2,869 karma · joined December 7, 2017
If you're going to use a VPS for anything remotely sketch you probably don't want to go with a reputable provider - they're reputable for a reason.
2. I mean, I have no idea but for-profit insurance companies aren't out there really blaming anyone as they're just a faceless corporate entity. I've only heard hospital staff and normal people blame the uninsured.
3/4... no - poor people don't have insurance. I've grown up around people who were not economically privileged/who were struggling and this is just 100% untrue that poor people can get insurance as you posit. I've had private insurance and it's just not something someone can afford if poor. And, if you're referring to things like "Christian Healthcare Ministries" they're straight-up scams. Outside of that, there is no way American restaurant owners, retail franchises, etc will cover an unskilled laborer's health insurance - that just does not happen here.
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> I still don't *believe our healthcare costs are due to the uninsured.
When it comes to hospital billing - yeah. It is a huge thing that's baked into their SOP. See item #1 above.
https://www.forbes.com/sites/jimcamp/2013/03/11/revisiting-w...
The reason I am firmly in this school of thought is that I've made the absolute mistake of a decision to try for "win-win" situations in a capitalistic society, specifically in regards to contract negotiations and ultimately pricing/billing.
When I'm making sure that the person on the other end of the table "wins" I'm putting myself at a capitalistic disadvantage; and - if both parties "won" then didn't both ultimately lose?
I get your ideal, but when money is involved I find that the "win-win" is very much that: just an ideal. And, anecdotally over the years I've found many business experts write on the topic of why "win-win" is a losing position which validates my position on this.
There's way more people involved in that supply chain then me and the store. This is an over simplification.
Outside of the obvious answer of "the cows" - factory farming has been destroying my home state causing huge problems in rural America. Also - the environment. Big time the loser there is the environment for literally any bovine farming.
> The last time you paid money for a hair cut
When I was getting my hair cut professionally I tipped a $20 because I knew the gal cutting my hair working at the midwestern mall Regis Salon was making jack-all. I knew this because I worked at Geeksquad with her boyfriend, eventually husband. If I were not to tip well she would be at-risk for making minimum wage for that hour - and since you can't support yourself on minimum wage I see that as her losing.
I've always tipped my butt off because I know without that they lose.
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So yeah - sorry... I anecdotally do see losers in the situations you described. I don't have to look hard to see them.
It's bad enough that I've heard office gossips complain about other employees leveraging their healthcare turning into higher premiums the year after. Like, as evil as complaining their coworker's kid got cancer.
When employees go through big health events it's hard to keep it under wraps in a work environment... especially in this "race to the bottom" society we happen to live in. You can bang on about privacy all you want, but people talk.
I guess I'm shocked it happened in an office of ~250 as I've always seen it happen at much smaller places.
Until someone financially incentivizes a higher quality of care I don't expect to receive it, especially by a bundled pricing model.
> No one benefits when hospitals have a separate line item charge every time a nurse administers a pain killer over the course of a hospital stay.
And as someone who's been billed insane amounts for things like OTC painkillers I disagree with this so hard. I have zero, and I mean zero, confidence that they will not continue to overcharge me. When everything is individually coded then at least a patient can go back and "look at the receipt"...
In my adult life I realize that almost everything is weaponized against me (the patient) in healthcare. I cannot expect in good faith that removing the line items from the receipt will help me in any way. In America, I can only expect this to hurt me or I'd be an idiot.
Sorry to disagree, but there is no way that bundled pricing is going to serve the patient better as it makes auditing services rendered much much harder. As someone who's had to get into the weeds on this stuff between insurer, hospital billing, etc. I can only imagine that bundled pricing would have made my life more difficult as it really did come down to the codes.....
The privatization of healthcare is a conflict of interest which is a product of our hyper-capitalistic society. You can't make a profit center out of human services without dehumanizing it in the process - the very nature of profit/capitalistic societies means someone has to lose and I see no place for these interests in healthcare or education.
Edit: yep - expected that. Maybe someone argue as to why privatization (which is a product of capitalism) isn't a conflict of interest in regards to healthcare?
> All adults have tests and follow-up visits to prevent and treat everything from iron deficiency to H.I.V. It’s all free. If people don’t show up for their appointments, she makes sure their team finds out why and figures out what can be done.
