US vs Canadian Healthcare – a story of personal experience

As anyone not in a coma knows, there is a great deal of debate in the US right now about Health Care Reform. During this debate, there are many references to the Canadian Health Care system, typically by Americans who have absolutely no idea what the hell they are talking about – including a former governor of Alaska. It is referred to as “socialized medicine”, and Americans argue that it reduces efficiency, costs the government great sums of money (note that the US government already spends more per capita on health care than the Canadian government does), reduces innovation, has longer wait times, and even leads to people dying while awaiting treatment.

I recently became ill while in Los Angeles for a conference. While being sick is never a fun experience, being diabetic and being sick while travelling in a foreign country by yourself is especially stressful.

However, this gave me an opportunity to experience the US health care system first hand, albeit a little superficially. Also, since my employer provides me with out-of-country health insurance, my experience is from the perspective of someone with health insurance, not someone without. In addition, my opinion of the US health care system is based on a single experience, not a broad sample.

Lets start with my arrival at the ER. I arrived at about 9 PM on a Tuesday evening.The first step was to fill out a little form with basic information – name, address, nature of my complaint. This form is passed through a little hole in the plexiglass partition, and my information is entered into their computer system. I then waited about an hour to see the triage nurse and be prioritized. Between myself, my wife and my kids, I have been at emergency rooms in New Brunswick, Ontario, and Alberta, and do not recall ever waiting more than a small number of minutes to be triaged. It should be noted that the triage process seemed to be mostly a “first in, first out” kind of process – I did not notice anyone being triaged faster based upon the nature of their complaint.

After being triaged, I guess I was ranked fairly low in terms of priority (hey, I was only vomiting up large amounts of blood), because I then sat from about 10 PM Tuesday evening until 4:30 AM Wednesday waiting to see a doctor. Many people came in, were treated, and left before I was seen, but I understand that once you are triaged, priority are based on who is at the most risk. I also understand that I was only seeing the “walk in” side of the ER – there was another whole flow of patients coming in through the ambulance entrance with a fair number of trauma patients. Still, 7 and a half hours of waiting to see a doctor is longer than anything I have seen in the Canadian health care system. And remember, I was at a private hospital in LA, not a public clinic. I would thus expect that this was on the good side with respect to performance.

Once I actually got to see the doctor, I was treated fairly quickly. Note that the goal was not to treat the root cause in my ailment, the primary intent was to stabilize my condition so that I could return to Canada for full treatment. At this, they were very efficient, and I was out in about 3 hours. It was also made much more smoothly because my out-of-country health coverage worked very well with the hospital’s admissions/accounting people with regards to payment. God only knows how the experience would have played out had I not had insurance.

In short, my visit to the ER in Los Angeles involved wait times which were significantly longer (for both triage and treatment) than anything I have ever experienced at a hospital in Canada.

To finish off the story, I will describe my follow-up treatment after returning to Canada. On the Wednesday following my return to Canada, I called my family doctor, and got an appointment to see her that afternoon. After that appointment, she referred me to a GI specialist, who I saw the next afternoon. He decided I needed an endoscopy, which happened the next day. Seems pretty efficient to me!

Perhaps Americans (especially American citizens) should educate themselves on the reality of the Canadian Health Care System rather than blindly believing the rhetoric of their politicians who are bought and paid for by the insurance companies and HMOs, or simply know nothing about the Canadian system which they are criticizing.

Republic Air CEO puts his faith to work

 Republic Air CEO puts his faith to work – The Denver Post

I find this extremely disturbing. It is part of a major trend over the last couple of decades whereby self-proclaimed “people of faith” try to inflict their beliefs on those around them. It is especially inappropriate when the CEO of a corporation makes it clear that the organizations beliefs are Christian beliefs. While the article says:

Bedford says he doesn’t try to convert anyone or require faith as an employment litmus test.

Unfortunately that fact that he makes it clear that the organization’s beliefs are Christian beliefs, any employee who does not share those beliefs is going to feel extremely threatened. If I am an Atheist, Wiccan, Buddhist, or an adherent to any belief system which does not match the Christian view of God, I would feel pressured to either pretend to share Christian beliefs, or leave. I would certainly feel like I had no career path in this organization.

I am not saying an organization should no put forward a value system. What is wrong is to bring an explicit statement of a specific religious doctrine into it. If his vision statements such as “every employee, regardless of personal beliefs or world view, has been created in the image and likeness of God.”, that is imposing upon me a creationist, fundamentalist view of the world, which is inappropriate.

Also implicit in this kind of thing is the commonly held belief (among “true believers”, anyway) that if you do not believe in God, and specifically a Judeo-Christian God, then you do not have beliefs, or morals, or values, or principles. I would put my beliefs and morals and principles up against any Christian on the planet – and am fairly confident my values are more “Christian” than those who support war, capital punishment, intolerance, racism, and yet call themselves “Christian”.

