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(c) 2010-2026 Jon L Gelman, All Rights Reserved.

Sunday, November 17, 2013

Fix the Handful of U.S. Hospitals Responsible for Out-of-Control Costs

Today's post was shared by NEJM and comes from blogs.hbr.org

In May 2013, the Centers for Medicare and Medicaid Services (CMS) released CMS Medicare Provider Analysis and Review (MEDPAR) inpatient data that contain discharge information for 100% of Medicare fee-for-service beneficiaries using hospital inpatient services. This data shows what more than 3,200 hospitals in the United States were being paid for the most frequently performed 100 inpatient procedures. The variations were extraordinary. Some hospitals in the New York State were being paid 40 times as much as the world-famous Mayo clinic for some treatments.

This kind of variation is understandably a huge cause of concern at a time when health care costs are widely seen to be spinning out of control. Our research suggests, however, that the data contains a silver lining: The bulk of excess costs to CMS and inpatients for all the procedures — a total of $5.3 billion above the average across all hospital by procedure — are highly concentrated in just a small number of hospitals.

When we applied the techniques of Six Sigma analysis to the CMS data, we found that just 32 hospitals — less than 1% of the hospitals in the data — accounted for about 25% of the excess accepted charges. (Hospitals determine what they will charge, or bill, for items and services, and CMS then decides how much of that amount is appropriate and will be paid.) A handful of hospitals in New York State accounted for nearly half of them. Add some hospitals in...

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Federal jury finds JM Eagle liable for fraud for making, selling faulty pipes

Today's post was shared by Legal Newsline and comes from legalnewsline.com

Gordon
Gordon

LOS ANGELES (Legal Newsline) — A federal jury on Thursday found JM Eagle, one of the largest pipe manufacturers in the world, liable for knowingly manufacturing and selling to government entities substandard plastic pipe that was used in water and sewer systems in various states.

As a result of the decision, JM Eagle, formerly known as J-M Manufacturing, will have to pay out an undetermined amount of damages to Nevada, New Mexico and Virginia and 42 cities and water districts that joined the whistleblower lawsuit, and dozens of other states, cities and water districts that bought JM Eagle pipe but didn’t join the suit.

Gordon

The seven-week civil trial, held in a federal district court in Los Angeles, focused on the company’s efforts to cut costs by using shoddy manufacturing practices to make weaker, albeit more profitable, polyvinyl chloride, or PVC, pipe.

“The jury obviously decided that JM Eagle management cared only about the amount of pipe JM produced, not the quality of that pipe,” said Eric Havian, an attorney with Phillips & Cohen LLP, who argued the case on behalf of the plaintiffs.

“JM Eagle deceived outside inspection agencies and ignored over a decade of failing test results.”

Nevada Attorney General Catherine Cortez Masto, in a statement Thursday, called the situation a “budget nightmare.” The state was one of the largest purchasers of JM Eagle pipe and experienced many failures because of it.

“We...

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Democrats say minimum-wage battles to help 2014 turnout

Wages determine rates of workers' compensation benefits and ultimately insurance premium costs for employers. Today's post was shared by Steven Greenhouse and comes from www.usatoday.com

Rep. Steve Israel

WASHINGTON — Democrats hope a slew of potential ballot initiatives to increase the minimum wage next year in key states will drive up voter turnout and help their party in midterm congressional elections.

Advocates of wage increases are pushing 2014 ballot measures in several states, including Massachusetts, Idaho, Alaska and South Dakota. Legislative campaigns are planned in other states, including Illinois.

Last week, New Jersey voters overwhelmingly approved an increase in the state's minimum hourly rate by $1 to $8.25. It became the fifth state to hike its minimum wage this year, joining California, New York, Connecticut and Rhode Island.

The flurry of state efforts comes as President Obama and some congressional Democrats push an increase of the $7.25-an-hour federal minimum wage, unchanged since 2009. In February, Obama proposed raising the hourly rate to $9, but it has not gained traction in the GOP-led House. House Speaker John Boehner has said it would result in fewer jobs.

