Nope. There's some of us left. I'm also getting fed up with "ooh, I like SlackPotatoHat distro" and will likely be rolling my own in the near future.
When so many packages have so many compile time options (Apache, PHP, Perl, etc) and with just about every distro being so lame with respect to the filesystem standard, why bother with 'em? God forbid you have library problems with RH, and god forbid you have to use dselect.
Yeah, I could probably at least try the different packages, submit bug requests, etc., but my time is better spent rolling my own at this point.
(Actually, I'd probably get slack, but I'm so used to the RH style init-scripts. Yeah, lame excuse)
But the original story was about using laptop components. I took that to mean chips, drives, ram, etc. If you were suggesting just plugging up a laptop into a docking station and calling it a server (or workstation) I'd agree with you. But if someone were building a new hybrid (workstation with low power consumption drives, chips, etc.) there's no reason to believe that someone would put a fan on the chip. Also, if the goal of the original system is low power consumption, underclocking of some components could decrease the heat output, and lower consumption even more.
Also, I'm not sure where you get that laptops are not made for constant use. Maybe they aren't. Again, I don't use 'em, and I don't buy 'em. But they are certainly sold and reviewed as such.
Let me reiterate: there's a difference between throwing a laptop onto a desk and plugging in a monitor, and what the story is about. The story (in my estimation) is asking why not build one of those dinky PC's, but with low consumption, probably notebook based, parts.
Due to having to be built to be dropped and exposed to greater heat/cold cycles, I would venture to say that the average laptop component is better built than a desktop. Further, if placed in a non-mobile, desktop environment, it should last longer.
I agree. I have a Space Invaders cocktail and a Superman upright (and wife has a 13 foot Skeeball machine). Wife would like Ms. PacMan. Personally, I was more of a Donkey Kong fan, but...
Anyway, those Ms Pacs are expensive. But this project does not really address the problem. I looked at the price sheet. He got his Ms. Pac board in trade. I know from Usenet and elsewhere that that is considerably cheaper than what I would pay for a board.
To reiterate your point: let's see a new controller that only requires a <cough> legal </cough> ROM image to run. Controllers, cases, screens. All fairly easy to come by. But the elusive PCB...
It won't work because, quite honestly, the RIAA and pals don't want it to work. Given their profits, it should be trivial to buy big number crunching machines (to watermark the music and house our public keys). Then they only have to do two things:
First, put a terminal into Sam Goody, Coconuts, etc. that reads your ID (username/password or smartcard. The latter is cool and could be combined with a discount card) and then burns your disc.
OR, cheaper still, let you enter your username/password and dl the music to your machine. While cooler, and while it would be a 'legitimate' method of selling emusic, it also would let you make a copy to a cd.
But, since THEY want you to buy a copy for the CD, a copy for the computer, a copy for your RIO, etc, they won't do the second option. At least not for so much money that we are right back where we started (CD's too expensive, so rip 'em off)
The former plan won't work: it takes too long to burn a disc (no, not really, but after you pay your money, are you gonna wait for 30 minutes to get a copy of Britney98SyncAguilera? No, you gotta go show it off to your friends.) There is also the issue of coasterization. I imagine there are essentially zero flawed discs coming from the music makers' plants. Even in a well designed system, in store burners might turn out.1%-1% flawed discs. Expensive both in terms of replacement and PO'ed consumers.
It is a good idea, and one that I think all parties SHOULD be able to live with. Problem is, it takes away enough freedom from the consumer, and enough profit from the manufacturer to make it unlikely to happen.
Let's not minimize point three. With the convergence of content providers with equipment providers (Sony being the most obvious example) what is to prevent Sony from making a CD/DVD/etc that will only play in Sony branded or licensed equipment?
Maybe that's what you are getting at, but I felt it needed to be repeated.
BTW, I've got several Beta tapes that have been 'archived' to VHS. Guess that won't happen again (and the ones that were worthwhile have been bought again on DVD. But suppose that, as often happens, the old, under-performing movies are not released in the new format. What happens then?)
Yes, you can't infringe your own copyright, but I think that the poster was also pointing out something else: in this legal climate, the technology won't even exist to violate your own copyright.
While no fan of Napster (it's called a business plan people), the situation is similar. There is nothing inherently illegal about what they do (a p2p.mp3 facilitating system), rather it is the way in which it is used (hey, got that new Britney Aguilera track?).
