery Sgt. Art Tucker rides a sport motorcycle. "I enjoy it. ... It relaxes me," he says.

Despite crashes, Gunnery Sgt. Art Tucker rides a sport motorcycle. "I enjoy it. ... It relaxes me," he says.

Twenty-five Marines have died in motorcycle crashes since November -- all but one of them involving sport bikes that can reach speeds of well over 100 mph, according to Marine officials. In that same period, 20 Marines have been killed in action in Iraq.

The 25 deaths are the highest motorcycle death toll ever for the Marine Corps.

Gen. James Amos, the assistant commandant of the Marine Corps, told CNN that commanders are trying to drill down on what "we need to do to help our Marines survive on these sport bikes."

"The Marines are very serious about it," he said. Video Watch these aren't your father's Harleys »

Marine Gunnery Sgt. Art Tucker knows all too well about the dangers of sport bikes. An owner of a Kawasaki Ninja, Tucker has had two crashes, and the second one nearly killed him.

"I sustained a broken collar bone; I tore the shoulder out of the socket; I tore three ligaments in the shoulder, the rotator cuff; I broke three vertebrae," said Tucker, a drill instructor for new officers.

"The worst was a head injury I received: a bruised brain. And it caused hemorrhaging, and from that I had partial paralysis of the left leg, full paralysis of the left foot and toes, and that was for approximately six months."

Amos said he and other top Marine officials will spend half the day Monday "focusing on nothing but motorcycle issues." The commandant of the Marine Corps, Gen. James Conway, and other senior leadership will attend the meeting at the Quantico, Virginia, Marine base, he said.

About 18,000 of the nearly 200,000 Marines are believed to own motorcycles, Amos said.

The Marines have taken some measures. The Marine Corps has had a long-standing policy for all Marines who ride motorcycles to take a mandatory basic riding course. More recently, it added a second training course specifically designed to train Marines who ride sport bikes.

Any Marine caught riding, even on leave, without going through the training courses faces Marine Corps punishment, officials say.

On a recent day at the Quantico training track, Marines whizzed by on their bikes.

"I think the basic rider course has been great," said Cpl. Austin Oakley. "Here, they put you in situations you want to be wary of out in that open road."

Oakley said he recently returned to the United States from Japan, and he immediately jumped at the chance to buy a sport bike. He said it's not uncommon for Marines to have motorcycle clubs within their units.

"We'll go out on rides together. Fridays for lunchtime, we'll all meet up and go to lunch," Oakley said. "When I get on my motorcycle, it's me and the motorcycle. I don't need to go fast. I don't need to do anything like that. It's just being free."

The rise in motorcycle deaths isn't confined to Marines. The Navy says it's had 33 deaths on motorcycles over the past 12 months, a 65 percent jump from the previous time period. And authorities say motorcycle deaths have been a problem in the civilian world, too.

Military officials say they're not sure why the deaths are on the rise. They initially believed that the accidents might involve mostly young Marines and sailors about 18 or 19 years old. But Navy statistics show that five of the victims were 25, the most prevalent of any age involved in the crashes. And two 40-year-old sailors were killed in motorcycle crashes.

Amos said the Marines have seen a similar trend.

But he says the new training seems to be working: Of the 300 young men and women who have gone through the sport-bike course, only three have had accidents.

The safety course instructors said some Marines who go through the training decide the sport bike is not for them.
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But even some Marines who've survived past crashes still want to ride again, even after they get the new training.

"I enjoy it," said Tucker. "I can actually get on my motorcycle and ride, and it's just like if I were to do bowling or rock climbing or scuba diving. It's something for me. It relaxes me."
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Post by IJ »

The death rate is 21 times that of car drivers. At least it was about 10 years ago when I looked. Cycles may be a gas solution but they're not safe--maybe the Marines want to stress that part of the service is keeping yourself alive and fit to serve as best you can? I also don't pay taxes to support a year of rehab for injured hotdogging Marines... :/
--Ian
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Post by Bill Glasheen »

IJ wrote:
The death rate is 21 times that of car drivers. At least it was about 10 years ago when I looked. Cycles may be a gas solution but they're not safe--maybe the Marines want to stress that part of the service is keeping yourself alive and fit to serve as best you can? I also don't pay taxes to support a year of rehab for injured hotdogging Marines... :/
Fair enough, but... You are asking a Marine not to be a Marine.

Some folks who don't have the need for speed just wouldn't get it. There will always be a small number of big risk takers in our country. They may be the first to hit the ER, but they're also the first to make great discoveries and push through new initiatives. And they're the ones who protect you so you can get a good night's sleep and save more lives tomorrow.

- Bill
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Post by IJ »

Well, notice that I didn't request any rules, rather, something like a plea. I'd probably leave it up to the military since they're the experts on how their troops work, but I have heard news items about the consequences of risk taking, including one pilot who liked skimming mountaintops in his jet, and ended up taking himself and crew members with kids down in a multimillion dollar fireball. The military IS interested in keeping their men and women and machines in working order. And we all remember when Charlie Sheen, the Navy SEAL, took a risk in Lebanon that got the nice engaged SEAL guy killed. At the funeral:

Almost Widow: "If we had been married, would I have gotten the flag?"
Michael Biehn: "Yeah, you would have gotten the flag."
Almost Widow: (Cries)
--Ian
Stryke

Post by Stryke »

Umm that was a movie Ian , I dont think Charlies really a seal .....

Let those that ride decide
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Post by IJ »

Not really a SEAL? Huh? Fooled me.

As far as letting those who ride decide, that is, up front, the right thing to do. Their bodies, their cycle--hey! Let freedom ring! Problem is when they get injured, in and out of the military, it's not on their dime. Someone else pays for their hospitalization, surgeries, medicine, disability, spousal benefits, rehab, the works. When we're both on the hook, we both have an interest in the behavior. As a taxpayer, I'm essentially their insurance company, and you must be aware that insurance companies raise the rates of people who are more likely to have accidents or who have unsafe vehicles, right?
--Ian
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Post by Bill Glasheen »

So, Ian, where do we set the limits on their behavior?

I'm all into both libertarianism and personal responsibility. For example I am all for allowing someone to smoke, and I don't want to have to pay for their COPD later in life. But... it's kind of crazy you know. Smokers save us on average 7 years of Medicare and Social Security benefits. So on the net, it's better to kill the stupid off early.

It's like "saving money" in healthcare by preventing illnesses. Problem is, all the studies show that very few things other than immunizations save money. Everything else COSTS money. Quality is certainly good, but you don't expect to "save money" by buying a Lexus instead of a Chevy.

What do you suggest, Ian?
  • Telling them they have to take training classes before riding?
  • Telling them no bikes allowed at all?
  • Telling them they can't drive a car because it's too dangerous?
  • Telling them they can't smoke?
  • Telling them they can't have premarital sex because they might get HIV?
  • Telling them they can't eat junk food?
I'm with you on the "something like a plea." And I'm absolutely all about requiring training or no bike allowed.

Quite frankly, I think they should make it really hard for the average person to get a motorcycle license. The more difficult, the better. But if the training is good and you are trained...

- Bill
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Post by Jason Rees »

IJ wrote:Well, notice that I didn't request any rules, rather, something like a plea. I'd probably leave it up to the military since they're the experts on how their troops work, but I have heard news items about the consequences of risk taking, including one pilot who liked skimming mountaintops in his jet, and ended up taking himself and crew members with kids down in a multimillion dollar fireball. The military IS interested in keeping their men and women and machines in working order.
The military, all branches actually, pounds this message, day-in, day-out, every year. It really gets rediculous during the '101 days of summer' campaigns they do. Anyway, you can tell people this stuff till you're blue in the face, but these guys will still drive motorcycles, go boating without life preservers on, and yes, sadly, drink and drive.

The point is, the military tries to nip this in the butt, and nothing works very well. Ask people to risk their lives for an entire year overseas... well, don't expect safety-conciousness to be high when they get back, no matter how much commands hammer the message home.

As far as I know, all bases of any branch require a motorcycle safety class before you're allowed to ride one on base.
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Post by Bill Glasheen »

By the way, here were the two bikes in my life.

My first...

Image


My last, and the one I rode every single day for 2 years - including on I-64 on a day when it was 0 degrees F.

Image


What isn't readily apparent to those who haven't ridden vehicles from various countries is that things on the British bike (the BSA) were backwards from what you find on Japanese and American bikes. I guess they felt a need to do that because they drive on "the other side" of the road. In any case, it was an interesting adjustment going from a British to a Japanese machine - not the least of which was having a bike that you could actually expect to run on any given day.

- Bill
Stryke

Post by Stryke »

I still got the Bsa A65 in the garage Bill 8)

everything everyone does could affect you Ian somehow , so basically my suggestion is vote wisely for your beleifs and/or get over it . Why does it matter if there military or anyone else ? , do we impose such things on only military , maybe public servants , hay public at large .... slippery slope ......

maybe we need a system were we pay less tax , and people are more personally responsible , maybe thats preferrable to limiting individuals freedoms , maybe we should consider individuals rights and liberty , hmm maybe they could found a country on such notions .......
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Post by TSDguy »

A country or two has been founded on those principles, but you won't find one anymore.
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Post by IJ »

Stryke, what is it I need to get over? The suggestion that we leave it to the military to try to keep their troops safe from themselves and the idea I shouldn't be on the hook for their mistakes? Seem like tame ideas for me.

Also, the issue with the military is that I pay their healthcare (presumably, so do you). You know how usually everyone on this forum says "it's not their money!!"? Well, it isn't, they're right; I have better things to do than work to pay healthcare for someone who felt like they needed to risk life and limb on a cycle. Disney requires a cleanshaven nonpierced look, which is their business; the military and the taxpayer has a say in how their troops conduct themselves. As for the slippery slope... well, don't we already mandate helmets most places? Why shouldn't there be a heightened training requirement and why shouldn't there be a fee proportionate to any increased services daredevils use? I sure wouldn't want to be the insurance provider who found out my client was a basejumping lunatic unless I could figure that into their rates, and the same applies here. As for the usual refrain that we'll just make everyone free and responsible for their freedoms (wheee! principle!) do you really think that you'd like to live a country where they confirmed you had insurance before managing your motorcycle crash injuries?

There are many, many QI projects which show healthcare savings, Bill. One problem is they tend to reduce charges as well as costs, and since US healthcare providers are paid to screw up, this is a perverse incentive to continue doing it wrong.
--Ian
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Post by Jason Rees »

Hey, base jumping isn't for lunatics! There's nothing wrong with engaging in extreme sports, as long as you take reasonable precautions.
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Post by Bill Glasheen »

IJ wrote:
Stryke, what is it I need to get over? The suggestion that we leave it to the military to try to keep their troops safe from themselves and the idea I shouldn't be on the hook for their mistakes? Seem like tame ideas for me.
In principle you are on sound footing, Ian.
IJ wrote:
Also, the issue with the military is that I pay their healthcare (presumably, so do you). You know how usually everyone on this forum says "it's not their money!!"? Well, it isn't, they're right; I have better things to do than work to pay healthcare for someone who felt like they needed to risk life and limb on a cycle.
This is where your argument falls apart.

Along with the principle of libertarianism is the concept of earning your keep. Well... I happen to believe that teachers and soldiers don't get paid enough for all that we ask of them. If you want to call VA healthcare a luxury that soldiers aren't entitled to, well, I have multiple channels to challenge you on that one.
  • While VA healthcare is at times innovative (medical records now are completely electronic), they hardly compete with the specialty care at the finest medical institutions in the country. Fortunately VA doctors are there accepting lower pay because they want to be there and believe in their mission.
  • The women and men in the military risk their lives so that the rest of us don't have to. Some of them come back from their service in pieces. Libertarianism would suggest that they deserve a bigger piece of the pie. Come to think of it, to suggest otherwise would cast you as a member of the wealth redistribution crowd.
  • We're seeking people who would risk their lives for their country, and yet you are suggesting they shouldn't engage in risk-taking and thrill-seeking activity? What's wrong with this picture?
  • Let's not forget that many victims of "donorcycles" provide a source of organs for transplant. While the thought is morbid, the act is priceless.
I respect your right to disagree. But I happen to think they deserve all the healthcare they get - and more.
IJ wrote:
Why shouldn't there be a heightened training requirement and why shouldn't there be a fee proportionate to any increased services daredevils use?
There is (read the article), and for the most part there is. Perhaps you've never purchased motorcycle insurance, Ian. Also remember that typical medical insurance has a lifetime cap, and long-term care is a separate coverage.

But speaking of slippery slopes... Should commercial insurers charge more for people who smoke? Should commercial insurers charge more for people who can't control their weight? Should commercial insurers charge more for people who don't exercise? Should commercial insurers charge more for people who engage in more risky sexual habits - with our without the concept of monogamy involved? Where do we draw the line, and how much do we want to invade in individuals' personal lives?
IJ wrote:
There are many, many QI projects which show healthcare savings, Bill...
... most of it being self-serving crap published by disease management vendors. The truth is that the DMAA (Disease Management Association of America) hasn't been able to establish a consistent picture which backs these assertions.

We have presented on the methods which risk-adjust these studies, Ian. I have a better view of all this. In the long run, there is no proof that typical disease management services save money. You do it because it's the right thing to do and it makes people better. But if you're going to come to me and tell me you'll save me money because you're going to do blah, blah, blah, I'm holding very tightly onto my wallet.

Read the literature. Immunizations are one of the few healthcare services which SAVE money, mostly because it's primary prevention (as opposed to secondary like BP management) and the intervention is now cheap as heck. Infection control in hospitals would also fall into that category. Throw in a few curative interventions, such as the triple-Rx therapy which makes duodenal ulcers go away and helps people avoid a lifetime of H2 antagonists. For most everything else, a COST of a few tens of thousands of dollars per QAYL (Quality-Adjusted Year of Life saved) is considered a pretty good deal.

Pay more attention to the long-term outcomes, as well as all the other medical and administrative services which don't quite make it to the balance sheet in the studies. Also pay close attention to selection bias, and the issue of not doing either an RCT or a stratified, risk-adjusted comparison.

- Bill
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Post by IJ »

"Along with the principle of libertarianism is the concept of earning your keep. Well... I happen to believe that teachers and soldiers don't get paid enough for all that we ask of them. If you want to call VA healthcare a luxury that soldiers aren't entitled to, well, I have multiple channels to challenge you on that one."

WHOA there Bill. Strawman. I never said that our troops didn't deserve VA healthcare! Absurd charge! I am saying that VA healthcare was not established to treat their volitional, totally avoidable, self induced injuries! I am saying that they signed up to protect the country and that means keeping themselves well to do so. I am saying that ALL of us have to think about the consequences to others when we take chances with ourselves. That means... *I* have a responsibility to keep myself healthy to work because that is my calling and because the state contributed to my education. *I* have a responsibility not to go get HIV and expect others to buy my meds (even my own paid insurance). I am saying responsible people who work for a cash strapped enterprise don't waste resources on anything, especially their own amusement.

"The women and men in the military risk their lives so that the rest of us don't have to. Some of them come back from their service in pieces. Libertarianism would suggest that they deserve a bigger piece of the pie. Come to think of it, to suggest otherwise would cast you as a member of the wealth redistribution crowd."

Again, I am ALL for compensating injured troops and supporting uninjured troops too. I thank veterans for their service when I meet them--that was in the hospital including the VA and also at the polls yesterday. I don't think libertarianism has spoken specifically to the issue of whether public servants are entitled to extra funding for self induced injuries. And the name calling "wealth distribution" label was voted on yesterday. McCain wanted to raise MY taxes by taxes health benefits. All politicians I know of support taxing those who can pay and funding projects that benefit everyone, so they all redistribute wealth.

"We're seeking people who would risk their lives for their country, and yet you are suggesting they shouldn't engage in risk-taking and thrill-seeking activity? What's wrong with this picture?"

When we hire police, we're looking for people willing to engage in hand to hand and firearm battles with antisocial thugs. And we expect them to REIGN IT IN limiting that to appropriate circumstances.

"Let's not forget that many victims of "donorcycles" provide a source of organs for transplant. While the thought is morbid, the act is priceless."

Very off topic. So many better ways to improve healthcare than cheering when a young healthy adult is squash crushed and distributed to needy sick people.

"But I happen to think they deserve all the healthcare they get - and more."

This is something of a platitude. I have worked in the VA (two sites). They deserve better care than they get there. I strove to provide it. I complained about deficiencies. I know for a fact that entirely well vets also create tales of suicidality to be hospitalized when their checks run out (after drug binges--same goes for nonvets, too). They know the VA psych ward makes no effort to move people out efficiently (no incentive for performance). I know of vets who read up on PTSD symptoms and seek benefits for them just because of financial circumstances. that's fraud, that's stealing, and thats ALSO something nonvets do all the time. Really--vets should get top notch care for the injuries they sustain, general medical conditions, and also semi volitional problems like alcoholism which are often related to their difficult work. So yeah, they deserve all that healthcare and more, but that doesn't mean we should be on the hook for risk taking (unless the military tells me it's the price of military service and the behavior unavoidably spills into civilian life). That's an almost deliberately, Karl Rovian statement that makes me out to be a villain I most certainly am not.

"There is (read the article), and for the most part there is. Perhaps you've never purchased motorcycle insurance, Ian. Also remember that typical medical insurance has a lifetime cap, and long-term care is a separate coverage."

I wasn't saying there wasn't a higher training expectation or higher rate. I was appealing to the common sense practice that insurers aren't there to lose money, and if they insure higher risk people those people should pay higher premiums. If I were a serviceman, or anyone, who took undo risks jumping off cliffs, speeding in motorcycles, or fighting in the UFC, I would view myself as a bit of a thief if I didn't pay a proportionately higher rate.

"Should commercial insurers charge more for people who smoke?" --Absolutely.

"Should commercial insurers charge more for people who can't control their weight?"
--certainly. However, I question your use of the word "can't." It rarely applies.

"Should commercial insurers charge more for people who don't exercise?" --Why not?

"Should commercial insurers charge more for people who engage in more risky sexual habits - with our without the concept of monogamy involved?" --I personally am repulsed by the very risky sexual behavior of some members of the gay community, along with their expectation that others should pay for their STD testing, treatment, and extremely expensive HIV therapy. I tell anyone who listens that unprotected sex is the new gaybashing. I believe it is assault and or murder to, knowingly or by deliberate ignorance, even with a partners approval, risk spreading HIV. *IF* there were a way to measure this risk taking and hold participants responsible without impeding the overall goal, I would whole heartedly support it. Problem is, you pretty much need anonymous clinics and testing to effectively fight HIV. And I sure don't want anyone equating my long term relationship to bathhouse attendance because both parties being discussed are gay. That would be like you taking a hit for your BMI (not your waist-hip ratio). This is EXACTLY the same as what I asked of the vets. BE responsible, DON'T abuse governmental or other charity, and DO make risk takers accountable unless doing so screws up more than it solves (ie, leave it up to the military, make sure insurers don't excessively invade our privacy or use lousy methods, and so on).

"Most of it being self-serving crap published by disease management vendors. The truth is that the DMAA (Disease Management Association of America) hasn't been able to establish a consistent picture which backs these assertions."

Um, actually, I was just talking about the kind of research and projects that I am involved with. Here are some examples:

--make sure everyone has aspirin, betablocker, statin ordered after acute coronary syndrome, or documentation of contraindications.
--provide recommended DVT prophylaxis to prevent avoidable blood clots.
--give pneumonia care as advised by guidelines.
--treat heart failure with diuretics, specific education, salt restriction, ACE inhibitors, and betablockers; monitor people closely to avoid hospital stays.
--follow ventilation weaning protocols to reduce ICU stays.
--don't do cardiac cath or unnecessary tests when they're not indicated.

Your general logic on immunizations is fair, but far from universal. Thiazides are basically free for hypertension and work well; aspirin saves about as many people in heart attack as does expensive and riskier thrombolytics. In contrast, the Gardasil vaccination is expensive (about 600 bucks) and since the recipients need the same screening for HPV lesions and because most of the lesions are easily treatable and cancer is rare, it is highly likely to be cost ineffective. The meningitis vaccine prevents a very rare disease and mostly won on scare concerns. A possibly soon release HSV vaccine will target only type 2 herpes and many young adults are getting type one on their genitals. Many classic vaccines could probably be scaled back a little now that they are so rare (who's getting polio in the USA anymore). Smallpox vaccine for the military and stockpiles has benefits yet to be seen which may be zero. In short, a blanket term isn't wise here. I also wouldn't say that immunizations are great BECAUSE they work in primary prevention or that they ARE primary prevention; many primary prevention strategies target many low risk people and don't work well; many times, vaccines are used for secondary prevention (after pneumonia; for your AIDS patient; etc).

Jason: I'm not opposed to base jumping either. Just take out base jumping insurance. That's not was BC/BS signed up for when they wrote you a policy.
--Ian
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