One possible strategic error in the Obama reform

In his NYT essay Obama talks about making medicare more efficient.

I wonder why his team chose to tie insurance reform and access to any kind of changes to medicare. Politically, would it have been wiser to have kept the two topics completely separate? The problems of medicare are huge, but perhaps should have been addressed in year 2 or 3 of the administration.

We'll get something, but it will be another patch. We'll be back in 10 years.

Alas, a large portion of America seems to suffer from Stockholm syndrome. They prefer familiar misery to the terrors of hope.

The CDC's vaccine data mess - please help them out

This page is how America distributes the data set that's supposed to represents all the vaccine information used in electronic health records and national reporting: Vaccines: IIS/Stds/CVX-Vaccines Administered

You know, the kind of reporting that's useful, for, say managing swine flu vaccine programs.

It's not being distributed in some UMLS data format, or a tab delimited UTF-8 file, or a Microsoft Acccess table or XML or even Microsoft Excel or ... or ... or even a 4 column RTF or .DOC table.

It's distributed as an HTML page with inline comments and footnotes or as a PDF document.

Anyone wanting to actually implement this has to cut and paste into something like Excel, move the inline annotations around, get rid of the footnotes, represent color and font changes as attributes, and so on.

This isn't rocket science guys. The management of this sort of data set was well understood in the 1960s. Forget about all those wonderful visions of just-in-time clinical decision support, this is really simple, basic, stuff.

Every American should give the CDC a penny so they can engage an underemployed informaticist to fix up their CVX distribution system.

Or maybe the CDC could, you know, hand this over to the NLM to manage?

PS. This story is consistent with the way ICD-9 was once managed. ICD-9-CM (diagnostic) is the payment justification code set that's sort of used to track diseases and horribly misused in clinical care reporting and automation. I'd love to see a sociology researcher dig down and find out why it is we end up with such bad management of fairly simple things.

Update: The CVX to CPT map table is even worse.

American Express credit card information theft

We just received official notification that our AMEX credit card information was stolen. Inside job, as usual.

Same old, same old.

I'm astounded that web services expect me to give them my Google authentication credentials. They're conning us when they claim mere encryption will secure the data.

Incidentally, this emphasizes the stupidity of the "secret security question" fail (see US Bank security shield makes me scream). Not only do they make it easier to hack into user data, they do nothing to protect us from the commonplace insider thefts and other, old, tactics.

Update 9/24/09: When exploring the 5000 post Blogger bug, I found a 2003 post about an "epidemic" of credit card fraud.

Galaxies like stars in the sky

There's an antidote to reading about the Cheney torture program and the GOP's insurance-company funded attack on health insurance reform.

Download the images linked here, and open them in a robust image viewer. Browse at will. Visit galaxies as they were billions of years ago. Squint very hard, and image you're seeing something squinting up from one of the billions of worlds in the billions of stars ...

ESO - ESO 39/08 - A Pool of Galaxies - Associated Image

... The new image released by ESO combines data obtained with the VIMOS instrument in the U- and R-bands, as well as data obtained in the B-band with the Wide-Field Imager (WFI) attached to the 2.2 m MPG/ESO telescope at La Silla, in the framework of the GABODS survey.

The newly released U-band image – the result of 40 hours of staring at the same region of the sky and just made ready by the GOODS team – is the deepest image ever taken from the ground in this wavelength domain. At these depths, the sky is almost completely covered by galaxies, each one, like our own galaxy, the Milky Way, home of hundreds of billions of stars.

Galaxies were detected that are a billion times fainter than the unaided eye can see and over a range of colours not directly observable by the eye. This deep image has been essential to the discovery of a large number of new galaxies that are so far away that they are seen as they were when the Universe was only 2 billion years old....

Be sure to try the zoom tool.

Inmate Kyle Foggo – Creator of the post-2003 torture facilities

It looks like the Obama administration will investigate and prosecute senior CIA officials who broke American law. 

In the meanwhile CIA officials are spinning their stories to the NYT, with usual welter of self-justifications and contradictions.

