Is AI our enemy? Former world chess champion Garry Kasparov answers that question through Deep Thinking. It's a fascinating record of how chess machine programming has evolved over decades, from a concept by Alan Turing to IBM's Deep Blue supercomputer that finally defeated the grandmaster.

Millenials should take notice. They missed the era when computers were easily out-maneuvered by good players. Kasparov walks us through that history. The problem wasn't simply the feeble computation power (there are billions of possibilities in the first few moves, yet the fastest computers were much slower than today's average smartphone). Engineers thought they could teach computers a kind of intelligence, to make smart decisions beyond the permutations they had time to scan and analyze. Yet the skills remained shallow. Software could play tactically well, for example in end game situations. It was still no match for the imagination and aggression of a top player.

As computer processors became more powerful, the applications could look more moves ahead, and the approach shifted to brute force. The algorithms also got better. For example, the programs could assess a bad position earlier in the search tree, short circuiting it to avoid further computations on that branch.

Kasparov knew that computers would eventually dominate. And he didn't disdain them. Like other players, he'd been using chess programs in his match preparation, to help assess positions. He remained confident, however, that he could continue beating them one on one. And he prevailed for several years in the mid-1990's against the best IBM had to offer. The relationship was good for both sides. IBM got publicity for its technology, which was still centered on hardware. Kasparov got a nice paycheck, a novel challenge, and the chance to share information with IBM's architects.

The pivotal moment came in 1997. Having won 4-2 against IBM's Deep Blue computer a year earlier, Kasparov agreed to a re-match. However, the contest was no longer collegial. IBM wouldn't share any of their preparation, including their practice match results, as they had in previous meetings. And during the match, IBM withheld the print-outs of what moves the program considered. Kasparov lost insight into how the computer analyzed the board. And he lost the match, 3.5 to 2.5.

Kasparov recounts how, under pressure, he made some incredible blunders, worse than any he'd ever made against top competition. He resigned one game without realizing that he could have salvaged a draw. He played his worst game ever in the finale, resigning after 19 moves. While blaming the secrecy of the IBM team -- he found out later they'd hired several grandmasters to improve Deep Blue's "opening book" database -- he accepts that the machine he lost to was radically improved. He might have drawn the match with better play. Still, there was no question that the best chess-playing computer would soon be more formidable than the best human.

What lessons does Kasparov draw for artificial intelligence? He's a strong believer in embracing new technology, without abandoning our own mental faculties. At the same time, machines shouldn't make us lazy. Just as Kasparov criticizes young prodigies who memorize openings but can't explain why they're the best choice, he expects people to learn along-side their silicon assistants.

Fear is the worst reaction, Kasparov argues. If we're afraid of a future where machines have an augmented role, then we're no better than machines ourselves.

Note: This review is based on the unabridged audiobook, not the printed edition.

• Garry Kasparov, Deep Thinking: Where Machine Intelligence Ends and Human Creativity Begins
• Hardcover: 304 pages
• Publisher: PublicAffairs; 1 edition (May 2, 2017)
• Language: English
• ISBN-10: 161039786X
• ISBN-13: 978-1610397865

This post was originally published on my other blog, https://tech.surveypoint.com

Franklin Foer's World Without Mind bears an ominous sub-title: "The Existential Threat of Big Tech". Unfortunately, the book doesn't deliver on its broad promise.

A more accurate title would have been, "How Amazon and the Free Web Are Destroying Journalism". That's the area Foer understands well, from his career as a writer and editor at The Atlantic, Slate, and The New Republic. It's his stint at the latter publication that fuels his theme. Foer hoped to re-establish the magazine as an outpost of serious journalism.

Instead, TNR fell under the same financial pressures as its peers. Web advertising depends on how many times your article is viewed. The way to get more clicks is by increasing "virality". And users are more likely to share gossipy topics than long-form pieces. Although TNR resisted stories that were pure clickbait, it turned to "sponsored" corporate content. These placements undermined the church-and-state separation between who paid the bills and what stories the editors commissioned.

