For a typical waterfall you're doing roughly these steps: Requirements Analysis, Design, Implementation, Testing, Maintenance. So let's start at the beginning...requirements. So off you go notebook in hand to get some requirements. When are you done? How do you know you got them all?
When you take the brief description of the project goal that you was generated before even requirements gathering, before a decision was made to start work on a project, and which is what the decision being made to start work on the project was based on, and take the list of the requirements gathered so far, and the answer to the question "Will the system satisfy (brief description) if it satisfies (all of requirements gathered so far)?" Then you know you've gathered all of the requirement at the level you are gathering requirements currently.
(You also should ask "Will the system satisfy (brief description) without any of (requirements gathered so far)?" so you can parking lot anything that is out-of-scope.)
Next up - Design! Woot, this bit is fun. So we crank up Rose or whatever and get to work. But when do we stop?
When you have a design for a system that meets the requirements.
So we stop when it's "good enough" - according to who?
According to a decision-maker whose job it is to review the design against the requirements.
Sure this isn't the waterfall model as published in the text books, but it's how it works (fails) in real life.
Yes, if you do it wrong, it fails. So does Agile, and the problems are pretty much of the same type. The principal advantage with Agile is that it manages risk by reducing the harm resulting from any single failure, by breaking up the work into smaller chunks which are specified, designed, developed, etc.
Unfortunately, that doesn't make as good a kvetch. He's right about one thing though...the current financial collapse is due to financial decision makers (mostly accountants) putting too much faith in a calculation that can be done on a spreadsheet.
Which has nothing to do with spreadsheets. Decision-making focussing on measures that are of dubious prospective utility but that are easily quantified and manipulated has been a problem since people started applying math to decision making in the first place.
Thinking that "...with a spreadsheet!" makes this any different is the same kind of thinking that generates (and supports) the idea that "...on the internet!" or "...with a computer!" makes something novel and patent-worthy.
I'd more likely say that it showed that aggressive people tended to be attracted to violent media.
That's certainly a valid interpretation of the causal relationship underlying the linkage (i.e., correlation), if it exists at all. I'd even agree that it is a fairly probable explanation of whatever correlation actually exists.
Of course, since the warning as stated only refers to the linkage, and doesn't saying anything about any underlying causal relationship, that validates the literal text of the warning, even if it undermines what it is clearly meant to suggest.
No, and it uses whitespace as a delimiter, and, at least in many dialects, differentiates between kinds of whitespace (at least, between newlines and everything else.)
If you wouldn't mind, answer me this; if there is a disagreement between the patient and the administration on the care or lack of care provided, what are the patient's options?
There is no one answer to this question that applies in universal healthcare systems.
In the USA at least, the current public care and HMO systems put the patient at a disadvantage in the event of a disagreement. With private insurance, I have the control. If I do not like a doctor, I find a new one, without having to file a request through the HMO.
Which is fine, if your disagreement is with the doctor and not with the insurance company; and, of course, if you can find a doctor that takes your insurance company that agrees with you. Of course, not all doctors take all insurances, and not all decisions are in the doctor's hands anyway.
Further, most HMOs have processes to get a second opinion within the system, and many states have agencies one can go to for a medical review of contested managed care decisions.
I may also choose to see the same doctor, instead of getting whoever the HMO has on staff that day.
This is also possible through most HMOs that don't directly operate the provider network (e.g., Blue Shield HMOs), since the doctor you see is often controlled by the medical group not the HMO (I recently switched from a traditional plan to an HMO plan, with the same medical group; there is no effect on who I see for routine appointments -- I still see my regular doctor if they are available, and if I need to be seen at a particular time and they aren't, I see whoever is on staff at the medical group that day.) For those where the HMO also directly operates the provider network (e.g., Kaiser) this may not be the case, though when I was with Kaiser, several years ago, you could see the doctor you wanted at the Kaiser facility, if you asked and were willing to be flexible to meet their schedule, just like any other medical group.
HMO's, the closest entities to national healthcare here, are what the federal proposals are based upon.
