skysight-inc/HackerNews huggingface dataset:
The most insightful and thought provoking analysis of health care I've seen in the last several years is this one:

https://randomcriticalanalysis.wordpress.com/2016/09/25/high...

It argues that the high cost of health care in the United States is explained by its extreme wealth and that health care is a superior good (https://en.wikipedia.org/wiki/Superior_good).

This is a much different explanation than what is given by either political party.

Anyone have any points in support of or against this argument?
Zero comments as well?
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I'd expect surprised if it wasn't just the daunting compatibility work: it's a complex legacy codebase and if you make a mistake you impact security or performance on every Windows box in the world.
Historically, retail banks made their money off of the spread between their loan interest rate and the rate they pay out on deposits. So they borrow from your deposits at 2% and loan it out at 5%, pocketing the 3% difference. Over the past 20 or 30 years, extremely low interest rates and competition with money market funds and other more complex savings vehicles have reduced depository interest to essentially nothing, which sets a ceiling for the spread. So for a bank to make money off a regular joe who doesn't have enough money to access investment banking services, they need to charge fees to make a profit. For example, if you have an average $1000 in your account, the bank may only make $10 off of that in a year. Many lower end clients, the ones who tend to pay high fees for overdrafts, have even less money than that deposited on average. Also it's worth pointing out that most banks charge withdrawal fees only if you use another bank's ATM. It's entirely possible to have a checking or savings account at a bank and never pay significant fees if you don't overdraft or drop below minimum amounts. Of course, those issues tend to affect poorer customers disproportionately, but it's not without reason even if it is problematic socially.
That was pre-ACA. Given the min 80% payout rule, it would seem the only way to increase profits is to increase the costs of everything, no?
1. You can have single payer with the option for private insurance. Many countries do that. From what I can gather, here (Norway) one can get quicker service with the private doctors. The national health plan still pays the private doctors the national rate, and you pay the difference.
Do you realize that this is happening in Canada because certain people are pushing for privatized health care, draining more and more resources away from the public health services, causing the service quality to go down?

It's a tried and tested technique. Take a well working system which doesn't generate profits, push to reduce costs, entirely destroying the service then point it out and say "See? It doesn't work. Better privatize it!"
Maybe they don't have enough Android-carrying traffic on rural lanes to calculate an average speed?

All I know is I frequently get really goofy route suggestions from Google Maps that seem totally clueless about the difficulty of driving narrow UK backroads.
+1 - speaking as an ex-sceptic, the only people I know that don't like unit testing and/or TDD are the people who either misunderstand their purpose or have not learned how to utilise them properly yet.

Once TDD "clicked," the quality of my code shot up very rapidly indeed.
I'm curious about this - why are other people able to get doctors while you are unable to (asking in utmost earnestness)?

Also, it seems that your condition isn't life-threatening (considering you're posting here and all). While the average, generally healthy, person will likely need to wait longer, they at least have access to care in developed countries outside the US.

The final point I would add is that private healthcare is still available, even if only available in a different country. I think that's a reasonable trade off- most people can get care readily, while those who need more can pay more to get more timely care.
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> Between myself and my employer, it costs about $20,000 to insure my family a year.

Wow, that's an awful lot. What's the level of service like? For comparison when I lived in Switzerland my family, ie my wife and 2 kids, were about 750 CHF a month. All paid from my pocket.

The level of care was stunning though. That 750 was for single room care, and we had two babies by caesarean. Also the times I was in the emergency room there were zero other people in line. Almost wondered whether it was actually an emergency room.

You can get less comfy care, I think at about 500 per month, sharing a bedroom with one other patient.

By contrast the NHS in the UK is pretty stretched when you go there, but paid via taxes.
I think the problem lies with the definition of "unit" which you quote above. As with designs stacking on top of one another at various levels, one level's functional test is often the next level's unit test. Your app's unit test might mock the very same things that are covered by the functional test for an underlying library. That library's unit tests might mock the very same things that are covered by the functional tests for one of its own dependencies, including the OS. And so on, even down to the level of functional units within a chip. (Chip verifiers have a lot to teach us software types about this kind of thing BTW, and I know because I've worked with a few.)

The distinction I always try to make is whether you're testing a contract or an implementation. If you're testing a contract, ROI is likely to remain high even as you move to finder granularities. If you're testing an implementation, so that the tests fail even when the implementation is 100% correct, then ROI falls off a cliff.

