Wednesday, October 30, 2013
Tuesday, October 29, 2013
Greenspan: Corporations Can't Be Trusted
The former chairman of the Federal Reserve, Alan Greenspan, has released a new book about how wrong he was about the crash in 2008, The Map and the Territory. In an interview on The Daily Show, he says that he always assumed that people in the markets would behave rationally, and that they wouldn't take risks that would destroy their own companies. He now understands how completely wrong he was.
What's interesting about his analysis of the crash is that he squarely places the blame for the crazy risk-taking on the fact that the brokerages were corporations and not partnerships (starting at about 3:20):
The entire purpose of a corporation is to shield officers from any economic responsibility for the decisions they make. And it's even worse than that: officers of major corporations have contracts with golden parachutes that guarantee them a huge payoff no matter how much harm they cause the company. They have no incentives to do the right thing, and there are no consequences for incompetence and malfeasance.
When conservatives talk about personal responsibility it's always in the context of keeping poor people off welfare and denying abortions to women. But when BP is fined for ecological catastrophes in the Gulf, or JPMorgan Chase is fined for its economic calamities, conservatives characterize these slaps on the hand as revenge and shakedowns.
When are we going to hold CEOs to the same standards as welfare moms?
What's interesting about his analysis of the crash is that he squarely places the blame for the crazy risk-taking on the fact that the brokerages were corporations and not partnerships (starting at about 3:20):
Greenspan: When we began to see what was going on, you couldn't believe that there would be people that would be that disregarding of their own companies. How could you run, as you say, 30 times...
Stewart: Right. Thirty times on the leverage. Isn't it because they don't pay the penalty.
Greenspan: Yes.
Stewart: Isn't it the rewards that they were getting... the system was incentivized for these crazy short-term bursts of rewards.
Greenspan: Back in 1970, the New York Stock Exchange said that broker-dealers -- which is who all these people are -- could incorporate. Prior to then, they were all partnerships. And let me tell you something about a partnership: your partners don't let you take any risks that can affect them. And I remember they wouldn't lend you a nickel overnight.
And the system worked. You did not get anybody failing because the equity was protected. As soon as they started to go to corporations, they took risks for exactly the reason you suggest.Here we have one of the foremost proponents of capitalism telling us that corporations cannot be trusted to do the right thing, because the people who make the decisions have no skin in the game.
The entire purpose of a corporation is to shield officers from any economic responsibility for the decisions they make. And it's even worse than that: officers of major corporations have contracts with golden parachutes that guarantee them a huge payoff no matter how much harm they cause the company. They have no incentives to do the right thing, and there are no consequences for incompetence and malfeasance.
When conservatives talk about personal responsibility it's always in the context of keeping poor people off welfare and denying abortions to women. But when BP is fined for ecological catastrophes in the Gulf, or JPMorgan Chase is fined for its economic calamities, conservatives characterize these slaps on the hand as revenge and shakedowns.
When are we going to hold CEOs to the same standards as welfare moms?
Did They Like It?
Lisa Myers current story about the ACA, the president and health insurance is sure to elicit many adolescent "n'yah n'yah's" from the right wing blogsphere. Yet all the hubbub over this is missing an answer to a key question: Did people like their health insurance?
Before we dive into answering that questions, let's remember a few key facts. First, the people in question who are "losing" their insurance are those in the individual market, not the majority of Americans (85-90%) who get their health insurance through their employers. For me, this translates into most Americans not really caring about "Gotcha #538 of Infinity" because it doesn't affect them. If they liked the president before this still will. If they didn't, they won't and will accuse him of being Richard Nixon. Oh well.
Second, people aren't actually having their policies cancelled as they did in the past. They are being brought up to a certain standard so if they do have have health issues at some point in the future, they aren't going to soak the rest of us. This is a correction to a massive flaw that was in the old system of insurance. That leads us to the third point and back to the question I posed at the start of this post. The market for individual coverage sucks. Premiums rise at the whim of the insurance company, people are kicked off plans or not allowed on for preexisting conditions, rates fluctuate wildly resulting 50 percent of the people in this market are churned through it every year.
So, when the president said, if you like your insurance, you get to keep it, I have to wonder, did people actually like their insurance coverage? Of those that did, how many watch Fox News and read right wing blogs? More importantly, did these people know what was in their policies and was it in their best interest to continue with such policy? I realize that bringing up the words "best interests" is sure to cause an explosive adolescent stomp down the hallway but people who make poor choices in terms of health care affect my life, with or without the ACA, so I welcome the regulation.
If the people in the individual market do not like their insurance or have issues with their current policies, that effectively means the president is not a liar. Did they really like it?
Before we dive into answering that questions, let's remember a few key facts. First, the people in question who are "losing" their insurance are those in the individual market, not the majority of Americans (85-90%) who get their health insurance through their employers. For me, this translates into most Americans not really caring about "Gotcha #538 of Infinity" because it doesn't affect them. If they liked the president before this still will. If they didn't, they won't and will accuse him of being Richard Nixon. Oh well.
Second, people aren't actually having their policies cancelled as they did in the past. They are being brought up to a certain standard so if they do have have health issues at some point in the future, they aren't going to soak the rest of us. This is a correction to a massive flaw that was in the old system of insurance. That leads us to the third point and back to the question I posed at the start of this post. The market for individual coverage sucks. Premiums rise at the whim of the insurance company, people are kicked off plans or not allowed on for preexisting conditions, rates fluctuate wildly resulting 50 percent of the people in this market are churned through it every year.