No, in fact, they aren't; maybe you are confusing the current federal proposals with something from the early 1990s. The proposals both Obama and Clinton made in the primary season and that Obama made in the general election season had nothing to do with HMOs vs. traditional insurance, they involved income-dependent insurance subsidies and some degree of purchase mandates, imposing a few additional regulations on private insurers so that people don't get categorically excluded, and providing a particular plan or set of plans that would serve as a "fallback" that everyone would be eligible to buy into and which would be within reach of those dependent on the maximum subsidy alone to purchase insurance. HMOs, traditional insurance, and presumably even the newer HDHP + HSA style plans would continue to operate in this system, and people would continue to have choice between plans.
They cost less, but also provide less, with much less freedom.
Actually, by many measures, they provide more, covering more services, and covering a greater share of the cost of those services. But it doesn't matter, since nothing in the proposals for expanding healthcare coverage in this country requires HMO-like plans.
So while it is more expensive, private insurance allows for that individuality that us Americans prefer.
Actually, I suspect that a substantial portion of the public, especially the tens of millions without any coverage now, and the additional tens of millions with low-quality plans that cover little because they work for small employers that can't get into good, large group plans, would prefer to have coverage that was both meaningful and affordable to the "individuality" and "choice" of not having any covera
We have to write parsers almost on a carrier by carrier basis because so much of the spec is optional everyone does it in their own way.
The 835 spec doesn't include much that is optional in terms of how to report particular things, or even in terms of what is reported. The 837 (the corresponding billing) has a little more flexibility. A bigger problem is that there is very little enforcement, and a lot of participants violate the standard in lots of ways. (And not the same ways.)
So it seems the task is coming up with a standard format and enforcing it.
Do you have any idea how much money has been spent implementing the HIPAA transactions and code sets rule, which is basically the same task, but just applying to insurance billings and some related transactions, not the whole gamut of health records. (I don't, in total, but from what the agencies I am familiar with have spent, I have no problem believing scaling it up to health records in general, the implementation cost nationwide would be on the order of $100 billion.)
But most of those databases are already manned by DBAs. Some of them may not be up to the task, but most can convert their tables to the specified format if you tell them what that is.
Presumably, most health insurance records holders currently pay enough of an IT staff to support their current development and maintenance needs, unless they are just wasting money paying people to sit on their thumbs. Even if those people are technically proficient, a major new mandate will require hiring some new people, even if you can meet some of the need with (in some cases, mandatory and uncompensated) overtime.
But hospitals and insurance companies are quite used to such bureaucracy, so it's difficult to understand where they're pulling this $100billion figure from.
Probably from estimates of what actual real agencies spent implementing similar mandates and estimates of how the scale of this relates to the scale of those mandates.
While your post is intended to be a dig at Microsoft, HIPAA may actually require a form of DRM.
Whenever I see "HIPAA may require..." I suspect that ultimately, the source of information is a vendor of some kind trying to gin up a market for a product or service that is, in fact, not required under HIPAA. What is actually required by HIPAA is spelled out in black and white in the statute and the regulations adopted under it;
If we made all medical records the same "format" or made all Health systems capable of exporting data into a common format, the major problem is that those records are going to be missing valuable meta-data that is used by different providers to facilitate all kinds of functions such as billing, referals, preventative care pre-screening.
Actually, I doubt that's the case. First of all, because billing is already done in standard formats (when it comes to electronic billing, this is a government mandate under the HIPAA transactions and code sets rule), the needs to support billing are already going to be similar. Further, the kind of process used to build standardized formats (like the standard transactions mandated under HIPAA) tends to incorporate opportunities to ensure that the needs of the various participants are met.
The second problem is that even if the data is in a common format the problem is transferability; how to facilitate transfers between providers without a central database, in a timely manner, at a reasonable cost.
Sure, common formats aren't enough for exchange, you need an exchange channel. But you need a language that you can speak over that channel, as well.
fourth problem is that often times, I don't want records transfered from specific providers.
