Adventures in healthcare (revisited)

The coming week is going to be, well, interesting for yours truly.

Tuesday: Kidney stones blasted with sound waves. General anesthetic.
Wednesday: Painful cyst removed from my wrist. Local anesthetic.
Thursday: Gallbladder removal surgery. General anesthetic.

These procedures will all take place at different locations. It’s an insurance thing. Hence, I’ve gone through pre-op at two different hospital, sharing only a few of the tests. I have multiple specialists, their separate offices, and drugs galore.

I’m only a little anxious, but what’s been crystal clear to me as an observer of life is the need for a single medical database with multiple entry points. It would save billions and dramatically increase efficiency within the healthcare system (although it might cost a lot of jobs). Imagine if I carried a little device with my data and simply plugged it in at each place. No more forms. No redundant testing. Everybody would know my history, my drug regimen and pending appointments, regardless of when or where they were scheduled.

Of course, there’s the whole privacy thing, but let me tell you as a guy who is shelling out $3,000 in insurance deductibles this week that the benefits vastly outweigh the negatives. We simply MUST get a handle on healthcare costs, or only those who can afford treatment will get it.

In other words, kind of like what we have today, although the line keeps moving northward every year as insurance companies raise their rates and deductibles get higher.

Despite great services, Google is always all about Google

The inescapable reality of doing business online as a local media company is that Google, Yahoo, MSN, AOL and a host of other pureplay internet companies are our competition. With six of every ten local online ad dollars going to these pureplays, we’re slowly being squeezed into a shrinking corner reserved for local content companies. Local media companies may say they believe this, but few behave as though it impacts them, because we’re convinced we’re in the content business. We’re not; we’re in the advertising business.

Google's ad footprintA couple of announcements over the past week by Google ought to have the attention of anybody in the online advertising business. Last week, the company unveiled “Google Trends,” an application that helps publishers compare how they’re doing against online competition. This week, Google revealed “Ad Planner,” software designed to show advertisers where to put their money based on where their target audiences visit. Together, these new moves put the squeeze on all of the incumbent players in the online advertising world, include online measurement giants comScore and Nielsen.

At first glance, these new applications seem enormously helpful to all web denizens. After all, the lack of a reliable third-party measurement system is one of the things agencies say is holding back the advertising floodwaters. And since both applications provide information about the whole Web, this appears to be just Google being useful Google. We applaud their brilliance and go about our daily routines thankful for all these tools that Google has provided.

But as I wrote last year in “Google Lifts Only Google,” the company’s efforts are all aimed at positioning itself to win. Google defines itself as an advertising system. To be sure, it’s a search engine, and its mission is to organize the world’s information, but when it comes to business, Google is an advertising system.

Google begins the day with the assumption that people come to the Web, because they’re looking for something. We begin the day with the assumption that people are looking for us. In our minds, we are the ones who control growth, because everything has to happen on what we view as our property. In the collective mind of Google, the people who make up the network that is the Web control the growth by their actions, and Google’s ad mechanism doesn’t care where that takes place. As the network grows, so grows Google. Not so for local media.

When I’ve noted that we MUST work to outdo Google at the local level, the immediate reaction is one of disbelief. After all, the thinking goes, Google already does a fantastic job of organizing local information, and we’re fooling ourselves if we think we can do better. But this argument presupposes that Google’s business is information organization. It isn’t. It’s an advertising system, and this is where we can beat them.

But how? Google knows that the real growth in online advertising is at the local level (so do the other pureplays), but it lacks one thing that local media companies have: feet on the street to sell its advertising system. The company has put sales forces in a few cities, but it needs a ubiquitous sales force in order to reach its goal of dominance. So the matter isn’t one of coming up with a better system or organizing information — or creating information portals — it’s coming up with a local advertising system that treats the Local Web as its platform.

Jeff Jarvis is writing a book tentatively called “What Would Google Do?” The idea came from various writings of his about this very topic. In one of the earliest, he wrote that we shouldn’t blame Google for leaving everybody else behind:

Big, old media handed them this opportunity on a platter. Google was the one company that truly understood the economics of the open network. It understood that it could grow much bigger enabling than controlling. We in media should have followed that model. We should have asked WWGD. What would Google do?

