With a long-awaited sequel due out at the end of next month, Abby and I decided it was time to revisit that near-cultish classic, The Boondock Saints. We sang the praises of it back in 1999 (or whenever we actually heard about it) and recommended it's brashness and brogue to all of our compatriots.
Wednesday, September 30, 2009
Re-Visiting The Saints
Tuesday, September 29, 2009
Re-Visiting The Sisters
One of those movies I inadvertently saw a lot as a kid was Sister Act, a light-hearted family comedy in which Whoopi Goldberg witnesses a murder and hides from the mob in a convent, where she teaches the nuns to sing classic R&B and, in the process, discovers herself. Or some such. Turns out it was a staple of Abby's late-childhood as well, so she purchased a copy of it and we re-watched it. Such exercises are always... interesting. Even movies that I really enjoyed in my early twenties have soured as I approach thirty (e.g., Boondock Saints, but that's a rant for another post). Sister Act came out when I was eleven. How does it hold up now?
Monday, September 28, 2009
Wii Don't Get It
Where are the Wii 3rd Party titles that don't suck? There's a ton of shovelware and lots of movie tie-ins and gimmicky titles, and you just sort of expect those to suck, but consider the list of good Wii titles:
- Super Mario Galaxy
- The Legend of Zelda: Twilight Princess
- Metroid Prime 3: Corruption
- Super Smash Bros Brawl
- MarioKart Wii
What do they have in common? They're all made by Nintendo. But what about the hotly-anticipated 3rd party titles? Well, consider this list of would-be must-haves:
- Mad World
- The Conduit
- TMNT: Smash-Up
- Marvel: Ultimate Alliance (the original and the recent sequel)
- Red Steel
- Star Wars: The Force Unleashed
- No More Heroes
Almost all of them were disappointments. Most of them aren't bad (except Red Steel, Red Steel was awful, and Marvel: Ultimate Alliance 2 is pretty damned shoddy from what I've heard), but none of them are great, with the possible exception of No More Heroes, which was quite good, but also quite flawed. There are a few under-the-radar titles 3rd-party titles that are supposed to be pretty good, like Okami and Trauma Center: Second Opinion, both of which I've played, but neither of which I've bothered to finish. There are some outliers, like World of Goo, which is a PC game that got a Wii port. I haven't played da Blob or Boom Blox, so I can't really speak to them, but in general, if it's on the Wii and really enjoyable, it's almost certainly been made by Nintendo. Even the exclusives have felt under-developed.
I've just accepted that the forthcoming Red Steel 2 and No More Heroes 2 are going to suck.
On the plus side, knowing all this in advance has saved and will continue to save me money.
Just ranting,
]{p
Sunday, September 27, 2009
Play That Funky Music, White Space
Stay out of my personal (white) space.
I got a message from a friend via Facebook, asking for grammar advice. She was torn between "that" or "who" and had left a blank space in the sentence, which rendered as such in the e-mail transcription but not when I read the message on Facebook to reply to it. Which leads me to question: why are we still swallowing white space?
I program, and white space is about the only thing in the world that keeps code readable sometimes. It doesn't interfere--it's there purely to keep things visually organized. But most browsers just ignore it. If you're doing HTML (which is how most websites are ultimately displayed), then you have to use special tags for paragraph breaks, because the rendering engine ignores carriage returns.
Or does it? I don't know the mechanics, and it could possibly vary by browser--I simply don't know enough about how HTML works under-the-hood. But as an experiment I've indented one paragraph. My preview screen doesn't indicate which it was. How does it look on the page? Can you tell which one it was?
The point of all this is that eliminating white space used to make sense, but in a Web 2.0 world, I think it would be useful to get back indentations and such. Just food for thought.
]{p
Saturday, September 26, 2009
Where Are The Ugly Chick Sites?
So, do you like your pictures of semi-clad or ostentatiously attractive women with a little side dollop of weird? You're in luck, thanks to The Internetz!
The Tubez are teeming with hotts in bizarre circumstances, all graciously grouped by bizarreness.
There's the perennial favorite Hot Chicks with Douchebags. But it doesn't stop there. You can also check out Hot Chicks with Hot Dogs In Their Mouths. Not enough? We can also take a peek at Hot Chicks With Dogs With Boners or, if you like the idea of dogs and filth, but are not so interested in vaguely unsettling animal eroticism, you can check out Hot Chicks Picking Up Dog Shit.
Whew.
If you prefer a more generalized "weird", you can take a look at The Hawtness, and last but certainly not least, my personal favorite, Hot Chicks With Stormtroopers.
Hot chicks. Weird stuff. It's like everything a nerd could want in a single URL. Thank you Internetz.
]{p
Friday, September 25, 2009
Busy, Busy, Busy
Man, but we've got a busy weekend. Tonight, going with a group to see a midnight showing of Serenity. Saturday we're going to Columbia for my mother-in-law's birthday. Then Monday is a Ben Folds concert.
I was going to consider going to a St. Vincent concert on the following Thursday, but we're going to be in Houston all of that weekend and then we have a They Might Be Giants show.
So, I might miss a post or two. 'Sall I'm sayin'.