The book isn't as compelling when Foer ventures away from publishing. It begins with a ramble about Silicon Valley's hippie origins, focusing on people like Stewart Brand and Ray Kurzweil but skipping Steve Jobs and Bill Gates. Today's big tech is represented by four companies: Google, Amazon, Facebook and Apple. Foer writes little about the last two. His anecdotes about Larry Page's engineering pedigree don't increase our understanding of how Google operates today. It's as if Foer included them only to show how far the founders have strayed from their idealistic roots.

But then again, Foer doesn't seem that interested in the technological implications of Google's or Amazon's dominance. He's making an anti-trust argument. Drawing evidence from the history of U.S. monopolies, he warns about letting so few companies control so much information. These historical digressions are the most insightful parts of the book. Foer explains how Western Union built a 19th century telegraph monopoly -- a precursor of the internet -- and how WU colluded with the Associated Press to keep out competitors.

It's persuasive story-telling, because Foer uses it to trace the evolution of newspapers, reminding us that American journalism was far from pure. It was heavily partisan, promoting presidential candidates (sound familiar?) and influencing who got nominated. Journalistic standards emerged only over decades. The point is, don't take reporting for granted. It's susceptible to corruption like other enterprises. We may eventually sift out the truth by reading a million blogs and Facebook posts. It'd be easier if we kept the most powerful companies from becoming all-powerful.

• Franklin Foer, World Without Mind: The Existential Threat of Big Tech
• Hardcover: 272 pages
• Publisher: Penguin Press (September 12, 2017)
• Language: English
• ISBN-10: 1101981113
• ISBN-13: 978-1101981115

This post was originally published on my other blog, https://tech.surveypoint.com

James Surowiecki's The Wisdom of Crowds, published in 2004, has been influential in financial markets and corporate transformations. It also has plenty of ideas relevant to social networking's future.

The book's leading concept is that that collective intelligence -- aggregating diverse opinions -- can out-perform judgments made by alleged experts and executives. Estimates are better when they pool many invidividual investors' bets; decisions are better when produced by decentralized organizations than by top-down initiatives.

This work has plenty of cautionary tales, and the failures are what makes it worth reading. The author warns that the group isn't smarter when individuals start trusting public information more than their own private knowledge. He points to information "cascades" where people do something because everyone else is doing it. The clearest examples are the last two stock market bubbles, when investors put aside their doubts and started following the ticker tape. The product of this lemming-like behavior can be worse than decisions made by a central committee. I would add that the ability of the crowd to estimate is limited even more than Surowiecki acknowledges. Group estimates work much better for predictable bell-curve type distributions than for rare but catastrophic events like market crashes, as Nassim Nicholas Taleb demonstrates in The Black Swan.

At first glance, social networking would seem the perfect environment for crowd wisdom. Participants are often anonymous to one another. Contrary to organizations, the average social media participant has no paycheck, relationships or loyalties that could interfere with her honest assessment. Surowiecki's enthusiasm for applying stock market simulations to other forecasting like elections and foreign affairs would seem to work well on an internet site.

However, there are several barriers to making effective use of mass participation. The tendency of internet forums to attract people with anti-social behavior is a significant problem. While a troll would be quickly silenced in a face-to-face meeting (and unlikely to even be in the room), the internet poses no such barriers to entry. Financial motivation may be replaced with something equally bad: the need to aggrandize one's ego, and impatience and hostility towards other members who don't agree with one's reasoning or conclusions.

Also, internet forums have some of the same problems as business task forces and focus groups. They're rarely a random cross-section of people. Internet sites are often self-selected samples of people with keen interests in a topic and a willingness to write or vent about it. They're hardly disinterested observers. In addition, even when the posts are civil, the cyber-atmosphere isn't. People have the burden of introducing and proving themselves. Depending on one's personality and confidence in his writing, the internet may be either an incentive or detriment to venturing an opinion. My own belief is that forums are excellent for sharing and arguing about technical information, but less suited when it comes to fuzzier issues that require contributions from the quieter members of the group.

