domain:mgautreau.substack.com
Rov_Scam
1d ago
I was supposed to be hearing a lot about arcologies in the near future since at least 1993. I don't know that there's much call for anything self-contained, since the megaprojects of the 1960s that promised housing, retail, and office space all without leaving the building mostly went out of business when they discovered that people like going outside from time to time.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Ah... This is so good. I didn't know I needed to read this, thank you. The Missile Officer is a character.
anon_
1d ago
Sure. So 1/2 the price of Concorde but connects all the major cities of the world at Mach 1.7 instead of the 0.85 of a 777?
ActuallyATleilaxuGhola
Axolotl Tank Class of '24
1d ago
Faster Than Light. Yes, I'm late to the party.
You're a lone spaceship trying to outrun a massive, constantly advancing enemy space fleet while you must fight random enemies and avoid running out of fuel and ammo. It's a roguelike so sometimes you just get screwed by RNG.
The best part of the game is the tension during difficult moments. You are low on fuel and only have a few missiles left, and the enemy fleet is only two jumps behind you. Suddenly, as you try to jump past a star, a well-armed mercenary ship uncloaks and demands you give up your ship and your crew as slaves. As you begin to engage, a warning blares across the screen -- the nearby star is unstable! Moments later your ship is hit with a massive solar flare, causing random fires to break on your ship. Your crew scrambles to put these out, sustaining burns in the process. Luckily, you've kept your best pilot and gunner away from the fires, but BANG! the merc ship has fired a hull-piercing missile into your ship's bridge which is now rapidly decompressing. Your pilot attempts to repair the hull breach, but you're not sure he'll be able to fix it before asphyxiating. You may need to sacrifice a different crew member to perform this repair to have any hope of escape. You pause the game to consider your options...
ToaKraka
Dislikes you
1d ago
Nobody wants to live in Antarctica. I would rather raise kids on a container ship.
Wikipedia indicates that British Antartica is only a little colder than Greenland, and actually warmer than Nunavut and Siberia. So it really isn't the most outlandish place to live, assuming that services are available.
philosoraptor
1d ago
Anecdotally from someone who's never watched any of it, I have actually heard of all the other ponies you named save Rarity, but not Fluttershy.
Why political revenge narratives don't make sense to me.
I submit it's because you subscribe to a revenge framing in the first place, as opposed to a relationship framing. So long as you adopt a misleading framing, you will continue to be misled.
For example, when you give this paragraph-
After all if you care about the country, I would assume you want good and effective policy. If you see the left's policy ideas as bad and harmful to our future, it's not a great idea to join in on the self-harm. Unless you're a traitor and hate the country, you would be pushing for what you think is the best policy. Now people might disagree on what is best for growth, what is best for the people, and what is best for the country but we should expect them to pursue their ideas in the same way if they care about America, towards ideas they think are good.
-this leads off with abstractions ('the country', 'the left'), but no acknowledgement of a relationship. Even the traitor allegation is framing it as treat to the abstraction (hate the country). Even that treats the action as an initiation, as opposed to a response, as if treason is a state of being unprompted at odds with a natural/healthy state of behavior.
This is wrong in the same way that 'the organization decided to do something' is wrong. Organizations do not make decisions. People in organizations make decisions. Political parties do not try to appeal to, or deliberately offend, parts of the population. People within political parties try to appeal to, or deliberately offend, other people in the population. The tolerance / encouragement of such behavior is not conducted by The Party, but by the consent / support of other people within the party.
When people make a series of decisions over time in regards to, and affecting, other people, this connection is a relationship. Sometimes the established relationship is amicable, and sometimes the relationship is hostile.
People responding negatively to a hostile relationship are not traitors. Nor does their response to hostile relationship come off as them never believing the words they were saying.
...unless, perhaps, the only paradigm you can conceptualize for responding negatively to a hostile relationship is 'revenge' against abstractions.
Throwaway05
1d ago
This is probably the best summary I've ever seen on this topic. Thank you.
Quantumfreakonomics
1d ago
Going on ill-fated Antarctic expeditions is exactly the kind of long-lost British passtime that could reutite civic pride.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
I am very much not a survival game person, but I do appreciate the idea of a Minecraft for adults. I've seen a bit of gameplay, and it's clear to me that the game conveys 1% of the difficulty of bootstrapping even medieval civilization from scratch (which is a hundred times more than most offer). People seem ready to weep when they finally get copper tooling.
Throwaway05
1d ago
Usually (and especially here) my angst is generated by people's frustration with physician salaries, as it's an easy target for frustration but is A (but not the) load bearing feature of the U.S. health system and angry people don't care.
netstack
Texas is freedom land
1d ago
I’d say suicide-by-Antarctica is a lot more trouble than suicide-at-home…but this is the UK we’re talking about.
I mean, the patient likely can get the treatment regardless (see also the main NYT article). Doing so with a not-yet-settled pre-auth battle is approximately equivalent to doing so without a pre-auth battle at all.
Also without pre-auth, the patient has more leverage; it's the provider who is on the hook if nothing is done
This isn't really true, though. If they get the treatment without the pre-auth completed and agreed (or none done at all), and the insurer ultimately denies it after-the-fact, the patient still owes the bill. There's still a whole range of things that can occur with the resulting cluster of a negotiation after-the-fact. The only thing that I see that has changed is that services have already been rendered, the patient is now potentially liable for a gigantic bill, and the negotiation for who actually pays what just hasn't happened yet. The patient has even less leverage, because they've already agreed to buy the thing. They almost certainly can't un-buy the thing. They're purely at the mercy of the other parties to decide how much they're going to get stuck paying.
OliveTapenade
1d ago
Hm, it wouldn't be that surprising, I suppose, if the materialist Mormon cosmos, and relatively creaturely God, lends itself to a very different type of science fiction story than the Catholic cosmos.
I might need to unpack that a bit further to myself, though, and since we've rolled over into the next week's thread, I'll leave that here for now.
Skibboleth
It's never 4D Chess
1d ago
The US has a very peculiar arrangement where you don't buy healthcare. Your insurance provider buys healthcare on your behalf from healthcare providers, (except when they don't). But at least you buy health insurance, so if you get bad service from your insurance provider you can switch Your health insurance, in turn, is bought for you by your employer. Basically everyone in the system has terrible incentives.
- Healthcare providers are incentivized to overtreat because it mitigates risk (less likely to get sued for malpractice), allows them to charge more, and the patient (usually) isn't footing most of the bill, so they're often price insensitive. (Also, the patients are clueless so they have no real ability to argue with the doctors about treatment plans)
- Health Insurers are generally trying to sell the cheapest product possible to employers and pay out as little as possible to providers. They're not terribly worried about customer service quality beyond an absolute bare minimum, because their customers have limited ability to leave. So they stiff patients and deny coverage whenever they can get away with it.
- Employers are generally trying to conform to their legal obligations and need to retain employees as cheaply as possible. Fortunately for them, your employees aren't sick most of the time, so you can actually get away with buying them fairly low quality health insurance.
- The patient wants treatment, but lacks the information and expertise to make an informed decision. Almost as importantly, they want to avoid being left holding the bag. If the doctor recommends it and insurance approves it, they'll probably agree to it, because better safe than sorry. After all, it's (mostly) not their money (until it is).
The result is that the consumer (i.e. patient) is marooned in an incredibly capricious system which is only tenuously interested in his welfare and which may saddle him with a colossal bill as a result of processes completely opaque to him.
AvocadoPanic
1d ago
A cult feels a lot like a "committed affectionate relationship" to people who are vulnerable to or already in a cult.
I'm reading Steve Hassan's Combating Cult Mind Control, that's not exactly how he describes his time with the Moonies.
self_made_human
amaratvaṃ prāpnuhi, athavā yatamāno mṛtyum āpnuhi
1d ago
Better men than me have tried to grapple with cost-disease in the American healthcare system. From my perspective, it is a 'good' problem to have, if only because it proves you guys have so much fucking money that you can piss away such large sums of it without causing the system to go up in flames. Everyone gripes and kvetches, nobody seems happy, but happiness is a tall ask when lives and money are on the line.
For all the flaws of the system, it is clearly adequate, in the sense that the majority of the country is unwilling to set the rest of it on fire in a bid to fix it. I don't mean to damn with faint praise, it's not like medical systems elsewhere don't have their flaws. The "good/quick/cheap, pick two" problem has never been solved anywhere that I know of. America is like a whale, so huge that even the most aggressive cancer doesn't amount to more than a pimple.
ABigGuy4U
1d ago
I think civil war is actually more likely.
Perfect! That’s how you get a constant supply of enthusiastic colonists to settle the wretched frontier.
roystgnr
1d ago
I thought thr idea is absurd, and would have walked right into taking the "not gonna happen" side
I thought Musk was making a joke. If I fight the Absurdity Heuristic hard enough I can see how much sense it makes, but until they started mounting the tower arms I still thought maybe it was a joke.
They're not even doing it for the Falcon 9, Starship is probably exponentoally more difficult.
Counterintuitively, no. You'd think that "bigger is harder" in engineering as a general rule, but there are exceptions. The control problem that lets Falcon 9 land within meters and Starship get caught within centimeters is one. Surviving atmospheric entry is another - it helps to be as big and "fluffy" (high surface area to mass ratio) as possible, so you start decelerating sooner and slow down higher and peak at a lower heat flux. Size also lets Starship get away with using steel - previous steel rocket stages needed to be "balloon tanks", pressure-stabilized because of their thinness, but Starship is so huge that even "thin" relative to that is thick enough to worry less about buckling, and they get far more thermal resilience "for free".
But that aside, it's the recovery of the second stage that is more likely to do them in.
Reuse is; recovery they could definitely do. They've already managed to bring three ships to a soft powered splashdown (albeit just barely, that first time) after atmospheric entry, despite one of the three being a "let's try stripping the heat shield way down and see what breaks first" test. I can't imagine any of those were in shape to launch again (or would have been even if they were caught rather than splashed down), but being able to do even a brief short main engine relight right on cue for the splashdown is a pretty good step in the right direction.
