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Accountability sinks - A Working Library
Accountability sinks - A Working Library
In The Unaccountability Machine, Dan Davies argues that organizations form “accountability sinks,” structures that absorb or obscure the consequences of a decision such that no one can be held directly accountable for it. Here’s an example: a higher up at a hospitality company decides to reduce the size of its cleaning staff, because it improves the numbers on a balance sheet somewhere. Later, you are trying to check into a room, but it’s not ready and the clerk can’t tell you when it will be; they can offer a voucher, but what you need is a room. There’s no one to call to complain, no way to communicate back to that distant leader that they’ve scotched your plans. The accountability is swallowed up into a void, lost forever.
Davies proposes that: For an accountability sink to function, it has to break a link; it has to prevent the feedback of the person affected by the decision from affecting the operation of the system.
Another mechanism of accountability sinks is the way in which decisions themselves cascade and lose any sense of their origins. Davies gives the example of the case of Dominion Systems vs Fox News, in which Fox News repeatedly spread false stories about the election. No one at Fox seems to have explicitly made a decision to lie about voting machines; rather, there was an implicit understanding that they had to do whatever it took to keep their audience numbers up.
you could conclude that to be accountable for something you must have the power to change it and understand what you are trying to accomplish when you do. You need both the power and the story of how that power gets used.
an account is something that you tell. How did something happen, what were the conditions that led to it happening, what made the decision seem like a good one at the time? Who were all of the people involved in the decision or event? (It almost never comes down to only one person.)
#core-term#bureaucracy#foxnews#organization#business/hierarchy#govt
·aworkinglibrary.com·
Accountability sinks - A Working Library
The CrowdStrike Outage and Market-Driven Brittleness
The CrowdStrike Outage and Market-Driven Brittleness
Redundancies are unprofitable. Being slow and careful is unprofitable. Being less embedded in and less essential and having less access to the customers’ networks and machines is unprofitable—at least in the short term, by which these companies are measured. This is true for companies like CrowdStrike. It’s also true for CrowdStrike’s customers, who also didn’t have resilience, redundancy, or backup systems in place for failures such as this because they are also an expense that affects short-term profitability.
The market rewards short-term profit-maximizing systems, and doesn’t sufficiently penalize such companies for the impact their mistakes can have. (Stock prices depress only temporarily. Regulatory penalties are minor. Class-action lawsuits settle. Insurance blunts financial losses.) It’s not even clear that the information technology industry could exist in its current form if it had to take into account all the risks such brittleness causes.
The asymmetry of costs is largely due to our complex interdependency on so many systems and technologies, any one of which can cause major failures. Each piece of software depends on dozens of others, typically written by other engineering teams sometimes years earlier on the other side of the planet. Some software systems have not been properly designed to contain the damage caused by a bug or a hack of some key software dependency.
This market force has led to the current global interdependence of systems, far and wide beyond their industry and original scope. It’s why flying planes depends on software that has nothing to do with the avionics. It’s why, in our connected internet-of-things world, we can imagine a similar bad software update resulting in our cars not starting one morning or our refrigerators failing.
Right now, the market incentives in tech are to focus on how things succeed: A company like CrowdStrike provides a key service that checks off required functionality on a compliance checklist, which makes it all about the features that they will deliver when everything is working. That’s exactly backward. We want our technological infrastructure to mimic nature in the way things fail. That will give us deep complexity rather than just surface complexity, and resilience rather than brittleness.
Netflix is famous for its Chaos Monkey tool, which intentionally causes failures to force the systems (and, really, the engineers) to be more resilient. The incentives don’t line up in the short term: It makes it harder for Netflix engineers to do their jobs and more expensive for them to run their systems. Over years, this kind of testing generates more stable systems. But it requires corporate leadership with foresight and a willingness to spend in the short term for possible long-term benefits.
The National Highway Traffic Safety Administration crashes cars to learn what happens to the people inside. But cars are relatively simple, and keeping people safe is straightforward. Software is different. It is diverse, is constantly changing, and has to continually adapt to novel circumstances. We can’t expect that a regulation that mandates a specific list of software crash tests would suffice. Again, security and resilience are achieved through the process by which we fail and fix, not through any specific checklist. Regulation has to codify that process.
