Fri, 09 Nov 2012
I recently started a new job and my new manager wanted me to give him a periodically-updated task list showing what I was working on, its progress, and any deadlines I had. I like Emacs' Org Mode, so I set out to set up something in Org Mode that worked for both of us. This is my story.
In general, I want to have a main directory for my files and, within that directory, use a separate file for each distinct project I work on. My manager wanted to easily see project progress via milestones, so each level-1 heading represents a milestone, while the deeper headings are more fluid and are more for my benefit than his. It was pretty easy to set up HTML publishing from the Org file directory to a web server, so my manager could browse through the details of my org files.
My manager also, however, wanted to see an overview page with sections for current, future, and recently-past projects, with detail lines for the milestones on current projects. That proved to be the trickiest thing to implement: since I dislike repeating myself, I wanted as much of the "current project status" part of the overview to be automatically generated from the individual project files, including any milestone deadlines but ignoring all of the more minor details.
Org Mode is big, so I spent a while reading through the manual about
custom agenda views and such until I stumbled on the C-c / d key
sequence, which folds all the file's subheadings and displays any
deadlines on the level-1 headings. In combination with C-c C-e v Spc,
which exports only the visible portions of the current buffer to a new
org-mode buffer, I was able to create an org-mode formatted project
overview. Thus, my general overview page (named index.org so it becomes
index.html during publishing) looks something like this:
* Active Projects
** [[file:project-1.org][Project 1 Description]]
DEADLINE: <2012-11-16 Fri>
#+INCLUDE: "project-1.org_overview" :minlevel 2
** [[file:project-2.org][Project 2 Description]]
DEADLINE: <2012-11-30 Fri>
#+INCLUDE: "project-2.org_overview" :minlevel 2
* Future Projects
** [[file:project-a.org][Project A Description]]
** [[file:project-b.org][Project B Description]]
* Recently Completed Projects
** [2012-11-01] [[file:project-x.org][Project X Description]]
I added a few CSS tweaks at the top of the index.org file to better fit its purpose. Mostly, they just put related things closer together and deemphasize some of the extra information on the page:
#+OPTIONS: H:2 num:nil toc:nil tasks:t
#+STYLE: <style>
#+STYLE: .outline-3 h3 {
#+STYLE: margin-bottom: 0;
#+STYLE: }
#+STYLE: .outline-text-3 p {
#+STYLE: margin: 0;
#+STYLE: }
#+STYLE: .outline-4 {
#+STYLE: line-height: 0.5em;
#+STYLE: }
#+STYLE: .outline-text-4 {
#+STYLE: font-size: 0.75em;
#+STYLE: }
#+STYLE: .outline-4 h4 {
#+STYLE: margin-bottom: 0;
#+STYLE: }
#+STYLE: </style>
I also wrote the following two elisp functions. The first one generates the overview file for a given buffer, while the second looks through a buffer for included overview files and regenerates all of them.
(defun org-export-overview (file)
(save-window-excursion
(find-file file)
(org-check-deadlines org-deadline-warning-days)
(org-export-visible ?\ 0) ; calls switch-to-buffer-other-window
(write-file (concat file "_overview"))
(kill-buffer)))
(defun org-export-overviews-for (buffer-or-name)
(let ((plan-dir (file-name-directory (buffer-file-name (get-buffer buffer-or-name)))))
(with-current-buffer buffer-or-name
(save-excursion
(goto-char 1)
(while (re-search-forward "^#\\+INCLUDE: +\"\\(.*\\)_overview\"" nil t)
(org-export-overview (concat plan-dir (match-string 1))))))))
Finally, I wrote a simple function that goes through all the stuff I need to publish my org files and I call that hourly, so my manager can see my current project status at pretty much any time with no manual steps on my part:
(defun pmg-org-publish ()
(org-save-all-org-buffers)
(org-export-overviews-for "index.org")
(org-publish-all))
(run-at-time "00:45" 3600 'pmg-org-publish)
All I need to do is periodically update index.org as I add or complete projects, and the rest of my work is done, as it normally is, in the project files. Thanks, Org Mode!
