Cass

I think Facebook has thought this stuff out quite well: When people use real names on their service, it's easier for family, friends, and college acquaintances from thirty years ago to find them, thus increasing user engagement with the site. It also gives them an easy excuse to delete troll accounts. Furthermore, having people's real names (and often address etc.) makes them a more attractive target for advertisers. Most of the Facebook biographers seem to agree that the real-name policy was one of the factors that helped it win out over MySpace and other social networks. (Among many, many others, of course.)

In light of how much money this policy is presumably making them, and considering that they have about a billion customers who seem to accept the policy as is, I strongly suspect they don't care in the least that the occasional person with an unusual name falls through the cracks, or that they're screwing over people who need to remain anonymous for legitimate safety reasons.

Do I agree with their decision? Not at all. But I think they know exactly what they're doing.

In addition to the things you mentioned, I'm also quite happy about the existence of a party containing many young, inexperienced members in the government. They seem to be reinventing the wheel at least partly out of ignorance of the way things have always been done in German politics, and while that does lead to some chaos within the party, in some cases they're reinventing it for the better.

Even if they don't manage to push through any meaningful changes at all by themselves, their mere presence seems to be enough to shake up the traditional parties, and show them that they need to be more open and inclusive towards the general public, and particularly younger voters.

I don't suppose you have a link to whatever article's that from? I'd like to read it, but google's not bringing it up.

Is this going to be programmers/engineers only? I hang out on HN because I'm interested in general tech news and like the entrepreneurial spirit of the site, and would enjoy meeting like-minded people. But I'm not a programmer myself, and if this is a meetup intended more for people who want to discuss whether Rails should ship with ActiveRecord::Base.attr_accessible(nil), enabled, I'm afraid I'm going to be rather far out of my depth.

You don't need to be a doctor to run an MRI scan, but you do need to be one to interpret the results. In addition, you should really have at least one doctor around to decide exactly what you need to MRI in which way for optimal results for any given clinical problem, as the doctors who ordered the MRI done aren't usually specialists in that area.

MRIs aren't much use for screening. They can't be used to diagnose many diseases at all, and for many others, their sensitivity and specificity are quite low. In addition, they produce a large number of huge, highly complex images that have to be reviewed by a human being, and it's incredibly easy to overlook something if you don't know what to look for. If I had a coffee for every time our radiology specialist has said some variant of "I wouldn't even have noticed that if I didn't know that's where the pain is -" well, let's just say, I'd find it a lot easier not to fall asleep in the radiology demonstration.

If you want one yearly screening procedure available to anyone, there are many better choices than MRIs, especially considering their high costs (even in non-US countries.)

MRIs in Germany (or at least my part of it) tend to be relatively rare and booked almost completely full, because with the prices the way they are, they're not profitable unless they're utilized as much as physically possible. There's therefore usually a waiting period of a few days for a non-emergency MRI, which tends to make them a less attractive option for doctors and patients than they might be if they were instantly available. On top of that, they're still relatively pricy compared to other diagnostic procedures, and in Germany, a doctor or hospital who prescribes too many expensive procedures may get personally stuck with the cost, instead of being able to pass them on to the patient or insurer.

I'm surprised Fog Creek kept commissions around for so long, considering that Joel has been writing articles about how incentive pay causes dysfunction since 2002 (Edit: 2000, even!)

http://www.joelonsoftware.com/articles/fog0000000070.html

http://www.joelonsoftware.com/news/20020715.html

http://www.joelonsoftware.com/items/2006/11/10b.html

It's really not, though. I'm not a programmer, but I can solve Fizzbuzz and Hello World in Ruby, and I still wouldn't know where to start with a bingo card creator.

I could manage to randomly reorder a series of words, but putting them into a nice graphical layout and programmatically making sure that short words and long words both look okay without anything getting squished or cut off is already beyond what I can do without hours of research. And that's as a geek who's generally interested in programming. My mom, who's far more likely to need bingo cards, panics every time I minimize a window.

It's probably at least partly a matter of how the rest of your room is lit. Your sight is sharpest when your pupils are small, so a bright monitor in a bright room will work best for many people.

However, if you're looking at a dark monitor in a bright room, or at a bright monitor in a dark room, your pupils may be too large for the amount of light that reaches them to be entirely comfortable, which causes squinting and eyestrain.

A dark monitor in a dark room won't have that problem, but you may still be dealing with some increased blurriness because of your enlarged pupils, which may bother you depending on how good your eyesight is.

