polygotdomain

if a private business with all the incentive in the world can't figure out how to lower healthcare costs

What if their incentives aren't to lower cost? Insurance companies make more when the obfusicate pricing and payout less. That's the opposite of incentive, it's a way to cover up your profits.

Everyone that proposes a single payer can't explain who makes less money.

If you think the healthcare industry is just doctor-insurance-you, then you're nuts. Look up pharmacy benefit managers. They're basically third parties that are in place to jack up prices.

Even if you're able to do everything the health insurance company does and capture 100% of their margin with equal efficiency, you'll capture a profit margin of around 2-6%.

Insurance companies have had their profits capped via the ACA for more than a decade now. Where they're making their money is by using more third parties in the middle to jack up pricing and increase costs so that A) their 2-6% is bigger, and B) their "investments" in the third parties are not regulated by the ACA so they can get their massive profits their.

The only argument I hear is "other countries do it", which is just unpersuasive. It's not a serious argument. Propose something better

Its a very serious argument, you're just happy to dismiss it for some reason. If the entire developed world uses a different system than us, gets better results and for less money, then you'd have to be insane to insist that mimic those systems is not a serious alternative.

Competition based on benefits really comes in at the low end and the top end of employment.

If you're a tradesperson, just having insurance coverage is a big thing. It doesn't matter if it's not great, it's better than nothing. Leaving a job with insurance for one without insurance is likely going to cost you thousands of dollars out of pocket for the same coverage.

At the top end, companies will have plans that cover so many things at very high percentages, meaning that your out of pocket for health insurance will be surprisingly small. Less competitive companies simply can't offer that.

It's only in the middle where the details of a plan matter, and those are going to be the hardest details to find.

I completely agree. While it's counter intuitive, many businesses want to maintain control of employee's healthcare. Some companies look at it as a way to compete by offering better benefits than their competitors. A lot of companies like controlling healthcare because it keeps employees tied to their employer. If you temporarily lose your insurance when you switch a job, all of the sudden switching doesn't look as good. When you get to really larger companies, then they have the ability to self-insure, which means they can control the costs a hell of a lot more.

Of course, since many companies prefer less regulation, the last thing they'd want to do is hand over the keys to what they do for the healthcare for their employees over to the government. With things how they are now, they can always cut or pair back their plans if they want to cut costs. That lever would be gone with single payer.

Like many things, the system is set up to benefit those in charge rather than those who it's meant to serve. You can look just about anywhere outside the US and see that universal healthcare is a much better system, but better for who? Not much of a benefit for those who make the decisions, so we keep the flawed system we have.

To start, it was clear that many were Musk fan boys. I don't think "bright" was a driving force, but "young, with no prior experience" would be great if you wanted people to make decisions that have the potential to negatively impact millions of lives. You need people with a lack of context to realize those are the stakes at hand. Since it was also clear they were going to "throw AI at it", I also doubt they were looking for anyone who acknowledged the shortcomings and pitfalls of an all AI approach.

I think this approach got them exactly what they wanted. Musk clearly wanted access to as much data as he could get his hands onto; legally or not. There were contracts and investigations into Musk's interest that he wanted control over, and got. Overall, chaos is not seen as an issue for those in this administration. The attitude from the top was clearly that these agencies and contractors "deserved it" for some reason, even though they have no idea what they really do or why they're doing it.

I'm sorry, but I can't help myself with this one... https://youtu.be/dalNQF8NmIs?si=lHyKeTiCLDFczZk6

Psychopath? No. But it's also not insulting their intelligence by having that little catch up. You're asking someone for something that they don't have to do for you. Showing up in their inbox saying "Give me something" might seem to you like you're being concise and to the point, but to the person reading it, there's not much motivation for why they should give you that thing you need.

The catchup, as mundane and obvious as it is, at least signals to the person that you see some value in them and value your relationship, even if it's transactional in nature. Does it need to go on for paragraphs or multiple emails back and forth? Absolutely not, but having some lead in makes it less like you're only concerned about what you can get from the person.

Would you rather a waiter just come up to your table and say "Order!?" or have a little bit of pleasantries before asking what you'd like to eat. There's no more transactional relationship than a diner and a waiter, but most people would prefer the latter.

