read paul starr article

Adverse selection: "cherry picking"

economies of scale: one person in sales force database who can do a ton, (ex: towels in bulk; save money), want volume purchasing power which increases profit by more units sold

Costs of goods sold= (variable costs + fixed costs) / (units produced)

Value= (outcomes +safety+service) /(total cost of care/time)

Alike: Different: never know how much youre going to pay, prices arent transparent, no planning ahead, no choosing the hospital, no guarantee of satisfaction, stay length is unknown,

Payers: insurance companies or governments

slide 10; providers make induced demand because they run tests to diagnose Insurance; health insurance through employment, employer creates contract w insurers and dictates how patients can move through the system (act as purchasers) CMS: payer section because they cover 40% of the public through medicare and medicaid

know all three, can have genetic defect in AIRE,

know first three

spndylitis: s shaped spine

He thought that them getting milkmaids protected them from smallpox

we dont need to memorize, we just need to know that there are interactions between CAMs and each cell to get into areas of lymph nodes

homing: we most likely will get infected with pathogens the same ways so its most beneficial to have effector memory near those sites (if we get norovirus through gut we dont want all our cells sitting at our skin surface)

we replace p-selectin activation by activating E selectin

treating; anything that decreases T cells activation

chart

inflammation

Why dont we vaccinate against it?

create chart with each of these

losing tolerance to yourself and our ability to generate Antibodes towards self

can work first time, but second time it could result in a huge immune response unless you strip away serum proteins, (this was from 15 yrs ago) now we have a much better system of taking out serum proteins

IgG + antigen form precipitant (large immune complex), dont need to know C5a or C1

Not a great action plan, dont want to use a sledgehammer when we just need a hammer. Depleting complement would have serious impacts on other parts of immunity

Baby developed jaundice, placed under light and color goes away

Ketones= no gem-diols (except when substituents are highly electro neg)

More electronegative-->more hydrate