]{p
Thursday, September 24, 2009
Signal Broken, Watch For Finger
I know I give St. Louis drivers a bunch of shit for driving without their turn signals, but I saw someone today use theirs today, and I couldn't help thinking that perhaps I should tone down the rhetoric a bit.
I mean this guy was zealous--kept his turn signal on through three or four intersections.
]{p
Wednesday, September 23, 2009
Movie Cliches
Things that don't happen in real life that do happen on television and in movies:
- Digital clocks click when they change.
- Anyone shaving will cut himself.
- All microphones feedback when spoken into.
- All couples have sex in their underwear (and don't even get me started of L-shaped sheets).
- Dogs know who the bad guy is.
- Anyone watching a video of any kind will rewind it and watch some shortened part again. Often several times.
- It is possible to go into a bar and order "beer".
- Lightning is always accompanied by thunder.
- It is possible to drive across New York or LA in less than five hours.
Don't let these happen to you.
]{p
Tuesday, September 22, 2009
And Open Letter (Ahem) To My Letter Carrier
Dear Mr(s) Post(wo)man:
Monday, September 21, 2009
Jon And Paul And Also Storm
Saturday night Abby and I went downtown to see Jonathan Coulton play at Off Broadway. He is the indie-DIY-er of the geek-rock scene with a catalog of pop/folk songs about math, zombies, vampires, and mad scientists. Etc.
The opening act was a duo called Paul and Storm who were extremely fun, performing a set that ranged from meta (Opening Band) to crude (Captain's Wife's Lament, in which the captain's wife complains about finding seamen all over the house) to absurd (Nun Fight, in which an announcer introduces two boxing nuns in the style of Benedictine chant). Other highlights included Frogger! The Frogger Musical and If James Taylor Were On Fire.
I felt ruthlessly entertained.
Then came JoCo. I had no idea what an excellent guitarist he is--the complexity of chord structures and arrangements doesn't come through when you simply listen to his recordings. He played the requisite favorites (Code Monkey, Re: Your Brains, Skullcrusher Mountain) and some requests (Presidents, The Mandlebrot Set, Dance Soterios Johnson Dance) and brought Paul and Storm up for a few songs, including a rendition of Soft Rocked By Me that devolved into an impromptu medley of sappy love songs, which then devolved into the audience singing the chorus of Hey Jude while Paul (of Paul and Storm) sang C is for Cookie over it.
And since Saturday was also International Talk Like a Pirate Day, there were no shortage of pirate jokes to be had. And because keeping things timely is good, one song was interrupted by Kanye West (the song in question, Mr. Fancy Pants, was played on what Coulton described as a $1300 purse). All in all, I think the most compelling thing about the show was the the performers were clearly having a great time up on stage. There was a lot of back-and-forth and interaction with the audience (Paul and Storm gave out prizes periodically and explained the ridiculous inside-jokes on their T-shirts). But my favorite joke might have been when Jonathan Coulton announced is "last song" in air quotes, only to leave the stage to thunderous applause afterward and then run back on 10 seconds later talking about what a shocking and surprising turn of events it was to be called back up for an encore.
He sold out the venue and the crowd was really responsive to him, so it's reasonable to think that he'll be back through again some time, probably playing someplace larger, and if you get a chance, it's a show I highly recommend--not just because it was a great show, but because of what it means for independent, and I mean truly independent, music. Neither Paul and Storm nor JoCo are on labels. They don't have professional recording studios or radio play. They are do-it-yourself-ers, and they are part of a growing trend towards middle-class-musicianship. And it's nice to think that part of the aftermath of Napster and P2P is that it's becoming easier to make a living as a musician without having to satisfy all of the superstar formula.
Also, I tried a Colt 45, and it did work every time. So that's good to know.
]{p
Sunday, September 20, 2009
Away, Do You Fly?
Was listening to Lenny Kravitz's Fly Away for the first time in forever, and I realize, it kind of sucks. It's not awful, and it passes the gut-test: it's enjoyable to listen to more than once. But when you start looking at the nuts and bolts of the tune, there's not much there.
The song has exactly one chord progression: A, C, G, D, all major chords. Pretty standard alternative rock fare, the typical box-pattern riff that made riff-rock so laughable as the 90's drew to a close. During the verses, it's driven by bass, but it's the same chords. And while the choruses are guitar-driven. And what's with that intro? The guitar riff starts out in one channel, which is fine, and then there's a cymbal crash and the rest of the band comes in. 2 measures later, the guitar comes in on the right channel. What?
The lyrics are... "trite" is a polite word for it. Let's take a look at the first verse, shall we?
I wish that I could fly, into the sky, so very high
Just like a dragonfly.
I'd fly above the trees, over the seas in all degrees
To anywhere I please
Ignoring the fact that dragonflies aren't known for attaining mad altitude, what is this supposed to mean, exactly? I get a little bit about "freedom" from the end there, but more than that I get the feeling that Kravitz phoned this one in. If "degrees" isn't a cheap rhyme, I don't know what is. Let's see how the second chorus measures up.
