jaltekruse

Lots of studies have shown that the US spends a much larger portion of our GDP on healthcare than other countries, there is plenty of money to solve this problem already allocated to healthcare. I am aware that Medicare does aggressively negotiate prices, and our current system is a complex mess of different parts of the system subsidizing other parts to keep hospitals somewhat solvent, but this is largely just to enable all of the useless insurance middlemen to take big chunks of the money for no good reason (and its not all yacht money, its also just bullshit jobs that accomplish nothing productive but are sufficiently complex to require expertise, training and pay decent wages in many cases).

And I do know that you mentioned a real material reason why this isn't pushed harder by either political party despite the nearly inevitable massive savings if we pull it off. Causing an upheaval in the job market by removing a bunch of unnecessary admin work has real short-term impacts that will be hard for any US political party to weather well. That being said, I do think there are very real paths to achieving this and rhetoric about needing to copy-paste big parts from other countries distracts from how achievable it is. 90% of the work is already there with Medicare, and expanding the list of covered drugs and having a price negotiation with hospitals to make Medicare a good customer rather than a burden in some cases is definitely possible with some political will. A public option if it had been included in the ACA would have likely moved us a lot closer to universal coverage, especially if the mandate was still enforced, and likely would have spurred some of these necessary discussions.

I had a team that insisted on a linear history and was constantly rebasing things. This workflow strongly favors "just squash it all together" before a rebase to avoid re-resolving the same conflicts. This workflow often produces big patches that reviewers end up asking to be broken back up. This experience and a recommendation from my manager at the time made a good git GUI like sourcetree a daily driver for me. It's just second nature to review my own changes every time I stage files and quickly do a mix of staging whole files or "hunk-based", even allowing clicking to select specific lines within a hunk intuitively, rather than using the terminal UI and asking git to take a guess at splitting a hunk. I find a good git GUI invaluable, I have used sourcetree for years and love it. Unfortunately sourcetree isn't available for Linux, but I recently found SourceGit which seems to be a decent substitute.

Highly recommend trying a good GUI out, I think you would likely have similar ah-ha moments about workflow optimizations, and honestly I just cannot understand how people get by in git without a convenient way to visualize the commit tree (and yeah I know there is a decent command line treeview, but the context switching all the time in the terminal to go from viewing the tree or even the simple log to exit out and ask for commit contents just is so much more fussy and tedious).

The US already has a national health insurance network that pays the vast majority of all providers, and as far as I know it is widely popular and covers everyone legally present in the US for a portion of their life, Medicare. Old people experience just about every ailment young people do, we can just get rid of the age restriction on Medicare, it's already fully integrated with our medical system. No need to copy-paste from Sweden.

It feels like at some point we're going to need to re-evaluate the concept of intellectual property. I don't know how to bring about this conversation in a way that broader society will actually engage with it, but it really feels like software and digital assets are just too fundamentally different from the things we've been selling and buying for most of human history. Even if you think about a printed book, sure we've been defending peoples' rights to restrict reprinting of their ideas for a long time, but that came alongside broad support for institutions like libraries.

We now live in a world where you cannot be a professional engineer without expensive CAD software, you cannot run most businesses without some expensive licensed software for managing your books, HR, supply chain, etc. or you will just get destroyed in the market by more efficient competition. I guess my thought process on this is a little simplified, as I was thinking about how software you can run yourself is "infinitely copyable" for free. This question gets more nuanced with SaaS. While some of the enshittification can be argued to be rent-seeking behavior to have a bigger moat, you cannot perform a "DRM crack" of a webapp like you could with software restricted by CD keys and the like, creating SaaS versions of most products provide real benefits. Running a large hosted service is a serious ongoing commitment that takes real investment to maintain.

It feels like we haven't finished this necessary conversation in the pre-LLM world, about how software was creating giant powerful institutions that we were totally unprepared to regulate. In a world that looks so likely to be coming pretty soon, where LLMs can maintain a SaaS with very little human input, I just don't think we're ready for the consolidation of power that is coming.

And to the particular point being made about biomedical research, it is already pretty trivial to argue we have cartoon villain levels of evil already happening with both deciding how research dollars are allocated (diseases that disproportionately affect the poor are worked on less), and how many people we are leaving out of the modern medical system to just suffer or die at home.

We need to grapple with the fact that we have developed really powerful tools to reduce suffering, and alongside that development we have created legal tools and institutions that indefinitely keep innovations behind paywalls with prices chosen by powerful rich people. Maybe these two things need to exist together to create incentives for investment, but it feels like we need to have better conversations about how we can actively manage the knobs and levers of the economy to produce better outcomes for more people.

Sorry about the link, chrome was showing some old auto fill suggestion near where the clipboard contents appear. It looks like I can't delete posts that include text content and a link, as it creates a comment right away and blocks deletion. Recreated the post with the correct link, but I guess this now sits here as a sign of my shame for using my phone wrong while complaining about my phone ...

What the fuck is this, if you hold the home button on android it now enters a special search mode that refuses to let you run a search without sending your whole screen along with the search. And it is rather difficult to even get it to not do it. There is an "x" to leave, but if you miss that touch target it assumes you are highlighting some part of your screen you want to focus the search on and send the whole thing. My background image and things I keep on my homepage are not public data, fuck off Google

What the fuck is this, if you hold the home button on android it now enters a special search mode that refuses to let you run a search without sending your whole screen along with the search. And it is rather difficult to even get it to not do it. There is an "x" to leave, but if you miss that touch target it assumes you are highlighting some part of your screen you want to focus the search on and send the whole thing. My background image and things I keep on my homepage are not public data, fuck off Google.

I have been involved in open source projects with various structures and sustainability models. Open-core Enterprise software startups, unfunded or underfunded middleware/libraries and underfunded end-consumer software/apps. A real problem that I have with lots of open source is a mismatch between technical talent to produce software, an open ethos/philosophy (finding true believers in a much more open future), AND the most important often missing piece, a product mindset and willingness to do work that isn't just software dev. So many FOSS projects I have seen, with capable engineers spending years of their lives working on them, are lacking product management, a willingness to let users actually push the project in a direction that is more approachable to a mass audience, and the willingness to do the hard boring work of making software run everywhere. Lots of stuff falls into this general gripe, and a bunch of it isn't news to anyone. Lots of open source has shitty design/UX, every damn one of us that lives with desktop Linux knows exactly why it's not the year of the Linux desktop. The sleep function on the laptop I am writing this comment on doesn't work right (when booted into Linux), and every few months you have to find terminal wizardry to fix normal shit that should have a GUI config interface to un-fuck it, but "real software people don't touch their mouse unless they absolutely must". This comment got a bit off the rails, anyway, long live FOSS!