It's common sense why they have better results and outcomes than we do here... Our system is optimized for capitalistic profit. I've got insanely good insurance and I still have no idea how screwed I am if I go to the doctor or especially a hospital. Although I've only had one major billing snafu years back I have real anxiety about going to the doctor here.
And hell, even if I go my PCP is going to be stuck in an "all or nothing" mentality where it's either OTC or getting in their own conflict with my insurer... ie: "If I can't justify this test with your insurer..."
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Costa Rica's model is better than America's. The reason for this is because it's not optimized for profit, it's designed from the ground up to optimize for patient outcome.
Also this isn't going down to your corner liquor store and flashing your drivers license... that thing is going to get scanned etc.
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Actual protip: If you're uninsured and need care they legally can't turn you away at an ER. They have to provide the healthcare to get you stabilized regardless if they're going to be able to bill for it or not... which ironically this is a big part of why the insured end up subsidizing the uninsured at the hospital.
Also, if this ends up being you - don't sign anything until you're in the right mind to sign something. They're going to try to pin you to bill your ass off one way or another and if you're half way through a heart attack or something do not sign anything until you can 100% understand what you're legally agreeing to.
I've heard rumblings of this too but every time I've interacted with healthcare it's still the same coded system that you see in regards to the chargemasters etc... even as recent as-of a few weeks ago this was the system in a modern hospital in a large west coast city.
So, two things:
1. I think we're on the coded system indefinitely, or at least that's only what I can expect given recent experience
2. Even if we were to implement this, providers and insurers will still fight like cats and dogs because there's just too much money to be made here that I can't imagine the same problems won't manifest itself in a "bundled payment" system. I would actually expect this to make matters worse. Often when you bundle something it obfuscates and confuses the value of the individual "things" in the bundle - the middlemen will do everything they can to extract margin from this. I'd personally like to stay with codes to maintain transparency through having an auditable receipt of known services directly tied to a fair price.
That is until you call the hospital and find out there's all sorts of "sliding" prices etc...
I had a procedure billed for one of these drastically larger "insured" codes which got denied based on the nature of the procedure from the insurance company (apparently too new of a procedure at the time, however common now).
It all got worked out in the end but what I realized was that hospitals are largely subsidizing the cost of the uninsured by over-billing the insured folk's insurance companies. We've set the American healthcare system up to be a cat and mouse game where those in need are represented the least.
Best insurance here is "don't get sick"
I get the whole "do your research", but often it's in areas in-which I have no real capability - especially with healthcare.
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> And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.
Agree. And to add, all it takes is one procedure that your insurance company doesn't want to cover to put you into literal billing hell for months on end. My point being, even with price transparency they can just chose not to pay even if they're obligated (and they do this). If there's any way they can weasel out of paying they will.
I'm still 100% in support of price transparency in healthcare however... there's just so much broken with it and I've lived through the hell.
But in the American system it's setup that you must. This is the whole "coding" thing that you hear people refer to which is taking a procedure and breaking it into individual codes that can be used in billing you/your insurance.
This was addressed in the "Methodology" section of the article:
> Data was collected for three services, determined by specific codes.
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> I’m very interested in how the community might think it would affect the value based healthcare industry with respect to total cost of care management and bundled services?
You mean... releasing pricing for individual codes.....? Finally showing that hospitals will bill different prices for the same code based on the patient's insurer...?
I read the article and all I got was that hospitals are releasing pricing information under the Trump mandate. I'm not sure what you're positing for an "effect" here as the effect is literally just transparency in hospital billing?
I will never buy another pair of flip-flops. So comfortable and the durability is so good I'm only on my second pair after 15 years of very consistent use. I literally run the treads out.
Breaking them in takes a solid month which is just getting your foot imprinted into the cork... but any initial discomfort is 100% worth it, and minimal in my experience.
There's also a very good warranty but I haven't personally used it.
> No, heh, no it is not, at least not in the context we're discussing. Capitalism didn't start in the last 20 years.
I did not make the claim that Capitalism started in the last 20 years - I made the claim that debt/credit is at the basis of a capitalistic society which is econ 101.
> Not sure we're going to agree here though.
We very much will not, and I don't appreciate how you literally were putting words in my mouth to back your claim. Good day.
> Instead, I think that buying massive mansions (as per how people in the 50s may think of it), could be part of the problem.
