You get what you pay for.

Canadians have been told for years how great their socialized "free" healthcare system is; that it is the envy of the rest of the world. The truth is somewhat different though.

My wife is actually the only member of our family who has a family doctor. He doctor won’t see my sons and I because we don’t make enough appointments with her.

In fact, she requires my wife to make a different appointment for every health concern. She won’t discuss more than one thing at an appointment. She also will not gove my wife more than a single month’s prescription, even for drugs that she needs to be on every day. She instead insists that my wife make another appointment every month just to renew the prescription.

Last week my wife had surgery and she is not allowed to drive or really go too far for two weeks. Her doctor is fully aware of this. Yet to renew a prescription for a drug that she must take every day, her doctor insisted that she come in for an appointment, against the advice of her surgeon. Fortunately the pharmacy knows her and they gave her a seven day advance on that medicine.

This doctor has done other things that border not only on the questionable, but also the unethical.

Now you might suggest that we simply find another doctor. But that isn’t how it works in Canada. Where we live, and area with a population of around half a million people, there are about 20,000 without family doctors. Few doctors are taking on new patients, and those that do often will not take on someone with pre-existing health conditions. So if you have a doctor, no matter how bad, you really can’t risk jeopardizing that.

Imagine a situation where you are receiving poor healthcare, but you can’t complain or do anything about it, because the only other option is no healthcare. You can’t even complain about unethical situations for the same reason. Bad doctors are protected by the mere fact that they are just slightly better than no doctor at all.

Of course we don’t have to imagine it; we live it every day.

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A moral and spiritual challenge.

You could be forgiven if you, as I, thought that global warming or climate change was a scientific challenge. Yet in his statement upon being awarded the 2007 Nobel Peace Prize with the IPCC, Al Gore had this to say:

“The climate crisis is not a political issue, it is a moral and spiritual challenge to all of humanity,” Gore’s statement said. “ It is also our greatest opportunity to lift global consciousness to a higher level.”

Not a political issue. Not even a mention of a scientific issue. It’s a moral and spiritual challenge. So if you believe that climate change is man-made, then you are good. If you don’t believe, then you are evil.

Sounds a bit more like a religion actually.

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Sound familiar?

I was reading the article Diet and Fat: A Severe Case of Mistaken Consensus the other day in the New York Times, and parts of it sounded quite familiar. The article uses the mistaken belief that high-fat diets cause heart disease to explain an "informational cascade", where groups are prone to reaching mistaken conclusions, or consensus.

Does this sound familiar?

The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the food industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.

With skeptical scientists ostracized, the public debate and research agenda became dominated by the fat-is-bad school. Later the National Institutes of Health would hold a “consensus conference” that concluded there was “no doubt” that low-fat diets “will afford significant protection against coronary heart disease” for every American over the age of 2. The American Cancer Society and the surgeon general recommended a low-fat diet to prevent cancer.

But when the theories were tested in clinical trials, the evidence kept turning up negative.

What if we substitute global warming for high fat diets? Might it look something like this?

The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the energy industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.

With skeptical scientists ostracized, the public debate and research agenda became dominated by the man-made global warming school. Later the IPCC would hold a “consensus conference” that concluded there was “no doubt” that humans were causing global warming. The IPCC recommended reductions in carbin emissions.

But when the theories were tested in trials, the evidence kept turning up negative.

Yes, that’s where I’ve heard it before. And that turned out to be a false consensus, even though it was perpetuated by numerous experts:

Mr. Taubes told me he especially admired the iconoclasm of Dr. Edward H. Ahrens Jr., a lipids researcher who spoke out against the McGovern committee’s report. Mr. McGovern subsequently asked him at a hearing to reconcile his skepticism with a survey showing that the low-fat recommendations were endorsed by 92 percent of “the world’s leading doctors.” [emphasis mine]

Yet that 92 percent of the worlds leading doctors turned out to be wrong.

My favorite part of the article is the final two paragraphs:

“Senator McGovern, I recognize the disadvantage of being in the minority,” Dr. Ahrens replied. Then he pointed out that most of the doctors in the survey were relying on secondhand knowledge because they didn’t work in this field themselves.

“This is a matter,” he continued, “of such enormous social, economic and medical importance that it must be evaluated with our eyes completely open. Thus I would hate to see this issue settled by anything that smacks of a Gallup poll.” Or a cascade.

