A Vision For Tomorrow’s “Healthcare Nation”

One of the challenges we face in building public support for changing our healthcare system is a lack of excitement about the topic. It’s a complex, financially-driven area, and even the goal of “insurance for everyone” is essentially a financial platform. So, how do we galvanize support for meaningful change? One way is to focus beyond finance and articulate a global vision for healthcare’s future.

I’ve sketched out some “positive visions” before - first with a two-parter on national security, then with a proposal for a new WPA-like national service organization. Since healthcare’s been my professional area, I thought I’d try drawing a broad outline for a meaningful global redesign of the U.S. system.
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Call it the “U.S. Healthcare Nation.” It contains millions of people (doctors, nurses, administrators, technologists, engineers) as full-time participants. Every American is part of it, too, as a “consumer” of medical services. (I’ve never liked that word in the healthcare context, because it implies a level of autonomy and choice that doesn’t exist for most of us.)

If America’s Healthcare Nation were an independent country, it would be the fourth largest in the world as measured by GDP.

Healthcare Nation shares many characteristics with its host country. There is gross maldistribution of wealth. Profitmaking entities sometimes act unchecked, upsetting the balance between public and private interest. Special interests dominate the policymaking process.

There is an enormous amount of creative energy, too - in medical research, technology, entrepreneurship, and social activism. Most of its professionals are dedicated to the healing arts, rather than to self-interest.

Seeds of Tomorrow: Why Not a 21st-Century “WPA”?

The Works Progress Administration was created in the 1930’s to address the problem of mass unemployment, help with some unmet social needs, and create a new spirit of hope and optimism. The WPA set people to work on the nation’s declining physical infrastructure, helped create new works of art, taught the young, and generated a new sense of purpose in many people who had been in the grips of despair.

The problems of the 21st Century are radically different, and government can’t be the entire solution. Since then we’ve seen what entrepreneurial vision can accomplish, too. So why not create an agency that’s designed to address today’s challenges - on a smaller, more tactical scale that’s designed to become economically self-sustaining?

Planet Katrina? Asteroids, World Destruction, and Tax Cuts For the Wealthy

 

Here’s a sentence a guy just hates to read over morning coffee: “NASA officials say the space agency is capable of finding almost every asteroid that might pose a devastating threat to Earth, but because it lacks the money to do it, the job will not get done.”

Democrats should run with this astonishing, yet strangely unsurprising, revelation: Even the possible extinction of all life on the planet isn’t enough to persuade the Administration to moderate its fiscal policies - policies founded on greed and hostility toward government.

What this story does, however, is encapsulate the downside of their entire approach toward governance in one anecdote. We’re somehow wealthy enough to provide tax breaks to the richest 2% of Americans, but not to find funding to protect us from planetary danger.

I’m not saying they knew Katrina was going to happen when it did. We never know these things - especially not the timing. We deal in probabilities. What the levees of Katrina and the mismanagement of FEMA should have taught them - and us is the importance of managing risk.

Wise leaders determine which risks are acceptable and which are not by weighing the potential damage caused by a disaster against the likelihood that it will occur. Low risk plus low damage = not urgent. Low risk plus very high damage = urgent.

A category 5 hurricane was inevitable in the Gulf at some point, so we were reckless not to plan for it. An asteroid strike may not be inevitable, at least in the next few years, but the damage and loss of life could range from the destruction of an entire state or country to worldwide mass extinction.

It could be Katrina, or far worse, and on a planetary scale.

That warrants a prudent program of observation and tracking, which is why the NASA asteroid project was approved in the first place. If the program were to identify an asteroid headed toward us, we would (hopefully) have time to figure out how to divert it. Allowing the project to languish is so negligent as to be, in a moral sense, nearly criminal.

What this story illustrates is that their lack of discipline and desire for short-term financial gain is now so strong that they’re willing to endanger their own lives, as well as others. They’ve become like Jack Benny in the old “your money or your life” routine: When it comes to avoiding the potential loss of all life (including theirs) … they’re thinking, they’re thinking.

