Tapscott: the healthcare reform battle

Don Tapscott explains why healthcare reform is going to be hard, a huge battle, and we shouldn’t be surprised to see the shouting and worse. But we might still see a real change, because citizens can organize like never before. [Link]

There is no possible compromise on health care and the myth of Obama as a “post-partisan” president is exactly that – a myth.   The health care industry generates billions of dollars in profits and many people are seething that these profits might be curtailed.  This issue can never be negotiated in Washington back rooms as there are huge interests vested in the status quo – such as the big insurance companies, health maintenance organizations and pharmaceutical giants.  Like many social changes, for this one there will be winners and losers and an historic battle will determine the outcome.

As Obama noted in his message to supporters, “In politics, there’s a rule that says when you ask people to get involved, always tell them it’ll be easy. Well, let’s be honest here: Passing comprehensive health insurance reform will not be easy. Every President since Harry Truman has talked about it, and the most powerful and experienced lobbyists in Washington stand in the way.”  But this time Obama has what those presidents lacked:  the Internet and a powerful social movement that potentially can shift the relationship of forces in America away from the traditional entrenched interests towards the needs of the population.

Shabbir on Healthcare Reform

My friend Shabbir Safdar has posted an articulate response to some of the myths about healthcare reform here.

…the rising cost of healthcare is driving people to lose their coverage because costs of employer funded healthcare are rising faster than we can keep up. When I co-founded my web agency in 1997, we offered healthcare and paid the entire cost. Today that isn’t possible anymore and employees share part of the cost, and many business don’t even offer coverage, or offer “sham” coverage.

The reality is that the current approach to health insurance has resulted in a loss of coverage for millions of people. From 1998 to 2008, the percentage of large employers who offered health coverage shrank from 66% to 31%, and the trend continues downward today . Rising costs will mean that many employees who are offered coverage won’t be able to afford to accept it.

Bureaucrats

After experiencing politics in action via the crowd at Lloyd Doggett’s town hall meeting on health reform yesterday, and considering the opposition to health care reform, I tweeted “It always surprises me that some sheep would rather be guarded by a wolf than a bureaucrat.” That tweet was ported to Facebook, where there were several responses, some critical of bureaucrats. I posted this comment in response:

Having been part of a bureaucracy in my first career, I know something about this. Bureaucracies exist to manage complex policies and civic processes. What we generally regard as “bureaucratic inefficiency” is a manifestation of legal and regulatory complexity, often more complex than the bureaucrats themselves can grasp, certainly difficult for most citizens to understand. The policies and systems are complex because they emerge from a political process that is responsive to many often conflicting interests. I’m not sure what an alternative to this complexity would be, but I don’t think it would be a Good Thing. What we might hope for is smarter bureaucrats, just as we hope for more and better engineers and scientists.

Here’s video I shot at the town hall meeting. Lloyd Doggett is talking. I just shot his talk. When he was done, he invited people to speak, alternating healthcare reform proponents and opponents.

Happiness Is Mobile Loaves and Fishes

Mark Horvath (aka @hardlynormal), who is an advocate for the diverse and generally invisible homeless population, is in Austin hanging out with our friends at Mobile Loaves and Fishes, just in time for this week’s social-mediated screenings of Andrew Shapter’s film “Happiness Is” on Thursday, preceded by a Tweetup (info blogged here by the MLF crew). A “tweetup” is a meetup coordinated via Twitter, but you don’t have to be a twitizen to go there and have a great time.

Mobile Loves and Fishes is featured in the film, a documentary that asks how we can create more happiness (however defined) in our lives. Here’s a clip…

Barker’s aliens

Schwa instigator Bill Barker has turned up, having responded to Mark Frauenfelder’s “where are you, Bill?” post at bOING bOING. Gareth Branwyn spoke with him – Bill’s doing well, and planning a new project.

What was Schwa? From the Wikipedia article:

Schwa is the underground conceptual artwork of Bill Barker (born 1957). Barker draws deceptively simple black and white stick figures and oblong alien ships. However the artwork is not about the aliens: it is about how people react to the presence of the aliens and Barker uses them as a metaphor for foreign and unknown ideas. Schwa became an underground hit in the 1990s.

I suppose that’s correct from someone’s perspective, and it gives you an idea. How accurate can you be about the “meaning” of art? I have a Schwa sticker on my laptop that says “Every picture tells a lie,” and another on my car (see above) that says “You are what you see!” Are those about “foreign and unknown ideas?” I think they’re remarkable koans, still puzzling after 15 years.

