Aggregating Reality

Some people like to have one or two primary, presumably trustworthy news source from which they derive the overwhelming majority of their information about the world. Maybe they watch one particular news show, or read one particular newspaper. I prefer to consult as many sources as I can get my hands on. I feel this mitigates any bias that might be inherent in a single source. I also feel this gives me a much better feel for “the big picture.” Thank goodness for Google news and RSS readers.

Oh yeah, and I occasionally read the Sunday Paper.

And that is how I came to a startling discovery. When even Dave Barry thinks the Budget Deficit is a concern, we are all in trouble.

Also from the morning paper, evidence that if there is a housing bubble, it is real close to going off. Low income housing is increasingly hard to find Oh, and getting harder to find thanks to the Bush Administration. The ability to find affordable housing is even more strained in areas where real estate has already been expensive, such as Southern California.

This is one singular area where I think Fannie Mae is actually helping keep prices from accelerating even more rapidly, by regulating the maximum loan amount they will repurchase from other lenders.* If you want to finance more than this amount, you will have to either break it into multiple mortgages, or get a “super jumbo” (or “non-conforming”) mortgage. Because the mortgage holder can’t sell this debt to someone like Fannie Mae, you will pay a higher interest rate. So, by saying they won’t buy a mortgage of more than $333,700, and assuming you have a 20% down-payment, they are effectively putting a lid of $417,125 on housing prices in most areas. There is also anecdotal evidence that appraisers are helping put a lid on housing prices by refusing to rubber-stamp high valuations. Yes, they are saying “that house is not worth that much money,” and mortgage companies are refusing to put in a first mortgage for more than the appraiser says it is worth.

Finally, a follow-up. I said months ago that high-handed TSA tactics would result in more business charter flights, more privately owned aircraft, and less traditional air travel. From the New York Times: “The number of corporate jet flights is on the rise as the economy rebounds, in planes owned by major corporations or shared through fractional ownership, sold somewhat like time-share condominiums. And manufacturers of private planes are planning new “microjets” — small, relatively cheap planes designed for flying at the altitudes, if not the speeds, of the big airliners.”

In summary, Private Jet ownership is up. The three big players appear to be Bombardier, Raytheon, and Cessna, but it seems like there is plenty of room for an upstart, particularly one that can offer some economic advantage.

* What does this mean? Well, when Local Bank of America sells their mortgages to someone like Fannie Mae, that frees up money they can loan to someone else, making a nice origination fee in the process. Fannie Mae will still get all the money, but they may have to wait 30 years until the loan is paid off. Search my site for “Fannie Mae” to get more links and information.

Beating the Drum Again

The official United States employment numbers for February have come out, along with figures revised downward for both January and December. Although I think by far this Reuters story is the best coverage, here is the Associated Press version. This one from CNN includes a pretty graph. This one from The New York Times admits some of their “reporting” was contributed by the Associated Press. For the hard core financial news junkies, don’t forget Bloomberg. In short, 21,000 jobs were created — an average of 420 per state — falling far short of the 125,000 jobs that economists expected.

Both sides of the political spectrum are concerned about these numbers. Democratic heir apparent John Kerry says there is one more guy who needs to lose his job, and that man is George W. Bush. On the other side, we have Treasury Secretary John Snow, who called the number “disappointing.” He went on to say this was why we needed to make the Bush tax cuts permanent.

Do not be fooled by those who say “Unemployment is still only 5.6%. Back in the Clinton Administration we considered that low. What is your problem?” Problem one is that the unemployment rate doesn’t really mean that much. It only measures those who had a full time job, lost it, are looking for a full time job, are receiving unemployment benefits, aren’t going back to school, aren’t temping, aren’t taking part time work to make ends meet, aren’t giving up, aren’t declaring themselves an independent contractor. Think about the adults you know. Would you say more or less than one in twenty is unemployed? How many of them are underemployed? Even Alan Greenspan says it is more accurate to measure the people actually getting paychecks.

