🔗 MRI costs: Why this surgeon is challenging NC’s certificate of need law
Tuesday, 7 August, 2018 — civics links
Dylan Scott Writing for Vox:
Dr. Gajendra Singh walked out of his local hospital’s outpatient department last year, having been told an ultrasound for some vague abdominal pain he was feeling would cost $1,200 or so, and decided enough was enough. If he was balking at the price of a routine medical scan, what must people who weren’t well-paid medical professionals be thinking?
The India-born surgeon decided he would open his own imaging center in Winston-Salem, North Carolina, and charge a lot less. Singh launched his business in August and decided to post his prices, as low as $500 for an MRI, on a banner outside the office building and on his website.
There was just one barrier to fully realizing his vision: a North Carolina law that he and his lawyers argue essentially gives hospitals a monopoly over MRI scans and other services.
I hope Dr. Singh’s lawsuit succeeds. American healthcare in 2018 is supposed to be driven by consumerism. Call around to different providers and determine how much you’ll pay for quality care. Choose a provider based on wherever you want to land on the quality/price matrix that accepts your insurance and you’re golden, right?
Healthcare is not a market. First, not all qualified players can join the market, as is the case here. That effectively prevents Dr. Singh (and others) from putting downward pressure on prices. Second, medical pricing isn’t necessarily discoverable, transparent or negotiable.
🔗 Escaping the SPA rabbit hole with modern Rails
Wednesday, 25 July, 2018 — development links
Jorge Manrubia writes:
I remember thinking that Rails was focusing on the wrong target when DHH announced Turbolinks in 2012. My conviction back then was that offering an instant response time to user interactions was key to excellent UX. Because of network latency, such interactivity is only possible if you minimize your dependency on it and, instead, manage a lot of state on the client.
I thought this was necessary for the kinds of apps I was working on. And with that in mind, I tried many approaches and frameworks for implementing the same pattern: Single-page applications (SPA). I believed that the SPA wagon was the future™. A few years of experience later, I am not sure what the future is, but I really want to have an alternative.
I think a lot of it is getting used to having these rich tools available to solve problems. I also think, in many cases, we’re over-applying these tools when simpler solutions would fit many problems better than the full framework Single Page App approach.
The Post-Meritocracy Manifesto
Friday, 25 May, 2018 — development
Coraline Ada Ehmke, creator of the Contributor Covenant, has created the Post-Meritocracy Manifesto:
Meritocracy is a founding principle of the open source movement, and the ideal of meritocracy is perpetuated throughout our field in the way people are recruited, hired, retained, promoted, and valued.
But meritocracy has consistently shown itself to mainly benefit those with privilege, to the exclusion of underrepresented people in technology. The idea of merit is in fact never clearly defined; rather, it seems to be a form of recognition, an acknowledgement that “this person is valuable insofar as they are like me.”
After reading and digesting the document, I signed on. It reflects the values I aspire to and value for myself and in my peers.
Meritocracy, as a term was always intended as critique and satire:
The co-author of a classic work of sociology, “Family and Kinship in East London” (1957), Mr. Young was also known for coining the word “meritocracy,” first used in his biting futuristic satire, “The Rise of the Meritocracy” (1958)
…but, in the libertarian space that is much of big tech, it’s not at all rare to see the term used as a value statement. Red Hat’s CEO, Jim Whitehurst has specifically defended the concept as a core Red Hat value:
Seeking consensus and creating a democracy of ideas is not what we at Red Hat would call collaboration. In fact, it’s a misstep. Rather, managers at Red Hat make it a practice to seek out ideas from those who’ve shown that they typically have the best ideas—those who have risen to the top of our meritocracy.
To get to the top, though, it’s not enough to merely have an idea; you’ll also need to defend it against all comers. That means there may be disagreements. Voices will be raised. Building your reputation, therefore, can take time, patience, and a thick skin.
That sounds like a hyperaggressive Thunder Dome where the loudest, most stubborn, person “wins”.
This environment can seem harsh at first. But keep this in mind: Open source software developers say, “In the end, nothing matters but the code. The code wins.”
This is a recipe that rewards “brilliant jerks” and assholes. Our industry has far too much of that. It chases valuable contributors with differing communication styles or different valuations about empathy out.
We can do better.
The Post-Meritocracy Manifesto goes in a different direction and sets a more inclusive vision:
We do not believe that our value as human beings is intrinsically tied to our value as knowledge workers. Our professions do not define us; we are more than the work we do.
We believe that interpersonal skills are at least as important as technical skills.
And, directly countering Whitehurst’s point about the code being paramount:
- We understand that working in our field is a privilege, not a right. The negative impact of toxic people in the workplace or the larger community is not offset by their technical contributions.
I feel fortunate that my coworkers and company, from where I sit, are substantially closer to the values expressed in the Manifesto and further from the world Whitehurst lays out. I hope anyone reading this would be so similarly fortunate. However, we have to actively encourage, support and reinforce this vision of an empathy-driven, diverse and inclusive tech industry.
If you’re involved in any part of the tech industry, please give it a read and consider signing on. Thank you.
NCGA Republican leadership to everyone else: 'Drop dead'
Thursday, 24 May, 2018 — civics
Paul A. Specht and Will Doran writing for the News & Observer, covering the latest in a long series of the North Carolina GOP freezing out Democrats from involvement in the legislative process:
Democrats are upset that Republican legislators are mostly excluding them from state budget talks, as it’s unlikely any proposed changes will be adopted once the budget is revealed.
Republican leaders plan to gut an old bill and amend it as a “conference report” to include their budget plans, meaning state lawmakers will have no method for amending the legislation.
The NCGA leadership isn’t denying the accusation.
Shelly Carver, a spokeswoman for Senate leader Phil Berger, said the purpose of the short session is to adjust the two-year state budget that was passed over a six-month period last year — “not to write an entirely new plan.” Republicans hold a supermajority in the House and Senate, so it’s unclear whether Democratic proposals would be adopted even if under a more open process.
“It’s clear Gov. Cooper and legislative Democrats are upset they won’t be able to abuse that process to try to score political points in an election year, but lawmakers of both parties will have the opportunity to vote on the bill and make their voices heard,” Carver wrote in an email.
The thing is, this supermajority is the result of an unconstitutional racially-based gerrymander. Delaying motions have allowed the state GOP to delay a reckoning with redrawing both the state legislative districts and the state’s congressional districts. So, the reason why Democrats won’t be heard during the budget process is because the NC GOP explicitly set up the process to allow exactly this.
“(A)n entirely new plan” talks past recent events in Raleigh, specifically the May 18, 2018 rally of state public school teachers in Raleigh for better pay and better school funding.
Jeff Jackson, a state senator representing Charlotte put it this way, as part of a thread put it thusly:
Ultimately, this is about teachers. Republicans know that Democrats are going to offer amendments to raise teacher pay and Republicans don’t want to be on record voting against that. So they’re going to torpedo the whole process to avoid publicly saying “No” to teachers.
Both my NC Senate and NC House representatives and neither is involved in this process. I effectively have no representation at the state level.
🔗 2017 Police Violence Report
Monday, 1 January, 2018 — links civics
The team at Mapping Police Violence has released their 2017 report. The report covers general statistics behind the 1,129 people killed by police across the United States in 2017 with some effective visualizations.
Of note, the discrepancy in the number of killings against the number of incidents where an officer was charged with a crime. Related are the number of killings where a video record exists.