Thursday, December 2, 2010

Truly Alien Aliens

With today's news from NASA about arsenic-substituted microbes from Yellowstone, I've decided to vent about an issue that has bothered me for many years.  Nearly everyone that talks about alien life commits horrible acts of anthro-bias.  The most annoying canard is the assumption that life will require water.  Astronomers focus their hunt for planets in the 'goldilocks zone', not because it might harbor nice planets for humans to live on, but because it is somehow more likely to support any kind of life.

I don't see any strong reason to assume that alien life will resemble life on Earth.  Perhaps Star Trek polluted everyone's mind with visions of bipedal blue-skinned aliens that just happen to be the same size as us?

There are two huge anthro-biases of scale: size and time.  A single example can explain both: imagine a life form in a gas giant (like Jupiter), where each individual's diameter is measured in kilometers.  For obvious reasons this lifeform will 'run' at a slower pace than something that is our size... it may take hundreds of seconds for a signal to move from one part of its body to the other.  The organism, were it intelligent, might experience time at a far slower pace than we do.  The time between stimulus and action, e.g., a decision to move away from a threat, might be measured in minutes.  Such an organism might seem horribly impractical to you, but from the point of view of the organism - that's just the way time moves.  It might view humans as outrageously frenetic; an exaggeration of the way we look at hummingbirds.

A contrasting example comes from Robert Forward's book "Dragon's Egg", where a nano-scale lifeform evolves in a matter of weeks on the surface of a neutron star.  Most likely it was this book that originally opened my mind to the idea of truly 'alien' life.

Other biases are easy to spot now: assumptions about gravity, density, temperature, etc.  I believe life will arise any place where a certain threshold of complexity is met.  In Earth's case, the huge oceans, freely mixed, with an abundance of heavier elements are probably what made the difference.  Carbon chemistry has definitely been a big win, but is it really impossible to imagine other kinds of 'organic' chemistry, like Silicon?

Thursday, November 4, 2010

How government broke the auto industry, an alternate history.

How broken is health care?  Very.

Trying to explain how broken our current health care system is a difficult task, because it's nearly impossible to imagine an 'unbroken' system.  It's a counterfactual.  The system has been broken since the 1950's.  The fact that it just keeps getting worse makes us long for the days of our youth, when it was only 'mostly dead'.

So I'm going to try an analogy tack.

What is it that is broken about health care?  Well, the prices are out of control.  The costs of health care spiral year after year, always outpacing inflation.  This is an unsustainable situation.  But how did this happen?

Imagine if the government stepped in and mandated that employers pay for your auto insurance.  Actually, that's not quite right, the original sin is more subtle.  The government provides a *tax break* to employers who pay for your auto insurance.  Now let's follow this exercise through, and see some of the follow-on effects.

First, you quit really shopping for your auto insurance.  It comes as a perk with the job.  The best jobs will offer you outrageous auto insurance plans, where you can basically plow through a flock of BMW's in a parking lot with your Bentley and walk away unscathed.

You're not the only person taking advantage of this perk.  Lots of people are.  The end result is a rise in the accident rate.  Also, the subtle market pressure that would have made people want to buy cars that 'break' less is gone.  So cars become flamboyant and fragile.

Now, let's imagine what happens to the auto repair business.  Well, you take your car down to the shop to get it tuned up.  They replace some fluids and belts, and check the air in your tires.  Then they tear down the engine to replace all the gaskets and o-rings.  What?  Well, it's the only way to be sure, sir.  Can't risk having the engine blow out, that would be dangerous!

When they're done with your car they don't give you a bill.  Instead, you just file a claim with your insurance, and they take care of it.  You don't notice that it cost over $2000 to get your car 'tuned up'.  But even if you did notice, you wouldn't really care.  Because you're not paying for it.

And cars are no longer built to last.  The design of cars actually changes over the years, to one that favors cheaper manufacture, but requires regular maintenance.  Some cheap cars are essentially rebuilt every 12 months.

After decades of this broken system, the cost of auto insurance begins to dominate the cost of an employee.  Companies are in trouble, and they want to back down on these insurance plans.  Some companies try to get by without providing auto insurance to their employees, but they are demonized by the public.  Some try to offer scaled-back plans, but this is no better... the cost of auto insurance has risen to ridiculous levels, and few could afford it without employer subsidy.  The government has a plan where the elderly and the poor get assistance with their auto insurance, but many people are still unable to drive.  Or they decide to drive without insurance.  That's right: we get the elderly and the poor driving these fragile, unreliable vehicles out on the roads with no insurance.

