Tuesday, January 29, 2013

High functioning schizophrenia: an academic's story.

"THIRTY years ago, I was given a diagnosis of schizophrenia."

That's a helluva way to start one of the most important NYT OpEd's of 2013 ...
Successful and Schizophrenic - ELYN R. SAKS NYTimes.com 
... I made a decision. I would write the narrative of my life. Today I am a chaired professor at the University of Southern California Gould School of Law... 
... Although I fought my diagnosis for many years, I came to accept that I have schizophrenia and will be in treatment the rest of my life. Indeed, excellent psychoanalytic treatment and medication have been critical to my success... 
... Over the last few years, my colleagues, including Stephen Marder, Alison Hamilton and Amy Cohen, and I have gathered 20 research subjects with high-functioning schizophrenia in Los Angeles.. 
... At the same time, most were unmarried and childless, which is consistent with their diagnoses. 
... in addition to medication and therapy, all the participants had developed techniques to keep their schizophrenia at bay. For some, these techniques were cognitive... 
... One of the most frequently mentioned techniques that helped our research participants manage their symptoms was work... 
... Personally, I reach out to my doctors, friends and family whenever I start slipping, and I get great support from them. I eat comfort food (for me, cereal) and listen to quiet music. I minimize all stimulation. Usually these techniques, combined with more medication and therapy, will make the symptoms pass. But the work piece — using my mind — is my best defense. It keeps me focused, it keeps the demons at bay. My mind, I have come to say, is both my worst enemy and my best friend... 
Elyn R. Saks is a law professor at the University of Southern California and the author of the memoir “The Center Cannot Hold: My Journey Through Madness.”
My freshman roommate developed what I believe was schizophrenia. He dropped out for years, then one day returned to school, completed a PhD and started working. I suspect he was not "cured", just as Elyn Sanks is not cured.

Whatever the limitations of the "schizophrenia" as a diagnostic label (they are many), we now know that a few people are able to manage around a grievous and terrible disability. They have shown that it can be done.

That's important. Remember Roger Bannister? He was one of the first Europeans to officially run a 4 minute mile (I suspect other humans had done it before). Before he did it, few tried. Now many men have done it, including one runner in his 40s. It's still hard to do, but it's not news any more.

Succeeding with schizophrenia is the psychic equivalent of running the four minute mile. Terribly hard to do, but once done methods can be refined, goals set, support provided, lessons learned.

Lessons that I suspect will be of value to many persons, not just schizophrenic and autistic adults, but also all inheritors of the 150,000 year old human mind; hacked together in a blink of Darwin's eye. The techniques used to manage severe psychic turmoil can also be used to manage the lesser afflictions we all experience.

Elyn Saks and fellow champions, we salute you.

See also:

Sunday, January 27, 2013

Parc-nature du Bois-de-Liesse: XC Skiing in Montreal Quebec

My two home towns are Minneapolis and Montreal. They have quite a bit in common, though on this trip I was struck by how much diverse manufacturing Montreal has.

Both cities, for example, have a superb network of bicycle trails and public parks. Minneapolis bicycling is rated #1 or #2 in the US, and Montreal is #1 or #2 in North America. In the winter they both feature extensive urban cross-country ski networks.

On my prior winter visits to the Old Country I have rented nordic skis at Mt Royal (excellent!), but this trip I needed something closer to my parent's home. I chose Parc-nature du Bois-de-Liesse, one of Montreal's 17 "grands parcs".

It was somewhat familiar territory. In the mid 20th century I bicycled country roads and walked wooded areas in this part of the island. Most of that is now industrial park and residential land, but a good section of the forested area became a park in the 1980s.

The park has two attractive chalets, shown on this Google satellite photo as 'A' and 'B':
B is "La Maison" Pitfield on 9432 Gouin West. There used to be a restaurant there but sadly it's been closed. It's an attractive building, I think it was built by the Pitfield family who owned the wooded land I once bicycled through. A is at 3555 Douglas B. Floreani, this is a newer building of a similar style. (I got lost finding it; Nav software is recommended! I use Navigon when I visit Canada as it doesn't require a data connection to work. [1])

Site A has the ski rental operation. For a token fee of $8/hour I got first rate gear, comparable to my own waxless skis. There's a parking fee, but on Sundays you can park on the street and walk a bit. There are no trail fees.

