Category Archives: Current Affairs

Toxic Assets Take a Back Seat to Health Care Reform

WASHINGTON - MARCH 31:  (L-R) TARP Special Ins...
Image by Getty Images via Daylife

Elizabeth Warren made an appearance on  Morning Joe this morning and woke me up at 5 AM PDT with the force of a revelation: those toxic assets are still on the books of the banks.  The banks, which have taken so much of our children’s futures in the form of TARP money and similar bailouts, have won — not by asking for money, taking it, and using it to fix things, but by taking money and doing nothing.

Remember the good old days, before we got sidetracked by euthanasia, pulling the plug on granny, and letting illegal immigrations hijack our health benefits and take them back to their home countries? (Yes, I heard that all being discussed in the Town Halls I watched yesterday.) Well, we were talking about boring stuff like mark-to-market, an obscure little accounting rule that says you have to call your pig a pig when you take it to market and you can’t call it a Ferrari.

The banks are still accounting for their piles of pigs (or maybe pig droppings) as Ferraris, because Congress now allows them to do so. And they will not sell those assets, even to the government, because to do so would mean they’d have to acknowledge them on the books as pigs, throw away those glamorous photos of  Ferraris that adorn their annual reports, and quietly slink away with their pig tails between their legs, giving the field over to newer, smarter banks.

I was with the conservatives on this issue.  I didn’t want us to bail out the banks. But we did, because we thought the system would collapse if we didn’t. OK. So we put off the collapse for two years, but–my fellow Americans — while you are all worrying about death panels and tax-supported abortions, don’t take your eye off the world around you. Multi-task if you can.

Because 30% of the homeowners in the country are now under water.  Job losses, while not accelerating at such a rapid rate, are still happening, and more and more people can’t pay their mortgages.  The gigantic economic re-set is not over, as the next wave of adjustable mortgages come due in 2010.

This means more foreclosures, along with the imminent collapse of the commercial real estate market as well.  Who needs office space when you are laying off workers and can’t get a credit line to keep your business alive?

What will happen? Bank failures at long last. I’ve got my bets on who goes down first as Congress, now threatened by its constituents with full scale revolt, fiddles with health care while the financial underpinnings burn. One set of lobbyists has replaced another.

At least when we spend money overhauling the health care system the money will reach individuals. Following Elizabeth Warren on Morning Joe was Joe Califano, who was around when Medicare was passed. What he said? No one could have predicted forty years ago the revolution in medicine that led to the explosion in life expectancy. We can’t predict what will happen when the next wave of innovation in neurology and cancer research make life even longer. So the only way to control costs is to keep people out of the sick care system.

So let’s put our eye back on the ball. Focus on ourselves. Let the banks fail, but the people succeed. Survive the re-set in the economy, which is believe is permanent, by getting in shape. I will see you at the gym.

Reblog this post [with Zemanta]

Leave a comment

Filed under Business, Current Affairs, Health Care, Politics

Friend, Follower, Fan, or Fake?

It’s a beautiful morning to think about what’s happening to the winning social network sites as we early adopters all get what we thought we wished for: mainstream acceptance. Well, now here came everybody and we have to deal with it.  Chris Brogan has a great post about this called Quid Pro No, which deals with unwelcome reciprocal friend/follow requests, and Brian Solis tackles the problem of “sponsored conversations,”  over on Tech Crunch. Ugh. The mere fact that the FTC is getting involved with how brands use Twitter means we’ve got problems, no matter which way it shakes out.

Here’s Brian: As you could possibly imagine, the reality of mass-sponsored tweets will raise a Tweetstorm that will immediately trigger a blogstorm, which will ultimately escalate into a full-blown Category 5 media hurricane. But the reality is, whether you agree with them or not, sponsored conversations and paid tweets are already here.  The question is how to use them correctly and responsibly.

And here I am, participating in the blogstorm.

