bonsai_spool

Wow, you’re my twin! I’d watch these on XBMC/Xbox Media Center with some other video podcasts - it was a magical moment in tech

What does the ‘I’ stand for in DEI?

Say a man thinks nursing is for women and not for men. Say an employer wants more nurses irrespective of sex. Is that employer engaging in DEI if they spend more money on male re-education than on recruiting women?

Why not touch or echo? No reason for an editor or cat

This is from February 2026 and notably there’s no way for the public to try out the model, nor is it published in a peer-reviewed journal

I wish the doctors had been clearer with us about his chances of survival

What would they have done differently from what they actually did?

Okay. And what is the 30-day survival for cases where CPR would be otherwise indicated but are not performed?

Great question, but it's obviously not possible to answer.

I suspect the survival rate won't be 0, and maybe won't even be less than 10%.

The point of this whole subtree is that there are interventions that people wouldn't want for themselves because the expected outcome is very poor.

Did you read what you linked? It's not a study of the effects of cpr, it's a list of facts about cardiac arrest that occurs outside a hospital. It explicitly says cpr is life saving:

Oh my goodness, did YOU read anything on the page? Here's a literal quote with a link to a study you could have followed if you weren't just here for outrage points:

"For the past 20 years, the survival rate for cardiac arrest has hovered around 10 percent for out-of-hospital incidences and 21 percent for in-hospital events, yet research shows that high-quality CPR has a significant impact on survival outcomes, whether inside or outside the hospital."

link: https://mycares.net/sitepages/uploads/2026/2025_flipbook/ind...

Early CPR (+AED if available) absolutely saves lives. Article is from 2011 by a family med doctor.

You have to provide a denominator to make this statement. 30-day survival for out-of-hospital CPR is 10%, and discharge from the hospital (let alone functional status) is even lower.

CPR is thus a great example of the OP's thesis that doctors refuse certain things based on their poor efficacy.

https://www.redcross.org/take-a-class/resources/articles/cpr...

I don't do SNP design but I don't think 23andMe made their own chips at first (if they have ever). SNPs are chosen based on being informative for population discrimination, with traits being overlaid afterwards

In the US it's legal-sorta but the NIH can't fund it and the FDA is not allowed to approve treatments based on it

What references are you following? Haven't heard this before.

I'm curious whether Opus4.8 or similar can attain Mythos level through good system prompting and steering? You would expect this to work if it's true that the strength of Mythos is its unwillingness to quit before it gets a desired outcome

I remind you that we began this with the idea that doctors are prescribing treatments for their own financial benefit: https://news.ycombinator.com/item?id=48621445

At the diffuse 401k ownership level, individual actions are not relevant - the Stark law is clearly dealing with the first case and that was how this whole discussion began.

It looks like owning a chunk of the place you refer to is fine

The article you link to says that anyone can be liable even if she didn't realize her referral violates the law.

I cannot imagine any reasonable physician risking this after the decades of training required to get a doctor. I would not, for sure.

From the article you sent:

Some of the most widely used regulatory exceptions are longstanding and foundational across healthcare organizations. These include:

    In-office ancillary services exception: Allows physicians in the same practice to refer patients internally for DHS such as lab work or therapy, as long as certain supervision, location, and billing criteria are met.

    Rental of office space exception: Permits lease agreements between a physician and an entity, but only if the space is used exclusively for legitimate business purposes, rent is fair market value, and the agreement is in writing for at least one year.

    Employment exception: Protects compensation arrangements between hospitals and employed physicians, as long as compensation is consistent with fair market value and is not based on referral volume.

    Personal service arrangements exception: Covers contracts where a physician provides services (like medical directorships) to a DHS entity. The agreement must outline duties, last at least one year, and pay a fixed, fair-market-value fee unrelated to referrals.

But what you are trying to get at is that there is law about self-referral ("Stark law") but in reality there are exceptions that render it fairly useless

What are the exceptions that render it useless? I have never heard of them in my 10+ years of hearing about it.

I did not know that I-cards do office work, not my area of medicine.

IR is in the angio lab daily without cataracts, thyroid cancer, etc., so that part of your statement is clearly not true.

I also don't understand what you mean about knee replacements... humans are generally capable of standing without requiring surgical intervention.

Absolutely is - this is such a no-brainer of a public health intervention. We're not touching on the cost of treatment (including inability to have future children! very much something a State should be interested in avoiding).

Everything above is fair, if true. I don't see a reference in your answer so I can't assess the quality of evidence.

