My take on the US healthcare debate

I’m an American living in the UK for the past few years so I have a unique perspective on the US healthcare issue that I wish to share. I’ve experienced both the US private insurance based system and the UK state-run healthcare system and I do feel that people in the US are missing the point and that the arguments for and against miss some very important facts.

I’m an IT contractor, I do network engineering, security work, plus some coding and perl scripting thrown in. I’m the director of a limited company which hires me out to difference companies on short-mid term contracts. In the past I have had a several permanent jobs both in the US and UK. In the US one of the primary concerns anyone has is healthcare for themselves and their family. When chosing a job one of the big questions is the provider and policy the employer offers. Insurance is a huge concern for those who are self-employed and in many cases the costs involved for private coverage are exhorbitant enough to prevent people from starting their own business. And if you lose your job you have the unenviable choice of either paying way over the odds to keep your old policy or taking a huge gamble and going without. I know American Ex-pats who can’t move back to the states because they have pre-existing medical conditions and would be denied health coverage. Can you imagine being barred from your own company because you have diabetes or MS? What does that say about America?

In the UK it’s completely different. If I lose my job I don’t have to worry about being covered until I get a new one. When looking for a job I don’t have to think about insurance, I can chose the best job for me. I can start a business, quit work for 6 months and write a book or iPhone apps all without a second thought. I pay into the system so I’m entitled to the benefits.

Some people are saying that state-provided healthcare makes one less free, but that couldn’t be farther than the truth. For me it’s given me freedom from worry and the freedom to pursue my own career goals.

Some of the arguments against state-run healthcare make me crack up because they actually support the case more than they damage it if you look past the emotionality:
– “There will be a department of doctors who decide what care people get. They’ll decide who lives and who dies!” OK, so how does this differ from private healthcare companies? They have whole departments which have the whole purpose of deciding how they can give you the least care possible. They also have whole departments tasked with denying people care they are entitled to so they can save money. Which would you rather have, a system which is trying to save its stockholders money or a system which is trying to save your money?
– “There will be huge lines to see the doctor!” Why? Are people going to go for the sheer novelty of it? I spend as little time as possible at the docs and I suspect others would be similar. In the UK I don’t wait any longer to see a GP than I would in the states, why would I? What’s the basis of this statement?
– “I’ll have to pay for other people’s coverage!” I hate to tell you but you already do. You want to know what people without coverage do in the US? They go to the emergency room where they can’t be turned away. They get treated because it’s illegal and unethical for the hospital not to. And guess who pays for it? You do either through taxes or in your insurance premiums. So you pay either way.
– “yeah, but it will cost me more because they’ll all use it more!” Better people see the doctor for a minor condition than go to the ER with a major condition, it will cost less. I know a guy with no health insurance and no money who had chest pains and had a quadruple bypass. He didn’t pay a thing because he had nothing to give them. That cost the hospital, and therefore society more than $300,000. He hadn’t seen a doctor in years because he didn’t have insurance and couldn’t pay. If he had he would have been diagnosed with heart problems years before he needed surgery and received preventative care which would have cost a fraction of emergency care. All these people going into the ER with acute conditions cost the system about the same as if they could go to the doctor before things get that desperate.

It seems that some people think that if we adopt socialized medicine in the US that the 4 horsemen of the apocalypse will appear, the sky will fall, and time itself will end. Get a grip! In the US we have a state-funded education system that goes from nursery through grad school, we have state funded roads, parks, water supplies, waste removal, and social security amongst many other state-funded systems. We are better off for all these things, so why not healthcare? What’s the big deal?

I love being a dad

My son Joshua is 3 and a half months old now and I’m so glad we decided to have a baby. Holding him in my arms is one of the joys of life and I can’t wait to see what comes next. He’s going to be a handful I think as he’s definitely got brains! I’m going to have to watch out or he’ll run rings around me. It’s not all fun, it’s hard as hell sometimes but it’s so worth it.

