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Carl Alexander
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"We all need that guiding principle to get us to do a little more every day. That’s what DRY helps you with." #Coding

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So I want to talk about health care for a second.

As a pretty ardent leftist, I've looked askance at this whole bill from the beginning. My critiques have been from the left, tempered by a healthy dose of realization that this was liable to be the best we could get because of the dumb way our country runs. But I supported and still support it, even if it wasn't far enough and was reliant on a free (but regulated) market which has abjectly failed in this area maybe more than any other. I have personal reasons why.

In 2002, I was diagnosed with Crohn's Disease. When I was diagnosed, I was working part time at a book store. About 32 hours a week or so, just shy of full time. The dirty secret of a lot of retail places is that they'll keep a lot of part timers hovering just below the full time line to avoid paying benefits. That's just the way it is (well, was; I haven't worked retail since that job, actually).

So when I got sick, I didn't have insurance. And once I was sick without insurance, my condition deteriorated. Quickly. Moreover, my deterioration meant that, as arthritis and physical anorexia kicked in, I could not get insurance. I couldn't work full time. I couldn't afford the premiums if I had been able to due to pre-existing, if it was covered at all.

In 2003, the bottom fell out of my health. I was in the bathroom, no exaggeration, 20 odd times a day. I am six feet tall; I bottomed out at 105 pounds.

My gastroenterologist at the time was lazy. Terribly lazy. My weekly appointments were 40 bucks or so and involved him sticking a finger up my ass, wandering out of the room for 15 minutes, and then returning with, "Well, you still have Crohn's." That was it. That's all that happened, because my lack of insurance precluded anything else. I did get a sigmoidoscopy... go google it. It's as horrifying as it sounds.

At my worst, shortly before my wife and I moved to Raleigh, my doctor told me about a drug which was having a lot of success treating Crohn's. It was called Remicade. But it was too expensive for someone without insurance, he said, so he wouldn't give it to me. That's exactly what he said to me. He told a dying man that his lack of insurance was grounds to let him waste away. Choice? Doctor choice? This was the only gastro who saw people without insurance in town.

We ended up moving to Raleigh. My wife had a job offer, and I'm glad she did. I ended up seeing a new doctor, of course, who immediately gave me Remicade despite my insurance situation and hooked me up with a compensation system which the manufacturers had, a little detail which my old doctor never, ever mentioned, presumably because it would cost him money.

My new doctor wouldn't countenance that. On the day of my first examination, I remember him looking me over and then stepping outside the room. There was a flurry of activity and I heard some very serious discussion going on. He walked back in and, very calmly, said, "I don't want to alarm you, but you're going to be dead within three months if we don't get you turned around." I asked of what, starvation? He said maybe, but more likely organ collapse. Just one of my vital organs shutting down, probably my heart.

He wanted to put me in the hospital that night, with a feeding tube and an immediate Remicade feed; I declined and took my chances. I didn't want to saddle my family with a huge bill, after all. I was uninsured.

I also got on disability, something which my old doctor said I in no way would qualify for. How little did I qualify for it? I walked in and was put on permanent (meaning reviews every 7 years because they don't expect you to ever really recover) disability almost immediately, with no appeal. Anyone who's ever dealt with Disability Services will tell you how rare that is.

My intent is not to rattle this off for sympathy; I've found that, on the occasions on which I did look for sympathy, it was sorely lacking from even those I was close to. I don't want it anymore. My intent is to try to convey just how bad off I was.

Because it was all preventable. The misery, the eight lost years of my life, the missed return to school, the broken friendships, the constant pain, the humiliation of shitting uncontrollably, the lingering anxieties I still have when I go out to eat or go shopping or am somewhere without a bathroom handy... all of it was preventable with even a modicum of sanity in the system we have.

If the ACA was in effect in 2002, when I was sick, I would have had insurance. It wouldn't have been great, my bills would still have sort of sucked, but I would've gotten my life back together in much quicker order.

As it is, there almost was no Ian Williams. There would be no Age of Bronze, no Gonzo, no GameHead reviews, no return to school, no happy family in an owned house, no Iris. And despite all my faults and mistakes, and boy, there have been a lot, this one wouldn't have been on me.