The Wisdom of Crowds distinguishes between problems involving collective agreement and ones requiring coordination or cooperation. But collective agreements are of two fundamentally different types. One type is a decision to act by picking among two or more choices (what should we do); the other is an estimation or forecast (what is happening, or what will happen). Social media in its current state is more suited to the latter. The limited ability to make decisions isn't only because the group is for discussion only -- it can advise but it lacks the authority to act on anyone's behalf. Good decisions often can't be made until you've gathered all the facts, and some of the best decisions are ones whose choices are framed by the discussion, not generated in advance. Therefore, to even advise on complex decisions, social networking needs tools where the options can evolve from the group debate. The poll or voting booth, with its canned multiple choices, is a poor substitute for this negotiation.

Nevertheless, I wouldn't bet against the ability of social media to acquire the necessary sophistication. The ubiquity of e-mail and instant messaging, plus the growth of mobile apps and virtual companies, suggests that decision-making is only going to get more distributed. The technology will become wiser, because it has to.

The Wisdom of Crowds, by James Surowiecki, Anchor, August 16, 2005, ISBN-10: 0385721706 ISBN-13: 978-0385721707

This post was originally published on my other blog, https://tech.surveypoint.com

Jaron Lanier’s recent book, You Are Not A Gadget, is a broad criticism of the internet. Lanier thinks cyberspace is full of unimaginative software. Web 2.0 is window dressing on a tired paradigm. Silicon Valley is funding trivial applications.not much better than than the hasty business plans of the dot-bomb era. Users have bought into a mash-up universe where authorship is not rewarded and content is divorced from context. Anonymity and incivility rule.

All information is becoming one big book, managed by Google’s search engine. Lanier derides those who think this trend is desirable, calling them digital Marxists who believe in the eventual “singularity” of knowledge with the same fervor as a fundamentalist Christian awaiting the Rapture. This vision is anti-humanist, because it treats people as unimportant once their contributions have been uploaded to “the hive."

Lanier is eager not to be judged a Luddite. He's one of the fathers of virtual reality programming. His disappointments are similar to those of a pioneer reviewing the settled civilization that followed him. As the book's title suggests, he's not impressed with the landscape. Instead of exposing us to new experiences, internet applications are dumbing us down. People are becoming more like machines in order to interact with their computers. It should be the other way around. This theme may sound like the growing backlash of articles about the dangers of internet dependency. (See, for example, Is Google Making Us Stupid?.
However, this work isn't a signal for retreat. It's a call for us to demand more from technology.

The author worries about where we're heading as the internet erases geographic, business, and personal boundaries. He questions whether the mass unpaid participation of the “free" social web can produce the same quality as commercial software. As a Microsoft fellow, he may appear self-interested in this subject (although he points to Apple as the exemplar of quality engineering). But a closer reading of this book shows that he's more concerned about the artist than the entrepeneur. The internet and the Creative Commons model allow others to re-mix a performer's or writer's work without compensating him and without even his knowledge and consent. This freedom to copy dissolves the relationship between the performer and the audience. A musician in his spare time, Lanier thinks the value of recordings can only be restored by re-introducing them in physical packaging. He proposes the creation of "songles" -- micro-chips embedded in everyday objects -- that would enable playback of a purchased tune, functioning like a dongle but connecting wirelessly to any audio system in the vicinity.

