Turning the Health World Upside Down

There’s a growing acceptance of the links between health, wealth and wider society. Not just the impact of wealth inequalities on measures like life expectancy. But the importance of fixing the underlying social causes of medical problems, rather than just administering the medicine and wondering why the patient doesn’t get better.

It’s convenient to frame this as a Third World problem. And while it is, it’s also a problem within and between developed countries. For example, people from one area of Glasgow (in Scotland) live a decade longer than people residing in another area of the same city, in spite of (theoretically) having access to precisely the same medical expertise.

A most basic analysis of Great Britain (and much of the developed world) reveals an organizational chasm, which most people are not prepared to cross: For example, medical services and social care provision are completely different activities – separate funding, differing structures, responsibilities, professional bodies. Even though individual “patients” shift seamlessly between them. It’s an organisational situation made worse by the difficulty both groups seem to have integrating with anything – in my experience (largely failing to integrate public transport into health and social services), a combination of:

Complexity is the biggest problem, because it keeps getting worse: More (medical) conditions and treatments to know about, higher public expectations, greater interdependence between different cultures and areas of the world. Inability to manage growing complexity ultimately threatens modern civilization – it will probably be one of the defining problems of the current age. So adding even further complexity in the form of understanding about “fringe issues” is far from straightforward.

Beyond these practicalities lurk difficult moral debates – literally, buying life. Public policy doesn’t come much harder than this.

Into this arena steps Nigel Crisp. Former holder of various senior positions within health administration, now a member of the UK‘s House of Lords. Lord Crisp’s ideas try to “kill 2 birds with one stone”: For the developed world to adopt some of the simple, but more holistic approaches to health/society found in the less developed world, rather than merely exporting the less-than-perfect approach developed in countries like Britain.

To understand Crisp’s argument requires several sacred cows to be scarified: That institutions like the National Health Service (which in Britain is increasingly synonymous with nationhood, and so beyond criticism) are not perfect. That places like Africa aren’t solely populated by people that “need aid” (the unfortunate, but popular image that emerged from the famines of the 1980s). That the highest level of training and attainment isn’t necessarily the optimum solution (counter to most capitalist cultures). If you’ve managed to get that far, the political and organisational changes implied are still genuinely revolutionary: To paraphrase one commenter, “government simply doesn’t turn itself upside down”.

While it is very easy to decry Nigel Crisp’s approach as idealistic, even naively impractical, he is addressing a serious contemporary problem. And his broad thinking exposes a lot of unpleasant truths. This article is based on a lecture Crisp gave to a (mostly) medical audience at the University of Edinburgh. And the response of his audience. The lecture was based on his book, Turning the World Upside Down: the search for global health in the 21st Century (which I have not read). Read more of this article »

A Strange Game

Deathwing. So it happened again. The player client software for the latest World of Warcraft expansion, Cataclysm, leaked into the public arena long before it was intended to become public. Again, because this also happened with the previous 2 expansions. A third leak is beginning to look careless.

WoW.com’s (unofficial) explanation of this “failure of secrecy” ironically fails to explain most of reasons behind the Cataclysm leak. Perhaps because the politics are rather too Machiavellian?

This article discusses the relationship between the game developer and its “fansites”. It uses the Cataclysm leaks to try and explain the underlying politics. The article questions why Non-Disclosure Agreements continue to be used, when they are worse than useless. Finally, it ponders the risks of such apparently one-sided relationships.

I’ve tried to present a fair and balanced analysis, which raises some important issues that aren’t getting discussed, and should be. Obviously, I can’t know everything. Read more of this article »

Animal Farm

Pandaren Monk We finally have some reliable figures for the commercial value of “minipet” micro-transactions in the game, World of Warcraft. Specifically, the sales of just 1 item: In November and December 2009, at least $2.2 million worth of Pandaren Monk pets were sold. 220,000 at $10 each. We know this because “50% of the purchasing price” was donated to charity, and “more than $1.1 million” was donated (via WoW.com).

Over 220,000 sales to a market of about 4-5 million potential customers (only active WoW players can use the minipet, and the pet does not appear to have been sold in China or Taiwan). Roughly 5% of potential customers spent $10 on an ostensibly useless vanity item: A small pet that follows you around, looking cute.

Like most virtual goods, the cost of making and selling this pet is marginal: Primarily some additional art and marketing time, all built on the back of existing systems (store, staff, world). The first 2 months of Pandaren Monk sales will have made contributions to Blizzard’s profits of about $1 million. That’s only around 1% of the business’s turnover in that 2-month period. But that 1% is “free money”. Blizzard (-Activision) would be doing a dis-service to its investors if it did anything other than continue to milk this virtual cash cow.

Apply a healthy bit of European cynicism, and it is easy to conclude a scam. Tobold‘s:

“Send me $10, and I promise to send $5 of it to charity.”

Of course, Europeans fundamentally don’t understand US philanthropic culture: The idea that it’s fine to exploit your fellow human and make outrageous amounts of money, so long as you give some of it away in the end. Some philanthropy is able to take a somewhat rational, balanced view of what is good for the world. But there is a tendency to support visually appealing issues, such as charities servicing the needs of children.

The purpose of this article is not to argue that a European, government-centric re-distribution of wealth is preferable to an approach lead by personal responsibility. (I’m not sure it is.) The problem emerging here is more fundamental: That virtual goods are replacing trade-able value with non-trade-able value. Non-trade-able value that, by definition, can not offset inequality in (game) society. Donating part of the price of sales to charity is pure irony. In true Orwellian style, we’re sleep-walking into a potentially broken social structure with the best of intentions.

This article started as a box during my Adventures in the Invisible Tent, but has been expanded here in much greater detail. This article describes what a minipet is, highlights the role of money to balance inequality in society, and explains the problem with virtual goods. Read more of this article »

Adventures in the Invisible Tent

Here’s a tent.

Invisible Tent

It’s invisible. But it is. There. Walk forward into the space it occupies, you find yourself within the tent.

Inside Invisible Tent

The tent only exists when one is within it. When outside, we see the world without the tent.

This article explores the implication of this uncanny art form on how we build and use virtual environments. It first explains why this invisible tent is considered to be a software bug. The article explores how our ability to accept the uncanny varies from person to person. It then suggests that the spatial, built, environment is far less important than the social structures that exist within them. This topic contains a lot of images. Read more of this article »

Valuing Nothing

In 2007 I wrote some introductory Thoughts on a Socio-Economic Environment based on Nothing. This article continues to explore the value of things in a highly intangible, knowledge-based economy. It wanders through internet-based payment systems, economic structure, role of government, organisation of information, community, and society, before disappearing into the realms of philosophy. It contains no answers, but may prove thought-provoking. Read more of this article »

De-Analysing Blizzard’s Add-On Policy

Blizzard Entertainment’s new add-on policy has been discussed by everyone from Lum to Slashdot. The number of developers directly affected by the change is small, since only a few add-ons are popular enough to be considered commercial ventures. The policy is more significant because it changes a lot of established conventions, and goes to the heart of how Blizzard embraces (or increasingly, shuns) the talent within its player community. This article is an attempt to analyse the real motivations behind the policy, and highlight the apparent contradiction in policy between in-game add-ons and web-based services. Read more of this article »

WeeWorld

WeeMee. WeeWorld is a teen-orientated social network, best known for their customized avatars, “WeeMees”. WeeWorld has evolved into an eclectic mix of community, casual games, and virtual goods. Steve Young, creative director, spoke to a small group in Edinburgh. Steve discussed the motivations and behaviour of WeeWorld’s users, and explored the challenges of working with 2D WeeMees, particularly as they move into WeeWorld’s new virtual (synchronous) world.

Users

WeeWorld’s core market are teenagers, mostly in North America. Average age 16 (minimum 13, although younger users may simply lie about their age). 60% are female. The dominant market segment was characterised as “spoilt rich kids” – typically those with their own computers. Of the 23 million registered users, about a million visit the WeeWorld site each month, and 80,000 login each day.

Usage differs from other teen social networks, such as Gaia Online: Only 6% of logged-in users visit the site’s forums, while 80% alter their WeeMee. Teen worlds are evidently not generic.

WeeMees (from the Glaswegian, “little me”) can be placed within personalised 2D rooms (in the style of “cardboard theatre”), used as characters within casual games, or rendered as avatars in a new virtual world called, simply enough, “World”. WeeMees are also used on third party websites and services, including messenger services, such as AIM or Live. Initial ideas for WeeMees had resulted in a lot of avatars simply being copied. APIs now provide some control over how WeeMees are reused.

Users’ main aim is “to gather as many friends as possible”. And to chat in a variant of the English language that even JeffK would find almost unintelligible: $iNG-UL?

Virtual Goods

WeeMees can be customized for free: Body, clothes and accessories. However users can also buy “Points”, which can be spent on specific items.

Points can be purchased via PayPal transactions or pre-paid cards, which are sold in US stores. Kids tend to regard these mechanisms like free credit cards: They are not seen as real money.

People pay for “uniqueness”. However, items need not be complex: The most popular item sold is a simple Alice band.

The most fascinating revelation was that the introduction of the new synchronous (virtual) world doubled the sales of virtual goods. This “World” is not even out of beta testing yet. “World” places WeeMees in the same interactive space as one another. This contrasts to the other areas of the site, where WeeMees are not competing for space. I think that implies the more an avatar needs to stand out from the crowd, the more virtual “Bling” is worth to that avatar’s owner.

WeeWorld is keen to avoid its Points being traded as a virtual currency. Money can only be converted into Points, not back again.

Design

The key to WeeWorld’s success is “immersion”. The key to its revenue is “engagement”. These concepts guide development.

Although WeeMees are cartoon-like (in the style associated with South Park), customizations still need to reflect what people would wear in “real life”. For example, T-shirts branding needs to be subtle – a small logo on part of the garment.

The goal for user-generated content (customizations of WeeMees and rooms) is to make it hard for the user to create something that looks bad. For example, MySpace customisations can (and in my opinion, sadly often do) look terrible.

WeeWorld has adjusted to match conservative US culture. The cannabis plants created in early experiments are long gone. There are no alcoholic drinks. Negotiations with Walmart even forced WeeWorld to disable the customization of boob (brest) size.

The development of “World” posed an interest problem: How should WeeMees move? All the artwork and customizations had been designed for static display, without movement animations. The World uses embedded Flash objects to display information to users, so the amount of data transferred about other users’ movements needs to be minimal.

The solution was to make WeeMees hop. Users can also select a trajectory and fire their WeeMees in a particular direction. Navigating World’s 2D platform-ed environment is quite cereal, but strangely fun!

Development

Social networks are becoming more like virtual worlds, while virtual worlds are becoming more like social networks. WeeWorld is trying to steer a path down the middle. Like all the businesses involved, they are still “feeling their way”, finding out what works.

Development time-scales for WeeWorld (and similar products) are very short. Steve was somewhat frustrated that development of the “World” had taken a whole quarter (3 months). The contrast to video-game style virtual worlds is stark: Those typically take 3 years to construct.

WeeWorld use a Scrum/agile development process (which suits the constantly evolving product). Casual games (a commonly requested feature) are often out-sourced to other developers.

The ability to develop content quickly makes it very easy for good ideas to be copied by competitors. For example, Zwinky might seem remarkably similar…