[Plura-list] Private ambulances wants a ban on firefighters rescuing babies; Podcasting "Jam To-Day"

Cory Doctorow doctorow at craphound.com
Mon Nov 22 11:55:27 EST 2021

Read today's issue online at: https://pluralistic.net/2021/11/22/amr-vs-babies/


I'm going overseas for work on Dec 7, which means time to order signed/personalized copies of my books from Dark Delicacies is running out!

Attack Surface:

Little Brother/Homeland:

How to Destroy Surveillance Capitalism:

Poesy the Monster Slayer:


Today's links

* Private ambulances wants a ban on firefighters rescuing babies: American Medical Response says Prescott Valley's firefighters shouldn't be allowed to operate an ambulance.

* Podcasting "Jam To-Day": How to free Big Tech's hostages on day one.

* This day in history: 2006, 2011, 2016, 2020

* Colophon: Recent publications, upcoming/recent appearances, current writing projects, current reading


🍳 Private ambulances wants a ban on firefighters rescuing babies

Prescott Valley, AZ is home to 150,000 people and a single private ambulance operator with the exclusive regional franchise: Lifeline Ambulance, a division of American Medical Response (AMR) - a predatory monopolist that has snapped up many smaller ambulance companies and locked in lucrative exclusivity deals with many US cities and towns.

Unlike AMR's EMTs, the firefighters in Prescott Valley are public servants, working for the Central Arizona Fire and Medical Authority (CAFMA). AMR hates CAFMA, because CAFMA has its own, unauthorized ambulance that it uses to save lives when AMR's penny-pinching gets in the way.

For example, last August, a 911 operator took a call about a baby that had drowned in a bathtub and wasn't breathing. AMR's staff said they were 12 minutes away. So CAFMA's firefighters used their "unofficial ambulance" to transport the baby to a helicopter, and thence to a hospital. The baby lived.

AMR was livid. They narked out the firefighters to the state authority, demanding an investigation as to why the firefighters were cutting into their business.


It's not the first time, either: AMR has filed at least 15 complaints with the Arizona Department of Health Services, seeking to limit firefighters' use of their own ambulance.

AMR's regional director John Valentine told ABC 15's Dave Biscobing that he isn't filing "complaints" - rather, these are "information requests." This is the private ambulance ghoul version of one of those t-shirts that says, "It's not a bald spot, it's a solar panel for a sex-machine."

Across the state, local emergency authorities are begging the regulator to let them add more ambulances than are provided by monopoly private contractors like AMR. AMR insists that it's "meeting deadlines."

Meanwhile, CAFMA Chief Scott Freitag is intent on forcing the issue. Rather than furtively using the firefighters' ambulance to save lives, he's sending the regulator a weekly list of every time the ambulance has to be dispatched because AMR was too slow.


🍳 Podcasting "Jam To-Day"

This week on my podcast, I read my Medium column "Jam To-Day," a look at how slow antitrust enforcement can be, and what regulators can do to offer relief to the hostages in Big Tech's walled gardens right from day one: through interoperability.


Antitrust is a very slow-moving process. The AT&T breakup in 1982 was the culmination of *69 years'* worth of enforcement action.

1982 was also the year that IBM's 12-year antitrust sojourn ended, without the breakup the DoJ had been seeking. The IBM case (which wonks call "Antitrust's Vietnam") is an instructive lesson in why antitrust is so slow. IBM was a powerful, wildly profitable monopolist. It had a lot at stake in preventing a breakup - and it had a lot of money to spend to defend that stake. Every year, for 12 consecutive years, IBM outspent the entire DoJ Antitrust Division on high-power lawyers who held the DoJ at bay. They held out long enough for Ronald Reagan to be elected and kill the enforcement action, and emerged intact.

It's a *lot* easier to prevent monopolies than it is to fight them. By the time a company has a successful monopoly, it has the ammo it needs to defend that monopoly.