In theory there are about 15km of trails of which 6.3km are "expert", but many of the trails overlap and the "expert" trails is beginner-intermediate. A good skier with decent wax could do the entire system in about 1-2 hours:

The trails are largely groomed for classic skiing; some segments are two way - that can be tricky. I was barreling along when I looked up and realized that a panic stricken family was only 30 yards ahead (easily avoided). Grooming is more than adequate, though not "state of the high tech art".

On a Sunday there are many skiers of all ages but the route is quiet. On weekdays I'm told there are few skiers, but you would hear traffic noise in a few limited sections. I read a review complaining that it felt "urban"; I wonder if they got it mixed up with another system. Yes, there are some houses near the perimeter, but it is, after all, within a city. I thought it was exceedingly pleasant, though I did spend much of the trail racing against a younger rival who was about my speed. (I'm not sure she realized she was in a race - but I think she did.)

There are no ski trails east of Autoroute 13; it's snowshoe only and this park does not allow skis on the snowshoe trails. Alas, there's no skijoring at all (many MN parks allow skijoring on snowshoe trails and some ski trails). There is a small sledding hill by the Douglas B. Floreani chalet. In summer there's mountain biking a mixture of the ski and snowshoe trails.

I had an excellent time.

PS. One of the curious features of Quebec is that the web is fairly sparse -- even in French (English sites are very limited). So this may be the best coverage of this trail on the web!

[1] The phone can't be in airplane mode though, that disables the GPS wireless. Just turn off roaming and turn off cellular data.

Update: I found a list of Grands Parcs that rent XC skis as of Jan 2013:

Jean-Drapeau doesn't really count, it's tiny and it rents for a winter festival. So the parks that rent XC skis include:
  • Pointe-aux-Prairies (way out there!)
  • Ile de la Visitation
  • Bois-de-Liesse (this blog post)
  • Bois-de-l'ile Bizard: bit remote, very quiet
  • Cap-Saint-Jacques: big park, also quiet, NW end of island.
  • Mont-Royal: queen of the park system.
Angrignon, which I remember as a good ski park, doesn't rent. Maybe my memory is off.

Wednesday, January 23, 2013

Boom market 2013?


The S&P is approaching its 2007 peak, which is basically equivalent to the peak just prior to the .com crash. 

As an essentially passive index fund investor I like to take a look back at times like this:

The market stopped making sense to me around 1995 -- almost two decades ago. So I like to put a ruler on the 1980-1995 trendline and see what the S&P would be today if the market had continued to make sense.

Today I get about 1,000, so we're currently 50% above that old-timer trendline.

For whatever that's worth.

Monday, January 21, 2013

Why ending the war on drugs may have unintended consequences

Imagine you have very limited or no legal employment opportunities. Or perhaps you have some opportunities, but they pay poorly.

Dealing drugs may be a semi-rational choice then. American jails are famously nasty, but if you can avoid prolonged incarceration and drug trade violence you can earn money.

If we end the failed war on drugs though, those income opportunities vanish. Walmart and Philip Morris take the profits, and distribution becomes another high-competition minimum wage option.

Ending the war on drugs, without providing an answer to mass disability, may have unintended consequences.

We might do better to keep drugs illegal, but reform prisons -- turn them into enhanced skills development programs.

Wednesday, January 09, 2013

Why I love app.net (ADN)

I joined App.net ($5/month or $36/year) about five months ago. Although it's fundamentally a messaging infrastructure it's currently marketed as an ad-free social network.

I paid $50 at launch, and my account was extended when the cost dropped. That was money well spent; I expect to subscribe as long as they are in business. I love App.net because ...

