While we're discussing optimizing emacs keybindings...I've found it key to have my bindings set up such that my thumbs operate the control modifier key.
I got a pretty bad case of RSI with that setup, since it encourages one-handed chording (e.g. pressing C-x C-s by holding down your pinkie on Caps Lock while twisting your wrist to tap X then S using other fingers on the same hand). It’s far more ergonomic to do two-handed chording, where you press one key at a time with each hand to the extent possible. For me, that meant using Karabiner Element (Mac) and Keyd (Linux) to map Return to another Ctrl key when held down (in addition to the Caps as Ctrl mapping). Then I can simply hold down Return with my right hand and tap X then S with whatever fingers feel natural on the left hand, without twisting my wrist at all.
Indeed. I had RSI issues very early in my career, and the standard advice by ergonomists was "Use both hands when doing any multi-key sequence". If you're doing Ctrl-C, use the right Ctrl button, and so on.
I could never get used to that. I should probably try forcing the issue to see if I can rewire my muscle memory, but I'm afraid that it'll be a problem in places where I don't want caps lock rebound to ctrl.
I've made it a second ctrl decades ago... you so rarely need caps lock (unless you're shouting on the internet) that it's a gain rather than a loss. Your pinky can rest much more comfortably on the key and you don't have to twist your joint to reach CTRL.
It's a tale as old as life itself. Some organisms succeed in coping with the environment they find themselves in. The genes and culture of these organisms gets passed on to the next generation.
If you planted an apple tree and it never produced apples, you might start to wonder what's wrong with the tree. Maybe there's something wrong with the soil?
How do you know if an organism is thriving in its environment? You count the offspring over generations.
Nearly 2 in 5 Americans are covered by Medicare or Medicaid. TANSTAAFL. The other 3 bear the burden. At some point Atlas shrugs and decides welfare is a better deal.
The amount of money the US Government pays just for that 40% should be enough to cover all 100%. We know this is possible because it happens in other countries, which have shorter waits and more coverage since that talking point keeps being brought up despite collapsing in the face of reality.
> The amount of money the US Government pays just for that 40% should be enough to cover all 100%
This is true as long as the following changes are made: 1) wages for healthcare workers are scalled back ~50%, 2) many drugs and medical procedures are not longer covered (a good example is CAR-T for cancer or drugs for rare diseases).
The quality of health care in the US is significantly higher than anywhere else in the world.
Whether that quality is necessarily (or good) is debatable, but we are getting something for the money.
You also are just completely wrong in your main point. We cannot provide the same efficacy of healthcare as we are now for 60% less. We are the richest country in the world, labor costs more here than other places.
I tried an American PPO with $10 co-pay and no deductibles. It was awesome :)
Nobody could tell me what anything would cost, or if the insurance would cover it. But I always ended up paying $10, whether it was a few pills or an expensive MRI I didn't need.
Oh, yeah the downside is you can accidentally convince your doctor to get procedures you don't need.
Health care in Denmark is decent. But I've been told, no when I wanted to run some tests. That would never happen on an American PPO :)
I have had go wait, while unpleasant, it's fairly harmless (otherwise they don't let you wait).
So if you're on an great PPO plan in the US, healthcare is great.
Whether the outcome is better for the average Joe, is probably a different question.
My sister used to cook on private Yachts in the Mediterranean, and mingle with that part of the population that pay 3-5k/month for private insurance, helicopter evacuation and all that. I'm pretty sure they can ask their clinics any unnecessary tests they want, too.
I've had PPO insurance for a few decades. I've been denied tests and procedures many times, even when I had radiologist exams that supported the surgery according to their own rules. I've been forced to wait for procedures on many occasions.
Ive been to doctors in different countries including the USA. Theres nothing special with general practitioners with the USA.
Or if you end up in China, you can get blood panels for like 10RMB, MRI for 30RMB, and damn near automated to boot.
Go to Mexico for dental work. What costs you here $30k costs you $2k, and they take your insurance.
The US citizens are being gouged, because our government has been bought out by corporate interests who bribe, err, campaign donate to both parties. And thats across every economic activity. Medical is just an egregious one, alongside academics.
