Mish's Global Economic Trend Analysis

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• Physicians, Others Chime in on Who's to Blame for Rising Healthcare Costs
• Sunday Funnies 2010-08-29 Double Dipping
• Email From "Morally Conflicted" One Year Later After Walking Away

Physicians, Others Chime in on Who's to Blame for Rising Healthcare Costs Posted: 29 Aug 2010 08:23 PM PDT I received a lot of emails in response to Who's to Blame for Rising Healthcare Costs? Some reader suggestions might save you some money. Overpaying for Generics "Dr. P" a front line working family physician for 30 years writes .... Hello Mish Thank you for exposing some of the many scams on health care insurance. Here is another example of industry wide ripoffs: Many generic medications now cost $4.00 for 30 days or $10.00 for 90 days without insurance. Sadly, many mail in companies require patients to pay a $15.00 - 30.00 dollar co-pay for 90 days for the same drugs. Just this week one of the mail in companies informed a patient of mine that they will be only filling the prescriptions for 30 days and will require a $15.00 co-pay monthly for a medication which is only $4.00 per month. My patients were surprised when I told them to just go to a local pharmacy and not use their insurance. One patient had 4 medications he was paying more than double for. In the most flagrant example, a patient paid $60.00 per month for his medications that he could get for 90 days for $40.00 if he did not use his employer paid insurance. That is $180 instead of $40! The insurance company walks away with the money on the back of the patient in all of these instances. I find this way over the top in the ethics department. To your health, Dr P. Drugs from Canada "CB" writes ... Hello Mish Keep up the good fight. I want to let you know, however, that Americans can buy drugs from Canada - as individuals. No bulk purchasing for resale is allowed, but to get one's own drugs at a big discount (like I do), the place to check out is called Canada Meds. Their phone number is 1 877 542 3330. I save 50%. I pay directly for them, so trying to buy from Canada under an insurance plan might not be possible. I don't know. The drugs I get from Canada Meds come from other countries, and are usually made in India, but they are the exact same thing and I've been taking them for years now with no ill effects. CB I cannot and do not vouch for the above claims nor do I deny them. I simply do not know. Moreover, I do not know if buying drugs from Canada is against any state laws. I did check and I do not see complaints against Canada Meds, so that is a good sign. Another physician Chimes In "MB" MD writes .... Hello Mish I am a long time reader and have written previously. I am also a physician. Your post regarding health care costs hits close to home but I think you have missed the real crux of the issue. I will not pretend that I can offer a comprehensive review in a short email. There is more than enough blame to go around. Who shares the blame? Insurers, the Congressmen they've bought and the Americans who can look only at the fact that they can get mostly free care (Medicare and Medicaid recipients, government employees and a decreasing number of lucky beneficiaries of large corporate policies) and many of my peers who are paid per service regardless of need, benefit or outcome. One need only look at the enormous amount of waste in the system in regards to gross and repeated over-testing to no patient benefit. I could write pages about over-testing. I have a little aphorism that I believe sums up the failure of American health care: 30% of health care delivered was never necessary and 30% of necessary health care is never delivered. "MB" Cost of Illegal Aliens "JC" writes ... I know a nurse in a major metro area and she deals with the illegal immigrants flooding into her hospital emergency room every day. They come with their diagnosis in hand from the country they left. Major metro hospitals are magnates for illegal aliens coming to the US for free medical treatments. In my post of who is to blame I came up with this list. So Who's To Blame? Obama Congressional Republicans Democrats Insurers Public Unions State Government President Obama just wanted a bill. He did not really give a damn what was in it, as long as it did not upset public unions. Moreover, Obama sold the youth vote right down the river. There is nothing but pain for them. Public unions do not give a damn about healthcare costs because they and their families pay next to nothing with deductibles that are next to nothing. Taxpayers pick up the cost. Democrats also did not want to upset the unions. Republicans refused to allow competition between states or cheaper drugs coming in from Canada. State governments pander to unions and also act to restrict competition. The insurers bribed both parties to get what they wanted out of the legislation. Other Notables Lobbyists for pharmaceutical companies, lobbyists for insurers, lobbyists for lawyers so tort reform is not passed, etc. Local Governments for pandering to unions. Fear Mongers who talk of "death squads" every time a discussion comes up regarding health care rationing. Organized religion for fighting to keep brain-dead zombie patients alive at enormous expense. A nurse friend of mine told me how hard it is to "pull the plug". The public at large for obesity, poor eating habits, smoking, etc. Case for Rationing At some point the system just has to say no. Spending hundreds of thousands of dollars to extend someone's life by three months is simply not rational. Nor is spending hundreds of thousands of dollars when the odds of success are slim. Yet every time the discussion comes up, political hacks start screaming about "death squads". Other than the public at large, everyone has a vested interest in not fixing the system. It is pretty tough to get reform when nearly every major industry group is against anything and everything that is likely to do any good. If additional comments come in, worthy of posting, I will add an addendum. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com Click Here To Scroll Thru My Recent Post List Mike "Mish" Shedlock is a registered investment advisor representative for SitkaPacific Capital Management. Sitka Pacific is an asset management firm whose goal is strong performance and low volatility, regardless of market direction. Visit http://www.sitkapacific.com/account_management.html to learn more about wealth management and capital preservation strategies of Sitka Pacific.

Sunday Funnies 2010-08-29 Double Dipping Posted: 29 Aug 2010 12:05 PM PDT Here is a funny clip from Seinfeld on double dipping. Embedding disabled. What We Call The News - Jib Jab In case you missed it, please take a look at Nonsense from NBER on Odds of Double-Dip. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com Click Here To Scroll Thru My Recent Post List Mike "Mish" Shedlock is a registered investment advisor representative for SitkaPacific Capital Management. Sitka Pacific is an asset management firm whose goal is strong performance and low volatility, regardless of market direction. Visit http://www.sitkapacific.com/account_management.html to learn more about wealth management and capital preservation strategies of Sitka Pacific.

Email From "Morally Conflicted" One Year Later After Walking Away Posted: 29 Aug 2010 01:57 AM PDT Slightly over one year ago, I received an email from "Morally Conflicted in Arizona" who at the time was considering "Walking Away". I responded to his email on August 18, 2009 in Bright Side of Falling Home Prices It turns out "Morally Conflicted" did indeed walk away. Here is a followup email I received a few days ago, about his experience. End of the Line "Morally Conflicted" writes ... Hello Mish, It's been over a year since I asked for your opinion about how long it would take for the housing market to "recover," which was about the same time that I stopped paying my mortgage and decided to walk away. Well, the game is finally over. I moved out last week, and the trustee's sale occurred last Thursday. After thinking repeatedly about it recently, the end results look something like this: After purchasing the house in 2005 for about $740K with only $40K down, if you count my mortgage payments as "rent," in a sense, I recovered my down payment over the past year by living "rent" free over the past year. The current value of the house is most likely around $400K. Thus, I was able to "get out from under" a $300K loss by walking away. After a bit of looking over the past couple of months, found a two-bedroom house I can rent for $1200/month. The rental is in Scottsdale, just a few miles from my old house. It's definitely smaller and not as nice, but it's more than adequate. Given my new rent payment, I am estimating that I will be saving at least $1500/month by renting the new house vs. staying in the old house, even with a modified payment (and yes, I am accounting for the tax break on my old property. Therefore, as things currently stand, I believe I will "save" $150K over the next 100 months - assuming of course that my rent doesn't change and/or I don't move again. Thus, I believe I can conservatively estimate that my decision to walk on the house will essentially increase my net worth by approximately $300K over the next 100 months had I struggled in the existing loan. Moreover, that assumes the old house increases in value in that timeframe. If not, the number may be more like $450K. On top of everything, just this week, I was contacted by the real estate agency that will be selling the house for the new owner (i.e., the bank - it looks like they bought the house "from themselves" at the trustee's sale), and I am being offered $2500 to leave the appliances, etc., in the old house. The only real downside I see at this point is that my credit is shot. I guess I'll have a foreclosure on my "record" for the rest of my life. However, the irony is that if there has ever been a time in my life when I do not want to borrow any money for anything, it is now. I'm not trying to make light of the situation. This is not something that I'm proud of. However, it does feel good to have it over with, and looking at the math, it really seems like the right thing to do. Sure, I "could" have been paying my mortgage over the past year, but given the hit my income took last year and the first part of this year, I would essentially be living paycheck to paycheck right now. As always, I appreciate your work. Please keep it up. Thank you, Morally Conflicted in AZ P.S. I did consult with an attorney before making the final decision to walk away. Glad I could Help Thanks "Morally Conflicted" I am glad I could help. For more on the morals and ethics of "Walking Away" please see Moral Obligations Of Walking Away Walking Away Revisited - Reader Mailbag - Moral Dilemma Emails from Housing Hypocrites about Ethics Many Chime In On "Housing Hypocrites" Post Seek Legal Counsel That "P.S." line above regarding consulting an attorney is very important. I did advise"Morally Conflicted" to do just that. For more on the needs to seek proper legal advice, please see ... Before Walking Away Consult An Attorney How to Find a Bankruptcy Attorney There are many potential snags to consider if you go it alone. Don't do it! Walking Away Goes Mainstream The moral stigma regarding "Walking Away" is now pretty much gone. That it ever existed in the first place is quite hypocritical. Henry Blodget and Aaron Task discuss the hypocrisy a few days ago in It's Okay To Walk Away: Let's End The "Morality" Double-Standard On Mortgage Defaults I was way out in front of this issue, almost two years ago. If "Walking Away" is in your best financial interest, there is nothing wrong with doing just that. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com Click Here To Scroll Thru My Recent Post List Mike "Mish" Shedlock is a registered investment advisor representative for SitkaPacific Capital Management. Sitka Pacific is an asset management firm whose goal is strong performance and low volatility, regardless of market direction. Visit http://www.sitkapacific.com/account_management.html to learn more about wealth management and capital preservation strategies of Sitka Pacific.

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Crawl Errors now reports soft 404s

Crawl Errors now reports soft 404s: "Webmaster Level: All

Today we’re releasing a feature to help you discover if your site serves undesirable 'soft” or “crypto” 404s. A 'soft 404' occurs when a webserver responds with a 200 OK HTTP response code for a page that doesn't exist rather than the appropriate 404 Not Found. Soft 404s can limit a site's crawl coverage by search engines because these duplicate URLs may be crawled instead of pages with unique content.

The web is infinite, but the time search engines spend crawling your site is limited. Properly reporting non-existent pages with a 404 or 410 response code can improve the crawl coverage of your site’s best content. Additionally, soft 404s can potentially be confusing for your site's visitors as described in our past blog post, Farewell to Soft 404s.    

You can find the new soft 404s reporting feature under the Crawl errors section in Webmaster Tools.



Here’s a list of steps to correct soft 404s to help both Google and your users:

1. Check whether you have soft 404s listed in Webmaster Tools
   
2. For the soft 404s, determine whether the URL:
   1. Contains the correct content and properly returns a 200 response (not actually a soft 404)
      
   2. Should 301 redirect to a more accurate URL
      
   3. Doesn’t exist and should return a 404 or 410 response
      
3. Confirm that you’ve configured the proper HTTP Response by using Fetch as Googlebot in Webmaster Tools
   
4. If you now return 404s, you may want to customize your 404 page to aid your users. Our custom 404 widget can help.

We hope that you’re now better enabled to find and correct soft 404s on your site. If you have feedback or questions about the new 'soft 404s' reporting feature or any other Webmaster Tools feature, please share your thoughts with us in the Webmaster Help Forum.

Written by Jonathan Simon, Webmaster Trends Analyst

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Our new search index: Caffeine

Our new search index: Caffeine: "

(Cross-posted on the Official Google Blog)

Today, we're announcing the completion of a new web indexing system called Caffeine. Caffeine provides 50 percent fresher results for web searches than our last index, and it's the largest collection of web content we've offered. Whether it's a news story, a blog or a forum post, you can now find links to relevant content much sooner after it is published than was possible ever before.

Some background for those of you who don't build search engines for a living like us: when you search Google, you're not searching the live web. Instead you're searching Google's index of the web which, like the list in the back of a book, helps you pinpoint exactly the information you need. (Here's a good explanation of how it all works.)

So why did we build a new search indexing system? Content on the web is blossoming. It's growing not just in size and numbers but with the advent of video, images, news and real-time updates, the average webpage is richer and more complex. In addition, people's expectations for search are higher than they used to be. Searchers want to find the latest relevant content and publishers expect to be found the instant they publish.

To keep up with the evolution of the web and to meet rising user expectations, we've built Caffeine. The image below illustrates how our old indexing system worked compared to Caffeine:

Our old index had several layers, some of which were refreshed at a faster rate than others; the main layer would update every couple of weeks. To refresh a layer of the old index, we would analyze the entire web, which meant there was a significant delay between when we found a page and made it available to you.

With Caffeine, we analyze the web in small portions and update our search index on a continuous basis, globally. As we find new pages, or new information on existing pages, we can add these straight to the index. That means you can find fresher information than ever before — no matter when or where it was published.

Caffeine lets us index web pages on an enormous scale. In fact, every second Caffeine processes hundreds of thousands of pages in parallel. If this were a pile of paper it would grow three miles taller every second. Caffeine takes up nearly 100 million gigabytes of storage in one database and adds new information at a rate of hundreds of thousands of gigabytes per day. You would need 625,000 of the largest iPods to store that much information; if these were stacked end-to-end they would go for more than 40 miles.

We've built Caffeine with the future in mind. Not only is it fresher, it's a robust foundation that makes it possible for us to build an even faster and comprehensive search engine that scales with the growth of information online, and delivers even more relevant search results to you. So stay tuned, and look for more improvements in the months to come.

Posted by Carrie Grimes, Software Engineer

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Quality links to your site

Quality links to your site: "A popular question on our Webmaster Help Forum is in regard to best practices for organic link building. There seems to be some confusion, especially among less experienced webmasters, on how to approach the topic. Different perspectives have been shared, and we would also like to explain our viewpoint on earning quality links.

If your site is rather new and still unknown, a good way marketing technique is to get involved in the community around your topic. Interact and contribute on forums and blogs. Just keep in mind to contribute in a positive way, rather than spamming or soliciting for your site. Just building a reputation can drive people to your site. And they will keep on visiting it and linking to it. If you offer long-lasting, unique and compelling content -- something that lets your expertise shine -- people will want to recommend it to others. Great content can serve this purpose as much as providing useful tools.

A promising way to create value for your target group and earn great links is to think of issues or problems your users might encounter. Visitors are likely to appreciate your site and link to it if you publish a short tutorial or a video providing a solution, or a practical tool. Survey or original research results can serve the same purpose, if they turn out to be useful for the target audience. Both methods grow your credibility in the community and increase visibility. This can help you gain lasting, merit-based links and loyal followers who generate direct traffic and 'spread the word.' Offering a number of solutions for different problems could evolve into a blog which can continuously affect the site's reputation in a positive way.

Humor can be another way to gain both great links and get people to talk about your site. With Google Buzz and other social media services constantly growing, entertaining content is being shared now more than ever. We've seen all kinds of amusing content, from ASCII art embedded in a site's source code to funny downtime messages used as a viral marketing technique to increase the visibility of a site. However, we do not recommend counting only on short-lived link-bait tactics. Their appeal wears off quickly and as powerful as marketing stunts can be, you shouldn't rely on them as a long-term strategy or as your only marketing effort.

It's important to clarify that any legitimate link building strategy is a long-term effort. There are those who advocate for short-lived, often spammy methods, but these are not advisable if you care for your site's reputation. Buying PageRank-passing links or randomly exchanging links are the worst ways of attempting to gather links and they're likely to have no positive impact on your site's performance over time. If your site's visibility in the Google index is important to you it's best to avoid them.

Directory entries are often mentioned as another way to promote young sites in the Google index. There are great, topical directories that add value to the Internet. But there are not many of them in proportion to those of lower quality. If you decide to submit your site to a directory, make sure it's on topic, moderated, and well structured. Mass submissions, which are sometimes offered as a quick work-around SEO method, are mostly useless and not likely to serve your purposes.

It can be a good idea to take a look at similar sites in other markets and identify the elements of those sites that might work well for yours, too. However, it's important not to just copy success stories but to adapt them, so that they provide unique value for your visitors.

Social bookmarks on YouTube enable users to share content easily

Finally, consider making linking to your site easier for less tech savvy users. Similar to the way we do it on YouTube, offering bookmarking services for social sites like Twitter or Facebook can help spread the word about the great content on your site and draw users' attention.

As usual, we'd like to hear your opinion. You're welcome to comment here in the blog, or join our Webmaster Help Forum community.

Written by Kaspar Szymanski, Search Quality Strategist, Dublin

"

Sitemaps: One file, many content types

Sitemaps: One file, many content types: "Webmaster Level: All

Have you ever wanted to submit your various content types (video, images, etc.) in one Sitemap? Now you can! If your site contains videos, images, mobile URLs, code or geo information, you can now create—and submit—a Sitemap with all the information.

Site owners have been leveraging Sitemaps to let Google know about their sites’ content since Sitemaps were first introduced in 2005. Since that time additional specialized Sitemap formats have been introduced to better accommodate video, images, mobile, code or geographic content. With the increasing number of specialized formats, we’d like to make it easier for you by supporting Sitemaps that can include multiple content types in the same file.

The structure of a Sitemap with multiple content types is similar to a standard Sitemap, with the additional ability to contain URLs referencing different content types. Here's an example of a Sitemap that contains a reference to a standard web page for Web search, image content for Image search and a video reference to be included in Video search:

<?xml version="1.0" encoding="UTF-8"?>
<urlset xmlns="http://www.sitemaps.org/schemas/sitemap/0.9"
       xmlns:image='http://www.sitemaps.org/schemas/sitemap-image/1.1'
       xmlns:video="http://www.sitemaps.org/schemas/sitemap-video/1.1">
 <url>
   <loc>http://www.example.com/foo.html</loc>
   <image:image>
      <image:loc>http://example.com/image.jpg</image:loc>
   </image:image>
   <video:video>
   <video:content_loc>http://www.example.com/videoABC.flv</video:content_loc>   
     <video:title>Grilling tofu for summer</video:title>
   </video:video>
 </url>
</urlset>

Here's an example of what you'll see in Webmaster Tools when a Sitemap containing multiple content types is submitted:



We hope the capability to include multiple content types in one Sitemap simplifies your Sitemap submission. The rest of the Sitemap rules, like 50,000 max URLs in one file and the 10MB uncompressed file size limit, still apply. If you have questions or other feedback, please visit the Webmaster Help Forum.

Written by Jonathan Simon, Webmaster Trends Analyst

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New Message Center notifications for detecting an increase in Crawl Errors

New Message Center notifications for detecting an increase in Crawl Errors: "Webmaster Level: All

When Googlebot crawls your site, it’s expected that most URLs will return a 200 response code, some a 404 response, some will be disallowed by robots.txt, etc. Whenever we’re unable to reach your content, we show this information in the Crawl errors section of Webmaster Tools (even though it might be intentional and not actually an error). Continuing with our effort to provide useful and actionable information to webmasters, we're now sending SiteNotice messages when we detect a significant increase in the number of crawl errors impacting a specific site. These notifications are meant to alert you of potential crawl-related issues and provide a sample set of URLs for diagnosing and fixing them.

A SiteNotice for a spike in the number of unreachable URLs, for example, will look like this:


We hope you find SiteNotices helpful for discovering and dealing with issues that, if left unattended, could negatively affect your crawl coverage. You’ll only receive these notifications if you’ve verified your site in Webmaster Tools and we detect significant changes to the number of crawl errors we encounter on your site. And if you don't want to miss out on any these important messages, you can use the email forwarding feature to receive these alerts in your inbox.

If you have any questions, please post them in our Webmaster Help Forum or leave your comments below.

Posted by Pooja Shah and Jonathan Simon

"

To err is human, Video Sitemap feedback is divine!

To err is human, Video Sitemap feedback is divine!: "Webmaster Level: All

You can now check your Video Sitemap for even more errors right in Webmaster Tools! It’s a new Labs feature to signal issues in your Video Sitemap such as:

• URLs disallowed by robots.txt
• Thumbnail size errors (160x120px is ideal. Anything smaller than 90x50 will be rejected.)

Video Sitemaps help us to better crawl and extract information about your videos, so we can appropriately feature them in search results.

Totally new to Video Sitemaps? Check out the Video Sitemaps center for more information. Otherwise, take a look at this new Labs feature in Webmaster Tools.

Written by Jackie Lai, Video Search Team

"