Today in Technology December 6, 2013

  • Why Your Kid Will Never Ask You for a Stereo
    Getting “a good stereo” was one of those rites of passage into adulthood when I was young. You got your own place, and the stereo was usually the highest priority after a bed and things to make food with. Sometimes higher.

    No more. The stereo, the boom box… Dead. Over. Gone the way of the transistor radio. As this (politically incorrect by American standards) ad I saw in a French subway station says:

    Image: Ad for Beats Pills bluetooth speaker by Radio Shack (it gets better — or worse — so keep reading).

    Nowadays, it’s all about mobile and bluetooth. Bottom line: a portable bluetooth speaker is what your kid will want for Christmas. And you should get one too. Your kid will think you’re cool(er). These speakers are the must-have, 21st-century device for playing music. No muss, no fuss, you simply take it wherever you go, send the music on your mobile device to the wireless speaker via bluetooth and — instaparty. You can use them at home too, to play the music on your computer and other things, which I’ll go into later. There are tons of bluetooth speakers out there, with a wide range of sound quality, features and aesthetic appeal (mostly lack thereof, if you ask me).

    I became a true believer just a few weeks ago in a Swiss train station…

    Across from me in my train to Lausanne were two handsome, well-dressed men talking tech in English. So of course I eavesdropped on the whole conversation, being a tech blogger and lover of serendipity. And handsome men.

    As we got off the train, I smiled and said to Handsome #1, “You never know when you’ll be sitting across from a tech blogger in a train in Switzerland. So whatcha got?” At which point he smiled back gorgeously and opened his dufflebag to produce a cute and curious object. I never get excited about gadgets, but for some reason, I found this one very appealing, and I’m sure it wasn’t only because of the adorable retro elephants… Seriously, though, I’m a sucker for good design, and the object he was holding (the UE Boom), definitely had that delectable Euro high-design look to it. In a word: #class.

    2013-12-06-UE_BOOM.jpg

    Image: Rory Dooley, Senior VP Ultimate Ears, holding the limited edition “Tippsy” model UE Boom featuring cover design by Jason Maloney.

    Then Rory placed the object in my hands… The look of the gadget had already piqued my interest, as you know. Holding it, I could feel the quality; it was solid, but not too heavy to carry in my purse. And handling it was a tactile delight, thanks to the texture of the unique material covering the speaker and the attractive and functional rubber strip that runs the length of it.  Rory took out his iPhone, tapped here and there, and suddenly my hands and the entire station were filled with rich, loud sound. It turned heads. It was awesome.

    I’d heard and held a bluetooth speaker for the first time just a few months before this. It was light and flimsy and had such tinny, weak sound quality that I dismissed the whole concept. At home, I AirPlay the music on my iPhone through the set-top box to my TV (which is connected to “the good stereo”). I sometimes listen to music on my iPhone with my earbuds when I’m out and about. But at my age, I couldn’t really see myself needing one of these toys; it’s not as if I often feel the need to pull a speaker out of my purse and start an impromptu rave in a park in Paris…

    Since Switzerland, however, even if I don’t hold a flash rave, I can see myself taking a bluetooth speaker on a picnic. Or to the bathroom for a long, hot soak (I’ve lost more than one pair of earbuds to the tub). Or into the basement if I need to be digging around in there for a while. Or on the road to use in my hotel room. Or to the house of my friend who had the sucky bluetooth speaker. Endless possibilities, as you can see.

    Unfortunately, gadget-makers seem to be unaware that women buy tech.

    I know one of the reasons I’m not into gadgets is that they’re generally just too dude. Too butch. Too ugly! Manufacturers of gadgets seem to completely disregard the WAF (“Woman Acceptance Factor” on French and German wikipedia, but “Wife Acceptance Factor” on the English one, hello #everydaysexism), and the fact that we spend tons of money on tech and toys.

    We are essentially invisible to them. In an article I wrote here not too long ago, I touched on the fact that “women’s” magazines neglect tech, and that tech journalism neglects women (although Mashable has come a very long way in just a couple of years, to become my favorite tech lifestyle blog). And just the other day, in The Guardian, I read Women’s magazines ignore technology and demean women, which expands on the topic of the glaring absence of tech in women’s mags:

    Women spend more on smartphones than men, they spend one and a half times as much on technology and influence 57% of new technology purchases. The glossy mags have yet to acknowledge that women are now fully involved as technology consumers.