These disappointing jobs numbers are important for several reasons, which are outlined particularly well in the Reuters and CNN articles above. First, in order to keep up with people just entering the job force, the economy needs to add roughly 150,000 jobs each and every month. Yes, if we don’t add those jobs, the new people don’t count as unemployed because they never were employed in the first place. In fact, the experts would really like to see a consistent 200,000 to 300,000 jobs created monthly before they declare the job market “good.” Even at that rate, it will be a long while before the 2.3 Million jobs lost over the last 3 years are replaced.

Not only were there 24,000 fewer construction jobs. Manufacturing jobs declined for the 43rd month in a row. Even the much ballyhooed service sector, the sector that would save us all, has not produced the expected jobs. In fact, the second paragraph of the Reuters article above points out that private job growth was flat; the 21,000 new jobs were all in Government.

Oh, and the 8.2 million unemployed people — and I hope they are all registered voters — have on average been unemployed over 20 weeks, the highest level in decades. Think about that. On average, 5 months unemployed by the very strict Government definition. Many of these people are close to exhausting their unemployment benefits and perhaps their savings too. This is to say nothing of how demoralizing it is to be out of work for months on end. No wonder there are so many “discouraged workers,” people who no longer count as unemployed because they have given up looking for work.

As if that were not reason enough to consider this number important, it also means that Greenspan cannot raise interest rates. The Fed Funds rate sits at 1%, the lowest level since 1958, a rate the Fed has already said is unsustainable. For reference, the Bank of England has rates set at 4%. This low, low interest rate helps anyone looking for a mortgage, anyone with debts they can refinance, but has been almost completely ineffective at it’s stated goal: spurring business investment.

The final reason this number matters may have escaped your attention altogether. You will hear it glossed over in the news, with statements like “The Dollar dropped against the Yen/Euro on sluggish jobs data.” The Administration is letting the Dollar drop against other currencies, on the theory that it will make American goods cheaper overseas, thus stimulating job growth. Of course, the fact that it makes imported goods more expensive in the middle of a huge trade deficit just means we will all have incentive to “buy American,” right? Wrong. One of several reasons gas is so expensive these days is that crude oil is bought and sold in dollars. With the dollar this low, the members of OPEC have trouble making money on oil, as they have to pay their oil-field workers in local currencies. Therefore, they are cutting production and forcing prices up. As a strict aside, oil and oil services companies (such as Halliburton) have historically made more money when crude oil prices are high.

It’s tough to fill up the car to get to a job interview with gas prices near record highs.

Do you hear what I hear?

The “fat lady” is not singing.

Not yet anyway.

But that sound you hear is her accompanist’s overture.

John Kerry had a fabulous “Super Tuesday,” winning 9 of the 10 races. His closest opponent, John Edwards, has scheduled a 4 PM press conference at which he is almost universally expected to drop out of the race. Kerry is expected to be the Democratic Presidential Candidate. He is starting to talk about how he will pick the Vice Presidential Candidate. The international press is reporting that Kerry has won the candidacy.

But here’s the thing. Kerry hasn’t actually got the necessary delegates yet. As of this writing, he only has 1361 of the 2162 he needs to be officially anointed. It is true that the remaining candidates have less than 100 delegates combined. However, it is also true that before yesterday’s contests, Howard Dean still had more delegates than John Edwards. Dean, you probably recall, dropped out of the race weeks ago. At least he keeps his blog current. And speaking of Dean, guess who won the one Primary that Kerry did not take yesterday? Yes, that would be Howard Dean.

In fact, by my read of CNN’s handy chart of delegates, Kerry isn’t even quite the winner if all the delegates earned by candidates no longer in the race are released to support Kerry. Edwards and Dean are still in a position to force some of their opinions into the Party Platform.

This also means that Bush will have to actually spend time worrying about campaigning, spending from his vast war-chest, as opposed to “looking presidential” in the Rose Garden. The TV blitz starts right about….. now.

Kerry had better be ready to talk about job creation, offshoring, the weak dollar, Social Security, and schools.

Oh, and he’d better be ready to go on Jon Stewart’s “Daily Show,” “Where more Americans get their news than probably should.” Maybe even consider a blog.

“I’ll take his Spam! I love it!”

Got Spam?

If you’ve got an email account, chances are you have received some spam — unsolicited commercial email — over the years. In fact, in February of 2004, over 90% of all email sent was spam. This figure is rising, despite the fact that the United States has a nice new anti-spamming law on the books. Indeed, over half of all spam is proudly made in the USA.

