"Give me a lever long enough, and a fulcrum strong enough, and single-handed I can move the world." - Archimedes Martin Jensen makes commentaries on real issues, or at least interesting essays. Banality filter is on.


Oh, and I thought I was so clever thinking that blogging on HIPAA hadn't been done. Then I found this guy named Jeff Drummond, an attorney down in Dallas, whose hipaablog has been up for well over a year. He concentrates on privacy, but he seems to know a train wreck when he sees it.
Six Degrees of Bloggeration
So I put a message out to someone I met during my blog apprenticeship. "I want to blog to save healthcare. What should I do?" He not only gives me great advice, he references me in a blind link. Talk about trust.

He's a pretty popular guy, and he drives traffic up to my site by, well, I'm not sure how much, because I just got the hit counter installed on the day I sent him the message. But a lot.

Meanwhile, I give him his props by commenting on his blog, and ask for some help, too. Some guy with all the right background comes out of nowhere (blogwhere?) and offers his expertise. Turns out, he lives 1500 miles away, but the little girl I saw grow up and move away from Tulsa had a baby in his wife's birthing center in NYC. The baby was born very sick, but is well now, thanks to the care he received there. For all I know, his wife helped save the life of my best friend's first grandchild, and now he is offering to help me.

Life is good. Now if I could just get my archives to reappear.


Idle blogging. I started this blog nearly two years ago, calling it "fulcrum" based on the ancient Greek saying, "Give me a fulcrum strong enough, and a lever long enough, and I will single-handed move the world." Well, I fell from the Blogosphere, but I never lost sight of that concept. I've been walking along with my lever looking for a fulcrum to wedge it into. Here is what I came up with:

The HIPAA EDI Train Wreck

See, I belong to this odd group of techical/medical/business persons who understand that HIPAA is not just about privacy, it's about remaking the way that healthcare insurance transactions are conducted. Big deal, eh? Well, it is when you realize that one-seventh of the US economy is built on those transactions. And that the rules they came up with are flaky enough, yet strict enough, to make the whole segment fly off the tracks in October.

I've made my living for twenty years asking stupid questions. See my "Generalist Rant" somewhere on this site. When I started asking stupid questions, I started getting scary answers. That's the way, sometimes. When I started working with all these scary answers, I realized I needed to explain it to people outside the (relatively) small, specialized community I was working with. So I wrote a paper The Looming Financial Crisis in Healthcare: A Management Analysis of the Scheduled October 2003 "HIPAA Train Wreck."

Today, some people from the government got on a conference call and said they couldn't do anything -- the law required the train to wreck. But they published something quite different. It said the tracks could run in parallel -- old format and new, until everybody could make the new format work. I don't know if I had anything to do with it. I may never know. That's the way, sometimes.

I just keep sticking my lever under likely-looking rocks.


Tonight I wished my father (see below, above, before and after) his happy 81st birthday. Tonight my daughter, now 10, said something about the mathematics of date sequencing -- that October 10, 2010 would be 10-10-10, then there would be 11-11-11, then 12-12-12, and not again for nearly a hundred years. She said she did not want to live to be old enough to see it. I explained that when I was a kid, 80 meant decrepit, but now Grandpa Al was hale and hearty. Had a few health challenges, of course, but doing fine. When she was a hundred, I said, a hundred might very well be a good age to be.

I was in my endocrinologists' office today. He's in a "heart specialists" practice, but so many heart patients have diabetes that he fits right in. Next to me in the waiting room was a slender teenage girl, and I nearly shed a tear seeing her there with the old and overweight, the walker-bound and wrinkled. I hoped she was waiting for someone -- a grandma given a ride, maybe, or a daddy in the exam room. Presently she pulled a meter from her purse, just like mine at home, and I wanted to move to the chair next to her and say, "How long, honey? How long have you been Type 1?"

I couldn't, because it would have seemed like a come-on, all her tender sadness there in its magazine-cover glory. So I continued my counseling in my head. "I had a great aunt who lived to 90 before the days of insulin," I would say. "This really sucks for you, I know, but it sucked more before, and it will suck less in the days to come."

