More About Racial Inequality in Healthcare

I found this Newsweek article interesting for the comments people made. You can see that there are some pretty heartless souls out there, as well as some more mindful and prepared to take the time to try and educate their fellow citizens. One comment points to this very useful set of resources based on the Institute of Medicine's report: Unequal Treatment, Confronting Racial and Ethnic Disparities in Healthcare. This was published in 2002 and the basic finding was that

a consistent body of research demonstrates significant variation in the rates of medical procedures by race, even when insurance status, income, age, and severity of conditions are comparable. This research indicates that U.S. racial and ethnic minorities are less likely to receive even routine medical procedures and experience a lower quality of health services.

I think there will be several reports in 2007 that ask "How far have we come in five years?"
--S--

Keep Google Earth Rocking

I am a fairly recent 'discoverer' of Google Earth but it has quickly become my favorite non-work application. Call me easily amused but I love 'playing' the trip between my house in Florida, my Mum's place in England and my brother's place in Spain.

Now I have started to explore the Google Earth community and the enhancements people are making to the raw data. This is fascinating in a way that goes before mere fun. I have a strong sense that it is not merely educational, but exploratory. We humans are 'learning on the job' when it comes to geo-spatial self-awareness and what it means for the future of our planet. Try it! You'll like it. And the more people try it, the better the data will become.

The Age of the Domesticated Terabyte is Here

Two computer hardware ads hit my in-basket today offering consumer-oriented storage capacity of such an amazing price-to-volume ratio that it may represent a new stage of digital evolution: the domestication of the terabyte. One ad featured a desktop PC with a terabyte of hard drive capacity (via a pair of 500 gigabyte SATA drives) for under $2,000. The other ad featured a one terabyte external USB drive for under $500.

To put this in perspective, I can remember driving out of San Francisco one day in 1986 just to get the unbeatable cash price of $300 on a 30 megabyte hard drive, from the back office of an obscure industrial unit in Sunnyvale. And I thought myself lucky!

No, I won't lapse into a geek's version of the Four Yorkshiremen sketch, but just ponder for a moment the difference between the cost per megabyte then and now. In 1986 it was $10.00 a megabyte. Today, based on the $200 price tag of a half-a-terabyte SATA drive (from Tiger Direct for example) the cost of one megabyte is $0.0004. Heck, if you play the rebate game at eCost.com right now you can get 1 gigabyte of of postage-stamp size solid state storage for $0.004 per megabyte. Only need half a gigabyte? That's free, all but for the shipping and handling.

But it is the sub-$500 terabyte external hard drive that really tells you the gigabytes have come home to roost by the thousand. Just a year ago one blogger was making fun of LaCie's introduction of the Big Disk 1TB under the heading "LaCie 1 Terabyte USB Porn Drive." I'm not taking issue with Steve for that posting, and I love the site, but what a difference a year makes.

I'm tempted to get one of these thing and no, I won't be using it for porn. After all, there are family values to think of, and it's not unusual to find families today that have one computer each: Mum, Dad, and the 2.5 kids. A terabyte external drive would let each one back up 222 gigabytes. That's about the amount of storage built into an entry-level desktop and just over twice what you get in a new notebook. What are people using it for? Music, photos, and video. Lots of it.

Mobile Blogging from a Treo 650

Checking in from my Treo 650.

Yep, mobile blogging comes to Blogger. At first I thought this would be a big yawn. After all, one has been able to email blog postings to some blog systems for years. But I like Blogger more than other systems and this new feature lets me text a posting to Blogger (with image if I want) in very short order, right from my trusty Treo. When I get a chance I will test the formatting possibilities of this channel, which are obviously limited (I added the title after the fact, via the web). Despite these limitations I think I will be using this channel quite a bit.

--

Mobile Email from a Cingular Wireless Customer http://www.cingular.com

New Versions of Windows Will Always Be Late

...and seldom worth waiting for. What you want to wait for is the second update to the new version, the 3.11 to the 3.0, the SP2 to the XP, and so on.

I am quite familiar with the problems of inductive reasoning so I won't say it is impossible that a future version of Windows will ship on time. But I would never bet money on the folks at Microsoft giving me what they promised when they first promised it. Indeed, I would humbly suggest that IT managers who take Microsoft timetables at their face value are gambling with their company's profitability.

Those who don't learn from history are doomed to repeat it. Remember that Windows 1.0 was announced in late 1983, promised for April 1984, only to be delivered in November, 1985. As someone who tried to use Windows 1.0, I can say in all honesty, it was not worth the wait. Arguably, we did not get a really worthwhile version until Windows for Workgroups 3.11 in November of 1993, a decade after the initial brouhaha. The rest, as they say, is history.

Racial inequality in healthcare

Even when enrolled in identical Medicare health plans, black patients have worse health outcomes than white patients, according to a study by researchers from Harvard and Brown universities, who studied data from 431,573 patient visits covered by 151 Medicare managed care plans from 2002 to 2004. The findings appear in the Oct. 25 issue of The Journal of the American Medical Association (as reported by WebMD).
--s--

My Friend the Treo 650

I have said it before and have said it elsewhere, but I will say it again, the Treo 650 is the best hi-tech purchase I have ever made, and the best computer I have ever owned (it does input-output-storage-processing ergo it is a computer).

