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Health Savings Accounts: Two Interesting Articles on Their Effectiveness

02-Mar-10

Recently I’ve read two good recent articles on Health Savings Accounts and their usefulness reducing health care costs, increasing health care quality, and helping employees take home more cash.

When I was on the management team at a former company, we agonized about employees’ health care. Not just how (or whether) to absorb the astonishing annual increases in their health insurance premiums, but what we could do to help them get better care, not to mention even to let them actually take home the money we were willing to pay on their behalf (as opposed to having it vanish into those insurance premiums). Seems HSAs, if implemented properly (that is, the employer not trying to hold on to too much of the savings), would be a good technique.

A non-ideological, results-driven report on how even public sector employees are choosing Health Savings Accounts when HSAs are offered. Be sure to read the reader comments – quite a useful discussion going on there. I like Daniels’ summary paragraph, too.

The Indiana experience confirms what common sense already tells us: A system built on “cost-plus” reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with “free” to the purchaser consumption, is a machine perfectly designed to overconsume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right.

I’ve no idea what this blog is – this is the first I’ve run across it. Has the sort of scary vibe of a libertarian polemic, but this article, at least, is almost entirely reasonable. Emphasizes how the structure of the HSA can reduce the distortions in the US health care market. Makes good sense to me. And I like how the author links HSAs to health insurance portability.

True portability.   As stated earlier, typically health insurance for an employee and perhaps their family disappears with the loss of the job.   It is common to hear of people staying with jobs they don’t like, “just to have the health insurance”.   What does the employer gain from that?   What do the employer’s customers gain from that?   Note that the savings account of the HSA is owned by the employee, not the company.   So over time, this pool of money can grow and provide financing for medical expenditures regardless of employment. Furthermore, since the accompanying catastrophic policy would be dramatically cheaper than a “traditional” plan, it would be inherently more affordable during an period of unemployment.

As I mentioned in an earlier post touting David Goldhill’s cover story in The Atlantic (September 2009), I think the structure of health care financing in the US is the primary cause of both rising health care costs and poor health care outcomes. Would be nice to see HSAs in wider use, see if they help address the problems.

An Indiana experiment that is reducing costs for the state and its employees.

“Lean Usability” at Meetup

22-Feb-10

My friend Andres Glusman works at Meetup in some capacity (Insights? Marketing? Strategy? Products? any/all of the above?) concerned with web product design.

Earlier this month (February 2010) he gave the following excellent presentation at a Meetup in NYC. I don’t know his co-author Anna DeYoung, but let’s give her some credit, too.

Really good stuff here for web product managers and interaction designers. Some nice real-world adaptions of the techniques described in Steve Krug’s Don’t Make Me Think, the first book anyone concerned with web usability should pick up.

Written and Oral: They’re Both Verbal

16-Feb-10

Sometimes the plea for better grammar isn’t just pedantry, but rather a desire for clearer, more efficient communication. (At least that’s how I’ll justify this post to you, my three readers.)

It seems obvious to me that “written” (committed to paper) and “oral” (spoken) are just two more distinct forms of “verbal” (using words). Yet in the workplace I frequently hear the more general “verbal” confusingly used as a synonym for the more precise “oral.”

Statements like, “We have a verbal [agreement],” are seemingly meant to indicate that a potential client or employee agreed to something on the telephone, and that the only step remaining is to sign a paper contract.

But aren’t all business agreements verbal (made in words)? Isn’t the only meaningful difference whether they’re spoken (oral) or on paper (written)? It seems needlessly imprecise (and therefore unclear and inefficient) to confuse verbal with oral!

Rather than consult the Trusty Tubes of the Interweb for their participants’ thoughts on this question, I went to the English style and usage guides my own bookshelf.

Turns out that while my angst over this confusing usage is widely shared, different pundits suggest handling it in different ways. Here’s a summary of what I found.

I started with what’s usually the best – Fowler’s Guide to English Usage. This excerpt is from the third and most recent edition by R.W. Burchfield. Unfortunately he’s uncharacteristically verbose and wishy-washy. But he does point out that this “misuse” of verbal to mean oral is quite longstanding.

verbal. This common adj. has several established senses including:

1 Of the nature of a verb (verbal noun).

2 Concerned with or involving words only rather than things or realities (Opposition between these two modes of speaking is rather verbal than real–B. Jowett, 1875).

