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Living out on the left coast

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 Saturday, November 22, 2003
Top 10 Personal Computers [Slashdot]
comments < 5:26:10 PM        >

"Adapt to offshoring or die says Amit Maheshwari on C|Net, "The survivors will be those who embrace offshore operations as yet another opportunity to expand their professional skill set and position themselves as offshore management leaders...."

"Expand your professional skill set" is a polite way to say "abandon your programming skills, as those have become commodities." You know, just last year we considered "Software Craftsmanship" as a finalist for a Jolt Award. That book argued that engineering was a failed metaphor for software development and that instead we should look to the guild model, with apprenticeship, journey(person), and master stages. Sigh. The age of the artisanal programmer lasted less than a year.

[Thinking In .NET]" [Edward Mitchell: Common Sense Technology]
comments < 12:18:29 PM        >

This is excellent common sense. The Wall Street Journal recently ran a story regarding doctors who have discontinued working with insurance companies and now provide fee-for-service medical services exclusively. By going to a fee-for-service model, they have eliminated most of their bookkeeping and billing services staff, and reduced physician time spent consulting with insurers. That means they have more time for patient care, often eliminating the need to hire an additional one or two R.N.s. All this leads to tremendous cost reductions in their practice. And they charge significantly less for their fee-for-service at the time of an appointment. Some also carry and sell the most common prescription medications, eliminating many patient trips to pharmacies. The result has been a service that is more convenient for the patient and is priced much lower than "regular" office practices.

In response to their excellent article, they received the following Letter to the Edtior, which qualifies for a Common Sense Award:

Quoted from today's Wall Street Journal "Letters to the Editors" page (link to original letter - paid subscription required).

"Employer Insurance Results in Spiraling Medical Costs

Your Nov. 6 article "Pay-as-You-Go M.D.: The Doctor Is In, but Insurance Is Out" demonstrates the absurdity of our medical system. Few people think of paying for medical care without using their insurance and one of the reasons they do so is the astronomically high cost.

Our system expects everyone to have employer-provided group insurance that covers even small and expected medical bills. Such coverage makes people think someone else is paying, leading to increased demand for services and higher prices. Individual policies are ridiculously expensive because of the inflation caused by employer-provided insurance as well as other factors. When the uninsured need to pay for care out-of-pocket, they face cost-shifting, where hospitals, laboratories and physicians charge them absurdly high prices to cover the overhead incurred by dealing with insurance plans and government programs.

It doesn't need to be this way. If physicians would require patients to pay at the time of service, we would start to remove ourselves from this quagmire. This doesn't mean patients can't necessarily use insurance. Physicians can hand the patients a bill, which patients can submit for reimbursement on their own.

Mark Schiller, M.D.
President
Association of American Physicians and Surgeons
San Francisco"

This is more true than most people realize. On average, the percent of monthly household income spent on health care actually went down for about 30 straight years, until 1999. Most people disbelieve this insisting that health care costs have gone up. But according to the U.S. Census, the percent of monthly income devoted to health expenses did indeed go down during this period. The result has been that from about 1980 to 1999, we doubled our use of health care services - with no measurable improvement in overall health. When visible prices are invisible to the consumer we consume more of the goods or services. This is economics 101 stuff - when prices go down, we are more likely to buy more. The solution to fix this broken price signaling is already underway - its cost shifting health care back to the consumer, especially through much larger deductibles. [Edward Mitchell: Common Sense Technology]


comments < 12:17:40 PM        >

China Regrets Decision by U.S. to Limit Fabric Imports. China expressed its opposition to the U.S. action, but stopped far short of retaliating with its own limits or appeals to the W.T.O. By Keith Bradsher. [New York Times: Business]

Lets get this straight - we enact tariffs on steel, lumber and clothing products to protect those industries, while simultaneously enacting policies to export as many of our tech jobs as possible. Our 19th century-minded political "leaders" protect 19th century jobs while eliminating 21st century jobs in the U.S. Our politicians are working to destroy the future economic strength of the U.S. I just cannot make sense out of their actions. [Edward Mitchell: Common Sense Technology]


comments < 12:16:55 PM        >

AT&T Wireless to layoff its U.S. software staff and "outsource" - to India? That's not specified but its a safe bet that AMERICAN Telegraph & Telephone will move its workforce overseas. (Tnx to N7FSP for the link). [Edward Mitchell: Common Sense Technology]
comments < 12:16:02 PM        >


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