Monday, December 27, 2010

Having The Last Word

Effective Jan. 1, U.S.Medicare will pay physicians who counsel patients seeking information regarding end of life planning.  This includes patient-generated health care advance directives that instruct doctors whether or not to use extreme measures in a medical crisis to keep him /her alive or when (s)he becomes incapable of making that decision due to senility.

However, Medicare coverage is unavailable to Americans living outside the U.S.  And because of the pervasive influence of the Catholic Church in the Philippines on matters regarding public policy in general and control over personal autonomy, especially in the matter of beginning and end of life decisions,  I had assumed that hospitals here did not offer patients such health care options as advanced directives and DNR (do not resuscitate) orders.  Fortunately, it turns out that I was wrong.

When I checked in to undergo a procedure at The Medical City Hospital, a non-sectarian medical center located in Pasig City, Metro-Manila, I was given a pamphlet that discusses these these and other choices, such as living wills and  SPA's (special power of attorney for health care).  I confirmed that these patient-generated instructions are also honored  in Catholic medical facilities as wells.  

A patient who chooses to issue these orders and who has a family member at hand who will ensure compliance if they are ever needed is of course at an advantage. But even for the those expatriates whose next if kin, if any,  is thousands of miles away and not readily accessible to look after his / her wishes, an advance directive and / or DNR order if properly implemented can prevent needless suffering and depletion of the individual's  and / or family's finances resources.

For more information about these rights and how to ensure access to them, contact your physician or any hospital patient services / customer services department.

Friday, December 3, 2010

Dirty Windows

Recently, an announcement appeared in one of the local newspapers regarding a planned random inspection to be conducted by the Pilipinas (Philippines) Ant-Piracy Team (PAPT).  This agency will be checking businesses in certain areas of Metro-Manila in order to determine if they are illegally using unlicensed systems to run their computers.

How rampant is software piracy in the Philippines? Well, the fact that the above enforcement program is being carried out speaks volumes about the problem.  However, the matter is not as cut and dried as it may seem at first glance.  I know this from personal experience.

A few years ago I took the computer that I had at the time in to a repair facility which appeared to be a legitimate operation.  It was located in a large mall, not in some hole in the wall behind a sari sari store. The problem with my computer turned out to be damaged hardware that would have to be changed. However, the technician advised me that the Microsoft Windows software would also have to be replaced (not to mention formatting my hard drive and thus wiping out my settings, but that's another matter).   I consented to this recommendation, unaware that what I was getting was an unlicensed version of Windows, to  which I would never have knowingly consented.  It wasn't until sometime later when I couldn't perform administrator-related functions and was not receiving automatic system updates on line that I finally realized something was wrong.  But by then it was too late. The repair facility blew off my inquiries, and the payment receipt for the repair service  was vaguely worded and didn't properly list the platform software that was being installed. In short, I had no recourse; I was stuck.

But a consolation about this affair was that it was a leaning experience.  Eventually  the time came to buy a new computer.  After shopping around I purchased one from a well known local computer chain store.  However, the installed Windows operating system that came with it was only a trial version. The permanent one was available separately either as licensed software for sale at the store or as a purchase to be download directly from Microsoft.  I opted for the latter and decided to defer buying it until the temporary subscription expired.

After the computer purchase was completed and as I was leaving, the salesperson took me aside  and offered to personally  install the permanent Windows system at a lower price than that offered by the store or by Microsoft. Immediately, alarm bells went off in my head. I knew exactly what he was up to:  an attempt to sell me an unlicensed edition of  Windows.  He even had the nerve to try to assure me that it would run  just like the real thing.  To his surprise I told him that I knew what was going on and wasn't about to be fooled (again) and walked away.   When it came time, I purchased the approved version and have full administrative options.

So bearing in mind the consequences  of running an unauthorized systems platform, I don't understand why commercial organizations, which have so much more to lose from the consequences of bogus software than someone like me on a home computer, would choose to risk damage to their equipment and a run-in with law enforcement. That's extremely shortsighted and inefficient way to conduct business.

IMO this practice by local business people of taking such short cuts as well as their lack of patience and disdain for long term planning is a major reason that the Philippine economy lags behind that of its neighbors. Nothing short of a seismic cultural shift will change their attitude.  Until then, if agencies like PAPT are disbanded, it won't be for lack of  companies that deserve to be investigated.