Globalization of celebrations

The last day of October, i.e. the coming Thursday is Halloween, a US originated holiday that allows kids to go trick or treating. In other words, kids get to dress up as their favorite characters and go to neighbors house and demand candy for not playing a trick on them. Its that time of year when kids get to eat a variety of candy in virtually unlimited quantity.

Yesterday Reia mentioned that her cousin had gone for a Halloween party. Not unusual until you realize that her cousin is in India. The last effect of Globalization was brought about by hallmark and the card companies exported all available holidays worldwide to increase sales of their cards and even invented a few.

This round of globalization seems to have been triggered by the availability and constant consumption of global visual imagery. Most kids are now interconnected with friends across the world in a manner where they can not only exchange e-mails, but visually communicate both online using apps such as Skype, and offline such as Facebook, Instagram and the recent favorite of Teenagers, Snapchat.

This has contributed in a large part to the globalization of holidays and festivals. Diwali, Navratri, Holi, ... are promoted and celebrated with greater gusto in US colleges than in Indian colleges. There is also the trend of reverse cultural bonding. When you have something, you don't want it. And when you don't you yearn for it. This is visible in the various ethnic groups in the US. The Indian parents want their children to not only learn at least one Indian language, they also want them to learn Indian culture.

On an average, Indian Americans know more about Indian culture than Indians. And this is probably true about the other cultures. Its very visible amongst many ethnicities, the Chinese, the Irish, the Korean, the French, ...

If all of this is reasonably accurate, it leads me to 2 interesting conclusions. Both of which our ancestors have known for years. You yearn for what you don't have. And the grass is always greener on the other side.

Affordable Healthcare. Why did it fail and what could be done.

Oct 1, was the day that the Affordable Healthcare launched the Healthcare marketplace website. This was the website where people could browse and find plans.

Day 1 was a disaster. No one could get to the website. In the meanwhile the Government was shutdown and the focus shifted to the Government shutdown. Day 2 to 7 was equally bad and by now the focus was shifted to Congress not increasing the debt ceiling and the risk of a US Government default. Oct 17 was when finally there was a deal, albeit temporary and kicking the can down the road by around 3 months.

And the website and its accessibility was as bad as ever. With the other major news out of the way, the focus was back on how the website still wasn't working and how millions of people had frustrating experiences in finding or comparing plans, let alone sign up.

Initially President Obama and the administration blamed the issues on the traffic, i.e. the number of people who were trying to access the website. They continued to use this as the main cause of the issue until it has now become obvious that its simply not true. The media was able to eliminate this as the root cause by a very simple experiment. Trying to use the website even in the middle of the night, early morning, 4 a.m. Nothing worked. And there's no way there could be more than a few hundred people trying to access the website.

I tried using the website on several occasions. On most occasions I had similar experiences to most people, but because of the sheer number of attempts, I was able to proceed several steps into the website. Several states (13) had put up their own marketplace, including Connecticut and New York. Whilst these had some issues, they were relatively minor and overall they functioned relatively well. It was the Federal government website, applicable to States that did not have their own marketplace, which had the major glitches.

The Government according to media estimates has spent over 600 million dollars on this effort over a 3 year period. And it doesn't work. I'm confident that the administrator will be able to fix most of the issues in a few weeks, but there are several things that could or should have been done, which could have resolved most of the issues in a couple of days. And would be as effective as the several hundred million dollar fixes.

Here's a list of the top 5 things I would do to improve the same. It would cost under $10,000 and would resolve over 95% of the aggravation. No that was not a mistake. Ten Thousand Dollars. That's it. Not 100s of millions, not 10s of millions not even a couple of million. Just a few thousand dollars. And not even that, as the people required to make these changes are probably on staff and being paid anyways.

Fix 5
Redirect to State Home on Fed Home page
The Fed website gets traffic from all the 50 states. And then after asking several questions, redirects you to either the State's healthcare website where applicable or continues with the process. By making this the point of entry, you are reducing a significant load of those whose States already have their own health marketplace. And by having multiple sites, 1 for each State, the ability to manage the load as well as make State specific changes becomes simple.

Fix 4
Create a quick reckoner calculator of Healthcare options   
At the end of the day, the healthcare options are a factor of a few basic factors.
1. No. of persons
2. Sex of each person
3. Age of each person

This is the Law. It does not allow the insurance companies to use other factors that may impact premiums such as health, race, family history or any of those zillion things. That's it. A simple ready reckoner can give you the options available when you input these basic values. And most of the millions who were frustrated and want to know their options would have it in minutes. Automatically reducing the number of people accessing the website.

Fix 3
Minimal details required to compare
The current website requires loads of data to compare plans. After the previous steps, those who want to go further and want a formal proposal can be made to input the personal data. Such as Name, Address, Date of Birth and other required data. Again this can be reduced and restricted to under 10 parameters per individual.


Fix 2
No need to register
The current system required every visitor to register before they could get any info. Considering that the large majority of these visitors aren't likely to purchase the plans, its a waste of time and resources. Both of the individual and of the portal. Make as much info available outside of the registration. That way, only those who want to take the next steps towards purchasing healthcare need to register. Automatically reducing loads and resources by over 90%. Think of the impact a single road accident has on traffic. Its a cascading impact. Get the accidents off the road, and give a separate lane for fast traffic, and the traffic moves smoothly.

