I believe in defense in depth. Even though the guards inside the castle may be trained to password challenge everybody walking around and check coats of arms, it never hurts to raise the drawbridge when there isn't anybody using it and there is a besieging army.
Sure, have firewalls all over the place, but any route into and out of the network itself needs to be HIGHLY secure. NOTHING goes IN or even OUT without a reason. Nothing wrong with the airport having a flight status board, but you have the ATC central database polled by some central server which generates an xml digest of the important info and have it dump that data across a serial line (transmit only) to another server which then puts it onto a webserver which the airports can parse. Flight plan requests come into some intermediate server on the internet (but well secured). That server validates the requests and sends xml files to some intermediate server (perhaps over serial) which otherwise isn't on any network. That server re-validates the input and then makes it available to a more trusted server that then does the application logic.
Of course the internal network has a firewall at every WAN connection that only passes the minumum defined data to make the system work. That still doesn't mean that you shouldn't keep the actual traffic on the mission critical network down to the minumum necessary. There shouldn't be a single packet on that ATC network that doesn't originate from an FAA-validated piece of software. Any connection to the outside should be sanitized, and they should be few in number.
This isn't about being smarter than the hackers - it is about being thorough and having a fully specified architecture.
The only issue with an Active IDS is having zero false positives. You don't want some TRACON to go down when some IDS update causes a router to alarm and shut down JFK approach with 18 aircraft enroute to final on 3 runways.
The issues with IT security are due to smart marketing - they know where the money is and they cash in on it.
There isn't much money in helping a CEO to find some guy who can competantly run his IT show.
What the CEO needs is a way to get his friend's cousin an IT security certification so that he can justify hiring him. You see, his friend is the CEO of OtherCorp and he just hired his nephew for $250k/yr, and it is time to pay back the favor. However, the guy's cousin could turn out to be an idiot and that could get the guy who decided to hire him canned. However, if the cousin had a SuperS+ Security Certificaton and there is a big mess, then the cousin could be shifted to some other job and the guy who hired him could be safe since he had the credentials. Plus, as an added bonus the CEO of OtherCorp now owes you a favor for saving the guy's job and that could come in handy if OtherCorp has an opening on the board of directors.
So, the SuperS+ Security Certrication company will issue a cert to anybody who can sit through classes and cram their way through a test, and pony up $5k in fees.
And what is the chance that anybody will break into any particular company anyway?:)
This is a specious argument. Unless you plan to sit at home and die quietly how exactly is the ER physician supposed to determine if you did this to yourself or not?
They don't decide - they render emergency care unless you refuse it - implied consent and all that. Who pays the bill is a different matter, and that can be figured out after the fact.
You can see an MD, DO, PA, DDS, NP, acupuncturist, aromatherapist, shaman, voodoo doctor, crystal healer, televangelist or anything else that floats your boat.
What we do say is that the average person does not understand pathology, physiology, pharmacology, and pathophysiology to make complex judgments about the medication they should be taking.
So what you're saying is that I can choose to destroy my organs by refusing medication, or by drinking some cocktail with who-knows-what effects, but I should not be allowed to choose to take a medication whose properties are actually fairly well characterized? How exactly is the one better than the other?
If I want to drink water from a stream polluted with chromium nobody in the medical community will stop me, but heaven forbid that I want to take 5mg of lisinopril which might cause some liver damage after a few years!
Again, I encourage anybody who is ill to work with their doctor, but in my opinion the current medical system takes the patient out of the loop. Sure, you can refuse treatment, but you can't administer a treatment without a doctor's consent.
Here is a piece of paper with readable language on it. Are the dots in the columns where you wanted your votes to be cast? You can answer that.
Not really. Is a tiny dot in the column a vote or a mistake? How about a mark in three columns, two of which look like they might have been erased? How about three erased marks of which one was re-marked? How about two dots in one line and no dots in the next in which the voter cast votes for a single party - can we just assume they voted straight party and put their mark in the wrong line for the one position? If a ballot contains invalid votes does that disqualify only part of the ballot or the whole thing?
Paper voting has lots of problems. They only matter in close elections, but you'll never get two recounts to agree to a single vote in a large district.
I favor a hybrid approach. Use a computer to generate the ballot since a computer can validate the input and print an unambiguous ballot that is clearly readable. The voting machine might even subject the ballot to an extra-sensitive optical scanner to validate that the printout was clear. Then the voter looks at the ballot, confirms that they are satisfied with it, and then they drop it into a ballot box.
Use the GUI for what it is good at - validating the ballot and interactively working with the user to capture their true preferences. Use paper for what it is good at - making a hard-to-modify record of the event where a voter has some assurance that due to process control that the vote will eventually be counted.
"Attention all employees - you are hereby given a one hour break to go and vote. Just be sure to bring back your voter receipt ID numbers so that we can verify that you were voting and not just goofing off during your paid time off. Anybody who fails to return with one will be fired. Oh, vote your conscience but I think Candidate X would be great for our industry." -- Public address announcement at local factory.
"Ok, Fred, can you go through and see who all those workers voted for and be sure to sack anybody who voted for Candidate Y!" -- Less public conversation with plant foreman.
A voter-verifiable receipt is not a very good idea. I agree that voters should be able to leave a booth assured that their vote will be counted, but they should not have proof of how they voted or whether they voted.
But when the same product is made by the same company and sold for one third the cost in a foreign market, we should be free to import the discounted product.
Couldn't agree more - I think I tried to mention this in my post but I agree wholeheartedly with you here. While patents are a legitimate issue the equivalent of DVD Region Protection is an entirely different issue.
Remember also that a great deal of medical research IS government-funded. There is a tendency for grant-funded university research to magically morph into private patents.
