Who deserves an MRI?

Given the enormous amounts of capital funneling into the health care system it’s easy to think there must be plenty of money for equipment.There isn’t. There are many hospitals, especially in poor and rural areas, that can’t afford top-notch equipment.

Siemens Medical is taking advantage of this with a contest called Win an MRI. Hospitals can send in videos through the end of November. Site visitors can choose their favorite through December 31.

The hospital with the most votes wins a MAGNETOM Essenza, a new 1.5 Tesla model it says is lighter, and uses less energy, than earlier MRIs. Publicity will help Siemens sell more units to large, urban hospitals that can afford it.

It’s clever marketing. Siemens is telling paying clients they can save $500,000 by buying the new gear. The company calls the new MRI ”the most affordable” ever.

But not for everyone.

As of today 41 hospitals have sent in videos. Some are heart-wrenching. My favorite is the one from Sumter County Regional Hospital,  in Americus, Georgia, which was destroyed by a tornado last year and faces a $13 million hole in its re-construction budget.

Most of the hospitals which have entered so far are in small towns. Cut-Off, Louisiana. Machias, Maine. Chamberlain, South Dakota. Keosauqua, Iowa.

I do have a fear that someone might “freep” this poll, that is, find a way to pile in a ton of votes at the last minute, corrupting the result. It’s the video entries which give me some hope, and the responsibility I’m sure Siemens Medical feels to get this right.

The rising cost of equipment has been pushing medical care into our largest cities for some time. This contest is a living testament to that fact. Given the costs, that trend is not all bad. We can’t afford to put every piece of equipment in every town if the equipment costs $1 million or more.

But how bad should it be — how far should someone have to travel for a scan?

Internet Explorer 7 update: Now WGA-free

Microsoft has issued an updated Internet Explorer (IE) 7 release that no longer requires Windows Genuine Advantage (WGA) validation in order to download.Internet Explorer 7 update: Now WGA-free

Program Manager Steve Reynolds announced the news on October 4 on Microsoft’s IE Team blog:

“Because Microsoft takes its commitment to help protect the entire Windows ecosystem seriously, we’re updating the IE7 installation experience to make it available as broadly as possible to all Windows users. With today’s ‘Installation and Availability Update,’ Internet Explorer 7 installation will no longer require Windows Genuine Advantage validation and will be available to all Windows XP users.”

WGA is the anti-piracy mechanism Microsoft uses to check whether users are running “genuine” Windows before allowing them to download certain product updates, fixes, white papers and other related information.

Microsoft posted to its Download Center on October 4 refreshed versions of IE 7 for Windows XP Service Pack (SP)2, Windows 64 client/server, and Windows Server 2003 SP1/SP2. It also posted an update to IE 7 for Windows XP that resolves a phishing-filter problem with the browser.

Users interested in downloading the refreshed IE can get it from Microsoft’s Internet Explorer home page or go thorugh a third-party site thatis authorized by Microsoft to deliver customized IE releases. Microsoft officials said they also have pushed the refresh out via Automatic Updates, but those already running IE 7 “will not be offered IE7 again” via this mechanism.

Other changes that are part of the IE 7 refresh:

* The menu bar is now visible by default
* The Internet Explorer 7 online tour has updated how-to’s and the “first-run” experience includes a new overview
* A new MSI installer that “simplifies deployment for IT administrators in enterprises,” according to the Softies

Microsoft rolled out IE 7 last fall. Since then, the company has said next-to-nothing about its future plans for its Web browser.

Why spam can only be managed, not ended

Years ago when I was still a bit more naive, I thought we could end the spam dilemma if we would simply implement domain-level sender authentication using digital signatures.  In fact when David Berlind wrote  “Why spam could destroy the Internet” in November 2002, Berlind quoted me saying that every domain’s official SMTP server should digitally sign each message to prove the email came from that domain.  SenderID and Yahoo’s DomainKeys came out around 2004 gave me the satisfaction of knowing that I wasn’t alone in calling for domain-level authentication and DomainKeys is very similar to what I was proposing in 2002.  The difference is that I proposed using standard commercial digital certificates from commercial Certificate Authorities to distribute public keys whereas DomainKeys used DNS to publish its public key information.

I was so sure at the time that if we could only get people to use this system we would surely stop spam.  Microsoft’s Bill Gates gave me some company in 2004 when he proclaimed that “spam will be a thing of the past in two years’ time”.  As it turns out, we were both wrong and naive to say that we can stop spam because it’s like saying you can stop crime and the most we can ever hope for is to manage it to tolerable levels when there are determined adversaries who will do anything to get around any barrier you can put up.  I am coming clean on this now because there are still so people who believe that stopping spam is simple and that if it isn’t stopped, it’s must be the fault of the major ISPs and corporations for dragging their feet.

My colleague David Berlind blamed the spam problem on the big-four email vendors and declared rDNS (reverse DNS) and maybe SPF (Sender Policy Framework) the solution.  Now I’m certainly not trying to belittle David Berlind because his heart is definitely in the right place.  In fact, I’m essentially saying that Bill Gates and I were wrong to say that say that spam could be stopped and that it’s about time my colleague David Berlind takes a good hard look at the problem and stop implying that spam could be stopped if only we did XYZ.

The fundamental challenge here is that we’re will never stop spam because we will never go to the pure white-list model where we will only accept email from verified entities.  In fact there’s the little problem of human rights we have to deal with because words can get you imprisoned or executed in many countries.  I never gave much consideration to this issue in the past but I’ve given it some thought over the years and I’ve given in to the legitimate need for anonymous and decentralized email.

Why charging for email to stop spam is just plain dumb
One of the most commonly floated ideas for stopping email spam is that if only we charged a postage fee for every email ever sent, then the cost of spending spam would be so outrageous that it would deter spammers.  Not only will it not work, but there is the risk of abuse by some larger ISPs to charge users and legitimate companies for sending legitimate bulk email under the justification of stopping spam.  Why bother charging honest people for email when you can simply fine the bad apples and leave everyone else alone?For one thing, spammers don’t send the spam directly; they have their hijacked botnet armies send it for them.  These are personal computers (and some servers) that have been taken over with malicious software by criminal.  If anyone is going to pay, it will be the owners of those computers who pay.

The second most obvious thing that proponents of the email postage idea missed is that if you actually had such a massive billing scheme in place, it would have to have every sender registered with their credit card on file and every email ever sent had a digital signature that proves it was sent by the purported sender.  If this were the case, you would have already stopped spam without charging a dime for any emails because you can slap them with a massive fine if they ever dared send spam.  Why bother charging honest people for email when you can simply fine the bad apples and leave everyone else alone?