Personal

  • Customer Service,  Personal

    Cancelling Amazon Prime… and saving money

    Amazon-prime

    One of the first things I did when we moved to the United States was to subscribe to Amazon Prime.  The early days especially were a non-stop flurry of boxes from Amazon, containing all the things we thought we needed as we transitioned from living in a relatively smaller high-rise condo, to a much larger single family home.

    Almost exactly four years later, we cancelled our Prime subscription.  I’ll share the reasons why below, but it had an unexpected side effect – saving money.  I’m not just talking about the $99/year subscription fee either.

    Why Cancel?

    Given my affinity with Chromecast, the straw that broke the camels back is going to be fairly obvious – but in truth, a number of things had already happened that gave me increasing concern about the nature of being a Prime member.  These were roughly as follows:

    • Service Bundling.  When Amazon raised the price of Prime from $79/year to $99/year, they justified it by the “extra services” they had recently added – by which they mean Prime Instant Video, their competitor to Netflix (and later, Prime Music).  This was simply a service I didn’t want, and never used.  The incremental content it provided over Netflix at the time was minimal (and Netflix had the kids programming and a kid-friendly UI that we depended on), and the interface for actually finding anything was poor.  To me, there was zero reason to bundle two completely unrelated services – free shipping on physical purchases, and online streaming video/music.  Ultimately, I rationalized that the convenience of fast, free shipping alone justified the $99/year, and stuck with the service.
    • Hachette Books Dispute.  I don’t even buy books, generally speaking, but the tactics of holding physical books hostage in negotiations over ebook pricing seemed a little questionable.  I don’t really know enough about the issues on either side to comment on who was really right or wrong in this dispute, but it did make one thing clear – Amazon knew that I, like others, was a captive audience (as opposed to a group that would simply buy elsewhere if Amazon didn’t carry something), and was using this as a negotiating tool.
    • Movie Studio Dispute.  One category of items I’ve consistently purchased via Amazon is movies and videogames, as they’ve got a great policy of having it to you on release day, at the lowest price the item had any time between when you ordered, and when it shipped. Despite the convenience of streaming, when I really care about watching the film in the highest quality I can, I still buy the Blu-ray disc. Then something very odd happened; the release date of something I’d been waiting for was coming up, yet the item wasn’t even visible on Amazon for pre-order. While there wasn’t a lot of press around this, what did exist pointed to an ongoing negotiation between Amazon and the studio for this film (I don’t remember which it was).  I finally did pre-order it, with the usual promise of release day delivery.  But disappointingly, release day came and went, and that weekend, I had to skip watching the film despite it being available at Costco for the same price, because it was already in transit from Amazon.  It felt like a worse outcome for me, so that Amazon could strike a better bargain.
    • Banning Chromecast (and Apple TV).  This one hit far closer to home, but also – in my likely biased opinion – crosses way many more lines than the above.  If you didn’t see this, Amazon decided to remove both Chromecast and Apple TV, on the basis that it was “confusing” to their customers that these products did not work with Prime Instant Video.  As some articles pointed out, this argument didn’t make a lot of sense; Chromecast (and now also Apple TV) allow app developers to support the device if they so choose.  More importantly, this was a very clear sign that Amazon didn’t actually intend to be “the everything store“, and that it would favor its own products over others.  Chromecast might have been the first publicly visible example of this, but what about the Amazon Basics products I’d bought – were competitors against Amazon in other areas being treated similarly?

    The net of all this is that Amazon lost the trust I once placed in it to act in its customers’ interests first and foremost, and to be a great source (even if not the absolute cheapest on everything) of anything I wanted to buy online.  Moreover, I didn’t want to buy a “buys-everything-on-Amazon” Prime subscriber that allows them to make moves like the above that are only in their own interests.

    Saving Money

    In cancelling Prime, I expected to save $99/year, at the cost of waiting a few extra days for my purchases, and not being able to impulsively order something that cost $5.  Entirely unexpectedly, I’ve saved far more than that.  You might be expecting a noble tale about how this led to an epiphany about the plague of excess consumerism, but unfortunately while we do definitely buy way too much stuff as a society, I don’t have such a tale to tell.  My experiences with not defaulting to Amazon are actually quite different:

