Efficiency's Inner Bound

The financial services industry makes its money helping capital find its way most efficiently to markets. But improving efficiency is not an endless game. You can't go beyond 100%.

Consider the rural electric transformer on a pole. It is about 90% efficient. That means that 90% of the electricity which goes in one end comes out the other. The rest departs as heat. The transformer could, in theory, be made 10% more efficient, but that's all.

The better the financial services industry does its work, the less there is to further achieve.

This suggests that so long as the biennial doubling of info system power continues, the financial services industry will converge on an ISO-9000 like efficiency. It will not be a growth industry.


Another version of the inner bound problem appears as quarterly report bottom-line creep. A business needs to be more efficient every year, spending less on costs and rendering a greater percent of income to its owners as profit.

But reducing costs is a game of diminishing returns. The more you work at reducing costs, the less productive your efforts. The ideal of reducing costs to nil and simply passing through any income directly to the owner is a model that - so far - only works for an author who sells her works online. Others who try this end in jail.

There may be a built-in imperative to the financial services industry that leads its members toward landing in jail.

Publish The Medicare Billing Codes?

Dear Mr. President,

Could you help us elders fight Medicare fraud by putting the descriptions for billing codes and diagnosis codes up on the internet where we can see them?

I'm being forced to pay for my free PSA screening exam for the second year in a row due to clinic mis-billing. Please give me what I need to fight this.

My latest free PSA screening exam was billed with an obesity diagnosis code.

Medicare rejected it as not medically necessary for obesity. Blue Cross agreed. It took me four days of research online to discover that the correct billing for these PSA annual screenings is

HCPCS screening code G0103 in company with ICD-9 diagnosis code V76.44

My clinic's Medicare billing coder steadfastly refuses to use this V76.44 code. He has now submitted my latest test's billing a third time without it.

He tries instead to use case management diagnosis codes. He sends the bill to the diagnostics service, they then put CPT treatment code 84153 on the billing - their web site has no mention of G0103, but it preaches 84153 - and it fails every time for screenings. Eventually, dunning letters close the box. This is happening here in Hyde Park, Chicago, IL.

To me, maybe to many.

When Medicare rejects a billing, the insurers are freed of obligations, and poor old men have to pay. We cannot fight numeric codes. Can you please set a visible and understandable public standard for these codes?

Can you chisel them on a column?

Can Moore's Law Unwind Tribalism?

A lot of Earth's troubles these days take shape as conflicts between modern countries and such old-style governments as the harsh monarchies in Southeast Asia and the the tribal governments in the Middle East. Power is hard to let go. Holding power for centuries makes it seem natural to hold. Incredibly poor people slave for the incredibly wealthy. Naturally, they are revolutionaries.

Can we sell these people cellphones? With cameras and internet access? What would happen then?

Cellphone prices are cut in half every two years, thanks to Moore's Law. Even the poorest will someday have Blackberries. When people so gather, how can tyrants survive?

How Can We Teach The Entrepreneurial Art?

My father always wished that his father had taught him the knowledge of money and how it is made. But his father didn't know, either.

Tap a proletarian and you find a petit-bourgeois. A majority of the workers that I've known over the years dreamed of going into business for themselves. Become your own boss and maybe somebody else's, too.

How does one become an entrepreneur? How does one learn to see opportunity?

Identify a need. Find a way to fill it.

That's all I know. But there's more. If we could only find someone to teach it.

Someone entrepreneurial could make a nice living teaching the art.