Do as you say

Today in a New York Times Article reviewing President Obama’s press conference, held Wednesday April 30th 2009, he is quoted to have said:

“We cannot go back to an economy that is built on a pile of sand — on inflated home prices and maxed-out credit cards, on over leveraged banks and outdated regulations that allowed the recklessness of a few to threaten the prosperity of us all,”

Reading these words all I can say is YES.  Yet, I remain troubled.  We’ve all read about the various programs our government is implementing to “fix” our economy.  Too often these programs are simply a mechanism to take money from Honest Tax Payers and distribute it to those that over-leveraged themselves and where reckless.  President Obama that is not what those word would suggest your policy is.

We seem to think that whatever we do the Government will bail us out.

  • Build on the Mississippi flood plane and when the river does what it has always done help those who built where the water has always been supreme.
  • Live on the cliffs in California.  When the rain comes, and it will, the land will be washed out from under the foundation. Washington will come to the rescue.
  • Build on a fault line and when the earth shakes don’t worry too much papa will rescue you.
  • Run up your credit card debt, buy a home you can”t afford and daddy will punish the lender and protect the reckless.
  • Leverage yourself as Bear Stearns did and we will make it all better

Nature is and has been since God set the universe in motion.  Moses in his dialogue with God learned of the beginning and in Genesis he recorded those first days of Adam’s life and how easy it would have been to follow the rules. 

 The LORD God put the man in the Garden of Eden. He put him there to work its ground and to take care of it.

 The LORD God gave the man a command. He said, “You can eat the fruit of any tree that is in the garden. But you must not eat the fruit of the tree of the knowledge of good and evil. If you do, you can be sure that you will die.”

He gave us the chance to live in paradise for eternity.  He gave us plenty.  All he asked is that we work the ground, take care of it and not eat of the fruit of the Tree of Knowledge of …

I do not mean to look at original sin nor do I want to talk about how the serpent beguiled woman and man simply ate with her.

What I am concerned with is that Obama is saying all the right things.  Yet, when we look to the results we see money flowing into the pockets of those that took us into the abysm.  We tell credit card companies that they should reduce interest charges and not protect themselves.  We simply seem to be protecting those that are reckless.

So President Obama, please do as you say,

  • Don’t bail out the banks and investment company, then let them skirt the rules.
  • Don’t fix it so people with maxed out Credit Cards can get themselves back in trouble.
  • Don’t help people and mortgage lenders who agreed to mortgages that could not be sustained by the home-owner.

This idea that some companies are just to big to let fail sounds smart.  Yet, unless they are also made to appreciate their failings we will simply see it happen all over again. 

They personally must feel the pain not simply do as Merrill, AIG and all the CEOs want to and do  do, get a government hand out and still get the big bonus.  They need to be held accountable and made to put their money where their mistakes are.

Is the UAW focusing on helping or simply being greedy

http://www.nytimes.com/2009/04/28/business/28auto.html?th&emc=th

G.M.’s Latest Plan Envisions a Much Smaller Automaker

By BILL VLASIC and NICK BUNKLEY Published: April 27, 2009 New York Times

Over the last months countless articles and news commentaries have discussed the plight of the US auto makers.  Bankruptcy, restructuring and foreign buyouts are all on the table as the US Government pushes Chrysler and General Motors to fix itself or get fixed.

One item that keeps appearing and as I think back over the last years, starting when Asian auto makers built factories here in America, I am constantly amazed to see that the UAW is not part of the solution.  I appreciate that their role is to protect the interests of their members.  Yet they simply  focus on protecting the lavish pensions (developed when Detroit was ever so profitable) that these individuals are “entitled” to.

I have a profound respect for much of the work the union movement has done to protect the American worker and to assure them that they are paid a fair wage, work in reasonably safe conditions and various other initiatives that escape my mind.

What disturbs me these days is that we complain about Outsourcing and the migration of jobs to India, Malaysia, in years past Ireland and countless other countries willing to work for less than the American worker and do those jobs that are “Beneath Us”.  Why we have the human resources, just look at the current rate of unemployment.  When it is zero then OK let’s outsource.