Of course it is an annoyance to delete all the unwanted offers for mortgages, debt consolidation, “herbal viagra”, and other stuff you don’t want. Of course office workers collectively spend many hours doing the same at work — time they could be spending doing actual work. Spam costs money by using bandwidth and storage space that could be used for much more important things. Nobody feels this more than ISPs, who unwillingly transmit gigabytes of spam each and every day.

Spam prevention as we know it usually relies on blacklists of servers known to send spam. This technique works acceptably for most users, but depends on a continually upgraded list combating continually moving spammers. An alternate technique, sometimes used alongside a blacklist, is the algorithmic approach. In this method, a smart program looks at your email, analyses it, compares it to known spam, and decides how likely it is to be spam. The program might take the liberty of routing suspected spam directly to your “deleted items” folder. This carries the risk of accidentally deleting something important.

Part of the problem is that spam is very cheap to send. All it takes is one person to submit a credit card number, and the day is profitable. Another part of the problem fighting spam is the anonymous nature of the internet. It’s easy to be nobody, or anybody. You might get spam with a “forged header” that makes it look like it came from somebody famous, somebody you know, maybe even from yourself.

The next wave of spam control, we are told, will be about identifying senders. This will make it possible to prosecute spammers who break the law. This will also open the door to charging spammers. A Microsoft solution to this problem is expected tomorrow.

The “caller ID” paradigm of spam prevention is doomed before it begins. First, the vast majority of them do not verify that someone is John Doe, they verify that someone is at John Doe’s computer. This same flaw plagued the much protested security features of the Pentium 3 chip some years ago. This distinction is critically important. Not only might somebody else be at the computer, the computer might be under the control of a virus. You knew viruses could use email to send themselves to all your contacts, but maybe you didn’t know that a virus can use your computer to send spam. In fact, some experts think as much as 30% of spam is sent by “zombie-bot” virus infected computers. There you have it, the reason most computer security experts consider spam and virus control related.

There is another reason that “being at your computer means being you” will not control spam. It doesn’t allow for the possibility that you might not be at your computer, sending mail from your email client. Anyone who uses a web-mail client, anybody who must use email remotely, anybody who uses the “send this link to a friend” feature of a website may find themselves shut out of a “caller ID” model of spam filtering. Although some sites that run web-based email services appear to be sensitive to that, most people forget that there are many reasons you and your computer are not the same thing.

There is one sure way to keep spam and viruses off your computer. Unplug it.

Tort End of the Stick

I have said before that “Insurance makes things cost more,” and that “Tort reform is not the same thing as damage caps.” These facts are still true, and you are welcome to see my arguments in the archives. Today, I would like to focus on the Medical Malpractice Crisis. In short, yes there is a crisis, no simply capping non-economic damages will not make it go away.

There is definitely a crisis, make no mistake. Malpractice insurance rates are going up by double-digit percentages — as much as 82% in one case — in many places. Because insurance is regulated at the state level, the actual figures vary wildly from state to state. Doctors are not in a position to pass their added expense on to their patients. In some states, things are worse than in others. According to the AMA, about 19 states (almost 40% of all states) are in “crisis.” The AMA prescription for the crisis is caps on non-economic damages. Republicans agree. Mostly, anyway.

There is anecdotal evidence that doctors in some areas are closing practices, limiting the scope of their practice, leaving the state, retiring early, or making do without malpractice insurance at all. According to these tales, there is a particular problem with specialists, such as Obstetricians and Neurosurgeons. This evidence may or may not stand up to objective scrutiny.

One thing many people do not understand is that the malpractice insurance your doctor carries has limits, just like your auto, renters, or homeowners insurance does. In many places, the standard policy has limits of $1 Million per incident and $3 Million per year. In theory, anything over those limits awarded to a plaintiff must be paid out of the doctor’s pocket. In real life, this is not really the case. Perhaps more defendants (such as the doctor’s partners or a nice deep-pocketed hospital) have their insurance tapped. Or rather than spend years in appeals, a settlement is reached.

