4 October 2015

When should you not report a name?

We're back in that cycle of a post-mass-shooting where some struggle or denounce, faux heroically, naming the shooter. The logic is that the shooter wanted attention and, by getting it, will spur on other potential shooters who want attention. The Wikipedia article, Umpqua Community College shooting, gets over with it in the second sentence by naming Christopher Harper-Mercer. Facts are facts, whether you choose to suppress them or not.

The Reddit post, This just happened on CNN..., is a prime example of the do-not-name camp. It includes a video from CNN with a clip of the local sheriff refusing to name the shooter, followed by the reporter naming him. Reddit's opinion as represented by the multi-thousand up-voted comments, several of which were given gold, is that this is an example of media hypocrisy (how?), irresponsibility, arrogance (again, how?), and blood lust (what?). Reddit rarely shocks me with large subreddit, highly up-voted posts going completely opposite to my opinion. However, others who I respect, notably Charlie Brooker back in 2009, also disagree with me.

On The Media, regarding the 2012 Aurora shooting, discussed the issue in the segment Don't Say His Name. Interviewing the father of a victim who is part of a group trying to get media outlets to hide shooters' names, Bob Garfield cites the five Ws as a basic tenant of reporting. The exceptions to reporting "who" are usually (always?) that of rape victims or minors. That is: the assaulted, innocent survivors receive the solace of anonymity.

To hide facts of a car chase or the oft romanticized bank robbery or a home invasion or mass shooting based on the fear that there is someone who will then want to replicate it takes us into a labyrinth of reactively filtered speech. It proposes to remove information from the news if it might trigger any imbalanced fetish out there. That, ultimately, reduces the well-informed-ness of the public.

posted by sstrader at 11:11 AM in Culture & Society | comments (0) | permalink

18 September 2015

Health cost

Do emergency room medical costs of the uninsured affect the insured?

Trauma in the ER: Who pays for the uninsured? from the LA Times on 18 Jun 2012 describes how and why the federal Emergency Medical Treatment and Active Labor Act was passed in 1986. It requires hospitals to provide emergency room care regardless of the patient's ability to pay.

But the bills come due. And although emergency care accounts for a small fraction of total healthcare spending, many hospitals are feeling increasingly strained by the free care they provide.

Last year, MedStar Washington reported delivering $107.2 million in care for which it was not reimbursed. Nationwide, the total amount of uncompensated care provided to the uninsured reached an estimated $56 billion in 2008, according to one study.

Those costs have prompted financially strapped hospitals to rely on a complex system of shifting costs. Most of the burden falls on taxpayers, with the government providing tens of billions of dollars annually to help hospitals care for the uninsured. Privately insured Americans also pay a price as insurers raise premiums to reflect higher charges from hospitals. [ emphasis mine ]

In other words: the costs of emergency room use by the uninsured gets shifted to government-reimbursement (potentially raising taxes) and insurance company reimbursement (potentially raising individual coverage costs).

How much is emergency room spending compared to total health care spending?

Does emergency care account for just 2 percent of all health spending? from PolitiFact on 28 Oct 2013 examines what percent emergency room spending represents of total health care spending. In 2008 (the same year referenced in the LA Times story), total health care costs were $2.4 trillion. The PolitiFact article quotes two valid estimates of <2% and from 4.9 to 10%, pointing out that there are diverse metrics to use and no single calculation is definitive. These percentages represent costs from $48 billion to $240 billion. The LA Times story says uncompensated care was $56 billion in the same year. Compared to the emergency room estimates, this number suggests that it could represents emergency room plus elsewhere.

Has Obamacare reduced insurance premiums (by reducing un-reimbursed emergency room visits)?

Obamacare was signed into law in Mar 2010. Considering the many assumptions above: has the hospitals' burden been reduced in order to reduce the government's, taxpayers', and insurance companies' burden? And have insurance premiums changed for the larger pool of policy-holders? Patient Protection and Affordable Care Act > Impact > Public Policy > Effects on insurance premiums from Wikipedia provides CBO estimates pre-implementation from Dec 2009, along with Kaiser Family Foundation findings from Jun 2013. The definition of who will be affected and how is by the nature of the problem not straightforward, as is suggested by the opening sentence:

Several studies on insurance premiums expect that with the subsidies offered under the ACA, more people will pay less (than they did prior to the reforms) than those who will pay more, and that those premiums will be more stable (even in changing health circumstances) and transparent, due to the regulations on insurance.

For additional variables in the equations, we could look at whether the person is self-insured or employer-insured. Here are the CBO's estimates of percent cost increase by group:

  • Individuals (17% of the market): 10-13% increase, over half are eligible for subsidies
  • Small groups (13% of the market): 1% increase to 3% decrease; for those eligible for subsidies: 8-11% decrease
  • Large groups (70% of the market): up to 3% decrease; for high premium plans: 9-12% decrease

By Sep 2013, the actual premiums were better than predicted. The Jun 2013 Kaiser study found that for individuals purchasing their own insurance, Obamacare saved this group of consumers $1.2 billion in 2011 and $2.1 billion in 2012, reducing their 2012 costs by 7.5%. This does not immediately reconcile with the predicted 10-13% increase, but may be explained by the subsidies provided.

posted by sstrader at 10:39 AM in Culture & Society , Politics | comments (0) | permalink

26 August 2015

Techniques after using Swift for a month

At work, I was put on an iOS/iPad app project a little while ago. I've never written anything in the iOS ecosystem so I spent about a week to research before digging in.The transition was smooth primarily because I'm using Swift--a much more succinct and modern language than Objective-C--and my somewhat dated Android experience and very dated Windows dev experience provided me with all of the patterns I needed to understand iOS. Also, coming off of Groovy development, Swift's syntactic sugar was immediately understandable.