    It’s easy to see who the target for bluetooth speakers is if you look at the marketing: it’s the 18-35 year-old male, of course. But makers of tech toys need to wake up, which the Atlantic article Sorry young man, you’re not the most important demographic in tech makes crystal clear: “it actually turns out the majority of technology users are women in their 40s, 50s and 60s.” (Hey, that’s me! Hear me roar! We are here!)

    Imagine how much adopting we’d do if these companies actually acknowledged our existence…

    And also, gadget companies, you need to reflect on the implications of the 36% of young adults ages 18-31 living with their parents (Pew research study, August 2012). Mom is present. Mom is paying attention. Mom should be your sweet spot. Or at least one of them.

    Even more unfortunately, gadget-makers seem to be unaware that women are people.

    Now, before you write me off as some frigid, man-hating prude, please note how this article began. But I have a bone to pick with the people marketing these gadgets. So to speak.

    Let’s take a look at Beats Pills from the boombox ad above, for example, and their lingerie-clad babes with open mouths and large red cylindrical objects, etc.:

    2013-12-06-beatspills.jpg

    2013-12-06-beatspills2.jpg

    I don’t really need to comment, do I? Didn’t think so. And guess what else, Radio Shack? Your “#uwantit” hashtag promotes rape culture and I’m #notbuyingit.

    (Who the hell raised the boys who are making these ads? Do they have daughters? Would they watch their own garbage with their little girls?)

    I was dismayed to find that the UE Boom campaign targeting the US market was worse… The premise for this series of videos was that music can start a party anywhere and do other things for you, including “get you laid.” But in the “Can music start a party anywhere?” video (I didn’t — couldn’t — watch them all), it was less about the music than it was about the — how should I say this — set decoration…

    In the video the shots below were taken from, UE leaves the realm of metaphor altogether and unabashedly instrumentalizes women. In the first image, some guy is essentially using a thong-and-wet-t-shirt-wearing woman as a device to clean a windshield.

    2013-12-06-uewindshield.jpg

    In this next shot, it’s pure, gratuitous objectification. This poor girl, a gadget herself, rather than a human being, is doing what I can only describe as a spread-eagle handstand twerk in some guy’s face. (I’m sure there’s an industry-specific term for this move, but I don’t know it). In a laundromat. And there was a kid in that laundromat, a boy of about 11. What are you teaching little boys? Shame on you. And what, pray tell, does any of this have to do with the quality of your speakers??

    2013-12-06-uetwerk.jpg

    UE was somewhat redeemed in my eyes, however, by its European marketing, which takes a radically different tack, with a nice young man who goes around doing things like getting seniors to sing and make beatbox noises while he plays his Boom. The more people he can get to play along, the more points he gets. Again, #class.

    2013-12-06-uesenior.jpg

    (These two video campaigns emphasize some drastic cultural differences between the US and Europe… America, it looks like you have some growing up to do. And some manners to learn.)

    Sex sells anything, quality sells itself

    Ultimate Ears may not have had women or their tastes in mind when they designed their lovely gadget, but they do have an Italian woman designer doing the color design. Despite the demographic their website clearly targets, their product has wide appeal for the same reasons that Apple products do: looks, quality, class. I’m sure the brand will ultimately benefit from having had the guts to break out of “the boy’s row” and create an object that appeals to discriminating people of either gender and all age groups who have good taste and demand quality.

    Now if only they’d fire that “music can get you laid” guy (and give someone like me his job instead).

    What can we do?

    Should we buy products whose advertising denies our existence or even treats us all like blow-up dolls? Probably not. But how do we make our objections known without denying ourselves things we may want or need? The boys aren’t going to change their puerile ways if we leave them to their own devices… That’s why organizations like The Representation Project exist, and why we should support them.

    I admit I want a UE Boom. It’s the only gadget other than the iPad mini that has ever made me drool. It’s the only portable bluetooth speaker you can use in stereo: get two of them and turn them into a pair of speakers using their iPhone app. It’s the only one that can be used as an alarm clock (after that party in your hotel room, you can set it to wake you up with a song from your phone or your preferred streaming service). And it’s the only one featured in this year’s Apple gift guide (which tells me I do, indeed, have a good eye). If you want more details, the ladies at ChipChick did a nice review.

    Chances are I’ll get one. Or two. But if I’m going to be a sheep led to the consumerist slaughter, at least I won’t go quietly. Both of those handsome men will read this article. And lots of other people too…

  • You Will Be Mesmerized By These XBox And PlayStation GIFs
    As much as the consoles change, the controllers really stay pretty much the same. These hypnotizing GIFs from the folks over at Gadget Love prove it.

