Monday, February 22, 2010

Blogging

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Since I’ve been getting as ‘into’ blogging as I have been, I decided to research it a bit. This guy, Seth Godin, has a blog of his own, wherein he explains some tips on how to blog better. There’s quite an extensive list of dos and don’ts, some of which even contradict each other, but that just made it more interesting for me to read. That interest factor has led me to link to it (here if you missed it the first time). Thanks Seth!

Saturday, February 20, 2010

The Real Cost of Healthcare

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(preface: Any potential solutions outlined here are not universal and may not be feasible for all cases, but that doesn’t mean nobody can do it!)

It seems health insurance companies raising premiums for individual members (as opposed to a group health plan) and people are upset about it. (Here, here, and here are some recent news stories about it.) Well, they should be! How can anyone afford healthcare, especially without insurance?

But wait! Why do insurance companies raise rates? Profit, of course! But they also do so to compete with the cost of the healthcare they ultimately pay for if you get hurt. The total bill that an insurance company (or an uninsured individual!) receives for emergency medical care can be staggering. While most bills really aren’t this high, some can easily total $50,000 to over $1,000,000 for one hospital visit!  It shouldn't cost a year's salary (or any multiple of it) to get urgent medical care.

While most bills won’t be that high, a simple visit to the ER, regardless of what treatment one receives is almost certainly an instant $500 – or more - bill. One reason for this is to entice the injured to seek out other sources for their care, unless an ER visit is absolutely necessary. The basis for this is the hospital doesn’t want to have to accept every individual who needs help; they would be inundated by too many cases to handle efficiently. If someone can receive care at another, non-emergency facility, then it is for them to receive it elsewhere.

However sound that logic may be, setting an arbitrarily high fee for a visit is not the way to handle it. The reason for this is sometimes people don’t have another option. For example, they get hurt late at night, and an urgent care center (as opposed to an ER) would surely suffice for them to receive appropriate treatment, but at 2 in the morning, there are no urgent care centers open, so their only option is to wait it out, which could potentially be worse, or go to the hospital ER.

Instead the hospital could open up an adjacent UCC, and have that operate 24 hours like the ER, with one centralized triage process. Those patients who need immediate emergency care can be shuttled to the ER, and those who don’t can be directed to the UCC. From there, charge a nominal fee for triage (so the bottom line doesn’t suffer) and you have your solution to the over-crowding issue. Why isn’t this already done? Doctors don’t like working nights (hence the not-open-late-UCCs)? Hospitals don’t want to invest in infrastructure that would actually decrease profits (despite helping the general public)?

Let’s segue into the next point about why medical care costs so much. Doctors (and facility administration) have big paychecks. Why? Because they provide an important service. Surely that’s true, but then, so do teachers, firemen, policemen, etc. Teachers in particular are important, for if it weren’t for them, we’d have no (well trained, educated) doctors! But the pay for teachers is for another discussion… Back to doctors, another reason they make so much is offset the cost of their education. (Wait, is that another conversation about teachers coming back???) Doctors, especially emergency doctors, also deal with a great deal of stress that many would not want to be burdened with, but does lots of money really help offset that? Does a nice, fancy car and nice, fancy house make failing to save someone’s life that much more tolerable? And counter to the stress, does successfully saving a dying patient not reward the doctor? Bottom line here is that being a medical anything is a respectable and worthwhile career, but how much do you really need to compensate for it?

Another cause for excessive medical bills is the equipment and medicine used by the hospitals. Medical facilities have minimal control over the cost of these externally supplied resources, so the trickle down goes to the manufacturers of said resources. There are, of course, a number of factors that increase the cost of these goods, such as R&D, manufacturing and shipping costs, and employee compensation. As part of employee compensation, executive compensation also comes into play. (Here is a single source listing of executive salaries from 2007. There are more out there, so look them up if you want to see.)