As the spokesperson for American workers and hoping they are aware that we cannot practice isolationist policies and impose tariffs and taxes to protect American jobs.  I worry that they are not out there working with business and the government to protect those jobs or better yet grow the n umber of jobs while still exploiting the virtues of technology and the goal to reduce the end cost to the consumer, their members.

Instead they slow down progress.  They do not take the lead in driving for quality and do not help to make sure what we build or do with American hands and minds is the best that can be made or provided anywhere.

In the article, what I am once again reminded of is the fact that they insist that the “Pensions” be protected 9screw the stockholders and debit holders.  i do not see them thinking about the fact that the future of our children is at risk.  Jobs will continue to go to where it is less expensive to produce and where equally skilled people demonstrate a willingness to work to put food on their tables.

The unions are one of the great strengths of America.  At this time of economic turmoil, where greed is at the core of our housing crisis, the introduction of high risk derivatives and a truly expensive health care system.  They should be leading the workforce to understand that the American dream never was intended to guarantee anyone everything and that the American dream was built on hard-work, prudent investment and quality.

If we can return to these roots and focus on quality, hard-work and assuring the future of America for our children, then we will see an upturn in the market and a return to full employment where immigrants are seen as a positive influence and not illegals stealing American jobs.

At the same time Management is equally responsible for our plight.  Sub-prime mortgages, derivatives, short sighted corporate planning and yes greed leads them also to be UN-American.  They are to focused on the next analyst briefing and their quarterly results and make sure they could sell more for less.  So they purchase materials produced by non Americans.   They do not insist on an equitable balance between pay, quality and work.  Then to make matters worse they insist that they are paid millions of dollars, the Government then bail them out when they make stupid decisions; for what?

We are all in this together and although we know that communism and socialism does not work.  Capitalism only works when we do right by everyone and devise a fair distribution of wealth: based on ability, hard work and ingenuity.

Our Financial Market must embrace the spirit of Social responsibility and avoid the power of the Dark Side

Geithner, as Member and Overseer, Forged Ties to Finance Club

 By

Did Timothy Geithner help or assist in bringing Wall Street and the world at large to the brink of disaster?  A brilliant man yet was the force of the Wall Street lobby able to easily sway the path of the New York Federal Reserve to allow risk that lead to the collapse.  

Morals and a solid foundation of right, wrong and mutual satisfaction must return to the market if it is to be the leader of the world.  Has the financial market been seduced by the dark side and falls fowl of the seven deadly sins (Greed, Pride, Sloth, Gluttony, Lust, Wrath and Envy)?  They in the end should be the machine that assures liquidity and assures the foundation of our economies ability to grow and prosper.   Losing their way and focusing on their personal wants and not the needs of everyone is a disaster worth of the fallen one.

I am happy to see Wall Street and the City of London prosper as long as they remember Jesus’ two commandments and embrace them as part of the principles and goals that drive their actions.

Our Medical System should be run by doctors not corporations

Shortage of Doctors Proves Obstacle to Obama Goals

By ROBERT PEAR 27 April 2007 the New York Times

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

I wonder if Congress should instead focus on improving the income of doctors, reduce the fear of Mal-practive and insisting on deepening their education.  So that people will once again see it as a worthy profession and thus there will be enough doctors to serve our growing population, not simply here, but all over the world.

 As the Grandson, son and brother of doctors, I am driven to suggest to our Congress and the people that we must consider the investment someone must make to becoming a care practitioner and realize that we must encourage people to want to dedicate the time it takes to become proficient.  These dedicated individuals, unlike CEO’s and Wall Street millionaire, must excel in their studies and invest  four years at university, four years at  medical school and then finally before having the skills to serve us, invest an additional three to six years as a journey man (i.e. their their internship and residency).  Hundreds of thousand of dollars later and so much time and study does desire a fair reward. 

I also believe that we should begin to think about training our internist better, so they can be more effective and not simply pass the patient on to a specialist.  they as the gatekeep should have the education and practical training so unlike today thare are able to properly diagnosis the problem we the sick are facing. 

Simply look at the TV series House.  his dedication and effectiveness of his team is what we need.  People who truly think and only turn to specialists when they fibnally accept that the specialists skills are required.  Just to put a value to House.  my father a retired Park Avenue and renowned diagnostician finds this one medical program stimulates his thinking.

The other key issue that Obama and Congress must address is that medicine should be a cottage industry.  Instead corporations and insurance companies now run our health care system, Hillary Clinton’s efforts, although altruistic, probably drove corporations to seek profits at the expense of the real care-takers and unltimately you and I.  These new “medical?” tycoons are more worried about shareholder returns and annual bonuses than the health of the people who should be their focus and are in their care.

Is it a national health system that we need simply to “FIX” the problem.  Or is it a return to a system run by doctors who are properly trained and rewarded. We should think first of investing our taxes on helping the gatekeepers (family practitioners, gynecologist and internists) to be the front line, capable of dealing with most medical issues.  We should encourage their selfless commitment and  drive for education and practical training so they can effectively serve, thus drive down costs by being better at what they do.

Finally thought.  Risk is endemic in any system.  Lawyers drive risk out of the system by pursuing law suits because someone took at risk or was just like the rest of us a made an error.  The net result,t doctors have become overly cautious, dependent on too many tests and unwilling to say this is what I think is wrong and if we don’t do something (however risky) now MY patient will die.

e-ID – a public utility or a space of trusted third parties

In response to the article published by Consult Hyperion

Conference paper e-ID as a public utility Neil A. McEvoy

 

 

Universality

Interesting that as soon as you identify that I should be able to provide my identity to anyone anywhere you state that a national government can offer such a scheme.  That is counter intuitive and fraught with the issue of achieving global standards of identification, given the bureaucracy of most national governments. 

Yes, ICAO was able to agree on a template and specification for the e-passport.  Fortunately they had a template and various agreements and treaties to justify the work.  But when we start out with the basic premise that my identity is how I wish to project myself; we immediately move into a world of nuance with built in mechanisms to embrace and resist change.  That being said Homo sapiens’ have a perchance to employ tools we morph as society and our world evolves.

Picking the right band of stakeholders to assure universality requires that at some point people abandon the idea that there is Profit in defining how we will digitally represent a person’s identity.  Instead because the consumer/citizen wishes to project or required to provide their identity; we leave it to those seeking to receive the information to find the profit in knowing something about me. 

Having been raised in America I am drawn to the words in our declaration of independence that give us the right to life, liberty and the pursuit of happiness.  Behind these words I believe I also have the right to my privacy and do not want to learn that morphing my identity into a digital form puts my identity at risk.  The citizen/consumer must be able to decide when and what information someone is able to scan.

All of this tempers my thinking about who should be engaged in defining the global standard for digital identity.

The two-way street

I could not say it better myself.  Like my business card, a police persons badge or a company id card.  We present these to each other to create trust between various parties and provide a degree of certainty that:

·         I am who I say I am

·         This is how you can locate and communication with me

·         Here is proof that I have the following rights and capabilities

Quick transaction

Very well said the exchange of information about my identity must be as easy as handing you my business card.  Everything after that is about the context of the transaction and will parallel the discussion and negotiations between the parties.

The gadget

My only addition to the supposition that the phone is the right gadget is the reality that we are talking about something that the citizen must be able to carry most anywhere.  So it must be the one object we always carry.  Some would argue this is the mobile phone; I would suggest that we not forget the more primitive device the purse or wallet.  Maybe as we think of identity we must also think of ergonomists and think about merging the phone into the wallet not the wallet into the phone.  Leather is eco-friendly warm and comfortable to the touch.  Metal or plastic tends to be brittle and cold. 

The next thought in respect to the gadget is it becomes the device I trust and will protect at almost any cost.  Should I worry about how trustworthy your device is?  All I want from you is the information you wish to share and any certificates others provide you that allow me to authenticate your rights and capabilities.  My trusted gadget is what I use to share information and certificates and what helps me absorb and as appropriate verify information and certificates others offer to me.

Extensions

Yes my information is mine and what I offer to others is my choice.

Scheme considerations

I am not convinced of the need for a central register.  Yes there is a need for third parties to attest to the citizen’s identity that others can trust and in lies the complexity of introducing a digital solution.  In fact what the citizen needs is a device they trust.  A device we trust, carries the information and certificates that third parties, who the counterparty trusts, capable of exchanging the appropriate digital data electronically.  In order to achieve this goal we must develop and support a cascade of standards, regulations, contracts and relationships that enable global interoperability thus assuring a meaningful means of exchanging our digital identity.

Before we go about defining the techniques that should be employed, I think we must first establish base principles.  Key must be the idea that there is no centralized register.  Instead those parties we as consumers are willing to trust and wish to position themselves as trusted third parties can build registries, recording those individuals they are willing to authenticate.  The citizen may wish to contract with an entity to provide support for the trusted gadget and the various relationships it supports. 

The author’s position on protecting privacy and meeting the needs of law enforcement is laudable yet scary.  I’d rather the protection offered by a distributed environment that still is capable of responding to directed queries from law enforcement and not blanket access to everything I or others have collected about me.

Make my gadget the gate keeper; allow service providers and those parties wanting the security of digital identity the ability through standards to build affordable infrastructure to read, with my permission, data stored in my gadget.  Avoid the complexity of establishing a global resister.  What we need to define is the architecture for a gadget that is capable of carrying and supporting a myriad of digital relationships with their linked need to assure proper identification.  We then need to agree on a common set of information that all sectors share.  Maybe the v-card is the base.

For more information I offer the following background and a concept for consideration.

The Promise of multi-application Smart Cards, refined to consider the device as the media

A bit of research to prove the consumer will understand

Mobile Payments and Banking – Consumer reaction is negative

UK consumers reject mobile payments

Security is a major hindrance, says study Written by Angelica Mari, 23 May 2008

I must admit I am confused about the potential for the Mobile Phone becoming a mechanisms we employ when making payments.  If I was simply to take the reaction in an article recently published on VNUNET.com, I would worry.  Yet in other articles and industry analyst speculate that by 2012 we will evolve to employing the mobile phone as our i means of payment.  As I suggested in a previous posting there is still a lot of work to do in developing the business case. 

Yes Vivotech reports phenomenal numbers of devices installed and Inside Contactless talks about the significant numbers of contactless cards deployed.  Standards are emerging and I am sure that EMVCO will develop the necessary security to protect Mobile Payments (assuming you don’t lose your phone).  Then there is the interesting reality that there are more mobile phone users than there are people with Bank accounts.  Micro-finance and developing worlds are embracing work like what Vodaphone is doing to drive payments in the P2P space to the mobile device. Yet when will all of these experiments and trials prove that the key issues of security and stakeholder profit are there?

Interchange is under threat

Judiciary Committee Antitrust Task Force
Hearing on H.R. 5546, the “Credit Card Fair Fee Act of 2008”

Today I sat down and read through all of the testimony and must admit, understanding the concepts of interchange, I am troubled by the testimony provided by both Visa and MasterCard.  Neither provided sound arguments to justify interchange.  Whereas those opposed, clearly demonstrated that Interchange benefited the large issuing banks at the expense of the merchant and consumer.  The only testimony that offered any sound support for interchange was that offered by John Blum.  Yet his arguments simply argued that without a fixed interchange structure smaller players would not be able to play, which does suggest the interchange mechanism, as a competitive process, is flawed.

Regulation is not the answer.  Yet, something must be done to assure that there are sufficient free market forces surrounding the calculation of the default Interchange rates.  

 Chairman’s Opening Statement

Witness list and links to their statements

Thomas L. Robinson
Vice President of Reglations
National Association of Convenience Stores
Joshua R. Floum
General Counsel and Corporate Sec.
Visa Inc.
Steve Cannon
Chairman
Constantine Cannon, LLP
Joshua Peirez
Chief Payment System Integrity Officer
MasterCard Worldwide
John Blum
Vice President of Operations
Chartway FCU
Edward Mierzwinski
Consumer Program Director U.S. PIRG

Alternative Payment Methods

Ed Kountz of jupiter in his recent blog on Alternative online Payments offers an opinion that credit and debit cards where not designed for the Internet. It is interesting to reflect back in history and remember when it was not the magnetic strip that was important to the execution of the transaction but the numbers printed on the front of the card a merchant could simply would say into a phone or type onto their telephone keypad to get an authorization.

Move to the Internet and instead of asking the merchant to type in the account number and expiry date we ask the consumer to fill in an Internet form. How can one argue that ISO7810-3 cards where not built for the Internet.

Back in the day, circa 1993, when we began to think about how we would secure payments over the Internet and address words like dis-intermediation. It was clear that by any definition the ubiquitous credit card was already a vehicle for enabling eCommerce. All the internet did was to take mail order and catalogue business and give it the power to become a global operation; no longer limited by the cost of a telephone call or postage. Nowadays, of course, the internet has become such a vital part of our everyday lives, with people looking up things like “internet in my area” to make sure that they are getting the best deals possible so that they can be confident that their connection won’t let them down.

And, of course, Mr Kountz is correct, there is a real issue with security and the Internet. Yet the issue is no greater than what was faced when Card Not Present transactions started happening as telephone ordering became common place. Did the payment associations attempt to keep up? MAYBE!

First we saw the introduction of CVC2/CVV2 and address verification as tools to address the risks of someone who had captured the data on the face of the card from employing that card maliciously. Not a bad solution, if the merchant was willing to make the changes to their web sites and call center procedures.

Next came SET, now here was the perfect solution, yet at a cost that simply did not offer anyone a reason return on investment; even if Card Not Present Fraud was an issue. Since then the payment associations tried to develop a simpler yet equally secure solution called 3D-Secure, Verified by Visa or SecureCode. The idea is sound. The issue of adoption came down to the simple issue of figuring out how to get the consumer to go through the additional step of activating their 3D-Secure password and better yet remember it. Versus what became the reality, they simply said this is too difficult, I don’t need to buy that today, so they abandon the shopping cart. Merchants saw 3D-Secure as a way to lose potential business and at a rate alarmingly larger than the cost of fraudulent transactions.

So what is the answer? Create new means of payment that are designed for the specific trading environment (mobile, Internet, Mail Order, telephone Order, face to face …) or figure out how to get everyone to work together to come up with a workable solution that exploits the power of the Visa, Discover, MasterCard and American Express Brands.

In my opinion it is about communications and working together as a team. Not once has the merchant been asked to participate in developing more secure solutions to payments. They are simply told through compliance and rule changes this is what they shall do.

Maybe the new Visa and MasterCard will find that merchants are now shareholders and bringing them to the table is in the interest of everyone especially the consumer. Or is it time for a new payment Brand that is built to serve the merchant and operated by the Banks?

Interchange under judicial and legislative review

Today on Payments News – from Glenbrook Partners” they posted an article referencing the hearing taking place

Thursday 05/15/2008 – 11:00 AM
2141 Rayburn House Office Building
Judiciary Committee Antitrust Task Force
Hearing on H.R. 5546, the “Credit Card Fair Fee Act of 2008”

House Judiciary Committee Holds Hearing on US Interchange Fees

As we mentioned here on Payments News on Monday, the House Judiciary Committee is holding a hearing on Thursday, May 15th beginning at 11 AM Eastern time on H.R. 5546, the “Credit Card Fair Fee Act of 2008”. As of tonight, the committee’s website doesn’t list the witnesses who will be testifying – but it promises that a live webcast of the hearing will be available.

As an editorial comment, many of us in the payments industry find the “solution” proposed in this legislation to be overly complex. Read the actual text of the draft legislation – and you may reach the same conclusion! We wonder whether the merchant community in fact would be well served by the remedies proposed. A very basic question comes to mind: “Is this the best you can do?”

The legislation that is under review can be found at http://judiciary.house.gov/hearings.aspx?ID=204

My sense is that like Australia, Europe and other countries the USA Congress is ready to challenge the nature of how interchange is calculated and define methods of assuring merchants much reduced rates.  How the financial lobby will engage and how the associations will defend there position, should make for an interesting debate.

European ATM Skimming Fraud Jumps 43%

Reported by Epaynews.com

May 08 2008 : In 2007, ATM fraud losses rose by 43 percent in Europe to €439.01 million (US$683.7 million) from €306.48 million in 2006, reports EAST (the European ATM Security Team). Most of the losses in 2006 and 2007 were due to card-skimming at ATMs, the non-profit organization says.The year-on-year increase in fraud losses was mainly due to a €173.6 million increase in cross-border losses in 2007.
“These (cross-border) losses are occurring globally in countries where all or part of the ATMs deployed are not yet EMV-compliant,” EAST says. “Domestic European fraud losses have fallen year on year, an indication that the roll out of EMV-compliant ATMs is driving down fraud.”
 According to EAST, 78 percent of European ATMs are now EMV-compliant.
Card fraudsters are being forced to seek out non-EMV compliant ATMs to obtain cash, EAST says. “Incidents continue to be reported where data skimmed from EMV cards in European countries where ATMs are EMV-compliant, has been sent by criminals to European countries where ATMs are not fully EMV-compliant,” it says.
The skimmed data is used to make counterfeit cards that enable fraudsters to illegally withdraw cash from ATMs.

According to EAST, skimmed data is also increasingly being sent to countries in and outside Europe where EMV cards can be used as magnetic-stripe cards in ATMs. This takes advantage of a process known as “mag-stripe fallback”, which is designed to ensure that a card can be used even if its EMV chip is damaged or faulty.

Crooks Have Your Card and You Don’t Even Know It

How Thieves Copy Credit and Debit Cards and Drain Accounts

By ELISABETH LEAMY – ABC News

May 2, 2008—

 While your ATM card is tucked in your wallet, thieves half a world away could be cloning it and using it. The crime is called “white card fraud,” and ABC News investigated just how easy it is for thieves to make a copy of your card and use it to drain your account.

It’s difficult to get an exact figure, but it’s estimated that identity thieves net an estimated $345 million this way every year. Gary Burkey of Wilmington, Del., discovered somebody was withdrawing money from his account at ATM machines in a part of Pennsylvania he had never even visited.

Criminals get people’s numbers in a variety of ways. One way they capture card numbers is by installing skimmer devices over the slot where you insert your card when you use an ATM.

They also use hidden cameras to record your PIN. Miami Beach police have actual footage from a crook’s camera in Florida that shows a victim inputting his PIN. Clear as day: 1-4-2-6.

Click here for tips to protect you from today’s modern identity thieves.

“What makes this really sneaky, really devious, is once the criminals get the account information, they wait on it for a little while, said Cpl. Jeff Whitmarsh of the Delaware State Police. They replicate the cards and when the consumer least expects, that’s when they go in and hit the account.”

ABC News found the machines used to copy cards for sale right on the Internet, even though there are very few legitimate uses for them. We had our choice of 30 machines and bought one for about $500. We were even able to request priority shipping and received the package the next day.

ABC took the device to Chris O’Ferrell, an ethical hacker for a computer company called Command Information, which helps the federal government secure its systems.

We handed over an ABC News credit card and O’Ferrell swiped it so the machine could capture the information on the magnetic strip. Right away, the data popped up on the computer screen: name and account information.

With another swipe, O’Ferrell transferred it to a blank white card that came with our kit. Any card with a magnetic strip can be made into a clone — gift cards, hotel key cards, etc.

In less than five seconds, we had a duplicate credit card.

“That’s it. That’s all there is to it,.” O’Ferrell said.

We cloned an ATM card too. At one point we even accidentally deleted the data on one of our source cards, but since we had a clone, we were able to put the data back on.

Once we had clones of our cards, the question was, would they work? We tried the Visa card out at a gas pump. Without actually making a purchase (we didn’t want to violate any laws) we inserted the card to see if it would get authorized.

When the “lift the handle and begin fueling” message came up, we knew our clone was working. We tested the cloned ATM card by checking our balance at an ATM machine. When the screen read “Hello Elisabeth Leamy,” that was our first clue that that one was working.

It’s a bonanza for crooks. They used to have to risk going into stores to buy pricey merchandise, which they then sold for cash. Now they can just drain ATMs. Authorities say specialized crews do nothing but hit ATMs, cashing out on behalf of other identity thieves and taking a commission. One Bulgarian gang pulled $200,000 out of a single cash machine in Florida.

More than 65 other countries in Europe, Asia and South America now use smart chip technology that makes card cloning almost impossible. But the United States has stayed with magnetic strips to avoid the cost of converting ATMs. By one estimate, we have 400,000 cash machines in this country.

“It’s totally unacceptable,” O’Ferrell said. “It makes it extremely easy for the criminals to clone our cards and steal our identities.” Experts say since U.S. credit and debit cards are so much easier to tap, U.S. cardholders have become targets.

Copyright © 2008 ABC News Internet Ventures

China, socialism and the world of electronic health records.

Today during a most enlightened networking meeting, beyond what someone in transition normally speaks of, we got into a most interesting and thought provoking conversation.

Electronic Health Care Records

Somehow we got into a discussion of the evolution and problems involved in developing the electronic patient record.  The gentleman, who will remain nameless, remembered a conversation he had with a man who was involved with the United Kingdom’s work on the exploration of space.  This knighted individual apparently suggested the key issue with developing the electronic health record was the issue of creating the patient’s electronic history from the previous pencil and pen records.

His approach to solving this problem was to use prisoners as the codifiers.  Of course such an idea immediately causes one to worry about privacy and the threat to the patient and doctors when these prisoners were freed.

As we talked an interesting thought occurred.  How often is a patient’s history relevant?  How often is the doctor quite happy to meet with a patient and simply focus on the symptoms described during that  persons visit?

As we reflected, we both realized that often the patient’s history will never be pertinent to a future diagnosis.  In those situations where the history is relevant, let’s say 10%, then there is value to the effort of codifying historic medical records, charts and the like.  The doctor and his office staff can find the time to organize the codification of the relevant data.  Clearly such an approach with the reduction is the cost of establishing the basic health record, is connected with the value a complete electronic health record will have in reducing the cost of long term care, something insurance companies and public health authorities can understand.

For that 90%, after the doctor has become automated and is part of a system designed to capture and retain the Patient Health Record, at the next appointment the doctor in conjunction with the patient can record important facts such as allergies, reactions to drugs, existing conditions and any pertinent operations or procedures the patient can remember.

Only when this basic profile indicates conditions that will have future implications, is there a need to go through the effort of backtracking through the records and recording any pertinent information.

China and Socialism

I asked my companion what he was up to.  He talked about the five companies he was working with in China and the various trips he had taken to remote parts of that great country.  He said three things that stuck in my mind.

  1. He remembered a bus trip where he asked about unemployment.  His Chinese companions asked him to look out the window and tell them what he saw.  His response “everyone is working”, “there are no beggars on the street”.  They smiled and he was reminded that in this socialist environment one of the fundamentals is that everyone has work however menial it may be.
  2. We then spoke of the economic divide that is emerging and like in all countries this is a reality that will always exist unless we can evolve to that social utopia described as the purest form of socialism.  A society where every man works to his ability and everyone shares equally. He then reflected on the reality that mobile phones, TVs and other luxuries were everywhere and the age old work ethic that is China, will drive these people to want more, therefore, work harder to get more.  It is this work ethic that is China’s strength and will be the issue we will have to address as the world moves forward in time.  If we in the west continue to expand our leisure time and the Chinese continue to follow their nature and continue to focus on work.  Who will win?  I think the answer is evident.  Those that work  will be the ones who win.
  3. He then spoke of issues within the industrial complex where mine accident occurred or dangerous products are released.  The interesting comment was that those in power, the top three managers, are shot when such things happen.  Of course this form of behaviour is abhorrent and clearly a violation of Christian thinking or western thoughts of punishment.

Yet what is interesting, assuming they learn to balance the punishment (100 dead in a mine cave do to poor conditions and insufficient safety standards) to the crime, is that those ultimately responsible are ones that are punished.

I then reflected on what happens in our society.  The executives always seem to go unscathed.  They successfully push the blame down to the supervisors and little people who work and manage the place where the disaster occurred.

If we were to dig deep enough I am sure we would find that they did all they could do with the tools and budget they were provided.  Budgets and tools authorized by executives sitting in big offices taking down big salaries and only getting worried when shareholders not employees come screaming for justice.

Assuming that China is going to continue to evolve.  That they are going to embrace compassionate forms of punishment.  While at the same time maintaining their work ethic and maintaining the premise that responsibility is top down not middle down.  They will become not only an economic power to deal with, but a country with a strong moral sense of responsibility and thus a threat to the soft life that has become the western dream.

A dream that balances not working more than 40 hours a week with demands for more and more vacation.  China will be a country where hard work is rewarded, pleasures are sought and people have a moral sense of responsibility to each other.

We in the west need to be mindful and learn from those countries that take the goodness of socialism, merge it with the power of capitalism and the forces of the global economy.