Ben Perreira

My head's dropbox.

Month: August, 2012

Convenient Un-truths

Why aren’t mom’s eight specialists aware of each other’s existence? Why is health care mostly conducted via a pad and pen, and beepers and fax machines, in the iPhone era? Why are there so few geriatricians when the first wave of Baby Boomers is already turning 65? Why is it still so hard to find usable information about quality and prices?

The reason isn’t a lack of hospital administrators or technocratic experts. More often than not it’s that patients aren’t the true consumers. The government is, and medical providers inevitably serve the paymaster.

An unattributed Wall Street Journal article contains the above quote in its rebuking of Obamacare. As an author of a forthcoming article on business models and strategy of mobile technology in healthcare, I find the statement unfounded.

Obamacare is taking a lot of flack from both sides of the aisle, and deservedly so. Conservatives find it too far-reaching and will destroy business; liberals think it doesn’t change much in delivering health services to the uninsured.

Still, my research has shown that the main barrier to getting technology in healthcare is getting doctors to use it. Consumers demand technology and get it from a variety of sources. The problem is that doctors have no incentive to input the data into the systems that ultimately interface with patients.

The statement is a convenient assumption for someone trying to poke holes in Obamacare, but ultimately untrue.


Polls and Poles

I try to stay away from politics in my daily life as well as on these sacred pages, but I found a supremely juicy and erroneous tidbit I simply could not afford to let pass.

This morning I was watching Fox News (you know, for the “fair and balanced” reports) and saw some poll results. They looked something like this.

Fox News Poll: Who do you think the media wants to win the presidential election?

Obama – 61%

Romney – 15%

Unsure – 17%

No word on what happened to the other 7% of respondents.

The proof, as Sancho Panza said, is in the pudding that is eaten. Does this poll possibly offer anything of remote value to anyone? Yes. What it shows is that people who watch Fox News (the population subset polled) tend to believe what Fox News tells them.

This poll, like those “proving” many political narratives, is patently offensive to the democratic process. It takes the focus away from what people seem to be unwilling to focus on, which is the issues. But that would take mental effort, and it is much easier to tell stories like this.

Killing Maybe

“Many of the things you can count, don’t count. Many of the things you can’t count really count.” – Albert Einstein

In business and life, many of our pursuits are directed at the elimination of “maybe.” Making money means the possibility of “maybe” being evicted is stemmed. The unlikeliness of a line of business involving Mars tourism means that “maybe” is off the table. Waking up early means we are going to be at work early, no longer “maybe” getting fired for being late. 

Maybe means risk, and risk is seen as bad.

However, eliminating risk also eliminates possibilities. Change is created in the gray areas, not in the well-defined zones of present enterprise. Financial managers get this to some extent because they pay interest on their debt. Interest primarily accounts for default risk except in very few instances. The problem is that financial managers also try to control risk by quantifying risk factors whose parameters are not so easily mapped (see: market research).

Next time you look at financial projections (US national debt or corporate income, for example), remember that anything beyond what is in the past is simply an opinion. Once a formula is created in Excel it is easy to copy it to subsequent years or quarters. Projections create the illusion of a lack of risk that something will “maybe” change in the coming years. It’s right there on paper!

I love risk because it means there is an upside. There is a chance to create something great. If we knew what was going to happen the game wouldn’t be much fun anyway.

Ad Hominem

I enjoy competition more than almost anything. I love to compete in sports and I love to debate. There is a point in competition when you know you’ve defeated your opponent. In tennis it could be when he loses his composure when you’ve taken a lead. He is broken.

In debate, you know you’ve won when your opponent uses the ad hominem argument – the personal attack. Your points are strong and he decides to beat you he must say things that are related to your appearance, lifestyle, income, etc. This is the equivalent of a baseball player using steroids. You can justify it however you want, but it is cheating and it is certainly a way to concede a spirited conversation.

Finish Line Effect

I have finished* my MBA, I tell people. That is because I will not receive that piece of paper until I turn in my thesis. 

I have been working on my thesis (tentatively entitled “Mobile healthcare adoption strategy in the United States and Scandinavia”) with my team since last September. It has been a long process that has included several diversions in topics, frustrating meetings and an incredible trip to Scandinavia. We are set to present our findings in just over two weeks.

This morning I got the first taste of the “finish line effect” (partially aided by coffee) for this project. It is a sweet taste that comes from having gravity of the sense of near-completion draw you in. My fingers are almost done hammering away at my keyboard and the end is imminent. 

Next step: real world.


Patterns in human behavior tend to repeat themselves. One of those is the pattern of balance. Enter the chiasmus. In literature a chiasmus refers to a story’s structure containing similar ideas in the beginning and end, with separate ideas clustered in the middle. Picture an hourglass or the letter “X” (in Portuguese the letter is pronounced “shis” ~ “chi”) in which shape is mirrored from top to bottom.

We use the word “palindrome” to describe a word or phrase whose spelling is identical front to back and back to front. See: race car, otto and wow (which is also an onomatopoeia, as some nerds will notice). Again, it’s all about balance.

And then we get life’s structure. Depending on how one wishes to define success and where one grows up, it can go something like this:

As babies things are very structured, so attached to our mothers arms that our eyes have yet to develop sight beyond a couple feet. Pre-school, kindergarten and elementary school follow highly regimented methods of education. 

Things begins to change in junior high when we are allowed some choice in courses. This trend continues in high school, and structure loosens when most of us learn to drive, transporting ourselves free from the need of caregivers.

Likewise, college is fairly undefined. We choose majors and are expected to plan careers at age 18. Coming from such a tightly planned schedule, it is no surprise that this is a challenge. Graduate school leaves us with even less definition, even more so for those who pursue PhDs and must largely direct their own work.

And then we have work. We find that we are only able to create value in the commercial sphere by connecting dots. Doing things by the book significantly curtails success. There is no roadmap. Even classically well-defined professions (law, accounting, medicine, etc.) are now being forced to change how they operate.

Then, some day, maybe, we retire. We return to structure that is more self-defined, but heavily structured nonetheless. Routines dominate. Conservatism wins. The target for happiness becomes less nuanced and thus more easily reached and appreciated. 

Regardless of the level of structure, we can find solace in the awareness of our place in it. So as my buddy likes to say “Put a smile on that ugly face, it will make you look cuter.”