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Jon Garfunkel
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Jon Garfunkel

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Given the fascination for stats that the US Election brings out -- people checking Nate Silver's latest prediction percentage multiple times per day -- I'm surprised this hasn't been met by a similar drive for recovery statistics. Specifically, how many people are without homes, or with homes and without electricity or hot water (and likely trapped in high-rises)? This page from NYCHA at least has some of those stats for public housing: 7,000 without electricity, and 19,000 without heat. From there, it seems sensible to get a picture of which groups are servicing which apartment complexes.
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I have a need for spare parts for home improvement. For some things it's just  easier to provide a picture of part than a text description (e.g. a shelf-holder nub). Does not a service exist where people can post pictures of things they need, and retailers (or other agents) can respond where to buy them? Something with the ease of Twitter, but the focus of posting to a consumer forum.
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Steve Coll, in The New Yorker's Comment this week: "The uproar over 'Innocence of Muslims' matters not because of the deep pathologies it has supposedly laid bare but because of the way the film went viral. A sectarian auteur with modest means used the Web to provoke enemies directly."

Wait -- just how did the film go viral? Mr. Coll did not explain, and the famously scrupulous fact-checkers at the New Yorkers glossed over this.

The first two links in the chain, the expatriate Christian Copts, one of whom apparently produced the film, and the other who forwarded it to Egyptian journalists, did the provoking, but it only provoked the powers-that-be. What likely provoked the masses was the deliberate airing of it on an Islamist television station. That's crucial to understanding how this happened. Some responsibility on the part of the leaders in Egypt -- and Pakistan as well, following the actions of a government minister over the weekend -- should be understood.
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The current fight over the birth control mandate underscores a fundamental problem with health care reform effort initiated in 2009-- and it falls squarely on the problem of choice.

It's not, as the opponents of "Obamacare" falsely charge, that your decision-maker is now "the government." (the next politician who says that ought to be voted off this island). Instead, most people have their healthcare coverage choices through two intermediaries. You most likely get your insurance through your employer, which presents with a "choice" of maybe 2 or 3 health plans, which are mostly distinguished by difference is price (i.e., do you want to pay more for a lower deductible.)

To be fair, at my last company I had worked somewhat with the benefits team, and I got an appreciation for the effort they expended on choosing health insurance providers. But on the face of it, it's ridiculous for them to be the ones making these choices in the first place. Sure, it helps for them to get a bulk discount, as companies are able to do in offering various insurance benefits. But the specific health-care coverage choices are often obscured away.

This is similar to the problem in the cable/satellite television market. Even if you're lucky to have more than one provider, the cable companies mostly allow the consumer to choose from a set of very broad packages -- as opposed to specific channels. It's very likely that you end up paying for channels you don't want, or you can't get channels you do. New Yorkers on Time Warner Cable currently can't watch the MSG Network to see the Knicks and other sports teams. Fox News, on the other hand, gets $900M out of cable fees nationwide from viewers who may or may not want to watch it, let alone support. When consumers can't buy the exact product they want from suppliers, that market is broken.

I had pursued such an investigation regarding cable several years ago. The cable companies had complained that the technology wasn't there, digital cable deployment nonwithstanding. They mostly argued that giving consumers the ability to back out would raise, as they could no longer guarantee (like Groupon or any other bulk consumption). And thus it's in the collective interest of the cable systems & cable networks -- a century's worth of antitrust law be damned -- to enjoy a cozy monopoly of choosing your channels.

Similarly in healthcare reform, we should not be surprised to see institutional resistence to change. The money, and controls, come too easily right now to be tinkered with.

But let's say we wanted to still solve this problem, even if the time to solve it was 2 years ago. We want a system to give people real choices, without having people get chosen out of coverage altogether.

Let's assume that even the most diehard libertarians agree that it does not serve society for an individual or family to go bankrupt over catastrophic health bills. I know of no simpler way to fairly spread the cost than a mandate. Just like car insurance, that's the required minimum that you have to buy. And, just like car insurance, you can choose the optional coverage, too.

Most of us would also agree that preventative medicine ought to be supplied for everyone as well. This is a service, that, if I'm not mistaken, is generally cheaper to supply in urban areas because of the density of doctors, medical centers, teaching hospitals, residents, etc. (Contrast this with public education, which is often relatively more expensive in urban centers because of the need to attract teachers with higher salaries vs. suburban schools). People in rural areas with less density (and less doctors/medical centers) would need more subsidies for preventative health. If rural libertarians would protest those subsidies, they are free to...

Now over to the elephant in the room to begin with: birth control. It is preventative, obviously, but it's different because it's not preventing illness. It's also relatively cheap -- $15-$50/month (compare to the staff costs for most healthcare services). Suppose that an insurance plan simply offered an opt-in for birth control. This would not be for the instituation to choose -- it would be for the individual employee. Ok, what about the objection that not enough people would buy in? Now remember that 98% of women practice birth control. And also, the choice is private. (If you can find a conservative Republican who privately does not want the poor to exercise birth control, I'll find a liberal Democrat who doesn't want to regulate Wall Street.)


And why stop there? Consider the continued controversy over the efficacy of psychopharmacology. 1 in 5 Americans take medications for mental health illnesses, and most of the plans I'm aware offer complete coverage for them. It's possible that some of the other 4 of 5 might think that number's too high. Of course, overall, I'd expect more people to object to mental health drug coverage than birth control. Would this drive prices higher? Possibly. Would that be an adverse public policy effect? I don't have the expertise to say -- but, under the current regime, pills are covered by plans and thus pharmaceutical makers have a guaranteed market. Anytime a market is guaranteed -- just like Fox News, locked into every cable home -- the market is imperfect.

We can go on. End-of-life care is extremely expensive -- a quarter of the Medicare budget is spent on people in the final year of their life. Indeed, as it's largely covered by Medicare, Americans have no direct choice whatsoever! But imagine, if you will, an America with full-life, cradle-to-grave health insurance policy. You would have the choice every year to pay into a fund as to how much emergency measures you want spent on yourself over the age of 65 -- for yourself and others. (We could even have a separate payment pool for under-65 end-of-life care -- I suspect that would be a more popularly chosen option).

Indeed this can be complicated. But it shouldn't be. It is certainly not complicated for computers and business systems; the only complications come about because people switch have to switch health plans too damned much, because they are provided at the whim of employers.

It certainly should not be complicated for consumers. At present, the system of choices we get is a joke. The main difference that most consumers can tell between Blue Cross and Aetna and Wellpoint is the color of their brochures. The design of the packaging is acceptable for choosing soft drinks or gas stations... but for health care?

We should be empowered instead to make value choices. Do I believe in wider access to birth control? Do I believe in guaranteed coverage for mental health drugs? Do I believe in unlimited emergency measures to be spent in my subset years? And for all of those choices, I wouldn't be choosing in the abstract. I'd be choosing for myself as well.

Left unsaid is whether the employer should know our individual value choices in order to price our plans. Of course not. Which is as good a reason as ever why employer-brokered health insurance should be retired.
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Jon Garfunkel

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"The riskiest thing is to take no risks." - Mark Zuckerberg
"The tricky thing about parables like this is that people remember." -- the Times, quoting Zuck.
"The greatest risk is not taking one." -- AIG"
"And the trouble is, if you don't risk anything, you risk even more." -- Erica Jong
"The policy of being too cautious is the greatest risk of all." -- Jawharwal Nehru
"If you take a risk and it pays off, you'll be happy. If you take a risk and it doesn't, you'll be wiser." -- brotips #481
"If one is forever cautious, can one remain a human being?" Alexander Solzhenitsyn
"The cautious seldom err." -- Confucius
"It is a good thing for an uneducated man to read books of quotations." -- Winston Churchill
"That includes Harvard dropouts." -- me
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Jon Garfunkel

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Roy -- I heard about your Herculean effort via Alex G. and Stacy R. -- maybe I'll be able to help next weekend. You seem fairly stat-minded, I was wondering whether you had any thought as to why the recovery stats weren't more front-and-center (as compared to the election).
 
Given the fascination for stats that the US Election brings out -- people checking Nate Silver's latest prediction percentage multiple times per day -- I'm surprised this hasn't been met by a similar drive for recovery statistics. Specifically, how many people are without homes, or with homes and without electricity or hot water (and likely trapped in high-rises)? This page from NYCHA at least has some of those stats for public housing: 7,000 without electricity, and 19,000 without heat. From there, it seems sensible to get a picture of which groups are servicing which apartment complexes.
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I've had it with people who have no fricking clue about social media responses to disasters. I actually grew tired of this practice 5 years ago, when I wrote for PBS MediaShift about the generally cluelessness among the blogs following the Virginia Tech shooting. But, now, disaster has struck home.

The latest idiot is French Caldwell, VP of Gartner. I call him an idiot because he should well know better, and his clients should demand better -- Gartner is a $1.4B research firm, and one of the leading research firms in Information Technology. True, most of the solid research that customers pay for come in the form of subscription reports. But, given that he's a smart guy, probably enough people pay attention to him. I don't regularly follow him myself, but I remember him having some stature in the Business Process Management area, and I happened to see someone on Twitter or LinkedIn post a link to his latest off-the-cuff musings on social media and disaster response-- http://blogs.gartner.com/french_caldwell/2012/10/31/expect-to-hear-about-how-social-tech-enabled-self-relief-in-sandy/ 

What offends me most is that this rhetoric isn't a concerted effort to actually understand how disaster response systems work using coordinated approaches -- it's just to champion a particular technology segment by spouting off popular buzzwords. So we get ridiculous phrases like "flash mob of chain saws." Really, if that doesn't exist today, is that something we want? Of the people who own chain saws, there are probably two camps -- those who have other crap to deal with beyond cutting trees around downed power lines, and those connected in contractor networks who get a notification by phone or email for work to do. I assume that somewhere in the Gartner research knowledgebase -- or journals of operations research -- someone knows how these contractor networks work.

Caldwell: "I am also expecting these stories to take a twist -- we will hear about how neighbors organized self-relief efforts using social media."

This is 3 days into the Hurricane. People are using social media. And he hasn't heard of any stories yet?

Well, here on Earth (more specifically, the blackout city of downtown Manhattan), this is what happened: People met each other in the hallways. People saw charging stations, and met each other -- in real life. I live in an apartment building of about 200 units. It's not a named building, but, nonetheless, I could have created a hashtag for the building's address and tweeted that. Searching Twitter, I see none for my current building, and none for my last building (a "named" building). In one building I visited doing a water/food haul up/down stairs, I saw something novel in the stairwell: a sign, posted on the wall, informing neighbors that somebody was lending out a landline for emergencies.

Of course, these are all low-tech ideas are spread by media, both social and traditional. I don't see a reason to celebrate one vs the other.

At NYC bus stations, I finally noticed ads for Ready.gov. It's a compelling image of a girl in front of a canvas showing a mockup of some disaster theater, and the punchline is something about readiness theater. But, it has ZERO information besides the website address. Memo to FEMA: I failed to even recognize this sign before this week, let alone go to the website. Why not use that ad space to actually post the checklist? It's possible that this readiness checklist came in a new mailing. I do remember getting a mailing for recycling info (which we recycled, since our building already has that information in the garbage area). Maybe there's a way to get people to register proactively with the city once they move into to a new place? And combine that with the voting registration?

In many ways, "social media" should be understood as "a giant hack until better systems are built." Generally, we talk about systems like Facebook, we understand that it connects friends & families. When we talk about Twitter, we see it as a system which allows ad hoc communities to form, often around hashtags. Sometimes that works -- following a stream of tweets about ConEd, I did see the news about the ConEd substation explosion, and I figured we didn't have much time to prepare before the power shutoff. Granted, had someone said that they saw the explosion all the way from Brooklyn, I would have immediately realized how large and imminent the problem was. 

As I noted above, searching for building names comes up blank. So does searching for #SubwayShuttle -- the service that was inaugurated today to connect. I'm trying to find the rough timetables for the southbound route (the reverse times are hellish, that I can see on Twitter), and confirmations on how late it's running tonight. Yesterday I had asked an unrelated transit question on Quora -- a system designed for questions & answers -- but got no responses, and see no participation on the part of public agencies. 

You can see where I'm going. I don't want to keep hearing the calls for Twitter to be declared a civic defense resource and beefed up accordingly. I want a system to be built which works specifically for disaster response. I want a system which has a generally strict grammar for hashtags, and where the traditional media can effectively broadcast these hashtags to a mass audience. For example, #BucketBrigade should not be confused for various unrelated fundraising campaigns (as is the case on Twitter), but, instead, a very real bucket brigade that is needed to carry water up the stairs. Which works like Quora for asking & answering questions. Where people are encouraged to post very precise data (which ATMs are out of cash, which food stores are open) to spare the rest of us from having to plumb through a flood of information.
I expect to hear a lot of stories about social technology keeping people connected in the aftermath of Sandy — just as after Katrina. However, I am also expecting these stories to take a twist — we wi...
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FTR, French Caldwell sent me a very cordial note, dignified in responding to my indignant name-calling, and expressing that he understood my frustration in being in a disaster zone. I wrote him back, telling him that I had robbed myself of the knowledge of whether the substance of my argument, or the name calling, had got his attention.
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The studies by Gallup and Burch at the University of Albany (SUNY) regarding semen's anti-depressive qualities have been getting a lot of smirking press lately. What few people have picked up on is that they are the likely source for Rep. Akin's comments.

As Scientific American's Jesse Bering summarizes the research in a blog post 2 years ago: "women’s bodies can detect 'foreign' semen that differs from their recurrent sexual partner’s signature semen, an evolved system that, Gallup believes, often leads to unsuccessful pregnancies because it signals a disinvested male partner who is not as likely to provide for the offspring."

Of course, this is mere theory, and I don't think there's firm consensus on this. And the authors don't anywhere near claim that the reproductive system can "shut down" all pregnancies via rape. And, furthermore, it's absolutely shameful for politicians to cherry-pick science for their own extreme agendas. But for those (like myself) who were wondering at the start of this week what got into Rep. Akin's mind, it's clear now that he pays much better attention to science-of-sex stories than most of the punditry. 
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Never mind this comment, look at the commenter. Facebook says that they don't want pseudonymous commenters because they want a community where accountability is the norm. Fine. But it's acceptable to form a community (group?) and then post a comment on a discussion thread? did I miss something here? paging #nymwars ....
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Jon Garfunkel

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glad to see @Facebook has their ads properly matching in advance of their upcoming IPO. How did they know I was in the market for a $7.9M co-op??
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