I’m in a Sicko-inspired debate over on Brian’s ISBS, which led me to the following thought.

It’s been repeatedly established that American health care just ain’t all that and a bag of chips. Meanwhile, medical tourism seems to be thriving—and importantly, provides an interesting free market window into the prospect of how people would manage their medical care if they had the freedom to do so.

As I see it, there are three things that would artificially depress American medical tourism, lower than what might be considered a rational norm:

1. The widespread and erroneous belief that American medical care is the best in the world; if you think you’ve got the best in the world here (even if it’s being denied to you), why would you look for substandard care elsewhere?
2. The low percentage of people who leave the US for any reason in their lifetimes. Partially a geographic effect, partially cultural; we are, after all, the physical size of Europe. Almost all of us have been to other states, but most people are taught that it’s silly or expensive to go to other countries. That’s a high psychological bar, especially for sick people.
3. The internalized and externalized costs of medical care. People are used to paying thousands of dollars for insurance, and then minimizing their out-of-pocket expenses afterwards. A flight to Thailand for surgery is entirely out-of-pocket, even if the entire cost is far cheaper than similar surgery in your neighborhood.

So my question: how about an insurance company that leverages these differences to provide top-notch health care at very low cost? As follows:

1. The company provides all of the advance research necessary to make you fully-informed about the care you’re getting, and that it’s as good or better as American care. When American care is the best and the most economical, that’s what you get. But you don’t have to do the 1,000 hours of research necessary to engage in medical tourism or shopping around for medications.
2. Your meds are purchased by the insurer and drop-shipped to you; they get them at the best possible cost. You get what you need with no exclusions and a low deductible.
3. When you need hospitalization or outpatient treatment, and it’s far too expensive in the US, the company pays complete costs for travel and lodging to ensure that you get the treatment you need, wherever it’s provided. Again, you’re provided with ample documentation to show that you’re getting US-equivalent or better care.

It seems to me that the costs for this company would be far lower than other insurance companies, which translates into lower premiums, wider coverage, and lower (or no) deductibles.

So—why doesn’t this exist?

It’s vitally important to trademark all of your blog ideas before your competitors friends borrow them.

Bob, Bob, Bob. It’s less than 24 hours until T-iPhone-0. Is this really a good time for you to alienate your best customers?

I went to your retail store to spec out the Nokia UMA phone, or as you guys call it, the Hotspot@Home. Talk about a phone UI that made my eyeballs bleed; to think there was a time when I was an admirer of Nokia design. But I decided to grit my teeth and hope that I could strip out enough of your ill-advised graphics to make the phone workable.

But the real problem came with the sales experience—or rather, the complete lack of a sale that accompanied your sales experience. I was pretty much ready to just buy the damn phone provided you had a decent return policy. Too bad your sales rep talked me out of it.

It was bad enough that it took me a while to derail your rep from the network promos to the phone I had come for—he quite literally wouldn’t stop until I said, “Look. Phone first. Network next. Maybe.”

Seriously, Bob, you’re selling me a phone that lets me use Wifi instead of cell minutes. Do you really think it’s a good time to try to lock me on a new contract right now before I’ve had a chance to see what this phone does for me? What exactly is the mean IQ of your customer base?

But then came the breaking point:

Me: (pointing to the demo phone, which is now showing “Application Access Not Allowed”) I read in an online review that T-Mobile was blocking access from Opera Mini, so I tested it out on this phone.

Sales rep: What’s Opera Mini?

Me: Full web browser, the most common application I use on my current Motorola.

Sales rep: Oh. Right. Well, that’s the demo model. They frequently don’t install the entire OS on the demo models.

Bob, I could relay for you the rest of the conversation, but that would really just be a waste of time. Because when one of your employees first demonstrates that he is less knowledgeable than I am, and then proceeds to try to drop me into a steaming bucket of horseshit, you’re not just losing a phone sale, you’re poisoning a customer relationship.

Point 1, your staffer lied to me, Bob. Point 2, I’m the kind of guy who gets pissed off by that, partially because it annoys me that you do that to other customers who don’t have my expertise. Point 3, not only are your hardware offerings weak, but now I have to stop telling my clients that T-Mobile has a track record of not crippling phones. You’ve crippled the one I was going to buy, in a way that makes me not want it anymore. Point 4, I’ll remind you that EVDO is faster and AT&T has the iPhone.

I can think of one and only one reason why I’m a T-Mobile customer today, Bob, and that’s your hotspot network. But I’m looking pretty hard at Boingo now that they’ve got that free global roaming in place. I’m sort of running low on loyalty options. Planning on addressing that?