    Many gamers will remember the monolithic controller of the original Xbox that shipped with the system in 2001. Microsoft slimmed it down for Xbox 360 and the current Xbox One version features only incremental changes. These include a more responsive D-Pad, better textures and grip on the analog sticks, and impulse triggers that feature unique vibrations.

    PlayStation on the other end, made their biggest jump with the PlayStation 4 controller since they introduced the DualShock controller during the original PlayStation’s run in 1998.

    Unlike the Xbox — which axed the black and white buttons and added the left and right bumpers — the PlayStation’s buttons have remained uniform. For the PS4, Sony’s biggest addition was the multi-touchpad along the front of the controller, with smaller things such as a headphone jack for quieter late night gaming sessions coming as welcome tweaks.

    And Nintendo…well who can keep track of all those controller changes?

  • The Bright Side of Telephone Metadata
    Since the exposure of the NSA’s data collection tactics, telephonic metadata has become an unlikely star in the popular press. The Verizon order leaked by Edward Snowden has prompted a critical public education about how much can be learned from the information routinely recorded by our phone companies. But the same data currently playing a sinister role in national security surveillance is also fueling a wave of new research that will help international aid organizations save money and lives.

    Global Pulse, a United Nations initiative, recently released a primer showing how cell phone metadata about the placement of phone calls and the location of the cell phone user can be mined during periods of crisis. A leading example comes from Haiti. When the devastating earthquake hit Port-au-Prince in 2010, cell tower geo-location data created a more accurate record of the destinations of evacuating city residents than the estimates of the Haitian government. Moreover, the destinations of the fleeing residents could have been predicted in advance: when disaster strikes, people go where they have social networks, and their social bonds are revealed through calling patterns that preceded the disaster. Thus, with some rudimentary network analysis, aid organizations can figure out where to send help before the emergency migrations are complete. Metadata can get the right amount of aid to the right places, faster.

    Similar studies linking calling network data to migration patterns have been used to track the spread of Malaria in Kenya , and to validate Mexico’s containment efforts during the H1N1 flu epidemic. So far, the research has been retrospective, but in the future cell phone data could be used to control the spread of disease in real time, with as few restrictions on mobility as possible.

    Cell phone metadata also can be used as an indirect measure of a community’s economic health. A 2010 study of UK cell phone data confirmed that areas placing and receiving calls from more diverse geographic locations are more prosperous, and have more economic opportunities. Knowing this, humanitarian groups can use aggregate calling patterns to monitor an area’s financial security. They can also gauge whether development efforts in a particular region have worked.

    These promising programs are a helpful reminder that mass data collection can be used in socially desirable ways, and that the NSA is not the only institution with an interest in this data. Of course, Global Pulse’s data mining differs from the NSA’s in one important respect: traceability. Cell phone metadata prepared for research purposes has been de-identified, and researchers are usually obliged to refrain from re-identifying any of the subjects. In contrast, the very goal of criminal and national security investigations is to identify, and possibly seize, the subjects of investigation. But the larger implication of data-driven humanitarian aid is that data collection is not inherently bad.

    Global Pulse’s projects are antidotes to the tired parade of New York Times articles generically criticizing modern data collection practices. Productive discussions of data policy should not attempt to reverse the ever-increasing reserves of data that accumulate in modern life. Instead, since data continually surprises us with new uses and insights, information policy should align incentives to increase socially valuable uses of data (like the ones described here) while decreasing uses that lead to adverse consequences.

  • Tweet vs. Weeb: Twitter Valued 3x China's Weibo
    We all know what a Tweet is… so what’s a Weeb? Weeb is my term for what people in China are doing on Weibo, the Twitter-like service for Chinese.

    For those new to Weibo it’s pronounced “we bow.” But does Wall Street? Bow, that is. Not yet it seems.

    Let’s take a closer look at each, especially in two ways: 1) what they mean for media and 2) the value compared to each other. How they stack up on Wall Street among investors.

    When I first went to China in 1998 there were 6 million people online — in the whole country, and most of them were government researchers or university students.

    Today there are about 800 million, many connecting via mobile.

    Most of them are Weebing or using something similar using other services from Tencent or others. But my focus is these two head to head: Twitter vs. Sina’s Weibo. Twitter (NASDAQ:TWTR) went public last month and has had a rollercoaster ride so far but up significantly from its $26/share pricing.

    First off, I think the short and snappy bleating (the goat sound) both do is the future of media and marketing. The world of Information is free and accelerating. I also see the short form media becoming more widespread vs. the TV/radio/newspaper formats. I Tweet, therefore I am… all in 140k, or less.

    Point two, how do these two compare in valuation? Investors value a Tweeter more than 3x that of the Weeber. The interesting thing is that both companies have about the same level of annualized sales if we take the most recent quarter and annualize it.

    Let’s go to the tables and charts, made with painstaking care:

    2013-12-06-twtrsinatable.png
    (all $ in millions, except market cap ratios)

    Note that Weibo is only a part of Sina (NASDAQ:SINA) but for sake of value it only emphasizes the gap even more with Twitter. All of Sina is valued about 80% less.

    I don’t own shares of either company. In terms of market I believe China’s consumer and ad market is very attractive. Income is growing in China, people are buying gadgets and cars. Just ask any commuter in Beijing stuck in traffic with their smartphones.

    We are entering the micro-media age. Welcome. Or should I just say ;)

  • In the Throes of an Inflection Point
    “The jobs are not coming back,” said Steve Jobs, former CEO of Apple, to President Obama when asked about why Apple products cannot be made in the U.S. It was a dramatic moment: cold reality had just reverberated at the highest level. Everybody already knew that the U.S. economy had been hemorrhaging manufacturing jobs since the early 2000s. It was alarming to hear that high-tech has also been following suit. And once they go, it is hard to bring them back. It is a lose-lose situation. We are not only losing the jobs, but also the accumulation of expertise, which may otherwise have led to other innovations.

    The invention of the printing press and injection moulding gave rise to a few great works of literature as well as affordable furniture and appliances for the masses. Today we are in the throes of another inflection point in the ease of materializing and exploiting new ideas. The global proliferation of the Internet and mobile computation devices has brought about cloud services, mobile app stores, and crowdfunding. It is now possible to go from ideation to prototype in a few days and sign up paying customers before building products. All one needs is a new idea, the will to create and enough domain knowledge to get the ball rolling.

    For instance, you could have an idea on a Friday afternoon, throw together a quick prototype of the interaction model in AngularJS or JQuery that evening, get a bunch of friends to try it out on Saturday so you can iteratively demonstrate product-market fit, build a scalable and reliable back-end for the data using AppEngine or AWS on Sunday, and on Monday morning you can launch a KickStarter project to build mobile clients for it.

    With unemployment riding a plateau, many young people find themselves with ample time to brainstorm new ideas and hack on them. What they don’t necessarily have is the requisite skill to forge the initial prototype that gets people fired up about their vision. That’s where massive open online courses (MOOCs), YouTube videos and the like can help. But sometimes there’s no substitute for the immediacy and simplicity of an actual human expert on site. That’s where ScriptEd volunteers are making an impact in classrooms, sharing the fruits of their training and experience with the next generation of movers and shakers.

    Instead of putting students through months of mathematical rigor before they feel the power and joy of creating new software, ScriptEd has them writing code on day one. Sure, they will make mistakes. But even the best software engineers make mistakes; learning happens best through experimentation! More importantly, seeing their code result in visual artifacts before their eyes gives students a taste of what is possible with the skills they are picking up and inspires them to play around instead of plodding through a series of assignments.

    In the spirit of quick experimentation, hackathons have been growing in popularity at college campuses across the country. As the term might suggest, a hackathon is a marathon hacking session during which a small group of avid programmers combine their talent and efforts to build something from scratch. Hackathons vary significantly in theme and scope but the notion of banding together to quickly solve a problem using technology remains a central tenet. Not all the results are shining examples of engineering but some of them do go on to improve lives in nontrivial ways, much as Kitty Hawk paved the way for the 747.

    If programs like SciptEd succeed then humanity will reap the benefits of a population that doesn’t care about unemployment levels and corporate ladders because they know how to build stuff that other people want instead of waiting around for HR departments to call them back. We may see groups of people coming together to invent new products and then scattering to form new alliances later. The future looks promising.

    December 9-15 is Computer Science Education Week. On December 11, ScriptEd will host an Hour of Code event at Harlem Village Academies High School in New York City. On December 14, ScriptEd’s students will put their programming skills to the test in ScriptEd’s December Hackathon.

    To learn more, go to ScriptEd.org.

  • Husband Told To Choose Between Wife And Harley Is Selling Both On Craigslist
    Given the choice between a motorcycle and a spouse, what would you choose?

    Bob White of Virginia is letting the Internet decide for him. The Charles City man is selling his Harley Davidson motorcycle or his wife on Craigslist for $5,900.

    According to the ad, posted on Richmond’s Craigslist this week, he’ll consider the best offer — for either the bike or his wife — and will also except trade-ins. In the humorous posting, White, who owns a motorcycle repair company, gives a rundown of both the 2006 XL1200L Sportster’s and his wife’s features.

    “Sportster: Beautiful bike… pearl white with black and orange accent strips,” the Craigslist ad reads. “Wife: Beautiful edition… white with a mean streak.”

    man sells harley

    The Virginia husband isn’t the first biker who’s put his Harley up for sale because of his wife, but we think White’s tongue-in-cheek ad has some better selling points.

    Unfortunately, the ad seems to have been removed from Craigslist, so prospective buyers will have to look elsewhere.

    (Hat tip: Gawker)

  • Obamacare Website Races To Catch Up
    WASHINGTON (AP) — It looks like President Barack Obama’s fickle health insurance website is finally starting to put up some respectable sign-up numbers, but its job only seems to have gotten harder.

    Two months in and out of the repair shop have left significantly less time to fulfill the White House goal of enrolling 7 million people by the end of open enrollment on March 31. Signups were just over 100,000 nationally as of the end of October. The 36 states served by the federal government’s website accounted for a paltry one-fourth of that, fewer than 27,000 people. But officials now say an additional 29,000 people enrolled through the revamped HealthCare.gov in just two days at the start of this week, despite heavy volume that not long ago would have caused the system to lock up.

    HealthCare.gov is the online portal to subsidized private health insurance for people who don’t have job-based coverage. Though it’s too early to say whether the corner is being turned, Obama is inviting consumers to give the website a second chance. Here’s a look at the changes you can expect:

    SPEED AND AVAILABILITY

    Independent testers question the blazing Internet speeds claimed by techies at the Health and Human Services Department but say there’s been noticeable progress.

    “The trend is in the right direction … but there are still things they can do to make the user experience better,” said Michael Smith, a vice president of engineering at Compuware Corp., which helps companies monitor the technical performance of their websites.

    As of Thursday morning, the number of states where consumers are experiencing unacceptably long wait times had been cut in half, down to 13 from 26 states in late October.

    Compuware defines “unacceptable” as more than 8 seconds average response time to load the home page. The government claims a response time of less than 1 second. But Smith says that is likely being measured from computers with fast Internet connections and doesn’t account for the experience of consumers with less than ideal access, which is incorporated in his company’s testing.

    HHS spokeswoman Joanne Peters acknowledged: “As with any website, the response times for individual consumers will vary depending on their computer’s performance and the speed of their Internet.”

    Compuware says availability — a measure of consumers’ success accessing the site — is up to 98 percent, close to the standard for commercial websites.

    WINDOW-SHOPPING

    Many consumers were puzzled and frustrated when the federal website went live because it would not let them browse health plans without first setting up an account. That’s the opposite of how e-commerce generally works. Most websites ask consumers to open an account after they’re ready to purchase.

    The flaw drove many people to an accounts creation page that turned out to be riddled with bugs and contributed to the system’s early woes.

    On Monday, HHS announced the deployment of a window-shopping function that lets prospective customers see plans and prices in their area, including previously unavailable details such as deductibles and cost-sharing, as well as provider networks.

    RESET BUTTON

    People who got stuck in the system can now zap away their old applications and start over.

    To do that, you log into your account, select the application in progress and hit “remove.”

    You have to follow that by closing and reopening your web browser. Then you log back in and start a new application.

    The reset process may not be entirely foolproof because HHS advises consumers to reach out to the call center at 1-800-318-2596 if they have trouble.

    ORDERLY LINES

    To help stave off problems during periods of high user volume, the website now has a queuing system. Consumers can request email notifications of when is a good time to come back. The feature kicked in this week as people flooded back to check out the revamped website.

    The site can now handle 50,000 simultaneous users. Each visitor spends an average of 20 to 30 minutes on the site. In theory, the site will support more than 800,000 consumer visits a day.

    The big spikes in traffic are still to come. Expect that to happen after the middle of this month, since Dec. 23 is the last day that people can apply for coverage that will take effect Jan. 1. Even heavier volume is likely toward the end of open enrollment March 31, as procrastinators jump in.

    Confident that the site is stable, the government is emailing people who got stuck in the system and inviting them back.

    Still, reaching the goal of 7 million sign-ups seems like a tall order. The government’s initial projections estimated that 1.2 million people would have enrolled by the end of November, and the number is likely to be only a fraction of that.

    And the March 31 deadline doesn’t mean that enrollment comes to a full stop.

    That’s because under the law, people who experience a significant change in their life circumstances can still get coverage after the open enrollment period is over. Such changes include divorce, the birth of a child, loss of coverage, moving to another state or losing a job.

    Rick Curtis of the nonprofit Institute for Health Policy Solutions estimates that as many as 20 million people could become eligible for coverage later in 2014, though it’s not clear how many of those would enroll.

    “About as many people will become eligible over the course of the year as are eligible now,” Curtis said.

  • AT&T Says It Doesn't Need To Disclose All NSA Data Requests

    SAN JOSE, Calif. (AP) — AT&T, under fire for ongoing revelations that it shares and sells customers’ communications records to the National Security Agency and other U.S. intelligence offices, says it isn’t required to disclose to shareholders what it does with customers’ data.

    In a letter sent Thursday to the Securities and Exchange Commission, AT&T said it protects customer information and complies with government requests for call records “only to the extent required by law.”

    The telecom giant’s letter was a response to a shareholder revolt sparked on Nov. 20 by the New York State Common Retirement Fund, the ACLU of Northern California and others. The groups are demanding that AT&T and Verizon be more transparent about their dealings with the NSA.

    In the letter, AT&T said information about assisting foreign intelligence surveillance activities is almost certainly classified. The company said it should not have to address the issue at its annual shareholders meeting this spring.

    Nicole Ozer, technology and civil liberties policy director at the ACLU of Northern California said AT&T has overstepped its bounds.

    “It’s outrageous that AT&T is trying to block the shareholder proposal,” she said. “Customers have a right to know how often their private information is ending up in the government’s hands.”

    After the Sept. 11 terror attacks, U.S agencies established a warrantless program to monitor phone calls and e-mail between individuals in the United States and other countries who are suspected of having links to terrorism. But disclosures in recent weeks from former intelligence contractor Edward Snowden have exposed the breadth and depth of U.S. government surveillance programs on the Internet and over other telecommunications networks. The Washington Post reported this week that the NSA tracks locations of nearly 5 billion cellphones every day overseas, including those of Americans.

    Companies are responding to the revelations in a variety of ways. Tech firms including Yahoo and Google are pushing back, adding encryption, filing motions in the FISA court, and arguing that the NSA is overstepping its bounds.

    But telecommunications firms appear to be cooperating fully.

    “AT&T has not made it clear to investors or customers what data it shares or with whom. Customers should not be the last to know how their personal information is being used by governmental agencies,” said New York State Comptroller Thomas DiNapoli.

    DiNapoli co-signed the AT&T shareholder resolution on behalf of the New York State Common Retirement Fund, which holds assets totaling about $161 billion. The fund owns more than 15 million shares of AT&T valued at roughly $517 million.

    “Customer trust is critical for any business, but nowhere is it more so than for those corporations that handle our personal data and communications,” DiNapoli said.

    Follow Martha Mendoza at https://twitter.com/mendozamartha.

  • Shopping Season

    The holidays are right around the corner. It’s no wonder I’ve got shopping on the mind. And as with the contagion of Christmas music in a mall, I can’t help but join the carol of intrigue surrounding the new health care marketplace.

    The health insurance exchanges are open. Unfortunately, we can’t really shop there. No, I’m not jumping on the bandwagon and killing the government for ‘technical glitches.’ The exchanges’ fits and starts may very well impact which party takes seats in the legislature and wins out in the court of public opinion, but will not likely be the undoing of the exchanges or their promise. However major, the kinks will be worked through and when thought about in the context of what has been spent to date in comparison to the size of the health care market itself, the dollars against the rework are pedestrian. The real reason we can’t shop on the exchanges is because they are not true marketplaces with choice. In our normal everyday shopping experiences, American consumers are accustomed to choice. We can splurge for the deluxe version, or go for the budget option. We can buy from the local guy, or from our favorite national chain. With shopping, we can always go elsewhere, or if we’re not satisfied with the options, we can give up on the shopping adventure entirely. These are the fundamental principles of shopping, and Americans have mastered them. So how can we have designed a national storefront for health care that offers no real choice or the freedom to navigate within a truly open market?

    On the plus side, with the insurance exchanges the government has dipped the health care industry’s toe into shopping. Despite an inability for most to get from look-see to sign-up, HealthCare.gov has seen more looks than the most popular kitten video on YouTube. Any new online retailer would be thrilled to attract that traffic. Of course, having shoppers turn up en masse is certainly easier to achieve when the alternative is a federal fine. Regardless, the entire country is talking about HealthCare.gov (we are engaged), and the needle has been moved in the right direction in terms of focusing the American people on health care plans, policies, and enrollment. That’s good news. However, the popularly-held belief that the “glitches” are the hurdle the exchanges need to overcome to truly be impactful is shortsighted. Sure, the glitches have prevented the all-important front-door from opening for too many, and there are back-end issues that need resolve; still, I can’t help but focus on how we missed the mark on introducing the fundamentals of shopping. It’s an opportunity wasted in the exchange setting, and as an example to be set for the broader health care marketplace. It is this – the lack of true shopping – that may prove the undoing of the exchanges, or in the very least will severely diminish their impact on reshaping health care.

    The limited choices offered within the exchanges remind me of Wendy’s 1987 “Russian Fashion Show” commercial. Remember it? “Daywear!” “Eveningwear!” “Swimwear!” And they were all the same despite some cheesy accessory. The current reality of the insurance exchanges is a less humorous illustration of how illusory “choice” can be in an unimaginative and over-regulated environment. Government tells sellers what they can offer and what they can charge, and buyers what they are allowed to buy.

    To get shopping to work in health care, we need to create real market dynamics, with many sellers constantly bumping up against one another to compete for the customer. Right now, all four medal plans (bronze, silver, gold, platinum) that the government allows on the shelves are wearing the same gray uniform – all required to offer the same roster of “Essential Benefits.” Everything looks the same because the scope of benefits is the same.

    In the rest of our dynamic economy, disruptive innovations frequently change the game, making incumbent players compete harder to sustain brand leadership and customer share. Until the exchanges can move beyond the government’s oversight of who can sell what, to whom, and how, we’ll never see truly disruptive health plan offerings that are necessary to stoke competition and change the landscape of shopping today. The role of government is to protect power from concentrating in market, not to define the boundaries and players of a market.

    For the exchanges to become ‘true’ marketplaces a few things need to happen. Neither of which expressly focus on getting the technology right. We will assume that happens on whatever timetable a mulligan of this magnitude takes, December 1 or thereafter.

    First, insurers must be allowed and incented to compete on policy design and on price. For that to happen, more variation in plans must be allowed. We need more players and products, which requires a reimagined definition of what an insurer is and can be. I am but one example, but I’d love the plan that doesn’t cover in vitro fertilization (I have five kids), leaves me high-and-dry if I get stage four cancer (because I’d want to die at home), doesn’t support primary care (because I’m willing to manage this on my own), but covers me from sunrise to sunset on pharmaceutical alternatives and natural remedies. I can’t buy this today.

    Second, we need to get a handle on the subsidies. Right now the very subsidies that allow the masses to get insurance also obscure the total cost from too many consumers. As a result, “shoppers” on the exchanges behave much like “shoppers” before the exchanges, making decisions primarily on convenience rather than the ordinary metrics of shopping: price and quality. We need to arm patients (shoppers) with real data so they can direct where they go for care – where they send their health care dollars.

    Nobody who exists in our current economy today would argue with the proposition that technology can be a powerful enabler of shopping. And I’m willing to bet the majority of the millions of people who have tried to enroll or window shop in the insurance exchanges these last two months would agree that the intent of the exchanges is good, but the service delivery and product design is bad. I deeply admire the well-meaning social good and zealous intent of the exchanges, but if the exchanges are to survive and truly make a difference not only must the storefront improve (and it will), but as important, the merchandise must become distinguishable, the seller bench must grow, and buyers need a clear window into price and quality. By bringing these elements that revolve around creativity, personalization and ‘informed’ choice to the fore, we can make shopping for health insurance as American as shopping for cars, jeans or a new tablet computer. With any luck, by the time the holidays roll around next year, it will be easy for a loved one to give a custom gift of health insurance.

    Jonathan Bush is CEO and president of athenahealth, a provider of cloud-based services for electronic health records, practice management, and care coordination.

  • Increasing Innovation by Removing Patent Threats
    Yesterday I was proud to support H.R. 3309, the Innovation Act, which will help to rein in patent trolls, which have seriously damaged American businesses and consumers.

