in search of sustainable and effective health care coverage reform

To this point, most of the discussion on health care coverage reform has been vastly disappointing.  The sides are so polarized that it’s degenerated into an unproductive shouting match.  The uninsured are the ones who will pay the price for this irresponsibility.

When I first heard the term “Death Panel”, I was convinced that former Governor Palin was referring to bad science fiction.  It is not surprising to hear reactionary populist tripe coming from a person whose primary focus appears to be self-promotion, not responsible leadership.  The short attention span mobs have seized control of the public dialog, while tangible progress in Congress has stalled.  The president has not shown the necessary visible leadership that would refocus the debate on what the goals are.  Charles Blow captures the mood well in this op-ed piece.

Complex problem.  No easy solutions.  No clear consensus.  I’ve had a number of conversations with people I disagree with politically.  It’s amazing what happens when two adults who disagree but want a positive solution work at it a bit.  In a number of cases, we seemed to arrive at some very common conclusions.  Each of us is experiencing conflicted thinking between healthy suspicion of large government-run efforts, and a common goal of social justice.

In yesterday’s New York Times, David Brooks wrote a very  interesting op-ed column on health care reform.  He cites an interesting article on health care reform, written by David Goldhill in this month’s issue of The Atlantic .  His gist is that we need to change the system at its core.  Reduce, rather than expand the role of insurance.  Focus the role of government on what it can do most effectively (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition).  And preserve or establish incentives for people to "do the right thing" – both from the health and financial standpoint.  It jibes with my belief that we need to change the basic business model of the health care industry in order to get the desired result.

Brooks also cites what looks like an interesting report from the Brookings Institute on ways to reducing health care spending, while improving quality. 

Also worth pointing out is an interesting clip of Senator Al Franken speaking to some concerned citizens (including some tea party folks) at the MN state fair about health care reform :

http://www.boingboing.net/2009/09/03/al-franken-talks-an.html

There are some interesting contrasts drawn in these examples with the hardline liberal stance on reform.  For example, Franken cites Swiss universal health care coverage as an example of a highly regulated but privately owned option that appears to work pretty well, and is more financially sustainable than a public option layered on top of the current health care model is.

I’m no subject matter expert, but recognize that the system as is needs some kind of disruptive change in order to reach even the simplest of goals. 

These articles are definitely food for thought.

seattle pride, watching and marching

This past Sunday, I took my daughters to the Seattle Pride Parade.  I’d always been interested in attending Pride.  It’s a great chance to show support for equal rights for all.

The girls took to the equality issue right away, and loved carrying the rainbow flag.

 

The parade was fun, albeit a bit long for us.  The beginning with "Dykes on Bikes" was LOUD.

 

There were many groups represented, many we’d heard of, and some we’d not.  For the most part, the day was all about equal rights and fairness.  The girls and I talked about the folks representing marriage equality and parental rights.  We also spoke about how things have changed over the years – even within my lifetime.  And we also spoke about how important it was to express support for equal rights, especially because their Uncle Matthew and Uncle Patrick deserve the same legal protection and rights as we do.

 

Not all of the people in the parade were "kid appropriate", but that was a chance I knew I was taking.  I could explain the nude roller bladers with body paint, but there were a few others I skirted explaining.

From my perspective, the point of taking the girls out there was to show them that not only is it okay to be gay, it’s important that we treat them fairly.  We spoke about how gay couples face challenges in the medical rights realm.  I explained to them that if Kris and I had been a gay couple, the doctors would not necessarily have asked Kris for permission to operate on my brain bleed following my accident last year.  Instead they would have asked my parents, or made their own decision about it.  This despite the fact that Kris and I have talked quite a bit about how we each wish to handle medical life/death questions.  We trust each other to make the decision that the other would want made.  This level of trust is the basis for all kinds of love, independent of whether you’re gay or straight.

And love is what binds people and families together, independent of whether you’re gay or straight.

After watching much of the parade go by, we got to join in and march with the Unitarian-Universalists, including people from our church.  We’d not coordinated with my parents, but were very pleased to join them as we all marched together.  All in all, a good day, with some great learning experiences.

 

how to best protect american engineering jobs

Interesting article in yesterday’s New York Times about immigration in the software field.  It centered on an engineer that Google had hired who was offered an H1-b visa to come work here.  He’d opted to live and work in Canada because his wife was permitted to work there, but not here.

Recently there’s been some controversy over whether engineers from outside the U.S. should be offered H1-b visas while American engineers are being laid off.  Even before the recession, people were wondering whether we want to encourage foreigners to work here, instead of hiring Americans.

As someone who has interviewed lots of candidates, I’ve observed a number of things.  Fewer Americans have been entering the software field these past ten years.  The numbers support this observation.  Put simply, we are not able to fill available positions with strong American-only candidates.  There just have not been enough good ones to select from.  On many interviewing trips, the majority of my candidates are folks who will require a visa, particularly amongst graduate students.

