jaredhansen

This is one of my favorite things about HN.

I'm into rockets, and clicked the link earlier today. I shared the suggestor's view, but didn't bother to post. I came back now, saw the comment thread had updated significantly, noticed that OP had addressed the suggestion, clicked again -- and noticed, hey wow, there are cool screenshots now, these are a lot more interesting, this is better than I thought!

The license plate, combined with cross border surveillance data providers, is enabling dragnet surveillance and enforcement of unconscionable law. [snip] Stop trying to play down how tech is enabling authoritarianism.

Yes, that's the whole point of tech used by law enforcement: to enable the enforcement of law. If we don't like the law (and I don't), we should change it!

But focusing on the ALPR here is just silly, as a quick glance of this partial list of other technologies used by law enforcement officers in the course of enforcing the law will show: * cars * guns * phones * handcuffs * computers * the internet * notebook and pen

All of these can be used to "enable authoritarianism", and indeed, any authoritarian regime would be hard pressed to run without them. Some of them are more important than others, and ALPRs are definitely a major improvement in the "who is going where" part of law enforcement -- but the problem is the bad law, not the enforcement thereof.

Your argument reduces to "some laws are bad, so we should have weak enforcement mechanisms, because otherwise people will be unable to evade prosecution for breaking bad laws, and that is bad, because the laws are bad and therefore those who break them should not be subject to prosecution." This is not as helpful a move as it might seem, since it just sends us back to the original question, which is "ok, what laws should we have?"

For better or worse, we have a setup in which we have one branch charged with answering that question, and another charged with enforcing whatever laws we happen to have. Trying to undermine one branch in order to compensate for the stupidity of another is unlikely to help.

I think there's a decent chance you may have just created the ideal name for what will become one of the most important concepts ever. Bravo!

Many HN readers with an interest in HFT will find the Sniper in Mahwah blog excellent reading. No longer publishing since 2019 as far as I can tell, but it was great while it lasted:

https://sniperinmahwah.wordpress.com/

I don't begin to understand why the bank should have to "justify" its decision to replace workers with AI in the first place. Maybe it works better? Maybe it's worse? Who cares? Shareholders bear the risk of getting it wrong, and can fire management if they think they aren't doing a good job of getting it right.

If the humans are in fact more expensive than the chatbots, it's not like the shareholders just say "oh, ok, I guess we'll just take lower compensation for slightly more risk". Instead, they'll pressure management to pass the higher cost on to the customer.

If you want to "protect workers" by making sure they get paid x amount regardless of whether they're the most efficient way to achieve y goal, why not just do that through taxes? You're basically taxing bank shareholders and subsidizing employees, but with a lot of extra steps. Plus, the employees have to actually show up to work every day, which I understand can be kind of a drag.

A union carpenter with one year of on the job training will run circles around a veteran carpenter from the south with 15-20 years of experience who never had access to such training.

Can you elaborate on this point? What is it about the union that makes their on the job training so effective? Veteran carpenters with 15-20 yrs of exp have, in general, a very strong skill set -- what is the union doing that makes people catch up so fast? And if that's true, why do more people not defect from the union?

Good point, let's just shut it down, nobody should do anything

This is the friendliest comment I've seen on the World Wide Web today. Thank you for posting.

Spinnaker might be great - I don't know them - but if you're in the market for sailing lessons in SF Bay I can highly, highly recommend Club Nautique out of Alameda[1].

The quality of instruction is very high, with a focus on safety and building a strong foundation of knowledge. Especially if you ever might want to charter in remote locations or sail across oceans, it's really an excellent foundation.

[1]https://www.clubnautique.net/school/introduction-to-sailing/

Very cool! More info on an equally charming old website here, including a remarkable letter from his wife: http://josephoster.com/billsvoyage/index.html

That letter from his wife, Naomi, contains a link to her website[1], which is itself fascinating. Its About page contains the following, which made me think her particular brand of value-add in the world is of the kind that will survive:

I fill-in the details of the couple in each Ketubah by hand, with ink and pen, as Jewish scribes have done for thousands of years. Nowadays, most Ketubah artists use fonts and fill-in the texts by computer rather than by hand, because many have not studied calligraphy, an art which takes much time and practice to master. I, personally, like writing the details by hand, though it is not easy work, because it is traditional, and because it connects me in a personal way with my clients and my prints.