That's exactly what happens when the "unit" gets too small. If certain private methods can't be called a certain way because of constraints imposed by the class's public methods, then testing those calls is testing things that can't happen. That takes time away from testing (and implementing fixes for) things that can happen. If the class's contract changes so that those internal methods can be called in new ways, then yes, a 100% code-coverage unit test might catch the error. So, in all likelihood, would the new functional test accompanying the public-method change. The delta between the two, times the likelihood of such a scenario occurring in the first place, is too small to justify the cost of writing those tests and the likelihood that they'll generate false negatives.
There are no sane constraints on the prices. Instead of "price is what the market will bear," it's "the market will bear whatever price." This creates an irrational drain on the rest of the system. Whoever is sucking on that drain is doing well, though.

My grandfather used to get a shot that was $12,000 a pop, and didn't do anything.
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Agreed re: note for note covers. I have covered other songs, and while I strive to play the original composition mostly note for note, it may be in a different key or have some other approach taken. Often the drums are changed, because a) recording drums in my music room is time consuming b) I'm a barely serviceable drummer and c) I can't always make that much noise for as long as it would take to get right without upsetting the wife and kids.

Also to your first point, DAW software is now akin to a canvas and recording can also be part of the creative process. I used to try to record in stages, write, rehearse, record, produce, master. Now I find that I'm kind of doing it all at once and the results don't end up any worse except for one thing. The compositions are usually less complicated without having the time to think about it and practice it.
The pharma industry should open up; it is dominated by corporatism and their monopoly patents driving up prices, which make individual spending on drugs rise till an unaffordable level for the lower income.
Researchers create touchpads with a can of spray paint
WhatsApp quietly added encryption to iCloud backups
Other thread is up at: https://news.ycombinator.com/item?id=14296959 (although doesn't mention that MSFT have released a fix already).
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To dispel the myth about the Swedish "free" health care system, today about 650 000 swedes have private health care insurance, 70% paid by the employer. This is on top on the already public tax funded health care system.

So basically Sweden is slowly introducing the US system.

https://www.svt.se/nyheter/inrikes/privat-sjukvardsforsakrin...
Very strange, it appears that the HN submission algo didn't flag this as a duplicate of @grej's post of this from yesterday:

https://news.ycombinator.com/item?id=14291548

My apologies for the duplicate post, @grej!

Still hoping that I can learn more about the mechanisms that allow it work, if anyone is able to share their hypotheses.
When banking becomes optional, I agree, however I need a bank and I ain't paying to take money out of it. When banking is optional, by all means they may charge, but I will take my cash in £20 pound notes in Royal Mail Special Delivery at the end of the month cheers!
I'm not particularly good in group settings, but here's a strategy I've found that works in most cases: give the person a complement, then ask them a question about themselves. It's important that the complement isn't about their appearance or something that might make them uncomfortable. And keep the question light.
> Elon Musk stated that their technology is 2 years away from full autonomous driving. Tesla is planning LA -> NY fully autonomic drive by end of this year.

While that's nice, it's kinda the low-hanging fruit.

I'll be impressed if somebody manages autonomous driving in, say, New York (or Kolkata if you're feeling ambitious), at night, during snowfall, navigating a construction site and/or traffic regulated by policemen.

This is taxing but completely possible (and entirely expected) for a human driver. Whereas the lane-following autopilot in my car is routinely confused by shadows on a pleasant day.
What is a non-trivial procedure? In fact the issue would be trivial (or unjustified) procedures, since anything life threatening would obviously have priority over anything else.

In northern Italy I have seen two "simple" (easily removed surgically) cancer cases going through all diagnostic steps in less than 2 months (including ultrasound, biopsies, CT scans), followed by surgery and/or radiotherapy, all at absolutely zero cost for the patient.

If you need heart surgery (valve replacement, coronary stents, stuff like that), your GP can get you an ambulance straight to the ICU, and you can stay there for free until everything is ready for surgery, maybe in a couple days.
Hence the laws prohibiting price negotiation!
I wonder if you can apply that to modern politics as well. Why try to have well-informed citizens when you can scare them?
Ironically, this happens in the US despite the private insurance system. It's the worst of both worlds.

If you want to be seen quickly and you're not literally dying, you have to go to an urgent care clinic and pay a much higher fee.

And even that is only available for very minor, primary-care issues. I recently took my girlfriend to the emergency room for a very serious illness, and we ended up being there for 12 hours. About 1 hour of that time involved actual treatment or seeing a doctor -- the other 11 hours were just waiting. The bill was $20,000.
A few banks (USAA, Schwaab, others) offer ATM fee reimbursal, but most US ATMs will charge you unless you're part of that bank's network. It's really not the best, especially when you're at cash only places, which seem to be popping up a lot near me.
Serious props to Microsoft for getting the fix out the door so quickly. I'm glad that they took this seriously because this is a major vulnerability.
I'm saying the French people undermine your testimonial better than I can. The typical argument (all over this discussion) for bureaucratic medicine is "it's all over Europe and it's awesome!" But I don't think Europe thinks it has everything figured out.