Of course, there's value in antitrust enforcement even if it doesn't achieve its nominal goal. 12 years in antitrust hell sapped IBM of its killer instinct and made it cautious about attracting enforcers' wrath anew. That's why the operating system for the IBM PC came from an obscure startup called "Micro-Soft": IBM knew the DoJ hated the practice of tying hardware to software. Likewise, IBM just sat back and watched as the market for "IBM PC clones" proliferated: they knew that the DoJ hated their earlier war on "plug compatible" mainframes and peripherals and didn't want to wake the dragon.

Micro-Soft became Microsoft, a vicious monopolist that spent 7 years in antitrust hell, but it, too, emerged intact from a breakup effort. Nevertheless, the trauma of antitrust investigation (including a humiliating deposition of Bill Gates that went viral on VHS) tamed Microsoft.


When Google came around, Microsoft didn't subject it to the same abusive treatment it had visited upon Netscape, allowing Google to grow into a competitor, and then a monopolist in its own right.

Google today is a master of predatory conduct: catch-and-kill acquisitions, walled gardens, price-fixing, collusion, and out-and-out fraud:


An antitrust action against the company might make it more pliable and less flagrantly abusive - the same goes for our other tech monopolists, including Microsoft (again!), Apple, Salesforce, Amazon, etc.

But we can't afford to wait 69 years (AT&T) or 12 years (IBM) or 7 years (Microsoft) for relief from the tech giants' oppressive dominance of our digital lives. We need relief now, and regulators can deliver it, by fostering interoperability.

Here's why: the tech giants grew through "network effects": new users join Facebook because the people they want to talk to are there already. Once they join, they become a reason for more people to join.

But tech companies have *always* had network effects on their side. How was it that we once had a dynamic tech world where yesterday's giant was tomorrow's punchline (Askjeeves, Commodore, Cray), and today, the internet is just five giant websites, filled with screenshots of text from the other four?


The answer is "switching costs" - the economists' term for the things you have to give up when you leave a product or service. Tech companies have gone to extraordinary - and illegal lengths - to make the costs of quitting prohibitive:


The go-to tactic for increasing switching costs is blocking interoperability. If Facebook had to federate with smaller services - including ones that you could run yourself for you and your family or friends - then you could quit Facebook and still stay connected to the people you love.

Which means that if governments moved to increase interop, they'd offer immediate relief to the hostages in Big Tech's walled gardens - by letting you move your media, conversations, address books, apps and other valuable digital assets to new services.

One way to do this is through legislation. The ACCESS Act is an excellent bill and it deserves your support:


But we don't have to wait for Congress to pass a bill. Federal, state and local governments could act today, by changing their procurement rules to require interop from vendors. It's just prudent: every vehicle in every public motor-pool should be serviceable by independent mechanics with third-party spare-parts. Same for every phone, tablet, server and client.

This is a very old tradition in US government. The Union Army had a rule requiring rifle-makers to use interchangeable tooling, ammo and parts (it would have been unforgivably idiotic to do otherwise).

Buying high-tech stuff that isn't designed for interoperability is dereliction of duty. No government agency would commission a hospital from contractors who refused to say where the ducts and pipes were, or what math was used to calculate the load stresses, or who insisted on a contract that gave them the exclusive right to provide sheets and IV bags for the hospital once it was running.

The US government's procurement rules are a lever that regulators can yank on at any time, and they *should*. Not just because it's irresponsible to spend public money otherwise - but also because doing so would ensure that we in the private sector would always have the option of an interoperable system, by buying the same stuff as Uncle Sam.

Here's the podcast episode:


And here's a direct link to the MP3 (hosting courtesy of the Internet Archive; they'll host your stuff for free, forever):


And here's the RSS feed for my podcast:



🍳 This day in history

#10yrsago Interactive chart: understanding the chokepoints for censorship https://www.eff.org/free-speech-weak-link/

#10yrsago Open letter from an Army vet to military servicepeople: what will you do when they send you to fight Occupy? https://www.nakedcapitalism.com/2011/11/an-open-letter-to-the-winter-patriot.html

#5yrsago Apple’s ebook store bans books that use Apple trademarks in unapproved (but legal and accurate) ways http://www.theendofownership.com/blog/2016/11/18/why-you-cant-buy-our-book-from-apple

