Markle (without imported items)

The Democratization of Sensitive Social Information

Wed, 28 Jan 2009 00:36:42 GMT

How frequently have you quietly wished for a way to correct someone's errant behavior without actually having to:

A) Upset them
B) Have a long (and invariably boring) conversation wherein the person defends themselves

If you're anything like me, which you almost definitely are, then you have cruised through life assaulted from all sides by affronts both minor and major. Cringing at vulgar odors, errant nose hairs, questionable social mores. A familiar feeling that lump of sticky but unwelcome corrective noise caught in your throat. "It would be impolite to tell them about their bad breath," you think to yourself.

You'd be wrong.

It is, instead, impolite for you to hold you tongue. Wouldn't you want someone to tell you if you were the perpetrator of some regular slight? You are! We are all a part of the churning, stinking, vulgar multitudes and as such guilty of myriad wrongs. There are people I work with, no doubt, that shudder when they have to meet with me. People for whom, the very memory of me is enough to bring their bile tumbling up to the back of their throat.

If only there was some socially-acceptable way for those poor souls to reach out to me and give me a nudge. To tell me that my laugh is grating. To remind me that polite society frowns on noisily passing wind in one's office. To delicately steer me away from my proclivity for late-afternoon pill-fueled tantrums.

There is!

We've been swimming around with frowns on our faces for too long now while the tool of our salvation has been sitting on the sidelines for years: anonymous email.

We all have faults. We all have friends. We all have email accounts that we check with some regularity. In combination, these three factors can change the world.

The only things standing in the way are:

A) People's deep-rooted fear of being impolite
B) People's deep-rooted fear of being caught

Both are moot. You're reaching out to someone in an attempt to better both of your lives and anonymous email (in my preliminary tests) is just that: anonymous. Try it out for yourself. As the idea spreads it will lessen the, "But they'll know it was me..." thoughts you have before hitting 'SEND'. A world of transparency awaits us. A world free of minor annoyances caused by someone's socks not matching their trousers.

So I submit to you, my friends, an experiment in social engineering, behavior modification and willful masochism. If you're reading this you probably know me, know my email address and have some idea of what my glaring (and this bit is important!) easily changeable foibles are.

Use one of the following services to send me a note:
http://www.google.com/search?q=anonymous+email

I'll let you know how it goes. Don't be mean.

21 Monkey Bee

Sat, 24 Jan 2009 06:24:31 GMT

Monkey - Monkey Bee I'm listening to this on repeat until I go to bed.

How hospitals get paid... kind of.

Fri, 23 Jan 2009 19:01:09 GMT

http://economix.blogs.nytimes.com/2009/01/23/how-do-hospitals-get-paid-a-primer

The comments on the above NY Times article all seem to be calling for a tearing down of the veil of secrecy and/or the heads of the profit-mongering hospital fatcats. The comments seem to indicate a truly fundamental misunderstanding of the system despite the good job the article does of explaining it. Comments like this are just plain wrong:

"There were identical procedures carried out on the same day, which Blue Cross would pay for one and not the other. The total initial bill was about $500,000, which was settled for about $48,000 as a preferred provider. I can only presume that the ludicrous initial bill was engineering to provide a $452,000 write-off, was so that the hospital would appear to be "not-for-profit" as it covers the cost of care for the indigent."

Unreimbursed care (mostly legitimate charity care for legitimate indigent people) provided by the hospital is used to maintain the not-for-profit tax-exempt status. It isn't based on artificially-inflated bills or some great conspiracy though. Hospitals operate at ridiculously thin profit margins for the most part. See the gloomy news about recent hospital closures and bankruptcies: http://www.iht.com/articles/ap/2008/12/27/america/Meltdown-Hospitals-List.php

Some of that is because of mismanagement, administrative bloat and general inefficiency but more of it is due to slipping Medicare/Medicaid reimbursement rates, worsening payer mixes (insured patients:uninsured patients,) rising costs (labor, materials, etc...) and a tightly-regulated/policy-bound industry.

The call for price transparency is well understood but entirely inappropriate at this time. The 'cost' is just one part of a larger equation that a healthcare consumer should be looking at when attempting to compare the value of one provider with another.

Peter Bjorn and John - Nothing To Worry About

Mon, 19 Jan 2009 18:33:18 GMT

Peter Bjorn and John - Nothing to worry about

04 Long Term (Remote)

Mon, 19 Jan 2009 18:31:18 GMT

The Caretaker - Long Term (Remote) Makes me think of holidays for some reason. Haunting.

11 Ashley

Thu, 08 Jan 2009 22:29:54 GMT

The Dodos - Ashley

Trying to make sense of just how fucked we are...

Thu, 08 Jan 2009 06:05:36 GMT

http://www.nytimes.com/2009/01/08/business/worldbusiness/08yuan.html

I watched a (top secret) video today about some investments China is making in its infrastructure. Significant investments designed for a wealthy country that is happy investing in itself.

It strikes me that the Chinese devaluation of the Yuan is a necessary part of this whole global economic see-saw we're on.

If China stops buying American assets (see: NY Times article...) then America won't be able to afford Chinese trinkets.
If America doesn't buy Chinese trinkets then China can't afford to fund the infrastructure growth for its burgeoning middle classes.
If China's economy collapses then it has no choice but to cash in some portion of its trillion dollars in US assets.
If China pulls back existing US investments then the dollar collapses further, taking Europe down with it.
If the dollar collapses further then the remaining Chinese assets are worthless and their treasury lies in ruins.
Then what?
We're all left with massive inflation, worthless currencies and global poverty on a scale we haven't seen in hundreds if not thousands of years?

