Everyone thinks of changing the world, but no one thinks of changing himself.
Count Leo Tolstoy
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Release of Myanmar Pro-Democracy
Activist/Nobel Peace Prize winner Aung San Suu Kyi
Some Obvious Lessons From the
Democratic Party Health Care Law
I have written several academic and professional articles on documentation. What stimulated my interest in documentation was my professional experience as an APL programmer/analyst. APL is an interpretive computer language that was created by IBM in the 1960's to facilitate rapid computer application development; it uses a powerful syntax using mathematical symbols and objects (for example, you can invert a matrix in just 2 characters) with an unconventional right-to-left execution process within lines. I got my start at a well-known, respected insurance company, which decided to create an end user support team in its property casualty actuary department. The company had problems trying to develop their own programmers and hired me as a trainee. Because of company politics and no training program, I ended up teaching myself well enough to get a job offer with a significant raise in pay from the leading specialized APL computer timesharing company in Houston the following year. [The niche APL timesharing disappeared within a few years of the introduction of the IBM PC; most of our customers were functional areas of major oil companies and/or their subsidiaries, primarily end user workarounds to bureaucratic IT departments.]
APL programmers tended to be typical computing jocks, ego-driven, highly skilled with idiosyncratic coding styles. In earlier years of computing, economy of symbols in executed code was a criterion of program quality. This manifested itself in certain dysfunctional ways, including obscure variable names, the use of parentheses and/or comments, which coders sneered at as unnecessary symbols serving no functional purpose. (I remember one program where I literally had to count the number of X's in a redefined variable name to determine which array I was dealing with.) Production programs were composites of convoluted programming styles, and if there was documentation, it was literally yellow with age and no obvious relationship with current code. Fortunately, I've always had a knack to reading and understanding the code of others. Probably the most humorous anecdote was when my colleague Jeff came to me with a listing of his own code, because he couldn't remember what he had done in troubleshooting his own production code two weeks earlier. (Macho programmers never ask for help unless they absolutely have to.)
I always prided myself at leaving an assignment or a job better than the way I found it. In addition to robust, well-defined programs and patches, I paid special attention to practical program documentation, realizing that future programmers might need to modify application functionality. Quite often, documentation is paid short shrift; programmers prefer to work on code and often have conflicting priorities. It is difficult to evaluate and is typically noticed only when needed (when the original programmer may not be available or remember salient details).
I decided to address the evaluation issue in my doctoral research; it was not focused on prescribing a normative set of guidelines but looking from the experiential perspective of the reader. I was driven by questions like why readers didn't access and use relevant documentation (and/or the corresponding functionality of relevant systems or software). One of the highest compliments I got was during a keynote address at the 1985 ICIS doctoral consortium when the IT practitioner specifically signaled out my research topic (from over the thirty or so participants selected from different universities). A jealous attendee whispered to me that the practitioner didn't know the details of my research; this was an area reflecting my own experience, not some arcane study reflecting my dissertation chair's own research interests.
Here's the point and a critical distinction between conservatives and progressives. Conservatives are often driven by practical considerations, not by paternalistic, prescriptive approaches. Take the health care bill; the progressives, driven by Obama, Pelosi, and Reid, started from an issue of the 15% or so of people not currently covered. The fact of the matter is many prefer to pay for medical services on an as needed basis; others are temporarily without insurance between jobs. (Others are unauthorized immigrants.) But, in fact, existing laws already guarantee emergency care, regardless of ability to pay, and lower-income people often qualify for but have not applied for low-cost subsidized Medicaid coverage.
Instead, progressives swiftly and dubiously jump to the discussion of people with preexisting and/or catastrophic health conditions (a tiny fraction of that 15%), wanting private companies compelled to cover unlimited risk, which is not a viable business model in an industry with thin profit margins. There are ways to handle catastrophic conditions without doing what the progressives are doing (e.g., a flat tax on medical services), with the government reinsuring the private sector for the costs of high-cost medical care. A significant percentage of states have assigned risk pools. The primary issue is that the progressives are promising not just catastrophic care but extra medical services which aggravate capacity constraints. and they are imposing mandates on businesses, some of which (e.g., smaller businesses) do not have the economies of scale to self-insure or pool employees in a way to attract the best rates.. It's not entirely clear why businesses should be told how to compensate their employees.