(First, second, fourth?) Anyhow, assuming HIPAA's privacy provisions aren't weakened, transfer of information requires a release, so that shouldn't be a problem. I haven't heard anyone advocating standardized digital records suggest weakening HIPAA privacy protections.
As soon as you have something exotic wrong with you, you are in a world of hurt.
And, yet, by most measures of outcomes, most of the developed world does far better than the US, at far less cost.
Probably because most of the "exotic" things that would cause problems in those systems aren't really exotic, they are just the kind of things that preventive care, which most universal systems do really well, could catch early as something routine, but when they get missed, become extreme, acute problems that are expensive to deal.
I read about a study done in Canada to determine why knee replacement operations failed so often in Canada (while not failing in the USA nearly so much).
Everyone that opposes universal healthcare always points to Canada. Which isn't surprising; while Canada, like all other major developed nations, spends less and scores better in every study of quality and outcomes than the United States, it pretty consistently, among advanced countries, scores second to last, ahead only of the United States, so its the easiest one to take things from to make the whole idea of universal healthcare look scary.
Of course, the actual proposals for universal healthcare that have been put forward recently by prominent politicians, including the President-Elect, have been far more like the German model than the Canadian model, and use some combination of subsidies for insurance purchases for low-income individuals and purchase mandates to acheive universal coverage, rather than relying on the kind of direct government control that most anti-universal-healthcare arguments rail against.
New processes like Agile are not excuses for sloppy coding.
Unfortunately, in other shops, new processes, and particularly any that, like Agile, become trendy buzzwords, are often, IME, used as excuses for sloppy, well, everything. Sloppy coding, sure, but also sloppy requirements gathering, sloppy project planning, sloppy change management, sloppy test development, sloppy testing...
Waterfall is Requirements, Design, Implementation, Testing, Maintenence. An iterated waterfall is not a waterfall, it's a series of (possibly overlapping) waterfalls.
Or, rather, its a bunch of subprojects, each of which are developed with a waterfall methodology. The key difference between "traditional waterfall" and "agile" methods, in terms of big-picture process, is that agile methodologies involve some analysis as to the proper units of work to which the basic waterfall methodology is applied (different specific methodologies that are within the broad "agile" umbrella often have slightly different approaches to determining what the appropriate units of work are), whereas the more traditional waterfall doesn't even consider this factor and just takes the whole project scope as the unit of work, putting the determination of the unit of work to which the basic series of tasks are applied outside the scope of the methodology. And organizations that use the waterfall methodology will divide work into subprojects (usually, larger ones than the units you'd expect with most agile methodology), but usually in an ad hoc way, agile methodologies tend to present particular (even if somewhat subjective) criteria to apply to determine what the units of work should be.
Agile methodologies are probably best seen, collectively, as refinements to the basic waterfall methodology, rather than rejections of it.
As a very good example, look at all the old COBOL programs still running banks and payroll systems. Just why do you think they are *still* running them? Hint: cost of upgrading isn't a problem for the kind of companies that do run these.
Because the bugs have been slowly worked out over decades of use, the requirements are basically static, and, contrary to your suggestion, the cost of upgrading would be exorbitant even for the large players involved, for very little gain because, again, the requirements are static. Plus, incremental updates are made difficult, because the interrelationships between components and systems aren't well documented. Where these considerations don't all apply, you do see massive legacy production COBOL systems being replaced, either all at once or piecemeal, by newer systems.
"Excessive exposure to violent video games and other violent media has been linked to aggressive behavior" Except that it hasn't been.
There have been some studies that have found linkages (the warning doesn't claim causality, it merely implies it), and others that haven't.
An even bigger problem is that a game can be rated T or higher (even as high as AO) without any violent content, so even assuming that a direct, substantial causal linkage was established between violent video games and aggressive behavior, the proposal -- to require the warning on all T or higher rated games -- would still be nonsense.
So what they're saying is that this system will require 212,000 more people to operate than the current one.
No, they are saying it will take 212,000 people working for several years to implement it, not that it will take more people to operate. The job creation is considered part of short-term stimulus; the long-term effect is supposed to be increased efficiency and lowered costs for similar work due to administrative simplification in the medical field.