Fixing healthcare costs will require a lot of people losing their job, and that wont be popular.

Agreed, but I also don't think it _has_ to be this way. First and foremost, a switch to single payer would mean that a lot of the infrastructure that's currently in medical insurance industry would need to shift towards being government employees. While there'd be massive administrative savings with single payer, there wouldn't be zero administration at all.

I'd also posture that the US would never go full single payer, and that there'd be supplemental plans similar to the German model (and Medicare, to be fair), so while private insurers would still exist, the administrative burden would significantly lower.

In the end, you'd still end up with a lot of people losing their job, but it wouldn't be a complete wipe out of the industry. Certain areas would get hit harder than others with the insurance brokers likely getting cut out big time.

In truth I think about 20% of US workers are involved with the healthcare industry and the surrounding insurance and other supporting industries

That seems pretty high to me. I wonder what made you come up with those numbers.

The thing that debt to GDP misses is the rates which need to be paid on that debt. For a while those rates were so low, it meant there was little reason to focus on paying down the debt, which is only going to keep that ratio relatively stagnant.

What is far more telling is the debt servicing to GDP ratio, which is far more useful in telling us how much our debt is costing us. This winds up looking wildly different than debt to GDP and has been a lot less concerning up until we've seen the latest spike in rates.

Debt to GDP - https://fred.stlouisfed.org/series/GFDEGDQ188S

Interest to GDP - https://fred.stlouisfed.org/series/FYOIGDA188S

But why did the US lose their AAA rating? It has nothing to do with how much debt we have. It has far more to do with a non-functioning congress that simply decided it wasn't going to pay it. As has been said several times in this thread, it's political, not about the numbers themselves.

This story is incredibly frustrating because it seems to throw a lot of numbers at things (which isn't a bad thing, it's just not super useful) as if that's going to change things politically. Debt is political and the fundamentals of government debt have not changed at all.

Government debt is a red herring that many fiscal conservatives wave to say we're spending too much. Unfortunately those same conservatives don't actually want "fiscal responsibility", they want to cut programs they don't agree with and continue handing out lucrative military contracts that we arguably don't need.

Government debt has always been about borrowing today to fund growth for tomorrow. However, that's not what we're actually doing at all. Much of our current debt is due to COVID stimulous, which was an incredibly exceptional event. Of course that was more to "keeping things going" than fund growth initiatives. That's not to say that debt was "bad" or that we shouldn't have done it, but that much of the debt we're taking on is not going to fund infrastructure, education, or health which are all things that have significant long term benefits to society.

Lastly, debt only matters in comparison to rates. If you're borrowing lower than growth of GDP, then that borrowing is generally considered a net positive. Artificially deflating rates in the late 2010s and the rapid increase in rates post-COVID is not going to do well for government debt because we can't shift our budgets quickly enough to adjust. Of course that also assumes a functioning congress, which we certainly don't have.

Since it is a political issue, it will be a football and a dog whistle. Cut programs for minorities from the right, and raise taxes on the rich from the left. While one party is likely to be more irresponsible with this than the other, it's still not going to go away because it's never supposed to. Government debt is all about the cost to borrow compared to growth. The challenge we're at is that the cost is no longer cheap and we haven't been truly focusing on growth as much as we should. Instead we've just had political distractions.

I think this quote misses that there can (and arguably should) be differences between your persistence model and your actual data structures. I'd argue that keeping things 1:1 with your underlying tables is incredibly restrictive and leads to models that miss out on the expressiveness that's available in modern languages.

To give a slightly more technical answer, at a large insurance company I used to work for, the legal department had provided definitions on what conditions we would consider various components of PII a match. So between SSN, DoB, First Name, Last Name, and a couple others, there were potential combinations that our system would say, "yes this is the same person". Note that we didn't necessarily need exact matches on things like names, but "close enough" matches were sometimes sufficient.

This misses the mark for me completely.

My theory is that neither individuals nor organizations feel comfortable being frivolous or indulgent with their wealth anymore.

