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How is sql used to query healthcare claims?

Typically a hospital will have an Electronic Medical Record system (EMR henceforth). This is usually stored as a relational database on enterprise servers which generally means that SQL will be used to access that data.When you fill in the forms at the doctor’s office disclosing your medical history, the reason for your visit, family relations, etc.; this is probably transcribed or scanned into the EMR. Additionally, when the doctor makes notes, prescribes medications, or orders procedures these are also submitted. There is quite a lot of information in a healthcare claim, and no two EMR vendors structure it quite the same, but it breaks down into the following general categories:Patient Demographics: Name, Age, Race, Gender, etc. What uniquely identifies you as you. At this level you will probably be assigned a Medical Record Number (MRN), or Patient Identifier. This is the primary way to link all your records together.This MRN will probably be a key to any of the other areas of a healthcare claim - which includes information from the two categories which follow.Medical History: What conditions you sought treatment for (diagnoses), what was done (procedures), and the results (laboratory results). These will be grouped by an episode or visit identifier. This is another key link that ties together all the different activities above - i.e. you don’t want to mix the treatment for a broken femur you had two years ago with the pneumonia you are dealing with today.By knowing the MRN and the Visit ID you can quickly assemble a dataset to report on the patient’s health history. This is where an accurate relational component is critical.When looking for patients with certain medical conditions you would look for that item (designated by a DX, CPT, HCPSC, or similar code), and then join to all patients and possibly all financial records with MRN and Visit Identifiers related to the condition.Financial History: Who paid what portions of what claims - you probably have an insurance package with at least medical, but likely also prescription, and dental coverage. A claim is not a single line item, and often times is not part of the same bill, and the reason is that while you experience the healthcare/provider episode as a single entity, there are actually several entities behind this.The facility (hospital, clinic, etc.) may bill for service and use charges, the provider (usually an M.D. doctor) may have their own billing schedule - in a hospital setting there is a good chance that the doctor is not quite an employee of the hospital in the normal sense; they may have a contract, or shared practice arrangement or such.As indicated above the insurance may be complex as well - depending on the benefit you use, it may not even be the insurance company you have a contract with; dental, prescription, and vision benefits are usually subcontracted. For example I used to have a United Healthcare package which actually paid it’s own dental, but the vision was subcontracted, and there was a prescription discount program (I want to say ExpressScripts) which kicked in if your meds were appropriate for mail-order - i.e. for chronic conditions.

What are some mind-blowing facts about the U.S. military?

1) The United States Military is one of the world's largest providers of international aid and disaster relief.I enjoy this fact because so little is it remembered. Not only is the US military usually involved with most global conflicts, but they are also present in the time of need for almost every international natural disaster in which aid can be rendered. I love advertising this fact because so often I hear about all the evils of the United States, but not once have I ever heard the phrase, "Hey America. Thanks a bunch for the assist. Tsunamis really suck."As well as this, the military also makes regular deployments to disenfranchised and impoverished developing nations to provide immediate health and medical support during times of non-violence or disaster. These services are free to the people of those nations and supported entirely by United States taxpayer dollars.Case in point, the USNS Mercy.This is the USNS Mercy. She is a massive hospital ship and, along with her sister ship the USNS Comfort, has the proud and distinguished mission to sail around the world to places in desperate need of medical aid and support. Officially, their primary mission is to:provide rapid, flexible, and mobile acute medical and surgical services to support Marine Corps Air/Ground Task Forces deployed ashore; Army and Air Force units deployed ashore; and naval amphibious task forces and battle forces afloat.Secondarily, they provide “mobile surgical hospital service for use by appropriate US Government agencies in disaster/humanitarian relief or limited humanitarian care incidents to these missions or peacetime military operations.”Looking at the record, you'll find that the Mercy and Comfort have been quite busy with "secondary" missions. Here is a list of some of the Mercy and Comfort's "secondary" missions:1987 - (USNS Mercy) Over 62,000 outpatients and almost 1,000 inpatients were treated at seven Philippine and South Pacific ports during training in 1984 through 1987.1990* - (USNS Mercy) Admitted 690 patients and performed almost 300 surgeries. (USNS Comfort) More than 8,000 outpatients were seen, and 700 inpatients. 337 surgical procedures were performed. Other notable benchmarks include: more than 2,100 safe helicopter evolutions; 7,000 prescriptions filled; 17,000 laboratory tests completed; 1,600 eyeglasses made; 800,000 meals served and 1,340 radiographic studies, including 141 CT scans.2001 - 9/11 - (USNS Comfort) The ship's clinic saw 561 guests for cuts, respiratory ailments, fractures and other minor injuries, and Comfort's team of Navy psychology personnel provided 500 mental health consultations to relief workers.[5] Comfort also hosted a group of volunteer New York area massage therapists who gave 1,359 therapeutic medical massages to ship guests.2003 * - (USNS Comfort) 590 surgical procedures, transfused more than 600 units of blood, developed more than 8,000 radiographic images and treated nearly 700 patients including almost 200 Iraqi civilians and enemy prisoners of war.2005 - Indian Ocean Tsunami - (USNS Mercy) Combined, provided 108,000 patient services, rendered by members of the Department of Defense, Project Hope, and the United States Public Health Service.2005 - (USNS Comfort) Comfort deployed on September 2, 2005, after only a two-day preparation, to assist in Gulf Coast recovery efforts after the devastation of Hurricane Katrina. Starting in Pascagoula, Mississippi and then sailing to New Orleans, Comfort personnel saw 1,956 patients total.2007 - (USNS Comfort) Central and South America. In all, the civilian and military medical team treated more than 98,000 patients, provided 386,000 patient encounters and performed 1,100 surgeries. Dentists and staff treated 25,000 patients, extracting 300 teeth, and performing 4,000 fillings, 7,000 sealings, and 20,000 