I enjoyed Lanier's irreverent shrugs about Linux (it's just an extension of Unix, a decades-old operating system) and Wikipedia (there are usually better sources of information just below it in a Google search). The most interesting chapter is the explanation of software "lock-in". By this term, Lanier doesn't mean a single vendor's strategy. He's talking about the unintended inflexibility of software design as a code base grows larger and more inter-dependencies are created between packages. So-called standards enable rapid development of new software -- you don't have to re-invent the wheel -- but at the price of creativity. The patterns become entrenched and we quickly lose the ability to do things any other way. He illustrates how even a revolutionary concept like MIDI notation, which was designed for keyboard instruments, has narrowed our idea of the musical note, and therefore musical composition, to fit within its limits.

You Are Not A Gadget has the marks of a cogent essay stretched into a rambling disorganized book. If you take it as a tonic against internet hype, it's a fun read.

You Are Not A Gadget: A Manifesto, by Jaron Lanier, Knopf, January 12 2010, ISBN-10: 0307269647, ISBN-13: 978-0307269645

This post was originally published on my other blog, https://tech.surveypoint.com

I've been reading The Long Tail, the 2006 blockbuster extolling the unlimited consumer choice made possible by the internet. The book was written by Chris Anderson, editor of Wired magazine. Its title is now part of the marketing lexicon, and aptly captures the author's thesis: there's a lot of money to be made by offering goods beyond the top sellers. Niche products individually don't account for much revenue, but cumulatively they add up to a lot of profit.

How well do Anderson's observations stand up four years later? Better than most predictions, I'd say. Anderson's examples are derived largely from the behemoths of internet retailing. He documents success stories that continue in 2010, such as Amazon, eBay, and Netflix. He's at his most prescient when writing about the entertainment industry. Anderson once worked in the music business and correctly predicts the increasing demand for lesser known artists at the expense of major labels and mass marketing. His description of the new generation of consumers rings truer today than ever. Younger people are accustomed to scanning the internet and picking things that establish their identities and individualities from this universe. Traditional methods of broadcasting and controlling content are hopelessly outdated for this audience.

The Long Tail doesn't claim to be a crystal ball, so it's a bit unfair to critique it for omissions. Nevertheless, it gave scant notice to a a few emerging trends. The most obvious is the connection between social media and internet video. Anderson pictured internet video as a means of selling old TV episodes, but didn't mention self-production, distribution, and promotion using this avenue. At the time of publication, Google hadn't yet purchased Youtube. Yet, it's interesting that Anderson failed to see how the same "democratization" he describes in the recording industry would also apply to video.

Anderson also takes a cursory look at the economics of software-as-a-service (SaaS) companies. Although he illustrates the success of Salesforce.com and how this model creates a secondary market of platform developers to customize it, he doesn't deal with competition and survival -- how these new services will supplant old software, change the consulting business, and whether these spaces will inevitably consolidate as they mature or remain fragmented.

The Long Tail is written for the mass market, but it's not a how-to book. It won't tell a start-up or small retailer how to compete with big businesses that have already mastered the distribution system of the internet economy and its virtual warehouses. It's still highly applicable to e-commerce today, and recommended reading for refreshment and inspiration. There's likely demand out there for whatever you offer, if you can find a way to connect with it.

The Long Tail: Why the Future of Business is Selling Less of More, by Chris Anderson, Hyperion July 11, 2006, ISBN-10: 1401302378, ISBN-13: 978-1401302375

This post was originally published on my other blog, https://tech.surveypoint.com

Rework is as much a manifesto as a business guide. The content is less bombastic than some of its advance publicity, but be prepared for a polemic. Authors Jason Fried and David Heinemeier Hansson (the inventor of Ruby on Rails) argue why you should keep your company's size and products as small as possible. Their attitude toward growth for the sake of growth is skeptical, if not outright antagonistic. Their main exhibit is 37Signals, the company they founded, which has only 15 employees serving millions of customers.

They make a compelling case why start-ups and entrepreneurs (two terms they detest) should put aside plans for creating a big splash in the market. The book advises anyone with business ambitions to do what they love, embrace constraints like lack of outside funding, launch quietly and work to build incrementally on small successes with real customers. Readers who have spent a few years in high tech won't find many surprises here, as these observations have now become industry imperatives. However, newer entrants will find some inspiration in them. Rework assures you that you can build a sustainable business without 80-hour work weeks, consultants, and major expenses -- if you focus on the right things.

The authors are at their best when applying their small-is-beautiful credo to operational decision-making. Without jargon, they apply concepts recognizable from agile software development. According to Fried and Hansson, business plans, even medium term ones, are guesses; therefore, one shouldn't waste much time on them. Instead, a business should focus on the immediate weeks to come. It's important that your team have an exact understanding on where you're heading at the moment. You'll decide on what happens next when you get there. They note how a new, anonymous company can use this stepwise cycle to its advantage, for instance by experimenting and collecting feedback to guide the next stage.

Another consequence of this just-in-time approach to planning is that it simplifies prioritization for most workers. There's only two classes of things: what we're working on now, and what can wait until later. As an example of their commitment to this extreme, the writers brag that they launched their flagship product, Basecamp, without even an invoicing system -- knowing that they'd have 30 days to put one together for their first monthly billing.

As a product manager, I was particularly interested in the book's argument for sticking to a limited feature set. There are multiple reasons against adding new features. They make the software too complex for some customers; they distract you from improving your core competency into doing too much; they make you less innovative, too worried about imitating competitors. The authors are so passionate about sticking with your own vision of the product that they caution you against listening too much to your customers, even at the risk of losing them. Talking about their experience with Basecamp, their project collaboration software, they say they resisted the urges of existing clients to make it into a more full-blown project management system. Their rationale? They're more interested in selling to the vast millions who want basic features than the smaller number who want an advanced product.

The latter chapters fail to sustain the promise of the early stories that lay down the principles. The text feels like a scatter-gun attempt to cover subjects in which the writers have little or no interest. There's criticism of marketing, customer service, hiring practices and policy manuals, yet little advice you haven't already thought about. An exception is the explanation of why you should promote your business by freely educating your audience. Rework contains some good illustrations why sharing your expertise can build your brand, and why you shouldn't worry about giving away too much.

Whether you like this book will depend on your temperament. The authors value control over their work and question why anyone would want to see it diluted by factors like venture capital and expansion into new markets. They don't see themselves as overprotective for foregoing the chance to make their company larger. On the contrary, they believe that growth makes you more timid and risk-averse, as you struggle to scale your model and please investors.

Five years ago, Rework might have provoked intense debate about business practices. Today, its ideas have less novelty. The book is nonetheless valuable as a reminder that bigger often isn't better, and as a challenge to teams within all enterprises to seek simplicity and set boundaries.

Note: this review is based on listening to the full unabridged audiobook of Rework, not the hardcover edition.

Rework, by Jason Fried and David Heinemeier Hansson, Crown Business, March 9, 2010, ISBN-10: 0307463745, ISBN-13: 978-0307463746

This post was originally published on my other blog, https://tech.surveypoint.com

I've previously given arguments why the private insurance industry is not worth preserving and how nationalized health care would boost the economy. But even if legislation passes, there's a justifiable fear that health care reform will fail -- by making too many compromises, or by escalating costs even further.

There's a lot we can do to control the costs, and it doesn't take a congressional commission. The blueprint already exists, many employers have tried it, and it works. It's the Health Savings Account, a medical savings account linked to a high-deductible medical policy. John Mackey, CEO of Whole Foods, cited them in a Wall Street Journal op-ed among private enterprise alternatives to "ObamaCare".

Mackey was pilloried by the left, including some angry customers, but he had a point. Premiums for policies linked to HSA's cost businesses a lot less. They also reward consumers for assuming more of their initial costs, while providing a backstop against catastrophic medical expenses.

My main disagreement with Mackey is that he sees HSA's and government health care as opposing choices. That's a false distinction. Part of the HSA's advantage is that your medical savings account is tax-deductible. Unlike an IRA, though, you don't pay taxes on it later. An HSA is inherently a government-funded program, whether or not Mackey admits it.