I guess the author hasn't paid attention to the rise of the mega-yacht or having personal jets. If you also don't think that the wealthy live in opulent real estate, then I've I'm not sure what rock you've been living under.

What I assume the author is really referencing is how skyscrapers and other buildings are no longer as "beautiful" as they used to be. Beyond the survivor bias of the older buildings that we perceive as "beautiful", a real explanation probably ties more to corporate accounting and business practices than anything else.

The big grand skyscraper for a company HQ pre-dates the exodus of city centers in the 70s and 80s. In the meantime, the construction of these types of buildings is now being pursued by developers, rather than corporations. Those developers have a much different approach to building, which is much more about making profitable real estate, rather than something that's a statement or a symbol. Corporation also needs more flexibility in their office space that makes renting vs owning a much more viable approach to meeting space needs. We no longer need all employees working under one big roof, and corporations are far more likely to have far more office locations than they did.

I also think that the definition of what this author and the one they're responding to consider "beautiful" is largely missing. We still build fantastic buildings, but they likely don't look like they were built in the 1920s or 1930s and may not align with everyone's preferred aesthetic.

Having recently bought a metal lathe, and in general having a long time fascination with manufacturing, broaching is freaking mind blowing. Imparting form into metal by extremely strategic shaving off thousandths until you get to what you're looking for. It just doesn't seem like it should actually work at all, yet we wouldn't have things like allen bolts, splines, or keyways without them. Turns out all you need is the right geometry and super hard metal to make it work.

Rotary broaches are just so cool in that getting the right angle and wobble to the tooling is incredibly important, but it just seems like magic when it actually does it's thing. https://youtu.be/GWyHJVOxKK4?t=444 It's only when I saw what it was doing with the rotary motion stabilized that it started to make sense. https://youtu.be/4-3gPWl6wfU?t=95

It's hard to really understand why it matters that the previous rounds occurred at all

It's not hard at all. Humans are not perfectly rational beings. It's not purely about odds, it's about emotions and psychology. In a version where there's no previous selection and it's 50:50, than I pick one and live with it. In the canonical example, the previous selection means that the contestant has already staked their claim, and changing it to the loosing door would have a different emotional response than a simple 50:50 shot with no previous selection. There's a reason why Roulette shows you the last X spins and whether they're odd/even, red/black... because humans make the assumption that the last disconnected data point somehow impacts the current one.

You're also glossing over the fact that there was a 1:3 chance you picked the right door to begin with, and 2:3 chance the "other" door was right. The last round isn't 50:50, as you so claim, because there was prior information

This is the same reason why the 1000 door example helps explain things; because the math is fundamentally the same, yet significantly more imbalanced. We can also think about how we'd feel about our selection in the 1000 door version, which is likely significantly less confidence, and therefore more likelihood of switching. Whether it's 3 doors, or 1000, the math still say switching is optimal, and our psychology and emotions deal with the choice of switching different in each case.

I love this, and it brings an interesting twist to an old favorite. What initially tripped me up is the cells at the points are considered a neighbor. Of course as I write that it makes perfect sense, but because of the irregular nature it's a bit harder for me to register them as such. Not a complaint, just an intriguing side effect of the irregular grid.

A few things you're missing. You're making a batch in your kitchen. They're making a significantly higher volume through an industrialized process. You probably throw things in a ziplock bag, then into the freezer. They need to think of actually packaging a product. You can source the highest ingredients you can, as you only need a little. They need to be able to source ingredients at a volume that can satisfy production and at a cost that makes the item profitable. You don't really worry about how long it'll last because you plan to use it in a month or two. They need to ensure the product stays fresh during storage, on the shelves, and in your fridge/freezer for longer than you expect.

Each of these components requires compromises in a way that the home cook doesn't need to worry about. These are the things that cause compromise in quality, the addition of ingredients you'd never add yourself, and a lack of freshness that's apparent to anyone who makes their own versions from scratch. The best you can do is buy items from small, local, specialty shops, but it will be much more costly and just about anything you find in your average grocery store isn't going to be produced at that scale at all.

