*michael parekh on IT*

ON MEDICINE GOING DIGITAL

SHARP CURVES AHEAD

The Economist recently had a Special Report on healthcare, with a focus on medicine going digital.  It frames the current place we find ourselves particularly well:

"Menno Prins of Philips, a Dutch multinational with a big medical-technology division, explains that, “like chemistry before it, biology is moving from a world of alchemy and ignorance to becoming a predictable, repeatable science.

” Ajay Royyuru of IBM, an IT giant, argues that “it’s the transformation of biology into an information science from a discovery science.”

It goes on to introduce the piece itself:

"This special report will ask how much of this grand vision is likely to become reality. Some of the industry’s optimism appears to be well-founded. As the rich world gets older and sicker and the poor world gets wealthier and fatter, the market for medical innovations of all kinds is bound to grow. Clever technology can help solve two big problems in health care: overspending in the rich world and under-provisioning in the poor world.

But the chances are that this will take time, and turn out to be more of a reformation than a revolution."

This reader is a bit more optimistic than it will be more of a revolution than a reformation, particularly because once technology starts to get into the driver's seat of the business model of a particular industry, a slow roll quickly becomes a land-slide.  Notice how business models have already changed in media and telecommunications, for instance.
Here's to big changes in the right direction in a timely manner, for all our sakes.

ON A KEY LEHMAN RIDE

PUNCHY TIMES

Reading this article titled "How Lehman Brothers got it's real estate fix", one gets a clearer sense of how companies can be caught up in the thrill of a chase, just like people.  The New York Times piece chronicles the up and down cycle of Lehman's real estate infatuation, lead by 49-year old Mark Walsh:

"Many factors, of course, contributed to Lehman’s demise last fall. Near the end, it carried $25 billion in toxic residential mortgages.

It was wildly overleveraged. And the federal government made the fateful decision not to rescue Lehman from its mistakes. But when real estate overheated in the years before Lehman’s implosion, Mr. Walsh made billions of dollars in loans and equity investments that also ultimately helped bring down the bank."

There are compelling anecdotes that make up the story, including how premier Manhattan buildings like the Chrysler building were bought and sold at ever increasing prices.  The whole piece needs to be read to get the full impact, but here's one that hits home:

"Developers also loved the fact that Mr. Walsh was willing to lend them enormous sums. In 1997, Barry Sternlicht, then the chief executive of Starwood Hotels and Resorts, needed $7 billion to buy ITT.

“I called up Mark and Goldman Sachs and said, ‘Would you be interested?’ ” he recalls. “Goldman said they were. They came to see us. But we needed to get it done really quickly. Mark said, ‘Yeah, we’ll do it.’ I said, ‘Really? You are going to do it yourselves?’ He said, ‘Yup.’ ”

Mr. Sternlicht says Mr. Walsh brought Mr. Fuld (then Lehman CEO) himself to a meeting at the hotelier’s home to assure him that Lehman would back his acquisition. “Dick Fuld sat there in my living room and said: ‘You have our word. We’ll get this done,’ ” Mr. Sternlicht recalls.
“We paid a $20 million fee. I was never so happy paying a fee.” Mr. Fuld declined to be interviewed for this article."

And then one much later:

"SOON after Lehman’s bankruptcy, a former executive who declined to be identified because he wasn’t authorized to speak publicly about his time at the firm went to Mr. Walsh’s office to talk. But they sat in silence. After two minutes, the executive left. “It became clear that neither one of us was going to say something that the other didn’t already know, or that we were going to actually have a new idea or bring greater clarity to the situation,” he recalls."

That's going to make one heck of an ending scene in the movie. 
Fade to black.

ON EDUCATION IN PAKISTAN

ROOT CAUSES

There is an eye-opening story in the New York Times today on the state of education in Pakistan.  It matters to us for a whole host of reasons, not the least of it being that we may bear some responsibility for it.  First the context:

"...the state has forgotten the children here, the mullahs have not. With public education in a shambles, Pakistan’s poorest families have turned to madrasas, or Islamic schools, that feed and house the children while pushing a more militant brand of Islam than was traditional here.

The concentration of madrasas here in southern Punjab has become an urgent concern in the face of Pakistan’s expanding insurgency. The schools offer almost no instruction beyond the memorizing of the Koran, creating a widening pool of young minds that are sympathetic to militancy.

In an analysis of the profiles of suicide bombers who have struck in Punjab, the Punjab police said more than two-thirds had attended madrasas."