    • Some things are just cheaper elsewhere.  Amazon offers good prices and never tries to float a price that’s a ripoff compared to other sources, but it’s not always the best.  Once my shopping tended to start with search instead of on amazon.com, I found that I’d occasionally get the best deal on what I wanted with B&H Photo, Monoprice, Newegg, or some other source.  It’s a little more hassle to have accounts with various sellers, but not being lazy had some benefit.
    • Brick & mortar makes sense for some items.  In the early days of e-commerce, retail stores generally still had margins that ensured that buying online was virtually always a better deal, unless you picked up a loss leader on Black Friday.  But that’s changed, and retailers now understand they can’t sell non-impulse items at higher-than-online prices.  In fact, for some items, the manufacturer dictates the same price across both online and offline sellers.  This was the case with an LG OLED TV that I bought to replace my monitor; Amazon, Best Buy, and other sources all had identical prices (technically, Amazon had it for $2 less).  Purchasing it in an actual Best Buy came with three benefits.  First, I had it home and setup the day I hit a particular personal goal I’d gated this decision on.  Second, we could choose when to go to the store, rather than having to set up a 4-hour delivery window (or greater), probably on a weekday, that would have been inconvenient.  But finally – and per the “save money” comment – a promotion to sign up for a Best Buy Visa led to a 10% discount, which in the case of this TV made a $300 difference!
    • Minimum advertised price is not minimum price.  In some categories, retailers seem to be held to a requirement that the prices they can post/offer online have a certain minimum.  I’d previously assumed that this was just “the price”, and if it seemed reasonable enough I’d buy it from Amazon.  But as I looked at replacing two key components of our home theater that have provided close to a decade of service but are getting somewhat dated, I discovered that A/V dealers you still have to call over the phone can still do better than “minimum advertised price”, even when they are authorized dealers.  My replacement projector was $200 less from a dealer than from Amazon; the updated A/V processor I went with was $250 less through that dealer.  The right dealer will also be very knowledgeable; I actually wound up making a different choice on the projector after speaking with the dealer and doing some additional research.

    It’s hard to quantify the small items, but the three big-ticket items (which I hope will last a decade, like their predecessors!) added up to $850 in savings over my previous “Buy with 1-click” default behavior.  And so far, we’ve only had to pay $5 once for expedited shipping.  Add in the $99 annual fee, and that’s a net improvement of $944 not counting smaller items!

    Amazon is still a great source of many things, and whenever I’ve had to reach out to their customer service, they’ve been great.  When I am buying something online, I don’t avoid shopping there, and I’m glad that by going to smile.amazon.com, you can elect to support a charity with a small portion of your purchases.  Cancelling Prime just means I don’t default to shopping there – and so far, that’s saved me a ton.

  • Personal

    Progress

    My first home in Kuala Lumpur, Malaysia, which we lived in when I was 6 through 9 – along with my grandparents, aunts, uncles, and cousins – was demolished long ago.  Although my mom’s generation had grown up there, the transformation of KL since the 50s made the land far more useful even as a downtown parking lot.  Ironically, decades after it’s destruction, the land remained undeveloped – a fact we regularly observed while eating at the tea shop across the street from our original home.  I’ve eaten more meals in this tea shop than in any other restaurant, bar none:

    Indeed, we just had some roti in that shop this morning – and it’s basically open around the clock, so whether it’s lunch at 1pm or a late night snack at 1am, you’re covered. Even if you’re feeling for something like Maggie Goreng – basically, fried instant noodles – that you probably won’t find outside Malaysia:

    Epitomizing the “cultural melting pot” label Malaysia sometimes gets, this mostly-Indian teashop, frequented largely by local Malays, shared their space with a Chinese vendor who has known us since childhood, and that we know only as “Fruit Juice Lady” – and who still refers to me as “Boy”.  Sadly, I learned today that she’s closed up shop after a few decades to take care of her diabetic father.

    The reason we ate here so frequently is that after our first home, we moved just around the corner – to a low-rise “flat” that was home from age 9 through 12 and whenever I visited over the ~25 years since I left Malaysia. Each visit, it was stunning to see the modern high rises popping up all around us, starting with the Petronas Twin Towers, and continuing at an unrelenting pace.  From any angle, our 5-story flat was surrounded by towering skyscrapers:

    Our building (“Flat Jalan P Ramlee”) is completely obscured in Google Maps satellite imagery – even though that imagery is a few years old and is missing a new skyscraper on the other side of the street from us:

    Screen Shot 2014-12-21 at 7.40.48 AM

    If you came across our old building, you’d definitely think – rightfully – that it was a relic of the past.  Employees at the office on the first floor punched in and out daily on this:

    The back entrance was indeed a little dilapidated:

    If you’ve never lived in Asia, you might be forgiven for assuming that our front door looked like a prison:

    It’d be valid to wonder why a bulldozer hadn’t wiped out our anachronistic home – and indeed, after that question being asked any number of times, our home’s time was finally up. I took these photos a year ago, in December 2013; the building was demolished a few months ago. Today, I returned for the first time to see an empty lot, surrounded by metal panels, where our home used to be. This fruit tree, which I’d planted from a seed as a child – and which even the subsequent creation of some parking spaces had spared – was cleared away along with everything else:

    I suppose the price of progress is that sometimes, it involves the demolition and paving over of your childhood memories. But that’s why I carry my camera, and keep this blog! Now, my mom lives out in the suburbs; the twin towers no longer cast a shadow over us, but they’re still visible from here, on a clear night like tonight:

    The skyline may not look any different with our tiny little home missing, but it all depends on your vantage point.