So, yes, the mandate is tough to stomach. Insurance companies suck. But this law, this law, would have changed my life for the better in so many ways if we'd had it when I first became ill. And I get it... we want better. We want that single payer or we want, on the opposite side, the free market to take care of our ills. But this is the country and system we actually deal with. People are dying and suffering now, needlessly, and have for years.

I thought I had mixed feelings about the impending SCOTUS ruling. Just a couple days ago I'd said something like, "Fuck yeah, part of me hopes it gets overturned so we can do the real work of getting single payer!" But you know what? That was an asshole thing to say. And when that ruling came down, I realized I didn't have mixed feelings at all. I found myself crying like a baby, because it's a start. Not perfect, not the best we could do in the best of all worlds, but good enough to relieve some serious suffering on the part of America's citizens. And that's a fine thing.

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This speech, by +Cory Booker, makes me feel so small

Small? Yes, small. I have done so little with so much. My family gave me so much. I have not faced the challenges Booker's family has. I have not held the body of a dying child, the way Booker has. I have not helped a community the way he has. 

We need more leaders like Cory. 

This inspires me to do more. A must watch.

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That's awesome. Really cool usage of satellite imagery.
More than 99% of Ancient Egypt remains to be uncovered. Satellite imagery is the trick. Sarah Parcak at TED.

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Beautiful
Eastern Coast of United States at Night from the +International Space Station

One of the Expedition 30 crew members aboard the International Space Station took this nighttime photograph of much of the eastern (Atlantic) coast of the United States. Large metropolitan areas and other easily recognizable sites from the Virginia/Maryland/Washington, D.C. area spanning almost to Rhode Island are visible in the scene. Boston is just out of frame at right. Long Island and the Greater Metropolitan area of New York City are visible in the lower right quadrant. Large cities in Pennsylvania (Philadelphia and Pittsburgh) are near center. Parts of two Russian vehicles parked at the orbital outpost are seen in left foreground.

February 6, 2012

Image Credit: NASA
Explanation of the image from: http://www.nasa.gov/mission_pages/station/multimedia/gallery/iss030e078095.html
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The Real Reason for Bandwidth Caps

+Dane Jasper of Sonic.Net explains why he thinks bandwidth caps really exist: to prevent the development of an alternative to television:

"My opinion is that caps make little technical sense, and I believe that the fundamental reason for capping is to prevent disruption of the television entertainment business model that feeds the TV screens in most households....

"As of 2008, the Nielsen Co. says that the average American household consumes just over 8 hours per day of TV. To replace this with some sort of innovative and interesting new Over-The-Top offering, it would consume roughly 480 Gigabytes per month (based upon Netflix consumption at their current top “HD” rate.)

"Keep in mind that this is the normative household TV consumption, so roughly half of homes view more than this! Add in day-to-day Internet use and clearly the 150GB to 250GB caps which are typical today are an effective blockade."

The other thing Dane points out is that even if "bandwidth hogs" were indeed the problem, putting in data caps wouldn't solve the problem, since it's not total data usage that creates problems, it's peak time usage, and the people who cause peak-time problems are not necessarily the same as those who use a lot of data overall.

The piece is well worth a read, and includes a link to a study of Sonic's users that analyzes data usage and bottlenecks.

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The Future of Technology
http://envisioningtech.com
A long term look at new technology. At first look, it’s a bit boring and geeky – but the interactive popup descriptions really flesh it out. It would be easy to quibble about where things fall on the timeline, but overall I really enjoyed reading about all the hypothetical tech. Now that we have realized most of the science fiction from the 1900s, it was nice to see that we still have ways to dream and imagine.
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Must-read perspective on what's wrong with our economy: Hernando de Soto's Business Week piece, "The Destruction of Economic Facts." http://www.businessweek.com/magazine/content/11_19/b4227060634112.htm

Here are some snippets, the core of the argument:

"During the second half of the 19th century, the world's biggest economies endured a series of brutal recessions. At the time, most forms of reliable economic knowledge were organized within feudal, patrimonial, and tribal relationships. If you wanted to know who owned land or owed a debt, it was a fact recorded locally—and most likely shielded from outsiders. At the same time, the world was expanding. Travel between cities and countries became more common and global trade increased. The result was a huge rift between the old, fragmented social order and the needs of a rising, globalizing market economy.