The White House recently endorsed a separate measure by Sen. Tom Harkin, D-Iowa, that would hike the minimum wage to $10.10 an hour by 2015 in several increments.

"The refusal to increase the minimum wage is just one of the ways House Republicans have inflicted harm on the economy and hurt people's pocketbooks," said New York Rep. Steve Israel, who chairs the Democratic Congressional Campaign Committee. "2014 is going to be a referendum on who has helped the middle class and...

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Privatization of workers, compensation continues throughout WV

A program set into motion by U.S. Sen. Joe Manchin, D-W.Va., continues to bring benefits to the state.

On Nov. 1 this year, the workers' compensation loss costs filed by the National Council on Compensation Insurance, or NCCI, over the summer became effective. The numbers reflected a massive overhaul that was nearly a decade in the making.

Then-governor of West Virginia, Manchin signed a law in 2005 fully privatizing the state's Workers' Compensation Commission and transforming it into a private insurance carrier — what became known as BrickStreet Insurance. Since the process completion in 2008, workers' compensation rates declined an average of 30 percent statewide, saving employers annual costs of $150 million in 2010. The number of protested claims is now hovering at about 4,000 a year — a dramatic difference from 2004 when it was about 24,000. In just the first two years, the number of outstanding, unfunded liabilities from the old state-run system dropped from $3.2 billion to $1.9 billion.

The current loss costs now reflect an overall reduction in cost levels for the voluntary workers' compensation insurance market of less than 8.8 percent.

From first filing the classification plan and loss costs on July 1, 2006, the state has enjoyed a continuous decrease in workers' compensation claim costs resulting in a cumulative loss cost level change of less than 46.5 percent.

Back in the early 2000s, West Virginia was experiencing one of the worst-managed...

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Iowa justices: Illegal immigrant entitled to workers' comp

Today's post is shared from desmoinesregister.com .

The Iowa Supreme Court ruled Friday that a West Liberty woman, an immigrant from Mexico who stayed in the United States after her visa had expired, is entitled to receive workers compensation benefits for a work-related injury.
The case involves Pascuala Jiminez, who came to the United States in 1991 and had a visa for 10 years. She remained after it expired and continued to work. She had lived in West Liberty for 19 years.
Jiminez worked for the Chicago-based temporary employment agency Staff Management and was assigned to the Proctor & Gamble plant in Iowa City where she packaged shampoo and prepared boxes and pallets for shipping.
In September 2007 she was lifting a pallet and became injured with what doctors later identified as two abdominal hernias. She returned to work and was limited in her ability to lift until she had surgery in November 2007. She returned to work again in December. In mid-January 2008, she was fired. Managers told her it was because she did not have legal authorization to work in the U.S.
She sought and won benefits from the Iowa Workers Compensation Commissioner in October 2010. Staff Management appealed to Polk County District Court, which upheld the commissioners decision. The company further appealed to the Iowa Supreme Court.
The company argued that a worker living in the country without legal permission should not receive workers compensation benefits because Iowa does not include undocumented workers in its definition of an employee under...
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CEO resigns from California state workers’ comp insurer

California's workers' compensation program in beginning to unwind with the resignation of the CEO of the State Fund. Waves of reform have deciminated the system in recent years resulting in the mass delay and denial of claims. Today's post is shared from the scabe.com .

Two top leaders resigned Friday from State Fund, a quasi-governmental agency that sells more than $1billion a year in workers’ compensation insurance, after overseeing a major restructuring of the organization’s bureaucracy.
Tom Rowe resigned as State Fund’s chief executive, and Dan Sevilla resigned as chief financial officer.
Fund spokeswoman Jennifer Vargen wouldn’t offer an explanation for their departures but said the resignations were voluntary.
The agency, formally known as the State Compensation Insurance Fund, isn’t well known but often plays a major role in California’s workers’ comp insurance market. It typically becomes the “insurer of last resort” when private carriers exit the state, as they did when costs soared and the market began imploding a decade ago. During that period, State Fund’s annual premiums zoomed from $1billion to $8billion, Vargen said.
After former Gov. Arnold Schwarzenegger signed a reform bill that reduced workers’ comp costs, the market turmoil subsided and private insurers moved back in. State Fund’s business began shrinking, and “we really had more staff than we needed,” Vargen said. Annual premiums have fallen back to around $1billion.
Since Rowe joined the organization in 2009, staffing has been reduced by 40percent, and some offices have been closed. The fund, based in San Francisco, employs 4,400 workers.
“The executive team has done an...
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Saturday, November 16, 2013