  • Personal

    Optimal Viewing Distance

    THX recommends a 36 degree viewing arc when setting up a screen for an optimal viewing experience.  Sit a little closer in an actual movie theatre, and it’s apparently about 54 degrees – unless you paid extra for the IMAX experience, in which case you might get up to 70 degrees from some seats, supposedly creating a more immersive experience.

    Leo, however, finds these recommendations highly inadequate.  Fortunately, he was able to rearrange a seat at the Disney Store to suit his expectations:

    At least Oculus and other VR companies apparently have a target customer!

  • Personal

    Holiday & Seahawks Lights

    If you’re going to decorate the outside of your home with lights over the holidays, or you want to show support for your favorite sports team (in this case, the Seattle Seahawks), make sure you don’t move in next to these folks from up the street:

    This shot doesn’t capture everything; the lights you see to the top left are Santa’s sleigh, being pulled by reindeer, and mounted high up in the trees! This magnificent show of lights is an annual thing for them, which they’ve been doing since they moved to the area.  That Seahawks logo is actually strung together using what looks like regular strings of holiday lights – very carefully and precisely arranged. Every year, a few thousand people come by to see the lights and, thanks to the generosity of the hosts, stop by inside where the show continues:

    This year, we already outdid ourselves by actually having a (plastic) Christmas tree, and one outdoor light (a pre-made candy cane that was on sale at Costco).  By contrast, they had Christmas trees by a running stream near the village you see above:

     

  • Personal

    Stacking The Odds

    “Everybody guess how many pieces there are!”, says Olivia, organizing her guessing contest.  “But no counting!  That would be cheating.”

    To her credit, despite setting the game up, she didn’t actually count, so despite a few extra tries, Uncle Peter was still the winner :).

  • Personal,  Photography

    Toys on Christmas Morning

    I guess when you do Christmas morning with six adults and just two kids, the grown-up toys seem to outnumber those for the kids. This is especially true when four of the six decide that Christmas morning is a good time to take some photos – and bust out the toys to do this with:

    Counterclockwise, from the right – the Nikon D7100, Nikon D7000, my Nikon D800, a Pentax 645 medium-format film camera, Leica R4 35mm film camera, and in the pouch, a Fuji Finepix f31d. At least in the unlikely event that our kids ever become famous, they’ll be used to the paparazzi!

    Not shown is the couple of strobes used to light the living room.

     

  • Personal

    Suspension of Disbelief


    pacific-rim-poster

     

    It goes without saying that if you’re going to watch any Hollywood sci-fi blockbuster, that you’d better be prepared to check your sense of reality at the door.  Perhaps a post-kids lapse in movie watching has something to do with me forgetting this fact.  But with streaming services improving in quality – image quality is getting a little closer to Blu-ray, and 5.1 sound is now not a rarity – I was able to watch Pacific Rim recently. And boy did it provide a reminder that filmmakers these days feel free to take a few… liberties.

    If you haven’t seen the movie but intend to, the rest of this post will probably have some spoilers, so stop reading maybe.

    Whatever else I have to say about the film, I will acknowledge that as far as giant robots taking on giant monsters in hand-to-hand combat goes, you really can’t beat this film.  Visual design and effects are truly top notch.  In fact, they’re so good that it’d be perfectly enjoyable – perhaps even more enjoyable – to watch Pacific Rim in a foreign language you don’t understand, without subtitles, so that you can marvel at it’s beauty without wasting any of your brain cycles thinking “wait, what!?”  In fact, in the absence of dialog, you’d probably come up with a more plausible explanation for what you were seeing on screen.  And indeed, if you haven’t yet seen the movie, don’t let the mountain of criticism below deter you, as its production values alone may well be enough to keep you entertained; if a boxing match can be entertaining, well, then certainly this movie can be too.