“rec” – a review

I didn’t know anything about rec before I started to watch it besides the fact it’s horror-thriller genre, but if I had heard that the plot contained zombies, trapped people, and government conspiracy I would have thought been here done that, bought the tee-shirt, wore it out, then used it as a rag in a bottle full of gasoline and motor oil that I would have hurled at the next movie with all three of those elements.
Zombies are overused as baddies to the point where they are almost expected, and people trapped somewhere while bad things happen to them is such a staple of horror cinema that you’d think there’s no way to have a genuinely new movie about it. Also the documentary single-camera point of view has also been done. Truly there was nothing new about this movie you can point to, so you’d think it’s not even worth pulling out of the cover.

But you’d be wrong.

Just as every other overused genres have occasional brilliant pieces this movie for all its seemingly recycled ideas is done so well that I couldn’t have cared less. It’s well acted, well shot, and the direction keep the action flowing as well as the screams. Even when you know what’s coming, and you do know what’s coming because it’s fairly transparent, you still jump and to me that’s what makes this one of my favorite zombie movies of all time. It’s amazing that a film that truly doesn’t have an original concept in it can be so well done as to be as good as many of the movies it’s literally stolen ideas from. I recommend you watch this in the dark with the sound up, it’s worth it.

I’m going to stop squeezing

Like most other practical fathers I’m always looking to get something done faster, and that even extends to burping my baby son. There seems to be some sort of societal mental block when it comes to baby care where any sort of shortcut is automatically deemed bad parenting. According to the books taking care of babies is a massively time-consuming process that would, if you followed their directions to the letter, take at least 30 hours a day to complete.
What’s the big deal? Why can’t we as parents take some shortcuts which free up time for the more pleasant aspects of parenting? Take burping for example. Burping is where, after feeding, you help your baby get rid of the gas he/she has swallowed. Failure to do so is usually unpleasant and at the very least will end up with your baby positing. Positing is a delightful event, kinda a mini-puke, where undigested milk comes trickling out of the corner of your baby’s mouth all over their brand-new, freshly washed outfit their grandmother knitted out of a decade’s worth of lint that she spun together using her toes. This requires an instant response to lift the baby out of their basket, clean their mouth and kneck, change into a less lovingly-generated outfit like the used baby-grow you got at a charity shop, change the sheets and blanket in the basket, then put the baby, who has since woken up and started bawling, back to sleep. And since you forgot in all this work to burp the baby you have to do it all over in 5 minutes when they posit up again.
The lesson is: burp your baby. There’s many techniques, most of which involve thumping the baby lightly on the back, and then rubbing said back to calm said baby. You will spend many hours doing this, many hours which you would rather spend doing something else like sleeping. I’ve learned to love the magical sound of a baby belching louder than I can as it means I can shortly go back to bed at 4:00 in the morning.
I, like most fathers, would like to re-balance the burping:sleeping ratio farther to the sleeping side, so I will try anything that won’t damage the little tyke to get that lovely gurgle, or better yet a full-blown out-gassing from deep down. At first I was using the standard over the shoulder technique, then I moved onto the on the knee technique, then I started trying the over the arm technique. Now I use an eclectic mix, 2 minutes one way, then swap to another because I’ve found that none of them does any better than other, in fact it’s the transition from one to another that usually brings it up.
The other day I had a brilliant inspiration: why not squeeze him a bit? When he’s on my shoulder why not just press his back a bit to put a teeny-tiny bit of pressure on his stomach? So I tried it, and low and behold I got a belch! That saved me at least 10 minutes of tedious burping that he could have spent more productively sleeping and myself productively playing Xbox! Wow, i’ll have to try this again! So I did, and this time the results were more mixed. The little squeeze made him struggle a bit uncomfortably and after a couple more minutes (and one more tiny little squeeze), I did get a belch. hmm, that worked some. Next time I tried that no belch, not much of anything. Fourth time I did it he struggled a lot, then started to hiccup for the next 10 minutes, time he could have spend more productively sleeping, and me playing Xbox. So much for cutting corners.
I got the feeling that a coin was flipped as to whether he would get the hiccups or decide to projectile vomit, and I got lucky. I think I’ll stop squeezing.

stuff-alanche? sheesh, learn to deal!