You draw this comparison of what people in the 50's would think of our world today when in all reality the cost of everything has skyrocketed since the 50's. The dual-earner expectation is a new thing since then, the post-WW2 credit boom happened, the expectations of higher education to enter careers is different, housing markets are night and day, etc... Anyone who's looking at this modern world through the lens of the 50's ideals must realize that this is an incredibly skewed/distorted way to think about today. Or at least I would hope they realize this.
> And other factors, cell phone, cable, internet, tablet, laptop, gaming system, monthly fees can run hundreds in some households, with hardware costs amortized, even a thousand per month for a family!
> How'd they get those toys?
Much of that isn't a toy in this day in age... I would argue that cell phone and internet are utilities NOT toys. I would argue that a laptop/tablet/phone is a requirement to stay relevant in even entry level positions... and sure - I can understand not subsidizing TV and video games as they're pure entertainment. But, I would very much argue that folks who are worried about improving conditions for wage earners are not advocating for everyone to get a free Xbox and 42" LCD.
> But I agree, then isn't now.
I'm at odds with this too - when you spend so much time drawing comparisons between the 50's and today I am left to wonder, "where does this person draw the line of 'then' and 'now'? Do they believe in 50's ideals being exercised today? And if so, which ones?"
All of these comparisons you've drawn make me feel like I'm suppose to feel guilt for having purchased things with credit as well... admittedly things like TV's, etc. I've never paid "2-3x" for something as I've never fell for that trap... but I have purchased expensive things like computers and used my credit to spread that hurt out over a year...
And... oh god... if I get a house how do I live with myself knowing it's a mansion or not...? I guess I should stay within the arbitrary <= 1499 sqft limit and move away from any population centers or I may accidentally end up with a mansion in the eyes of someone from the 50's!
> I wonder what they'd say [...]
My grandparents and parents are not involved in my finances. They're all dead now, but they lived a life so very different than mine that I really don't care what they'd say... my answer to that is "So what?"
> More than anything, credit is the big problem.
Credit/debt is the basis of any capitalistic society - it's literally in the blueprints. If you truly believe this I would argue you have a fundamental issue with capitalism as well.
Also, hard disagree which is why I asked you the original question. Wage stagnation and commodification of everything we need to live is the "more than anything" problem.
I do not disagree that credit is a problem. But it is not the "more than anything" problem. Actual livable wages for everyone willing to work is the "more than anything" problem.
> Fifty years ago that average person would have been able to support a family, buy a house, and not live under the constant threat of bankruptcy from a surprise medical bill.
I want to circle back to this. I read your comment assuming you are arguing that now things are "more" (cost++) this ideal is now less obtainable or unobtainable.
Do you think that the average person (median wage earner) should be able to support themselves in this way? Should we let go of this ideal as "old fashioned"?
Obviously anecdotal, but not really IMO. I've bounced back and forth between being in business for myself and working for the man.
Between healthcare, saving for retirement, etc. things are really optimized against someone "pulling themselves up by the bootstraps" in this way. I've listened to the politicians in the US scream how important small business only to vote against that very interest (tax cuts for rich + corporate tax breaks).
I can't get good healthcare unless it's tied to my employment here. The healthcare I get independently is of lower quality for much, much more money out of pocket... Lord help you if you do something stupid and show a profit on your books... etc etc... The first 2-3 rungs of the "small business owner" ladder are missing by design.
If I had a family I would likely never consider being a business owner again due to the health implications, financial risk, and time commitment.
100% the average working Joe is better off.
Even with the above SSD upgrade, $250 is a bit much for a bog-standard T440 - recycling centers have them here working for approx $150 USD, usually the i5 variants.
Just watched the "Bob vs. Nintendo" documentary where they quote some weird autobiography he posted to his site where he admits to killing a kitten earlier in his life:
> "I got a kitten, named it Mew, and accidentally killed it the first night I had it. I was stoned, and it woke me up somehow. I got angry and put it in a big plastic bucket in the closet, half asleep and confused. In the morning it was dead - it had suffocated. [...] I shoved me further into a haze"
The thought of that is horrifying to me. This guy has clear impulse control issues and reminds me of someone who's BPD/manic enough that their actions killed an innocent animal. "I was stoned and angry" isn't a valid excuse for suffocating an animal - this guy is wired wrong. Assuming this event happened before the whole "Bob's Game" fiasco I'd definitely say the mental illness came first.
I'm going to go pet my cat now...