3 Consisting or composed of words (the verbal wit and high-flown extravaganza of thought and phrase which Euphues had made fashionable–J.R. Green, 1874).

4 Expressed or conveyed by speech instead of writing: oral (The archbishop believed that a verbal agreement was all which would be demanded of him–J. A. Froude, 1877).

All four senses have a long history of recorded use (1, 3, 16c.- ; 2, 17c,- ; 4, late 16c.-), but since the late 19c. some usage commentators have drawn attention to the possibly ambiguity of sense 4, and have expressed a preference for oral in such contexts. Perhaps the best policy for the present is to restrict verbal in sense 4 to a few fixed phrases (e.g. verbal agreement, contract, evidence); but use oral in most other circumstances when a formal distinction is contextually called for between a spoken and a written statement. It is worth noting that the oral tradition believed to have preceded the writing down of ancient poetry (Greek, Old English, etc.) is always so called, never the verbal tradition, verbal composition, etc.

Burchfield, R.W. ed. The New Fowler’s Modern English Usage. 3rd ed. Oxford, England: Oxford University Press, 1996. 820-821. Print.

My two news-oriented style guides (from the Associated Press and U.S. News & World Report) are nicely brief and to the point:

oral, verbal, written Use oral to refer to spoken words: He gave an oral promise.

Use written to refer to words committed to paper: We had a written agreement.

Use verbal to compare words with some other form of communication: His tears revealed the sentiments that his poor verbal skills could not express.

Goldstein, Norm, ed. The Associated Press Stylebook and Briefing on Media Law. Fully Revised and Updated with a New Internet Guide and Glossary. Cambridge, MA: Perseus Publishing, 2000. 183. Print.

oral/verbal. Oral refers to what is spoken; verbal refers to what is conveyed in words, either written or spoken.

Grover, Robert O., ed. U.S. News & World Report Stylebook: A Usage Guide for Writers and Editors. 9th ed. Washington, DC: U.S. News & World Report LP, 2001. 166. Print.

However, if we have to acknowledge that using “verbal” to mean “oral” is indeed long-established practice, may we at least approach it the way that Theodore Bernstein so elegantly suggests in The Careful Writer?

ORAL VS. VERBAL Although it is true that verbal means in the form of words, and has even taken over the specialized meaning of in the form of spoken words, it cannot be denied that much would be gained in the cause of precision if writers would use oral when they mean spoken words and written when they mean words committed to paper. Verbal might well be confined to those situations in which it is desired to distinguish communication by words from other forms of communication like gestures, smoke signals, and the light that shines from lovers’ eyes. To speak of a verbal agreement may leave some doubt whether the agreement was made in conversation or signed in a lawyer’s office. Confronted with a choice between a word that can mean two things and another that can mean only one, are we not making better use of the tools of language if we select the precise word?

Bernstein, Theodore M. The Careful Writer: A Modern Guide to English Usage. New York, NY: Atheneum, 1980. 319. Print.

Yes. What he said. Bergen and Cornelia Evans, scions of the $64,000 Question game show in the ’50s, seem to agree in their Dictionary of Contemporary American Usage:

oral and verbal are not synonymous, though verbal is misused for oral quite often, perhaps by persons encouraged to take as precedent the very special case of verbal agreement, which means oral agreement, agreement in speech only. Actually oral means uttered by the mouth, spoken (He teaches oral interpretation of literature), as opposed to what is conveyed in writing. Though verbal is used for oral in verbal agreement, it normally applies to the words, spoken or written, in which thought or feeling is conveyed. When we refer to a verbal account of an event, we mean an account conveyed in words instead of one conveyed by gestures, pictures, or other means. Thus verbal is the more inclusive term, emphasizing words themselves as distinguished from ideas, emotions, actions, images.

Evans, Bergen, and Cornelia Evans. A Dictionary of Contemporary American Usage. New York, NY: Random House, Inc., 1957. 341. Print.

