Tag Archives: waste

Planned Obsolescence

Guiyu-ewaste

Our digital technologies bring us many benefits: improved personal and organizational efficiency; enhanced communication and collaboration; increased access to knowledge, information, and all manner of products and services. Over the foreseeable future our technologies promise to re-shape our work-lives and our leisure time ever-more, for the better. Yet, for all the positives, our modern technology comes with an immense flaw. It’s called planned obsolescence. Those who make and sell us the next, great digital gizmo rely upon planned obsolescence, combined with our magpie-like desire for shiny new objects, to lock us into an unrelenting cycle of buy-and-replace, buy-and-replace.

Yet, if you are over 30, you may recall having fixed something. You had the tools (some possibly makeshift), you had the motivation (saving money), and you had enough skills and information to get it done. The item you fixed was pre-digital, a simple electrical device, or more likely mechanical — positively ancient by current standards. But, you breathed new life into it, avoided a new purchase, saved some cash and even learned something in the process. Our digital products make this kind of DIY repair almost impossible for all but the expert (the manufacturer or its licensed technician); in fact, should you attempt a fix, you are more likely to render the product in worse shape than before.

Our digital products are just too complex to fix. And, therein lies the paradox of our digital progress — our technologies have advanced tremendously but our ability to repair them has withered. Even many of our supposedly simpler household devices, such as the lowly toaster, blender, or refrigerator have at their heart a digital something-or-other, making repair exorbitantly expensive or impossible.

As a kid, I recall helping my parents fix an old television (the kind with vacuum tubes), mechanical cameras, a vacuum cleaner, darkroom enlarger, doorbell. Those were the days. Today, unfortunately, we’ve become conditioned to consign a broken product to a landfill and to do the same with our skills. It would be a step in the right direction for us to regain the ability to repair our products. But don’t expect any help from the product manufacturer.

From WSJ:

We don’t have to keep buying new gadgets. In fact, we should insist on the right to keep old ones running.

Who hasn’t experienced a situation like this? Halfway through a classic Jack Lemmon DVD, my colleague Shira’s 40-inch TV conked out. Nothing showed up on the screen when she pressed the power button. The TV just hiccupped, going, “Clip-clop. Clip-clop.”

This was a great excuse to dump her old Samsung and buy a shiny new TV, right? But before heading to Best Buy, Shira gave me a call hoping for a less expensive option, not to mention one that’s better for the environment.

We ended up with a project that changed my view on our shop-till-you-drop gadget culture. We’re more capable of fixing technology than we realize, but the electronics industry doesn’t want us to know that. In many ways, it’s obstructing us.

There’s a fight brewing between giant tech companies and tinkerers that could impact how we repair gadgets or choose the shop where we get it done by a pro.

At issue: Who owns the knowledge required to take apart and repair TVs, phones and other electronics?

Some manufacturers stop us by controlling repair plans and limiting access to parts. Others even employ digital software locks to keep us from making changes or repairs. This may not always be planned obsolescence, but it’s certainly intentional obfuscation.

Thankfully, the Internet is making it harder for them to get away with it.

My first stop with Shira’s TV, a 2008 model, was Samsung itself. On its website, I registered the TV and described what was broken.

Our TV problem wasn’t unique: Samsung was taken to court about this exact issue, caused by a busted component called a capacitor. With a little googling of the TV model, I found our problem wasn’t unique. Samsung settled in 2012 by agreeing to extend warranties for 18 months on certain TVs, including this one. It also kept repairing the problem at no cost for a while after.

But when a Samsung support rep called back, she said they’d no longer fix the problem free. She passed me to an authorized Samsung repair shop in my area. They said they’d charge $90 for an estimate, and at least $125 plus parts for a repair.

Buying a similar-size Samsung TV today costs $380. Why wouldn’t Shira just buy a new TV? She felt guilty. Old electronics don’t just go to the great scrapheap in the sky—even recycled e-waste can end up in toxic dumps in the developing world.