I'm not entirely sure that those were all Kubrick's tricks though. Classical music is used throughout the book as a way to humanize Alex playing on stereotypes that someone who would've been more refined and upstanding than Alex's character was. While I can't remember what was in the book, it's entirely possible that Alex's narration of the the fight had mentions of music.

I also would argue that Kubrick's tricks weren't all that effective, in that they didn't really humanize Alex or pull the viewer into Alex's perspective, but rather just made the film into more of spectacle.

A lot of the visual elements of the movie struck me as very cartoonish in a way that wasn't conveyed at all in the book. The book is not all that descriptive of aesthetics and visuals in terms of fashion and architecture/decorations. I feel like those are some areas where Kubrick took the most liberties (because there wasn't as much to go off of) and I just found it distracting.

I think the most important aspect of "A Clockwork Orange" is it's use of language as a literary tool. It's also key to its misunderstanding, as it tends to lead towards secondary interpretations (i.e. Kubrick's film) more than the text itself.

In addition to freewill being a key theme in the book, the nadsat language is used to disassociate the reader from the actions and events partaken in by the narrator. Alex describes in clear detail the fact that he's beating the crap out of old ladies in the book, but you, the reader, don't interpret it that way. Those acts are hidden behind a language that doesn't hold the same connotations to you, the reader, so you don'tt look at Alex the same way because of it.

Conversely when his punishment and "re-education" begins you view that as harsh and inhumane, because those things are expressed in more familiar terms simply because the reader is more comfortable with the language Alex uses. Worse, he had something that he loved taken away from him (his classical music), which you understand wholeheartedly as the reader.

The fact that Alex punishment was arguably justified (if not grotesque in it's own way), is something that's missed because language disassociates the crime and amplifies the impact of the punishment. It makes you question the humaneness of criminal punishment, because it's expressed from a perspective rarely portrayed.

All of these things are completely lost once the story is taken into any visual medium. The idea of making it a film was flawed before Kubrick even touched the project, and any other director would have struggled to have the same impact as the book. I genuinely think that the project attracted Kubrick for the wrong reasons and he was far more interested in making something provocative, which "A Clockwork Orange" had plenty of opportunities.

If you haven't read "A Clockwork Orange", I strongly recommend you do, and I strongly recommend reading it as quickly and in as short a timeline as possible. Understanding the language is key, and it makes it a slow read at the start. The quicker you can become familiar with it, the easier the rest of it goes.

Then after you're done reading it, reread it again. Being familiar with the language from the start makes some of the more graphic scenes at the start really stand out in a way that they don't the first read through.

From OP's comment history, I'm going to assume this is about https://www.fretboardhacking.com/fretpro-app/

As a guitarist myself there is incredible saturation in the market right now for learning guitar, whether it be apps, courses, or other content out there on YouTube/Ticktoc/etc. My first question is why to you is why you think "the path to something like ~$1M/yr seems very clear to me."? My second question is what does your app do to distinguish it from any other of the readily available guitar learning/fretboard apps (from quick google https://guitar.com/guides/buyers-guide/best-guitar-learning-... and https://americansongwriter.com/best-guitar-learning-app/)?

If you're looking to potentially quit your fulltime employment or potentially take some extended time off, that it feels like you should have some pretty solid answers to those questions before doing so.

At $600/mo, there's about a 10X gap between where you're at and revenues you could actually sustain yourself on, and ideally you'd like to hit 5 figures recurring revenue a month before you start seriously thinking what this would mean becoming a "real business". Assuming you have ideas on how to grow that revenue, I'd suggest focusing on some of those strategies. I'd also start making strides in marketing that can start to grow market share and get some exposure.

While I don't want to discourage you, it's also okay if a side project stays a side project. You can continue to invest the side time you have and grow your passive income to supplement your 9 to 5.

Growing up my best friend and I loved The Far Side. In many ways it was the basis to the quirky humor we both shared, and would continue to explore throughout our youth. In elementary school we had countless Far Side books between us, and by middle school a few shirts too (I remember having "Midvale School for the Gifted").

Well he turned 40 just a few weeks ago, and I needed to find a present. I don't know why, as The Far Side hadn't crossed my conscious in quite some time, but I thought "I'll get him 'The Chickens are Restless'". After some quick searching, he ended up with the Complete Works containing every thing from The Far Side.