So, when the president said, if you like your insurance, you get to keep it, I have to wonder, did people actually like their insurance coverage? Of those that did, how many watch Fox News and read right wing blogs? More importantly, did these people know what was in their policies and was it in their best interest to continue with such policy? I realize that bringing up the words "best interests" is sure to cause an explosive adolescent stomp down the hallway but people who make poor choices in terms of health care affect my life, with or without the ACA, so I welcome the regulation.
If the people in the individual market do not like their insurance or have issues with their current policies, that effectively means the president is not a liar. Did they really like it?
No Revolution
I poked my head into Kevin Baker's site, The Smallest Minority, for the first time since I was voted off and found this. Aside from the usual warped and psychotic rightwingblogspeak, I'm trying to figure out what he meant by this...
I'm reminded once again of Thomas Sowell's A Conflict of Visions: Ideological Origins of Political Struggles, his magnum opus. I recommend you read (if you haven't) my überpost on it from January, 2010.
This will not end well.
Obviously it could be the usual bloviating anger and irrational fear backed up with absolutely nothing (why do they continue to think that posting on blogs makes you powerful and scary?) but I think perhaps that Kevin truly believes that he and his fellow cult members might need to "take back the country." To that, I say this..
There will be no revolution as long as men have titties.
I'm reminded once again of Thomas Sowell's A Conflict of Visions: Ideological Origins of Political Struggles, his magnum opus. I recommend you read (if you haven't) my überpost on it from January, 2010.
This will not end well.
Obviously it could be the usual bloviating anger and irrational fear backed up with absolutely nothing (why do they continue to think that posting on blogs makes you powerful and scary?) but I think perhaps that Kevin truly believes that he and his fellow cult members might need to "take back the country." To that, I say this..
There will be no revolution as long as men have titties.
Monday, October 28, 2013
A Tale of Two Web Sites
Great piece on Bloomberg discussing how the state run sites are faring much better than those in the states who refused to set up their own exchanges.
Don’t tell Elisabeth Benjamin it’s tough to sign up for Obamacare. For two weeks, she has been enrolling uninsured people from her New York City office through an online marketplace created by the law.
Most recently, she helped a Bronx home-health worker in her 30s get health coverage for $70 a month. “By week two, the system was pretty smooth,” said Benjamin, who’s certified to assist people signing up for health insurance.
It does help if you live in a state that isn't actively trying to sabotage the ACA's efforts. Kentucky, the only southern state to set up their own exchange, is doing just fine.
Elizabeth Watts of Kentucky, which runs an independent exchange, had her application accepted at 12:04 a.m. on Oct. 1, making her one of the first to start the enrollment process. Because of a rare disorder, she has already had a heart attack and a stent put in place. She makes $220 a week working at a Shell service station. Previously, the only insurance she could find was for $300 a month, which was too much for her to afford. Using the exchange site, Watts learned she was eligible for Medicaid, the state-federal program for the poor that was expanded under the law and will cover most of her costs. “It’s been such a relief,” said Watts, 31. The last time she saw her heart doctor, “it took 15 minutes and cost $160.”
Ms. Watts is a fantastic example of why the Right are shitting themselves right now. They know that once people like her in other deep red states start to sign up, they lose votes.
And then, they lose power.
Don’t tell Elisabeth Benjamin it’s tough to sign up for Obamacare. For two weeks, she has been enrolling uninsured people from her New York City office through an online marketplace created by the law.
Most recently, she helped a Bronx home-health worker in her 30s get health coverage for $70 a month. “By week two, the system was pretty smooth,” said Benjamin, who’s certified to assist people signing up for health insurance.
It does help if you live in a state that isn't actively trying to sabotage the ACA's efforts. Kentucky, the only southern state to set up their own exchange, is doing just fine.
Elizabeth Watts of Kentucky, which runs an independent exchange, had her application accepted at 12:04 a.m. on Oct. 1, making her one of the first to start the enrollment process. Because of a rare disorder, she has already had a heart attack and a stent put in place. She makes $220 a week working at a Shell service station. Previously, the only insurance she could find was for $300 a month, which was too much for her to afford. Using the exchange site, Watts learned she was eligible for Medicaid, the state-federal program for the poor that was expanded under the law and will cover most of her costs. “It’s been such a relief,” said Watts, 31. The last time she saw her heart doctor, “it took 15 minutes and cost $160.”
Ms. Watts is a fantastic example of why the Right are shitting themselves right now. They know that once people like her in other deep red states start to sign up, they lose votes.
And then, they lose power.
This Is Spinal Fusion: a Medical Dilemma
The Washington Post has a major story about the increasing number of spinal fusions in the United States. Spinal fusion is a medical procedure that bolts vertebrae together to relieve pain and restore limb function.
The Post story looks at the large number of fusions done by a Florida neurosurgeon, Federico C. Vinas. There are suggestions that many of these procedures were not medically necessary, and Vinas did them just for profit (he makes $2 million a year). Spinal fusion is not cheap: in the United States it costs on average of $111,000.
Spinal fusion, like almost everything in American medicine, is overpriced. Based on outcomes from countries similar to the United States, the costs of medical procedures are artificially high: probably five to ten times what they should be (which is obvious from the fact that even within the United States they vary that much).
The Post talked to several patients who did not benefit from the surgery, some of whom are in severe pain and unable to walk. Others are now leading normal lives. These newspaper anecdotes are compelling, but don't really address the efficacy of spinal fusions. The problem is that there is no real consensus on the efficacy of fusion for treating nonspecific low back pain.