    So, with the good out of the way, on to the point of this post – the logic and the science of the movie are downright stupefying. I’m fully aware that you really can’t make a giant robot vs. giant monster movie that’s grounded in any sort of truth, but I think what disturbed me enough to write this is that beyond just making up flux capacitors or something to that effect, there are just so many things wrong here that I’m pretty sure even Olivia (who is 5) would be confused. There’s no particular narrative to my criticism, so in no particular order, here are some of the biggest head scratchers:

    • Knee Deep Jaegers.  Jaegers, the name given to the human-built robots designed to fight the Kaiju (monsters) are enormous creations, probably 20 stories or so in height (though scale varies about as much as reality in this movie; I’m basing this on scenes where the Jaeger above is walking in the streets of Hong Kong).  Yet somehow, even when fighting way out at sea far beyond any visible land, Jaegers stay between knee and waist deep.  Despite that the average depth of the Pacific Ocean is somewhere around 4,0000m.  Near the beginning of the movie, when you first see this, you naturally assume they must have some kind of propulsion system that allows this.  Then they show it actually walking.  Guillermo Del Toro should probably have lunch with James Cameron sometime, I think.
    • Let’s just build a wall.  The movie shows us images of increasingly large Kaiju smashing through buildings with abandon.  Apparently, the plan that world leaders agree upon after seeing this is construction of a wall around the entire Pacific ocean.  Now sure, after the U.S. government shutdown, perhaps the concept of elected officials coming up with incredibly boneheaded ideas isn’t so far fetched.  But seriously, the Pacific ocean is about 40% of the Earth’s surface, so with the radius of the earth being just about 6,300km, a “simple” circular wall would be over 30,000km long; and a wall is only as good as its weakest point.  Also, the Kaiju can (a) fly and (b) spit acid that dissolves buildings instantly. But as if all this wasn’t enough, what do you think are the odds that we’d go for a solution in which we co-exist on a planet with hostile, powerful creates on the other side of a wall?
    • Dinosaurs Version 2.0.  At one point in the movie, it’s posited that the dinosaurs were an earlier incarnation of the Kaiju, but they died out because the earth’s atmosphere wasn’t sufficiently conducive – but now, thanks to our polluting, we’ve essentially terraformed the planet for them.  I’m no climate change denier, but really, Santa Claus going rogue and striking back at commercial toy factories by making Kaiju instead would rate higher on the scale of possibilities than this.  First, the dinosaurs were around for millions of years – Wikipedia says they were dominant for 135 million.  Since their estimate lifespan is +/- an order of magnitude of that of humans, we’re talking a couple million generations of dinosaurs.  For a species capable of evolving a biological EMP generator in a few weeks between attacks, you’d think a few million generations would be enough time to adapt to carbon dioxide levels.  Also, if you can survive in the molten core of the planet and under the pressure present in the depths of the Mariana trench, it seems unlikely that the lack of pollutants in the atmosphere are going to pose much of a problem.  Besides, if the Kaiju are the dinosaurs, returning, well, that would make them the indigenous species on this planet, wouldn’t it?
    •  Just One Nuke.  If there’s one thing that Hollywood taught us, it’s that no matter whether you’re spacefaring invaders attacking earth through a dimensional portal above New York, an advanced artificially intelligent lifeform that conquers the entire planet with Tom Cruise clones, or – in this case – evolved dinosaurs that live in lava and liquid metal, you’re always susceptible to that one well-placed nuke.  Unless you’re the aliens from Independence Day, in which case, you’re impervious to nukes but come with the typical single-point-of-failure design flaws also on display in this movie.  Considering that the earth’s substantial internal heat is believed to come largely from ongoing radioactive decay that keeps the core of the planet at a toasty 11,000F – hotter than the surface of the sun – it seems like if that’s what you call home, then one nuclear reactor going critical would probably seem like a blinking LED.
    • Neural Overload.  It takes two (or three) people to control a Jaeger, because apparently the neural load of controlling a big robot with two arms and two legs that mimic what you do with your own anyways is a bit too much. Have the writers of the movie ever seen the likes of Innovation playing Starcraft 2?  (You’d think so, since the initial Jaeger suit-up sequence borrows a huge number of elements from the SC2 Wings of Liberty opening cinematic). Anyways, how do they overcome this neural load? Oh, that’s right, by keeping you in a continuous mind-meld with another human. That ought to help!
    • Steam Machine.  At one critical juncture, a single Kaiju creates an EMP shockwave that not only renders nearby Jaegers completely inert, it also has a blast radius big enough that it shuts down all of Hong Kong from offshore. Naturally, the Jaeger used by our heroes isn’t affected, because it’s an older model. Which runs on what, steam?! Which then connects into your brain exactly how?
    • Must Be A Hanzo Sword. After losing all offensive capability, our clever heroes remember that their Jaeger is equipped with a handy sword (with it’s own dedicated button, because I guess it’d just be too much to include this as part of the neural link). This weapon-of-last-resort just happens to be so darned sharp that it can cleave even the largest of Kaiju clean in two (where plasma cannons, giant spinning saws, and other such things seem to leave little lasting impact). Clearly, they must have enlisted the help of Hattori Hanzo in crafting such a blade. The sword is in fact so effective that you’d think our defense strategy would consist of a whole bunch of ICBMs outfitted with a sword tip.  But since Kaiju are apparently a delicacy – and pop out of a relative small fissure in the ocean at a known location – I’m thinking the more likely solution is a USDA Prime Kaiju factory built on top of the fissure that just applies sword to Kaiju immediately upon emergence.  Seems more practical than a 30,000km wall, in any event.
    • Battle Etiquette.  When watching movies about historical warfare, few things seem more ridiculous than battles in which both sides line up on opposite ends of a field, march at each other, wait till the other side is in range, and then open fire. How you’d convince a solider to stand in the front row is beyond me. Anyways, despite adapting the ability to withstand shots from a plasma cannon in short order, the Kaiju apparently have their own sense of battle etiquette, which is to attack one at a time – but at ridiculously complex yet largely irrelevant intervals. You’d think that you’d at least build up a small handful of troops – or better yet, an overwhelming army – before firing the first shots in a war. Instead, not only do they attack linearly, they send their weakest variants out first. Oh, and they also send pregnant moms that are almost ready to gestate into battle, despite that the attacking Kaiju are all supposedly engineered clones.
    • What We Already Knew.  Finding a compatible human pair that can link to each other neurally is a difficult and complex process, where apparently the best predictor of compatibility is how well you spar against each other with a staff (good thing they didn’t cast Jet Li in this movie). On the other hand, a random pair of scientists is apparently quite able to pair with a newborn hive-minded Kaiju baby. What critical, game changing piece of information do our intrepid scientists discover? That if we do exactly what we did before (throw a nuke in the hole), exactly the same thing will happen as in all prior attempts to do the same thing. Who’d have guessed!
    • Manual But Not Quite.  It seems like the first thing to break in just about every piece of high-tech equipment is the self-destruct timer or autopilot or whatever a heroic character needs to escape their demise. Whether it’s Star Trek’s autopilot being knocked out even while main navigation, impulse power, phasers, life support, and communication are all working properly, or the timer on the bomb in Armageddon, this has become a Hollywood cliche. Still, Pacific Rim manages to surprise here; when the automatic timed self destruct fails and requires a manual override, you think you know how things are going to end.  But no, it turns out the manual override also has a nice delay, which happens to be just long enough to escape the blast radius if your escape pod moves at impossibly high speeds on account of being so far underwater that in reality, it’d actually be crushed by water pressure like a tomato at a Heinz factory.