We saw during the health care debate that there were some proposals being forwarded by Democrats--like raising the income level for Medicaid eligibility or lowering the age of Medicare: since Medicaid costs are shared with the states, the federal government was essentially funding a liability on the backs of the states, whom have to balance their budgets. In terms of lowering the age of Medicare, a program in even worse shape than social security, simply hastens the day of reckoning.
I've written about the bad economics underlying the new health care law, but as you might expect, there's a different twist in this discussion. What has happened since the law has been enacted? Individuals and companies have faced a steep increase in premiums--the exact opposite of what the progressives intended; companies have (predictable) dropped out of the individual coverage market after Obama and the Democrats demagogued against sharp increases in California and elsewhere--mostly due to healthier risks deciding to drop expensive coverage in a tough economy. Companies are flirting with the idea of dropping private sector health care insurance and simply paying a less expensive tax penalty: this, of course, doesn't shrink aggregate costs. In fact, less competition will likely result in even higher private-sector insurance rates. Publicly-held companies have had to add to account for expected higher costs (to current employees and/or retirees), which partisan Democrats immediately attacked as a conspiracy to attack the health care law, although the inadequate costing of risk contributed to the earlier economic tsunami. You've seen a lot of companies seeking for exemptions (e.g., McDonald's) from conditions (minimum direct benefit payment percentage) which are impractical for more limited insurance plans. Finally, we've seen a high-cost regulation on smaller businesses to reporting certain minimal cost expenditures.
So what you have is administrative patchwork on a convoluted, ill-designed system: granting waivers, exemptions, etc. Should we be surprised? In fact, the Democrats have routinely had to do this sort of thing. They hyped pay-as-you-go as fiscal discipline, but the exceptions created to pay-as-you-go (remember the Jim Bunning kerfuffle about wanting to fund increased unemployment benefit costs--up to 2 years and climbing--out of already deployed federal resources instead of new debt?) are about as big as the leaky US-Mexico border.
This is fairly indicative of what a statist philosophy leads to, and we are only scratching the surface of a 2000-page law which does not build on the local/state solutions and experience of regulating health care. This law was enacted in the middle of a year which would end with a $1.3T deficit. This was not the time to introduce a radical reform, with underestimated costs and dubious savings from unprecedented Medicare cost savings, actually needed to shore up the intrinsic costs of Medicare itself.
We see the government not learning from things we've seen in the private sector for years. I've mentioned in past posts my first DBA gig was with a regional EPA center. Laboratory information management system design decisions were made by a vote from regional lab managers--managers whom were not the day-to-day chemist/users (and did not consult with them). [Let's just say, system design is not a democratic process.] It turned out the network group's backups were useless: they never tested that backups were usable. They were relying on software status reports saying the backups were completed successfully. [Not to say "I told you so", but I had specifically raised the issue of testing the backups several times with network administrators and they assured me there was no problem with backups.] When the RLIMS specialist came to upgrade the application software, he ran into an unexpected upgrade issue and wanted everything restored from our last (offline) backup. So we effectively lost 3 months of RLIMS data. When I went to talk to the chemists to relay the bad knews, they weren't concerned. In fact, this was probably the third or so system imposed on them without their knowledge or consent, and they maintained a separate set of records. So the "real data" were never lost, but the redundancy had its own costs (not to mention morale issues among the scientists). This is a classic example of a dysfunctional information system.
Over the last few days, I've described other usability issues, e.g., with elections, including the Maryland GOP primary where my ballot summary said I hadn't cast a vote for a certain race, when in fact I had, and then there's the question of the Murkowski spelling bee election by Joe "Sore Loser" Miller (see below).
The bottom line is there is an intrinsic risk, with unintended consequences, to radical reforms, never mind convoluted laws resulting from crony capitalism, federal sausage making and wheeling-dealing partisan leaders, when you assemble a bill based not on the crucible of state experience, building on things like Medicaid and high risk pools, and unprecedented, dubiously constitutional steps like individual mandates for insurance products.