Some of these individuals make so much money in one year that unless something seriously changes, most Americans will not earn this in their lifetime. With some quick math (of course hypothetical), if an individual works for 50 years before they die/retire, starting at $10.00/hr, and accounting for no increase aside from 3% cost of living increase annually, that individual will have only made $2.3 million in that time. Someone starting at $15.00/hr with an annual 5% increase will make only $6.5 million in that time. The top 9 from that list linked to above made about double that in one year. (More on executive pay later…) With so much money being made/paid to individuals, wouldn’t one think that the excess profit can be reduced in order to help the greater good? To add to that, if costs came down, those who choose to forego medical care/pharmaceuticals due to the cost may actually start to buy these products, and these companies may see an increase in sales. Maybe not, but what’s the harm in helping people get access to care they need?

Lastly, there are just some interesting charges/fees for things that just don’t make sense. $800 dollars for an overnight stay at a hospital? This is not five-star quality. And yes, there are people who monitor patients and drugs may be given blah, blah, blah, but those ‘extras’ are also billed for in addition to the room and board fee. That $800 covers just the room and board. What about little things like $8.00 for a gauze pad, when Walgreens will sell 25 of the same pads for a whopping total of $8.00. And worse still, $100 for a few pills of ibuprofen?!? CVS sells bottles of 1,000 pills for $20!! And while the hospital variety may be more potent, surely the difference can’t be that great, otherwise it’d kill you.

Sure we need healthcare reform, but not health insurance reform. Government subsidy of insurance would just lead to an increased cost of care, because those supplying the goods and services will nearly be guaranteed to be paid - out of all our pockets. What we need is to get control of the profiteering on the part of those who provide the goods and services themselves.

Wednesday, February 17, 2010

RSVP

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Répondez S'il Vous Plaît

It means 'please respond'. Don't believe me?

Proof.

There.

If you receive an invitation to some event, there is often a request for an RSVP. If there is one, you should respond. Even if not, you should reply just the same. First - for just general courtesy - if someone took the time to invite you, take the time to tell them if you accept or not. Second, often an RSVP will inform those planning whatever event that they need to be prepared for x number of people, then they will make sure to by food for x number of people. If you don't get back to them, they have to guess how many x will be and there might not be enough food and drink, or there may have been too many seats booked, costing more money. If you are courteous enough to respond, do what you say you will do; if you say you will be there, then you should show up, if not, then don’t!

Thursday, February 11, 2010

Verizon Part I

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For those who haven’t heard, Verizon is now implementing a charge for all but the most generic phones in their offering. The charge as described by Verizon is for a data plan, which “gives customers quick access to Mobile E-mail, games and the Internet.” The plan costs $9.99 per month (in addition to what you already pay, unless you currently use a data plan by choice) and covers 25MB of data transfer. As just stated, if you happen to already have a data plan that you pay for, this won’t matter to you, since you already chose to pay for it. But what if you don’t want to pay for these services, or more precisely, what if you don’t want to USE these services? Verizon says, ‘too bad.’  The options you have are:
1. Get a decent phone and pay the service charge.
2. Get a “Simple Feature Phone” (see more below) to avoid the charge.
3. When your contract is up, leave for another provider.
4. Leave now and pay the early termination fee for ending the contract ahead of schedule.
If you have only recently upgraded your plan and you were not already affected by this change, then you should be good until your contract is up, or your phone breaks. As it turns out, VZW will also be forcing this charge if you upgrade replace your phone if it becomes damaged. This includes replacing a phone that you bought 6 months ago with no charge added, with an identical model.
However, if you choose to downgrade to a “Simple Feature Phone” to avoid the charge, you are soon to be discouraged. There are only 3 (of 16) phones listed at the time this was written that have a QWERTY keyboard. There are only 5 phones listed that have a 2.0 megapixel camera; none have anything higher, while many have none. Only 1 has a user rating higher than 4/5. Of course, none have a touch screen. Some of these little additions are not for everyone, and the SFP categorization is actually fairly accurate. But that’s what you get if you don’t want to pay the charge.
If you do want something a little more snazzy, pony up. You want a decently rated QWERTY phone or anything else listed above? You’re going to have to pay for it, but you will do so indirectly. You will not be paying for the extra features that you are looking for with the $9.99 charge (you will be paying for it with an increased phone price, but that is what is expected). Instead, you will be paying a fee for a data plan, that has nothing to do with a touch screen, QWERTY keyboard and the like. It is for browsing the web and retrieving and sending email. Verizon has taken the stance that if you want to do that, then pay for it, if you don’t want to do that, they pay for it.
There have been a few disgruntled customers out on the web who have wonderfully analogized this situation as follows: This situation is the same as if your cable company charged you for HBO, because it was a feature available through the cable system, even if you never watched it, and told them you never wanted to watch it. Just because the availability is there does not mean every customer wants or is going to use it.
From Verizon’s community message boards, many unhappy customers are reporting that they are sending letters to VZW Execs, and getting responses. In most cases, it seems the response is empty, but it is something. I have actually considered this myself, and if that happens, I will be posting the letter and any responses that come. If not, I’ll still be updating the blog with any new news about it. Why? Because when I search for anything related to this issue, I have trouble finding much of anything in the way of public exposure. Most of the search results are either simple press-release-type descriptions of Verizon’s new business plan, or else message boards with angry customers.
Stay tuned…