One of the consequences of government-provided services, for example, is that it pits native citizens against 'new' and aspiring citizens on the years that everyone decides life is a zero sum game.
You would probably enjoy the book "Iron John", as written by Robert Bly.
Your entry for today in the Improbable Ideas forum, was how things happened in the past.
Children would go to work with their parents, in the pre-Industrial Revolution era.

Father was a blacksmith? Children would go with him, and sweep the floor, pump air into the furnaces, and organize things. As they matured (both in age and skills), their tasks would grow.
Father's brother was a leather worker, so it was easy to send your kids to work with your brother, so they would see if they wanted to be blacksmiths or leather workers.

The Industrial Revolution destroyed the father-son relationship. Fathers would leave the house at 6:00am, and come back at 8:00pm. Young boys would have a blackhole regarding what their fathers did during the day. This blackhole, Bly argues, would get filled with "demons". Not voodoo-demons, yet "demons" in the sense of a "lack of knowing what my dad does every day".

In part, we as a society in the West have been suffering the effects of this destruction ever since.
In the 80s and 90s, with the increase of mothers in the workforce, the same thing is now happening to the mother-daughter relationship.
We have to wait a couple of generations to see what effect this has on women.
It's properly named, because you say "wow..." when you figure it out.
How was the deductible? But yes, Switzerland is basically the US system done right.

Though with the cost of education and all the mess around malpractice, it seems very hard to _fix_ the US system.
Shame that there's no mechanism to automatically execute a script from the internet someway...
I know plenty of family members in the US who have waited months for health care procedures. Being poor or rural brings rationing, waiting lists, supply shortages and all the kinds of things you don't want when dealing with people's lives.
First because reducing malpractice is a goal that does not depend on the way a system is funded. We should reduce medical errors full stop.

The two you mentioned give direct costs increase and indirect in the form of defensive medicine. UnNecessary treatments because the doctor is scared of potential lawsuits could event hurt patients since there is no such thing as procedure without risk or complications.
If Facebook and Twitter were also ISPs and you could only intereact with them and not with any other social networks.
I really think health care costs in the US are a byproduct of Americans obsession with convenience. Most lifestyles can be lived without any physical activity - the whole country is designed around the car.

Traveling around a bit I've seen other cultures still require people to walk somewhat to get places and people will also just go on "walks" whereas Americans will go for a "drive"

Food culture is also responsible, just jamming food into your face as quickly as possible rather than enjoying a meal is for sure and American thing.

Add all this up and you get 60% obesity rates in adults and getting worse.
One directory listing back gives a wealth of further information
https://ned.ipac.caltech.edu/level5/March01/Carroll3/
1. Netflix has been doing "chaos engineering" for years (earliest public reference I can find is 2011), especially w.r.t. to public cloud.

2. Netflix has done a great job at publicizing their efforts and open sourcing software that helps you do this kind of testing in a continuous, automated fashion.

So I think the "basically what google has been doing" comment is reductive.
Thanks. This page actually loaded for me, unlike FCC's page yesterday.
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No. We fetishize experience too much. I've known a great many competent inexperienced developers who could weigh tradeoffs and use the right approach to a given task, and a far too many highly experienced developers who destroyed productivity through dogmatism.
While just 4 percent of Trump's supporters say they would back someone else if there was a redo of the election, fully 15 percent of Clinton supporters say they would ditch her. Trump leads in a re-do of the 2016 election 43 percent to 40 percent after losing the popular vote 46-44.

https://www.washingtonpost.com/news/the-fix/wp/2017/04/23/tr...
> "My transaction page has been showing the following"
Is something missing there? I don't see a link or anything.

If you haven't, contact coinbase and your bank, and see if you can get any details on what's happened. Depending on how soon it's been, your bank may be able to stop the payment.

Lastly, I would also hesitate to jump to malicious intent. I've been in plenty of situations where there's been a bug at a company I've worked at, and the users first assume malicious intent.
This may be a misconception. In other countries there are also insurance companies at work making good money managing premiums and payments. And yes, they are not liked there ether particularly when they find excuses not to pay. The US problems however run deeper.

