Why do you feel like you need to post this from an alt account? Because you know such snarks tend to be downvoted and you want to preserve your precious "karma" points? So who is behaving like this is reddit?
The entire healthcare system seems to be built against the population.
I've come to see healthcare providers like doctors, nurses, technicians, and the like, as a conniving, essential part of the scheme. They're incentivized to make you wait hours unnecessarily, rush every visit, and involve as many different people as possible in your care. And then, in the end, send ridiculous bills to both your insurance provider and to you at home. The person who spends the most time with you is usually the one trying to collect the payment. It's absurd.
There is absolutely no reason for a doctor to make over $1000 for a 15 minute conversation.
There is absolutely no reason for a medical equipment provider to bill more than the retail price of a piece of equipment, especially after insurance has already paid more than the full cost of the equipment on each installment.
There is absolutely no reason for a family to receive a bill of almost one million dollars because their baby was premature and was in the NICU (see @thepasinins on instagram).
There are too many layers in the system making a fortune off the public's back while adding little to no actual value.
There is a reason that doctors in the US make multiples of what doctors in Europe makes: the AMA lobbied the US CMS, back in the 1990s, to limit the number of residencies opened up every year, to avoid a "glut" of doctors. We have artificial scarcity of doctors.
What is artifical when talking about a program that subsidizes residency?
Focus on limited federal residency funding seems to be a red herring. Most modern economic analyses seems to show residency programs are net profitable before federal subsidies.
IMO the problem is largely structural, around how these are positions and services are handeled by regulation and insurance.
This seems to missing the point. Why is the number of doctors so so dependent on federal residency funding (or is it?).
I suspect people overweight it for reasons above. Underweight factors would the long US education path to become a doctor being twice that of many countries, and extremely high cost and high accreditation of medical schools.
Im asking if or how much that actually matters. Im asking if it must matter.
By way of hypothetical, if we doubled residency funding. Would new doctors double, go up 10%, or stay the same?
If education time and obscene school costs are the bottle neck, it might not matter much. Some 25% of residents are already paid out of pocket by hospitals because residents make hospitals money.
The scaling limit on the number of doctors we have is residencies, not medical school slots, and further, medical school slots can't usefully be scaled up because of the residency cap.
That's part of the problem, but we also have a problem with limited medical schools in general and with those schools charging through the nose because of that scarcity.
I have a nephew training to be a doctor now. He's looking at $500k in student loan debt by the end. That's a major problem.
When my surgeon charged $250,000 for my hand reconstruction surgery, how much of it did he personally pocket, and how much of that went towards that $500,000 debt vs. his brand new S-class Mercedes?
If it's his own private practice then yeah, he pockets a lot of that 250k. If he's working for a hospital, then he has basically no influence on the price he's not payed per surgery.
Blaming nurses and technicians feels a bit of an exaggeration. It's not as tho they're high in the hierarchy and have little say in pricing or other facets of why our healthcare system sucks. Maybe start the blame at politicians, insurers, pharmas and hospital owners and work your way down from there. Those with power and control should be the first to attack.
The entire "blame" paradigm is unproductive. Does Lyft "blame" Uber for it's lowered market share?
The entire system (including nurses and technicians) are just agents making semi-rational decisions in their own self interest. Is it important to judge people within an existing system or is it important to look at locus points that, when pressure is applied, can make durable changes to the system?
> There is absolutely no reason for a doctor to make over $1000 for a 15 minute conversation.
The doctor isn't making $4000/hour, although you might be getting billed for that.
That doctor (unless some exotic specialist) is probably making not too far from ~300K, so that's around 144/hr, or $36 for that 15 minute conversation.
> There are too many layers in the system making a fortune off the public's back while adding little to no actual value.
Yeah, it basically all comes down to the bureaucratic nightmare that ultimately benefits the owners of all things medical. Prices have nothing to do with the value of the good or service and everything to do with the maximum amount of profit that can be extracted from a 3rd party.
One of the worst moves in the last 30 years was Clinton adding private insurance options onto Medicare. In the last 60 years was making medicaid a state run program rather than a national program (or just medicare all together). It's actually crazy that we have 53 different government healthcare options. 1 for every state, medicare, and the VA. It's even more crazy that the government doesn't simply directly employ doctors and medical equipment. It's so crazy inefficient to involve 3rd and 4th parties into something that should be direct care.
