We’ll get back to health care tomorrow, but first I have several video clips to share.

Adam Smith is a best-selling author and for 14 years had a weekly show on PBS called Adam Smith’s Money World that won four Emmys and a Peabody Award.  He’s a very smart guy.  Smith was Tom Wolfe’s editor at Esquire, founded Institutional Investor and New York magazines, and somewhere in there about 25 years ago became a friend of mine.  I try to collect heroes and this guy is definitely one of mine.

Smith lives in Princeton, NJ, next-door to Paul Krugman, Princeton professor, New York Times Op-Ed columnist and oh, by-the-way, winner of the 2009 Nobel Prize in Economics.

I wonder how he invested that money?

On July 8th Smith and Krugman put on a little show for fewer than 100 folks at a meeting in Princeton of New Jersey Common Cause. Someone was there to take bad video of the event which I have here and intend to share with you over three posts today and tomorrow then we can get back to health care.

Krugman is a very smart economist working at the top of his game and explains things pretty well.  In these clips (there are 17 in all) he presents what could easily be the contents of a dozen or more columns.  And what I like is it is presented colloquially with us getting a much better sense of the man than from his very polished work in the Times.

I am not saying Krugman is right about everything, but I think these clips are very worth watching for a sense of our time and current thinking about it.  And it is odd how little it has to do, really, with economics and how much with government and just the way things do and don’t get done in our culture.

I look forward to reading your comments.

Podcast: Play in new window | Download

This is the first of probably three columns on health care.  The Obama Administration right now has in Congress legislation for reforming the U.S. health system so that sets my agenda. But the point of these columns isn’t to comment, per se, on the current proposals, but instead to look at what I believe to be my two areas of some strength — Information Technology and understanding complex systems — and see how they can be applied to this problem.

And it IS a problem.  That’s the only part of this debate that all sides agree on.  The doctors feel beleaguered and Lord knows that sick and uninsured people sure do, too.  Even corporate fat cats are appalled at the explosive growth in health spending which today takes more of our GDP than any other expense category, costing approximately $2.5 TRILLION per year.

So if we can all agree on the goals of better and more efficient health care with some way to make it available to the largest possible number of people, the question then becomes what’s the best way to do that?

Government isn’t very good at answering such questions, but then in many cases neither is industry if their business model has to include ever-increasing earnings.

Imagine, just for a moment, what the U.S. health care industry would look like if it were managed solely by that paragon of capitalism, Goldman Sachs.  The 48 million Americans without health insurance would probably be ignored completely while those who could pay more would get boutique medical services beyond belief and doctors would come to rely on substantial year-end bonuses.  For some, such a system would be better but for most it would be worse, though supremely profitable.  And when that “most of us” come to constitute most of the American working population, too, it will ultimately come to effect U.S. productivity and then we’re hosed.

So while it is convenient and fun to criticize government programs, let they who are without sin cast the first stones.

There are some things government is actually good at, among which are setting goals for good behavior.  The Clean Air Act and Clean Water Act in the 1960s changed America for the better by setting environmental goals then letting the marketplace figure out how best to reach those goals.  Without a target and a penalty for not reaching it, we wouldn’t have improved our environment as much.

So let’s step gently into this health care debate by looking at one area where Information Technology is central — health records.

There are lots of advantages to computerizing health records.  A couple of years ago I visited the Mayo Clinic in Rochester, Minnesota, to discuss this very issue.  Mayo has been in the forefront of digitizing all of its six million patient records.  This is a bigger job than most of us realize since it involves not just blood tests and doctor’s notes but also X-Rays and CAT scans.

Mayo, which was a century ago the first clinic in America to standardize the way it kept records in the first place, is also at the forefront in creative ways to use those records once they are in the system.  You see Mayo doesn’t have six million patients, they have six million patient records — many of those being records of people long dead.  But keeping extensive records of dead people creates a powerful database for statistical testing of possible treatments and even drug interactions.  “Surely in those six million records there is something similar to this medical mystery we are trying to solve today.” And often there is.

Figuring out from an analysis of records that combining drugs A, B, and G sometimes kills people can be good to know.

Mayo is taking the process even further to include DNA data for many patients with the goal of being able to statistically identify genetic trends within the population through records analysis.

That’s the good side.  The negative side of all this record keeping is that many people see it as a possible invasion of patient privacy.  This is what led to the Health Insurance Portability and Accountability Act (HIPAA) of a few years ago which forced health providers to be more strict in how they managed health records, adding at the same time about $25 billion per year to the cost of keeping us all in the system.

Hey, isn’t Information Technology supposed to SAVE money?

Sometimes.  Ideally, it should.

So medical records are an area where IT could make us healthier and, if done correctly, ought to save lots of money, too.  What we need is some form of centralized medical record keeping that preserves patient privacy yet, at the same time, keeps us from shopping all over town for bogus Oxycontin prescriptions.

Here is an ideal opportunity for government to set a standard for medical records and possibly even to develop medical records software, though I don’t think it has to go that far.  What’s required is a specification that would allow health care providers to interface with a medical database, knowing how to insert and retrieve data.  It’s a specification, NOT a national database.

And here’s what we do with the specification.  We establish that patients own their own records.  Supposedly they already to but doctors and clinics do a darned good job of keeping us from moving by retaining those records.  Under my system we’d take the records away from the health care providers entirely, at the same time relieving them of the need for records clerks and much of their current HIPAA responsibilities.

Then we’d let a thousand databases bloom.  Organizations could establish health record databases compliant with the Federal standard but not otherwise subject to Federal control.  These databases could be accessed by any authorized medical care provider — authorized by you.

Patients could decide where they’d like their health records to reside, with that service possibly becoming a perk for membership in certain organizations.  So you could keep your health records at the National Rifle Association, for example, while I might keep mine at the American Civil Liberties Union (or at Pep Boys, whichever is cheaper).  If you are worried about government snooping, trust your records to an organization mortally opposed to government ANYTHING.

Record access becomes a lot like an electronic funds transfer.  Banks have spent a lot of money working-out the technical details of giving and denying access to databases with a variety of key systems.  You give your doctor access to records of a certain kind for a certain period of time and that’s it.  The system ought to work well for everyone.

And it even can be the basis of new types of business.  I can see third-party outfits popping-up to parse your records (at YOUR request) to look for likely genetic problems or for past and present medical mistakes concerning multiple prescriptions, bad drug interactions, etc.  Here $10 per year could save hundreds — maybe thousands — of not just dollars, but lives.

And what does this record system look like, when you come down to it?  It’s the World Wide Web — medical records as a web app.  And one thing we know about web apps, as opposed to any kind of medical technology — the price only drops over time.

More to come.

Podcast: Play in new window | Download

A lot of online behavior is habitual.  My e-mail client is Eudora, for example — an orphaned program that hasn’t been updated since 2006.  People keep telling me to switch to this or that but I like Eudora and have 17 years of mail stored in it, though I sense an end coming there.  I also use Orbitz, primarily, for my travel planning.  And it isn’t that Orbitz is particularly better (though not particularly worse since I use Kayak from time to time to compare) but that it holds already in its digital innards a whole succession of my credit cards as well as my five frequent flier numbers.  Or it did.

You see Orbitz has lost my numbers.

Last week I took a flight to Dallas and they were right there on the screen in my user profile — a bunch of credit card numbers dating back to the late 1990s and my frequent flier numbers for American, United, US Airways, Delta, and Northwest.  I know those last two have merged but I’m not sure my frequent flier numbers yet reflect that.  Frankly I don’t KNOW any of those numbers, relying instead on Orbitz to keep track of them.  But then today I went to book a flight to LAX and while the web site knew who I was from the cookie I was carrying, it suddenly had no idea how I paid for tickets or what affinity programs I was with. I only hope it guessed that I prefer windows to aisles — I’ll have to check on that.

Remember last week we discussed in this space how you’d manage personal data following the demise of a photo-sharing or social networking site? Well here’s an analogous problem — how do you manage YOUR data in ANY e-commerce site?  And what does it mean if THEY do a lousy job of managing it for you, as Orbitz has done with me?

So I called customer support.  When I eventually got through a guy named “Richard” told me my numbers were hosed, though he claimed never to have seen the effect before.  Somehow I doubt that.  And from his accent I doubted that he was born “Richard,” either.  Still he tried to be helpful.

By this point I was down to two questions: 1) How the heck did this happen?, and; 2) will my numbers reappear during some restore or is it up to me to find and reenter them?

“Richard” had no idea how it happened and, sadly, it’s up to me to do the dirty work of restoring the data.

I hope he’s wrong on that last part.  I hope that the Orbitz technology is robust enough to correct such a problem, especially after it has been brought to their attention.  But the somber finality with which”Richard” gave me the bad news suggested that you can’t go home again. Or at least I can’t.

If so, think what this means.  Even if cosmic rays somehow nuked my and ONLY my profile information from among millions of registered users (my new and old reservations were intact) the idea that the information couldn’t be restored was disturbing.  What kind of an outfit is this, anyway?  And if the problem extended beyond me and thousands or millions of Orbitz users were inconvenienced, well then my loyalty is at an end.  Because a company that can erase my information can also lose it, and I don’t need that data floating around.

If you are an Orbitz customer please check YOUR profile information and see if your frequent flier numbers and credit cards data are intact.

Get back to me on that, okay?

Thirty years ago I wrote a book about the nuclear accident at Three Mile Island.  One of the central characters in that book was Jon Ward, a producer for CBS News who ran the network’s coverage of the accident. Ward had actually anticipated such an event, gathering information on all U.S. nuclear plants in case one ever melted-down. My book made Ward a minor celebrity for a millisecond and may have helped his promotion to producer of the CBS Evening News.  But the story Ward still likes to tell about that experience was of the waitress at a New York restaurant who asked for his autograph, ignoring completely Ward’s lunch partner, Walter Cronkite, who found the whole event hilarious.

I met Cronkite several times. He was a cub reporter in Kansas City with my friend Martin Quigley and they were lifelong friends, which was a testament to Cronkite if you knew Quigley.  Cronkite and Ward partnered for more than 25 years making documentaries and we discussed having Cronkite involved in my Moon shot as recently as last year.  It would have been a unique opportunity to see the icon in a reality TV environment.  If only I’d been able to raise the money quicker.

Cronkite, like my friend the late Fred Rogers, was exactly as you expected him to be, only funnier.  What a great way to be remembered.

Podcast: Play in new window | Download

After this week’s Google/Microsoft column appeared in the New York Times, I got a message from an old friend, Rohit Khare, that sparked some thinking about our vulnerability as individuals when our data is held in the cloud — somebody else’s cloud.  How do we save it, get it back, destroy it? Given the recent case of Facebook hanging-on to old user data essentially forever, this is not just a theoretical concern.

“’Cancellation on a whim’ is a key insight,” wrote Rohit.  “After all, with desktop software you at least had the right to keep using what you wanted, as long as you kept the old hardware/software/OS running — I know of mission-critical custom apps still running on Win98!”

“SaaS (Software as a Service) for businesses may have SOME rights, but consumer services leave you completely out in the cold, and are unavailable afterwards at ANY price.”

Well Rohit, whom I met when he was an undergraduate at CalTech, who later earned a PhD from UC Irvine, and has worked for both the World Wide Web Consortium and some startups, ought to know, but I find myself wondering if, in fact, we really ARE out of luck when our SaaS vendor packs it in?

Say your favorite web-based application is suddenly unavailable because the group that wrote it has disbanded, are you truly SOL, those embarrassing pictures of your old girlfriends gone forever?  Today I’d say “yes,” unless you’ve made a heroic effort to save the data in some database or file system that is unlikely to be compatible with the original application. No vendor I am familiar with has created an end-of-life (EOL) migration tool, though they certainly could.  What we need is an API and I am here to propose one.

If web- and cloud-based application software is here to stay (it is) then there will inevitably be backup and EOL issues as platforms and companies die or are acquired.  The best way to handle this in my view is for the Internet Archive to propose an Application Programming Interface to handle data migration and preservation issues for obsolete web applications and services.

I think there is nothing Brewster Kahle, the Archive’s founder, would like better than to preserve for posterity such code and associated data.

Imagine a social network app that would continue to work after death, at least to the extent that members could retrieve (or destroy) their own information.

The problem with this idea, of course, is that this also creates a very attractive interface for hackers and thugs.  But I have an answer to that, too.  What we need is the digital equivalent of one of those envelopes characters sometimes leave in books and movies — an envelope inevitably labeled “to be opened in the event of my death.”

Participating organizations would store compressed and encrypted versions of their data with the Internet Archive, where they would be held in an inactive state but updated frequently.  Then, in the event of that outfit’s death, the digital envelope would be opened, revealing a decryption key and enough application code to get a vanilla version of the original net app up and running.  It would, as archives are intended to do, preserve the final state of the application as well as its final data.

This is going to be a big problem in the future .  I suggest we think about it now.

Meanwhile, back to Rohit, whose new company is called Ångströ.  Two obscure punctuation marks in a single name tell me this is a company to spelled with. Ångströ apparently creates real time notifications when specific data changes in social network applications, creating a kind of cross-platform news feed about you or anyone else you happen to be stalking.  Cool.

Everything Rohit is involved with is interesting.  His threaded discussion group, Friends of Rohit Khare (FoRK) has been around for more than a decade and has long offered some of the most interesting (and funniest) examinations of technology news on the Net.  It is now an age-restricted group on Yahoo.

Rohit does everything his own way.  When he was still an undergraduate I employed Rohit and his business partner Adam Rifkin as consultants, bringing them to Japan to make a presentation to a major client.  The trip was L.A. to Tokyo and back but Rohit and Adam parsed the United Airlines routes until they found a way to get to Tokyo for the same money by going around the world FIRST CLASS, earning quadruple frequent flier miles in the process.  The boys arrived on schedule though lubricated the entire way with Johnny Walker Blue Label.

We dried them out a bit and their presentation was boffo.

A couple times per year the New York Times calls me up asking for an Op-Ed column on some technology topic.  I don’t know how they found me but I’ve been writing these pieces since 1995.  I think they call because I’m good at meeting tight deadlines.  Lord knows that if there was a piece I actually wanted to get in the Times (my idea, not theirs) I have no confidence that I could get them to run it.  Op-Ed at the Times — at least to me — is a sort of black box.

Here’s the column they asked for on Google’s Chrome OS: http://www.nytimes.com/2009/07/13/opinion/13cringely.html

The opinions expressed, as always, are ruthlessly my own.

I had intended to write a post about Google’s Chrome Operating System, but then the New York Times called looking for an Op-Ed piece on exactly that so I gave it to them.  Look for the column to appear Monday and I’ll put a link to it here.

The Times column is here.

Beyond the broader implications of the Chrome OS, one reader asks about the strategic involvement of Adobe Systems in the project, since Adobe is in the short list of companies mentioned in the Chrome OS FAQ.  Why is Adobe on this list, asks the reader, and is Google likely to buy Adobe?

I have no inside information here, just the usual informed guesswork.  The logical acquirer for Adobe, if the company is to ever be acquired, is still Apple, which would gain some real synergies in its entertainment endeavors as well as some needed technical depth.

What Google needs from Adobe is primarily Flash video.  Remember that YouTube made Flash video a factor in the streaming market and Google now owns YouTube.  Remember, too, that Apple’s iPhone has specifically shunned Flash, somewhat to its detriment.  Apple’s reasoning — that Flash takes too much horsepower for smart phones — no longer really stands with the iPhone 3GS shipping.  So Google’s embrace of Flash video for the Chrome OS AND Android helps YouTube while differentiating both products from Apple.

But does Google also need Adobe’s Flex and AIR platforms?  That is less clear.  Both Flex and AIR are runtime environments for cross-platform applications (Open Source applications in the case of Flex). Knowing a bit about how Google thinks, it is very possible that Flex and AIR will be seen as too heavy and — more importantly — too non-Google.  So we might see Flex but not AIR, for example.  I simply don’t know.

But I seriously doubt that Google will be buying Adobe or, for that matter, making ANY huge acquisitions in the months ahead.

Podcast: Play in new window | Download

Headed this week to the Grand Canyon in our old Winnebago RV (now minus mice, we think) Mary Alyce, the boys and I stopped outside Kingman, Arizona at this place, freshjerky.com, managed by Gus, whom you’ll find pictured below, handsome devil that he is.  And that’s Mary Alyce taking pictures of the boys in the Freshjerky parking lot at left.

Just as the sign says, Freshjerky has a limited product selection — various kinds of meat jerky including buffalo; honey (minus “expanders,” whatever those are); olives; nuts, and cold drinks.  Everything is very good for what it is and nothing is particularly cheap.  Nobody goes to Freshjerky, for example, to buy cheap jerky.  That’s why God invented truck stops.

But Freshjerky is a terrific example of American enterprise and how easy it can be to find a niche in our enormous and varied consumer economy.  I found it hard to believe at first that people would really be drawn to such a place (Mary Alyce is the jerky fan in our family). And from one look at Gus, handing out tiny bites of cowboy jerky to lure customers, they aren’t drawn by his innate sex appeal.

So how is the company doing?  Just fine, thanks, though most of the sales are online — about $2 million per year.  The recession has had no significant impact yet on Freshjerky sales, according to Gus.

This is, in a way, a story similar to Parrot Secrets, which caused such a furor in this space a few months ago.  Freshjerky is perfectly mundane. There is nothing Gus does that any of us couldn’t do as well — nothing.  But he’s the guy selling $2 million per year online from a quarter acre beside the highway outside Kingman, Arizona, and we aren’t.

Heck, if Gus can do it why can’t we all?

Well we can.  And in the current recession, as more jobs are lost and people become desperate for work, more of us should try channeling our internal Gus.  We could make our own declarations of indendence by coming up with our own something good to sell.