If you read this somewhat confused NYT article carefully you’ll see examples of those contradictions – in addition to being generally incoherent. In one spot it says waterboards were built on the spot, in another paragraph it says waterboarding had been discontinued when the prisons were built. I

The article reads like multiple leaks with different aims. Some statements seem intended to help Mr Foggo, others to convict him …

Interrogation Inc. - A Window Into C.I.A.’s Embrace of Secret Jails - NYTimes.com

WASHINGTON — In March 2003, two C.I.A. officials surprised Kyle D. Foggo, then the chief of the agency’s main European supply base, with an unusual request. They wanted his help building secret prisons to hold some of the world’s most threatening terrorists…

… Foggo went on to oversee construction of three detention centers, each built to house about a half-dozen detainees, according to former intelligence officials and others briefed on the matter. One jail was a renovated building on a busy street in Bucharest, Romania, the officials disclosed…

… a small company linked to Brent R. Wilkes, an old friend and a San Diego military contractor…  provided toilets, plumbing equipment, stereos, video games, bedding, night vision goggles, earplugs and wrap-around sunglasses. Some products were bought at Target and Wal-Mart, among other vendors, and flown overseas. Nothing exotic was required for the infamous waterboards — they were built on the spot from locally available materials, the officials said.

… Mr. Foggo .. pleaded guilty last year to a fraud charge … and he is now serving a three-year sentence in a Kentucky prison … He was not charged with wrongdoing in connection with the secret prisons, but instead accused of steering other C.I.A. business to Mr. Wilkes’ companies in exchange for expensive vacations and other favors. Before leaving the C.I.A. in 2006, he had become its third-highest official…

… Early in the fight against Al Qaeda, agency officials relied heavily on American allies to help detain people suspected of terrorism in makeshift facilities in countries like Thailand. But by the time two C.I.A. officials met with Mr. Foggo in 2003, that arrangement was under threat, according to people briefed on the situation. In Thailand, for example, local officials were said to be growing uneasy about a black site outside Bangkok code-named Cat’s Eye…

.. Eventually, the agency’s network would encompass at least eight detention centers, including one in the Middle East, one each in Iraq and Afghanistan and a maximum-security long-term site at Guantánamo Bay, Cuba, that was dubbed Strawberry Fields, officials said. (It was named after a Beatles song after C.I.A. officials joked that the detainees would be held there, as the lyric put it, “forever.”)

The C.I.A. has never officially disclosed the exact number of prisoners it once held, but top officials have put the figure at fewer than 100.

At the detention centers Mr. Foggo helped build, several former intelligence officials said, the jails were small, and though they were built to house about a half-dozen detainees they rarely held more than four.

The cells were constructed with special features to prevent injury to the prisoners during interrogations: nonslip floors and flexible, plywood-covered walls to soften the impact of being slammed into the wall…

… C.I.A. analysts served 90-day tours at the prison sites to assist the interrogations. But by the time the new prisons were built in mid-2003 or later, the harshest C.I.A. interrogation practices — including waterboarding — had been discontinued…

As the investigations proceed there will be more leaks. Eventually a case may be built against Mr. Foggo, but more likely the feds will lean on him, and whoever he implicates, to turn in someone else.

Oddities of modern video – frame rates and more

We have two CRTs on which “we” (meaning the kids) watch Netflix DVDs and local broadcast TV sports. The DVD display is a 15 yo SONY CRT. It will still be running when all of our neighbor’s LCDs need their light tubes replaced. The television is a 9” “portable” CRT that, I think, has color. The “TV” uses a “free” converter box and our rabbit ears.

So this story on how those newfangled HD TVs intersect with the complexities of capturing motion in analog film and digital sensors, both converted in various ways to travel through various digital to analog transformations (including some back and forth in fiber optic backbones) and then to photons (themselves both digital and analog) and then to quantum sensors (retinal neuron photo receptors) and to analog signals (brain) and then to perception and meaning (?) …

Well, it’s all a voyage to a foreign and exotic world that, one day, when the children are old enough to buy their own TV, we might visit.

