Employment benefit complexity: we are sheep

Baaaaaaa said the sheep, on the way to be ... sheared.

My wife and I have just selected our family's employment benefits for 2008. There were 4 basic health plans, two indemnity and two "health savings accounts" (they used some other name this year). In addition, one could create another 11 variants of one of the four plans.

The plans had wildly different pre-tax monthly paycheck deductions (so the true cost varies depending on one's tax bracket). They also have different providers, different deductibles, different out-of-pocket maximums (but are they really maximums?), different networks, and a complex mix of co-pays and percent uncovered for each transaction. Not to mention x-rays and labs.

Some costs that might be post-tax dollars can be covered by a pre-tax flexible spending account -- but you must be sure to spend all of it. Then there's a Dependent Care account, but be sure your spouse earns at least as much as what one claims -- or that's lost too.

If I had a team of lawyers, statisticians, and software developers, I could create simulations based on our known risk factors and run them against the plans. I would use Monte Carlo methods to create random variations around means, and then produce a probability distribution of likely costs.

Oh, wait a minute. It's the insurance companies that have that team. We just have ... a coin toss.

I feel like I've just signed a contract with Satan -- or, worse, Sprint Minnesota. I had to sign the contract, but I know it's hopeless. My immortal soul will be stuck in Hell

Do the French put up with this kind of stupidity? I like to imagine not.

Americans are sheep.

Complexity + Tight Coupling = Catastrophe

Years ago I was keen on the strategic advantages of loosely coupled software solutions and an associated ecosystem.

I'd forgotten that until recently, when both "ecosystem" and "coupling" became fashionable terms.

Good, they're important concepts.

I agree with this, for example: Complexity + Tight Coupling = Catastrophe.

The genetic engine is very loosely coupled. Not a bad idea really.

File for the mythical startup - operations

I have a small collection of these "pearls" of startup wisdom. Come the day I'll be able to find them all, using my newest tag - "startup" (it'll take a while for me to tag the back posts): 

Operations is a competitive advantage... (Secret Sauce for Startups!)

...In my experience it takes about 80 hours to bootstrap a startup. This generally means installing and configuring an automated infrastructure management system (puppet), version control system (subversion), continuous build and test (frequently cruisecontrol.rb), software deployment (capistrano), monitoring (currently evaluating Hyperic, Zenoss, and Groundwork). Once this is done the "install time" is reduced to nearly zero and requires no specialized knowledge. This is the first ingredient in "Operations Secret Sauce".

This kind of scaleability becomes really interesting when you find yourself suddenly popular, as iLike did when it launched its Facebook app and had to scale up fast (Radar)...

Major League Baseball leads fight for digital freedom

MLB changed their video contractor and disabled all the copy-protected videos they'd previously sold.

Yeoman's work! MLB is doing a wonderful job discrediting the entire digital rights management industry.

Major League Baseball is thus this week's winner of the Gordon's Notes' "Digital Freedom" medal.

Sometimes the stupid also serve.

Skinnies burn fast, plumpies less demented

I caught this Kolata article in the NYT a few days ago, but I hard a hard time finding it just now. I suppose the results seemed so odd that most bloggers have rejected it as yet more evidence that medical science has a consistency problem . (A position towards which I have some sympathy.)

It turns out that skinnies die younger than the pleasingly plump (but not obese). Odd indeed, since near-starvation diets promote longevity in worms and mice alike. Not only that, the skinnies get demented faster.

I think there's a quite plausible explanation. First the article (emphases mine)...

Causes of Death Are Linked to a Person’s Weight - Gina Kolata - New York Times

About two years ago, a group of federal researchers reported that overweight people have a lower death rate than people who are normal weight, underweight or obese. Now, investigating further, they found out which diseases are more likely to lead to death in each weight group.

Linking, for the first time, causes of death to specific weights, they report that overweight people have a lower death rate because they are much less likely to die from a grab bag of diseases that includes Alzheimer’s and Parkinson’s, infections and lung disease. And that lower risk is not counteracted by increased risks of dying from any other disease, including cancer, diabetes or heart disease.

As a consequence, the group from the Centers for Disease Control and Prevention and the National Cancer Institute reports, there were more than 100,000 fewer deaths among the overweight in 2004, the most recent year for which data were available, than would have expected if those people had been of normal weight.

Their paper is published today in the Journal of the American Medical Association.

