Want to blame someone for Obamacare, blame republican and democrat congressman and senators and GOP Taliban state legislators

8982-figure-2Republicans and democrats in the US congress and red state GOP Taliban legislators are responsible for Obamacare’s failure in some segments of the population.

Obamacare failed for middle-class people whose rates were jacked up and their deductibles mercilessly cut. Why? Because insurance companies contributed large sums to republican and democratic congressman and senators’ reelection campaigns to prevent the reform of health insurance. That simple.

Obamacare brought reforms in healthcare that hurt many small medical clinics and doctors, especially those doctors that deliver primary care. It was a perceived a necessity because the country was bankrupted by the $6 Trillion wasted on the Iraq war and the $2 Trillion to bail out the banks after the mortgage crisis. Otherwise, healthcare reforms could have been postponed and the disruption small clinics and doctors suffered could have been postponed and implemented without damaging their practices and careers.

The senate and congress did; however, postpone reforming the industry because, well, they like money and power. Reelection always takes a back seat to doing the right thing. Instead of reforming the insurance industry, I will not mention the options, just emphasize that with the shift to universal basic healthcare, insurance reform was necessary.

Fourteen or fifteen states, for the most part where Taliban GOP legislators controlled the state government refused to pass the Medicare expansion and in so doing, denied the working poor access to healthcare. States like Alabama, Georgia, Florida. IF you do not know what Medicare Expansion is, it is a provision of the Affordable Care Act (ACA) aka Obamacare by which the Federal government funded 90% of the costs to expand Medicare to cover the working poor. The legislators in these states acted without a conscience.

If you were hurt by Obamacare, do not blame President Obama, blame the US senate and congress for their failure to reform the health insurance industry and the GOP Taliban state legislators for refusing to pass the Medicaid Expansion.

I should note that none of the federal or state legislators are affected by Obamacare, because they have Cadillac healthcare plans that are exempt from the taxes paid by wealthy people for their luxury healthcare.

The Kaiser Family Foundation has published much obective information about the ACA. http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-future-directions-for-the-aca-and-medicaid/

Obamacare, the 100 old movement will not be stopped by Trump


Trump and the GOP can try to repeal Obamacare, but they will not stop the 100 year old movement for the basic right to healthcare.

Two Harvard-affiliated doctors published in the Washington Post today their finding that 43,956 more people will die every year if the Affordable Healthcare Act (Obamacare) is repealed. Their research study comes from a perspective, from their DNA so to speak of looking at the epidemiology of the health of the population that has evolved over almost a century at Harvard Medical School. It is a response to the republican majority Senate and House and President Trump’s threat to dismantle Obamacare. In the context of the history of the right to basic healthcare, the threat will be hard to fulfill.

The idea of Obamacare isn’t new. The idea dates back to Paul Dudley White a post-World War I British doctor at Mass General Hospital and professor at Harvard Medical School.

I learned this from my mother, Ruth Patterson, a C-level executive at Harvard Teaching Hospital, Beth Isreal and member of the board of the American Heart association. A busy woman, raising a family and balancing a significant career, she brought her work to our dinner table discussion every night.

White was a British medical officer sent to Turkey immediately after WWI joining the fight against an epidemic where he learned practical epidemiology, or how to treat the health of an entire population.

After joining MGH shortly after his father’s death from a cardiac arrest, he became inspired to study heart disease. He applied the lens of practical epidemiology to cardiac disease and was the inspiration for the ongoing Framingham Heart Study founded in 1948. Like antibiotics and polio, White’s epidemiological approach to heart disease was another public health proof case inspiring the conversation of universal healthcare at Harvard Medical School and in other medical communities around the country.

Harvard Medical School trained Howard Hiatt MD, later Dean of the Harvard School of Public Health and Dr. Richard Nessen former President of Boston Brigham and Women’s Hospital and long-term proponent of healthcare as a basic right studied the British healthcare system and returned with Hiatt to create Harvard Community Health, the predecessor of Harvard Pilgrim Healthcare.