Enter Plan B: Searching the Web, I found a ton of people talking about this TV’s broken capacitors. There were even a few folks selling DIY repair kits. The parts cost…wait for it…$12.

Read the entire story here.

Image: Digital trash, Guiyu e-waste town, 2014. Courtesy of Mightyroy / Wikipedia. CC.

Deep Time, Nuclear Semiotics and Atomic Priests

un-radioactive_warning_signTime seems to unfold over different — lengthier — scales in the desert southwest of the United States. Perhaps it’s the vastness of the eerie landscape that puts fleeting human moments into the context of deep geologic time. Or, perhaps it’s our monumental human structures that aim to encode our present for the distant future. Structures like the Hoover Dam, which regulates the mighty Colorado River, and the ill-fated Yucca Mountain project, once designed to store the nation’s nuclear waste, were conceived to last many centuries.

Yet these monuments to our impermanence raise a important issue beyond their construction — how are we to communicate their intent to humans living in a distant future, humans who will no longer be using any of our existing languages? Directions and warnings in English or contextual signs and images will not suffice. Consider Yucca Mountain. Now shuttered, Yucca Mountain was designed to be a repository for nuclear byproducts and waste from military and civilian programs. Keep in mind that some products of nuclear reactors, such as various isotopes of uranium, plutonium, technetium and neptunium, remain highly radioactive for tens of thousands to millions of years. So, how would we post warnings at Yucca Mountain about the entombed dangers to generations living 10,000 years and more from now? Those behind the Yucca Mountain project considered a number of fantastic (in its original sense) programs to carry dire warnings into the distant future including hostile architecture, radioactive cats and a pseudo-religious order. This was the work of the Human Interference Task Force.

From Motherboard:

Building the Hoover Dam rerouted the most powerful river in North America. It claimed the lives of 96 workers, and the beloved site dog, Little Niggy, who is entombed by the walkway in the shade of the canyon wall. Diverting the Colorado destroyed the ecology of the region, threatening fragile native plant life and driving several species of fish nearly to extinction. The dam brought water to 8 million people and created more than 5000 jobs. It required 6.6 million metric tons of concrete, all made from the desert; enough, famously, to pave a two lane road coast to coast across the US. Inside the dam’s walls that concrete is still curing, and will be for another 60 years.

Erik, photojournalist, and I have come here to try and get the measure of this place. Nevada is the uncanny locus of disparate monuments all concerned with charting deep time, leaving messages for future generations of human beings to puzzle over the meaning of: a star map, a nuclear waste repository and a clock able to keep time for 10,000 years—all of them within a few hours drive of Las Vegas through the harsh desert.

Hoover Dam is theorized in some structural stress projections to stand for tens of thousands of years from now, and what could be its eventual undoing is mussels. The mollusks which grow in the dam’s grates will no longer be scraped away, and will multiply eventually to such density that the built up stress of the river will burst the dam’s wall. That is if the Colorado continues to flow. Otherwise erosion will take much longer to claim the structure, and possibly Oskar J.W. Hansen’s vision will be realized: future humans will find the dam 14,000 years from now, at the end of the current Platonic Year.

A Platonic Year lasts for roughly 26,000 years. It’s also known as the precession of the equinoxes, first written into the historical record in the second century BC by the Greek mathematician, Hipparchus, though there is evidence that earlier people also solved this complex equation. Earth rotates in three ways: 365 days around the sun, on its 24 hours axis and on its precessional axis. The duration of the last is the Platonic Year, where Earth is incrementally turning on a tilt pointing to its true north as the Sun’s gravity pulls on us, leaving our planet spinning like a very slow top along its orbit around the sun.

Now Earth’s true-north pole star is Polaris, in Ursa Minor, as it was at the completion of Hoover Dam. At the end of the current Platonic Year it will be Vega, in the constellation Lyra. Hansen included this information in an amazingly accurate astronomical clock, or celestial map, embedded in the terrazzo floor of the dam’s dedication monument. Hansen wanted any future humans who came across the dam to be able to know exactly when it was built.

