Archive for October, 2014|Monthly archive page
Bundling is excused with the argument that only by bundling money-losers with winners can the quality losers hope for existence. The same argument has been used for every other form of art in modernity. The unsold masterpiece subsidized by its more popular but less respected (critically, that is) brethren. There are some problems with this notion of valuation. For instance, in college, it’s almost always the esthetically valuable, if not commercially that is taught. Graduates are left ignorant of the actual impact that the things people actually read had. But they know their Joyce.
Unbundling could then end up tossing the unprofitable but supposedly aesthetically (or social, but yet unpopular) art into the dustbin of history. But not necessarily. For the same reasons that Wheeler would propose unbundling—the technology’s cheaper and more ubiquitous—so too can one imagine less expensive production and even distribution of works of art that have not been gilded with corporate dosh.
Or not. But then there are “community” or “crowd” funding mechanisms that are still evolving and that replace the work that was once done by government agencies tasked with distributing fairly and for the public good money accrued through taxes and other revenue sources. Neo-Libertarianism has voided society and government as the thing we are all in together in favor of the much less obligatory community. But it’s also provided the notion of crowdfunding.
The open data survey is more than academically interesting. It can lead to a more engaged populace, which is to say, a better and more sustainable democracy–and not its fake image, commodity democracy, where freedom is pretty much defined by being able to buy what you are led to desire at a chain.
“They then mined the data to find out what kind of projects frequent investors were most likely to back. “We find that frequent investors are likely to fund projects that are well-managed; have high pledging goals; are global; grow quickly; and match their interests,” say An and co.”
From personal and professional experience, the better the startup, however large or small, is managed, the more likely it is to instill the sort of confidence in its future as a business and thus garner investment—to a point. And most true when the investor class is able to perceive and evaluate the narrative pitched. But this makes sense. The market is that frothy pool of received knowledge collapsed fantasy. Fiction is the domain of the outré and unrealized (and unrealizable, at least now) fantasy.
I started this long post curious if the economic logic of the private, not-for-profit Dallas Presbyterian Hospital where Thomas Duncan was treated led to his demise, a point raised by Amy Goodman in Democracy Now! But the issue of the scandalous treatment obviously goes beyond that.
Reportage on Ebola in Africa has been lacking, to put it inoffensively. At its worst, what I’ve seen (admittedly not much) could have come out of a zombie show or movie and slides into racist narratives of African savagery. Ebola seems but a new twist on the wars that ravaged the region, and both are presented without history, context, nuance: No Why has been asked, let alone answered. But the reportage that I’ve caught (I’ve not studied this; capture has been incidental and cursory and entirely via the Web) has only now begun to investigate Whys that Americans can put forth.
The BBC Tuesday had a decent comparison of the MSF procedure and the so-far opaque but increasingly alarming lack of coherent protocols practiced at the Dallas hospital. And the recent accounts by unnamed nurses at the Dallas hospital describing the lazy and frankly appalling procedures only points to some other questions.
Let’s start with money. Duncan walks into Dallas’ Texas Health Presbyterian (also called Presbyterian Hospital of Dallas), a private, not-for-profit hospital whose parent system is Texas Health Resources. US News & World Report rated it highly. It’s not a cheap hospital. In Duncan’s case, according to two reports, from the Christian Post and the Dallas News, the cost of his terminal care (starting with this second trip to the emergency, where he arrived via ambulance), is likely to be around 500,000 USD (The Christian Post). That sum, the Dallas News points out, will likely never be recovered from his family and will be used to justify the hospital’s not-for-profit status; as well, it will be “‘covered by the margin on commercial insurance,’ said Scott Schoenvogel, CEO of Compass Professional Health Services in Dallas” (Dallas News). [Cost is “recovered” by Dallas hospitals via a “practice known as ‘cost shifting.’ Insured patients have a hidden surcharge in their bills, which winds up raising the cost of annual health insurance premiums for workers and their employers” (Dallas News).]
But who paid for the initial CT scan and the lengthy if utterly meaningless evaluation the first time around? It seems that Duncan was given a CT scan of the head, which could have been of the brain (I don’t have the data) and might have cost as much as 2,925 USD (New Choice Health)—or a lot less, 210 USD. The other costs, including the evaluation, even the acetaminophen (Tylenol brand, it seems), would have been added to the charge.
Then he was sent home, with no effort to monitor him at home, or to see if he was contagious.
Put another way, the tests that were performed seemed more to satisfy a wholly ineffectual but costly ritual than to address a known problem and one that had that day, or the day before, been broadcast to hospitals as a serious threat by the CDC.
But the Texas Health hospitals, like any hospital system in the US, it seems, was under no legal obligation to abide by the CDC guidelines. I find that incredible, in that I can’t quite believe it. But then I remind myself that the US still operates under a laissez-faire medical system that seeks to maximize patient cost at the expense of social health.
This situation was predicted a long time ago by me and many others. My cry now is for wide reform. But my guess is that the situation, like the ferry disaster (itself one of many instances of government corruption and misprision), will be essentially ignored. Which points to where the power lies.
I would love more detailed work, especially something that actually lays out the steps–and the anticipated obstacles. Otherwise, this is nice, but there’s no end of happy ideas for the future that then become sad reflections.
Seems kind of like a belated whine. Or did anyone think that Linus had altered his colorful ways and manner? And it’s also a well-known truth that open source (and this includes some parts of Linux, too) is not a simple thing but has continents of difference in how community is envisioned and organized.