Three million Californians are newly insured thanks to Obamacare, but they can't find any doctors willing to take them. One of the big philosophical problems with Obamacare is that it makes the assumption that getting someone health insurance will inevitably lead to that person getting health care. That isn't true.

Thinn Ong was thrilled to qualify for a subsidy on the health care exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?

"Yeah, I sign it. I got it. But where's my doctor? Who's my doctor? I don't know," said a frustrated Ong.

Nguyen said the newly insured patients checked the physicians' lists they were provided and were told they weren't accepting new patients or they did not participate in the plan.

Dr. Kevin Grumbach of UCSF called the phenomenon "medical homelessness," where patients are caught adrift in a system woefully short of primary care doctors.

"Insurance coverage is a necessary but not a sufficient condition to assure that people get access to care when they need it," Grumbach said.

Those who can't find a doctor are supposed to lodge a complaint with state regulators, who have been denying the existence of a doctor shortage for months.


The NYT has a great piece about direct primary care: doctors who have stopped taking insurance and instead work for cash. Like a normal business. Surprise! It works pretty well.

Lee Spangler, vice president of medical economics with the medical association, said Texas was seeing an increase in practices like these because they gave doctors more flexibility to determine the services they provide and to cut costs for their practices.

"A physician has very little ability to negotiate all policies and procedures that come with insurance contracts," Mr. Spangler said, adding that some insurance companies can even dictate the business hours during which doctors can be paid. "Basically you get rid of all those shackles in terms of having a carrier dictate to the practice how to deliver medical services."

It is the direct primary care business model that proves most attractive, Mr. Spangler said, adding that doctors "want to get out from under what has been stacked up on them."

Bizarrely, "some people" seem to be more worried about health insurance than actual health care. Could it be that these "some people" make their livings as middlemen who don't want patients to go straight to doctors?

Some health care specialists worry that if too many practitioners choose this path, the state could be left struggling to find doctors to accommodate patients with insurance as the federal health care overhaul is making such coverage mandatory for most Texans. So far, efforts to enroll Texans in the federal insurance marketplace -- crucial to the success of the Affordable Care Act -- have made a small dent in the state's uninsured population, which has reached 6 million, according to United States Census Bureau data. The federal Department of Health and Human Services reported that 295,000 Texans had signed up for insurance coverage in the federal marketplace as of March 1.

"We have to find ways of stretching the current number of primary care doctors to meet that demand," said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. "Direct primary care goes in the other direction."

What if you passed a law mandating insurance, but no doctors showed up?


Divorce is never pretty and my point here isn't to focus on the relationship between Tony Podesta and Heather Miller Podesta. Their relationship is their business. What is of public interest, however, is that the Podesta divorce proceedings reveal a lot about the Washington power culture. It is revolting that our government is structured in such a way that parasitical lobbyists can enrich themselves by building labyrinthine laws and regulations to dole out favors to politically-connected rent-seekers. Argh! Sorry for all the buzzwords.

Our country and our civilization are being strangled by over-regulation. I'm not against all regulation, but even the Library of Congress has no idea how many laws, regulations, and court decisions there are.

As government expands, extending its reach to every aspect of business, every sector of the economy, private citizens and corporations require sherpas to lead them through the mountains of regulations and tax provisions, to discover exemptions and special favors and other forms of relief or favoritism to improve the bottom line. And who better to act as sherpas than the relatives of the Democrats who impose the regulations and tax provisions in the first place, who better than the lively proprietors of a family business operating in the luxurious and morally uncomplicated world of the caste of limousine liberals who dominate politics, culture, news, and finance.

Corporations give to Democratic politicians, avoiding the scrutiny of liberal attack dogs in the media and nonprofit sectors, and enjoying the ego boost that comes with being on the "right side of history." Then those corporations hire the Podestas to get them out of the Rube Goldberg traps the Democrats have enacted into law. John's innovation was to establish a corporate-funded think tank where the burdensome policies would be concocted, and whose staff would go on to man the regulatory agencies that put their wool-headed ideas into practice. And to whom do the corporations turn when they find themselves on the receiving end of all this uplift, all this do-goodery, all this progress, hope, and change? Why, to the man in the red Prada loafers, and to his flamboyantly patterned wife.


Thanks to the Heartbleed exploit announced earlier this week we basically need to change all our passwords for everything. Here's some detail from Bruce Schneier:

Basically, an attacker can grab 64K of memory from a server. The attack leaves no trace, and can be done multiple times to grab a different random 64K of memory. This means that anything in memory -- SSL private keys, user keys, anything -- is vulnerable. And you have to assume that it is all compromised. All of it.

"Catastrophic" is the right word. On the scale of 1 to 10, this is an 11.

Half a million sites are vulnerable, including my own. Test your vulnerability here.