He used the clock to mark major historical events of the last several thousand years including the birth of Christ and the building of the pyramids, events which he thought were equal to the engineering feat of men bringing water to a desert in the 1930s. He reasoned that though current languages could be dead in this future, any people who had survived that long would have advanced astronomy, math and physics in their arsenal of survival tactics. Despite this, the monument is written entirely in English, which is for the benefit of current visitors, not our descendents of millennia from now.

The Hoover Dam is staggering. It is frankly impossible, even standing right on top of it, squinting in the blinding sunlight down its vertiginous drop, to imagine how it was ever built by human beings; even as I watch old documentary footage on my laptop back in the hotel at night on Fremont Street, showing me that exact thing, I don’t believe it. I cannot square it in my mind. I cannot conceive of nearly dying every day laboring in the brutally dry 100 degree heat, in a time before air-conditioning, in a time before being able to ever get even the slightest relief from the elements.

Hansen was more than aware of our propensity to build great monuments to ourselves and felt the weight of history as he submitted his bid for the job to design the dedication monument, writing, “Mankind itself is the subject of the sculptures at Hoover Dam.” Joan Didion described it as the most existentially terrifying place in America: “Since the afternoon in 1967 when I first saw Hoover Dam, its image has never been entirely absent from my inner eye.” Thirty-two people have chosen the dam as their place of suicide. It has no fences.

The reservoir is now the lowest it has ever been and California is living through the worst drought in 1200 years. You can swim in Lake Mead, so we did, sort of. It did provide some cool respite for a moment from the unrelenting heat of the desert. We waded around only up to our ankles because it smelled pretty terrible, the shoreline dirty with garbage.

Radioactive waste from spent nuclear fuel has a shelf life of hundreds of thousands of years. Maybe even more than a million, it’s not possible to precisely predict. Nuclear power plants around the US have produced 150 million metric tons of highly active nuclear waste that sits at dozens of sites around the country, awaiting a place to where it can all be carted and buried thousands of feet underground to be quarantined for the rest of time. For now a lot of it sits not far from major cities.

Yucca Mountain, 120 miles from Hoover Dam, is not that place. The site is one of the most intensely geologically surveyed and politically controversial pieces of land on Earth. Since 1987 it has been, at the cost of billions of dollars, the highly contested resting place for the majority of America’s high-risk nuclear waste. Those plans were officially shuttered in 2012, after states sued each other, states sued the federal Government, the Government sued contractors, and the people living near Yucca Mountain didn’t want, it turned out, for thousands of tons of nuclear waste to be carted through their counties and sacred lands via rail. President Obama cancelled its funding and officially ended the project.

It was said that there was a fault line running directly under the mountain; that the salt rock was not as absorbent as it was initially thought to be and that it posed the threat of leaking radiation into the water table; that more recently the possibility of fracking in the area would beget an ecological disaster. That a 10,000 year storage solution was nowhere near long enough to inculcate the Earth from the true shelf-life of the waste, which is realistically thought to be dangerous for many times that length of time. The site is now permanently closed, visible only from a distance through a cacophony of government warning signs blockading a security checkpoint.

We ask around the community of Amargosa Valley about the mountain. Sitting on 95 it’s the closest place to the site and consists only of a gas station, which trades in a huge amount of Area 51 themed merchandise, a boldly advertised sex shop, an alien motel and a firework store where you can let off rockets in the car park. Across the road is the vacant lot of what was once an RV park, with a couple of badly busted up vehicles looted beyond recognition and a small aquamarine boat lying on its side in the dirt.

At the gas station register a woman explains that no one really liked the idea of having waste so close to their homes (she repeats the story of the fault line), but they did like the idea of jobs, hundreds of which disappeared along with the project, leaving the surrounding areas, mainly long-tapped out mining communities, even more severely depressed.

We ask what would happen if we tried to actually get to the mountain itself, on government land.

“Plenty of people do try,” she says. “They’re trying to get to Area 51. They have sensors though, they’ll come get you real quick in their truck.”

Would we get shot?

“Shot? No. But they would throw you on the ground, break all your cameras and interrogate you for a long time.”

We decide just to take the road that used to go to the mountain as far as we can to the checkpoint, where in the distance beyond the electric fences at the other end of a stretch of desert land we see buildings and cars parked and most definitely some G-men who would see us before we even had the chance to try and sneak anywhere.

Before it was shut for good, Yucca Mountain had kilometers of tunnels bored into it and dozens of experiments undertaken within it, all of it now sealed behind an enormous vault door. It was also the focus of a branch of linguistics established specifically to warn future humans of the dangers of radioactive waste: nuclear semiotics. The Human Interference Task Force—a consortium of archeologists, architects, linguists, philosophers, engineers, designers—faced the opposite problem to Oskar Hansen at Hoover Dam; the Yucca Mountain repository was not hoping to attract the attentions of future humans to tell them of the glory of their forebears; it was to tell them that this place would kill them if they trod too near.

To create a universally readable warning system for humans living thirty generations from now, the signs will have to be instantly recognizable as expressing an immediate and lethal danger, as well as a deep sense of shunning: these were impulses that came up against each other; how to adequately express that the place was deadly while not at the same time enticing people to explore it, thinking it must contain something of great value if so much trouble had been gone to in order to keep people away? How to express this when all known written languages could very easily be dead? Signs as we know them now would almost certainly be completely unintelligible free of their social contexts which give them current meaning; a nuclear waste sign is just a dot with three rounded triangles sticking out of it to anyone not taught over a lifetime to know its warning.

Read the entire story here.

Image: United Nations radioactive symbol, 2007.

There’s Gold in Them Thar Dumpsters

One enterprising person has taken his passion for recycling and reuse to extraordinary lengths. Matt Malone is a professional dumpster diver, making a profitable business from others’ trash. And, there’s another great benefit to his growing business — keeping untold quantities of discarded goods, and some of it hazardous material, out of our landfills. Ours is a thoroughly wasteful society and sadly our consumer culture still rewards businesses for this wastefulness.

From Wired:

Matt Malone doesn’t mind being called a professional dumpster diver. He tells me this a little after 2 am on the morning of July 7 as we cruise the trash receptacles behind the stores of a shopping center just off the Capital of Texas Highway in Austin. Given the image that conjures, though, it’s worth pointing out that Malone has a pretty good day job, earning a six-figure salary as a security specialist for Slait Consulting. He is also founder of Assero Security, a startup that he says has recently been offered seed money by not one but two separate investors. Nevertheless, the 37-year-old Malone does spend a good many of his off-hours digging through the trash. And the fact is, he earns a sizable amount of money from this activity—more per hour than he makes at his Slait job.

Malone stops his Chevy Avalanche next to the dumpster in back of an Office Depot. Within seconds, he’s out of the truck and sticking his magnetized flashlight to the inside of the dumpster’s wall. He heaves himself up onto the metal rim to lean inside and begins digging through a top layer of cardboard and packing materials. Half a minute later I hear what I will learn is Malone’s version of eureka: “Hell yes! Hell yes!” He comes out with a box containing a complete Uniden Wireless Video Surveillance System—two cameras and a wireless monitor—which normally retails for $419. A quick inspection reveals that it’s all in perfect condition, although someone has clearly opened and repacked it. “A return,” he says, then plunges back into the dumpster.

Ten minutes later, when he’s again behind the wheel of the Avalanche, Malone continues to tell me about the material benefits of dumpster diving. If he were to dedicate himself to the activity as a full-time job, he says, finding various discarded treasures, refurbishing and selling them off, he’s confident he could pull in at least $250,000 a year—there is that much stuff simply tossed into dumpsters in the Austin area. He lists a few recent “recoveries”: vacuums, power tools, furniture, carpeting, industrial machines, assorted electronics. Much of it needs a little love, he says, but a lot of it, like this Uniden system, is in perfect condition.

But, he quickly adds, his foraging isn’t just about dollars. It’s also about the knowledge he acquires and the people he shares it with. He prefers to be known as a “for-profit archaeologist.” After all, archaeologists have always studied garbage. The esteemed William Rathje, who established the Garbage Project at the University of Arizona, observed shortly before his 2012 death that refuse, more than anything else human beings produce, “gives us insight into the long-term values of a civilization.”

As for Malone, the main insight he’s obtained from digging through our civilization’s trash is that most people don’t place a lot of value in value anymore.

Malone started dumpster diving nine years ago, when he was working at a lower-level corporate security job. His employer had assigned him to conduct what’s called a “zero-knowledge attack” on an Austin-based company. “That means you hire me and don’t give me any information about your operation,” Malone explains. “I’m just a random guy who wants to break into your system.” The most effective way to do this was to dig through his client’s trash; many hacks and identity thefts come from information left in dumpsters. Sure enough, after just a couple of weeks of looking through the dumpsters outside the client’s offices, he had amassed a box full of documents, loaded with the confidential information of thousands of customers. (“It made quite an impression” on his client, he recalls.)

But he also discovered something else. One night while doing his research, he decided to poke around in neighboring trash bins, including the dumpster at OfficeMax. Inside he discovered “a whole bunch of printers, discontinued lines that were still in the boxes.” He took the printers home and put them in his garage. But he couldn’t stop wondering what else was out there in the dumpsters of Austin. Before long, he went back out to see what else he could find.

A short and wiry man whose manic enthusiasm and radiant smile lend him a quirky charm, Malone says that at first he looked for items he could use himself, especially in his main passion, building and riding “mini chopper” motorcycles. On a hunch he checked the dumpster behind the Emerson Electric warehouse in an industrial park near his home, where he discovered several discarded motors that would provide enough power to move a mini chopper along at 40 to 50 miles per hour. Then, out of curiosity, he turned his attention to the dumpsters at Home Depot, Harbor Freight, Big Lots, Sears, Best Buy, and a few others. He was astounded at what he found: building materials, power tools, HEPA filters, and a dizzying array of electronics.

At first, Malone mainly used his discoveries for various hobby projects. Along with his mini choppers, he built an electric skateboard, a set of plasma speakers, several 3-D projectors, and a computer that ran while submerged in mineral oil. “People would come over and ask, ‘Man, where’d you get that?’” he recalls. “I’d say, ‘Well, I made it.’ I didn’t say right away that I made it mostly from stuff I got out of dumpsters.” Inevitably his friends would ask to buy his various toys, and—usually already bored with them and having moved on to a new project—he would agree to sell. Even so, his garage soon overflowed, and Malone decided he should make some space by staging a weekend yard sale.

That sale provided several revelations. The biggest was what sold with the drive-by public. “I had all my cool stuff out front, a couple of very nice computers, mini choppers, some high-end printers—the big-ticket stuff—thinking, ‘This is what’s going to make me the money.’” It wasn’t. Instead, people flocked to “the small stuff”: the photo paper and toner he’d pulled out of the dumpsters at OfficeMax and Office Depot, the hand tools he’d found in the trash at Harbor Freight, the CDs from GameStop dumpsters, the assorted seasonal tchotchkes that had been tossed by the employees at Pier 1 and Cost Plus. “I eventually figured out that I had to sell the big stuff on Amazon or Craigslist,” Malone says. But all those small sales added up: By Sunday afternoon he had collected a little more than $3,000 in cash. “And that was when I realized, ‘This has the potential to be something.’”