Fri, 07 Oct 2011
A question that perturbed me when I lived in Owings Mills was why there were so many roads named "Dolfield". There are three different Dolfield Roads, one South Dolfield Road, and three Dolfield Boulevards. I finally got around to researching the question, and now I share the answer (to the degreee that I have one) with everyone.
This is a map of Dolfield Road, past and present:
The thick, dark blue line is where Dolfield Road once ran. At one point, it connected Painters Mill Road and Deer Park Road.
The thinner, light blue line shows where Dolfield Road, in all its parts, runs today. When Interstate 795 was built, Dolfield Road was cut in two, as happened to many roads during the construation of the Interstate system. At the same time, part of the eastern portion of Dolfield Road was diverted to make room for the ramps from Owings Mills Boulevard to Interstate 795. The section of Dolfield Road south of Owings Mills Boulevard was renamed South Dolfield Road, for reasons I cannot find.
At some point--I cannot tell when, exactly--the chunk of Dolfield Road that extends from present-day Red Run Boulevard to Pleasant Hill Road was closed, though I was unable to find out why. The small section between Red Run Boulevard and Interstate 795 now serves as an access road to a SHA facility, and the rest of the closed section has been turned into a hiking/biking trail (colored in light green on the map). Finally, the section of Dolfield Road just west of Pleasant Hill Road was realigned when Dolfield Boulevard was built.
Here's a map of Dolfield Boulevard:
At some point in the past, the county planned to build a road named Dolfield Boulevard that would connect Owings Mills New Town with the eastern area of Reisterstown, both areas that were slated for new development. The road was planned to have two lanes in each direction with a raised median dividing the road. The dark purple line on the above map shows where it was to have gone, as far as I can tell. I'm not sure whether the original plans included anything further north, though it might have made sense to connect it to Owings Mills Boulevard.
Unfortunately for the county, a number of people living in the proposed path of the new road put up sufficient objections that the project stalled. Portions along Reisterstown Road and Academy Avenue were built and, in both cases, partly divided and partly not--the light purple lines are the divided sections and the pink lines are the undivided sections. Furthermore, the southern end of Dolfield Boulevard was built without incident as part of the development of Owings Mills New Town, though part of Pleasant Hill Road was rechristened Dolfield Boulevard but left undivided.
From what I can tell, the county never entirely abandoned its plans for Dolfield Boulevard, but they seems to be shelved indefinitely. Separately from those plans, they are currently considering adding an interchange between Dolfield Boulevard and Interstate 795 (which would have been really convenient for me if it had been in place when I lived there).
So there are three sections of Dolfield Road (and a South Dolfield Road) because Interstate 795 and other factors caused a former road to be split into pieces, and there are three sections of Dolfield Boulevard because that's as far as the county has gotten on the plans for a new road. This ends today's episode of "I'm a geek and will research anything that catches my fancy".
Wed, 21 Sep 2011
This is a thing, apparently: "Take knife from pocket, post pic on the internet."
My main knife, and the one that best matches the intent of the
meme, I think, is a Myerchin Lightknife L377P, which they
apparently don't sell anymore. It's a very nice, light, compact knife,
with a multipurpose half-straight half-serrated blade; a marlinspike,
which is useful for knot- and ropework; and a small red LED, which is nice
for seeing things without ruining your night vision. I use the
marlinspike a lot less these days, because I don't do as much decorative
knotwork, but it's still occasionally useful.
The knife was a Christmas gift from my dad and stepmother a number of years ago. (Possibly 2004 or so.) I'd been thinking about replacing my at-the-time pocket knife, something from Spyderco, with a lighter, more compact knife, when I read a Cool Tools review of the Myerchin L377P. It sounded like it would do everything I wanted and more, so I made a Christmas request and then got what I asked for.
The Myerchin isn't the only knife that meets the letter of the meme's
wording, though. I also have a credit-card-shaped multitool from
Brookstone in my wallet. I use it mostly for its tweezers, but its pen,
needle, scissors, and knife blade are also occasionally useful.
A knife I also usually have on me is my
Victorinox Swiss Army CyberTool. Technically, it lives in my
laptop bag, not my pocket, but I usually have the bag with me. It's very
useful for dealing with all sorts of small-scale hardware, because it's
got the screwdriver with interchangeable phillips, flat, and torx bits,
plus the small pliers (which also include a wire cutter).
This was a birthday gift from my parents back in 2000 or so. It replaced my previous everyday knife, a Swiss Army Automobile Special, which had also been a birthday gift from my parents. Victorinox had just come out with the CyberTool and I'd been working for a couple of years in a hardware and software tech support position, so I let my parents know I was really interested in the new knife. More than ten years later, it's still serving me well.
The last knife that I usually have on me (also in my laptop bag) is a
Columbia River Knife & Tool Rollock, which doesn't appear to be
for sale anymore. It's got an interesting opening mechanism; instead of
unfolding, the blade flips up a little and slides out of the body, locking
into place at its fullest extent. It's mostly in my laptop bag because
it's very slim, so it doesn't take up much extra room and it's handy if
I've forgotten my Myerchin somewhere. Because it's got a completely
straight blade, it's less of a pain to sharpen than the Myerchin, so it's
usually the sharpest knife I have on me, which sometimes means I use it
instead of the Myerchin even if I have both with me.
This one was a gift from my youngest sister at her wedding as thanks for being a groomsman and playing trumpet in the wedding.
Mon, 02 May 2011
Just today I found about GTFS, a standardized data format from Google for describing public transit schedules. I subsequently discovered that the MTA has a GTFS feed.
Back when I didn't have a car, I used the MTA daily and had a set of scripts to extract their schedule data from the website and import it into trainsched on my Palm Pilot. I asked them for more structured data at one point but was rebuffed, so I stuck with my scripts that had to be updated every time they changed their schedule pages.
I don't have a Palm Pilot any more (and trainsched doesn't even run on the PalmOS emulator on my WebOS phone), but I thought it would be nice to update my old scripts to use the new GTFS feeds. This should even work with other GTFS feeds; there's nothing really MTA-specific going on.
The updated scripts are here: GTFS to trainsched converter.
Mon, 25 Jan 2010
I've been having intermittent problems with my car that have now stumped two mechanics, so I'm turning to the Internet for advice. I have a 1996 Jeep Grand Cherokee, with Selec-Track four-wheel-drive and a 6 cylinder engine.
The problem I'm having is that the engine will sometimes just stall (the motive power goes away and the engine RPMs drop to zero). It only seems to happen right after starting the car (so the engine hasn't warmed up yet), and it's much more common in wet weather (rain, snow, heavy fog). Often times, I can feel the engine losing power and can prevent a stall by stepping on the gas pedal. If the engine actually stalls, I have to wait at least a minute to restart it; if I try restarting it immediately, I hear the chug-chug-chug of the starter, but the engine won't start running.
I've had a few times when the stalling seemed to hit as I was braking, just as the automatic transmission was downshifting from second to first gear. I've had the car sall at times apparently unrelated to shifting, though.
This morning, it was particularly bad. I barely got out of the parking lot at home (after several stop/wait/restart cycles) before the engine stopped being useful--it would only run for 30-45 seconds before stalling, and I couldn't prevent the stall. I had the car towed to a mechanic, but by the time they took a look at it, the engine started and ran normally. They couldn't find anything wrong with the engine, and there were no codes from the onboard diagnostics.
The coolant system has a slow leak (my regular mechanic tracked it to the water pump, I think), but I've had that for over a year now and I doubt it's related. In the time since the problem first manifested, I've had a system tune-up (including replacing the spark plug wiring, apparently a common contributor to problems such as these), had the oil changed, had the transmission fluid changed, and had a (presumably unrelated) badly-leaking coolant hose replaced.