Update from feedback:

A smart phone is designed to use the data package and paying for the data package makes perfect sense. When the Droid was released, it came with a required data package. That's fine, because that is a phone that people will buy for that reason; part of the draw to the Droid is that it is a super fancy phone that has advanced capabilities that most phones don’t have.

But I am not talking about those phones. I am talking about the phones that have a built-in capability to access the 3G network Verizon offers, but the functionality to do so is not the main drive behind the phone's particular design. Take the LG enV3, for example. It is NOT a smart phone, but it has a lot of nice features. Verizon will force the data plan for this phone. The problem with this is that on December 1st, anyone could have purchased this phone without the service charge. Assuming someone did just that, but today the phone broke and they have to go and buy a replacement. Now suddenly, even though the phone would be replaced with the same exact model, they have to pay the $9.99 service fee. Why, if they didn't have to before?

Monday, February 8, 2010

Space

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We need to go to space, if not physically, then at least in spirit. It is going to be a LOOOONG time before we will put a human on an extrasolar planet, and I of course do not expect to see this in my lifetime. It's so far out there, that I will venture to say that (at least at this moment in the history of mankind) traveling to a non-neighboring planet should not even be considered. However, we can do so much with what we have, and with what is within reach, even if only to robots, satellites and the like.

With as long as we have looked up into the sky and imagined what is 'out there,' now that we have better technology than ever before, it seems very few people even care about the 'out there' anymore. Sure, there are hobbyists and a few wondrous minds still out there, but the lack of news coverage regarding new exploration and discovery, and hence the lack of public awareness, is saddening. What was the last news you heard about our lost planet Pluto? Here's some new stuff, for those who haven't heard...
NASA
NASA
NASA
NASA

I don’t think I have an opinion on the specific course NASA is taking (by choice or otherwise) other than whatever the plan ultimately is, it can’t change every 3 years!


There is sooooo much more to say on the subject, but for now, I'll end on this. Look up something about space. You won't be disappointed.

Tuesday, February 2, 2010

Customer Service

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How many times has this happened to you? You enter a business - let's say a restaurant - to buy some goods or services - in this case, a hot meal with service - and immediately you are greeted by a rude, tactless, unhelpful employee. How dare they, right? You are coming to give them your hard-earned money! This is obviously uncalled for and there is no reason for any of their behavior. Of course, a good, well-trained representative of this restaurant would be able to control their actions and force a smile for all to see without any second thought. Now when this happens, what do you do about it? You are rude back, you tip poorly, or perhaps even take it up with their manager. NOW they'll have something to be grumpy about, won't they?

