Why health care is so expensive

A couple weeks ago I finally got around to reading Atul Gawande’s excellent New Yorker essay on why health care costs vary so wildly throughout the country. His conclusion—that this variance results from whether doctors approach their profession as a business or as a commitment to caring for patients—is so simple that many seem to have a difficult time accepting it. His article and follow-up are must reads for anyone who cares about health care in America.

Habitats – For a Writer, a Home With a Hideout –

Today’s New York Times profiles novelist Roxana Robinson. I can’t agree more about the need to have times and spaces where you know you won’t be interrupted.

Ms. Robinson, whose works include an acclaimed biography of the painter Georgia O’Keeffe and most recently the novel “Cost,” realizes that in choosing the unprepossessing small room over the more generously decorated bigger one, she has rejected a space most writers would kill for.

She can explain.

“I did everything but write in that room,” Ms. Robinson said. “I paid bills. I printed things out. I sent faxes. I was connected to the Internet.

“The assumption is that writers can write wherever they can sit down,” she added. “But the main thing you need as a writer is a sense of certainty that you won’t be interrupted.”

Distance from the Internet is part of the issue, but so is having a space that offers minimal distraction. For a writer living in New York, distraction can be the unwelcome flip side of inspiration.

Twitter Weekly Updates for 2009-07-10

Twitter Weekly Updates for 2009-07-03

  • I timed my run last night to arrive at Three Lives & Co. just before 8:30 closing to pick up Bruno Schulz's stories, but they closed early! #
  • How great a song is "Back to the Old House" by the Smiths? Really, really great. #
  • Has anyone used Google Street View to help them write about a place they've never been? #
  • Tired after sitting on the plane for two hours before leaving New York, but back to save the universe. #

Twitter Weekly Updates for 2009-06-26

  • Returning from four days in Woods Hole with Boone and Lori, testing @pandora_radio on 2g. Quality is good,, but how do I expunge the ads? #
  • Sublet my large studio next to City Hall Park in Manhattan for the month of July. Send me an @ reply if you're interested. #
  • What happens when #IranElection tweets start disappearing from search results because too many days have elapsed since posting? #
  • Check out the work of @joshto
    Josh! Big Water! #
  • RT @EliseBlackwell: In praise of the print journal. Thoughts from Granta's new editor: #
  • Just downgraded @TwitterFon to remove the ads. #
  • Picked up Rhett Miller's "The Believer" at Newbury Comics last week. Really enjoying "Fireflies": #
  • Banana, date, and lime smoothie and falafel sandwich at Taim. Yum! #
  • A rough list of my favorite #iPhone apps: What are your favorites? #

How to make your own ringtones for the iPhone

One odd limitation of the iPhone is that you can’t use songs from your iTunes library as ringtones. However, there’s an easy way around this restriction. Just create AAC files of 30 seconds or less that you want to use as ringtones and change their extensions from .m4a to .m4r and import them into iTunes. A full step-by-step guide is available here. What’s my ringtone, you may ask? Currently, I’m using the opening 30 seconds from Radiohead’s song “Fog.” Here’s a live version for those of you not familiar with the song.

My favorite iPhone and iPod Touch apps

I’ve been playing around with these devices for most of the year and have come to some conclusions about my favorite applications. Because Apple’s App Store is a bit of a mess, I’ve picked up most of my recommendations from other blogs and forums. So, here’s the list of apps that I wish I hadn’t had to spend time discovering because my iPod is better with them than without them, in no particular order:

  • The New York Times – I previously posted about this application and how I would be willing to pay a fair amount for it. The only things I can fault this application for are that it’s not always clear when it’s finished downloading the day’s paper and it runs sluggishly on the iPhone 2g. Otherwise, the ability to save and email articles is great, and the interface makes browsing the paper easy. This is probably my favorite app, in part because it downloads the paper for offline reading and because I love the New York Times.
  • MLB At Bat 2009 – This app costs $9.99, but it’s awesome. You can watch two live games a day and listen to any broadcast of any game live. I remember when I was a kid, I could barely get reception on the AM radio at night to listen to Vin Scully call the LA Dodgers games. Now I can listen to the Dodgers and the Yankees and the Red Sox and the Giants whenever I want. This app also features in-game video highlights from almost all games, which are nice, but the key feature is being able to listen to live broadcasts. More →

