Marion was a teammate of mine on the cross country and track teams at Cupertino High School in the early '70s. I stumbled on this last night, which is an obituary from the San Jose Mercury. He was a sophomore when I was a senior, but we were pretty good friends anyway. He was a good kid and a great runner and pole vaulter. He set the school pole vault record as a sophomore and seemed destined to go quite a bit farther.
He had been teased as a child about having a girls name so he usually pronounced his name "Morion". He was definitely not a girl, although I have no idea about his sexuality. We talked about all sorts of things in the two years we were teammates. I think he thought of me as a sort of mentor, although he was a better runner than I was by far.
His older brother Baron was also a teammate and I knew him well too. The last time I saw either of them, Baron had just enlisted in the army, and would join up after finishing high school. Apparently Marion joined the army too and worked as a recruiter.
The article says Marion had a stroke which made him quadriplegic. It doesn't give a date, but it looks like it happened in 1990, give or take. Marion would have been about 38. 19 years later, in July 2009, the house he and his family had grown up in burned. His mother was able to get out, but Marion was not. (This house was in Rancho Rinconada, a housing development in Cupertino, not far from the High School)
My heart aches. Rest in peace, Marion.
11 May 2020
17 April 2020
Date of Stay at Home Orders
19 Mar
California
21 Mar
Illinois
New Jersey
22 Mar
New York
23 Mar
Connecticut
Louisiana
Ohio
Oregon
Washington
24 Mar
Delaware
Indiana
Massachusetts
Michigan
New Mexico
West Virginia
25 Mar
Hawaii
Idaho
Vermont
Wisconsin
26 Mar
Colorado
Kentucky
27 Mar
Minnesota
New Hampshire
28 Mar
Alaska
Montana
Rhode Island
30 Mar
Kansas Maryland
North Carolina
Virginia
31 Mar
Arizona
1 Apr
Nevada
Pennsylvania
2 Apr
Maine
Texas
Tennessee
3 Apr
Alabama
Florida
Georgia
Mississippi
Missour
7 Apr
South Carolina
Cities have orders but no statewide
Oklahoma
Utah
Wyoming
No Orders
Arkansas
South Dakota
North Dakota
Iowa
Nebraska
https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html
California
21 Mar
Illinois
New Jersey
22 Mar
New York
23 Mar
Connecticut
Louisiana
Ohio
Oregon
Washington
24 Mar
Delaware
Indiana
Massachusetts
Michigan
New Mexico
West Virginia
25 Mar
Hawaii
Idaho
Vermont
Wisconsin
26 Mar
Colorado
Kentucky
27 Mar
Minnesota
New Hampshire
28 Mar
Alaska
Montana
Rhode Island
30 Mar
Kansas Maryland
North Carolina
Virginia
31 Mar
Arizona
1 Apr
Nevada
Pennsylvania
2 Apr
Maine
Texas
Tennessee
3 Apr
Alabama
Florida
Georgia
Mississippi
Missour
7 Apr
South Carolina
Cities have orders but no statewide
Oklahoma
Utah
Wyoming
No Orders
Arkansas
South Dakota
North Dakota
Iowa
Nebraska
https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html
25 March 2020
Politifact Lie of the Year.
I haven't done one of these in a few years, mainly because the election of Donald Trump has resulted in an almost constant stream of pants on fire level lies coming out of the liar-in-chief. One of the effects of this is that Politifact only has a hard time choosing among Trump and his allies lies for the the worst of the year, and none of the D's minor lies or misstatements rises even close to competing.
2019: Trump's repeated false claim that the whistleblower got Trump's Ukraine call almost completely wrong
2018: Online smear machine tries to take down Parkland high school students
2017: Trump's repeated false assertions that Russian election interference is a "made up story"
2016: Fake News
2015: Trump's campaign lies
2014: The Ebola Scare.
2013: If you like your health care you can keep it. (Had this been expressed "If you like your qualifying health care, you can keep it" it would have been true: the plans that were closed by ACA were fraudulent in some way. In 2008, they had rated this same statement as true)
2012: Romney/Ryan completely false claims that Jeep was moving its factory to China
2011: Democrat's completely true statement that Republicans voted to end medicare as we know it.
2010: Republican's absurdly false claims that the ACA is a government takeover of healthcare.
2009: Republican's dangerously false claims about death panels.