Tax deductions for private savings accounts are a kind of soft paternalism. Instead of mandating which insurance policy to buy, government is encouraging a particular choice by subsidizing you when you choose that option. It's not government control, but government is definitely influencing demand and decisions in the market.

Now, if government is offering tax deductions to incentivize HSA's, why shouldn't it take further steps to spur their adoption? The obvious problem to address is the portability of the medical insurance linked to an HSA account. People would be more likely to choose an HSA if they knew that they could maintain eligibility for their current insurance, through any changes in employment. Without this guarantee, HSA's are at best a small hedge against future medical costs. If you lose your insurance, a single hospital stay could wipe out your HSA account. Why save if even diligent saving won't do you much good?

A good national health care plan would couple incentives for HSA's with high-deductible medical insurance that is guaranteed renewable. The latter will never happen if insurance industry lobbyists have their way. And that's why government has to step in and set the terms, including the so-called "public option".

HSA's and high-deductible accounts on a massive scale would be sustainable, unlike Medicare. Your policy wouldn't pay for everything. But it would be there to limit your risk and keep you -- and your country -- from going broke.

This post was originally published on my other blog, https://tech.surveypoint.com

My last post about the failure of private health insurance was prompted by a conversation with a friend. Both of us are baby boomers, at that life-stage where we and our spouses work as much to secure affordable group health insurance as for the wages. Neither of our families has suffered major illnesses that would invite insurers to deny us coverage or offer us policies riddled with exclusions for "pre-existing conditions." (Can conditions be otherwise?)

You could say that our self-interest in national health care is driven by our hope that we can retire someday. It's not the economy or the state of our investments that most concerns us; it's the threat of sudden bankruptcy due to a major illness or accident.

The linkage between health insurance benefits and full-time employment got me thinking: what if the two were de-coupled? Could the benefits of guaranteed health insurance outweigh the costs of insuring everyone? That question can't be answered comprehensively. The equation depends on your philosophy -- about the role of government, what we owe the elderly and the economically disadvantaged, and what must be left to individual responsibility.

I have a narrower goal. I'll state the case for national health insurance in terms of one set of benefits: how it would help the U.S. economy, leaving aside questions of social justice. I'm not going to argue all the particulars of the legislation, including the mix between private insurers and the public option. For now, let's define national health insurance as health insurance that is:

• Mandatory for all Americans and covers all Americans.
• Guaranteed coverage. You cannot be refused insurance by any company or government agency participating.
• Portable. Your insurance is not linked to any employer. You do not have to re-apply and your rates don't change when you switch jobs or lose one.
• Uniform, with the same choice of benefits regardless of where you work or what insurance company administers the plan. This means you could opt for, say, Plan A or Plan B or Plan C. If you choose Plan B, it will be the exact same policy whatever company (or government) you buy it from.
• Paid for 100% by consumer premiums and the federal government. You might continue to pay your premiums by payroll deductions; however, your employer would not pay any part. Your policy costs you the same whether you pay it from your paycheck or your checkbook.

These conditions -- especially government defining the terms of policies and the absence of employer contributions -- are stronger than the legislation currently stalled in Congress. Many insurers would balk at participating (good riddance). A nationalized system like this, however, would have immediate and long-lasting economic benefits:

• Profits. Conservatives believe that every dollar businesses pay in increased taxes and mandated wages causes a corresponding decline in worker hiring and pay. If that's true, then the cost of employer-funded health insurance is also a damper. The average monthly premiums for small businesses (including worker contributions) are approaching $500 a month. Freeing business from kicking in for workers' health insurance would be the biggest boost to the corporate bottom line in decades, and job growth would follow. Smaller businesses pay the highest premiums and would benefit the most. Our exports would also increase, because U.S. businesses would have a cost structure more like foreign companies whose governments already provide for everyone's health care.
• Productivity. Millions of Americans loathe their jobs. Many won't leave them because they can't afford to lose insurance, even temporarily. They're squatters, motivated by fear of losing their benefits. If they could carry their health insurance with them, some would vacate, leaving job openings for people who really want the positions.
• New jobs. When insurance is portable, it will lead to new jobs, not just mobility between existing jobs. More workers could afford to go from full-time to part-time work, and take the leap into contracting or starting their own businessses. New jobs will increasingly have to come from these smaller companies, as larger companies continue to cut their workforce to please their lenders and the Wall Street analysts.
• Brains. Job squatting leaves few openings for youth in this stalled economy. It negates much of what we spent on their education. When someone graduates from college without a job, (s)he's not acquiring the experience that will prepare her to take over jobs from older generations. The cost of delaying entry into serious jobs isn't measured in our economic statistics, but it's surely not good for our future to keep young talent waiting. A recent Atlantic magazine article by Don Peck documents how the recession is affecting the young -- effects that may linger as they age. By everything I've mentioned above -- job mobility, new hires, new businesses -- national health insurance would accelerate job advancement, bringing more of them into middle-class status. Good for them, good for consumer demand, good for innovation.

I hear well-meaning people advise Obama to put health care on the back burner in order to focus on jobs creation. Don't they get it? National health care is a jobs program, a rare "two-fer" in politics. Compared with so-called stimulus efforts to date, it's far more defensible. Rather than a stopgap solution to keep some programs afloat, it would lift every business and many workers.

So cry socialism if you want. Businesses should be cheering for national health care. They have nothing to lose but their chains.

This post was originally published on my other blog, https://tech.surveypoint.com

I was talking with a friend recently about health care reform and how it has divided the public. Both of us understand the concerns about government control. However, we can't understand how our country could do worse than the private insurance "system". As my friend put it, private insurers "add no value". An insurance company wants a return on its money greatly exceeding its administrative costs. And the industry has done whatever it takes to get those returns: slow-pay on claims, denying coverage, excessive paperwork that frustrates physicians and patients alike.

If other companies ran their businesses with this kind of attitude, they'd be out of business. And legitimate businesses suffer along with families. Every year, they go shopping for new health plans because of double digit rate hikes. Insurers have no incentive to keep customers; indeed, they thrive on this turnover. They get to underwrite newer and less comprehensive policies, based on latest medical histories. By the time they even bother to send out the new identification cards, and employees learn to navigate the chaos, it's February. What a way to generate cash flow.

About the only other enterprises that benefit from this cynical game are ones that also leech off its complexity: benefits consultants who help companies shop for policies; and banks and financial services firms who administer tax-deferred spending accounts (FSA's and HSA's) and get to play with the deposits. Yes, some of the same folks whose gambles brought down Wall Street are now in charge of our medical savings accounts. They vacuum off as much as 25% of the premiums paid by employers.

You couldn't design a worse demonstration of capitalism than U.S. private health insurance. The parts of American medicine that one might brag about compared with other countries -- technology, high-end care, operations without waiting lists -- don't depend on perpetuating private insurance as the consumer's only option. In fact, insurers often inhibit these services in their policies and practices. Their goal is to spend as little of your premiums on care as possible. What they can't outright deny, they're going to make difficult to get.

Moreover, the efficiencies that insurers claim are based on false economies. It's easy to pay claims when you're cherry picking from the national workforce, leaving government to pay for the old, the indigent, the unemployed and underemployed. If the insurance market serves only the part of the population least in need of medical care, on top of expensive and indifferent administration, then what's the value of the industry to us all? Government has left them alone for too long. They've prospered for themselves and failed to deliver. The national conversation shouldn't be about competing with them. It should be about replacing them.

It's clear that private insurance doesn't serve the public good – whether you judge it by business standards or social justice.. Would a national health insurance program improve things much? I'll cover that in a future article.