The bug has been patched. After you patch your systems, you have to get a new public/private key pair, update your SSL certificate, and then change every password that could potentially be affected.

At this point, the probability is close to one that every target has had its private keys extracted by multiple intelligence agencies. The real question is whether or not someone deliberately inserted this bug into OpenSSL, and has had two years of unfettered access to everything. My guess is accident, but I have no proof.

I strongly recommend creating a new unique password for each of your accounts. Yes, this is a headache, but LastPass will make it a lot easier.


It's conventional wisdom that you can detect lies by watching for signs of nervousness: sweating, blinking, eye contact, etc. However, apparently it's much more reliable to watch for signs that your quarry is thinking hard: signs of cognitive load.

Lying can be cognitively demanding. You must suppress the truth and construct a falsehood that is plausible on its face and does not contradict anything known by the listener, nor likely to be known. You must tell it in a convincing way and you must remember the story. This usually takes time and concentration, both of which may give off secondary cues and reduce performance on simultaneous tasks.

When nervous we blink our eyes more often, but we blink less under increasing cognitive load (for example when solving arithmetic problems). Recent studies of deception suggest that we blink less when deceiving -- that is, cognitive load rules. Nervousness makes us fidget more, but cognitive load has the opposite effect. Again, contra-usual expectation, people often fidget less in deceptive situations. And consistent with cognitive load effects, men use fewer hand gestures while deceiving and both sexes often employ longer pauses when speaking deceptively.

[The Folly of Fools: The Logic of Deceit and Self-Deception in Human Life]

It's also worth reading about red flags that police detectives use to identify liars.

When questioned, deceptive people generally want to say as little as possible.

Although deceptive people do not say much, they tend to spontaneously give a justification for what little they are saying, without being prompted.

They tend to repeat questions before answering them, perhaps to give themselves time to concoct an answer.

They often monitor the listener's reaction to what they are saying.

They often initially slow down their speech because they have to create their story and monitor your reaction, and when they have it straight "will spew it out faster," Geiselman said.

They tend to use sentence fragments more frequently than truthful people; often, they will start an answer, back up and not complete the sentence.

They are more likely to press their lips when asked a sensitive question and are more likely to play with their hair or engage in other "grooming" behaviors. Gesturing toward one's self with the hands tends to be a sign of deception; gesturing outwardly is not.
Truthful people, if challenged about details, will often deny that they are lying and explain even more, while deceptive people generally will not provide more specifics.

When asked a difficult question, truthful people will often look away because the question requires concentration, while dishonest people will look away only briefly, if at all, unless it is a question that should require intense concentration.


Joe Biden loves community college professors and sleeps with one every night:

He profusely praised the educators and argued they're "the best kept secret in America."

"Jill is probably right," he added. "I think I'd have the same attitude...did I not sleep with a community college professor every night."

As the audience laughed, Biden interjected.

"Oh, the same one, the same one," he said, waving his hands in an attempt to clarify. "The same one."

His wife. Good stuff.


Guess what? The penis is not the worst place to be stung by a bee.

"The Schmidt Sting Pain Index rates the painfulness of 78 Hymenoptera species, using the honey bee as a reference point. However, the question of how sting painfulness varies depending on body location remains unanswered. This study rated the painfulness of honey bee stings over 25 body locations in one subject (the author). Pain was rated on a 1-10 scale, relative to an internal standard, the forearm. In the single subject, pain ratings were consistent over three repetitions. Sting location was a significant predictor of the pain rating in a linear model (p < 0.0001, DF = 25, 94, F = 27.4). The three least painful locations were the skull, middle toe tip, and upper arm (all scoring a 2.3). The three most painful locations were the nostril, upper lip, and penis shaft (9.0, 8.7, and 7.3, respectively). This study provides an index of how the painfulness of a honey bee sting varies depending on body location."

beefig.jpg

Ok, so I'm estimating the number of bee-stings... the actual number could be as few as 75 if the author didn't test all 78 species. But still.


Eerily silent.

Why do these animal fight videos always include alligators or a crocodiles? Because they're slow, so there's plenty of time to prepare the camera? Because reptiles are alien and scary to our mammalian brains? Because gators and crocs get into lots of fights?

Lions vs. Crocodiles vs. Buffalos and Crocodile vs. Elephant.

And yes, it looks like I posted this video four years ago! What does it say about the title-generating hash-function inside my brain that I came up with the exact same post title last time?


Everyone has heard about BitCoin by now, but did you know that crypto-currencies are just a subset of Distributed Autonomous Corporations?

Distributed Autonomous Corporations (DAC) run without any human involvement under the control of an incorruptible set of business rules. (That's why they must be distributed and autonomous.) These rules are implemented as publicly auditable open source software distributed across the computers of their stakeholders. You become a stakeholder by buying "stock" in the company or being paid in that stock to provide services for the company. This stock may entitle you to a share of its "profits", participation in its growth, and/or a say in how it is run.


