Author: Serkadis

If you look at how our radio spectrum is allocated today, you discover that TV broadcasters have a huge chunk of spectrum (that chart doesn’t directly display how much spectrum is actually included — I remember seeing another chart, which I can’t find now, that shows proportionally how much more spectrum broadcasters have). This was given to them — entirely for free — years ago, when spectrum wasn’t used for much. These days, however, spectrum is precious for so many different things, and certainly much of it could be put to better use. Of course, the broadcasters aren’t thrilled with giving up any of their windfall. For years, they dragged their feet, kicking and screaming, about switching from analog to digital broadcasting, which was needed to reclaim some spectrum. More recently, they’ve been fighting attempts to use “white space” spectrum — which is spectrum that’s unused, but close to used spectrum. The broadcasters insist there will be interference, while technologists insist the technology is good enough to block interference.

So, it’s interesting that, just as we’re hearing of the first tests of white space networks, the FCC is also talking to broadcasters about other ways to reclaim some spectrum and put it to use on something more useful and productive. Apparently, the plan on the table right now would be for broadcasters to give up the spectrum in return for a cut of the revenue the government would get in auctioning off the spectrum for wireless use. Of course, some may find it distasteful that public spectrum that was given to these companies for free can then get sold off with at least some of the money going to those who never bought or truly “owned” the spectrum in the first place. But, given that the FCC set things up in a way where it basically created a de facto ownership structure of the spectrum, it’s difficult to see any reasonable way to get that spectrum back without paying for it.

In the link above, Adam Thierer suggests we just give the current holders property rights in the spectrum, and assume that they’ll then sell it off to those who can do something more innovative with it (or change and do something more innovative themselves). I’ve long been a proponent of giving up the ridiculous idea of having the government decide how each slice of spectrum must be used. Why not let the companies who control the various slices of spectrum make use of it as they see fit? It seems more likely that we’d get more efficient uses of the spectrum. So, it’s good to see more thinking about ways to put some of that spectrum to better use, but it would be nice if we allowed the market, rather than the government, to figure out how to best use it.

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Cruising Craigslist usually brings up some interesting things. And this is definitely one of the most terrible and yet oddly funny posts I’ve seen in a while.

When doing the Empire Strikes Back costume of Chewbacca, most people would just get a few C3PO parts and throw them over their back. One resident of Austin, Texas however, wants to take it the next step. This guy is looking for:

A double amputee (someone missing both legs – preferably at the hip) to accompany me as C3PO for the evening. We should meet ahead of time so that we can work out the backpack/harness system. There are a few parties that I want to hit and I think we will be the hit of any event we attend.

Hey, dude’s upfront about it. If you’ve always wanted to be everybody’s favorite protocol droid, but you’re missing a few appendages, this might be for you.

When Cablevision first bought Newsday, Charles Dolan admitted the company knew very little about the newspaper business, but promised to consult widely with newspaper experts in coming up with a plan. That seemed like a really really bad idea, since all the newspaper experts we’ve seen don’t seem to even recognize what business they’re really in. But, it looks like that’s exactly what Dolan did. Back in February, the company announced that it was going to put up a paywall for its content. Since there had been no update or any action since then, I’d actually begun to wonder if the company was rethinking that idea. No such luck. Apparently it just took a bit of time to fully plan out Newsday’s self-destruction.

The company has announced that it will start charging a whopping $5/week (not month, but week) to access the website unless you’re an existing paper newspaper subscriber and/or a Cablevision subscriber.

Let’s be absolutely clear what this is. It is not a plan to build a 21st century news organization. It’s a plan to try to reduce churn elsewhere, by putting up a slight hurdle for Cablevision cable customers and Newsday newspaper customers to prevent them from leaving. Cablevision’s customer base and Newsday’s subscriber base overlaps quite a bit, so for plenty of those folks there will be no change at all. But this won’t do anything to actually help the news organization grow. Those who don’t subscribe to the paper edition or who use a competitor for broadband (like Verizon Fios which is pushing hard in Cablevision’s market) will simply go elsewhere. While the NYC papers don’t cover Long Island news quite as completely, they do a pretty good job with the basics, and other local news sources will fill in the rest. Cablevision is basically saying that it’s giving up in the online news business. It’s an admission that it doesn’t know how to compete. This won’t help it sign up new customers, and may only barely help it prevent old customers from leaving.

It’s basically a suicide play for Newsday. This is really a disappointment, since Cablevision — amazingly — had actually been one of the most forward thinking cable companies out there in terms of offering real value on the broadband side of things. But apparently it bought Newsday as an asset to let it wither away.

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As lawmakers continue to shape a health care overhaul bill to increase the number of Americans with insurance while driving down costs, one group is being deliberately barred from receiving any government benefits associated with the effort: undocumented immigrants. This brief explainer looks at some of the questions surrounding immigrants and health care in the United States. 

How many are there and what is the law now?

There are nearly 12 million illegal immigrants in the U.S. In 2007, almost 60 percent of the adults had no health insurance, more than double the proportion of uninsured adults among legal immigrants and four times the share among U.S.-born adults, according to the Pew Hispanic Center.

Undocumented immigrants are barred from Medicaid and the Children’s Health Insurance Program (CHIP) – the federal/state government programs for the poor. However, everyone – including illegal immigrants – have access to emergency room care through the 1986 Emergency Medical Treatment and Labor Act, which ensures public access to emergency health services regardless of an individual’s ability to pay.

How do undocumented immigrants get medical care now? 

Low-income immigrants — both legal and undocumented — are less likely than citizens to receive primary or preventive care, and they have lower rates of emergency room use than those of citizens, according to a 2007 policy brief by the Kaiser Family Foundation. (KHN is a program of the foundation.) But low-income non-citizens turn to health centers and clinics at a significantly higher rate than insured low-income citizens, with six in 10 relying on clinics and health centers as the place to go when they need medical help. 

Who pays for their care?

Undocumented immigrants who seek care at health centers and clinics are typically billed on a sliding scale based on their ability to pay.

If illegal immigrants cannot pay their bills, hospitals and other providers first look to the federal government and charities for help in covering their uncompensated costs. The federal government, through the Disproportional Share Hospital program, allotted about $20 billion in 2009 to help hospitals and providers cover the costs they incurred treating uninsured patients, including citizens, legal immigrants and the undocumented.

But those government funds are generally not enough to cover the costs, and hospitals raise their fees for other patients to help provide the revenues needed to treat the uninsured.

Researchers estimate the cost of all uncompensated care was roughly $56 billion in 2008, according to a recent study published in the journal Health Affairs. However, because hospitals cannot inquire whether a patient is in the country illegally, it is difficult to tease out the cost of uncompensated care attributed to illegal immigrants.

How will reform proposals affect illegal immigrants?

All of the bills specifically exclude undocumented immigrants from qualifying for Medicaid or CHIP.

Neither the House bill nor Senate Health, Education, Labor and Pensions (HELP) Committee bill restricts illegal immigrants from being eligible to purchase coverage through a health insurance “exchange” or gateway set up in the legislation. However, the House bill explicitly states that undocumented immigrants would not be eligible to receive government subsidies to buy insurance, regardless of income. The Senate Committee Bill is much tougher and bars illegal immigrants from purchasing health insurance through the exchange.

Baucus’ proposal also includes verification requirements to ensure that illegal immigrants are blocked from receiving federal subsidies or entering the exchange — an effort to quell Republican concerns that loopholes would allow illegal immigrants to benefit from receiving health insurance at a reduced rate.

The Senate and House proposals also call for reducing the federal DSH payments to hospitals for uncompensated care on the assumption that health care reform would provide insurance to more people. 

None of the bills would change the requirement that hospitals offer emergency services to all patients, including illegal immigrants.

Sources

Affordable Health Choices Act, Senate HELP Committee bill, section 171

America’s Affordable Health Choices Act House bill H.R. 3200, sections 246, 1704

America’s Healthy Future Act of 2009, Senate Finance Committee bill 

Covering The Uninsured In 2008, Health Affairs

Disproportionate Share Hospital Allotments for FY 2009, U.S. Health and Human Services

Five Basic Facts on Immigrants and Their Health Care, Kaiser Family Foundation, March 2008

Health Insurance Coverage and Access to Care for Low-Income Non-Citizen Adults, Kaiser Family Foundation, June 2007 

Immigrants’ Health Coverage and Health Reform: Key Questions and Answers, Kaiser Family Foundation, September 2009 

Medicaid Disproportionate Share Hospital Payments, National Policy Forum, June 15, 2009

Portrait of Unauthorized Immigrants, Pew Hispanic Center, 2009 

Treatment of Noncitizens in H.R. 3200, Congressional Research Service, August 2009

Dr. Antonio Falcon, a physician in the border town of Rio Grande City, Texas, considers himself to be the “luckiest family doctor in the world.” In his nearly 30 years of practice, he has worked in the emergency room as well as the operating room and has delivered at least 6,000 babies. Currently, he says he is a geriatrician, aging along with his patients.

Falcon, a member of the Texas Medical Association and the United States-Mexico Border Health Commission, is concerned about several health threats facing border communities, including tuberculosis, diabetes, obesity and the H1N1 virus that causes swine flu. He says the current efforts to overhaul the nation’s health system will benefit both the Hispanic community, which has the highest rate of uninsured of any ethnic group; and Texas, which consistently fares among the worst for state health care measures. Still, he worries that lawmakers in Washington are failing to address several important border health issues, including illegal immigrants’ health care.

KHN’s Jessica Marcy recently spoke with Falcon, who warned that failure to recognize the high, unreimbursed costs of caring for this population could undermine hospitals and providers along the border and open the door to public health risks for the entire nation. Edited excerpts of the interview follow.

Q: Since you began practicing medicine in 1980, how has the health delivery system’s approach to illegal immigrants’ health care changed? What impact has the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) — which requires hospitals to provide emergency services regardless of a patient’s ability to pay — had on health care in border communities?

A: Back in the 1980s, the patient from Mexico was usually the best paying patient because in order to get care here, they would have to pay for their deliveries up front. It was a system that worked very, very well. When EMTALA [was enacted], it basically caused a very large influx of patients from Mexico … because labor and delivery became an emergency and patients had to be seen whether they paid or not. What happened in a lot of communities along the border, where the Mexican patient was the best paying patient, [they] became a huge liability because they were no longer paying for their care. So all of a sudden, these hospitals and providers were faced with this huge volume of uncompensated care. After several years of struggle, Emergency Medicaid [which helps pay for such emergency treatment of immigrants] came in … [and] alleviated some of the burden.

Interestingly enough, it seems that nobody can answer the question of what’s going to happen to border providers and hospitals if illegals aren’t covered under a new health care bill. If they’re not covered and EMTALA continues to exist and providers and hospitals are going to have to provide the care without compensation, it’s going to cause a catastrophic situation along the border, which already has a very fragile health care system.

Q: What do you think about provisions in some health overhaul measures that would prohibit illegal immigrants from purchasing insurance on proposed exchanges?

A: The biggest risk is the financial failure of [border] health care institutions. If illegal immigrants are not going to be covered under a national health plan, then there must be a mechanism for reimbursement for the care of those patients. If that doesn’t happen, then all of a sudden border hospitals and providers have to take a 35 percent cut in their gross income and they’re not going to make it.

As it is, the border area already has a much higher percentage of Medicaid patients than other areas in the country. Providers and hospitals are strapped with the bare minimum of financial resources because of the reimbursement mechanism that exists. I would venture to bet that one-fourth to one-third of the hospitals along the border would close and you would see an exodus of providers in a system that already has very, very poor ratio of patients to providers. Right now, as far as I know, there isn’t a discussion on how to make up for the losses that would be incurred by border institutions.

