ARTS & FARCES internet

This week, two congressional committees—the House Ways and Means committee and the House Energy and Commerce committee—are scheduled to vote on a new Medicare bill. If passed, the bill would move to the full House of Representatives for a vote. The draft bill includes a provision that would increase the level of payment to dialysis centers. The payment increase would be funded by lowering the payments for home dialysis by 20 percent. Currently more than 340,000 people are on dialysis or have a kidney transplant in the United States and total treatment costs are US$17 billion each year.

The proposed payment level increase is problematic for hemodialysis patients for a variety of reasons. Most of us currently dialyze in dialysis centers—only about ten percent of U.S. end-stage renal disease (ESRD) patients dialyze at home—but the home dialysis technology improvements are promising. Most disturbing is that lower home dialysis payments will likely create a disincentive for dialysis centers to continue their home dialysis programs. Such a situation would, in turn, create a disincentive to the continued development of innovative home dialysis technologies.

While I have no plans for home dialysis, it’s important to me as a treatment option, especially since I’ve seen the level of care I receive at the dialysis center steadily decrease over the past two years. Dialysis technicians that six months ago seemed grossly incompetent—and obviously so—now bring relief when I find they’re on duty. It’s not because they’re suddenly competent, it’s just that some of the newer technicians are even more incompetent.

Joanna Glasner reports in a Wired article that the U.S. citizenry is plenty grumpy about a recent law—the Financial Modernization Act of 1999—that requires them to opt-out if they want to prevent financial institutions from sharing their personal information.

Opt-out notices buried in junk mail, confusing legalese, and potentially invasive sales tactics are the specific problems most cited in a survey conducted by the U.S. Treasury’s Office of Thrift Supervision over the past two months.

Adam Curry’s “The Big Lie” provides more evidence that the webloggers are doing a better job than Big Media of covering breaking news and providing in-depth analysis. Curry’s coverage of and reflection on the assassination of Dutch political candidate Pim Fortuyn is orders of magnitude better, more accurate, and more fair than anything on Fortuyn that has appeared in the mainstream media.

The common wisdom is that only Big Media can undertake the research necessary to report complex, difficult stories. Curry proves this to be unquestionably false in the extreme.

Business Week online technology reporter Jane Black has a good interview with Lawrence Lessig covering Lessig’s concern about the entertainment industry’s power grab for control of the Internet.

Lessig mostly regurgitates snippets from his latest book, The Future of Ideas: The Fate of the Commons in a Connected World, but it’s still worthwhile reading.

The result of a controlled network, as envisioned by the entertainment industry, is a significantly higher cost of innovation, according to Lessig: “Before, you just had to worry about complying with basic network protocol. Now you have to worry about making your program run on the full range of proprietary systems and devices connected to the network. Before, the network would serve whoever and whatever people wanted it to. Soon, you will need the permission of network owners.”

Lessig calls for immediate political action:

1. Mandatory low, fixed, compulsory license fees for distribution of content on the web;
2. Repeal of the 1998 Digital Millennium Copyright Act (DMCA);
3. Defeat of new legislation designed to protect the entertainment industry, specifically the Consumer Broadband and Digital Television Promotion Act (CBDTPA).

One of the gospels of the dot.com boom was Peter Schwartz, Joel Hyatt, and Peter Leyden’s The Long Boom: A Vision for the Coming Age of Prosperity, which—like an alarming number of similar works—actually started out as a Wired article. The technological, fiscal, and political revolutions of the last two decades of the previous millennium would reshape the world as we know it, according to the authors.

Unfortunately, the “revolutions” never really happened, and while technology continues its march to wherever it is that it’s going, the fiscal and political arenas are more corrupt and inhumane than ever. Looking back on The Long Boom, three short years after publication, it reads like a Panglossian fairy tale of what could have—should have—been, had this been the best possible of all worlds. To the authors’ benefit, and likely a result of Schwartz’s experience as a future scenario planner (Schwartz’s The Art of the Long View: Planning for the Future in an Uncertain World is one of the most important business books ever published), the premise of The Long Boom is presented not as prediction, but rather as vision.

And make no mistake. With two glaring exceptions, the authors’ 10 guiding principles are as useful and effective mileposts now as they were then:

1. Open up
2. Let go
3. Always adapt
4. Keep learning
5. Value innovation
6. Get connected
7. Be inclusive
8. Stay confident