  • It has a very robust ecosystem of tools and services including multiple Mac and iOS clients and multiple web apps. I use Wedge, Netbot, NoodleApp and Appnetizen and will soon try Felix. There are multiple integration points to my Pinboard feed, including IFTTT support. Most of my posts start with Reeder.app [1] then go to Pinboard and turn into App.net posts via IFTTT.
  • The community I interact with on app.net is exceptional. More on that below.
  • I love the mission: a public (pay) communications infrastructure and related services that I purchase. I love paying for things I use.
  • The app.net development team is delightful. I mean that literally; it's a joy to see them play and build on the platform - like @duerig's early stage Google Reader Share alternative, Patter-app rooms and private messages (EdChat) and vidcast shared video commentary.
  • 128 characters is stupid. 256 is not twice as good, it's eight times better. (Though URL characters count, so I use URL shortener services)
  • I'm 50+ and this is a relatively young community (though plenty of 40+ too). I'm old enough to enjoy that. The only young people I otherwise interact with are my kids (10-15) and their friends.
  • I have the (illusion) of helping build something good without, you know, actually having to do anything. (Hence the illusion bit.)
  • No advertising. Of course that doesn't mean no marketing; it means I choose the marketing I want)
The real hook for me, however, is the community. I follow a very smart and mutually respectful group of people. The conversation reminds me of Google Reader Shares, some of the BBS forums I joined via packet switching networks before there was public net access, but most of all it reminds me of my undergraduate conversations.
 
During my undergrad days I got to know 4 institutions, partly because I wanted to escape from the one I graduated from, partly because in Quebec everyone went to "junior college" (CEGEP) after grade 11. Whether they were elite or accessible I found great conversations everywhere.
 
There were good conversations at graduate school, medical school and residency as well (I spent a long time in school), but the undergrad conversations were the most interesting. App.net reminds me of the best of those. It is, for example, the only place I can learn from the insights of a (gasp) republican.
 
The group I follow is a pretty tough bunch. If I'm sloppy, I get called on it. I love that -- it makes my thinking better. I learn things.
 
App.net won't last forever -- nothing does. But it's a good place now; it succeeds where Twitter failed me. 
 
If you'd like a free trial let me know at jgordon@kateva.org or in comments below -- I can share 3 invites.

[1] Alas Reeder.app may have been sunset. It's very unstable on the iPhone 5. Fortunately there are alternatives I can explore.

See also:

Saturday, January 05, 2013

Supporting sports teams - what I do now

Over the past ten years I've been the manager for a variety of hockey and baseball teams. Along the way I've tried a variety of technologies to try and support the teams, including blogs, wikis, traditional web sites and the like.

I've gradually settled on a handful of overlapping technologies that seem to work well for a diverse audience using Facebook and Google services.

Here's what I use now:

Communication - Gmail and Facebook both

Gmail

I prefer Gmail because of ease of access at work, home and on my phone.

I manually build a group of correspondents; this typically takes a few weeks to get right but then changes little over the course of a season.

I have one structured email for each team I support; I use the last email sent as template for the next. I use a large font and ample white space - not least because I'm 50+ myself. I use a consistent footer with links to a Google Docs team page, Photo album (if any), Team Calendar, and Facebook Page.

The primary limit to email is personal/work access issues and the global problems many people have with email in 2013. Many subscribers do not use email at home, and some do not have work access.

Facebook Team Page

I use Facebook because that's where our people are -- both athletes and families. They don't do blogs, they may have limited email access, but most use Facebook in one way or another [1]. Facebook Pages are always Public, and so web accessible for non-members -- albeit with an obnoxious popup pushing Facebook. Many athletes get SMS notices with Page activity, so it can be a quick way to notify of weather cancellations and the like.

I create a Facebook Page for each team. The UI for managing these pages is awkward and confusing, but by now I'm familiar with it. It takes me about ten minutes to setup a Page.

I copy paste emails into Page status updates, it takes only a minute or so to do that.

It's awkward to associate persistent links with a Facebook Page, but if you play around a bit you can make them show in the Page header; that's where I put links to our Team Page and Calendar.

Reference Page - Google Docs

I've recently started using a Google Doc "Team Page" with basic reference information including a simplified roster (no private information). There's no authentication, I share it using the "secret" URL but typically these pages get indexed one way or another.

Google Docs is easy to update and produces documents suitable for print or web access. It is the current version of the "personal web page".

Roster - Google Spreadsheet

I maintain the team roster in Google's Spreadsheet. Access requires authentication as this can contain private information including email and phone numbers.

Calendar - Google Calendar

I setup a Google Calendar for each team. I don't know of any alternatives. My family subscribes to the team calendar on our phones and devices, but most simply view it online.

