Bad backs: not necessarily hopeless

I set a Crossfit deadlift "PR" (personal record) today.

My best is not a big deal for anyone else. I'm among the weakest of the men; many of the non-competitive women are in a similar range (the competitive women are in a different universe).

The interesting bit, and the reason I put this in a blog post, is that six years ago I was rigging up a back support so I could be driven home on the bottom of a van. I'd had a pretty bad back since a body surfing accident in 1980 [1], but after 30 years it was getting worse. I definitely wasn't doing any deadlifts.

Until then, based on what I'd read and seen in my own patients, I was a therapeutic nihilist. Manage the acute pain, get back to work and activity asap. Nothing much to be done otherwise. By 2008 though, nihilism wasn't looking so good. I could see a bad future.

So I saw a doctor, a burned out dude with an attitude who'd helped create an aggressive evidence-based back therapy program in the Twin Cities. He wasn't the comforting sort, but I kind of like bad attitudes. Worked for me, I did the program, I got better. Five years later I do the stretches before I get out of bed. Every morning, without fail. And I work out ...

I'm now 8 months into crazy Crossfit stuff, which, were I my doctor, I'd say was stupid. Guaranteed to blow that back and put me back where it was. I didn't say I was smart.

I'm just one data point, but Intensive monitored exercise programs can work. Insurance companies should pay for 'em -- mine was a hell of a lot cheaper than surgery (which I never considered, that rarely works for more than 1-2 years except for atypical problems).

Back backs aren't hopeless -- at least not for everyone. 

After the Smart TV debacle: what we really want

Years after everyone else, I reluctantly retired our 25yo SONY Trinitron CRT and it's (free, subsidized) A/D converter box and naively bought a Samsung Smart TV (Wirecutter, you are dead to me.)

The crapware infested box and usability were bad enough, but an app.net thread on intrusive ads overlayed on an Apple TV input brought the full horror home.

My Samsung experience, and the strange death of rabbit ear (OTA, "over the air") media recording in America [1] made me think more about what kind of TV we really want. I think it would be a set of modules like this:

• Plain display with simple speakers, single HDMI input, no tuner, no remote.
• Separate Tuner/DVR and switch control. 4-5 HDMI in, single HDMI out, digital audio and analog audio out, speaker connections, antenna connections.
• Apple TV

I can imagine some permutations, but I think this is the right setup. Given the subsidies that support Smart TV prices [2] the way to build that today is to buy a Smart TV, don't connect it to the network, set the input to HDMI 1 and hide the remote. Then buy something like the (overpriced) $250 Channel Master DVR+ and an Apple TV.

Sure, Samsung could change their Smart TV so an internet connection was essential, but they won't. There aren't enough geek customers to bother with the customer complaints; we will get subsidized by Smart TV's victims.

- fn -

[1] After a 5-7 year hiatus solutions for recording OTA digital broadasts are reemerging -- albeit at $250 price points instead of the $80 one would expect given parts costs. Why is this? I think some mixture of bad patent law, DMCA, and probably illegal conspiracy and price fixing between cable companies and content owners.

[2] Revenue comes from the things that the Smart TV delivers.

Valerie Plame Wilson on the NSA, Keith Alexander, and Edward Snowden

Ten years ago Karl Rove, Richard Armitage and Lewis Libby took revenge on a man who'd exposed some of Bush/Cheney's Iraq lies. Their revenge was to blow the operational cover of his wife, Valerie Plame, a CIA covert agent. Scooter Libby was convicted of lying to investigators and sentenced to prison. Bush commuted his sentence.

Yeah, the Bush/Cheney years were like that.

Today I heard Valerie Plame speaking on the NSA, Keith Alexander ... and Edward Snowden. If you have any doubt that Snowden is a heroic figure in American history you should listen to the speech.

Plame's description of Keith Alexander is particularly memorable -- and chilling. There are always people like Alexander lurking in the shadows of American history, waiting for their main chance. Most miss out, but 2001 was a very good year for Alexander. He is now a terribly powerful man, and a much greater threat to American democracy than Bin Laden ever was.

We're all living in his shadow now, and he's not gone yet.

Why do corporations do lifestyle "wellness" programs?

Even with rather generous tax breaks, wellness programs cost corporations money. So why pay companies like South Africa's Vitality Group to run them?

It's not because they save money on health care expenses. A Rand study of long tenure employees found that over 7 years PepsiCo got 48 cents in savings for every dollar in expenses. Other recent studies have had similar results; better results with older studies may reflect higher smoking rates back in the 80s.

So why do it?

One reason is that current implementations do a great deal of cost shifting from the young and/or healthy to the older and/or sicker. With Vitality programs a low cholesterol healthy slender non-smoker pays less each month for health insurance than the average employee. (A "3000 point" gap -- enough to qualify for @$1000+ yearly insurance cost reductions.)

These programs follow the same logic as a briefly infamous 2005 Walmart healthcare memo. They shift costs to employees with family or personal health risks....

Wellness programs don’t save money | The Incidental Economist

Horwitz, Kelly et al ....Our evidence suggests that savings to employers may come from cost shifting, with the most vulnerable employees—those from lower socioeconomic strata with the most health risks—probably bearing greater costs that in effect subsidize their healthier colleagues. ..

Is that enough of a shift to make wellness programs covertly cost-effective? Or are corporations just being irrational? I suspect a bit of both, but we gotta remember that Walmart memo. At the very least, they shift costs from the blessed to the unblessed.

The Incidental Economist has covered this topic in some detail ...

• The Feel-Good Promise of Wellness Programs - Bloomberg
• Wellness programs aren’t ready for prime time | The Incidental Economist 9/13 - link to white paper on Penn State program
• Wellness programs don’t save money | The Incidental Economist 5/13 - previous studies on
• On wellness programs: Part 1 | The Incidental Economist 9/13 - earlier RAND study
• On wellness programs: Part 2 | The Incidental Economist 9/13

See also

• Hey Republicans: If you want to cut ObamaCare, try wellness programs 11/2012
• Corporate wellness programs: Not quite the cost savers Wonkblog 3/13

Beware fees and interest payments if you use credit card to wire money

Due to a family emergency I had to send money to a relative twice in two months. Each time I used MoneyGram and paid for the transaction with my VISA card.

I'd done that years ago and it worked well, but it's a bad idea now. VISA treats this transaction as a cash advance, and attaches a fee (roughly 5%) and an immediate interest charge (no grace period). Since I never pay fees or interest to credit card companies this was easy to spot on my statement.

I called VISA and, keeping my temper of course, asked if there was anything that could be done. They reversed the fees but kept the smaller interest charge.

If I had a Debit card I could have used that; there are no fees with Debit cards. I may need to get one.

Of course there are alternatives to MoneyGram (PayPal, sigh) but they require a digitally capable recipient. In this case that's not an option.

Update: If your recipient can manage email, app.net's danielgenser recomments https://square.com/cash