Google now offers "the ability to restore" texts, original quality photos and videos as a service, which they have almost certainly been archiving anyway.

Correct. FTR, I tried sets and tabs; It was a drag om my dev machine. Tabbing took seconds with alt-tab. All my embedded links would open in edge instead of my default browser. It was a mess IMO.

Onlyoffice is very nice and affordable. It would be my "go to" if I was abandoning MS on a budget.

No, it is just that easy. And forget about OX if you dont have 10,000 users unless you want to go full cloud. Deploying dovecot and postfix on a headless ubuntu server is well documented. If you dont ldap, then ispconfig is super easy and covers all your basics. Otherwise, certs are covered by letsencrypt/certbot. Postfix smtp is protected by saslauthd. Spamassasin is called on-demand by amavis and updates each night. Just need to be sure you have your own local caching server for DNS or your free spamhaus RBL will not work very well if at all. An affordable groupware that I think is well rounded is OnlyOffice -- it's super nice and partially integrates with nextcloud if you are into that. Also in place of activesync you can use Z-push. There is literally an alternative for everything if you are brave enough to RYO and work out of command line to create inboxes and aliases cuz I have never seen a good ui outside of full blown groupware.

Did not test before repeal. Tested from Des Moines to Dover Delaware ( Comcast ) however. Had the similar results. Makes no sense about scanning the uploaded archive because the entire archive would need to be uploaded to extract the compressed content. Even without a file extension, the first 4 bytes of a file will generally tell you what type of content you are dealing with. There was clearly content filtering / throttling going on, and no, it was not my Juniper SRX doing the filtering. Since there are no guarantees for bandwidth or speed on residential lines im sure they are well within their rights and there is no recourse -- with or without net neutrality.

I am 100% certain this is true. Today i was uploading files from behind mediacom in Des Moines to earthlink in Houston on my residential mediacom account. Files with different extensions transferred at different rates. A file with a .zip extension would upload at 100kbps average A file with a .msi extension would upload at 2.5mbps average. Tested this several times afyer noticing to confirm.

Exactly. By "We weren't making our own coders" I think they mean we didn't over-saturate the market enough to drive down the value of the job for prospective U.S. employees. Only a couple weeks ago I read an article on tech companies nagging over paying US developers US wages, now this nonsense? A long time ago I argued that off-shored services should be taxed like an imported good and to my astonishment someone argued back that companies already pay taxes for those employees in their respective countries. I find it insulting corporations think we are actually dense enough to buy into this garbage or that anyone gives a snip about the pittance of taxes corporations pay in foreign countries to drive up profits at the expense of US jobs.

Not many EHR's are built around a practice management. Except for example Athena, which in that case I completely agree.

indeed, which will ultimately affect how you are rated for health and life insurance. This is a terrible approach to healthcare because if I know my rates will be affected by what I share with my doctor and how they diagnose me, then I probably wouldn't have the proclivity to disclose important information about my health to a physician in the future.

You must work for one of them, and Im guessing you only work in the acute care segment. Epic is the most linear, rigid, and costly system in the market. Although I will admit its tightly integrated between acute and ambulatory care. I feel like they might be afraid of competition when it comes to inter-operability. Cerner's products are half-assed at best but they offer much more inter-operability because EMR is a secondary or tertiary market to them and like McKesson, they make their money in other places.

Im gonna say you are half correct. Doctors are buying MU certified electronic records systems for two reasons.

1. The government believes they know what is meaningful in healthcare. As part of a 600 billion dollar stimulus they committed 29 billion dollars on a first-come first-serve basis to general practices and hospitals in order to adopt electronic systems they deem to be meaningful.
2. Medicare will reduce reimbursements if you are not using an electronic system certified ONC-ATCB. 2% this year, then 3% next year and so on.

Here is where I disagree. The push for MU certified EHR's has not helped to create more jobs and EHR software vendors. ONC-ATCB, CCHIT, and Electronic prescribing certifications are very costly. Smaller companies with tighter budgets have been squeezed out of the market, and those lucky enough to be bought out have seen their staff and products suffer attrition. So the market is not being saturated with more shitty software products. The market has the same shitty products and is being under-saturated with higher quality innovative products during this meaningful use money-grab.

Doctors are buying up these systems under the impression that the cost of ownership over 5 years is practically nothing because the government will give them meaningful use money. I never thought MU would be solvent through 2019, and I happen to know doctors who have received letters from the state where they practice advising that they dont have money to pay them for MU at this time. So the docs absorb this cost up front, some may never see any money, and once the MU program ends, they are stuck in a subscription contract paying over 600 dollars per month per physician for a shitty EHR that is more of a hindrance than a tool the treat patients and run a business.

What's even crappier is as some of these systems are sunset, if the provider attested for meaningful use, then they must maintain their records for up to 9 years for audit; or be forced to pay back the MU money they received. The vendors that have bought out and terminated products do not have to offer a comprehensive migration path for their patient records and have no responsibility to maintain those systems as long as the doctors need to keep them for audits. That is bullshit! Back in the day, if the doctor switched brands of tabbed manilla folders this was not a problem. It doesn't end there though. When they are pigeon-holed into a new product it costs a lot of time and money to train staff. Training is often around $125 per hour, and usually runs about $3000 total for any decent training.

If the governments head wasn't up its own ass, they would have committed 29 billion dollars to small vendors and startups to produce more innovative EHR's and drive competition in the market to create these more inter-operable systems.

Oh, and IMO, CCHIT really isn't an inter-operability standard. I think of HL7, CCD, CCR and things of that nature when I think of standards. In my free time I write software to help doctors get their data out of their old system and into their new system as seamlessly as possible. I have a SOAP based model I have coded from the bottom up for data conversions in these systems, which i recently added some exposed methods for interfacing. That is what they really need to make these systems communicate with each other. Take HL7 to the next level... maybe they can call it HL8. :)

This is what you get when the federal government intervenes in things they have no business in or knowledge of directing. The role of the government is to enforce the constitution, protect the country and foster a healthy economy; none of which they are doing particularly well at this time. Instead we have the government focusing on subsidizing another program that will end up in a money-grab and trigger inflation. This is not FREE healthcare, and there is no such thing.
Want to drive the cost of healthcare down?
1. Go back to individual liability with the patient or their guarantor. Carry insurance for reimbursement. If the government wants to help underprivileged people then they can provide vouchers.
2. Cap malpractice suits. Doctors are certified by a board and if they are grossly negligible, then their license is revoked anyway.
3. Enforce more ethical practices with evidence based medicine. Stiffer penalties for doctors performing unnecessary procedures without a clinical diagnosis that such a procedure is necessary.

ObamaCare is "Robinhood" bullcrap that is failing at implementation and is neither manageable or unsustainable. It will ultimately collapse under its own weight. The simplest solution is often the correct one. ObamaCare is not that.