But wait! What good is that going to do? Let's take a few steps back to before your entry into this fine dining establishment. Let's go back to the moment the employee walked in the door. Here, we have a happy, eager-to-work person ready to get their work day going. Then, unexpectedly, their cell phone rings and they answer. They've just been informed that their favorite grandma from out of state has just suffered a heart attack! Now, there's no point in leaving, as grandma lives 4 hours away by jet, plus she's stable now. So now our somewhat-less-perky employee continues their day, but now can't wait for the end of the day to come. While getting their first order out of the kitchen, they slip and drop a whole order all over the floor. This is rough enough, but add it to poor old grandma, and today is starting to look like the pits.

Now let's move back up to your service. You decided to make their worse, remember? Now, the next person they serve after you will receive the same or worse service, and so goes the rest of the day. Despite constant attempts, the employee is unable to bring themselves out of that hole. In the end, this resulted the employee having the worst possible day, given the beginning circumstances, and it resulted in your dinner and everyone else's after yours to be a disappointing experience. You sure told them, didn't you? With your lack of tip and rude behavior. You made it all worth it, didn't you?

So, what if you had chosen to not be overtly rude? What if you had instead remained pleasant yourself, and engaged the employee at least enough to let them know you consider their service to be worth more than a doormat? Now the employee, despite other earlier issues, begins to start looking up. In turn, they work each of their other tables just a little bit better, and in turn, the other patrons continue the trend. This time, who benefited? You? Maybe not quite as much as others, but sure, it ended better than the first scenario. And who else? Both the employee and all the later restaurant guests! The employee perhaps ended up with more in tips, and all the other customers ended up having a slightly better experience. How is this all a bad thing?

Much of the responsibility lies in the hands of the employee providing customer service, but that doesn't mean it's all on them. It is also the customer's job to not make the employee's job harder. How would you like it if someone came in to your place of business (even if not a customer service job) and started intentionally making your day worse? What if you were alredy having a bad day to start with? It would ruin your day, wouldn't it? Now, by no means am I saying that 'the employee is always right,' no, sir. If our same employee from above was being inattentive to their guests and spending more time with their buddies than helping customers, then be my guest and lessen their tip and complain to their manager. But be receptive and notice if the employee is just a slacker who couldn't do a good job to save their life, or if they have something else going on that may be out of their control. This also covers new or training employees! It's not their fault they don't know what they're doing yet - that's why they're training!

Market Research

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Recently, I read a news article from CNN (I don’t frequent CNN or any other specific news source. I browse around and cherry-pick articles.) and came across a poll for something mostly revolving around the Obama Administration. Being that I used to manage the data collection part of the polling process, I was interested.

I looked over the article, then began to peruse the user comments. Almost immediately I came across a user who did nothing but complain about the validity of the study. Again, being that I used to manage the data collection part of the polling process, I was interested.

Here is the article, and here is the comment from it:

“I just want to say, that regardless of what this poll says, it is wildly inaccurate. They only surveyed a sample size of 1,009 people, which by NO MEANS represents the millions that live in America. Where are the people from? How old are they? Also, a sampling error of plus or minus 3 percentage points is beyond terrible. Studies aim to be within 1%, and in the scientific world, this study would be dismissed due to its large inaccuracies.”

In response to that comment, I give you the rest of this post, some of which is in argument with the comment, some is in agreement, and some I feel is just clarification. The following wraps up a conversation had with a coworker about this and does not necessarily flow logically immediately from this point. I apologize for that and may correct a bit later. Until then, enjoy.

RESPONDENTS

In addition to the fact that they are ranting about something they know nothing about, I am willing to bet they are the kind of person who would yell at us when we call. The reason I bring this up is this: They complain about how the 1,009 interviews does not constitute a proper sampling of the millions of Americans out there, and I gave you my argument as to why that assumption is invalid. However, they are technically right, but not for the reason they think they are. The total number of completed interviews (down to a certain point… 10 is not really a valid sample) is going to be representative, assuming a proper regional breakdown. However, there are still more factors to improve the accuracy, such as making sure to interview 500 Repubs and 500 Demos, which for SOME of the CNN surveys we actually did. That was a nightmare to manage, but we did it.