No doubt. I've spent the past two weeks (nights only:) in front of my 98 machine playing Red Alert (yes, the first one) and I'll be in front of it for the next two with RA2. These games (and most RTS) aren't 3D, so they should be MUCH easier to port. I guess. I'm not a programmer either.
(BTW, got C&C:RA2 Spec. Ed. at www.ebworld.com for the same price as the regular edition.)
It shouldn't be too much longer. Eventually, Linux will surpass MacOS on the desktop (hell, it did on mine, and I used to bleed six colors) and we might be seeing games at least as early (late?) as the Mac versions.
Now if only Quicken2000 were available on Linux...
My company purchased some software at the beginning of the summer. We are in Maryland. State number two to ratify the UCITA, I believe (after Virginia). The vendor insisted on having the purchase occur under NJ law (which at the time hadn't passed UCITA. Not sure of current status).
BTW, the license still sucks. I argued against signing it at all, but was overruled by higher ups.
The two attitudes correlate quite easily: TVM (time value of money). In the future, I may have to spend money to retrain. But since that is in the future, it is less expensive then than to train today.
You further make my point, saying:
"besides, retraining people is something not easy to do."
Exactly. That's why we don't retrain today. I can go to most high schools in the area, and any kid who has a computer at home, or one at school is using Word or Works. Ergo, no retraining for them to use Word at my company (this is hypothetical. We actually don't use Word, but I'm trying to explain yet another reason why StarOffice can't be just a great product). So my training costs are much lower than if I had to train them to use StarOffice.
BTW, I'm not sure why it would take weeks or a month or two to convert documents. Why not just update on the fly? No sense in converting a contract or letter from 4 years ago if you will never need it again. But the letter that you were working on yesterday would need conversion to send out the final copy tomorrow. But that *should* be quick.
Perhaps this is another area where the smaller-market share office suites could improve: scan the drive for.doc files, convert them en masse, then back them up in a tarball. Give it a GUI interface, but, if there is a text based install, allow the backup/conversion to be automated into that process. (Just thinking out loud in this last paragraph).
Like so many things M$, the PR sounds good. In exchange for a fee, I get an easily updated, constantly state of the art office software product. As it is a 'lease' or 'rental' as opposed to a purchase, it is now a cost of doing business as opposed to a capital improvement (or that is my understanding of the appropriate tax law). In addition, if forthcoming improvements don't exist, I end the revenue stream from my company to them.
Problems:
It will probably be a dumbed down version, no matter what. Expect even worse 'support' for other file formats. Probably some lame requirement that my subscription can't transfer to a new machine without some additional fee. I expect it to be as easy to cancel your subscription as an AOL subscription (now we know what those two are REALLY cooking up;).
What would be most useful for my company:
Have M$ Word substantially cheaper than Office. A whole lot cheaper. We don't use PowerPoint or Excel. It would be nice to not have to pay 50% for 20% of the functionality.
Let us buy based not on time, but on the number of documents created. We don't even do much stuff in Word. Why pay that much for something used so infrequently?
(Yes, yes, Star Office, Abi Word, etc. We don't have the time/money to do the training on them. And I don't have the will or desire to support them, (I'd do it alone, whereas others in the office would be willing to install/support more commercial based solutions.))
Not sure how the contracts were written, but I don't think/. belongs to CT anymore.
BTW, not trying to troll, but: what the heck does he do all day? Submissions don't seem to be cleaned up (links corrected, speling, grammar, etc.) and while it might take a while to check out 500 submissions, does it really take that long when your office has a T-1/OC-3/something-much-faster-than-my-dial-up.
BTW, I could be wrong about the length of time taken, or what clean up of submissions occurs. But when CT's favorite refrain is "we don't have time", it sounds a bit like an excuse from the days when he was still studying for exams. I'm just curious. How about a/. feature entitled "A Day in the Life of CT"?
You need to work for a better quality repair shop. FWIW, the white box shop in my town has done this. Twice that I know of. Yet another (of many) reasons that we do about 90% of our business with them.
Oh, this was only on laptops, BTW. Don't think they do it on desktops.