#bureaucracy#ethics#metrics v humanities#business#trends#themes#legal/regulations#tech#security
·lawfaremedia.org·
The CrowdStrike Outage and Market-Driven Brittleness
The Complex Problem Of Lying For Jobs — Ludicity
The Complex Problem Of Lying For Jobs — Ludicity

Claude summary: Key takeaway Lying on job applications is pervasive in the tech industry due to systemic issues, but it creates an "Infinite Lie Vortex" that erodes integrity and job satisfaction. While honesty may limit short-term opportunities, it's crucial for long-term career fulfillment and ethical work environments.

Summary

  • The author responds to Nat Bennett's article against lying in job interviews, acknowledging its validity while exploring the nuances of the issue.
  • Most people in the tech industry are already lying or misrepresenting themselves on their CVs and in interviews, often through "technically true" statements.
  • The job market is flooded with candidates who are "cosplaying" at engineering, making it difficult for honest, competent individuals to compete.
  • Many employers and interviewers are not seriously engaged in engineering and overlook actual competence in favor of congratulatory conversation and superficial criteria
  • Most tech projects are "default dead," making it challenging for honest candidates to present impressive achievements without embellishment.
  • The author suggests that escaping the "Infinite Lie Vortex" requires building financial security, maintaining low expenses, and cultivating relationships with like-minded professionals.
  • Honesty in job applications may limit short-term opportunities but leads to more fulfilling and ethical work environments in the long run.
  • The author shares personal experiences of navigating the tech job market, including instances of misrepresentation and the challenges of maintaining integrity.
  • The piece concludes with a satirical, honest version of the author's CV, highlighting the absurdity of common resume claims and the value of authenticity.
  • Throughout the article, the author maintains a cynical, humorous tone while addressing serious issues in the tech industry's hiring practices and work culture.
  • The author emphasizes the importance of self-awareness, continuous learning, and valuing personal integrity over financial gain or status.
If your model is "it's okay to lie if I've been lied to" then we're all knee deep in bullshit forever and can never escape Transaction Cost Hell.
Do I agree that entering The Infinite Lie Vortex is wise or good for you spiritually? No, not at all, just look at what it's called.
it is very common practice on the job market to have a CV that obfuscates the reality of your contribution at previous workplaces. Putting aside whether you're a professional web developer because you got paid $20 by your uncle to fix some HTML, the issue with lying lies in the intent behind it. If you have a good idea of what impression you are leaving your interlocutor with, and you are crafting statements such that the image in their head does not map to reality, then you are lying.
Unfortunately thanks to our dear leader's masterful consummation of toxicity and incompetence, the truth of the matter is that: They left their previous job due to burnout related to extensive bullying, which future employers would like to know because they would prefer to blacklist everyone involved to minimize their chances of getting the bad actor. Everyone involved thinks that they were the victim, and an employer does not have access to my direct observations, so this is not even an unreasonable strategy All their projects were failures through no fault of their own, in a market where everyone has "successfully designed and implemented" their data governance initiatives, as indicated previously
What I am trying to say is that I currently believe that there are not enough employers who will appreciate honesty and competence for a strategy of honesty to reliably pay your rent. My concern, with regards to Nat's original article, is that the industry is so primed with nonsense that we effectively have two industries. We have a real engineering market, where people are fairly serious and gather in small conclaves (only two of which I have seen, and one of those was through a blog reader's introduction), and then a gigantic field of people that are cosplaying at engineering. The real market is large in absolute terms, but tiny relative to the number of candidates and companies out there. The fake market is all people that haven't cultivated the discipline to engineer but nonetheless want software engineering salaries and clout.
There are some companies where your interviewer is going to be a reasonable person, and there you can be totally honest. For example, it is a good thing to admit that the last project didn't go that well, because the kind of person that sees the industry for what it is, and who doesn't endorse bullshit, and who works on themselves diligently - that person is going to hear your honesty, and is probably reasonably good at detecting when candidates are revealing just enough fake problems to fake honesty, and then they will hire you. You will both put down your weapons and embrace. This is very rare. A strategy that is based on assuming this happens if you keep repeatedly engaging with random companies on the market is overwhelmingly going to result in a long, long search. For the most part, you will be engaged in a twisted, adversarial game with actors who will relentlessly try to do things like make you say a number first in case you say one that's too low.
Suffice it to say that, if you grin in just the right way and keep a straight face, there is a large class of person that will hear you say "Hah, you know, I'm just reflecting on how nice it is to be in a room full of people who are asking the right questions after all my other terrible interviews." and then they will shake your hand even as they shatter the other one patting themselves on the back at Mach 10. I know, I know, it sounds like that doesn't work but it absolutely does.
Neil Gaiman On Lying People get hired because, somehow, they get hired. In my case I did something which these days would be easy to check, and would get me into trouble, and when I started out, in those pre-internet days, seemed like a sensible career strategy: when I was asked by editors who I'd worked for, I lied. I listed a handful of magazines that sounded likely, and I sounded confident, and I got jobs. I then made it a point of honour to have written something for each of the magazines I'd listed to get that first job, so that I hadn't actually lied, I'd just been chronologically challenged... You get work however you get work.
Nat Bennett, of Start Of This Article fame, writes: If you want to be the kind of person who walks away from your job when you're asked to do something that doesn't fit your values, you need to save money. You need to maintain low fixed expenses. Acting with integrity – or whatever it is that you value – mostly isn't about making the right decision in the moment. It's mostly about the decisions that you make leading up to that moment, that prepare you to be able to make the decision that you feel is right.
As a rough rule, if I've let my relationship with a job deteriorate to the point that I must leave, I have already waited way too long, and will be forced to move to another place that is similarly upsetting.
And that is, of course, what had gradually happened. I very painfully navigated the immigration process, trimmed my expenses, found a position that is frequently silly but tolerable for extended periods of time, and started looking for work before the new gig, mostly the same as the last gig, became unbearable. Everything other than the immigration process was burnout induced, so I can't claim that it was a clever strategy, but the net effect is that I kept sacrificing things at the altar of Being Okay With Less, and now I am in an apartment so small that I think I almost fractured my little toe banging it on the side of my bed frame, but I have the luxury of not lying.
If I had to write down what a potential exit pathway looks like, it might be: Find a job even if you must navigate the Vortex, and it doesn't matter if it's bad because there's a grace period where your brain is not soaking up the local brand of madness, i.e, when you don't even understand the local politics yet Meet good programmers that appreciate things like mindfulness in your local area - you're going to have to figure out how to do this one Repeat Step 1 and Step 2 on a loop, building yourself up as a person, engineer, and friend, until someone who knows you for you hires you based on your personality and values, rather than "I have seven years doing bullshit in React that clearly should have been ten raw HTML pages served off one Django server"
A CEO here told me that he asks people to self-evaluate their skill on a scale of 1 to 10, but he actually has solid measures. You're at 10 at Python if you're a core maintainer. 9 if you speak at major international conferences, etc. On that scale, I'm a 4, or maybe a 5 on my best day ever, and that's the sad truth. We'll get there one day.
I will always hate writing code that moves the overall product further from Quality. I'll write a basic feature and take shortcuts, but not the kind that we are going to build on top of, which is unattractive to employers because sacrificing the long-term health of a product is a big part of status laundering.
The only piece of software I've written that is unambiguously helpful is this dumb hack that I used to cut up episodes of the Glass Cannon Podcast into one minute segments so that my skip track button on my underwater headphones is now a janky fast forward one minute button. It took me like ten minutes to write, and is my greatest pride.
Have I actually worked with Google? My CV says so, but guess what, not quite! I worked on one project where the money came from Google, but we really had one call with one guy who said we were probably on track, which we definitely were not!
Did I salvage a A$1.2M project? Technically yes, but only because I forced the previous developer to actually give us his code before he quit! This is not replicable, and then the whole engineering team quit over a mandatory return to office, so the application never shipped!
Did I save a half million dollars in Snowflake expenses? CV says yes, reality says I can only repeat that trick if someone decided to set another pile of money on fire and hand me the fire extinguisher! Did I really receive departmental recognition for this? Yes, but only in that they gave me A$30 and a pat on the head and told me that a raise wasn't on the table.
Was I the most highly paid senior engineer at that company? Yes, but only because I had insider information that four people quit in the same week, and used that to negotiate a 20% raise over the next highest salary - the decision was based around executive KPIs, not my competence!
#jobs#hiring#tech#work/productivity#work-life#bureaucracy#bullshit#culture#interviews#ethics#careers#business
·ludic.mataroa.blog·
The Complex Problem Of Lying For Jobs — Ludicity
How to Make a Great Government Website—Asterisk
How to Make a Great Government Website—Asterisk
Summary: Dave Guarino, who has worked extensively on improving government benefits programs like SNAP in California, discusses the challenges and opportunities in civic technology. He explains how a simplified online application, GetCalFresh.org, was designed to address barriers that prevent eligible people from accessing SNAP benefits, such as a complex application process, required interviews, and document submission. Guarino argues that while technology alone cannot solve institutional problems, it provides valuable tools for measuring and mitigating administrative burdens. He sees promise in using large language models to help navigate complex policy rules. Guarino also reflects on California's ambitious approach to benefits policy and the structural challenges, like Prop 13 property tax limits, that impact the state's ability to build up implementation capacity.
there are three big categories of barriers. The application barrier, the interview barrier, and the document barrier. And that’s what we spent most of our time iterating on and building a system that could slowly learn about those barriers and then intervene against them.
The application is asking, “Are you convicted of this? Are you convicted of that? Are you convicted of this other thing?” What is that saying to you, as a person, about what the system thinks of you?
Often they’ll call from a blocked number. They’ll send you a notice of when your interview is scheduled for, but this notice will sometimes arrive after the actual date of the interview. Most state agencies are really slammed right now for a bunch of reasons, including Medicaid unwinding. And many of the people assisting on Medicaid are the same workers who process SNAP applications. If you missed your phone interview, you have to call to reschedule it. But in many states, you can’t get through, or you have to call over and over and over again. For a lot of people, if they don’t catch that first interview call, they’re screwed and they’re not going to be approved.
getting to your point about how a website can fix this —  the end result was lowest-burden application form that actually gets a caseworker what they need to efficiently and effectively process it. We did a lot of iteration to figure out that sweet spot.
We didn’t need to do some hard system integration that would potentially take years to develop — we were just using the system as it existed. Another big advantage was that we had to do a lot of built-in data validation because we could not submit anything that was going to fail the county application. We discovered some weird edge cases by doing this.
A lot of times when you want to build a new front end for these programs, it becomes this multiyear, massive project where you’re replacing everything all at once. But if you think about it, there’s a lot of potential in just taking the interfaces you have today, building better ones on top of them, and then using those existing ones as the point of integration.
Government tends to take a more high-modernist approach to the software it builds, which is like “we’re going to plan and know up front how everything is, and that way we’re never going to have to make changes.” In terms of accreting layers — yes, you can get to that point. But I think a lot of the arguments I hear that call for a fundamental transformation suffer from the same high-modernist thinking that is the source of much of the status quo.
If you slowly do this kind of stuff, you can build resilient and durable interventions in the system without knocking it over wholesale. For example, I mentioned procedural denials. It would be adding regulations, it would be making technology systems changes, blah, blah, blah, to have every state report why people are denied, at what rate, across every state up to the federal government. It would take years to do that, but that would be a really, really powerful change in terms of guiding feedback loops that the program has.
Guarino argues that attempts to fundamentally transform government technology often suffer from the same "high-modernist" thinking that created problematic legacy systems in the first place. He advocates for incremental improvements that provide better measurement and feedback loops.
when you start to read about civic technology, it very, very quickly becomes clear that things that look like they are tech problems are actually about institutional culture, or about policy, or about regulatory requirements.
If you have an application where you think people are struggling, you can measure how much time people take on each page. A lot of what technology provides is more rigorous measurement of the burdens themselves. A lot of these technologies have been developed in commercial software because there’s such a massive incentive to get people who start a transaction to finish it. But we can transplant a lot of those into government services and have orders of magnitude better situational awareness.
There’s this starting point thesis: Tech can solve these government problems, right? There’s healthcare.gov and the call to bring techies into government, blah, blah, blah. Then there’s the antithesis, where all these people say, well, no, it’s institutional problems. It’s legal problems. It’s political problems. I think either is sort of an extreme distortion of reality. I see a lot of more oblique levers that technology can pull in this area.
LLMs seem to be a fundamental breakthrough in manipulating words, and at the end of the day, a lot of government is words. I’ve been doing some active experimentation with this because I find it very promising. One common question people have is, “Who’s in my household for the purposes of SNAP?” That’s actually really complicated when you think about people who are living in poverty — they might be staying with a neighbor some of the time, or have roommates but don’t share food, or had to move back home because they lost their job.
I’ve been taking verbatim posts from Reddit that are related to the household question and inputting them into LLMs with some custom prompts that I’ve been iterating on, as well as with the full verbatim federal regulations about household definition. And these models do seem pretty capable at doing some base-level reasoning over complex, convoluted policy words in a way that I think could be really promising.
caseworkers are spending a lot of their time figuring out, wait, what rule in this 200-page policy manual is actually relevant in this specific circumstance? I think LLMS are going to be really impactful there.
It is certainly the case that I’ve seen some productive tensions in counties where there’s more of a mix of that and what you might consider California-style Republicans who are like, “We want to run this like a business, we want to be efficient.” That tension between efficiency and big, ambitious policies can be a healthy, productive one. I don’t know to what extent that exists at the state level, and I think there’s hints of more of an interest in focusing on state-level government working better and getting those fundamentals right, and then doing the more ambitious things on a more steady foundation.
California seemed to really try to take every ambitious option that the feds give us on a whole lot of fronts. I think the corollary of that is that we don’t necessarily get the fundamental operational execution of these programs to a strong place, and we then go and start adding tons and tons of additional complexity on top of them.
#design#ui#public-life/welfare#public-life#technical#interviews#case-study#bureaucracy#govt/policy#ai
·asteriskmag.com·
How to Make a Great Government Website—Asterisk
The most hated workplace software on the planet
The most hated workplace software on the planet
LinkedIn, Reddit, and Blind abound with enraged job applicants and employees sharing tales of how difficult it is to book paid leave, how Kafkaesque it is to file an expense, how nerve-racking it is to close out a project. "I simply hate Workday. Fuck them and those who insist on using it for recruitment," one Reddit user wrote. "Everything is non-intuitive, so even the simplest tasks leave me scratching my head," wrote another. "Keeping notes on index cards would be more effective." Every HR professional and hiring manager I spoke with — whose lives are supposedly made easier by Workday — described Workday with a sense of cosmic exasperation.
If candidates hate Workday, if employees hate Workday, if HR people and managers processing and assessing those candidates and employees through Workday hate Workday — if Workday is the most annoying part of so many workers' workdays — how is Workday everywhere? How did a software provider so widely loathed become a mainstay of the modern workplace?
This is a saying in systems thinking: The purpose of a system is what it does (POSIWID), not what it fails to do. And the reality is that what Workday — and its many despised competitors — does for organizations is far more important than the anguish it causes everyone else.
In 1988, PeopleSoft, backed by IBM, built the first fully fledged Human Resources Information System. In 2004, Oracle acquired PeopleSoft for $10.3 billion. One of its founders, David Duffield, then started a new company that upgraded PeopleSoft's model to near limitless cloud-based storage — giving birth to Workday, the intractable nepo baby of HR software.
Workday is indifferent to our suffering in a job hunt, because we aren't Workday's clients, companies are. And these companies — from AT&T to Bank of America to Teladoc — have little incentive to care about your application experience, because if you didn't get the job, you're not their responsibility. For a company hiring and onboarding on a global scale, it is simply easier to screen fewer candidates if the result is still a single hire.
A search on a job board can return hundreds of listings for in-house Workday consultants: IT and engineering professionals hired to fix the software promising to fix processes.
For recruiters, Workday also lacks basic user-interface flexibility. When you promise ease-of-use and simplicity, you must deliver on the most basic user interactions. And yet: Sometimes searching for a candidate, or locating a candidate's status feels impossible. This happens outside of recruiting, too, where locating or attaching a boss's email to approve an expense sheet is complicated by the process, not streamlined. Bureaucratic hell is always about one person's ease coming at the cost of someone else's frustration, time wasted, and busy work. Workday makes no exceptions.
Workday touts its ability to track employee performance by collecting data and marking results, but it is employees who must spend time inputting this data. A creative director at a Fortune 500 company told me how in less than two years his company went "from annual reviews to twice-annual reviews to quarterly reviews to quarterly reviews plus separate twice-annual reviews." At each interval higher-ups pressed HR for more data, because they wanted what they'd paid for with Workday: more work product. With a press of a button, HR could provide that, but the entire company suffered thousands more hours of busy work. Automation made it too easy to do too much. (Workday's "customers choose the frequency at which they conduct reviews, not Workday," said the spokesperson.)
At the scale of a large company, this is simply too much work to expect a few people to do and far too user-specific to expect automation to handle well. It's why Workday can be the worst while still allowing that Paychex is the worst, Paycom is the worst, Paycor is the worst, and Dayforce is the worst. "HR software sucking" is a big tent.
Workday finds itself between enshittification steps two and three. The platform once made things faster, simpler for workers. But today it abuses workers by cutting corners on job-application and reimbursement procedures. In the process, it provides the value of a one-stop HR shop to its paying customers. It seems it's only a matter of time before Workday and its competitors try to split the difference and cut those same corners with the accounts that pay their bills.
Workday reveals what's important to the people who run Fortune 500 companies: easily and conveniently distributing busy work across large workforces. This is done with the arbitrary and perfunctory performance of work tasks (like excessive reviews) and with the throttling of momentum by making finance and HR tasks difficult. If your expenses and reimbursements are difficult to file, that's OK, because the people above you don't actually care if you get reimbursed. If it takes applicants 128% longer to apply, the people who implemented Workday don't really care. Throttling applicants is perhaps not intentional, but it's good for the company.
#work/productivity#reviews#bureaucracy#burnout#jobs#tech#software#business#ux#history#data structures
·businessinsider.com·
The most hated workplace software on the planet
Scarlet Witch - Wikipedia
Scarlet Witch - Wikipedia
Marvel licensed the filming rights of the X-Men and related concepts, such as mutants, to 20th Century Fox, who created a film series based on the franchise. Years later, Marvel started their own film franchise, known as the Marvel Cinematic Universe (MCU), which focused on characters that they had not licensed to other studios (see below). At the time, the rights to Quicksilver and Scarlet Witch were disputed by both studios. As they both held the rights to the characters, with Fox citing the characters' mutant status and being children of Magneto and Marvel citing the twins' editorial history being more closely tied to the Avengers rather than the X-Men, the studios made an agreement wherein both of them could use the characters on the condition that the plots did not make reference to the other studio's properties (i.e. the Fox films could not mention the twins as members of the Avengers while the MCU could not mention them as mutants or children of Magneto).[215] The arrangement became moot following the acquisition of 21st Century Fox by Disney – the parent company of Marvel Studios, and the confirmation that future X-Men films will take place within the MCU.
#superheroes#business/models#history#bureaucracy#companies/disney
·en.wikipedia.org·
Scarlet Witch - Wikipedia
I Set Out to Create a Simple Map for How to Appeal Your Insurance Denial. Instead, I Found a Mind-Boggling Labyrinth.
I Set Out to Create a Simple Map for How to Appeal Your Insurance Denial. Instead, I Found a Mind-Boggling Labyrinth.
I tried to create a spreadsheet that would guide readers through the appeals process for all the different types of insurance and circumstances. When a patient needs care urgently, for instance, an appeal follows a different track. But with each day of reporting, with each expert interviewed, it got more and more confusing. There was a point when I thought I was drowning in exceptions and caveats. Some nights were filled with a sense that I was trapped in an impossible labyrinth, with signs pointing to pathways that just kept getting me further lost
You may think that UnitedHealthcare is your insurer because that’s the name on your insurance card, but that card doesn’t tell you what kind of plan you have. Your real insurer may be your employer.
Government insurance is its own tangle. I am a Medicare beneficiary with a supplemental plan and a Part D plan for drug coverage. The appeals process for drug denials is different from the one for the rest of my health care. And that’s different from the process that people with Medicare Advantage plans have to follow.
The federal government sets minimum standards that each state Medicaid program has to follow, but states can make things more complicated by requiring different appeal pathways for different types of health care. So the process can be different depending on the type of care that was denied, and that can vary state to state.
I sought help from Jack Dailey, a San Diego attorney and coordinator for the California Health Consumer Alliance, which works with legal-aid programs across the state. On a Zoom call, he looked at an Excel spreadsheet I’d put together for Medi-Cal, California’s Medicaid program, based on what I had already learned. Then he shook his head. A few days later, he came back with a new guide, having pulled an all-nighter correcting what I had put together and adding tons of caveats. It was seven single-spaced pages long. It detailed five layers of the Medi-Cal appeals process, with some cases winding up in state Superior Court. There were so many abbreviations and acronyms that I needed to create a glossary. (Who knew that DMC-ODS stands for Drug Medi-Cal Organized Delivery System?) And this was for just one state!
It’s especially complicated in oncology, said Dr. Barbara McAneny, a former president of the American Medical Association who runs a 6,000-patient oncology practice in Albuquerque, New Mexico. “My practice is built on the theory that all the patients should have to do is show up and we should manage everything else … because people who are sick just cannot deal with insurance companies. This is not possible,” she said. McAneny told me she spends $350,000 a year on a designated team of denial fighters whose sole job is to request prior authorization for cancer care — an average 67 requests per day — and then appeal the denials. For starters, she said bluntly, “we know everything is going to get denied.” It’s almost a given, she said, that the insurer will lose the first batch of records. “We often have to send records two or three times before they finally admit they actually received them. … They play all of these kinds of delaying games.”
McAneny thinks that for insurance companies, it’s really all about the money. Her theory is that insurance companies save money by delaying spending as long as possible, especially if the patient or the doctor gives up on the appeal, or the patient’s condition rapidly declines in the absence of treatment. For an insurance company, she said, “you know, death is cheaper than chemotherapy.”
#healthcare#govt/policy#bureaucracy#journalism#americanism#profiles
·propublica.org·
I Set Out to Create a Simple Map for How to Appeal Your Insurance Denial. Instead, I Found a Mind-Boggling Labyrinth.
Why Other Countries Have Better Sunscreen - The Atlantic
Why Other Countries Have Better Sunscreen - The Atlantic

key ingredients in better sunscreens:

  • bemotrizinol
  • bisoctrizole
Bioré markets some of its products in the U.S., but its ultra-popular facial sunscreen contains bemotrizinol, a chemical filter that’s popular overseas but has not yet been approved in the U.S. The substance is on a short list of those that Dobos told me have the strongest case for FDA approval—it’s widely used around the world and very effective at absorbing UV rays. Another ingredient at the top of her list is bisoctrizole, a favorite in Europe, which she said degrades more slowly in sunlight, is less readily absorbed by the wearer’s skin, and helps stabilize other UV filters when mixed with them, potentially improving their efficacy
#skincare#health#wellbeing#lifestyle#legal#americanism#bureaucracy#red tape
·archive.li·
Why Other Countries Have Better Sunscreen - The Atlantic
Google has a company strategy, not a product strategy
Google has a company strategy, not a product strategy
The VP in charge of Google Plus hosted the Friday all-hands several times to get us all excited about what they were building. It was obvious to me and many others that there was no reason for people already on Facebook to switch from Facebook. Someone asked a direct question, but the VP deflected and talked about how easy it would be to group your friends with the Circles feature — which was not at all a reason to switch.It seemed like Google didn’t have the processes or experience to get the product strategy right. “Who are our potential users and what does it take to win them?” is product strategy 101. Maybe someone raised this question in an exec review, but it didn’t become a launch blocker. Google+ never took off, and was eventually shut down.
If Google didn’t start with a conviction that they needed the product, it makes sense that they wouldn’t have the stamina to keep iterating and investing. Most other companies don’t have the money to build and launch products with such little conviction and oversight. Other companies need their products to succeed, so they try harder & smarter to make the products successful.
IME people often don’t realize that product strategies are actually way more important and influential than company strategies. Simply because it’s the products that have an impact on people’s lives, not the company.
Google has a company strategy, but they don’t make product strategies.
Google’s company strategy is “Hire all the smart people.” Hire all the smart people and let them build. Hire all the smart people so they can’t work at a competitor. Hire all the smart people even if we don’t have something important for them to work on.Google acts like a venture capitalist, investing in promising people with the expectation that most will fail. They invest broadly in search of the idea that will deliver 100x. Let 1000 flowers bloom, and see which are the best.
#metrics v humanities#product strategy#project management#bureaucracy#business/strategy#companies/microsoft#companies/google#critiques#bts
·jackiebavaro.substack.com·
Google has a company strategy, not a product strategy