Read both the story and the comments, I’ve excerpted enough here to show why this is academically intriguing …

Help Key: Why 120Hz looks “weird”

John Biggs

I’ve been testing an HD projector here at the house and, in its initial, out-of-the-box setting we found that the picture was ridiculously “sharp.” The picture, I suppose, looked like an old Dr. Who episode where the action on screen is smoother than the background, creating a jarring disparity when watching movies with lots of movement. It’s sometimes called the “Soap Opera Effect.” We decided to do a little digging to figure out why.

Most film is recorded at 24 frames per second, but your LCD TV probably either displays at 60 fps or 120 hz (hertz is just a measurement of frequency per second). There are three main ways to cope with this…

Paul Spurrier

… The problem with motion interpolation is that it is having to create new frames that weren’t on the original film..

… Your TV is having to do this in 1/24 of a second.

Which is impossible.

So it cheats. It uses warping and other motion compensaton/interpolation techniques to create inbetween frames that sort of fool the eye…

…And not surprisingly it looks weird…

… Nowadays, as more movies are shot digitally, filmmakers are trying hard to work out what it is that makes a movie looks like a movie. Then they’re trying to alter the digital picture to replicate that look…

… Gamma. It’s complicated but basically film and video react to light in different ways. Film still sees more detail in the brightest and darkest parts of the picture and sees colour in a different way. Another thing that filmmakers do to make digital images look like film is to alter the gamma, either in camera or in post-production…

… Frame-rate. To bring this back to the original subject, traditionally the biggest give away that one is watching a video-originated image and not film is the frame rate. In the US, video cameras shoot 60 frames a second. They cheat a bit to do this…

… Nowadays, we can set digital cameras to not do this. We change them to film in what’s known as a ‘progressive’ mode, which shoots full 24 frames a second.

In the old days, filmmakers used to go to great lengths to get rid of this interlacing….

… It was clear that the higher frame-rate was a give-away that the image had been shot on video not on film. So even if we degraded the picture somewhat by throwing out half the data, it still sort of looked ‘better’.

… audiences react differently to video and film. They don’t know they’re doing it, and it’s working almost entirely on a subconscious level, but when someone thinks they’re watching a movie, their mindset is that this is something more special, bigger budget, more worthy of their attention.

So imagine the frustration of filmmakers when new TVs undo all of the work we have put in to making something look like film and make it look indeed like a ’soap opera’…

Health insurance reform – 8 points to repeat and repeat

It will be useful to keep this list at hand and repeat it often …

The White House - Blog Post - The Return of the Viral Email

… 8 ways reform provides security and stability to those with or without coverage

1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.

2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.

6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.

8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

Learn more and get details: http://www.WhiteHouse.gov/health-insurance-consumer-protections/

Personally I want health insurance severed from employment. That was part of McCain’s proposal during the last election; I recall thinking that the overall proposal was quite bad but I liked that bit. If we had a reformed GOP the McCain proposal would be a starting point for a great discussion on health care reform, but since we have the party of Cheney/Palin/Limbaugh we won’t get to have that discussion.

In the absence of a rational discussion on health care I’ll go with these eight items. They will raise premiums for large corporations (I’ll pay more) while shrinking premiums modestly for smaller businesses and by large amounts for individuals. That’s good in my book.

These proposals would also have lots of unexpected consequences, but that’s the nature of policy …

Governing America – the manual

Mr. President, here is your manual.

A strange note of optimism on health care reform

It's not looking so good. The whackos are pulling ahead. The media is feeding off hate and fear, and amplifying the dark nihilism of the modern GOP.

Rationalists realize that reason has no sway. There's a whiff of despair ...

Bernie Madoff and the birthers - Paul Krugman Blog

... How did Madoff pull off his scam? A lot of it probably involved affinity fraud: Madoff’s victims, largely affluent Jews, trusted him in large part because he seemed like one of them.