Bryan Garner gets a touch more prescriptive in his similarly-titled Dictionary of Modern American Usage:

verbal = (1) of, relating to, or expressed in words, whether written or oral; or (2) of, relating to, or expressed through the spoken word; oral. Many regard sense 2 as a SLIPSHOD EXTENSION. In fact, given the primary sense, the movie producer Samuel Goldwyn wasn’t really very ironic when he remarked, “A verbal contract isn’t worth the paper it’s printed on.” After all, a written contract is verbal. The phrase requires oral.

The error is especially acute when verbal is opposed to written — e.g.: “Take care with words, verbal [read oral] and written.” Sydney Omarr, “Horoscope,” Wash. Post, 22 June 1997, at F2. Take care indeed!

Garner, Bryan A. A Dictionary of Modern American Usage. New York, NY: Oxford University Press, 1998. 676. Print.

As do Wilson Follett and Jacques Barzun in the also similarly-titled Modern American Usage:

verbal means relating to words without specifying whether the words are spoken or written. Consequently, the common phrase verbal agreement to mean one that is not written down is a misnomer. The proper term is oral agreement–oral meaning by [word of] mouth. To capture and preserve the distinction, this or oral exam and verbal aptitude test.

Follett, Wilson and Jacques Barzun. Modern American Usage: a Guide. New York: Hill & Wang, 1966. 341. Print.

Bill Bryson, the most recent commenter, errs on the permissive side in Bryson’s Dictionary of Troublesome Words:

oral, verbal. “The 1960 understanding  … was a verbal understanding that was never written down” (New York Times). Because oral can apply only to the spoken word, it would have been a better choice here. Verbal, which can describe both spoken and written words, is more usefully employed to distinguish between words and gestures or between words and substance. In the example above, however, neither word is necessary. It would be enough to say, “The 1960 understanding was never written down.”

Bryson, Bill. Bryson’s Dictionary of Troublesome Words. New York: Broadway Books, 2002. 153. Print.

While the surprisingly lame Oxford Companion to the English Language avoids the issue almost entirely:

VERBAL [15c: from Latin verbalis to do with words]. (1) Relating to words or consisting of words, often in contrast to something else: verbal ability; a verbal protest, as opposed to a protest in writing; a verbal distinction, as opposed to a distinction in reality. [...]

McArthur, Tom, ed. The Oxford Companion to the English Language. New York, NY: Oxford University Press, 1992. 1085. Print.

What does that muddle even mean? Sigh.

But I saved the best for last: the “real” Fowler’s English Usage, the 1965 second edition by Ernest Gowers (buy this book right now if you don’t own it – only Strunk & White is essential in the same way). While his isn’t quite the answer I expected when going to the shelf, given the historical precedent for using “verbal” to mean “oral,” Gowers suggests a reasonable approach in the warmest possible way:

verbal. The object of the provision was to apply it to all contracts, whether in writing or verbal. / The British Embassy have made both written and verbal protests to the Soviet Foreign Office. The primary meaning of verbal is consisting of words. Written contracts and protests consist of words no less than spoken ones, and we have for more than 300 years another adjective–oral–with which to distinguish the spoken word from the written. To give verbal that narrower sense was therefore both quite unnecessary and also a possible cause of ambiguity unless it is expressly contrasted with the written word, as in the above examples. But its use with this meaning is very common; the OED recognizes it without any deprecatory comment, and gives examples from the 16th c. The COD however calls it “loose”, and the supersession of oral is not yet so complete that those whose care for the niceties of language leads them to prefer it need fear a charge of pedantry.

Fowler, H.W. A Dictionary of Modern English Usage. Ed. Sir Ernest Gowers. 2nd ed. New York, NY: Oxford UP, 1965. 674. Print.

Just like Scotch whisky takes two forms, blended and malt, verbal expression takes two forms, written and oral. So skip your “verbal” contracts – be clear and efficient with “oral.” Nothing pedantic about it!

Report: 10th Annual Double IPA Festival at The Bistro (2010)

11-Feb-10

On Saturday (February 6, 2010) I attended “The Bistro’s 10th Annual Double IPA Festival” in Hayward, CA. This was my fifth time attending what has become a predictably wonderful beer event.

However, the DIPA Festival has also become quite expensive! This year’s tariff was $35 for a souvenir glass and just five small pours (4-5 ounces each). Additional drink tickets were $2 each. I remember when it felt expensive at $25 entry and $1.50 drink tickets.