Like many people who have been on all three major sites, I face the problem of potential “relationships” with both people and brands every day, because once people get on social media and figure out why they are there, they all become brands, even me.The same people who teach courses like “Advanced LinkedIn” teach “Growing Your Personal Brand.” I am, of course, throwing up in my mouth as I write this. I’m both a victim and a perpetrator.

As a person, and as a human-brand, I finally decided to treat online relationships like I do IRL. My brand is authenticity. I am fond of saying “I am transparent.” Well, I am. For example: I have quit following back on Twitter, am deleting people I followed back in the beginning when Twitter was smaller, and only follow people I have something in common with, know, or who post great content that can teach me something. I also have separate accounts for health care (ushealthcrisis) with @Karoli and @azentrepreneurs for my startup conferences. I’ve announced this on Twitter multiple times, and will continue to do so. It was getting so I couldn’t see the tweets of my guru, my daughter, and my business partner. Not to mention breaking news and other interesting links I want to follow, posted by people I respect.

On Facebook, I now actively friend only people I’ve already met IRL. I accept friend requests, but if I don’t recognize the name I don’t add the new people to my feed. I have several different lists, too. And I don’t become a fan or join a cause except in exceptional cases of true belief. I have also announced that. I spend one day a week hitting ignore. Events are a different story; I still want to know about them so I can decide to attend if I’m in town. If your event is in Cleveland, don’t invite me. I can’t come, and I probably won’t even RSVP, which will throw off all your food counts:-)

On LinkedIn, a site I hate, I maintain a public CV for speaking engagements and accept connections as a courtesy if I know the people.  I don’t spend much time there, because I find it an awkward site to manipulate. To me, it needs a total makeover. But I stay there because I want to connect people I value when they need my help. Having been there a long time I have a large network. I actually WANT to make that useful in the right circumstances. But I get to choose. Reputation is all I have. And connecting people is like fixing them up on blind dates. If they have a lousy time, they blame me.

It’s very hard to get me to write a recommendation for you, though, even if you write one for me:-) unless I mean it. I’m not a person who feels compelled to reciprocate about anything. People who have repeatedly invited me to dinner would starve if they waited for me to invite them back. (I don’t cook.)

These curious curations and apparently frivolous filters allow me to be authentic without relinquishing the joy of discovery or my “privacy.”

And thank you Chris and Brian for forcing me to collate my thoughts around this crucial subject. I would friend you both anywhere:-

1 Comment

Filed under Current Affairs, Daily Living, Early Adopter Stuff, Social Media

What InterSolar Told Me About the US


I walked the floor of InterSolar, the big solar trade show show in San Francisco yesterday. It was full of huge booths, the kind that used to belong to semi-conductor companies ten years ago. Clearly there’s an enlarging market for solar, and I saw solar collectors, including Solyndra’s interesting spherical collectors, sun tracking mechanisms, mountings, and other manufacturing process componentes. A “really big shew,” as Ed Sullivan used to say.

And most of the companies were from outside the United States. While we were sleeping, fighting the War on Terror, Germany became the leader in solar, followed by China. Even Canada does solar manufacturing and innovation. Many American venture capitalists are investing in the space, but I wonder if they are investing on our shores or elsewhere.

American has an arrogant attitude we really can’t afford. The halls of Moscone Center were full of Chinese people. It reminded me of ten years ago, when the halls were full of people from India. Do we have to learn this lesson all over again?

I just heard on the radio that China has exited the recession, because of an “engineered” stimulus from the government. I guess we have a shortage of stimulus engineers, too, in the US. Maybe we need to tune up our education system.

Leave a comment

Filed under Current Affairs, Early Adopter Stuff

Is Social Media a Waste of Time?

No way. Social media has given me a platform on which to share my knowledge of things I care deeply about. Health care and the environment are two of those, and still another is the current economic crisis and how it is affecting me and my world. Without social media, I’d be in a far smaller community around these very troubling issues, and I could easily be very depressed.

Most people also think I care deeply about new technology, because I write so much about it. They’re wrong. I only care about technology to the extent that it enables a person like me, well-informed about things I care about, to offer some information to people who don’t have the time to acquire it first-hand, and to gain strength from others who have found ways to deal with problems I also have.