I came up with two small techniques for the project. One helps with data persistence using Core Data with models and entity managers, a la JPA. The other technique simplifies updating multiple views using the Notification Center with type safe additions. They've helped to speed development and--the thought of every developer who thinks they've discovered something new--some aspects aren't commonly known (which could be good or other).

My Core Data code starts with the NSManagedObject model generation. In a separate file, I create an extension class so that the model can always be re-created without wiping out my custom methods. I also create a class derived from a DAO utility class to implement all CRUD methods using generics. The DAO util:

class DaoUtil {
    var managedObjectContext: NSManagedObjectContext
    var managedObjectModel: NSManagedObjectModel
    var entityName: String
    init(managedObjectContext: NSManagedObjectContext, managedObjectModel: NSManagedObjectModel, entityName: String) {
        self.managedObjectContext = managedObjectContext
        self.managedObjectModel = managedObjectModel
        self.entityName = entityName

    // ... create, find, count, and delete methods


The find, count, and delete methods come in an *All() version and a *(fetchRequestName: String) version. The implementation for a User model would be as follows:

extension User {

    // ...


class UserDao: DaoUtil {
    let EntityName = "User"
    init(managedObjectContext: NSManagedObjectContext, managedObjectModel: NSManagedObjectModel) {
        super.init(managedObjectContext: managedObjectContext, managedObjectModel: managedObjectModel, entityName: EntityName)
    // ... custom methods


This design favors the data mapper pattern over the active record pattern, which I think is more common in iOS. I prefer a separation of data object and persistence.

The other technique is a type-safe wrapper around the notification center. iOS's notification center calls reminded me of Windows SendMessage (and, with dispatch queues, PostMessage). One potential issue with these is the lack of type safety since you're effectively passing around a void pointer. Using Swift's generics again allows us to create small, typed versions based on a named string constant, an event (e,g, BeforeUpdate or AfterDelete), and an object type.

The core of the implementation:

    private func observe(id: String, event: Event?, notify: (observable: T?) -> Void) -> NSObjectProtocol {
        var observer = notificationCenter.addObserverForName(id, object: event, queue: NSOperationQueue.mainQueue()) { notification in
            if let userInfo = notification.userInfo, observable = userInfo[id] as? T {
                notify(observable: observable)
            } else {
                notify(observable: nil)
        return observer
    private func notify(id: String, event: Event?, observable: T?) {
        if let observable = observable {
            notificationCenter.postNotificationName(id, object: event, userInfo: [id: observable])
        } else {
            notificationCenter.postNotificationName(id, object: event)
    func observeUser(event: Event?, notify: (equipment: User?) -> Void) -> NSObjectProtocol {
        return observe(NotificationService.Name.User, event: event, notify: notify)
    func notifyUser(event: Event?, user: User?) {
        notify(NotificationService.Name.User, event: event, observable: user)

With this, I can trace publishers and subscribers by type and event, but still take advantage of the built-in message queue. Still much to learn ...

posted by sstrader at 11:41 PM in Programming | comments (0) | permalink

23 August 2015

The children of Infinite Jest

Listening to dialog from the movie The End of the Tour (which we will probably go see tonight), spoken by David Foster Wallace:

So look, as the internet grows in the next 10, 15 years, and virtual reality pornography becomes a reality ... we're gonna have to develop some real machinery inside our guts to turn off pure, unalloyed pleasure or I don't know about you, I'm gonna have to leave the planet. ... 'Cause the technology is just gonna get better and better and it's gonna get easier and easier and more and more convenient and more and more pleasurable to sit alone with images on a screen given to us by people who do not love us but want our money and that's fine in low doses but if it's the basic main staple of your diet you're gonna die.

Taken from the On The Media interview that Brooke Gladstone had with David Lipsky 'We've Sort of Become Friends': The Original Tapes from David Foster Wallace's '96 Book Tour (transcript here).

This fear is examined and realized in Peter Watts' book Echopraxia in several forms: biological sex has become non-existent, relationships are created by altering each others' personalities to be more compatible, a large percentage of the human population lives only hooked in to a virtual world, etc. He suggests that our basic desire to eliminate pain will inevitably lead us to become not-human. Our toolmaking will destroy us. DFW worried in a similar manner concerning drug addiction and pleasure-seeking. The idea of a rat continually pressing a button for pleasure until it dies is unnerving. When I had written about Echopraxia, I recognized the connection to works by several other SF writers but hadn't considered how deeply these themes are encoded in Infinite Jest until I heard the quote above.

posted by sstrader at 3:48 PM in Language & Literature | tagged david foster wallace, posthuman | comments (0) | permalink

11 July 2015

Peachtree Road Race 2015

After a 40+ min delay from the rain, we swam our way to a late finish: 56:14. Down four minutes from last year.

Retired my now 3-year-old Vibrams (!) and got my 3rd pair. Went to Abadabba's in Buckhead again; excellent selection and staff.

I look horrible in the photos as I retired both my Vibrams and my 2009 Crescent City Classic t-shirt:

posted by sstrader at 11:45 AM in Where was I? | tagged jogging | comments (0) | permalink

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