Harvard Community Health founded in 1969 was the template for Romneycare, the Massachusetts public healthcare system signed into law by former GOP governor, former head of Bain Capital and presidential candidate Mitt Romney because he said the financials just made sense. Romneycare was the template for Obamacare.

Now we have the GOP majority in Washington threatening to dismantle Obamacare, more respectfully called the Affordable Healthcare Act. They may, or just weaken it. But only for a time. Movements have momentum. And the idea of universal healthcare is backed by and well understood throughout the medical community. It is not only the inspiration for Harvard Community Health but also other affordable large-scale similarly inspired healthcare systems such as Kaiser Permente.



A Mexican-American veteran who left the US for a better life

A Mexican-American veteran introduced himself to me on a train from Oberschleißheim to Nűrnberg Germany in 2004. He heard me speak English during a mobile phone call and struck up a conversation. I asked him how he came to live in Germany.

He was born in Mexico, came to the US and won his citizenship through military service during which he spent time in Germany and understood the German systems for employment and social benefits.

After his military service, He returned to Los Angeles, married and had two young children. He worked at a union job with Federal Express.

After considering the cost and uncertainty of being American, the cost of healthcare and the cost of educating his children in the US he decided to emigrate from the US to Germany.

His American union and the German union had a reciprocal arrangement in which he was guaranteed a job if he applied to Federal Express Germany. He would have to wait a year because the union hired in order of application, and a year’s worth of applicants stood before him.

It is a little easier to get a residency permit in Germany than in the US. With the union’s support, little more is required than proof of health insurance and employment and no record of a felony conviction presented at the town hall. His confirmed application to Federal Express and union membership met the residency permit requirements.

He moved to Germany. During his one year wait for employment he and his family took German as a second language courses.

Immigration to Germany availed him to an equivalent job, real pension benefits, 6 weeks vacation, free college education for his children and a healthcare system that costs less than half of what it costs in the US and according to the CDC produces a greater longevity than the US where the Bundestag (Germany’s congress) would never repeal health insurance. Maybe he had more modest aspirations, like family and security, compared to his fellow Mexican-American Trump supporter and real estate developer, Marco Gutierrez. Esquire reported that Gutierrez lost his real estate license because of his business practices.

Given the outcome of the 2016 presidential election, and the Trump cabinet appointments, my Mexican-American acquaintance must feel he made a good decision.

Who will pay for real news? Döpfner’s question to Google still unanswered two years later


News quality and a free press shouldn’t be the price paid for internet media

Jason Pontin, MIT Technology Review Editor-in-Chief posted Mathias Döpfner’s Why we fear Google on his Facebook page last weekend. It is Op-Ed piece that ran in English and German in the Frankfurter Allgemeine  written in 2014 as an open letter to Eric Schmidt Executive Chairman of Google. Pontin didn’t get many bites from the many writers that follow him but his post infected me. My professional and cultural experience with Germany began in the early 1990’s when publications like the Allgemeine and Handelsblatt’s ventured into the United Kingdom and the British Financial Times’ ventured into Germany seeking print subscribers and it continued through the digital transformation of the country’s networks, media and markets.

It is a very important culturally influenced essay written by Mathias Döpfner Vorstandsvorsitzender (loosely translated but not exactly chairman of the board) of Germany’s largest publisher Axel Springer. The most important distinction in his role compared to the American chairman is the German board of directors has a social charter with labor leaders sitting at the board table instead of across the table. In a socially progressive country the transparency of a free press is more highly valued than it might be elsewhere.

Döpfner’s letter reminded me of the movie Spotlight’s sad theme. Not sexual abuse of course, but the relentless digital erosion of the once formidable Boston Globe. After shuttering bureaus around the world and cutting staff a visit to the Globe’s Boston headquarters on Morrissey Blvd in Dorchester arouses the uncomfortable chill of a mausoleum. The Tomb of the Unknown Investigative Reporter should be built on the Globe’s grounds to represent the crimes, corruption and political malfeasance like the Catholic Church’s sexual abuse scandal that will now go unreported because so many of the Globe and other publishers’ investigative staffs were let go.