Twitter Weekly Updates for 2009-06-12

  • Anyone know a good place in NYC for a vegetarian dinner + watching the NBA Finals? #
  • RT @PublishersLunch: New Generation Is Sprucing Up Paris’s Shakespeare & Co. #
  • It seems like @mcnallyjackson has been recording its events, but how can I listen to them? #
  • The one time I got up during the game in the 8th, my favorite player hit a homer. Nonetheless, a fun night in the Bronx, Mo saves a 5-3 win #
  • Looking to buy a used iPhone 3G for $200. Tips, anyone? #
  • Goooooooaaaaaaal! Go Pens! 2-0. #
  • RT @GrantaMag: We have video of Mavis Gallant and Jhumpa Lahiri reading and talking in Paris #
  • Penguins! #

Twitter Weekly Updates for 2009-06-05

Samantha Power’s commencement address at Pitzer College


I recently discovered and immensely enjoyed the above commencement address that Samantha Power gave to Pitzer’s graduating class last year. Two topics it covers that I think are wildly overlooked by not just college graduates but by high-achieving people in general are a) the importance of whom you choose as your friends to your future success (above where you go to school or where you choose to work) and b) the importance of resilience and following your nose rather than your head. Confused about what that means? Well, turn up the volume on your computer and watch the speech.

Twitter Weekly Updates for 2009-05-29

  • This week’s New Yorker cover was made with an iPhone: #
  • NYT iPhone app: You can’t tell what kind of a story something is–news, column, news analysis. You can’t tell how long it is either. #
  • Checked Twitter this morning, hoping for reactions to Obama’s SC pick, but there are none in my feed. Maybe Twitter is for frivolity. Hmm. #
  • “…justice doesn’t threaten society and fairness doesn’t make us weaker.” -Tom Wilner #
  • “If something happened to me, I would definitely monetize it.” –@colsonwhitehead #
  • Just asked @colsonwhitehead if he had fired @assistantjarvis. Dude was not happy about the question, but the answer is Not Yet. #
  • I vow to leave #BEA09 with no more than 5 books, one of which will be the new Lorrie Moore. Suggestions for the others? #
  • Before dropping an F-Bomb at #d7 today, Yahoo! CEO Carol Bartz told it like it was during last quarter’s earnings call: #
  • Why you should never buy AppleCare from the Apple Store: #mac #apple #
  • Free trial from the Foundation Center. Awesome directory of grants: (via @pndblog) #
  • How about the opposing managers and catchers all getting tossed in the Red Sox game today?! #
  • Steven Johnson: Make individual landing pages and AdWords campaigns for each of the different topics in your book. #BEA09 #pubkeys #

Carlos Zambrano goes nuts

Carlos Zambrano got tossed from a game for the fourth time in his career yesterday, and it was quite a doozy. The play at the plate was extremely close and Carlos should have at least questioned it. And the umpire actually bumps ‘los before he pushes him away, so Zambrano has a reason to be upset over being tossed. However, what he does after the ejection is completely bonkers but what fun for us to watch.

How to get AppleCare cheap? The answer is eBay.

Like many but not enough people, I understand that extended warranties are, statistically, a rip-off. The odds are that I’ll pay extra for the warranty and then never use it. Best Buy, among others, makes a killing from selling its customers on extended warranties. However, I have one weak spot when it comes to extended warranties—well, two actually when you count that for car warranties—AppleCare. Ever since my PowerBook G3’s motherboard failed and left me high and dry back in the fall of 2001, I’ve consistently bought AppleCare for my subsequent Mac laptops. Sometimes I’ve needed it, and sometimes I haven’t.

And despite that mixed record, I just purchased AppleCare for my MacBook Pro, whose standard one-year warranty expires in a couple weeks. (Apple gives you one year from the original date of purchase to add AppleCare to its products.) AppleCare for the MacBook Pro and formerly the PowerBook is most expensive extended warranty that Apple sells at $349 for an additional two years of coverage. However, no one should pay full price for any Apple Care package. But how do you avoid paying full price? Well, that’s easy: buy AppleCare on eBay. I just got AppleCare for my MacBook Pro for $127. If you are patient and willing to following the auctions for a couple weeks, you should be able to find a similar deal. If you’re not, most Buy It Now prices for the package hover around $160-$170. That’s still a savings of over 50% off the normal retail price. How is this possible? The answer I’ve heard is that Apple requires its resellers to meet quotas for AppleCare sales and many of them end up dumping the warranties at low prices to meet those quotas. You can even find AppleCare for the iPhone, which normally sells for $69, for around $40 on eBay. So, if you feel compelled to buy an extended warranty for your Apple product, eBay is certainly the way to go.