One recurrent Schwa theme was about alien presences and detection. I have a glow-in-the-dark Schwa t-shirt that says “ALIEN DETECTOR: the XenonTM coated figure above [the archetypal alien image, shaped like a guitar pick with almond-shaped eyes and no mouth] will flash red in the presence of any alien.” Schwa scwhag often counseled you to “STAY AWAKE,” aliens are in your midst. I related this to the Buddhist and Gurjieffian notions of being awake, being mindful, and invited Bill to create the cover for FringeWare Review #5, the “Stay Awake” issue, which was generally about consciousness vs that other, ordinary somnambulist state. I always thought Schwa art was meant to shake us awake and aware.

Welcome back, Bill! We could use a good shake about now.

Politics and Climate Change

I like to think climate change is settled – we have scientific consensus, we know it’s happening, we generally understand the human actions that have accelerated climate change since the dawn of the industrial era. Many of us are feeling energy about reducing our carbon footprint and our overall planetary impact and concern that it’s too late for mitigation, time for adaptation. I personally have been involved with projects like Austin350, Worldchanging, and Powersmack, and I’ve blogged about global warming at Change.org. I’ve been thinking and writing about global warming since Bruce Sterling made me aware of it in the late 1990s. I worked with him on the Viridian Design Movement and wrote an article on climate change for the issue of Whole Earth Magazine he edited. In researching the article, “Being Green in 2001,” I learned that scientists were concerned that their commitment to scientific method – to hypotheses rather than certainties – was misinterpreted as uncertainty about the anthropogenic drivers of climate change. Since then broad scientific consensus has developed, especially via the UN’s Intergovernmental Panel on Climate Change, IPCC.

I was surprised, then, to have a conversation recently with an intelligent, articulate local businessman who told me that this scientific consensus doesn’t exist, and while he could acknowledge that the climate is changing, it’s a natural cycle associated with solar activity. He’s sent me various charts and links. He’s just forwarded an email that mentions Ian Plimer and his book Heaven and Earth, Bjorn Lomborg, and Kimberley Strassel’s Wall Street Journal op ed piece, “The Climate Change Climate Change,” which says that “the number of skeptics is swelling everywhere.” Among other things, she mentions a list that Senator Jim Inhofe has assembled of scientists who supposedly deny that human action is associated with global warming, and says that the earth’s temperature “has flatlined since 2001.” (Has it?) If you read the comments on the op-ed piece, you see that the question of human action and climate change has been politicized – challenged by the right as a left-wing scam. This is really unfortunate – the science is lost in a fog of political wrangling.

The Hurt Locker

When “The Hurt Locker” screened at SXSW, I thought it was one of the better films I’d seen in years, and Jeremy Renner established himself as a world-class – not just actior but presence. While Katherine Bigelow has always been a sklled action director, she’s never quite had story and actors equal to her ability. In “The Hurt Locker” she shows the other side of post-traumatic stress. Renner plays a detonation pro who embraces, is almost addicted to, the stresses of modern war experienced through his job, one of the most dangerous in today’s field of battle, defusing bombs planted in and around the streets of the city. Even inside the citizens, as we see in one literally gut-wrenching scene. Put this film at the top of your list – one of the year’s best.

Free as in beer

In the New Yorker, Malcolm Gladwell runs a sanity test on Chris Anderson’s book Free: The Future of a Radical Price.

There are four strands of argument here: a technological claim (digital infrastructure is effectively Free), a psychological claim (consumers love Free), a procedural claim (Free means never having to make a judgment), and a commercial claim (the market created by the technological Free and the psychological Free can make you a lot of money). The only problem is that in the middle of laying out what he sees as the new business model of the digital age Anderson is forced to admit that one of his main case studies, YouTube, “has so far failed to make any money for Google.”

Why is that? Because of the very principles of Free that Anderson so energetically celebrates. When you let people upload and download as many videos as they want, lots of them will take you up on the offer. That’s the magic of Free psychology: an estimated seventy-five billion videos will be served up by YouTube this year. Although the magic of Free technology means that the cost of serving up each video is “close enough to free to round down,” “close enough to free” multiplied by seventy-five billion is still a very large number. A recent report by Credit Suisse estimates that YouTube’s bandwidth costs in 2009 will be three hundred and sixty million dollars. In the case of YouTube, the effects of technological Free and psychological Free work against each other.

Note that Gladwell’s review is available free online, and Anderson’s book costs $17.19 via Amazon.

Open Architecture Products

Andrew Lippman on “open architecture products,” and viewing customers as partners who will contribute to the evolution and design of the products they buy and use.