The point is that they cannot refer you to one of their companies. Of course, there may not be a meaningfully-competitive local market, so patients may end up needing to go to the physician-owned imaging facility. I do not thing this is a large issue for most of the US population though it's probably an issue on a spatial basis.

You see a cardiologist and they recommend a stent. They aren’t going to recommend a different cardiologist does it.

Things must be different in NZ.

First, it's true that you're going to want to go to who your doctor knows/recommends. The law in the US is just that they can't refer you to a group they own/their spouse owns, or for which they get a financial benefit.

Next, you're speaking about the doctor doing a consult visit before doing a procedure. That is not the same thing as ordering a treatment for you to go get the treatment elsewhere—which describes what happens you go to the pharmacist to get drugs.

Finally, the cardiologist you see in the office is almost certainly not doing stents for you as those are very distinct skillsets (in the US).

There was actually a project at an innovation center at a well-known medical center which leveraged ML to maximize the amount of codes they could bill for without being rejected. T

I think this perspective makes sense from someone who works on the insurance side of things.

On the other side, there is no way for the insurance company to acknowledge the clinical severity of a patient except via abstruse ICD code choices that only billing clerks know. So this is a perfect case for an LLM - map normal human words onto ICD claim codes to accurately convey patient severity.

Doctors are incentivized to prescribe treatments, because that's how they make money for themselves and their practice.

This is literally illegal! Physicians cannot refer patients to entities they own or have an interest in.

What is perverse is that, while we have the Stark Law to constrain physician behavior, we've decided that it's okay if a diffuse group like a non-physician-owned hospital chain enforces rules to this effect.

5% of denied in-network claims were turned down because the care was deemed not medically necessary".

I think the truth is murkier than what you're providing. With the caveat that I am presenting a strong case here that likely isn't what occurs most of the time, consider this:

A person may require long-term therapy after an illness. There are data suggesting that beginning this therapy works better once you attain a certain level of clinical recovery in the hospital. There are also data suggesting that it's better to begin the long-term therapy as early as possible.

Both sets of data are, on their face, credible. There is no obvious reason to always believe one set of data over another. Reasonable people can make reasonable arguments to reasonable listeners for either case. Note that this does not mean that there is not a 'correct' interpretation for any given person's clinical situation!

So what does your insurance company favor? Obviously it will always favor the less expensive option, and there will be no way for them to be convinced otherwise because the underlying question is just not well-determined.

Uh ok bud.

I have yet to see an argument as to why a company isn't incentived to drop a health insurer if they're forcing employees _not_ to do a $50/month option and instead pick a $1k/month option.

That definitely does happen, but companies have a lot of levers to pull around how employees select health insurance. When I bought health insurance for a small firm (~60 people), I provided a set number of dollars and workers could use these for any plan they wished (an ICHRA plan).

if you punch into a chatbot questions about the employer pool insurance product, your comment is exactly how the chatbot characterizes it.

That's because it's the truth? I've taken graduate health policy classes from people like Don Berwick - I assure you that I did not and do not need to ask chatgpt to explain self-insurance to me.

f course, "administrative sides of [health] insurance" includes...

How does this have anything to do with the fact that the self-insuring entity bears the risk for its insureds? The problem with the GP comment about 'giving money back to Apple' is that the money always belonged to Apple and its co-insurance / copays only exist to steer employee behavior.

Employer funded plans are not all the same. Large entities with a lot of money (like universities, big firms) self-insure. Thus the insurance company in those cases is simply managing all the administrative sides of insurance while the plan owner is the actual insurer of risk.

There’s an article about how a Wall St employee’s expensive care came up in C-suite meetings, as a real world consequence of this

Did you actually read that article that spends many pages explaining how there is no good way for a firm to patent a repurposed drug that is working the same way as it worked in a prior indication, but is being used for a new indication where it has the same function - exactly what you’re asserting and what I said is not possible?

Thanks for the article, it is a good one.

It’s somebody’s random blog instead of three published, peer reviewed articles. I’m not sure what you expect to hear

Yes.

lol, hilarious.

I actually don't think we have the data available that I want

I get the sense you haven't looked...

intentionally sticking our heads in the sand forever makes no sense.

Because you make statements like this instead of citing the extensive literature on this question.

I’d want to see the data

https://pmc.ncbi.nlm.nih.gov/ Go right ahead!

"Because Mexican immigrants have much less education than the average U.S. worker, they increase the supply of less-skilled labor, driving down the wages of the worst-paid Americans."

That doesn't sound like the claim you made. It is also a prima facie reasonable claim to make.