The Post story isn't the first on this topic: Bloomberg examined the same issue in 2010. The Bloomberg story is interesting because it's about the Twin Cities Spine Center and Ensor Transfeldt, a surgeon who examined me 20 years ago. Several years ago I had a minimally invasive cervical laminoforaminotomy by a different Twin Cities Spine surgeon. I passed on proposals by other surgeons for a fusion or a disc replacement: the Terminator-like spine model with the titanium ball-bearing design really creeped me out.
Limitations of Spinal Fusion
By its very nature spinal fusion reduces the patient's flexibility by bolting together two or three vertebrae with bone transplanted from the patient's hip or a cadaver. The fusion prevents rotation of the spine at those levels, putting stress on other parts of the spine, which can cause serious damage and pain, and potentially limits the patient's activities. It's therefore not something you should consider lightly. Other surgical procedures, such as disc replacement, still have serious limitations.
I'm therefore inclined to agree with the thrust of the Post and Bloomberg's reporting: some doctors are doing too many fusions.
Playing Golf and Tennis
The increase in the number of fusions is by no means motivated solely by profit: many people are simply not willing to suffer excruciating pain, become dependent on narcotic painkillers, or become invalids, and they look to surgery to make them mobile (from the Post):
Keeping People Active and Healthy
Ask any doctor how to prevent diabetes and heart disease, and the top two answers go hand in hand: weight control and exercise.
If you can't walk, you can't run, and you can't do any serious exercise. If you don't exercise you gain weight and your heart and lung function decline. You get diabetes, heart disease, high blood pressure, and are at increased risk of stroke and even cancer. You lose your sense of proprioception, which is essential to avoiding falls. You experience bone loss, which makes serious fractures from even minor falls likely. In particular, hip fractures are a major factor in the decline and death of the elderly ("ma was doing great until she fell and broke her hip").
In strictly monetary terms, the question is: Are the long-term costs of treating chronic organic problems like diabetes, hypertension and heart disease caused by being sedentary greater than the costs of correcting orthopedic conditions that exacerbate those organic problems?
The cheapest solution is to keep people active and healthy, and off expensive painkillers (with their addictive and debilitating side effects), and diabetes and blood pressure meds for as long as possible.
No Responsibility for Patient Healing
The motivation shouldn't be for surgeons to do spinal fusions because they make more money. The only motivation should be to restore good health and function to the patient.
The problem with our health care system is that it's so fragmented: no one entity is responsible for healing the patient; they're all focused on their own particular specialties. That pits caregivers in different specialty areas against each other as they try to sell their own solutions to patients. There's usually no neutral arbiter with sufficient medical expertise to help a patient decide on the best solution. Patients have to decide for themselves, with only the advice of the specialists with a vested interest to go on. Often the best salesman -- not the best solution -- will win.
Practices at the Mayo Clinic and the Cleveland Clinic try to resolve that issue, but they're initially expensive and geographically limited.
The Health Care Cost Spiral
Ultimately, the question of spinal fusions cannot be simply characterized as "doctors are money grubbers" and "baby boomers are getting fusions so they can play tennis." Our health care system is not focused on healing people, but on making money. The profit motive distorts medical care.
On the other side, patients want to be able to work, pick up their grandchildren, use their hands and arms, walk on their own two feet, get themselves out of bed and into the bathroom and bathe themselves. Most people would pay anything to do that.
Whenever someone talks about fixing the first problem someone yells, "Free Market!" and whenever someone talks about fixing the second problem someone yells, "Death Panels!"
Hence the problem of ever-spiraling health-care costs.
Given all the fretting about the number of nursing assistants we'll need as baby boomers age, it will probably be cheaper in the long run to to fix orthopedic problems -- back, knee and hip -- by whatever means necessary to keep an aging population mobile, healthy and self-sufficient as long as possible.
The Post story looks at the large number of fusions done by a Florida neurosurgeon, Federico C. Vinas. There are suggestions that many of these procedures were not medically necessary, and Vinas did them just for profit (he makes $2 million a year). Spinal fusion is not cheap: in the United States it costs on average of $111,000.
Spinal fusion, like almost everything in American medicine, is overpriced. Based on outcomes from countries similar to the United States, the costs of medical procedures are artificially high: probably five to ten times what they should be (which is obvious from the fact that even within the United States they vary that much).
The Post talked to several patients who did not benefit from the surgery, some of whom are in severe pain and unable to walk. Others are now leading normal lives. These newspaper anecdotes are compelling, but don't really address the efficacy of spinal fusions. The problem is that there is no real consensus on the efficacy of fusion for treating nonspecific low back pain.
The Post story isn't the first on this topic: Bloomberg examined the same issue in 2010. The Bloomberg story is interesting because it's about the Twin Cities Spine Center and Ensor Transfeldt, a surgeon who examined me 20 years ago. Several years ago I had a minimally invasive cervical laminoforaminotomy by a different Twin Cities Spine surgeon. I passed on proposals by other surgeons for a fusion or a disc replacement: the Terminator-like spine model with the titanium ball-bearing design really creeped me out.
Limitations of Spinal Fusion
By its very nature spinal fusion reduces the patient's flexibility by bolting together two or three vertebrae with bone transplanted from the patient's hip or a cadaver. The fusion prevents rotation of the spine at those levels, putting stress on other parts of the spine, which can cause serious damage and pain, and potentially limits the patient's activities. It's therefore not something you should consider lightly. Other surgical procedures, such as disc replacement, still have serious limitations.
I'm therefore inclined to agree with the thrust of the Post and Bloomberg's reporting: some doctors are doing too many fusions.