Now, how will you fix this broken system?

Saturday, October 30, 2010

can exaggerate how much the U.S. sucks

This is a response to a self-hating paragraph in a Thomas Friedman column.  I typed this in a hurry, and it's woefully incomplete.

The original article is here: Can't Keep a Bad Idea Down

Although it mostly talks about how the Tea Party sucks and the Republicans are dragging us into hell, this paragraph pissed me off:

"Here is a little dose of reality about where we actually rank today," says Vest: sixth in global innovation-based competitiveness, but 40th in rate of change over the last decade;"

This is not bad, considering we are competing with relatively small countries like Norway and Hong Kong.  And of course when you're already near the top your rate of change is likely to be small compared to places like China, who have nowhere to go but up.

11th among industrialized nations in the fraction of 25- to 34-year-olds who have graduated from high school

Again, probably not as shocking as it sounds.  We're a big, diverse country, and it's harder for us to compete with a country like Germany that has a low birth rate.

16th in college completion rate

This tells me nothing.  Perhaps we throw more people into college than we should?  Maybe we have state-subsidized college education that encourages the children of the wealthy to party for a couple of years before giving up?

22nd in broadband Internet access

Fiber-to-the-burbs!  So grandma and grandpa Kim in South Korea have gigabit fiber to their apartment?  Why?

24th in life expectancy at birth

Don't have a quick answer for this one.  Get back with me.

27th among developed nations in the proportion of college students receiving degrees in science or engineering

And yet we have a higher education system that is the envy of the world.  Why do students from all over the planet come here to study science and engineering?

48th in quality of K-12 math and science education

Again, difficult to believe.  How is this measured?

29th in the number of mobile phones per 100 people.

That's because we still cling to land lines.  This is totally disingenuous.  There are many poor areas of the planet that have leap-frogged over landline technology directly to cell phones, this should be something to celebrate, not used as some kind of criticism of the U.S.

Saturday, June 5, 2010

Hammers and Operating Systems

When the only tool you have is a hammer, everything looks like a nail.

I've had the good fortune to play around with Windows Vista a little over the past couple of weeks.  I've been considering the upgrade to Windows 7, so I've read up a little on the newer features in Windows.

As a security-conscious developer, all the new security features in Windows sound very impressive.  You've got your DEP (data execution prevention), your ASLR (address space layout randomization), your stack canaries, stack-smashing protection, sandboxing, virtualization, etc...

When I first saw all these 'technologies' described in one place, an image leaped into my mind.

Picture a guy holding a hammer.  He's wearing special metal gloves to stop from smashing his fingers.  He's got a sophisticated helmet and face shield to keep from bouncing the hammer back into his own head.  He's got a safety harness on, and there's a 10-ft exclusion zone around him to make sure nobody else gets hurt.  It takes him about 5 minutes to hammer a nail in.

Of course, the guy is a developer, and the hammer is C.  (a more apt metaphor might be a hand-made black powder rifle, but stay with me here...).  Instead of fixing the inferior tool that's used to build things, they try to mitigate the damage it causes.  Every one of these 'technologies' is needed because the C language is inherently unsafe.  Even a highly skilled programmer with decades of experience can still make the kind of mistakes that lead to your system getting pwned by the Russian Mafia, and it's all because of this antiquated, unstable-land-mine of a language.

There's no good excuse for writing critical infrastructure like operating systems (or applications) in a language like C.  There are plenty of bad excuses.  For example, "it's difficult to hire people to write code in better languages, there aren't enough of them".  That's like complaining that everybody's trained to use a hammer, and it's too hard to train people to use a nail gun.

It's not like the technology isn't here.  Microsoft themselves have been working on an entire suite of tools to replace C (C#,F#,.NET, Singularity, etc...), but they haven't been able to pull the trigger yet.  Why is that?  It's true that the development timeline for a huge project like a new operating system could easily span 10-15 years.  But let's not make perfect the enemy of good.  They could start by rewriting IE in C#.  They have the talent, they have the tools, the ability.  That one simple step would make Windows far more secure.