2019: Trump's repeated false claim that the whistleblower got Trump's Ukraine call almost completely wrong
2018: Online smear machine tries to take down Parkland high school students
2017: Trump's repeated false assertions that Russian election interference is a "made up story"
2016: Fake News
2015: Trump's campaign lies
2014: The Ebola Scare.
2013: If you like your health care you can keep it. (Had this been expressed "If you like your qualifying health care, you can keep it" it would have been true: the plans that were closed by ACA were fraudulent in some way. In 2008, they had rated this same statement as true)
2012: Romney/Ryan completely false claims that Jeep was moving its factory to China
2011: Democrat's completely true statement that Republicans voted to end medicare as we know it.
2010: Republican's absurdly false claims that the ACA is a government takeover of healthcare.
2009: Republican's dangerously false claims about death panels.
18 March 2020
Coronovirus Statistics
As I write this (18Mar2020) the deaths from the Novel Coronavirus have risen to just under 9000 worldwide, 150 in the US. China appears to be the only country that has a declining number of new cases, after draconian measures sharply reduced the spread of the disease. They so far have had just under 81,000 cases, nearly 70,000 of them have recovered.
The incubation period is between 2 and 14 days, with a peak between 3 and 7. The disease itself seems to last about 2 weeks if symptoms are mild, 3-6 weeks if they're severe. Severe cases seem to become severe about one week from the onset of symptoms. The cause of death seems mostly to be hypoxia (shortness of breath: can't get enough oxygen into the blood), either from the disease itself or from opportunistic infections, mostly pneumonia.
The symptoms start out with malaise, muscle pain and low-grade fever, sharpening to higher fever and a dry cough. Oddly, very few cases seem to have a runny nose, sneezing or sore throat. The patients that do have these symptoms seem to have simultaneously had a cold or some other issue.
The death rate for previously healthy patients is under 1%. Heart disease, Diabetes, Chronic Respiratory disease, Hypertension and Cancer multiply the death rate by 7-14x.
The worst case scenario I've seen is that we will need nearly 1 million medical ventilators at the peak of the crisis. There are presently about 160K, about 100K of them obsolete but could be used in an emergency. The problem is not just the disease itself. The US loses about 2.8M people a year. The top causes are Heart disease (650K), Cancer (600K) Accidents (170K), Chronic Respiratory diseases (160K), Stroke (146K). Normally, something like a million people a year require a ventilator--about 60K at a time. If at the peak of the crisis, we need 150K ventilators, we will only lose 30K of them. A terrible catastrophe, but small on the scale of heart disease and so forth. It's obviously cold comfort if one of them is someone you cared about. If, at the peak of the crisis, we need 500K ventilators, we will lose nearly 400K. A great many of them will be people who never had coronavirus at all, but did have a life threatening condition that required medical assistance and/or ventilation.
The appallingly terrible response by the Trump administration has made the problem much worse than it needed to be. China sprang into action very aggressively and used many tools which are not really available in the US. China may manage to keep its deaths under 5,000. While they've only had about 3000 deaths so far, Italians are dying at over 450 a day and it's unlikely this will slow down for some time. They have 35K cases and had 4200 new ones today. Extrapolating the curve looks like 30-50K deaths. The US is much bigger and our response has been in many ways worse.
e.g.: Trump poo poohed the problem and did literally nothing for over a month.
The original tests provided by the CDC were defective and there are still far too few tests available. This cost us a month or more.
He fired the team of advisors that would have been the most useful in 2018--apparently because they were warning him that something like this might happen.
He's given a very mixed message on the border controls, such as announcing that all trips from Europe except the UK (where he owns resorts) would be cancelled, triggering panic travel, massively overwhelming the medical checks for re-entry. If any one of those people actually did have the disease, there are now a thousand new vectors, and sure enough, New York and California, which previously hadn't had many cases, immediately because major centers. If you're going to close the border, close it completely and immediately. Better yet: leave the border open, and be prepared to maintain distancing while you're doing your entry checks on what would be normal travel levels. He got this exactly backwards.
