Month: January 2014

My health care posts from 2013

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David has a good idea. I often read the archives of my personal blog to see how I did in forecasting the future or understanding the present. A major concern of mine is, of course, health care and what is happening. When I retired from surgery after my own back surgery, I spent a year at Dartmouth Medical School’s center for study of health care. My purpose was to indulge an old hobby. How do we measure quality in health care ? I had served for years on the board of a company called California Medical Review, Inc. It was the official Medicare review organization for California. For a while I was the chair of the Data Committee. It seems to have gone downhill since I was there. First, it changed its name in an attempt to get more business from private sources. Then it lost the Medicare contract.

Lumetra, which lost a huge Medicare contract last November, is changing its name and its business model as it seeks to replace more than $20 million in lost revenue.
The San Francisco-based nonprofit’s revenue will shrink this year from $28 million last fiscal year, ending in March 2009, to a projected $4.5 million, CEO Linda Sawyer told the Business Times early this week.
That’s in large part because it’s no longer a Medicare quality improvement contractor, formerly its main line of work. And in fact, the 25-year-old company’s revenue has been plummeting since fiscal 2007, when it hit $47 million.

I see no sign that it is involved with Obamacare which is being run from Washington with a state organization that seems no better run than the parent organization.

Beginning Jan. 1, 2015, the Affordable Care Act no longer will provide federal grants to fund state health exchanges. In addition, California law prohibits using the state’s general fund to pay for the exchange.

Anyway, for what it is worth, here are the links to the 2013 health posts.

The Lost Boys

Alternatives to Obamacare.

Why the Obamacare Site Isn’t Working.

Where Healthcare May be Going.

Conservatives Invented the Mandate; say the Democrats.

A Critical Insight.

A Rolling Catastrophe.

Why Health Care is in Trouble.

Where Do We Go Now ?

Building the Airplane During Takeoff.

Selected Posts from 2013

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I’m reviewing my posts over the last year, and will be linking some of them here, in some cases with additional commentary. Here’s the first batch…

The bitter wastes of politicized America, on the toxic social effects of ever-increasing government power.

Also relevant to the subject of this post are some of Sebastian Haffner’s observations on inter-war Germany. He notes that during the Stresemann chancellorship, when a certain level of stability and normality was achieved, “there was an ample measure of freedom, peace, and order, everywhere the most well-meaning liberal-mindedness, good wages, good food and a little political boredom. everyone was cordially invited to concentrate on their personal lives, to arrange their affairs according to their own taste and to find their own paths to happiness”…BUT a return to private life was not to everyone’s taste:

A generation of young Germans had become accustomed to having the entire content of their lives delivered gratis, so to speak, by the public sphere, all the raw material for their deeper emotions…Now that these deliveries suddenly ceased, people were left helpless, impoverished, robbed, and disappointed. They had never learned how to live from within themselves, how to make an ordinary private life great, beautiful and worth while, how to enjoy it and make it interesting. So they regarded the end of political tension and the return of private liberty not as a gift, but as a deprivation. They were bored, their minds strayed to silly thoughts, and they began to sulk.

I’m afraid that in America today, we also have a fair number of people who expect to have “the content of their lives delivered by the public sphere,” and this is another factor in the growing politicization of absolutely everything.

The Dream(liner) and the Nightmare (of Social Toxicity). How reactions to the problems with the Boeing 787’s battery system exemplify the declining levels of trust in American society.

Excusing Failure by Pleading Incompetence.  Hillary Clinton’s testimony on the Benghazi debacle clearly demonstrated her inability and/or unwillingness to understand the nature of executive responsibility. It is truly appalling that anyone could seriously consider this woman for the job of United States President.

Respect her Authoritah. Nancy Cartman-Pelosi thinks it would be disrespectful to cut congressional salaries because it would reduce the dignity of lawmakers’ jobs.

Connecting the World. Undersea cables, and their social & psychological impact.

Adding Up the Old Year, Looking Towards the New

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In a meditation that I posted about this time last year just as we came down to Christmas and the last frantic dash to the end of the year I laid out the things that I wanted to do, or ought to do during 2013. Time to take stock and look at which ones I did manage … and those that I shall have to try harder to do in 2014.

#1 – I was resolved to change my main bank account from Bank of America to a Texas institution. Check. Actually accomplished this the first week of the new year, and it went quite painlessly, changing the automatic deposit from DFAS and the automatic payment to the mortgage company. Check.

#2 Finish and publish The Quivera Trail in time for launching in November, 2013. Done and check. Also begin on the next book, or at least the research. I had thought it would be tentatively entitled The Golden Road, starring young Fredi Steinmetz and the usual cast of characters historical and created … half-check. Started research, but was detoured into writing another picaresque adventure, Lone Star Sons, which will be a short and adventurous bagatelle and a re-working of the Lone Ranger, as a historical adventure in 1840s Texas – which I am posting, chapter by chapter at the book blog and website, here. Lone Star Sons will be my November 2015 book … but I will be well along in writing The Golden Road by then.

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ETAOIN SHRDLU

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I was trying to figure out the not-very-intuitive interface for presetting stations on my car radio, and remembered a car radio we had when I was a kid: it could “memorize” the frequencies of selected stations in an entirely mechanical manner. IIRC, you pulled out a setting button when the radio was on a station you wanted to “remember,” and when you later wanted to return to that station, you simply pushed the appropriate button in. (I believe this feature was mechanized via clamps gripping a continuous string that drove the tuning mechanism.)

Which got me thinking: there was once a whole range of cunning mechanical devices that performed memory, logic, and arithmetic tasks that would now be done with a microprocessor or some other form of digital logic. Things that come to mind include railway signal interlocking systems, Linotype and other typesetting machines, mechanical calculators, mechanical analog computers, and ship and aircraft autopilots.

Googling around, I found that there is actually a feature film about the Linotype:    a bit about the history of typesetting, the development of the Linotype machine, the basics of how it works, some of the social/economic implications, and much nostalgia from former Linotype operators (and also from younger operators, who are working to keep the trade/technology alive.) The film is available free to those who have an Amazon Prime membership.

This video explains how the Linotype works and then goes into considerable detail about the mechanism.

Regarding the social/economic implications, the first video notes that while Linotype reduced typesetting labor requirements by a factor of 6:1, it also drove an explosion in the volume of printed material, and a concurrent increase in literacy, and wound up actually increasing the number of people involved in the printing trade. I would also suspect that the high capital cost of Linotype equipment was one factor that drove a consolidation of the newspaper industry toward a small number of highly dominant papers in each city.

One place where a Linotype can be seen in operation today is the Baltimore Museum of Industry, which has a machine which is periodically activated.

 

Quote of the Day

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Caroline Glick, Khodorkovsky and the freedom agenda:

Both the Iranian democracy activists then and the Ukrainian protesters today demonstrated through their actions that they do not seek the mere overthrow of unrepresentative, repressive governments. They seek freedom, and are willing to work for it. All the Iranians needed then, and all the Ukrainians ask for today, is assistance from foreign powers, just as George Washington’s Continental Army required French assistance to defeat the British Empire.
 
While those are easy cases to understand, the lesson of Putin’s Russia and of post-Saddam Iraq is that freedom doesn’t sprout from thin air. The only way to plant democracy in nations unfamiliar with the habits of liberty is to cultivate them, relentlessly and unapologetically, over time.