Let's go and see the stars, the Milky Way, or even Mars
Where it can just be ours
Let's fade into the sun, let your spirit fly, where we are one
Just for a little fun
So, I'd say we're firmly out of dragonfly territory. Why "Mars" is a bigger draw than "The Milky Way" eludes me, but whatever. Now we're starting to see a little bit of narrative. This isn't about getting away, it's about getting away with someone else. The second half of the verse gets a little abstract, but that's fine, although the line "just for a little fun" seems to undermine the spiritual context that came out just a few syllables earlier.
So now we've figured out what the song is about. Sneaking off to go get laid. In the spirit of I Think We're Alone Now, which is fine for pop music. But how does this register in the chorus? The chorus just repeats "I want to get away, I want to fly away, yeah, yeah, yeah" over and over. Or does it?
There's something else there, something that I'd never noticed until a few days ago. Under the cacophony of "yeah, yeah, yeah", there's a smaller "with you" also being sung. So it sort of makes sense, and there's a hell of a hook at the root of this song, it's just kind of a sloppy execution of concept.
In short, Mr. Kravitz has committed a "Jack White" crime of songwriting--he's taken an awesome idea and not bothered to develop it enough. Which is why Fly Away was a hit. Hell, it was 1998--we rockers needed something to pull us out of the sea of boy bands. But ten years on, it's proven to be a pretty forgettable tune.
Which goes for most of Lenny's catalog, in my opinion.
]{p
Saturday, September 19, 2009
Catch a Wave
So I finally got around to watching Google's hour-and-a-half developer's preview of their new product Wave, which is due out this year. And I'm excited. First off, this thing is incredibly geeky--the name "Wave" came from Firefly (and this is no mere creative interpretation on my part--the crash notice is "Curse your sudden but inevitable betrayal"). But I also admire the chutzpah of this project.
The team that brought you Google Maps thinks they can do e-mail better than e-mail does it.
And they may be right, when you think about it. E-mail is forty years old--that's older than the internet. There are some limitations built into the model--you create a document and send it to someone, which is all well and fine in principle. But people have conversations more than they have correspondence, and e-mail soon begins to emulate that, which it isn't really meant to do. In a typical instance, it means that generally one person alone has the most recent part of that conversation. When you get into having multi-threaded conversations over e-mail (and anyone who has office e-mail knows that this happens all the damned time), that's when the model starts to noticeably break-down. People are replying to different threads, people joining the conversation miss out on the beginning, conversations fork.
Wave treats a Wave as a conversation. Rather than create a message to send to people, with Wave, you create a message/document/photo-album and invite others to participate in it. Anyone can see new information, replay the entire conversation, reply to isolated bits of it, fork and rejoin without disrupting the whole thing. It's a wholly different approach.
Coming back down to Earth for a second, nobody honestly thinks Wave is going to replace e-mail--e-mail is absolutely perfect for sending a message to another person quickly and cheaply without needing them to see it and respond in real time. But there are a few things that we use e-mail to do that Wave will be able to do better, particularly things that involve coordinating the efforts of a group of people that is larger than, say, two. This can be anything as complex as document editing to things as simple as a planning where to go for lunch. I anticipate us keeping it open at work at all times (a "standing Wave", if you will).
And the feature I find the most intriguing is the context-smart spellchecker. During the demo, someone typed the phrase "Icland is an icland" and the checker auto-corrected it to "Iceland is an island". I was impressed, and I'm excited. I hope it takes off. I worry that it might actually be overly ambitious--it does try to be several technologies at once, and things like that can collapse under their own weight. But the folks over at Google are pretty clever--if anyone can make this work, they can.
We'll find out this year.
]{p
Friday, September 18, 2009
Dawn of the Retread
I rented Dawn of the Dead, the 2007 remake. During the movie it occurred to me that I had little ground to compare it, because I've never seen a plain-old ordinary zombie apocalypse film before. I've seen a few send-ups: Shawn of the Dead, and Dance of the Dead, and I've seen some of the genre peripherals, such 28 Days Later and some of the (gawd-awful) Resident Evil films. But I've never seen any of the George A. Romero "classics" like Night of the Living Dead.
Thursday, September 17, 2009
WTF, Sansa?
So my wife bought a Sansa player. It's not that she's anti-iPod, she used to use a Shuffle, but the price was right and she's not Apple-loyal. We put some music on it for her, but she wanted me to rip a few more albums, which I did. When we plugged it in to the ol' iMac to add those... nothing happened.
Wednesday, September 16, 2009
WTF, Apple?
I upgraded my iTunes to version 9 and sync'd up my iPod and, what do you know, it can't sync because it needs more space for firmware. The orange "other stuff" bar measures a full 400MB. 400 megs? Really? For non-music? It's bad enough that two and a half gigs are taken up by marketing.
I'll explain.
There is some distinction to be made about whether a Gigabyte is 1024 to the third (technically a gibibyte) or 1000 to the third. What it comes down to is that the back of the iPod says 30 GB, but when I plug it in, I'm told I only have 27.6GB, of which a full 400M is now busy taken up by "other stuff".
Clearly the discrepancy doesn't bother Apple too much.