fluoride applications. In addition to treating patients, bio-medical professionals fixed about a thousand pieces of medical equipment at local health facilities. The ship's crew also delivered nearly $200,000 dollars worth of donated humanitarian aid.2008 - (USNS Mercy) Over the course of one deployment, Mercy would treat 91,000 patients, including performing 1,369 surgeries.2010 - (USNS Mercy) Treated 109,754 patients and performed 1,580 surgeries in Southeast Asia.2010 - (USNS Comfort) Haiti Earthquake disaster. Between January 19 and February 28, 2010, the ship's staff treated 1,000 Haitian patients and performed 850 surgeries. Also, the mission saw the ship's first on-board delivery, of a 4-pound, 5-ounce premature baby named Esther.2011 - (USNS Comfort) - The ship deployed for five months providing medical services to locations in the Caribbean and Latin America.It is important to remember that all this is done, by only two ships. Beyond these two ships, the United States Navy takes part in many humanitarian service missions each year. Several ships are deployed with missions other than warfare to provide free aid and medical support.There are also ongoing operations such as the Pacific Partnership. The Pacific Partnership is an annual deployment of forces from the Pacific Fleet of the United States Navy (USN), in cooperation with regional governments and military forces, along with humanitarian and non-government organizations.The deployment was conceived following the 2004 Indian Ocean earthquake and tsunami. The goal was to improve the interoperability of the region's military forces, governments, and humanitarian organisations during disaster relief operations. Specifically, it focused on providing humanitarian, medical, dental, and engineering assistance to nations of the Pacific, and strengthening relationships and security ties between the nations. Between 2006 and 2010, Pacific Partnership has visited 13 countries, treated more than 300,000 patients, and built over 130 engineering projects.The MEU to the RescueWithin the United States Marines, there exists elements that specialize in being the first into a war zone. Most of the offensive parts of the Marine Corps are built around this idea, but particularly there is one capability that is most crucial to this mission.The Marine Expeditionary Unit (MEU for short) is capable of deploying troops anywhere within reach of a the water within 48 hours. They are prepared for potential long-term hostile engagements, which means they have supplies and armaments to survive and thrive a long a long military campaign even without the support of the United States vast logistics network. As they say, “First to the Fight”. They are specialized to patrol every ocean in the world for signs of danger and disorder, and to do something about it.The Marine Expeditionary Units were built for an unforeseen sudden conflict, but their specialties make them particularly useful for rendering aid when less nefarious forms of disaster strike. They are adept to address and adapt to the needs of millions of people throughout the world in need of immediate emergency assistance. They are able to move so quickly that they outpace more formal relief organizations, like the Red Cross or the United Nations, by days or weeks. This is why these lethal warfighters are often given the mission to be the vanguard of western nations helping less fortunate nations in times of dire need.Marines supply civilians after the 2005 tsunami.Medical staff giving aid to displaced villager.3rd FSSG Marines assist with the distribution of humanitarian aid at Palonia Air Field, Medan, Indonesia, as part of Operation Unified Assistance.And Yes, There’s MoreMore recently, after the devastation from the 2010 Haiti Earthquake disaster, soldiers from the United States Army were deployed to assist in delivering badly needed supplies, such as food, water and other necessities to the region.Soldiers prepare food and water for Haitian victims of the Earthquake.I'm going to lay it out straight. I am willing to bet almost no one knew about the scale of the United States' disaster relief history before reading this answer. You probably had no idea of the depth of support that the United States military contributes to the world each time a major disaster strikes somewhere on the planet Earth. You know that help was sent, but did your ever really ask who it was or what form it took? You may have seen many headlines about the brave 150 doctors that went as part of the Doctors Without Borders program, but were you aware of the tens of thousands of soldiers, sailors, and Marines that were there before even the news journalists were present?And no, this isn’t just easy photo ops for the cameras. What the military does for those in need are things no one else would even attempt for people no one else seems to care about. In May of 2015, a UH-1Y with the III Marine Expeditionary Force, crashed while delivering aid to the remote mountain village of Charikot in Nepal following a 7.3 magnitude earthquake. The six Marines on that flight lost their lives, but you probably never heard about their great sacrifice, I’m sure.It’s easy to rattle off statistics and popular viewpoints about what monsters the American warfighters are. Cynics will moan about all the people that the harm and suffering wrought by the US military worldwide, but no one in the history of the world can declare that they have made such great strides in providing aid and relief like the Americans.This should ring especially significant, since we have absolutely no real obligation to do so if previous major world powers are to be our example.You could compare us to the Raubwirtschaft (plunder economies) of Germany, Japan and Russia during their time in power. You could also look at "aid" the European people provided the African colonies during their time as superpowers. Even better... look at what they are doing for the world right now. Where is their great big white boat with doctors and dentists? Where are their Marines after an earthquake or hurricane? At home, on their porches, sipping on a cup of self-righteousness as they lecture the world about the virtues of pacifism and the horrors of the American military. It's hypocritical and it's ignorant.While many find that the superstructure that is the US military is a bloated and imperialistic beast, it's still the largest and most efficient source in the world to get help where help is needed. That help happens whether that be in calming a diplomatic hot spot, giving food to a devastated rural village or fixing cleft pallets for children in a part of a country that has never seen a dentist or surgeon. Would I like to see other, more pacifist organizations do the job? Sure I would, but so far the world is more content to complain than attempt to do what we do.The US military doesn't suffer from that handicap.Say what you want about us, but without that aid provided by hundreds of thousands of American service people and a few hundred million taxpayers, millions upon millions of people who have been fed, vaccinated, operated on, given shelter, given homes, bathed, birthed, and listened to would not have the quality of life they now have. Let’s not forget how many of them, would also now be dead without us.Sure it's easy to gauge the military on violent metrics, (which is also appropriate) but how do you measure the value of those we have helped? That's a philosopher's discussion; not one for the Marines. Yeah, the Americans and their military have an ugly job, but if you're one of the veterans, you ought to be pretty proud right now. [2]That is such a pretty medal isn't it? About that...2) The uniforms are not provided by tax payer dollars. They are paid for by the troops themselves.Neat how I segued from the Humanitarian Service Medal to my point on how much uniforms cost, huh?See this beautiful example of a human being above? People who can read his rack (the medals on his chest) know this man is truly a boss. I'll list a few of the really cool ones. He's stellar: Two Navy Commendation Medals, Three Navy Achievement medals and a few Good Cookies. He's also a bona fide war hero: Two National Defense Medals (two different periods of war), several combat action ribbons, two devices known throughout the Corps as the “Recon Combo”, and the crème de la crème, the Enemy Accuracy Medal, better known as the Purple Heart. Plus, this flower looking thing I can only assume means he's awesome (or Canadian?) not to mention at least 13 different pieces of insignia I don't care to mention.Do you know how John D. Taxpayer thanks the honorable Gunnery Sergeant Awesomesauce? By making him pay for each and every freaking thing you see... even down to the buttons on his stinking coat. Did I mention those medals are gold plated?These are the Uniforms of the USMC. [3] I will make the caveat that it is true that military personnel are provided with one piece of every item they need when they first enter boot camp. What most don't know is that these also come out of their paycheck. It is sort of a hidden cost since we are more involved in boot camp than watching our finances. We all know it happens, but just have to get it done. It is assumed that this uniform item is supposed to last throughout their enlistment which could last 30 years. And those medals you earn? You're given one when earn it. It's like the Humanitarian Service Medal above. It isn't the gold plated version and basically, you have no uniform you are allowed to wear it in. For all the medals you actually wear, you have to pay between $13 and $60 for the pretty gold plated one. Interesting huh?This is made easier by a stipend military folks receive that is around $200 every year for replacement of uniform items. Let's look closer at that, though.I am going to go over an estimated cost of what is shown by the Gunnery Sergeant in this picture.Section A: CoverAnodized Cap Button Set: $3.95Black Chin Strap for Service Frame (All Ranks) $5.00Cap Ornament for Dress Frame Enlisted $6.95Enlisted Frame Only Bernard $33.50White Cover ONLY for Bernard Officer Frame $34.00Total Cost of "Cool Hat": $83.40Section B: MedalsAnodized Finish Full Sized Medals range from $13 - $80Purple Heart - $54Navy & Marine Corps Commendation Medal - $13Estimated cost of the other 10 medals at an average of $20 each: $200Combatant Diver Badge Regulation: $8.95Parachutist Wings Regulation, Anodized: $9.951/8" Single Star - $1.49 x 7 (visible): $10.43Total cost of "Bling" - $296.33Section C: Other DevicesRibbons: $1.15 x 8: $9.201/8" Single Star - $1.49 x 8: $11.92Other devices: $9.00Extra Doo-Dads - $30.12Section D: The Blues CoatButton Set for Enlisted Male Dress Blue Coat: $52.95Collar Ornament for Blue Dress Enlisted: $6.95Marine Corps Dress Blue Coat: $349.95Gunnery Sergeant Rank Insignia: $13.95Total for the Coat: $423.80Total for everything visible:$833.65[4]I'll remind readers that this is just what is visible in that image. I am only showing you the parts visible in the picture. Not shown, but simply must be there, are $83 pants, $99 shoes, a $50 belt buckle, service stripes, blood stripes and at least four other trinkets I can think of off the top of my head.Let's not forget that that guy doesn't look like a seamstress, so add in tailoring. And not to be topped, this is all still just one uniform of the six regulation uniforms that Marines are required to upkeep at all times, not to mention multiple sets of pristine camouflage utilities.You might not realize this from the outside, but military troops' uniforms come at a very high cost, so to speak.Not only is there the cost of earning the right to wear it, but the sacrifice of time and money to upkeep it. As I have said, we receive the few items we are issued (bought) at boot camp. We are issued one cheap version of the medals we earn, but aren't really allowed to wear them (because it's the cheap version). We also receive a regular pittance to upkeep it. I hope I have shown that that is hopelessly insufficient for all the gear and uniform items we are expected to maintain.I could go on about how many pairs of combat utilities I went through on my two Iraq deployments and my many training missions and how the two they gave me just didn't make it. I could go on about how if one of those gold medals got scratched... it was worthless and you had to get a new one. Did you know that gold is one of the most malleable metals on Earth? You will once you replace a $22 medal because Corporal saw a scratch on it. I could go on about the countless inspections to ensure that our uniforms were perfect... perfect. But I won't bore you with the detail on those. What I will say is that they are important to us. We work exceptionally hard to make sure that they are pristine and represent all the greatest qualities we can put into them. They are trying to convey an image and ideal of respectable men and women that instill courage and a sense of pride and security in the people they serve.Of course this is also why we write answers like this Nick Layon's answer to What is the fashion trend you dislike the most, and why? or go ballistic when we see celebrities do this:It’s also why comments such as this don’t usually have the intended result of shaming us back into our place:So what you don't like is when the citizens you protect wear the uniform you wear while preserving our freedom? And for this you raise your voice at them? Are you aware sir, that the taxes those people pay on the clothes you don't like them wearing are what pays your salary?Yes. In case you didn't know. Military personnel can easily spend more than a third of their after tax disposable income a year on uniform items. They do this out a sense of pride. They do this out of a sense of honor and respect to the uniform and what it represents. They do this so that when you see them, you can gain a sense of pride and feel safe knowing that when all hell breaks loose, a professional is ready to meet it. They do this to not be yelled at during inspections. They do this because it proves that they are special.What I hope you take away from this, if nothing else, is that your tax dollars are a drop in the bucket for what military personnel pay every year for their uniforms.Also, don't be surprised to receive a knife hand to the temple if you expect praise, gratitude, fealty, or admiration because you were so generous to pay your obligatory taxes this year. Military people don't owe you anything just because you pay taxes and you didn't put those medals on our chests. We look good because we paid for the right to, in more ways than one. [5]3) Our Navy Were Basically Pirates.Ok, I know I just made the biggest deal about how the United States military has relatively unheard-of aspects that include noble and virtuous service to disaster-stricken regions and that our uniforms mark us as some of the proudest and most professional military personnel on the planet.So why on Earth would I say that we started off as pirates? Because someone who reads the facts and has a vague understanding of military practices has some hard truths to deal with when looking at American military history. There are some colorful factoids hidden in sunken chests down under the sea that paint a picture few have ever really seen. There was some downright swashbuckling going on back then. I've taken a pretty liberal historical licence, but there is, as is the case with everything else, much more to the story than what made it to our history books. Let's take a look.Take a look at this flag. What do you see? Anything familiar?You guessed right! It's the flag of the British East India Company! How smart you are! Doesn't look at all like anything else after all...Notice again some of the elements of the flag. The first thing we need to know is that this was a Naval flag and all the elements have important naval meanings. It was colonial practice to place the mother nation's standard at the top corner against the mast. Here we see the Union Jack, the national flag of the United Kingdom, present, as it appeared during the time of the American Revolution. What is also important was the red field.In those days, such a flag would denote the ensign of the trade navy; ships not meant specifically for war, but to support the economic empires of the sea. Such a flag as the one below would indicate that it was an official trade ship flying under the protection of the crown of England. The red color also meant that it was a civilian ship and that its only mission should be one of trade.So alright, well still the stripes are a big deal though. It's hard not to see those stripes, right?Yes. It is hard. That's why many of the major shipping companies of that era made special marks on their flags by simply sewing white stripes across the field. Don't think of it as red and white stripes, but as a red field with white stripes on it. In fact there was one such company that made a remarkable effort to emulate the Colonial Flag, nearly 70 years before we ever flew it. They were the East India Trading Company, and had been waving a flag virtually identical to the Grand Union Flag, the first flag of the United States, for the better part of a century before the Revolutionary War.Now it's just me, but if I were a British ship just looking over and see a flag that looked like that, I probably wouldn't think of some navy that no one has heard of yet coming to buckle my swashes.With that said, I’m willing to bet that was the intention of the Continental Colors as it was used by the ragtag fleet of the American navy. Some might call that a case of mistaken identity, or clever use of unconventional warfare, while others might go as far as to say that it is downright piracy. Still some might just say it is one big convenient coincidence.I don’t believe in such coincidences.On MarinesHere are a few things that you should know about my beloved Marine Corps. One of the first facts that every good Marine knows, myself being among that noble tradition, is where the Marine Corps was born. Do you know? It was Tun Tavern in Philadelphia, Pennsylvanian.Yep, at a bar.The proudest and most lethal fighting men in the planet are the ancestors of a bunch of rowdy drunks. Well, for better or worse, little has changed.Our first recorded battle was the Battle of Nassau, led by Captain Samuel Nicholas, which consisted of 250 Marines and sailors who landed in New Providence and marched to Nassau Town. There, they wreaked much damage and seized naval stores of shot, shells, and cannon, but failed to capture most of the desperately needed gun powder. The forts at Nassau and Fort Montagu were raided and stripped of their armaments, while Marines occupied the town of Nassau for a lengthy stay. While in Nassau the Marines "relieved" them of some of their unwanted burdens, as well. Governor Browne complained that the rebel officers consumed most of his liquor stores during the occupation, and also wrote that he was taken in chains like a "felon to the gallows" when he was arrested and taken to the Alfred.Since then, for the most part, we have cleaned up our act — a bit. For those early days, however, it is my belief that the Continental Marines' use of "unconventional warfare" to complete their missions might warrant a closer look at our views of their history, or at least just reveal them as the colorfully exuberant fellows of cheer and good character that they were.The Father of the American NavySwitching back to the Navy, meet John Paul "Jones" and the Continental Navy. After combing the web for information on John Paul, on his best day, he was a jerk. Let's begin. This man is often cited as one of the founding fathers of the U.S. Navy. His sarcophagus even, rests to this day, in the US Naval Academy in Annapolis. Pretty cool, but let's check his resumé.Began work on a slave-trade ship.Next, worked on a brig (prison ship) where his first mate and captain conveniently died of disease, leaving him the de facto captain of the ship.He later captained his own ship where he savagely flogged two of his sailors for disciplinary actions, one to death.After this, he killed one of his sailors for mutiny by stabbing him in the chest. Following that incident he fled the Royal Navy and went to Virginia and added the surname "Jones" in an effort to avoid his pursuers for what amounted to murder. By his account, it was an act of self-defense, but no one I know runs to a non-extradition country and changes their name for self-defense. Just saying, I don't think he was all-in-all a stand-up guy.Following this John Paul Jones was recruited to the Continental Navy, because hey, beggars can’t be choosers. His successful exploits with the Royal Navy made him a prime candidate for a new navy starving for officers, even legit psychos. He then captained one of the vessels bound for Nassau in the Bahamas. The small fleet of ships captured the city, several ships and supplies, the whole time waving what was believed to be the Grand Union Flag that looked suspiciously like the 70 year old flag of a very, very famous trade company.From this point on, John Paul Jones led many other raids on naval shipping and port towns. He was successful enough that he was given the go-ahead to become a curse on English shipping.After touching base in France he actually sailed up to the coast of England and Ireland and started