Bear in mind that the word "Madrasa" used in the piece simply means "School" in Arabic.  It's being used incorrectly here to refer to Islamic schools.
That aside, the piece does make some sobering points:

"President Obama said in a news conference last week that he was “gravely concerned” about the situation in Pakistan, not least because the government did not “seem to have the capacity to deliver basic services: schools, health care, rule of law, a judicial system that works for the majority of the people.”

He has asked Congress to more than triple assistance to Pakistan for nonmilitary purposes, including education. Since the Sept. 11 attacks, the United States has given Pakistan a total of $680 million in nonmilitary aid, according to the State Department, far lower than the $1 billion a year for the military.

But education has never been a priority here, and even Pakistan’s current plan to double education spending next year might collapse as have past efforts, which were thwarted by sluggish bureaucracies, unstable governments and a lack of commitment by Pakistan’s governing elite to the poor.

“This is a state that never took education seriously,” said Stephen P. Cohen, a Pakistan expert at the Brookings Institution. “I’m very pessimistic about whether the educational system can or will be reformed...”

"...Literacy in Pakistan has grown from barely 20 percent at independence 61 years ago, and the government recently improved the curriculum and reduced its emphasis on Islam.

Failures in Education

But even today, only about half of Pakistanis can read and write, far below the proportion in countries with similar per-capita income, like Vietnam. One in three school-age Pakistani children does not attend school, and of those who do, a third drop out by fifth grade, according to Unesco. Girls’ enrollment is among the lowest in the world, lagging behind Ethiopia and Yemen.

“Education in Pakistan was left to the dogs,” said Pervez Hoodbhoy, a physics professor at Quaid-e-Azam University in Islamabad who is an outspoken critic of the government’s failure to stand up to spreading Islamic militancy."

"This impoverished expanse of rural southern Punjab, where the Taliban have begun making inroads with the help of local militant groups, has one of the highest concentrations of madrasas in the country.

Of the more than 12,000 madrasas registered in Pakistan, about half are in Punjab. Experts estimate the numbers are higher: when the state tried to count them in 2005, a fifth of the areas in this province refused to register.

Though madrasas make up only about 7 percent of primary schools in Pakistan, their influence is amplified by the inadequacy of public education and the innate religiosity of the countryside, where two-thirds of people live.

The public elementary school for boys in this village is the very picture of the generations of neglect that have left many poor Pakistanis feeling abandoned by their government."

And to the point of our bearing some of the blame:

"The phenomenon began in the 1980s, when General Zia gave madrasas money and land in an American-supported policy to help Islamic fighters against the Soviet forces in Afghanistan."

The whole piece is worth reading in it's entirety, since at the minimum, it illustrates the multi-generational nature of this state of affairs.

ON PROTECTED TEACHERS

HARD RULES

For an eye-opening look at one of the key tenets of our education system, this investigative piece by the LA Times is a must-read.  The title says almost says it all: "Firing tenured teachers can be a costly and tortuous task".  And the news gets worse from there:

"It's remarkably difficult to fire a tenured public school teacher in California, a Times investigation has found. The path can be laborious and labyrinthine, in some cases involving years of investigation, union grievances, administrative appeals, court challenges and re-hearings.
Not only is the process arduous, but some districts are particularly unsuccessful in navigating its complexities. The Los Angeles Unified School District sees the majority of its appealed dismissals overturned, and its administrators are far less likely even to try firing a tenured teacher than those in other districts.
The Times reviewed every case on record in the last 15 years in which a tenured employee was fired by a California school district and formally contested the decision before a review commission: 159 in all (not including about two dozen in which the records were destroyed). The newspaper also examined court and school district records and interviewed scores of people, including principals, teachers, union officials, district administrators, parents and students."

The findings are eye-opening to say the least, as a couple of examples show:

"* Building a case for dismissal is so time-consuming, costly and draining for principals and administrators that many say they don't make the effort except in the most egregious cases. The vast majority of firings stem from blatant misconduct, including sexual abuse, other immoral or illegal behavior, insubordination or repeated violation of rules such as showing up on time.
* Although districts generally press ahead with only the strongest cases, even these get knocked down more than a third of the time by the specially convened review panels, which have the discretion to restore teachers' jobs even when grounds for dismissal are proved.
* Jettisoning a teacher solely because he or she can't teach is rare. In 80% of the dismissals that were upheld, classroom performance was not even a factor."

It's an extraordinary state of affairs, and would never stand in the private sector of course.  Yet, it's as natural in our highly politicized education system, as breathing.

* Image source.