Any suggestions on what to look for to fix this will be gladly accepted. I'll be cross-posting this to several social media sites; responses there are fine, or just send an email to phil_g@pobox.com
Update 2010-01-02: I've gotten a number of suggestions for problem areas that could be causing this problem. The most-suggested item was the fuel filter, which I haven't replaced since I got the car five years ago, so I'm taking care of that to start with. I'll see how well the car behaves with a new filter. Other suggestions have included the idle valve, O2 sensor, or fuel pump. If replacing the fuel filter doesn't work, I'll check out some of the other possibilities.
Wed, 02 Dec 2009
I've been contributing to Kiva for a number of months now, and am sufficiently appreciative of them to want to tell others about them. The short version is that Kiva is a distributed, peer-to-peer microlending non-profit with the goal of alleviating global poverty.
Microlending
Microfinance is the practice of providing financial services to people in low-income parts of the world who are not generally considered profitable-enough customers to warrant service from traditional banking institutions.
Microlending (or microcredit) is a subset of microfinance that provides loans to low-income people, typically entrepreneurs in low-income area of the world, who do not have access to loans from traditional banking sources. Sometimes there simply are no banks in the area, but more typically the entrepreneurs don't make enough money to qualify for loans, don't have sufficient collateral, or don't have a sufficient credit history. Modern microlending started in the 1970s with the Bangladesh-based Grameen Bank.
The advantages of microlending over traditional aid programs are in its benefits to developing economies: it encourages growth of local businesses, puts more money into local economies, encourages local employment opportunities, and gives entrepreneurs a foothold to establish their businesses and a credit record. In some areas, it provides an alternative to tribal moneylenders, who charge high interest rates and respond to repayment failures with physical violence. In short, traditional aid addresses people's basic needs: food, shelter, clothing, education, sustainable agriculture; while microlending works on the next step of growing local economies.
Kiva's contribution
Kiva was created as the first distributed, peer-to-peer microlending organization in the world. It's peer-to-peer because all Kiva does is list loan applicants on their website; it's up to the users of the website to supply the money to fund the loans. As the loans are repaid, those repayments go to the people who supplied the money. Kiva is distributed because the funding for any given loan is made up of contributions from many different Kiva users. (And as the loan is repaid, each contributor is repaid according to his or her portion of the overall loan.)
The actual process is a little more involved. Kiva doesn't make loans directly. Instead, they partner with microfinance institutions (MFIs) in other countries. The MFIs accept loan applications, evaluate the applicants, disburse loans, and collect payments. During this process, the MFIs tell Kiva about the loans in batches, Kiva lists the loans, collects the contributions from Kiva users, and sends the money to the MFIs. When the MFIs collect money, they send the payments (again, in batches) to Kiva, which distributes the payments to the loan contributors. The MFIs often fund the loans before telling Kiva about them (to avoid the delays in the funding process and get the money to the applicant quickly), and then backfill the accounting once the loan is actually funded. In some cases, a loan will expire on Kiva without being fully funded; when that happens, any contributors will have their contributions refunded, and if the MFI already disbursed the loan, they will have to find another source of funding for it.
Loan repayment
When payments are received on a loan, the money is made available to contributors as "Kiva Credits". If you have Kiva credits, you can apply them to a different loan, donate them to Kiva itself, or transfer them into a PayPal account.
Defaults
Because most loans are made in developing areas of the world, if someone defaults on their loan, there is often no workable legal recourse for requiring repayment and the people who contributed to the loan are not repaid. The MFIs do research on the applicants before granting loans, and do a generally good job of selecting people who will repay their loans. Kiva has an overall default rate of about 2%. (For comparison, in 2004, the federal Small Business Administration, which makes loans to small businesses in the US, had a 2.4% default rate, which has hit 11.9% with the recession.)
This does mean that any loan made through Kiva carries the risk of losing the money contributed.
Interest
Kiva does not collect any interest on its loans. Consequently, Kiva users will only get back exactly what they put into the loan in the first place, unless the loan defaults. This means that anyone contributing to Kiva loans over a long term can expect to lose some money to defaults. Because Kiva is operated as a non-profit organization with the goal of alleviating poverty, they don't feel it is appropriate to add interest payments to the loans they fund.
The MFIs that Kiva partners with do charge interest, however. The interest that they charge pays for their staff and administration costs. Typically, they charge a small percentage of the loan in interest, plus a flat fee to cover the effort necessary for any loan, regardless of its size. This includes things like interviewing applicants and researching their financial history and dependability. Because the loan amounts are small, that fee often adds a noticeable percentage to the loan, leading to interest rates that seem surprisingly high. The average interest rate on Kiva is about 35%, but I've seen rates as high as 50%.
The MFI interest rates are another reason that Kiva doesn't charge interest themselves; they don't want to add any more to the borrower's repayment load.
For each of its partners, Kiva shows both the average interest rate for that MFI and the median interest rate for other MFIs in the same region. People worried about the high rates are encouraged to check up on the MFI before committing to a loan.
Kiva's Funding
Since Kiva doesn't collect interest and they apply all of a contributor's money to the loans themselves, they rely on donations to keep running. After you contribute to a loan, they ask for a donation and suggest an amount equal to 15% of your loan contribution. You have the option of choosing a different percentage (including 0%) or specifying a particular dollar amount. You can also give the repayments on your loans to Kiva as a donation, either manually (by donating your Kiva credits) or automatically (by specifying that all repayments should be automatically donated).
Kiva is a 501(c)3 nonprofit, so all donations are tax-deductible, although loans are not. (As mentioned above, loans are not even guaranteed to maintain value.)
Criticism
I feel it would be unfair to talk about Kiva without acknowledging that some people have criticisms of the microlending process.
The most common criticism about microlending in general is the high interest rates. Kiva does as well as it can in this area, recognizing that MFIs need to charge enough to fund their activities, but also being as transparent as possible about what is being charged. Kiva also periodically reviews their partners' claims and practices. (They have closed relations with at least one partner because of fraud--not interest related, in this case; the partner was claiming much higher amounts on its loans than it was actually disbursing.)
Conversely, some people argue that Kiva should themselves be charging interest. I can't find the article now, but I read a piece a while back that argued that when microfinance funding organizations like Kiva pay interest, contributors change from a "charity" mindset to an "investment" mindset and end up putting more money into system. Personally, I think that the charity mindset is a better fit here. If the goal is to alleviate poverty, then helping people establish businesses with as few impediments (including additional interest) as possible is a better approach than one that is beholden to the best return on investments.
There are also claims that microlending doesn't help all that much. There was an article in the Boston Globe a few months ago titled "Small change: Billions of dollars and a Nobel Prize later, it looks like ‘microlending’ doesn’t actually do much to fight poverty". Despite the inflammatory subtitle, the article is reasonably balanced. It refers to two unpublished papers about studies that concluded that microlending is not as effective as many people think. For one thing, I'd want to wait until the papers are published; peer review is likely to shake out any methodological problems in the studies. But the article points out that the studies found that microlending did make a difference for a lot of businesses and helped them either establish themselves or grow. It's not a panacea--if for no other reason than that the eligibility requirements for "who can take out a loan and be counted on to repay it if there's little government enforcement to rely on" mean that only a small part of the population will be considered in the first place--but it is a step in the direction of helping establish functioning local economies in poor regions. The article provides a number of pro-microfinance perspectives, most of which boil down to, "The studies show that microlending isn't magic, but it's a useful tool--as long as you understand that it isn't magic."
Kiva in particular was the target of some criticism recently when they began offering loans to entrepreneurs in the US. Many people felt that people in the US are either well-served by the standard banking system or have access to many government programs and would not get much additional benefit from a microloan. I tend to regard this as a place where it's best to give people the ability to make their own decisions. Kiva felt that there was benefit to offering loans in the US, and those who agree with them can now participate in those loans. Those who disagree have no obligation to fund US loans, and there are plenty of available loans in poorer countries. (There was a time when Kiva funded every loan it offered and sometimes ran out of new loans to fund. These days, there's more demand, and loans do periodically expire unfunded.)
Conclusion
I think that Kiva provides an important service to developing areas of the world, and I put a portion of my charitable giving into the site each month. Personally, I don't plan to take money out of it; what I put in goes either towards funding more loans or donations to keep Kiva running. Other people have different financial approaches, of course.