There are lots of other terrible problems. I rank the new coronavirus as only 3rd or 4th on the list, although its pressing and immediate. The most pressing, immediate problems is that we must remove Donald Trump and his toadies from power as soon as possible. I think when the accounting is done, Trump will have killed over a million Americans.
https://www.worldometers.info/coronavirus/#countries
The incubation period is between 2 and 14 days, with a peak between 3 and 7. The disease itself seems to last about 2 weeks if symptoms are mild, 3-6 weeks if they're severe. Severe cases seem to become severe about one week from the onset of symptoms. The cause of death seems mostly to be hypoxia (shortness of breath: can't get enough oxygen into the blood), either from the disease itself or from opportunistic infections, mostly pneumonia.
The symptoms start out with malaise, muscle pain and low-grade fever, sharpening to higher fever and a dry cough. Oddly, very few cases seem to have a runny nose, sneezing or sore throat. The patients that do have these symptoms seem to have simultaneously had a cold or some other issue.
The death rate for previously healthy patients is under 1%. Heart disease, Diabetes, Chronic Respiratory disease, Hypertension and Cancer multiply the death rate by 7-14x.
The worst case scenario I've seen is that we will need nearly 1 million medical ventilators at the peak of the crisis. There are presently about 160K, about 100K of them obsolete but could be used in an emergency. The problem is not just the disease itself. The US loses about 2.8M people a year. The top causes are Heart disease (650K), Cancer (600K) Accidents (170K), Chronic Respiratory diseases (160K), Stroke (146K). Normally, something like a million people a year require a ventilator--about 60K at a time. If at the peak of the crisis, we need 150K ventilators, we will only lose 30K of them. A terrible catastrophe, but small on the scale of heart disease and so forth. It's obviously cold comfort if one of them is someone you cared about. If, at the peak of the crisis, we need 500K ventilators, we will lose nearly 400K. A great many of them will be people who never had coronavirus at all, but did have a life threatening condition that required medical assistance and/or ventilation.
The appallingly terrible response by the Trump administration has made the problem much worse than it needed to be. China sprang into action very aggressively and used many tools which are not really available in the US. China may manage to keep its deaths under 5,000. While they've only had about 3000 deaths so far, Italians are dying at over 450 a day and it's unlikely this will slow down for some time. They have 35K cases and had 4200 new ones today. Extrapolating the curve looks like 30-50K deaths. The US is much bigger and our response has been in many ways worse.
e.g.: Trump poo poohed the problem and did literally nothing for over a month.
The original tests provided by the CDC were defective and there are still far too few tests available. This cost us a month or more.
He fired the team of advisors that would have been the most useful in 2018--apparently because they were warning him that something like this might happen.
He's given a very mixed message on the border controls, such as announcing that all trips from Europe except the UK (where he owns resorts) would be cancelled, triggering panic travel, massively overwhelming the medical checks for re-entry. If any one of those people actually did have the disease, there are now a thousand new vectors, and sure enough, New York and California, which previously hadn't had many cases, immediately because major centers. If you're going to close the border, close it completely and immediately. Better yet: leave the border open, and be prepared to maintain distancing while you're doing your entry checks on what would be normal travel levels. He got this exactly backwards.
There are lots of other terrible problems. I rank the new coronavirus as only 3rd or 4th on the list, although its pressing and immediate. The most pressing, immediate problems is that we must remove Donald Trump and his toadies from power as soon as possible. I think when the accounting is done, Trump will have killed over a million Americans.
https://www.worldometers.info/coronavirus/#countries
13 February 2020
The Spectrum
Here's the way I see the present economic spectrum
Communist:
There hasn't ever been a communist with national political creds in the United States. The nearest is probably the Wobblys (IWW) of the John Reed era or Longshore chief Harry Bridges. There have been numerous small communes that were somewhat successful over the years, but they are imbeded in the larger culture. By Communist, I mean that most or all of the means of production is owned and controlled by "the people", meaning the state. Whether this state is democratic, authoritarian or something else is a separate issue, although the large ones have all been authoritarian. Significant free enterprise is not allowed although there may be small businesses with government licenses.
Socialist:
There have been a few socialist politicians with national credibility. The most important was probably Eugene Debs. Most of the present national people who call themselves socialists really are Democratic Socialists. By Socialist, I mean that a sizable share of the means of production is owned by the state, but significant free enterprise is allowed although with regulation. Again, whether the state is democratic, authoritarian or something else is a separate issue.