A little further research (care of my wife) has indicated to me that iTunes is now automatically including album artwork when it does a sync, and that's what is taking up that extra hundred megs or so. I had this feature turned off before, but now I can't find it.
I don't mean to rag on them--I'm an Apple fanboy if ever there was one, but I'm quick to acknowledge their flaws, and my biggest pet peeve is that they assume they know better than I do how I want to use my computer. They have marvelous user interfaces, but they are horribly inflexible. So yes, I'm a little bit bitter about it and yes, I intend to stay mildly bitter until I learn how to turn that particular feature back off.
]{p
Tuesday, September 15, 2009
Oh, Bugger!
The moral of the story is: don't watch videos on Facebook.
So I was eating lunch at my desk and I see a post from a Facebook friend saying that they have a new video up. I decide to give it a look and it tells me I need to update my Flash Player. Oh yeah, there was a thing recently about updating Adobe Flash Player, had I done it on this machine yet? I click the link and run the executable.
Nothing happens.
About that time I notice the url in Facebook page hosting the video and guess what: it gives an IP address. It does not say Facebook.
Well shit.
About that time a window pops up from Windows Defender informing me that a bit of malware is trying to run on my machine and asking me if I want to remove it. I say that I do. Whew, that was close, but thank god for windows defender.
I resume my normal surfing and see a new installment of Penny-Arcade has posted, so I click the link and I get sent to a page that has nothing to do with Penny-Arcade.
Shit, shit, shit. I know what's happened before the pop-ups start hitting. I instinctively type in a search for MBAM, the anti-malware software that was recommended to me by our IT person (who was conveniently not in the office today). If came back with an unloadable page. I open the downloads page of my browser, but it's empty. I was infected.
I then remembered that I had previously installed MBAM and started running it. Eight minutes later, it had found 14 malicious files. I left a message for my Facebook friend that she was, like me, mostly infected with Koobface and that she needed to scan her machine and notify Facebook. All in all, it took three scans and about three hours for me to finally get every last trace of it off. So much for Windows Defender.
And I know better than to run strange executables. But I let my guard down for a second and it cost me an afternoon. The worst part was that I had everything open when the infection struck. I had Gtalk running, my DropBox was active, my e-mail and Twitter and Facebook clients were open. Koobface is geared towards social network sites, so I had to change those passwords. If anything in my DropBox got infected it could infect other computers I use. And if anyone ever got my e-mail password, they could get into everything: my online banking, my auto insurance, everything.
So I had to come up with new passwords for everything, which means my clients are all going to need to be reconfigured, and I'm a programmer: passwords have upper and lower-case letters, numbers, and if I'm feeling really ambitious at least one non-alpha-numeric character the latter of which, incidentally, aren't supported by Bank of America's website. And God, did BOA piss me off, nothing like a minor security crisis to make you remember how cruddy your bank's web interface is.
All I wanted to do was change my password. But I couldn't find it. Account settings only applied to Bank Accounts. I could change my address or order checks, but I couldn't change my password. In one FAQ menu I found a Live Help Chat, so I opened that up giving it my full name. Twice. The conversation went something like this:
Pablo: Hello, my name is Pablo, and thank you for using Bank of America's automated support. How can I help you make better use of our products and services?
Me: I need to change my password but I can't seem to find it.
Me: Oh, nevermind, I just found it. Thanks anyway.
Pablo: I understand that you need help changing your password. I'm sorry that you're having difficulty.
Me: Thanks for your time, you might let your tech department know that it's a bit hard to find the password change page on your site.
Pablo: I can walk you through the steps to do that.
Part of the reason it was so hard to find was that BOA's website refers to your "password" as a "passcode". I suppose this is meant to be hip and trendy. In reality, all it does is foil the site-search.
So I got to experience BOA's web-non-savvy once more. And I got to fight with a virus all afternoon. And I got to endure the jeers of being "Malware Man" for a day. And I have a whole new set of passwords to re-memorize. And then I get home and manage to lock myself out of my own Twitter account.
So that's my Monday. How was yours?
Monday, September 14, 2009
Get While The Gettin's Good
Made my way up to the G's in my playlist, and the first big stretch is "Get". Here's what we... um... get... damn, the puns are just too easy with this group. Anyway.
- The Beatles - Get Back (3 versions, Let It Be, Let It Be... Naked, and Love)
- Alice in Chains - Get Born Again
- Fiona Apple - Get Gone
- Fiona Apple - Get Him Back
- Barenaked Ladies - Get In Line
- Billy Joel - Get It Right The First Time
- Cracker - Get Off This
- Red Hot Chili Peppers - Get On Top
- Sublime - Get Ready
- 2 Unlimited - Get Ready For This
- Beck - Get Real Paid
- The Youngbloods - Get Together
- Bob Marley & The Wailers - Get Up Stand Up
- Marilyn Manson - Get Your Gunn
- Ben Folds - Get Your Hands Off My Woman
- Five Iron Frenzy - Get Your Riot Gear
- Audioslave - Getaway Car
- Limp Bizkit - Getcha Groove On
- Weezer - Getchoo
- Prince - Gett Off
- The Beatles - Getting Better
- Nine Inch Nails - Getting Smaller
Sunday, September 13, 2009
Thanks, Comrade
Russia just announced a new national holiday, and it is today, September 13th. Except on Leap Year, when it will be September 12th.