The researchers also confirmed that obese people and people whose weights are below normal have higher death rates than people of normal weight. But, when they asked why, they found that the reasons were different for the different weight categories.

Some who studied the relation between weight and health said the nation might want to reconsider what are ideal weights.

“If we use the criteria of mortality, then the term ‘overweight’ is a misnomer,” said Daniel McGee, professor of statistics at Florida State University.

“I believe the data,” said Dr. Elizabeth Barrett-Connor, a professor of family and preventive medicine at the University of California, San Diego. A body mass index of 25 to 30, the so-called overweight range, “may be optimal,” she said.

... A woman who is 5 foot 4, for instance, would be considered at normal weight at 130, underweight at 107 pounds, overweight at 150 pounds and obese at 180.

... The higher death rate in obese people, as might be expected, was almost entirely driven by a higher death rate from heart disease.

But, contrary to expectations, the obese did not have an increased risk of dying from cancer. They were slightly more likely than people of normal weights to die of a handful of cancers that are thought to be related to excess weight — cancers of the colon, breast, esophagus, uterus, ovary, kidney and pancreas. Yet they had a lower risk of dying from other cancers, including lung cancer. In the end, the increases and decreases in cancer risks balanced out.

As for diabetes, it showed up in the death rates only when the researchers grouped diabetes and kidney disease as one category. Diabetes can cause kidney disease, they note. But, the researchers point out, the number of diabetes deaths may be too low because many people with diabetes die from heart disease, and often the cause of death is listed as a heart attack...

Now, how do I make sense of this and say it strikes me as quite plausible (I'm technically on the low end of overweight based on my BMI, thank you)?

I'll wager it's the aging clock and an associated "burn rate". The old "metabolism" metaphor doesn't do too badly, though I think it's fundamentally an aging rate issue.

If you have a slower-aging clock you tend to burn slower and gain weight. If you have a fast aging clock you tend to burn faster and stay skinnier.

In today's calorie and taste rich and exercise-light environment most people with normal or subnormal BMI have pretty fast clock and fast burn rates. They age more quickly, and so develop dementia and age-associated cancers more often.

People with very slow burn rates and slow clocks become obese, and die of obesity complications. (Though if they make it to old age I think they can last quite a long time.) In a world of fewer calories and more exercise they might do the best of all, however.

People with average to slow burn rates and average to slow clocks get plump and, if they dodge diabetic complications, they live longer and better. They do need to work to stay shy of obese however.

Which would put us back to the weight/health definitions we used in the 1980s, before new BMI standards made everyone overweight.

Oh, and the near-starvation diet and the ultra-skinny mice? That's a different effect, a physiologic response to prolonged famine. The clock slows down.

So the diet pill of tomorrow will both slow the clock (like the near-starvation diet) and cause the body to dump its calories into the GI tract.

Great news for all those plump folks out there ...

PS. Note this means that stuffing a skinny with calories won't actually help them. You'd need to slow the clock.

Diabetic non-compliance explained

I took care of lots of Type II diabetics back in the day, but not so many Type I diabetics. It's far less common than type II. I'm pretty sure, however, that I never understood: Diabulimia.

Skipping insulin for someone who's insulin dependent can be a great way to lose weight. Of course it can lead to total weight loss (as in death), but that's not quite guaranteed -- at least, not right away.

The article, which is appropriately sympathetic, provides a lot of insight in a quick read.

Pat Robertson does not believe in God

Of course we always knew it was about power, not virtue, but Pat Robertson's support of Giuliani tells us something even more remarkable.

Robertson can't believe in the God he preaches about. In particular, he clearly doesn't believe in a personal and judgmental deity who consigns sinners to eternal damnation.

If he did believe in that monster, he wouldn't touch Giuliani with a 10 foot pole.

To a reasonable approximation, it appears Robertson doesn't believe in his God.

LinkedIn goes exponential

They're such an obvious Google acquisition target. Maybe too obvious.

I've been on LinkedIn for about a year, but for most of that time my network wasn't too large. I didn't really press it. More recently several things boosted my use and even led to some proselytizing:

• a high school reunion led to some sentimental additions
• I started attaching my LinkedIn profile to my email signature
• I decided I wanted a net presence (a facade or facet identity) that was less revealing than my old web site.
• I added a link to my LinkedIn profile to my corporate Sharepoint profile
• LinkedIn will now process a Gmail contact list and look for matches to LinkedIn members (among others I located a sister-in-law that way)
• organic growth
  

The result is my network is getting fairly large and it's growing very quickly:

19,053 new people in your network since November 1

People in your network are hiring:
* Sr Data Warehouse Architect at Yahoo! Inc.
* SAP HR and SD Consultants at Bluefin Resources
* SAP Business Analyst (various disciplines, levels, all perm/full time) at Goodrich Aerostructures

This is going to be interesting. The trick for LinkedIn will be to extract revenue without getting too greedy -- though their end point is most likely to be a Microsoft or Google acquistion.