    Normally, I can’t remember the names of the characters in a movie even immediately after I watch it. That I can remember any of the above is only a testament to how outrageous some of the ideas from the movie are. If anyone is in doubt about the need for better science, technology, engineering or math education – then I highly recommend watching Pacific Rim.

  • Personal

    US Healthcare

    Healthcare-Reform-Act

    One topic I want to capture my thoughts on, before I just get used to things, is the state of U.S. healthcare.  While in many areas of daily life, you can’t really tell much of a difference having crossed the border, with healthcare the differences are legion.  And not for the better, so far as I can tell. The following a random assortment of things, that I’ve either read about (primarily in the NYTimes) or experienced directly that induced the most head-scratching.

    I should note first and foremost that the actual practitioners I’ve dealt with have all been capable and professional  (though my family and I are still fortunate enough not to have needed any particular difficult care).  It’s the system, model, companies, and bureaucracy that I find amazing.

    1.  Rates for the uninsured.  I remember my friend Herman telling me, after he’d returned to Canada, about a visit to his dentist.  Since he’d been away and hadn’t started working yet, he didn’t have dental coverage (in Canada, healthcare is free, but you still pay for a trip to the dentist if you don’t have a plan). But seeing that Herman didn’t have insurance yet, the dentist helped him out by giving him a favorable rate that was less than what insurance would have been billed. By contrast, here, I’m stunned to see that rates for the uninsured are simply exorbitant; every time I get some kind of statement, it reflects standard pricing that is sky high, followed by a negotiated rate that are my “savings” thanks to my insurance company.  I’ve seen the uninsured rate be up to 5x as high, sometimes $1,000+ for a simple visit of less than an hour.

    2.  Better have a crystal ball.  Even if you are fortunate enough to have insurance, there’s a myriad of choices all of which rely on your ability to predict your medical future. Considering that insurance is there in large part to deal with potentially catastrophic expenses that you by definition cannot predict, this seems counter-intuitive. Perhaps everyone who has lived here long enough understands the difference between HMOs and PPOs, which of multiple PPOs are best, standard and high deductible plans, the right allocation to an FSA, how likely you are to need out-of-network care, and so forth, but to me, putting these decisions in the hands of an average consumer is pointless.