ON CAR BUSINESS AS USUAL

NO CHANGE

At first glance it was a bit startling to see the President of the United States, accompanied by his auto industry task force, holding a press conference to announce that a private sector company, Chrysler, will be imminently filing for Chapter 11 Bankruptcy.  As the New York Times reports:

"Chrysler, the third-largest American auto company, will seek bankruptcy protection and enter an alliance with the Italian automaker Fiat, the White House announced Thursday.

The bankruptcy case, which officials envisioned as a swift, “surgical” process, was filed in United States Bankruptcy Court in New York. It marks the first time a major American car company has tried to restructure under bankruptcy protection since Studebaker in 1933.

“I have every confidence that Chrysler will emerge from this process stronger and more competitive,” President Obama said during a noontime appearance at the White House."

But on further reflection, it shouldn't be surprising that the leader of the free world should be involved in such a way over the restructuring of a private sector company.  As Jenkins Holman Jr. explained in his WSJ op-ed titled "The Truth about Cars and Trucks" yesterday,

"For three decades, the Big Three were able to survive precisely because they skimped on quality and features in the money-losing sedans they were required under Congress's fuel economy rules to build in high-cost UAW factories. In return, Washington compensated them with the hothouse, politically protected opportunity to profit from pickups and SUVs.

Doesn't sound much like what you hear incessantly from your Congressman, about how Detroit's problems are all due to management "incompetence" in deciding to build "gas guzzling" SUVs, does it?"

And despite the current seemingly Herculean efforts by the government, the prognosis isn't much better going forward, as Mr. Holman goes on to explain:

"Yet the muddled, covert bailout continues: Washington's latest fuel-economy rules actually reward manufacturers for increasing the size and weight of some vehicles. The truck tariff remains in place. The fuel-mileage rules continue to protect the UAW monopoly by discouraging the Big Three from shipping small-car production offshore.

In a real bankruptcy, which is the natural fate of companies unable to meet their obligations, Chrysler and GM would be run (or liquidated) for the benefit of their creditors, not their workers. But, here, "pattern bargaining" will remain the law of the Detroit jungle. The UAW will continue to use its unnaturally augmented clout to extract uncompetitive pay and benefits (it can do no other given its internal incentives).

As it has for 40 years, Washington will pitch in with one improvisation after another, disguised as energy policy, trade policy, health-care policy or environmental policy, to stop the rivets from popping off. Politics, especially Democratic electoral politics, will play a more dominant role than ever."

Read the whole piece, and one gets the distinct sense that all this is not just business as usual, but bigger than ever.  Maybe one day, it'll be different.  But not today.

ON OVER-HYPING "PANDEMIC"

EAGER COVERAGE

We seem to be moving to the next stage in the morphing of the global Swine Flu crisis, as this Wall Street Journal piece describes:

"The United Nations public health agency raised its global pandemic alert level on Monday to "phase 4" from "phase 3," recognizing that the A/H1N1 virus is spreading from person to person and urging countries to prepare for a pandemic. Moving it up one notch, to "phase 5," would indicate that the virus is causing multiple outbreaks, or widespread human infection.

With multiple outbreaks in Mexico and human transmission now occurring in New York City, where people at a school in Queens were infected after some students traveled to Mexico, the disease has moved closer to that definition, Dr. Fukuda said."

As always in these types of situations, the mainstream media is almost ahead of the evolving reality, with almost every other report having the word "Pandemic" in it in one form or another.  This Business & Media Institute piece is on point:

“Are we on the verge of a swine flu pandemic?” That was a question asked by Larry King for CNN on April 27, but also by many Americans since April 24 as the number of confirmed cases around the world grew.

NBC’s Robert Bazell said the government didn’t “want people to panic,” but then panicked viewers saying “it appears to be an outbreak unlike anything we’ve seen in our lifetimes.”

That scary, hyped tone reflected how many in the media covered the swine flu. Some media outlets hyped the threat with nearly constant coverage, worst-case scenarios or comparisons to the 1918 Spanish flu, while many others missed crucial points of the swine flu story, including the former president’s work to prepare in case of a pandemic flu and the issue of border security with Mexico."

Some in the media are taking note of this heightened focus on "pandemic", as the article goes on to describe:

"Fox News Channel’s Brit Hume and media critic Howard Kurtz both criticized the national news media for portraying the outbreak as “a full-blown crisis.” Hume called it “much ado about – I’m afraid to say this – not very much.” Kurtz particularly noted the “front-page headlines, constant cable-news updates and top-story status on the evening newscasts.”