Class I Recall: Medtronic's Worldwide Voluntary Field Action on Guidewires

Medtronic, Inc. (NYSE: MDT) announced today that the U.S. Food and Drug Administration (FDA) has classified the company's recently initiated voluntary field action related to certain guidewires as a Class I recall.
Based on an internal investigation following a limited number of complaints, including one patient injury, Medtronic began notifying hospitals and distributors worldwide the week of Oct. 21 that some models of its guidewires from recent lots have the potential for the coating on their surface to delaminate and detach. The notification requested that all potentially affected units be quarantined immediately and returned to the company as soon as possible for credit and replacement.
Medtronic has also taken the necessary steps to prevent future shipments of the recalled products and notified regulatory agencies around the world as appropriate.
The FDA defines a Class I recall as a situation in which there is a reasonable probability that use of, or exposure to, a violative product will cause serious adverse health consequences or death.
The guidewires covered by this recall are designed to facilitate percutaneous coronary interventions or the placement of left ventricular leads for cardiac rhythm devices. They include specific lots from the following eight product lines that were manufactured after mid-April 2013:
  • Cougar nitinol workhorse guidewire
  • Cougar steerable guidewire
  • Zinger stainless steel workhorse guidewire
  • Zinger steerable guidewire
  • Thunder extra-support guidewire
  • Thunder steerable guidewire
  • ProVia crossing guidewire
  • Attain Hybrid guide wire
Additional information about the recall, including the lot numbers of affected product, is accessible through the Medtronic website – specifically, http://www.medtronic.com/for-healthcare-professionals/index.htm.
Observations and consequences of the coating issue related to these guidewires should be reported to Medtronic in the United States by calling +1-877-526-7890 on weekdays from 8am to 5pm U.S. Central Time.
Adverse reactions or quality problems experienced with the use of these products may be reported to the FDA:
ABOUT MEDTRONIC
Medtronic, Inc. (www.medtronic.com), headquartered in Minneapolis, is the global leader in medical technology – alleviating pain, restoring health and extending life for millions of people around the world.
Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results.
….
Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

H.R. 982 is anti-victim, anti-veteran and anti-privacy

Today's post was shared by Take Justice Back and comes from thehill.com

My husband, Alan, was diagnosed with mesothelioma in 2003. We had never heard of the asbestos-caused cancer, mesothelioma, and shortly learned it was incurable.
Alan chose to have a radical surgery which removed a rib and his left lung, stripped off his pericardium from his lungs and surgically replaced his diaphragm – all in hopes of more time with us.
In 2005, the cancer came back on his remaining lung. Alan felt like he was breathing through a pinched straw, every breath, every minute, every day.  When his oxygen levels became critically low, he was tethered to supplemental oxygen. He fought a hard battle with chemotherapy for nearly a year.
In 2006, Alan took his last breaths with our then 13-year-old daughter and me by his side.  Alan paid the ultimate price for his job – his life. Our daughter was only ten years old when we began our arduous family battle to fight mesothelioma and work with Congress to ban asbestos.
Today I fight on behalf of Alan and those who have been exposed, are suffering, or have been silenced by asbestos.
I can tell you that the FACT Act (H.R. 982) is just another special interest bill.
Sick and dying patients suffering from mesothelioma and other asbestos-caused diseases and their family don't have the time and money to endure one more bureaucratic hurdle that delays compensation, denies justice and puts asbestos warriors privacy at risk.  This is just what H.R. 982 would do.
H.R. 982 is just the latest tactic in this...
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Chris Christie's Failure Shows Just How Popular He Is

Today's post was shared by Mother Jones and comes from www.motherjones.com


Former New Jersey governor Tom Kean is apparently pretty annoyed with Chris Christie, partly for personal reasons and partly because Christie failed to help any other Republicans get elected to the state legislature.