You'll notice that I haven't mentioned either Apple or Linux yet.  That's because they're nowhere near as far along as Microsoft is on this front.  Yup, I said that.

The Great Divide

One big reason for the foot-dragging (or should I say knuckle-dragging) are systems programmers.  These guys are true Luddites, and they cling, snarling, to their 40-year old tools.  They want nothing to do with the highly mathematical, cryptic, and slow-as-molasses-in-January high-level languages like ML.  The thought of garbage collection gives them that sinking feeling of lost control you get just after the plane takes off and throttles back a little.  These two camps - the systems programmers and the high-level language guys - don't interact at all.  And the high-level language guys are just as much to blame.  They're often ignorant of the needs of systems programmers, and even when they are aware of them they dismiss them.  Their languages are too hard to use, too hard to read, and too hard to write, and one reason is that they still live mostly in academia, where the motivations are all twisted the wrong way.

I've spent some time in both camps, and would dearly love to bridge them, if for no other reason than this: until it happens there will be no secure operating system, and no secure applications.  Also,  it's a little lonely being one of the few guys that knows how to use the nail gun.

I know of only one project that's trying to bridge the gap, and that's BitC.  If you're interested in both sides of the bridge, you should read The Origins of the BitC Programming Language.

Thursday, May 27, 2010

The Ultimate Database

I've been digging around in my genome, using the data collected by 23andme.  They collected about a half million SNPs, or "single-nucleotide polymorphisms".  Each SNP is a single-letter change in DNA that researchers have teased out by comparing genomes between humans, and even between humans and other animals.  You could say that our SNPs are what make us each unique individuals.

For example, the SNP rs12913832 has been found to have a very high likelihood for predicting blue eyes.  I have "GG" in that location, which is spot on.  But wouldn't it be cool to look at that bit of DNA?

That's where the UCSC Genome Browser comes in.  This has got to be the coolest database browsing tool I've ever used.  Yeah, it's a little clunky, but when you think about what you're looking at, you are gobsmacked.

Here is the zoomed-in view of the SNP for blue eyes.

In the center of the image lined up with the SNP you will see a series of A's.  This shows that in all of those animals, that portion of the HERC2 gene has an A there.  In other words, it's a "highly conserved" allele.  The graph in the center portion shows how conserved that area of the gene is within the animal kingdom.  The HERC2 gene encodes an enzyme that controls the OCA2 (oculocutaneous albinism) gene.  Stuffing a G into that location causes blue eyes.  (yes, I'm simplifying a bit).

Ok, now to explain a bit more of what's going on in the browser.  Above the main image is a smaller image.  That's a picture of the actual chromosome, in this case Chromosome 15.

You can navigate through the chromosome by hitting the left and right arrow buttons, and zoom in and out.  The image changes radically depending on the level of zoom, showing different levels of detail.  The number of SNPs gets very dense as you zoom out.

Here's another interesting gene, TTN.  This encodes a muscle protein Titin, and is the largest gene, encoding the largest protein known to man, with the chemical formula C132,983H211,861N36,149O40,883S693.  It's just one springy piece of the complex mechanism that muscles are made of.

Looking at the section in the middle you can see that the TTN gene is highly conserved, forming that dark band down the middle of the image.  Even the stickleback has a very similar TTN gene.

The dense graph on the bottom are the SNPs in this region of the chromosome.  Each of those SNPs is a potential area for research.  It's staggering how much is known already, but even more amazing is the sheer size of this project, the database, and animal genomes.

If you scoot over a couple of pages to the left from TTN, you'll find the Homeobox D (or HOXD) genes.  These affect things like limb development.  If you type 'HOXD13' in the gene box and hit 'jump', you'll zoom in on that single gene.  Somewhere in that gene I have a mutation that gives me strange thumbs, just like Megan Fox.

Friday, April 23, 2010

Lipitor - another sign of a completely borken market

Atorvastatin, a.k.a Lipitor, is the best-selling drug in history.  Annual sales are nearly $13B.

Lipitor is a great drug, and it probably saves a lot of lives.  The patent expires next June, so expect to hear how a slightly reformulated Lipitor is actually much better for you over the next year.

Since I'm paying my own health insurance costs these days, I got quite the shock in January when I had to meet the deductible for my meds.  For the first time in ten years of taking Lipitor, I actually tried to find out how much it cost.