Playing Golf and Tennis
The increase in the number of fusions is by no means motivated solely by profit: many people are simply not willing to suffer excruciating pain, become dependent on narcotic painkillers, or become invalids, and they look to surgery to make them mobile (from the Post):
“Patients want to be able to play tennis and golf and go surfing at much higher ages than they did in the past,” said Gunnar Andersson, chairman emeritus of the department of orthopedic surgery at Rush University Medical Center in Chicago and president-elect of the International Society for the Advancement of Spine Surgery, a professional group. “They are more likely to seek out treatment and more likely to accept surgery as an option.”This echoes a popular refrain: "Baby Boomers don't want to age gracefully." This attitude is dead wrong.
Keeping People Active and Healthy
Ask any doctor how to prevent diabetes and heart disease, and the top two answers go hand in hand: weight control and exercise.
If you can't walk, you can't run, and you can't do any serious exercise. If you don't exercise you gain weight and your heart and lung function decline. You get diabetes, heart disease, high blood pressure, and are at increased risk of stroke and even cancer. You lose your sense of proprioception, which is essential to avoiding falls. You experience bone loss, which makes serious fractures from even minor falls likely. In particular, hip fractures are a major factor in the decline and death of the elderly ("ma was doing great until she fell and broke her hip").
In strictly monetary terms, the question is: Are the long-term costs of treating chronic organic problems like diabetes, hypertension and heart disease caused by being sedentary greater than the costs of correcting orthopedic conditions that exacerbate those organic problems?
The cheapest solution is to keep people active and healthy, and off expensive painkillers (with their addictive and debilitating side effects), and diabetes and blood pressure meds for as long as possible.
No Responsibility for Patient Healing
The motivation shouldn't be for surgeons to do spinal fusions because they make more money. The only motivation should be to restore good health and function to the patient.
The problem with our health care system is that it's so fragmented: no one entity is responsible for healing the patient; they're all focused on their own particular specialties. That pits caregivers in different specialty areas against each other as they try to sell their own solutions to patients. There's usually no neutral arbiter with sufficient medical expertise to help a patient decide on the best solution. Patients have to decide for themselves, with only the advice of the specialists with a vested interest to go on. Often the best salesman -- not the best solution -- will win.
Practices at the Mayo Clinic and the Cleveland Clinic try to resolve that issue, but they're initially expensive and geographically limited.
The Health Care Cost Spiral
Ultimately, the question of spinal fusions cannot be simply characterized as "doctors are money grubbers" and "baby boomers are getting fusions so they can play tennis." Our health care system is not focused on healing people, but on making money. The profit motive distorts medical care.
On the other side, patients want to be able to work, pick up their grandchildren, use their hands and arms, walk on their own two feet, get themselves out of bed and into the bathroom and bathe themselves. Most people would pay anything to do that.
Whenever someone talks about fixing the first problem someone yells, "Free Market!" and whenever someone talks about fixing the second problem someone yells, "Death Panels!"
Hence the problem of ever-spiraling health-care costs.
Given all the fretting about the number of nursing assistants we'll need as baby boomers age, it will probably be cheaper in the long run to to fix orthopedic problems -- back, knee and hip -- by whatever means necessary to keep an aging population mobile, healthy and self-sufficient as long as possible.
A Change of Heart On Inflation
My latest installment on Stiglitz was heavily centered on the issue of inflation and how the Fed seems completely obsessed with keeping it low. Yet, a recent piece in the New York Times indicates that there might be a sea change with the appointment of Janet Yellin.
The Fed has worked for decades to suppress inflation, but economists, including Janet Yellen, President Obama’s nominee to lead the Fed starting next year, have long argued that a little inflation is particularly valuable when the economy is weak. Rising prices help companies increase profits; rising wages help borrowers repay debts. Inflation also encourages people and businesses to borrow money and spend it more quickly.
I agree. We have to end the inflation hawk hysteria and move towards a more balanced approach towards growth. This is exactly what Stiglitz was hoping would happen when he wrote his tome two years ago and we may finally be heading in that direction.
The Fed has worked for decades to suppress inflation, but economists, including Janet Yellen, President Obama’s nominee to lead the Fed starting next year, have long argued that a little inflation is particularly valuable when the economy is weak. Rising prices help companies increase profits; rising wages help borrowers repay debts. Inflation also encourages people and businesses to borrow money and spend it more quickly.
I agree. We have to end the inflation hawk hysteria and move towards a more balanced approach towards growth. This is exactly what Stiglitz was hoping would happen when he wrote his tome two years ago and we may finally be heading in that direction.
Sunday, October 27, 2013
Your Lack Of Insight And Compassion Make You Ugly
Check out this piece from addictinginfo. Not only do the images discussed lack compassion and insight but they really show how self loathing the Right is today. I think the key to understanding why conservatives behave the way they do is to look at their relationship with their parents and how poorly the have developed as human beings after that.
Make sure you follow these four steps if you lose your job!
1. If / when you lose your job, be sure to sell all your nice electronics and luxury goods immediately and make sure you are always dressed well in public (but not too well, because then you are clearly not in need of any financial assistance and will be judged for not immediately selling all your nice clothing, too).
2. Cover up your tattoos, or people will snark that you are spending your welfare money on body art, even if you have had those tattoos for years, or you have a friend who is a tattoo artist who did them for free.
3. Are your shoes nice? Better not wear them in public, especially while at the grocery store paying for food with food stamps, because you MUST have somehow magically converted those food stamps into enough expendable income to buy those shoes. Never mind that they were a gift, or you bought them years ago, or that they actually have huge holes in the soles and tattered insoles because you can’t afford to replace them.