An astonishing fifty-eight Double IPAs were on tap (with a couple of notable exceptions to the style), nearly all from California. The average quality was very high, certainly much more consistent than several years back. I’ve scanned and posted the complete list below (click the images to view full size).

I tried eighteen of the beers (but missed two of three winners of the formal judging, the results of which you can find on Jay Brooks’ excellent Brookston Beer Bulletin here). Following are my notes on each, listed in descending order by how much I liked the beer:

  • Firestone Walker Double Jack (9.5/10): My favorite of the day, but not typical of most approaches to this style. Double Jack keeps the malt as an almost equal partner to the hops. There’s tons of both in this beer, and that’s how I like it.
  • Green Flash Pallet Wrecker (9.0+/10): My preferred profile, with lots of bready (but clean) malt backing up the hops. Marin Brewing’s White Knuckle, which I didn’t try at this festival, is my go-to beer with this character. Of the Green Flash I wrote, “Great balance.”
  • Russian River Pliny the Younger (9.0+/10): The cult of this beer overpowers what can be rationally said of it. But yes, it’s very, very good – even great. Just feels more like a brewing parlor trick than an actual beer – a virtuoso brewer’s showpiece rather than something to be deeply enjoyed. No one else wrings as much flavor – and dryness – from the style as Vinnie Cilurzo does with Pliny the Younger.
  • 21st Amendment Hop Crisis (9.0/10): The ultimate exemplar of the fruit-forward style of DIPA, where citrusy American hops are the king and malt there just for texture. I loved this year’s batch of this beer so much I had it again at the brewpub on Monday night.
  • Speakeasy IIIPA (9.0/10): This brewery is really coming into its own after several years of boringness. The IIIPA tasted like juicy fruit, almost bubblegum. Was there wheat in there? Quite scrumptious, and noticeably different from many others I tried. Loved it.
  • Drake’s Donogginizer (9.0/10): This one’s becoming a local favorite, and I can see why. Just a great all-rounder. Heavy on malt, heavy on hops, but still relatively clean. A pleasure to drink.
  • Moylan’s Hopsickle Imperial XXX IPA (8.5/10): This beer has changed a lot over the years (and seems they never know what to call it, either). But it has usually been very good, and the current version is excellent. I wrote, “Wow! All hop showcase. Less malt than others, but not bad for it.”
  • Sierra Nevada Hoptimum (8.5/10): Nice, and different! I tasted grass, not just citrus and pine. Maybe some noble hops in here, like Saaz or Hallertau?
  • Drake’s Hopocalypse (8.5/10): Edgier than Drake’s round Denogginizer. “Great hops, a little thin on the finish.”
  • Rubicon HopSauce (8.0/10): The only beer I tried that placed in the formal judging. “Not overly hoppy, closer to a single IPA.” “Very good drinker.”
  • Port Brewing Mongo IPA (8.0/10): I tasted this from a friend’s glass before knowing what it was. I said, “This is a really good regular IPA, but it’s out of place here!” Probably put itself at a disadvantage compared to its heavy hitting competition.
  • Bear Republic 11 (8.0/10): Fascinating beer, and very well made, but not sure if it’s something I would want to drink regularly. Almost as if they denatured the hop flavor to focus primarily on bitterness – sort of like the essence of pure bitterness. My notes: “not too fruity” and “a little thin, some edge”.
  • Glacier Brewhouse Double IPA (8.0/10): The prettiest beer of the day. “Beautiful head – clear, dark beer.” And “malty.” But even though I prefer relatively malty DIPAs, this one didn’t have the accompanying hop character. “Like a bitter brown ale.”
  • 21st Amendment Two Lane Blacktop Imperial Black (7.5/10): The “Black IPA”, pioneered by Stone Brewing with their Eleventh Anniversary Ale (now a regular release called Sublimely Self-Righteous Ale) is a favorite pseudo-style of mine. Adding that tiny bit of roasted flavor to the American IPA, and turning it black, just really appeals to me. But I didn’t love 21A’s attempt at a Black DIPA at the festival. Tasted little or no roastiness, and found the texture a little watery. However, I liked it better when I tried it again at their brewpub on Monday night.
  • Lagunitas Hop Porno (7.5/10): Lagunitas’ Hop Stoopid is often one of my favorite DIPAs (though the bottlings have wild variation, so you’re never sure what you’re going to get). But Hop Porno had an off-smell and initial attack that put me off. The middle palate and finish were great, but this beer didn’t hang together as well as some others.
  • Fat Heads Hop Juju (7.0/10): This Cleveland brewery won the formal judging at a recent festival (maybe the IPA Festival?), but I didn’t enjoy this beer as much as most others. “Minty – wow, mint!” was my note.
  • Bear Republic Five Zero (6.5/10): Still my favorite brewery overall for their sublime Racer 5 IPA and Hop Rod Rye, but their festival-oriented one-offs have not been big hits with me. Based on the name, I was hoping on some relative of the juicy Racer 5, but I noted Five Zero as “close to flavorless” (presumably in comparison with the other richly-flavored beers present).

And I should mention the dark horse unsung hero of all of this year’s San Francisco Beer Week Events, the “Imperial Common” brewed by a collection of San Francisco Brewers:

  • SF Brewers’ Guild Imperial Common in Jack Daniels (9.5/10): Not a Double IPA by any stretch. Wonderfully round all-around drinker, close to a perfect beer. Barely a hint of barrel, perfect texture – not too thick, not too thin. A beer that just feels right. I’ve tried it four or five times so far over San Francisco Beer Week – every sip makes you know you’re in good hands. Spectacular accomplishment.

Another great event, very nicely pulled off by Vic Kralj and the team at The Bistro. Let’s just hope the prices stabilize or decline – there’s no longer a hop shortage to use as an excuse!

A Favorite Quote: Taking the Long View

29-Jan-10

I’m no fan of spectator sports, but I often like the writing they inspire.

And I love the following sentence, from John Updike’s 1960 New Yorker article about Ted Williams:

For me, Williams is the classic ballplayer of the game on a hot August weekday, before a small crowd, when the only thing at stake is the tissue-thin difference between a thing done well and a thing done ill.

The entire paragraph celebrates more about life than just the game it describes:

For me, Williams is the classic ballplayer of the game on a hot August weekday, before a small crowd, when the only thing at stake is the tissue-thin difference between a thing done well and a thing done ill. Baseball is a game of the long season, of relentless and gradual averaging-out. Irrelevance—since the reference point of most individual games is remote and statistical—always threatens its interest, which can be maintained not by the occasional heroics that sportswriters feed upon but by players who always care; who care, that is to say, about themselves and their art.

I don’t love baseball like Updike does, but in my own endeavors I still try to focus on that long trajectory, to take pleasure in good work for its own sake – regardless of who’s around to notice. To realize that both the highs and lows smooth over time – that just like in investing (or weight loss!), it’s the direction that matters, not the day-to-day changes. But that only by caring about how each little thing gets done will that trajectory improve.

In any case, Updike’s mastery of language here is almost as wonderful as Williams’ of baseball. Such a beautiful way to convey those multi-layered ideas.

  • Hub Fans Bid Kid Adieu, by John Updike (full text of 1960 article posted on Baseball Almanac)
  • On Writing Well, by William Zinsser (superb book on nonfiction writing; I first encountered this sentence in an earlier edition – I think later editions omit it)

My Most Popular Flickr Photo: Jaco Pastorius Artist Series Fender Jazz Fretless Bass

18-Jan-10

Jaco Pastorius Artist Series Fender Jazz Fretless BassOver the past few years I’ve posted more than a thousand photos to Flickr. A few of them are actually good.

But somehow this mundane shot of an electric bass is the most-viewed. Thousands of looks at this unremarkable photo, followed by hundreds of others in the same set.

Posted only as a supplement to a for-sale listing on Craigslist. Yet orders of magnitude more attention than my funny Japanese signs or artistic shots of Vienna’s giant ferris wheel.

I’m guessing it has been linked from someone’s blog, or has been caught in some virtuous loop of search engine image search.

Time to pour some fuel on the fire. A gallery of the entire set is below (the three good ones in there – the final three – are just the stock catalog photos from Fender).

Ah well.

Here’s the whole gallery: