No Freaking Wonder Health Care Costs are Sky High

Item: Shoes without internal seams needed for my big ass feet. My feet hurt.

Go to Podiatrist (nice guy), says I need diabetic shoes.

Go to an orthopedist on my plan.

Diabetic Shoes at Orthopedist: $200.00 for Shoes, $200 each for 'orthodontics.' $800.

Orthodontics? $200 and I need 3 sets? Why?

"Because they wear out." Duh, but OK, I've worn my $100 chiropractor-fitted orthodontics for about five years now and the glue holding the spongy-junk on top is disconnecting with the leather bottom.

These $200 shoes are wide enough, right? "Yes."

Wait two weeks (!)

The orthodontics are 1/4" flat pads.

I look questioningly at the orthopedist, "they'll shape with your foot."
I explain to this health care 'professional,' this is not an orthodontic. You didn't taker a cast of my feet while I was standing, they're not blue, they're not about  1/2" thick rubber-link material for cushioning.

These are 1/10th inch felt. If I wanted them to mold to my foot, I'd buy clay. I want something that'll help my posture and my aching back.

"They are what they are, Mr. Witt."


If I hear that stupid line one more time....
The shoes are too narrow.They're rubbing against my outer toes,

"We got you the widest they make."

I told you three times I have really wide feet.

"We can put them on the widening machine."

Hold it.

I saw that episode of the Dick Van Dyke Show, you're going to use a broom.

"No, it's a real machine."

Lemme see it.

"Sorry, insurance won't cover you in the machine room."

Yeah. Right. All right. Give it try. OK.

 (Ten minutes pass to the second).

I try them on again.

They're still rubbing my left foot.

My left foot has been almost totally numb for more than a year. This is one reason I want good shoes.

Some vertical bra is pushing on a emphatic node in my back, squeezing the nervous system until it bleeds nerves. Or something...

So my bad foot feels like the shoe doesn't fit. They're $200 shoes...$300 if you count the fancy felt lining.

Right. Send the $800 shoes back.

"We already billed and received the claim from your insurance."

Then send them a refund.

I had to call Blue Cross because those thieves actually made the claim before I got the shoes and that company's claim was already posted to my account. It felt like going to the neurologist. I felt he was more interested in my co-pay than in my back and neuropathy.

  Figure 1a: You thought I was kidding, didnja?

Yeah. Kinda like going to a chiropractor- when you call for an appointment no a days, they want your VISA number before they'll even set up an appointment.
I am sooooo glad there's a new university out my way making more of these people.

Palmer method my ass.

Well, we could write these things off as bad egg, but I needed a new strap for my Sleep Mask.

I went in, showed the receptionist the strap.

It only fits only one style of A-PAP/C-PAP mask. Sleep Apnea machine stuff. It works.

The mask keeps slipping off even when the strap worked.

She typed for 45 minutes.

I use a keyboard all day. Never for that length of time. Never stopped for a breath.

I said, Really? for a $5 strap?

"I was billing your insurance."

But I haven't bought anything yet.

"Oh, you're self-paying?"

I suppose you can call it that.

In olden days we called it retail commerce.

I give you money and you give me what I picked out.

(ten more minutes of typing).

"That'll be $38.12, please."

How much?

"$38.12"

Really?

"That's what the computer says."

No, really, this is only two cut bands of elastic cut in a V with velcro ends.

"Yes, Mr. Witt, I know. That'll be $38.12"

Thanks, but no thanks.

The reason they can get away with this crap is because someone else is paying the freight. And because someone else is paying for it, no one gets indignant, combative or huffy or outraged (like me). Our third party payers threw in the towel years ago.

It's not like I was buying syringes or, forgive me, alcohol wipes. The mail order pharmacy charges $10/box. I found them this morning at Walgreen's for $2.67. Why dies it cost $10 for alcohol-soaked paper in tin foil?
So, I'm going to ask my wife to sew two pieces of elastic together and plop Velcro on the ends.

I bought the Walgreen's wipes because I'm too lazy to find the cotton puffballs and the alcohol bottle ion the linen closet.

And I found seamless shoes at SAS for $525 less than the price at the orthopedist. They were made in San Antonio by Americans. And they fit.  And I didn't pay extra for the Velcro.
www.sasshoes.com.

This is my second pair...the first pair bit the dust about a year ago. Nine years after I bought 'em. They are the most comfortable shoes made...and they can fit most anyone.
Is it any wonder we needed health care reform? Or that so many people can't afford it because if these silly prices.
Bah. Humbug.

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CBAP and Me: Why I'll Have to be Dragged Kicking and Screaming to Study for that Test

It must be me. Companies are all piling on and requiring CBAP (Certified Business Analyst Professional), offered by the IIBA (International Institute of Business Analysis). Check this out: IIBA CBAP Stuff.

Excellent work (I surmise it's from the IIBA BOK or Body of Knowledge) and an interesting summary of requirements gathering.

See, this is why I didn't take the PMI (Project Management Institute) test for PMP (Project Management Professional) . After going through the boot camp and finding out what that test was really all about, I didn't say no, I said Hell No.

That test is a measure of how much you can memorize about processes and procedures you wouldn't use on a project in a million years. Yes, having a methodology is a good thing since it can be the backbone of projects you come into cold. But more often, the PMs I see using the PMBOK (Project Management Body of Knowledge) are much more concerned about keeping their Microsoft project plan nice and neat and pretty much leaves the real work to the project team.

Obviously there are exceptions and there are some really dynamic PMs around.

So I looked over the CBAP requirements.

Modeled on PMI. It takes about three days just to finish the application.

So I really have to wonder if memorizing really tells your client or your end user that you are an effective and ethical BA. Wouldn't previous folks with which I've worked be a better read on how well I do my job?

Is this CBAP stuff going to help me create a gaps analysis? Vision Statement, Statement of Work, Status Report?

Will it certify I can help a developer on a spike/sprite and research quickly and efficiently?

And what will a CBAP certificate on my desk (we don't have walls or cubes) certify I can write an acceptance criteria on a User Story? Identify controls with the UxD expert? Model Workflows? Group the workflows into scenarios with the designer? Setting up a a one to one mapping of my Actors to her Personnas?
And, oh yeah, I'm hearing these certificates are now good for Agile methods.

I think mentoring folks who want to become BAs is a better idea. Have them, I dunno, research and write some use cases? Listen to how they question end users and stakeholders- create questionaires- create a risk or a couple of communications plans. During the project are they quickly and efficiently revising the artifacts?  Are they doing sanity checks against the end user and business requirements?

So instead of memorizing, I'll learn what my client needs, how the end users will use the software, run JAD (Joint Application Design) meetings and work with the UxD expert to figure out how we're going to meet the stakeholder's requirements in the best way for end users.

In Agile, everyone on the team can and do help out where ever they can. I'll do that and help let the Devs develop.

I think that kind of study time is well spent.

Agile in a Regulated Environment

Now, I don't know what happened when the Initiation phase was done a year ago this month, but I know what I've been doing since October on this project for a healthcare hardware maker.

It's been a while since I was exposed to FDA and HealthCanada and European Common Market regulation- and even then, it was a glancing blow- for medical gases- pretty straight forward.

With testing equipment, the load's a lot different.

The Agile Principal:

"The most efficient and effective method of
conveying information to and within a development
team is face-to-face conversation."

Is pretty much thrown out the window. Like Waterfall, paper seems to be king.

So we adapted. We put all the User Stories, comments, hazard analysis and developer notes on database changeson our wiki. A junior team member goes up to the wiki, picks a User Story, then uses  a <ctrl><a> and <ctrl><c> to save it in the clipboard then<,ctrl><v> to push it to a  Word template, clean it up and then go back for all those nice pictures the devs and managers like (because they never read the tests- sorry- Acceptance Criteria; actually, we have one dev who really reads the stories- shocked the bejesus out of me). Curse me for making Work Flow Diagrams!

Then, we add the title to a spreadsheet template with 6 to 12 bazillion acceptance signatures. Seriously. Signatures. And we get 'em, too! Then save 'em, batch print them to annoy non-project staff.

Add a test case result sheet from the QA guys (who are the only others who actually read the stories- sorry, this a class project; there's someone else who actually reads the stories, we have an actual tech writer stealing hours from my time card), a paper clip and then it gets scanned into some other application that actually freezes the User Story's state and requires an Act of Congress for a change.

This also scares me. I don't spell that well, my grammar's off sometimes when I forget 7th grade sentence parceing and I forget stuff when I'm getting whipsawed while writing a story-editing the one from last month the to which the QA team got (how's that fer grammar, eh?)-seeing my product owner making the mistake of walking by so I can grab him for just a few questions- redoing what the QA wanted me to do because he called me on a quick change instead a comlete job- and a dev asking me questions about a story written a month ago.

So, you're likely to see a few numbering, um, issues and a single word from a previous requirement I forgot to delete. My editor, who happens to be the Risk Analyst and the fellow that wrote the original version of this software, just caught two more of my , er, issues.

So the big changes the team had to make are:

• Realize we have throwback to the Waterfall/Iterative demand that 'Documentation is King.'  We created a process that isn't too heinous, but keeps the stories short, to the point and on the wiki as the primary story keeper while meeting our customer's documentation requirements.
• Sign-offs are not a simple head nod in this environment. In fact, sign-offs are worse than Waterfall.
• When you do the sign-offs after implementation (and after the head nod), it becomes a paperwork process you can hand off to a junior level team member so it doesn't get in the way.
• HIPPA, Good Manufacturing Practice. The Regulatory Guy (Gal) is the king after you meet the business needs.
• Scot needs a remedial English Course. You don't gotta know how to spell in radio.
  

Good News!

So I was notified my services would not be required as of October 1 on September 23.

On September 27, the fellow who taught me how BAs fit into Agile Development (yeah, I capitalized it, wanna make sumpin of it?) calls me in the evening, after work.

We exchange pleaseantries and he asks if I'd be interested in working on a potentially Huge Project (yeah, I did it again, didn't I?) downtown for a non-profit.

Now, I hate communting into the city for any reason. Besides being a big guy (OK. I'm fat), one knee has arthitis I found out four months ago) and the other's patella (knee cap-pretty cool that I knew that- I watch Bones) is improperly placed all of a sudden (which I found out on the same visit).  Then the left foot went numb- the MRI (Magnetic Resonance Something or Other- I'm on a roll, no?) says two important disks are either pinching or something. Oh yeah, you have mild neuropathy (duh, I'm diabetic)- surgery really isn't an option- go get PT (Physical Therapy- this medical stuiff just rolls off my tongue, doesn't it?), that'll be $750 please.

Well- that's why I hated going into the city, I thought as I mildly said, "Hell yeah," to my former and now current boss-guy. But for the rate, I guess I can take a cab,

Just like last time I worked at Pathfinder (the other names change by the phase of the moon- first it was Pathfinder Associates [PFA]- that changed to Pathfinder Development [PFD] after I was 'flipped' from contracter to employee (they don't have to pay me as much, but I get paid holidays) and now it's (I think) Pathfinder Software [PFS]). That marketing stuff is better handled by the experts, not moi.

So I went downtown exactly once. The two hugely intelligent guys doing the rationale for revamping the non-profit's IT Architecture pretty much handled it exquistely. I did some wiki stuff that nobody will use- just like 2005-1008.

And just like 2005-2008, another project desperately needed help, and I got assigned. It was originally for three days a week, but the non-profit project won't need me until the overall project gets approved and my company gets a piece of it (happy assumptions here).

So I'm working with a, as per usual for PFA/D/S, superb team with an exteremely talented whipper-snapper Project Manager (he can't be a day over 20 even if he graduated at Georgia Tech with a Masters and worked there for a number of years and has two kids). The project is exceedinlgy complex as a result of business requirements (pretty much standard for all the projects I've worked on).

But it's supposed to go through January- probably even longer since it's health related and there's a lot of FDA junk that needs to be done.

While I'm happy as a pig in...um..er...you know, I still can't figger out how the hell I dumbly get assigned to projects with really smart people. Blind luck? Probably....

Update

So my time at large financial company is over. Like October 1.

The time was well spent in a cool project. Except:

• How can you create a new user look and feel when you've already coded, marketed and have begun user instructions when half the application before you hire the UxD or BA contractors, and then demand they adhere to non-existent control and design standards?
• Why does the head honcho not know such a major overhaul requires an As-Is snap shot to make certain the requirement "All previous version functionalities must be present in the new version" is met?
• How can you deal with a project manager that asks contracting companies, half way through the project, to prepare bids without budget requirements and on what basis the company will choose its contracting team.

Yeah. My team lost.

Oh well. I got paid, I created some useful, if convoluted, requirements and diagrams. And worked with some really sharp people.

Since I don't have to support the application on implementation, I'd say it was a fair trade. But I feel bad for the folks that have to stay.

Down and Dirty Baseline

Management wants As-Is documentation for its existing application. It handles billions of dollars each month. And the developers have already started working on the Manufacturer side of the application and want a lot of code and reporting re-use. I'm with the Dealer side.

Coding starts in mid August.

How to get this done was the first meeting I attended after my company laptop was issued and I found my cube int he farm.

I suggested a light weight requirements process- a description of current functionality, a screen capture, a process flow activity diagram and functional descriptions we can infer from playing with the application. Once these "use cases" are complete, we'll walk SMEs through them to correct errors, add stuff we had no clue about and the like.

We will have the required baseline done in a very short period. Enough to do a Gaps Analysis of Version 1 compared to plans for Version 2.

So far we've created a "use case" number and title for each major major page and cross referenced to menus.

It seems to be working- at least the boss is very happy check marks in the tracker are increasing in quantity and the 'now published' announcement e-mails are coming a lot faster. The BA team has access to the QA/Development environment. I got the Create User doc done in about a day and a half. The current system, as you'd expect, has had several changes over the years and is, um, complicated.

Abstraction is a wonderful thing.

Since Create User is the first major design issue, I'm already talking about Version 2.0 with the IA/Designer as I delve deeper into this really cool piece of work that has combined two or three legacy applications and several upgrade security tools. This archeological stuff is interesting. The boss is a SME and quite amazing himself. So this isn't going to be the cluster ***k it could have been.

I'll letcha know. This Agile stuff works great. But of course, you and I already knew that.

Scary, Kids, Scarry!

<I've added a few musical touches, tell if you like/hate them>

OK, County Floyd from SCTV, I'm officially creep-ed out.

Google's new 'social networking' tool, Google+ is crawling around our computers. See PC World Article for background.

(upbeat banjo licks)

My own moment of clarity came about two weeks ago. I got a message concerning Google's new two part security system. There was a big hack job a few weeks ago and this was Google's answer.

(organ mystery stab)

The new system requires you to use a second password to get to your Google stuff. I set it up from my laptop and  Android Smartphone (which really isn't smart at all...but that's a different rant you can expect in the days to come). Worked great the first time I did it.

(heavy timpani role)

Then I programmed my password manager to handle the duties.

(Theramun stuff like in The Day The Earth Stood Still)  Yeah, it's a real instrument played with your hands weaving in and around an antenna looking thingie. Some say it was the first electronic instrument.

Anyway, back to our story!

Dummy me.

I did it from the smartphone.

(another organ stab)

See, the new system makes you download a new password generator app on your phone.

(Banjo up and under the next paragraph)

So you gotta log into Goggle, then your phone and then generate a second password the laptop site is demanding.

Hurry Up,. though! (banjo speeds up) You have only a couple of minutes to use it!

(banjo stops abruptly, timpani increase rhythm and under...)

And yes, you have to log out of Google on your phone, generate a new code, copy it, go back into Google and use the second password before it expires.

Have you ever tried to do anything fast on one of these touch pad keyboards? (Spike Jones something or other)  It's like trying to use a bat with cooking mittens on.

I did this on a Saturday. I needed Google Maps on Sunday. On my phone.

As soon as I got home, I ran everything back to default.

So, problems with Google+ don't surprise me in the least. And I'm getting worried about the smartphone I bought.

It uses Android (the cut down LINUX operating system), made by Google.

(Descending trumpet wah-wah's)