What I think is going on here, at least partly, is that the peddlers of anti-progressive lies are managing to convince a certain kind of American — white, socially conservative, etc. — that the hate-mongers are people like them; and, even more important, that progressives are Those People, people not like them.

Obama’s skin color makes this easy; but the Clintons faced the same kind of thing. Why? Well, the old line about Clinton being the first black president gets at something: even if Bill Clinton had a regular skin and name, he was obviously comfortable with people who didn’t, which made him one of Them.

And anti-intellectualism is also part of it.

In any case, it’s scary: you’ve got a good segment of the American population that is completely impervious to any kind of evidence, any rational argument. I mean, who collects statistics? People in black helicopters!...

America is looking pretty sick. So why do I feel some hope?

Well, for one thing, Obama is the President. That helps.

For another, he's dealt with a lot of fear and hate in his life. If anyone can shift it, he can. If he can't -- well, then nobody can.

Not lastly, the frothing chumps that the GOP is playing are going to run out of steam. On the one hand they thrive on hate and fear, but on the other hand they will get tired of punching at the air.

Lastly -- this isn't new. America has been binging on cheap rotgut since the late 90s. This isn't just one night off the wagon, it's going to take years to get the nation to out of the flophouse. Even so, we sobered up long enough to elect Obama. That means there's hope.

Keep you head down, keep moving, keep the pressure on your state Senator (in MN, Thank Wellstone, we're now much better off than most).

Academia collides with public health

This is not a pretty picture ...

The Doctor's World - Seeking Lessons in Swine Flu Fight - NYTimes.com

... Officials and experts say they have learned a lot about human swine influenza. But relatively little of that information, including periodic summaries of what has been learned since the beginning of the pandemic, has been reported and published. Some experts said researchers were waiting to publish in journals, which can take months or longer. Journals impose severe penalties for disclosing information before publication, although they say they exempt matters of public health importance. Whatever the reason, delays in reporting such information can hamper plans for public health responses...

So when someone dies of Swine Flu, and lawyers trace the outcomes to suppressed pre-publication, will the journals be liable?

Silly Gartner hype cycle charts and "idea management"

Silicon Alley Insider's Here Comes The Twitter Backlash post includes a Gartner Hype Cycle chart.

I've seen these before, and I'm a wee bit suspicious that the items on the right side of "time" axis (which has no units) don't correspond to prior chart left side items.

In addition to selective recall and publication the unit-free time axis is key. That lets Gartner put SOA and "speech recognition" relatively close together on the graph, even though the maximal hype for SOA was about 3 years ago and for speech recognition it was 21 years ago.

There's one item in the cute info-free graphic that caught my fancy though. They list "idea management" as "post-hype".

Idea management?!

That one has completely passed me by but (thanks G) this blog post helped. Wow, I managed to almost completely dodge a very silly management fad. Until now. Yuck.

Clue to Gartner - ideas are easy.

Android comments from an iPhone perspective

Now that Apple has been condemned to the innermost circle of Geek Hell, I'm on the lookout for Android overviews like this one ...

notes on "google phone day 1"

... I'll write about the software later. For now I can say I won't have a problem using it for 30 days. I am sure I'll miss a few games, but most of the apps I use are simply front-ends to web services like Twitter or Google Reader. Google Voice is EXCELLENT. The whole Google Account integration 'just works'. I launched maps for the first time and the system knew who I was and signed me into Google Latitude. Also, my calendar is updated and synced as are my contacts pulled over from Google Voice...

My 12yo is getting into cell phone range and he really likes sliding keyboards. Hmmm.

Update 8/11/09: He couldn't stand the G1 and switched back early. I appreciate his courageous exploration of the wild lands.

Google reader “like” and the shared discovery process

I use my Google Reader shared items as my general repository for all things I find interesting, including using the “note in reader” feature to attach comments to web pages I visit (see also – memory management). This works particularly well in my iPhone Byline reader client.

I also use the “star” feature to tag items for later reading or processing. Some of those I get to, some I don’t.

I haven’t known what to make of “Like” however (emphases mine) ….