"To prevent the breakdown of industrial and commercial progress, hundreds of creative reformers concluded that the world needed a shared set of facts. Knowledge had to be gathered, organized, standardized, recorded, continually updated, and easily accessible—so that all players in the world's widening markets could, in the words of France's free-banking champion Charles Coquelin, "pick up the thousands of filaments that businesses are creating between themselves."

"The result was the invention of the first massive "public memory systems" to record and classify—in rule-bound, certified, and publicly accessible registries, titles, balance sheets, and statements of account—all the relevant knowledge available, whether intangible (stocks, commercial paper, deeds, ledgers, contracts, patents, companies, and promissory notes), or tangible (land, buildings, boats, machines, etc.). Knowing who owned and owed, and fixing that information in public records, made it possible for investors to infer value, take risks, and track results. The final product was a revolutionary form of knowledge: "economic facts."

"Over the past 20 years, Americans and Europeans have quietly gone about destroying these facts. The very systems that could have provided markets and governments with the means to understand the global financial crisis—and to prevent another one—are being eroded. Governments have allowed shadow markets to develop and reach a size beyond comprehension. Mortgages have been granted and recorded with such inattention that homeowners and banks often don't know and can't prove who owns their homes. In a few short decades the West undercut 150 years of legal reforms that made the global economy possible.

"The results are hardly surprising. In the U.S., trust has broken down between banks and subprime mortgage holders; between foreclosing agents and courts; between banks and their investors—even between banks and other banks.

...
"We are now staring at a legal and political challenge. A legal challenge because American and European governments allowed economic activity to cross the line from the rule-bound system of property rights, where facts can be established, into an anarchic legal space, where arbitrary interests can trump facts and paper swirls out of control. The rule of law is much more than a dull body of norms: It is a huge, thriving information and management system that filters and processes local data until it is transformed into facts organized in a way that allows us to infer if they hang together and make sense."

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How manufacturing is changing

This article about how Apple has changed its manufacturing over the years is very interesting. Great journalism.

I visited China a few years ago and I totally agree. There's no way those jobs are coming back to America. The scale of the factories is totally stunning.

America still has manufacturing, but it's disappearing pretty quickly and this has deep impacts on our economy.

I'm very fortunate to live and work in one of the hot, job-producing sectors in the U.S.: technology. I wonder what my sons will do.

On the way to DLD a group of us discussed what we should tell our kids. One of the folks said everyone should learn to code. I through out that everyone should learn Chinese. "Learn to code and learn Chinese and you're set for life," I said to a small group that included mostly startup founders and a Techcrunch writer. No disagreements there.

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The Impact of the Internet on Global Economic Growth

I was talking with +Brad Burnham the other day about the issues that the tech industry needs to get on the radar of Congress as we move forward into the inevitable next step in the SOPA/PIPA drama. One concern I have about the current framing is that it appears to accept the copyright industry's assertion that piracy causes multi-billion dollar economic losses and kills jobs, and opposes it with non-economic issues like the risks to freedom around the world.

I've argued elsewhere based on my experience as a publisher that there are economic gains from the free flow of information on the internet, and that those gains far outweigh any losses to piracy, but I haven't seen that argument made as widely as I think it should be. So I was very interested to learn, via +Hari Ravichandran, of a McKinsey Report from last year entitled Internet Matters: The net's sweeping impact on growth, jobs, and prosperity. From the executive summary:

"New McKinsey research into the Internet economies of the G-8 nations as well as Brazil, China, India, South Korea, and Sweden finds that the web accounts for a significant and growing portion of global GDP. Indeed, if measured as a sector, Internet-related consumption and expenditure is now bigger than agriculture or energy. On average, the Internet contributes 3.4 percent to GDP in the 13 countries covered by the research—an amount the size of Spain or Canada in terms of GDP, and growing at a faster rate than that of Brazil."

While the issues of freedom versus censorship are important, let's not leave the economic arguments to the pro-SOPA forces. We know that Congress and the White House are rightly concerned about the economy, so let's make sure that the positive economic impact of the free flow of information via the Internet is also a key part of the discussion.

You can download the full report at the link below.
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