Apple Tablet: what the heck is it good for?

Daring Fireball thinks the Apple tablet rumor will turn out to be true:

Apple Tablet PC is real, says Asus - Crave at CNET.co.uk:

...So, can Apple turn the Tablet PC into a success when previous attempts have failed? The short answer is 'yes'. Any company that can make a mobile phone with no buttons, no picture messaging, slow Web access and no video capture into the most desirable phone on the planet can easily make tablets popular...

I wasn't paying attention until DF spoke. So now it's at least mildly interesting.

I have no idea what I'd use it for, but I'm not Apple's demographic. They haven't done anything new since the original Nano that's ready for me to buy. (I very much want an iPhone with 1993 Palm Pilot 1.0 capabilities, but that's just another proof point that Apple isn't selling to me.)

What the heck would a slate/tablet be good for besides vertical markets? Did you ever try reading the newspaper on one? (Hint: laptops don't require a stand and they have other value.)

I'll be looking around for a clue ...

Emmy Noether and symmetry: we ought to know HER name

[If you look at the URL of this post, you'll see I originally wrote "his name" in the title. Brilliant mathematical physicist? Tell me you wouldn't make the same blunder. Ok, so not everyone would.]

CV tells us we ought to honor the name of Emmy Noether:

Higgs 101 | Cosmic Variance

...I believe that the greatest (and I mean THE greatest) discovery of the 20th century was to recognize that every symmetry in nature coresponds to some conserved physical quantity. It is a great sorrow that Emmy Noether did not win the Nobel Prize for this profound work. Symmetries are all around us - some are very simple, and some not so simple. For example, consider symmetry in time. The laws of physics are (we presume) the same now as they are at the time you finish reading this sentence, and will be the same 100 years from now. If you move (translate) in time, the rules stay the same. This symmetry in fact leads to conservation of energy. Likewise, if you move in space, the laws of physics are the same. This leads to conservation of momentum. If you rewrite the laws of physics in a frame of reference rotated 42.6 degrees from the one where you are writing them now, they are the same…conservation of angular momentum...

I did not understand the relationship of symmetry to energy conservation.

Alas, Nobels are not given posthumously, which is why there's a correlation between longevity and becoming a laureate. Emmy died young ...

... Emmy fled Germany in 1933; she had been forbidden from teaching undergraduate classes by the Nazi racial laws. She joined the faculty at Bryn Mawr College in the United States. She died at Bryn Mawr on 14 April 1935 in mysterious circumstances. Her doctor told her that she needed an operation, and she scheduled it during a college break at Bryn Mawr, without telling anyone. She perished during or shortly after the surgery. Emmy never married, and she had no relatives in the USA. Emmy was buried in the Cloisters of Thomas Great Hall on the Bryn Mawr Campus.

There was at that time a common operation performed secretly with a high mortality rate, but Ms. Noether was 53 when she died.

NYT subscriptions fall sharply

My read of this article was that the NYT had the steepest circulation fall of the national journals:

More Readers Trading Newspapers for Web Sites - New York Times

The New York Times, which shed less-profitable circulation and increased some prices in the last year, lost 4.5 percent of its weekday circulation (to less than 1.04 million) and 7.6 percent of its Sunday circulation (to 1.5 million)..."

I think it's plausible that the NYT has mostly lost readers to the NYT web site, but it's one heck of a circulation drop.

The evanescence of the net

Crooked Timber remembers Faflbog, DeLong and my wife were fans. Fafblog went offline 2-3 years ago, from the comments we learn that the author is known to some and that he stopped writing due to illness.

Another comment references Chris Lightfoot, a 28 yo UK activist, programmer and writer who, I read, committed suicide in February 2007. He left a fairly large amount of writing behind, his last blog post was in July 2006.

I suspect there will soon exist, or may already exist, businesses that will use a robot to snarf a blog and put it on an "immortal" server. Cryogenics may not be the best idea, but blog post "immortality" is a practical runner-up.