[1] https://www.ketubotbynaomi.com/

I don't understand this take. Are you saying it's in-principle impossible for them to accomplish these goals?

Thank you for posting this! I'd never heard it, and it's great.

This is the best thing I've seen on HN or indeed on the internet in general for quite a long time. Excellent work and thank you for brightening my day.

2. We can't even take care of Earth. I'm no expert but I have to believe it would be far cheaper and easier to solve Earth's problems.

This is a popular view but I think it is wrong. Yes, we have problems on Earth. But if you compare Earth today, in terms of "carrying capacity for human beings", or "utils generated per day" or some other metric you like, vs pre-human Earth, I don't think it's a close contest.

The few early humans were hungry, naked and vulnerable to all manner of dangers. Now there are billions of us, and most live in relative safety, comfort and material luxury. If we can do for Mars what we did for Earth, that will be the best thing that has ever happened to Mars.

Extreme Misogyny in Incels Probably the Primary Cause of Their Sexual Frustration

To our knowledge, this is the first study to examine the relationship between dietary creatine intake and risk of depression in a nationally representative U.S. sample. We found that MDD prevalence among U.S. adults follows a step-wise decrease corresponding to an incremental increase in dietary creatine consumption. Depression prevalence was 42% higher among adults in the lowest quartile (0–0.26 g) compared to adults in the highest quartile (0.70–3.16 g) of creatine consumption. In comparison, depression prevalence among persons with low creatine intake mirrors what has been estimated among persons with chronic medical conditions such as Type 2 Diabetes Mellitus50. After controlling for demographic and lifestyle variables, the risk of screening positive for depression was 31% lower among adults in the highest, compared to the lowest, quartile of creatine consumption.

This might be right, but I'm not so sure. Public perception is that dealerships are adverse to customers because of information asymmetry + price haggling, and that online sales will hurt them -- but in many conversations with multiple different car industry insiders, they all say that dealers make almost no money car sales, and instead make almost all of it on financing, service and parts. That you can almost model the car dealing parts of a dealership as lead gen for the service desk / finance desk.

I don't know if that's right (anybody with more info care to comment?), but it's at least enough to give me pause on the "dealers will hate nonnegotiable pricing" claim.

From 'blooood filled capillaries' to closing by calling kissing a 'non-sexual intimate behavior', this was hilarious. Thanks for posting!

About damn time.

All past years you mean. It's not exactly a recent phenomenon.

Yep, fixed, it's 70 shoppable services and 230 they choose.

There is a lot of misunderstanding in this thread. I have a significant expertise on the price transparency rule and hospitals' responses to it, and will try to shed some light.

Disclosure/source: I'm a former lawyer and the founder/owner of ClearCare[0], a price transparency compliance platform for hospitals that's purpose-built to help them solve exactly the requirements of this rule.

I'm actively seeking someone to take it over, as I recently got a once-in-a-lifetime opportunity to join a plant-based bacon company as a cofounder, and I'm taking it. I don't want to shut ClearCare down, but I don't have time to focus on it since the bacon company is growing so quickly.

I was actually pretty shocked to find so few HN-crowd startups tackling this. There's some competition in the market but it isn't very strong, and the distance to, at the minimum, a nice lifestyle-business that does a few hundred $k to a few million in ARR is pretty low. It took about a year to get ClearCare where it is today. The platform is written in React, uses Auth0 for auth, and is currently on Netlify. If you're interested in running with it, please reach out - jared.hansen [ at ] clearcare dot io.

Also one other disclaimer: the following is an oversimplification. Obviously.

----------------

Background

The Affordable Care Act[1] (aka "Obamacare"), passed by Congress and signed by Pres Obama in 2010, required hospitals to “make public... a list of the hospital’s standard charges for items and services provided by the hospital,” and to update this list annually. The standard way hospitals met this rule was, for many years, to simply post a link to their chargemasters[2] - which you can think of as, essentially, an almost aggressively user-hostile data dump of opaque billing codes and amounts that didn't actually mean anything for patients.

In June of 2019, Pres Trump signed an executive order[3] requiring the Dept of HHS to create new regulations that would more clearly codify the requirement. HHS' sub-agency CMS created a draft rule in September of 2019, which became final around 14 months later.