    3.  Gambling your healthcare on the stock market.  One of the amusing constructs that exists in the U.S. is a Healthcare Spending Account (HSA).  Your employer may deposit some funds into it annually, you can also put some of your own pre-tax dollars into it.  If you optimize things correctly, you’ll figure out exactly your lifetime out-of-pocket healthcare costs, you’ll accumulate exactly enough in the account, then spend it over time as you get old and your bills increase.  Maybe that already sounds crazy to you (if you don’t live here), but there’s more!  You can actually invest your balance in instruments of your own choosing, and yes, equity funds are available!  If a sudden market meltdown causes you a heart attack, good luck paying for it.  I have one of these things, but I can’t for the life of me figure out how this added complexity is supposed to bring about a better outcome for anyone.  There’s a parallel kind of account that is similar (LPFSA), but that one is even more like a lottery, you put money in and whatever you don’t use by the end of the year – you lose! All just to save some tax dollars.

    4.  Hope you’re a good negotiator.  Want to know who gets to resolve things if your healthcare provider and insurance provider can’t seem to agree on who exactly should pay how much for what? You, of course. Because if your insurance company decide they’er not paying, then you get the bill. And errors/disputes seem sufficiently common that you should expect to find yourself in this situation – all it takes is one coding error when a procedure is being documented and you may be spending quite some time on the phone. When we did the mandatory checkups as part of applying for a green card, I didn’t know if that was actually covered or not. Apparently, neither did they, because for the same procedure on the same day, mine was covered, Valerie’s wasn’t, and our kids were. I didn’t even bother trying to figure that one out.  Just this past week, even a regular annual checkup got billed incorrectly and is now in the process of maybe being corrected.

    5.  One visit, many bills.  Going to the doctor feels like it can create a stream of bills, which trickle in for months after the actual visit. That’s because your doctor bills you, the hospital bills you, the lab that did some analysis bills you, then any specialists or others that got involved in some way bill you. This happened a few times when Leo went in out of concern about his asthma; we get way more bills than visits, some of them bigger, some of them smaller, and frankly we have no idea what some of them are for.  I swear that someone could send us a bill for the oxygen we inhale in the waiting room and if they had the visit dates right we’d probably just pay it.

    6.  In-network vs. out-of-network and balance billing.  On the surface of things, in-network vs. out-of-network is simple, even if crazy.  Your insurer has a network of participating doctors, hospitals, etc.  If you use a provider that’s in-network, most of the bill is covered; if you go out of network, you have to pay a much higher percentage *and* because you don’t get the “discounted” rate, you’re paying that higher percentage against a much higher base amount. As a consumer, you better make sure you understand this, or seeing the wrong doctor could be rather expensive. But even if you do understanding this, balance billing as explained in this New York Times blog post, will scare you:

    A report issued by New York State in March cited the case of a patient who went to an in-network hospital emergency room after severing his finger in a table saw accident. The finger was reattached by a nonparticipating plastic surgeon, and the bill was $83,000. The insurer estimated the going rate for the procedure was only about $21,000.

    That’s right, if you have things together enough to get to a participating hospital in an emergency, that doesn’t guarantee that all doctors working there are participating, and you may be stuck paying the difference.  For a lot of folks, I imagine that a surprise extra $62,000 due to an accident could be enough that they can’t pay their mortgage or stay in their home.

    7.  Exorbitant pricing.  I still get sticker shock when I see $1,000+ bills for a quick asthma visit for Leo (fortunately, these are less frequent); even when the insurance company picks up most of it, it’s pretty horrifying. Once we’ve lived here long enough, maybe my reaction won’t be as visceral. Why do things seem so expensive? Well, at least one good explanation came in another recent NYT article, which described how patients were billed up to $546 for a bag of saline solution which actually costs between 50 cents and $1, due to a combination of complex deals between suppliers & hospitals, and obscene 100x-200x markups.  Another recent article called out medical device pricing as particularly rife with anti-competitive practices, including effectively paying fees back to a physician that proscribes use of a particular device.

    8.  Live piano.  I appreciate a grand piano played live as much as the next person, perhaps even more. But it was nonetheless a bit stunning to hear one in the lobby of a hospital facility we visited for our green card blood test. I’ve been to hospitals in Canada, Malaysia, and Taiwan, all of which seemed to have things related to healthcare – not amenities that I’d expect to see as I walk through Neimann Marcus (a high-end department store here) or the lobby of the Bellagio.  But I guess when you’re paying up to $8 million to hospital CEOs, then splashing on a huge foyer replete with a grand piano played live isn’t so excessive.  I’m pretty sure it does raise the bills, though!

    9.  Acquire and gouge.  Another interesting article from a year ago was this one, about an unfolding situation in Boise, Idaho. The largest hospital in town began buying up individual physician practices.  Prices rose, referrals to doctors that weren’t “in the club” dropped, which made it straightforward to drive further consolidation. This all sounds fairly anti-competitive, but so far as I can tell actual anti-competition laws are only really applied at a federal level, so there’s little to stand in the way of this kind of thing.

    It’s ironic that living in a country that generally believes very deeply in capitalism has convinced me that there’s areas, like healthcare, where it just doesn’t work.

     

  • Personal,  Technology

    Chromecast

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    Five and half months, zero posts.  Where have I been?  As it turns out, fairly busy with work – on features that support Chromecast, which we finally launched this week.

    I’m really excited about the product that we shipped, the accessible price at which we shipped it, and the support for multi-screen experiences that both ourselves and partners have now integrated into truly broad offerings like YouTube, Netflix, Google Play, and Chrome.  As I’ve mentioned here before, we cut the cord when moving here to Washington, relying on streaming services and Google TV, with Blu-ray discs where needed, to get the content we wanted.  So the opportunity to work on bringing a better experience for streaming & web video to everyone has truly been both a joy and privilege.

    I’m not going to say more about Chromecast here, as this is my personal blog, doesn’t reflect the views of Google, and would be an inappropriate place to share anything about the product.  But since I only ever posted here for people that I know, I did just want to share why I’d been so quiet as of late :).  It was a huge amount of effort working with a really talented to team to ship what we did, but this really still is the very early days of enabling a whole different way to consume content, so I’m guessing things don’t get less busy from here!

  • Personal

    Cord Cutting

    I originally wrote most of this as part of an earlier post on losing weight, as part of noting how critical good content was to keep me going while exercising. Finding several hundred hours worth wasn’t that natural for me, since that’s far more than I’d normally watch in an entire year. To make matters more interesting, since moving to Kirkland, we’ve been cord-cutters – we don’t have cable, satellite, or even over-the-air TV! What we watch is either streamed over the Internet, or purchased on Blu-ray discs.

    In Toronto, the programming package we have would cost probably $100/month; it was a bulk package negotiated by our condo that we had no choice in (beyond paying $20/month more for each HD PVR compatible with Rogers proprietary infrastructure; no CableCard in Canada!). We had a gazillion sports channels, a gazillion news channels, and a gazillion movie channels. So what do we use down here, and what did I wind up watching for a few hundred hours?

    Netflix

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    For $7.99 a month, Netflix Instant Streaming really is quite the value in comparison to any traditional TV subscription. This is especially true if you haven’t subscribed to Netflix since it was first available – because then you can catch up on a number of quality titles that you might have missed.

    Much is made of Netflix’s recommendation engine; they even ran a contest to see if anyone could come up with improvements to their much-optimized algorithms.  And to be frank, you really do need a filter with Netflix’s catalog; there is a ton of low quality and/or low budget content on Netflix that you’ll want to avoid. But I don’t really want a recommendation engine that assumes because I liked the Avengers and the Dark Knight that I really ought to like every superhero movie out there. By far the best indicator of whether I’m going to like something or not is the IMDB rating for a film. I’ve rarely seen a film with an IMDB rating below 7.0 that I enjoyed, and it’s similarly rare that I disliked something above 8.0. Sure, I have my personal preferences, but that just lowers the bar for certain genres; a historical drama likely needs an 8.0+ for me to watch it, but I can probably tolerate a Chinese kung-fu flick down to 7.0.

    Sadly, I assume due to IMDB policy, sites can’t just state the IMDB rating for a movie.  Indeed, within the past few months they even seemed to have review scores stripped out of Google search results, which I find quite annoying. Unfortunately, Netflix’s own user ratings for content are comparatively much less useful; they’re not completely uncorrelated with quality, but when Transformers: Dark of the Moon (6.3 on IMDB) gets 4 stars and ranks in the top 20 action/adventure movies on Netflix, with a higher rating than Once Upon a Time in the West, it becomes apparent pretty quickly that the taste of other Netflix users differs significantly from my own. Fortunately, one useful list for recent Netflix subscribers is this one, which lists the films in the IMDB top 250 that are available for Netflix streaming.

    Despite my vested interest in 20Mbit/s 1080p 7.1 content, and preference for high production values and nice visual effects, a great film is just a great film. And while Netflix didn’t have that many classic films that I hadn’t already seen, it did have several – Once Upon a Time in the West, Apocalypse Now, and The Pianist deserve the ratings they have, and are available for streaming. I wish they had more old-but-great movies like that which I’d missed – I auto-watch anything in the IMDB top 100 when available, but have still missed a few.

