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"Good surgeons know how to operate, better ones when to operate, and the best when not to operate."

Alternatively one of the rules of The House of God - "The delivery of good medical care is to do as much nothing as possible."

Both are far harder than they sound.

Concorde wasn't transformative because it never scaled.

My claim is that merely achieving "equal to Concorde but consistently adds at least a handful of new routes every year" is transformative, even if it's not any better or cheaper. And they are already notionally aiming for $7000 tickets, which is 1/2 the inflation-adjusted price of Concorde.

Or maybe the other way around: Concorde wasn't transformative because they only built 14 of them and only served 3 airports, which was downstream of the fact that the thing could barely fly and bled[1] money.

All that is very true, but they managed to also appeal to a female audience with baby Yoda and the Mandalorian being the protective figure there. I mean, there's a decent and simple plot that was difficult to mess up (until they managed to do so).

Man, fascism used to be hip and happening.

Where can I read more about this? None of the related articles have anything to say on the subject.

I'm old enough to have been there when the first Star Wars movie was released (mid-teens), and I honestly never thought Lucas would get the second and third sets of trilogies made.

Now it's almost a shame that happened.

History? They're still doing it, just the other way around. Plenty of undesirables coming to the bitter dampness of Albion, including me.

Some people would say you should go out and watch all of SG-1 now, but don't listen to them; it's fine to stop after season 8.

BSG, on the other hand ... "The humans haven't figured out what the Cylons are doing" is a compelling premise, right up until you add "the BSG writers are humans" and complete the syllogism.

I'd think LotR was the least nerdy thing you've mentioned, though. Pre-Peter-Jackson, sure, knowing the name "Frodo" marked you as an ubergeek, but today they're still top-100-lifetime-gross movies; when The Return of the King came out it was like top 10.

I remember liking Star Trek 1 and I was surprised when I got older and found out everyone hates it. But I also was obsessed with the Voyager probes as a child, so I guess it hit the spot for me.

You're not mixing up 1 and 4, are you? Everybody thought 1 was dull but loved 4.

I don't know what the Xer and Millennial parents of my cohort raised their kids on.

I tried to suggest to them at least a little of everything I knew was decent as soon as it was mostly age-appropriate; sometimes sooner if the writing was clever enough to slip by ("Under a blacklight this place looks like a Jackson Pollock painting!" - Guardians of the Galaxy) or pointless enough to edit out ("What if we reuse the same joke but don't understand subtext?" - Taika Waititi). I try to tell them which yet-unwatched options are better or worse or scarier or slower or whatever than others.

And they take turns getting to pick what we watch together, which is sometimes the hard part (Gravity Falls was good, Owl House less so, and was Amphibia really worth three seasons?) but is still the important part, because their preferences often surprise me. They've all soured on the MCU and Star Wars (except that we're planning to watch Andor). My oldest loved TNG and likes DS9 but dislikes Kirk too much to watch more TOS. My younger two just tolerated Trek (and won't watch any more scary Borg episodes) but they really like Babylon 5. Everybody loved The Martian, though not as much as the book.

This is even funnier if you ignore the context of the blurb and assume that "Australia's claim to sovereignty" refers to the actual continent/country of Australia.

17 million people and twice that in kangaroos? Do we have to recognize that as an independent nation-state? I've lived in larger cities! Also, it seems very unfair to give an entire continent to a single country, not Westphalian in the least.

Hello! I have just rewritten the Kzinti, where the males are smart and the females are dumb breeding machines!

Ah well, you gave me a laugh at least.

Oh, I have. The interesting thing is that they are pissed they get insurance consults on patients they want to send to surgery, but they freely admit that there are some of their colleagues (and it's a "everyone knows who it is" kind of thing) that propose surgery for literally anyone that comes through the door.

Can't have nice things ...

Hang on, don't tar all the West with that brush. The US actually behaves like an agentic superpower, even if it can be a senile one. The rest of the Anglosphere or Europe? You have a point.

I am happy to award you Bayes points for (likely) being right in our discussion. I could have sworn that we had a monetary bet myself, but I had looked for it a while back and didn't find anything. If even my 90% CI is unmet, can I interest you in a $10 giftcard from Amazon or equivalent? That would be from me to you, no need to pay if I'm right.