*Update* Consumer Reports has found that buying AppleCare actually is worth its cost. Nonetheless, why pay full price when you don’t have to?

Twitter Weekly Updates for 2009-05-08

  • Read David Lipsky’s Rolling Stone profile of DFW, looking forward to Zadie Smith’s essay about Wallace. #
  • PEN World Voices Jean-Marie Gustave Le Clézio in conversation with Adam Gopnik #
  • A new, larger Kindle is coming soon? Seriously? #
  • A phrase that should be banned: “top of mind.” #
  • “…the Web is like an endless novel populated with characters who reveal way too much about themselves…” #
  • People don’t understand attention is a finite resource, like money. Do you want to invest your cognitive cash on Twittering? -W. Gallagher #
  • RT @yodiwan: Amazon’s Kindle DX page is now live: [$489 for this thing+sub fees+obsolete in a year? Sticking w/ print!] #
  • Amazon’s Kindle DX page doesn’t mention anything about textbooks, pilot program only for now. What will be NYT sub rate for this device? #
  • Is the new #Amazon #Kindle DX worth it? Not on the back of my envelope: #
  • On Kindle subscriptions for newspapers/magazines, Amazon gets 70% of subscription revenue, provider 30%. #
  • And Amazon gets rights for All mobile devices. That’s the split the Dallas Morning News is getting. Wonder how NYT, others compare…. #
  • Anyone know of iPhone apps that do the following: a) automatically scroll when you’re reading at a pre-set pace or b) read PDF books well? #
  • Just voted for the all-star game. Choices include Griffey, Manny, and my old neighbor in Berkeley, Conor Jackson. #

The Kindle DX is great, except that it’s a rip-off

Amazon Kindle DX

I eagerly read the news this morning about Amazon’s new, larger Kindle DX. The larger screen and the PDF capability seem to make it an ideal reader for not only newspapers and magazines, but also for books and and Word files and, well, nearly everything. The thought of 200-page books becoming 500-page books on the Kindle 2 never sat well with me, but it looks like the Kindle DX could preserve the original page dimensions for most books, which is great news. 

However, the problem I have with the Kindle is that it simply doesn’t make economic sense as a replacement for the publications I read. I subscribe to two magazines that are available on the Kindle—the New Yorker and the Atlantic—and sometimes subscribe to several others that aren’t, including the New York Review of Books, Elysian Fields Quarterly, the Believer, McSweeney’s, n+1, the Paris Review, I.D., and Open City. I also read the New York Times on a daily basis and am often a print subscriber. 

So, let’s see how switching to reading my subscriptions on the Kindle DX would work out. The initial cost of the Kindle is $489. I would also probably purchase the extended two-year warranty for an additional $109 because I’m a sucker for those things. I would probably purchase some sort of case for the device, but won’t include that cost here. Throw in sales tax of 8.25%, and you have an initial Kindle cost of $647.33. That’s a lot of money for a reader, but is it worth it? 

Well, let’s see. Subscribing to the New Yorker on the Kindle costs $2.99/month, the Atlantic $1.25/month, and the New York Times $13.99/month. I currently pay $29.99/year for the New Yorker, so I’ll just assume that there’s no cost savings at all for that magazine. I pay $24.90/year for the Atlantic, which works out to a savings of $0.79/month. Now, I’m aware that it’s not entirely fair to compare cash flows for a yearly magazine subscription paid all at once and the monthly Kindle costs, but it doesn’t make much difference in this example. Finally, let’s assume a print subscription cost of $30/month for the New York Times. Given the Times’ frequent promotional offers and my tendency to alternate between seven-day, Sunday-only, and weekend-only subscriptions, I think that value is fair enough for these purposes. Switching to the Kindle edition of the Times produces a monthly savings of $16.

Now, let’s assume an annual discount rate of 6% in better economic times. With a monthly savings of $16.79, it would take nearly four years before you broke even on the original cost of the Kindle. Four years from now, your extended warranty will be expired and your battery shot. It doesn’t seem like a very good deal.

Let’s include books in the mix and say that I purchase one new Kindle book each month, saving $6/book over Amazon’s existing hardcover prices. Even then it’ll take me two years to break even on the purchase price, by which time my Kindle DX will be obsolete. So, the Kindle never really generates any sort of sustained savings over its traditional media equivalents, at least for me. 