    Another plus with Netflix is foreign content, which was rarely available on cable. I hadn’t watched that much Chinese action/kung-fu films recently; most aren’t really that great, but if you haven’t seen Ip Man, Red Cliff, or Fearless, I felt that all three of those were worthwhile (though I had seen a couple of those prior to Netflix). A post on Penny Arcade also wound up getting me to watch this sub-genre of Korean “revenge” films – The Man from Nowhere, Sympathy for Mr. Vengeance, Oldboy, and Lady Vengeance. All are pretty brutal and disturbing, and not recommended if you dislike violence, but unlike the senselessly gory North American “horror” films (which I can’t stand to watch), the aforementioned films all have really strong acting and are good overall films.  The IMDB ratings for these films are 7.8, 7.7, 8.4, and 7.6 respectively; and Oldboy is in the top 100 of all time.  Other foreign films of note were Battle Royale (which I think is similar to, but precedes and outrates The Hunger Games), and the The Girl who Kicked the Hornets Nest (the latter two films in the trilogy weren’t worth watching, IMO).

    The final film I thought I’d mention doesn’t fit the classic or foreign categories above, but I greatly enjoyed – Warrior.

    Unfortunately, I’m now essentially out of Netflix content that I want to watch; there’s still some highly rated films that I intend to get to – The Twilight Samurai, Cinema Paradiso, Amadeus, The Kings Speech – but movies that are 3 hours long or are dramas that require more active brain attention are less well suited to exercise.

    Gomtv.net GSL

    Gsl

    Okay, this isn’t going to be the ideal exercise programming for everyone, but it worked pretty well for me! Who doesn’t want to watch the best Korean Starcraft 2 pro-gamers go at it?

    The GSL provided a ton of content, and was relatively inexpensive; the normal price for ad-supported access is $15 for a season, but a season has literally hundreds of matches and well over 100 hours of content. For the price of a single Blu-ray disc, if you’re into SC2, it’s a great value! Since I was doing exercise instead of playing, it was a good way to keep up with what was going on in the game (strategy in SC2 evolves over time, and it’s downright bewildering if you don’t know how to deal with some of the things that you face).

    The nice thing about SC2 matches is that since a match typically lasts 15-20 minutes, it’s not too hard to find just the right amount of content for a given target amount of exercise; there are very natural stopping points as you watch through the matches in a season. With a feature film, you’ve got to decide if you have the endurance to do the whole thing, if you want to break it into two, etc.

    Crunchyroll (and anime generally)

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    I watched a little Japanese animation in University, due to friends who were interested in it, and mostly liked it – I particularly remember liking Ghost in the Shell – but was never attached enough to make an effort to seek it out thereafter. Netflix’s selection of a few animation series got me watching again – but my colleague Pete from work pointed me at a site called Crunchyroll, which has a huge collection of anime, without ads, and in generally high quality. Having exhausted Netflix, it was a welcome boost and I’ve really enjoyed a couple of series that I’ve watched there.

    I generally gravitated towards highly rated series that were semi-short, and didn’t have a ton of episodes (I like to get a beginning-to-end story where possible, not a 300 episode series like Naruto!), and highly rated. Here’s what I watched:

    • High School of the Dead – I was reminded with this show that Netflix ratings mean nothing (this is among the top rated animes on Netflix). The animation in this show is highly fluid, but other than that, this show was a waste of time.
    • Elfen Lied – disturbing, beautiful, haunting, and strangely peaceful at the same time; I enjoyed this a lot, though I don’t know why.
    • Fullmetal Alchemist – great show, all episodes on Netflix, well worth watching.
    • Fullmetal Alchemist: Brotherhood – an even better retelling than the original (but watch the original first). However, Netflix only had 3/4 of the episodes (and it now pulled the series). So it cost me like $70 to buy the whole series on Blu-ray in order to get what Netflix didn’t have!
    • Sword Art Online – the first 14 episodes are fantastic. The 11 that follow should be deleted. But despite the second half fail, I still enjoyed this series a lot overall.
    • Puella Magi Madoka Magica – at a glance, you’d think I should be embarrassed to watch something like this, and after the first episode or two I thought I might be. Then you realize how deceiving superficial impressions are. A really solid 12-episode series that doesn’t stop getting better.

    Overall

    There’s definitely some things I miss – specifically, the Olympics, and coverage of the Grand Slam tennis matches, that are available only sporadically online, or not at all (thanks to NBC’s decision to require you to be a cable subscriber to receive it’s online coverage).  Hopefully, this business model induced silliness is time limited – countries in Africa and elsewhere got the entire Olympics via YouTube.

    But all in all, I definitely found enough to keep myself busy; and it’s great to see the online model of supporting niche content like foreign films or anime that have never been so easily accessible.

    Best of all is how economical this model is. Over the half-year exercise program, the total cost of all this entertainment was roughly $48 (Netflix) + $30 (2 seasons of GSL) + $25 (6 months of Crunchyroll at 50%-off Thanksgiving rate), just over $100 in total for several hundred hours (excluding what it cost to get the remainder of FMA:Brotherhood).  Rogers charged that for a single month of cable, and wouldn’t have provided even close to the same quantity of entertainment.