Official Google Reader Blog: Following, liking and people searching

… Have you ever wanted to tell an author or publisher that you appreciate an article they wrote? Or maybe you want to let your friend know that you enjoyed the blog post he shared with you. With a quick click of the mouse (or a swipe of the "L" key -- for the keyboard shortcut pros), you can "like" any item in Reader. All "likes" are public, so anyone reading an item you've "liked" in Reader can see that you're a fan. Checking out shared items for people who have "liked" the same items as you is a great way to discover other people with interests similar to your own….

Aha. Now I get it.

“Like” is necessarily public, whereas sharing has privacy restrictions (though I share with all). Part of being public is that “Like” is associated with user-tags; if you click on the “# Like” link you get a list of names (I did get a 404 not found when I clicked on that link for an item that had been shared, but it resolved anyway). The names link to show items the person “liked”; you can then choose, I suppose, to follow their “shared” item list.

It doesn’t work in Byline though – they haven’t added support for that marker. Still, I’ll check it out as a discovery mechanism when using the reader web app. The intersection between Shared and Like is a bit weird, but that’s kind of the rule with today’s social software. There are lots of conventions and intersections we haven’t figured out yet. As a general rule, I assume everything I do is completely public.

I like who Reader works, and I’m hoping for more interesting developments in the world of shared-mind discovery. Twitter on the other hand … (more about that in a post I’m plugging away at)

COBOL and the surprising longevity of enterprise software

In my industry, we might substitute MUMPS for COBOL …

Coding Horror: COBOL: Everywhere and Nowhere

… I'd like to talk to you about ducts. Wait a minute. Strike that. I meant COBOL. The Common Business Oriented Language is celebrating its fiftieth anniversary as the language that is everywhere and nowhere at once:

As a result, today COBOL is everywhere, yet is largely unheard of among the millions of people who interact with it on a daily basis. Its reach is so pervasive that it is almost unthinkable that the average person could go a day without it. Whether using an ATM, stopping at traffic lights or purchasing a product online, the vast majority of us will use COBOL in one form or another as part of our daily existence.

The statistics that surround COBOL attest to its huge influence upon the business world. There are over 220 billion lines of COBOL in existence, a figure which equates to around 80% of the world's actively used code. There are estimated to be over a million COBOL programmers in the world today…

I’m skeptical about those numbers, but even if we cut them in half that’s still a lot of code. The linked essay skirts the subject, but I suspect very little of this code is related to new projects – the vast majority must be from projects launched in the 1970s.

It’s not just COBOL. A friend of mine is nearing retirement still maintaining and extending an RPG app he started in the 1970s. His software runs a very successful privately held company.

The longevity of enterprise software, to me, is the interesting nub of this story. Successful enterprise software has a very long lifespan – on the scale of the lifespan of a publicly traded company. This software can outlast careers, much less employment at a single company. I wouldn’t be surprised, given virtualization technology, if today’s enterprise solutions end up with sixty year lifespans.

There are interesting implications for the way we organize businesses and business processes…

Breeding even smarter dogs

The studies are probably not terribly rigorous, but it wouldn't be surprising to learn that that dogs are smarter than we thought they were -- seems just about every animal is smarter than we thought ...

Dogs as Smart as 2-year-old Kids | LiveScience

... While dogs ranked with the 2-year-olds in language, they would trump a 3- or 4-year-old in basic arithmetic, Coren found. In terms of social smarts, our drooling furballs fare even better.

'The social life of dogs is much more complex, much more like human teenagers at that stage, interested in who is moving up in the pack and who is sleeping with who and that sort of thing,' Coren told LiveScience.

The hypothesis is that dogs are getting smarter fairly quickly, that over the course of a few hundred years we've substantially increased the IQ of certain breeds.

So what would happen if we really tried to breed a dog that was smarter and lived longer? Could we get them up to, say, four year olds? Pretty soon we're in "uplift territory".

At what point do smarter dogs get civil rights? Reminds me of my childhood attempt to develop a non-species specific theory of ethics ...