I’m aware that I’m not considering the value that users might put on the Kindle’s convenience and other features. Likewise, I’m not considering the premium that readers might put on traditional books—and the ownership rights, longevity, portability, and tangibility that come with them—either. Are any of those enough to make up for the shortfall? Or do they only swing the pendulum further against the Kindle? 

I have no problem with paying for digital content and the convenience that comes with it. In fact, I would probably prefer a less expensive device and more expensive content. At its current price-point, the Kindle DX is only going to attract early adopters and is far from becoming a product for the masses.

They might not know it’s dog food, but they know it doesn’t taste good

A recent study from the American Association of Wine Economists has been receiving online attention for its claim that people can’t tell the difference between paté and dog food. However, in the study, subjects still consistently identify the dog food as the worst tasting of the bunch. Then why don’t they go on to pick it as the dog food from the paté samples they taste? The problem is that asking subjects to identify the dog food is asking them to think too much about a question that doesn’t really require any deep thinking. If it tastes bad, it tastes bad, and thinking about it only allows you to convince yourself that it’s not that bad (or that your idea of dog food isn’t that bad). 

This tendency was best exemplified by a study performed by Timothy Wilson at the University of Virginia. He asked college students to rank a series of different strawberry jams. The students’ rankings were accurate when they only had to consider which one they like best. However, when Wilson asked them to consider more specific aspects, such as each jam’s texture, their rankings no longer reflected their own (or experts’) jam preferences. Thinking about these other, irrelevant factors prevented them from making accurate calls about the jams. The point: if you know something tastes bad, it doesn’t really matter what it is or how consistent its texture and color. It still tastes bad, even though they might fool you into thinking otherwise.

Jonathan Lethem’s Fortress of Solitude mix CD

Apparently, Jonathan Lethem handed out CDs containing his own personal soundtrack to The Fortress of Solitude after the novel came out back in 2003. The Millions was able to unearth the track listings on the Internet Archive, but the Archive’s page is now down. So, I’m posting the track listings here in the hope of preserving them a while longer.

    Disc One

    1. David Ruffin — No Matter Where
    2. Four Tops — Ain’t No Woman
    3. Bill Withers — World Keeps Goin Round (live)
    4. Randy Newman — Short People
    5. Syl Johnson — Anyone But You
    6. The Spinners — One of a Kind Love Affair
    7. Marvin Gaye — I’m Goin’ Home
    8. The Prisonaires — Just Walkin’ in the Rain
    9. Hot Chocolate — Brother Louie
    10. Manhattans — Shining Star
    11. Gillian Welch — My First Lover
    12. Marvin Gaye — Time to Get it Together
    13. Phil Ochs — City Boy
    14. Billy Paul — Let Em In
    15. Howard Tate — Get it While You Can
    16. The Spinners — Sadie
    17. Pete Wingfield — 18 With A Bullet
    18. Marvin Gaye — You The Man
    19. The Last Poets — Two Little Boys
    20. Maxine Nightingale — Right Back Where We Started From
    More →

Neuroenhancers and the key to productivity

Margaret Talbot published an excellent piece about neuroenhancers in last week’s New Yorker. One of the drugs that Talbot cites and whose use has spread this decade is Modafinil, which I wrote about back in 2002. I said, “The existence of a wonder drug that could abolish a person’s need for sleep … should be just as impossible as it sounds.” As I feared, off-label use of the drug has only increased since I wrote that. And even neuroethicists have moved towards endorsing cognitive enhancement.

Talbot writes:

Every era, it seems, has its own defining drug. Neuroenhancers are perfectly suited for the anxiety of white-collar competition in a floundering economy. And they have a synergistic relationship with our multiplying digital technologies: the more gadgets we own, the more distracted we become, and the more we need help in order to focus. The experience that neuroenhancement offers is not, for the most part, about opening the doors of perception, or about breaking the bonds of the self, or about experiencing a surge of genius. It’s about squeezing out an extra few hours to finish those sales figures when you’d really rather collapse into bed; getting a B instead of a B-minus on the final exam in a lecture class where you spent half your time texting; cramming for the G.R.E.s at night, because the information-industry job you got after college turned out to be deadening. Neuroenhancers don’t offer freedom. Rather, they facilitate a pinched, unromantic, grindingly efficient form of productivity.

There’s a much cheaper way to achieve productivity that we inexplicably gave up in the name of progress. It may be painful, but it’s worth a shot: Turn off your cell phone, unplug your wireless router—I know it feels strange, but vaguely familiar like how things used to be—sit down at your desk, and get to work.