Democratic Socialist:
Most successful countries over the last century have been Democratic Socialists. Major US leadership figures include Franklin Roosevelt, Bernie Sanders, Elizabeth Warren, and arguably, Abraham Lincoln. By Democratic Socialism, I mean that the majority of the means of production is free enterprise, but a significant amount are operated by the government or at least strongly regulated. Usually these are those industries that have been in some sort of market failure. The associate government is democratic or republican.
Capitalist:
Most successful countries have passed through a capitalist phase. By capitalist, I mean that the vast majority of the means of production is individually owned, there is little regulation, and there are few industries in market failure. It is inherently an unstable circumstance: businesses will try to grow and dominate markets, and without limits, some will succeed and drive the others out. It also tends to breed various labor abuses, including chattel slavery, wage slavery, debt slavery. The capitalist era in the US ended with the rise of "the guilded age" after the civil war. Most "businesses" were family farms and most industries were small and isolated enough that there was no monopoly. Interestingly some of the most successful were substantially sponsored by the government, e.g. the Springfield Armory.
Those that profited most, and those who see only the opportunity to maximize profit and not the collateral damage of capitalism and the unique circumstances that make it possible are always trying to "revert" to capitalism. Capitalism is highly transitional and can only thrive while there are literally hundreds of businesses in each market: enough to allow true competition and natural selection.
Oligarchist:
What happens when a capitalist society fails to deal with market failure. Individual businesses grow so large and powerful that they dominate their markets--often with tacit or explicit collusion from their competitors. Before long they can afford to buy any regulation they may face. Sometimes growth is for the good, but more often, the giant prioritizes profit over providing good service or decent wages.
Laissez Faire:
There has never been a successful Laissez Faire society. There are two failure modes: Chile and several others gave it a try but it went so badly they needed to put down near constant rebellions with extreme force, including secret disappearances. The other way tends to last longer: it's called A Dark Age. The tools of civil society break down--banditry is rampant and there is little or no distinction between bandits and police. There is no rule of law. There are people who claim to advocate Laissez Faire. They're profoundly ignorant.
There's also a political axis. How leaders are selected and replaced, what powers they have, how they respond to popular opinion, etc.
Authoritarian:
Leaders grab power by force, are free to do anything they want including manipulate the selection process. They invariably are subject to frequent coups d'etat, especially after a previous leader dies. There is usually extensive manipulation of media to quell almost constant grumbling from the powerless. How the economy works, whether there is rule of law or not, etc., are separate issues.
Aristocracy:
Leaders initially gain power by force but agree that replacement will be based on some predictable scheme, usually hereditary. This tends to reduce the violence after a leader has died. Again, the workings of the economy is separate. Monarchy is a different name for the same thing.
Republic:
Representatives gather and make decisions about what to do. How the representatives are selected is based on various mechanisms--sometimes they're elected, sometimes they are land owners, Ancient Athens drew lots to decide who would lead, various other systems have been used.
Constitutional Monarchy:
The same as a Republic but there is an aristocratic figurehead who may or may not have some power.
Democracy:
The people vote on most things. There have been no successful democracies larger than a few hundred voters. All have either regressed in some way or have functionally been a republic.
Fascism is Authoritarian Oligarchy: a dominant leader grabs and maintains power through alliance with monopolist or near monopolist businesses. There are some stylistic things that usually accompany fascism: persecuted people who are supposedly the cause of all of these problems, state control of an extremely dishonest media, etc. Technically, there are other ways to be Authoritarian Oligarchist, but fascism is the most common.
Chinese and Soviet Communism is Authoritarian Communism or Socialism.
There are several democratic socialist monarchies in western Europe: Holland, Sweden, etc. Politically, these are republics but they retain a figurehead. For example, functionally the German and Swedish political systems are pretty similar, but Sweden has a ceremonial king. Saudi Arabia is an oligarchic aristocracy. The US has regressed to its second oligarchic phase, having advanced to democratic socialism for most of the 20th century. The current president has very, very strong authoritarian tendencies and we may go all the way to Fascism if we're not careful.