Bloggers aren’t a replacement for investigative reporting because crowd sourced editorial oversight is no match for editors who run retractions and corrections and fire reporters who intentionally misreport the news. Reports from Facebook, Buzzfeed or Fox News are not credible without corroborating them with Bloomberg, the Economist, BBC or other reliable and responsibly edited publication.

Döpfner has presided over dismantling and remaking Axel Springer in the face of digital transformation. He was appointed Editor-in-Chief in 1998 just when the internet began to boil news media in a sea of electrons. The turmoil of Germany’s equivalent of People Magazine, Bunte or the New York Daily Post, Bild don’t really measure the social loss. The loss can be seen in the debilitation of German publications of record like the Allgemeine by the same forces that put the Boston Globe on life support.

Steven Johnson wrote an insightful piece this summer for the York Times Sunday magazine the Creative Apocalypse That Wasn’t in which he assessed the economic impact of the digital transformation of the arts on artists and performers. He concluded that the creatives are thriving; it is only management such as the record labels that have been squeezed by digital transformation without any loss to society.

But management is what news readers pay for when they buy a paper or digital newspaper. Editors manage the news content quality and Editors-in-Chief like Döpfner, Mark Thompson of the New York Times or Mike Sheehan of the Boston Globe try to balance the social contract to deliver real news with arts, entertainment and whatever else produces the clicks that keep the lights on. For the last decade they have been distracted by keeping the lights on as the free fall of prices paid for digital display revenue continues and print advertising dies off with its subscribers.

Pro Publica president Richard Toefel recently challenged McKinsey’s report that the print newspaper decline is leveling off in an analysis posted to Medium.  If Toefel is right the clicks will continue to grow diluting a declining amount of news.

News is an exception to Johnson’s conclusion that there isn’t a social loss from the internet’s eliminating the management layer that once produced the arts because editorial management is more than promotion and distribution, it is reputation that is eroding even at the formerly dependable New York Times . Without editorial oversight there is no news. If a way to pay for editors to manage news reporting in a free market continues to elude the best efforts of almost every publication in the developed world, perhaps the freedom that a free press brings should be subsidized like solar energy.

Döpfner’s fear of Google must extend to the angst of peering into an internet abyss because he is faced with breaking a much stronger social and cultural contract to produce news.

Find everything by Steven Max Patterson on Twitter @stevep2007


Contrary to what Topolsky and Malik say, Twitter’s model is sustainable

twitter problem
Comparing Twitter to Facebook boosted VC IPO returns but didn’t help the company. But thinking Twitter is failing because its not Facebook is sheer folly

Rant: To protect the health and safety of venture capitalists’s children, VC offspring shouldn’t be allowed to compete at sports – for fear the VC’s would shoot their child-athletes so full of steroids to be mistaken for the Russian Olympic track team. Twitter is that steroid bloated clumsy Baby Huey VC offspring, straining to look coordinated and graceful next to the gifted child Facebook.

Steroids were necessary for Twitter though, in the VCs’ perpetual quest to parlay one overvalued private investment round into the next until finally the company like a listing cargo ship over–laden with VC hype crashes onto the rocks of a public offering while the VCs sell their holdings and take the women and children’s lifeboat seats.

That sadly is Twitter’s story. A wonderful company with a great idea that just wasn’t going to go to college on a sports scholarship giving the VCs a huge return without some help overstating expectations. The most valued VC skill is repeatable overvaluation schemes because real value like Apple, Google and Facebook are too rare to be counted on for fat returns. Right now twitter is recovering from an overdose of VC steroids.