I agree with this also - to a point. Keep in mind that the government-funded research tends to only cover the concept behind a drug. The optimization of a drug molecule, development, and clinical trials are all paid for by drug companies almost entirely. This is by far the bulk of the cost of developing a drug. It is also boring work, which is why nobody in academia does it. I'm all for the government auctioning off patent rights to their ideas, but they'll get what the market pays for a concept with no clinical evidence to back it up, which isn't the same as what drug rights sell for once they're on the market.
To get an idea of how drugs are valued at various stages just look at deals between pharma companies for drug rights. At the one extreme are established products - those are valued at many billions of dollars in some cases, and valuation of these are trivial since they're already making profits. At the next tier are drugs that have strong clinical data but no established sales - maybe just before approval - and these also sell for a pretty penny since marketers have a good idea what they'll sell for and chances are they'll be approved. Then you get into drugs with some clinical data but short of major trials - the value of drug deals drops quickly when there isn't clinical data as lots of drugs look good but fail in trials. Finally you get to licensing deals for molecules with nothing else except maybe some in vitro assay - these are worth tens of millions of dollars, and maybe a share of future profits, but that is about it.
Basically the value of a drug is a risk-adjusted matter. As risk drops the value goes up. Alternatively profit-sharing (and consequently risk-sharing) agreements make sense - a company might pass up a few tens of millions of dollars in certain profits to sell a molecule in exchange for a share of future profits (which might never appear). It is easy to see the price of marketed drugs and to think that every R&D idea is worth that kind of money, but that is like saying that every lottery ticket is worth a million dollars. One lottery ticket may be worth a million dollars, but "any" lottery ticket is worth less than it is sold for.
I agree with you on the nurses - that is what I'm getting at. However, the basic principle is one of triage - there is no reason why somebody with the sniffles needs to be going to see the best respitory therapist on the planet.
I'm not sure if doubling admissions would be productive - in theory it could just burden the schools more, but I don't know enough to do more than guess on that.
I didn't mean doubling the admissions at the existing schools so much as doubling the number of people admitted into a medical school. This would involve creating many more schools to accomodate the demand (and drive down the prices).
Also making most drugs over the counter is a seriously bad idea. Yes, there are some that could be OTC and the impact would be minimal. But if you have hypertension do you know if you should be on an ACE inhibitor, beta blocker, Calcium channel blocker, ARB, or something else. Careful 'cause if you "guess" wrong you could cause renal failure or even kill yourself.
I have to disagree with you here. I would NEVER just take a drug like this OTC without talking to a doctor. However, I believe that the drugs should be available to me nonetheless.
How is it any of your business if I want to destroy my kidneys or kill myself? Now, you shouldn't have to pay for this if it happens, but my body is my own responsibility to care for, so how as a society do we get off telling people how to care for themselves?
Again, I think the issue is that the current system is designed to keep patients out of the loop with regard to their own care, and I don't think that this is a good thing. Nobody has more incentive to take care of my body than I do - I'm going to be certain to use discretion when self-prescribing medications.
Ok, I've had to deal with medical bills in the US for serious hospitalizations. The US system is lousy in this regard - you get 500 bills from 75 people you've never heard of and you end up cross-indexing everything 14 times to make sure everybody gets paid the right amount and nobody is paid twice and everybody bills you what they're supposed to (since 2/3rds of the bills get written off due to insurance contracts). It is a real mess.
On the other hand, service is relatively quick and I have access to state-of-the-art care. Major surgeries can be scheduled in less than a month - or even the next business day if the condition is life threatening. As an illustration I know somebody who had difficulty breathing. We went to the ER at 9:30PM. We didn't get out of there until 1:30AM or so, but the condition was stabilized with O2 and a nebulizer, an X-Ray was given and Pneumonia was diagnosed, an initial dose of antibiotic was administered, and we left with a prescription in-hand to continue this treatment.
In contrast, I have a coworker in the UK who went to his doctor with similar symptoms. He was essentially just given an aspirin and told to come back in a few days if it got worse. When it did he was sent to a hospital for an X-ray a few days later. Then they had to wait a week to have the result read (something that took 1 hour in the US at 11PM). At that point they made the diagnosis and prescribed antibiotics, but he had deteriorated substantially in the ~2-3 wasted weeks of time. He was out of work for a month (I don't ask how that can be saving money). On the other hand, there were no bills or anything like that involved, so he never had to think about it again after it was over. I'm sure he pays far more in taxes than I do for insurance as well.
Socialized health systems have some serious problems. I actually think they're inevitable, and in theory it is a great way to handle medicine. The current US system is broken and unsustainable. However, the fact is that right now if you can get good insurance in the US you're far better off with the current US system. The problem is that good insurance in the US is contingent on your employer and not everybody works for a decent employer. Those of us who do might not at any time based on some whim of management.
The switch to socialism is inevitable in a few years anyway (maybe 10-15, but it is coming). Even if current efforts to socialize don't pan out there is something no politician can control: genetic testing. Genetic testing will end voluntary private insurance. Insurance only works in the absense of knowledge (you don't know when your house will burn down, you don't know when you'll get hit by a car, etc). Once you know with a high degree of confidence whether you'll get diabetes or heart disease the equation is thrown out of balance. Either companies will be allowed to exclude you from insurance and you'll never be insured, or companies will be forced to provide insurance to you, in which case you'll decline coverage for these diseases unless you're likely to get them and then the insurance companies will go out of business or have to charge astronomical premiums (which will then put them out of business). What makes insurance work is people who buy it but don't use it - but why would anybody buy insurance that covers diabetes when they know they'll never get it? People will buy much cheaper policies that exclude conditions they know they won't suffer from, and when everbody does that then the result is the same as if companies were allowed to discriminate based on genetics. The only thing that works when there is a high level of knowledge is an involuntary insurance system - then everybody is covered for everything and it all gets paid for involuntarily.