#5yrsago Even if you’ve ripped out your laptop’s mic, hackers can listen in through your headphones https://www.wired.com/2016/11/great-now-even-headphones-can-spy/

#15yrsago Berlusconi used Hollywood studios for money laundering http://news.bbc.co.uk/2/hi/uk_news/politics/6166076.stm

#15yrsago Newsweek on the anti-DRM movement https://web.archive.org/web/20061123162740/http://www.msnbc.msn.com/id/15818852/site/newsweek/

#10yrsago Swedish Pirate Party MEP Amelia Andersdotter, on taking office at long last https://torrentfreak.com/pirate-to-join-european-parliament-as-youngest-member-111120/

#5yrsago Roller Girl: Newberry-honored coming of age graphic novel about roller derby and difficult tween friendships https://memex.craphound.com/2016/11/21/roller-girl-newberry-honored-coming-of-age-graphic-novel-about-roller-derby-and-difficult-tween-friendships/

#5yrsago London Mayor sends VW a £2.5m bill for Dieselgate cheaters’ Congestion Charges https://citiesofthefuture.eu/sadiq-khan-asks-volkswagen-to-pay-2-5m-in-lost-congestion-charge/#.b3rekdtnw

#1yrago Nintendo vs Nintendees https://pluralistic.net/2020/11/21/wrecking-ball/#ssbm


🍳 Colophon

Today's top sources: @0xMatt (https://twitter.com/0xMatt).

Currently writing:

* Spill, a Little Brother short story about pipeline protests. Friday's progress: 262 words (31711 words total)

* Picks and Shovels, a Martin Hench noir thriller about the heroic era of the PC. Yesterday's progress: 1035 words (7548 words total).

* A Little Brother short story about remote invigilation.  PLANNING

* A nonfiction book about excessive buyer-power in the arts, co-written with Rebecca Giblin, "The Shakedown."  FINAL EDITS

* A post-GND utopian novel, "The Lost Cause."  FINISHED

* A cyberpunk noir thriller novel, "Red Team Blues."  FINISHED

Currently reading: Analogia by George Dyson.

Latest podcast: The Unimaginable (https://craphound.com/news/2021/11/15/the-unimaginable/)

Upcoming appearances:

* The Kids Are (Kinda) All Right (San Diego Comic-Con), Nov 28

* Internet Governance Forum (Warsaw), Dec 10

Recent appearances:

* Move Fast and Fix Things (Aaron Swartz Day)

* Tales From the Bridge:

* Seize the Means of Computation (Internet Archive):

Latest book:

* "Attack Surface": The third Little Brother novel, a standalone technothriller for adults. The *Washington Post* called it "a political cyberthriller, vigorous, bold and savvy about the limits of revolution and resistance." Order signed, personalized copies from Dark Delicacies https://www.darkdel.com/store/p1840/Available_Now%3A_Attack_Surface.html

* "How to Destroy Surveillance Capitalism": an anti-monopoly pamphlet analyzing the true harms of surveillance capitalism and proposing a solution. https://onezero.medium.com/how-to-destroy-surveillance-capitalism-8135e6744d59 (print edition: https://bookshop.org/books/how-to-destroy-surveillance-capitalism/9781736205907) (signed copies: https://www.darkdel.com/store/p2024/Available_Now%3A__How_to_Destroy_Surveillance_Capitalism.html)

* "Little Brother/Homeland": A reissue omnibus edition with a new introduction by Edward Snowden: https://us.macmillan.com/books/9781250774583; personalized/signed copies here: https://www.darkdel.com/store/p1750/July%3A__Little_Brother_%26_Homeland.html

* "Poesy the Monster Slayer" a picture book about monsters, bedtime, gender, and kicking ass. Order here: https://us.macmillan.com/books/9781626723627. Get a personalized, signed copy here: https://www.darkdel.com/store/p1562/_Poesy_the_Monster_Slayer.html.

Upcoming books:

* The Shakedown, with Rebecca Giblin, nonfiction/business/politics, Beacon Press 2022

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