miercuri, 30 octombrie 2013

I know Game 6 starts soon, but:

 

 

Hey, all --

Moments ago, President Obama finished speaking at Faneuil Hall here in Boston. And while it's home to Big Papi and my beloved Red Sox, it's also home to the birthplace of health reform in America.

The state's progressive vision of universal coverage and the conservative idea of market competition are what formed the blueprint for Obamacare: that everyone should have access to quality, affordable health care, and no one should ever go broke just because they get sick.

And we're seeing the benefits of reform extended nationally: According to a new report this week, nearly half of single, uninsured Americans between the ages of 18 and 34 can get coverage for $50 or less, often lower than the cost of their cable bill. That comes on top of the new benefits -- including free preventive services like mammograms, and a prohibition against denying coverage for pre-existing conditions.

Now HealthCare.gov has experienced its share of bumps in the road, to all of our frustration, but every day people are signing up and getting insurance. President Obama has said many times that he's open to making the health care law work better. If folks could leave the politics aside for a bit -- if Republicans spent as much energy trying to make the law work as they do attacking it -- we could be much further than we are today.

Last week we sat down and spoke with folks who have applied through the Marketplace, and their stories remind me why we fought so hard to pass this law in the first place.

Will you take two minutes to watch this video -- and then forward it to a friend?

If you want an example of the difference this law will make in someone's life, you don't have to look any further than Janice -- a new registrant from Selbyville, Delaware. She was the first woman to enroll in the Delaware exchange, and she says her new policy will save her $150 a month for more coverage benefits than ever before.

Or David -- a self-employed IT consultant and Air Force veteran living in Washington, D.C. David picked his plan the morning D.C.'s online health insurance marketplace opened. His previous plan was $600 a month. His new one? $250 cheaper.

That's who we're fighting for here. And while it can get lost in the fray of the 24-hour news cycle, I hope you'll keep folks like Janice and David in mind in the weeks and months ahead. It's just too important to lose sight of the big picture.

I know that Game 6 of the World Series is on soon, but this is important:

Take a couple minutes to watch Janice and David tell their stories -- and then pass it on.

Thanks.

David

David Simas
Deputy Senior Advisor
The White House
@Simas44

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Photo: Two Presidents

Here's What's Happening Here at the White House
 
 
 
 
 
 
  Photo of the Day

Photo: Two Presidents

President Barack Obama greets former President Bill Clinton prior to a memorial service for former House Speaker Tom Foley

President Barack Obama greets former President Bill Clinton prior to a memorial service for former House Speaker Tom Foley, D-Wash., at the U.S. Capitol in Washington, D.C., Oct. 29, 2013. (Official White House Photo by Pete Souza)


 

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Young People & Obamacare: Coverage for $50 Per Month

As a Department of Health and Human Services report shows, half of single young adults eligible for the Health Insurance Marketplace could get coverage for $50 a month or less -- or less than your cable bill.

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Yesterday, the administration announced the start of the 45-day public comment period for the Preliminary Cybersecurity Framework. This announcement represents an important milestone in this collaborative effort to develop the framework, and the feedback received during this period will inform the final version.

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President Obama Welcomes James Comey as FBI Director

On Monday, President Obama welcomed James Comey to his new post as the seventh Director of the FBI. Comey previously worked as an attorney and later served as deputy attorney general at the Department of Justice. At the FBI Headquarters, the President praised Comey’s dedication, judgment, and commitment to the ideals of the FBI.

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  Today's Schedule

All times are Eastern Time (ET)

8:30 AM: The Vice President meets with Prime Minister Nouri al-Maliki of Iraq

10:30 AM: The President receives the Presidential Daily Briefing 

11:15 AM: The President meets with Secretary of the Treasury Lew 

1:15 PM: The President departs the White House en route Joint Base Andrews

1:30 PM: The President departs Joint Base Andrews

2:40 PM: The President arrives in Boston, Massachusetts 

3:00 PM: The Vice President delivers remarks at the National Domestic Violence Hotline WATCH LIVE

3:55 PM: The President delivers remarks on healthcare WATCH LIVE

4:30 PM: The Vice President attends an event for the Democratic National Committee

5:35 PM: The President delivers remarks at a DCCC event

6:50 PM: The President departs Boston, Massachusetts en route to Andrews Air Force Base

8:10 PM: The President arrives Joint Base Andrews

8:45 PM: The President arrives at the White House

 

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Case Study: White-Hat Link Building in the Gambling Industry

Case Study: White-Hat Link Building in the Gambling Industry


Case Study: White-Hat Link Building in the Gambling Industry

Posted: 29 Oct 2013 02:52 PM PDT

Posted by sammiranda

During 2012, Google clamped down on poor link building tactics, eliminating directories, article submission sites and adjusting the criteria for natural links. Consequently, the gambling industry has been facing the daunting task of restructuring its content marketing and SEO initiatives. Abusing article directories and paying for guest posts with keyword rich anchor text no longer cut the mustard.