The AHA sued to block the rule but lost, and the compliance requirement has been live since January 1 of this year.

There are many reasons the Chargemaster rate bears little resemblance to the rate paid by any actual patients, medicare reimbursement rules chief among them. Too much to go into here.

So what does the rule actually require?

The Rule

In short, hospitals must post two things:

(1) a list of Standard Charges (i.e., the chargemaster), for everything. This has to include negotiated rates with each payer (E.g.: Blue Cross pays 7500 for a given kind of knee surgery; Aetna pays 562; United Health pays 812), and the cash discount rate, if any. One thing that's interesting about this list (and overlooked, frankly, by most of the providers in the space) is that it is described by CMS as a "machine-readable file" - and they give examples as CSV, JSON and XML. Historically, hospitals would post chargemasters often as PDF(!), sometimes XLS, txt, csv, god knows what all -- but CMS is trying to move toward a world where you can create an API on top of all of the data and build more of the "kayak for healthcare" tools that the industry has been trying (and failing) to build for so long.

(2) for 300 procedures designated as "shoppable services" (meaning: can be scheduled in advance, and patients might want to shop around), a "user-friendly", "searchable" and generally better-designed disclosure of prices and various other information about the services. CMS designated 70 of these, and hospitals choose the other 230.

*THAT'S IT.* Contrary to popular belief, especially elsewhere ITT, the rule does not require hospitals to provide the kind of price transparency you see elsewhere in life. You just have to post certain kinds of data in certain formats. It's not actually that hard, but it's pretty hard for hospital IT departments to do on their own -- especially IT departments that don't really exist, because they're at small hospitals with small budgets.

=======

Misunderstandings ITT

Myth: "The price transparency rule requires hospitals to explain what things cost for patients"

Reality: The price transparency rule requires hospitals to list the "standard", or "chargemaster" price, along with the "negotiated rate" the hospital has reached with each payer.

Myth: $300/day is nothing to hospitals

Reality: that's true for large hospital systems maybe, but there are >2k small, rural hospitals that the rule still applies to, regardless of their tiny budgets. For these hospitals, 109k/year is a lot of money (incidentally: this also means that spending say 10k/yr on price transparency saas is a lot more attractive than doing nothing and paying the fine). Moreover:

Myth: the fine is the only penalty for noncompliance

Reality: CMS has indicated stronger penalties will come if compliance does not increase, including impact on the medicare reimbursement rate, which is a core driver of hospital revenue. Hospitals do have good reason to try to comply, and many of the larger ones are already doing so. In fact, the data show that the larger hospitals are much more likely than smaller ones to be compliant at this time.

Myth: this is way too hard

Reality: If complying with the rule meant you had to figure out what every patient was going to pay in advance, then yeah, it would be largely impossible right now, for reasons adequately documented elsewhere in this thread. But that's not what it requires. You can comply by posting a very specific, pretty well-understood set of information, which consists largely of a transform on information that each hospital absolutely already has.

----

I started ClearCare basically the day I read the Trump executive order, because within an hour of hearing about it, it was obvious to me that either 6k+ hospitals would have to do a bunch of bespoke web design to comply, OR there would be a pretty straightforward SaaS platform that would do it for them, and that there was good opportunity in building that platform. I still believe this, and if I weren't busy taking orders for plant-based bacon I'd be recruiting instead of looking for someone to hand it off to. Call me if you want to talk.

---------

[0] https://www.clearcare.io -- and there's a corporate deck here: https://www.beautiful.ai/player/-McFhWCjOS_FBay_aAy3

[1] https://en.wikipedia.org/wiki/Affordable_Care_Act

[2] https://en.wikipedia.org/wiki/Chargemaster

[3] https://nationalhealthcouncil.org/blog/blog-president-trumps... - note the text of the order is no longer available on the whitehouse site, but this is a decent summary.

I bought one of these during the early-access program, as my old Charge 3 had recently died. I really wanted to like it.

Sad to say, it's terrible. Mostly what it did was remind me how much I appreciate stuff that actually works well (e.g., wrist position sensing, so that it turns on when it's supposed to, a reliable touch interface, etc). I ended up buying a Fitbit Sense when they came out a month or so later. I don't regret it, even at >10x the price. I have my gripes with the sense but most of the time it is vastly more usable.

~$1.5M ARR. Isn't that a bit low for SaaS at 7 years?

The median and modal ARR for SaaS businesses 7 years after founding is zero.

1. Pretty easy to assay the vaccine itself and the blood of vaccine recipients and figure out (1) is it what they're saying it is? and (2) does it do what they're saying it does?

2. No. Google around for this; there's plenty of info on how this can be done more quickly. Also, "even if we find a vaccine it will take a year or more to produce it at scale" is no reason not to develop one or to celebrate progress in such development.

3. Possible? Uh, sure, yeah, most things are possible. Probable? I'm not aware of any evidence suggesting that "early vaccine trials result in super virus" is a remotely probable scenario. If you are aware of any such evidence, please post it here because I'd like to read it and update my view accordingly.

The article doesn't go into it, but the actual paper[1] states that this vaccine has "has previously been reported to be immunogenic and protective against pneumonia in a rhesus macaque challenge model", and cites to [2].

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

[2] https://www.biorxiv.org/content/10.1101/2020.05.13.093195v1

I think it would be appropriate to break out the black bar for this one.

For those not familiar: https://en.wikipedia.org/wiki/Freeman_Dyson

I speak 5 languages (learned through school and life choices) but when I tried to learn a 6th on Duolingo I felt like the experience was not good enough for me.

Well of course it isn't, but that's like saying "I'm a fighter pilot (trained in the air force), but when I try to use Flight Simulator X, it feels like the experience isn't good enough for me." The DL experience isn't really for you at all. It's for people would a little bit like to learn a new language. Not people who want to do it so badly that they'll invest substantial time in school and "life choices" to make it happen.

Well, it finally happened: we outlasted Google!

Hi, founder of Breezy here (www.breezy.com), a secure cloud / mobile print infrastructure that actually is "enterprise-ready". (For example: we have tens of thousands of active users across thousands of retail branches for one of the top 3 banks in the US, plus thousands more across dozens of countries around the world.)

I started Breezy in 2009 because, as a corporate lawyer at the time, I needed a way to print from my BlackBerry and couldn't find one. I applied to the 2010 YC batch with Breezy, got rejected, went through Founder Institute instead, raised a 750k seed round in 2011, almost ran out of money, pivoted to an enterprise focus, raised a bit more money, barely survived a BS patent lawsuit from a Canadian competitor now owned by HP, went through lots of other ups and downs, and here we are.

We're never going to be a unicorn, but it's a neat little business in a niche that while "nice to have" for most companies, is critical to some. If you need quality cloud print infrastructure, hit me up.

---

Meanwhile, a few thoughts from a 10-year industry veteran:

- GCP was never enterprise-class in any way. "Utterly unreliable" was the most common complaint we heard from customers.

- The core problem for a lot of enterprise use cases isn't driver incompatibility; it's network routing. Your MFPs are on this network segment over here, but your users (especially mobile devices) are on that one over there. Cloud printing can save you a lot of network headaches.

- "Driverless printing" doesn't work very well, and never has. This goes double for Mopria, which while by far the most successful of attempts, is pretty shaky in real-life usage, and lacks most basic capabilities around security, audits, encryption etc etc.

- AirPrint is pretty good and is consistently getting better, but it's always been very consumer-focused and remains so today as far as I can tell. One of the really great features they could add to simplify enterprise adoption would be to enable querying "Print Servers" (which the AirPrint spec does recognize) for lists of printers served by them. Right now there's no way to do this, so in order to reach an AirPrint print queue that's not bonjour-routable from your current IP, you have to have a config profile that points you to that specific queue, rather than to a server that returns a group of queues.

- The other major improvement opportunity there would be the ability to use certs to completely identify the user, thereby enabling (say) an Intune-provisioned iPad to print natively to a Xerox-managed enterprise pull-print / badge-release system, so that users get a native experience of printing via one queue, to any printer in the org. This is possible with Breezy today but there are a number of hoops to jump through on the admin side.

"hereby ordered" means exactly nothing without legal authority behind it. The President can't just "order" companies to randomly do things. I mean, he can, but they don't have to comply, and there's no legal penalty if they don't.