There are also other factors that we have only the TINIEST amount of control over; namely, getting people to do the survey. As I stated above, I’m willing to be this person would not wait for us to say ‘hello’ before they hung up on us, which is fine; that’s their choice. However, when a multitude of respondents do that (as is always the case) you start to get a ‘hidden’ alteration in the data. In other words, the answers provided by those 1,009 respondents do NOT represent the whole population of America, rather, it very well represents the population of Americans who are either willing or easily persuaded to complete telephonic interviews. If that person wants to complain about the validity of ANY survey results (not just CNN or whoever) they need to first take responsibility for the opinion of the American people by providing their input and adding their voice to the chorus.

MARGIN OF ERROR

NOW – with all that being said, I have yet more to say on the subject. This next part involves more about the respondents who DO complete the survey. Now, the person who made the comment about the CNN poll was complaining that a 3% margin of error is unacceptable, and that is somewhat true. Remember, we targeted 2% or less when I was in charge of the study. But for your information, in case you are currently unaware, the ‘margin of error’ comes from not actual ‘errors’ but respondents either not answering a question, or replying with a ‘no preference’ or ‘I don’t know’ reponse. When I was running it (though I cannot speak for the current job, I assume it is similar practice), we trained our interviewers to terminate the calls prematurely if a large portion of the answers were these types. One or maybe two in a survey is reasonable, sometimes people don’t know, but once they hit 3 in a survey, it was to be ended. Some people like to mess with pollers by giving bad data. Even worse, some will knowingly answer the Qs with bad responses. To that, I go back to the end of the last paragraph, wherein I call for the people of America to take responsibility for the results of these polls.

Back to the margin of error, we terminated calls that hit 3 DK responses, but what if they only had 2. Well, in a survey of 50 questions, that leads to a 4% error rate! It is VERY difficult to master a 0-0.5% error rate. Either you have to have a complete survey of over 100 questions and only accept those with 1 or fewer DK responses, which would be so stupid to manage, I’m not even going to go into the details, or you would have to complete many more surveys than your original sample requires in order to remove those interviews which have DK responses. In both of these cases, by doing ANYTHING outside of a direct polling would result in invalid data. Now, would you prefer the pollster had a 3% margin of error, or would you prefer a 0% margin with potentially important opinions being censored?

SURVEY BIAS

And LASTLY, I do have beef with the CNN survey itself. There is a certain way that CNN chose (chooses) to word certain questions, which I feel biases the answers given. Having taken Linguistics courses, I know the name of such questions, but not knowing the name, the error should be obvious. However, when I brought my issues up with management, project management, and other senior leadership, I was basically told ‘oh well’. Here’s the problem: Do you see a difference in the following two questions? Before moving on to the next paragraph, really study these next two lines.

(1.a) Do you feel Obama is doing a good job, or don’t you think so?

(1.b) Do you feel Obama is doing a good job, or do you feel he is not doing a good job?

Before I describe which one is invalid (whether you’ve figured it out on your own or not), I will explain the linguistics of the dilemma. In some languages (we’ll focus on English, of course) there are things called ‘tag questions’. These are questions which ask a question, then add to the end of that question, a phrase which indicates a desire of the answerer to respond a certain way. From one of the true authorities on the field of linguistics, SIL, the definition of a tag question is as follows: “A tag question is a constituent that is added after a statement in order to request confirmation or disconfirmation of the statement from the addressee. Often it expresses the bias of the speaker toward one answer.”[1] I would like to reiterate here the last sentence, “Often it expresses the bias of the speaker toward one answer.” Now look again at the two versions of the questions above and compare to the following two, which have simply been reworded, but reflect the same meaning as the original:

(2.a) Don’t you think that Obama is doing a good job?

(2.b) Do you think Obama is doing a good, or a bad job?

Do you see the bias now? By the way, here’s a very cool website cataloging a good number of polls over more than a decade. Here is a search of that site for the horrible CNN Tag question suffix “or don’t you think so?”

Source:

[1] SIL - Tag Questions

Monday, February 1, 2010