Walgreens wasn't allowed to tell me how much it cost.  But they wanted to!  And since I already knew the scam, no harm was done.

You can look this up yourself, on  100 Lipitor pills @ 20mg costs $415.  Guess how much 100 pills @ 40mg costs?  $415.  And the 80mg?  Yup, $415.  I could have been saving about $1200/year by chopping 80mg pills into 10 or 20mg pills.  (Since the half-life of atorvastatin is only about 24 hours, it would probably be a bad idea to take a larger dose every other day).

The kind folks at Walgreens pointed out that some insurance companies actually require their customers to get the higher dose pills and chop them up.  But nobody designs a pill to be chopped into 8 pieces.

Pfizer considers chopping up the pills to be a form of 'cheating'.  From their point of view (and I have some sympathy with it), they are renting you their intellectual property, and in a way that doesn't discriminate against people who need higher doses.

Understand, my complaint here isn't about Pfizer's pricing strategy.  My complaint is that the vast majority of people taking Lipitor have no idea how wildly expensive it is, and that there's a simple way to cut the price down to a small fraction.  Most of those people just don't care.  And that is what is broken in the health care market.  That simple problem explains most of the unsustainable rise in health care costs.

Now for the kicker... you can buy generic atorvastatin from overseas pharmacies for a fraction of the cost of Pfizer's product.  A sample price - $75 for 100@20mg.  That's actually less than my co-payment through my insurance company.  Prices will plummet further by next year.

Thursday, April 22, 2010

Tea Party Freaks

I don't know anything about the Tea Party.  Their website claims three tenets: Fiscal Responsibility, Limited Government, and Free Markets.  As a libertarian, I couldn't be tickled any pinker by the idea that a huge movement has embraced half of my political ideology.

But everything I see in the news and on the net seems to be making fun of them, and some of this criticism is pretty ugly.  I'm looking at you, John Stewart.

When I was involved with protesting Gulf War I, I spent a lot of time around protesters on the left.  Yup, I was one of them.  I was even kind of involved in organizing some of it.  One of the things you could count on with any protest was the Freaks.  We had some freaks.  And it was a little annoying to me, since I wanted to get my freak on, but when a TV camera scans over you and your pals, the marijuana-leaf t-shirts, giant pink afros, conspiracy nuts, and wide-eyed crystal-worshiping space aliens, you can fall a little off message.

To combat this, at one protest (in front of an Orlando TV station, for sponsoring a "bring your kids to visit the Patriot Missile and crew" event...) I even wore a suit jacket and a tie.

I suspect there are a few suit-and-tie folks at the Tea Party protests wishing that the tiny fraction of 'birthers', racists, and red-baiting nutjobs would stop drawing attention away from their main point: that  the government and the tax burden are growing unsustainably, and that a massive expansion in health care smack in the middle of the worst economic crisis in generations might not be the best idea.

Hey, you know how it makes you feel when someone calls you a 'socialist' for supporting health care reform?  Yeah.  That's how the tea party people probably feel when you portray them as illiterate racist rednecks.

Wednesday, April 21, 2010

why you don't want network neutrality

It's nice to go down to the grocery store and buy a loaf of fancy whole-grain organic unbleached homeopathic artisan bread.  But sitting a couple shelves lower is the wonder bread, at a fraction of the price.

Advocates of "network neutrality" want you to believe that wonder bread will kill you, and want to make everything but the fancy whole-grain bread illegal.  That means fifth-grade kids will have to eat peanut butter and jelly sandwiches on 'ferrari bread'.

Let me explain the difference between the breads.  See, about 90% of the bandwidth on a network like Comcast's is used by something like 1% of their customers.  Those customers are almost certainly using bittorrent to exchange  huge media files, much of it (though not all) illegal copying.  The other 99% of customers are paying for all the extra infrastructure needed to support this.

Comcast (or any other high-speed ISP) would love to segregate those customers out, and offer a cheaper product to the masses.  Right now they achieve this partially by filtering or slowing down the traffic used by the gluttons.  But if 'network neutrality' laws are passed,  Comcast won't have that option.  They'll be forced to feed the gluttons from everyone else's wallet.

Yes, I hear ya.  I know, yeah... big bad corporations are going to block protocols that they don't like.  They'll likely censor data, spy on you, etc.  They'll likely sell cheaper access to their networks to their corporate friends and co-sponsors.  Oh, the horror.  It might even one day lead to free network access for the non-porn-sharing majority.