And, "The government is talking about a healthcare initiative to address chronic diseases. So much has happened in the last 10 years."

And, "Remember that this is your life and your disease -- it is you that must live with it. Forget all the 'shoulds' and 'shalts.' You have to find a way to live, and the others will have to learn they must live with your decisions."

I looked at her and thought of my own beautiful children. And was grateful and ashamed.


Reply from an Octogenarian (Eight Years on the Net)

As you know I live in a gated over-55 retirement RV park resort, yet computers are so widespread here that those who do not make some use of one stand out... and often try to explain their position. Most who do use computers use them fairly simply, for writing, for correspondence and family/friend contacts, and for keeping up to date. Some are whizzes, and they are often asked to help friends and acquaintances. We have a computer club and a geneology group deeply involved in computer archaeology. Several of our fifty clubs have email contact letters. And we are not strange!

I would suggest getting a look at the business and goals of the Datamonitor sponsor of this crap


The Reverend J.
"Let's print the internet so everyone can read it!"

From a health industry newsletter I receive:

New research from Datamonitor finds that while there is an abundance of breast cancer information and support groups on the Internet, the vast majority of breast cancer patients are over 55 and are therefore the least likely to use the Internet or have access to a home PC. As such, most breast cancer patients may find themselves unaware of the support available to them. One solution to this problem would be to focus on promoting offline support resources, such as books, telephone help lines and support groups, since the availability of these services now is not readily explained to patients.

The idea that 55+ patients are not capable of learning to use a computer even to save their own lives, implicit in this conclusion, is perhaps the most insulting thing I've read in a great while.



I pulled up a video clip on David Weinberger's JOHO Weblog just now.

It's a mean-spirited thrashing of President Bush's inability to handle common figures of speech. We enjoyed it immensely.

My wife and friend Michael were looking over my shoulder as I played the clip, and we began offering opinions as to what the president really did say. Are you familiar with this game? "What did he say? No, I think it was ____."

I've christened this game as "Bushfill," the process that goes on in one's head when you try to take W's actual words and create complete sentences and/or ideas. I became aware of the phenomenon as I listened to an audio clip from some key speech on NPR. They played it several times in the morning as I was getting ready and driving to work. I thought about it all day, "What'd he say?" Then I listened again on the way home, and they played it again. "Man, he really did say that!"

This is somewhat encouraging. Because if I do it, hearing the president's words only a few times over the course of a month, then the people who work with him, and talk to him every day, must be grand masters at the game of Bushfill. That, I presume, is how Colin Powell and Donald Rumsfeld can walk out of the same cabinet meeting and issue completely contrary statements on what the administrations current policy might be.


How to Annihilate Terrorism

Here’s the thing. The title of this essay is, “How to Annihilite Terrorism.” Sounds pretty militaristic, especially coming from me, right? But if I was really militaristic, I’d say, “How to Annihilate Terrorists.” See, the “Bomb’em to the Stoneage” crowd thinks that “terrorism” is a thing, like mosquito larvae or microwave ovens.

But terrorism isn’t a thing. It’s a tactic. It’s a tactic used by desperate, disenfranchised people who would rather be selling rugs or herding goats or building hotels.

Okay, that’s a bleeding heart liberal perpetrator-as-victim mentality. So I’ll admit it. Terrorists are irredeemable scum-sucking vipers whose twisted mentalities sprung like a seed from their mothers' wombs without external influence of any kind.

But for some reason, their communities support them.

Maybe it’s because Al Qaeda builds schools, and we bomb them.

No, still too simplistic. Unpatriotic.

So let me put on my patriotic hat, play my fife and beat my drum.

Our way is better. We are ten times more humane, twenty times more generous, seventy times more forgiving than those bigoted zealots. Our system of government, our guarantees of individual liberties, our religious tolerance is superior to their theocratic dictatorship, their self-righteous oppression.