The US remains one of the only wealthy nations in the world without nationalized healthcare. And we pay through it through the nose.
The standard GP consult fee in Ontario Canada is $77.15. (just over us$50). That's gross, the nurse, receptionist and rent have to be paid out of that.
Some doctors will do 4 of those an hour, but most will do 6. And they'll try and find ways to bill additional codes above the consult.
That pay scale assumes you are banding together. A typical doctor has 30-50% overhead. Without sharing nursing/receptionists/offices the overhead would likely be > 100%.
nurses are just following the protocol established by their organization; as are technicians; they have very little authority to deviate from prescribed protocols or they will be fired; it's unfair to ascribe any blame to them
physicians bear responsibility if its a private practice, but otherwise they're operating within the constraints of their org's protocols too, though they do have more autonomy (depending on the situation)
but really, your beef should be with the health organizations themselves
and also, many of these protocols are in place because _insurance companies_ require them to be in place
The best way to ensure maximum throughput is to maintain a large buffer. A waiting room of patients is that buffer. No matter how many cancel or come late, the doctors/nurses will always have another patient "on deck". Zero downtime is the goal. An empty waiting room, and potentialy underworked staff, is waste.
But why mention it as the first item when specifically mentioning doctors - isn't most every kind of business or even non-profit ‘incentivized’ in that way - they can serve more customers if there is a large waiting buffer?
Choice and competition greatly alleviate that in other markets. With the medical system in the US, you often don't have much of a choice as switching doctors can be tough, and even if you can find one accepting patients, they are all controlled by the same administration and effectively collude to maximize their profits.
This is much needed. I’ve had family members sending me videos about what looked like news when in fact it was 100% AI.
There are photorealistic AI videos pretending to be an old man giving life advice, or business advice, etc. and the disclosures were all the way at the bottom of the video description, very hard to find.
Note that the uploader apparently still retains control over labeling in most cases; uploaders that intentionally misrepresent AI-generated content might not be discouraged by this. Whether youtube will (and can) ban accounts that do that might determine in practice if this matters or not.
Anyone can write anything, it doesn't make it true.
Eg, I can say: "ai wrote this comment".
Or I can say: "ai did not write this comment".
Looking at the comments alone does not tell you whether they were or were not written by ai. Same for videos.
What is going on is that you are trusting the disclosure is significant and real. So, when you see the disclosure you are concluding something on the basis of TRUST. Same for the video itself.
Seeing something on a screen does not make it a true representation of reality. You do not know reality; you only know that you saw a video. This applies to disclosure, video, comments - anything on a screen.
Grok sucks. Not only because it's seemingly made only to serve the goal of ethnically cleansing non-whites or whatever, but also because it's just not even close to being as useful as other models. In human terms, grok is the job candidate who's simply not qualified. That candidate being a virulent racist is beside the material point.
Here's the thing though, the point of functional LLMs with fewer guardrails is still a good one. Grok is not that model. But such a hypothetical model would have broad application. (For good and for ill. Of course.)
I don't agree. I avoided grok because of Musk for a long time, but having used it more, I think it is one the best models around and grok.com is an extremely good chat app. My evaluation was based on trying it before gpt-5.5 and obvious before grok 4.3, but it was, for me, the 2nd best model/chat app after claude. It's much less edgelordy than you might think based on the news.
All my usage of Grok for technical topics shows it regularly deeply misunderstanding things and just parroting back my question in fancy language. It’s the only frontier model I get this impression of. That makes it super annoying when it tries to market itself as good at engineering tasks when it seems (to me) to be much worse at them.
Interesting. I have not had this experience. I would like to learn more. Can you point me to any examples or domains where I might be able to replicate this?
I was asking questions about compiler techniques. Then when I got annoyed I started asking about experimental design. Both were very frustrating experiences once I started realizing how limited its responses were.
Though yeah the edgelord-y style faded after I criticized it a couple times.
No, it's telling that people like you have watered that word down so much that people don't trust it anymore.
So yes, if someone says "they're a great programmer, but they're racist" I'm going to ask, how are they racist? And at that point, if they can't give me a specific reason for why they're racist, I'm going to hire the guy.
It's also telling that you seem to think a tool is capable of "being racist". Hopefully this doesn't ruin your relationship with it, but LLM's cant think.
Yes, but I think that particular commenter is just throwing a bone to people that think that way so he doesn't get the "don't bring politics" treatment.
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