Why would it be bureaucracy? In places with universal healthcare, you go to the doctor, show your card, then go to your appointment. Go to the pharmacy with your script, show your card and pay whatever is left to pay, if any.
That's it. No open enrollment, no surprise bills, no trying to figure out which ppo or hmo works best, no wondering if it's in network or not or any of that BS.
The apparent fear of universal healthcare many Americans seen to have is incredible.
And to call it out in a thread where someone has literally shared that they're forced to attend a pointless appointment at an exorbitant cost like that isn't itself some form of wasteful bureaucracy. But if the time and money is going to a corporation instead of the government it's better :/
The US has managed to combine the worst aspects of universal/socialized health care with the worst aspects of an attempted free market system. It’s quite an achievement.
It works as intended. It's a part of cutthroat capitalism. The goal here is to make sure that basic service is unevenly distributed so that people who don't have it are motivated to work extra hard and get it.
There’s no “cutthroat” about it. The system intentionally removes as much competition as possible. It’s cushy, taxpayer-funded socialism for the rich. (Also known as corporatism.)
At this point, China is doing capitalism better than us in its consumer industries. They actually have real competition, so fierce at times that the government worries about what it calls “involution”, or destructive competition (which Marx predicted as the end state of capitalism). Of course, its healthcare system is not run through capitalist competition like its consumer industries; it is fully state managed.
Some real competition might actually help if we’re going to keep pretending to be capitalists. Or we could move from socialism for the rich to socialism for the people. I don’t really care which as long as we move on from the current dysfunctional system.
> In places with universal healthcare, you go to the doctor
NHS experience: you might have to wait two weeks to see the doctor, and it will be a ten minute appointment. (Which in this case might be fine.) If you can use a nurse things tend to be much easier.
The NHS relies on heavy triaging - so, for primary care, emergency cases will be seen immediately (either at a hospital or at the nearest GP surgery with an available slot), urgent will be seen same day (at your usual GP surgery), and non-urgent medical problems (eg. back pain that isn't getting worse) might take 2-3 days.
But everything else (eg. discussing blood test results, medication reviews, mental health issues) will get dumped into the "routine" appointment bucket and, yes, will often take 1-2 weeks.
You do hear occasional horror stories about the triage process, but my experience has been pretty reasonable. For example, I lost my voice last year but had no other symptoms - so I expected to have to wait a few days to be seen. But I was treated as an urgent case since it affected my ability to work, and got an appointment that afternoon.
I've had a checkup with the NHS once or maybe twice in my life, and it was not with a doctor. (I'm not saying that it should be, maybe a nurse and a blood pressure check is all you need?)
Part of the issue is that KSI events are so rare, and it's the same issue that AV companies face. If it takes you millions of miles to encounter a single event, how can you even start to quantify the rate of events, and even prove a different rate?
To scale it in human terms, say that you're a human driver and you're 2x better than the average human driver. If you wanted to prove that you're better than the average driver, you'd need to drive multiple hundreds of millions of miles to statistically demonstrate so.
Given that the rate is significantly lower for taxi drivers in aggregate, to prove that they're safer than taxi drivers if Waymo is 2x safer, they'd still need to drive multiple billions of miles to statistically prove that they're safer.
Yes that's what I've read. As far as I know the approach should transfer well to hybrid model architectures like modern Qwen and sizes like 27B by using multiple chips. LoRA-steered Qwen 27B at 10K+ tokens per second would be transformative for some workflows.
I can't recall the last time that it was useful knowledge when writing code. Reservoir sampling, online softmax, Otsu, sure, Tianenmen square not really.
It could, but exposing that would doom the company entirely, and AI doesn't generate code with near the quality needed to get a model to mass adoption, insert malicious underhanded code, ensure that consistently looks innocuous enough to never be noticed, and- most importantly- actually exfiltrate data without being noticed. Once it is noticed, it's game over across the board.
> The standard answer is greed: rapacious ambulance operators, owned by villainous private equity firms, exploit patients at their most helpless. But I don’t think that’s actually what’s going on. Ambulance providers are chronically unprofitable businesses; margins are thin, crews are underpaid, and operators exit the industry every year.
The cost isn't about the actual mileage though, it's having two paramedics each earning about 100k/yr per ambulance, while having coverage 24x7x365. So fully loaded, the labor for one ambulance might be in the high six figures to seven figures.
Even if we assume we need to cover their downtime between rides, at a conservative estimate of "we're the only call today" that's $2400 of labor at your rate (≈$400/d, 2 paramedics, 3 shifts). TFA suggests they're not paid well.
> No CFO approves a $1.4 million annual commitment on the strength of a chart showing that the commitment scales.
Except the company probably approved a budget for AWS or another cloud provider, and basically gave a blank check to developers to deploy whatever is needed. So developers are going to just deploy MSK or whatever is trendy, instead of trying to get the most throughput from the servers they got from IT.
In my experience, this is the path many developers take. I’ve consulted to hundreds of companies over the years, and it’s alarming how often I’ve encountered decisions driven by what someone wanted to learn or work with, rather than what was actually right for the problem.
That happens at every level, from individual developers through to project leads and CTOs.
Consultancies are often no better. Choosing technologies that require substantial or highly specialised skill sets seems almost routine. I’m looking at you, Kubernetes.
I’m not entirely innocent here either. I owe a decent portion of my mortgage to MuleSoft consulting. That said, I don’t think I ever pretended it was always the best solution. Even while working directly for MuleSoft, my recommendation in probably half of the engagements was some variation of: ‘You’re using the wrong technology for this.’
But by then, an executive had usually tied their reputation to the project and the platform, commitments had been made, and changing course had become politically harder than continuing.
And so we persist.
In my experience, the best technology choices are boring ones. There’s still a large area of immature technology you can get creative with (like Backstage or Port for software catalogs and setting up a nice golden path”), but the meat and potatoes of development work should be a boring choice, that follows a well-tread path within a large ecosystem of developers.
There are exceptions, but they’re not for the majority of organisations.
No real feedback other than it's pretty awesome. It'd be cool to have a version of the display above the doors that shows the upcoming stations, but I'm not sure in practice if that would be that useful since I assume most people would have that in the background as you point out.
Ha! Just before I began work on Yamanote.fun I actually asked Claude Design to replicate that display. It didn't go especially well and it led to me designing a custom interface in Figma that would work far better on mobile.
There are quite a few other mitigations that could be done by providers that aren't mentioned in the article.