I hope that SpaceX finally figures out a single solid Starship configuration and flies it, but to their credit, they're consistently pushing the envelope and have the money to burn/blow up. I don't think anyone else would be crazy enough to imagine catching skyscrapers with chopsticks, and pull that off too.

atheists to be outperforming the LDS by far.

Don't they? (Stephen King, JK Rowling, etc)

Otherwise it sounds like we're in agreement here... until you used the term "gnostic theology." Catholicism is pretty anti-gnostic. Bodies are great, Jesus has a glorified body, we'll have one in the resurrection of the dead in the world to come.

Yup. I mean, it’s bad alright.

Are we talking high co-insurance costs here? I've never been on or been offered a health plan with a significant co-insurance burden although I'm aware they could hypothetically exist.

Interestingly, google-gpt says about 20% of plans have co-insurance.

So they certainly exist but aren't common.

If you are paying co-insurance charges would matter more but that dovetails into the rest of the discussion on this topic.

Outside of co-insurance - am I brain farting on anything other than: premium, deductible, co-insurance, co-pay? I guess uncovered nonsense.*

*Out of network costs are a separate problem that I forgot to mention in the other line of questioning (which is why my point is that shit is stupidly complicated!). Health systems don't really control who is and is not in network, it's usually a insurance fucking the consumer and hospital mechanism since canceling a scheduled surgery because Phil is the only anesthesia provider networked and he's off today or because the thing is emergency. This is one of the reasons why the hospital "know" they usually know what they charge, rarely know what the price is, and have zero ability to control and generally predict what the insurance company will pass along to the patient especially in uncontrolled situations like a hospital stay.

But yes thank you for reminding me of some of the other insurance related expense elements that I don't think about as they aren't in my plan, I dont think this alters the thrust of my argument though which is that the insurance is in charge of how much a patient pays and they have lots of ways to change that number away from the "price" and "charge."

Cialdini's Influence is about why people don't listen to advice. Hickman on Twitter wrote:

Many times, "advice-giving" has little to do with advice, and more to do with posing thought experiments that expose weakness in men.

The guys with energy, who got "the juice" say OK, you're right, go try it. The low-energy types just get madder than hell, seethe over the advice, say it's "bad advice" but can't say why -- and the guys who don't need the advice are perfectly secure, well-aware they don't need it.

Much like Moldbug’s “demotism,” that model sounds dramatic, but doesn’t hold up under scrutiny. The bits which resemble each other are not the ones with explanatory power.

If nothing else, the U.S. comes out way ahead on body count. We have a distinct lack of Holocaust or Holodomor or Great Leap Forward. Surely that reflects a difference in methodology.

These difference might help explain why the rest of modern society likes the fictional contributions of the LDS more than devout Catholics in the past 20 years.

It's not just "the rest" of modern society though; Meyer has sold more works to Catholics than any living Catholic author.

It's got to be more complex than just that LDS theology is more materialist than Catholic. If this were the case you'd expect atheists to be outperforming the LDS by far.

I do think there are theological second-order effect. In some ways LDS theology may speak to materialists more than Catholic theology. We have totally different answers to the most fundamental questions in religion--the problem of evil, the nature of God, the nature of sin, etc. This trickles down to inform author worldviews and sprouts in new and interesting ways from the gnostic theology that has dominated Western philosophy over the past couple thousand years. Maybe that's all it is--we're saying new, interesting things.

FDR’s USA

Interesting how the wiki entry for the National Industrial Recovery Act makes no reference to fascism despite it being part of FDR and the brain trust's inspiration for the act.

Do you mean Out of Pocket Maximum when you say deductible?

After reaching deductible the patient still pays more money the more money is spent. It is possible to reach the Out of Pocket Maximum (I did one unfortunate year). At that point they can't take any more money.

Most of the time I give birth I reach the deductible, but other considerations can make the amount I pay in addition to insurance anywhere from 2k to 6k. And these other considerations don't have much to do with how hard the birth was to manage - I always have a natural birth, 1 day hospital stay, pretty much the same experience every time. The things that change are things like an out-of-network admitting OB.