Expenses are definitely higher, and doctors and hospital CEOs and med school CEOs do drive nicer cars and have bigger summer dachas, but I can't say the same about quality. Six month waits for a specialist, every PCP and shrink you'd want to visit not taking on new patients, ER wait times comparable with other developed nations, worse overall outcomes...
Maybe the top 0.5% is getting better care, but I really wouldn't shed a lot of crocodile tears for them.
> See what the wait times are for the specialists in other countries, if they even exist!
I assure you, they exist, I have been to them, and the wait times were about as long.
> It’s very hard to solve these things are such a massive scale.
That's goalpost-shifting nonsense that doesn't justify the outrageous cost of healthcare. And most of these problems become easier to solve with a higher population and density and larger economy, because you have way more slack in the system, and you have way more economies of scale that you can put to work.
I'm also not complaining about healthcare in the middle of Alaska, 50 miles from a highway (or deep in the poverty belt). I'm talking about overpriced, underachieving care in wealthy metro areas.
> The quality of health care in the US is significantly higher than anywhere else in the world.
Simply not true.
Infant mortality and under-five mortality rate (U5MR) are one of best simple indicators of the quality of healthcare. USA's mortality is x3 (!!!) of the countries on top. This puts USA around place 50 in the world, worse than Russia...
If you define quality as range of treatment options available, sure. If you define quality as range of treatment options that are accessible, absolutely not.
> 15 out of the top 50 and 4/6 top hospitals in the world are in the US
Outliers do not say much about the overall quality of healthcare in a country. Rather obvious lesson in statistics.
Reminds me of the Russian mathematician who moved to the US after the fall of the Soviet Union. Most of his essays were criticizing American students, but in one essay he was quite frank:
Russians who graduate with math degrees are better than Americans who do so, by a wide margin. However, the average American is better at math because they still get access to some math education in university and do not need to be a top student for admission. Whereas in Russia, if you didn't meet a rather high bar, you simply couldn't get admitted as an engineering/physics/math program, and thus couldn't further your math education (I believe he said the cutoff was even before university).
Country with the top mathematicians, but country with worse math outcomes.
My argument is that specifically the best care in the US is the best in the world. We have the best doctors and the best technology and the best treatments. This is not completely universal but it is also generally accurate.
Whether or not this care is accessible or the median quality is care is good, that is different.
I’m just saying we do get something for the money, it’s not like it all gets thrown down the drain. The best and brightest come to the US to get some of the huge spigots of money in the US healthcare system and it does drive innovation.
This is a highly recycled talking point that only applies to people lucky enough to live in the vicinity of Standford, UCLA, Mass Gen, Cleveland Clinic, or Johns Hopkins AND afford a visit and is extremely dismissive of the millions of other Americans who can't. Rural hospitals have been shuttered and some people have even been turned away at emergency rooms now. This claim simply does not match up to reality, no matter how many graphs you put together.
> the best care in the US is the best in the world
For a few Americans. Not for all Americans, and probably not even for most Americans. There's far more to the United States than New England and Southern California.
Don't get me wrong, if I had some rare cancer or other strange disease, chances are I'll want to try and get in to one of these few rare ultra premium hospitals. But if I break my leg or get some normal infection or have a child or any of the other normal kinds of issues people have? Will that still be the best tier of care?
> if I break my leg or get some normal infection or have a child or any of the other normal kinds of issues people have? Will that still be the best tier of care?
Does it need to be? I imagine it's far easier to treat a broken bone, in most cases, vs a rare complex disease
I'd have different standards when researching where to have teeth cleaning vs oral surgery
Can't you just look at life expectancy, and life expectancy in good health? Because the data I found doesn't put the US in the top anything. Even if you're in the top decile of earners.
Your mistake is separating those items from healthcare, when it's part of it.
Even in the US, many (most?) insurances and healthcare systems have programs to address all those. My HMO certainly does - I can engage with them and craft a healthy nutrition plan, and my doctor can be involved in that as well. Ditto for exercise.
So you're saying the US optimizes entirely for the best of the best care, without regard for what happens to the 2nd tier? (that the majority of the population actually use)
If care is not affordable and makes average people just one accident away from bankruptcy, then it might well not exist in calculations. This is akin to saying the USA is the richest country because it has more billionaires than any other country.
On an anecdotal basis, I relied on the Taiwanese National Health (NHI) for years and found it vastly superior in terms of quality and cost to the United States.
Perhaps a more accurate claim might be: The quality of the health care system in the U.S. is unparalleled provided that you are in the 1% that can afford it.
In Australia 5 out of 5 people are covered by Medicare, and 5 of them bear the burden. (at some point in their life. assuming they become a tax payer, which seems likely for most.)
On top of that many things that are 'not urgent' you have to pay for yourself.
I have recently paid over 20K for back surgery. Prior to the back surgery I could barely walk. This was deemed 'not urgent' and had I would have had to have waited at least 18 months for surgery via Medicare.
I also have private health cover.
So, it's important for non-Australians to understand, our health system is far from a panacea where taxes pay for everything.
Currently 778 K Australians are waiting for 'elective surgery' .
If everyone costs the system $10, and the five people pay $8, $9, $10, $11, and $12, respectively, I think it’s a mistake to say only the last two net-positive taxpayers are paying for the system.
The burden of this isn't a big one to bear. I just compared tax rates for a $65k USD income in Australia vs the US. You'd be taxed ~$800 less in Australia.
Superannuation is not a tax. It’s a compulsory retirement saving/investment scheme.
However to calculate total income taxes you do need to include the 15% tax on superannuation contributions.
If your pre-tax take home salary is $100k AUD, then your total salary package is 111.5k including the 11.5% compulsory employer superannuation contribution.
You’ll pay regular income taxes + 2% Medicare levy on $100k and your $11.5k super contribution will be taxed at 15%.
So your total income tax including the Medicare levy (but assuming you don’t pay the Medicare surcharge or claim any deductions) will be $24,513. Giving an effective tax rate of 20.2%
There are no state or local income taxes in Australia so that’s it for personal income taxes. However states do charge payroll tax on most companies payroll (e.g. 4.85% on annual payroll over $1M in the state of Victoria for companies in the Melbourne metro area).
Health spending in 2023–24
In 2023–24, Australia spent an estimated $270.5 billion on health goods and services– an average of approximately $10,037 per person. In real terms (adjusted for inflation), health spending increased by 1.1%, or $2.8 billion more than spending from 2022–23.
In 2023–24, health spending accounted for 10.1% of the gross domestic product (GDP) in Australia, approximately 0.2 percentage points higher than in 2022–23.
In Australia, 15% of all expenditure on health care comes directly from individuals in the form of out‐of‐pocket fees — this is almost double the amount contributed by private health insurers.
There is concern that vulnerable groups — socio‐economically disadvantaged people and older Australians in particular, who also have higher health care needs — are spending larger proportions of their incomes on out‐of‐pocket fees for health care.
A 2019 study identified that one in three low income households are spending more than 10% of their income on health care.
There's little to no public advertising of prescription drugs, cheap generics are widely available from federal scale bulk negotiation deals.
Health outcomes are greater life expectancy than the US, national scale cancer survuival rates are better by a few percentage points (IIRC - they are close but higher).
Australia has long had an innate "we're all in this together" society built on individualism. It's not great, it's not perfect, but the first instinct is generally to look after our own - across the board.
When I was in the USA just paying for things like a GP and a single specialist didn't seem outrageous coming from Australia.
If I worked in the US, I would have health insurance and would be paying lower out of pocket costs than I would in Australia. Combined with the higher salary and cheaper housing that's a pretty good deal.
Edit:
We allegedly have universal healthcare but that doesn't cover any actually competent specialist (need private healthcare for this) so paying $400 for 25 minutes of a psychiatrist every 2 months and $95 for 7 minutes of a GP is common.
Weird, I've seen a lot more people bitch about welfare and how easy people on the dole have it, than actually give up their nice jobs and lifestyles to go try living it.
I don't think the critique is that "welfare is objectively preferable" to a high paying career, but rather that the effort:reward ratio isn't scalable to society at large (without some level of social cohesion, I guess).
It was likewise striking how few of America's slave owners thought that slavery was such a sweet deal that they should be enslaved. It's not always true, but it should always give you pause if you find yourself insisting that other people have it too good and yet you've been careful to ensure that you'd never have to trade places...
Fortunately, a good number of people in the 3 of 5 population have the imagination to see that they or people they love will someday be in the 2 of 5 population.
I've found it crucial to have Control mapped to the keys immediately next to and on both sides of the spacebar. Thumbs are stronger than pinkies for modifying keypresses.
Yes, that's a good idea since Control is the most common keybinding modifiers, so helps in other apps as well (likewise, using Cmd on a Mac would be preferable to using the literal Control)
I always think of it as learning to see hidden dimensions, and once seen, investigate deeper or just imagine transformations of that dimension -- extrapolation, inversion, etc. Once found, you can drag around these hidden dimensions from one domain or one instance to the next.
Like sometimes I seem to be in alignment with someone, but things feel off. I once realized the "off" feeling was because I was running toward something I believed in, and they're running away from another thing that scared them. It's only circumstantial we were intellectually walking in the same direction, so I tread thoughtfully in collaboration with this person. It's attractive force vs repulsive.
Once I knew to look for this "away vs toward" dimension, I see it often :)
very nicely articulated.. so, you are suggesting to be "sensitive" to "feelings" - such the one of being "off" - since feelings primarily provoke thought. Another feeling that i have is one of "inconsistency" - again it feels like something is off, and you are suggesting to pursue this feeling rather than to brush it aside.
aw hey thanks. haha yeah, "feelings" are maybe just the subjective experience of a mind interpreting high-dimensional data. so I guess I'm arguing for using "feelings" as a dowsing rod for a truer dimension hidden beneath, to which the feeling is drawing your attention :)
Meditation has totally helped me widen my scope and soften my awareness. I've found these two exercises also help me get out of my default mode of perception.
Image Streaming[1] is a fun little exercise that has helped me expand my perception of things or problems. I try to do it in a very high dynamic range way -- where I zoom out of a scene describe it in detail and then zoom in a describe it in detail.
There is also a fun improv exercise where you walk around looking at objects and calling it the wrong name. It sort of gets you our of default mode and you start seeing things 'differently' (a touch more vivid). I think the exercise is described in Impro by Keith Johnstone.
Mathematician David Bessis describes similar exercises in his book [ref] - wherein he explores a room blindfolded to awaken other senses, or visualize the places he has been to.
Don’t ignore any question is the strategy I’ve found. The problem is that some questions fall just below the conscious threshold. Meditation seems to help dredge up the questions and take them seriously.
Physicist Bohm has written about this. That, the beginning of new perception is in mindful listening or mindful awareness.. But most of us are stuck in our thought-rut preventing this.
Perception itself carves out categories almost unconsciously leading to the thought-rut we are in. ie, Bootstrapping the perception of new detail in everyday life is very hard.
The way I did it was by deliberately going against my normal impulses. The rule was "whatever you would normally do, do the opposite of that". If you would stay home, go out. If you would eat a steak, eat spaghetti instead. If you would get drunk, stay sober. If you would stay sober, get drunk. Basically, as long as it's not something that's likely to do irrevocable harm, do things that don't seem like good ideas and just see what happens.
The limits on our experiences are usually self-imposed by the fact that we tend to make specific choices limited to specific contexts. The experiences you have are the experiences that derive from what you think is a good idea. So doing things you think are bad ideas tends to result in a lot of new experiences.
I think the idea is to reduce the set of memory that needs to be frequently collected. Long lived objects age to the old generation which can be large and infrequently collected. I've used this kind of collector in the past for applications which held a large and mostly static dataset in memory.
While we're discussing optimizing emacs keybindings...I've found it key to have my bindings set up such that my thumbs operate the control modifier key.
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