Wrapped, he didn't have a clue what I'd got him or why it was so damn heavy. The first glance as he opened in and realized what it was instantly brought a smile to his face. It's amazing how small things bring people together, and The Far Side will always be one of them for my best friend and I. I'm sure there will be some new comics we'd missed and there will be some new chuckles.

The filling mechanism of the pen is what tends to dictate whether there is a shutoff valve, and there two mechanisms that have this feature; vacuum fillers, and Japanese eyedroppers.

Vacuum fillers are generally higher end pens, but the best, cheapest option is a PenBBS 456, which is a Chinese pen. The Pilot 823 is very well loved pen in the community, and a good "next level" pen if you're looking for one. Viscontis are high end luxury pens that feature a vacuum filling mechanism, although their marketing calls it a power filler.

Japanese eyedroppers aren't really a "filling mechanism", per say, but can be thought of in that manner, even though you have to fill them with a syringe or pipette. Unfortunately far fewer pens make use of this, and tend to be very high end pens. The one exception are pens from Opus88, which pretty much all feature this mechanism, and are very reasonably priced. Then there's a big gap until you get to the high end urushi pens like the Pilot Emperor.

There's other one offs, like the bulkfilling mechanism from Conid and used on the PenBBS 355. The Diplomat Nexus uses an integrated shutoff valve that's engaged when capping the pen.

I don't disagree that those are potential cons, but it also highlights how much versatility you can have with a fountain pen. For instance, there are ones that travel very well with shutoff valves to prevent ink leakage. There are options for filling that can all but eliminate getting ink on your hands. Nibs can be tuned and ink choices can align with what paper you write on, so you don't absolutely have to change the notebooks you use.

You highlighting the language issue is interesting because it makes the assumption that one can get the line width they'd like from a ballpoint pen, which personally, I didn't. Ultimately you need to choose what works best for you, and the language you write in is certainly a consideration. I'd much rather have the option, than be stuck with "one size fits all" of most ballpoints. So saying that's a con is a misnomer for me.

All that being said, a fountain pen is not a tool for every use case. I was a lot happier when I realized that a ballpoint or rollerball is far better suited for tossing in a bag or having at the ready when traveling.

Paper that mentions that it's fountain pen friendly is usually helpful. My go to "cheap" paper is Black & Red Notebooks. I tend to use Rhodia a lot, but that may be pricier for some. In general, a lot of the Japanese papers are great for fountain pens, and Jet Pens has a ton of options at different price ranges.

I always feel that fountain pens should come with bigger caveats than they're typically presented with. I absolutely love them (more than you'd even guess), but if someone is just going to "pick up" a fountain pen and just start writing they might be in for a bit of shift. Writing with a fountain pen isn't really the same as writing with a ball point, and there will be some adjustment that goes along with it. If you're just starting out, I'd say to stick with it for a while.

Here's a couple of pointers when it comes to fountain pens...

+ Paper matters... a lot! A lot of feathering and bleeding issues are because of the paper

+ Ink is a whole avenue of exploration in and of itself. Inks have different properties and come in just about any color imaginable.

+ You have far more of a choice of _how_ your pen writes with a fountain pen. This first one is line width, commonly referred to as nib size or point size. If you think about it a little bit before you purchase your first one, you'll be well served.

+ You can use significantly less pressure when writing with a fountain pen. Relax your grip as much as you can.

+ Many in the fountain pen hobby use their pens for more than just utility (notes, forms, etc.) Having an avenue to write for pleasure can help you connect with fountain pens.

+ Your penmanship doesn't need to be good in order to use a fountain pen, and while it may improve with use, it also may be exactly the same. You don't have to do calligraphy or have that be your end goal.

I see a lot of tech people in the fountain pen hobby, and there are cross over hobbies with mechanical keyboards, headphones, watches, and EDC gear.

I can only speak of my experience having gone to school for Architecture. They told us that with each recession, the profession loses a generation of Architects. I was wrapping up grad school just before the Great Recession, and professors were surprised that a relatively greater percentage of graduates had stayed in the field due to continued economic prosperity since the mid 90s and the dot com boom hadn't impacted the Architecture field all that much.