So, bring all the values and principles you want into a company, but please leave your religious dogma at the door.

PS – I did not mean to imply that my values are perfect, or that I am in any way perfect – only that being “Christian” is hardly proof positive that you have strong values, or any values at all for that matter.

Off to PDC09

Really looking forward to the Microsoft Professional Developers’ Conference in LA this week – except for the getting up at 4 AM to get to the airport tomorrow!

There are a number of areas I am exciting about for the conference. On Monday I am in an all day workshop on Software in the Energy Economy which should be very interesting given a number of projects I am involved in lately regarding energy management systems and systainability support.

At the conference proper, other than the keynotes, there are a fair number of session I have put in my schedule related to Azure – still very much interested in cloud computing, even though I have had little time to look at it.

I am also planning to attend a number of sessions on Workflow Foundation 4.0, even though it will not be available in SharePoint 2010 (at least initially).

Then there are a number of sessions I want to go to just out of personal interest – those involving Silverlight, touch and multitouch applications, and many others. As always, far more things I want to learn than I could possibly have time for!

While there is some great content around SharePoint 2010, I will probably not focus on that since I got a lot of good SharePoint information at SPC09 a few weeks back.

I am hoping do more blogging from PDC than I did at SPC – not hard since I did not blog at all from SPC! Damn twittier took all of my time!

One Sentence Debate

This is a very cool blog idea One Sentence Debate

SharePoint Conference 09 Wrapup

It had been my intention to write daily blog posts from SPC09, but honestly there was just too much going, and I was tweeting all day anyway. I thought I would, however, post a summary of the things I saw and learned at the conference (well, the SharePoint things, not the “people acting silly” things ). It was a great conference, well organized, and with lots of information – too much information actually, so much that I could not see all the sessions I wanted to and will have to wait for the videos to be posted.

There is a lot of new stuff coming in SharePoint 2010, and a lot of improvements to existing features. Before I get into my thoughts on the conference and SharePoint 2010 in general, I would like to recommend looking at this post. Tony Byrne makes some good points. For me, it can all be condensed down into one statement: No matter what the hype, no matter what fancy new features are there, always, ALWAYS, keep business needs front of mind – upgrade when there is a clear business reason, and not before. All of the features in the world will not help you if you do not know what you are building and why.

So, on to the good stuff! There are many things I saw at the conference which really make me excited about SharePoint 2010. The things that caught my interest can be broken down into the following groups:

• General SharePoint features
• Service Architecture
• Office services
• Development support and tools

General Features

I am not going to dwell too much on the general SharePoint features, as I am sure there will be lots of articles covering them. Obviously there are considerable user interface enhancements (though the design experts out there will no doubt crap on the overall UI). The ribbon interface is pretty impressive for things like editing pages, working with lists, and similar activities. I am not sure how well it applies in a more generic “web” world, and how it can be made to be non-intrusive in a highly customized deployment.

It is also nice to see a considerable amount of AJAX-like behaviour in the UI, thus greatly reducing the number of post backs and screen refreshes. This includes the new dialog framework – many of the actions which previously sent the user to a second page to collect information, and back again when the action was completed, are now done through layered dialogs (which are also customizable for consistency with your desired look and feel).

There have also been significant improvements to the capacity and scalability of SharePoint lists and document libraries.

Finally, it is nice to see SharePoint moving towards compliance with standards such as WCAG, XHTML, and CMIS.

Services Application Architecture

A major change in SharePoint 2010 is architectural – the introduction of the  Service Application Architecture. This is a replacement for the Shared Service Providers (SSPs) in SharePoint 2007. SSPs hosted such things as the User Profile Service, Search Services, and BDC Services. There were a number of deployment, scaling and manageability issues with SSPS, however.

Service Applications are a far more flexible approach. A Service Application can consist of a package of assemblies, databases, and other components which are deployed to a SharePoint App Server. The service is exposed via a proxy deployed to the WFE. This proxy knows how to talk to a custom WCF service on the App Server. The client (for example a Web Part) talk calls the proxy in order to consume the Service Application, without having to know where the Application Service is deployed – on the same farm or even another farm. The architecture also has built in round-robin load balancing.

Office Services

Among the services deployed in SharePoint 2010 are various office services:

• Improved Excel Services
• Improved InfoPath Forms Services
• Visio Services
• Access Services

I know there are some great improvements in Excel and Excel Services from the keynote. Excel rendering is improved, as in the interaction experience. Additionally, Excel Services now exposes REST interfaces, making it easier to consume server-based calculations and charts from other pages or web applications.

Something that specifically caught my interest is PowerPivot – which allows Excel to work with huge datasets in an effective way (the keynote showed it working with 100+ million rows – but that of course was a demo). I did not get a chance to go to the PowerPoint sessions, but will definitely have a look at the recordings when they are available. In the meantime, have a look here.

Something new which has been added in SharePoint 2010 are Visio Services allowing for the rendering of Visio diagrams in the browser, with interactivity and data binding. The Visio diagrams are rendered in a SharePoint web part using Silverlight technology. I already have a few ideas for how this could be applied to projects on which I am working.

Also added are SharePoint Access Services. This allows the publication of Access Solutions to a SharePoint where they can be centrally managed, and provides multiuser access and distribution difficult to achieve with an Access desktop solution.

There are a lot of improvements for developers in SharePoint 2010 and Visual Studio 2010.  So much so that I am going to do a completely separate post to cover them. To summarize:

• Many new and improved templates in VS 2010
• Visual designers in VS2010
• Support for Features and Packaging in VS2010
• Improved APIs (way too much to get into here)
• Developer Dashboard view
• Development support on 64-bit Vista/Windows 7
• Improved tools in SharePoint Designer

I will be posting another write up later today specifically focused on the development improvements.

The Microsoft SharePoint Team Blog has a post summarizing these and many other features I have not gotten into here.

Using Twitter at a conference

I am finding an interesting use for Twitter at a conference. Normally I would be taking notes during the sessions. Instead, I am just tweeting the interesting points. Then, back in my room, I can pull up all my tweets for the day, and POOF – there are my notes for the day.

I think I may write a OneNote add-in to import my tweets to save them as my notes

SPC09 Coming Up

So, it is less than a week to the sold out SPC09 in Las Vegas – hoping I feel better by the time I get there. Looking at the conference schedule, there looks to be an abundance of great content. My one complaint is that so much of it is concurrent – at least they will be recording all of the sessions so I can at least watch all of them.  

I will be blogging and tweeting live from the conference – so check it out (among the several thousand others who will be, as well lol)

Man fined $305 for smoking in workplace – his truck

 Man fined $305 for smoking in workplace – his truck – Canada – Canoe.ca

Ok, this is going to be another rant.

This is absolutely ridiculous. Another example of our government sticking their noses into things that are none of their damn business. Whether smoking is bad for me or not, it is none of the government’s business if I do it in an environment which is not harming anyone else (I do not smoke, by the way).

If they can give a ticket to a truck driver for smoking in his own truck with no one else around, what is next? Will they come into my house and give me a ticket because I work from home?

It is long past time to stand up to our governments and stop them from invading our privacy. It is none of the government’s business if I smoke when I am by myself. It is none of government’s business if I wear a helmet on my motorcycle, or a seatbelt in my car. I wear both helmets and seatbelts because I am a compulsive “rule follower”, but I should not have to. It is none of the governments business if I want to watch TV purchased from south of the border, without the CRTC’s interference. I should even be able to smoke a little marijuana if I so choose (I do not do that either).

Just think of all of the money our various levels of government could save if they would just stay the hell out of things which are none of their concern!

Kindle 2 not coming to Canada? Who Cares?

 

Kindle 2 not coming to Canada | Quill & Quire

So, Kindle 2 is coming to 100 countries worldwide, and Canada is not one of them. Certainly not surprising. From the quote in the above post, it would seem that most of the issues preventing Kindle form coming to Canada involve digital publishing rights and negotiations with wireless carriers (isn’t that what held up the iPhone from coming to Canada for a long time?).

For me, it is really a non-issue. I cannot imagine spending that much money (it will probably be $500 in Canada, even with the favourable exchange rate) on yet another single-purpose tool.

I read eBooks on my slate Tablet PC. Google Reader and other tools in full screen mode provide a great reading experience. I can also use tools like PDF Annotator to mark up, red line and highlight  to my heart’s content. I can take pieces of text and print them to OneNote to consolidate research on a subject. Then on top of that, I have an actual PC so I can do all of the PC things I want to do.

Why on earth would I want to downgrade to a Kindle?

UPDATE:

Also reading this article on CNN. I notice the statement:

Apple is working on a tablet computer that is expected to launch in the coming months and which includes all the functionality of an e-reader.

Either the author did not do any homework, or is purposely biased (as most of the tech media is) towards the uber-coolness that is Apple (note extreme sarcasm here). Microsoft has had Tablet PCs for 7 years which also includes all of the functionality of an e-reader (I know, since I have been using it for that purpose for most of those 7 years).

It must be nice to be like Apple and Google, and have the so-called press do much of your marketing for you.

Guardian: “Microsoft beats Apple to the Tablet”. Really?

I hate to point this out, but contrary to what the Apple fanboys would have you believe, Microsoft beat Apple to the Tablet 7 years ago lol – they just f***ed up the marketing (as always).

As always, Apple loses the time-to-market battle, but will no doubt win the fanboy opinion battle. A few months a from now, the notoriously anti-Microsoft media will be proclaiming how brilliant Apple is for “inventing” the Tablet. 

Guardian: “Microsoft beats Apple to the Tablet”. Really? « Sharing the truth one thread at a time