Philip Greenspun’s Weblog

Yesterday I had the opportunity to participate in the harlequinade that we Americans choose to call “health care”. A woman with top-of-the-line insurance had an infection and, before prescribing an antibiotic, her doctor wanted an ultrasound to rule out a 1 in 1000 chance that there was an abscess. The doctor suggested that she visit the emergency room at Emerson Hospital in Concord, Massachusetts, though in practice any clinic with a machine and a radiologist on-site or connected via the Internet could have done the scan. She arrived at the E.R. at 2:00 pm, was seen about 7:00 pm, and was discharged around 8:00 pm (I delivered emergency supplies of food at 5:30 and stayed until 7:30). Had she gone to a veterinarian, her odyssey in the health care system would have been complete, but hospitals and doctors aren’t generally able to send patients home with the required medications. So our exhausted patient had to make a trip to a separate pharmacy a few miles away.

One complicating factor yesterday was Patriot’s Day, a holiday for some folks in Massachusetts. Most personal service industries add staff during holidays. If a customer came into a restaurant on a weekend or holiday, he or she would not likely have to wait 5 hours for service “because it is a holiday and our waiters and cooks wanted to stay home with their families”.

The most painful knowledge for me was that there was almost surely an ultrasound machine and radiologist waiting idle somewhere in eastern Massachusetts but there is no Web-based system for finding facilities with short waiting times. This is presumably because customers’ time has no value in our health care system, but I reflected that even the Massachusetts Registry of Motor Vehicles took mercy on its victims and posted facility waiting times on the Web starting in the 1990s.

So… by spending a greater percentage of working hours paying for health care than any group of humans in the history of the world we Americans have managed to create an industry that is less customer-friendly than the DMV.

One exciting positive: Thanks to the heroic efforts of Barack Obama, a gay couple can pay the same $17,000 per year and wait the same 6 hours for a 20-minute procedure as a straight couple. Egalitarianism seems already to have been implemented at Emerson. I was not asked to explain my sexual orientation (if any) when visiting.

More: my own health care reform plan

[How would this have played out in countries that spend less than our $8500/year per person on health care? She would have gone to a pharmacist rather than a doctor, described her symptoms, and been handed the antibiotic 5 minutes later at a cost of between $5 and $50. Had there been an abscess she would have gone to a doctor a couple of weeks later.]

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The Spring 2010 issue of City Journal carries an article on the history of California public employee unions, their political influence, and the cost of pension obligations to the unions: “The Beholden State.”

Related earlier postings:

• History of Public Employee Unions
• The bankrupting of San Diego by Republicans
• California’s $500 billion in unfunded pension obligations

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Folks:

I’m helping a friend with a trip to Orlando, Florida this coming weekend. We would like to find a good hotel with the following characteristics:

• within a 25-minute drive of MCO
• in a neighborhood where it is possible to walk to restaurants, shops, entertainment, etc.

The last time we visited Orlando we stayed near International Drive and were forced to use the rental car all the time.

Separately, is there a good place to take tennis lessons near the recommended hotel?

Thanks in advance for the advice.

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The volcanic ash shutdown of transatlantic air travel makes me wonder why videoconferencing hasn’t been more popular over the last few years. The typical company still does not have a high quality videoconference capability built into every conference room, which may make sense given that the cost of a 1000′ conference room is about $30,000 per year and high quality hardware/software can be comparable in cost to a year of rent. I’m confused as to why schools that teach foreign languages don’t have a videoconference wall built into every language classroom. A Spanish language class, for example, could have a wall that opens into a classroom in Argentina or Mexico. The cost of a public school teacher in the U.S., including pension and health care obligations, can exceed $200,000 for a 4.5 day workweek over 9 months. The videoconference hardware/software cost would be insignificant compared to the cost of the teacher and one would expect learning to be greatly accelerated if the kids could be bridged to native speakers in a comfortable and natural manner. Even if the American school had to pay for the hardware/software on both ends it would still cost less than paying a teacher to stick around for one summer school.

So how come school trips to Europe have become steadily more popular and videoconference systems in our wired-up schools are uncommon?

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I’ve drafted a review of a new book, The Design of Design. Comments/corrections would be appreciated.

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In the past couple of weeks, we’ve put about 70 people through helicopter ground school (outline of topics), followed by a 25-question multiple choice exam. The goals of the ground school include developing a student’s understanding of qualitative physics such as the Bernoulli effect (through conservation of energy), of basic aerodynamics (no equations), and of the practical requirements that lead to the helicopter being constructed the way it is (e.g., Why is there a tail rotor?). The class is conducted as a discussion around a conference table with about one third of the time devoted to students answering questions from the teacher (me so far!). Some reading is assigned prior to the class, but mostly the oral questions can be answered based on material presented in the class and with commonsense physics reasoning.

In looking over the 70 exam scores, what has surprised me the most is the lack of predictive value of a bachelor’s degree in science or engineering from an American university. One customer showed up wearing a Boston University Engineering sweatshirt, confirmed that a bachelor’s degree in engineering ($150,000?) had been obtained two years ago, and proceeded to score 6/25 correct on the exam (the all-time low score and worse than picking answers at random).

People who’ve done the best in the class and on the exam:

• certificated airplane pilots
• foreigners with science or engineering degrees from universities in India, Germany, and Israel
• Americans with advanced degrees in science or engineering

Some Americans who held bachelor’s degrees in science/tech did reasonably well, but no better than those who’d majored in Art.

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It’s official: East Coast Aero Club is looking to hire at least one helicopter CFI.

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Art: In Harold and Kumar Escape from Guantanamo Bay, Kumar lights up in airplane bathroom and is handcuffed by federal air marshals. Harold and Kumar are deported to a foreign country (Cuba).

Life: Qatari diplomat lights up in airplane bathroom and is handcuffed by federal air marshals (full story). The young diplomat is deported to a foreign country (Qatar).

I did a quick search on Google News, but could not find any journalist who noticed the parallel.

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I’m hoping that video experts among the readers will be willing to share their knowledge. I want a consumer-priced and compact HD camcorder that has a built-in wireless microphone system.

I have a Flip HD, which I love for its ease of use. This is my first camcorder that makes native digital files and I find myself much more willing to use it than a tape-based camcorder that requires a conversion operation. I like to make 1-minute videos and simply do-over rather than try to edit. My complaint with the Flip is that, in common with all other camcorders using on-camera microphones, it captures room sound rather than the voice of the subject.

I have an HDV tape-based Sony HDR FX-1, which yields excellent video quality from three CCDs. Unfortunately it is bulky and requires an additional set of boxes, each with its own 9V battery, to capture video from lav mics on the subjects. So now I am charging multiple batteries for the camcorder and perhaps lights as well as keeping a stock of 9V batteries for the mic system. Then when I get home I need to read from the tape onto a hard drive and divide up into clips using desktop video editing software. The effort required here is simply too great.

I have a Canon EOS 5D Mk II, which has near-Hollywood video quality, but the interface is not designed for camcording (is that a word?). I don’t know of any practical way to focus while rolling. Off-camera microphone use would require the same bulky additions as the Sony HDR FX-1.

So… how about a camcorder that has a built-in receiver for some kind of wireless microphone? I think Sony comes pretty close to this with a Bluetooth-based system (pictures). The receiver slides into a powered shoe on the camera. Still at least one too many boxes (the receiver is almost as big as the camcorder!), but the only extra battery is with the microphone itself.

I’m surprised that this isn’t a more active area of competition for camcorder manufacturers. The creeping featurism between the $500 and $1500 models does not seem nearly as useful as higher quality sound. What am I missing? Are more skilled videographers able to do great things with the standard on-camera microphones? Is there some company besides Sony that has put the receiver into the camcorder itself? (I checked Canon and Panasonic and they did not seem to have any kind of wireless mic systems for their consumer products.)

Incidentals: I would prefer not to pay more than $1500 for the system and I don’t want it to be any larger than a Canon Rebel.

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Here’s a report from some Stanford graduate students estimating that the California pension systems are underfunded by approximately $500 billion or approximately $36,000 for every California household (i.e., taxes on Californians are likely to increase by $36,000 per household at some point in the next decade). The report covers only three of California’s pension systems, so the total overhang will presumably be larger. This report makes one realize the impossibility of being a municipal bond investor. You can’t rely on the ratings agencies, whose corruption and incompetence were exposed in the Collapse of 2008 (every bond was rated AAA until it became worthless and then Moody’s or S&P decided to downgrade it). You can’t rely on public budget numbers because pension obligations are obscure and may be hidden in union contract fine print. So why buy these assets? If you want a bond in dollars, buy a Treasury (the federal government can and will print money to pay you). If you want to get higher yield along with diversification, buy the sovereign debt of some other country, preferably in that country’s currency (since that is the only way to mitigate the risk of a U.S. dollar collapse, as predicted by John Paulson, the most successful investor of the last decade).

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