But back to the million dollars. Let’s imagine that a 40 year old man in killed through medical negligence. First, lets look at the real damages. He made $50,000 last year, and planned to work until he was 65 (yes, that’s ambitious planning these days). That means if he worked 25 years for $50,000 — never got another raise — there are real damages of $1.25 Million before we even calculate the cost of his funeral. The insurance company has already reached the limits of what they will pay, regardless of what might be awarded for “pain and suffering.” In fact, it turns out that “only a handful” of cases exceed $1 Million verdicts. According to the National Practitioners Data Bank, the average payout of a doctor to a patient was $135,000. This figure likely averages in out-of-court settlements, which account for 96% of all cases.

To say that mega-verdicts have anything to do with rising malpractice rates is disingenuous. To say that capping non-economic damages will fix malpractice rates is doubly so. Non-economic damages account for 24% of the money spent on malpractice; more than any other single category, but not by much.

Critics who say that damage caps work normally point to California as their poster child. The truth is that California’s MICRA statute is just one part of an elaborate insurance reform and cost control scheme. It is furthermore worth noting that “California’s medical malpractice disputes are settled 23 percent faster.”

Proponents of damage caps prefer that you not look at Nevada. In 2002, they passed damage caps. That year, 7 doctors came to Las Vegas to practice medicine, an area that sees 5000 new residents every month. Despite passing damage caps, malpractice rates have still risen double-digits for 2004. Further reforms of the reform propose limiting lawyers fees, telling the jury when insurance paid for treatment (that would be “most of the time”), allowing payment of verdicts over time, and some shuffling of percentage of liability. I am at a loss for how most of this stuff is supposed to help. It is ironic that Nevada’s Senator Harry Reid is co-sponsoring a bill to bring damage caps to the nation.

One of the problems with Nevada’s reforms is that it abolished a medical review panel. Before, many cases could be dismissed as frivolous by a panel of actual doctors — whom one must assume are competent and impartial. Not surprisingly, the number of malpractice suits has risen. Now, everybody is entitled to his day in court, and this is costing everyone a lot of money. It can cost tens of thousands of dollars just to get to the point where a judge can decide to dismiss a frivolous suit, or take a clearly uninvolved party out of a suit.

Oh, and those legal fees are usually paid by the malpractice insurance carrier. It might take only one frivolous and quickly dismissed case against a family practitioner to obliterate the premium he paid. For reference, in West Virginia 29% of malpractice cases were dismissed in the last decade. Nationally, 70% of cases are closed with no money changing hands — except of course among the lawyers.

As if that is not bad enough, it turns out that the majority of malpractice complaints are against 1-5% of doctors. The figure varies by state. Some of this may well be “personality issues,” but the fact remains that as much as 80% of malpractice claims could be eliminated by getting “Dr. Nick” the heck out of the hospital.

Getting the malpractice crisis in hand will really impact health care costs by less than 1% according to the Congressional Budget Office. Others say that reduced “defensive medicine” such as unnecessary tests will help bring costs down. However, it may very soon impact the availability of healthcare in general. That would be bad. Here are some options we might consider instead of liability caps:

Insurance reform. Insurance needs to be reformed in many ways, all across the nation. We can start with re-mutualizing insurance companies (so no money is funneled off as profits), or setting up state insurance pools for high-risk groups.

Medical malpractice review boards. These impartial medical/legal experts would be the equivalent of a grand jury, determining whether there is sufficient evidence for a malpractice case to make it to trial. If they see the same doctor over and over, they should have the authority to open an investigation into his competence. For that matter, if they dismiss cases by the same lawyer over and over, they should turn him over to the local Bar Association for review.

More arbitration, fewer trials. Utah is considering this approach. There are pros and cons, of course, but it will be interesting to see how it works out.

Remember, sometimes bad things happen. Not everything has to be somebody’s fault. Does it?

On the lighter side, I thought you would enjoy this image.

Will Work for Rice

Yesterday morning’s CNBC Squawk Box Poll asked very simply whether there should be government regulation of offshore outsourcing. To the great surprise of host Mark Haines, 53% of respondents favored such regulation, 47% against. That it should be statistically even among a viewer base that is largely business people brought the guest host to rhetorically ask what the percentages must be like for the Average Joe. Indeed, the subject has already come up in the political arena.

As I see it, there are several issues to be addressed when discussing overseas outsourcing: the impact on American businesses, the impact on foreign nations, the impact on American workers, and the impact on American consumers. Please note that “impact” can be positive or negative. Sometimes one point can be both.

So how does this impact American business? They believe it saves them money. Indeed, it’s the only way to remain competitive, they say. After all, wages are much lower in places like India and China than the United States. Depending on the area, offices and factories might well be cheaper too. But some might argue that the lower costs are offset by productivity losses: working around cross-cultural issues; language barriers; security issues; differing regulations and local politics; differing time zones. Ah, but although differing time zones may make it difficult to get ahold of responsible parties and resolve problems, it may be an advantage if your business demands 24/7 service. For example, if you have a call center.

What about foreign nations? Well, the incoming wages — low by American standards but often still generous by local standards — often boost the local economy. Just like here in the states, people earning paychecks have money to spend. It is a difficult siren song to resist. But the same factories and offices which bring money to ordinary people may also bring pollution, opportunists, unexpected migration, and crime. Furthermore, the same American corporations that bring jobs to the region bring American ways of doing things, eroding traditional customs and social structures, if not outright demanding that things be done the Corporate Way.

You may find it curious that I have broken out the concerns of American workers and American consumers. Although these may well be the same group of people, overseas outsourcing effects average Americans in two distinct ways, depending on whether they are a customer or an employee of the company in question. Let’s look at the employees first.

Employees stand to lose jobs. There, I have said what everyone knows to be true. When there are not constraints of time or space, an American employee has to be at least twice as productive as a low-wage foreign employee to be cost effective. And this is where the “invisible hand” theory of market economics breaks down: American workers are only semi-mobile; they can pick up and move across the state or maybe even across the country, but with few exceptions they can’t just move overseas to follow their outsourced jobs. The tired old rhetoric of “training for the jobs of the future” no longer works. Not only are there roadblocks along this path, not only is it nearly impossible to tell what will really be a necessary profession in 5 or 10 years (remember when web design was the next big thing?), but what is to say those jobs won’t be long since filled by the time workers can possibly be trained? Perhaps by foreign workers? Thankfully, some things can’t be done overseas. Other things simply shouldn’t be.

And thus, we come to the American consumer. Theoretically, we should reap the benefits of reduced cost by paying reduced prices. Just think how much a pair of Nikes would cost if they had to be made by workers making American wages. Oh wait, some of those cost savings actually go towards hefty executive salaries and beating Wall Street profit estimates. Of course it’s a good thing if some of those cost savings are passed on to the consumer, particularly if they are one of the people who has been impacted by jobs moving overseas in the first place.

There is one more important consumer concern regarding overseas outsourcing, one that has grown larger in the post-9/11 world. In short, one of the easiest things to send overseas is data: computer code, information that needs to be processed. Some of this information is sensitive, and sadly the same kinds of protection we would expect this data to have in the United States should not be assumed to exist overseas. Not only proprietary corporate data is at stake, but also personal information, such as financial and medical records. This should concern you. Data which you consider private may potentially be in the hands of people who are under no legal obligation to keep it private. Should it be released or used in a fraudulent manner, law enforcement in the United States has no jurisdiction. The “419” scammers will no longer need any information from you to drain your bank account. This is a national security problem in the making: the terrorist of the future may have the benefit of using your Social Security Number, knowing your medical history, having access to your financial information, even knowing where you went to college and that you dropped PolySci.

Calls to “regulate” overseas outsourcing are often met with the the obvious reply, “How?” Tax penalties for American corporations who engage in the practice? Prohibiting government contracts with such corporations? There are frankly limited legislative remedies for this problem. However, the one thing we should all be able to agree on is that the practice of sending personal data for processing overseas must stop immediately: anything that might normally have a Social Security Number attached to it; anything the average American would expect to be kept confidential; anything subject to privacy laws and policies. This would certainly include financial data, medical records, and educational records.

In conclusion, I bring you two views of Ralph Nader. One, several years old, by New York Times economics columnist Paul Krugman. My favorite passage: “Mr. Nader did not begin as an extremist. On the contrary: in the 1960’s, when he made his reputation, the striking thing about Mr. Nader was his relative moderation. Fashionable radicals were preaching revolution; he was demanding safer cars.” This particular article is reproduced in his book, The Great Unraveling, which is a good read but slow. No matter how interesting an economist is, you can only read so many pages at a time. The other item is a very interesting analysis of Nader’s 2004 Presidential campaign by Elisa Camahort.

Totally Sweet

Perhaps you remember about a month ago, when the World Health Organization came out with guidelines for tackling what is turning out to be a global obesity epidemic. They said nothing less radical than too much sugar is bad for humans. Representatives of the Bush Administration quickly objected to this (emphasis mine): “The Bush administration, which receives millions in funding from the sugar industry, argues there is little robust evidence to show that drinking sugary drinks or eating too much sugar is a direct cause of obesity. It particularly opposes a recommendation that just 10 per cent of people’s energy intake should come from added sugar. The US has a 25 per cent guideline. Thompson’s representative… will be Bill Steiger, godson of George Bush Sr. He will argue there is no evidence that selling junk food to children increases overweight. [sic]”

The sugar industry has become a political linebacker, set to tackle any politician or scientist that dares speak ill of it, let alone attempt to rein it in. This means they have a two-front war for profits to wage.

The dietary front is only half the story. I have said before that every weight loss diet that works involves drastically if not completely eliminating refined sugars from your life, in the context of reducing total calories. Other experts agree that too much sugar, including too much corn syrup, is not good for you. Even the most rabid of high-carb low-fat proponents must concede this point. However, to listen to this commentator, sugar is great for you: the article is long on out of context quotes such as “Yes, even our “children benefit from eating some sugar,” says Ellyn Satter, a childhood weight specialist and clinical therapist…” and not-cited research by unknown researchers who “have found that added sugars and sodas – like other high-calorie, low-nutrient dense foods – are unrelated to weight. Consumption is high among all kids. In fact, the skinniest teens actually drink the most sodas, and the fattest drink the most sugar-free ones.” Did you notice that even her cited expert said “some” sugar is beneficial? I smell an agenda.

The other battlefront for Big Sugar is world trade, where they are in the process of winning two big skirmishes. The Central American Free Trade Agreement (CAFTA) is only going to allow 110,000 additional tons of sugar to be imported tariff free into the United States in return for opening Central American markets to American rice. Doesn’t sound like much of a free trade agreement, does it?

The other Big Win for Big Sugar is in a trade pact with Australia. Now, please keep in mind that Australian sugar producers are not faring as well as their American cousins. Last month the Australians made it clear that if the Americans wanted a Free Trade deal, it would have to include sugar. American Big Sugar made it clear that it had better not. Alas, the article is premium content, but The Economist had this to say in their February 14, 2004 print issue:

The deal has once again underscored the clout of the American sugar lobby — scattered across America from the powerful interests of Florida, a key electoral state for Mr. Bush in November, to the beet growers of North Dakota. The industry and its executives are among the biggest donors to congressmen and to the president. The sugar quotas they favour mean Americans pay around three times the world-market price. The inclusion of tiny concessions to cane growers in five Central American countries, in the recently negotiated Central American Free Trade Agreement, is one reason why that pack is guaranteed a rocky ride through Congress.

Not only does Big Sugar effectively own enough congressmen to possibly scuttle an international trade deal, they are doing everything in their power to suck money out of your wallet.

Don’t Let The Moment Pass

But day after day
The show must go on,
And time slipped away
Before you could build any castles in Spain…
The chance had gone by.

With nothing to say
And no one to say it to,
Nothing has changed.
You still got it all to do,
Surely you know.
The chance has gone by…

(Excerpted lyrics from “Day After Day (the Show Must Go On)” by A. Parsons and E. Woolfson (The Alan Parsons Project), from the album I, Robot. Song copyright 1976 American Woolfson, Inc. (BMI))

Don’t let this happen to you. It’s one thing to wake up one morning and say “Well, I guess I will never be Queen of England and I will never be an Astronaut.” It’s another thing to wake up one morning and realize that all the things you wanted to do with your life just haven’t happened, and that you have nobody to blame but yourself.

Do yourself a favor. Take 5 minutes out of your busy day to write down some things you would like to do with your life. Don’t think too hard about it, don’t rationalize any of it, and don’t spend too much time on it. We both know you have other stuff you have to do today. Fold up the piece of paper and don’t think about it again until tomorrow.

Tomorrow, take another 5 minutes with that bit of paper. Sort the items into Short Term Goals (“Christmas in Florida” or “Give money to [name of charity]”), Medium Term Goals (“Earn Black Belt”), Long Term Goals (“Own chain of Pizza Parlors”), and Impossible Dreams (“Win Lottery”). Remember that one person’s perfectly reasonable Long Term Goal might be another person’s Impossible Dream. Just because I will never win an Oscar doesn’t mean you shouldn’t try to do so yourself. In an ideal world, there should be some goals for each of the areas of your life: professional goals, relationship goals, personal growth and spirituality goals, you get the picture.

Now, I will be honest. I had such a bit of paper. It sat in a side compartment in my purse for some years, forgotten. When I opened it and read it again, I realized I had accomplished much of what I had written down. By that time, most of the things I hadn’t accomplished didn’t matter to me anymore. Maybe the magic of writing such things down is that it forces you to admit what you really want in clear, concise words. Maybe it’s that writing it down is an automatic reminder.

If you really want to achieve, you will look at that list and figure out how to make those things happen. Break it down into manageable steps. Be realistic about what you can do, what you need help doing, and what you need to learn to do. Do you want to see the cherry blossoms in Japan? You’d better start by getting a passport, finding out when cherry blossom season is, and maybe learning a bit of Japanese. After that, all you need is time and money.

Don’t make excuses. This is what you want. You wrote it down. If there is something standing between you and your goal, find a way around it. Some obstacles will be insurmountable, most will not. Please, don’t let your life pass you by, one dreary routine laden day after another.

HIPAA Compliance

HIPAA, or the Health Insurance Portability and Accountability Act of 1996, is a law that among other things codifies patient privacy rules. It says when a doctor or hospital can release data, when they must release data, when they must not release data, what data they can give to whom, and under what circumstances. Compliance is a highly necessary very expensive legal nightmare — and your doctor probably did not attend law school. The 5 year cost of implementing it is estimated at $22.5 Billion. If you really want to know about HIPAA you might try looking here or here, but the short version is this: healthcare providers must try to keep your private data private; they can send information to your insurance company because you sign a form that says they can; they can send your information to an insurance claims clearinghouse for processing — and they have to keep your data private too — because they are a middleman between your doctor and the insurance company; some data must be reported to a state or local health department under state or local law (e.g., sexually transmitted diseases, signs of abuse); data which does not personally identify you can be used in academic medical studies (“total cases of flu reported” or “male patient presented with unusual symptoms”). There are even limits on what they can tell your immediate family without your direct permission.

Figuring out the rules and helping healthcare institutions follow them is big big business. There is physical security of keeping people who don’t belong out of the files. There is educating the staff so they don’t say things they shouldn’t in front of people who do not have a right to know. There is computer security, since most medical offices use electronic billing and some use electronic medical records. Double this concern if anyone uses the internet to obtain the most up-to-date medical data; triple it if anyone uses email to communicate with patients or other healthcare professionals. Beyond all this, theoretically medical offices must insure that other businesses they deal with are also compliant, from the insurance companies and clearing houses, to any outsourced billing, right down to the cleaning service that sweeps the file room.

These things being said, I offer three current news items with HIPAA concerns. The first happened in Denton, TX. Denton, less than an hour north of Dallas-Fort Worth is home to the University of North Texas. It is also home to a pharmacist who refused to fill a prescription for a “morning-after pill” presented by a rape victim. You may recall having seen this story last week. Today’s news is that the pharmacist in question and 2 coworkers have been fired. Yes, one of the issues was that he violated company policy: “Eckerd’s employment manual says pharmacists are not allowed to opt out of filling a prescription for religious, moral or ethical reasons.” Frankly problems could have been avoided with a proper new employee orientation meeting. The other reason he was fired is that he violated HIPAA, and admitted it on CNN: “I actually called my pastor … and asked him what he thought about it.”

Violating company policy is one thing. Violating Federal law is another.