Kiva also isn't the only place I donate. In addition to local giving, I also contribute to more traditional aid organizations, because microlending is only effective if people are already healthy, educated, and empowered. For giving along more traditional lines, I recommend Heifer International, which mostly focuses on sustainable agriculture in developing regions.
Competition
Kiva was the first peer-to-peer microlending website, but many others have followed in its footsteps, and some of its competitors take different approaches to microlending. If you don't like Kiva, there might be another organization that's a better fit for you.
- The Microfinance Gateway is a large database of microfinance organizations, including aggregators like Kiva. It contains links to many more organizations than I'm going to link to here.
- United Prosperity doesn't directly give contributed money to borrowers; it uses that money as collateral for traditional bank loans. They feel that this approach is better at integrating people into the traditional banking system.
- The Rotarian Action Group for Microcredit works to assist Rotary groups with setting up their own microlending operations.
- MicroPlace collects interest on its microloans, so contributors earn a return on their contributions.
- Prosper is a more general peer-to-peer lending broker. Contributors can use it either as a general investment fund or a broker for choosing individual loans to fund. Anyone with a decent credit score can request a loan, which is bid on by lenders.
My Kiva History
If you want, you can look at my lender page on Kiva. So far, I've contributed to 11 loans:
- Ibrahim (last name withheld for privacy) in Lebanon: Owns a sewing factory. Currently 58% repaid on a $3,000 loan.
- Neang Soknoeun in Cambodia: Weaves and sells groceries. Currently 33% repaid on a $700 loan.
- Khosiyat Kuldasheva in Tajikistan: Sells foodstuffs at a local market. Currently 37% repaid on a $3,000 loan.
- Harriet Namugabo's group in Uganda: A 5-person group who are collectively responsible for the loan. The leader sells medicines. Currently 66% repaid on a $875 loan.
- Lilane (last name withheld for privacy) in Lebanon: Owns a clothing store. Currently 24% repaid on a $1,000 loan.
- Emélido Oporta Alvarado in Costa Rica: Raises cattle. Currently 0% repaid on a $1,175 loan. (His payment schedule is one payment every six months. The first one is due next April.)
- Efrain (last name withheld for privacy) in Peru: Grows and sells potatoes and raises cattle. Currently 0% repaid on a $1,200 loan. (He doesn't have a monthly payment schedule; the entirety of the loan is due next March.)
- Felix Alberto Tórrez Machado in Nicaragua: Runs a cybercafe. Currently 13% repaid on a $975 loan.
- Anonymous in Iraq: Runs an auto repair shop. Currently 0% repaid on a $3,000 loan. (First payment is due in January. Kiva also notes that government regulations on foreign loans are murky and they might not be able to receive the money from the borrower's payments. I figured it was good to support a business in Iraq, though, so I accepted the risk.)
- Nuevo Amanecer Group in Bolivia: a 13-person group who would be collectively responsible for the loan, with various jobs. Loan expired before being fully funded and my contribution was refunded.
- Gaibullodjon Sobitov in Tajikistan: Processes and sells dried apricots. Currently 70% raised on a $1,500 loan, with 2 days before the loan expires.
Thu, 12 Feb 2009
Betsy McCaughy has written an opinion piece for bloomberg.com titled Ruin Your Health With the Obama Stimulus Plan. In it, she characterizes the stimulus package (as passed by the House) as containing sinister language that will allow the government to control and reduce the quality of health care available to the American public. I took a look at the sections of the bill that she has issues with, and I found that her conclusions are gross distortions at best. More or less everything she points to in the bill is focused on providing a healthcare information technology infrastructure to allow doctors and hospitals easy access to patients' complete medical information--nothing more.
(Since I wrote my analysis, the people at FactCheck.org have done their own analysis, which is more in depth than mine. The conclusions are similar--McCaughey is misunderstanding a lot of the bill--although they allow that some parts of the bill don't necessarily forbid her worst-case scenario. (They also note that much of what she worries about has been in place already, under a program created by George W Bush: the bill just turns an executive order into established law.))
She also makes a lot of comparisons to Tom Daschle's book Critical: What We Can Do About the Health-Care Crisis, drawing sinister inferences from the comparisons. I haven't read the book, so I can't judge how right or wrong she is about its contents, but the contents of the actual bill are not what she says they are.
To begin with, she claims that the government will be overseeing what your doctor does and dictating treatments:
One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446).
The actual text of the bill is as follows:
page 441
19 “(b) PURPOSE.--The National Coordinator shall per-
20 form the duties under subsection (c) in a manner con-
21 sistent with the development of a nationwide health infor-
22 mation technology infrastructure that allows for the elec-
23 tronic use and exchange of information and that--
page 442
1 “(1) ensures that each patient's health informa-
2 tion is secure and protected, in accordance with ap-
3 plicable law;
4 “(2) improves health care quality, reduces med-
5 ical errors, reduces health disparities, and advances
6 the delivery of patient-centered medical care;
7 “(3) reduces health care costs resulting from
8 inefficiency, medical errors, inappropriate care, du-
9 plicative care, and incomplete information;
10 “(4) provides appropriate information to help
11 guide medical decisions at the time and place of
12 care;
13 “(5) ensures the inclusion of meaningful public
14 input in such development of such infrastructure;
15 “(6) improves the coordination of care and in-
16 formation among hospitals, laboratories, physician
17 offices, and other entities through an effective infra-
18 structure for the secure and authorized exchange of
19 health care information;
20 “(7) improves public health activities and facili-
21 tates the early identification and rapid response to
22 public health threats and emergencies, including bio-
23 terror events and infectious disease outbreaks;
24 “(8) facilitates health and clinical research and
25 health care quality;
page 443
1 “(9) promotes prevention of chronic diseases;
2 “(10) promotes a more effective marketplace,
3 greater competition, greater systems analysis, in-
4 creased consumer choice, and improved outcomes in
5 health care services; and
6 “(11) improves efforts to reduce health dispari-
7 ties.
The whole thing is talking about making patients' medical information available by electronic means to hospitals, doctors, and insurance companies while maintaing the patients' privacy. Clause (4), in particular, refers to doctors being able to have all of the information they need when making decisions. It does not imply anything about the government dictating doctors' decisions to them.
She goes on to talk about hospitals and doctors not being "meaningful users" of the system, and she seems to imply that this will result in doctors abandoning treatments that aren't government-sanctioned:
Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. ... What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment?
Here's what the bill has to say about "meaningful users":
page 511
14 “(o) INCENTIVES FOR ADOPTION AND MEANINGFUL
15 USE OF CERTIFIED EHR TECHNOLOGY.--
16 “(1) INCENTIVE PAYMENTS.--
17 “(A) IN GENERAL.--Subject to the suc-
18 ceeding subparagraphs of this paragraph, with
19 respect to covered professional services fur-
20 nished by an eligible professional during a pay-
21 ment year (as defined in subparagraph (E)), if
22 the eligible professional is a meaningful EHR
23 user (as determined under paragraph (2)) for
24 the reporting period with respect to such year,
25 in addition to the amount otherwise paid under
page 512
1 this part, there also shall be paid to the eligible
2 professional (or to an employer or facility in the
3 cases described in clause (A) of section
4 1842(b)(6)), from the Federal Supplementary
5 Medical Insurance Trust Fund established
6 under section 1841 an amount equal to 75 per-
7 cent of the Secretary's estimate (based on
8 claims submitted not later than 2 months after
9 the end of the payment year) of the allowed
10 charges under this part for all such covered
11 professional services furnished by the eligible
12 professional during such year.
page 540
6 “(3) MEANINGFUL EHR USER.--
7 “(A) IN GENERAL.--For purposes of para-
8 graph (1), an eligible hospital shall be treated
9 as a meaningful EHR user for a reporting pe-
10 riod for a payment year (or, for purposes of
11 subsection (b)(3)(B)(ix), for a reporting period
12 under such subsection for a fiscal year) if each
13 of the following requirements are met:
14 “(i) MEANINGFUL USE OF CERTIFIED
15 EHR TECHNOLOGY.--The eligible hospital
16 demonstrates to the satisfaction of the Sec-
17 retary, in accordance with subparagraph
18 (C)(i), that during such period the hospital
19 is using certified EHR technology in a
20 meaningful manner.
21 “(ii) INFORMATION EXCHANGE.--The
22 eligible hospital demonstrates to the satis-
23 faction of the Secretary, in accordance
24 with subparagraph (C)(i), that during such
25 period such certified EHR technology is
page 541
1 connected in a manner that provides, in
2 accordance with law and standards appli-
3 cable to the exchange of information, for
4 the electronic exchange of health informa-
5 tion to improve the quality of health care,
6 such as promoting care coordination.
7 “(iii) REPORTING ON MEASURES
8 USING EHR.--Subject to subparagraph
9 (B)(ii) and using such certified EHR tech-
10 nology, the eligible hospital submits infor-
11 mation for such period, in a form and
12 manner specified by the Secretary, on such
13 clinical quality measures and such other
14 measures as selected by the Secretary
15 under subparagraph (B)(i).
"Meaningful EHR users" will be given financial incentives to use the electronic system. If a doctor or hospital is not a "meaningful EHR user", that means only that they're not making use of the electronic medical information infrastructure. It has nothing to do with what treatments they offer. Furthermore, non-"meaningful users" don't face penalties; they just don't have the government helping them pay for the upfront cost of implementing the electronic system.
Next, she claims that the bill creates a department to prevent people from using new medical treatments because they're more expensive:
In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make. The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs.
Again, the bill:
page 190
7 SEC. 9201. FEDERAL COORDINATING COUNCIL FOR COM-
8 PARATIVE EFFECTIVENESS RESEARCH.
9 (a) ESTABLISHMENT.--There is hereby established a
10 Federal Coordinating Council for Comparative Effective-
11 ness Research (in this section referred to as the “Coun-
12 cil”).
13 (b) PURPOSE; DUTIES.--The Council shall--
14 (1) assist the offices and agencies of the Fed-
15 eral Government, including the Departments of
16 Health and Human Services, Veterans Affairs, and
17 Defense, and other Federal departments or agencies,
18 to coordinate the conduct or support of comparative
19 effectiveness and related health services research;
20 and
21 (2) advise the President and Congress on--
22 (A) strategies with respect to the infra-
23 structure needs of comparative effectiveness re-
24 search within the Federal Government;
page 191
1 (B) appropriate organizational expendi-
2 tures for comparative effectiveness research by
3 relevant Federal departments and agencies; and
4 (C) opportunities to assure optimum co-
5 ordination of comparative effectiveness and re-
6 lated health services research conducted or sup-
7 ported by relevant Federal departments and
8 agencies, with the goal of reducing duplicative
9 efforts and encouraging coordinated and com-
10 plementary use of resources.
The supposedly sinister Federal Coordinating Council for Comparative Effectiveness Research seems to be more like the Department of Homeland Security for existing federal health care systems. Programs like Medicaid, veteran's benefits, and federal employee health insurance already make estimations on the effectiveness of various treatments, just like every private health insurance company. The new council would share information across the federal programs that already exist.
Following that, she claims that the bill would change the standards for approved Medicare treatments, implying that fewer treatments will be approved:
Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).
Page 464 contains references to implementing things specified under section 3004, which describes the process for adopting and implementing the previously-mentioned technology infrastructure. I can find no mention of Medicare. It seems very much like this claim is completely fabricated.
Every complaint that the author raises, everything that she claims will affect what care doctors are willing to give, seems to only concern the healthcare information technology infrastructure that Obama has been talking about implementing for months. I see no places where the government will be dictating anything to doctors, aside from providing financial incentives (not punishments) to work with the new infrastructure. None of the author's claims about the government cutting off healthcare seem at all founded in fact. At best, she's consistently misreading the text of the bill. I think it more likely that she has other reasons not to want the bill to pass and is distorting the reality of the situation to steer people in the direction she wants them to go.
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