Though most media accounts were less hyperbolic than NBC and AP’s, the word pandemic cropped up in fifteen stories on the three networks in four days (April 25-28). During that same time, CNN used “pandemic” in 51 stories and Fox News Channel in 10 stories according to Nexis."

It's too much to ask of course, but it'd really be something if the media for once tried to keep pace with this story, rather than gallop way ahead of it.

In the meantime, for a more balanced perspective on the situation, check out this piece by Dr. Mercola on the Mercola medical site.

ON ANOTHER SIDE OF DUBAI

STRETCHING LIMITS

The Independent has a long but sobering piece on the reality of Dubai titled "The Dark Side of Dubai", covering both the recent boom and the current bust.  Some searing excerpts:

"Once the manic burst of building has stopped and the whirlwind has slowed, the secrets of Dubai are slowly seeping out. This is a city built from nothing in just a few wild decades on credit and ecocide, suppression and slavery. Dubai is a living metal metaphor for the neo-liberal globalised world that may be crashing – at last – into history..."
"...There are three different Dubais, all swirling around each other. There are the expats, like Karen; there are the Emiratis, headed by Sheikh Mohammed; and then there is the foreign underclass who built the city, and are trapped here. They are hidden in plain view. You see them everywhere, in dirt-caked blue uniforms, being shouted at by their superiors, like a chain gang – but you are trained not to look..."
"I approach a blonde 17-year-old Dutch girl wandering around in hotpants, oblivious to the swarms of men gaping at her. "I love it here!" she says. "The heat, the malls, the beach!" Does it ever bother you that it's a slave society? She puts her head down, just as Sohinal did. "I try not to see," she says. Even at 17, she has learned not to look, and not to ask; that, she senses, is a transgression too far..."
"...Dubai is not just a city living beyond its financial means; it is living beyond its ecological means. You stand on a manicured Dubai lawn and watch the sprinklers spray water all around you. You see tourists flocking to swim with dolphins. You wander into a mountain-sized freezer where they have built a ski slope with real snow. And a voice at the back of your head squeaks: this is the desert. This is the most water-stressed place on the planet. How can this be happening? How is it possible?

"...Sheikh Maktoum built his showcase city in a place with no useable water. None. There is no surface water, very little acquifer, and among the lowest rainfall in the world. So Dubai drinks the sea. The Emirates' water is stripped of salt in vast desalination plants around the Gulf – making it the most expensive water on earth. It costs more than petrol to produce, and belches vast amounts of carbon dioxide into the atmosphere as it goes. It's the main reason why a resident of Dubai has the biggest average carbon footprint of any human being – more than double that of an American..."

"...Dubai had expanded so fast its sewage treatment facilities couldn't keep up. The sewage disposal trucks had to queue for three or four days at the treatment plants – so instead, they were simply drilling open the manholes and dumping the untreated sewage down them, so it flowed straight to the sea."

The whole piece is worth reading, along with the many vocal comments from many residents who take issue with many aspects of the article.

ON A FAILURE TO COMMUNICATE

NOT AGAIN

(Updates below)

By now the brouhaha over this morning's "Photo-op" flyover of lower Manhattan by the backup Air Force One and some F-16s, is old news.  For those not familiar with the event, here's a good summary:

"An Air Force One lookalike, the backup plane for the one regularly used by the president, flew low over parts of New York and New Jersey on Monday morning, accompanied by two F-16 fighters, so Air Force photographers could take pictures high above the New York harbor.

But the exercise — conducted without any notification to the public — caused momentary panic in some quarters and led to the evacuation of several buildings in Lower Manhattan and Jersey City. By the afternoon, the situation had turned into a political fuse box, with Mayor Michael R. Bloomberg saying that he was “furious” that he had not been told in advance about the flyover.

At 4:39 p.m. Monday, the White House issued an apology for the flyover. Louis E. Caldera, director of the White House Military Office, who served in the Clinton administration as secretary of the Army, said in a statement:

Last week, I approved a mission over New York. I take responsibility for that decision. While federal authorities took the proper steps to notify state and local authorities in New York and New Jersey, it’s clear that the mission created confusion and disruption. I apologize and take responsibility for any distress that flight caused.

The flyover, which began around 10 a.m., resulted in widespread confusion and a flood of calls to emergency hot lines. Perplexed officials at the Port Authority of New York and New Jersey and other authorities were inundated with calls from anxious ferry passengers, office workers and residents."

