Philip Greenspun’s Weblog

My son, Alexander Daniel, was born this morning at 6 am. I attended the birth of my 4-year-old, Greta, but it was a C-section and over before there was any time to think. Also, the docs and nurses strategically place a big white sheet to screen their activities from laypeople.

It was a fairly conventional birth by American standards, with three medical interventions: antibiotics to prevent infection, pitocin to hurry the baby out because the water broke before labor started, and then an epidural to ameliorate the intense pain caused by the pitocin. A midwife presided over an all-female team at Mt. Auburn Hospital in Cambridge, Massachusetts. The actual pushing lasted about 30 minutes during which time the room was active with five or six women monitoring for the mother’s blood loss and blood pressure, the baby’s health and position, the baby’s health once out in the world, etc.

I’ve become moderately accustomed to life-or-death situations, but those that arise during helicopter instruction last for just a few seconds, not for 30 minutes. Sitting next to someone whom you love and who is putting herself at this much risk for the benefit of someone whom you’re going to love deepened my feelings in ways that I wouldn’t have expected. Even from a position up by the mom’s head, it is impossible not to notice the flood of blood and tissue that come out with/after the baby and wonder “How can a person survive that kind of loss?”

Generally I’m not a medical worrier. If I have a pain in my side I think it must be from playing LEGO with Greta, not rib cancer. And throughout the pregnancy I hardly gave a thought to the possibility of a baby or mother with problems. But in the last hour or so I was plagued with worries about something going wrong or something being wrong. The sometimes-worried looks on the faces of the professionals didn’t help. Nor did it help when a nurse said “I don’t like the way he’s breathing.” Soon enough, however, the new baby was nursing apparently happily.

In http://philip.greenspun.com/politics/health-care-reform I argue against the idea of spending 18 percent of our GDP on health care. And the idea that the typical American hospital charges more to handle a delivery than does the most deluxe private hospital in England where the royal baby was born (story) is kind of ridiculous. But the staff at Mt. Auburn made me a believer for about an hour. I’m grateful to them.

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Having switched from an iPhone 4S to a Samsung Note 3, I am amazed almost every day at some of the user interface decisions made by Samsung. (Apple fans: please don’t post comments about how it wasn’t smart to switch; I needed the Note for a work project.) Today I installed an operating system upgrade and was hopeful that some of the most glaring problems had been fixed. Sadly, they hadn’t…

One of the most heavily used parts of the phone is the “Phone” app. This has a “Contacts” tab. If I search for a friend whose last name is “Bailey” I would think that the first result would be the single contact in the phone that has a phone number attached to a person with a last name of “Bailey”. Yet astonishingly the contact with the phone number is not even on the first page. The app, which the owner entered by touching the “Phone” icon (presumably indicating an intent to make a call) shows first three random people that I don’t know at all but perhaps at one time might have replied to an email from them from my Gmail account using a browser. Then I get eight email-only contacts that have the same first and last name as the contact with the phone number. Mr. Bailey is an entrepreneur who wears a hat at a lot of distinct small enterprises and consequently has many distinct email addresses. Google Contacts wasn’t smart enough to merge these when I instructed it to merge whatever it could. But why isn’t the phone smart enough, given a list of contacts with the same name, to show the one with the phone number first?

Another crazy bad interface is from the “Messages” app. It will show a notification of a new text message in red. If I touch the icon, though, it takes me to an unrelated text message conversation with someone who might not have sent me anything for several days, i.e., whatever the last conversation I was in.

The camera is simply unusable if the subjects are humans and moving. It seems that most of the sites that test mobile phone cameras do it with studio scenes. That capability has nothing to do with a mobile phone camera being a practical photographic tool. This seems like something that Google should take over as part of the core Android software. It is too important to leave to the handset manufacturers, particularly if the goal is competing with Apple, whose camera software seems to be the world’s best (Canon, Nikon, and Sony obviously make better cameras, but because they use huge sensors and heavy traditional optics).

I’m thinking the Samsung software for the Note 3 was developed by someone who did not use Google Contacts, did not have many friends, and never used text messaging…

[Separately the phone/contact software freezes frequently, e.g., after one has unsuccessfully tried to make a call to a person’s office phone and then wants to navigate back to the contact and try a mobile number.]

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A friend of mine works in a big law firm where attorneys commonly charge $1000 per hour. These are among the best legal minds in the country, but Obamacare has at least some of them stumped. Here’s an email that went out on a firm mailing list….

Client has employed his housekeeper and paid her through payroll over the last few years. Her insurance was cancelled because of Obamacare, and she was told that her employer (our client) has to provide her with insurance. Is there someone who is our Obamacare expert who can tell me why that is false? (Less than 50 employees? She doesn’t work 40 hours? I read the papers but that doesn’t mean I know the law!!)

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Here’s a conversation that I had over Thanksgiving:

• My 16-year-old cousin: I broke my phone.
• Me: I will give you an iPhone 5s if you agree to one condition.
• Young cousin: Deal.
• Me: I’m also going to send you a three-pound bronze plaque that says “Donated by the world’s best uncle/cousin” and you need to superglue the phone to the plaque and carry both with you at all times.
• Young cousin: That’s fine.

And then I had to send my old iPhone 4S to her little sister… So now I am firmly committed to the Samsung Note 3 and Galaxy Gear geek watch. The Note 3 is good for reading Amazon Kindle books but it is painful to use as a camera or phone and there are a lot of software freezes.

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Illustrating the magic of choosing one’s statistic carefully, today’s New York Times front page carries a story about how the jobless rate has fallen to a five-year low of 7%. Investor’s Business Daily, however, calculates unemployment at nearly a modern-day high of roughly 12% by holding labor force participation constant at the 2007 level (66% of working-age adults actually working). See “Labor Force Exodus Hides Nearly 40% of Hiring Shortfall”.

I was able to observe the statistics in action this week in Denver, Colorado. I stayed in a Marriott Courtyard on the 16th Street Mall. The sidewalks were populated by native-born Americans who had dropped out of the W2 workforce in order to panhandle. The hallways of my hotel were populated with Spanish-speaking immigrants who were being paid to clean rooms.

Related: my August 2010 posting about whether or not unemployed Americans today are like draft horses during the Industrial Revolution.

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If you’re feeling grumpy this year and irritated by relatives, here are some stories that may make you appreciate them more…

Frozen, a Disney movie that I previewed in order to see if there was anything in there that would upset my 4-year-old. It turned out to be too upsetting for me (85% dead) and my companion (26). A little girl loses both of her parents in a shipwreck and then her older sister won’t talk to her for years. I would be interested to hear from parents who have taken children to this movie. How old is old enough?

Wave, a book by a woman who loses both parents, her husband, and both of her children while vacationing in her native Sri Lanka during the 2004 tsunami. She gets angry and crazy at the same time, her life duct-taped together by the constant companionship of extended family.

“Where is Your Mother?” a New Yorker story by Rachel Aviv that is sadly behind a paywall. Niveen Ismail, who grew up in Kuwait with Egyptian  parents, comes to Orange County without the support of friends or family and makes one bad decision after another. She becomes a single mother, which in California can be a lucrative occupation if the father is chosen correctly (see https://www.cse.ca.gov/ChildSupport/cse/guidelineCalculator and plug in the salary for a plastic surgeon. for example), but her profit from child support in this particular case was apparently not sufficient to pay for full-time day care. One day in 2005 Ismail snaps and leaves her three-year-old son home alone. The police arrive 90 minutes later and take the kid away, but instead of saying “You’re a bad mother and we’re putting your child into foster care” (an immediate tsunami-like loss) they subject Ismail to nearly three years of legal and psychological torture where she (unsuccessfully) tries to demonstrate her competence as a parent to a variety of social workers and psychologists.

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After the shock of the recent fatal crash of a Metro-North train in New York (Wikipedia) wore off I began to wonder… Google and BMW are very close to creating practical self-driving cars (see recent New Yorker article and one in Technology Review). Why aren’t trains, which operate in a much more structured environment and whose capital cost per vehicle is much higher, already self-driving?

Separately, when my American friends hear about a train crash or a building failure in China they use that as more evidence that something is fundamentally wrong with the Chinese social and political system. But when a train derails in the U.S., that is just bad luck and not a reflection on anything having to do with America or the U.S. social/political system.

And finally, though not related to trains, the above articles make me wonder what happens when most of the cars on a highway are self-driving. Each car is putting out a huge quantity of signals via laser, radar, and ultrasound and depending on getting clear returns. This seems easier when there is only one self-driving car on a given highway. What happens when signals from different cars collide?

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A friend of mine has a risky new startup. He was able to secure angel funding recently and I asked him on what terms. “It is a convertible note that will turn into shares at the same price as the Series A investors, plus a 20% share bonus.” In other words, if the company navigates its way through all of the risk that afflicts a startup’s first few years the investor will buy in at almost the same price as the professional venture capitalists who waited for the concept to be proven with customers and proven to be executable. Given that venture capital in general returns about the same as the S&P 500, such an investment should only be sensible if there is at least an 80 percent chance of the startup making it all the way through to Series A ($2-10 million in VC money).

The other seed funding rounds that I’ve heard about are happening at valuations of around $3 million pre-money. That’s a lot more value put on a team of three 25-year-olds than in most years.

Aside from sky-high valuations, another obstacle to earning a good return from a venture capital investment is the recent increase in tax rates. Tax law changes, including the Obamacare surtax, mean that capital gains that formerly faced a federal tax of 15 percent are now taxed at 23.8 percent, a 1.6X increase in the amount of investment profits that will feed the federal government instead of the investor and his or her family. And unlike with an investment in the S&P 500, the angel investor does not get to choose when to take a capital gain or loss. The company will either fail or be acquired on a schedule that cannot be controlled. (There are possible exemptions from capital gains tax for qualified small business stock investing, but it seems hard to predict whether or not one will in fact qualify (see this article).)