Another news item with HIPAA compliance concerns is being whipped up by none other than Attorney General John Ashcroft. The Government wants 6 hospitals to hand over sensitive medical records for hundreds of women — to determine whether a medical procedure they may have had was medically necessary. Yes, the procedure is a type of abortion, this time. Maybe next time it will be Botox injections; after all, botulism is a dangerous germ that could be used by terrorists you know. The hospitals in question have correctly maintained that turning over the records would violate patient privacy. Legal wrangling before a series of Federal judges has ensued. From the article: “Citing federal case law, the department said in a brief that “there is no federal common law” protecting physician-patient privilege. In light of “modern medical practice” and the growth of third-party insurers, it said, “individuals no longer possess a reasonable expectation that their histories will remain completely confidential.”” Perhaps the Department of Justice should read the HIPAA rules.

Finally, I present what must at first seem tangential. This week Microsoft admitted there is a security flaw in Windows that “could allow hackers to break into personal computers and snoop on sensitive data.” Or three, including one that could “offer up complete control of the computer. From there, the sky’s the limit: a hacker could install new software (including, for instance, Trojan horses), wipe hard drives, hijack files, or any of a thousand other things.” One computer security firm claims there are 7 more to be reported. TechWeb’s Security Pipeline, in an article about the still circulating “MyDoom” virus, says “In other words, there will be vulnerable machines and those machines will become infected, no matter how heroic your efforts. It’s a reminder that even the leanest of enterprises faces security challenges of daunting complexity. Even the most rapidly responsive IT security team must deal with attacks that spread in minutes.”

Yes, they just said that no matter what you do, your Windows network will be attacked by viruses. And personal data on such a computer or network is not secure. Yes, including personal data on, say, the computers your doctor’s office uses for billing your insurance company. It is therefore my contention that Windows is inherently not HIPAA compliant.

Maybe Ashcroft would have better luck sending crackers after those medical files.

The Magic Job Machine

Wand? Check. Fairy dust? Check. Smoke and mirrors? Check.

Today, the White House predicted the creation of 2.6 million jobs in 2004. It is worth noting that last year’s White House prediction of creating 1.7 million jobs was not reached; job creation in 2003 fell short by almost 1.8 million.

It sounds like a lot of jobs: 2,600,000 jobs created in one year. Now, divide that by 12 months in a year. Feel free to use a calculator, but my figure is 216,666.67 jobs per month. In the interest of simplification, lets say between 216,000 and 217,000. This number is already optimistic. Remember when we found out there were only 1000 jobs created in December of 2003? That number was revised upwards to 16,000 (320 jobs per state). Just Friday we learned that although the economists figured there were 160,000 jobs created in January (still far short of 216,000), in reality only 112,000 jobs had been created (51% of 216,000). Oh, and please note that this ambitious level of projected job creation in 2004 still falls short of what was achieved in the Clinton Administration. People are starting to wonder how this jobless recovery thing works.

But wait, it gets worse. Remember, economists pretty much agree that just to keep the unemployment rate from rising, the economy must add something like 150,000 jobs each month. This is a consensus number, an average; some economists think the number is closer to 100,000, others believe it’s more like 200,000. So not only does the January number fall short of helping the unemployment rate, the unmet projection would barely have helped. Indeed, the whole 2.6 million jobs this year might be needed just for new additions to the workforce. And that’s before we go giving work permits to non-citizens.

But remember that 1.7 million jobs that was supposed to have been created last year? That would have only worked out to 141,666.67 jobs per month. Even if that modest goal had been achieved, we would still be looking at rising unemployment.

Oh wait, you say. I have forgotten that the job creation numbers are skewed by the self-employed and independent contractors, that legion of people who have created jobs for themselves. Tell it to this guy:

Even those who still count themselves among the employed in America are struggling to make ends meet. Self-employed computer programmer Thomas Mooney — who bills himself as the “president/janitor” of his Minneapolis company, TeleProc — said he cannot last much longer with so little work in an industry that was once booming. “I’m barely employed — no income yet this year,” Mooney said. “I have $7,000 in future prospect business and that is all I know about for the rest of the year.”

Yeah, being your own boss is great. It’s even better when you have an income.