attacking British merchant shipping. In his career he captured many ships and a vast amount of supplies for the Colonial cause. All this while routinely facing problems from his crew who, as his journal accounts "'Their object,' they said, 'was gain not honor.' Among other actions his men were famed for raiding villages and conducting arson attacks on the English towns. In another report, Jones stated that at one point he wanted to leave, but his crew wished to "pillage, burn, and plunder all they could".Now this is just me talking, but I am surprised that a man who once beat his sailors to death would be having such discipline problems. Just sayin'.Now, I know that not everyone is a fan of 18th century naval warfare, but his tactics were conducive to a rather different form of naval warfare than his famed Bon Homme Richard, where he is famed for his saying, "I have not yet begun to fight!" No, this was a different form of naval practice. If you haven't pieced it together yet...John Paul Jones and much of the Colonial Navy were as close as it gets to pirates. [6]4) The United States Military is one the Most Educated Industries in the World.The United States military boasts some of the most educated warfighters in the world, not to mention in the history of warfare. All US service members must have at the time of their enlistment a high school diploma or the general equivalency diploma. To be more clear, more than 99% of those enlisted have a high school education comparable to about 60% that you will find in the general population. Also, compared to the population of the United States, more service members have also attended some college compared to their typical 18- to 24-year-old counterparts. They have all also passed a standardized test on English proficiency, mathematics, science and government. This test also serves as a placement exam for military jobs. [7]To top this, most Military Occupational Specialty (MOS) schools boast world-class educational training. First, you have to place high enough on the test to get into the school you want, which can have very high scores requirements to place. No, we don't have the greatest recreational facilities and the dorms suck; it isn't the Ivy League, but the education level is beyond par. While stationed in 29 Palms California, a hole in the middle of the California desert, I received two years worth of the most rigorous training in Computer Science, Data Network Administration, and Information Systems Maintenance. I say two years worth, except that I only had six months to do it. The training is taken very seriously. While typically, civilians are allowed to pass with virtually any grade so long as they beg enough, every test in a military school is a fail if scored under 80%, and if you fail you can be booted from the program.The Marine Corps InstituteThe United States Marine Corps even has an amazing secret that few on the outside know anything about. We have a correspondence college, which is a universal part of nearly every Marine's military experience. It is called the Marine Corps Institute (MCI for short).The MCI began when Major General Lejeune issued a Post Order establishing three new schools: Automobile Mechanics, Music, Typewriting and Shorthand with Special Order No. 299 on January 5, 1920.Of course, we have courses you won't find at Stanford, Harvard, or UCLA, or any state school, for that matter. There doesn't seem to be a need for 0321B - The M240G Machine Gunner, 0090A Pistol Marksmanship, or 0365 Antiarmor Operations there, but what you might be surprised by are the other courses one wouldn't expect to see by the barbarian warmongers that are the United States Marine Corps: 0119H Punctuation, 0120 Basic Grammar and Composition, and 1334 Math for Marines. Perhaps that's where Marines figure out what it takes to re-calculate the trajectory of an object traveling at 3,110 ft/s for a three-inch change in elevation at 5 times the length of a standard football field (American football, obviously) when factoring in for wind speed and direction, as well as differences in elevation?Commandant’s Reading ListOne more shocker regarding the nerdiness of the US Military? How about this, the Marines have a book club. This isn't Oprah's Book Club. It's the Commandant's Reading List [9]. On this list are books and documents intended to both encourage the martial spirit in the minds of young warriors and inspire the intellectual capabilities of scholarly warfighters. What follows are some of the more impressive works that appear. This is by no means a complete list.You will obviously find on the list titles such Marine Corps classics as:MARINE! THE LIFE OF LT. GEN. LEWIS B. (CHESTY) PULLER, USMC (RET.) - Burke Davis,AMERICAN SPARTANS: A COMBAT HISTORY FROM IWO JIMA TO IRAQ - James Warren,FLAGS OF OUR FATHERS - James Bradley.Also listed are many other works on warfare such as:THE ART OF WAR - Sun-TzuATTACKS - Erwin RommelBooks on Moral Codes and Ethics:ON KILLING: THE PSYCHOLOGICAL COST OF LEARNING TO KILL IN WAR AND SOCIETY - Dave Grossman,JUST AND UNJUST WARS: A MORAL ARGUMENT WITH HISTORICAL ILLUSTRATIONS - Michael WalzerBooks on Leadership, Management Philosophy and Administration:TEAM OF RIVALS: THE POLITICAL GENIUS OF ABRAHAM LINCOLN - Doris Kearns GoodwinBLINK: THE POWER OF THINKING WITHOUT THINKING - Malcolm GladwellSOURCES OF POWER: HOW PEOPLE MAKE DECISIONS - Gary KleinOUTLIERS: THE STORY OF SUCCESS - Malcolm GladwellWorks on military history:BATTLE CRY OF FREEDOM: THE CIVIL WAR ERA - James M. McPhersonTHE VIRTUES OF WAR - Steven PressfieldAs well as important world studies for the military minded:DIPLOMACY - Henry KissingerTHE LANDSCAPE OF HISTORY: HOW HISTORIANS MAP THE PAST - John Lewis GaddisTHE LITTLE BOOK OF ECONOMICS: HOW THE ECONOMY WORKS IN THE REAL WORLD - Greg IpTHE REVENGE OF GEOGRAPHY: WHAT THE MAP TELLS AS ABOUT COMING CONFLICTS AND THE BATTLE AGAINST FATE - Robert D. KaplanThere is even one on environmentalism!HOT, FLAT, AND CROWDED: WHY WE NEED A GREEN REVOLUTION AND HOW IT CAN RENEW AMERICA - Thomas L.Even books that show the importance of a civilian leadership and the consequences when they don't do a good job.SUPREME COMMAND: SOLDIERS, STATESMEN, AND LEADERSHIP IN WARTIME - Eliot A. CohenDERELICTION OF DUTY: LYNDON JOHNSON, ROBERT MCNAMARA, THE JOINT CHIEFS OF STAFF, AND THE LIES THAT LED TO VIETNAM - H. R. McMasterAnd there is even a nerd section. You know that new movie Ender's Game? You know it was first a book written by Orson Scott? You know that it has been on the reading list for decades?ENDER'S GAME - Orson Scott CardMost importantly, there are two other works which are required reading. These are works that cement what it is that every military person stands for and what they fight for. They are the clear definition of the values of their nation. When you see what else is on this list... you'll wonder why no one else is required to read them as well besides members of the US military.U.S. CONSTITUTION - United States of AmericaTHE FEDERALIST PAPERS - Alexander Hamilton; James Madison; John Jay; Garry Wills (Introduction by, Editor)5) The military has a plan for everythingI was just watching a video on realism in medical shows and was reminded of a very disturbing fact.The US Army created a guideline for surgically removing unexploded ordnance (bombs) from a living person. Really. You can read it right here.Even stranger, the Department of Defense also created… wait for it… a zombie preparedness strategy, too. Here that is.Now, a big part of me is like, now why are we spending money on this?But the reason that plans like this exist are to test creativity and come up with innovative solutions to problems we never faced before. Flexibility is a skill. I believe for the zombie plan, it was play around with figuring out out to combat a mass panic mixed with a pandemic level viral plague.More feasibly, the military also uses these skills when they aren’t goofing off to create plans for every foreseeable military incursion imaginable. Iran? I guarantee you they have a mountain of digital documents into the many approaches to taking out the nation and then just as many on what to do with after we’re done. North Korea? Everything people were predicting would happen a few years ago under Trump probably fits into about 6% of the possible scenarios these boys have cooked up.The tradition dates back at least as far as the 1920’s where the US military created War Plan Red, a hypothetical plan to defend the Atlantic coast in the event of war with United Kingdom. I’ll be honest, it’s mostly about finally correcting history by annexing Canada. Yes, those crazy plans even include our allies… and still do.There’s actually an office that oversees all this planning. It’s called the J7 under the Joint Chiefs. J7’s mission, as their website states:The J-7 is responsible for the six functions of joint force development: Doctrine, Education, Concept Development & Experimentation, Training, Exercises and Lessons Learned.Yes, in case you’re curious, what that looks like in practice are the nerdiest nerds of the military (who are still terrifyingly dangerous) masterfully compile the best practices and learned experiences of the US military into doctrines that they apply to situations that most of us in civilian world can’t possibly imagine. Then to let those scenarios sit on a shelf for a number of years, until someone starts getting uppity. Then they are dusted off, revisited, revised, and used as reference for war planners. For that reason, when a new war pops up, we are without a doubt more prepared to end a regime than anyone could possibly imagine.6) You’ll be fine in it.Many assume that the only people who would want to join the military are those who want to die from some car bomb in Iraq. Just as many assume that the majority of us have seen more than we actually have. There is also this myth that we are all just "the lucky few" who survived four years in the middle of some never-ending artillery barrage. The truth is, while there are plenty of risks, which are widely known, you are far safer in the United States military than most would believe possible.For example, what if I told you that there is less than a one in a thousand chance that you might actually be killed if you even go to war when you go with the Americans? Granted that risk goes up drastically if you fight against the Americans, but that’s an article for another day.We have currently about 2,518,542 people in the United States military. Since 9/11, estimates would safely place the number of people who have served in some branch to be about 6 to 7 million people, probably more. As of the time of this writing, the total people who died as a result of action in either Iraq or Afghanistan since 9/11 is about 6,660. That means that fewer than about 0.088% of the people who have enlisted have been killed as a result of that decision. If you consider wounded, then the number increases to about 0.738% percent. For those not blessed with the ability to conceptualize such things, here's a tasty pie.To better answer this question I also wanted to address these statistics reflected when considering only those who actually participated in a combat deployment. I asked the question How many US troops have been deployed to either Iraq or Afghanistan since 2001? to gain a better picture of just that question. From that, Daniel Kearns produced this document (Page on Senate) which is a brief and simple, but important piece of information on the Iraq War. From that, we have a best estimate of 1.5 million warfighters deployed to Iraq during the war. Taking this with earlier data, we see total killed accounted for .29% of those deployed while wounded accounted for 2.15%. So, to be clear, of those deployed to the hottest combat zone in recent American military history, the highest chance of death was .29% for deployed troops and risk of violent injury was still only 2.15%. [6]This trait, however, isn't anything new. The US military, at least since the dawn of the 20th century and perhaps because of the carnage of our own civil war, have adapted a mentality and strategy that ensures our military does not easily sacrifice its own. We simply have values that don't allow us to experience heavy troop losses and a wealth that affords the ability to win without them. In truth, we live today in a time-period where we have proven that experience matters more than assets and that a troop's life is almost always more valuable than the patch of Earth they are fighting for. But we still need that patch of earth.That's why modern warfare doesn't allow for high losses. Take a look at the figures for the 2003 invasion of Iraq, pulled straight from Wikipedia. This doesn't include the insurgency years that followed, but showcased the last time we fought a full-on war with an advanced national military.That last statistic is significant.The Coalition's troop strength before the battle was 265,000 troops, mostly from the United States and the UK. The Iraqis' troop level was 1,119,000, more than 4 times that fielded by the Coalition. The end result, however, was that through great strategic, technological, and logistical superiority, the American led Coalition was able to inflict as many as 261 times as many casualties as the Iraqi were capable of delivering in return. That's more than 250 Iraqi killed for every Coalition death. A more lopsided battle has never been fought.Perhaps it is just that we don't fight that much or stay safely behind our big walls. We just send out the evil drones and high powered missiles, snipers, and other cowardly means of fighting a war. Well, given the option... wouldn't you? I know these guys certainly would if given a second chance.A grim look through history will show that American military doctrine has focused on a few key tenets throughout at least the last century. We focus on augmenting our troops through overwhelming technology, training, and tactics, rather than creating a culture that loves war.The facts are that average Americans deeply hate conflict. We will do whatever we can to avoid it on an interpersonal level, regardless of whatever you think about our foreign policy. This is reflected in our demographics. Today, after 13 years of war, and with a sizeable portion of our Vietnam-era veterans still alive, US veterans still only number 22 million individuals and account for less than 7% of the total population. Note, that is veterans, not active service members. The Department of Veterans Affairs projects that that number is set to decrease, not only in percentages, but in real value. They project that by 2043 we will only have 14 million veterans alive for a total percentage of the population at only 3.5%. The decreasing number of veterans means a country culturally disconnected from the realities of its wars because of the peacefulness of the daily lives of its citizens.And that's how we want it.The alternatives are thus: during the Second World War, you saw very different social military philosophies come head to head. Among these were the Americans and the Japanese. The Japanese were fantastic engineers and created marvelous machines. One such was the Zero fighter. It had a turning capability and climb that was far superior to other fighters. It was more agile and a deadly threat.The trade-offs? It's aluminum coating was brittle and the plane offered no armor for the pilot, engine, or other critical points of the aircraft. Its light construction also made it prone to catching fire and exploding during combat. Add this to the practice of Japanese fighters on the ground routinely combating US Marines with suicidal "Banzai" charges, the human-wave attack and we see a culture which adopted an ancient form of warfare: the military death cult. Death and the warrior were at that time so intertwined through a perversion of the Samurai Bushido culture that the leadership of Japan could order hundreds of thousands of Japanese to their deaths without the Japanese people resisting at all. This culminated in the ultimate corruption of bravery and honor; the creation of the Kamikaze pilot and the "Baka" Bomb.The Kamikaze (Divine Wind) is named for the legendary holy force which protects the Japanese from invasion by outsiders, namely because of a storm which swallowed up tens of thousands of Mongol invaders hundreds of years ago before they ever set foot on Japanese soil. The Kamikaze myth was resurrected for the creation of a force of airmen who volunteered and trained for a mission in which they would surely die, once again, like a storm from Heaven protecting Japan from foreign invaders. So committed were these soldiers and those who commanded them to this idea of a glorious death for their nation and their emperor, they even attended a ceremony before their mission which could only be described as their funeral.The ultimate expression of this “Kamikaze” culture was the Japanese Yokosuka MXY-7 Ohka ("cherry blossom"), a rocket-powered parasite aircraft used towards the end of the war. The U.S. called them Baka Bombs (baka means "idiot” in Japanese). They called it this, because the only intended purpose of the aircraft was to be guided to impact directly with an enemy ship by a pilot who had reserved himself to die in the effort.In contrast, the American philosophy emphasized an entirely different approach. We preferred to keep our warriors alive, if for no other moral reason than to pass on their experience and be useful on a better day. We engineered fighter aircraft with more power that could give us the strength and survivability to keep fighting.Add to this the individual support given to the individual troop. While the base soldier thrown away during a Japanese suicide charge was said to be worth less than $10 by their own admiralty, the United States Marine, the most underfunded of the military branches, would deploy with supplies of everything from ammunition, food, water, and bandages, to paper and pencils, and eve glass eyes of every imaginable size and color... just in case. This excerpt from Flags of Our Fathers displays in the days and weeks leading up to the Battle of Iwo Jima the American philosophy, strategy, and implementation of sending every man with all the gear to have a dominating edge, and the greatest chance possible of coming home.... the movement of over 100,000 men, Marines, Navy support personnel, Coast Guard units across 4,000 miles of ocean for three weeks is a triumph of American industry galvanizing itself in a time of great national peril. At the outset of the war, Japan's naval strength was more than double that of America's, but across the American continent, the idling factories steamed and sparked to life. Most of the vessels came splashing off the industrial assembly lines in the six months before this assault...... And it has not just been a matter of hardware. The civilians of America have mobilized behind these fighting boys. Behind each man on board the ships are hundreds of workers. In the factories, in the cities and towns, on the heartland farms; Rosie the Riveter, boy scouts collecting paper and metal, the young girl who would become Marilyn Monroe, sweating away in a defense plant.Here is some of what those mobilized civilians have generated for this tremendous force: For each of the seventy thousand assault troop Marines 1,322 lbs of supplies and equipment. Some of it sounds weirdly domestic: dog food, garbage cans, light bulbs, house paint. Some of it suggests an island business office: duplicating machines, carbon paper, movie projectors. Some sounds like kids' camping gear: toilet paper, socks, shoelaces, paper and pencils, flashlights, blankets. Some begin to suggest a sterner mission: flares, plasma, bandages, crucifixes, holy water, canisters of disinfectant to spray on corpses. And some of it gets exactly to the point: artillery, machine guns, automatic rifles, grenades and ammunition. The transport ships carry six thousand five-gallon cans of water, enough food to feed the population of Atlanta for a month or the assaulting Marines for two months. The Marines brought along one hundred million cigarettes.This isn't to say our strategy made us invulnerable. We endured great losses to be sure; 19,000 at the Battle of the Bulge, 16,293 at Normandy, 12,513 in Okinawa, and countless other battles throughout the war, totaling around 405,000 dead Americans. While that number is appalling, it pales compared with others. Soviet Union - up to 13,000,000 military dead, Germany - up to 5,500,000, Japan - 2,120,000. These figures do not include civilian dead, of which the United States had virtually none.That said, we dominated the Japanese in World War II once we steadied ourselves from the attack on Pearl Harbor. We suffered 1/24th their total losses in a war they began. The same can be seen in Iraq or Afghanistan and can be seen, as well, in any major conflict we have been a part of in the last one hundred years. This is because our philosophy wins wars in this modern age. War isn't won by weapons; it is won by warriors. Make the warrior a weapon and give him the tools to succeed and come home, and no other force on Earth can defeat him.Liked this? You might also like my YouTube Channel. You can also connect with The War Elephant on Facebook. If you want to help me make more content like this, please visit my Patreon Page to find out more.