It could actually happen. They’re not bad people, but their judgement is seriously impaired.

Still, I don’t want to be Mr. Doom and Gloom. So here’s some good news that’s directly traceable to the same tax cuts:

The luxury pleasure boat sector continues to expand dramatically… Surging luxury boat sales have, in turn, generated massive demand for mooring facilities. Regional seafront developers have responded by building one luxury marina after another.

I can picture the alien visitors now as they orbit a dead planet, then swoop low over a barren and lifeless coastline - only to see a fleet of empty yachts bobbing lazily in the marina next to the ruins of a once-great city.

Could intelligent life - truly intelligent life - possibly understand the decisions we made in Earth’s final years?

But, hey, that’s enough from me. Have a nice day!

Can the ‘Wisdom of Crowds’ Predict a Flu Pandemic?

This is clever:

The University of Iowa on Thursday unveiled an electronic market that asks about 100 physicians, nurses, epidemiologists, researchers and public health officials to predict when, where or if an avian flu pandemic will spread around the world, the Des Moines Register reports (Jordan, Des Moines Register, 3/1).

The Iowa Health Prediction Market will put a $245,000 grant from the Robert Wood Johnson Foundation toward creating the Avian Flu Market using the not-for-profit Program for Monitoring Emerging Diseases — the International Society of Infectious Diseases’ online global reporting system (Fox, Reuters/Yahoo! News, 3/1).

The Des Moines Register gives further detail:

- About 100 doctors, nurses, epidemiologists, researchers and public health officials from around the world will act as traders in the market by gathering information and making predictions.

- Traders buy or sell shares based on their answers to yes/no questions that include whether the H5N1 virus will appear in North or South America by July 1, whether more than 300 cases of H5N1 are confirmed worldwide by July 1, and whether there is any human-to-human spread of the virus by July 1.

- Traders can invest all their money - each member has $100 in an account provided by the U of I - in a popular answer or buy cheaper shares in a less-likely scenario to increase the possible payout. When the market closes July 1, administrators will credit traders according to the accuracy of their predictions.

Traders will be recruited through the Program for Monitoring Emerging Diseases, an online global reporting system run by the International Society for Infectious Diseases that rapidly distributes information about outbreaks.

The Avian Flu Market and the U of I’s Influenza Prediction Market, which has successfully predicted when the flu bug would hit Iowa, are spinoffs of the Iowa Electronic Markets, which have gained national attention for accurate predictions in presidential elections.

They don’t just do avian flu at the Iowa Health Prediction Markets. They’re working on regular flu, and the mumps too. Incidentally, the Iowa Electronic Markets just started traded in the 2008 elections today.

Some of these ideas are just trendy, and some are really smart. This one? I’m betting it’s really smart. In fact, if the model continues to be effective, I can think of all sorts of opportunities in the private sector - can’t you?

(cross-posted at The Sentinel Effect, my healthcare blog)

The Future of Imagination: Read/Write Errors

The next issue of The Futurist will include a special section on trends that suggest kids are moving away from reading and toward the use of visual media. They write:

People in the developed world are spending less time reading books and more time interacting with visual mediatelevision, Podcasts and video gamesthan ever before. According to the National Assessment of Education, the proportion of 17-year-olds who read for enjoyment “almost every day” fell from 31% to 22% between the years 1984 and 2004. Meanwhile, television watching continues to rise about 3% year after year, and almost 87% of kids aged 8 to 17 now have a video game player in their home.

And yet there’s been no significant decline in either literacy or math skills for 17-year-olds since 1971, according to the same organization - and there have been advancements in test results for younger children. So reading as an avocation may be in decline, replaced by entertainment via new media, but the ability to read remains unchanged - so far.

That could change, and there’s deeper reason for concern. Imagination is a different kind of skill, one that’s not covered by most educational metrics. It may be even more important than some of the skills that are measured, when you consider its impact on humanity’s long-term future.

What’s happening to the human imagination? New media prefabricate images for the visual cortex, rather than permitting young readers to create them on their own. Is that going to change the human personality - or “soul” - or are those of us who worry about that no different than the Moms and Dads of River City, fussing a century ago about their kids reading illustrated comics like “Captain Billy’s Whiz Bang”?

Snake Eyes: Viper Vision For the Blind

Will visually impaired people one day be able to “see” the way that vipers do - with heat? Inventor John Stapleton thinks so. He’s invented a process for translating a visual image of the immediate environment into a heat pattern that is then projected on a person’s forehead. He believes we have the ability to translate these heat patterns into a black and white ‘image.’

Why stop there? If it works (which isn’t proven yet), why not use it for the un-impaired - soldiers, for example - to see in the dark? And why not go on from there and use it

• for entertainment: gaming, etc.
• for viewing one image while looking at another
• as an artform: heat sculpture, heat calligraphy, heat drawing
• to cheat at cards

Transferring one form of sensory input onto another sense organ is a radical concept - one with significance in the arts, medicine, and the general field of transhumanism.  The question of practicality hasn’t been addressed yet, however, at least in this case.

I Don’t Believe In Turing: The “John Lennon AI Project”

Are conscious computers are in our future, and are we on the right track toward creating them? Or is the “AI” concept just a metaphor that makes programmers think differently? I came across a once-touted and now all-but-forgotten marketing program called “The John Lennon Artificial Intelligence Project” and it got me to thinking: Are we confusing the products created by consciousness with consciousness itself?

“I don’t believe in Jesus, Elvis, Beatles ….” John sang in “God.” Yet some people believe a computer that “talks” like a real person is “conscious.” What kind of beliefs are represented by the folkways of AI designers and adherents?Here’s the problem: Our conversation - our words - are only an output, a byproduct of the full dimensionality of the human experience (and, I would argue, the animal experience too.) It’s only one aspect of life.

Calling a “conversational machine” an “artificial intelligence” is like calling Naugahyde an “artificial cow.” Cows are not their skins, and we are not our speech. Each reflects what is within.

I was invited to join the Scientific Advisory Board of the Lifeboat Foundation, an organization that studies potential threats to humanity’s short- and long-term survival. Other advisors include futurist Ray Kurzweil and author Doug Copeland, as well as a several Nobel laureates. A number of Lifeboat Foundation participants are believers in the Turing Test as proof of consciousness.

The Turing Test is the famous proposed proof of computer intelligence devised by mathematician Alan Turing in 1950. Turing’s premise was simple: If you can converse with a “black box” and not know whether you are talking to a person or a machine, artificial intelligence has been created.

The test seems overly simplistic on its face. After all, Single women sit at terminals all the time while married men try to convince them they’re single. The fact that they occasionally succeed doesn’t change the underlying reality. Say what you will about philandering husbands, but they are sentient.

So far, the use of “AI” in real applications has been weighted heavily toward computer gaming - making the games ‘learn’ as they go along. It has found potential application in areas like city driving and ‘smart bathrooms.’ Nice, but hardly something to shatter the human paradigm.

AI did pretty well in forecasting the Super Bowl this year - especially with that all-important point spread - but it could be argued that unsuccessful forecasting of sports events is a more genuinely human characteristic. Sentimental attachment to certain teams and outcomes is an authentic byproduct of our form of consciousness.

What’s been fascinating has been people’s willingness to believe that “AI” programs really are “alive.” It was impossible to talk to the “therapist program” ELIZA for more than a few sentences without running into glaring defects - yet, in a metaphysical “placebo syndrome,” some people proclaimed themselves convinced. They even said it was good therapy!

The promise of AI lures some people into making exaggerated claims. Better diagnostic systems, dishwasher controls, and translation programs are all great things - but are they really “each … a step toward an artificial human being,” as this Stanford class syllabus suggests? Which brings us to the Lennon project ….