Calculate the cost of raising your kids and then freak out when you read the article. Are you back?

I'm expecting a third baby "any day now". My two ex utero children feel expensive at times, but I can guarantee you that I'm not spending anywhere close to the yearly estimate of that calculator. When our new baby is born my wife is going to stop working full time to take care of the kids and do some freelancing. When those paychecks stop it will "cost" us some money, but she's still going to be very productive with non-baby activities and likely still earning some income.

As with many financial articles, I'm left wondering "what are they spending all that money on???". The top rated comment to that CNN article, by "Guest", sums up my perspective quite well:

The hardest financial way for a parent to raise a kid? To try and live up to the American Upper Class ideal with a bedroom for every child, multiple bathrooms, car payments, smartphone plans for every teen, all the cable TV channels, all the brand name clothes, etc., etc., etc..

As a parent, when you quit being materialistic, and help your kids be free of materialism - it is amazing how much more affordable it is to raise children!

Here's an article from 2007 that mentions some flaws in the USDA's methodology.


Bloomberg has an infographic about how automation threatens various jobs. I think it captures some interesting categories, but I don't agree with the bottom line.

automation.jpg

For "Manipulation"-type jobs, it is only a matter of time before automation miniaturizes and catches up to humans.

For "Creativity", internet distribution makes it possible for elite creative workers to share their products very widely and cheaply, thereby pricing middling/poor creative workers out of the market. Non-elite creative workers will only get paid for making unique creations, and the pay will be poor. Example: quilt-making.

The "Social/Perception" field is likely safe for the foreseeable future... but what does that mean? Humans will be better than automation at social interactions with other humans... but will there be any money in that when no one has any other jobs?

Obviously I don't think the future is that bleak. I believe that humans and machines will continue to cooperate in voluntary collaborations and we'll all be better off for it. The modern corporation is basically a massive human/machine hybrid.

(HT: WH.)


This piece by Aswath Damodaran is a great explanation of why Facebook paid $19 billion for Whatsapp. There's a lot there, but it's an elegant read.

Returning to the Facebook/Whatsapp deal, it seems to me that Facebook is playing the pricing game, and that recognizing that this is a market that rewards you for having a greater number of more involved users, they have gone after a company (Whatsapp) that delivers on both dimensions. Here is a very simplistic way to see how the deal can play out. Facebook is currently being valued at $170 billion, at about $130/user, given their existing user base of 1.25 billion. If the Whatsapp acquisition increases that user base by 160 million (I know that Whatsapp has 450 million users, but since its revenue options are limited as a standalone app, the value proposition here is in incremental Facebook users), and the market continues to price each user at $130, you will generate an increase in market value of $20.8 billion, higher than the price paid. Are there lots of "ifs" in this deal? Sure, but it does simplify the explanation.

Bonus content: an explanation of the difference between how traders and investors see the world.

This week, I was at the Tuck School of Business at Dartmouth, talking about the difference between price and value. I built the presentation around two points that I have made in my posts before. The first is that there are two different processes at work in markets. There is the pricing process, where the price of an asset (stock, bond or real estate) is set by demand and supply, with all the factors (rational, irrational or just behavioral) that go with this process. The other is the value process where we attempt to attach a value to an asset based upon its fundamentals: cash flows, growth and risk. For shorthand, I will call those who play the pricing game "traders" and those who play the value game "investors", with no moral judgments attached to either. The second is that while there is absolutely nothing wrong or shameful about being either an investor (No, you are not a stodgy, boring, stuck-in-the-mud old fogey!!) or a trader (No, you are not a shallow, short term speculator!!), it can be dangerous to think that you can control or even explain how the other side works. When you are wearing your investor cape, you can be mystified by what traders do and react to, and if you are in your trader mode, you are just as likely to be bamboozled by the thought processes of investors. So, at the risk of ending up with a split personality, let me try looking at Facebook's acquisition of Whatsapp for $19 billion, with $15 billion coming from Facebook stock and $4 billion from cash, using both perspectives.


Cardinal Raymond Burke, formerly archbishop of St. Louis, is pushing back against the compartmentalization of religion in the public space. He asserts that free exercise of religion permeates society and is not confined to the walls of a church.

The former archbishop of St. Louis stated that Obama is trying to "restrict" religion.

"Now he wants to restrict the exercise of the freedom of religion to freedom of worship, that is, he holds that one is free to act according to his conscience within the confines of his place of worship but that, once the person leaves the place of worship, the government can constrain him to act against his rightly-formed conscience, even in the most serious of moral questions," Burke said.