Illustrating this point, about seven years ago, my team consisted of nine people, eight of whom were from outside the U.S.  They were all fairly top notch engineers, and hailed from all over : South America, South Africa, India, eastern Europe, and also Montana.  Without all of this foreign talent, things would have been a lot tougher for me as a manager.  These folks earn the same amount of money as American engineers.  In fact – it’s more expensive to relocate them here (relo costs as well as legal costs associated with the visas).  It’s more expensive to hire H1-b candidates, but is generally worth it, because they’re top notch engineers.  In essence, you’re getting people who are ‘one in a million’ from these countries – verses a broader range of American candidates – so generally speaking the talent level is stronger.

In making this assertion, I’m drawing from lots of experience interviewing both American citizens from domestic universities as well as international candidates, interviewed overseas.

Folks who contend that the H1-b holders threaten American jobs are completely missing the point.  Bringing the best and brightest into the U.S. to work, pay taxes, and make American companies successful is the best way to protect the most American jobs.  It’s also the best way to promote America as being the best place to come and pursue one’s dreams, much the same way immigrants have done here for a couple of centuries.

Think about the alternative.  If you don’t bring the best and brightest here, you create incentive for companies to open new subsidiaries overseas, and beef up R&D centers in India, China, the Middle East, and other places with strong or emerging university systems.

In addition, it’s definitely healthier for American students to compete with the worldwide talent pool.  It drives their skills and aspirations higher.  It drives excellence in the university programs as well.

My $0.02.

seattle post-intelligencer – r.i.p.

This week marked the final paper edition of the elder of Seattle’s daily newspapers – the PI.  I have several sentimental attachments here, which make me very sad to see it go. 

First off – my good friend John was the Photo Editor for the paper.  In addition to being a great runner, and a really nice person, John was very good at his job.  You can check out some of his handiwork yourself by checking out the photo archives available on http://www.seattlepi.com/pimemories/final.asp.

Secondly, owing in large part to John’s input – a group of us graced the front page of the PI back in November of 2006.  This was for an article talking about Marathon Maniacs in general and the Seattle Marathon in particular.  The article and accompanying photo appeared between articles about Iraq War casualties and suicide bombers – an upbeat diversion with some good human interest as well.  I remember being interviewed for the article via cell phone, while in the car with two very unhappy, noisy kids.

Another sentimental time with the PI was seeing our late friend Peter commemorated there in 2005. 

The central issue for me is who will fill in the estimable gap for responsible local news reporting?  The few times I’ve watched local TV news have not impressed me.  The Seattle Times has been hit with staff reductions in recent years, and the emphasis is more and more on aggregating news from the wire services.

Over the years, the PI demonstrated good journalistic discipline and focus, which serve to keep public figures more honest.  Irony was evident in the Everett Herald’s account of the PI’s closing, in which they quoted controversial political activist Tim Eyman as attributing the PI’s closing to " … all the liberal policies they’ve advocated all these years have come home to roost and contributed to them going out of business,".  Eyman would definitely have motivation to dance on the grave of the PI, because the paper exposed him as skimming money off the top of his PAC in February of 2002.

The new PI will employ 20 reporters and 20 advertising folks.  That isn’t likely to yield much journalistic reach, no matter how hard they try.  Who’s going to keep people honest?  I understand that the business side of things needs reworking, but know that somehow – there’s got to be a financially viable way to do real journalism.

Check out the pictures of the last day of the paper PI too.  It illustrates that the people behind the paper will miss doing this.

Sadness.

nightline and gma redux

So – a couple of weeks back, my former GM Megan was profiled on Good Morning America and Nightline.

I’ve drawn a couple of conclusions after watching the interviews :

1. My wife and I will never agree to be interviewed on national television.  It requires a type of courage I simply do not have.  Anh and Megan demonstrated great poise in the spotlight, especially when fielding such incredibly personal questions.
2. I can’t believe that Megan makes time to get a run in, and cook pancakes for her son each morning.  That’s amazing!

Not forgetting for a moment that Megan and Anh are real people, I very much admire how they’re willing to share their journey with the rest of us.  A real family’s story is much more powerful and convincing than anything that the Human Rights Campaign (or any other fine organization like that) can say.

vietnam : not just a simile for “quagmire” anymore

There was a startling moment in President Bush’s speech to the VFW yesterday. He intimated to the crowd of veterans that we erred in withdrawing, leaving a power vacuum in places like Cambodia.  There was no mention of western interests destabilizing these governments in the first place.

His recommendation, given nearly 35 years of hindsight after the cease-fire was "stay the course".

This development is alarming in numerous ways. 