The insurance industry is only one problem with US health care. Just as serious are the way US liability works (defensive medicine and higher costs), the supply of doctors, and availability of care once everybody and their uncle can go to the ER for free wit
If anything IT can make this kind of institutional incompetence worse. IT tends to put a premium on process over individual expertise. I can see the logic in this as it leads to a more consistent experience. The problem is that in the article you cite it led to a consistently bad experience.
I think that we've become far too process-focused in IT, and IT is seen as a way to solve problems using machines without the need for strong employees. Managing employees right is hard work - better to just outsource and have the machines catch the problems. Except, of course, it doesn't actually work.
I know somebody who works in an IT organization in a large corporation. Their department just had a big re-org, and in the 1.5 weeks following the annoucement his only contact with his new manager was a 10-minute meeting. It turns out the managers are all in non-stop meetings with each other (which is pretty typical at this company). Individual contributors are effectively unmanaged and just run their own projects as a result. You can imagine how much company loyalty any of them have - if their building burned down with everybody inside but them their biggest concern might be getting their paycheck and maybe the one or two people they managed to actually form a closer relationship with while there. Too much process, not enough humanity...
I've had loved ones in the hospital with fairly serious conditions. They do NOT get much attention from doctors. Maybe their charts get a little more attention, but the patients are lucky to see them for more than 5 minutes a day except when they're in surgery.
I think that the solution is they need more tiers of medical care. Right now you have mostly just doctors and nurses (I do realize there is some graduation in-between right now, but in a typical hospital those two categories will cover 90% of everybody who cares for a patient).
Hospitals could use everything from volunteers, to aides, to basic-intermediate-advanced nurses, to basic-intermediate-advanced doctors. Go ahead and put limits on what that guy who currently couldn't pass medical school can do, but chances are they're qualified to do quite a bit. Having more people will lower costs (start paying doctors less).
Also - I'm not convinced that doubling the size of medical school admissions would lower quality at all. Go ahead and have the same standards - right now the problem isn't people not graduating, but people not getting admitted. Also - if you had 10X as many medical schools out there then tuition costs would go down (more competition). Doctors should be well-paid, but not to the extreme they are today.
Also - doctors should have limited hours - certainly no more than 50 per week and no shift longer than 12 hours (with at most one 12 hour shift in a week). Why is it that we can regulate how many hours a truck driver can spend behind the wheel and yet we have interns working 100 hour weeks as some kind of way to weed out anybody who has a shred of humanity in them?
Getting prescription prices under control is as easy as opening the door to Canada, India, or wherever. God knows, the pharmaceutical companies are quick to go with offshore outsourcing when it serves THEM. Why should the customers think differently?
I agree with this - but only to a point. Unless the drug R&D model is substantially changed it should only be legal to import drugs manufactured with a patent license (for patented drugs). Now, if the government wants to take over drug development (after the discovery of a lead) and just pay an up-front fee for any leads not generated with government dollars in the first place (some are, some aren't), then patents might not be necessary. However, that will cost a LOT of tax dollars (well, not compared to the recent bailouts I suppose - the meaning of "LOT" seems to have changed).
Aside from the patent issues, I'm all for US citizens getting the same price as those in Canada/etc. Of course, drug companies will likely raise their prices internationally and drop the US prices a tiny bit until it is about a wash, but that is perfectly fair.
Again, I'm all for changing the system. However, what a lot of people are proposing (compulsary licensing or non-enforcements of patents) sounds about as ethical as spending three hours with a salesman at a high end electronics shop and then once you've figured out exactly what you need going and ordering it online for less. If we want to have new drugs then somebody needs to pay for them (and not just the blue sky R&D component of the research which tends to be government funded now, but which is only the tip of the iceberg where costs are concerned).
If the attacker is some guy with some cash and contacts and they want a photocopy of one person's medical record, chances are that paper will be easier to defeat. However, there is a substantial risk of getting caught (if the guy you approach who works in the file room doesn't take your bribe). If you do successfully bribe the clerk, however, nobody else will ever know about it (no access controls, audit trails, etc).
On the other hand, electronic records are vulnerable to some hacker in Indonesia who copies the records of 30 million patients from a NYC hospital without anybody even realizing that it had happened. Most likely the attacker didn't target any one patient or hospital in particular - in fact the security at 99% of all the hospitals was probably completely effective at keeping him out. However, since this was a trawl they will extort anybody of interest whose records they do get, and since somebody will mess up electronic security chances are there is someplace they'll manage to break into. A successful theft might even leave a trail - but most likely beyond the jurisdiction of whoever performed the theft. In fact, the theft victims might just get the guys home phone number when he calls to demand money - and they'll be powerless to do anything but pay it.
Paper and electronic both have strengths and weaknesses. The ways they are likely to fail from a security standpoint are very different.
If the medical journals say that there is a 0.0001% chance of deadly condition Y being present given the patients symptoms, and a $5k MRI test has a 0.001% chance of detecting Y, then the doctor is going to have to order it. Otherwise when the 1-in-1-million patient dies from undiagnosed Y the jury will be handing money to the plaintiff hand over fist.
The expectation of modern juries is that every patient gets tested with every modern technology available, has access to experimental technologies that are just emerging, and has a board of doctors meeting in a conference room with House to discuss every aspect of the patient's care.
Frankly, just getting a copy of your records is almost impossible it seems. Doctors treat them like they're confidential materials not to be shared with patients, and only grudgingly with other doctors (that they like).
A law should be passed requiring all patients to be given a full copy of every record that is generated on any visit. If the patient wants to throw it out when they leave that is fine, but they should be issued. Patients should not be required to even request them - otherwise you'll end up with situations where the office worker tells them "sure, just sit here for 2-4 hours and we'll get right on that." It should be illegal to collect payment for services (including copayment) before those files are in the patient's hands.
Half of the problems in medicine stem from the fact that we treat patients like they should have no involvement in their own care. Heck, I'm all for making almost all drugs over-the-counter (perhaps prescriptions should be required for insurance coverage, and where there is a compelling public interest such as with antibiotics there should be restrictions on access). If you want to mess up your body more power to you. That guy wouldn't have ended up having to beg for his life if his wife could have just given him an injection of the needed drug on her own legally.
The genes do exactly what they're supposed to do - they make crops from sold seed sterile so that you need to buy more the next year.
The genes aren't intended to destroy other crops any more than the DRM on a music CD isn't designed to destroy the rest of your music collection.
Again, just as with DRM I'm not sure this is the best solution (especially since there is a risk of cross-contamination of this trait into other crops). However, anybody who thinks that Monsanto is deliberately trying to destroy non-GM crops has been watching too many Michael Moore movies...
If their goal is simply killing people, why do they hijack planes at all? Wouldn't be a whole lot easier to blow up busses or shopping malls?
If a terrorist is going to go to the trouble to hijack a plane they're after more than just some dead bodies.
I agree that what I suggested isn't a holistic response to terrorism, but I don't think that negotiating for hostages is a whole lot better than paying ransom for kidnap victims. Do everything you can to rescue hostages, but make sure the terrorists end up worse off than they were before they made the attempt.
Absolutely - if those desktops are all used for the same purpose.
My approach would be to set moderately agressive power saving settings and distribute them via SMS/etc. However, I wouldn't lock down these settings - if a user has a business purpose for changing from the defaults they can do so. Likewise I might send out a corporate-wide email to educate users about power consumption, and let them make the call.
What I'm not a fan of is having the energy police demanding justifications for any powered-on PC found after hours.
The point is to kill the criminals before they board your ship/homes. That way they will never board any more ships/homes.
Agreed. Ships in particular should be almost trivial to defend (homes are not). The pirate has the objective of capturing a ship - sinking a ship does nothing but tick off the Navy. The ships are large and that makes them very hard to board. Pirates should be detectable miles away via radar with plenty of time to prepare to repel a boarding attempt.
When pirates approach a vessel they're completely without cover in open seas. Most likely their ships are far less substantial than the ships they aim to capture. They probably have little more than handheld automatic weapons and RPGs to work with. A well-prepared defense force should be able to sink them before they can even close within the range of their own weapons - and that is only with relatively light armaments like machine gun mounts and maybe a light cannon or two.
A home is much harder to defend - motion sensors are useless to detect an approaching intruder unless you have a very wide property clear of trees/wind. Your first warning will be once they are actually inside the house (if you have an alarm), at which point you are waking up from sleep and they are fully prepared to confront you. Your only defense is that most crooks will take off at the first indication the owner is awake - if they actually mean to do you harm then you're going to be in trouble. Unlike a ship you can't stop them before they are inside when you have the advantage of cover.
I dunno - I think you need to look at the incentives involved. These pirates are businessmen - not crusaders. They do it to make money. If they know they aren't going to make money they'll stop doing it.
I once heard somebody argue that when a plane is hijacked that the military should just shoot it down with hostages and terrorists alike perishing. Of course that sounds dumb, until you realize that you've eliminated any negotiating power the terrorists might obtain from holding hostages. A saner approach would be to simply not sincerely negotiate at all and always mount military responses if the terrorists don't surrender after a reasonable period of time.
The US Navy should offer protection to any US-Flagged ship, and the ships flying flags of nations that pay the US Navy to provide this service (possibly via services in kind from their own militaries).
US-Flagged ships should be taxed accordingly to pay for this service.
What I can't stand is the though of US tax dollars going to pay to help corporations who can't be bothered to fly a US flag on their ship, because they don't want to pay US taxes and be subject to things like US labor and safety laws. If you want the world's strongest navy to defend you, then you should pay your share.
I imagine that most first-world nations would be happy to arrange for mutual support in this way, paying for each others services either through genuine mutual military support or by other means if a nation doesn't have a strong military. This isn't about US nationalism or anything like that - this is about getting corporations to pay for the services they require.
Agreed - lots of stuff could be detected spectroscopically on an Earth-like world.
Those kinds of technologies can't be applied to other planets in our own solar system. I mean, sure, technically we can do a spectrocopic study to rule out Mars being a jungle paradise, but I don't think that is really at issue.
We need probes for nearby planets since we already know they aren't teaming with life, but there is a question as to whether they are absolutely sterile.
Now, if a spectroscopic study of an exoplanet shows no sign of life that isn't proof positive that there isn't some microbe buried in a rock somewhere, but it would be a strong indicator that we're not going to find green men and other advanced organisms walking around on the surface.
Uh, I don't think anybody at Monsanto has announced any goal to get terminator genes to cross-contaminate other crops. I can't see how this would be likely to happen from an evolutionary standpoint - sterile crops clearly would be at a selective disadvantage in the wild. The only way you can end up in a situation where there are no crops are if farmers deploy terminator seeds all over the place and then the company goes out of business, leaving insufficient seed stock the next year. As long as the company keeps a stockpile for a good year's worth of seed that shouldn't be a problem - a year should be enough time for seed companies to produce normal seeds.
The issue with GMOs is the same as the issues with copyright/patenting/etc - it costs quite a bit of money to develop a GMO and very little money to copy them once you've bought a single seed. Contracts and licensing are probably a saner way to handle this sort of thing but then you get complaints when pollen from GMO crops lands on somebody else's fields and then they get served with a lawsuit.
What commercial model would you advocate for GMO food? This isn't exactly a trivial problem to solve, and the knee-jerk reaction of simply making it unprofitable to develop GMO food neglects the question "why are so many people buying expensive GMO crops if they don't really need them?"
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I believe in defense in depth. Even though the guards inside the castle may be trained to password challenge everybody walking around and check coats of arms, it never hurts to raise the drawbridge when there isn't anybody using it and there is a besieging army.
Sure, have firewalls all over the place, but any route into and out of the network itself needs to be HIGHLY secure. NOTHING goes IN or even OUT without a reason. Nothing wrong with the airport having a flight status board, but you have the ATC central database polled by some central server which generates an xml digest of the important info and have it dump that data across a serial line (transmit only) to another server which then puts it onto a webserver which the airports can parse. Flight plan requests come into some intermediate server on the internet (but well secured). That server validates the requests and sends xml files to some intermediate server (perhaps over serial) which otherwise isn't on any network. That server re-validates the input and then makes it available to a more trusted server that then does the application logic.
Of course the internal network has a firewall at every WAN connection that only passes the minumum defined data to make the system work. That still doesn't mean that you shouldn't keep the actual traffic on the mission critical network down to the minumum necessary. There shouldn't be a single packet on that ATC network that doesn't originate from an FAA-validated piece of software. Any connection to the outside should be sanitized, and they should be few in number.
This isn't about being smarter than the hackers - it is about being thorough and having a fully specified architecture.
The only issue with an Active IDS is having zero false positives. You don't want some TRACON to go down when some IDS update causes a router to alarm and shut down JFK approach with 18 aircraft enroute to final on 3 runways.
The issues with IT security are due to smart marketing - they know where the money is and they cash in on it.
There isn't much money in helping a CEO to find some guy who can competantly run his IT show.
What the CEO needs is a way to get his friend's cousin an IT security certification so that he can justify hiring him. You see, his friend is the CEO of OtherCorp and he just hired his nephew for $250k/yr, and it is time to pay back the favor. However, the guy's cousin could turn out to be an idiot and that could get the guy who decided to hire him canned. However, if the cousin had a SuperS+ Security Certificaton and there is a big mess, then the cousin could be shifted to some other job and the guy who hired him could be safe since he had the credentials. Plus, as an added bonus the CEO of OtherCorp now owes you a favor for saving the guy's job and that could come in handy if OtherCorp has an opening on the board of directors.
So, the SuperS+ Security Certrication company will issue a cert to anybody who can sit through classes and cram their way through a test, and pony up $5k in fees.
And what is the chance that anybody will break into any particular company anyway? :)
This is a specious argument. Unless you plan to sit at home and die quietly how exactly is the ER physician supposed to determine if you did this to yourself or not?
They don't decide - they render emergency care unless you refuse it - implied consent and all that. Who pays the bill is a different matter, and that can be figured out after the fact.
You can see an MD, DO, PA, DDS, NP, acupuncturist, aromatherapist, shaman, voodoo doctor, crystal healer, televangelist or anything else that floats your boat.
What we do say is that the average person does not understand pathology, physiology, pharmacology, and pathophysiology to make complex judgments about the medication they should be taking.
So what you're saying is that I can choose to destroy my organs by refusing medication, or by drinking some cocktail with who-knows-what effects, but I should not be allowed to choose to take a medication whose properties are actually fairly well characterized? How exactly is the one better than the other?
If I want to drink water from a stream polluted with chromium nobody in the medical community will stop me, but heaven forbid that I want to take 5mg of lisinopril which might cause some liver damage after a few years!
Again, I encourage anybody who is ill to work with their doctor, but in my opinion the current medical system takes the patient out of the loop. Sure, you can refuse treatment, but you can't administer a treatment without a doctor's consent.
Agreed. If quantum mechanics were truly practical then we chemists would be out of jobs. :)
Here is a piece of paper with readable language on it. Are the dots in the columns where you wanted your votes to be cast? You can answer that.
Not really. Is a tiny dot in the column a vote or a mistake? How about a mark in three columns, two of which look like they might have been erased? How about three erased marks of which one was re-marked? How about two dots in one line and no dots in the next in which the voter cast votes for a single party - can we just assume they voted straight party and put their mark in the wrong line for the one position? If a ballot contains invalid votes does that disqualify only part of the ballot or the whole thing?
Paper voting has lots of problems. They only matter in close elections, but you'll never get two recounts to agree to a single vote in a large district.
I favor a hybrid approach. Use a computer to generate the ballot since a computer can validate the input and print an unambiguous ballot that is clearly readable. The voting machine might even subject the ballot to an extra-sensitive optical scanner to validate that the printout was clear. Then the voter looks at the ballot, confirms that they are satisfied with it, and then they drop it into a ballot box.
Use the GUI for what it is good at - validating the ballot and interactively working with the user to capture their true preferences. Use paper for what it is good at - making a hard-to-modify record of the event where a voter has some assurance that due to process control that the vote will eventually be counted.
"Attention all employees - you are hereby given a one hour break to go and vote. Just be sure to bring back your voter receipt ID numbers so that we can verify that you were voting and not just goofing off during your paid time off. Anybody who fails to return with one will be fired. Oh, vote your conscience but I think Candidate X would be great for our industry." -- Public address announcement at local factory.
"Ok, Fred, can you go through and see who all those workers voted for and be sure to sack anybody who voted for Candidate Y!" -- Less public conversation with plant foreman.
A voter-verifiable receipt is not a very good idea. I agree that voters should be able to leave a booth assured that their vote will be counted, but they should not have proof of how they voted or whether they voted.
But when the same product is made by the same company and sold for one third the cost in a foreign market, we should be free to import the discounted product.
Couldn't agree more - I think I tried to mention this in my post but I agree wholeheartedly with you here. While patents are a legitimate issue the equivalent of DVD Region Protection is an entirely different issue.
Remember also that a great deal of medical research IS government-funded. There is a tendency for grant-funded university research to magically morph into private patents.