The plane apparently flew pretty low, by some accounts as low as 500 feet, over several prominent buildings:

"In Jersey City, construction workers were evacuated from a condominium tower under construction at 77 Hudson Street. The workers, who were on the 32nd floor of the construction site, said the plane circled three times past the Goldman Sachs tower, the tallest building in New Jersey. On the second pass, they said, the jet appeared to be only a few dozen feet from the building — close enough to clip the side of the skyscraper. A fighter followed right behind, mirroring its moves. "

Here's what it looked and sounded like from the ground:

Several questions obviously still remain unanswered (Updated):
1.  What exactly was this "photo-op", and why was it so important to be done in this manner?

    This report from CBS explains:

    "The flyover -- apparently ordered by the White House Office of Military Affairs so it would have souvenir photos of Air Force One with the Statue of Liberty in the background..."

2.  Why use the backup to AirForce One, one very customized Boeing 747 that's obviously pretty expensive to operate?

This Bloomberg report puts the cost at a touch over $328,000.  This while leading members from both the Executive and Legislative branch has gone out of it's way to castigate private businesses that have received federal "bailout" loans for private jet travel and off-site business meetings.

3.  If those who orchestrated this event thought they had done all the communicating with various authorities, what did they think would happen when these planes flew over lower Manhattan on a Monday morning?
4.  Did they think eight years is long enough for people not to be spooked by something like this?
Hope we get some answers to these and other questions soon.

ON GOD MAKING A COMEBACK

BIGGER THAN EVER

"God is Back" has got to be one of the best titles ever for a new book.  The review of the book by the New York Times promises more between the covers as well:

"Not all that long ago, the great minds of Europe predicted a future with little or no religion. Science would make us highly skeptical of miracles. Psychiatry would direct all of our awe and wonder inward. Changing roles for women would weaken the patriarchal structure that props up clerics. Whatever script for modernity one followed, it had God playing a bit role.

As we all know, it didn’t happen that way. Modernity arrived and improvised new starring roles for God. The Americans led the way by becoming both “the quintessentially modern country” and a very devout one, John Micklethwait and Adrian Wooldridge write in their new book, “God Is Back,” and most of the world has followed that model.

In rich countries and poorer ones, democratic and undemocratic, primarily Islamic and primarily Christian — everywhere, basically, except Europe — devotion to God has remained surprisingly robust.

“The very things that were supposed to destroy religion — democracy and markets, technology and reason — are combining to make it stronger,” write Mickle­thwait, editor in chief of The Economist, and Wooldridge, the magazine’s Washington bureau chief, who together have written previous books about globalization and American conservatism, two ­similarly sweeping topics."

Here's the bit that surprised me from the review:

"While fundamentalists of all kinds get most of the attention, the authors zero in on another phenomenon: the growth and global spread of the American megachurch. With no state-sanctioned religion, American churches began to operate like multinational corporations; pastors became “pastorpreneurs,” endlessly branding and expanding, treating the flock like customers and seeding franchises all over the world. The surge of religion was “driven by the same forces driving the success of market capitalism: competition and choice.”

Definitely a side of religious expansion that's not been in the mainstream view.  Just added "God is Back" to my Kindle reading list.

ON THE LONG ROAD TO CURE CANCER

EARLY DAYS

The New York Times has a good start on a series on the "struggle to defeat Cancer" in this piece titled "Advanced Elusive in the drive to cure Cancer".  They start by making the point:

"Cancer has always been an expensive priority. Since the war on cancer began, the National Cancer Institute, the federal government’s main cancer research entity, with 4,000 employees, has alone spent $105 billion. And other government agencies, universities, drug companies and philanthropies have chipped in uncounted billions more.

Yet the death rate for cancer, adjusted for the size and age of the population, dropped only 5 percent from 1950 to 2005. In contrast, the death rate for heart disease dropped 64 percent in that time, and for flu and pneumonia, it fell 58 percent.

Still, the perception, fed by the medical profession and its marketers, and by popular sentiment, is that cancer can almost always be prevented. If that fails, it can usually be treated, even beaten."

The piece does highlight the progress that has been made on a variety of fronts, including less harsher treatments for many types of cancer.
But it also goes on to ask and answer the "Big" questions:

"What has happened? Is cancer just an impossibly hard problem? Or is the United States, the only country to invest so much in cancer research, making fundamental mistakes in the way it fights the cancer war?
Researchers say the answer is yes on both counts.
Cancer is hard — it is not one disease or, if it is, no one has figured out the weak link in cancer cells that would lead to a cure. Instead, cancer investigators say, the more they study cancer, the more complex it seems. Many are buoyed by recent progress in cancer molecular biology, but confess they have a long way to go."

There's a lot to understand about this question and the piece is a good start to a promising series.
*Image source.