My solution: let them.  As long as you give me the choice to pick another provider, one that doesn't filter or tarpit my data, then I'm fine with it.  I'll be happy to pay the premium.

What you should watch out for: when they make network neutrality illegal.  When the government starts filtering or blocking anything that looks encrypted.  Stop lobbying on Google's behalf, and lobby on your own: it's the government you need to fear, not 'corporations'.  Because every Comcast will have an AT&T breathing down its neck.  But there's only one Big Brother.

Richard Dawkins in Hiding

Jul 7, 2011 (Reuters) Evolutionary Biologist Richard Dawkins has disappeared from public view after narrowly escaping an abduction attempt by members of the fanatical Teapot Church.  Several of his speaking engagements have erupted in madness, when thousands of followers overwhelmed security, forcing the audience to flee. Earlier this year the religious group publicly declared Dawkins to be the "Second Coming", based on interpretations of biblical scripture and the writings of Nostradamus.  According to his spokesman Robert Nearly, "Richard is quite terrified - he doesn't understand why a cult would choose one of the world's most outspoken atheists as their savior.  He is baffled."  Although many theories have been proposed, Dr. Ebenezer Grue, Professor of Religion at Cornell University, believes "this may have something to do with the Pope".

Wednesday, March 24, 2010

soldiers and drugs

The military is worried about all the drugs that soldiers are taking:

Abuse of pain pills by troops concerns Pentagon

Senator Jim Webb has made comparisons to his time in Vietnam, when soldiers were mostly getting hooked on heroin.  Now it's prescription antidepressants and pain killers.

Your first reaction may be to wonder how things have changed... but I bet they haven't changed much at all.  One of the things that most people don't know about the opiates - they are some of the best antidepressants known to man, even in this modern age of Prozac.  They haven't been prescribed that way since the 1950's, because they're addictive (and somewhat dangerous).

Most likely war is a pretty depressing thing, and soldiers who can't get treatment one way will find it another way.  So they take speed on the way in, and opiates on the way out.

Tuesday, March 16, 2010

"Hurry up on healthy food"

The administration is telling manufacturers to hurry up and make food more "healthy". The hidden message with this sort of prodding is that if an industry doesn't move voluntarily, they'll sic the Congress on you and make it a law.

The problem with such government meddling: it assumes that we know what 'healthy' is. Not only does the government not know what 'healthy' is, neither does Science. We have some ideas, but nutritional science should have a little more humility.

For a while now, evidence has been accumulating that we don't really understand how or even whether fats are bad for us. Thirty years ago Americans dropped butter as if it were made at Love Canal, and switched to margarine. Of course, now we know that margarine is actually worse than butter, and that the ill effects of butter were exaggerated. Similar damage was done to the reputation of Palm Oil and other saturated fats.

Conventional wisdom holds that lots of fat in the diet leads to high cholesterol and other problems. But the evidence shows otherwise:

Metabolic Syndrome
After decades of lazy 'consensus science', researchers are taking a fresh look at 'metabolic syndrome' - the very heart of the current 'obesity epidemic' - and may (once again) learn that we've been given bad advice:

A Game of Consequences?

The Food Pyramid
Another great government victory... not. The 1992 food pyramid turns out to have had a lot of problems. Of course, the 2005 pyramid is much better. We should all switch to its guidelines immediately. Not.

My Point
You should view dietary pronouncements with a healthy dose of skepticism (but no more than 1000mg daily!). It's one thing for the government to distribute dodgy information - another entirely to legislate on it. Science has a particularly bad reputation in this area - it doesn't help that food choices have a kind of 'moral' component to them. Government has no business telling people what to eat.

By the Way
If you've never tried Foie Gras, you might want to do that soon. In some parts of the U.S. (including California) it will soon be illegal.

Friday, March 5, 2010

Nerds and Diet Coke

Have you ever wondered why nerds drink so much Diet Coke? So did I.

My Diet Coke habit started in about 1986. Within a year or so, I was up to 4 liters a day, sometimes more. That's about 12 cans in a day. I drink morning, noon, and night. I knew other nerds with the Diet Coke Monkey on their backs, but didn't think much of it. Once, my friends at NASA tried to help me kick the habit, but after a few days of Head Down on the Keyboard they enthusiastically supported my return to the caffeine.