Out of Pocket maximums are going to be pretty high, like 12k even on a good plan.

If you believe that state ownership of private enterprise is a good thing for the nation then you don't need to talk about "the other side" to begin with, you can justify it off the merits of state ownership.

If you don't believe it's a good thing for the nation, then why would you want the country to harm itself?

I didn't mean your specific situation, apologies if it came across that way.

In this case, there is a pre-negotiated master charge list

Those numbers should still have been negotiated with some bullshit juju thought right?

One of the crazy things

Ahh shit, I meant to also blame providers in my post and may not have. Yes it's not uncommon to see someone and have them go "oh I can't handle that" and send you to the ED. A good chunk of that is absolutely to shift liability and is inappropriate but common. Biggest issue is when you say something unrelated to a specialist. Tell your endocrinologist that you checked your blood pressure at home and it was 160 over something and they'll send you to the ED even if that isn't quite appropriate. Another common problem is increasing specialization leading to specialists not knowing as much outside their field and PCPs being limited in what they can do and know (especially with midlevels). Lastly you have legitimately complicated shit, I don't really do peds at all IIRC from med school people are super fucking careful with kids that young. I think an urgent care would probably also sent you to the ED especially if ultrasound was standard of care.

Incidentally peds providers get paid way way way way way less than adult medicine.

If our child was on telemetry

It sounds like you were paying for hospital level of resources and in ye olden days your kid would have been admitted but now instead it can be managed conservatively outpatient - but you need inpatient level equipment (the ultrasound). One of those weird gaps.

Ultrasound is in a weird spot because it's evolving from a "nobody in the ED to can do this" to "we are starting to train everyone from day one to do this because its safe and cheap" but we are in the middle of that process. Wouldn't be shocked if in 5-10 years most PCP offices were doing it.

I know Texas state reps are happy to(have their staffers) research obscure state regulatory issues for constituents who call complaining about it, at least if you are a precinct chair in the same party.

I would suggest reaching out to local republican Apparatchiks to ask state legislators if they can find the regulation.

I've never actually watched either Stargate or Battlestar!

My parents are boomers, so they watched Star Trek and The Next Generation when they aired, and especially saw the films when they started coming out. Talking to them about movies is an interesting experience: they remember a time when movie theaters were everywhere, and going to see a movie was almost an everyday occurance. My dad talks about how when Star Wars came out in 1977, he saw it several times before it left theaters.

So I grew up on watching Star Wars films with my parents, we'd pull the lounge chair into the center of the living room and I'd curl up with my dad and watch the OT. When the prequels came out, we watched those too, but my favorite was Empire, obviously. When I was a little older we started watching Star Trek too, I remember liking Star Trek 1 and I was surprised when I got older and found out everyone hates it. But I also was obsessed with the Voyager probes as a child, so I guess it hit the spot for me.

Star Trek and Star Wars have always been the most mainstream of the space franchises, so I grew up with them as normal popcorn movies that my parents liked. Now, if you start talking to my mom about Lord of the Rings, that's where you'll start finding the nerdiness.

So part of this is that I grew up on a bit of an older wave of nostalgia, and I don't know what the Xer and Millennial parents of my cohort raised their kids on.

Even though it's super awkward, this is my favorite norm of the rationalist community, because you don't realize how reluctant people are to make specific, testable predictions until working out the terms of the bet forces them to.

Yep.

I think its less awkward when its actually a norm, but sometimes it does get used as a backhanded way to 'beat' someone by claiming "hah, you don't actually believe [thing] unless you put money on it!" Sometimes there's just too much uncertainty or the terms are inherently poorly-defined, even if the belief is tightly-held.

But that said, man, when you know there's some status hanging in the balance (i.e. if you 'lose' a few bets people might keep using that to undermine your arguments in the future), even if you're perfectly calibrated (i.e. you win your 50% bets 50% of the time) a couple losses in a row can make you feel like you're losing face.

Prediction markets offer a decent alternative because it makes the situation less directly adversarial. I would kill for there to be a way to publish your own positions in a way that others can verify and take positions 'against' yours, without it locking both of you into "one must win, the other must lose" proposition.