Fix 1
No server side validation of data at application
And finally get rid of all of the validations at the application stage. All you need to do is have a 1 line disclaimer that says "The policy is subject to all data provided being accurate". The same can be verified offline in a batch process at a later stage by the insurance companies issuing the policies. And the benefits can be verified by the Government when they are submitted by the Insurance company for verification. This will speed up the process and give the exact same accuracy as the current cumbersome system that uses interfacing with several systems including Credit Rating Agencies for verification of an individual. The Government is collecting money upfront. The payer (Beneficiary) needs to worry about the data being correct and accurate.

And the reason, all of this can be done in a coupe of days at low cost is that you're getting rid of all the complicated systems that have several bugs, issues, flaws, holes,... and replacing with a simple yet robust, scalable and equally or rather more effective system.

ZocDoc

Ever since my walk in the park, I've been meaning to visit a doctor. Mainly because there is the concept of Primary Care Physician and I didn't have one. A couple of weeks ago, I finally decided that I should go meet a Primary Care Physician, before something goes wrong.

I did what we normally do when we want a new trustworthy provider. Ask your colleagues and friends. They gave a few suggestions, I should check out. In most cases, it was their family physician. Unfortunately for me when I checked them out, they were either too far, or not taking new patients, or the earliest appointment was in a couple of months or ...

And so I did the next thing we do when we want to find something. Search for it n the Net. And whilst Google gave the names and addresses of a few providers, I came across a site called ZocDoc, which seemed to do exactly what I wanted. And so I registered. And searched for doctors in my area.

I made an appointment to meet a doctor in Norwalk close to where I work after a couple of days. I got an automated mail saying the appointment would be confirmed by the doctors office. The next day I received a voicemail saying I needed to call in to give my insurance details and confirm the appointment. I called in and the clinic's coordinator wanted to know what my illness was. As mentioned in the ZocDoc form, I said I just wanted a General Consultation in order to have a Primary care Physician and I had no ailments. She said in that case the doctor did not have time to see me. The earliest appointment available would be after 2 months. She claimed that they only do a few a month. This was weird and strange. The only reason could be is that ailing patients revenue / minute is greater than people who aren't well. No wonder the cost of treatment and medical premiums in the US are astronomical.

I wasn't happy with the doctor or with ZocDoc. And then I got a call from ZocDoc. They wanted to know what happened, were apologetic and send me a $10 Amazon Gift Card. The person who I spoke with was a real person, intelligent and who knew her stuff. So either I got lucky or they have an amazing back office operation. This interaction encouraged me to give ZocDoc 1 more try.

I found another doctor in Westport. And made an appointment. This time the appointment was confirmed almost immediately. I went in, met the doctor who seemed to be as good in person as his reviews suggested. I came away happy at having finally got my very own personal Primary Care Physician. And that was not the end.

I received a mail the next day, with a request to give feedback on the interaction with the doctor. What made it even more interesting was that it was a simple format that allowed the feedback to be given in the email itself with 3 simple clicks. And thus ensuring that the feedback percentage and thereby the effectiveness of the system was very high.

US government closed

Earlier this week on the stroke of midnight on Tuesday, Oct 1, the US Government was partially shut down. This sounds absurd. How can a government shut down ? And what does it mean ?

Great questions and there are several answers out there. There are also many opinions on who to blame. And depending on whose opinion it is, it varies from the Republicans, to Congress, to the Senate, to the President. The way the Government works is that there are 2 types of methods in which Government departments., or Government programs get funded. The first is those programs which are automatically funded. Programs such as Social Security, Medicare, Armed Forces. And then there are those which are funded on the basis of yearly congressional appropriations or basically congress approving an annual budget for the year. And these have to be approved by October 1, for the coming year, else those departments need to start cutting on spending. These departments include the National Park Service and so parks and monuments are closed as well as agencies such as the Pentagon, so civilian employees will start getting forced leave.

The television media is covering the negotiations or rather the lack of negotiations between the Democratic Senate, Republican Congress and a Democratic President. And whilst I have several opinions on why each of them is behaving like a spoilt brat, I'll let that pass for fear of being yet another voice who knows nothing about nothing.

Interestingly this is an annual event. And on most occasions a budget does not get approved. What does happen is that a Continuous Resolution is passed, popularly called a CR, which is nothing but akin to maintaining the status quo, until the next event.

I have a very simple solution to avoid the impasse. Its called "Tacit Approval". And what this implies is that whenever any decision is not arrived at by the majority in both houses which has been approved by the President, the TA (Lets give it an acronym so that its easier to get approved), automatically kicks in. In other words, the government can never be closed.

A question that may come to mind is that this could be misused by the political parties to avoid coming to an agreement. The interesting aspect in this methodology is that it can't be misused, since it doesn't allow any new events. So, if any party wants a new provision or want to do away with an old provision, they will in any case need to get approval of both houses of Congress as well as get the President's acceptance. What the TA does is avoids closing of any program due to a non decision or lack of consensus. So if parties are passionate about agendas, they'll need to work doubly hard to make it happen since inaction will achieve nothing.

IMHO TA is perfect for Government. It ensures that when the politicians do what they do best, "Nothing", "Nothing Happens" and yet everything will continue to function normally, leading to a lot of happy people. And more important very few unhappy people, except of course the politicians, since they would have lost the ability to have nuisance value.