First, it confirms that the hand of Kissinger is still active in our foreign policy.  Remember that his tack during the Paris Peace talks in the early 1970s was to establish just enough of regional strength to be able to withdraw without appearing to "lose the war".  Didn’t work then either.  Second concern here is that bush wasn’t immediately laughed off the podium.  I worry that there isn’t enough memory of Vietnam’s costs weighing into our decisions today.

The costs go well beyond the immediate human toll, both civilian and military, but those are pretty staggering.  Remember hearing about soldiers without the appropriate body armor?  Think reports that our military resources are spread very thin are hyperbole?  What about the scandalous care offered at Walter Reed?  Read this article from yesterday’s NY Times about a photographic exhibit of injured vets.  Read about the substandard medical care we offer our veterans.  90% of war injuries are survivable now, owing to advances in emergency medical care, meaning many more vets return requiring long-term care.

Now – about those Iraqis.  Think about the lack of infrastructure available in Baghdad.  Access to basic services like clean water and electricity remains very sporadic, four years after Mr. Bush rode in on a jet under the "Mission Accomplished" banner.  Control over the electrical grid is very much in play among the local militias.  There’s no way that our military can impose and sustain control under these conditions.  This is exactly what happened in Vietnam, except that the enemy was more exposed, and therefore much more easy to confront.

The truly worrying thing about all of this is that there is not nearly enough solidarity around a cogent set of solutions.  The Democrats focus way too much on using the right words for the "withdraw now" crowd, and not enough on providing adult supervision for the inmates currently running the asylum.

politics as usual populism

Many of us in the technology field have been watching unamused as our elected officials have been duking it out over immigration.  They’ve concentrated on whether or not the president’s guest worker program should be included as part of the bill.  Yesterday prospects dimmed again.

The GOP folks seem concerned about providing a legal means for people to enter the country, apparently forgetting that we want the US to be the place where people want to come to work. 

The Democrats are focused on providing this means, but are ignoring all other facets of immigration – such as the H-1B visa program.  Also – they tend to worry about "losing American jobs" to foreign workers.

Why do I care?  Well – last December I traveled to Cairo Egypt for my employer to recruit some bright engineers to come and work for us in the Seattle area.  At a cost of tens of thousands of dollars, six of us went there, and invited candidates from Egypt and South Africa to come and interview.  We ended up extending full time offers to (I think) about 11 of them, and began the arduous process of applying for visas.  Back in April we received word that there would be a lottery for these visas, and that given the number of applications, there was a less than 50% chance for each candidate to get in.

The consequences of not getting in mean that a candidate must wait a full year for a new H-1B 1quota to open up.  Best case scenario is that an application is approved and the candidate starts work ten months after an offer is tendered.  Otherwise, it’ll be a minimum of 22 months.  You read that right.  These talented engineers who want to come to work here with us, pay taxes, and contribute to the economies of Washington State and the US aren’t allowed to do so because of our ‘protectivist’ laws.

And there’s a growing gap in the number of engineering school graduates vs. the number of available jobs (from http://www.wsechicago.org/02_novdec_socnews.asp):

Declining numbers of engineering school graduates, which dropped 25 percent from 1985 to 2000, will collide with boomers’ retirement plans and with growth in engineering opportunities. The U.S. Department of Labor predicts 138,000 additional engineering jobs in the next decade.

Yet, according to Engineering & Technology Enrollments, published by the Engineering Workforce Commission, the number of foreign nationals enrolling in engineering bachelor’s degree programs is increasing significantly. In the fall of 2001 the enrollment level of foreign national students rose 18.6 percent at the freshman level and 14.7 at the graduate level.

Get all that?  Fewer Americans are studying the engineering disciplines, more foreign nationals are coming here to do so, and more US engineering jobs are available.  For some reason we’re willing to educate foreign nationals (often subsidizing their education), but let’s not let them stay and pay taxes!

And there are unintended consequences.  Over the past five years, companies have significantly increased the amount of offshore R&D they do, as a means of tapping into those otherwise closed labor markets.  Microsoft has grown their development centers in India and China, while opening up many more.  They’re devoting significant dollars to training up engineers and management, with an eye to pursuing culturally-specific projects as well as moving more jobs where there are people to do those jobs.  Can you blame them?

All of this is a long-winded way to saying I think things are horribly messed up.

By the way, I received word yesterday that at least one of the H-1B applications filed for our candidates was denied.  Very very frustrating.

wean at any price

It was bound to happen.  Just as the Republican answer to weaning us from oil has been Nu-cue-lur energy, The Democrats were bound to come up with an ineffective, costly, populist plan of their own.

The "coal state" senators have begun a push to subsidize coal as the emergent alternative fuel.  You can read about it in Tuesday’s New York Times.  Coal is plentiful, and doesn’t require getting into bed with Islamic nations, so what’s the problem?