I agree with this also - to a point. Keep in mind that the government-funded research tends to only cover the concept behind a drug. The optimization of a drug molecule, development, and clinical trials are all paid for by drug companies almost entirely. This is by far the bulk of the cost of developing a drug. It is also boring work, which is why nobody in academia does it. I'm all for the government auctioning off patent rights to their ideas, but they'll get what the market pays for a concept with no clinical evidence to back it up, which isn't the same as what drug rights sell for once they're on the market.
To get an idea of how drugs are valued at various stages just look at deals between pharma companies for drug rights. At the one extreme are established products - those are valued at many billions of dollars in some cases, and valuation of these are trivial since they're already making profits. At the next tier are drugs that have strong clinical data but no established sales - maybe just before approval - and these also sell for a pretty penny since marketers have a good idea what they'll sell for and chances are they'll be approved. Then you get into drugs with some clinical data but short of major trials - the value of drug deals drops quickly when there isn't clinical data as lots of drugs look good but fail in trials. Finally you get to licensing deals for molecules with nothing else except maybe some in vitro assay - these are worth tens of millions of dollars, and maybe a share of future profits, but that is about it.
Basically the value of a drug is a risk-adjusted matter. As risk drops the value goes up. Alternatively profit-sharing (and consequently risk-sharing) agreements make sense - a company might pass up a few tens of millions of dollars in certain profits to sell a molecule in exchange for a share of future profits (which might never appear). It is easy to see the price of marketed drugs and to think that every R&D idea is worth that kind of money, but that is like saying that every lottery ticket is worth a million dollars. One lottery ticket may be worth a million dollars, but "any" lottery ticket is worth less than it is sold for.
I agree with you on the nurses - that is what I'm getting at. However, the basic principle is one of triage - there is no reason why somebody with the sniffles needs to be going to see the best respitory therapist on the planet.
I'm not sure if doubling admissions would be productive - in theory it could just burden the schools more, but I don't know enough to do more than guess on that.
I didn't mean doubling the admissions at the existing schools so much as doubling the number of people admitted into a medical school. This would involve creating many more schools to accomodate the demand (and drive down the prices).
Also making most drugs over the counter is a seriously bad idea. Yes, there are some that could be OTC and the impact would be minimal. But if you have hypertension do you know if you should be on an ACE inhibitor, beta blocker, Calcium channel blocker, ARB, or something else. Careful 'cause if you "guess" wrong you could cause renal failure or even kill yourself.
I have to disagree with you here. I would NEVER just take a drug like this OTC without talking to a doctor. However, I believe that the drugs should be available to me nonetheless.
How is it any of your business if I want to destroy my kidneys or kill myself? Now, you shouldn't have to pay for this if it happens, but my body is my own responsibility to care for, so how as a society do we get off telling people how to care for themselves?
Again, I think the issue is that the current system is designed to keep patients out of the loop with regard to their own care, and I don't think that this is a good thing. Nobody has more incentive to take care of my body than I do - I'm going to be certain to use discretion when self-prescribing medications.
Ok, I've had to deal with medical bills in the US for serious hospitalizations. The US system is lousy in this regard - you get 500 bills from 75 people you've never heard of and you end up cross-indexing everything 14 times to make sure everybody gets paid the right amount and nobody is paid twice and everybody bills you what they're supposed to (since 2/3rds of the bills get written off due to insurance contracts). It is a real mess.
On the other hand, service is relatively quick and I have access to state-of-the-art care. Major surgeries can be scheduled in less than a month - or even the next business day if the condition is life threatening. As an illustration I know somebody who had difficulty breathing. We went to the ER at 9:30PM. We didn't get out of there until 1:30AM or so, but the condition was stabilized with O2 and a nebulizer, an X-Ray was given and Pneumonia was diagnosed, an initial dose of antibiotic was administered, and we left with a prescription in-hand to continue this treatment.
In contrast, I have a coworker in the UK who went to his doctor with similar symptoms. He was essentially just given an aspirin and told to come back in a few days if it got worse. When it did he was sent to a hospital for an X-ray a few days later. Then they had to wait a week to have the result read (something that took 1 hour in the US at 11PM). At that point they made the diagnosis and prescribed antibiotics, but he had deteriorated substantially in the ~2-3 wasted weeks of time. He was out of work for a month (I don't ask how that can be saving money). On the other hand, there were no bills or anything like that involved, so he never had to think about it again after it was over. I'm sure he pays far more in taxes than I do for insurance as well.
Socialized health systems have some serious problems. I actually think they're inevitable, and in theory it is a great way to handle medicine. The current US system is broken and unsustainable. However, the fact is that right now if you can get good insurance in the US you're far better off with the current US system. The problem is that good insurance in the US is contingent on your employer and not everybody works for a decent employer. Those of us who do might not at any time based on some whim of management.
The switch to socialism is inevitable in a few years anyway (maybe 10-15, but it is coming). Even if current efforts to socialize don't pan out there is something no politician can control: genetic testing. Genetic testing will end voluntary private insurance. Insurance only works in the absense of knowledge (you don't know when your house will burn down, you don't know when you'll get hit by a car, etc). Once you know with a high degree of confidence whether you'll get diabetes or heart disease the equation is thrown out of balance. Either companies will be allowed to exclude you from insurance and you'll never be insured, or companies will be forced to provide insurance to you, in which case you'll decline coverage for these diseases unless you're likely to get them and then the insurance companies will go out of business or have to charge astronomical premiums (which will then put them out of business). What makes insurance work is people who buy it but don't use it - but why would anybody buy insurance that covers diabetes when they know they'll never get it? People will buy much cheaper policies that exclude conditions they know they won't suffer from, and when everbody does that then the result is the same as if companies were allowed to discriminate based on genetics. The only thing that works when there is a high level of knowledge is an involuntary insurance system - then everybody is covered for everything and it all gets paid for involuntarily.
The insurance industry is only one problem with US health care. Just as serious are the way US liability works (defensive medicine and higher costs), the supply of doctors, and availability of care once everybody and their uncle can go to the ER for free wit
If anything IT can make this kind of institutional incompetence worse. IT tends to put a premium on process over individual expertise. I can see the logic in this as it leads to a more consistent experience. The problem is that in the article you cite it led to a consistently bad experience.
I think that we've become far too process-focused in IT, and IT is seen as a way to solve problems using machines without the need for strong employees. Managing employees right is hard work - better to just outsource and have the machines catch the problems. Except, of course, it doesn't actually work.
I know somebody who works in an IT organization in a large corporation. Their department just had a big re-org, and in the 1.5 weeks following the annoucement his only contact with his new manager was a 10-minute meeting. It turns out the managers are all in non-stop meetings with each other (which is pretty typical at this company). Individual contributors are effectively unmanaged and just run their own projects as a result. You can imagine how much company loyalty any of them have - if their building burned down with everybody inside but them their biggest concern might be getting their paycheck and maybe the one or two people they managed to actually form a closer relationship with while there. Too much process, not enough humanity...
I've had loved ones in the hospital with fairly serious conditions. They do NOT get much attention from doctors. Maybe their charts get a little more attention, but the patients are lucky to see them for more than 5 minutes a day except when they're in surgery.
I think that the solution is they need more tiers of medical care. Right now you have mostly just doctors and nurses (I do realize there is some graduation in-between right now, but in a typical hospital those two categories will cover 90% of everybody who cares for a patient).
Hospitals could use everything from volunteers, to aides, to basic-intermediate-advanced nurses, to basic-intermediate-advanced doctors. Go ahead and put limits on what that guy who currently couldn't pass medical school can do, but chances are they're qualified to do quite a bit. Having more people will lower costs (start paying doctors less).
Also - I'm not convinced that doubling the size of medical school admissions would lower quality at all. Go ahead and have the same standards - right now the problem isn't people not graduating, but people not getting admitted. Also - if you had 10X as many medical schools out there then tuition costs would go down (more competition). Doctors should be well-paid, but not to the extreme they are today.
Also - doctors should have limited hours - certainly no more than 50 per week and no shift longer than 12 hours (with at most one 12 hour shift in a week). Why is it that we can regulate how many hours a truck driver can spend behind the wheel and yet we have interns working 100 hour weeks as some kind of way to weed out anybody who has a shred of humanity in them?
Getting prescription prices under control is as easy as opening the door to Canada, India, or wherever. God knows, the pharmaceutical companies are quick to go with offshore outsourcing when it serves THEM. Why should the customers think differently?
I agree with this - but only to a point. Unless the drug R&D model is substantially changed it should only be legal to import drugs manufactured with a patent license (for patented drugs). Now, if the government wants to take over drug development (after the discovery of a lead) and just pay an up-front fee for any leads not generated with government dollars in the first place (some are, some aren't), then patents might not be necessary. However, that will cost a LOT of tax dollars (well, not compared to the recent bailouts I suppose - the meaning of "LOT" seems to have changed).
Aside from the patent issues, I'm all for US citizens getting the same price as those in Canada/etc. Of course, drug companies will likely raise their prices internationally and drop the US prices a tiny bit until it is about a wash, but that is perfectly fair.
Again, I'm all for changing the system. However, what a lot of people are proposing (compulsary licensing or non-enforcements of patents) sounds about as ethical as spending three hours with a salesman at a high end electronics shop and then once you've figured out exactly what you need going and ordering it online for less. If we want to have new drugs then somebody needs to pay for them (and not just the blue sky R&D component of the research which tends to be government funded now, but which is only the tip of the iceberg where costs are concerned).
This depends greatly on your threat model.
If the attacker is some guy with some cash and contacts and they want a photocopy of one person's medical record, chances are that paper will be easier to defeat. However, there is a substantial risk of getting caught (if the guy you approach who works in the file room doesn't take your bribe). If you do successfully bribe the clerk, however, nobody else will ever know about it (no access controls, audit trails, etc).
On the other hand, electronic records are vulnerable to some hacker in Indonesia who copies the records of 30 million patients from a NYC hospital without anybody even realizing that it had happened. Most likely the attacker didn't target any one patient or hospital in particular - in fact the security at 99% of all the hospitals was probably completely effective at keeping him out. However, since this was a trawl they will extort anybody of interest whose records they do get, and since somebody will mess up electronic security chances are there is someplace they'll manage to break into. A successful theft might even leave a trail - but most likely beyond the jurisdiction of whoever performed the theft. In fact, the theft victims might just get the guys home phone number when he calls to demand money - and they'll be powerless to do anything but pay it.
Paper and electronic both have strengths and weaknesses. The ways they are likely to fail from a security standpoint are very different.
Better to get rid of the lawyers first.
If the medical journals say that there is a 0.0001% chance of deadly condition Y being present given the patients symptoms, and a $5k MRI test has a 0.001% chance of detecting Y, then the doctor is going to have to order it. Otherwise when the 1-in-1-million patient dies from undiagnosed Y the jury will be handing money to the plaintiff hand over fist.
The expectation of modern juries is that every patient gets tested with every modern technology available, has access to experimental technologies that are just emerging, and has a board of doctors meeting in a conference room with House to discuss every aspect of the patient's care.
Frankly, just getting a copy of your records is almost impossible it seems. Doctors treat them like they're confidential materials not to be shared with patients, and only grudgingly with other doctors (that they like).
A law should be passed requiring all patients to be given a full copy of every record that is generated on any visit. If the patient wants to throw it out when they leave that is fine, but they should be issued. Patients should not be required to even request them - otherwise you'll end up with situations where the office worker tells them "sure, just sit here for 2-4 hours and we'll get right on that." It should be illegal to collect payment for services (including copayment) before those files are in the patient's hands.
Half of the problems in medicine stem from the fact that we treat patients like they should have no involvement in their own care. Heck, I'm all for making almost all drugs over-the-counter (perhaps prescriptions should be required for insurance coverage, and where there is a compelling public interest such as with antibiotics there should be restrictions on access). If you want to mess up your body more power to you. That guy wouldn't have ended up having to beg for his life if his wife could have just given him an injection of the needed drug on her own legally.
I'm sure the movie factored into the name. :)
The genes do exactly what they're supposed to do - they make crops from sold seed sterile so that you need to buy more the next year.
The genes aren't intended to destroy other crops any more than the DRM on a music CD isn't designed to destroy the rest of your music collection.
Again, just as with DRM I'm not sure this is the best solution (especially since there is a risk of cross-contamination of this trait into other crops). However, anybody who thinks that Monsanto is deliberately trying to destroy non-GM crops has been watching too many Michael Moore movies...
If their goal is simply killing people, why do they hijack planes at all? Wouldn't be a whole lot easier to blow up busses or shopping malls?
If a terrorist is going to go to the trouble to hijack a plane they're after more than just some dead bodies.
I agree that what I suggested isn't a holistic response to terrorism, but I don't think that negotiating for hostages is a whole lot better than paying ransom for kidnap victims. Do everything you can to rescue hostages, but make sure the terrorists end up worse off than they were before they made the attempt.
Absolutely - if those desktops are all used for the same purpose.
My approach would be to set moderately agressive power saving settings and distribute them via SMS/etc. However, I wouldn't lock down these settings - if a user has a business purpose for changing from the defaults they can do so. Likewise I might send out a corporate-wide email to educate users about power consumption, and let them make the call.
What I'm not a fan of is having the energy police demanding justifications for any powered-on PC found after hours.
The point is to kill the criminals before they board your ship/homes. That way they will never board any more ships/homes.
Agreed. Ships in particular should be almost trivial to defend (homes are not). The pirate has the objective of capturing a ship - sinking a ship does nothing but tick off the Navy. The ships are large and that makes them very hard to board. Pirates should be detectable miles away via radar with plenty of time to prepare to repel a boarding attempt.
When pirates approach a vessel they're completely without cover in open seas. Most likely their ships are far less substantial than the ships they aim to capture. They probably have little more than handheld automatic weapons and RPGs to work with. A well-prepared defense force should be able to sink them before they can even close within the range of their own weapons - and that is only with relatively light armaments like machine gun mounts and maybe a light cannon or two.
A home is much harder to defend - motion sensors are useless to detect an approaching intruder unless you have a very wide property clear of trees/wind. Your first warning will be once they are actually inside the house (if you have an alarm), at which point you are waking up from sleep and they are fully prepared to confront you. Your only defense is that most crooks will take off at the first indication the owner is awake - if they actually mean to do you harm then you're going to be in trouble. Unlike a ship you can't stop them before they are inside when you have the advantage of cover.
I dunno - I think you need to look at the incentives involved. These pirates are businessmen - not crusaders. They do it to make money. If they know they aren't going to make money they'll stop doing it.
I once heard somebody argue that when a plane is hijacked that the military should just shoot it down with hostages and terrorists alike perishing. Of course that sounds dumb, until you realize that you've eliminated any negotiating power the terrorists might obtain from holding hostages. A saner approach would be to simply not sincerely negotiate at all and always mount military responses if the terrorists don't surrender after a reasonable period of time.
Couldn't agree more - with a caveat.
The US Navy should offer protection to any US-Flagged ship, and the ships flying flags of nations that pay the US Navy to provide this service (possibly via services in kind from their own militaries).
US-Flagged ships should be taxed accordingly to pay for this service.
What I can't stand is the though of US tax dollars going to pay to help corporations who can't be bothered to fly a US flag on their ship, because they don't want to pay US taxes and be subject to things like US labor and safety laws. If you want the world's strongest navy to defend you, then you should pay your share.
I imagine that most first-world nations would be happy to arrange for mutual support in this way, paying for each others services either through genuine mutual military support or by other means if a nation doesn't have a strong military. This isn't about US nationalism or anything like that - this is about getting corporations to pay for the services they require.
Agreed - lots of stuff could be detected spectroscopically on an Earth-like world.
Those kinds of technologies can't be applied to other planets in our own solar system. I mean, sure, technically we can do a spectrocopic study to rule out Mars being a jungle paradise, but I don't think that is really at issue.
We need probes for nearby planets since we already know they aren't teaming with life, but there is a question as to whether they are absolutely sterile.
Now, if a spectroscopic study of an exoplanet shows no sign of life that isn't proof positive that there isn't some microbe buried in a rock somewhere, but it would be a strong indicator that we're not going to find green men and other advanced organisms walking around on the surface.
Uh, I don't think anybody at Monsanto has announced any goal to get terminator genes to cross-contaminate other crops. I can't see how this would be likely to happen from an evolutionary standpoint - sterile crops clearly would be at a selective disadvantage in the wild. The only way you can end up in a situation where there are no crops are if farmers deploy terminator seeds all over the place and then the company goes out of business, leaving insufficient seed stock the next year. As long as the company keeps a stockpile for a good year's worth of seed that shouldn't be a problem - a year should be enough time for seed companies to produce normal seeds.
The issue with GMOs is the same as the issues with copyright/patenting/etc - it costs quite a bit of money to develop a GMO and very little money to copy them once you've bought a single seed. Contracts and licensing are probably a saner way to handle this sort of thing but then you get complaints when pollen from GMO crops lands on somebody else's fields and then they get served with a lawsuit.
What commercial model would you advocate for GMO food? This isn't exactly a trivial problem to solve, and the knee-jerk reaction of simply making it unprofitable to develop GMO food neglects the question "why are so many people buying expensive GMO crops if they don't really need them?"