In Russia, the 256th day of every year is to be commemorated as... drumroll...
Programmer's Day.
]{p
Saturday, September 12, 2009
Healthonomics: It's The Economics, Stupid
This is the conclusion of a seven-part series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
I should have opened with this.
Economics is sometimes referred to as "the dismal science", and not without reason (although the reason has an awful lot to do with 19th Century Victorian slang, and... what was I talking about?). It is the hardest of all the social sciences, and by "hardest" I mean "math-iest" not "most difficult" (although some might use the two interchangeably), and I think it might be helpful to outline a few peculiarities to the discipline that give it such a skewed perspective of the world.
Again, I probably should have started the week of with this, but whatever. Live and learn, they say, or don't bother with either.
Economics is the science of decision-making. This is why incentives are so important to the study. An incentive is a push, not a mandate, and incentives are usually coming from opposing sides all at once (I want to spend money on this laptop, I also want to eat tomorrow), but they can produce some really bizarre results when no one's paying attention. In ways, it's a bit like vector addition. Let's say you and I run into each other as hard as we can. If I'm going East and you're going West then we end up keeping each other in check. On the other hand, if I'm going East and you're going North, we end up in Newfoundland. Or maybe I'm going East and you're going West in a Pinto and we both explode...
You think I'm exaggerating. Let's say I sell pizza. I have an incentive to make money selling pizza. You have an incentive to not spend a whole lot of money buying pizza. This keeps the prices reasonable. But I still want to make money, so I cut corners on sanitation. Then you get Ptomaine and die. And I got to prison. All thanks to the magic of incentives.
And speaking of magic... if anyone ever tells you about the "magic of the market", they have never studied economics. They have probably never read a serious book about it. There is nothing magic about it, unless you think of math as being magical, in which case you have no business studying economics. Most economic concepts can be reduced to applied abstract calculus. Supply and demand are always represented as a system of equations where both equations are quantity as a function of price (seriously, when sussing out someone's economics training, ask them about supply and demand--if they talk about fixed quantities, they're unschooled).
But that's just algebra, I promised you calculus. Here goes. Marginal cost is the cost of making one more unit, and it is figured by taking the derivative of the cost function. Marginal revenue is the money brought in for one more unit, or the price. Since revenues are figured by multiplying price by the number of units sold, then marginal revenue is also the derivative of the revenue function. If you want to maximize profits, you start with your equation for profits: revenues minus costs. Then take the derivative (marginal revenue minus marginal cost) and set it equal to zero. The math dictates that profits are maximized when marginal cost is equal to marginal revenue. And this turns out to be true. It makes sense to stop making new units exactly when the cost of making another one exceeds its price. But this also means that fixed costs, like rent, don't figure in when you're setting your profit-maximizing production numbers.
Which brings me to another point. Economics is often quite unintuitive, which should be evidence enough of its supreme physics envy (something a physicist would say: "Forget intuition, look at the math!"). Why is it this way? Honestly? Communism.
Your irony sensors should be going off right about now.
You see, economics was formalized in the 50's. An awful lot of math was infused into it because we wanted to prove scientifically that capitalism was superior to communism. There's nothing inherently wrong with this, I suppose, it's just that there aren't always a lot of readily available quanitifiables. Complex equations are helpful for understanding the mechanics, but actually generating those equations is part art, part science, part voodoo (but not magic), and when you do arrive at those equations, the numbers aren't pretty.
Sure, it's useful to understand that cost curves generally have the shape of third order polynomial, but it's a pain in the ass to actually nail down that equation so you can take a derivative.
Okay, enough seriousness. Next week, more light-hearted fluff. I promise.
]{p
Friday, September 11, 2009
Healthonomics: Potential Solutions
Happy September 11th Day, everybody! Sorry, I meant Patriot Day. I get those mixed up. Regardless, have a party, get drunk, slather yourself in flags. Just don't set off fireworks, that would be tacky.
This is part six of seven in a series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
So, hopefully I've sold you on government managed care (I'm sure I haven't, but it's my blog, I get to make up the rules). How do we do it? Contrary to popular belief, there are lots of different options, all of which are viable. You see, the goal is not to achieve a particular style of reform but rather to fix the existing problems: out of control costs, unreliable coverage, people without coverage altogether. Let's consider our options.
Single-Payer. This is my favorite. It's the most cost-effective, it's easy to implement. You take Medicare and open it up to everyone. Done. You can even make it optional, put the onus on citizens to mail in their own paperwork. Taxes would have to be raised to cover the costs, but you wouldn't have as high of co-pays or have to pay insurance premiums (end result, your costs go down or your paycheck goes up), and if the myriad economists who've crunched the numbers are correct, then you'll end up ahead. If they're wrong, then it's a small price to pay to never have to shudder at the words "pre-existing condition".