The biggest catch is that, even if they technically manage upper stage reuse, they need cheap reuse, with at least a few flights per ship, to make this worth all the effort. Space-Shuttle-style "if we go over everything with a microscope then we can launch this again next year" won't cut it.
In terms of Artemis, though, what's most likely to do them in is the schedule. They're not going to make 2027 for Artemis 3, and if they don't even get an unmanned lunar landing test by then, Congress is fickle enough to put HLS Starship (or the whole Artemis program) in the waste bin next to Constellation.
Throwaway05
1d ago
I can tell you that in my personal practice I try and be cost aware when possible but that a number of practical concerns come first. For one my job is to get people better, not spare their wallet, the threat of litigation makes it extremely hard to deviate from that even when both the patient and myself want to.
In some situations it appropriate (or required, most often with homeless people) to be more careful about this but I can't always do so. A classic example is inhalers, insurance change what they cover all the time, if I don't know your specific insurance plan well....it's just going to be wrong some of the time, even if I do know the insurance. Hospitals have invested in tools like e-prescribing which help with this.....but all kinds of negative effects of those things have also been generated.
One of those is that I am highly limited in what I can do. The hospital owns most physicians right now because of increased costs like EMRs we do what they say. Some times that involves practicing on our license essentially. It also frequently means things like me signing away my right to bill the hospital just does it for me based off of what I charted.
When it comes to inpatient medicine ultimately I'm going to be like "I'm sorry you are going to get a fuck off huge bill and I have no control over it and depending on your insurance that may or may not be a problem." I am also incentivized to not think about it too much to avoid burn out.
For outpatient medicine usually it's a stripped down professional fee that I have no influence over and a medication bill that I can try and save you money on.
I don't really know what percent of patients have co-insurance, and as you demonstrated and like I said I don't think about co-insurance at all most of the time. This is because legally and practically it has nothing to do with me, that's what the regulatory and legal environment have decided.
Usually when this kind of thing comes up it's "put the doctors on it" but the hospital and insurance company are in charge!
MadMonzer
Pedo! Pedo! Pedo! Out! Out! Out!
1d ago
And they are already notionally aiming for $7000 tickets, which is 1/2 the inflation-adjusted price of Concorde.
That is what I mean by a 2x improvement. Slightly less than half the inflation-adjusted price, for a marginally worse product (Mach 1.7 vs Mach 2.0). Still a niche product for rich people - the marketing spin is that the fare is competitive with business class, but airlines don't sell many full-fare business class tickets at the moment* - the average fare actually paid needs to go up a lot relative to subsonic business class for the economics to work out.
* As well as the usual discounted fares, the big volume business travel customers (mostly banks and consultancies) all have negotiated rebate schemes which means that the revenue to the airline is less than the face value of the ticket.
Throwaway05
1d ago
You know, the American edge of this kinda stuff runs into a few issues. One is our legitimate exceptionalism, we are the superpower, we don't usually need to make compromises. That's not a completely terrible approach and for long enough that most of the people alive in the country have only experienced that....it worked.
It limits our facility with actually going through this process however.
Part of it is that people know that something can be shaved off without impairing patient care. This is probably right but nobody knows (or agrees) what it is.
Then you have American specific attributes - we are pussies when it comes to pain for instance, we are more willing to seek and use care, we are too independent, and so on.
Low societal temperament to say "yeah let some mee-maws go down if it saves a few hundred million dollars."
But yes you are right that this conversation is happening just less transparently, and at the same time if you came over here I think you'd be shocked at how much we through at things.
Is it good that we'll code a clearly dead kid for 90 minutes? Is it good that we will give homeless crack cocaine Fred the standard of care 12 times a month when he presents with psychiatric issues caused by his recreational polypharmacy?
I don't know.
I am however at times horrified and at times proud.
faceh
1d ago
Too easy to game by making predictions about things that no one cares about, and are easier to gauge.
You know, this is a valid point. "my calibration is perfect when it comes to predicting coin flips, dice rolls, and card turns!"
That's the benefit to a somewhat adversarial system, you're forced to actually pick something that someone reasonably disagrees with you about and cares enough about to take on some risk. so it must be more meaningful.
but I think one can learn not to take it thay way.
I'm pretty close to that. I'm actually getting a little flippant about tossing out bets, even if I'm not too interested in the topic.
I actually made 50 bucks on Kalshi yesterday betting that Starship wouldn't launch, on the logic that if it didn't launch, I would be sad, and money would cheer me up some.
I mean I don’t think I’ve seen anyone in a position of power have concrete plans that they stuck to even at risk of losing. TBH, looking at how people in power actually behave, principles are not how you understand government. Principles and ideas are not end points, but tools to get power. And if you watch politics with such a thing in mind, outside of a few crazy true believers, you can probably figure out where the chips will fall with 80-90% accuracy.
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