A friend of mine sent me a link to a UK guardian article which is basically a big whine about the complexity of life.

To me it sounds like he’s blaming a lack of purchasing self-control on society providing him with choices. In the 70s there were still plenty of books to buy and not read. Why should everyone give up such a wealth of opportunities simply because one journalist lacks discipline?

When I was growing up I used to go with my mother to the supermarket, where you have a billion varieties of everything. My mother taught me how to analyse and make a choice based on cost, quality, and purpose, and to avoid impulse buys. When there are 10 different cans of tomatoes what do you buy and why? The value is cheapest but tends to taste like soggy cardboard, but are the really expensive ones better than the mid-prices ones? If you spend a bit of time studying your options and keep in mind what you really need you’ll spend less, enjoy your purchases more, and not have stuff you won’t use. If you took a full-grown adult who had never been to a supermarket before and told them to go shopping they would probably feel a bit overloaded, similarly if you take someone who has never been online and let them loose it can be a bit overwhelming. The question is will they learn to focus on what they want and make their own choices or let the choices make them? Whether it’s the supermarket or the internet in the end how they deal is more about their personality.

In an age where there is so much choice you have to become more discerning about what you decide to buy or see. You have to become a data connoisseur and be willing to invest the time to make good choices. It’s a skill, not some innate ability.

Where’s my baby dammit?!

I’m going to be a dad real soon, and I’m finally more excited than scared by it. My wife Claire is 4 days late but since statistically first babies are likely to be late this is entirely expected. Awhile back I expected to cherish these last days before the baby arrives but I’m in a different place than where I was at first and I really want the baby to come now. I think first-time fathers-to-be go through a series of stages before the baby comes:

Stage 1 – Wow! – When my wife handed me a small plastic stick with a blue line on it I had to look at it for a few seconds before I figured out what it was. We’d only been trying for about a month so I wasn’t expecting it to happen so soon. All I could say was wow. wow wow wow. wow? Wow!
Stage 1 – Oh shit. – After awhile it begins dawns on you how yes, this is really happening, and yes things are really going to change. Just because you know it intellectually before you start trying doesn’t prepare you for this.
Stage 3 – Oh Shit! – It was only beginning to dawn before, now the sun’s poking its head above the horizon and where there had been only shapes barely discernable in the pre-dawn light now suddenly reality blazes across the landscape and you see what the change really means. You start to really watch other parents to see how they do things, what equipment they have, how they make it all work. I actually started to listen to my workmates (who are almost all fathers of young children) to try and learn what I could.
Stage 4 – SHIT!!!!!!!! – I was at a boot sale (in England a boot sale is basically a flea market held in a field somewhere) and my wife and mother-in-law started buying loads of baby clothes. My first reaction was “what are they buying those for, we don’t need that…”, and I think then was when it truly hit me that it was all for real. Up till then I had been in some sort of denial, an adjustment period if you will. Now it all came to me in a rush. OMG, I’ve got so much I have to do! I have to buy a baby carriage, we have to decorate the room, get baby clothes, baby monitors, wraps, oils, wipes! I’ve got to read book on how to not completely screw up a child so he becomes a serial killer because I’ve got no idea how to do it right! I’m going to completely suck at this! We have to pick a name! What the hell are going to name this kid? And diapers. OMG DIAPERS! AAAAAAAAAAAA!!!!!!
Stage 5 – Let’s do this shit – You’ve had your freakout couple of weeks where all the dads at work are watching and nodding knowingly, now it’s time to make this happen. The list of stuff you need just keeps getting longer and longer, like a hallway in a horror movie, but you know you’re going to get through it because you have determination! Mentally you’re still coming to grips with it but at least you’ve come to grips with having to come to grips with it.
Stage 6 – Where’s the baby? – I’m at this point now, where we’ve bought all the stuff we need to buy, the room is decorated, we’ve got a short list of names, and we’ve read the books. I’m as prepared as I’m going to be and I’m looking forward to meeting my son in person. I finally got to this stage about a week and a half ago when I finally started to relax a bit. I’m still nervous about it which is natural, but I know I can do this. Billions of others have reared children so I know I can too.

