About Mark Cathcart

I am an Executive Director of Systems Engineering and a Senior Distinguished Engineer at Dell. Formerly I was an IBM Distinguished Engineer working for the Systems Group in NY and Austin. I'm also the ride leader for Jack and Adams Bicycle shop rides; I own the new Austin Triathletes and ATxD Multisports, a sports management company.

Out of control drugs

Of the many things wrong with the US Medical system, and there are a great many, not least it is the most expensive in the world, are the prices of ancillary parts of the healthcare system.

I’ve just been catching up on my bills, one of which was a visit to a chiropracter. A single visit, with a company provided insurance, my out of pocket cost was $485. Yes, it’s complicated, it involves deductibles, co-pays etc. and of course since it’s my only healthcare visit so far this year, I got essentially nothing from insurance. You then start to question what you got for $485. 10-mins with the specialist; 15-mins electrical stimulation; and about the same ultrasound. Sigh.

I have a mild form of psoriasis which randomly appears(stress?) on my right elbow, left thumb and a couple of other areas. It’s really no big deal, I use maybe two or three small tubes of Fluocinonide per year; in a couple of days and it’s gone. I went to get a replacement tube of cream from CVS recently. It’s a prescription cream, which comes with its own problems. The pharmacist gave me the cream and announced they’d changed providers and the price was now $8. No big deal to me, I can afford it. I paid and left.

Out in the car, I stopped and thought about it. I’d just been stung with 62.5% price hike. Seriously same active ingredient, same size tube; different generic brand. And there you have it, you have no control, no choice, no free market, it’s effectively too difficult to shop around because it’s prescription only. Yet, strangely you can buy it online for pets, it’s about the same price, meaning again, my drug insurance is effectively worthless.

The problem in America is that there is no effective control for the price of drugs. This report by Johns Hopkins Bloomberg School of Public Health report, highlights how this is commonly exploited, let alone specific deliberate abuse.

The 50 hospitals, they found, charged an average of more than 10 times the Medicare-allowed costs. They also found that the typical United States hospital charges were on average 3.4 times the Medicare-allowable cost in 2012. In other words, when the hospital incurs $100 of Medicare-allowable costs, the hospital charges $340. In one of the top 50 hospitals, that means a $1,000 charge.

Of the 50 hospitals with the highest price markups, 49 are for-profit hospitals and 46 are owned by for-profit health systems. One for-profit health system, Community Health Systems Inc., operates 25 of the 50 hospitals. Hospital Corp. of America operates more than one-quarter of them. While they are located in many states, 20 of the hospitals are in Florida.

For-profit hospitals appear to be better players in this price-gouging game,” says Bai, an assistant professor of accounting at Washington & Lee University. “They represent only 30 percent of hospitals in the U.S., but account for 98 percent of the 50 hospitals with highest markups.

We all pay the price for this abuse. It’s nonsense to think that a single payer, public healthcare system would cost anymore. If we had it, there would be drug price control. Those against price control often argue that would stifle innovation and invention of new drugs, they role out the enormous cost of bringing out new drugs and using the profit of successful drugs to underwrite research, and failures during the process.

This is simply invalid. Anyone who thinks that humans won’t become involved because they are prepared to standby and watch their fellow citizens die, is just plain wrong. While medical innovations have progressed dramatically over the previous century, the last 20 years specifically have resulted in monumental advancements that substantially increased medical care standards and improved overall global health, but most of those advances didn’t actually come from the actual drugs(*), but from a better understand about the human body, how diseases spread and much about healthcare. The real ripoff in drug use is both at source, manufacturers, and those that sell the drugs.

Lets hope the next President take drug pricing as a priority.

* Not withstanding massive public health crisis drugs, like HIV, Ebola et al. These serve as exactly as an example of the invention that will still come.