Q: Do you think there are any other specific health risks from excluding illegal immigrants from the health care system and reform?

A: I think [the risk is] the spread of any infectious disease, especially tuberculosis. TB is actually on the rise along the border. I think that 70 to 80 percent of these cases we’re seeing now are related to immigrants. It’s a very high percentage. That, together with the fact that we’re seeing more multidrug-resistant tuberculosis, causes an enormous amount of concern. If those patients are not going to get any treatment then public-health-wise we have a huge problem.

Q: What advice would you give to lawmakers in Washington about illegal immigrants’ care and health reform?

A: Illegal immigrants live among us all over the country. We should have learned from H1N1 that the potential door for emerging illnesses could exist through the Mexican-American border. To allow something to come in that is not attended to because somebody in Washington didn’t play close attention to border health issues would be lamented for a long time. We need to look at the border as a portal of entry for any of a number of diseases, including bioterrorism.

It seems like policy makers want to isolate [the issue of] illegal immigrants’ care as something that’s kind of standing out there on its own and it’s not. It’s mixed in with the rest of the soup. Like it or not.

A couple stories Friday examine just how Americans ended up with a system where employers pick up the tab for health insurance and which groups will end up paying more for health reform.

NPR on the history of the employer-based system: “The evolution of the American health care system began in the 1920s, when choices boiled down to which crazy cure you preferred.” Potions were the norm where health care for a year cost the equivalent of today’s $100. But advances in medicine created the need for health insurance as costs rose. “By the late 1920s, hospitals noticed most of their beds were going empty every night. They wanted to get people who weren’t deathly ill to start coming in.” So insurance was created that allowed people to pay a little bit every month to pay for health care. World War II and tax-free incentives on health care from employers added to the explosion in care (Blumberg and Davidson, 10/22).

BusinessWeek reports on the future — if health reforms are enacted — and that insurers and taxpayers will likely foot the bill for the system’s changes, and that doctors will feel the least pain. “It’s safe to say doctors will give up the least, pharmaceutical and medical device makers will fall somewhere in the middle, and insurers will be the big losers.” Consumers will foot the bill if they have too generous a plan — called “Cadillac” plans — while pharmaceutical companies, medical device makers and insurers will also lose (Sasseen and Arnst, 10/22).

The guys from Hotelsinus Sound Design has released the first test version of TonesynthDS, a matrix-based synth sequencer for the Nintendo DS. This pub…

Microsoft unleashed Windows 7 onto the public today, and the company’s Bing team has released some downloadable wallpaper things for the operating system. The themes are based on the images that the search engine uses on its homepage.

"A lot of people ask us for desktop versions of our images," says Stephanie Horstmanshof of Bing. "And now you (and your friends, and your family, and your casual acquaintances) can get them!"

Whether or not you are a fan of Bing as a search engine, there’s no denying that there are some visually pleasing images that appear there. Here are some of the wallpaper options:

The themes are more than just wallpaper images though. The themes are a combination of pictures, colors, and sounds for the computer. They include desktop backgrounds, screen savers, window border colors, and sound schemes. Some include icons and mouse pointers.

Microsoft reminds users that they can also integrate Bing right into the operating system by:

1. Downloading the Bing OpenSearch description document.

2. Double-clicking the downloaded document to add the Bing "Search Connector" on your machine.

3. From Windows explorer use the Search Box, type the terms for which you want to search and get the power of Bing into Windows.

"You can perform Windows actions on the search results, such as Open, Send to, and so on," says the Bing API Team.

So much for that new Obama administration “transparency” claim, huh? After three unsuccessful attempts at stalling a court order to release documents concerning who lobbied for telco immunity in warrantless wiretapping lawsuits, the administration has succeeded in its fourth attempt, delaying the release of the documents at least until next year. Of course, by the time this is decided, it should be long after Congress is done debating the whole warrantless wiretapping issue… so that’s convenient. I’m still trying to figure out who or what the administration is trying to shield. It seems pretty obvious that the telcos would lobby for immunity, so that’s not revealing much. So what’s so important to keep secret?

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 The latest round of update for the US PlayStation Store is now available. This weeks lineup includes the usual game add-ons, a few price drops, …

There are some men who pride themselves in their prowess at the gaming table or in bed and there are others who brag about being able to pick the winning horse at a racetrack. But how many men can write long, detailed posts about Moleskine notebooks, offering advice to the other Moleskine fans about how to best handle your Moleskine experience.

There is only one man who does that. His name is some dude who runs InkyJournal.

That’s right. InkyJournal. The site seems to be dedicated to Moleskin hacks including how to decide on the best notebook for the best activity and how to add tabs to tabless notebooks. He even reviews a pen holder for Moleskins.

I fell in love with Moleskine in Paris (where else?) when I bought my first one from a stationary store right by Breguet’s old workshop. While I love using them, I haven’t gone to the lengths we find on this dude’s site. However, that shouldn’t stop us from trying.

Lexar announced their new 600x compact flash cards today. It’s not unexpected that the faster speed memory cards are coming out, given the UDMA requirements of cameras like the Canon 7D.

The new Lexar cards have a amazing 90MB/s transfer rate when used in a device that supports the new UDMA 6 protocol. This is particularly important for the generation of cameras that shoot video, since the write speed is critical when you are shooting in HD.

The new cards are available in 8GB, 16GB, and 32GB sizes. The 8GB and 16GB cards are available now, the 32GB should be available in November. The 8GB version sells for $149, the 16GB version sells for $249. There isn’t any pricing available for 32GB version, but you can safely assume it will not be cheap.

You can read the press release here.

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There may be some glitches here and there, but that’s certainly not stopping gamers from getting hold of Borderlands — or at least trying to. Reports…

Get ready to get your worlds turned upside down as Namco Bandai announced Inversion for both the PS3 and Xbox 360 consoles. It’s a “whirlwind journey …

So let’s say you need a new clock. Sure, you could go spend $19.99 (or less) and just go buy one, but wouldn’t it be more fun to bust out the CNC machine and build one yourself? Alan Parekh of Hacked Gadgets thought it would be, and he just happened to have a new CNC machine lying around.

Alan cut the gears on his CNC router, used a micro-controller and a step motor, and created a pretty cool wall clock. He explains how he did it fairly well in the video, but his site has even more detailed instructions.

[via Make]

There have been a few reports lately claiming that file sharing is decreasing. Often, the “explanation” is that more people are switching to streaming services. But that doesn’t seem to make much sense, given that the streaming services are still greatly limited and have their own share of problems. And, indeed, it looks like at least some of these reports are being misinterpreted. The most recent story that got a bunch of headlines claiming that P2P was “dying”? Turns out that it’s all relative. What the report actually said was that P2P file sharing is growing less fast. So it has a smaller overall marketshare — but in terms of absolute numbers? It’s still growing. However, given the size of the “market,” that’s not too surprising. It’s pretty saturated.

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If you’re one of those folks still praying for that time when Splinter Cell: Conviction heads to the PS3 even if it’s a “true Microsoft exclusive”, th…

The Fable 3 announcement had creator Peter Molyneux saying he was throwing away the “foundation stone” of RPGs. Yeah, I thought, you’ve been saying that kind of thing for 20 years now buddy. Show me the money. And in a pleasant surprise, it looks like he may actually be doing that; he confirmed today that the game will use the Natal motion controller, which makes him probably the technology’s biggest on-the-record developer. He already hinted that this was the case, but now it seems that Microsoft is giving the go-ahead for making official announcements.

I can only speculate on the variety of sordid acts you’ll be performing with this thing. Dancing to impress the villagers? Throwing bottles at dragons? Impregnating your wife? The possibilities, I’m sure Molyneux will tell you, are many and various.