Almost everyone from Marc Andreessen @pmarca to Pope Francis @Pontifex announce daily magna opera and interpretations of the day’s most relevant personal and public developments on Twitter. Monetization and user growth doesn’t match Twitter’s over-stated expectations and it never will match the Facebook-sized social network expectations that the VCs created with the public to “enhance” their return. At the risk of endorsing Chris Anderson’s @chr1sa the Long Tail that was simply another VC start-up overvaluation scheme, Twitter has a very long tail, not because of the cash it has in the bank, but because people use it. Twitter’s model is sustainable despite what Om Malik @om and Joshua Topolsky @joshuatopolsky and the New Yorker @NewYorker say.

New Yorker Editor-in-Chief David Remnick needs to build some in-house technology talent instead of outsourcing Twitter opinions to Malik and Topolsky whose perspectives are tinted by VC-rose-colored glasses.

Twitter just needs a couple of changes: more verified users will give tweets authenticity, user-reputation-ranking will confront bullying and spam and user filtering that give users the same ability that geeks have to pan for the nuggets of gold in the rushing river rapids of Twitter without having to learn complicated tools.

Now I’m going to tweet this.

Find everything by Steven Max Patterson on Twitter @stevep2007

A writers temptation with Donald Trump

temptation of trumpA first hand account of the Trump Effect: Tempted by the devil of analytics to write about Trump

Google Trends tells the truth; Trump got more coverage by not attending last night’s debate than all the candidates put together. The search interest chart of the GOP candidates caused me to look up the analytics of my own postings. The reason for the nation’s interest in Donald Trump hit me like an epiphany. Writers can’t resist the temptation to write about Trump.

A single short post I wrote about Trump brought 5 times my average readership. Trump in a headline attracts more readers than putting Tim Cook, Elon Musk Steve Jobs, electric vehicle, Apple and Tesla all in the same headline.

My brain jumped to mental comparisons of the web results of a Trump story run with the digital publishers for whom I write: IDG, Fast Company, Quartz, TechCrunch…There’s always an angle that can be drawn. For all those eyeballs I could draw one between Trump and technology.

I regained control when I started to write an email to one of my editors pitching a Trump story. Steadied by my close call I reminded myself that politics isn’t my professional domain; I decided to live without Trump.

Find everything by Steven Max Patterson on Twitter @stevep2007

Finding the important posts on Facebook and Twitter

fb filterFacebook’s algorithm hides important posts in its newsfeed and Twitter’s overwhelming volume obfuscates them

After reading Walt Mossberg’s story Twitter has become secret-handshake software on the Verge, Dave Winer thought out loud on Facebook that “what Walt said about Twitter applied equally to Facebook.”

Perhaps Dave, Walt Mossberg and I are interested in the same special Twitter and Facebook use cases – My use case is breaking news, interesting developments and tasty treats that reflect the personalities of the people who run the companies and develop the technologies that we follow and write about.

Facebook’s filters don’t work for me. Technology related posts aren’t prioritized to the top of my newsfeed the way Robert Scoble says they should. I may be interfering with Facebook’s algorithm because I am fascinated and simultaneously horrified by American politics and post too frequently about it. Facebook filters much from the raw newstream and gives me what it thinks I want with about 20% accuracy.

Twitter is just raw data dropping the most recent tweet on top of the stack. I prefer this to Facebook’s approach.

As I look at both Twitter and Facebook’s APIs, custom filters are pretty easy to build. Here’s what I think the options are:

Convert Twitter and FB feeds to RSS on a tablet and just swipe through really quickly a couple times a day.

Tweetdeck gives basic keyword and handle filtering – it works well until about 15 rows and then my i7 16GB computer starts to protest. (Here I share Walt’s opinion that Tweetdeck needs improvement. At the top of my suggestions for Tweetdeck’s product manager is a scripting capability within columns; simple sandboxed JS would do.)

RSS and regex – Yahoo Pipes was really good at that but there are many ways to accomplish the same thing. Basic maintenance of the regex filter is an ongoing burden because interests change.

Find everything by Steven Max Patterson on Twitter @stevep2007