One of the biggest US health insurer is UnitedHealth Group. In their last financial quarter report they published:

Revenues $48.7 billion

Earnings From Operations $3.4 billion

Net Margin 4.5%

These type of good and enviable stable profits are not enough to explain the inefficiencies in the US. Insurance may be lobbying but that is dwarfed e.g. by the marketing expenditure of the pharmaceutical industry (same level as their R&D). Yes health insurance is living well on the inefficiencies and their (in part unnecessary) middle man role but there are way bigger money leaks.
Ultimately all the advice in the world leads to one simple starting point: You have to act, practice, and rehearse new skills to get their benefit and those first acts, as with any new skill, will be clumsy, embarrassing, and full of other challenges that will lead the novice to feel bad.

If you try, you will fail and feel bad, worse than if you never tried, but if you stick with it, you can overcome the failures. You'll never lose access to the skills you now have it you don't want to feel or act social, but you can when you want.

The reward for overcoming those failures, in my experience at least, is so much greater than the struggle to reach that reward, that I only wish I had started learning social and emotional skills earlier.
Details from Microsoft:

https://technet.microsoft.com/en-us/library/security/4022344
> what benefit... it served

Any regulation provides regulatory capture benefits to big players over small players, regardless of what the regulation is.

I'm not sure big business lobbyists were campaigning to stay in the health insurance business, but they weren't exactly campaigning to get out when all the players were at the trough back when the ACA passed.

Hopefully this is a start of a trend. Leaders like Buffet saying the baby tiger of "employer provided health insurance" has grown up to a maneater might help change some minds.
I'm not sure why you're getting downvoted, perhaps because people don't want to imagine modern child labour.

From my side, in the company where I work there are a small handful of people who could easily be replaced with fully unskilled labour (ie. an 8-12yo) with no negative effects.
Hmm, true, it may have been a different platform/slower, thanks. It can't have been hardware/software, as the GP said they were testing a library (which implies software).
Yes, remove the tax deductions for employer-provided health care is good start. Employers should not decide what kind of health care you have access to, as little as for food.
I like CK2 a lot, but its AI is nothing to write home about. The game doesn't effectively develop provinces, its strategic war AI is flail-y, and its diplomatic AI is largely deterministic.
As much as I'd love to think it's some yuge consipracy,

> "Never ascribe to malice, that which can be explained by stupidity."

In other words, it's probably the case that the server just couldn't handle the load.
That is showing only official profits. There is so much else being siphoned off within the insurance companies as inefficiencies. I agree there are efficiencies external to the insurance companies though, but I am not sure how incentivized these companies are to minimize costs.
Ah yes, Google maps which either thinks I want to take three transfers to avoid walking 1km at the beginning and end of my trip, OR cycle the whole way, but that having a bike which can cover that 1km is preposterous.
What is less impressive is that this exploit was even possible. Executing all incoming JavaScript as root user, what the heck?

Even if they patched this one bug in the interpreter, how many more are there that are not yet discovered / only known by dark market exploit vendors?
Our hacks so far, as startup parents :)
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I agree, I was just kicking GP's pedantry up a notch.
How long until another Industrial Revolution would have taken place?
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What are you moving to?
Embedded would be a field with longer-lived software, yes.

I used to work on helicopter avionics. I'd be surprised if the projected service life of the software was less than 30 years.

Downside: everything is amazingly old-fashioned, even during prototyping.
Combine it with allowing patients to buy their medicine from any country, tame the AMA, tame the FDA, allow non-profit insurance companies the freedom to sell insurance across state lines, sell more medications OTC, make becoming a General Practitioner easier (just the Family doctor, not specialists.), and then maybe tort reform for all health professionals? Oh, yea--allow certain patients the authority to refill their own prescriptions if they are on a maintenance drug (yes they would have to have a blood test,etc., but they days of doctors holding patients hostage would be over?

I'm sure the average Doctor could add a lot to the list. Maybe they don't want much to change, with the exception of making their club smaller, or just the changes that increase their wealth? Yea--my view of them has changed. I don't look at them as The Golden Boys anymore. I just look at most of them as greedy little business entities. Maybe they always were?
> I'm going to start to make a point of discussing tech-related subjects with non-technical friends more often, because their opinions often surprise me.

And you would be shocked to hear all the misconceptions and myths that the general populace have been fed by the media or picked up from someone at work with Dunning-Kruger effect. It's pointless to try convince them otherwise unless they are your close friends or family.
I think it's incredible how people can intuitively learn these skills. People who are considered "likable" probably have developed these qualities through social experimentation, paying attention to others' reactions in the forms of tone and body language. It demonstrates a very high level of social awareness and emotional intelligence.
> Although this major breaking change is likely to have a huge impact on the entire ASP.NET ecosystem, it was neither discussed nor announced publicly

Microsoft, although demonstrably more open-source friendly, still moving the cheese.