At the time, Malone explains, he was working for a company called Vintage IT and making only about half of his current salary, so he appreciated the opportunity to augment his income. He began to organize his approach, making daily checks of the various malls and business parks closest to his home to ascertain what days and times dumpsters were most likely filled with desirable items. Within a few weeks he knew exactly when the trash was collected at every store and business on his route so he could time his visits for when the dumpsters were fullest. He also learned to look for stores that were changing locations or—better yet—going out of business. Store remodels were also good targets. “I was learning as I went along and designing a kind of collection system before I even realized that was what I was doing.”

As we drive by a shopping center just off the Mopac Expressway, Malone remembers the weeks when the Circuit City that once anchored this mall was closing. “I went back day after day after day,” he says. “I got brand-new stereos, GPS devices, some really nice cameras, flatscreen TVs. I got a boom box there that was bigger than I am. And what was great was that you could sell it at retail, because it was all still in the boxes.”

Suddenly, Malone spots a huge “yarder” dumpster directly behind Bealls department store—an indication the store may be remodeling. Within moments he has pulled his truck alongside the yarder and used the truck bed to climb in. Wading through the cardboard and bubble wrap, Malone quickly finds three slightly used dress-form mannequins that he is sure can be sold to an owner of one of the pop-up clothing stores that have become popular in Austin. That’s just the beginning, though. During the next 15 minutes, he’s so deep in the bowels of the dumpster that at moments all I can see are his shoulders and the back of his head; he exclaims “Hell yes!” at least a half dozen times. When Malone is finished there are two large stacks of laminated MDF boards and plate-glass panels from discarded store displays in the back of the truck. He can use the boards at a workshop that he maintains in a small business park a couple of minutes from his North Austin home. “These precut boards are really expensive,” Malone says. “That’s money I won’t be spending.” Malone has operated a number of trash-related enterprises out of his shop, often with names like Chinese Scooter Repair.

Malone can get downright philosophical about the empire he’s managed to build out of garbage. “We can only do what we do here because we live in a society where most people have been conditioned to look past what’s right in front of them.”

Read the entire article here.

Why Sleep?

There are more theories on why we sleep than there are cable channels in the U.S. But that hasn’t prevented researchers from proposing yet another one — it’s all about flushing waste.

From the Guardian:

Scientists in the US claim to have a new explanation for why we sleep: in the hours spent slumbering, a rubbish disposal service swings into action that cleans up waste in the brain.

Through a series of experiments on mice, the researchers showed that during sleep, cerebral spinal fluid is pumped around the brain, and flushes out waste products like a biological dishwasher.

The process helps to remove the molecular detritus that brain cells churn out as part of their natural activity, along with toxic proteins that can lead to dementia when they build up in the brain, the researchers say.

Maiken Nedergaard, who led the study at the University of Rochester, said the discovery might explain why sleep is crucial for all living organisms. “I think we have discovered why we sleep,” Nedergaard said. “We sleep to clean our brains.”

Writing in the journal Science, Nedergaard describes how brain cells in mice shrank when they slept, making the space between them on average 60% greater. This made the cerebral spinal fluid in the animals’ brains flow ten times faster than when the mice were awake.

The scientists then checked how well mice cleared toxins from their brains by injecting traces of proteins that are implicated in Alzheimer’s disease. These amyloid beta proteins were removed faster from the brains of sleeping mice, they found.

Nedergaard believes the clean-up process is more active during sleep because it takes too much energy to pump fluid around the brain when awake. “You can think of it like having a house party. You can either entertain the guests or clean up the house, but you can’t really do both at the same time,” she said in a statement.

According to the scientist, the cerebral spinal fluid flushes the brain’s waste products into what she calls the “glymphatic system” which carries it down through the body and ultimately to the liver where it is broken down.

Other researchers were sceptical of the study, and said it was too early to know if the process goes to work in humans, and how to gauge the importance of the mechanism. “It’s very attractive, but I don’t think it’s the main function of sleep,” said Raphaelle Winsky-Sommerer, a specialist on sleep and circadian rhythms at Surrey University. “Sleep is related to everything: your metabolism, your physiology, your digestion, everything.” She said she would like to see other experiments that show a build up of waste in the brains of sleep-deprived people, and a reduction of that waste when they catch up on sleep.