We should cut them off at the knees.

Here is my insidious strategy:

For every fundamentalist, West-hating school they slap together out of mud and straw, we should build two schools and a hospital. Out of brick.

For every suicide bomber family subsidy, we should sponsor three legitimate entrepreneurs.

For every bag of rice, a case of medical supplies; for every AK-47, a half-dozen child-size flak jackets; for every shoulder-mounted missile, a bulldozer and a backhoe.

My cold and calculating approach has a precedent. When the US government wanted to destroy the Indians, they killed all the buffalo. To destroy terrorism, we must heartlessly defile the desperate and hopeless soil in which it thrives.
What Pop’s Under God?

Okay, I’m not a religious Pepsi drinker. That is, about Pepsi as a brand. But you know, I only drink diet soda, and Diet Coke tastes kinda like rusty bilgewater. And okay, so Allie feels the same way, and we’ve raised the kids so they don’t drink Coke either. They drink Dr. Pepper, or Mountain Dew or Slice.

So today I got a message from a friend. She’s passing along an email that got passed along, that got passed along. You know the routine. And according to the email, Pepsi doesn’t believe in God. Or at least, Pepsi doesn’t believe in under God. So okay, I read the email and it’s like one of those urban mythology chain letters that says how Pepsi is going to come out with a special Commemorative Can that has the flag and the Empire State Building and the Pledge of Allegiance. Only the Pepsi Pledge of Allegiance leaves out the phrase “under God.” Which is to say, they used the text of the original Pledge of Allegiance, rather than the version that congress revised in 1950 to point out how we were different from those godless communists, like if it weren’t for the new Pledge of Allegiance 2.0 nobody could tell the difference.

And the email says I should boycott Pepsi because they don’t want to offend anyone so they took Under God out. And so I’m looking at this urban email, this well-meaning spam and I’m thinking, “Should I pass this along to everyone I know, just like it says?” Well, I’m not really thinking that, of course. Instead I’m thinking, “Do I just delete this like all the other messages I get that have more strangers’ email addresses than actual text, or do I respond?”

I’m feeling ornery, so I respond.

This is what I say:

[Dear Friend]

We were just talking about this at the dinner table the other night.... As you probably know, the Pledge of Allegiance (with the "under God" phrase, which happens to have been added after the original text) is a mandatory part of the school day ritual in most classrooms across the US. I object to this for two reasons:

1 - I believe that religious expression -- even when this expression is to deny the existence of God -- is the supreme province of the individual. Government which impinges on the territory of religion compromises the authenticity of both government and religion.

2 - Even as a believer in God, I have trouble with the phrase "under God" on a personal level. It implies that God is "up there" and I am "down here." That separation is the antithesis of my beliefs and the very name of my chosen denomination: Unity.

So, I'm going to continue to enjoy my Pepsi....

And so now I’m thinking that religion is like email. Everybody should be allowed to say what they want, no matter how repetitive or wrong-headed I, in my ultimate wisdom, know it to be.

And maybe you’re one of those people that can’t tell Coke from Pepsi, or Catholicism from Protestantism, or Free Will Baptistry from Apostolic Bibolatry. But to some of us these are fundamental distinctions. Are you a Pepsi Drinker by drinking Pepsi, or was it predestined? Can those who choose the path of Coca Cola find redemption?

And I’m also thinking that some religions may very well be like this email – not even a true story, but something made up in a marketing office in Atlanta. The apocalyptic Pepsi Can they describe is never even going to arrive, and they know it. But they send it along so you will get the true message:

Drink Coke.


An Open Letter to My Schoolmates

Just signed up for that service
You know the one
See who
You may have knew
May be looking for you

A few
Names popped out, but shoo!
So many strangers,
Even those once known flew
From head like few
Last cells of brainstem, clues
Like faces dimmed
Like dances in the dew

This stew of friends remain
These memories glimmering
Like soft shoe in the rain

Hope springs anew
I look not particular
Just an instance of you

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