FDA Announces New Steps to Empower Consumers and Advance Digital Healthcare

I wondered out-loud in a draft version of this blog post the following:

I cannot tell if this is the career politician FDA speaking or what, and frankly, this shouldn’t be an issue with any administration, but it sure is with this one.

Upon further review, this is the type of announcement was expected and favored; and consistent with the history of the FDA Commissioner, a political appointee of POTUS45. I fully understand the temptation to speed the process up of software when it comes to medical capabilities. This process has been thought carefully, but two things stand out for me.

  1. HIPAA is the law of the land when it comes to digital medical records. This is a complicated system; that is where we are. How does this idea of a pre certification tie into these requirements? Blog posts on this subject here, here, here, and here.
  2. All of this is moot if the majority of citizens can’t access it due to not being covered under Medicare and Medicaid; the very constituency that can be best served by digital medical options in software including telehealth initiatives.

As for point #2, the rules for current Medicare reimbursement are found here (PDF) and are in my opinion, lacking. A change of mindset when it comes to payment overshadows any other aspect of our current system. In my ideal health care system, there would be Medicare for all with the private insurance market to fill gaps similar to Medicare Supplement policies of today and to “jump the line” in services for a fee. Digital medical options, such as Telehealth and Software based Medical Case Management would be included in the base Medicare and Medicaid plans.

FDA Announces New Steps to Empower Consumers and Advance Digital Healthcare [Official]

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The U.S. Could Adopt Universal Basic Income in Less Than 20 Years

Any discussion of Universal Basic Income must also include Universal Healthcare. Medicare and Medicaid are the primary vehicles to make this happen. It’s worth the time and effort to read, study, and explore these concepts with an open mind. Also, with the political leadership, this can happen within the next 5 years, but that will be a long-shot as politics as sport reigns supreme in Washington.

Scott Santens is a writer and advocate of universal basic income for all. He is the moderator of the Basic Income community on Reddit and Founder of the BIG Patreon Creator Pledge. His writing has been featured in the Atlantic and Huffington Post.

Source: The U.S. Could Adopt Universal Basic Income in Less Than 20 Years

8 years of suffering under Obama

I could go for that kind of suffering right about now.

Teri Carter's Library

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3C54DC7D00000578-4140672-Barack_Obama_waves_as_he_boards_Marine_One_and_departs_the_Capit-a-77_1484945371469 Photo credit: The Associated Press

The sentence I hear most from well-meaning, conservative friends since President Trump’s election is this: “We suffered 8 years under Barack Obama.”

Fair enough. Let’s take a look.

The day Obama took office, the Dow closed at 7,949 points. Eight years later, the Dow had almost tripled, closing at 21,414.

General Motors and Chrysler were on the brink of bankruptcy, with Ford not far behind, and their failure, along with their supply chains, would have meant the loss of millions of jobs. Obama pushed through a controversial, $8o billion bailout to save the car industry. The U.S. car industry survived, started making money again, and the entire $80 billion was paid back, with interest.

While we remain vulnerable to lone-wolf attacks, no foreign terrorist organization has successfully executed a mass attack here since 9/11.

Obama ordered the raid that killed Osama Bin Laden.

He…

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Graduation Speech: “You Said We Couldn’t Succeed, But You Were Wrong”

This needs wider distribution. This graduate speaks eloquently of the struggle that is public schools in our communities. He is speaking of New Haven CT, but can easily apply to Charlotte-Mecklenburg Schools; though they won’t admit it.

Diane Ravitch's blog

Jo Lieb, who blogs as “Poetic Justice,” posted the powerful graduation speech written and delivered by Coral Ortiz, with Coral’s permission. Coral just graduated from a public high school in New Haven, Connecticut.


When we were young, we were taught that we were “one nation under God, indivisible, with liberty and justice for all.” Our country taught us that no matter our income or race, we would all have the same chance to achieve our dreams. We were taught that there would never be a bias against a certain group of people, and that society believes in each and every one of us. These lessons of equality were taught as self-evident. These lessons of equality have and continue to be a lie.

The reality is that despite the fact that we recite the words “one nation under God, indivisible, with liberty and justice for all,” it has been 50 years…

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The Absurdity of Applying Industrial Lingo to Schools

Finally, someone articulated what has been on my mind for years, and yes the symptoms can be found locally as well from CMS (Charlotte-Mecklenburg Schools) in particular.

Diane Ravitch's blog

I recently read a post by Larry Cuban about the difficulty of “scaling up successful reforms,” and I was reminded how much I dislike the application of industrial terminology to schooling. Larry offers some examples of successful efforts to “scale up,” but I question the effort itself.

While it is possible for schools to adopt and adapt a program or a practice that has worked out for others, the very idea of reproducing cookie-cutter schools designed to get high test scores invalidates the professional wisdom of educators. You can stamp out cars and tools with the right equipment, but you can’t reproduce good schools via mechanical processes.

People who work in business, industry, finance, or the tech sector like to speak of “scaling up,” of “innovation,” of “best practices,” and of “replication,” which they know how to do.

They are frustrated that success in one school is not easily packaged…

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Basic Income and Choices

Most recent Duke Energy payment

Notice the key to the image on the left, this account has a remaining balance. I, like so many others, have to make this kind of choice every month; do I have groceries, OTC medicines, and dog basics, or do I keep the lights on? With Universal Basic Income, this would not be a choice, as there would be enough money to keep the lights on, and have an cash payout that would replace SNAP and not penalize a North Carolina resident for being, well poor, unlike what happens now. This is not unique to NC, of course, but with political aspirations of being the “new Alabama”, this is what sanity is up against.

Since I can not get an answer from the state level, maybe someone that reads this can explain this to me.

How does a person, who borrows money for graduate school and thus have “no income” gets the full SNAP benefit while in school (less BS deductions done at NC level because they could) but becomes disabled and has “income” that is about 1/3 less has to beg for a few crumbs in SNAP?

I have had at least 5 conversation attempts from my end about this discrepancy and drama just this year, and none of them have even come close to resolving this. If I/we had Basic Income, none of this would have mattered as SNAP and the people that administer it would have to do something else for a living and not exist only to provide drama, but could actually do something worthwhile with their social service “skills”. Consider me naive, but isn’t the point of digital government services is effective and efficient communication to the constituency?

Mecklenburg DSS response

This is the official policy of at least NC, and possibly the whole US that receiving SSA Disability is different money than Student Loan/Stipend money. I guess the Student Loan lobby is much more powerful because I thought dollars were dollars and didn’t distinguish between entities since it all spends the same. Elections have consequences, and the lack of voting allows representatives to condone this type of policy. Basic Income is paid to everyone independent of Disability, Social Security, retirement, employment, or even dividends. Basic Income does not place value judgments on cash, it just straightforward.

As this post was being edited and put to virtual paper while thoughts emanating from my head, I did hear back from NCDHHS in my county, while not answering the question above, did state that being a student had no effect on SNAP benefits while being Disabled.

The non-food portion of the EBT/SNAP side is a Federal-State program called Temporary Assistance for Needy Families (TANF). Since states administer it, the name and benefits vary based on locale. In North Carolina, where I live, it’s called Work First. The goal, at least to TPTB here is to encourage work for families so the “temporary” part of the program is emphasized.

Highlighted search field {without children} is key

Leave it to the US Government to define a family as having children. This is not to diminish the importance of child raising, but to those of us that do not have any, we are left out. So much for American choice!

A Basic Income replaces these programs with cash upon which there are no restrictions on how it is spent. With this also comes responsibility, in case a person does not spend the money to live on, finds themselves homeless or worse, and then expects the Government to bail them out. This is not to penalize a person who plays by the rules and S__t/Life happens, but to discourage reckless behavior.

…and with Universal Basic Income, it may not be in most months.

Medical Data Overload 2.0

Medical Data Overload 2.0

A previously embedded post on the subject discusses the wearables market with the potential to make better medical decisions and outcomes. A drawback of not being endowed with financial resources is that first-hand trial/error is not always possible. Now Verily, one of the Alphabet companies, is finally releasing a device that allows advanced data to be acquired for specific research purposes.

Verily Study Watch is designed with these key features:

  • Multiple physiological and environmental sensors are designed to measure relevant signals for studies spanning cardiovascular, movement disorders, and other areas. Examples include electrocardiogram (ECG), heart rate, electrodermal activity, and inertial movements.
  • A long battery life of up to one week in order to drive better user compliance during longitudinal studies.
  • Large internal storage and data compression allow the device to store weeks’ worth of raw data, thus relaxing the need to frequently sync the device.
  • A powerful processor supports real time algorithms on the device.
  • The firmware is designed to be robust for future extensions, such as over-the-air updates, new algorithms, and user interface upgrades.
  • The display is always on so that time is always shown. The display is low power and high resolution for an appealing look and a robust user interface. Note: currently, only time and certain instructions are displayed. No other information is provided back to the user.

(Harry Xiao, Tushar Parlikar, & David He, 2017)

This product is not currently available for sale, which means the greatest benefit to the targeted community will not be able to participate fully. Granted, it is early in the wearables game regarding the Center for Medicare and Medicaid Services (CMS) and thus their mechanisms that revolve around payment and access are not in place. Verily is associated with Google so their cloud will be used. Nothing against their cloud, but for this to become mainstream, the data must be agnostic when it comes to cloud storage, HIPAA requirements, and other aspects of this service.

via VERILY RELEASE STUDY WATCH FOR MEDICAL RESEARCH


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