I start with Google Reader, through which I subscribe to a dozen trade journals and blogs each about health care, environmental issues, and economics. I also subscribe to tech journals and blogs, and to major news sources like the New York TImes, Wall Street Journal, and my local papers in Arizona and on the Coastside in northern California. I read about 1000 items a day, often just scanning to weed out repetition. I try to read several sides of controversial issues, so I know how the doctors, the insurance companies, the patients, and the IT people feel about health care. When something’s really good, I “share” it with other friends of mine who are on Google Reader.

But it doesn’t stop there. I want to discuss what I read with people who can either help me understand it, or tell people what I’ve found out. So I also maintain profiles on Facebook and Twitter. On the latter, I maintain several accounts. One’s for general posts; another is @azentrepreneurs, and is specific to Arizona’s entrepreneurship community. Still a third is @ushealthcrisis, which a colleague and I use for our volunteer web site with health care reform information.

When, in the course of my day, I come across something that might help or interest one of these “constituencies,” I post a link or a mention to one of those accounts. Less important for general sharing, but very important for learning more, is Friendfeed, which aggregates the combined knowledge of many educated and intelligent friends and acquaintances of mine, often in extended conversations. Every so often, to spread news of professional opportunities and networking events, I’ll even use a status update on LinkedIn.

And oh yes, in addition to all this, I blog. That’s mainly a place to display my own thoughts and syntheses.

Do I tell people on Twitter what I had for breakfast? Never. Do I write about my personal problems? Only if they can be a metaphor or an example for other people’s experiences (like my effort to modify my mortgage loan). People who are not using social media always worry about lack of privacy. My theory? If you don’t want people on these platforms to know something, don’t tell them.

Now let me answer the questions I get asked all the time when I tell people what I’ve just written about.

"Wasting TIme on Social Media"How much time does this take every day? As much as I want it to take. If I’m very busy working, very little. On other days, or perhaps in the evening when there’s “nothing” on the 200 channels of digital TV in my home, several hours. It’s not a compulsion; it’s a pleasure. It makes me feel like 19th century people used to feel in a salon. Participation is a choice.

And what does it do for me?
It has introduced me to an entire new community of engaged, educated people who discuss the world. These people are located anywhere — Brazil, China, New York, India. It finds me friends, investments, and cousins I haven’t heard from in years. It increases the time I spend talking with my brother.

And last, but not least, it makes me money. It exposes me to the world and people can hire me to advise, to write, to teach. In other words, sometimes when you are useful, there’s a payoff:-) And no, I do not call myself a “social media guru.” I leave that for others.

2 Comments

Filed under Current Affairs, Daily Living, Early Adopter Stuff, Entrepreneurship, Social Media

To Change Education, Change its Funding

How we fund schools determines how we learn, and the funding mechanism is way out of date.
This guet post by a long-time friend of mine, Ted Kraver, who has been an advocate for educational transformation for twenty years, suggests a legislative strategy to modernize K-12 education. You can contact him directly using the information at the end of the post, or you can comment here and I will alert him:-)

What is necessary for education in our century includes
Competency learning to complement the seat time system
Data driven reporting and decision support;
Broadband use by everyone;
Teacher transformation for the digital age;
Global digital curriculum access with effective application.

There are many objectives for student learning, but the one the State of Arizona pays for is student competency over a wide range of disciplines. Some courses of learning are prescribed, and some of these are backed with state standards. Others courses are elected by students in their specialized areas of interest.

Today we are not getting what we pay for.

The problem is that the current funding system has evolved to prevent competency in well over a third of the student population. The current system funds seat time based on a 100 day average daily attendance formula resulting in lockstep promotion by grade level. Struggling students are passed through the system and gifted students are turned off by lack of effective learning engagement. When this system was designed in the late 1800’s there were no data to drive decision support systems to enable individualized learning. The economy could only accommodate a small percentage of the graduates with full competency of the course materials in a K-12 education.

In 1896 my grandmother graduated high school with a full curriculum including geometry, Algebra, Greek and Latin. Her first job was teaching high school. Most of her classmates learned their numbers and letters in the lower grades and prospered in retail, factories or farms in the Cleveland area.

Thirty students to a class with a teacher and the agricultural annual cycle worked just fine in 1896. Relating funding to costs of running this lockstep 13 yearly cycles settled on seat time as an effective administrative means. With manual accounting systems, it was a simple way to forecast and allocate educational expenditures.

The financial administration of all other aspects of our society have changed in the past 120 years. The funding mechanism for K-12 education must also change.

Many national experts and leading Arizona advocacy organizations are promoting the complex method of basing school funding on student competency learning vs. the more easily administratively measured seat-time. There are many pilot programs supporting this system design. One example is the large publicly funded K-12 Florida Virtual Schools which works at the single student-course level.

Online-virtual education has an education structure and results that are not currently available in the traditional classroom. They provide individual education that is at each student’s natural learning pace. The teachers provide significant one-on-one support along with some group collaboration. The current implementations are mostly in the 7-12 grade levels. The academic performance results from a 2009 US Department of Education study of online and hybrid education show significant academic performance gains over legacy education. This means of learning will continue its compound growth. In a hybrid form it will become a disruptive innovation that transforms legacy classroom education.

One of the first things we need to implement is an enhanced State of Arizona K-12 funding system. The current system must be transformed to support not only the online and hybrid forms of eLearning but all aspects of eLearning. The means a systematic transformation of many of the administrative centered funding mechanisms to student centered mechanisms. This systemic transformation will take 7 to 10 years to implement. For starters Arizona can legislate student centered competency education funding as an alternative to seat time funding.

The following elements are suggested for 2010 legislative attention. Both have low startup cost and are the foundational to the systemic transformation.

1. Design, fund and implement a system that will provide a Personal Learning Plan (PLP) that is individualized each student. The PLP will be the center of the data driven decision support system used by the student, teacher and parents to guide the K-12 student’s academic career. Elements of this plan will be used to determine course completion competency/proficiency and to report individual student status and progress to school, district, parents and the state data system.

2. Provide funding and assign responsibility to an agency(s) to assess, plan, redesign and implement a transformation of one aspect of the K-12 financial system. This transformation will enable the funding of any public school, in whole or in part, based not on average daily attendance, but on individual student course completion measured by end of course testing for competency. The level of competency set for each course within each PLP will vary based on student learning ability and ambitions. The individual teacher-parent-student team will make these determinations. The range of competency levels will be bounded at the low end to meet Arizona academic standards and the upper end by student ability, motivation and ambition.

Theodore C. Kraver Ph.D. President
eLearning System for Arizona Teachers and Students Inc.
not-for-profit 501-c3 volunteer systems design and advocacy organization
tkraver@qwest.net 602-944-8557(direct) http://www.azelearning.org
225 West Orchid Lane Phoenix, AZ 85021

Leave a comment

Filed under Current Affairs, Daily Living

Are There Economies of Scale in Medicine?

I’ve been listening avidly to all the different points of view about health care reform, and the only conclusion I’ve come to is that almost anything is better than what we have.

On Bloomberg the other day, I heard a call for a systemic approach to the practice of medicine from Dr. Eliot Fisher, Director of the Center for Health Policy at Dartmouth. He said there are always better outcomes where groups of doctors collaborate and practice together, as in the Mayo Clinic, the Cleveland Clinic, or even less renowned group practices such as in Grand Junction, Colo. The efficiencies come when a group of physicians are all responsible for a patient’s continuity of care, and when they share information such as that possible with electronic health records (EHRs).

Dartmouth has studies that show these kinds of group practices cut costs, and yet we have relatively few of them in the US. Most physicians still practice in groups of four or less, usually four of the same specialty. And fewer than 20% of these small practices have EHRs. In fact, in Arizona, where EHR adoption took off after Gov. Janet Napolitano mandated it, another article just said doctors who had bone to EHRs were abandoning them because they were costly to support and impossible to learn. Your basic family practice guy or pediatrician, practicing what the docs call “Hamster Medicine,” where he/she has to see 60 patients a day for five minutes each just to support his office, does not have the time or money to shut the office down to train people on an EHR.

So I dread what will happen when these small practices are forced to implement a complex EHR like GE Centricity, which is both the market leader and the product with the worst user interface. GE has already started a lobbying campaign on behalf of its product, part of which consists of interest-free loans to physicians to install it.

The learning curve for Centricity is steep, especially for the bi-lingual staff of many medical offices, where wages are low and turnover is rampant. I have a physician friend who wrote an EHR himself, and then left that product with his old practice (where they love it) to move to another state. There, he found a group that had chosen Centricity not just for the single group, but for the entire region — and nobody could use it! They had abandoned entire parts of it because no one knew how it worked.

That’s shameful. That won’t lower costs. Lower costs will only come from software that works like Amazon.com or Yahoo — interfaces that make it simple for users to pile in mountains of data without even realizing they’re doing it. And to keep the costs down and the learning curve short, the data should be kept in the cloud.

This is, of course, horrifying to the privacy advocates, who have never run a medical office. Well I have, and I can tell you that when the doctor’s fax machine is overflowing with test results, they spill out on to the office floor or sit there in a pile, and anyone walking by can see them, until some harried front office person collects them and (perhaps) misfiles them in the wrong patient folder.

How do I know this? Because not only have I run a medical office, but I helped a group practice install an EHR, and one of their “pain”points and biggest reasons for going electronic was the loss of patient records due to misfiling or non-filing.

What other business runs as inefficiently as a medical office? None. What other business is more dependent on paper? None.

What other business could become 1/16 of the American economy without being forced into business process automation? None.

But forcing EHRs down the throats of sole practitioners isn’t the answer to reigning in costs. Collaboration is. Collaboration is also the answer to many medical errors and misdiagnoses. I’m not saying that we should “crowdsource” the practice of medicine–although that’s happening through various online Health 2.0 sites that consumers rely on when they have insufficient access to care — but I am saying it might be time to streamline these small practices, put them in groups, and allow them to talk to each other over lunch about the same patient. That way I wouldn’t have to tell my internist what my cardiologist said, or wait for the cardiologist to fax over my results to him.

Any kind of information exchange would help. And whose ox does this gore, unless it’s the commercial real estate companies who have been building small medical offices?

Leave a comment

Filed under Current Affairs, Health Care, Politics

Bent Britain

Bent Britain

I have a friend in the U.K. who reads my blog, and who sent me a favorite poem from the recent British poetry season. Yes, we may have football season and basketball season, but the Brits apparently have a poetry season. So the BBC picked this poem as a favorite from this season:

Bent Britain May 2009

We are bent Britain right now,
In this land of heroes,
The upper houses are
Reeking with stale piss.

We are bent Britain right now
In this land of tolerance
And hard won basic human dignity
Our elites
Are no better than tin pot regimes
Smeared with hypocrisy .

We are bent Britain right now
In the midst of sweated labour
The working people did everything
Asked of them; did everything the right way
The honourable way.And now look
As shattered dreams pile up in Swindon town.
Betrayed again betrayed again.

We are bent Britain right now
Treating our heroes from unwanted wars
Like discarded items on an accountants page ,
We don’t have room for the gurkhas
Our brave defenders ;
But everybody else is welcome.
We are bent Britain right now
As our bankers and money people
Have trashed us thrashed us
Robbed us skinned us
Like in some English public school brawl
They return to their dishonest lairs
To lick their wounds and sneer.
Looking for the next churn .

We are bent Britain right now
And we need our heroes again
Put the search out for our heroes!
Please blow the bugle
Torch the signal pyre
To bring us back or take us forward,
Just bring back our heroes!

Read it out loud to feel its power, especially on a day when the credit rating of the British government has been cut.

Leave a comment

Filed under Current Affairs, Politics