Alongside brand building through social media and delivering value-added content, white-hat link building is high on the agenda to restore rankings. But it's often dubbed mission impossible by gambling marketers.

Traditionally, gambling websites are short of linkable assets. First-party games often constitute a casino's most valuable content, but they're developed infrequently and reputable websites are hesitant to link to gambling-related content because of the social stigma attached to the industry.

White-hat link building (an admittedly contentious term) is possible. In this post I'm going to outline four strategies that I have obtained from my experiences of content marketingâ€"specifically 'guest posting' for want of a better termâ€"for a gambling affiliate website.

To conclude, I'll also provide three examples of the valuable backlinks I've managed to obtain through using these tactics.

1. Lead generation

Gambling is a multi-faceted entity, incorporating psychology, legislation and social issues. It features heavily in sports, discourse surrounding marketing and advertising techniques, and even celebrity culture. Contrary to popular belief, the scope for gambling related content is massiveâ€"it stretches far beyond the roulette guides and blackjack strategies found on poorly constructed, niche gambling websites.

Content marketers let the stigma attached to gambling dictate their initiatives, saying "There's no way awesomedomain.com will link to a gambling website." But this blinkered outlook represents a wasted opportunity. Providing there's no explicit material, a website should link to any credible source that enhances reader understanding.


The kind of headline that demoralises gambling industry marketers

Start to build a diverse list of online publications that can be approached for guest posting. Ask yourself the following questions:

  • Do they accept freelancer contributions or guest posts?
  • Do they accept organic links in the article body?
  • If not, do they at least offer a promotional link in the author byline?
  • Are outbound links restricted to trusted contributors? In this case, you'll need to build up your credibility before benefiting from links.

Note: I dislike the term guest posting as it's often (now) associated with systematic efforts to produce mediocre articles and place them on any website in a similar niche. I do not endorse, nor follow this churned approach to content production. However, we'll use the term to keep it simple!

Finish by categorising your leads based on the subject (i.e. business, education, entertainment etc) and the website's SEO metrics (page rank, citation flow, trust flow, PA etc).

Top takeaways

  1. Don't let the stigma attached to your niche cloud your thought process.
  2. Think of guest posting as feature writing, not copywriting. Avoid the churn!
  3. It is not always about getting a link straight away. Sometimes you'll need to prove your worth with valuable posts to build up trust and credibility.

2: Topic generation

My topic generation tends to fit into three subject categories.

Gambling

The first is gambling itself. You should aim to cover the full emotional spectrum, from negative articles surrounding consumer gambling addiction to more imaginative, uplifting pieces covering novelty bets and celebrity gamblers. You don't have to glorify gambling. For instance, you might want to take a critical standpoint towards PaddyPower's agreement with Facebook to launch a sports-betting app, highlighting the perils of social gambling. This would interest any gambling B2B website.

Marketing and business

Ironically, the second subject area is exactly what I'm doing now. When you're discussing anything business or marketing related, you can write objectively about the gambling sector. Gambling websites are known for audacious advertising, flashy design and clever conversion optimisation, making them perfect case studies for marketing and UX-related articles.

Though valuable, deep-links to your gambling website's core landing pages are hard to embed as organic links within an article body. Rarely is it ever organic to link to a page full of gambling bonuses, but it is possible. If you're discussing website design and innovation, you can specify an excellent landing page, which gives you ammunition for an organic link in a user experience post.

You can also look within for an engaging business story. Does your company have a colourful history? Is your CEO a budding Richard Branson? Entrepreneur websites love to feature original case studies, and should be happy linking to your website if it underlines an intriguing corporate venture.

Shareable content

The third area is shareable, viral content. The internet is awash with trend websites that disseminate funny and digestible content. You should be looking to jump in with a snappy, "Top 10 Amazing Bets" kind of list that incorporates a mix of images, videos and memes.

I've hijacked a quirky "question asking" formula from viral scientist Jonah Berger to drill out facts and generate interesting ideas. Using 'roulette' for example…

Who chooses to play roulette?
What types of roulette are there?
What can we learn about the type of person who plays X version of roulette?

Now to mix it up a bit…

Where do those people come from?
What is the majority gender?

Now make it controversial…

Are people from region X more prone to gambling? Are men playing the "live" version more? Is this because they are physically attracted to the croupier?

As you can see, questioning your own topic triggers a web of interesting and contentious content - the kind of material which a much wider audience can relate to, enjoy and share. Another creative formula I use for topic generation is 'subject + random category or buzzword '. For instance:

Roulette + films (which brings me to the iconic Russian roulette scene from The Deer Hunter).

Roulette + social (which brings me to the webcam-based phenomenon Chat Roulette).

Roulette + travel (which in the case of Heineken, brought them to a video whereby holiday makers were offered to play 'Departure Roulette' and board a flight to a random destination).

Roulette + magic (which brings me to popular British mentalist Derren Brown's 'Russian Roulette' trick).