Of course, once the Great Recession hit, myself and many others that I graduated with either left the profession for other employment or simply never found jobs to begin with (that was me). Luckily I was already programming in grad school, and what was something I was filling my time with while looking for an architecture job became a new profession and I never looked back. Given all the comparative benefits of Software Engineering over Architecture, it's been a good move for me.

The short answer is to write ANSI 92 SQL and understand the variances between different RDBMS based on which ones you encounter.

The longer answer is that some RBDMS adhere closer to the standard than others. Generally the more open source and more long lived a platform is, the closer to the standard it can be. However, even an RDBMS like MSSqlServer isn't that far off from it, and while it may have things it supports that are outside of that standard, it will still support ANSI SQL (i.e. `ISNULL` vs `COALESCE`)

If you're looking for learning SQL that you can likely use in a wide number of places, I'd steer away from Oracle and DB2. Both are fairly proprietary, in my experience, and feel like writing in a different language that looks like SQL, but has a different set of rules and constraints.

The challenge with UPSERTs is ambiguity, and the variety of syntax options you see on the page indicates different attempts to try to address that ambiguity while still keeping a simple syntax.

Personally, I work with MSSQL which has skipped adoption of UPSERT syntax and supported MERGE statements for probably 15 years now. While there's a certain degree of complexity in a MERGE statement, there's also a strong level of explicitness that is helpful in making sure certain conditions don't fall through the cracks or don't perform an operation that isn't expected.

The ability to handle different conditions in match statements is incredibly powerful and allows potentially complex ETL statements to be handled within a single merge statement. I'm not saying that's always the best practice, but if things are structured in the right way, it may be.

I believe the transaction isolation of a MERGE statement (in MSSQL at least) means that the lock on the rows is not released between the read and the write, which means you'll have fewer issues with reading data, attempting an update, then having it fail bc another process made a change in between the two calls.

I regularly use output tables to debug the results of a MERGE statement, and in this case the $action keyword is incredibly helpful for knowing what was done.

While I agree that the housing market is significantly "planned", it's also not centrally planned. Zoning is determined by local citizens, which tend to have the opposite incentives to responsible growth, housing prices, and infrastructure costs. Also, the thing that make many housing decisions work is infrastructure, which is handled through entirely different mechanisms.

If we let the market build enough homes to meet the demand, an apartment would be incredibly affordable.

I'm not entirely convinced that just letting builders "build more" is going to solve the issue. The reality is that companies are only going to build what they can sell and/or lease at a level that makes it profitable for them to build it. The three factors are then land value, materials, and labor costs. Materials and labor are a separate thing, so you're effectively saying that changes in zoning would decrease the land value. At this point, I'm not really sure that you'd see that impact. In many of the cities and areas where you'd want more density, the land values are already quite high, and it's unlikely that bringing in that density would decrease the land value.

What you're banking on is more housing increasing competition and bringing prices down, which would be unlikely to happen, mainly because of how long it would take to go from an empty lot to "ready-to-move-in" apartments. At best it would slow down double digit rent increases, which would obviously be a benefit, but it wouldn't suddenly make housing affordable.

From my perspective, we need to incentivize the building of affordable housing, rather than investor driven product. An investor driven product is going to try and have higher end finishes, novel floor plans, and other amenities to distinguish it from the market to maximize rents and valuations. Affordable housing can be built with normal finishes, reproducible floor plans, and comparable amenities. That's what will keep the cost down for the other two factors, material and labor, so that the end result is something that's affordable. The biggest problem is that no one in commercial real estate really likes building this kind of product, unless it's in an area without much direct competition.

Data, information, doesn't rot...

Can you tell me what hieroglyphics mean? What about a phrase of latin or another dead language? Information is only as "fresh" as our ability to interpret and understand it. Dead languagues are the same as a file who's format we no longer have the spec for. Yes, the ones and zeros may still be there, but without the ability to understand what they mean, there's little we can do with that information. We're still at risk of losing those capabilities for data.