    Patent trolls are companies or individuals who obtain overbroad patents, and then send letters to actual innovators alleging infringement — often without clearly identifying themselves or the patent at issue — to demand money. If they sue, they may deliberately run up discovery costs to pressure the defendant into a settlement. Patent trolls may use shell companies in order to obscure ownership of the patent, sensing a large return on investment from threatening lawsuits against small entities that cannot afford to defend themselves in court.

    Organizations of all sorts are being targeted by patent trolls and face costly but unwarranted licensing fees and settlements. This is affecting non-profits that have been asked for $1,000 per employee just for using scanners, and thousands of small businesses that have received letters seeking licensing fees simply for providing wifi to customers.

    These businesses and organizations are either faced with the choice of not providing certain services or charging customers exorbitant costs for their use. In most cases, the targeted small organizations cannot afford to go to court to defend themselves. But when they do, the trolls lose over 85 percent of the time — indicating that most of these lawsuits are not legitimate. In our current system, however, it is too costly and time-consuming to defend against their attacks.

    Sadly, the impact of patent troll activity is estimated to be $29 billion per year. This is money that could be better spent by Silicon Valley innovators on research and development, and by small businesses on improving customer service or expanding operations. Patent trolls are stifling our economy.

    I cosponsored and support the Innovation Act because it is an important first step toward addressing this problem. It will allow the targets of patent suits to know what they are alleged to be infringing and who is bringing that allegation forward. It will shift the costs of litigation to patent trolls who lose cases that are deemed to be not reasonably justified, making it easier for defendants to fight off attacks. It will change the rules of discovery so that defendants will not be subject to wide-ranging requests that run up costs and drag out the process — an effort to drive frivolous cases to settlement. And it will allow manufacturers to step in and assist their customers who are accused of infringing on a patent simply for using a product they purchased off the shelf.

    H.R. 3309 enjoys broad, bipartisan support because it will make the patent system stronger, stop abusive behavior that has hampered the system, and save the court’s time and limited resources. It passed the House easily, and I look forward to working with the Senate so that we can send a bill to the president and remove the threat of patent trolls from the American economy.

  • 3D Virtual Simulator Shows What's Happening Inside A Mother's Body During Birth
    By: By Tanya Lewis, Staff Writer
    Published: 12/05/2013 02:09 PM EST on LiveScience

    It seems there’s almost nothing computers can’t simulate these days: Now, a new computer program simulates human birth using 3D virtual reality.

    The simulator is the first of its kind to take into account factors such as the shape of the mother’s body, and the shape and position of the baby. It could help doctors and midwives prepare for unusual or dangerous births, according to the researchers in England who developed it.

    birth simulator

    “You can’t see inside during a live birth. The simulator shows you what’s happening inside,” said Rudy Lapeer, a computer scientist at the University of East Anglia, leader of the research that was presented Nov. 22 at a conference on E-Health and Bioengineering in Romania. [Blossoming Body: 8 Odd Changes That Happen During Pregnancy]

    Hospitals have used models to simulate the birthing process since the 1800s, Lapeer told LiveScience. But whereas most current simulators are based on known scenarios, the new simulator models the physics of childbirth — the basic forces exerted by the cervix, abdominal muscles and the doctor or midwife — so it can simulate an unfamiliar birth scenario.

    The simulator is also designed to be patient-specific. Doctors can scan a pregnant woman, and then adapt the simulator to her anatomy. They can run through a number of scenarios based on previous births.

    For example, in macrosomia, in which a baby weighs significantly more than average, doctors could use the simulator to determine whether the baby could be delivered vaginally or would require a cesarian section to prevent shoulder dystocia (when a shoulder gets stuck in the birth canal), for instance.

    birth simulator

    The simulator can also be used for training. Currently, doctors or midwives must learn on mannequins or by watching live births, but these don’t let them see how the baby is moving inside its mother.

    The computer program is limited in that it doesn’t include movements of the perineal muscles of the mother’s pelvis, nor does it include movements of the fetus. And it currently only models one baby, and one pelvis.

    During the vast majority of births, the baby performs a distinct set of seven movements. Currently, the simulator can reproduce three of them, Lapeer said. But he hopes the system will be able to simulate all of these movements within a year.

    Ultimately, imaging technology will enable doctors to run the birth simulator during the birth itself. That kind of “augmented reality” would allow doctors to see how the baby is positioned, and adapt the delivery procedures accordingly. That technology is probably at least a decade away, Lapeer said, “but ultimately, we will get there.”

    Follow Tanya Lewis on Twitter and Google+. Follow us @livescience, Facebook & Google+. Original article on LiveScience.

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