Update 11/7/07: On reflection, the funeral home is the obvious site for one's digital ghost. I'm surprised I haven't heard of them doing this already. Well, at least after today the idea won't be patentable.

Living in a dream world - The American right not to know

In a bottom-line age, the media reports what the public wants to know. Too often, what the public wants is a comforting story ..

Michael Massing, "What Orwell Didn't Know" | Salon.com:

...In his reflections on politics and language, Orwell operated on the assumption that people want to know the truth. Often, though, they don't. In the case of Iraq, the many instruments Orwell felt would be needed to keep people passive and uninformed -- the nonstop propaganda messages, the memory holes, the rewriting of history, Room 101 -- have proved unnecessary. The public has become its own collective Ministry of Truth -- a reality that, in many ways, is even more chilling than the one Orwell envisioned.

I don't think the American public has changed all that much compared to earlier years, but I do think the media is more adept at giving us what we want -- perhaps because the media is facing financial ruin.

There's nothing in the story any informed citizen doesn't already know, but it's a good review.

The right declares in favor of torture - responding to the ticking clock

The GOP has smoothly moved from "we don't torture" to "yeah, we torture, but a man's gotta do what a man's gotta do". Their method is to first premise conditions under which the "good of the many" is so vast that any crime seems justified. Then, once the precedent is established, they move on to institutionalizing torture as "a last resort".

This honesty is a risky form of progress. On the one hand it fully exposes what they do in our name, on the other hand it moves American another step closer to Pol Pot. (I think we're close enough now to make out his smug expression.)

I figured it was time to refute this position, but today I found Clive Crook has already stated my position fairly well (emphases mine):

FT.com | Clive Crook's blog: Update: It depends what you mean by torture

...Whether the law leaves room for doubt about whether waterboarding is torture is one thing; whether the law ought to leave room for doubt on that point is quite another. In my view, the law should be clear: waterboarding is torture, and all torture is illegal.

Stuart is sympathetic to the view that ruling out a technique like waterboarding under any and all circumstances would be a mistake. Would it still be wrong, he asks, if the information elicited saved hundreds or thousands or millions of lives? It is a fair question, and one that most commentators on this issue are reluctant to confront. But one could ask the same question of any kind of torture, however vile. Would it be immoral to roast somebody over a slow fire, if the information elicited saved hundreds or thousands or millions of lives? I dare say that nobody, not even Alberto Gonzales, will argue that roasting somebody over a slow fire is not torture....

...One can conceive of rare circumstances in which waterboarding or any other kind of torture might be ethically justified. To say that torture is always and necessarily immoral seems to me to betray a lack of imagination. But a wise government would not allow for that contingency by making the practice legal. In those very rare cases, the interrogators would have to expose themselves to prosecution, and a jury would decide whether or not to convict, weighing what they did against their reasons for doing it. To make torture legal, even under rare circumstances, is to institutionalise it. That is both immoral, and for the reasons just cited, deeply unproductive in the war on terror.

Bush is putting millions of men and women in harms way. He asks them to risk their lives and health for America. In the unprecedented theoretical circumstance that torture is justified, he should take the responsibility and be willing to face the legal consequences -- including life in prison. If he can't take that responsibility he's a coward and should resign immediately.

Laws exist for a reason. I can imagine circumstances where I'd torture someone to save my children, but I'd expect to forfeit my own life for having made that choice.

That's the sacrifice civilization demands. If we can't do that, we don't deserve democracy, and we don't deserve civilization.

Breastfeeding and IQ: A stunning result

Ok, I'm stunned. I didn't see this one coming:

BBC NEWS | Health | Gene 'links breastfeeding to IQ': "

Children with one version of the FADS2 gene scored seven points higher in IQ tests if they were breastfed.

But the Proceedings of the National Academy of Sciences study found breastfeeding had no effect on the IQ of children with a different version.

The gene in question helps break down fatty acids from the diet, which have been linked with brain development.

Seven points difference is enough to put the child in the top third of the class, the researchers said.

Some 90% of people carry the version of the gene which was associated with better IQ scores in breastfed children.

The study was done on infants in Britain and New Zealand, we aren't given any ethnicity data. I'm assuming these numbers apply only to "euros" for now.

It's such an extraordinary result, with so many implications, we need to be cautious. It would be interesting to read the PNAS letter page next month.

It is worth noting that most children adopted as infants, or placed in orphanages, are not breastfed.