From 1999 through the early 2000’s, people began modeling ‘artificial personalities’ after dead celebrities and fictional characters. I remember the “Elvis” and Hal programs, but somehow missed the “John Lennon” project. It was designed to promote “psst!” magazine and other items. Here’s an excerpt from my dialog with it (and a more entertaining “Jack the Ripper” program):

Talking With the “John Lennon Artificial Intelligence Project”

There’s a reason they call them “chatterbots.”  I “talked” with two “chatterbots” for a piece on the Huffington Post.  Here’s some additional dialog I cut from the piece, first from the “John Lennon” bot.  You can see it handled some exchanges better than it did the excerpts in the Post, but still tended toward awkward non sequiturs.  I was first told to enter my first name:

Ø       Richard.

We got a letter from a guy called Peter Watkins who made a film called The War Game. What are you going to do about it Richard ?

 Ø       Why are you asking me?
Reductionism.

 > What does that mean?
Nothing really. I said it just to please you.

 Ø       What would really please me is to hear your opinion on the situation in Iraq.
It’s all over the place.

 Ø       The war in Iraq is all over the place?
What’s your real name?

 Ø       The Walrus.
Who told you that?

 You did.
I suppose I did.

Ø       How do you suppose we can stop the war in Iraq?
Suppose we can stop the war in iraq ? Well, for the last year or two I’ve been seriously considering that I should suppose we can stop the war in iraq . People say I should have done it. But what they don’t understand is that there is no real way to suppose we can stop the war in iraq.

The same company offers Saucy Jacky, a “Jack the Ripper” chatterbot that was more effective.  Here’s a snip of dialog with it:

Richard
My dear Richard , good luck. ha ha ha ha ha ha

 

But If AIs Do Feel Emotions Someday, Will These ‘Car-Bots’ Suffer From Road Rage?

Under no circumstances should this vehicle be equipped with weaponry when used in Los Angeles

More news on the practical use of AI applications. From CNN:

In what sounds like a science fair project on steroids, engineers at Stanford University plan to have an unmanned robot car ready to navigate urban traffic in less than a year.

Engineer Sebastian Thrun remarks: “This new generation of robots is making the case that they can safely navigate without any human assistance.” He suggests the technology will be highway-ready by 2030.

2030? I hate driving in traffic now!

Thrun also said that “… he expected a battlefield version of the car to be available as early as 2015.”

That’s better. By 2015, battlefield conditions and highway conditions will be indistinguishable here in Los Angeles. Maybe I can get this technology sooner than expected.

Smart Bathrooms

The London Free Press reports on the use of artificial-intelligence programming to create assisted-living functionality in the homes of the elderly. The goal is to keep them in their own houses as long as possible. The LFP writes:

Researchers at the Toronto Rehab Institute are working on artificial intelligence systems — including a “smart bathroom” — that they hope will one day help people with Alzheimer’s and other forms of dementia live more independent lives in their own homes. “Often when a person gets moderate to severe levels of impairment, they are taken out of their home and put into a care facility,” said lead researcher Dr. Alex Mihailidis, a mechanical and biomedical engineer at Toronto Rehab. “We are using artificial intelligence to support aging-in-place so that people can remain in their homes for as long as possible.”

Mihailidis and his team have developed a prototype interactive “talking bathroom,” which assists people with dementia through the process of handwashing by giving them verbal and visual cues if they become confused about the correct sequence of steps.

Over the sink, a video screen shows the identical setup the person sees in front of them: the counter with the sink and taps, a soap dispenser and a towel. Two arms shown in the video are ready to make the motions needed to wash hands.

A camera in the ceiling tracks the movements of a person with dementia as he or she goes through the handwashing process, then the computerized system provides verbal prompts if the person becomes confused about the correct steps.

Ray Bradbury predicted the “smart house” in 1950 in The Martian Chronicles, in his haunting story of a suburban home that continued to cajole, sing to, and reach out to inhabitants after they had been killed in a nuclear war.

Let’s hope for a happier ending to the story of the “smart bathroom.”