Turning in water is a lot harder than turning a wheeled vehicle on land. Cars can turn themselves in a tight radius, container vessels cannot.
I also don't think the weight of the guardrail is what matters. Its strength is derived from the strength of the materials and being anchored in the earth.
In any case, any vehicle driving directly into a guardrail is going to plow right through.
I just don't think this guardrail thing is a great analogy.
They're a pretty good analogy because you use a deflector style guard in the bay that ALSO is anchored in the earth. Nobody stops a whole cargo ship traveling straight at a thing via brute stopping power. You don't do it with cars and you don't do it with boats. You use deflectors that are roughly parallel to the direction of travel. Otherwise, all you can do is build a giant bunker which is not cost effective.
I think that's only true if you pretend the equity grant all vests in year one. In reality it takes some time, so you won't get that amount until after several years at the company.
I didn't say anything about the wage price spiral. One category that has had above-average inflation is food away from home. That's mostly driven by wages of the workers, not wages of the clientele.
The pesky law you mention is indeed the issue. Not enough people are willing to work in restaurants, and/or not enough people are willing to modify their habits to avoid eating in restaurants when the prices increase.
Whether "printing" money was a cause of generalized inflation is a matter of debate. It's hard to argue it didn't have some effect, but I think you'd probably expect the inflation to have been worse if it were just dependent on the amount of dollars in the system. Given the tightness in the labor market and reduced workforce participation, it seems to me that the pandemic was a large-scale, impromptu test of the UBI, and society failed it very badly. Turns out people will actually not work if they don't have to, and robots are not yet prepared to pick up the slack.
> Whether "printing" money was a cause of generalized inflation is a matter of debate.
It's only a debate for people who haven't looked at the history of money and inflation. Inflation is always the result of an increase in the supply of money relative to the value of goods and services in the economy. It happens when there are gold rushes, silver rushes, and running the government printing press.
Our current inflation happened soon after a massive increase in deficit spending.
That sounds like a you problem. I spend $400/month and that would be a lot lower without an obsessive cycling habit which necessitates eating about double the calories of a more sedentary individual my size.
Like please share a receipt that shows how you spent $325 for one week's groceries. $43/day?? Maybe you're eating fresh fish every meal?
I don't understand how the author can praise NHS for providing this expensive surgery free of charge, whilst simultaneously noting the hundreds/thousands of patients who die while on the surgery waiting list.
Not to be morbid, but every time a patient dies before this surgery, the NHS saves £50-100,000. So is it really a successful system if the only way to make the budget work is letting folks die? Why on earth would the author not be gleefully prepared to pump a little bit, or a lot, of his private funds into this system in order to improve on his chances of survival?
> If hip, hernia and cataract waiting lists had a similar mortality rate then tens of thousands would die before they got their op.
For these other types of operations there can be very long waiting lists, but these are not conditions from which people die suddenly without warning.
The NHS has its problems, but I, for one, am glad that if I get a life-threatening condition I will be treated according to my need without having to bankrupt myself in the process. Additionally, I'm glad the insurance companies don't drive the pricing of quite cost effective drugs and treatments until they are out of range of the uninsured, even though they could easily be priced affordably.
He gave sufficient numbers to do the math on how many people die while waiting for their turn. It is thousands in this case.
Regarding the NHS you are falling victim to the binary choice fallacy. It is not a strict choice between NHS’s model and the American hyper privatized healthcare. Where I’m writing this, Taiwan, there is a first-class healthcare system that has national single-payer insurance for all residents (only $27/mo!!), and generally no waiting list and patients can normally see any specialist they wish with walk-in appointments during usual working hours.
Also, almost anyone who wishes can, at any time, fly to a country that has affordable and efficient healthcare and be a customer.
I have friends (Americans) who have had procedures recently in South Korea, Turkiye, and Germany. Sometimes it's just easier and faster, and isn't that expensive even if you don't use insurance.
I'm honestly surprised there is not an entire class of insurance programs for people who happen to live in a jurisdiction that has basically said "we would rather you die on a wait list than allow private healthcare" (e.g. British Columbia in Canada[1]). That insurance would cover healthcare abroad, maybe constrained to certain geographies and conditions. Unlike travel insurance it would assume that your care abroad is necessary due to a lack of services in your home jurisdiction.
Perhaps the actuarial data is hard to collect, but I suspect it would be a booming business as most countries with socialised system seem to be heading towards a total decline, if not outright collapse.
> Taiwan, there is a first-class healthcare system that has national single-payer insurance for all residents (only $27/mo!!)
How?
At 27 USD/month/person, are you sure you're not failing to account for taxes and other government funding for healthcare?
Don't get me wrong. Healthcare could be better and cheaper. We could train more doctors to lower wages :)
But healthcare and care in general is a hard place to increase productivity. New treatments and drugs help, but anything advanced usually have to involve humans.
Yes I said it was nationalized healthcare. But Taiwan’s tax burden isn’t oppressive either. Tax brackets are pretty similar to the US.
They start by not paying the insane wages the rest of the first world has normalized. There is no reason a typical doctor should be expecting half a million $$ in total compensation.
They also cut out a lot of middlemen. No private insurance. Doctors offices are also pharmacies. No domestic pharma industry abusing the paten system to extract rents from medications. Etc.
> Yes I said it was nationalized healthcare. But Taiwan’s tax burden isn’t oppressive either.
Yes, but let's be clear: It's not 27 USD / month per capita.
I live in Denmark with public heathcare, it's not horrible, but wait times for non-critical things are longer than it was in the US (with a great insurance). Not that it's been a huge issue for me.
In any case, I'm pretty sure our healthcare system is more than 27 USD/month per capita :D
A random search for healthcare expenditure puts the number around 650 USD/month per capita (probably you can find a different number and make it larger/smaller, so I'd take this as a ballpark figure).
Doctors seem to get by just fine. They are paid a living wage like any professional, and take on little to no debt from medical school (one of the top schools is $4000/yr in tuition).
I had the same surgery done in the good old US of A and I only had to wait 3 months to schedule surgery in the SF Bay area. How bout that for service;) Knocking the NHS is getting really tiresome. The US with it's private insurance is already making people wait and also not providing optimal outcomes while still being overly expensive. The fact is either system can work - but we as a society have not prioritized the necessary training in volume to make these highly technical jobs available at scale.
[1] 28K new doctors are minted in the US each year.
[2] Predicted shortfall of doctors up 124K by 2034
> So is it really a successful system if the only way to make the budget work is letting folks die?
The NHS doesn't get to make that decision. The problem is that it has seen literally a decade of budget cuts, despite a rapidly aging population. Compared to countries like France and Germany, the UK has far fewer doctors and nurses per capita.
The Tories are intentionally trying to make the NHS fail by essentially strangling it as they really want to privatize it. As the decades before have shown, the NHS can operate perfectly well when it is supplied with a proper budget.
The only way to make the budget work, for all of medicine worldwide, is to let people die (!)
There's a marginal dollar cost on saving one extra life, versus not saving it. It's not that we're out of people to save, it's just not in the budget to save the next one. The one more.
No one wants to believe this. But it is absolutely true: there is no healthcare system that can save everyone forever.
The growing assortment of treatments to combat issues that arise naturally through aging gave rise to the expectation that we can live longer. Technically, that’s true, but the collective cost of care starts to go exponential. At some point, we must acknowledge that we will go bankrupt trying to save everyone.
I wish there was a way for people to check out before they become such a burden on society. Until then, we had better make peace with the reality that “death panels” are choosing for us, because we as a civilization can’t afford for everyone to live their longest possible life.
You can't see that a situation will come up, every day, where you have to make a choice between spending millions to keep someone alive for another year, or spending those millions on cheaper and more effective interventions for 100 children?
Here's the logic. Budgeting doesn't suddenly disappear and resources don't suddenly become infinite when healthcare moves from insurance companies to government. People who bash the NHS as a concept are people who prefer insurers to budget their healthcare instead of civil servants. Insurers are also death panels.
It's not that simple, though. You can't set a budget and let everyone die once you reach your limit.
Healthcare often uses "quality-adjusted life years", where the value of a medical intervention is judged by the amount and quality of the life years gained by doing the intervention. Once you set a value on a life year, it becomes a simple calculation whether the treatment is worth it. $5000 operation to save a newborn baby? Obviously worth it. $10M so a 90-year-old can live three more months? Yeah, not going to happen.
The best part is that you can apply a similar principle to other things. For example, at a certain point you gain more quality-adjusted life year per $ if you spend it on non-healthcare things, such as safer roads, better education, preventing homelessness, and fighting crime.
I agree it's not that simple, and finding better interventions in term of quality-adjusted life years seems really good!
I'm not sure though how much elasticity there is in people's willingness to contribute more in response to more effective medical interventions. Setting a value on a life-year makes sense when choosing intervention, but individuals looking at their taxes or charitable contributions don't have a step-change reaction where they're happy to give without limits to the $X QALY opportunity until it becomes $X+1
I do think you have that budget in a very real sense, and I'm not sure I know exactly how sensitive it is to the effectiveness of the interventions, especially as you expand out. I'd argue that the current price of a life year still seems relatively cheap, but the healthcare system does not often complain from being inundated with too much funding.
The NHS may save that much money, but the US government currently estimate the life of the average person to be worth $10 million (btw this figure was created in the ‘80s so keep inflation in mind). So how much is the UK losing here? It’s a net negative to let people die.
I don't know where that number comes from but I'm assuming it's a contribution to GDP over a lifetime or something. Seems high, but whatever.
The people dying of aortic stenosis have already completed a large percent of their lifetime contributions and may even be into the net negative territory (when you're retired and society has to take care of you).
> The people dying of aortic stenosis have already completed a large percent of their lifetime contributions
I was sure you’d be wrong here, as congenital stenosis is a thing. You were right - shows what you learn working in a centre when congenital disease is a specialty.
And how much do you estimate the cost of their early death to be? Their children who mourn and become bitter at the government and their society for not providing life saving surgeries to their parents while the rich preserve their fossilized parents… how much money will you advocate we should spend on propaganda to manage their vulnerable mental state? How much less money do enemies of the state need to spend in order to bring those people over to their cause and betray your government? And when terrorist attacks become worse, how much money will you advocate wasting on an increased police state?
If anything, the $10 million + inflation is an understatement. There’s no end to the potential monetary value of increased quality of life, and there’s no end to the monetary loss of decreased quality of life.
> Not to be morbid, but every time a patient dies before this surgery, the NHS saves £50-100,000.
Your looking at this too narrowly. There is a point when the NHS saves money by having patients die - this is true in every other health system too. But having a young tax payer die loses them money in terms of future tax take. One can do the equation and it would be something like healthcare cost versus tax take multiplied by years of life left paying tax.
Probably for privatised health care - once it's down to money it's the individual's fault for not being able to afford to live and no longer a failing of the system. Thus goes the libertarian concept of personal responsibility.
And yet this is a terrible plan because purposely killing people is actually terrible for the economy and any money saved will be drowned by the amount of money lost, especially since the money saved will go directly into the pockets of the people who own the privatized healthcare companies and not back into the pockets of the people.
You guys are tilting at windmills here. I didn't advocate for anything except common sense. Unless you value money more than lives, this system is clearly shite, but the author doesn't acknowledge that, probably due to politics.
The budget is part of the system. If you assume unlimited resources, then every system will work flawlessly.
You still haven't answered whether you're advocating for improving or starving the NHS. Although if you're intent on shitting on the NHS as if it's intrinsically bad (regardless of budget), I would strongly suspect you are advocating for more private health care, and vote conservative.
Feel free to elaborate on what your common sense dictates as a solution.
It’s only common sense to present the pros and cons of policy. You don’t seem to even think it’s worth your time to take an actual stab at estimating the cost of death, and so it’s only common sense to think you haven’t thought your way through this at all. You’re still arguing this is a budgetary concern without acknowledging the fact that your policy may actually result in a worse budgetary concern.
You know what’s also common sense? That death isn’t a good thing. More death = worse society. Bad society = no money.
The budget is also part of the insurance system. The problem is that you seem to think that resources should be expected (or demanded) to become infinite once healthcare is managed by the state. Insurance companies have turning you down for care as a priority.
If you live in the UK you have to be positive about the NHS. As soon as the NHS becomes broadly unpopular it will be replaced with a U.S. like system.
The fact is the Tory party has been kneecapping the NHS for nearly a decade now - austerity measures to underfund it, and brexit which cut off a lot of talent.
The current state is purely a result of politics - and likely lobbying efforts to change the UK system to a more profitable one.
Google is fine if you're searching for restaurants or a Wikipedia article. I'm sure they handle the vast majority of their mundane queries well.
It's awful, much worse than it used to be, if you're looking for some specific piece of information. Put a word or phrase in quotes, and it will still just ignore it after the first 3 or 4 results and give you a bunch of irrelevant garbage.
Not as weird as this meme. You assume it’s some signal expression rather than that I would just pay Google money every month to provide search results that don’t prioritize advertisements over more accurate results that don’t calculate a margin.
Interesting way to put it. Almost like refusing to pay the local thugs for "protection", and seeing the consequences of not paying get worse every year.
Google increased ads on youtube to the point where it's now ugly and excessive. This doesn't make premium more valuable in its own right. It makes avoiding premium more uncomfortable, which is a lot different than your implication that people refuse or can't see the value of premium.
Just because you got something for free at the start doesn't mean it will stay that way. Other platforms like Netflix, HBO, Hulu, etc keep increasing prices year after year, even creating paid ad-supported tiers, and since most people pay YouTube by watching ads, ads are increasing commensurately too. Where's the confusion? The "refusal" refers to there being options where you don't have to see ads. I don't get to watch Netflix for free with ads; how is that better?
Youtube contains endless "generative fill" content made with all the care and effort of a vending machine. Lifeless, worthless, rinse/repeat content made by content spammers. A slap in the face in terms of value for money.
On Youtube's homepage recently I saw this video: "5 Tallest Building Demolitions in History". Worth a look, right? Wrong. Narrated with an artificial voice, and containing about 11 minutes of stock video clips, padding things out to reach the 12 minute length. The few seconds of demolition footage is fleeting and extremely low quality because the uploader doesn't own the footage.
Netflix isn't infected with such blatantly empty clickbait rubbish, so is a poor comparison if you're tying to say "but you pay $15 a month for Netflix, why not Youtube"?
While Youtube provides a "tip jar" called "super thanks", Google takes a 30% cut of whatever is tipped to the creator, ON TOP of what they take from advertising and premium fees. Google takes and takes. They increase ads as if there's no limit. Do you think advertising should have limits? Or are you fine with YouTube becoming wall to wall repetitive intrusive ads unless people pay the protection fee to not suffer the onslaught?
Where did YouTube enter the discussion? Also yes the things I search for would be in the minority of overall searches, but apparently finding Google unable to fulfill searches for these things despite it being able to do so 7 years ago is just memetic transference and not an actual critique.
Your comment was hard to read for me but I took it as you want a premium search that prioritizes results instead of ads. And I’m telling you that another popular product, YouTube, has premium and people don’t want to pay for it. So premium search would not change anything, except for a small minority of people like yourself.
The internet has changed drastically and become orders of magnitude bigger in the last 7 years. Your expectations may be unrealistic when there are so many parties that want to game the system.
What is an acceptable rate of causing cancer and how do you determine what rate a new material will have?
I hope your answer to the first question is not zero because things like PFAS do have benefits that are directly translatable to health outcomes. For example, when used for water proofing clothing, they might prevent hypothermia and save lives in extreme conditions. Plastic water bottles enable the distribution of clean water in areas that don't have (can't afford) good infrastructure. Less glass and more plastic means less broken glass on city streets, which I appreciate as a dog owner who doesn't want his pooch to step on broken shards.
Some cancer (harm, in general) is going to have to be acceptable. Zero risk is rare. I am not a chemical engineering domain expert, so I can’t speak to the acceptable amount of harm caused to progress ratio. Do the math and make it public. With that said, I’d argue we’re too far to one side of the pendulum and need to find the middle close to less overall harm caused.
It’s not all doom and gloom. Switching from lead and MTBE to ethanol as an anti knock additive in auto fuel was an objective win. There are more wins like that out there I believe.
We have standards for acceptable risk. In the Chevron example, they were just ignored by the EPA.
Basically, every Chevron employee working with those products will likely develop cancer as a result.
Environmental issues are tough. It’s easy to focus on your dogs’ paw and not even be aware that people are needlessly suffering and dying to protect it.
Right, so, I suspect this didn't get much traction, despite being posted and re-posted many times, because the cancer risk assessment was total bunk:
> For exposure assessment, EPA develops conservative exposure scenarios which are designed to provide conservative estimates of exposure; this allows EPA to have high confidence – when it finds no risks of concern – that this is in fact the case. In some instances, due to a lack of information on which to based exposure estimates, the conservative assumptions can lead to an over-estimate of risk. For one of the PMN substances in this integrated risk assessment (a jet fuel), the Agency divided the total projected future annual production volume of the new jet fuel by the total number of locations expected to receive the fuel, and then assumed each location could be an end-use location (e.g., airport) and that all the fuel would be burned there. The scenario that was modeled effectively presumed that every plane at the airport was idling on a runway burning an entire tank’s fuel without ever taking off, that the components of the fuel that contribute to c risk are not fully combusted and are present in the exhaust, and that residents living nearby (in a fenceline community) would continuously breathe the exhaust each day over many years in their lifetime.
It's unfortunate we don't have a better risk assessment.
There’s a shit-ton of loopholes in this space because the legislation creating the EPA doesn’t require oversight for chemicals in use before 1976. Many of these byproducts are awful, but not subject to regulatory analysis. It’s similar to hoe people say that if we discovered acetaminophen in 2023, it would never be FDA approved!
One branch of my family grew up near the Mobil Refinery on the Newtown Creek in Queens, NYC. 12/12 have had cancers from that place, as do many others.
I would agree but we're talking about asbestos here. It was primarily used in building insulation. Are you suggesting we should have opted out of housing altogether as the sane people opt out of driving? Because I would have suggested we simply stop using asbestos, whether in houses or cars.
He's just getting angry at cars for the sake of it. It's very trendy now to pretend to forget that cars are one of the best tools available to a person alive in the last century. It's purely an emotional display.