Twitter Weekly Updates for 2009-05-01

Zadie Smith: The Internet is an absolute disaster for writers


I first met Zadie Smith in the summer of 2001 at a book signing in San Francisco. I waited in line with a friend for her to sign my first (American) edition of White Teeth. After she did, my friend, who didn’t have a book, approached her, and she signed his right arm. She also drew a dotted line around it and wrote “Cut Here.” I love her work for that very sensibility and humor.

Last night Jonathan Safran Foer interviewed Smith at NYU. (She has a collection of essays, Changing My Mind, coming out later this year.) I’ve read several polemical essays and books written in opposition to Internet culture. And I read them because I have the sense that life used to be different ten years ago, and, in many ways, it was better. Even four years ago, I was better able to concentrate on long projects than I am able to now; in short, the current iteration of the Internet has killed productivity—productivity at the things that actually matter. I think Malcolm Gladwell was right, in many ways, when he called Google “the answer to a problem we didn’t have.” But I don’t think I’ve heard anyone convey the problem as powerfully as Smith does in the snippet of last night’s interview that you can watch above. She calls the Internet “an absolute disaster for writers” because she spends too much time on Facebook and Google, and she imagines a generation of children who won’t know how to concentrate because they grew up with this Internet. And what will you get when everyone grows up with the web? Rebels who reject it! It’s powerful because Smith critiques with a seriousness that is funny rather than earnest, engaging rather than alienating. “Cut here,” she seems to say, “I dare you.”

Twitter Weekly Updates for 2009-04-24

  • If you think Twitter needs a value proposition, well, here it is: #
  • If web content and services are free, doesn’t that, uh, mean they’re worthless? #
  • Old favorite:”…he suddenly realized the meaning of the word ‘dissipate’—to dissipate into thin air; to make nothing out of something.”-FSF #
  • If the IndieBound iPhone app could check local stores’ inventory, it would be awesome #
  • Dowd’s interview with the Clutter founders in today’s NYT is hilarious but trite. #
  • Memories of DFW from Modernism/modernity: #
  • Hoping to check our Partners & Spade sometime soon: #
  • MacBook Pro battery % going crazy. Tried calibrating it yesterday, but still isn’t working well. Might be time for new battery. Suggestions? #
  • Someday the obsession with metrics will fall out of favor? #
  • My MBP battery only has 60% of original capacity. 🙁 Use coconutBattery to check your Mac’s battery: #
  • Anyone going to see Philip Roth on Tuesday? #
  • Listening to marketing directors from major credit cards. No mention of the millions of CC holders and shareholders they ruined. #
  • Fri. regression: RPS (but not exact %), tax rate, retail electricity price all matter in predicting state’s renew engy prod/capita. Others? #

Twitter Weekly Updates for 2009-04-17

  • Lost my Nike+ sensor in Chinatown. No wonder pace slowed! Time to stop tucking it under my laces and get a shoe wallet for the replacement. #
  • When the conditions are bad, Joba is on the mound. Yanks down 1-3 in KC. Ugh. #
  • Google bombing “Amazon rank” #amazonfail How long will my link last on Wikipedia? #
  • First game of the season in Central Park this morning! Shoulder = sore. #
  • Um, yeah, it works. See the Google search results: #amazonfail #AndYouWantMeToBuyAKindle?! #
  • Perry’s tee shot on 16 at Augusta: Wow! #
  • Fun event with @fredwilson I attended last Monday now posted on his blog:// #
  • This would get me to the farmers market: #
  • Fun event with @fredwilson I attended last Monday now posted on his blog: #
  • I can’t believe Spike Lee is copying the concept for “Zidane” with his Kobe movie: #
  • Can’t believe how quickly TriBeCa Film Fest tickets went online. Looking to see Racing Dreams, CBGB, and Kobe, if anyone has extras. #
  • Should apply critique to own blog. RT @amyoleary: RT @palafo: A critique of NYT article-level pages, via @NiemanLab. #
  • Just got back from #teaparty at City Hall. For the first time, felt utterly ashamed to be a New Yorker. #
  • Pitchers batting ninth and other bad baseball ideas from today’s WSJ: #
  • So much for opening day at the new Stadium. This game is over. Yankee down 9-1. #
  • Went to an excellent show with @rhettmiller at Le Poisson Rouge last night. Pictures are here: #
  • A great day at the new Yankee Stadium. Jeter homer puts us up in the 8th, Mo saves in the 9th, cue Sinatra. #