Photo sharing - Picasa vs. Facebook

Historically I've shared using Google Picasa web albums and emailing the "secret" URL. I don't think these albums get a lot of access however, which is disappointing since the photos are not trivial to prepare. I liked the idea of full resolution downloads but in ten years I doubt more than twenty images have been downloaded.

I've recently started experimenting with Facebook's improved Albums and these seem to get much more team traffic.

I don't put any namers or other identifying information into shared albums -- just the images.

[1] They don't do G+ either, but then nobody does.

Friday, January 04, 2013

How did the American South feel about losing the Civil War?

The second son asked me: "How did the American South feel about losing the Civil War?".

My first thought was that the South was deeply unhappy, but I immediately realized that wasn't true:

The 1860 Census and Slavery in the United States | Suite101

... Deep South states held the most slaves and this is where most of the larger plantations existed. Mississippi’s slave population stood at 55% out of a total population of 791,305. South Carolina’s slave population represented 57% of the total population. These percentages decrease with upper South states like Virginia (31%), Tennessee (25%), and Kentucky (20%). Border States like Maryland accounted for the lowest numbers (13%)."...

So the correct answer is that most Mississippian's were relatively pleased, if not joyful, that the South lost the war. On the other hand, Kentuckians were mostly unhappy.

White southern abolitionists, aka "Scalawags", would also have had mixed feelings. I couldn't locate percentages, but based on studies of human response to external evils [2]I'd expect about 10% of Southern Civil War whites would be at least somewhat pleased that their society was coming to an end. If I add those numbers to black Southerners then the answer would be "mostly unhappy, but many pleased, especially in Mississippi and South Carolina".

Incidentally, when Americans equate "Scalawag" with German opponents to Naziism [1], we will know the Civil War is coming to its end.

[1] The analog is somewhat stretched, the Nazi response to opposition was far more lethal than the Southern suppression of abolitionism.
[2]  There are always about 10% of humans that seem to resist evil, even when it is a societal norm.

Tuesday, January 01, 2013

Welcome to the 21st century: The primary themes

To be plausible, I've read, a novel must avoid reality.

What novel, for example, would start the 21st century with al Qaeda's attack on America? What novel would have an American President spend a trillion dollars and hundreds of thousands of lives attempting to recreate Grenada in Iraq while tossing aside the Laws of War?

Reality is not as cautious as writers. And so the 21st century began with the end of American exceptionalism. More than a decade later, we've got the feel of it. Not of the whole century for the whole world, but at least of the years from 2010 to 2040 for America.

What are the main themes? I'm sure I've missed a few, and of course there will be surprises, but here's my starter list: 

  • Demographics 1: From 2010 through 2040 America will be divided between an increasingly senile, largely white protestant, cohort born before 1964 and a relatively diverse and secular cohort born after 1964. The many "fiscal cliff" fights to come will reflect this shift.
  • Demographics 2: Even Hispanic birth rates are falling. The relative cost of children will continue to increase even as 93% of income growth goes to the top 1%. Given Demographics 1, American will have to attract millions of new immigrants -- even as the American brand struggles to recover from the Bush regime.
  • We are in the post-AI era of both great wealth and mass disability.
  • China and India - whether they thrive or struggle or both it's their story now.
  • Nuclear proliferation: More nuclear weapons, more launch systems, more hackable targets. Iran, North Korea, Pakistan, India ... and so on. [1]
  • The cost of havoc will continue to fall. I was really torqued about this in the months after 9/2011; I didn't see how we'd avoid turning into a surveillance society (at best) or an authoritarian state. Well, on the one hand we did turn into a surveillance society, but on the other hand we haven't seen any home-brewed bioweapons yet (except for this one of course)[2]. I still think this problem is not going away, and neither is the surveillance state. 
  • Innovation gap: AI aside, there's something wrong with the engines of our ingenuity. Maybe we've done all the easy stuff, maybe it's the NIH and the scientific-industrial complex, maybe it's because so much talent is wasted playing finance games, maybe it's the triumph of the Corporation and its IP laws, maybe it's all of the above and more. This gap is a bigger threat to our future than social security or even  health care expenses.
  • Winner take all: It is insane that growth in our economic output is going to such a thin slice of our population -- 37% going to 15,000 households.
  • The triumph of the mega-corporation: For better and for worse, but mostly for worse, the large centrally-planned Corporation will rule the American economic landscape for decades to come. Elephants have made the ecosystem of the African Plains, and Corporations have made the laws and accounting systems of America. Citizen's United will shape the decades to come.
  • Weather adaptation: The big devastation from CO2 emissions is probably in Book Two, but Book One will have big enough problems. We will eventually adopt carbon taxes; driven both by need to raise revenues (see above) and by the slow acceptance that we've whacked the Earth pretty hard.
  • Good enough health care: After exhausting every other option, the US will come to accept good enough health care.
  • No more big US wars: Being old and worried about budgets is not all bad.
It's a daunting list, but it's a list of challenges and fixable problems, not of disasters. Spicy food, chewy and a bit green on the edges, but edible with a bit of chewing. It could be worse.
 
- fn -
[1] There are two strong arguments for supernatural entities. One is the arrow of time (entropy low at t=0). The other is that we have not yet had a true nuclear war - despite all our close calls.
[2] Oh, yeah, and what novel would have a bioweapon attack follow 9/11, be used to justify a major war, and then be completely forgotten? 

Friday, December 28, 2012

The Post-AI era is also the era of mass disability

Is Stephen Hawking disabled?

Stephen Hawking 050506

Obviously this is a rhetorical question. Hawking is 70 and retired from the Lucasian chair, but he remains a tenured professor. He is a bestselling author of multiple popular books, has been married twice, and has three children.

He is clearly not disabled.

Is a physically strong male with an IQ of 65 disabled in Saint Paul, MN? Yes, of course. Forty years ago, however, there were many jobs that would pay above minimum wage for a strong back and a willingness to do tedious work. Heck, in those days men earned money literally pumping gas.

Would Stephen Hawking have been disabled in 1860? Yeah, for the short duration of his 19th century life.

Disability is relative to the technological environment. Once a missing leg meant disability, now it rules out only a small number of jobs. Once a strong back meant a job, now it means little.

Technology changes the work environment; it makes some disabled, and others able. It's an old trend, automated looms put textile artisans out of work 200 years ago.

Those artisans had a rough time, but workers with similar skill sets have done well since. Economic theory and history teaches us that disruptive technological transformation can produce transient chaos, but over time resulting economic growth will benefit almost everyone. More or less.

But history only repeats until it doesn't. Economic benefits don't have to be evenly distributed. If fewer jobs require strong backs, then people whose primary talent is the strength of their spine may earn relatively less. If supply exceeds demand, the price of labor will fall below the "zero bound" of the minimum wage. Some backs won't find work; those workers are disabled.

Most people can play in more than one game, but the competition is getting tougher and the space for human advantage is shrinking in the post-AI era. The percentage of the population who are effectively disabled has been rising along with national income and the Gini coefficient. It's not just the pioneers now, Respectable economists are wondering about tipping points.

So enter The Wolverine...

Screen Shot 2012 12 28 at 6 13 51 PM 

Krugman acts as though he's just started thinking about the post-AI economy, but he isn't fooling anyone. We know he grew up on Asimov and the Three Laws. Now that the election is done, and he doesn't have to be a strict non-structuralist any more [1], he's started writing about what the post-AI era means for income inequality using the phrase "Capital-biased technology". He has recently promised us a "future" column on policy implications.

Future - because he's trying to break it to us gently. I, of course, have no such qualms. A year ago I wrote about the policy implications of the Post-AI era (emphases added) ...

The AI Age: Siri and Me

... Economically, of course, the productivity/consumption circuit has to close... If .1% of humans get 80% of revenue, then they'll be taxed at 90% marginal rates and the 99.9% will do subsidized labor. That's what we do for special needs adults now, and we're all special needs eventually...

Or, in other words, "From each according to his ability, to each according to his need". In the post-AI era we will need to create employment for the mass disabled.

See also:

 and from the K (NYT):

elsewhere

- fn -

[1] Clark Goble made me read a critique of my team's champion. I found hurt feelings (K has claws), but no substantive critiques. That's a shame, I've long wanted to see somebody like Mankiw (who was once readable) engage K on his denial of structural factors in 2009-2012 unemployment. I suspect K has always known of ways to argue the structural case despite the persuasive low global-demand data. I wonder if he was disappointed that nobody dared challenge him. 

Saturday, December 15, 2012

Tax bullets to pay for better mental health care

We tax cigarettes to offset some of the social costs of tobacco use. This is type of Pigovian Tax.

We could tax bullets to offset the direct costs of America's weapons glut, but it's hard to make up for murder. 

Better to prevent the murders.

So tax bullets to pay for better mental health care.

All psychiatrists, social workers and primary care physicians know what a train wreck American psychiatry mental health care is. Rich state, poor state, it's a train wreck everywhere. Families don't know what to do for impaired loved ones - because, often, there's nothing available.

There are many things that could be done. We lack will, and we lack money.

The money problem is easy to solve.

Tax the bullets.

See also:

Saturday, December 08, 2012

Google Reader Shares and the history of the feed.

Google killed Reader Shares on October 31, 2011 ...

Gordon's Notes: Dapocalypse now: Google's day of infamy

I shared thousands of articles through Google Reader.

They were a part of my extended memory. I often searched that repository.

This evening they are gone....

These days I share on app.net, but app.net is a development platform and a better version of Twitter; it's not a GRS replacement. I miss Google Reader Share -- and I miss the GoogleMinus that built it.

It seems I'm not the only one. Today Rob Fishman tells the story of Google Reader Shares, and of RSS/Atom as well. (Confusingly, he refers to Google Reader rather than Google Reader Shares or Google Reader Social. Google Reader is still around. For now, anyway.)

Google's Lost Social Network

... In the beginning, the best word I can use is that Google tolerated the project. Then, they gave it — support is too strong a word. They gave it some thought,” Wetherell told me of Reader’s early days. “It was kind of like The Dirty Dozen, that movie, where we would meet people in the hall, and we’d kind of mention it and they’d give us a nod and join. ..

... a sign in the Reader offices ... said “DAYS SINCE LAST THREAT OF CANCELLATION.” The number was almost always zero. ..

... Shih found out in the spring that Reader’s internal sharing functions — the asymmetrical following model, endemic commenting and liking, and its advanced privacy settings — would be superseded by the forthcoming Google+ model. Of course, he was forbidden from breathing a word to users... Shih left Google in July....

 Between the article and comments several GRS-like products are mentioned:

  • The Old Reader: in beta
  • HiveMined: not yet available
  • Newsflock: public beta promised early 2013
  • NewsBlur: in production, and has clear similarities to GRS. You can import feeds from Google Reader. Ominously, NewsBlur doesn't appear to have a blog.

 Incidentally, one commenter tells us that it would have been quite hard to save GRS once Buzz was killed ...

Christopher Barth: Reader social was too interconnected with the Buzz API. Lashing it slowly into the +/API was the only choice once the plug was pulled on Buzz - that transition was horrible due to how underdeveloped the +/API was at the time. +/api had only people, comments, and activity when G+ opened. Sort by magic required the Buzz 'like' (+1), which was not available in the +/API.

I haven't signed on with any of the GRS replacements yet -- I'm focusing on app.net for a time. I'll be tracking them though.

Thursday, December 06, 2012

Minnesota DFL phone spam - might not be what it seems

Since the election we've received a nightly phone call with a Caller ID of MN DFL party and a return number of 651-251-6300. As others have noted, that is indeed the phone number for the Minnesota DFL Party.

I assumed it was simply a fund-raising robocall. We are good Commies and donate to the Party, so it's not surprising that they'd harass us. It has been, however, oddly persistent. So tonight I actually answered the phone -- but I heard only a few meaningless sounds. Nobody was there.

I wonder if this were really a DFL call, or if someone is spoofing their number. That would be a nasty trick; a small donation to the right offshore resources could paralyze a fund-raising program.

If so, it might be that the villains don't know the election is over. Or the nighty calls could simply be a malfunctioning robocall system. I'll try to contact the DFL and ask what's up (I'll need to disable some of my DFL email spam filters to get a response). Even if it's not a dirty trick in this election cycle, it's a sure-fire strategy for the next one. Just another way that the era of switched network voice telephony is over. We will need caller-authentication with reputation-based call triage.

