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"Everything People Think They Know About the Stimulus is Wrong"

US politics Obama stimulus Ezra Klein ARRA

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#1 QueenTiye

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Posted 10 September 2012 - 04:54 PM

http://www.washingto...mulus-is-wrong/

Link is to an interview conducted by Ezra Klein of the Washington Post, of Michael Grunwald, who is the author of the book The New New Deal: the Hidden Story of Change in the Obama Era. The interview is interesting enough to make me want to read the book.  A key excerpt:


Quote

EK: That gets to one of the central political problems the stimulus had, I think. It was called the Recovery and Reinvestment Act. The Reinvestment side was composed of long-term investments to jump-start tomorrow’s economy. But since it’s thought of entirely as a stimulus bill, those investments, which in another context would be huge accomplishments, are seen as a distraction from the central work of the law.
MG: Politically, one of the difficulties was the two-part messaging. You’re doing short-term recovery and transforming the economy in the long term. You’re doing tax cuts and spending. You’re doing stimulus now, and you’ll pivot to fiscal responsibility. You’re doing shovel ready and also looking for shovel worthy.
... take wind energy, which obviously it takes awhile to get a wind farm going. By the end of 2008, that industry was dead in the water. The day after the stimulus passed, one of the major wind companies, which was pulling out of America entirely, turned around and announced a $6 billion investment in the United States.
Health IT is another example I love. That’s one of the few where even they would admit there was no pretense of stimulus. The money didn’t go out the door till 2011. But right now, according to the Bureau of Labor Statistics, health IT is America’s fastest growing industry.

Hat tip to Andrew Sullivan at the Daily Dish, who excerpted some of the same portion of the interview here: http://andrewsulliva...e-stimulus.html

QT

Een Draght Mackt Maght


#2 Rhea

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Posted 12 September 2012 - 01:00 AM

I've already it on reserve at the bank (since I moved into an apartment, my space for new books is sadly limited).
The future is better than the past. Despite the crepehangers, romanticists, and anti-intellectuals, the world steadily grows better because the human mind, applying itself to environment, makes it better. With hands...with tools...with horse sense and science and engineering.
- Robert A. Heinlein

When I don’t understand, I have an unbearable itch to know why. - RAH


Everything is theoretically impossible, until it is done. One could write a history of science in reverse by assembling the solemn pronouncements of highest authority about what could not be done and could never happen.  - RAH

#3 Orpheus

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Posted 12 September 2012 - 01:45 PM

I was heavily into Health IT on a state and national level in the 90s, and even testified before Congress. However, I'm totally off it now. I thought it was just a basic matter of implementation (which remains completely screwed up after all the potentially easy fixes and approaches have failed), but it turns out that there are deeper reasons (still poorly understood) why Health IT consistently *increases* health delivery costs and resource utilization.

e.g Does Health IT Increase Ordering of Tests & Imaging? (list of articles)

It's the 21st century. IT is inevitably going to spread deep into medicine -- but right now (despite some great minds and sincere efforts) it's rampant Wild West snake oil hucksterism that I DO NOT believe should receive stimulus funds in the foreseeable future. Health IT is in desperate need of a deep industry-wide shakeout -- and I say that despite knowing that any shakeout would tend to favor conglomerates and proprietary business models that I personally despite. Truthfully, though self-built systems are expensive/risky for hospital groups to design, sometime have compatibility issues, etc, they are the source of the real success stories. "The Market" ends up consistently offering subtly crippled solutions whose negatives aren't realized until it's years too late to comfortably change  -- and some subtle but important effects that most will never realize are due to the software.

#4 QueenTiye

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    Behavior is not reproducible over multiple trials.

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Posted 12 September 2012 - 01:59 PM

^^ That's an interesting critique, and one I completely get.  The whole planned obsolescence g should absolutely not be built into our diagnostic machinery! And yet, the profit motive to do so in various ways is there.

At the same time, I was just today reading yet another article citing that the US wastes 750 billion dollars a year on health care - actual waste, in the form of overtesting, and delayed treatments for potentially worse/more costly diseases.  It seems that something has to be done - and the flip side of the health care IT issue you make is the burgeoning people-employing aspect.

It seems that health care is more like the arts - you want the passionate few - but what is the payment model for that that allows for there to be enough doctors, medicine, treatment facilities, nurses, etc?  An odd industry, health care.

QT

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#5 Orpheus

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Posted 12 September 2012 - 03:24 PM

It's not just obsolescence.

One example: the prevailing licensing/maintenance model often means that the IT company effective owns the stored version of your data (There have ben lawsuits for trying to retrieve/convert it to another vendor's product despite the "reverse engineering for interoperablity" clause of the DMCA and the body pf prior copyright. It's called "vendor lock-in" and buying your way out can be prohibitive. Keep in mind that YOU have a legal requirement to preserve those records for [depending on jurisdiction] decades past the lifetime of (effectively, the last surviving) patient.

You're also often limited to what they let you do. It's not uncommon to have to pay millions to have custom features programmed (which then add to the software company's portfolio of features to sell others -- or tell potential customers they installed for you, and only much later confess that they can't provide it to the new customer, unless they *also* pay for a custom coding job)

All together it makes highway robbery seems refreshingly honest and fair.

Medical IT is one of the big topics I mean to cover in "How IP abuse is ruining America"



Also tagged with one or more of these keywords: US politics, Obama, stimulus, Ezra Klein, ARRA

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