The full failure of Christie's "coattails" campaign is only now being known. Christie had wanted to win the state senate, cutting ads and campaigning for key candidates. None of his challengers unseated any Democrats. The total Republican gain in the Assembly appears to be... one. That's better than 2011, when Democrats gained a seat, but even if you factor in the gerrymander that protects Democrats, Kean and other Republicans are amazed that Christie could win by 21 points and carry almost nobody along with him.
OK, but isn't there another way of looking at this? It shows just how popular Christie is personally even in a state that shows no sign whatsoever of warming up to Republicans in general. That's fairly remarkable.
I'll admit this a slatepitchy kind of argument to make, and I don't know if I really even believe it. Weigel is certainly right that this leaves Christie in the unenviable position of having to scrape and compromise with Democrats for the next few years, something that's unlikely to help his presidential ambitions much. If his compromises succeed, he's a sellout. If they fail, he's a guy who can't get anything done. That kind of sucks.
Still! His personal brand is obviously pretty sky high. That has to count for something.
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Workers at 9/11 site get workers’ compensation and disability extension

Today's post was from nysaflcio.org

Workers at 9/11 site get workers’ compensation and disability extension
Workers at 9/11 site get workers’ compensation and disability extension
The re-opener of workers’ compensation and disability retirement registry for workers at 9/11 Site (A7803A -Abbate / S5759A -Golden) has been signed into law and is Chapter 489 of the Laws of 2013.
This bill reopens the registry for workers’ compensation and disability pension for those who were at or near the ground zero after the 9/11 terrorist attack. The new open period will extend through September 11, 2014. If eligible, workers who are on the registry will be presumed to have contracted certain illnesses that manifest themselves later in life as a result of their work at or near the site during that time period. The bill also addresses a shortfall in the law that prohibited vested members of a retirement system who worked at the site during the time in question but who subsequently left service, from being eligible for the registry.
The NYS AFL-CIO will continue to work with affiliates to spread the word and encourage any members or other workers who may be eligible for to register to do so prior to the new expiration date of September 14, 2014.
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“Stand By Your Pan”: Cook Safely This Thanksgiving to Prevent Kitchen Fires

Today's post was shared by U.S. CPSC and comes from www.cpsc.gov

Pan on fire on a stove

The U.S. Consumer Product Safety Commission (CPSC) is alerting consumers that the threat of fires in the kitchen triples on Thanksgiving Day.  From 2009 through 2011, there was an average of about 1,300 cooking fires on Thanksgiving Day. This is more than three times the average daily rate from 2009 through 2011 of about 400 cooking fires a day.

“As fire safety experts have said for years, ‘Stand by your pan!’” said CPSC Chairman Inez Tenenbaum. “If you are frying, grilling or broiling food, stay in the kitchen. Not following this advice can be a recipe for disaster on Thanksgiving and throughout the year.”

When it comes to fires in the home, cooking fires are number one.  They accounted for nearly 150,000 fires (more than 40 percent of  all annual unintentional residential fires) each year from 2009 through 2011.  Unattended cooking is the top cause of cooking fires.  Cooking fires also caused the most home fire-related injuries, with an estimated annual average of  nearly 27 percent, or 3,450 injuries each year.

Overall, CPSC estimates an average of 362,300 unintentional residential fires, 2,260 deaths, 12,820 injuries and nearly $7 billion in property damage attended by the fire service occurring each year between 2009 and...
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Obama Selects Health Policy Advocate as Surgeon General

Today's post was shared by RWJF PublicHealth and comes from www.nytimes.com

President Obama nominated Dr. Vivek H. Murthy, an early supporter and grass-roots advocate for the Affordable Care Act, as surgeon general on Thursday.
Dr. Murthy, 36, is a founder and the president of Doctors for America, a group that campaigned for the health care law before Congress passed it in 2010 and that was an outgrowth of Doctors for Obama, which worked to help elect the president in 2008. He is a doctor at Brigham and Women’s Hospital in Boston and an instructor at Harvard Medical School.
At a Rose Garden event in October 2009, held as the Senate Finance Committee was set to vote on the legislation, Dr. Murthy said that Mr. Obama “understands that the current system isn’t working for patients, but it’s also not working for doctors.”
Jay Carney, the White House spokesman, said Thursday in a statement that Dr. Murthy “will be a powerful messenger” on health policy. His nomination is subject to Senate approval.
Last year, he was the co-author of an article for The New Republic responding to criticism of the health care law and citing its support among doctors, although it acknowledged qualms among them. “Doctors will support the new law to the extent that it becomes visible in their everyday lives, and make these lives better,” it said.
He also has been a leader in H.I.V. prevention and AIDS education in both the United States and India. In 1995, he helped found Visions, a nonprofit AIDS and...
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Friday, November 15, 2013

Taxi cab assaults: A different danger behind the wheel

Today's post was shared by NIOSH Transportation and comes from www.thespec.com

When a passenger held a knife to his throat three years ago, Muhammad Azeez stopped driving taxi for a month. He's still too scared to work the night shift.
Azeez is not alone. According to a 2011 survey, Toronto's iTaxiworkers Association reported more than half of the respondents had been assaulted, and 70 per cent felt in physical danger while driving.
Many cities believe partitions in cabs are the best way to protect drivers. But new research from the U.S. shows that dashboard cameras, not partitions, are most effective at reducing taxi driver homicides.
These findings come amid a city-wide review of the taxi industry. Three Toronto drivers were stabbed in one week earlier this year, despite the requirement of cameras in cabs. The review will also assess the feasibility of adding partitions.
Azeez believes that might be the best option. "Maybe a partition would have stopped him putting a knife to my throat," he says of his assailant. "The camera takes a picture, but a partition actually shields you from a person with a gun or knife."
Crimes against taxi drivers dropped 75 per cent after cameras became mandatory in Toronto cabs in 2005. But the murder rate involving cab drivers still remains the highest of all occupations.
Following the brutal murder of driver Mahmood Bhatti by a passenger in 2006, Councillor Janet Davis brought forward a motion to approve partitions. It passed, and the idea is currently under review.
"The...
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Taxpayers pay high cost for low fast-food wages, lawmakers are told

Today's post was shared by Steven Greenhouse and comes from www.latimes.com

SACRAMENTO — Low wages paid by the fast-food industry come with a high public cost for California taxpayers, academics and advocates for the working poor told state lawmakers.
Workers at hamburger, pizza and other, mainly franchise, eateries are paid at near-minimum-wage levels, making them eligible for public assistance that totaled an average of $717 million a year in California from 2007 to 2011.
The condition of low-wage fry cooks and sandwich makers was the focus of a joint hearing of the Senate and Assembly labor committees Wednesday. The inquiry was held in the wake of a 60-city protest in August by fast-food employees. Protesters, backed by the Service Employees International Union, called for collective bargaining and a $15-an-hour minimum wage.
Simone Sonnier Jang, a mother of two who works at a Los Angeles McDonald's, said she wouldn't be able to survive financially without subsidized housing, day care and medical care for her children and cash assistance.
"Without that I wouldn't be able to pay rent, cover the cost of utilities," she said, "and I wouldn't be able to buy my own food."
The drain on the safety-net funding is alarming, said Assemblyman Roger Hernandez (D-West Covina). "The taxpayer should not have to subsidize one industry," he said.
The movement got a boost in September when Gov. Jerry Brown signed legislation raising the California minimum wage from $8 to $10 an hour, in two steps, by 2016.
Much of the data...
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Expediting Drug Development — The FDA's New “Breakthrough Therapy” Designation

Today's post was shared by NEJM and comes from www.nejm.org


Many people with serious or life-threatening illnesses for which there are no satisfactory treatments are understandably eager to gain access to new therapies and are willing to trade off greater certainty about a drug's performance for speed of access. 