4. As a bonus, be sure not to have a job with flexible hours or work from home or work as a stay-at-home parent, because judgmental people will be on your ass and assume you are on welfare based on limited or non-existent evidence (even if you are not) and whine bitterly about having to contribute to social safety nets for the needy. That is right: You don’t even have to be on welfare at all, you can simply be out in public with your kid(s) during normal business hours and have total strangers assume you are on government assistance if you don’t look prosperous. Isn’t that cute?
Make sure you follow these four steps if you lose your job!
1. If / when you lose your job, be sure to sell all your nice electronics and luxury goods immediately and make sure you are always dressed well in public (but not too well, because then you are clearly not in need of any financial assistance and will be judged for not immediately selling all your nice clothing, too).
2. Cover up your tattoos, or people will snark that you are spending your welfare money on body art, even if you have had those tattoos for years, or you have a friend who is a tattoo artist who did them for free.
3. Are your shoes nice? Better not wear them in public, especially while at the grocery store paying for food with food stamps, because you MUST have somehow magically converted those food stamps into enough expendable income to buy those shoes. Never mind that they were a gift, or you bought them years ago, or that they actually have huge holes in the soles and tattered insoles because you can’t afford to replace them.
4. As a bonus, be sure not to have a job with flexible hours or work from home or work as a stay-at-home parent, because judgmental people will be on your ass and assume you are on welfare based on limited or non-existent evidence (even if you are not) and whine bitterly about having to contribute to social safety nets for the needy. That is right: You don’t even have to be on welfare at all, you can simply be out in public with your kid(s) during normal business hours and have total strangers assume you are on government assistance if you don’t look prosperous. Isn’t that cute?
Saturday, October 26, 2013
A Software Developer's Take on Healthcare.gov
As a software developer I have some experience with projects like healthcare.gov. I worked for companies that provided computerized testing. They had worldwide registration systems and transmitted exam databases and software to a network of autonomous testing centers across the world, where high-stakes exams were delivered under the supervision of proctors and the results transmitted back to our central hub.
The tragedy of software development is that the launch of the health care website is all too typical. That's not an excuse: it's a simple statement of fact.
When Target came out with its site in 2011 it had a ton of problems. Best Buy also had serious issues with its site. When United Airlines and Continental Airlines merged their reservation systems they had terrible problems (United was still having problems as recently as September, when it was charging customers $0 for tickets). Pretty much every online game has launch-day blues, ranging from minor issues to major meltdowns that can take weeks or months to fix. Who can forget the problems that Microsoft has had with every major revision of Windows, including Vista (which had a redo with Windows 7) and Windows 8 (which just came out with Windows 8.1).
And of course, there are the problems that George Bush's signature program, Medicare Part D, had when it came out. Instead of jeering on the sidelines, Democrats helped the Bush administration resolve those issues.
The reasons for these problems are usually the same: late starts, uncertain scope and scale, shifting requirements and inadequate testing. The healthcare.gov site suffered from all of these problems, many of them foisted on the project by its detractors.
Late Starts, Cast-in-Concrete Deadlines
Most software projects don't get started on time, but the deadline rarely changes. This was especially true of the ACA, which had been delayed by legal action for years. The people who claim the developers had four years to write the software are flat-out wrong. Lawyers were still duking it out in the Supreme Court in June of last year, which meant that the software developers didn't even know whether the project would really happen until 16 months before launch date. At that time the justices threw out a major portion of the law -- the Medicaid expansion -- which affected the design and implementation.
Shifting Requirements
Then there are imprecise requirements. The health care exchange was clouded by uncertainty over the exact scope of the website: the law gives the states the right to create their own exchanges, and many did so. If all the states had created their own sites, that would have dictated a much smaller design for healthcare.gov, relegating it to a simple entry portal to the state exchanges and back-end data processor and validator.
But the developers of healthcare.gov had to wait for all the states to decide what they were going to do -- and many of them didn't make a decision until December of 2012, after the Republican Governor's Association asked the Obama administration multiple times to delay the deadline. That gave healthcare.gov only 10 months after finally learning the true scope of the project. At that point they learned that they had to set up exchanges for 38 states. And only 10 months to do it. Imagine how difficult it would be to design a skyscraper without knowing how many floors it was going to have.
It's rather hypocritical that the Republicans who forced delays in the development of healthcare.gov -- through lawsuits and dillydallying on deciding whether they would create their own exchanges -- are now complaining about its rocky start.
Full-Bore Launch vs. Incremental Development
Websites that people compare healthcare.gov to -- Amazon.com, for example -- have been developed incrementally, and have been up and running for more than a decade. When Amazon began they had few customers and little visibility. They had low volume on launch day and were able to fix their problems in obscurity. They had no deadline other than their own internally imposed one. They could push the launch back without any repercussions. They could grow slowly and incrementally.
The healthcare.gov website was a huge deal that everyone was watching. Its start date was dictated by law. Millions of people and thousands of companies are depending on it. The site got hammered by millions of hits on day one, and it collapsed -- just like thousands of smaller-scale private software projects before it.
Inherently Messy Project
The job this site is trying to accomplish is much messier than ordering a coffee maker. It's not trivial to find out whether people qualify for tax credits, and you can't find out the real cost of a policy without that information. You have to make sure that the person really is who they say they are, and you have to be concerned with privacy and security. Making something simple to use and making it confidential and secure are competing -- almost contradictory -- requirements.
I'm not making excuses for the problems. I'm just saying that we've seen them before, in thousands of private and government software launches. But we've got time -- two more months before any insurance policies issued under the ACA actually go live, and three more months after that for people to sign up.
People should give Jeff Zients his month to get the problems fixed. If we're still having these problems on Dec. 1, then we can go into full histrionics mode. Until then, healthcare.gov isn't all that different from many other software launches that limp along in their early days. Except that the project is beset by millions of people hoping desperately for it to fail and actively trying to sabotage it.
The real reason that this health care rollout is so messy is that it's basically the Heritage Institute and Mitt Romney's plan to keep the insurance industry profitable. Obama didn't originally want an individual mandate; he preferred a public option that would have looked a lot like Medicare, which would have eliminated many of the problems with healthcare.gov.
Thus, the left criticizes Obama for selling out to insurance execs, and the right criticizes him for a socialist takeover of health care.
I guess that's the definition of compromise: nobody is happy.
The tragedy of software development is that the launch of the health care website is all too typical. That's not an excuse: it's a simple statement of fact.
When Target came out with its site in 2011 it had a ton of problems. Best Buy also had serious issues with its site. When United Airlines and Continental Airlines merged their reservation systems they had terrible problems (United was still having problems as recently as September, when it was charging customers $0 for tickets). Pretty much every online game has launch-day blues, ranging from minor issues to major meltdowns that can take weeks or months to fix. Who can forget the problems that Microsoft has had with every major revision of Windows, including Vista (which had a redo with Windows 7) and Windows 8 (which just came out with Windows 8.1).
And of course, there are the problems that George Bush's signature program, Medicare Part D, had when it came out. Instead of jeering on the sidelines, Democrats helped the Bush administration resolve those issues.
The reasons for these problems are usually the same: late starts, uncertain scope and scale, shifting requirements and inadequate testing. The healthcare.gov site suffered from all of these problems, many of them foisted on the project by its detractors.
Late Starts, Cast-in-Concrete Deadlines
Most software projects don't get started on time, but the deadline rarely changes. This was especially true of the ACA, which had been delayed by legal action for years. The people who claim the developers had four years to write the software are flat-out wrong. Lawyers were still duking it out in the Supreme Court in June of last year, which meant that the software developers didn't even know whether the project would really happen until 16 months before launch date. At that time the justices threw out a major portion of the law -- the Medicaid expansion -- which affected the design and implementation.
Shifting Requirements
Then there are imprecise requirements. The health care exchange was clouded by uncertainty over the exact scope of the website: the law gives the states the right to create their own exchanges, and many did so. If all the states had created their own sites, that would have dictated a much smaller design for healthcare.gov, relegating it to a simple entry portal to the state exchanges and back-end data processor and validator.
But the developers of healthcare.gov had to wait for all the states to decide what they were going to do -- and many of them didn't make a decision until December of 2012, after the Republican Governor's Association asked the Obama administration multiple times to delay the deadline. That gave healthcare.gov only 10 months after finally learning the true scope of the project. At that point they learned that they had to set up exchanges for 38 states. And only 10 months to do it. Imagine how difficult it would be to design a skyscraper without knowing how many floors it was going to have.
It's rather hypocritical that the Republicans who forced delays in the development of healthcare.gov -- through lawsuits and dillydallying on deciding whether they would create their own exchanges -- are now complaining about its rocky start.
Full-Bore Launch vs. Incremental Development
Websites that people compare healthcare.gov to -- Amazon.com, for example -- have been developed incrementally, and have been up and running for more than a decade. When Amazon began they had few customers and little visibility. They had low volume on launch day and were able to fix their problems in obscurity. They had no deadline other than their own internally imposed one. They could push the launch back without any repercussions. They could grow slowly and incrementally.
The healthcare.gov website was a huge deal that everyone was watching. Its start date was dictated by law. Millions of people and thousands of companies are depending on it. The site got hammered by millions of hits on day one, and it collapsed -- just like thousands of smaller-scale private software projects before it.
Inherently Messy Project
The job this site is trying to accomplish is much messier than ordering a coffee maker. It's not trivial to find out whether people qualify for tax credits, and you can't find out the real cost of a policy without that information. You have to make sure that the person really is who they say they are, and you have to be concerned with privacy and security. Making something simple to use and making it confidential and secure are competing -- almost contradictory -- requirements.
I'm not making excuses for the problems. I'm just saying that we've seen them before, in thousands of private and government software launches. But we've got time -- two more months before any insurance policies issued under the ACA actually go live, and three more months after that for people to sign up.
People should give Jeff Zients his month to get the problems fixed. If we're still having these problems on Dec. 1, then we can go into full histrionics mode. Until then, healthcare.gov isn't all that different from many other software launches that limp along in their early days. Except that the project is beset by millions of people hoping desperately for it to fail and actively trying to sabotage it.
The real reason that this health care rollout is so messy is that it's basically the Heritage Institute and Mitt Romney's plan to keep the insurance industry profitable. Obama didn't originally want an individual mandate; he preferred a public option that would have looked a lot like Medicare, which would have eliminated many of the problems with healthcare.gov.
Thus, the left criticizes Obama for selling out to insurance execs, and the right criticizes him for a socialist takeover of health care.
I guess that's the definition of compromise: nobody is happy.
The Gun Free Zone Lie
The evidence continues to mount that the emotionally fueled and asinine idea that gun free zones are the proverbial honey to killer bees is completely ridiculous. A disgruntled National Guard recruiter shot two military personnel at an armory outside a Navy facility near Memphis on Thursday. Yes, that's right...an ARMORY.
Let's see...that's Kirkwood City Hall, Fort Hood, the Navy Yard in DC, the gun range in Texas where Chris Kyle was killed and now this. Those are just the ones off of the top of my head. A little research shows that there have been many more.
Of course Media Matters did a piece after the Navy Yard shooting that pretty much torpedoed the gun free zone lament. This study and this study point out that there is not a single case from 1982 to 2012 that contains evidence that the shooters chose their targets because they were "gun free" and that fewer that one quarter of mass shootings in public spaces from January 2009 through January 2013 occurred in gun-free zones.
Whether or not a facility is armed is inconsequential. We should be spending more time on the mental health aspects of these cases (and keeping guns out of the hands of said individuals) and zero time entertaining the adolescent feelings of the gun community who don't like being told what to do and where. I wish they would just be honest and admit that they want to be able to carry their gun wherever they want because they have a problem with authority and are fucking children who need to have their toys with them at all times.
Let's see...that's Kirkwood City Hall, Fort Hood, the Navy Yard in DC, the gun range in Texas where Chris Kyle was killed and now this. Those are just the ones off of the top of my head. A little research shows that there have been many more.
Of course Media Matters did a piece after the Navy Yard shooting that pretty much torpedoed the gun free zone lament. This study and this study point out that there is not a single case from 1982 to 2012 that contains evidence that the shooters chose their targets because they were "gun free" and that fewer that one quarter of mass shootings in public spaces from January 2009 through January 2013 occurred in gun-free zones.
Whether or not a facility is armed is inconsequential. We should be spending more time on the mental health aspects of these cases (and keeping guns out of the hands of said individuals) and zero time entertaining the adolescent feelings of the gun community who don't like being told what to do and where. I wish they would just be honest and admit that they want to be able to carry their gun wherever they want because they have a problem with authority and are fucking children who need to have their toys with them at all times.
Friday, October 25, 2013
More Backdoor Corporate Welfare
In the last election one party chose to portray people who receive public assistance as lazy moochers and takers. But the fact is, the companies that employ those same people are mooching off the government. More than half of fast-food workers are forced to receive some sort of public assistance, according to a study from the UC Berkeley Labor Center. That includes SNAP (food stamps), Medicaid, earned income tax credits, and Temporary Assistance for Needy Families. The McDonald's employee help line McResources even advises workers to go on food stamps and Medicaid.
The total cost to American taxpayers is $7 billion a year.
And it's not just McDonald's. It's Wendy's and Burger King and Walmart, whose employees also suck up billions of dollars of public assistance annually.
These are highly profitable companies that have grown almost exponentially over the past few decades. Walmart has put thousands of smaller retailers of all types across the country out of business, sending the profits to Arkansas. McDonald's has replaced thousands of independent restaurants with franchisees who are pressured to treat employees like cattle, siphoning billions of dollars of local profits to Chicago. Profits that had previously been spent and taxed locally and contributed to the local economy.
The business models of McDonald's and Walmart are based on paying workers slave wages, forcing federal and local governments step in to make sure these workers and their children are clothed and housed and don't starve. That is an indirect government subsidy to those companies: these people couldn't work at McDonald's and Walmart without government help.
If you buy what McDonald's pretends is food or the cheap cost-reduced junk that Walmart pawns off on their customers, you too are getting a handout from the federal government. Because these companies couldn't provide you these products at the prices they do if they paid their employees what they actually cost the economy at large.
Well, actually they could quite handily: but it would require lowering their profit margins. Other companies, like Costco, Trader Joe's and QuickTrip, give their employees decent wages and benefits and still make a profit. Not quite as much as Walmart and McDonald's, admittedly. But WMT/MCD business practices are costing all of us money, not just the people who buy their stuff.
If we really need the products that those companies sell, we should be willing to pay their actual costs. It's not right that our tax dollars subsidize the incomes of the McDonald's and Walmart employees who actually do the work, while all the profits go into the pockets of the guys at the top.
The total cost to American taxpayers is $7 billion a year.
And it's not just McDonald's. It's Wendy's and Burger King and Walmart, whose employees also suck up billions of dollars of public assistance annually.
These are highly profitable companies that have grown almost exponentially over the past few decades. Walmart has put thousands of smaller retailers of all types across the country out of business, sending the profits to Arkansas. McDonald's has replaced thousands of independent restaurants with franchisees who are pressured to treat employees like cattle, siphoning billions of dollars of local profits to Chicago. Profits that had previously been spent and taxed locally and contributed to the local economy.
The business models of McDonald's and Walmart are based on paying workers slave wages, forcing federal and local governments step in to make sure these workers and their children are clothed and housed and don't starve. That is an indirect government subsidy to those companies: these people couldn't work at McDonald's and Walmart without government help.
If you buy what McDonald's pretends is food or the cheap cost-reduced junk that Walmart pawns off on their customers, you too are getting a handout from the federal government. Because these companies couldn't provide you these products at the prices they do if they paid their employees what they actually cost the economy at large.
Well, actually they could quite handily: but it would require lowering their profit margins. Other companies, like Costco, Trader Joe's and QuickTrip, give their employees decent wages and benefits and still make a profit. Not quite as much as Walmart and McDonald's, admittedly. But WMT/MCD business practices are costing all of us money, not just the people who buy their stuff.
If we really need the products that those companies sell, we should be willing to pay their actual costs. It's not right that our tax dollars subsidize the incomes of the McDonald's and Walmart employees who actually do the work, while all the profits go into the pockets of the guys at the top.
It Begins (And Ends) With The Parents
Nearly all of the challenges I face as an instructor are due to poor parenting. Parents do indeed really suck and they are getting worse. Even the number of sucky parents are on the rise as our culture becomes more and more cemented in the misplaced and harmful values of the Michael Jordan Generation. It's very clear that parents are just not doing their job.
Never was this statement more true than with the parents of the shooter in the recent Sparks, Nevada Middle School shooting. While it hasn't been fully confirmed yet, the student who killed teacher and vet Michael Landsberry and wounded two other students likely got the semi-auto 9mm from his parents. What the hell were they thinking? And what kind of a fucking country do we live in where a guy who does tours of duty in Iraq and Afghanistan lives through that but gets shot in his hometown? It's stuff like this that completely disgusts me.
This would be a clear example of people who should not be allowed to own guns and why our laws regarding arms need to be changed. Their license to own a gun should be taken away and they should face criminal charges. I'm wondering if they were "live free or die" types like Nancy Lanza who also thought it would be nifty to let her mentally ill sun have access to her guns.
The facts of this case have been very slow in coming but my takeaways are that it's clear there was some sort of bullying involved (more on that later), the shooter was mentally ill, and his parents are directly responsible. Further, this latest incident has led me to reflect about Newton and come to the conclusion the ideology that bloviates from the gun community is also responsible. This is particularly true in the case of Nancy Lanza who bought their lies to such a degree that she felt she needed a fucking arsenal to protect herself.
It begins and ends with the parents, folks. If they don't do their job, we end up with situations like this. And more and more of them these days are failing miserably.
Never was this statement more true than with the parents of the shooter in the recent Sparks, Nevada Middle School shooting. While it hasn't been fully confirmed yet, the student who killed teacher and vet Michael Landsberry and wounded two other students likely got the semi-auto 9mm from his parents. What the hell were they thinking? And what kind of a fucking country do we live in where a guy who does tours of duty in Iraq and Afghanistan lives through that but gets shot in his hometown? It's stuff like this that completely disgusts me.
This would be a clear example of people who should not be allowed to own guns and why our laws regarding arms need to be changed. Their license to own a gun should be taken away and they should face criminal charges. I'm wondering if they were "live free or die" types like Nancy Lanza who also thought it would be nifty to let her mentally ill sun have access to her guns.
The facts of this case have been very slow in coming but my takeaways are that it's clear there was some sort of bullying involved (more on that later), the shooter was mentally ill, and his parents are directly responsible. Further, this latest incident has led me to reflect about Newton and come to the conclusion the ideology that bloviates from the gun community is also responsible. This is particularly true in the case of Nancy Lanza who bought their lies to such a degree that she felt she needed a fucking arsenal to protect herself.
It begins and ends with the parents, folks. If they don't do their job, we end up with situations like this. And more and more of them these days are failing miserably.
Thursday, October 24, 2013
Good Words
"In theory, lawmakers should hope that government programs work well, and if they don't, work to fix them. Elected representatives should hope that government agencies carry out their missions smoothly, and if something goes wrong, try to figure out what happened to avoid making the same mistake in the future.
Obviously that's not how things work in the United States, where one of the two parties doesn't actually believe in government. Republicans want to shrink government until it's small enough to drown in a bathtub! They think there's nothing scarier than the prospect of a government employee trying to help! With beliefs like those, it's perhaps not surprising that -- with disturbing frequency -- they root for failure in order to score points." --- JULIET LAPIDOS, October 24, 2013
Obviously that's not how things work in the United States, where one of the two parties doesn't actually believe in government. Republicans want to shrink government until it's small enough to drown in a bathtub! They think there's nothing scarier than the prospect of a government employee trying to help! With beliefs like those, it's perhaps not surprising that -- with disturbing frequency -- they root for failure in order to score points." --- JULIET LAPIDOS, October 24, 2013
Demons of Progess
A recent discussion on Facebook made me realize that my frustration with conservatives has two levels. The first is that I simply don't understand how they can believe the lies that are peddled to them inside of the bubble. These fictional tales can easily be torpedoed by a simple check of the facts. But that's not even the worst part.
The second level is what really drives me nuts. That's when they very erroneously believe that liberals are the ones that are actually brainwashed. Their media are the ones telling the lies and only conservative media tells the truth. They essentially turn it around (Projection/Flipping) and truly think people like me are the ones that have fallen victim to the "liberal" media. This notion is completely false.
With each level, no amount of reality will persuade them yet I think we are coming to a turning point in this country in terms of information gathering. The conservative bubble isn't going to hold for all that much longer as reality comes crashing in (climate change, antiquated gun laws, poor macroeconomic policy etc) and destroys it. I already know that, while there is certainly liberal bias out there, it's not the out and out lying and propaganda that we see coming from the Right. Liberals, by nature and definition, are very reflective people and recognize the shortcomings of their own views and policies. That's where the over-analysis comes in to play. Conservatives are the exact opposite. They don't reflect at all, are set in their ways, never change and under analyze.
They are, in short, the demon to progress and that's why I can never be one.
The second level is what really drives me nuts. That's when they very erroneously believe that liberals are the ones that are actually brainwashed. Their media are the ones telling the lies and only conservative media tells the truth. They essentially turn it around (Projection/Flipping) and truly think people like me are the ones that have fallen victim to the "liberal" media. This notion is completely false.
With each level, no amount of reality will persuade them yet I think we are coming to a turning point in this country in terms of information gathering. The conservative bubble isn't going to hold for all that much longer as reality comes crashing in (climate change, antiquated gun laws, poor macroeconomic policy etc) and destroys it. I already know that, while there is certainly liberal bias out there, it's not the out and out lying and propaganda that we see coming from the Right. Liberals, by nature and definition, are very reflective people and recognize the shortcomings of their own views and policies. That's where the over-analysis comes in to play. Conservatives are the exact opposite. They don't reflect at all, are set in their ways, never change and under analyze.
They are, in short, the demon to progress and that's why I can never be one.
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