What prompts me to say this right now? I dropped it. Again. Getting out of my pickup it fell onto a concrete parking lot. And just like last time it sustained a few scratches but kept on ticking. As an object of visual beauty it is now up there with the dented Leica of a famed photographer, the well-worn axe of a working guitarist. I now use my Treo 650 as twelve tools in one:

1. Alarm clock (playing one of the many great polyphonic tunes this thing can produce).

2. Flashlight (the screen is bright enough to find your way around a hotel room in the dark).

3. Camera (for all sorts of shots, notably evidence and possible shopping decisions--like a shot of a PC on sale at Circuit City, including model number and price--no typing required).

4. My diary/mustdo reminder, handily coordinated with my notebook computer...recently found to be very handy for birthday reminders as I am trying to be better about getting people cards, etc.

5. Casual reading (mainly news from the BBC while standing in line or sitting in a waiting room).

6. Emailing (I like the thumb keyboard and often catch up on email while flying, sending the messages out as soon as we land).

7. Texting (not a medium I love, but Treo handles it just fine when needed, including MMS).

8. Dictation (Palm Dictate works great--can dictate memos while driving and the sound is very acceptable).

9. MP3 playing (I have a collection of SD cards containing different mixes I can switch in and out--great for plane trips--and the same cards will work nicely in my truck once I get a radio with a USB socket).

10. GPS--just got a Bluetooth GPS puck and am learning to use it. Screen display does a great job of rendering maps.

11. Blogging--just getting this set up but should allow me to blog while travelling, etc..

12. As a phone--yes, it is also a phone and has great talk time and standby time. Truly excellent battery life in fact. The ease of adding contacts means it is now my central repository for people, companies, etc.

The Picco Z Micro Helicopter

Just got one of these from a good buddy for my birthday. Seems like Radio Shack is the place to buy them (don't pay more than $40). What you get for your money is a miracle of miniaturization, a tiny helicopter that actually flies, in my case around the living room. There is a plenty of cool video of these things on YouTube. It will fly for about 5 minutes before recharging, which is done with a cable from the controller box (which contains 8 x AA batteries). The box lets you know when the charge is complete (about 20 minutes). Although 5 minutes might not sound like long, it is plenty of fun as controlling the flight takes quite a bit of practice (besides how far can you go in a living room). This thing is surprising resistant to damage even when you crash terribly. Here you can see its size in relation to a regular check book.

The Lost Month: Migraines take a toll

"Businesses lose approximately $13 billion per year due to migraines, according to a study published in the April 1999 issue of the Archives of Internal Medicine. In addition, the National Headache Foundation estimates 157 million workdays are lost annually because of the pain and associated symptoms of migraines."

If you suspect, as many Americans do, that drug companies are not interested in curing illness, merely treating it--with perpetual cycles of expensive newly-patented drugs, then migraine would be the place to start looking for evidence. My wife has suffered from migraines for 40 years. They have now reached a level of frequency that renders impossible the type of paid employment she used to take for granted. In other words, migraines have rendered her unable to hold down a job in her field. She is disabled, by migraines.

And nothing that the medical community has done in the last 40 years has helped. Indeed, it is now more difficult and more expensive to get relief from the pain of migraine than it was 40 years ago. Believe me, my wife has not been sitting around waiting for a cure. Whenever she has been well enough she has vigorously pursued every lead, however improbable, in the quest for a cure. On more than one occasion attending physicians have ridiculed her for even mentioning research aimed at a cure.

So where did the last month go? It was spent holding down the fort, coping with a bad cycle of migraines and their fallout for the patient, her work, her family, and her friends. In this we were not alone. All across this country millions of people suffer with this disease, calling in sick, losing work time and personal time, depleting bank accounts with hospital visits and pharmacy bills, and wondering, in the occasional moments of clarity between bouts of pain: why hasn't someone figure out how to fix this?
--s--

Hacking Democracy: Some Things Were Not Meant to be Computerized

As a crucial election draws near in America, the debate over computer voting systems is again getting attention, notably from tonight's airing of Hacking Democracy on HBO. However, from some of the reviews of this program (like this one in the Boston Globe) it is clear that even well-educated and otherwise intelligent people don't "get" the problem.

The most vital ingredient in a fair election is trust. The current generation of electronic voting machines are already untrusted (and you can trust security expert Bruce Schneier to provide authoritative analysis of why this is).

Critics of current systems have advanced numerous approaches to making future electronic systems trustworthy. While this is laudable, I contend that the goal is not achievable. No hardware programmed by people will ever deliver the same level as trust as a system of voting based on hand marked paper ballots. To imply, as the Globe's critic seems to do, that electronic systems are no more problematic than their predecessors, is to miss the point. There is a known history of addressing and resolving past problems to the point where the electorate accepted the outcome as fair.

Certainly the replacement of hanging chads with software bugs is not a step forward, but reverting to pencil and paper is not necessarily a step backward. And objections to analog voting methods based on the need to get quick results simply don't cut it as far as I'm concerned. For myself, and quite possibly a majority of voters, a reliable result at 5PM the next day beats a dubious results about 2AM.

So, for the record, and after very careful consideration, my position is that the use of programmable electronic devices to cast votes is not now, nor ever will be, as trustworthy or as verifiable as it needs to be for elections thus conducted to be considered fair.