UK hospitals have been burning aborted and miscarried babies for fuel in "waste to energy plants". May God bring an end to this evil and have mercy on the souls of these children.

One of the country's leading hospitals, Addenbrooke's in Cambridge, incinerated 797 babies below 13 weeks gestation at their own 'waste to energy' plant. The mothers were told the remains had been 'cremated.'

Another 'waste to energy' facility at Ipswich Hospital, operated by a private contractor, incinerated 1,101 foetal remains between 2011 and 2013.

They were brought in from another hospital before being burned, generating energy for the hospital site.

Many are comparing this atrocity to the practices of the Nazis, but it reminds me of earlier child sacrifices to Molech, Cronus, or Saturn.


Austin Bay has some suggested hard-power responses we can make to Russia's annexation of Crimea. I particularly endorse the expansion of fracking and the exporting of American natural gas to Europe.

Russian hard-power aggression, annexation and expansion require a hard-power response. Here are some I recommend: (1) We can't flip-flop NATO Article 5, NATO's commitment to mutual defense. The U.S. must demonstrate it takes its NATO obligations seriously. So, deploy U.S. troops to Poland. The U.S. withdrew its last tanks from Germany in 2013. The Poland garrison needs a U.S. armor brigade. (2) Cancel all defense budget cuts. Faculty club snark aside, peace through strength means something. (3) Open federal lands to natural gas "fracking" and start shipping gas to Europe. Undermining Russian gas sales is a real economic sanction. (4) Arm the Baltic nations. They are also NATO allies. And (5) deploy the GBI's to Poland, and build a more robust missile defense system. As for permanently deploying U.S. Patriot PAC-3 short-range anti-missile missiles in Poland -- that's an idea whose time has come.


On Monday Mitt Romney wrote an op-ed in the Wall Street Journal saying "I told you so" on Russia -- that they are our greatest geopolitical opponent. When he first said so during a presidential debate with President Obama, he was widely ridiculed and Obama riposted with "the 80s called, and they want their foreign policy back". Well, Romney was right, and now he gets to rub the President's face in it.

Why are there no good choices? From Crimea to North Korea, from Syria to Egypt, and from Iraq to Afghanistan, America apparently has no good options. If possession is nine-tenths of the law, Russia owns Crimea and all we can do is sanction and disinvite--and wring our hands.

Iran is following North Korea's nuclear path, but it seems that we can only entreat Iran to sign the same kind of agreement North Korea once signed, undoubtedly with the same result.

Our tough talk about a red line in Syria prompted Vladimir Putin's sleight of hand, leaving the chemicals and killings much as they were. We say Bashar Assad must go, but aligning with his al Qaeda-backed opposition is an unacceptable option.

And how can it be that Iraq and Afghanistan each refused to sign the status-of-forces agreement with us--with the very nation that shed the blood of thousands of our bravest for them?

Why, across the world, are America's hands so tied?

A large part of the answer is our leader's terrible timing. In virtually every foreign-affairs crisis we have faced these past five years, there was a point when America had good choices and good options. There was a juncture when America had the potential to influence events. But we failed to act at the propitious point; that moment having passed, we were left without acceptable options. In foreign affairs as in life, there is, as Shakespeare had it, "a tide in the affairs of men which, taken at the flood leads on to fortune. Omitted, all the voyage of their life is bound in shallows and in miseries."

Romney is right: the reason we have "no good options" now is that Obama's foreign policy didn't protect our decision space. If I were to play chess with Garry Kasparov it might look (to a naive observer) as if nothing much happened for a while... but then I'd quickly find myself with no good options. I wouldn't run out of good moves because of misfortune, acts of God, or inevitability -- I would run out of good moves because I would be outmaneuvered and outplayed. That's where America is now. We've been strategically outmaneuvered and outplayed by our geopolitical opponents, and it's only becoming obvious now that we're out of good moves.

Final thought: maybe we should try to get some Reagan-era foreign policy going?


(HT: io9.)


I'm never swimming without my spear again.


Get a better night's sleep by picking the right type of pillow just for you! Yes, Pick-A-Pillow Guide is my first app! It's inspired by this Lifehacker post and data from SleepLikeTheDead.com.

Screenshot_2014-03-14-20-57-57.png


The missing Malaysian airliner is quite a mystery and most likely a tragedy; our thoughts and prayers are with the victims and their families.

It appears that two passengers on the plane were flying with stolen passports, but it's unclear to me how common this is. The Malaysian Home Minister thinks that the security screeners should have noticed something amiss:

Malaysian Home Minister Ahmad Zahid Hamidi said the unidentified passengers appeared to be Asians, and blasted the border officials who let them through while carrying passports from Austria and Italy.

"Can't these immigration officials think? Italian and Austrian [passport holders] but with Asian faces," Hamidi fumed.

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