> If by free you mean mandatory accounts, activity trackers, 50% screen ads, background crypto miners, 8gb ram for reading the news and email, abysmal performance for what is essentially displaying text, media and information, literally WASM VMs and background webagents running in browser.
Let me repeat... when you conflate my whole "information, capability, and expression all want to be free" with a ton of negative/gray-pattern stuff you're invalidating my original point in the above comments with what I see as a separate concern, ie: everything has to be built to milk money from people.
Exploitative capitalism/money making dark patterns !== "information, capability, and expression all want to be free"
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I'm done.
I'm glad someone is pointing this out as I felt like the author didn't even attempt to understand the Web Crypto API assuming an incorrect worst-case scenario.
I'm saying you made a bad-faith argument misrepresenting what I was saying when I said "information/capability/expression want to be free" by conflating that phrase/statement with literal anti-user dark patterns that I find are more rooted in capitalistic practices...
When I said "information/capability/expression want to be free" it was not inclusive of all of these negative things. And, I find it a direct bad-faith argument to say "well that's what you get when X", given "X" is my statement "information/capability/expression want to be free".
I find your "I'd like native back" statement to be akin to "people abuse stuff so we should just outlaw what they abuse"... Features in tech are going to be pushed toward capitalistic ends because we live in a capitalistic world. Truly - I am the money I make... I am as important as my bank account dictates. My access to healthcare, education, resources, everything dictates this. I live in America - if I am not profitable I literally do not deserve to exist within civil society, and this problem is not exclusive to the US.
"Mandatory accounts, activity trackers, 50% screen ads, background crypto miners, 8gb ram for reading the news and email" - these are more a product of the content of the above paragraph than my claim "information/capability/expression want to be free". My entire life has been about the world trying to milk every dollar it can from some sucker - in every freakin' aspect. I am what I spend.
Until we fix what I am outlining in the above paragraphs, I think every bit of tech is going to be pushed toward hyper-capitalistic purposes because it is literally our culture to worship money above all else. Even services/solutions that should service social means are bastardized for privatized profits - including browsers.
I probably shouldn't be making these arguments here on HN as I find most of us here are so stubborn that we would willingly neuter parts of our computing experience to realizing personal ideals which alienate us from the general population of computer users. Even re-reading this comment makes me feel like some self-aggrandizing prick which I find most of us here are.
I guess I'm one of those "duh" people. I think it already is an application platform/delivery system (has been for a long time), and I think that the ever-evolving web is a good thing.
In college, I had professors literally laugh at me when I said I believed most software was moving toward the internet. Fast-forward to today and I'd say that their actual insults against my chosen direction of software engineering (targeting standards-based web solutions) were not only unprofessional - they were entirely not correct.
Reading this document literally felt like I was hearing their arguments as to "what the internet should be" all over again... And, as someone who embraces the internet, I feel so much of this is regressive. Especially in regards to taking shots at stuff like WebRTC...
Your friend and I differ so much in-that they argue against things like communication, graphics, gaming, etc in the browser where-as I have built a career off of embracing it.
> I'm very sure it's profitable to turn the web into an application platform
The web has been an application platform since ECMA landed in Netscape, and arguably long before that too. The anti-application "content presentation only" take has been something for a long time, and it is not going to happen or we'd still be on the original "Hyper Text Markup Language" spec. The web has always wanted to be more than it's previous spec... it's an ever-evolving standard that is designed to meet the changing needs of it's users in an ever-changing world.
Information, capability, and expression all want to be free.
Piggy-backing... Contrast as a whole needs some adjustment - keep in mind that people's light situations drastically will affect (effect? hell I don't know) how readable text on a background is. I have a window behind my most used monitor which sometimes causes issues with light text on light backgrounds, or dark text on dark backgrounds. There's also color blindness, age-related issues, and many other situations in-which you will want more contrast than what has been implemented here. This is very low-contrast, and I think it wouldn't detract from the "clean look" by swapping some of your white/off-white text out with black/near-black/navy equivalents, and I promise you it will make this software accessible to more folks!
I also would love to see a general "cryptotemp" solution that allows this same thing for different currency pairs. ex: "https://cryptotemp.com/ETH-USD"
Great solution. Bookmarked. Sorry to nitpick!!!
(referring to controller/gamepad support)
Information wants to be shared, collaborated on, and worked on in real-time... both private intranets and/or public internet provide platforms to do this.