Vladyslav Vyazovskiy, another sleep expert at Surrey University, was also sceptical. “I’m not fully convinced. Some of the effects are so striking they are hard to believe. I would like to see this work replicated independently before it can be taken seriously,” he said.

Jim Horne, professor emeritus and director of the sleep research centre at Loughborough University, cautioned that what happened in the fairly simple mouse brain might be very different to what happened in the more complex human brain. “Sleep in humans has evolved far more sophisticated functions for our cortex than that for the mouse, even though the present findings may well be true for us,” he said.

But Nedergaard believes she will find the same waste disposal system at work in humans. The work, she claims, could pave the way for medicines that slow the onset of dementias caused by the build-up of waste in the brain, and even help those who go without enough sleep. “It may be that we can reduce the need at least, because it’s so annoying to waste so much time sleeping,” she said.

Read the entire article here.

Image courtesy of Telegraph.

The Nation’s $360 Billion Medical Bill

The United States spends around $2.5 trillion per year on health care. Approximately 14 percent of this is administrative spending. That’s $360 billion, yes, billion with a ‘b’, annually. And, by all accounts a significant proportion of this huge sum is duplicate, redundant, wasteful and unnecessary spending — that’s a lot of paperwork.

[div class=attrib]From the New York Times:[end-div]

 

LAST year I had to have a minor biopsy. Every time I went in for an appointment, I had to fill out a form requiring my name, address, insurance information, emergency contact person, vaccination history, previous surgical history and current medical problems, medications and allergies. I must have done it four times in just three days. Then, after my procedure, I received bills — and, even more annoying, statements of charges that said they weren’t bills — almost daily, from the hospital, the surgeon, the primary care doctor, the insurance company.

Imagine that repeated millions of times daily and you have one of the biggest money wasters in our health care system. Administration accounts for roughly 14 percent of what the United States spends on health care, or about $360 billion per year. About half of all administrative costs — $163 billion in 2009 — are borne by Medicare, Medicaid and insurance companies. The other half pays for the legions employed by doctors and hospitals to fill out billing forms, keep records, apply for credentials and perform the myriad other administrative functions associated with health care.

The range of expert opinions on how much of this could be saved goes as high as $180 billion, or half of current expenditures. But a more conservative and reasonable estimate comes from David Cutler, an economist at Harvard, who calculates that for the whole system — for insurers as well as doctors and hospitals — electronic billing and credentialing could save $32 billion a year. And United Health comes to a similar estimate, with 20 percent of savings going to the government, 50 percent to physicians and hospitals and 30 percent to insurers. For health care cuts to matter, they have to be above 1 percent of total costs, or $26 billion a year, and this conservative estimate certainly meets that threshold.

How do we get to these savings? First, electronic health records would eliminate the need to fill out the same forms over and over. An electronic credentialing system shared by all hospitals, insurance companies, Medicare, Medicaid, state licensing boards and other government agencies, like the Drug Enforcement Administration, could reduce much of the paperwork doctors are responsible for that patients never see. Requiring all parties to use electronic health records and an online system for physician credentialing would reduce frustration and save billions.

But the real savings is in billing. There are at least six steps in the process: 1) determining a patient’s eligibility for services; 2) obtaining prior authorization for specialist visits, tests and treatments; 3) submitting claims by doctors and hospitals to insurers; 4) verifying whether a claim was received and where in the process it is; 5) adjudicating denials of claims; and 6) receiving payment.

Substantial costs arise from the fact that doctors, hospitals and other care providers must bill multiple insurance companies. Instead of having a unified electronic billing system in which a patient could simply swipe an A.T.M.-like card for automatic verification of eligibility, claims processing and payment, we have a complicated system with lots of expensive manual data entry that produces costly mistakes.

[div class=attrib]Read more of this article here.[end-div]

[div class=attrib]Image: Piles of paperwork. Courtesy of the Guardian.[end-div]