Tax Reform? Hardly…

I just read this great line describing tax reform (vs tax cuts) in HBR

The idea of tax reform is to try to avoid these broader political and philosophical conflicts. Tax reform advocates start with a framework in which the amount of tax revenue raised and the distribution of tax burdens are held roughly constant. This does not suggest that the current levels of revenue and the tax burden distribution are necessarily optimal, but does suggest a willingness to work within the larger parameters established by the political system.

Tax reformers focus on improving how we raise a given level of revenue. They seek reforms that treat people more fairly by imposing the same tax burdens on people with equal ability to pay taxes, by reducing distortions that cause businesses and households to make inefficient decisions, and by making it as easy as possible for taxpayers to comply with tax law and for the IRS to administer it.

I nearly laughed out loud reading it.  If this is what tax reform is supposed to be, Republicans and Trump have ZERO interest in tax reform.  Their primary consideration is how much money they can such out of everyone else to redistribute to those who are already absurdly rich.


Support Net Neutrality!

Today, July 12, is an Internet-wide day of action to support net neutrality.  Net neutrality is the principle that keeps telecoms from using their dominant power to discriminate against what you can see, share and do on the Internet.

Take a few minutes to let your representatives and the FCC know you support net neutrality and want to keep an open, fair Internet for everyone.

Battle For The Net Video Bumper from FFTF on Vimeo.


A good editorial on the idiocy and lies about passing #Trumpdontcare.

News Technical

Silly Comcast!

Here is a great exchange about Comcast lying to local city officials in Colorado about their service versus a competitor.


Herd Immunity

Herd immunity is a key component of public vaccination campaigns that keep everyone healthy and safe from preventable diseases.  538 did an article on this topic recently, and included a reference to FRED.

FRED is pretty interesting.  You can pick a location and view the impact of a Measles case over time.  With an 80% vaccination rate, measles cases soar.  With rates of >95%, though, a case doesn’t spread.  The importance of high vaccination rates is pretty clear.


Response to Hospitals Are Dramatically Overpaying for Their Technology

HBR had an article that’s stuck with me all week about interoperability standards in healthcare technologies. They give a poignant example of how interoperability affects the delivery of care.

For critically ill patients on breathing machines, a simple step drastically improves their survival chances by almost 10% — from 60% to 70%. It involves programming the machine to deliver enough life-sustaining breaths, but not so much that it damages their lungs by overinflating them. Given that this intervention could prevent more suffering than many wonder drugs, one would expect that there would be zero market for a breathing machine that didn’t make lung-preventive ventilation as easy as possible. But in health care, few things work as expected. Fewer than half of patients, and in some hospitals fewer than 20%, receive this life-saving intervention.

One big reason why is that hospitals purchase technologies without requiring that they communicate with each other. The optimal air flow is based on a straightforward calculation using the height of the patient. Height data, however, resides in the electronic medical record, which typically does not communicate with the ventilator. As a result, physicians must retrieve this information from the medical record, perform the calculation (sometimes on paper), and enter the order. A respiratory therapist then takes the order and types it into the ventilator, often relying on memory.

Their primary recommendation is to have hospitals use their purchasing power to force vendors to improve interoperability.  Which this is a laudable goal, working at a major academic medical center I can see the challenges with that approach that would need to be overcome.

Power (and by extension funding) is often very diffuse, spread between different management structures.  In a more corporate environment, purchasing can be empowered to negotiate deals that embed certain requirements.  In our environment, on the other hand, different equipment can be purchased through different mechanisms.  Some items may be funded by the institution.  Other equipment, though, may be acquired through government grants, non-profit and private donations, or research contracts with private industry.  Because the processes, rules and ownership vary depending on the funding source, leveraging procurement to force this kind of interoperability is a significant challenge.

The recommendation needs to be further developed to address this type of structural challenge.



Internet Day of Action: July 12, 2017

July 12, 2017 is set to be a day of action to protest virtually in favor of net neutrality.  See more here.


BIAPA Notice: Now is the time to let our Senators know about the potential impact of cuts to Medicaid in the American Health Care Act

Below is a message from the Brain Injury Alliance of PA.  Please offer your support!

Action Alert:Now is the time to let our Senators know about the potential impact of cuts to Medicaid in the American Health Care Act

The American Health Care Act (ACHA) proposes significant cuts to Medicaid.  The proposed per capita caps and cuts will have serious consequences for individuals with disabilities and seniors.  The Senate is currently writing the bill, so this is the time to communicate with our Senators to educate them about the potential impact and what it means to you personally.

DC Rally:

BIAA is co-sponsoring a Don’t Cap My Care Rally on June 6th at 11:30 am with Senator Casey (PA), Senator Van Hollen (MD), Hon. Tony Coelho, and other members of Congress. The rally is at 1st St SE & Constitution, across from the Supreme Court.

This rally was organized on short notice, and we encourage you to attend if you’re in the DC area or able to travel there, but it’s not the only way for you to participate as a brain injury advocate on that day.

June 6 No Caps Call-in Day and Social Media Action:

June 6th will also be a national call-in day and day of social media action focused on opposing Medicaid caps. You can download the Day of Action toolkit, compiled by the Consortium of Citizens with Disabilities which BIAA is an active member of, with information about calling in and social media (primary hashtag #SaveMedicaid and secondary of #NoCutsNoCaps).

One more way to help: Share your story

Senator Casey, one of our senators from Pennsylvania, shared that his office is collecting stories of how individuals with disabilities lives have been improved because of Medicaid. If you would like to send your story to Senator Casey, please email it to

As always, thank you for your advocacy efforts on behalf of individuals with brain injury and their families.  Your voice is important.


Beware the Bots

HBR had an article today about how bots will help us become better versions of ourselves.  My overarching questions reading through the article is, will the bots really make us “better” versions of ourselves or just drive us toward some sort of homogeneity?  The underlying bias in the article, especially around management behavior, is that there is some sort of platonic ideal that bots will help us achieve.  Is that really true?

News Work

Two HBR Articles: Perspectives on Gender in the Workplace

HBR a few weeks ago had two interesting articles on gender in the workplace.  The unconscious biases highlighted in the VC funding article were eye-opening to me given that this occurred in what I perceive as a progressive northern European country.  The second article is a nice reminder on silly sex segregation ideas that just don’t go away.