What are the problems faced by Indian students in the USA?

Medical: In India, if you are sick, you just go to the doctor's clinic, pay the fee, get some medicines or prescriptions and come back. In US, if you don't have a proper medical insurance you are screwed. Therefore, most Universities enforce students to take a basic medical insurance coverage upon enrollment. When you go to a clinic or a hospital, you need to answer whether you are a new patient, fill up certain legal health forms to protect your privacy, understand whether the doctor is in-network or out-of-network, whether you are paying the full amount or just the copay, understand the big fat bill that comes after a few months. Also note that the 'Dental' and 'Vision' insurance may be not be covered as part of your medical insurance policy and you may have to purchase them as add-ons or as a separate policy.Public transportation: In India, you have better, affordable public transportation. In US, most states have poor public transportation and many people prefer to drive their own cars. Before, you can decide to buy your own car, you need to get a driving license, which is comparatively difficult to get than in India.Food: You will try the new Subway sandwiches, Burittos, Hot dogs, Tacos and Burgers for a while. Sooner or later your craving for Indian food will begin. In India, even if you don't know how to cook, you can get affordable Indian food at nearby restaurants, hostel canteens, or even get it prepared by your favorite cook, who comes home daily. That luxury would be taken away from you, once you land in US. Learn to cook; it is a valuable skill to learn and would be useful throughout your life to be an independent person and to stay healthy.Time management: In India, Parents pay your tuition and hostel bills, someone prepares food for you, gets your clothes ironed, cleans your room. You can start studying for your exams day before your test and still manage to get good grades. In US, you would have to juggle many things: pay your own rent and utilities, may have to work part time to fund your studies, do your own cooking, laundry and house cleaning. You will have to start preparing for your assignments as soon as it is given, otherwise a two week deadline will show up uninformed the next day. You should not copy it from your friend, as it would be considered cheating and against the honor code (hearing it for the first time?). You should not pull off something from Internet without a proper reference, as it would be considered as plagiarism.Weather: Most parts of India are warm and sunny. You don't have to tune to your Weather station or look at the Weather app before you start your day. You may even do the exact opposite of what it says. But, when you come to US, you would start relying on the meteorologists to prepare your day: Please watch for an icy road ahead, you could wear your favorite coat when you go for a cup of coffee at Starbucks or please hide yourself inside your apartment, as a category-5 hurricane is fast approaching. Weather sometimes can play a big role in your mood, health etc.Credit history: Indians are big on savings and a few years back credit cards were frowned upon. Once you come to US, you need to borrow and pay back money on time to prove your credit worthiness. You need to build credit history, without which it might be difficult to get a new mobile connection, a car, a home or a personal loan. Plastic card offers and identity protection plans will chase you. As long as you pay your bills on time and watch for any abnormalities in your account, you are good. Indeed, I would suggest spending everything on your credit card, which will help you keep track of every dollar you spend, will provide better shopping offers, additional warranty, car rental insurance etc. But, if you misuse it, it could become your worst nightmare.Lack of roadside small shops: In India, your mother would call you to go and get some milk and some vegetables from a local grocery store near your house. You would walk, take a bicycle or a scooter and rush back within minutes. In US, depending on your city, you may or may not find such stores. You may have to take your car or borrow it from someone or go for a 20-30 minutes bus ride to find a big store like Walmart, KMart, HEB or Target. Once you go there you would find the milk section filled with Whole milk, 1% milk, 2% milk, Soy milk, Almond milk etc. Multiple choices sometime make our life appear complex.Networking with people: You might be good at academics, but that alone is insufficient when it comes to securing internships, assistantships, student worker positions or a full-time job offer. Many on-campus jobs are not rocket science. You need to be at the right place and time to secure certain positions, for which you need to know people who could inform you about such opportunities. Participate in career fair info sessions, poster presentations, conferences, local meetups and connect with people who share your ideas. Genuinely help people to build lasting relationships that would help in your career.Obey laws: You might be surprised to get a ticket from a cop for not stopping your bike at the STOP sign (even when there is no one around) within the campus. Mostly you cannot bribe your way out and if you try, you might end up in jail. You should not work overtime than the allowed legal hours; otherwise, you might get deported. Whenever you travel, carry at least a copy of your legal documents that allow you to stay and study in the US. If you get into some legal trouble, watch out for what you say, as it might work against you. That's why the cops say "You have the right to remain silent". Seek help from school authorities when you get into such issues.

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