Government Option. This is like the single-payer method, only sneakier. The idea is to introduce government-managed care for people to opt into, providing competitive pressure on the existing companies without necessarily threatening to put them out of business. Since participants would have to pay premiums, you wouldn't need to raise taxes to cover the expenses, so the end result to the consumer (that is, you) would be basically the same. And if done correctly, it could be a way to transition to a government single-payer plan without making it look like that was your intent all along.
Forced participation, managed ignorance. Everyone has to have medical insurance, but insurers aren't allowed to cancel policies or discriminate against patients based on medical history. From what I've heard, the Obama plan resembles this, coupled with a limited government option for people who can't afford private insurance. It's not the solution I'd hope for, but it's probably the most feasible politically, and it does eliminate problems, even if it leaves a lot of corporate red tape goo all over everything.
Do nothing or deregulate. I'm kidding. These aren't really options.
]{p
Thursday, September 10, 2009
Healthonomics: The Supposed Benefits of the Market
This is part five of seven in a series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
Today it's time to change gears slightly and talk about the do-nothing choice. Lots of people think regulation is the problem, not the solution. We've mentioned the Wal-Mart Effect already, what are some other arguments for less regulation?
The story: This is socialism and therefore evil. Obama is Hitler.
The reality: Hitler was a fascist, not a socialist, and you're a moron. First of all, check your ideology at the door--real life is a series of case studies. Also, never vote.
Okay, glad to get that out of my system. I'll be serious now.
The story: Government-managed care will be crappy. Other countries have it and they see shoddy results, horrible wait times, etc. Do you want your hospital run like a DMV or the Post Office?
The reality: I'd rather it run like the Post Office than like a Cable Company, which seems to be where we are right now. It's a valid point, but the data just doesn't support it. The horror stories from other countries are exaggerated and even if they weren't, that still doesn't match the horror stories coming from our own. Crappy care is better than none. Anyway, the levels of care provided to run-of-the-mill citizens in countries with socialized health care is far better than that for all but the wealthiest Americans. And every Canadian, Australian, or Brit that I've asked about their health care systems have raved about them. They think we're nuts for resisting.
The story: So what if every other industrialized nation in the world has some level of socialized medicine? It's our heritage, our tradition to support the free markets. We're Americans, dammit, and we don't do things that way.
The reality: Yes we do. America is very pro-business, but it's not very pro-market. In fact, government regulations that support businesses generally do so by corrupting the market in some form or another. TARP, bailouts to the banking industry, Bush-era bailouts of airports--all of these are pro-business and anti-market. Oddly enough, businesses are hurting especially right now because they provide health insurance in the form of employee benefits and they're getting destroyed by ever-raising premiums. So, socializing health care would in fact be a very pro-business move. That said, just because we haven't done things that way in the past doesn't mean we oughtn't start. The "tradition" argument is really just another way of saying that you have nothing rational to back this up with.
The story: We don't know for certain that an unregulated market for health care would fail because we have a great deal of government intervention already. Maybe if we removed the regulation that is in place, the market will actually correct things.
The reality: Well, I've spent four days arguing against that, but when theory fails, check the data. America provides worse coverage for more money than countries with a higher level of government-provided (or supported) care. If you extrapolate backwards, the data would suggest that absent regulation there would be even worse, even more expensive care in America. But even if you were right (note--you aren't), some things are more important than efficiency. If it cost us ridiculous amounts of money, but we ensured that every American had access to health care, wouldn't that be worth it?
The story: Call it the All-You-Can-Eat-Buffet Effect. When health care becomes more affordable and available, won't more and more people will get treatment for less and less significant things. This means that any estimation of the costs are going to under-represent the actual costs.
The reality: This is a very real concern and one that needs to be addressed. I would hope that whomever does the number crunching would take this into account. That said, the effect isn't going to be all that drastic. Most of the people who forgo insurance these days are young people who are in generally better health than the average American and are pretty cheap to provide for. The most expensive are the poor and the elderly and, surprise, they're already covered by government programs. Medicare and Medicaid are expensive, yes, but they're extremely expensive and they cost far less than the ridiculous amount we spend blowing up sand dunes.
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Wednesday, September 9, 2009
Healthonomics: The Incentives Problem
This is part four of seven in a series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
Economic models are based on certain assumptions, and all this week we're talking about how the Health Care industry, by it's very nature, violates those assumptions. The things that compel us to action, economists call "incentives". Today, the assumption is that participants in a market are guided towards efficiency by market incentives. The producer has an incentive to outsell the competition. The consumer has an incentive to get the most for his/her money.
So what kind of incentives are at play in the market for Health Care? Let's look at providers, insurers, and patients separately.
People pay for care, and doctors, or at least hospitals, are generally paid by the procedure. This means that there is an incentive for hospitals/doctors to over-test. Now it's not quite so cut-and-dry as that. Obviously the potential disaster of under-testing needs to be considered as well--doctor's have an incentive to cover their asses. Regardless of what happens, the incentive is in place for the doctor to check as much out as possible, just to be sure.
A similar, and perhaps more daunting, side of the incentive scheme is that treatment is far more profitable than prevention. And this is not to say that doctor's consciously neglect their patients for a future payoff, but the incentive is certainly in place for health care providers to focus more on making sick people well than on making well people healthier.