I've heard rumor that China is trying to build up domestic demand for Chinese-produced trinkets but I'm guessing that will fall flat on its face. Chinese manufacturing relies on the devalued Yuan and a significant blue collar base to their class pyramid. Given the (aforementioned) burgeoning Chinese middle classes, the significant Chinese infrastructure investments and the pretty-much-tapped-out US consumer's credit cards, where does this leave us?

I'm sure I'm wrong. I've had a couple of beers and am wont to be wrong after a couple of beers. Where in the if-cycle above have I slipped up?

Newspapers: post-mortem

Wed, 07 Jan 2009 05:53:54 GMT

Here are a pair of articles gently patting the newspaper industry on the back for:

What it kind of, sort of did when the web was being born

and

What kind of a future it *might* have even though its time in the sun is over

The Atlantic article (the second one) is the better of the two articles but seems oddly pessimistic about the future of the standalone newsroom given that the LA Times just passed non-print breakeven.

The one thing I can say for certain: a lot of newspapers (majors potentially excepted) are fucked. I attended a lunchtime meet-n-greet/presentation with the editor-in-chief of the San Diego Union-Tribune a few weeks ago and their great idea that was to save the newspaper from extinction was an extremely poorly-executed, barely-usable Craigslist and Facebook competitor that (even if it were nicely-built) is ten years too late.

Of course, why does she give half a shit? She'll be gone when some sucker emerges to buy the wreckage.

A limerick about Dagger

Sun, 04 Jan 2009 04:04:06 GMT

There once was a man in Encinitas
Whose wife was growing a new fetus
A situation quite sticky
Leads to life getting tricky
Needhams four-strong you can't beat us

(the original version of this was somewhat more depressing and vulgar)

Mentalists with wingsuits. Just watching it made me feel ill.

Sat, 03 Jan 2009 21:34:39 GMT

Mentalists with wingsuits. Just watching it made me feel ill.

01_cape_cod_kwassa_kwassa_vampire_weekend_cover_1

Sat, 03 Jan 2009 21:22:07 GMT

Excellent cover of Vampire Weekend's Cape Cod Kwassa Kwassa by Hot Chip and Peter Gabriel.

"Value" and how America is being screwed

Wed, 31 Dec 2008 21:15:05 GMT

"Reformers need to determine how public programs, such as Medicare and Medicaid, can lead the market toward rational change in reimbursement approaches and levels."

From McKinsey Quarterly, Why Americans pay more for health care, Farrell, Jensen, Kocher

Value needs to become a priority for providers and payers. Tie cost-over-time to quality of care and use that as the primary fundament of healthcare reimbursement. Denis Cortese of Mayo outlines his equation in slide #6 of his presentation here.

Another quote which sparked a tangential thought spiral:

"One is the wealth of the United States, which enables it to spend more on economically superior goods, such as drugs. Another is that high US prices subsidize research and development for the rest of the world."

From McKinsey Quarterly, Why Americans pay more for health care, Farrell, Jensen, Kocher

We're currently faced with a perilous global financial situation where US dollars have been hyper-inflated by cheap borrowing, massive trade imbalance and Chinese market fixing.

The rest of the world (especially China) has reaped massive benefits, selling us all manner of tat which we happily gobbled up. What happens when the dollar inevitably declines? China's massive investment in America becomes worth less and less and they have less motivation to support us. But they can't let us fail because they have too much capital invested in our currency. So you have a threat of mutually-assured economic destruction.

No way to predict how it will end but I have to think that:

It will end.
The EU (who have seen their key markets buoyed on a massive scale by US trade) won't come to our aid when it does.

The intricately-built house of cards will collapse eventually.

Something's got to give

Wed, 31 Dec 2008 20:29:12 GMT

"Other countries also have low out-of-pocket expenses but use supply-oriented controls to compensate for the lack of demand-side value consciousness."

From McKinsey Quarterly, Why Americans pay more for health care, Farrell, Jensen, Kocher

The above quote, to me, represents the largest fundamental difference between our buffet-style healthcare and other countries' multi-tier and/or socialized medicine models. This gets terrifically ugly and expensive when you consider the cost of end-of-life care. Who decides that the market supplements massive healthcare costs for elderly and/or chronic patients while effectively pricing the young/poor out of the insurance market?

It spells "auden" in morse code!

Wed, 31 Dec 2008 19:40:56 GMT

It spells "auden" in morse code!

Sound that photographs make

Wed, 31 Dec 2008 19:12:23 GMT

Currently stuck in my head.

This seems like it should be significant

Wed, 31 Dec 2008 18:54:50 GMT

"In recent decades, the nature of medical risk in the United States has shifted dramatically. About two-thirds of all deaths in the United States now result from chronic diseases most often induced by behavior and lifestyle—for instance, obesity and related chronic conditions, type 2 diabetes and related conditions, smoking-related cancers, and alcohol-related liver disease. By contrast, before the 1940s or thereabouts, medical risk had largely been concentrated in random, infrequent, and catastrophic events such as injuries, congenital conditions, or contagious diseases. Health insurance was designed, at its inception, to address these kinds of events.

The increasing prevalence of chronic disease has significant implications for managing health care costs. For one thing, advances in medical technology and treatments mean that people with such conditions can now live much longer, though at a substantially higher financial cost."

From McKinsey Quarterly, Three imperatives for
improving US health care, Mango & Riefberg