Because the typical clinical drug-development program takes about 7 years, during which a substantial body of safety and efficacy data is generated, the Food and Drug Administration (FDA) has long-standing expedited pathways available for drugs being studied for such illnesses. However, many patients and their advocates continue to believe that clinical development is sometimes prolonged beyond what is necessary. 

During the congressional considerations leading up to passage of the FDA Safety and Innovation Act of 2012 (FDASIA), a variety of provisions related to this theme were put on the table. 

When the bill was enacted, two modifications of the Federal Food, Drug, and Cosmetic Act addressed the issue of drug development for serious illnesses: a new “breakthrough therapy” designation for investigational drugs and expansion of the statute regarding accelerated approval

The breakthrough-therapy designation has since been introduced into the FDA portfolio of expedited programs for serious conditions....
Perspective
Rachel E. Sherman, M.D., M.P.H., Jun Li, J.D., Ph.D., Stephanie Shapley, M.B.A., Melissa Robb, R.N., and Janet Woodcock, M.D.
N Engl J Med 2013; 369:1877-1880November 14, 2013DOI: 10.1056/NEJMp1311439
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White House rejects asbestos bill

Today's post was shared by Linda Reinstein and comes from www.politico.com

President Barack Obama’s administration came out against a key piece of asbestos legislation Tuesday just days after headlining a fundraiser at the homes of two of the top asbestos litigators in the country.
In a swing through Texas last week, two of the country’s top asbestos attorneys, Russell Budd and Peter Kraus, hosted fundraisers that brought in an expected $1 million-plus for the Democratic Senatorial Campaign Committee over the course of three hours at their Dallas-area homes.
Continue Reading
On Tuesday evening the White House put out a statement opposing a piece of legislation aimed at regulating asbestos bankruptcy trusts. Budd and Kraus both sit on the boards of several of these trusts.
The White House and the Office of Management and Budget did not respond to a request for comment.
The trusts allow companies with significant liabilities to secure protection for future claims, but often have advisory committees made up of people from the same law firms that represent the asbestos clients.
The Furthering Asbestos Claim Transparency (FACT) Act — backed by business interests such as the U.S. Chamber of Commerce — would require the trusts to disclose additional information about the claims the pay to victims, in order prevent false or inflated claims.
In a statement Tuesday evening, the White House warned that the legislation would make publicly available the personal information of individuals who had filed asbestos-related injuries. Additionally,...
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He Got His Wish

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com

I had put my airplane away for the evening after visiting my mom and dad yesterday, and was exiting the secured gate at the airport when a woman had pulled up and frantically waved me down.

Her 88 year old dad was at the airport, his hangar was "right over there" (we could see it from the gate) and his car was parked out front and the door of the hangar was partially open.

She was panicking. Her dad ALWAYS was home by 4 p.m., but her mom said he hadn't returned yet - it was about 5:15 when this encounter occurred.

So I let her through the gate and escorted her to the hangar where the lights were on and her dad was sitting in the back seat of his Navion, looking asleep.

Except he was cold to the touch when I climbed up the ladder to check on him. I called 911, flagged down airport security, and tried as best I could to offer some condolence to Julie (we finally introduced ourselves).

I couldn't help but think of the irony that I had just returned from yet another trip dealing with my dad in the hospital, on the border of life and death with all sorts of tubes and wires in him, making sure my mom was taken care of and dealing with the Business of Dad, and Julie's father seemed to have passed peaceably, quickly it seemed, in his airplane, still holding an approach chart in his hand.

Julie was distraught and sad, of course, at the sudden death of her father. But she told me that he had always said he wanted to die in his airplane.

He got his wish.

And that little tale has absolutely...

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