Shouldn't a new system like this actually eliminate jobs?
No, it should reduce the total (and particularly administrative) worker-hours needed for delivering the equivalent quantity (however measured) of healthcare services.
That's not the same as eliminating net jobs in the economy, or even necessary within the healthcare industry. It should increase productivity within that industry, but that's not equivalent to eliminating jobs.
First off, who is going to back this data up, how are they going to back it up, and how are the backups going to be tested? The public outcry that you'll have the first time a hospital administers medication that a patient is allergic to because the IT staff is still in the middle of restoring backups will (or at least should) be epic.
This happens all the time because of the absence of electronic medical records; studies of the places where they've been implemented show that they reduce the incidence of such errors.
Secondly, quite a bit of "medical records" is high-resolution images (X-rays, ultrasounds, MRI, CAT scans, and probably a lot of stuff I haven't thought of). A typical patient may only have one or two images in their files, but we are talking hundreds (or thousands) of patients per doctor. The storage space required will be astronomical.
All the information is currently being stored in some format already, probably a form that takes up a lot more physical space, so that even if the media itself is less expensive per unit of storage (questionable), the necessary ancillary costs of storing it (cabinets, building space, etc.) are greater.
The net expense of government healthcare is driven by mandate and legislation, not by economic factors.
Who is talking about "government healthcare"? While some of the major industrialized countries have universal single-payer systems, quite a few, despite having universal coverage, do not have universal government-provided healthcare. Universal coverage isn't the same as universal government-run (or even government-purchased) healthcare.
That, on average, the expense is lower in countries where it can be completely arbitrary should not be surprising.
Germany, for instance, has universal healthcare access acheived by government mandate, but its an insurance purchase mandate with subsidies for low-income individuals, there is a government plan available, but private insurers can and do operate, and individuals are free to purchase private insurance; like the rest of the developed world, its costs are below those in the US (both per capita and per GDP).
As for quality of care at a given price, talk to the people who take medical holidays to the United States.
And then talk to the people from the US that take medical holidays to Mexico or Canada (mostly for prescription drugs) or even India (for surgery), among other places.
And then, when you are done playing the anecdote game, look to all the studies of health care quality, equity, and outcomes that have been done over recent years.
Government can't create jobs, it can only re-purpose money.
Since not all purposes to which money is applied have the same effect on jobs, repurposing money can create jobs, and therefore government, by repurposing money, can create jobs.
Now, if he wants to hold a consortium a la IETF/W3C to create a standard format for records, I'd be all for that.
Probably, it would use a (possibly, already existing) ANSI workgroup, the same as the HIPAA transactions and code sets mandate did for most of its transactions.
These records should not be kept in a central location, rather they should be used as a means to exchange information between providers more easily.
Whether or not they are physically kept in a standard location, no proposal has been made, that I am aware of, to weaken the HIPAA privacy mandates that would apply to access to or release of the records.
What evidence do we have that it will actually make health care more affordable?
The fact that every other major industrialized nation has universal healthcare, provides outcomes comparable to or better than the US, and does so at lower expense (measured either per capita or as a share of GDP) than the US.
Will alcohol be taxed higher because it's bad for me? McDonalds? Doritos?
The first already is taxed higher, in part because of the health consequences, and proposals on the latter have been made independently of universal healthcare.
The Health Insurance Portability & Accountability Act of 1996 not only set up privacy rules, it was also supposed to require code sets and standards to allow the "Portability" of health care information.
The transactions and code sets rule does not apply to health records (which is what is being proposed to be standardized now), it applies to a variety of health insurance related transactions (billing, remittance advice, authorization, eligibility requests, etc.)
(And the "portability" in the name of the act has little to do with the portability of information: HIPAA has two major parts, Title I relating to portability of insurance coverage, and Title II ("administrative simplification") containing provisions relating to privacy of health information, standardization of insurance transactions, etc. The first part is the "portability" part, the second part is the "accountability" part.
If this can save so much money why isn't the health care industry already doing it?
There are two aspects here: standardized formats and electronic health records.
Standardization may save money for everyone in the long term, but it is a competitive advantage for no one in either the short or the long term. Consequently, there is little incentive for any party to pursue it in what is largely a competitive, for-profit industry, and the benefits of standardization rely on universal, or nearly so, participation.
Electronic health records, OTOH, can streamline operations for those implementing them internally regardless of standardization, don't require other people to participate for at least some of the benefits to be realized, and can be a competitive advantage; unsurprisingly, lots of participants in health care are implementing (or have implemented) electronic health records, without a single standard.
What's the point of profiles in a web browser when you have fast user switching (and/or whatever MS calls their equivalent function)?
Someone might want to create browser profiles for different activities without creating different OS-level accounts. "Profiles" don't have to correspond to different people.
Regardless of whether people are paying a copay to the government or to the insurance company, they are still shielded from the actual cost of service and have no incentive to shop around.
But neither the government nor the insurance company is shielded from the cost, and they do have an incentive to control costs, either by shopping around as to which providers they will contract with, imposing reimbursement caps, or both.
And every real government or private healthcare plan uses one or both of those means to control costs.
There are plenty of problems with our current healthcare system, but the one you point to isn't really a significant one.
You are forgetting a very critical point, it is primarily the U.S. the consumes and utilizes the goods in the first place. With no taxation on nationally produced goods and high tariffs on imports, it will be economical for Americans to purchase quality American made goods again relative to cheap imports.
You mean, like the Smoot-Hawley Tariff Act, the mere discussion of which was, at least arguably, a significant contributing factor to the crash of 1929, and the actual passage of which was a significant factor in the following Great Depression.
Lets not try that again, okay?
The United States holds the largest pool of natural resources in the world. Ultimately, because resources are scarce, all we have to do to remain the wealthiest nation is to utilize those resources and limit the amount of sharing we do with the rest of the world.
This theory is called mercantilism. It was a pretty big driving force in the 16th through the late 18th century, but its currency in economic thought has been rather on the decline since Adam Smith published An Inquiry into the Nature and Causes of the Wealth of Nations in 1776.
People talk of the Utopia of the 60's and 70's
Which people, exactly, talk about that? The 1970s were one of the worst periods in the US economy in the post-WWII period.
but they forget that in the 50's any high school dropout who was willing to work hard could own a home, a quality vehicle, and support a family on a single income.
Its impossible to "forget" something that isn't true. Some high school dropouts who were willing to work hard may have been able to do that, but most, even if willing to work hard, would not have been able to. Even moreso if they were (among other things) black, hispanic, or female.
Slashdot Mirror
When you take the brief description of the project goal that you was generated before even requirements gathering, before a decision was made to start work on a project, and which is what the decision being made to start work on the project was based on, and take the list of the requirements gathered so far, and the answer to the question "Will the system satisfy (brief description) if it satisfies (all of requirements gathered so far)?" Then you know you've gathered all of the requirement at the level you are gathering requirements currently.
(You also should ask "Will the system satisfy (brief description) without any of (requirements gathered so far)?" so you can parking lot anything that is out-of-scope.)
When you have a design for a system that meets the requirements.
According to a decision-maker whose job it is to review the design against the requirements.
Yes, if you do it wrong, it fails. So does Agile, and the problems are pretty much of the same type. The principal advantage with Agile is that it manages risk by reducing the harm resulting from any single failure, by breaking up the work into smaller chunks which are specified, designed, developed, etc.
Which has nothing to do with spreadsheets. Decision-making focussing on measures that are of dubious prospective utility but that are easily quantified and manipulated has been a problem since people started applying math to decision making in the first place.
Thinking that "...with a spreadsheet!" makes this any different is the same kind of thinking that generates (and supports) the idea that "...on the internet!" or "...with a computer!" makes something novel and patent-worthy.
That's certainly a valid interpretation of the causal relationship underlying the linkage (i.e., correlation), if it exists at all. I'd even agree that it is a fairly probable explanation of whatever correlation actually exists.
Of course, since the warning as stated only refers to the linkage, and doesn't saying anything about any underlying causal relationship, that validates the literal text of the warning, even if it undermines what it is clearly meant to suggest.
No, and it uses whitespace as a delimiter, and, at least in many dialects, differentiates between kinds of whitespace (at least, between newlines and everything else.)
E.g., in some lisps:
is not the same as:
Though they differ only in whitespace.
There is no one answer to this question that applies in universal healthcare systems.
Which is fine, if your disagreement is with the doctor and not with the insurance company; and, of course, if you can find a doctor that takes your insurance company that agrees with you. Of course, not all doctors take all insurances, and not all decisions are in the doctor's hands anyway.
Further, most HMOs have processes to get a second opinion within the system, and many states have agencies one can go to for a medical review of contested managed care decisions.
This is also possible through most HMOs that don't directly operate the provider network (e.g., Blue Shield HMOs), since the doctor you see is often controlled by the medical group not the HMO (I recently switched from a traditional plan to an HMO plan, with the same medical group; there is no effect on who I see for routine appointments -- I still see my regular doctor if they are available, and if I need to be seen at a particular time and they aren't, I see whoever is on staff at the medical group that day.) For those where the HMO also directly operates the provider network (e.g., Kaiser) this may not be the case, though when I was with Kaiser, several years ago, you could see the doctor you wanted at the Kaiser facility, if you asked and were willing to be flexible to meet their schedule, just like any other medical group.
No, in fact, they aren't; maybe you are confusing the current federal proposals with something from the early 1990s. The proposals both Obama and Clinton made in the primary season and that Obama made in the general election season had nothing to do with HMOs vs. traditional insurance, they involved income-dependent insurance subsidies and some degree of purchase mandates, imposing a few additional regulations on private insurers so that people don't get categorically excluded, and providing a particular plan or set of plans that would serve as a "fallback" that everyone would be eligible to buy into and which would be within reach of those dependent on the maximum subsidy alone to purchase insurance. HMOs, traditional insurance, and presumably even the newer HDHP + HSA style plans would continue to operate in this system, and people would continue to have choice between plans.
Actually, by many measures, they provide more, covering more services, and covering a greater share of the cost of those services. But it doesn't matter, since nothing in the proposals for expanding healthcare coverage in this country requires HMO-like plans.
Actually, I suspect that a substantial portion of the public, especially the tens of millions without any coverage now, and the additional tens of millions with low-quality plans that cover little because they work for small employers that can't get into good, large group plans, would prefer to have coverage that was both meaningful and affordable to the "individuality" and "choice" of not having any covera
The 835 spec doesn't include much that is optional in terms of how to report particular things, or even in terms of what is reported. The 837 (the corresponding billing) has a little more flexibility. A bigger problem is that there is very little enforcement, and a lot of participants violate the standard in lots of ways. (And not the same ways.)
Do you have any idea how much money has been spent implementing the HIPAA transactions and code sets rule, which is basically the same task, but just applying to insurance billings and some related transactions, not the whole gamut of health records. (I don't, in total, but from what the agencies I am familiar with have spent, I have no problem believing scaling it up to health records in general, the implementation cost nationwide would be on the order of $100 billion.)
Presumably, most health insurance records holders currently pay enough of an IT staff to support their current development and maintenance needs, unless they are just wasting money paying people to sit on their thumbs. Even if those people are technically proficient, a major new mandate will require hiring some new people, even if you can meet some of the need with (in some cases, mandatory and uncompensated) overtime.
Probably from estimates of what actual real agencies spent implementing similar mandates and estimates of how the scale of this relates to the scale of those mandates.
Whenever I see "HIPAA may require..." I suspect that ultimately, the source of information is a vendor of some kind trying to gin up a market for a product or service that is, in fact, not required under HIPAA. What is actually required by HIPAA is spelled out in black and white in the statute and the regulations adopted under it;
Actually, I doubt that's the case. First of all, because billing is already done in standard formats (when it comes to electronic billing, this is a government mandate under the HIPAA transactions and code sets rule), the needs to support billing are already going to be similar. Further, the kind of process used to build standardized formats (like the standard transactions mandated under HIPAA) tends to incorporate opportunities to ensure that the needs of the various participants are met.
Sure, common formats aren't enough for exchange, you need an exchange channel. But you need a language that you can speak over that channel, as well.
(First, second, fourth?) Anyhow, assuming HIPAA's privacy provisions aren't weakened, transfer of information requires a release, so that shouldn't be a problem. I haven't heard anyone advocating standardized digital records suggest weakening HIPAA privacy protections.
And, yet, by most measures of outcomes, most of the developed world does far better than the US, at far less cost.
Probably because most of the "exotic" things that would cause problems in those systems aren't really exotic, they are just the kind of things that preventive care, which most universal systems do really well, could catch early as something routine, but when they get missed, become extreme, acute problems that are expensive to deal.
Everyone that opposes universal healthcare always points to Canada. Which isn't surprising; while Canada, like all other major developed nations, spends less and scores better in every study of quality and outcomes than the United States, it pretty consistently, among advanced countries, scores second to last, ahead only of the United States, so its the easiest one to take things from to make the whole idea of universal healthcare look scary.
Of course, the actual proposals for universal healthcare that have been put forward recently by prominent politicians, including the President-Elect, have been far more like the German model than the Canadian model, and use some combination of subsidies for insurance purchases for low-income individuals and purchase mandates to acheive universal coverage, rather than relying on the kind of direct government control that most anti-universal-healthcare arguments rail against.
Unfortunately, in other shops, new processes, and particularly any that, like Agile, become trendy buzzwords, are often, IME, used as excuses for sloppy, well, everything. Sloppy coding, sure, but also sloppy requirements gathering, sloppy project planning, sloppy change management, sloppy test development, sloppy testing...
Or, rather, its a bunch of subprojects, each of which are developed with a waterfall methodology. The key difference between "traditional waterfall" and "agile" methods, in terms of big-picture process, is that agile methodologies involve some analysis as to the proper units of work to which the basic waterfall methodology is applied (different specific methodologies that are within the broad "agile" umbrella often have slightly different approaches to determining what the appropriate units of work are), whereas the more traditional waterfall doesn't even consider this factor and just takes the whole project scope as the unit of work, putting the determination of the unit of work to which the basic series of tasks are applied outside the scope of the methodology. And organizations that use the waterfall methodology will divide work into subprojects (usually, larger ones than the units you'd expect with most agile methodology), but usually in an ad hoc way, agile methodologies tend to present particular (even if somewhat subjective) criteria to apply to determine what the units of work should be.
Agile methodologies are probably best seen, collectively, as refinements to the basic waterfall methodology, rather than rejections of it.
Because the bugs have been slowly worked out over decades of use, the requirements are basically static, and, contrary to your suggestion, the cost of upgrading would be exorbitant even for the large players involved, for very little gain because, again, the requirements are static. Plus, incremental updates are made difficult, because the interrelationships between components and systems aren't well documented. Where these considerations don't all apply, you do see massive legacy production COBOL systems being replaced, either all at once or piecemeal, by newer systems.
All programming languages higher level than machine code that I've encountered, except for a few esolangs, use whitespace as a delimiter.
There have been some studies that have found linkages (the warning doesn't claim causality, it merely implies it), and others that haven't.
An even bigger problem is that a game can be rated T or higher (even as high as AO) without any violent content, so even assuming that a direct, substantial causal linkage was established between violent video games and aggressive behavior, the proposal -- to require the warning on all T or higher rated games -- would still be nonsense.
No, they are saying it will take 212,000 people working for several years to implement it, not that it will take more people to operate. The job creation is considered part of short-term stimulus; the long-term effect is supposed to be increased efficiency and lowered costs for similar work due to administrative simplification in the medical field.
No, it should reduce the total (and particularly administrative) worker-hours needed for delivering the equivalent quantity (however measured) of healthcare services.
That's not the same as eliminating net jobs in the economy, or even necessary within the healthcare industry. It should increase productivity within that industry, but that's not equivalent to eliminating jobs.
