xander's endeavours

Autonomy. Mastery. Purpose.

Day 10,396

Every day on Facebook comes with a smattering of birthdays posts flying left and right, and the occasional revelation from one of my friends that they’re  “getting old”. Interestingly, this doesn’t seem to have become more frequent over the years. For most, it seems that every year feels old when it starts, only to seem young when it’s past. Given this, years ago, I found it silly to be on the “feeling old” side of that equation (especially in your 20s!) and decided take a lifelong outlook to age, and have frequently wrote in terms of “Day or Year X of my life” as a subtle reminder that it’s a unique moment in time, with unique opportunities. Weird? Maybe, but to me, calling today Day 10,396 helps me treat it more significantly, than if it were just another Thursday.

Checking in today, as of November 8th, 2013, I’ve lived a good 28.46 years upon this great Earth. A simple life expectancy calculator estimates a reasonably long 92 years of life, telling me that as of today, I’ve lived 31% of my life in raw time.

life-timeline

For me, the time ahead seems simultaneously long and short. It’s nearly a century of time, long enough for you to speak of the currents events of today as history. Still, rather than being an abstract big number, a century almost seems managable. Looking at that, I can say that I feel about right for my age, and am excited for the years to come. The median age of the world population is 29.4 years old, and the median age in the US is 37.2 years old, so I can’t really complain there either.

As a whole, I’d say it’s been good so far, and that the remaining 63.54 years may just be enough to do everything that I need to do. If not, I may just need to buy myself some more time… ;)

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Pivot!

Hello world! Clearly my blog hasn’t kept up with my life, so with major change in mind, here’s an update!

Infinite-SugarGoodbye to an infinite supply of sugary drinks – you’d think MS Dining Services would consider healthier options, but this cabinet has barely changed in the 5 years I’ve been here.

What am I doing?

I am taking a productive sabbatical over the next six seasons to identify, understand, and selectively develop essential traits, skills, abilities. This will encompass the period from Septmember 10th, 2013 to May 23rd, 2015 (621 days – or 14,880 hours). These dates should be easy to remember, but I need to be mindful that I need to make these hours and days count over the long term (window including this time, and subsequent 5 years).

There is much I hope to accomplish in this time. These are in no particular order and more will likely be added until the start of the above period:

1st GOAL: SELF (RE)DEFINITION
Who I am, why I am here, what my life’s service can be to better the human condition. These won’t necessarily all be grand visions of the future. Some of these projects may be more fun-oriented (A happy civilization is a productive civilization!). More importantly, what the next five years of my life following this period (2015-2020) is best fit to be devoted to in relation to the previous. This is an open-ended goal, with the focus oriented on gaining a more perfect understanding of self.

A renewed focus on personal health and fitness is also a priority. My love for sugary drinks so far hasn’t killed me, but I would say that it’s higher on the list of unhealthy habits that I should probably replace. Among others include a way-too-unhealthy love for fast food, which should be replaced by a still-underdeveloped love for cooking. Leaving Microsoft then (with its infinite supply of carbonated beverages and easy fast-food) will serve well. But I think I want to explore further.

2nd GOAL: GLOBAL FOCUS
Identifying and understand my role in helping the challenges that humanity must solve to progress and endure past its thus-far brief existence. This is a multi-part goal, and is meant to be more of a brainstorm to identify and prioritize resources to each goal. During this period, I will focus on emerging problem spaces to prepare and plan for Phase 2 and 3 of my life.

3rd GOAL: COMPLETE FINANCIAL INDEPENDENCE
Develop an independent secondary income stream that can cover basic needs. For the purpose of this period, this will be defined as $2,000 USD per month, (cost averaged) over previous 6 months. Success in this goal will allow for continued productive sabbaticals in the future. Expenses should be minimized and focused on long term needs (looking over a period of 5 years). This will allow currently allocated capital to function over this time, and allow larger project spending as needed.

5th GOAL: Relationships
Developing purposeful, lasting, relationships in family, friendship, and community (yes, in that order). There may even be a purpose for a relationship with no purpose; as a control group, of course :).

Current Strategy: Explore, Develop, Direct (EDD)

That’s it for now. To life! Onwards!

Antithesis of Capitalism: Healthcare in America

A recent post I read in the Wall Street Journal exposed what I consider near-criminal margins that are enjoyed by our healthcare system. TL:DR–a man with very limited health insurance came in for a necessary procedure, and was quoted the treatment at $23,000, insisting on $20,000 up front. When the man nearly backed out of the procedure due to cost, the hospital re-classified him as a self-pay patient, and re-quoted the procedure at just over $3,000. In other words, the procedure cost $17,000 less by not using insurance.

It’s worth noting that the $23,000 figure, nearly 7-times greater than the cost the hospital was willing to charge, is determined not by the cost of the procedure and free-market principles, but by backroom negotiations between insurers and healthcare providers. Most people never see these numbers, conveniently shielded from such information by their insurance plan and seemingly well-intended doctors who (perhaps honestly) have no idea of the actual cost of their recommendations. Ultimately, had the man had insurance, and/or had the money to pay, $23,000 would be the cost he or his policy would pay out.

I always knew that there was an obvious gap between the prices set by insurer-hospitals and the actual cost of care, but I had no idea that it was that substantial. That kind of markup for such a simple (yet life critical) procedure is just wrong. I’m refrain from saying that it should be illegal, but given how much of the economy healthcare represents (though, now it’s just looking hyper-inflated), we need better regulatory oversight and policies against this type of anti-market environment, in any industry.

I thought him calling out that we’re not really using health “insurance” anymore, rather, we have “health plans” is particularly interesting. The current system of hospitals-insurance company confidentially and arbitrarily setting prices is obviously disruptive to engaging market forces here.

Clearly, we need some changes to this system. The current issues surrounding patient cost and insurer reimbursement raised two concerns:

Patients are kept in the dark about the actual cost of their healthcare care.
The medical profession seems to have developed the idea that if a patient knows the costs of procedures, that such knowledge will interfere with decision making, and have become reluctant to openly discuss costs with patients.

EFFECT: Disruption of market economics in the cost of healthcare, leading to a increasing inefficiency. This much is obvious. And rising costs disproportionately fucks over those with less means.

ISSUE #2. We need better oversight into the actual cost of care vs. the billed cost, including making it more clear to the patient.
In Singer’s case, it’s obvious why a number like this $20,000/$3,000 would be hidden–because it is absolutely obscene to charge that much of a margin on any product, let alone a “routine procedure” that also happens to be life critical. For every Jeffrey Singer in this article, I imagine there is a horde of less fortunate patients that were affected by this withholding of information. But what about these preferred provider contracts that prohibit sharing of this knowledge?

EFFECT: Increasingly frequent ridiculous margins to which are out of proportion with anything that an efficient market would consider a valid price given the demand and the base cost of goods. The ensuing pain is broad: The tax paying public at large, and the nation a a whole is paying for.

These are such systemic issues that a broad rethinking involving all stakeholders in the healthcare system is required. As a patient interacting with healthcare providers, I find the opaque nature of healthcare and the deliberate withholding of information to laypersons to be outdated.

We need policies that allow engagement of the market to incentivize improvements in healthcare (cost, efficiency, effectiveness).
At the provider–costs need to be made more clear at the onset. That includes any checkups, preventive care, cost of tests, and doctor visit cost. Across the industry (and within each relevant subsection region or subsection of the market), costs for procedures, particularly “routine” procedures need to be made public, and easily accessible to patients.

We also need policies that disincentives care providers giving and billing wasteful procedures.
I’m sure there’s a liability factor here, where the risk of getting sued (substantial) for a missed diagnosis leads to doctors to over-provide services; particularly if the patient is the one pushing to get the procedure. I think this can be partially solved by solving Change #1–the rest we’ll need political solutions for, including the legal framework for measuring and rewarding efficiency.

One last thought–I don’t know why the author feels the ACA is going in the wrong direction. The ACA at least provides for an oversight board to call out and publish reasonable rates for procedures. Also, his suggestion that insurance should just be insurance is short-sighted; people want health plans, and with health plans, we can develop broader strategies to improve health, including better incorporating preventative care. Totally worth it to just NOT CODE THE BUG instead of spending 10x more to fix the issues that come up later.

And we’re back! (I think?)

Two and a half years ago, a botched WordPress update broke this blog. And now, it’s back! And my, has the world changed since November 2010!

More random musings to come!

“Fuck you and crowdSPRING too.” – Who’s hatin’ on crowdsourcing now?

Here’s an old article, but since I’m sitting at a talk discussing the wisdom of crowds, it seems appropriate. Crowdsourcinging has become an increasingly dominant force on the internet ever since “social media” became a meme. Anyone can produce anything, and distribute/produce it for a fraction of the traditonal cost. This is a big win for consumers of content and the advertisers that support it, since distribution is basically free and the directory of content on the internte massive. People who believe in open-source, free access, and free content are nearly religious in their support of it. One simplely needs to observe the sheer number of manhours going into the Linux, or Mozilla project so see how much people care, and love to hate on things like DRM. Some are killed off publically by the old model of business (Napster comes to mind), but they’re quickly replaced by analagous services that make it even harder to derive value out of consumers of content.

Whether this is good or bad for the world at large is debatable, and there’s an increasingly vocal group of individuals, organizations, and companies opposing this disruptively open world, and their ranks seem to grow with each new web service designed to leverage the masses. The claim is made that today’s internet model is devaluing the work of traditional creative forces everywhere, music, movies… to which the average American consumer (and certainly, moreso elsewhere in the world) discounts as corporate greed. While the local-culture movement has helped sustain small-scale artists, ultimately if/when they get signed by a larger label, the ultimate value that can be derived from their work is declining.

However, now a couple new startups, crowdSPRING and 99Designs, are quickly bring this to another group of creative forces: artists and designers. These services allow a content consumer (for example, a business needing a logo), to connect with a huge number of designers. For each post, submissions can be received from several designers, for which, only the poster selected work receives compensation. Clearly, this is great for the consumers of content, but what about the producers? Judging my the backlash against these sites, designers don’t seem to like being reduced to doing “speculative work” without any guarantee for pay. Then again, maybe this is just market forces at work. Jeff Howe writes that, “The demand for low-end design has ballooned in recent years… so has the supply of what we might call “low-end designers” (amateurs, recent grads and the like).” He goes on to mention that there are some eighty thousand freelance designers in the U.S., a shockingly high number, but if there’s demand, why not create the market?

The two startups are certainly doing well–and for creating a marketplace where creative forces can meet consumers, why not? Apple did it with it’s App Store, and Microsoft with Xbox Live. Yet there’s a fundamentally different dynamic here; in that while the aforementionde two services help producers find a market of consumers, crowdSPRING exists more to level the playing field for designers. “Professional” designers now compete in the same space as freelancers, and that’s where the complaint’s come in.

In my mind, all this yelling is a sign that traditional economic models are changing; some win, some lose, but those doggedly holding onto the old will most certainly fall. If you, as a professional designer, can’t compete against new college grads, and hobbiests, too bad. There area couple instances where I feel the model fails, for example this story, where it’s said the Twitter “bird logo” designer only got paid $6 for his work, seems a little unjust. But this may be just a matter of too much supply–when you have 80,000 freelance designers, it’s not too hard to find someone that will work for just a little less.

Ultimately, it’s still a free market; if designers don’t want to work for $6 then they don’t have to. Tough luck for design firms; hopefully they’ll be able to find a way to differentiate their services. I do have one small consolation for the $6 designer; he might as just made the Twitter bird for $6, but I bet his next assignment will come a lot easier.

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