If course next there’s after the baby comes stage 1 – I’ve got a baby now, Oh Shit! – but I’m not there yet 😉

stupid startup tones

Why is it that mobile phone manufacturers have to try and out-do each other in making their phones as offensive as possible when you turn them on or off? Every phone I’ve had in the past few years has an absolutely deafening, nasty jingle to broadcast to the world that someone in the general area is adjusting their mobile device’s power state. My Omnia is one of the worst offenders, when I turn it on or off I have to hit the button and them clamp it between my legs and it’s still bone-shatteringly loud. It makes me want to stab my phone with a screwdriver, and there’s no option to disable the tones!

Consider when you are likely to want to turn your phone off subtly, like a darkened movie theater. You hit the button and your phone explodes in a hideous cacophony of badly synthesized piano music.

I mean imagine if I was stuck in a closet with armed terrorists roaming about around me, my only hope for survival would be to turn on my phone so I can send a message. I’d be so dead.

Please phone manufacturers, disable those awful startup tones, it’s not about marketing, it’s about survival!

why we should like the CIA

I like Obama and the majority of what he’s done so far, but I’m disappointed by his failure to support the CIA. The CIA takes their orders from the President of the United States, after 911 Bush said to go after the terrorists and they did. He approved rendition and the use of intense interrogation and even torture despite his supposedly higher moral christian values. He set the tone for what was to come, and what was to come is a dark time in the history of the US yet the focus is on the actions of the CIA and not those who set their policies.

After the cold war the Clinton administration gutted the CIA even though then more than ever it was needed because of the massive changes the power vaccum would bring. It also changed the rules so that the CIA had a much harder time gathering intelligence, for instance it became forbidden to recruit as an operative anyone who was or had been part of a terrorist group, which was madness! Terrorist cells are incredibly hard to penetrate and one of the very few ways they can do this is to recruit terrorists as agents. How can an intelligence organization function without co-opting the very people they need information on? The result was that through cuts and frustrated people leaving the CIA became under-resourced and undermanned at the very time it was most needed. If the CIA had been better supported they may very well have prevented 911 and history would have been very different.

It takes years of investment and effort to build up an intelligence network to watch terrorists, you can’t snap your fingers and make it appear. However, you can, if you are president, snap your fingers and make someone dissapear into the dungeons of a friendly foreign power for some “intense interrogation”, and when you’re as desperate for intelligence as the administration was at the time that would probably appeal. Now, 8 years later our heads are clearer, we’ve forgotten how we all felt after the attacks which sparked these policies and we don’t like what was done. We can’t go after our own former president and his staff can we? I mean, that’s way too hardcore isn’t it, so let’s instead go after a nebulous government agency that everyone likes to hate. What’s the worst that could happen? Try another 911 or worse.

Intelligence is not about satellites or spyplanes, it’s about people. People interpret the pictures, people listen to communications intercepts, and people piece together the disparate information from 100 sources into a cohesive picture that officials need to make decisions. The best people at the CIA are there because they want to be there, because they believe in it and they want to serve the people of the US. OK, it’s a government agency so there’s paper-pushers and bureaucrats galore, but at the core there’s some people who really know what they are doing and boy do we need them! These people gather and process the information that the government uses to make decisions from economic to to military posture, and they are the ones who are best places to protect the US against further terrorist attacks. These tasks are vital to the long-term welfare of the USA, so these people are vital as well. Most of them are well-educated and intelligent and could do very well in the private sector, the only thing keeping them in their moderately-paid government jobs is the motivation they get from doing the job itself. If we destroy the morale of the organization they’ll leave, the CIA loses skills and knowledge that are irreplacable. Intelligence networks will be lost, and it will take years to rebuild them even if it can be done. It takes years to make an intelligence officer, you can’t just hire them ready to go.