First, put everything on the network. (You can force this to happen on ANY operating system that you might be running. If you can't, you are running the wrong OS) Disable the floppies on every machine. Then lock the BIOS. (Getting ready to do this myself). Then, lock up the network drives. Steel door with dead-bolts.
Then lock down the servers. Lock them to each other, and lock them to a stud in the wall (you're not secure unless you get drywall dust on you).
Put a security cam in the server room, and probably in the chief's office.
Use a cable lock to lock the laptops to a desk. Better still: since he didn't take it home, he doesn't need a laptop. Make him use a desktop. Lock that to the desk.
Encrypt drives. You can do this in WinXX and Linux (and probably mac and everything else). There are also products for Windows that will call a specified site or phone number if plugged into a modem or 'net connection.
Register the hardware when you buy it. If the drives are encrypted or otherwise won't boot, criminals will often take them to white box shops to get them 'fixed'. Most shops will call the maker (in the case of some Dells, they HAVE to call them, depending on what is broken) and then it can be tracked. Oh, yeah, call the laptop manufacturer and let them know it was stolen.
Finally, if you can patent/trademark it, do it. If all of the above fails, you need to have 'first dibs'.
If something intervenes in treatment (ie, calculates dosages automatically) it is a medical device, and subject to FDA regulation. Contract or no, the FDA can kick Bill's ass. And, if there is action against Bill, that should be a tolerable defence in a malpractice case. And since Bill has more money than any doc I know....
FWIW, the question of when software becomes a medical device (and thus subject to the FDA) is a bit of a burning question that is currently stifling a lot of innovation in the industry.
The cost isn't an issue. (well, it is, with falling reimbursement rates, decreasing margins, etc. But that is a different story/rant.) But the ability to intermix systems and fix something is of great importance. The company I work for is now mired down with two systems, neither of which is remotely open source. Both companies take forever to respond and update. And given the fact that we pay fees for service...
And these two companies are typical of the (US) medical IT companies. None have a clue about how to achieve stability or have an idea that open (or Open, or Free) is the way to achieve widespread growth, HL7 compliance, etc.
Unfortunately, we get these products, because they are available now. It is not an option to wait. Something IS better than nothing (you should see the amount of paper we have to shuffle. Without a computer, it would be impossible.)
While sites like Linux Med News and openmed.org showcase products and ideas that are promising, nothing is quite ready for prime time yet.
Blame must be placed squarely in three areas:
First are practicing doctors. By and large, they are techno-phobic. At least when it comes to computers. Yes, when it comes to diagnostic tools and so forth, many want to be right on the cutting edge. But for billing and charting, most don't care. When a product fails, they are not surprised.
Second are docs to be. Docs in med-school do all sorts of nifty things and have neat toys to play with. Guess what? They cost money, and take time. Things like that don't work in the real world. In the real world, Dr. Romano (from ER) has some good points: if we don't stay in business today, we can't help anyone tomorrow.
Third, and perhaps most powerful, are the insurance companies. The problem with insurance companies are not that they deny care (on the contrary, they specify what they will PAY for. You can pay for yourself anywhere) but rather that each one has their own set of rules and requirements. This goes from the mundane (what drugs will be paid for for a given illness) to the absurd. The absurd lies in their billing and insurance eligibility. For the first, there exists a simple government form, a HCFA-1500 that contains anything you could possibly want to know about a charge for a visit. So why is there no comparable electronic form? Each company has their own electronic submission routine, some requiring a dial-up, some over the internet, some through a third-party intermediary. And the stream of information to each is DIFFERENT! Even sending a standard form to a third party results in different results. The second, time-consuming aspect is insurance eligibility. If your insurance is no good, you have to pay. Or else go to the doctor that YOU selected. To verify insurance requires a phone call. Or, we could use a card swiper to swipe a patient's insurance card. Problems are: not every insurance has a magstripe code. Each insurance requires their own mag stripe reader (which is truly difficult if you take 20-30 insurance plans) or their own web interface or their own phone number. Then there is the fact that only about 75% of the insurance companies out there are automated. For some, we have to wait for a human being to verify someone's eligibility.
Despite the public misconception that the AMA is a powerful lobby, it is not. It is also divided into at least two camps: primary care (internists, pediatricians, family practitioners, etc) and specialty care (surgeons, ENTs, radiologists, cardiac specialists, etc.) with their own agendas. Rural and urban groups can further splinter this.
There are only two entities with enough cohesion to make any changes. The first is the insurance companies. Problem is, they make money on the inefficiencies in the system. If a claim or chart is incorrect, they don't pay. But they still charge the patient their premium.
The second entity is the government. We can go on all day long about whether or not (and to what degree) the federal government should be involved in the health care industry. But the bottom line is that they are perhaps the only group that *might* have the patients' interests in mind when developing policy. However, neither of the major party candidates seems to have enough understanding of the issues. Ditto their likely surgeon generals, few of whom have ever been practicing doctors, and are usually teachers first, doctors second.
That should cover the billing side. The other side is diagnosing and charting. Rather than go on again at length, I will simply say that I place blame for this about 60% on the doctors and 40% on the federal government. The doctors refuse to go along with a low human-capital intensive electronic charting scheme, and the government has been screwing around for years to develop a common interface. Luckily, since these two camps have proven so incompetent, the insurance companies have not had to intervene to slow down the process and make it more inefficient.
Rather than my above email address, if you want to discuss this post:
Hey, Slashdot, how about some actual news. Such as, THE BILL NUMBER!! How else am I supposed to call my senator and complain?
The official/. mantra (I believe begun in earnest during the Hellmouth series): "It's bad, it's bad. Sit here and bitch, don't do anything about it. What would we bitch about?"
OTOH, to get that protection in Maryland, you have to live in the state fighting with VA to be the first to pass UCITA, fighting with CA to have the strictest gun laws, and fighting with MA to have the worst buracracy (sp?) to provide medical care.
Slashdot Mirror
And Cartoon Network, and Speedvision, etc....
Are there any plans to release this on tape/DVD or to show it on USA or some other network with which Sci-Fi channel is associated?
Nope. There's some of us left. I'm also getting fed up with "ooh, I like SlackPotatoHat distro" and will likely be rolling my own in the near future.
When so many packages have so many compile time options (Apache, PHP, Perl, etc) and with just about every distro being so lame with respect to the filesystem standard, why bother with 'em? God forbid you have library problems with RH, and god forbid you have to use dselect.
Yeah, I could probably at least try the different packages, submit bug requests, etc., but my time is better spent rolling my own at this point.
(Actually, I'd probably get slack, but I'm so used to the RH style init-scripts. Yeah, lame excuse)
But the original story was about using laptop components. I took that to mean chips, drives, ram, etc. If you were suggesting just plugging up a laptop into a docking station and calling it a server (or workstation) I'd agree with you. But if someone were building a new hybrid (workstation with low power consumption drives, chips, etc.) there's no reason to believe that someone would put a fan on the chip. Also, if the goal of the original system is low power consumption, underclocking of some components could decrease the heat output, and lower consumption even more.
Also, I'm not sure where you get that laptops are not made for constant use. Maybe they aren't. Again, I don't use 'em, and I don't buy 'em. But they are certainly sold and reviewed as such.
Let me reiterate: there's a difference between throwing a laptop onto a desk and plugging in a monitor, and what the story is about. The story (in my estimation) is asking why not build one of those dinky PC's, but with low consumption, probably notebook based, parts.
Due to having to be built to be dropped and exposed to greater heat/cold cycles, I would venture to say that the average laptop component is better built than a desktop. Further, if placed in a non-mobile, desktop environment, it should last longer.
But I'm no engineer.
I agree. I have a Space Invaders cocktail and a Superman upright (and wife has a 13 foot Skeeball machine). Wife would like Ms. PacMan. Personally, I was more of a Donkey Kong fan, but...
Anyway, those Ms Pacs are expensive. But this project does not really address the problem. I looked at the price sheet. He got his Ms. Pac board in trade. I know from Usenet and elsewhere that that is considerably cheaper than what I would pay for a board.
To reiterate your point: let's see a new controller that only requires a <cough> legal </cough> ROM image to run. Controllers, cases, screens. All fairly easy to come by. But the elusive PCB...
It won't work because, quite honestly, the RIAA and pals don't want it to work. Given their profits, it should be trivial to buy big number crunching machines (to watermark the music and house our public keys). Then they only have to do two things:
.1%-1% flawed discs. Expensive both in terms of replacement and PO'ed consumers.
First, put a terminal into Sam Goody, Coconuts, etc. that reads your ID (username/password or smartcard. The latter is cool and could be combined with a discount card) and then burns your disc.
OR, cheaper still, let you enter your username/password and dl the music to your machine. While cooler, and while it would be a 'legitimate' method of selling emusic, it also would let you make a copy to a cd.
But, since THEY want you to buy a copy for the CD, a copy for the computer, a copy for your RIO, etc, they won't do the second option. At least not for so much money that we are right back where we started (CD's too expensive, so rip 'em off)
The former plan won't work: it takes too long to burn a disc (no, not really, but after you pay your money, are you gonna wait for 30 minutes to get a copy of Britney98SyncAguilera? No, you gotta go show it off to your friends.) There is also the issue of coasterization. I imagine there are essentially zero flawed discs coming from the music makers' plants. Even in a well designed system, in store burners might turn out
It is a good idea, and one that I think all parties SHOULD be able to live with. Problem is, it takes away enough freedom from the consumer, and enough profit from the manufacturer to make it unlikely to happen.
Oh no. You are sending money to WebTV aka M$ boxtop. Look out for the /. flames!
At this point, isn't TiVO quickly winning the mindshare war?
Why license ReplayTV instead of TiVO?
What the fuck is a junk repetitive character post and why is it keeping me from posting a reply?
Let's not minimize point three. With the convergence of content providers with equipment providers (Sony being the most obvious example) what is to prevent Sony from making a CD/DVD/etc that will only play in Sony branded or licensed equipment?
Maybe that's what you are getting at, but I felt it needed to be repeated.
BTW, I've got several Beta tapes that have been 'archived' to VHS. Guess that won't happen again (and the ones that were worthwhile have been bought again on DVD. But suppose that, as often happens, the old, under-performing movies are not released in the new format. What happens then?)
Yes, you can't infringe your own copyright, but I think that the poster was also pointing out something else: in this legal climate, the technology won't even exist to violate your own copyright.
.mp3 facilitating system), rather it is the way in which it is used (hey, got that new Britney Aguilera track?).
While no fan of Napster (it's called a business plan people), the situation is similar. There is nothing inherently illegal about what they do (a p2p
No doubt. I've spent the past two weeks (nights only:) in front of my 98 machine playing Red Alert (yes, the first one) and I'll be in front of it for the next two with RA2. These games (and most RTS) aren't 3D, so they should be MUCH easier to port. I guess. I'm not a programmer either.
(BTW, got C&C:RA2 Spec. Ed. at www.ebworld.com for the same price as the regular edition.)
It shouldn't be too much longer. Eventually, Linux will surpass MacOS on the desktop (hell, it did on mine, and I used to bleed six colors) and we might be seeing games at least as early (late?) as the Mac versions.
Now if only Quicken2000 were available on Linux...
Good point. My Linux box has cables running out, cover off the case, some ratty stickers, magic marker marks, etc. It's also right next to the wall.
The Winblows box is easier to get to, has a nicer looking case, cover is on, etc, etc.
And most thieves would look at my cd collection and see that it isn't worth carrying out to his car:)
My company purchased some software at the beginning of the summer. We are in Maryland. State number two to ratify the UCITA, I believe (after Virginia). The vendor insisted on having the purchase occur under NJ law (which at the time hadn't passed UCITA. Not sure of current status).
BTW, the license still sucks. I argued against signing it at all, but was overruled by higher ups.
The two attitudes correlate quite easily: TVM (time value of money). In the future, I may have to spend money to retrain. But since that is in the future, it is less expensive then than to train today.
.doc files, convert them en masse, then back them up in a tarball. Give it a GUI interface, but, if there is a text based install, allow the backup/conversion to be automated into that process. (Just thinking out loud in this last paragraph).
You further make my point, saying:
"besides, retraining people is something not easy to do."
Exactly. That's why we don't retrain today. I can go to most high schools in the area, and any kid who has a computer at home, or one at school is using Word or Works. Ergo, no retraining for them to use Word at my company (this is hypothetical. We actually don't use Word, but I'm trying to explain yet another reason why StarOffice can't be just a great product). So my training costs are much lower than if I had to train them to use StarOffice.
BTW, I'm not sure why it would take weeks or a month or two to convert documents. Why not just update on the fly? No sense in converting a contract or letter from 4 years ago if you will never need it again. But the letter that you were working on yesterday would need conversion to send out the final copy tomorrow. But that *should* be quick.
Perhaps this is another area where the smaller-market share office suites could improve: scan the drive for
Like so many things M$, the PR sounds good. In exchange for a fee, I get an easily updated, constantly state of the art office software product. As it is a 'lease' or 'rental' as opposed to a purchase, it is now a cost of doing business as opposed to a capital improvement (or that is my understanding of the appropriate tax law). In addition, if forthcoming improvements don't exist, I end the revenue stream from my company to them.
Problems:
It will probably be a dumbed down version, no matter what. Expect even worse 'support' for other file formats. Probably some lame requirement that my subscription can't transfer to a new machine without some additional fee. I expect it to be as easy to cancel your subscription as an AOL subscription (now we know what those two are REALLY cooking up;).
What would be most useful for my company:
Have M$ Word substantially cheaper than Office. A whole lot cheaper. We don't use PowerPoint or Excel. It would be nice to not have to pay 50% for 20% of the functionality.
Let us buy based not on time, but on the number of documents created. We don't even do much stuff in Word. Why pay that much for something used so infrequently?
(Yes, yes, Star Office, Abi Word, etc. We don't have the time/money to do the training on them. And I don't have the will or desire to support them, (I'd do it alone, whereas others in the office would be willing to install/support more commercial based solutions.))
Not sure how the contracts were written, but I don't think /. belongs to CT anymore.
/. feature entitled "A Day in the Life of CT"?
BTW, not trying to troll, but: what the heck does he do all day? Submissions don't seem to be cleaned up (links corrected, speling, grammar, etc.) and while it might take a while to check out 500 submissions, does it really take that long when your office has a T-1/OC-3/something-much-faster-than-my-dial-up.
BTW, I could be wrong about the length of time taken, or what clean up of submissions occurs. But when CT's favorite refrain is "we don't have time", it sounds a bit like an excuse from the days when he was still studying for exams. I'm just curious. How about a
You need to work for a better quality repair shop. FWIW, the white box shop in my town has done this. Twice that I know of. Yet another (of many) reasons that we do about 90% of our business with them.
Oh, this was only on laptops, BTW. Don't think they do it on desktops.
First, put everything on the network. (You can force this to happen on ANY operating system that you might be running. If you can't, you are running the wrong OS) Disable the floppies on every machine. Then lock the BIOS. (Getting ready to do this myself). Then, lock up the network drives. Steel door with dead-bolts.
Then lock down the servers. Lock them to each other, and lock them to a stud in the wall (you're not secure unless you get drywall dust on you).
Put a security cam in the server room, and probably in the chief's office.
Use a cable lock to lock the laptops to a desk. Better still: since he didn't take it home, he doesn't need a laptop. Make him use a desktop. Lock that to the desk.
Encrypt drives. You can do this in WinXX and Linux (and probably mac and everything else). There are also products for Windows that will call a specified site or phone number if plugged into a modem or 'net connection.
Register the hardware when you buy it. If the drives are encrypted or otherwise won't boot, criminals will often take them to white box shops to get them 'fixed'. Most shops will call the maker (in the case of some Dells, they HAVE to call them, depending on what is broken) and then it can be tracked. Oh, yeah, call the laptop manufacturer and let them know it was stolen.
Finally, if you can patent/trademark it, do it. If all of the above fails, you need to have 'first dibs'.
If something intervenes in treatment (ie, calculates dosages automatically) it is a medical device, and subject to FDA regulation. Contract or no, the FDA can kick Bill's ass. And, if there is action against Bill, that should be a tolerable defence in a malpractice case. And since Bill has more money than any doc I know....
FWIW, the question of when software becomes a medical device (and thus subject to the FDA) is a bit of a burning question that is currently stifling a lot of innovation in the industry.
The cost isn't an issue. (well, it is, with falling reimbursement rates, decreasing margins, etc. But that is a different story/rant.) But the ability to intermix systems and fix something is of great importance. The company I work for is now mired down with two systems, neither of which is remotely open source. Both companies take forever to respond and update. And given the fact that we pay fees for service...
And these two companies are typical of the (US) medical IT companies. None have a clue about how to achieve stability or have an idea that open (or Open, or Free) is the way to achieve widespread growth, HL7 compliance, etc.
Unfortunately, we get these products, because they are available now. It is not an option to wait. Something IS better than nothing (you should see the amount of paper we have to shuffle. Without a computer, it would be impossible.)
While sites like Linux Med News and openmed.org showcase products and ideas that are promising, nothing is quite ready for prime time yet.
Blame must be placed squarely in three areas:
First are practicing doctors. By and large, they are techno-phobic. At least when it comes to computers. Yes, when it comes to diagnostic tools and so forth, many want to be right on the cutting edge. But for billing and charting, most don't care. When a product fails, they are not surprised.
Second are docs to be. Docs in med-school do all sorts of nifty things and have neat toys to play with. Guess what? They cost money, and take time. Things like that don't work in the real world. In the real world, Dr. Romano (from ER) has some good points: if we don't stay in business today, we can't help anyone tomorrow.
Third, and perhaps most powerful, are the insurance companies. The problem with insurance companies are not that they deny care (on the contrary, they specify what they will PAY for. You can pay for yourself anywhere) but rather that each one has their own set of rules and requirements. This goes from the mundane (what drugs will be paid for for a given illness) to the absurd. The absurd lies in their billing and insurance eligibility. For the first, there exists a simple government form, a HCFA-1500 that contains anything you could possibly want to know about a charge for a visit. So why is there no comparable electronic form? Each company has their own electronic submission routine, some requiring a dial-up, some over the internet, some through a third-party intermediary. And the stream of information to each is DIFFERENT! Even sending a standard form to a third party results in different results. The second, time-consuming aspect is insurance eligibility. If your insurance is no good, you have to pay. Or else go to the doctor that YOU selected. To verify insurance requires a phone call. Or, we could use a card swiper to swipe a patient's insurance card. Problems are: not every insurance has a magstripe code. Each insurance requires their own mag stripe reader (which is truly difficult if you take 20-30 insurance plans) or their own web interface or their own phone number. Then there is the fact that only about 75% of the insurance companies out there are automated. For some, we have to wait for a human being to verify someone's eligibility.
Despite the public misconception that the AMA is a powerful lobby, it is not. It is also divided into at least two camps: primary care (internists, pediatricians, family practitioners, etc) and specialty care (surgeons, ENTs, radiologists, cardiac specialists, etc.) with their own agendas. Rural and urban groups can further splinter this.
There are only two entities with enough cohesion to make any changes. The first is the insurance companies. Problem is, they make money on the inefficiencies in the system. If a claim or chart is incorrect, they don't pay. But they still charge the patient their premium.
The second entity is the government. We can go on all day long about whether or not (and to what degree) the federal government should be involved in the health care industry. But the bottom line is that they are perhaps the only group that *might* have the patients' interests in mind when developing policy. However, neither of the major party candidates seems to have enough understanding of the issues. Ditto their likely surgeon generals, few of whom have ever been practicing doctors, and are usually teachers first, doctors second.
That should cover the billing side. The other side is diagnosing and charting. Rather than go on again at length, I will simply say that I place blame for this about 60% on the doctors and 40% on the federal government. The doctors refuse to go along with a low human-capital intensive electronic charting scheme, and the government has been screwing around for years to develop a common interface. Luckily, since these two camps have proven so incompetent, the insurance companies have not had to intervene to slow down the process and make it more inefficient.
Rather than my above email address, if you want to discuss this post:
ghowell@nospam.familyhealthcarepa.com
The correct choice is to go into the voting booth and give them a blank ballot.
Not even $35. I went to www.businesscards.com and got more than I'll use in my current job for only $20.
Not an employee. Just a satisfied customer.
Hey, Slashdot, how about some actual news. Such as, THE BILL NUMBER!! How else am I supposed to call my senator and complain?
/. mantra (I believe begun in earnest during the Hellmouth series): "It's bad, it's bad. Sit here and bitch, don't do anything about it. What would we bitch about?"
The official
OTOH, to get that protection in Maryland, you have to live in the state fighting with VA to be the first to pass UCITA, fighting with CA to have the strictest gun laws, and fighting with MA to have the worst buracracy (sp?) to provide medical care.
Sounds like a good trade to me. (NOT!)