The Bucky-Gandhi Design Institution

The Reykjavik Briefing

Clip from http://files.howtolivewiki.com/reykjavik_briefing/ - recommend watching it over there where there’s a proper picture of the diagram, and also a link to download the whole one hour briefing. Enjoy.

the 20% dollar

I’m really scared about America if/when the dollar collapses.

How far does it have to go depends on how likely people think America is to pay its debts.

I just… shit. That was my country, my homeland, even if a series of regrettable events put me in Iceland. At some level I’ve always been an exiled American. That’s a mental position that’s slowly eroding with time and with the sheer unwillingness of the American people to get angry about the right things and ignore petty political bickering, but I still believe firmly in what the Revolution stood for, in what the Constitution represents, and in the greatness of spirit latent within the American people, wherever they may find themselves.

But all of that has been obscured by this filthy political process which has brought the best of the worst into positions of power, on the shoulders of people who would rather die than think - and do.

The wheel of the world has turned, and fortune’s favor has moved onwards, I fear, from the beacon of liberty. 200 years held aloft the torch, may it’s darkness be swiftly over and not too deep.

Good luck, America. Godspeed.

Health insurance for $10 per year using the network

Here’s the plan, in it’s simplest form: deploy medical expert systems using the cell phone network to help people make medical decisions. Use the ability to integrate data from each user into broad statistical patterns to improve the models and plot the progression of epidemics, for example. Then add bicycle-riding computer-aided pharmacists who prescribe basic medications and are paid for using very small health insurance premiums.

Now the detail!

1> Assemble global epidemiological data into a big database. Who gets sick where, what they get sick with, what happens to them. Data will be great in some places, crummy in others, we don’t care right now as long as an estimate of data quality is stored with the data.

2> Assemble simple guides on disease management and health maintenance, translate into 80 languages, including audio versions, and correlate with a symptom database to aid simple diagnosis.

3> From these two resources, assemble a simple (Baysian?) classifier for likely diseases and treatments given symptom input. Where additional questions can distinguish two potential conditions, flag.

4> Prune the tree of all dangerous treatments which have a low chance of success in the field, but keep things which cannot do harm if misapplied.

Result: a map of what’s going on out there, which can be prioritized by effectiveness of intervention and the number of people affected.

One area of this map is the “good intervention” area. This is the place where there are common diseases with effective interventions with low risks if you do something wrong. Typical cases might be non-insulin dependent diabetes, where simple lifestyle changes can have huge health effects. Diarrhea is another area where there’s an effective set of measures which are low risk.

Now crunch this into an expert system which is deployable on cell phones.

The expert system phones home, so the epidemiological database improves rapidly with time - the symptom data which is collected helps refine disease and mortality maps, but many of the illnesses reported cannot be effectively treated without material. The network alone cannot provide antibiotics, and knowing you are dying of a blood infection does not cure it.

However, even this basic system could save millions of lives a year and greatly increase general welfare where available.

The second advancement is the Simple Pharmacopeia. The WHO Essential Medicines List is a likely starting point. Here’s the modification.

1> Filter the drugs in the following ways - no need for refrigeration, no bad effects from over-prescription or likely abuse, less than $10 per course.

2> This probably gives a list of a couple of dozen drugs.

3> Prepare a training course and computer aided (expert system) prescribing guide. Data from this system drives both the logistics and also watches out for things like over / mis-prescription. Comparing all similar villages, one can spot people who’re mis-prescribing, or systemic failures in treatment protocols, lousy training and similar results. Think of the kind of monitoring fast food franchises do of franchise performance, but now make it much, much stronger because all this stuff is safety critical.

4> Villagers pay $10 per year for health insurance. One worker per 1000 villagers, say. Villagers report problems over the network (SMS today, tomorrow interactive diagnostic forms) and the health worker bicycles from village to village with a backpack full of drugs and diagnostic equipment (sugar test strips, pregnancy tests and so on.) They might even collect lab samples.

5> Each village may also have an old lady who gets free insurance for maintain a cell phone and knowing how to operate the expert system, knowing what words like “swelling” mean and how to take a pulse. Her primary job would be to get accurate data into the expert systems in advance of the more highly trained worker arriving, and critically she would be the person who’s job it would be to make people take their full course of antibiotics, by going to their house each morning, handing them their pill, and watching them take it. You can make sure she’s doing her job by, for example, getting her to take a picture of each person taking their pill or something if you’re paranoid, and maybe have a 2D barcode etched on each pill with a laser (in the future.)

6> When the health worker comes, they work through the expert system, doing diagnosis, and then offering whatever treatment they can. Their ability to do more sophisticated diagnosis is largely what drives their job - they can use a stethoscope fairly well, maybe identify where in the abdomen pain is, that kind of thing. All that goes into the machine, which suggests treatment where possible. Where nothing can be done at this level, it becomes a question of referral or palliative care.

7> Things like dentistry, which require special gear, are probably provided by a traveling service. I think there’s a ton of work to be done on low-cost dental technology, however, things like epoxy-based fillings which incorporate a bacteriocidal component to kill whatever is trapped under the filling, and possibly tooth extraction based on bonding things to the tooth to be pulled rather than using pliers.

8> Drugs are sold at no markup to the people who need them. Profit is made on the health cover, not the drug retail, which prevents people in the supply chain looking to make a profit by over-prescribing.

9> $10 per villager for 1000 people == $10,000 budget. $3000 for salary for the worker - this is a skilled job. $3000 for training and equipment and monitoring. $3000 for centralized services (the computer systems,) translations and so on. $1000 profit. 3 billion people on a few dollars a day, multiplied by $1 per person per year profit on health services equals $3bn a year or more in cold, hard cash. There’s room here for a whole new industry, and big business should be looking at this closely.

10> Birth control and sexual health services are a big part of this, but that’s one to discuss another day.

11> Environmental health services (public health, basically) is not a separate field in the developing world. The same health worker who looks in your ear is also the person who trains you how to wash your hands after emptying your composting toilet. It’s all one basic function: protection from illness.

12> The core of this service is accepting that the care is third rate from day one. People will die because we don’t carry the right drugs. They’ll die because the expert system diagnostics are only 80% in practice. They’ll die because the trained worker is sick that day and sends his brother. They’ll die because the software had bugs. We accept that for every ten lives saved, one to three are lost.

It’s this tolerance for a bad healthcare system which allows this system to work at all: you can’t provide 99.9% health care on $10 per year. But you can provide 80% health care, and right now, that’s far, far better access to medical support than the poor can get any other way.

I’m open to talk about this at any time to anybody: hexayurt@gmail.com

PS: a similar expert system plus big databases approach to pandemic flu care is also extremely plausible, and as the model is refined by measured performance (i.e. double blind trials conducted by giving different people different advice and seeing what happens to them) it might actually provide far better care for at least some patients than exposure to the overcrowded and collapsing pandemic-affected hospital environment. The ability to track disease progress through a population is a critical tool in fighting severe pandemics, and providing medical advice by machine helps keep people in their homes, which is critical.

Surveillance culture

Theres gotta be a record of you some place
You gotta be on somebodys books
The lowdown - a picture of your face
Your injured looks

The sacred and profane
The pleasure and the pain
Somewhere your fingerprints remain concrete
And its your face Im looking for on every street

A ladykiller - regulation tattoo
Silver spurs on his heels
Says - what can I tell you as I’m standing next to you
She threw herself under my wheels
Oh its a dangerous road
And a hazardous load
And the fireworks over liberty expode in the heat
And its your face I’m looking for on every street

A three-chord symphony crashes into space
The moon is hanging upside down
I dont know why it is I’m still on the case
Its a ravenous town
And you still refuse to be traced
Seems to me such a waste
And every victory has a taste that’s bittersweet
And it’s your face Im looking for on every street

Facebook, you know… who was that person at your party… big spiders that scrape it all into secret biometrics databases… how could it be otherwise, really, if the people who run that stuff are remotely rational.

Solution: humane control of those capabilities. They’re too powerful to allow knuckle draggers to run the show any more. We totally screwed up the nuclear weapon, and wound up putting the whole world at risk, and the same kind of thinking is going into combat robotics, nano-bio technology, and biometrics. That has to stop - we need productive, better alternatives, not this current vector towards destruction.

Village scale integrated solar power technology

http://www.igf-online.org/fileadmin/Images/Menue/Pdf-Dateien/RE_SunventionSept06_engl.pdf

Looks GREAT. Several devices, well-explored design synergies and so on. Cutting edge work from the Tamera Ecovillage in Portugal.

Amazing stuff, well done folks.

10th amendment case against… federal interference in state’s drug policies.

A landmark decision for all Californian’s quietly made history on August 20th in a Santa Cruz courtroom.

For the first time since 1996, when the Compassionate Use Act was passed, the federal authorities have been charged with violating the 10th Amendment for harassing medical marijuana patients and state authorities.

The case of Santa Cruz vs. Mukasey, was heard by U.S. District Court Judge Jeremy Fogel, who said the Bush Administration’s request to dismiss a lawsuit by Santa Cruz city and county officials, and the Wo/Men’s Alliance for Medical Marijuana (WAMM), wasn’t going to happen.

This might be interesting, or it might fizzle, but either way it’s a sign of the times in terms of state resistance to federal power and their willingness to make policy in directions the federal government can’t (or at least won’t) tolerate. Very bold move.

http://www.times-standard.com/ci_10461558?source=most_viewed

UN activity against freedom

A United Nations agency is quietly drafting technical standards, proposed by the Chinese government, to define methods of tracing the original source of Internet communications and potentially curbing the ability of users to remain anonymous.

The U.S. National Security Agency is also participating in the “IP Traceback” drafting group, named Q6/17, which is meeting next week in Geneva to work on the traceback proposal. Members of Q6/17 have declined to release key documents, and meetings are closed to the public.

http://news.cnet.com/8301-13578_3-10040152-38.html?tag=nl.e703

Action to suppress anonymity on the internet at a technical level, draft proposal made by the Chinese government. They don’t want you to own guns either.

Delightful.

The Economist on the internet becoming poor

http://www.economist.com/science/tq/displaystory.cfm?story_id=11999307

1 billion rich

1.5 billion in between

4 billion poor

(roughly, depending how you count, every time I put those numbers together I seem to do it differently.)

As the poor get wired, the internet becomes a poor place obviously enough. All kinds of dialogues about privilege etc. start there. I view social networking as the first line of defense that the rich are erecting against the poor - if you can’t just get random emails from half-starved peasants looking for food for their kids, because you only use Facebook, and those people aren’t on your friends list…

It’s the start of protecting people from reality online. Not good, but inevitable. It won’t be enough, there is far too much reality out there.

Rich flee the stock markets

A substantial number of the world’s wealthiest people have moved their money out of stocks and bonds and into cash, the head of HSBC’s Swiss private banking unit said on Monday.

“The first half of 2008 has seen a notable change in client expectations and investment choices,” said Peter Braunwalder, chief executive of HSBC Private Bank (Suisse), the British-based bank’s main affiliate catering to the ultra-rich.

“Faced with inflation worries, volatile asset prices and sudden changes in exchange rates, a majority of investors have reduced their transaction volumes in equities, bonds, and structured products,” he told a news briefing in Geneva.

http://dealbook.blogs.nytimes.com/2008/09/02/many-wealthy-investors-shift-to-cash-hsbc-says/

Secret insurgency-mashing technology

The dramatic drop in violence in Iraq is due in large part to a secret program the U.S. military has used to kill terrorists, according to a new book by Pulitzer Prize-winning journalist Bob Woodward.

Bob Woodward’s book, “The War Within: Secret White House History 2006-2008,” came out Monday.

The program — which Woodward compares to the World War II era Manhattan Project that developed the atomic bomb — must remain secret for now or it would “get people killed,” Woodward said Monday on CNN’s Larry King Live.

“It is a wonderful example of American ingenuity solving a problem in war, as we often have,” Woodward said.

http://edition.cnn.com/2008/WORLD/meast/09/09/iraq.secret/index.html