What the CIA needs is continuity, not chaos every time a new administration comes in. Good long-term intelligence requires clear goals set out years in advance and then be followed up, not a top-down disruption every time there’s a new president. In the era where nuclear terrorism is certainly possible more than ever weneed the CIA whether we like it or not. A global power must have a global intelligence service to function effectively. Yes, the CIA makes mistakes, and yes they sometimes do things we would consider objectionable but sometimes that’s the way it has to be in a nasty, brutal world. Yes, the interrogations went way too far, but Guantanamo Bay was also way too far, the invasion of Iraq on a pretext was way too far and it all came from the very top. Let’s remember that before we start a witch-hunt that will destroy the morale of the organization that is far and away our best defense against international extremism. I’m not saying the CIA should be above the law, instead let’s make that law apply to EVERYONE evenly, if we aren’t willing to prosecute those who gave the orders then we can’t go after those that followed them.

Outsourcing – cutting costs and brainpower at the same time

Outsourcing is the process where a company takes jobs from locals and gives them to the citizens of an impoverished nation who know nothing about how or where you live in an effort to decrease costs. When dealing with one of these people you frequently get the telephonic equivalent of the blank stare after you try and explain something and they have not the faintest glimmer of a clue what you are talking about. Most of the time this is aggravating but occasionally can actually be funny.

A case in point is this latest episode with BT. BT is British Telecom, the UK equivalent of Ma Bell. BT have outsourced their call centers to India, and since nobody there has any idea how Britain works they have an extensive system to lead them through whatever comes up. When what you want isn’t on this system the results can be….. interesting.

A couple of years ago I changed my last name from Pendergrass to Dolph (to make a long story short I was born Greg Dolph and I wanted to stay that way). The legal mechanism for doing this is by Deed Poll, which is the same thing as a statutory declaration in the States. When I sent in a name change request and a copy of my deed poll I thought there we go, job done. Today I got my first BT bill since the change and it was sent to a Mr. D Poll. My wife, who has been wonderful in helping me get all these details changed, called them to explain that my new name was not Deed Poll, that was simply the legal document sent as proof of my name change. The guy on the phone looked at the letter, looked at the deed poll, and simply didn’t get it. After numerous more attempts to bring the ray of knowledge to this understanding-impoverished man she eventually gave up and just told him what to type in.

It just goes to show that you can cut costs but you end up spending more than you think simply to make up for these knowledge gaps.

I have no doubt that the next bill will have something equally bizzarre on it.

across the pond – a cooks guide to the US-UK #1

I love to cook, so when I moved from the US to the UK I immediately set about getting used to the ingredients, measurements, etc. You can find just about everything in the UK as you can in the US although sometimes it has a different name. Measurements are a bit different as well, so it’s vital that you know where your recipes come from and have the right measuring equipment. I have a set of US cups and UK cups and I use whichever is appropriate. When baking especially if you use the wrong measurements things can go seriously wrong, so it’s worth double-checking. The metric system is supposedly the official standard in the UK but many recipes use the old imperial measurements. It’s confusing; road measurements are in miles but you buy fuel by the liter. weird.

everything below is UK first, then US second

measurements: the UK uses imperial measurements and the US US measurements. The thing is they both use ounces, cups, pints, etc but the systems are very different. In the UK a cup is 10 ounces and in the US it’s 8. The ounces are almost the same volume so a british cup is 1.2 times the volume of a US cup. In other words if you use a UK cup to measure for a US recipe or vice-versa it’s not going to work very well. teaspoons and tablespoons are US measurements but are used in the UK as well.
Weights are the same in the UK and US, so a pound is a pound. In the UK large weight measurements are sometimes in stone, a stone is 14 pounds. 10 stone 3 is (14 X 10) + 3, is 143 pounds, which is a pain in the ass. generally in cooking you’ll never use the term however