In the category of “things that surprise me more than they probably surprise anyone else,” I’m actually considering an iPhone. Yes, those new videos look pretty damned cool. But it was another calculation that really got me thinking along these lines.

To wit, I’m in the market for an iPod nano (ballpark $200-$250), and I’ve been dying to replace my crappy dumbphone for a really long time. That’s $500 right there.

So the only thing standing between me and an iPhone is Apple’s incomprehensible (to me, anyway) decision to lock it to AT&T.

It seems like a fairly simple matter for other companies to pry it open, although I’m not holding my breath. Therefore, there are two bits of news I’m looking for starting at around 6:03 PM tomorrow:

1) does the iPhone support dial-up networking? That is, can you use the EDGE connection over Bluetooth to provide Internet connections to your laptop? That’s why I bought my dumbphone two years ago, and it’s a dealbreaker for any phone that doesn’t have it.

2) how quickly will someone publish a SIM hack to get their T-Mobile card working in an iPhone?

I’ve also been watching the new T-Mobile wifi calling rollout; would sign up for that immediately if their phones on offer weren’t so blah. But my reluctant conclusion is that I’m probably best off waiting for T-Mobile 3G to roll out before making any changes. Nuts.

Tomorrow is the deadline for submitting comments to the Senate against the proposed nationwide identification system, REAL ID. Mine was fax #14,394:

In 1990, I had the opportunity to visit Leningrad for a student conference. I’ll never forget how shocked I was when the Russian students at the conference showed me their internal passports, which were required for traveling around Russia.

There was once a time when Americans were proud of these freedoms. Today, since I have never learned to drive, I have to carry around my US passport for routine identification. Perhaps you can tell me when America started thinking of Communist countries as a good-enough model for our own freedoms.

Hey, Bob. Jeff here, a T-Mobile customer who rocks out your hotspot network regularly enough that I’m strongly inclined to stick with your service. You’ve also generated some longterm loyalty from me by being the first provider on the block to offer a cheap, unlimited data plan.

Thing is, there’s this new phone coming out, and I hear that your industry is nervous about mass migrations to AT&T. Sprint and Verizon are about to discover that CDMA stands for See De Masses Abscond. But you’ve got GSM, and I’m thinking it’s about time you made that mean Got Some Mojo.

Here’s the deal:

1) With the unlimited data and Starbucks hotspots, you’ve got yourselves a nice geek community ponying up to you monthly—at least, everyone who didn’t get tired of waiting for your 3G service. But the people who switched to EVDO can’t use an iPhone, can they? So perhaps they’ll be coming back to a GSM carrier.

2) You can’t sell the iPhone, so a lot of your customers are going to be looking at AT&T…

3) but your network works just fine with the iPhone, provided the phone is unlocked.

4) In case you haven’t noticed, it’s illegal for Apple or AT&T to prohibit unlocking the iPhone. There’s a specific exemption in DMCA for this.

5) So the only real barrier for the unwashed masses using their iPhone with T-Mobile is a service to unlock their phones…

6) and the $175 service fee that AT&T will charge for buying an iPhone and immediately canceling.

7) $175 is what, 45 days’ revenue from the sort of heavy cellular user who would consider buying an iPhone in the first place?

8) Do you see where I’m going with this yet?

The iPhone ships at 6 PM Friday. So I’m thinking that on noon Thursday, you announce that any T-Mobile subscriber, old or new, can walk into any T-Mobile store to have their iPhone immediately unlocked, and receive a $175 credit on their account.

And if you’re not doing this—why the hell not?

Amtrak’s continuing record of excellence: employees apparently unable to spell either “Amtrak” or “Acela”.

I was giving serious thought to signing up for Earthlink Wifi for the Philly municipal network, but their web site, oddly enough, apparently doesn’t provide a form in which I can pay them money. So I figured I’d just grab a login screen at 30th Street this morning. Seems that 30th Street is not a sufficiently trafficked location for them to have covered it.

I already have wifi access in Philly at any Starbucks, Kinkos, Borders, and the airport. I’ve got slower access anywhere via my cell phone, which is working just fine for blogging from this here train. I’d consider spending more money to get my work done in more places, but if you’re not going to cover the train station, you’re not exactly raising confidence about your footprint elsewhere.

Is it just me, or is Earthlink just not serious about attracting my business?

Net radio goes silent on June 26th.

Transcript of a phone call I had this morning:

Genius: Apple Store Bethesda Row, Business Sales. How can I help you?

Me: I just got a call from an unhappy client; he’s got a MacBook with a dying battery and just discovered that his MagSafe power cable is still at home. Do you have any lying around in the service area that we can rent for the day?