This happens all the time because of the absence of electronic medical records; studies of the places where they've been implemented show that they reduce the incidence of such errors.
All the information is currently being stored in some format already, probably a form that takes up a lot more physical space, so that even if the media itself is less expensive per unit of storage (questionable), the necessary ancillary costs of storing it (cabinets, building space, etc.) are greater.
Who is talking about "government healthcare"? While some of the major industrialized countries have universal single-payer systems, quite a few, despite having universal coverage, do not have universal government-provided healthcare. Universal coverage isn't the same as universal government-run (or even government-purchased) healthcare.
Germany, for instance, has universal healthcare access acheived by government mandate, but its an insurance purchase mandate with subsidies for low-income individuals, there is a government plan available, but private insurers can and do operate, and individuals are free to purchase private insurance; like the rest of the developed world, its costs are below those in the US (both per capita and per GDP).
And then talk to the people from the US that take medical holidays to Mexico or Canada (mostly for prescription drugs) or even India (for surgery), among other places.
And then, when you are done playing the anecdote game, look to all the studies of health care quality, equity, and outcomes that have been done over recent years.
Since not all purposes to which money is applied have the same effect on jobs, repurposing money can create jobs, and therefore government, by repurposing money, can create jobs.
Probably, it would use a (possibly, already existing) ANSI workgroup, the same as the HIPAA transactions and code sets mandate did for most of its transactions.
Whether or not they are physically kept in a standard location, no proposal has been made, that I am aware of, to weaken the HIPAA privacy mandates that would apply to access to or release of the records.
The fact that every other major industrialized nation has universal healthcare, provides outcomes comparable to or better than the US, and does so at lower expense (measured either per capita or as a share of GDP) than the US.
The first already is taxed higher, in part because of the health consequences, and proposals on the latter have been made independently of universal healthcare.
The transactions and code sets rule does not apply to health records (which is what is being proposed to be standardized now), it applies to a variety of health insurance related transactions (billing, remittance advice, authorization, eligibility requests, etc.)
(And the "portability" in the name of the act has little to do with the portability of information: HIPAA has two major parts, Title I relating to portability of insurance coverage, and Title II ("administrative simplification") containing provisions relating to privacy of health information, standardization of insurance transactions, etc. The first part is the "portability" part, the second part is the "accountability" part.
There are two aspects here: standardized formats and electronic health records.
Standardization may save money for everyone in the long term, but it is a competitive advantage for no one in either the short or the long term. Consequently, there is little incentive for any party to pursue it in what is largely a competitive, for-profit industry, and the benefits of standardization rely on universal, or nearly so, participation.
Electronic health records, OTOH, can streamline operations for those implementing them internally regardless of standardization, don't require other people to participate for at least some of the benefits to be realized, and can be a competitive advantage; unsurprisingly, lots of participants in health care are implementing (or have implemented) electronic health records, without a single standard.
Someone might want to create browser profiles for different activities without creating different OS-level accounts. "Profiles" don't have to correspond to different people.
But neither the government nor the insurance company is shielded from the cost, and they do have an incentive to control costs, either by shopping around as to which providers they will contract with, imposing reimbursement caps, or both.
And every real government or private healthcare plan uses one or both of those means to control costs.
There are plenty of problems with our current healthcare system, but the one you point to isn't really a significant one.
You mean, like the Smoot-Hawley Tariff Act, the mere discussion of which was, at least arguably, a significant contributing factor to the crash of 1929, and the actual passage of which was a significant factor in the following Great Depression.
Lets not try that again, okay?
This theory is called mercantilism. It was a pretty big driving force in the 16th through the late 18th century, but its currency in economic thought has been rather on the decline since Adam Smith published An Inquiry into the Nature and Causes of the Wealth of Nations in 1776.
Which people, exactly, talk about that? The 1970s were one of the worst periods in the US economy in the post-WWII period.
Its impossible to "forget" something that isn't true. Some high school dropouts who were willing to work hard may have been able to do that, but most, even if willing to work hard, would not have been able to. Even moreso if they were (among other things) black, hispanic, or female.