I wrote about what a bad deal angel investing was back in June 2010 (posting) but the terms seem worse today.

What do readers think? Is the world of tech startups in a bubble? At the valuations and on the terms angel investors are offered, why isn’t it better to invest in big companies that can profit from the growth of robust economies around the world?

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http://www.technologyreview.com/featuredstory/520441/a-tale-of-two-drugs/ says that Vertex offers a cystic fibrosis drug for $307,000 per year to insurance companies and Medicaid/Medicare. The article also notes that Vertex offers the drug for free to patients who are uninsured. Doesn’t that give an incentive to an insurance company to cooperate with the patient? Instead of paying for 20 years of this drug ($6 million), the insurance company could give the patient $2 million to drop his or her policy. With that $2 million, the patient could buy health care as needed and get the $307,000/year drug for free.

What stops an insurance company from offering this incentive?

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The news media has been reporting on polls showing diminished public support for Barack Obama following the squandering of $5 billion on a bunch of semi-functional health insurance web sites (see this analysis of $4.5 billion in federal spending on state-operated exchanges, plus another $500+ million on the federal one).

At Thanksgiving gatherings with friends and family, however, I found that people who had previously supported Obama were no less enthusiastic about him than in previous years.

None of the Obama enthusiasts had any idea what web development typically cost or any knowledge about what healthcare.gov cost or what it was supposed to do. Therefore they didn’t have a strong opinion about the reported problems with the site.

To the extent that there were any problems with America’s healthcare system, Obama supporters blamed insurance companies and their inefficiency and greed. They didn’t see any contradiction between this opinion and the idea that the federal government should force people to do business with these inefficient and greedy companies.

Generally Obama supporters accepted that “health insurance” and “health care” were equivalent and therefore a person without health insurance would not be able to get health care. The Obama supporters believed that health care was a universal right and that, without insurance an American would not be able to obtain any care, so they were very happy that Obamacare was going to result in universal coverage [i.e., none were aware that Obamacare will leave approximately 30 million Americans uninsured (see this Washington Post article)].

The minority of Obama supporters who were were aware that the U.S. currently spends a much higher percentage of GDP on health care than other countries believed that with appropriate direction from Washington, D.C., our costs could be brought in line with the rest of the world’s, if only the central planners were given more power. [Health care spending in the U.S. was 4 percent of GDP in 1950 and is 18 percent today; Singapore spends about 4.6 percent of its GDP on health care, according to the World Bank, while most European countries are in the 9 percent range.]

Obama supporters believed that the only possible way for poor people to get health care was if the federal government paid for it through Medicaid. They believed that between 1776 and 1965, Americans who were poor and sick could not get any treatment at all. Obama voters who lived within walking distance of Boston City Hospital (founded 1864) were unaware that local or state governments had ever played any role in delivering health care to the poor. Obama supporters who lived within a short drive of one of America’s hundreds of Catholic hospitals were unaware that health care for the poor had ever been delivered through private/religious charity. If the federal government had not started paying in 1965, Americans who lacked funds would simply drop dead in the streets for want of a straightforward procedure (hence Obama supporters were very grateful for the continued existence of Medicaid).

Obama supporters felt much better about our continued wars in Iraq and Afghanistan than they had during the George W. Bush years. While Bush was president the same folks had argued for withdrawing our troops but since Obama was elected they no longer actively opposed foreign military intervention (they could have starred in this video). I asked if they wouldn’t have been happier if Obama had withdrawn our troops from Iraq and Afghanistan on January 20, 2009, using his authority as Commander in Chief. The answer was two-fold: (1) it might have made sense for Obama, in 2009, to continue the wars, even at the cost of thousands of American lives and tens of thousands of civilians’ lives, through his 2012 election campaign in order to improve his chances of being elected, (2) “Obama couldn’t do anything about the wars because of the military-industrial complex.” [i.e., Point 2 boiled down to them being passionate about Obama’s election and the election of similarly-minded successors, but at the same time believing that the president for whom they were actively campaigning didn’t have any power when it came to starting or stopping wars.]

Generally Obama supporters among my friends and family were happy with the way things were going, except that they wished that taxes were higher (ideally collected from people who earned more than they did). To the extent that they wished the U.S. economy would grow faster, they blamed Republicans in Congress for obstructing Obama’s proposed spending, regulations, and taxes. Generally there was no erosion in support for a centrally planned economy (see this poster that I made just before the 2012 election, after listening to the various promises made by Obama and Romney).

My poll was admittedly unscientific, but I did not find any erosion of support for Obama, centrally planned health care, shifting responsibilities from local/state to the federal government, or a larger percentage of the economy being given over to government. What are the readers seeing? Are friends and family who’d voted for Obama in 2012 now disillusioned because they read that healthcare.gov doesn’t work? If so, would they be motivated to vote differently in the future?

[Related: My 2009 health care reform article]

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