Genius: No, but you can just come in and buy one, then return it within 14 days.

Me: Great. 15% restocking fee, right?

Genius: Actually, there’s no restocking fee on that item, so just bring it back.

Incidentally, the last time I was at an Apple Store on behalf of this client, it was to set up a Mac mini for headless operation. They let me use a half-dozen peripherals for as long as I needed. This is at least the tenth time that Apple has acted as a free business center for me, and it’s at least part of why most of us feel like part of a club with concierge service.

Perhaps the start of a new series of blog posts, wherein I note a turn of phrase I coined while describing a technical issue, using a series of words that have probably never before been strung together.

The entry for June 21st, 2007: “thanks to a locally stored Emperor cookie.”

Arrived at my usual Barnes and Noble café to find more than the usual hubbub; Ralph Nader is speaking here in 2.5 hours, and already the sidewalk is sprouting police and local news trucks.

My being here is pretty much coincidence, which is also how I saw Michael Moore and met Terry McAuliffe a few years ago. Ralph picked a really inconvenient day to show, as I’m here with a stack of research and work I wanted to knock out tonight. He really should have checked with me first. That being said, I’m likely to wander downstairs, because it seems wrong not to.

Either way, this is the closest I’ve been to Nader since 1992, when our proximity was documented by the Daily Pennsylvanian. Front page photo, that crowd? That left arm and ear in the lower right hand corner? Mine.

Update, 7:04 pm: I can think of at least one loyal reader who’s going to get a kick out of this. Check out where in Barnes and Noble we’ve been seated for Nader’s talk.

Winnie the Pooh, Babar the Elephant, and the Cat in the Hat are here too, in the clouds on the walls, but were unfortunately cropped out of the shot.

Call me a bit surprised there are still seats available with 20 minutes to go. Nader got 12,485 votes in this county in 2000.

Update, 7:13 pm: I just burst out laughing really loudly, and I’m getting strange looks from the people sitting in front of me. An employee just came over the PA with: “And what goes great with free DVDs and Ralph Nader? An orange mocha cappuccino from our café.” She had trouble keeping the giggle out of her voice, too.

Update, 9:05 pm: Wow, wow, wow. Damn, I’m glad I showed up for that speech. One of the best public speakers I’ve ever heard. Several blog posts to follow from my notes. Disregard my comment about the empty chairs; they brought more and it was SRO before he started.

I live in a house that backs onto a park, which connects to a white-collar complex, which in turn faces the road that goes to the Starbucks, the Metro, and the grocery store. (Which my father bought for two zuzim, had gadya, had gadya.) The complex is private property, but it’s 2/3rds of a mile to Starbucks according to satellite mapping when takin’ it to the streets, versus a half-mile cutting through the park and the complex. Easy call.

Even then, my shortcut takes several cutbacks and u-turns, and it was 95 frickin’ degrees in DC yesterday, so I did some exploring to see if I could find a better way.

I wandered around to various other entrances to the complex, meandering through a few parking lots.  Noted that these parking lots had trees and shade, which is already a bonus over my usual route. Found a break in the hedges and fences that surround the place—apparently to protect the houses behind it, including mine, from the dangerous white collar workers. Walked around a tree, wandered up a short path, and found a fence with a gate—directly in front of my house.

The gate, of course, was locked.  With a particular brand of padlock.  Which, as was documented last year in various places on the Internet, I could learn to pick with about a half-hour’s practice, using tools that I probably carry around anyway. (Innocuous tools, mind you. Nothing shady or even techie.)

Next up was the long walk around the locked gate in the fence, to get home and simultaneously see if I had any better options. That trip was 3/4ths of a mile to get me from point A to point A plus a smidge, as illustrated in the accompanying photo. This just annoyed the heck out of me.

(If you’re wondering, yes, there is a huge difference between teaching myself how to pick a lock, and just climbing over the fence right then and there. One is a clever hack. The other is doing something you clearly aren’t supposed to. This goes without question.)

On that long walk home, I’m calculating a few things in my head:

1. The time and effort it would take to learn how to pop that lock, and in a short enough period of time such that no one would notice me repeatedly opening and closing the locked gate.
2. The extent of the risk if I’m caught, which has its own categories:
1. I could be stopped by a rent-a-cop, and forbidden to be on the campus private property again, in which case my walk rises from 0.5 miles to 0.65 miles.
2. I could be stopped by a real cop and tagged with a misdemeanor; I’m not sure what law I’m breaking, as I can easily walk around the fence, but I’m guessing that “opening locks that don’t belong to you” is on the books somewhere.
3. I could be tagged for something much worse, since I wouldn’t be a bit surprised if, in post-9/11 DC, what I’m describing here counts as an act of enemy combatant terrorist trespass. (And if you think I’m kidding, I’m fairly sure I committed a felony yesterday while troubleshooting a client’s network. No, I’m not going to tell you about that.)

By the time I got home, I was absolutely convinced that the next order of business was to look for the HOWTOs on popping locks with innocuous household objects. I had a clever hack, and it was going to save me time on a daily basis; that’s my favorite kind.  But just for the heck of it, and partially to prove to myself exactly how clever my clever hack would be, I pulled up the maps to get the exact distances I was saving.

My current, annoying route:

My new, timesaving, perhaps illegal route:

According to satellite mapping, total distance saved:

(wait for it)

16 feet, 10.7 inches.

Okay. So perhaps not quite so clever.

I’ve been fascinated recently by ways in which I’m unavoidably taking on character traits of my parents. This is doubly true of traits I’m getting from my mother, as she died five years ago—every time I pick up a new Mom habit, it’s like she planted a tiny nurture time bomb back in the Carter administration that was just waiting to go off.

So no big deal that I now sneeze after every meal, like she did; I figure there’s some bizarre genetic explanation for that, similar to why I sneeze every time I walk into bright sunlight. But somewhat disturbing that, after decades of teasing her for her inexplicable love of the smell of gasoline, I now find myself unconsciously taking deep shnuffs every time I’m walking past one.

Today another one snuck up on me. One of Mom’s favorite songs was “Puff the Magic Dragon,” which she loved but always found to be incredibly melancholy. Play it on the radio and there would usually be tears on her face by the time it ended. Me, I’ve always liked it, but it wasn’t particularly stirring.

Then it popped up 30 minutes ago on my iTunes shuffle, and brought me to such a complete emotional full stop that I had to stop to write this and clear my head before I could get back to work.

Thanks, Mom. I’m not thrilled with the being short thing, and I’m not looking forward to the diabetes, but this one I can live with. I just have to be careful where I am when it starts playing.

Liking gasoline, though, that still freaks me out.

If you thought “partly cloudy” during a major thunderstorm was strange, check out tonight’s forecast according to my menubar widget.

Prehistoric ancestors found of both Pac-Man and Mickey Mouse.

Does anyone else think there’s something extremely bizarre about today’s DC forecast?

Scattered showers and thunderstorms. Some storms could be severe, with large hail, gusty winds, and frequent lightning. Partly cloudy, with a high near 86.

At least the hail should melt quickly.

Every couple of years, I make a note of June 10th only because it’s exactly halfway to my birthday. Usually, this causes about 15 seconds of thinking “huh, time flies”.

Today, however, the evil subconscious demon in my head who’s good at math said, “Hey, you’re exactly halfway to 75.” He even just made me look at the clock and say, “As of about three hours ago.”

Damned evil demons….

When rapidly cleaning up after breakfast, with your laptop on the table, it is best to avoid jamming a steak knife into your optical drive.

Everyone once in a while, you meet someone who casually, in the space of a few moments, is able to make you despise humanity and hope that someday the cockroaches will create a more civil society.

The scene: Costco just before closing, in a cattle call line for the cafeteria. For those of you who haven’t had the pleasure, the food is cheap, good, plentiful and 90% pizza grease; before you can have any, though, you have to stand in a long line with people whose shopping carts contain the gross annual exports of Shandong province. These carts are like trucks at the tollbooth, making it extremely hard to judge which line is longer. You’ll almost certainly be wrong, so the right strategy is to pick one and try not to be in a hurry.

I’m standing in a line that ends in two different registers, longish when I get there. It’s much shorter when some guy arrives behind me, cherubic tyke in tow, and we have the following conversation:

Some guy: Which line are you in?

Me: I’m in the line.

Some guy: It looks like there are two lines here.

Me: There was a single line when I got here.

Some guy: Well (indicating the yellow stripe painted on the floor, on which I am standing), there are two lines.

Me: I thought the social purpose of lines was to allow the people who are waiting the longest to be served first. Do you intend to get in front of me? Because the only reason you could ask me which line I’m in, is so you’d have a chance to get lucky.

Some guy: No, you should just pick one.

Me: I have. (turning back around, still standing on the yellow line)

Thanks to the magic of camphones, I can share with you the picture of the man who does so much, in his breathtakingly efficient and negligent way, to ensure that existence remains nasty and brutish, if not short. Should you see him on the Beltway, I have not the slightest doubt that he’s the type to cut you off in traffic, so drive defensively.