My Doctors, Insurers?

My doctor, Garrison Bliss, and his two partners at Seattle Medical Associates are part of a group of practices that are being examined to see if they're actually insurers. Given that they provide a service in exchange for a fee and don't pay any of my bills for me, or act in any way like an insurance company -- I'm not eliminating any risk in my finances by paying them a monthly retainer fee -- this is absurd, but the law might be cast in such a way as to suck them into its net.Clearly, there's a problem when a middle-class guy like myself can afford to get great medical care outside insurance by paying a doctor a monthly fee regardless of whether I see him or not. This removes this doctor from the pool of all doctors that people with insurance might see. But the system itself is what's broken: health insurance, malpractice lawsuits and insurance, the medical bureaucracy, and the oceans governmental regulation have combined to make medical costs skyrocket. My doctor's practice had to raise their rates to cover what they estimated as $100,000 in costs to comply with the medical privacy rules recently passed. While those rules have good components, they're so overly broad and require so much implementation, that medically associated organizations have chosen in some cases to release no information to anyone because of the potential of fines and jail time! The investigation of my doctor and similar retainer-based practices appears to be driven by the insurance companies, who I guess are seeing a potential threat to their monopoly. My health insurance, in fact, doesn't include doctor office visits (which is why I'll be changing my insurance soon to add it). It's critical to distinguish my doctor's practice from The Polyclinic and others that are charging supplementary fees and collecting insurance as well. If I have to go to Olympia and protest for the right to have a private relationship with a doctor and pay him a retainer, I will.

Bandwidth Insights

On O'Reilly Network today, you can read my insights after almost facing an enormous bandwidth bill. You might have read about my bandwidth blowout elsewhere, but here's where I examine some of the costs for hosting and colocation, and some of the reasons why P2P (or edge to edge) bandwidth distribution haven't yet become popular outside of niche audiences.

Giga Culpa

I was so excited writing about gigabit Ethernet and IP-over-FireWire in my Seattle Times column on Macs today that I forgot to doublecheck a new bit of information. I incorrectly stated that eMacs have gigabit Ethernet now, even though I checked every other models' support for the 1,000 Mbps standard. Actually, eMacs have AirPort Extreme, the first consumer model to have the 54 Mbps-raw-draft-standard 802.11g networking.However, my points in the article are still valid: the 15-inch and 17-inch PowerBooks, all Power Macs, and the Xserve have gigabit Ethernet support and you can use an Asante PCI adapter for older Power Macs. (However, G3 Power Macs don't seem to be able to send more than 90 Mbps on a 1,000 Mbps pipe.) Part of the interest with gigabit Ethernet and IP-over-FireWire is that it provides a multiplicity of options for transferring lots of data really fast between peers, via switches, or across clusters. No other computer systems outside serious Unix/Linux boxes offer such built-in, no-configuration support for this scale of data transfer. You have to install a separate software package from the Apple Developer site to use IP-over-FireWire, but once you've installed it, FireWire is just another networking option in System Preferences, not yet-another-pane-in-the-system to manage. (Yes, that's a pun.)

Warped PowerBooks

A few weeks ago, I posted a query about warped 12-inch aluminum PowerBooks. People continue to post short notes about their own experiences. What I'm wondering now is the continuation of that story: is Apple servicing these units with the results you expect? Do they listen, send you a box, replace or repair it, and return it, or are you getting hassled about normal wear and tear?The stories that I've followed up on, people have fixed the case themselves through mild pressure or stacking books on top (both make me nervous), lived with it (for the time being), or had Apple service it with a minimum of fuss with just one exception -- in which Apple eventually did take care of it.

isbn.nu High on Bandwidth

Many of you all know that I run a book price comparison site that checks on prices at a bunch of online bookstores based on the title(s) you select. It's a good moneymaker, and a great way for me to try out ideas and learn about programming.The traffic to the site had gotten high enough that our office 768 Kbps DSL line couldn't support it: we weren't saturating our bandwidth, but we were filling it quite close most of the time. This line serves our regular needs as well as a bunch of locally hosted sites and isbn.nu. I decided to follow the precept that if you're bandwidth limited and you get money based on traffic -- in my case through sales that result from clickthroughs on book prices -- that removing the bandwidth cap should increase one's revenue. I signed a contract to use digital.forest, a nearly 10-year-old hosting and colocation firm. For about $300 per month, they give me up to 10 Mbps. I pay $1 a gigabyte when I exceed a preset amount each month. One of my decisions was whether to stick with Linux, or move to FreeBSD or Mac OS X Server. After discussing it with the digital.forest folks, I decided to spent a little extra money and get a dual-1.33 GHz Apple Xserve. It has a lot of nice features, including a pretty way to expand storage. I put an extra gig of RAM in for a total of 1.5 Gb. Since moving services over early this last week, I've watched bandwidth use grow from a few tens of Kbps up to an average during the day of over 1500 Kbps, sometimes peaking almost twice as high. So far, I'm not seeing the financial returns: several affiliate programs let me see the results of sales immediately or within a day. But I can't be feeding out that much more bandwidth and speeding up the system and not seeing results. Because I have to retrieve XML and similar documents from each bookstore for each search, being on a 10 Mbps Internet feed allows the searches to happen that much faster. Latency is lower. And the Xserve is somewhat more zippy than the previous isbn.nu box. This also allows me to have the horsepower in my office to build database more frequently. I'm currently nearly two days into a database build of all the subject, author, publication date, and related databases used for isbn.nu searches. It'll take about five or six hours to transfer these databases over from my site to digital.forest, so I'll copy them in the middle of the night. When I get clever, I'll wind up automating the database build and copy so that each week, when I have a new feed from my source, it'll run the build, and, when finished, initiate a mirror operation. My only problem will be that once I get on that cycle, I'll need to make sure that I put in another hard drive on the Xserve just for these mirrored databases -- otherwise I'll forget about it for a few weeks and the machine will start screaming about out of disk storage!