Saturday, September 26, 2009

PodRunner: A Beat for Feet that Run

From the "How Cool is That?!" department on the internet: I downloaded a couple one hour long music mixes targeted for running from PodRunner. Tried it out on the treadmill this morning (it's a rainy Saturday). Pretty nifty stuff. Steven Boyett, DJ and author, posts these techno-music compilations with targeted BPM to pace your run or workout. There's a bunch of them and they keep coming, technically free, though there is a tip jar or merchandise to help support your habit. An easy way to keep yourself in fresh music; put your energy into the burn.

Fig Tree With Green Lynx Spider

Spotted this critter in my back yard a couple days ago. I left her guarding her egg sac and my as-yet-unripened figs. Hopefully we'll get some cold weather after this rain and the fruit will go ripe. Mmmm.

Saturday, September 12, 2009

Ariel Update

I’m currently reading Steven R. Boyett’s book Ariel and enjoying it immensely.

I did just realize that even though it was published 26 years ago, that still means that it was published after I read some similar post-apocalyptic and epic journey books like Hiero’s Journey (Sterling E Lanier) and Shardik (Richard Adams). I’m liking Ariel in part because it is chock-a-block full of literary and pop-culture allusions that are from my coming-of-age era; and because I can see Boyett’s musical avocation seeping through – not just because it’s about mythical beasts and anachronistic combat.

Tuesday, September 08, 2009

We've Got To Relieve... Health Care Burdens

I was thinking about the health care morass on an airplane the other day; thinkin hard enough to jot down some notes. My thoughts aren’t all good, but this is important stuff and needs to be fixed. I heard back from my Congressman, Parker Griffith, who is a retired medical doctor. He used a Hippocratic Oath analogy: “first we need to do no harm to our current system.” I didn't swallow that cod liver oil. His is a misguided anthropomorphism – our health care system is not a human being. If you break it completely it may actually help you to rebuild it better than it was. Besides, there’s no reason to think that doctors and hospitals will stop treating sick people during a transition from one payment system to another. What else they gonna do?

We need meaningful reform. We need it on moral grounds, to help people who don’t get care for routine and treatable ailments. We need it on financial grounds, to make our businesses stronger and independent of the yoke of health insurance. We need it on equitable grounds, to stop the arbitrary nature of who has coverage and who doesn’t, just depending on which way the labor market winds are blowing. We need individual coverage that can negotiate the same rates that groups can. No more small group "death spirals".

We need to align the monetary goals of providers with healthy consumers. We need to flip the pay-per-treatment or “fee for service” system on its head. A pay-per-patient system is possible and being tried in certain places. I worry that that method incentivizes not performing needed treatments, at least in the short run. Maybe there could be monetary penalties if a treatment was skimped – this is basically the old HMO model and didn’t work out well in the US(although similar models work in other countries). The salient differences should be explored and overcome.

Or pay doctors via a salary, with bonuses for healthy patients. This seems pretty reasonable, but has a couple of pitfalls to guard against. For one, “the talent” will no longer be automatically getting paid for their high skills. Management will be seeing the cash flow (both on the insurance company side and on the hospital administration side), and they’ll rake off as big a share as they are allowed to. So it needs regulating, which is unsavory, but sane. Absolute control of the monetary pipeline leads to money-drunk plumbers -- I may have mixed my metaphors there, but unfortunately we need watchers when money is involved. And people to watch the watchers.

Health itself is not and healt care also is not and will not be, egalitarian. Maybe there is some solace for the less-well-heeled in that. That is, that everyone can fall ill or get injured, and all of us get old. Waiting for routine and typical care as a method of cost control is unacceptable. That is, back door rationing of health care through curtailed availability cannot be a solution. Apparently that is a diminishing state of affairs in Canada and the United Kingdom at this point. Their waits are often no more than ours for the same specialists. Have you tried to get an appointment with a dermatologist? Your best hope is for a cancellation to open something up -- or to look up a good poultice on the Interweb.

Extraordinary care remains another matter. Extremely expensive and experimental treatments have to be uncovered (except as part of research studies, but that's a special case). But the bar needs to be high and the decisions open and transparent. I'm sorry, it's not worth 2 million dollars to extend anyone individual's life by 6 months -- not to society (i.e. the rest of us). If there is a rich benefactor, okay, it's their money. But when it's our money, we can extend a lot of other people's lives a lot more than 6 months with $2MM.

Risk takers are a tough area for me. I haven't got that figured out. In some cases of course their health care is cheap -- if they fall while rock climbing and die, well, it's their funeral. If they only break their back, though, then it's everyone's bank account. I think in those cases they need to cough up some personal funds to help with coverage -- but which things are risky? Smoking? Of course (if you weren't already addicted in 1965). Failing to exercise? Eh. Over-exercising? Hmmm. Maybe we better hope this one comes out in the wash, that it evens out over the pool of citizenry.

Penultimately, I want to address what the correlation between health insurance and business should be: none. There's no rational connection. Health insurance should be more like the fire department; businesses can pay their share through taxes. Different businesses shouldn't pay different amounts per employee depending on the type of business they are, how big they are, etc. In the U.S., employer paid health insurance started as a differentiating fringe benefit. It's no longer effective in that role, except to stifle small businesses, consultants and entrepreneurs. And it allows large business management (and their customers) to squeeze the employees through passing on ever higher health insurance costs to the employees through higher co-pays and decreased coverages.

And finally, I find myself agreeing with some European voices that I respect, that treating the health misfortunes of others should not be a ticket to riches for anyone. It's just plain wrong.

Sunday, September 06, 2009

The Migraine Sufferer's Wife

We just saw The Time Traveler's Wife at the movie theater. I thought the movie was much better than the mediocre reviews that I've seen. The dialog is crisp. Rachel McAdams has a great smile. The treatment of time travel is as good as in any recent main stream movie; it's a fairly novel conceit: spontaneous, uncontrolled time travel triggered by some correlation to stress, just for one individual, just for Henry; it reminds me of my migraines -- they're pretty rare but take me completely out of the present -- I lose time to them (not so much now as before, but still sometimes). And they have something to do with stress and/or drugs like caffeine.
Also, I enjoyed the use of "Love Will Tear Us Apart" as a couple's wedding song -- sounds like a terrific cover by Broken Social Scene.

Wednesday, September 02, 2009

Stay Free Little Brother

I finally finished Cory Doctorow's Little Brother. Brief review here.

WorldCon Part Ten - Montreal Bagels

My flight out of Montreal was in the late afternoon, so I had
Sunday morning to do something else. Nothing was calling me back to the Con, nothing to top what I'd done already, so I made sure I had correct change for two bus rides and caught the #55 bus from the Palais north up Boulevard Saint Laurent to Avenue Fairmount Ouest. I walked west on Fairmount a couple blocks to la maison de l'original fairmount bagel where I learned that Montreal bagels are in fact wood fired, and even more delicious fresh than what I'd had at the party a couple nights earlier. It was a beautiful summer morning in the city and only a couple miles back to my hotel so I decided to save my second bus fare and walk and eat a couple bagels for breakfast. I strolled back along Avenue du Parc, between Parc du Mont Royal and Parc Jeanne-Mance. Lots of people out biking, walking or jogging in the pleasant sunshine.

I was back at the Hyatt Regency in plenty of time to check out of my room and wait for the shuttle to the bus terminal to catch L'Aerobus back to the airport. And enough time at the airport to jot down some notes (like these) and pick up a bottle of Sheridans layered liqueur before the flights home. They were, gratefully, un-interesting. Fin.