So the announcements over the past week about Google Trends and Google Ad Planner are good insofar as they can be used to help the online efforts we have with our brand extension sites and other content plays. We need reliable statistics, and the Ad Planner is likely to show advertisers that they want to spend money with us.

But let’s not be naïve as to what’s really taking place here, because if we continue to look the other way, we’ll only have ourselves to blame as online advertising continues to grow while our share of the overall market doesn’t.

(Originally published in this week’s AR&D Media 2.0 Intel newsletter)

George Carlin at the Pearly Gates

St. Peter: Welcome to heaven, George.

George: I’m surprised you let me in. After all, I haven’t exactly been kind to you guys of late.

St. Peter: You mean the jokes about religion and the anti-God stance you took down there?

George: Right.

St. Peter: Ha ha ha. We’ve had lots of laughs with you, George. Here’s our favorite.

(RECORDING OF CARLIN PLAYS) “Religion convinced the world that there’s an invisible man in the sky who watches everything you do. And there’s 10 things he doesn’t want you to do or else you’ll go to a burning place with a lake of fire until the end of eternity. But he loves you! ”

George: And you guys laughed at that?

St. Peter: But of course! You think you leave your sense of humor when you come up here? Besides, we understand that kind of bitterness better than most.

George: But, um, I don’t exactly believe in the invisible guy in the sky thing.

St. Peter: Doesn’t matter. We believe in you. Besides, you were more right than wrong. Sometimes I think we’re about as far from organized religion as the Pope is from Paris Hilton. Hee hee. Get it? It’s a joke, George.

George: You guys need some help up here.

St. Peter: Come on in. The old man’s waiting.

George (as they walk together into the clouds): Now, about that asshole Bush.…

The tribe known as “the professional press”

Jay Rosen has penned an important piece that articulates the conundrum for the professional press in a way that should help a lot of people understand what’s really taking place. He uses the metaphor of a migrating tribe to illustrate the problem:

Migration, which is easily sentimentalized by Americans, is a community trauma. Pulling up stakes and leaving a familiar place is hard. Within the news tribe some people don’t want to go. These are the newsroom curmudgeons. Others are in denial still, or they are quietly drifting away from journalism, or they are being shed as the tribe contracts and its economy convulses.

And like reluctant migrants everywhere, the people in the news tribe have to decide what to take with them, when to leave, where to land. They have to figure out what is essential to their way of life, and which parts were well adapted to the old world but may be unnecessary or a handicap in the new. They have to ask if what they know is portable. What life will be like across the digital sea is of course an unknown to the migrant. This creates an immediate crisis for the elders of the tribe, who have always known how to live.

When I think of the press in these kinds of terms, I’m reminded of a wonderful speech that C.S. Lewis delivered at the University of London in 1944 called “The Inner Ring.” Lewis felt that the internal drive to be within certain closed societies was one of the great evils of humankind, and it describes Rosen’s “tribe” of the press perfectly.

The quest of the Inner Ring will break your hearts unless you break it. But if you break it, a surprising result will follow. If in your working hours you make the work your end, you will presently find yourself all unawares inside the only circle in your profession that really matters. You will be one of the sound craftsmen, and other sound craftsmen will know it. This group of craftsmen will by no means coincide with the Inner Ring or the Important People or the People in the Know. It will not shape that professional policy or work up that professional influence which fights for the profession as a whole against the public: nor will it lead to those periodic scandals and crises which the Inner Ring produces. But it will do those things which that profession exists to do and will in the long run be responsible for all the respect which that profession in fact enjoys and which the speeches and advertisements cannot maintain. And if in your spare time you consort simply with the people you like, you will again find that you have come unawares to a real inside: that you are indeed snug and safe at the center of something which, seen from without, would look exactly like an Inner Ring. But the difference is that its secrecy is accidental, and its exclusiveness a by-product, and no one was led thither by the lure of the esoteric: for it is only four or five people who like one another meeting to do things that they like. This is friendship. Aristotle placed it among the virtues. It causes perhaps half of all the happiness in the world, and no Inner Ring can ever have it.

Jay Rosen thinks it’s time we expanded the press and our ideas about it. How about breaking the inner ring to not only let the press out but everybody else in?

Stupider or smarter? You be the judge.

Few people tell it like Stowe Boyd.

This weekend, Boyd added his considerable insight to a fascinating discussion that has grown out of Nick Carr’s provocative Atlantic Monthly article “Is Google Making Us Stupid?” Later, Scott Karp added his wealth of insight, and now Boyd. It’s a complex topic but boils down to Carr’s question about what’s happening with our his mind these days. He feels his mind shifting and doesn’t like it. Do yourself a favor and read all of the link references, beginning with Carr’s.

Karp elaborates on Carr’s premise by discussing the differences between absorbing knowledge in big chucks versus little chucks, and Boyd agrees with Karp that the answer to Carr’s question is a resounding “no.”

As I have been saying for years, the inherent conservatism of the mass media and other mass organizations (those that are based on one:many modes of communication, like government, religions, business, and so on) will lead them to say that this new sort of thinking is illegitimate: they war against it, saying that our new ways of talking and thinking and the social structures that they engender are bad, inferior, immoral, and stupid; and that those in favor of this web revolution are dumb, misguided, or evil fringe lunatics.

This is exactly the nut of the thing for me, too, but my take has always been the shift from the modernist, colonialist, hierarchical culture to the participatory, postmodernist, post-colonial culture. Traditionalists will love the concept of Google making people stupid, because it beautifully validates their illusions about knowledge and life and gives them a platform from which to point and say, “See? See?” It’s demagoguery, plain and simple, and I don’t believe for a minute that the cultural changes are “bad” for us. Does it make me feel uncomfortable? Perhaps, but that’s just fear of the unknown.

I’ve oft quoted my daughter Jenny, who at age seven got her first calculator (in the mid 70s). She asked me then, “If I have one of these, why do I need to study math?” Is she stupid, because her mind wants to explore other uses? If she uses her calculator, does that make her more stupid than one who doesn’t?

We’re always hearing how we humans only use 10 percent of our brains, but dammit, we sure seem to be comfortable with that. Why?

The ability to instantly deconstruct vastly complex arguments with a mouse click is certainly the enemy of a culture run by protected knowledge and absolute authorities, but it doesn’t follow that this means doom for humanity. Besides, cultural changes tend not to be “all or nothing,” so hierarchy of some form will always have its place.

R.I.P. George Carlin

I’m saddened this morning with the passing of my generation’s comedian, George Carlin. Comics, poets and artists are the prophets of contemporary culture, striking out against the status quo for its absurdities. Nobody did it better in my lifetime than Carlin. And when a modern prophet passes, we’ve all suffered a loss.

His most recent HBO specials were just a vapor of his real genius, and it was clear he was getting old (he was 71). But who of my generation isn’t? I wish he’d struck out against old age, but he didn’t, and his humor just wasn’t what it used to be. I hope his passing will result in an outpouring of some of his earlier and mid-career stuff, because this was a funny, funny man.

I loved George Carlin, and like most people my age, I use some of his stuff in everyday language. My favorite is: “These are the kinds of thoughts that kept me out of the good schools.”

The world is better for him having been here.

(UPDATE) I’ve been sitting here thinking about the cultural contributions of Carlin compared to Tim Russert. Will it be all-Carlin-all-the-time tonight?

Carlin’s brilliance was in his ability to call “bullshit” in the most unusual ways. Here’s a famous line from the “hippy-dippy weatherman:” Weather forecast for tonight: dark. Continued dark overnight, with widely scattered light by morning.

And as a nature lover, this was always one of my favorites: The caterpillar does all the work but the butterfly gets all the publicity.

I’ll bet the search engines are clogged with Carlin traffic today.