27 January 2020
2020 Calendar
Wed 1 Jan New Year's Day
Mon 20 Jan Martin Luther King Day (Holiday)
Sat 25 Jan Chinese New Year, begins year of the Rat, 4718
Sun 2 Feb Groundhog's (midwinter) Day
Sun 2 Feb Superbowl LIV, Miami, FL
Mon 17 Feb Presidents Day (Holiday)
Tue 25 Feb Mardi Gras
Sun 8 Mar Daylight Savings Time begins
Fri 20 Mar 03:50UT (Thu19Mar 20:50PDT) Spring Equinox
Wed 8 Apr Passover begins at sundown
Sun 12 Apr Easter
Thu 16 Apr Passover ends at sundown
Thu 23 Apr Ramadan begins
Sat 24 May Ramadan ends
Fri 1 May May Day (midspring)
Mon 25 May Memorial Day (Holiday)
Sat 20 Jun 21:44UT (14:44PDT) Summer Solstice
Fri 3 Jul Independence Day (Holiday)
Sat 1 Aug Midsummer day
Mon 7 Sep Labor Day (Holiday)
Tue 22 Sep 13:31UT (08:31PDT) Autumn Equinox
Fri 18 Sep Sundown Rosh Hashana begins year 5781
Sun 27 Sep Sundown Yom Kippur
Mon 12 Oct Columbus Day (Holiday for some people)
Sat 31 Oct Hallowe'en
Sun 1 Nov Mid autumn day
Sun 1 Nov Daylight Savings Time ends
Wed 11 Nov Veterans Day
Thu 26 Nov Thanksgiving (Holiday)
Fri 27 Nov Holiday
Thu 10 Dec Sundown Hannuka begins
Fri 18 Dec Sundown, Hannuka ends
Mon 21 Dec 10:02UT (02:02PST) Winter Solstice
Fri 25 Dec Christmas (Holiday)
Days off work in bold
Astronomical and calendar events in italic
Mon 20 Jan Martin Luther King Day (Holiday)
Sat 25 Jan Chinese New Year, begins year of the Rat, 4718
Sun 2 Feb Groundhog's (midwinter) Day
Sun 2 Feb Superbowl LIV, Miami, FL
Mon 17 Feb Presidents Day (Holiday)
Tue 25 Feb Mardi Gras
Sun 8 Mar Daylight Savings Time begins
Fri 20 Mar 03:50UT (Thu19Mar 20:50PDT) Spring Equinox
Wed 8 Apr Passover begins at sundown
Sun 12 Apr Easter
Thu 16 Apr Passover ends at sundown
Thu 23 Apr Ramadan begins
Sat 24 May Ramadan ends
Fri 1 May May Day (midspring)
Mon 25 May Memorial Day (Holiday)
Sat 20 Jun 21:44UT (14:44PDT) Summer Solstice
Fri 3 Jul Independence Day (Holiday)
Sat 1 Aug Midsummer day
Mon 7 Sep Labor Day (Holiday)
Tue 22 Sep 13:31UT (08:31PDT) Autumn Equinox
Fri 18 Sep Sundown Rosh Hashana begins year 5781
Sun 27 Sep Sundown Yom Kippur
Mon 12 Oct Columbus Day (Holiday for some people)
Sat 31 Oct Hallowe'en
Sun 1 Nov Mid autumn day
Sun 1 Nov Daylight Savings Time ends
Wed 11 Nov Veterans Day
Thu 26 Nov Thanksgiving (Holiday)
Fri 27 Nov Holiday
Thu 10 Dec Sundown Hannuka begins
Fri 18 Dec Sundown, Hannuka ends
Mon 21 Dec 10:02UT (02:02PST) Winter Solstice
Fri 25 Dec Christmas (Holiday)
Days off work in bold
Astronomical and calendar events in italic
01 August 2019
Single Payer?
I suspect, but don't know for sure, that private insurance can have no long term role in health care. The only role they seem to serve is to be a middleman who takes a substantial cut in return for work that is really pretty trivial, and insulates providers from consumers in a way that prevents the free market from working.
Whether medical care should be completely nationalized or can be implemented by a mix of public and private hospitals and other providers isn't clear to me, but what is clear is that the present system is rife with gouging and prevents a sizable part of the population from getting health care.
Here's my strategy:
1: Fix the PPACA. The mandate is critical. The regulatory constraints on what counts as acceptable insurance are critical. There are lots of details that need to be polished. The price of drugs needs to be brought under control. The numerous areas where there is huge gouging need to be regulated. (e.g. MRI) The medicaid expansion needs to be mandatory for all states and everybody needs to be eligible. If you have a contagious disease, you need to seek treatment, whether you're legally here or not. If you're afraid to go to the hospital because you might get deported, and you're sick, you are spreading disease.