I've had plenty of taxi drivers who could barely drive, let alone find any given address in their city. And as for doctors, see my answer to potatolicious above - I've seen some terrifyingly incompetent ones who really should have been screened out with a fizzbuzz level question.

"5 years at County General" for a MD, with a clean record, is a pretty decent guarantee that your candidate is in the ballpark."

Scary but true: There are plenty of experienced doctors who couldn't pass a medical Fizzbuzz. My supervisor at my last teaching hospital, who has been treating patients for at least five years, failed the Fizzbuzz question I asked him. ("What's that other class of antibiotics you can't give patients with penicillin allergies?", if you're wondering.)

(There's also a few stories of people faking medical licenses and working as doctors for years before anyone noticed [1], but those are probably too rare to worry about.)

1: http://www.sueddeutsche.de/panorama/hamburg-falsche-kinderae..., couldn't find an English language link, sorry.

I'd be interested in the link to that study, if you have it.

He's making quite a bit more than that.

"Today, Pinboard is Ceglowski's fulltime job, pulling in $250,000 in revenue over the past two years. He says the site has 25,000 registered users with about 18,000 active ones each month. Ceglowski's only costs are paying for server space, and Pinboard makes money by charging customers a one-time fee of $9.50. (The fee started at $2 and goes up a penny with every 400 people who sign up.) There's also a $25 a year archiving fee for people who want personal copies of links."

(http://www.time.com/time/specials/packages/article/0,28804,2...)

That's how it works in the best case. Unfortunately, medical research is not a perfect science. Realistically, with many medical treatments, you can't have a double-blinded study. With chemotherapy, the side effects will often quickly tell you what treatment you're receiving, and a treatment like for example extracorporeal photopheresis can't ethically be placebo-controlled or double-blinded at all. What are you going to do, hook half your patients up to a machine that will do nothing but run their blood around a bunch of tubes for hours for no reason?

And you can't get a "large sample size" of patients with rare cancers or diseases by definition. Sometimes, the best you can do is a case study of ten patients who agreed to try your treatment because the other option was death. Quite a few medical advances have been made that way, actually.

This is not a question of being "rational", and there's no right or wrong answer. People make trade-offs between quality and quantity of life every day. Do I want to quit smoking, drinking, drugs, and take up sports, etc for a chance at a longer, healthier life? Or do I grab all the fun I can, and if it costs me ten years, oh well? The right decision will look different for every person - and it's not black or white, but a continuum.

The choice of how much pain is worth it for how much of a chance at a longer life is going to look different depending on your religion, your responsibilities, your age, your experiences with pain, your family, your culture, etc. And yes, of course the cost of treatment will factor into that decision for both the doctors and the patient.

Medical research benefits hugely from terminally ill patients who are willing to try anything for even two more months of painful life. There are a lot of of experimental, highly dangerous cancer treatments that could never be justified if not for the fact that even without them, the patient would have about two months to live.

That said, there will always be enough patients who want to fight for their life no matter the cost (see other comments on this page for evidence) that if you'd prefer to die in peace, you certainly shouldn't feel obliged to play the guinea pig for science.

To everyone considering a "NO CODE" tattoo after reading this story: Don't. If you're really that serious about not wanting to be resuscitated under any circumstances, wear some kind of bracelet or necklace with those words on it, and, just as importantly, a recent date, and contact info for a person who knows your exact wishes. Make sure to update the date regularly.

Medicine changes, and so do your life circumstances. If you're presenting an EMT with a ten-year-old, faded tattoo, you're placing them in an awkward position due to the lack of context. Is this a decision you made ten years ago and got stuck with, or are these your current wishes? They might end up disregarding your wishes just to be safe. A bracelet with a recent date will be much less ambiguous.

And remember, with all medical decisions, you want the ability to change your mind when medical advances are made or your circumstances change. Tattoo removal sucks.

I'm not a huge fan of the idea of paying people for bone marrow, but "poor people won't be able to afford bone marrow" is fairly irrelevant as an argument. Poor people already cannot afford to pay for any of the costs associated with a bone marrow transplantation. You have to destroy the patient's immune system to allow the donated blood cells to grow - which means at minimum, if everything goes very well, six weeks in a high-tech isolation room, being treated with extremely expensive antivirals, antibiotics and antifungals, getting all sorts of expensive diagnostics, highly paid specialists taking care of your around the clock, etc.

The last number I heard was, I believe, about 100,000 Euro if everything goes well. If things go wrong, you're looking at the ICU for ~10,000 Euro a day for a month or two, or maybe ten years worth of intense, state-of-the-art immuno-suppressive treatment...