brown bread flour – whole wheat flour <- brown bread is whole wheat bread... kinda. There are so many varieties in both places strong flour - bread flour <- these flours have extra gluten added. Don't use them when not called for. The word "strong" is used in conjunction with the type, ie strong brown flour plain flour - flour <- the white stuff, comes in bleached and unbleached in both places bicarbonate of soda - baking soda <- they're both exactly the same - sodium bicarbonate baking powder <- same in both places sweeteners: caster sugar - superfine sugar icing sugar - powdered sugar or confectioners sugar <- this is finer than caster sugar demerra sugar - raw sugar <- less processed, I use this pretty often as it has a slightly syrupy flavor. The only thing is it doesn't dissolve as easily golden syrup - the closest thing I can think of is brown sugar syrup dark treacle - dark karo, maybe molasses, there's no direct equivalent light and dark muscovado - this is just a fancy name for light and dark brown sugar jam sugar - sugar with added pectin, I'm not sure if there's a US equivalent as most add it separately. general terms: jam - jam, preserves, or jelly <- in the UK jam is a catch-all term jelly - jello, ie fruit flavored gelatin desserts <- if you ask for jelly with your toast in the UK you will get strange looks. vegetables: courgette - zucchini aubegine - eggplant coriander - cilantro <- we're talking the leaves here. Coriander seed is the same thing in both places. temperature: You'll see both Centigrade and Fahrenheit on UK recipes, but on almost all ovens there's only C, and in the US the ovens use F, so know how to convert the two. On really old UK ovens you might see Gas marks, like gas mark 1-8. Gas mark 1 is about 275 F and each gas mark number is an increase of 25F, so 2 is 300F. In practice the thermostats in most old ovens in any scale (and many new ones as well) are wildly inaccurate so back it up with an over thermometer. equipment: pans, pots, spoons, blenders, mixers, etc all are pretty much the same makes and go by the same terms. there are some terms that can throw you though cooker - stove or range <- an integrated, free-standing combination of oven and gas or electric burners. In the UK ovens tend to be almost exclusively electric while in the US you can get either gas or electric. hob - cooktop ovens: in he UK most ovens are electric and have a circulating fan and so are called convection ovens. These fans cook things faster and tend to heat more evenly although the fan is not always what you want depending on what you're cooking. Better ovens have different modes where you can turn the fan off. In the US convection ovens are rare and gas is as prevalent as electric. US ovens tend to be much bigger than in europe and you can get all sorts of nice features like warming drawers. grill - broiler <- On UK electric ovens the grill tends to be on the top of the oven itself where in US gas ovens the broiler is a separate drawer at the bottom barbecue - grill <- OK, some people in the US call it a barbecue as well, but I was confused, or more often confused others over here when I talked about buying a grill baking sheets - cookie sheets hints and tricks: google has great tools for conversion. If you type in "100 c in f" it converts 100 centigrade to fahrenheit andd vice-versa. "8 uk oz in us oz" converts uk ounces into us ounces, whereas "8 uk oz in us cups" will convert to cups instead. you can do ounces to liters, cups to liters, weights, etc. Convection ovens heat more evenly and cook food quicker than non-convection ovens, so when using a recipe keep that in mind. If I'm using a convection oven and the recipe is meant for a non-convection I will generally turn it down by 40-50 C or 90-100F. things that are hard to find in the UK: buttermilk - you can sometimes find this in the dairy section but if you can't find it just make your own. Add 1 tbsp of acid (clear vinegar or lemon juice) to a US cup, then add milk up to the 1 cup mark. Stir and leave to sit for 5-10 minutes. There you go italian sausage - on the east coast of the US in any supermarket you can get packs of italian sausage and I used to use it in many dishes or just fry it up by itself as it has great flavor. Impossible to find except in italian stores things that are hard to find in the US: tea: lipton is nasty, weak, and horrible. Tetley is a watered-down version of the UK tetley tea. yech