As for the insurers, they find themselves in the unique position of losing money when they do their jobs. They have an incentive to not pay anything, and this manifests a couple different ways. First, there's the huge traffic in recisions that I talked about yesterday. Second, there's the bargaining factor. Insurance companies pay substantially less to the hospital than an individual patient would. I've seen instances where, literally, a quarter-of-a-million dollar hospital bill to the patient translated to several thousands of dollars to the insurance companies once the paperwork got settled. Mind you, that's not thousands of dollars paid to insurance, that's thousands paid by insurance. That's a 99% reduction, give or take. The patient's (or rather her family's) co-pay was about $150.
Since medical costs are slashed for the insurance companies, it stands to reason that they would be inflated for the uninsured.
Lastly, insurance companies can at least delay payment (and also treatment) through red tape and obfuscation. Think that's not important? Then you don't know what the interest would be on $10,000 sitting in the bank for a few months rather than being paid to the hospital if they can put it off that long, or worse, if the patient gets so sick of paperwork that they forgo treatment altogether.
So between the doctors and the insurers, no one has an incentive to make the patient healthier. The doctors don't get paid as much for that, and the insurers lose money. It seems the only person looking out for the patient's interest is, in fact, the patient.
Trouble is, the patient is about the least qualified person in the world to be dealing in this market. Not only are patients chronically under-informed, but the proximity of the patient to their own health problems makes them act slowly, and the costs of inaction can far exceed the costs of action. What we have here is a variant of the classic monopolistic monopsonistic bargaining problem. Monopolistic means that there is exactly one seller. Monopsonistic means that there is exactly one buyer. And in the case of a medical emergency (or perceived emergency), the market for your treatment for your problem is you, and it can only be provided by the emergency room that is nearest. Sure, doctors have other patients, and sure you could drive an extra twenty miles to the hospital (assuming you can drive), but essentially the monopoly/monopsony relationship holds.
Another example would be a hostage negotiation. And the hallmark of hostage negotiations is that they end up in a standoff that takes forever, despite the fact that a standoff doesn't do anyone any good. All parties are better served by negotiating quickly and resolutely and getting on with their lives, but because of the monopoly/monopsony relationship, negotiations are tedious, taking hours if not days. No wonder there's a growing industry in pirate-captive arbitration. So how does this play out for patients?
Let's say you start having chest pains. It could be acid reflux, but it could be a heart-attack. If you go the hospital, you're going to get billed. But if you don't go to the hospital, you might die. So the bargaining begins--do you, don't you? You put it off for minutes, maybe hours, maybe until your spouse gets home. That time could make the difference between life and death, but you bargain because you're dealing with what is essentially a monopoly on your health.
So let's say you decide to go the hospital. The hospital admits you and monitors you, but they don't know if you're going to pay. They'll treat you to make sure you don't die; they want to save your life, but they know that a lot of uninsured people get emergency care and then leave without paying. They know that their doctors have an incentive to over-test, so whatever is being prescribed (and might not get paid for) may or may not actually be necessary, and they also know that your insurance might get canceled and then you wouldn't be able to pay anyway. Once they've provided treatment, they can't take it back, so they bide their time, which might or might not be detrimental to your health, because they're bargaining against someone with a monopsony on your treatment.
So the doctors have an incentive to be over-protective, but the hospitals also have an incentive to be overly cautious. Patients have an incentive to be cautious, but mostly because they don't know any better, and insurers have an incentive to back away slowly, twiddling their thumbs, hoping no one notices. Again, I don't want to cast aspersions or make any assumptions about the way hospitals and doctors actually operate, but the market is creating these incentives for them, and incentives are not the same as action. But incentives are important, and these are all pointing away from efficiency. So the model breaks and the market fails.
Just as a final word, it is extremely common for the government to intercede when incentives add up to the wrong conclusion. It's quite common for a market to produce incentives towards undesirable ends. In the market for wages, for example, buyers (employers) have an incentive to pay their workers the lowest wage possible, but that wage might be less than a person needs to survive, and indeed, when there was a surplus of labor around the turn of the 20th century, many people starved despite working sixty and seventy hour weeks. Therefore, we have a minimum wage. The precedent is there to adjust broken models.
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Tuesday, September 8, 2009
Healthonomics: A Problem of Shopping Around
This is part three of seven in a series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
This week we're talking about underlying assumptions of the models used in market economics and how they break when applied to the Health Care industry. Today's assumption is this: it is easy for participants in a market to react to market forces.
Let's say you buy a Ford. It breaks. So you get it fixed or trade it in. Let's say you buy an iPod and hate it. You switch to Sansa. Let's say you decide you can no longer stand Burger King, so you switch to McDonald's. In all of these cases, the market is responsive, and what participants are responding to are qualitative elements. What is effectively happening is that the act of consuming increases your knowledge about the goods you consume and affects your decisions about what to consume.
As a consumer, you see this every day, but the real "magic" of this market phenomenon is the way it affects producers. As a producer, you see the en masse effect of your decisions. You switch your french fry recipe and watch your sales dip. Since consumers respond to everything from price to flavor to trends to quality to corporate image, producers will try and manipulate all of these things in order to grab a larger share of the market. This is the "corrective power" of the market, and it is dependent upon the abilities of consumers to shop around. One flavor of this is called the "Wal-Mart Effect". In short, even if you don't do price comparisons, other people do. Wal-Mart responds by lowering their prices, and you still reap the benefits.
But what we see in medicine is a breakdown into two distinct groups: general practitioners and everyone else. GP's are subject to this economic law. People shop around, get referrals, read online reviews, and do everything in their power to find the right family doctor. But when you're in the ambulance on your way to hospital after a heart attack, you can't do this. You can't look up online referrals if you can't breathe. There are no price tags attached to emergency room procedures. It should come as no surprise, then, that specialists make substantially more in wages and perks than GP's. In sure, GP's get hit with the Wal-Mart effect, but specialists don't, at least not as much.
On the one hand, we don't want price tags everywhere--medicine, unlike most markets--is one case in which consumers are rewarded for acting rashly, for going straight to the hospital rather than making sure it's really serious. But let's jump from providers to insurers, because the problem has manifested most clearly with the recent trend in recisions. Recisions are cases in which the insurance company cancels your coverage without warning or refund due to "fraudulent" claims made on your application.
Insurers claim that less than 1% of claims result in recision, and that doesn't sound like much, until you take a closer look at the numbers. You see, recisions only ever happen in cases where the patient is about to undergo a profoundly expensive treatment--and these cases are rare. In fact, they only happen about 1% of the time. So, if you are diagnosed with an expensive illness, there's about a 50% chance that your coverage will be retroactively canceled. Good luck getting insurance after that, what with your preexisting conditions. The practice of recision basically insulates insurers from the "corrective properties" of the market. It would be one thing if recisions were happening to lung cancer victims who lied about being smokers. But instead, we see breast cancer sufferers losing their coverage (and subsequently their treatments) because they forgot to mention acne medication. It would be one thing if insurance companies were combating fraud by re-adjusting premiums retroactively and demanding the difference, but instead, coverage evaporates, oftentimes effectively murdering the patient.
Shopping around simply isn't possible. You'll likely only have one heart attack in your life and you won't be in the mood to do any research. And apparently, if you don't like the way the insurance treats you when you have that heart attack, you're out of luck, even if they don't drop you. No one else would take you anyway.
The model breaks and the market fails.
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Monday, September 7, 2009
Healthonomics: The Valuation Problem
This is part two of seven in a series on how Health Care breaks typical economic models. You may find it helpful to start at the beginning.
Sunday, September 6, 2009
Healthonomics: The Asymmetric Information Problem
Today starts off another week-long series, this time talking about the economics of Health Care. The point of these posts is not to argue for a particular brand of reform (full disclosure: I, personally am in favor of single-payer system run by the government) but rather to illustrate the many ways in which regular market economics simply don't hold when applied to the business of keeping people healthy.
Saturday, September 5, 2009
Driving In St. Louis, A How-To
Went to Whole Foods for lunch the other day (they have a pretty decent deli counter) and nearly got back over by a woman in a Cadillac Land-Yacht. Is it really that bad? Does the rest of the world truly have zero sense of irony? It's amusing as hell for me, but still...
- Never, under any circumstances, use your goddamned turn signal.
- Stop signs are optional.
- If an emergency vehicle is coming through, you don't have to pull over unless someone in front of you is also pulling over (and this almost never happens). Even then, you can usually get by if you drive extra slow and make a confused face.
- If you aren't three inches away from the fender of the car in front of you, you're driving too slowly.
- If you're a large woman, you may find that blue minivans are "slimming".
- Try not to exceed a reasonable speed when driving on a highway. "Reasonable" can be determined by adding 40 to the posted speed limit and then subtracting your age. The exception is when you are merging, in which case "reasonable" is always 30 miles per hour.
- Kindly disregard the arrows painted in the center lane.
- Do not let others merge. Doubly so if you're in South County or one of the other formerly-monied areas.
- The posted speed limit on most of the highways through town is 60 mph, but don't worry, you won't be going nearly that fast. The signs are there to mock you.
- 270 now has variable speed limit signs that reduce as traffic becomes more congested. This way, they can mock you with greater precision.
- The posted speed limit on avenues is usually around 40, but should be read as "75".
Friday, September 4, 2009
What's With You, Quizno's? You've Changed, Man
Thursday, September 3, 2009
Nostalgia
Was watching Penn & Teller: Bullshit last week and saw their show on nostalgia. It was, in my mind, one of their weaker shows, if only because they walk right up to a very important point without really articulating it.
Wednesday, September 2, 2009
The New Symbols of Satan
Genetics, just as potent. How can you deny evolution with all this evidence of it laying about? Better demonize this symbol as well, and thankfully it's easier--call it a twisted ladder to the underworld. Am I right?
Tuesday, September 1, 2009
There's An App For That, Too
Some friends of ours have iPhones and have been raving about one app in particular: Trapster. Trapster allows you to report speed traps and get texts when speed traps are set up on your route.
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