2: A public option. The insurance companis exist to make a profit, and in far too many cases, they're making the bulk of their money by gouging. In addition, they are a major insulator between the provider and consumer, totally preventing any semblance of an effective free market. A public option would be an insurance company with the resources of the government behind it. When this has been tried before, it has been vastly more efficient than private companies. I am pretty sure that the insurance companies will not be able to compete with a public option, but I'd be more than happy to be wrong about this. In that case, the public option would simply be another option, which could help out in places where insurance doesn't reach for some reason. But I'm pretty sure that won't happen, and the insurance companies will fight hard and dirty, by lobbying, bribery and outright cheating, to keep their perquisite.
3: After a few years of a public option, most of the insurance companies will be gone. At this point, there will be three systems: 1: the various existing government systems, such as the VA and medicare. 2: the various existing employer based systems. Most of the insurance based ones will have already been turned into versions of the public option by this point, but the self-insurance ones may still exist. 3: public option. The employers and many employees will be seeking a way to rationalize this. I suspect the best way to do it is Medicare for All: Simply pay medical costs like any other government service. This is by far the cheapest way to do it.
None of this would ban private insurance. If you want private insurance over and above medicare for some reason, you can do that. More realistically, there are plenty of things the government shouldn't be paying for, such as optional cosmetic surgery, that will be paid for out of pocket, and that's fine. Other concierge services would also be perfectly ok.
I'm ok with a nominal cost per visit. One of the things that happens in government systems sometimes is that hypochondriacs and bored people often spend a lot of time with the doctor just to have someone to talk to. To some degree, this is ok--hypochondria is sometimes a cover for some more serious underlying condition. So charge a few dollars per visit, just to keep abuse to a minimum. The provider may waive this fee at the behest of the doctor.
Whether medical care should be completely nationalized or can be implemented by a mix of public and private hospitals and other providers isn't clear to me, but what is clear is that the present system is rife with gouging and prevents a sizable part of the population from getting health care.
Here's my strategy:
1: Fix the PPACA. The mandate is critical. The regulatory constraints on what counts as acceptable insurance are critical. There are lots of details that need to be polished. The price of drugs needs to be brought under control. The numerous areas where there is huge gouging need to be regulated. (e.g. MRI) The medicaid expansion needs to be mandatory for all states and everybody needs to be eligible. If you have a contagious disease, you need to seek treatment, whether you're legally here or not. If you're afraid to go to the hospital because you might get deported, and you're sick, you are spreading disease.
2: A public option. The insurance companis exist to make a profit, and in far too many cases, they're making the bulk of their money by gouging. In addition, they are a major insulator between the provider and consumer, totally preventing any semblance of an effective free market. A public option would be an insurance company with the resources of the government behind it. When this has been tried before, it has been vastly more efficient than private companies. I am pretty sure that the insurance companies will not be able to compete with a public option, but I'd be more than happy to be wrong about this. In that case, the public option would simply be another option, which could help out in places where insurance doesn't reach for some reason. But I'm pretty sure that won't happen, and the insurance companies will fight hard and dirty, by lobbying, bribery and outright cheating, to keep their perquisite.
3: After a few years of a public option, most of the insurance companies will be gone. At this point, there will be three systems: 1: the various existing government systems, such as the VA and medicare. 2: the various existing employer based systems. Most of the insurance based ones will have already been turned into versions of the public option by this point, but the self-insurance ones may still exist. 3: public option. The employers and many employees will be seeking a way to rationalize this. I suspect the best way to do it is Medicare for All: Simply pay medical costs like any other government service. This is by far the cheapest way to do it.
None of this would ban private insurance. If you want private insurance over and above medicare for some reason, you can do that. More realistically, there are plenty of things the government shouldn't be paying for, such as optional cosmetic surgery, that will be paid for out of pocket, and that's fine. Other concierge services would also be perfectly ok.
I'm ok with a nominal cost per visit. One of the things that happens in government systems sometimes is that hypochondriacs and bored people often spend a lot of time with the doctor just to have someone to talk to. To some degree, this is ok--hypochondria is sometimes a cover for some more serious underlying condition. So charge a few dollars per visit, just to keep abuse to a minimum. The provider may waive this fee at the behest of the doctor.
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