I'll update this with what I hear from the Minnesota DFL.

Update 12/8/2012: It seems to be incompetency, not malevolence. It seems the DFL really is spamming our home nightly.

Tuesday, December 04, 2012

Internet Trends 2012 (Meeker, KPCB)

KPCB annual internet trends presentation is online. KPCB does this yearly under the "Meeker" brand. The online version isn't displaying correctly today, but there's a link to the PDF version.

There's a lot of fluff in the report. These were the parts I thought were mildly interesting:
  1. Nigeria: 28% of popn has net access, 5th fastest growing access
  2. US: 20% of popn still no access (will require govt action to close that gap I bet)
  3. Android is awesome. (I sold my soul to Apple years ago btw)
  4. Almost 30% US adults have Tablet/eReader (I wonder if they count iPhones though)
  5. Mobile doesn't made ad money, so ad supported net sites are in deep trouble.
  6. Ad supported Apps look good.
  7. Internet ad revenue surpassed newspaper 2010 (assume FAR behind TV)
  8. Public has given up on privacy.
  9. Aggregate market cap global public companies is 36 Trillion. (So only 72 Apples?). Note this excludes privates like Aramco, etc.
  10. Advertisers want access to us while we're in the Car.

Friday, November 23, 2012

Hey Republicans: If you want to cut ObamaCare, try wellness programs

Few people will have noticed new rules around corporate "health-contingent wellness programs" (emphases mine):

Administration Defines Benefits Under Health Law - NYTimes.com

... The rules also give employers new freedom to reward employees who participate in workplace wellness programs intended to help them lower blood pressure, lose weight or reduce cholesterol levels. The maximum permissible reward would be increased to 30 percent of the cost of coverage, from the current 20 percent.

The rules would further increase the maximum reward to 50 percent for wellness programs intended to prevent or reduce tobacco use.

Rewards could amount to several thousand dollars a year, officials said, because total premiums in employer-sponsored health plans now average more than $5,600 a year for individual coverage and nearly $16,000 for family coverage...

The Hill's Healthwatch has more details. It is remarkable that CNBC can have a general freakout about an increase in marginal federal tax rates for persons earning over $250,000 a year, but say nothing about a program that costs middle-class workers $2,000-$3,000 a year.

Let us take a moment to contemplate this curious silence.

Yes, I said costs, because the money for these programs has to come from somewhere. In this case it comes out of take home pay - either as a direct benefit cost or as a reduction in future income. In some cases the money might come out of ACA mandated health insurance premium rebates ...

Health Insurance Refunds May Stall in Employers’ Hands - NYTimes.com

... while some employers are returning the money directly in paychecks, or planning “premium holidays” that increase take-home pay, others are weighing different options, benefits consultants said, like reducing next year’s premium, or spending the refund on so-called wellness programs that reward workers who lose weight or quit smoking.

Yeah, that's a bad sign.

In theory the money we're losing now might be offset by reduced healthcare costs over time, which might in theory reduce insurance costs and maybe one day the lost income might trickle back down again.

*cough*

Right. That's not going to happen.

It is also possible that, regardless of impact on health care costs, and after considerable administrative overhead is deducted, these programs will make some workers healthier than they might otherwise be. In that sense they might be considered a form of social transfer; all employees pay for improved health habits for some employees.

That wouldn't be so bad - if we knew the programs worked. But we don't know that; these programs were launched with very little research. What little I could find showed some surprises ....

New Research Shows That Prevention Is Key To Reducing Health Care Costs For All Employees, Even Those With Chronic Conditions - New York Times

... while a reduction in employee health risks leads to immediate cost savings, the accumulation of additional health risks soon leads to substantially higher medical and pharmacy costs...

I don't know why corporations are so keen on these programs, but I suspect there are sound business reasons. They may not be obvious; I'm reminded that Walmart liked defined contribution plans because they discriminated against unhealthy (and costly) spouses. I have read that some states offer tax credits for the programs, and I assume that the $2,000 a year or so I'm paying for our corporate program is treated as a tax deductible health care benefit.

Which brings me to the GOP. They're looking to cut money from the ACA. Why not do something useful and ask about corporate wellness programs?

Right. I bet this is one of those things that made it into the ACA as a sop to the GOP...

See also: