Saturday miscellany

It’s going to be a day of end-of-month and end-of-quarter bookkeeping.  But, before launching into a completely soul deadening abyss, let me share a few good links and short thoughts from the past week: two for business and two for expats.

• “Entrepreneurship is the last refuge of the troublemaker”

Our department chair at Cambridge Biotech offered this thought during his remarks to the graduating Bioscience Enterprise class at the St. John’s dinner last week.  I like the idea: it captures both the organizationally rebellious and conceptually disruptive sides of entrepreneurship at its best.

The quote actually originates with Natalie Clifford Barney, a 19th century American expatriate and early feminist who hosted literary and political solons in Paris (she also said “Scandal is the best way to get rid of nuisances”.

The general “X is the last refuge of Y” construct is lovingly catalogued on the Internet, proving again that there is no topic too narrow that it doesn’t  attract someone’s passion and a web page dedicated to it.

• “The healthcare industry is just not interested in or committed to innovation”

This came from a salon –style discussion of “The Quest to Disrupt Healthcare”, reported in MedCity News.  The  regulatory and reimbursement gatekeepers, the ACA tax on medical device revenues, and the lack of seed funding all came in for criticism.  But the lack of customer adoption still looms largest.  We talk about recruiting thought leaders, storming Guidelines, and developing evidence portfolios, but in truth it’s nearly impossible to push a new idea to the tipping point where doctors start to notice.

I’ve been talking with friends, discouraged with BigCo cutbacks and restructuring,  who want to create a spinout from their canceled projects.  What’s the biggest block?  Not corporate resistance or seed funding.  It’s “How will I pay for health insurance?”

I pay (no joke) $2,500 per month for a family of three.  It comes off the top, out of my own pocket.  I could build a house, invest in new business, or grow my own more quickly.  No wonder we have 20% uninsured: few can pay those premiums.

Republicans who see health care reform as a job-killer have to propose some alternative to the present system.  The proposals to replace government insurance with a health debit-card are completely unworkable.

• “France orders breathalyser for motorists”

BBC reports that France is requiring every car to have two at all times so that motorists are more aware of the risks of drinking and driving.  Cars must also be equipped with reflective safety vest and triangle, or face an 11 euro fine.

I drive in France for 20 minutes twice a month, connecting to ferries at Dunkerque and Calais.  For that, I’ll need to find and buy specialized kit for my (Dutch) car.

This is the example that the Republicans should have used to attack the Individual Mandate instead of asparagus (Euope-bashing is t’s the individual mandate at the asparagus level.   They’re happiest bashing the Europeans anyway (remember “Freedom Fries”).

David Foster Wallace gave a wonderful commencement address in 2005 at Kenyon Collage.  His thesis was that, since “large parts of adult life involve boredom, routine, and petty frustration”, the only way out is to challenge your visceral reactions and “decide how you're going to try to see it: You consciously decide what has meaning and what doesn't.”

I am consciously deciding that the French don’t matter.

• “Wietpas measure to be rolled out nation-wide in January”

Maastricht implemented the wietpas rules for coffeehouses on May 1.  I didn’t notice because I only go to koffiehouses and the action was not widely covered by my standard media of choice (airline magazines).

This is a problem because visitors always ask to be taken to a coffeehouse.  I asked a neighbor to take me for a dry run so that I would look less ignorant and embarrassed when the subject comes up.  Two folks are coming in July who have specifically telegraphed that this needs to be on their itinerary: I may have to ask if the red-light windows would be an acceptable alternative.

Ironic that this happens just as “medical marijuana” is becoming more common in the US.

And lest you think that the issue was covered by airline magazines and I just missed it…

A recent letter to the New England Journal of Medicine  analyzed the effect of commercial aircraft cabin conditions   It reported a 12% reduction in blood oxygen saturation, enough to affect awareness and cognition.  So I’ve adopted the argument that my failure to finish work during 8 hour airplane rides is a physical failing, not a moral one.