Alaska Senate Race Update
As of the end of the day Saturday, incumbent Lisa Murkowski had tallied 74,499 undisputed votes outright to Miller's 87,517, with another 15000 write-in ballots to count, plus military absentees. If the remaining ballots break out as the pattern to date (89.5%), we would expect Murkowski to end up with 87,924 ballots or more--without even tapping into the extra 8% or so of disputed ballots awarded to Murkowski based on clear voter intent. The Miller legal team is in a state of denial, questioning ballots on any possible technicality--a partially filled oval (indicating a write-in vote), a name that appears to bleed over the underline field, poor handwriting, not to mention phonetically-similar misspellings of 'Murkowski'. They've even implied unsupported allegations of voting irregularities
This is nowhere like the Florida vote count in 2000 where there were disputes over the intent of "dimpled" chads. It's clearer when they actually have to write the name. It's not just the Miller camp is in a clear state of denial; it's disingenuous. Miller is a lawyer--he knows better. Yes, of course, Lisa Murkowski wanted to win within state statutory guidelines for write-in votes. But you can argue the statute is discriminatory against candidates with more complex surnames; to vote for Joe Miller, all you had to do was fill in an oval; to vote for Lisa Murkowski, you had to fill in an oval--plus write out a hard-to-spell surname. If someone is allowed to make his mark (versus sign his name) for a contract in front of witnesses, why are we quibbling over minor misspellings, handwriting, etc., errors in casting a vote? The voter isn't supposed to conform to the idiosyncracies of the ballot, an imperfect measure; the ballot is supposed to accommodate the choice of the voter. It's like telling a voter that he flunked a spelling test and so his vote doesn't count. That's disenfranchisement of voters. People are allowed to vote without a high school diploma or GED. There is ZERO chance that Miller will win in either federal or state court, and the Republican Party, which has supported Miller's legal team, is treading on very thin ice; it may need Murkowski's votes, and she won this election without GOP support.
I am tired of seeing ideological candidates like Ned Lamont, Christine O'Donnell, Sharron Angle, and Joe Miller snipe candidates with broader support. Yes, we want principled lawmakers--but we need lawmakers whom can bridge the ideological divide, whom can put the interests of the nation above their next election.
Of course, if no suitable candidates emerge to contest Barack Obama in 2012, maybe I'll start my own write-in campaign for President. Of course, Snoopy (Charlie Brown's dog) would get more votes than I would. (And you thought Lisa Murkowski has a write-in problem...) You know it's bad when I write down my name on a restaurant's wait list. I can always tell when they finally get to my surname. Quite often they'll start, stop and eventually say, "Ronald?" [I automatically start walking at the first sign of hesitation...] Or maybe "Qwill-ee-met-tee". My Dad has a simple solution: he'll sign in with a surname of "Gill met". I was surprised one time when a young man of color pronounced it perfectly; when I expressed surprise, he mentioned that he was from the New Orleans area and there are plenty of Cajuns down there. If the Democratic Party has its James Carville, maybe the Conservatives can have their Ronald Guillemette.
Political Humor
For two days, the [Carnival Cruise] ship [off the Mexico Pacific Coast] drifted with no power, earning the nickname the “Democratic Party.” - Jay Leno
[After four years of dubious priorities, economic drift and ineffectual stimuli following the start of the recession in December 2007, with nothing to show for it except nearly $4T added to the national debt, outgoing Speaker Nancy Pelosi was asked, "Madam Speaker, you've just lost the most House seats in any election over the last 60 years; what are you going to do next?" Ms. Pelosi said, "I'm going to have a party to celebrate our successes and run for Minority Leader."]
An original:
- After the historic turnover election defeat of the Democratic super-majority in the House, Speaker Nancy Pelosi has announced her intention to run for Minority Leader in the coming session of Congress. Former BP CEO Tony Hayward, best known for his deft handling of the Gulf oil spill, said, "You can do that?"; perhaps he's going to consider filing an application for the post of Chief Operating Officer at BP.
Fred Knobloch, "Why Not Me". Perfect country lyrics, vocals, cadence and performance. One of my favorite country-pop crossover hits of all time.