Happy July 4th

MV5BMTM5MDY5MDQyOV5BMl5BanBnXkFtZTgwMzM3NzMxMDE@._V1_SY1000_CR22,0,630,1000_AL_[1]This year is my 15th July 4th, as a Brit’ abroad, I take my annual message to the occupiers of the former British Coloney, now known as America, seriously. This July 4th, as you ponder the growing inequality, and the gap between the rich and poor, consider this quote:

this summer when you’re being inundated with all this bi-centennial, fourth of July, broo-ha-ha just remember what you’re celebrating- that’s the fact that a bunch of slave-owning aristocratic white males didn’t want to pay their taxes

from the teachers speech in the Linklater classic, Austin TX based film, Dazed and Confused. The film is set in 1976. Somethings never change.

It’s all greek < How the US owns the Greek crisis

It’s worth remembering that while people criticize Greece and their socialist aka “communist” government for overspending and debt, while they’ve not been in great shape since the late 1990’s, all the US Media coverage conveniently omits the fact that is was the illegal activities of the too-big to fail US Banks, and the fraudulent bundling of worthless US mortgages… that caused the 2008 crisis that took Greece down.

The NPR reporting of this is woefully inadequate, the LA Times at least mentions it.

Huffman Discloses Husband’s Financial Holdings

Not exactly the mea culpa no one expected anyway, but rule #5 in the list of excuses when you get caught with you hand in the jar. #5 “For every action, there should be a reaction” > Justify your loophole by blaming another law for over reaching, that’s a typical GOP tactic, claim something is overreach and then hide something when undoing it, mostly because, like a cheap magician you’ve used slight of hand to distract.

The Texas Tribune has details, Huffman Discloses Husband’s Financial Holdings.

In full disclosure, I am a donor and member of the Texas Tribune and a principal sponsor of their livestreaming kickstarter.

Abbott Vetoes Spousal Loophole

Law_Enforcement_Ethics_3920_TCOLE_TCLEOSE_OSS_Academy_Texas_Telecommunicators_Online_Training[1]Since I’ve criticized Governor Abbott numerous times, I figured he deserved a quick post for vetoing the ethics bill that contained the spousal loophole as discussed in my Ethics the Texas Way post.

As predicated though, when doing so, the Governor did do his best Sepp Blatter impersonation, saying

“Serious ethics reform must be addressed next session — the right way. Texans deserve better.”

Of course in the mad way that Texas governs, that really means 2017. Maybe Sepp Blatter will be gone by then, but Texas ethics won’t have advanced. At least we will be able to see what the Spouses of the legislator are doing.

What many of us suspect goes on all the time in Texas in what is called the ol’ boy network is best seen in action by the sponsor of the Spousal loophole herself, state Sen. Joan Huffman, R-Houston. Turns out Sen Huffman is facing an ethics complaint related her own spouse. It is alleged the senator filed “false” information by failing to list more than 35 businesses in which her husband has a stake. Off the Kuff has a good round on on Sen, Huffman.

Texas ethics at its best. Well done Governor Abbot for vetoing the bills, they were not the ethics reform you were looking for. Hopefully by 2017 the legislator will take more notice of you than the board of FIFA did of Sepp Blatter.

War, what is it good for?

as we head towards the American 2016 Presidential Primaries, and given the continuing falling apart of the manufactured countries in the middle east, there will again be the inevitable warmongering hawks who’ll claim that we should bomb this, bomb that, or that we should have never pulled the troops out.

Yesterdays staggering revelations by Tim Weiner on Fresh Air, about American President Nixon, and Nixons utter contempt for the American public, and the total waste of lives among those who fought, and suffered Nixons war, contrasted magnificently with a docu-drama about London in the 2nd World War that I caught on TV Sunday afternoon while surfing channels.

Before you think I’m about to get all holly and sanctimonious about the British, I’m not. The documentary, available in 2-parts on YouTube(see below). It’s not significant because it’s about the British, or London, or anything related to my ancestry. It’s significant because as you listen and watch

“My feeling was one of anger, this is my city, whats happening out there, how dare they? It was ones’ own history burning, and who has any right to do this? How would you feel if you’d watched it? Your own home city burning. Put yourself in the shoes of the people that were watching that night” – Jessica Jacob

“The more we were hit, the more we had this spirit. I think they thought they could actually bomb us into submission, but it did the opposite. The more that was done to us, the more we responded by OK, we can take it, get on it with it, we are not going to submit.” – George Wheeler

“If someone came to your house and said I’m going to destroy it, and you’ve got a wife and children, you are going to fight like fury to save it, and thats what happened here. I’m not going to forget it, I don’t want to forget it.” – Richard Holsgrove

It is not about Britain, not even about America, watching the documentary about the London firestorm it is easy to imagine bombers bombing Iraq; the British bombers over Dresden; anonymous, invisible drones over Afghanistan; Japanese fighters flying into Pearl Harbor; the words of Jacob, Wheeler and Holsgrove would ring true from any human.

War, what is it good for?

npr embed


FIFA vs The Government

I heard the BBC reporting the Governor of the Bank of Englands remarks that the “age of irresponsibility” in the City of London is over as the Bank of England promised a crackdown on rogue traders. In a speech on Wednesday evening, the Bank of England Governor said that banks, regulators and individuals had collectively failed to prevent the market rigging that has led to bank fines worth billions of pounds and he recommended tougher rules for the City and longer jail sentences for those who attempt to manipulate markets.

This is a very British approach to a problem, introduce tough penalties, regulations and make things illegal. It made me wonder, how would either the British or the US Governments deal with FIFA, if FIFA was either a UK or US Registered company.

FIFA_Logo[1]The contrast couldn’t be more stark. In the UK they would spend ages trying to bring FIFA to court under numerous, increasing complex and confusing rules. The trial would last years and cost millions, only to collapse at some point for legal reasons.

Meanwhile, the US Government, rather than push ahead with an Untouchables Style prosecution, as it seems to be. They would settle for a financial penalty, and we’d have never heard about the FIFA corruption until the settlement was announced. FIFA currently holds a reserve of $1.52bn, so no problem in paying US Governments fines. Ironically, paying fines is of course a form of legal bribery not to participate in the theater of court, the exact opposite of what FIFA stands accused of, taking money to allow countries to participate in bidding and holding the theater of the World Cup.

Toyface: Follow the Rules of the Trainwreck

Cover art pictureI’ve not covered music and arts projects I am, or have been involved here, much to my changrin. My film ventures have taken a back seat this year, although Moving Day continues to garner awards, my role as Associate Producer has long passed.

Yesterday I had the chance to catch-up with Tamysn and James the two driving forces behind toyface. They are just off their frantic album launch phase, I was Executive Producer for, and we talked on Skype to look at the next few weeks and getting a promoter and publicist involved to help them gain wider attention for the album.

You can hear and buy the album from bandcamp, here. If you have any radio contact, even here in the USA, or especially in Austin, I have a few CD’s that I can send you to help promote their work.

If you like what you hear, they also have a soundcloud page here, which has some great remixes, including this one from Oilver Si.

Ethics the Texas Way

Just a few months ago, I’d have started this blog post with a comparison between Texas and a 3rd world government. Now, maybe I’ll be able to compare 1st term Texas Governor, Gregg Abbott with FIFA President Sepp Blatter.

BlabbottEvery FIFA Congress for as long as people can remember, Blatter has declared it’s time to clean up FIFA, as we know now, it’s never happened. Back in February, Governor Abbott declared five emergency proclamations for the 84th Legislature, The Governor’s issuance of an emergency item message to the Legislature enables that measure to be considered within the first 60 days of the legislative session.

Included in the five was this proclamation on ethics.

The faith and trust that Texas citizens place in their elected officials requires each of us to conduct the business of the state in the most transparent and honest manner possible. Strengthening our ethics laws relating to disclosure of state contracts with elected officials, prohibiting lawmakers from voting on legislation from which they could profit and increasing disclosure of campaign finance information will ensure a more responsible government for Texas.

So, the 60-days are up, they’ve pretentiously declared sine de which is a whole ‘nother issue. So, how’d the 84th Ledge do?

Well, in theory they had legislation to consider what were some of the most radical considered in years or even decades, including restricting legislators leaving and going straight to work as lobbyists, banning lawmakers from making money off of public debt-financing deals; and taking government pensions away from politicians who are convicted of public corruption charges.

In reality, what we got was

  • Special treatment for politicians and bureaucrats giving the ability to be tried in their home districts rather than where they commit corruption, giving them “home field advantage”.
  • A new way for Senators and Congressmen to avoid financial disclosure.
  • Continuing to avoid disclosing wining and dining by lobbyists.
  • A new spousal loophole that allows politicians to hide details about their spouses’ financial dealings.

What we did get was

  • Parity with the Federal bill that forced former Governor Perry and then (1st time) Presidential candidate Perry to disclose he was receiving a pension and salary at the same time from the State. Texas law at the time allowed this and allowed in to be secret.
  • A couple of other disclosure requirements including disclosing financial interests in State contracts.

Overall, pretty weak, hardly compelling, and definitely not the emergency legislation proclaimed. If Governor Abbott signs these changes into law, he has set course for a bi-annual Sepp Blatter moment.

If politicususa is right, and in actually went down like this, that’s pretty much how South Africa was awarded the 2014 World Cup minus the 15-deaths.

Koch-Pays-Abbott-Plays[1]

Greed, taxes and a lack of empathy

It’s tax time in Travis county and Austin, that means it’s the annual hand wringing and whining because the property values are up again, by huge amounts.

gop_greed_over_people_badge-r5803b6831b244f1ab8d9e1519c522292_x7j3i_8byvr_324[1]Taxes are all relative. The total of tax paid is still stunningly low compared to the quality of life and services you get for that. Yes, property taxes are high, but sales tax is relatively low, there is no state income tax, and while the Ledge and Republicans have you convinced that Federal Taxes are high, and money being wasted on drug taking, idle, work shy, “minorities”, it doesn’t matter that that is or is not true, taxes are not really high.

I have never had children in school in Austin, and will never have. I would guess I’ve paid over $60,000 for that choice alone. I’m guessing when most people complaigning were born or arrived in Austin, there were already schools? If thats true, someone paid for them. Probably a lot of people paid taxes for them and couldn’t use them as they were still being built. I’m guessing when they arrived the city had services, roads and other common amenities. How did they get there, someone paid taxes for them.

Those complaining are simply paying for the next generation and you are paying so that those families who can’t afford private education, have some expectation of having children who have a chance in life, and don’t become a burden on the same tax paying society.

I think the problem many of us have, is, those that complain about taxation seem out of touch or sheltered by comparison and lack empathy or sympathy for the real challenges. While I don’t know you, or anything about your quality of life, I’m guessing you don’t worry about water, food, and live in fear because you live in a dangerous environment? All the facilities, effort, and labor that goes into providing the conditions that allow you to live that way, were in general, provided by taxation. Usually that taxation was provided by someone else, your forefathers, others, the people that founded your city etc.

Too many people these days lack empathy, they are, in some respects selfish. They demanding they keep more of THEIR income, and not understanding that if they had to pay their fair share for the free facilities they get to use, in what is essentially a pretty dam good 1st world life, would be paying way over 50% of their total income in taxes. Even if taxes stayed the same, that would mean real cuts being made. Those cuts almost always are targeted at the people who will complain least, because they often are in real fear, too busy getting by.

Yep, I hate the way property taxes are done in Travis County, it’s a sham. Businesses are not assessed fairly, there are too many suspicious valuations. However, while my income has stayed relatively flat since I arrived in Austin from the UK via New York City, my total gross income is still way up and I do not participate in any tax avoidance schemes. So when the politicians promise homestead exemptions, reducing the tax bill etc. they are doing nothing but pandering to the lowest common denominator, and increasingly that represents a generation who don’t understand how good they have it.