Computational Health Informatics Program, 25th anniversary

by philg

It is sobering to think that I sat down and began writing a web interface to an electronic medical record system (the Oracle database at Boston Children’s Hospital) more than 25 years ago (see “Building national electronic medical record systems via the World Wide Web,” a paper from 1996).

Today is a celebration (agenda) of the 25th anniversary of the Boston Children’s Hospital Computational Health Informatics Program (CHIP). I’ll try to take some notes and write a blog post later about what I learned.

For at least 25 years we’ve had all of the tech building blocks that we’ve needed to implement almost any kind of IT support for health care. Yet in the US we have ended up with a unified database of every ad that we’ve ever clicked on and are discussing the possibility of a unified medical record.

Full post, including comments

Drama on Martha’s Vineyard

by philg

Preparing a short talk for an upcoming aviation gathering…

My friend David landed his Bonanza at Martha’s Vineyard and the police were waiting for him. “Do you live in Katama in the gray house with the ‘I’m with Her’ lawn sign and the Black Lives Matter and Rainbow flags on the pole out front?” David affirmed that he did.

“We have some bad news for you, sir,” said the officer. “Your house burned down and your children are at the hospital being treated for smoke inhalation. They might have to bring in Boston MedFlight to take them to Children’s Hospital.”

“That’s terrible!” said David. “Do you know how the fire started?”

The police officers shuffled a bit and looked at each other. Finally, one spoke up. “I’m sorry to have to tell you, this, sir, but I think you know that Barack Obama recently bought a waterfront house in the neighborhood. It seems that he was having an affair with your wife. They were smoking in bed, the marijuana cigarette got tangled up in the covers and ultimately set the whole house on fire.”

David looks stunned and takes a deep breath. He puts his right hand on his heart and bows slightly.

“Barack Obama? Came to my house?”

Full post, including comments

What is the point of 5G in a country that has coverage problems?

by philg

People are complaining that the latest iPhones can’t support 5G, a high-speed cellular data standard that uses high frequencies and therefore will presumably require new antenna and radio circuits.

I am not sure what the point of 5G is in the US, though. The range and ability to transmit through walls, rain, etc. is inferior with 5G. The problem with the US is not that the 30-50 Mbit speeds in areas with good LTE (4G, sort of) coverage are not fast enough. It is that the speed in a lot of places is 0 Mbps (i.e., there is no coverage).

Readers: What will be the practical advantage of 5G over LTE?

Separately, if 5G does prove useful, will 5G make our traffic-choked suburbs even less attractive compared to cities? If carriers didn’t want to invest in good LTE coverage for American suburbs why would they build 5G towers every 1,500’ in medium-density environments?

Full post, including comments

European perspective on Jeffrey Epstein, Brexit, Immigration, and Donald Trump

by philg

I spent three weeks with 471 fellow “explorers” through the Northwest Passage. Most were German, Scandinavian, or from the UK. Only 22 of us were American. Out of 150 staff and crew, only 1 was American (most were from the Philippines). Every day the ship provided us with a printed summary of news, organized by country. Thus, it turned out to be a great way to get the European perspective on current events.

[What was the racial composition of the passengers? The same as in American communities where residents hang Black Lives Matters signs and say that their top priority is racial diversity: 90+ percent white with the remainder being Asian.]

News about Jeffrey Epstein bewildered the Scandinavians and Germans. “If she wants to work as a real prostitute paying taxes she needs to wait until she is 18,” said a Dane. “But there is nothing illegal about a 15-year-old having a sugar daddy buying her whatever she wants. A 15- or 16-year-old is considered an adult in sexual matters.” Germans noted that the age of consent in their country was 14 and that prostitution, though not a career to aspire to, was legal.

A retired English lawyer doubted that Epstein had ever abused anyone: “the women kept going back.” She was scornful of the actresses who’d had sex with Harvey Weinstein and of the #MeToo movement in general. “I was the only female lawyer in my firm and then the only partner,” she noted. “I could have claimed harassment or discrimination dozens of times.” (Proof that criminal defense lawyers are right in wanting older women on juries in what used to be called “date rape” cases?)

The UK passengers were drawn mostly from the London/Southeast area and many had worked in multinational enterprises. Thus, the majority had voted to Remain, but there were quite a few Leavers. Nobody seemed to have any affection for the EU as an institution: “I voted to Remain,” said one woman, “but now that I’ve seen how the EU has treated us, if there were another election today I would vote to Leave.” The business experts noted that the EU had begun as a trade and customs union, but had morphed into an attempt to forge a single political entity. They considered that effort a failure, but the Remainers wanted to try to reform the EU from within (since reforming big centralized government has been so successful everywhere else?).

Just as with Americans, claiming to dislike Donald Trump is a mark of sophistication and intelligence. Hardly anyone wanted to admit that there was anything to like about our dictator. However, the folks who’d done business internationally said that Trump was doing exactly the right thing with respect to China and talked about how they’d been unable to get access to the market there without opening a factory and transferring technology. Others said that they thought Trump’s trade policies would be bad for Europe, but were in Americans’ best interest.

The Europeans were at least as hostile to low-skill migration as Donald Trump. They wanted a wall on Europe’s southern border. They wanted their welfare state, already stingier than ours (see Hartz IV, for example), further curtailed so that Europe would stop being a magnet for those who are helpless in a modern economy.

The Europeans who said that they didn’t like Trump also shared his fondness for low tax rates as a way of fostering economic growth. A Swedish business executive whose company has a U.S. division said that he thought U.S. taxes were currently higher than Sweden’s. He pointed out that Sweden has no estate (death) tax. What about their higher headline personal income tax rate? “Nobody pays that,” he said. “If you’re a corporate executive you will find a way to turn the income into a capital gain, taxed at 30 percent.” A Scandinavian who was generally in favor of big government earned most of his income through an Estonian corporation. As Estonia is tax free, he won’t owe any taxes on this income until he needs to get the money out and spend it, which could be 50 years from now.

It was interesting to be with people who don’t share our assumptions, but now I’m back in the land of GroupThink. From a Toyota at our local public library on Saturday:

Full post, including comments

Were young people in China studying and working during the Climate Strike?

by philg

Here’s a dumb question, but I haven’t seen it answered in the media: What were young folks in China doing while #ClimateStrike was trending worldwide last week?

Related:

Full post, including comments

Lightweight luggage review

by philg

We had a strict 8 kg. European carry-on and 23 kg. checked bag limit for our recent cruise. My roll-on bag was 10 lbs. (4.5 kg) empty and a touch oversized for Europe. My 26″ Delsey “super lightweight” checked suitcase was 10.8 lbs. empty.

After doing about two hours of research online (articles in Forbes, for example, and reviews at Amazon), I made the following decisions…

Soft-sided expandable bags rather than hard-shell. If limited to the rolling bag as the single carry-on, it would be awkward to have to crack open the entire hard-shell bag somewhere on the plane to get to a small needed-in-flight item. Also, an expandable soft-sided bag with international dimensions (55 x 40 x 23 cm; a couple of inches smaller than the typical American road warrior roll-on bag) could be expanded for use domestically.

Two wheels rather than the four-wheel “spinner” designs. The two-wheel designs seem to have 10-15 percent more space than a bag with the same exterior dimensions and four wheels. Two wheels will work better over imperfect surfaces, but they will likely be more tiring through the airport. On the other hand, the 23 kg. bag won’t be going far and the 8 kg. bag won’t be very heavy.

After reading everything that seemed relevant, what popped out were the latest Maxlite 5 suitcases from Travelpro, the company that invented the modern suitcase (Condé Nast Traveler). These aren’t the most stylish bags, but why would it be better to have a bag that screams “steal me”? Travelpro makes some bags with superior organizational capabilities, but all of them are heavier than the Maxlite series. Durability for bags that are so light? Travelpro says “We are proud to introduce our new Built For A Lifetime Limited Warranty starting with the Maxlite® 5 collection which covers defects on major components such as wheels, zippers, extension handles and carry handles.” Maybe a heavier bag would be more durable, but why wear out one’s body lugging around a heavier bag rather than buying a new one every 5-10 years?

Specific choices:

These weigh 5.4 and 7.1 lbs., thus leaving 8.3 lbs. of additional capacity compared to my previous bags. Travelpro says that these are lighter than the previous generation Maxlite 4, e.g., about 0.5 lbs. for the carry-on. The cost of both bags together was $237.

How did they work during five flights, two hotels, etc.? Fantastic! It would be nice if they were a bit more compartmentalized, but the high payload to vehicle weight was awesome. They seem to be at least reasonably durable.

[Of course, after all of this work, when we finally did show up for the charter flights there was no verification of the dimensions, weight, or even quantity of bags. Quite a few passengers completely ignored the directives and checked two large bags (for a three-week cruise).]

Full post, including comments

Why haven’t Democrats realized their own goals in Democrat-run states?

by philg

U.S. states are sovereign, have the authority to impose income, wealth, and consumption taxes, can borrow money, can make it illegal for employees to work for less than a threshold wage (and also illegal for an employer to pay more than a limit wage?), handle law enforcement and criminal justice for most issues, etc.

Why haven’t states run by Democrats achieved at least most of the social justice agenda that Democrats say they want?

Consider income inequality. California, for example, has a top income tax rate of 13.3 percent and a minimum wage of $12/hour. There is no reason the state income tax rate couldn’t be 30 percent with a minimum wage of $20/hour, right? (California Democrat and Presidential candidate Tom Steyer says that he wants a higher minimum wage that is a “living wage,” which would be roughly $50/hour in California to lift a family above the welfare eligibility thresholds.) That would narrow the spending power inequality (can be a measurement challenge) considerably, a goal that is related to the “income equality” goal that Democrats say is important to them.

(Same deal here in Massachusetts. Off-the-charts support for reducing income inequality and, simultaneously, among the highest levels of inequality in the U.S. Nobody in Washington, D.C. could prevent us from establishing a progressive income tax, raising wealth/property taxes, etc. and redistributing the money to poor residents. Yet we don’t do it, nor do we raise our minimum wage from $12 to $15 (or $20!)/hour.)

One objection to high tax rates is that people will move to avoid them. Yet Sweden was comfortable with this during its experiment with high tax rates back in the 1970s. If rich citizens moved to Monaco, the happy middle class Swedes said “good riddance.”

(Swedes experienced with multi-national business on our recent Northwest Passage cruise said that Sweden now has lower effective tax rates than the U.S. The nominal personal income tax rate in Sweden is comparable to Federal+California, but executive or entrepreneur Swedes are generally able to avoid this by turning what would have been ordinary income into capital gains.)

Democrats (e.g., Kamala Harris and Tom Steyer) say that they want a universal health care system. One third of Californians are already on Medicaid (“Medi-Cal”). Californians older than 65 should be on Medicare. Why not use the revenues from the above higher tax rates to automatically enroll everyone else on Medi-Cal and they can use it if they don’t have employer-provided insurance?

California Democrat Kamala Harris says that she wants free four-year public college (PBS). Why couldn’t California’s legislature vote to eliminate tuition at the University of California and Cal State?

Democrats say that they don’t want children to inherit wealth from parents. States have the power to impose estate taxes and a bunch do. Why wouldn’t the Democrats who control California change the state constitution to enable the collection of an estate tax?

California Democrats say that they would like less car-emitted pollution. They have the power to impose high annual registration fees on older high-pollution cars, highway tolls that are partially based on emissions output, and congestion fees to eliminate urban traffic jams. Yet they don’t do any of these things and instead blame the federal government for not letting them dictate emissions standards for new vehicles (which would do nothing to get a 20-year-old high-pollution car off the California roads).

Related:

Full post, including comments

Scale under the floor of a cruise ship cabin to reduce buffet consumption?

by philg

The biggest and best helicopter tour operators have scales hidden underneath the floor at the customer service counter. Thus they’re able to quickly capture passenger weights, oftentimes without the customers being aware.

What about the same technology for cruise ship cabins? Put a scale near the door and a display so that the passenger can see his or her current weight. This could reduce costs since a passenger who realized that he or she was gaining 0.5 lbs. per day could cut back at the buffet.

(On our recent Northwest Passage cruise on Hurtigruten, there was no scale in the room and also none in the (small) gym. Due to the challenges of resupplying in the High Arctic combined presumably with people pigging out, the ship ran out of a bunch of items prior to the end of the trip. The poor crew had to go 10 days without fresh fruit. The Germans were not happy that the yogurt had run out.)

Some of our food temptations:

(The French chef, Julien, cannot be held responsible for the poutine. I was the one who pointed out that we needed to celebrate Canada’s greatest culinary achievement and the kitchen crew raided a supermarket in Nunavut for cheese curds.)

Full post, including comments

Tale of two children

by philg

Photos from a recent visit to a friend’s house in suburban Massachusetts…

The daughter, an elementary school student, baked cookies from “women owned” dough:

(But how can anyone be sure that the owners of this dough company continued to identify as “women” after the package was printed and distributed into grocery stores?)

The son, a middle school student, showed off a home-decorated coffee mug:

Full post, including comments

Silver Lining of the Ivy League Admissions Circus

by philg

A friend who is a passionate fencer, and a former Ivy League fencing team member, said “Twenty years ago, you could just send a kid to a few fencing lessons and he or she might get into Harvard. Now it is much more difficult and the kid actually has to be great for it to boost his or her chances.”

What’s the silver lining? “So many of these parents, most of whom are middle class, are pouring all of their time and money into fencing lessons for middle school and high school kids that the U.S. is beginning to win international competitions.”

[Separately, one of his friends is a fencing coach at a university. The most recent semester started with “going through the roster and he was being told which pronoun to address two transsexuals and one gender-fluid student on the team.” One of the students who was to be referred to with male pronouns asked to compete with the men’s team, but lost every practice match. He then switched to the women’s team, but continues to insist on being referred to with male pronouns.]

If the U.S. sweeps up medals at future Olympic games, can we thank the elite universities that have made it almost impossible for white/Asian kids to get in? (since being sued, however, Harvard has found that Asian applicants have more merit)

Full post, including comments