I once lived in an apartment with some other nerds, and we collected the empty 2-liter bottles. Eventually we had enough to fill the kitchen to a depth of a couple feet, like a ball pit. Good times.

When I moved to Silicon Valley 10 years ago, it made perfect sense that Diet Coke should be free to all engineers. It would be insane to do otherwise.

The first glimmer of understanding came when my wife and I were considering getting ADHD meds for our 9 year old son. We had resisted this for a long time. I started to read about the symptoms, and the drugs, and how they worked. Mostly stimulants. They have a 'paradoxical' effect of calming you down and allowing you to concentrate on things.

Then I realized that all those jokes about my 'intravenous diet coke' maybe weren't so funny. Or at least not in the same way. Wow. I had been self-medicating for ADHD for over 20 years.

Ok, so you might be wondering "Why Diet Coke? What's wrong with just Coke?" Well, at about 100 calories per can, I would have put on about 2.5 lbs per week (~100 lbs/year). I made the switch to Diet during my freshman year, in 1986.

Monday, March 1, 2010

PS3 vs Xbox 360 - the quality wars

Just realized today why there may be a huge difference in quality between the Xbox 360 and the PS3... until recently Sony was losing hundreds of dollars on each PS3 sold, while Microsoft was actually making money (about $80) per console. Of course Sony's plan is to make that back in Blu-Ray and game sales.

So think about how the incentives line up: Sony really needs the PS3 to be relatively reliable, because the last thing they want is for people to run out and buy replacements once a year - that makes it even harder for them to break even. (not to mention that it might anger customers).

On the other hand, Microsoft doesn't really care about the Red Ring of Death, since they'll make money off of the replacement box as well.

The sad news for PS3 owners - now that Sony has a newer model, they're probably losing less money - maybe even making money by now. Which means they'll have a reduced incentive toward quality. Once a console is successful, owners will be invested in the platform... if you own $1000 in games you really have no choice but to plonk down for another box.

Note: I'm deliberately ignoring the issue with the lasers going bad, I gather this is something that even Sony couldn't really do anything about. The early Blu-ray lasers just don't last very long.

Saturday, February 20, 2010

The three invisible BMW's in your driveway

I currently pay for my family's health care directly, since I'm unemployed at the moment. It costs us roughly $1500/mo. for a family of five.

That's the equivalent of three leased BMW 528i's sitting in my driveway - ghostly reminders of the outrageous runaway cost spiral of health care in this country. And every few years I get new ghostly BMW's when the leases expire. But I never own them, or even get to drive them.

But somebody is! Who is driving my three BMW's? Some guy at Pfizer probably has one of them.

If only I could buy good, practical health insurance, like the used Toyota 4-Runner that I actually drive. Room for the whole family!

Why the Anthem Death Spiral is a Good Thing

Krugman, that embarrassment to economics, recently wrote an article about Anthem Blue Cross's "death spiral":

In a nutshell, Anthem wants to raise its rates because the healthy customers are leaving in droves. When a risk pool loses healthy customers, the remaining 'less healthy' customers cost more money to insure - leading to a rate hike. However, the rate hike itself will cause another layer of relatively healthy customers to peel off as well. Thus a 'death spiral'.

Here's why I think this is a good thing.

I have repeatedly pointed out that the core problem with health care in the U.S. is the complete disconnect between payer and payee. A variety of tricks are used to disguise the fact that the end user pays for his own health care. In the rare instance when a customer will see an actual bill, they say to themselves, "I'm glad I'm not paying for that...".

The way to fix runaway health care costs is to have people actually just pay for them. In other words, to shop for them, and to choose not to use a service or drug that's too expensive. The miracle of supply and demand will eventually lower those prices. Today, the only thing slowing down runaway health costs are command-economy-style committees whose interests are more likely to be aligned with the fox than the hen.

So the hundreds of thousands of ex-Anthem customers out there will stop buying an overpriced product, and start paying for things only when they're necessary and affordable. With enough customers like these, prices will eventually be driven down.

The next important fix is to have insurance companies sell actual insurance - what they call 'catastrophic insurance', rather than pre-paid, pre-priced health care plans that are little more than welfare for the health care industry.

Those two changes alone would be enough to save health care in America.