Writing

Once you've seeded a topic and an angle, you should be looking to delegate the writing of an article to a crack in-house writerâ€"someone with a passion for journalism and developing their online presence. In my experience, outsourcing to freelancers or an agency comprises quality and article authenticity. The work is thin on research, low on personality and possesses a 'churned' feel to it, which brings me back to my stereotypical guest post gripe. Make sure you leverage the knowledge of your internal teamâ€"i.e. your designer for design-related materialâ€"to cover all potential article bases.

Top takeaways

  1. Explore your niche. It is sure to bring up topics that bear wider social significance.
  2. Have you successfully implemented a marketing campaign? Is your business doing great? Tell your own company story.
  3. Brainstorm and generate shareable content. Use the "question asking" formula above to come up with interesting topics.

3: Original and convincing outreach

Here's a fantastic post entitled "Revealed: Outreach Campaigns from some of the Biggest SEO firms." It underlines just how useless some SEO agencies are at establishing credibility and building rapport with editors and webmasters. They have to resort to manufactured guest-post outreach.

My outreach is far more tailored and elaborate. I throw in a bio, examples of my published work and a brief employment history. There really is no substitute for published work, and I'm fortunate enough to have articles on websites like Buzzfeed and The Bleacher Report. My emails will be personalised, complimentary and explain why my content is suitable for the website's target demographic. Email outreachâ€"summarised perfectly by this infographicâ€"is a science in its own right.

I sugar-coat my job role (senior editor at a gaming information portal) and justify my outreach on the grounds of a writer wanting to broaden his horizons and bolster his portfolio. For the most covert infiltrations, I pose as a journalist looking for an actual job as a remote freelancer. Though I'm approaching these websites for a link to my company website, it's not always at the forefront of my agenda. I want to diversify my writing portfolio and elevate my own online presence to establish regular writing gigs in the future.

For first time contact with an editor, I always include an article attachment. I've enjoyed a lot more traction with this tactic. Editors receive and reject an inordinate number of pitches, but are far more likely to respond if you've gone to the effort of constructing an original article.

Another top tip is when I've linked to a business or website in a previous article, I'll approach them for a guest post later down the line so they can return the favour. This is a great way to break the ice simply by letting them know you mentioned their insightful article.

Top takeaways

  1. Personalise your outreach. Research the editor, the website and its target audience, and explain why your content is suitable.
  2. Ask yourself: Are you emailing a webmaster, or an editor? The former will be familiar with SEO, and will scrutinise your outreach more heavily. An editor with a journalistic background should be more receptive to content proposals.
  3. Be yourselfâ€"an ambitious, talented freelance writer. By mentioning your company, you run the risk of being ignored on the basis of seeking commercial gain.
  4. Where possible, include an original article for the target website as part of your email outreach.

4: Build your website's linkable assets

Successful link building means working with the internal content team to develop linkable assets. This can be a mix of ephemeral news content, infotainment articles and more academic, educational resources. Across our websites, we've covered the whole spectrumâ€"from a Vegas-themed HTML5 puzzle game that amassed 1,000 shares, to a serious investigation into casino design.

One of my company's more ambitious projects was the creation of an infographic documenting the probability of stumbling upon any given piece of image-based web content. The luck factor prevalent in gambling was a springboard for our tagline, "How Lucky Are You To be Reading This Infographic?" The outreach campaign went far beyond standard infographic "directories," earning us links from the likes of Cheezburger.com (the heart of many viral pieces), Shortlist.com (known for their magazines in the UK), and even a Mashable.com editor's personal blog.

Top takeaways

  1. Focus on all media types. If you're conducting a video interview with a key industry figure, get it transcribed and make it into a podcast to maximise your outreach.
  2. Formalise a comprehensive outreach plan: Find relevant twitter influencers through Followerwonk, track down key bloggers through Google blog search and contact industry journalists through Journalisted to cover your story.

Three "guest post" examples

Here are three examples of the aforementioned tactics being put into practice. Naturally, I can't divulge too many leads!

1: The Bleacher Report: "Should Gambling Be Given The Boot From English Football?"


The Bleacher Report is the world's fourth largest sports website. It thrives on user engagement, and its article base is growing rapidly courtesy of an advanced contributor program. Anyone can apply to write for Bleacher Report, and after a two stage screening process, you're awarded admin rights to publish an internal article. I was accepted into contributor program after providing examples of my sports writing. The Bleacher Report prides itself on attributing relevant resources, so I decided to produce an op-ed piece about gambling in football with a link to Roulette.co.uk's internal blog posts; "Footballers in Vegas."

2: Growth Business: "Five Reasons To Start An Affiliate Business"


Growth Business is a highly respectable business news and advice website. It doesn't advertise guest posting opportunities, but I noticed that a range of entrepreneurs supplied content in the comments and analysis section. On the back of my experience in affiliate marketing, I pitched an original article "Five Reasons To Start An Affiliate Business." Lists are an integral part of content marketing: they're tangible, digestible and make for convenient reference points. Since I was referencing my own websites as case studies, I was able to embed organic links, and my contribution was duly accepted. I linked to other affiliate marketing resources within the article body to aid reader understanding and avoid any suspicions of commercial gain.

3: Grads Blog: "Gibraltar: An Opportunity For Graduates?"


The Grads.co.uk blog welcomes student and career-related content. It's a growing, multipurpose website offering career advice, job listings and interactive student engagement, so I expect the metrics to increase significantly over time. Having graduated a little over two years ago and moved to gambling operator hub Gibraltar, I offered a featured article on the merits of relocating and finding employment abroad. I embedded a link to my company's Gibraltar infographic, which included a vexel replica of the peninsula and important stats about its economy and lifestyle. I want to cement a long-term relationship with the editor and avoid the 'one-off' guest posting tactic so I offer monthly contributions.

Conclusion

It's worth noting that the aforementioned tips shouldn't necessarily be followed in order. Topic generation might be the last thing I do if I've forged an editorial contact and secured a regular writing gig. I might publish an internal article on a whim to establish a relevant backlink, or build a whole guest posting campaign around a static, linkable asset.

I've written this post with reference to the gambling industry. However, it can be applied to any difficult niche. Left-field topic generation, skilled feature writing and tailored outreach can generate sterling results.

Finally, I want to stress that these guest posting tactics are more than a link building exercise. They're something we tie into an overall, content marketing strategy to drive referral traffic and social shares. After a three-month implementation period, we recorded an overall referral traffic increase of 45.54% on the previous three months. The majority of this came from social websites, with overall social referral traffic increasing 247.98% in the same period.

Do you agree with these tactics? Have you devised your own, unique outreach plan?

I'd love to hear the Moz community's thoughts on link building for difficult niches!


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Seth's Blog : On owning it

 

On owning it

If you announce what you want, if you are clear about what's on offer, if you set goals...

  • the chances of accomplishing your goal go up, and so does...
  • the chance that you will be disappointed

For many people, apparently, it's better to not get what you want than it is to be disappointed. The resistance is powerful indeed.

Every time you use waffle words, back off from a clear statement of values and priorities and most of all, think about what's likely instead of what's possible, you are selling yourself out. Not just selling yourself out, but doing it too cheaply.

Own your dreams. There is no better way to make them happen.

       

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marți, 29 octombrie 2013

Mish's Global Economic Trend Analysis

Mish's Global Economic Trend Analysis


Four New Challenges to Obamacare: Can Any of Them Possibly Work?

Posted: 29 Oct 2013 07:03 PM PDT

A few days ago an article the LA Times announced LA Times More legal trouble for Affordable Care Act.
The Affordable Care Act proposes to make health insurance affordable to millions of low-income Americans by offering them tax credits to help cover the cost. To receive the credit, the law twice says they must buy insurance "through an exchange established by the state."

But 36 states have decided against opening exchanges for now. Although the law permits the federal government to open exchanges instead, it does not say tax credits may be given to those who buy insurance through a federally run exchange.

Apparently no one noticed this when the long and complicated bill worked its way through the House and Senate. Last year, however, the Internal Revenue Service tried to remedy it by putting out a regulation that redefined "exchange" to include a "federally facilitated exchange." This is "consistent with the language, purpose and structure … of the act as a whole," the Treasury Department said.

But critics of the law have seized on the glitch. They have filed four lawsuits that urge judges to rule the Obama administration must abide by the strict wording of the law, even if doing so dismantles it in nearly two-thirds of the states. And the Obama administration has no hope of repairing the glitch by legislation as long as the Republicans control the House.

This week, U.S. District Judge Paul Friedman in Washington, a President Clinton appointee, refused the administration's request to dismiss the suit. Instead, he said the challengers had put forward a substantial claim, and he promised to issue a written ruling.

"This is a problem," said Timothy Jost, a law professor at Washington and Lee University. "This case could have legs," although "it was never the intent of Congress to establish federal exchanges that can't do anything.
Might Such a Challenge Work?

After reading the LA Times article, I pinged a couple of very bright lawyers and asked if there was any chance such a strategy might work. One of them replied ....
Hello Mish

It's hard to say, especially since there were probably matching changes in the Internal Revenue Code as well.

Usually you can make arguments to help interpret language like this from its context by reading other sections of the law. But what if other sections of the law are worded similarly?

I tend to think that no one intended this result. Will the court rule on intent?

This is highly political charged and tight legal analysis goes out the window when politics enters the room.

It will be interesting to see what happens.
More Constitutional Challenges

In addition to the above legal challenge, the Constitution Daily discusses three additional complications. Please consider Is Obamacare's legality still in doubt?
From the very day in March 2010 that the President signed that measure into law, it has been under assault on three fronts: in the courts, in Congress, and in nearly three dozen states.   Its central feature is a mandate that individuals obtain health insurance, or pay a penalty to the Internal Revenue Service. Many Americans believe, and even President Obama has been known to say, that the Supreme Court has upheld that mandate.   Perhaps only lawyers and judges can draw a point so finely, but the Court last year actually upheld the penalty without explicitly upholding the duty to obtain insurance, and now both are scheduled to go into effect next year.

One of the reasons why Obamacare cannot escape repeated challenges in court is that it has so many parts to it, and arguments can be made against a good many of them. And one of the reasons that it may continue to be vulnerable, in a potentially devastating way, is that so many of the parts are interacting, and a court decision against one may have a spreading impact on others.

The reality is that the Supreme Court has only begun to be asked to reject key parts of the law, with more cases making their way through the lower courts.  There are four potentially very significant new challenges under way.

Within coming weeks, the Justices are expected to act on the first of this new round of challenges. That is a case being pursued by Liberty University, the religious college in Lynchburg, Va., which contends that the individual insurance mandate interferes with its and its workers' religious beliefs – a point that the Supreme Court did not consider last year.
 
The administration itself has asked the Court to review, in the current term, the part of Obamacare that requires employers with more than 50 employees to provide their workers with coverage for a variety of birth-control drugs and pregnancy screening methods. This second challenge developed in more than five dozen lawsuits across the country, with conflicting results that the Supreme Court is likely to step in to resolve.

The third new legal protest that may reach the Justices in coming months is a claim, now under review by a federal appeals court in Washington, that the penalty provision that the court upheld last year is itself unconstitutional.  The argument is that, since the Constitution requires that all tax and revenue measures must get their start in the House of Representatives, this provision is invalid because it originated in the Senate. A federal judge blocked that claim, on procedural grounds.

The fourth new challenge is just getting started in several federal courts around the country, and it apparently has major potential for disrupting Obamacare's interdependent scheme of coverage and thus is growing in popularity with the law's critics.

Under the law, if individuals' income is too low for them to afford insurance coverage, they are exempted from the mandate to buy it and can expect to be eligible for government-provided medical care for the poor.

But the government wants many of those individuals to be able to shop for affordable coverage on the new "exchanges," or insurance marketplaces, that the law creates.   To make them eligible, Obamacare provides a tax credit they can apply toward insurance premiums.  The tax credit offer is considered vital to making the exchanges work, to assure that many of the nation's lower income families get covered, and to assure that there are enough customers to keep insurance companies offering affordable policies in those exchanges.

The Internal Revenue Service has ruled that this tax credit will be available to lower income people in every exchange across the country. But the new lawsuits contend that the IRS has simply misapplied the law. The law, as they read its wording, says that the tax credit only applies to those shopping at an exchange run by a state government, not at the federal substitutes.
Will Any Challenges Work?

I am not a lawyer, but the first two attacks presented in the Constitution Daily seem narrow enough in scope the court could easily uphold Obamacare but allow individuals to opt out of aspects of the law for documented religious beliefs.

If someone has no insurance now, corporate or otherwise, and can prove on religious grounds that religion is the reason, let those persons opt out, under the proviso they never take medical care at taxpayer expense. How many individuals will that be?

The second attack is even sillier. After all, the law does not force anyone to take birth-control pills or undergo pregnancy screening. If a person does not want those procedures, the remedy is easy: Don't take birth control pills and don't undergo medical procedures you don't want!

The second challenge is so ridiculous it's no wonder Obama actually wants as Supreme Court ruling.

The fourth challenge is the same one presented by the LA Times. My friend offered an educated guess worth repeating "This is highly political charged and tight legal analysis goes out the window when politics enters the room."

I suggest the same may apply to the third argument "Obamacare is invalid because it originated in the Senate".

It is the third and fourth challenges that may have legs.

Second Thoughts?

One California resident with second thoughts says "I was all for Obamacare until I got the bill".

Recall that the Supreme court ruling was 5-4. Is it inconceivable that one of the 5 has second thoughts? If so, Obamacare may die a sudden death and we can start all over.

Let's hope so. This law, as passed is a clear boondoggle in more ways than one.

As many as 16 million Americans will lose their existing coverage that they want to keep. For details, please see More Obamashock! Glitches Hit Paper, Phone Applications; Obamacare Glitch Great Quotes.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Need a Hand? Boy Gets Prosthetic Hand Made by 3-D Printer (Cost $5 vs. $30K Medical Device)

Posted: 29 Oct 2013 02:02 PM PDT

What do you do when you cannot afford a $30,000 prosthetic hand that your son needs?

Two years ago, Paul McCarthy began searching for an inexpensive yet functional prosthetic hand for his son Leon, who was born without fingers on one of his hands.

McCarthy came across a video online with detailed instruction on how to use a 3-D printer to make a prosthetic hand for his son. McCarthy made a prosthetic hand for his son for a cost of $5 and free time on a 3D printer.



Link if video does not play: prosthetic hand made by 3-D printer

Large Mechanical Hand

A "large mechanical hand" invention by Ivan Owen is what kicked off the technological progression to "Robohand".



Here is an interesting, 49 second Video on Owen's Mechanical Hand

Dexterity To Children With No Fingers

As noted by NPR, 3-D Printer Brings Dexterity To Children With No Fingers followed "Mechanical Hand". Here are a couple of images.





From NPR ...
Richard Van As was working in his home near Johannesburg, South Africa, in May of 2011, when he lost control of his table saw.

The carpenter lost two fingers and mangled two more on his right hand. While still in the hospital, he was determined to find a way to get back to work. Eventually, solving his own problem led him to work with a stranger on the other side of the world to create a mechanical hand using a 3-D printer. Other prosthetics, including a lower jaw, have been made with the technology before, but making a hand is particularly tricky.

In time, Van As from Ivan Owen. In the video, Owen, a special effects artist and puppeteer in Bellingham, Wash., was demonstrating one of his creations, a big puppet hand that relies on thin steel cables to act like tendons, allowing the metal digits to bend.

The two began working together long distance — Skyping, sharing ideas, even sending parts back and forth. Finally, Owen flew to South Africa to finish the work in person with Van As. And today, Van As has a working mechanical finger to assist him with his work.

But something else happened on Owen's visit to South Africa: While he was there, Van As received a call from a woman seeking help for her 5-year-old son, Liam Dippenaar, who was born without fingers on his right hand. The cause was a rare congenital condition called amniotic band syndrome. In ABS, fibrous bands can wrap around a hand or a foot in utero and cut off circulation.

Van As says he and Owen looked at each other and were of one mind: " 'Yeah, easy, no problem.' "

Within days, they developed a crude mechanical hand for Liam, with five aluminum fingers that opened and closed with the up and down movement of Liam's wrist. Owen still remembers the 5-year-old's reaction when they rigged up the device for the first time.

"He bent his wrist and made the fingers curl," Owen says. "You could see the light bulbs go off and he looked up and said, 'It copies me.' It was really an incredible moment."

When Owen flew back to the United States, he wondered if the device could be turned into printable parts.

So he emailed MakerBot, a firm that makes 3-D printing equipment, to see if the company would help out. It did, offering both Owen and Van As a free 3-D printer. "Then there was no stopping us," Van As says.

What had previously taken the pair a week's time or more — milling finger pieces, adjusting and tweaking parts — now took 20 minutes to redesign, print and test.

Eventually, Liam's crude hand was replaced with the improved 3-D printed version, which Van As and Owen call "Robohand."

"After practicing with it for a little while, Liam was able to pick up a coin, grab objects of different shapes and sizes," Owen says. "He's a really determined little guy."
Need a Hand?

If you literally "need a hand" you can Download the Plans and Instructions for Robohand on Thingiverse.

With a 3-D printer and about $150 in parts, you can make a hand. It will work better than the $30,000 prosthetic hands you can get from medical sources.

Strike that. 3-D printers can now make a newer "Lego-style" Snap Together Hand for about $5. Here is an image.



Before any insurance companies approve $30,000 devices, they ought to look into what they can get for $5.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Senator Harry Reid Supports Giving Illegal Aliens Tax Credits for Kids Not Even Living in US

Posted: 29 Oct 2013 11:09 AM PDT

U.S. Rep. Sam Johnson, R-Texas, left, wants to end the practice of giving illegal immigrants tax credits for kids, but U.S. Sen. Harry Reid, D-Nev., won't let the House-approved measure H.R. 556 through the Senate.

"The System is Working Fine" says Senator Harry Reid, even though the Joint Committee on Taxation calculates that enactment of H.R. 556 would save taxpayers $24.4 billion over the next decade.
The House of Representatives repeatedly has passed an IRS bill that could save U.S. taxpayers up to $24.4 billion over the next 10 years — but Harry Reid's Democratic Senate will not hear it.

The Refundable Child Tax Credit Eligibility Verification Reform Act, or H.R. 556, would require tax filers to provide Social Security numbers to claim child tax credits.

Currently, the IRS allows undocumented residents to collect the $1,000 credits for dependents not even living in the country. Watchdog reported that illegal immigrants received $4.2 billion from the tax agency in just one year.

"My bill (targets) billions of dollars in waste, fraud and abuse. Instead of hitting up taxpayers for even more taxes, Washington needs to go after these billions of dollars," said U.S. Rep. Sam Johnson, R-Texas.

Though the GOP-controlled House has passed Johnson's measure three times, Senate Majority Leader Reid, D-Nev., refuses to allow the bill to come up for a vote in his chamber.

"The IRS has been doling out the credit to tax filers claiming children who do not even live in the country," Johnson charged.

Tax preparers agree that the system is broken — and that the IRS must fix it. They say the agency has to stop disbursing ACTC refunds based on Individual Taxpayer Identification Numbers, which are available to undocumented residents.

Tax preparers told Watchdog they have seen clients from Guatemala, El Salvador, Honduras and Nicaragua claiming Mexican children as dependents.

A 2009 TIGTA audit concluded that the child tax credit "appears to provide an additional incentive for aliens to enter, reside, and work in the U.S. without authorization, which contradicts Federal law and policy to remove such incentives."

Johnson's bill would impose a 10-year ban on tax filers who commit fraud and a $500 penalty on tax preparers who knowingly bilk taxpayers through the ACTC program.

"I just think the child tax credit is working just fine, and there's no need to punish children," the Democratic leader told the Associated Press in February.
Better Ideas

Johnson's bill would impose a 10-year ban on tax filers who commit fraud and a $500 penalty on tax preparers who "knowingly" bilk taxpayers through the ACTC program.

Proving that a tax preparer "knowingly" sent in a fraudulent return would be next to impossible. What if we paid tax preparers $250 for every illegal immigrant removed from the system?

Active incentives to weed out existing fraud would certainly work better than passive incentives to stop further abuse. If Johnson's bill would save $24 billion, my idea would surely save more.

One could reasonably go further and kill the program in entirety.

Hypocricy and Partisan Politics

One would hope that with budget deficits wildly out of control and with interest on the nation's debt piling up even with historic low interest rates, that common sense measures to save $24 billion would get easy passage.

But such hopes are dashed on the hard rocks of partisan politics. What one party wants, the other doesn't.

Moreover,  I am quite sure enough Democrats would vote for this bill if they were allowed. But they aren't. Reid has blocked the measure.

Recall the outrage by Senator Reid, the media, and the Democrats when House Speaker John Boehner would not allow a vote on a clean budget resolution bill.

Now Reid is doing the same thing, and it's costing taxpayers $24 billion. Where's the media outrage?

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com

Unnecessary Surgeries? You Bet! Doctors Treat Patients as ATMs; US Healthcare System Explained in Six Succinct Points

Posted: 28 Oct 2013 11:16 PM PDT

There is little to no incentive in the healthcare industry to hold down costs. Worse yet, the rewards for performing unnecessary surgeries is huge, while the risks of doing them are essentially nonexistent. Here are a couple of articles that show what I mean.

Prostate Cancer Radiation Therapy Rises as Doctors Profit

Bloomberg reports Prostate Cancer Radiation Therapy Rises as Doctors Profit.
Urologists who buy their own equipment to provide expensive radiation treatment are more likely to use it to treat prostate cancer even when the benefit for patients is unclear, research shows.

Prostate cancer is the most common tumor diagnosed in the U.S., where an estimated 238,590 men were told they had the disease this year. While only about 12 percent, or 29,270 men, will die from it this year, all will have to decide how, and whether, they want to treat the cancer.

A study published in the New England Journal of Medicine suggests that profits urologists make from referring patients to their own radiation facilities play an outsized role in the treatment decisions. One third of men whose doctors own radiation equipment get the therapy at a cost of about $35,000 per treatment course. The same doctors prescribed the therapy for just 13 percent of their patients before they had their own equipment and could profit directly.

"The results are striking," said Jean Mitchell, the author of the report and a professor of public policy at Georgetown University in Washington, D.C. "It does appear that what's driving this is financial incentives linked to ownership. Their behavior changes dramatically."

Claims Data

Using claims data from the U.S. government's Medicare insurance program for the elderly, Mitchell found that urologists who didn't own the equipment prescribed IMRT for 15.6 percent of their patients in 2010, compared with 14.3 percent five years earlier. Its use among the NCCN doctors stayed constant at about 8 percent, while it soared to 44 percent among a matched-group of doctors who started to refer patients to their own radiation treatment facilities.

Self-Referral

"It's crazy the way the system is set up," Mitchell said in a telephone interview. "The patients are going to do what their physician tells them to do. The patient becomes almost like an ATM machine, with the doctor extracting as much revenue as they can."

Ethical Practices

Physicians in general aren't allowed to refer their patients for treatment in facilities that they also own, because of the financial conflict of interest. However, radiation, as well as in-office ancillary services, such as doing blood work and x-rays, are exempted under U.S. law.

The analysis found that doctors who owned the IMRT therapy were treating men ages 80 and older just as aggressively as younger men with early stage prostate cancer. Since the cancer is generally slow-growing, and radiation can carry immediate side effects, including erection problems and urinary symptoms, the older patients may experience only the harms and no benefits.

The study bolsters similar findings with other forms of self-referral. In fact, some urologists have incorporated pathology labs into their practices, boosting the number of biopsies they perform, Mitchell said. Research has found similar results in other areas, including advanced imaging and surgery at physician-owned specialty hospitals.
Spinal Fusion Cash Cow

The Washington Post reports Spinal fusions serve as case study for debate over when certain surgeries are necessary.
By some measures, Federico C. Vinas was a star surgeon. He performed three or four surgeries on a typical weekday at the Daytona Beach, Fla., hospital that employed him, and a review showed him to be nearly five times as busy as other neurosurgeons. The hospital paid him hundreds of thousands in incentive pay. In all, he earned as much as $1.9 million a year.

Yet given his productivity, some hospital auditors wondered: Was all of the surgery really necessary?

To answer that question, the hospital in early 2010 paid for an independent review of cases in which Vinas and two other neurosurgeons had performed a common procedure known as a spinal fusion. The review was conducted by board-certified neurosurgeons working for AllMed, a company accredited to audit health-care businesses.

Of 10 spinal fusions by Vinas that were selected, nine were deemed not medically necessary, according to a summary of the report.

More than 465,000 spinal fusions were performed in the United States in 2011, according to government data, and some experts say that a portion of them — perhaps as many as half — were performed without good reason.

The rate of spinal fusion surgery has risen sixfold in the United States over the past 20 years, according to federal figures, and the expensive procedure, which involves the joining of two or more vertebrae, has become even more common than hip replacement.

Washington Post analysis of 125,000 patient records also shows that roughly half the tremendous rise in spinal fusions in Florida has been on patients with diagnoses that experts and professional societies say should not routinely be treated with spinal fusion.

In 2009, a former compliance official at the hospital filed a whistleblower lawsuit alleging illegal financial incentives for doctors. The court filings make available an array of documents — e-mails, testimony, audits. These and other sources allow a fuller depiction of the financial rewards and relationships that depended on treatment decisions. They also show how hospital administrators responded when suspicions arose that a doctor, who was generating millions in profits, may have been performing unnecessary surgery.

Vinas and his colleagues in neurosurgery earned as much as thousands of dollars extra — above their base salaries — for each procedure after a certain threshold. The vast majority of Vinas's earnings came from such incentive pay, according to legal filings.

According to government estimates, each neurosurgeon at Halifax Health was generating more than $2 million a year in hospital profits. The hospital charged fusion patients an average of about $80,000, according to Florida records on Halifax Health analyzed by The Post, ranking the procedure as one of the more expensive.

Baklid-Kunz detected Vinas's rapid pace of work in an audit and asked for further review of his surgeries, documents show.

But she was discouraged from investigating further, she said.

"Hospital administrators didn't want to touch Dr. Vinas," she said in an interview.

Instead, they referred to Vinas and the hospital's two other neurosurgeons as "our high rollers," she said, and told her that rather than cracking down on their billing that "we need to make them happy."

Medicare In the Spotlight

Medicare, the nation's health-care system for people older than 65, is at the center of the debate.

The agency estimated the amount of money spent improperly on spinal fusions was more than $200 million in 2011, for example, and most of that was because the treatment was deemed unnecessary, often because a more conservative course hadn't been tried, officials said.

How could this happen?

The answer, in part, is that the Medicare system is not designed to discourage doctors from performing it, according to past and present Medicare officials.

At a very practical level, the bureaucracy offers little incentive to weed out unnecessary treatment: Medicare hires contractors to issue payments to doctors, and those contractors are paid based not on how many claims they reject but on how many they approve.
above emphasis mine

US Healthcare System Greased for Fraud

Medicare pays contractors based on how many claims they approve. Good grief!

Very expensive prostate radiation therapy is conveniently exempt from self-referral laws.

Although physicians in general aren't allowed to refer their patients for treatment in facilities that they also own (with the exception of radiation therapies), the problem of incentives is universal, across the board.

Physicians paid on an incentive model, like spinal fusion star surgeon Federico C. Vinas, have every financial incentive to perform needless operations.

Every step of the way, the US medical system is greased to perpetuate fraud against taxpayers, against patients, against insurers.

US Healthcare System Explained in Six Succinct Points

  1. A constant battle is underway between insurance companies that do not want to pay any claims, even legitimate ones, and doctors and hospitals incentivised to rip off patients, insurers, and taxpayers with unnecessary surgeries and Medicare fraud.
  2. Insurance companies demand massive amounts of paperwork out of rational fear of fraud and unnecessary treatments. Doctors perform for-profit (as opposed to for-patient) procedures that guarantee more explanations and more paperwork.
  3. Doctors and hospitals have direct personal contact with patients, but insurance companies don't. In cases where doctors put patients at huge risk with needless procedures and surgeries, it's easy for hospitals and doctors to point their finger at insurance companies. On the other hand, many sincere, honest doctors have difficulty getting patients the care they should have because insurers believe they are getting ripped off by unnecessary procedures, even when they aren't.
  4. Doctors make needless tests out of fear of being sued for not doing them. 
  5. The vast majority of healthcare costs occur in final last year or so of someone's life. Politicians who want to do something sensible about this issue get accused of "rationing healthcare". 
  6. Doctors not only have a financial incentive to prolong life needlessly, they also worry about not prolonging life out of fear of being sued by family members unless there is a living will, and perhaps even if there is a living will.


Obamacare Failings

It would have been nice if Obamacare fixed some of the above problems. Unfortunately, Obamacare did not fix any of them.

Fraud, ridiculous amounts of paperwork, and incentives to do the wrong thing were everywhere you looked before Obamacare. The same problems exist now.

Worse yet, Obamacare added to the mess by over-charging millennials and their kids, and undercharging smokers and others with unhealthy lifestyles. Except for those below certain wage thresholds, insurance costs are likely to increase.

Mike "Mish" Shedlock
http://globaleconomicanalysis.blogspot.com