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Comment Re:Start twisting (Score 5, Insightful) 292

The problem Chairman Pai must now confront is not unlike what his fellow Republicans in Congress are facing with healthcare: the market does not always produce socially optimal results. There is no market solution in which insurance companies will look at 55-year old cancer patient with diabetes, kidney stones, two knees in need of replacement, and a raging case of herpes and think to themselves "Hmmm...I smell Profit!". From the insurance companies' perspective, the most profitable healthcare plan for that fellow involves a coffin.

Likewise, if it costs $20-50K in trenching and cabling to connect a single rural user at halfway decent broadband speeds, there's no way the ISPs are going to ever break even on that customer if he's paying $50-100 a month. Hence, the market completely ignores the poor and those living in the sticks.

It's admirable that Chairman Pai recognizes that universal Internet access is central to economic prosperity, and I wish him the best of luck despite the source of his nomination, but achieving universal broadband will not happen unless there is a mandate from the government that it happen, as well as considerable funding in the form of tax credits or direct expenditures. Waving around hands and solemnly intoning "The Market knows all! The Market solves all!" will not make those realities go away any more than it would in the healthcare debate.

I am unaware of anyone ever being denied internet access because of gender, religion, or sexual orientation. However, there are racial disparities in internet access owing to our history of segregation. Many of the high-poverty neighborhoods bypassed by ISPs are, not surprisingly, places that fell victim to redlining and the urban blight that followed it.

Comment Re:Obamacare (Score 1) 314

Not exactly...


Short version: during an unexpected spasm of fiscal sanity in 2010, the government cut $58B in wasteful fees that were being paid to banks. Of that savings, around $9B was used to shore up the ACA funding. Nearly $10B went to shore up Pell grants. While it's true that more of those cost savings could (and probably should) have been passed onto students drowning in debt, it's not like there's a line item on your Navient statement that reads "ACA Surcharge".

Comment Re:And to think the DNC wanted to face Trump... (Score 1) 2837

During the 1970s, the wage gains that made the middle class grow in the 50s and 60s collided with crude oil shocks to create stagflation. In 1979, Carter appointed Paul Volcker as Fed Chairman, who jacked interest rates up all the way to 11.9%, intentionally sending the economy into a crater in an attempt to bring down inflation. This act tossed millions of people out of work (my father included), but it did bring inflation under control. The Reagan "boom", such as it was, came not from sound Republican policy, but from the good luck of being in office when the intentionally inflicted pain stopped.

Whether you view Volcker as a hero or a villain (I tend towards the latter), Reagan's economic policies had little if anything to do with it. He simply inherited the outcome of labor and capital battling over who would bear the cost of the oil shocks. In that battle, capital won. It won so decisively, in fact, that Wall Street named a credit card after it to commemorate the victory.

Comment Fine for basements, not for anything else (Score 5, Interesting) 264

I love Linux and open-source software. I used a Linux desktop for 15+ years as a software developer. For servers, it's a no-brainer. I'm rooting for Linux.

For audio work, I won't touch Linux with a 10-foot cattle prod. It's just not there yet, and it's not going to be anytime soon.

I spent several years attempting to keep Linux at the center of my studio, and I wish I hadn't. The user experience for a seasoned studio engineer is light-years behind Windows and Mac. I was forced to compile real-time kernels and custom versions of Ardour, got rid of my MOTU interfaces because the manufacturer hates Linux, spent countless evenings swearing at xruns, and developed a well-honed contempt for JACK's almost Windows NT-like stability. Working with MIDI and audio required lashing Ardour, Rosegarden, and Hydrogen together with duct tape and wishful thinking. Audio latency was never decent enough to use most effects while monitoring.

Every time I hit record with other musicians, I said a small prayer to the USB bus gods that nothing would explode mid-take. This is not a mindset conducive to creativity.

Did it actually work? Yes, after a fashion. There are some bright spots: Alsa Modular Synth sounds awesome, the Calf Audio plugins are as good as anything on the proprietary side of the fence, and Ardour is serviceable in a 2003 kind of way. I managed to record a few albums of material using that setup, but it was not an experience I would recommend to anyone. It felt like I was doing more tech support than creating.

Eventually I sucked in my open-source pride and bought a Mac with Logic Pro X on it. Pretty much everything that I've done on it worked right out of the box. It hurt my soul to hand $3K to an Apple Store genius, but now I spend my free evenings recording instead of swearing. I can only hope that Richard Stallman doesn't show up at my front door to lecture me, or worse yet, sing that god-awful GNU song at me.

Time is money, and free time is the most expensive of all. If you value your creative time in the slightest, don't bother with Linux. Get a Mac or PC, load it up with an industry-standard DAW, and make some noise. You may not please St. Ignucius, but you will at least be productive.

Comment Transactional DDL (Score 2) 244

PostgreSQL supports transaction DDL statements (e.g. ALTER TABLE, CREATE TABLE). MySQL doesn't. If you run a poorly-written upgrade script against a MySQL database and something goes sideways, your only recourse is to restore from backups. This means that any sane MySQL upgrade plan involves testing the upgrade on a replica of the database first. For large or mission-critical deployments that usually isn't an option.

If all you're looking for is a cheap DB to serve a Wordpress blog about your hamster, MySQL away. Otherwise, use PostgreSQL. You'll sleep better.

Comment Re:My sister is a nurse (Score 1) 232

Good certified professional coders working in a non-HMO setting can make north of $25 an hour if they are productive. They are also very difficult to find. Since the job that coders do determines whether or not your facility gets paid for a $20K procedure, most places tend to err on the side of caution and spend the extra cash on a good one.

The reason that Kaiser doesn't pay as much for their coders is because the only time Kaiser submits claims to an external entity is for certain subsets of Medicare patients. Otherwise, they are both the insurance company and the provider, which means that they don't have to spend lots of time and money convincing an insurance company to cough up the requisite payment. They will occasionally outsource care to a third party lab or surgery center, but that's the exception.

Comment Re:How Much? (Score 1) 232

Depends on whom is calculating the costs.

Insurance companies profit every time you need healthcare, and can find a plausible reason to ration it or deny it completely. Most insurance companies now do pre-authorization for services based on the diagnosis codes. By making diagnosis coding more granular, they have more of an opportunity to save money prior to dispensing care, or by denying your claim after the fact, by saying "You had diagnosis X, which our contract with your provider does not cover for procedure Y". Conservatives refer to this process as a death panel. Liberals refer to it as "bending the cost curve", which has a more pleasant ring to it, even if the net effect is that you don't get treatment in a timely manner, if at all. Please select your preferred side of the political spectrum and rage accordingly.

Providers' costs will probably be a wash. Most providers already have someone who is a Certifier Professional Coder on staff, or they contract it out to a third party coding company. Strangely, these people refer to themselves as Coders, which tends to confuse the hell out of the IT staff. This individual is tasked with reading the pre- and post-procedure diagnosis and procedure report, and assigning a set of CPT and ICD codes to the encounter. These are, in theory, used for clinical purposes, but the main reason procedure and diagnosis codes exist is that they form the terms of the contract between payer and provider. This coding process tends to have the same precision as a group of witches divining the future from cat entrails, because of a wonderful little concept called "unbundling". Let's say that an anesthesiologist is performing a spinal block in which they inject narcotics and steroids into multiple levels in your back. Some combinations of spinal blocks are issued their own procedure codes, whereas other spinal blocks can be billed for separately. If a coder fails to group the separate procedure codes into a proper bundle, or fails to justify the code with the correct diagnosis, CMS and an entire army of subpoena-wielding acronyms will crawl up their butt screaming "FRAUD!!!", because frequently the total of several individual codes will pay much more than a single bundled code. With a more granular coding system, the coder may need to spend a bit more time per report finding the right level of detail, but in theory the number of unpaid visits and claim denials will go down, because they and the insurance company now have a more accurate agreement on what diagnosis will justify the treatment they are providing. ICD-10 covers the diagnosis portion of the coding system, but rest assured, the AMA will soon be confusing the hell out of us with an equally arcane set of new procedure codes.

Incidentally, the procedure codes can and do create some perverse incentives in healthcare. For example, if an orthopedic surgeon is performing a knee procedure with an MCL repair and doing it laproscopically, she is actually paid MORE if she makes two incisions than if she makes one. Reason? There is a single code for "Knee arthroscopy with MCL repair", and separate codes for arthroscopy and MCL repair as their own procedure. Medically, it's safer if you do both procedures with a single incision because of lowered infection risk and less bleeding, but the the difference between the bundled code and the unbundled code is that second incision. So the coding system actually creates a financial incentive to perform a second incision. This is especially true if the procedure is done in an outpatient facility that the surgeon happens to have ownership in.

Universities, research companies, EMR vendors, and biotech firms using big data analysis to perform studies will consider this granularity a godsend, because they won't have to squint as hard at the data to tease things out. Whether you, the patient, want your record to be teased without your knowledge or consent is a debate for the future, but the medical benefits of being able to data-mine everyone's record will likely far outweigh the privacy concerns. Without a centralized way of accessing medical records in an anonymized manner, this will not happen anytime soon.

EMR firms will also be big winners. As of today, electronic medical records are not directly processed by the government, because there is no federal standard for medical record interchange. Some states, notably Massachusetts with their HiWAY program, have either built or are planning to build a statewide medical record exchange, so that each EMR vendor will only have to deal with one format in and out, and the exchange will handle the details of transferring records between providers (e.g. you have a lab test done that your surgeon needs to look at, but both are separate business entities). Although it isn't on the legislative roadmap yet, sooner or later Congress critters will get it through their Kevlar-plated skulls that this might be a good thing for the feds to subsidize and/or standardize, so that EMR vendors have one standard to deal with, rather than 50. Having a reasonably granular set of codes means that describing an encounter will be easier to do in a standardized manner, which in turn should lead to more portability. Of course, with every seismic shift in healthcare IT comes a slightly delayed tsunami of billable hours from IT consultants "helping" you navigate the transition, so providers will lose as much as EMR vendors will win, if not more in terms of productivity losses associated with reimplementations.

Patients, as always, will lose money, because the cost difference between what the provider pays and what the insurance company thinks they will pay will likely increase.

Comment No mention of Sonatype's business? (Score 5, Informative) 130

It should be noted that the company releasing this report, Sonatype, markets a product called Insight Application Health Check that scans your binaries for libraries with known vulnerabilities.

I have never used their service, and can offer no comments on its utility or value. However, it is a bit unseemly that TFA doesn't mention that the source of their information about this very real problem also sells a service that solves it. This is a knock on IT World, not Sonatype.

Comment Annoying, but workable (Score 1) 278

What the OP wants is perfectly possible. I'm typing this on an Ubuntu 12.04 box running the most recent Catalyst driver, and connected to three 1920x1080 monitors. Two are DVI, one is via a DisplayPort->DVI adapter. Video card is an older Radeon 6950. It works, more or less without issue, for what I do: coding in Eclipse, browsing the Internet, etc.

Using the open-source driver works for triple monitors, but the power management is not up to snuff in the open-source driver, and the fan on the video card gets annoyingly loud after a few minutes. This is the only reason I run the closed-source driver. Strangely video playback is smoother with the open-source driver in the triple monitor scenario.

Contrary to popular myths, you do not have to edit a config file for either closed or open-source drivers to enable magical triple monitor goodness. Both were able to detect and orient the monitors using either the Ubuntu monitor control panel or the Catalyst Control Center.

Things that don't work as well: video playback and 3D games. Video will get choppy full-screen if tear-free mode is enabled, and the tearing is intolerable when it's not. Likewise, performance for 3D games across 5760x1080 is iffy. I have a laptop for gaming and an HTPC for the video stuff, so it's not a deal-breaker for me. The OP did not specify what kind of engineering he/she does (circuit design? CAD? software?), so the 3D performance may well be an issue depending on the tools being used.

I have tried the Nvidia route several times, but always came away frustrated. AMD cards Just Worked for this application. Google 'Linus Torvalds middle finger' for a more complete technical discussion of why this is.

Getting a reliable triple monitor setup on Windows or Mac is much easier than in Linux, but most that experience can be chalked up to X. In theory, Wayland or Mir will handle this much better, but no stable distro uses them by default, and none of the high-level toolkits have mature support for it.

Comment Re:Um, wrong cause for the effect. (Score 3, Insightful) 530

Picture a desert island with two people. At first they both work all day long to survive. Later, they improve their lot, to where they each only have to work half the time to survive. The other half can be spent loafing, or working to get more comfortable. Is one of them entitled to relax and do nothing while the other needs to work all day long to support them? Of course not. Each person has the option of working full time to improve their position, part time to simply survive, or they may die. They aren't owed anything.

Your analogy is missing a third party: the absentee owner of the island. A more accurate analogy would be that, having developed a more efficient means of harvesting coconuts, one of the two island inhabitants receives a slightly larger number of coconuts than before, while the second fellow's previous coconut wages were instead diverted to the island owner's offshore pina colada factory, leaving the second fellow to eke out a decidedly calorie-free lifestyle.

This is, in the island owner's view, the proper order of things: he paid the fellow to develop a more efficient coconut harvesting strategy, and thus is entitled to a nice drink at the end of the day.

This is, in the first fellow's view, also the proper order of things: he developed the improved technique, and thus is entitled to a few extra coconuts.

In the second fellow's view, any discussion about the abstract problems of coconut division in an isolated island economy is pointless academic frippery because he is, at this point, starving to death on a fucking desert island.

Sooner or later, productivity gains will land us in a scenario where there isn't enough work to go around, and the jobs that do remain will require so much technical expertise as to render them unattainable for most people. For the remaining majority, the question is: what the fuck are we going to do in order to earn our daily coconuts?

Comment Re:PDF is fine (Score 1) 221

PDF is about the only format where you can mix a lot of elements, get it to look like you meant it to

Ah, but therein lies the problem...if you meant for the document to be printed on an 8.5x11" piece of paper, and I instead try and read it on my 7" Nook (rooted and running CyanogenMod, of course...), then we have a problem. Namely, that I need to zoom in and scroll around, when the text should just reflow.

Comment Re:You are right, and wrong (Score 1) 728

Simple...drive away with the Costco truck containing said pallet of 65" TVs while the driver is out in front gorging himself on cheap pizza and $2 hot dogs. And make sure you leave your gun at home.

Plus, if someone tries to mug you in the parking lot, you now have a truck with which to run them over. It's a win-win for everybody, except the mugger. And Costco, obviously.

Comment Re:Dear aunt, (Score 2, Informative) 221

13 years ago, when I entered the medical transcription industry, the fellow who sold us our dictation system told me that he was a dead man walking: voice recognition was going to KILL the transcription industry, and he almost felt guilty selling us the system. When we mentioned we had looked at Dragon, he practically cried. 13 years later, that salesman is now deceased, and the transcription industry is larger than ever. Voice recognition in transcription is like Linux on the desktop: every year, articles pop up saying that THIS year will be the year medical transcription dies at the merciless hands of voice recognition.

For a guy in an industry that Netcraft has confirmed is deader than FreeBSD, I'm doing pretty well.

I now own a medical services company that does transcription, so my opinion is certainly biased here, but I fail to see the economic logic in turning a physician, who makes between $120-250K per year, into a clerical worker editing his own files. Especially when said clerical worker can be seated in India. Time is money, and the time of physicians and surgeons is one of the most expensive line items on your medical bill. Even with transcription prices as they are today, tacking 20 minutes of extra editing time onto a doctor's already long work day means that I can do it cheaper with manual labor. Voice recognition just means that I need one MT and a voice recognizer instead of one transcriptionist and a QA person.

Internally, we use a batch speech recognizer based on Sphinx, as the Dragon source is too expensive to license in the volumes that we do. As one of the earlier posters said, the code is the easy part...it's generating the speech corpus that's the really expensive part. Developing that was easily a seven-figure outlay in labor, which is why you don't see any usable free medical speech corpi available for free* on the Internet. You'd think with all the federal money being thrown at making medical records electronic that they could spare a few million to develop an open-source speech corpus, but that would make too much sense.

As long as physicians and surgeons are better paid than the rest of us, someone will be doing transcription.


* If you know of one, post a link...believe me, we've looked.

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