The stability that we associated with products is gone. And so if you try to base your business on a product that you think will last a long time, then I suspect you’re likely to be in trouble — because society will change more rapidly….The young are not satisfied with products. They’re satisfied with things they can build into their own products. And so the challenge is to build those as open-architecture products. (From MIT Sloan Review)

www.hsmglobal.com

Kevin Kelly on Participatory Medicine

I’m part of the Society for Participatory Medicine, and we’ll soon be publishing the Journal of Participatory Medicine. (We already have a very active blog at e-patients.net.) Kevin Kelly posted a nice summary of our intentions at The Quantified Self:

The newest channel in this effort is the launch of a peer-reviewed science journal dedicated to research in the field of “participatory medicine” — as in patient participant. (Sometimes labeled Health 2.0) There is a great overlap with self-tracking and the quantified self (although by no means is all self-tracking health related), so I think this new journal will appeal to self-trackers and self-trackers to the patient-participant field.

This journal, called sensibly enough, the Journal of Participatory Medicine, will use an open source model (no fee to get the articles) which is both very much in the spirit of the paradigm, but also very future-proof (free is where all journals are headed).

Crowdsourcery in Austin

The Austin Web Crowd. Photo by John Anderson, Austin Chronicle

Several local web thinkers met recently with the IT staff from the City of Austin to discuss a best approach for redeveloping the city’s web site. The Austin Chronicle has a good article about the project focusing especially on my pal whurley and his efforts to help crowdsource a more innovative approach.

To kick-start the redesign process, Hurley initiated OpenAustin, a website where users can vote ideas for the city website up or down and submit their own. They range from the pedestrian (the currently top-rated suggestion is to pay Austin Energy bills online, followed by a system to list road closures across the city) to transparency-related (being able to track applications for city contracts, putting City Council meetings and video online faster) to the more arcane techy (“machine-readable data feeds” for all city info: crime, restaurant health inspections, etc.; and similarly, publishing every piece of city data as RSS feeds).

Hurley acknowledges OpenAustin is currently in the idea-generation stage. The final form of OpenAustin’s assistance in the redesign is still very nebulous – and of course, entirely dependent on the city’s response. Still, Hurley foresees several ways it could take place. “Maybe we don’t take all the RFPs [requests for proposals] when we do it, and maybe we don’t take everything and outsource it to the community,” he says. But he thinks OpenAustin could “help coordinate the community effort” by conceiving the redesign so volunteers could create mash-ups of applications: for example, overlaying a map of all the city’s bike routes with a map of free Wi-Fi hot spots or early voting locations.

My suggestion to the city was to scale the project to manageable chunks. Have an initial RFP for a framework so that technology and presentation are relatively coherent, but build the framework with the flexibility to allow City departments to RFP and manage their own subprojects.

Everyone in the conversation seems to agree that the city should make its data as accessible as possible, so that in addition to the city’s own site, innovative external applications could be developed that find useful ways to aggregate and analyze… this is what the Obama administration’s shooting for at the Federal level.

One other note: got this from Matt Esquibel at the City of Austin:

We also wanted to invite you to a public forum on Wednesday June 17, 2009 at the Carver Museum from 6:00 – 7:30 p.m. to discuss the AustinGO project moving forward. We hope to provide insight into the direction of the project and listen to the the thoughts and ideas of the community in attendance. We plan to have more public forums in the coming months and will provide more information as dates, times and formats are determined.

Remembering Bazooka

Bazooka with his PairODice BBS hardware.
Bazooka with his PairODice BBS hardware.

My good friend and cyberarts ally Bob Anderson, aka Bazooka, died May 31. I just learned of his death today via the Austin Chronicle. Found another obit in the Austin American-Statesman.

I interviewed Bazooka for an article on Howard Rheingold’s Electric Minds site in 1997. Here’s the interview:

JL: Why art?

BA: I figured out I didn’t want to do anything else, I guess. I couldn’t figure out why anybody would want to do anything else besides art.

JL: what was your first experience of artistic creation, that turned you on?

BA: making a drawing and having it turn into something I didn’t know it was gonna be. Rather than me making something and have it turn out exactly the way I wanted it to be. Isn’t that the opposite of what science is?

JL: sorta. In science you have a preconception of what you’re after, in your…

BA: building on the past

JL: theoretical stuff, but also… (cf writing)

BA: Marcel Duchamps: art coefficient, coefficient between what you’re doing and what’s really happening. (Also “I have forced myself to contradict myself in order to avoid conforming to my own taste.”) The difference is what makes it art. I did do a lot of fingerpainting. I remember painting in preschool, and I can’t remember doing much else in preschool. Surely I must have done other things? We had a xylophone made out of different kinds of water, and alphabet, and drawing.
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