Werecognize that we have mistakenly achieved false consensus in the past, and we understand the reason we made that mistake. Yet we can’t possibly admit that this might be happening again. Instead we seem to think that it is ok to accept the consensus. And to punish those that wish to think for themselves.

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Rewarding your best customers.

This post at productmarketing caught my attention:

Hertz has offered me the honor of joining their frequent renter program. For only $450, I can get a car whenever I want. Huh? Don’t I already get that? I have never been unable to rent a car… from Hertz, Enterprise, Avis, or everyone else! Oh, and preferred parking. Nice. (Actually, now that I mention it, it seems that they have been parking my rental car as far away as possible. Maybe they’re softening me up for this ludicrous offer.)

I agree. It is a ludicrous offer. But it got me thinking, why would someone want to charge their best customers a fee for better service?

These are the customers that you expect to spend the most money on your products.Why not create a frequent renter program that emulates those of the airlines; if you rent enough then you automatically attain prestige, elite, or super-elite statuses, and the extra special services that go along with them.

It would be great too if the highest volume renters received something special for themselves. A discount rate certainly benefits the companies they work for, but travel can be tedious, and something like a free car upgrade makes the trip much more pleasant for the travellers themselves.

You don’t build loyalty by allowing your best customers to buy the service they should already be getting; you build it by rewarding them for their patronage.

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Blocking Facebook.

I’ve read about institutions blocking Facebook, but I’ve never experienced it – until today that is.

My wife had some surgery today at Grand River Hospital in Kitchener, Ontario.When I came up to visit she was still quite drowsy, so I was overjoyed to find that they had a free WiFi network, which is so very rare in this area. So while she sleeps I can work.

However, the hospital blocks Facebook, and I’m writing a Facebook application, so I’m pretty much out of luck.

What surprises me most though is that all I see is busy people working and moving all around the place. When exactly does the hospital expect that they would sit around using Facebook?

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I’ve actually had conference calls like this.

I swear, if I hear the expression "Let’s grab the low hanging fruit" just one more time I’m going to explode. This and other expression haunt my thoughts of the thousands upon thousands of conference calls I’ve been on. Sometimes you wonder what these people are actually thinking, if they are at all.

For all of you who have ever suffered through this, Joe the Peacock captures the moment perfectly:

IF YOU SAY "Drink the Kool-Aid" ONE MORE GODDAMN TIME, I’M GOING TO BURST THROUGH THE WALL AT YOUR OFFICE, KILL YOU IN A VERY UNSIGHTLY AND BLOODY WAY, AND THEN SCREAM "Oh, YEAH!"

Via Valleywag.

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The future of web startups.

Paul Graham of Y Combinator has expanded on a keynote presentation to provide a detailed view of the future of web startups:

There’s a pattern that we see over and over in technology. Initially there’s some kind of device that’s very expensive and custom made in small quantities. Then someone figures out a way to make them much more cheaply, and orders of magnitude more get built. And that allows them to be used in ways that would have been inconceivable before. [...] Now as well as being produced by startups, this pattern is happening to startups. It’s so cheap to start web startups that orders of magnitudes more will be started. And if the pattern holds true, that should cause dramatic changes.

It costs virtually nothing to start a startup these days.And Rick Segal has already mentioned how easy it is for a university professor and a couple of bright students to throw something cool together for next to nothing – and beat the big guys to the punch.

Paul breaks it down into ten factors:

Lots of Startups When starting a startup was expensive, you had to get the permission of investors to do it. Now the only threshold you have to get over is whether you have the courage to.
Standardization We often tell startups to release a minimal version one as soon as possible, then let the needs of their users tell them what to do next. In essense, let the market design the product. We’ve been doing the same thing ourselves. We think of the techniques we’re developing for dealing with large numbers of startups as like software. Sometimes it literally is software, like Hacker News and our application rating system.
New Attitude to Acquisition Another thing I see starting to get standardized is acquisitions. As the volume of startups increases, big companies will start to develop standardized procedures for acquisitions, so they’re little more work than hiring someone.
Riskier Strategies are Possible If startups are easy to start, this conflict goes away, because founders can start them younger, when it’s rational to take more risk, and can start more startups total in their careers. When founders can do lots of startups, they can start to look at the world in the same portfolio-optimizing way as investors. And that means the overall amount of wealth created can be greater, because strategies can be riskier.
Younger, Nerdier Founders If startups become a cheap commodity, more people will be able to have them, just as more people could have computers once microprocessors made them cheap. And in particular, younger and more technical founders will be able to start startups than could before.
Startup Hubs Will Persist It’s true that you can now start a startup anywhere. But you have to do more with a startup than just start it. You have to make it succeed. And that is more likely to happen in a startup hub.
Better Judgement Needed If the number of startups increases dramatically, then the people whose job is to judge startups are going to have to get better at it. I’m thinking particularly of investors and acquirers. We now get on the order of 1000 applications a year. What are we going to do if we get 10,000?
College Will Change If the best hackers all start their own companies after college instead of getting jobs, that will change what happens in college. Most of these changes will be for the better. I think the experience of college is warped in a bad way by the expectation that afterward you’ll be judged by potential employers.
Lots of Competitors If it gets easier to start a startup, then it’s not just easier for you, but for competitors too. That doesn’t erase the advantage of increased cheapness, however. You’re not all playing a zero-sum game. There’s not some fixed number of startups that can succeed, regardless of how many are started.
Faster Advances If people get right to work implementing ideas instead of sitting on them, technology will evolve faster.

The full article provides a lot more detail and is worth reading in its entirety. Clearly there is a great advantage to being located in a startup hub such as the Waterloo Region, as wel as being able to influence what kinds of subjects are taught by the local universities. This has been obvious with addition of programs such as MBET and Software Engineering.

Cross posted at the Communitech Blog.

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We’re all criminals now.

It seems that Sony has changed it’s position on copying music:

Pariser [head of litigation for Sony BMG] has a very broad definition of "stealing." When questioned by Richard Gabriel, lead counsel for the record labels, Pariser suggested that what millions of music fans do is actually theft. The dirty deed? Ripping your own CDs or downloading songs you already own.

Gabriel asked if it was wrong for consumers to make copies of music which they have purchased, even just one copy. Pariser replied, "When an individual makes a copy of a song for himself, I suppose we can say he stole a song." Making "a copy" of a purchased song is just "a nice way of saying ‘steals just one copy’," she said.

That makes me a criminal, even though though I ripped the CDs I had purchased and put them away in a box, never to be used again.That probably makes every iPod owner a criminal as well even though they, like me, legally purchased the music they are listening to.

Of course that stands in direct contradiction to what they told the Supreme Court not so long ago:

MR. VERRILLI: I disagree with that, Your Honor. Certainly not — I don’t think there’s any empirical evidence to suggest, with respect to any of the things that Your Honor just identified — and let me pick out the iPod as one, because it’s the most current example, I guess. From the moment that device was introduced, it was obvious that there were very significant lawful commercial uses for it. And let me clarify something I think is unclear from the amicus briefs. The record companies, my clients, have said, for some time now, and it’s been on their Website for some time now, that it’s perfectly lawful to take a CD that you’ve purchased, upload it onto your computer, put it onto your iPod. There is a very, very significant lawful commercial use for that device, going forward. [emphasis mine]

It’s nice to know that Sony’s lawyers are so… flexible.

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Think before you talk.

Marc Andreessen has a funny take on Steve Ballmer’s comments about Facebook yesterday:

Via the UK Times:
"I think these things [social networks] are going to have some legs, and yet there’s a faddishness, a faddish nature about anything that basically appeals to younger people," Mr. Ballmer told Times Online yesterday.

Ballmer subsequently added:

"I think these things [talking motion pictures] are going to have some legs, and yet there’s a faddishness, a faddish nature about anything that basically appeals to younger people."

"I think these things [televisions] are going to have some legs, and yet there’s a faddishness, a faddish nature about anything that basically appeals to younger people."

It’s a bit odd that the company that wanted to put a personal computer in ever home would think that people might actually want to use them to share information. Other than Word and Excel documents that is.

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A disconnect.

As I spend this week at Entrepreneur Week and events like BarCampWaterloo I’m noticing a disconnect.

At BarCampWaterloo most people had their laptops open, blogging, twittering, and checking email, yet were fully involved in the conversation.They just had multiple information channels going simultaneously.

At the EntrepreneurWeek events, I’m one of the rare people with a laptop open. Some people have devices like BlackBerries, and I guess they feel that having email access means that they are connected. But with the multiple flows of information available now, email just isn’t enough.

As we move forward into the always on, always connected world, it makes me feel very comfortable that there are people around me who get it, and who realize the collaborative power of these tools.

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