Well – the plan includes construction loans for coal-to-liquid plants that generate more greenhouse gasses than just about any other current alternative.  Check out this graphic.  I imagine there are those who want to press on without promoting cleaner coal processes, meaning we’d see a huge increase in greenhouse gas emissions.

The proposed subsidies are significantly higher than for any other alternative too.

The emergence of climate change as a political issue doesn’t mean we’re necessarily ready to embrace sensible means of alternative energy, or that we’re willing to scale back energy usage.

kurt vonnegut, rip

One of my favorite authors in high school was Kurt Vonnegut, who passed away a couple of weeks back.  I’ve heard quite a few people say that he helped them make sense of an absurd world.

Kurt Vonnegut helped me embrace the absurdity in the world rather than make sense of it.  I think that’s an important lesson, because some things just don’t make much sense, do they?

This picture was lifted from the New York Times.

At one time I could claim to have read all of his published novels.  I can now claim to have read and forgotten much of what’s in his published novels, but think it’s time to dust some of them off and give them a try again.  I watched the film adaptation of his book Mother Night this past Friday – a fairly good film in its own right.  I cannot tell you whether it’s true to the book.  I enjoyed it for the same reason I remember enjoying the rest of his work – raucous comedy, unlikely people finding themselves in absurd situations, and a landscape thick with anti-heroes.  And always tenderness and an appreciation for human beings as wonderful and flawed creatures.

I had the good fortune to see him speak at the University of Washington about eleven or twelve years ago.  The first 30 minutes or so were a rambling series of stories, with no discernable relationship to one another.  Something about buying envelopes, having a secret crush on a local store clerk, and a bunch of other stuff I no longer remember.  Suddenly just as I thought he was going to either launch into another semi-coherent story, he tied everything up into a nice, neat package reminding us to do plenty of "farting around" (his words) and having fun, because that’s why we’re here.  Then he said "I’m outta here", and walked off.

By the way, the biggest laugh of the night was when Mr. Vonnegut talked about his eulogy for Isaac Asimov, his predecessor as President of the American Society of Humanists.  He cleared his throat and said solemnly "Isaac is in heaven now …".

If you’re interested, you can read some of Mr. Vonnegut’s columns in In These Times here.  The New York Times also has a nice index of Vonnegut writings, reviews, and resources here.

busy week in politics

The prosecutors scandal, Edwards continues his run, and Tom Delay is promoting his book!  But something I didn’t know is that Andrew Cockburn has a new book out about Donald Rumsfeld.  Check out this review in today’s NY Times, and check out the first chapter as well.

In the first chapter there’s a lengthy account of the former Secretary’s actions on 9/11 – an assertion that he "deserted his post" to grandstand amongst the wreckage and the wounded (it’s a bit shrill), and then a telling account of a discussion between Vice President Cheney and the Secretary.  Cheney brags that he’s given orders for the military to "take out" suspicious aircraft, including United 93 (hijacked, but by then crashed in a Pennsylvanis field).  Apparently the military commanders chose not to pass the orders along, because they were simply too vague (an easy mistake for someone without military experience to make).

Rumsfeld finally settled into the command center, and got to work on specifying rules of engagement for the fighter pilots now patrolling the skies.  He completed them hours after the last hijacked died.  And then :

"Later, when asked why he had taken no part in military operations that morning, Rumsfeld blithely insisted that it was not his job. "The Department of Defense," he told the 9/11 Commission in 2004, "did not have responsibility for the borders. It did not have responsibility for the airports … a civilian aircraft was a law enforcement matter to be handled by law enforcement authorities and aviation authorities." Expanding on this theme, he explained that the Defense Department’s only responsibility when a civilian plane was hijacked was to "send up an aircraft and monitor the flight, but certainly in a hijack situation [the military] did not have authority to shoot down a plane that was being hijacked." This statement was flat out untrue, but none of the commissioners dared call him to account. "

So great – now we have confirmation that Rumsfeld was far more successful as a politician and operator, than as a Defense Secretary.  Anyone else find stuff like this depressing?

The Delay book tour has been entertaining.  According to "The Hammer", the Bush administration has "shown their weakness in dismissing Don Rumsfeld".

The prosecutor’s scandal continues to unravel the career of one Alberto Gonzales.  Consensus is shaping up that the AG is probably already cleaning out his office for a departure by the end of the week.  Judging by the length of time it took for the President to secure Rumsfeld’s resignation, this means we only have about 13 months before Gonzales will be asked to resign.

The prosecutor’s scandal has pretty strong legs though.  Not only have people already mentally fired the AG, but the Republicans are beginning to talk about presidential impeachment.  Granted, this is related to Bush’s monumental failure in Iraq, but it never would have happened without he evolving train wreck that we have in office now.

Fellow voters, this is what you get when you confuse things like "charisma" "personal appeal" and "electability" with competence.