Right, just saying things like that -- aren't immediately apparent unless they're pointed out to you. The extended palette of alt+123 keycodes, unicode characters, stuff like that requires "exotic" macros or keypresses to type out. Despite decades of extensive experience with writing, writing software, programming, etc, I never crossed paths with em-dashes. They were a niche thing prior to AI making them a thing. I basically thought they were a font or style choice prior to ChatGPT. Most people wouldn't have a clue unless they went through classes that specifically trained on the use of emdashes.
I like them as an AI shibboleth, though -- the antennae go up, and I pay more attention to what I'm reading when I see it, so it raises the bar for the humans that ostensibly ought to be better at writing than the rest of us.
Edit: Interesting. I tried using -- and it doesn't work for me. I'd have to go change settings somewhere, or switch the browser I'm using to elicit an em-dash. I don't think I've ever actually written one, at least intentionally, and it wasn't until today that I was even aware of hyphen-hyphen.
Edit again: I had to go into system settings and assign a compose key — after that, I can now do em-dashes. Having degrees° will be nice, too, I guess.
They weren't exotic, they just weren't part of your writing style
The reason "--" autocorrects to an em dash in practically any word processing software (not talking about browsers) is that that's the accepted way to type it on a typewriter. And you don't need to go into any system settings to enable it. It came in around when things like Smart Quotes came in.
I noticed the other day that ChatGPT will now cite Grokipedia as a source (and presumably uses search there to ground results). That makes me trust ChatGPT even less than before.
Part of that cost is decommissioning and removing the existing tower-based system. But PG&E made the call years ago to use that fire-prone implementation to boost profits, and now we are paying for that short-sighted decision.
>>> And for most people, the healthcare system works fairly great. There are exceptions, like the denial described in this thread, and they usually get lots of attention because holy hell is that a messed up situation. But the everyday care that most people get is better than adequate.
As an individual who has lived in multiple countries in three continents, I dispute that “the care most people get is better than adequate”. Perhaps better than the world average, but certainly not better than in most first-world countries. And that’s not even counting the impact of delayed decisions and denied care, and the stress of dealing with the system overall.
And if you’re looking for more than anecdotes, there are plenty of studies that show that Americans have lower expected lifetimes than citizens of peer countries, despite much higher per-capita health care costs.
While I don't doubt that there are endless stories of bad care, especially among the non-unionized working class, the bulk of voters with middle class lifestyles do have good care. Which is why it's so hard to make it into an issue that drives political change.
> there are plenty of studies that show that Americans have lower expected lifetimes than citizens of peer countries, despite much higher per-capita health care costs.
Americans aren't dying earlier of diseases that are solvable with a doctor visit, surgeries, pills, or other easy medical interventions. The medically related early deaths are primarily because of overnutrition and lack of exercise leading to pre-diabetes, diabetes, high blood pressure, and heart disease. That comes from public policy mandating car dependence throughout society and huge subsidization of empty calories in the food system. Overeating and lack of exercise are problems that have been stubbornly resistant to the medical system's efforts to change behavior. There's also other heightened early death risks like car crashes, drug overdoses, and suicide, but few of these deaths could be prevented by increased access to the medical system.
>While I don't doubt that there are endless stories of bad care, especially among the non-unionized working class, the bulk of voters with middle class lifestyles do have good care. Which is why it's so hard to make it into an issue that drives political change
This ignores the outsized influence of lobbyists, especially post Citizens United.
The majority (depending on which polls you cite, seems to range anywhere from 57% to over 70%) favor a universal healthcare solution for all citizens. Yet like many other majority opinions, this doesn't translate into legislative action in that direction, in large part thanks to lobbyists and dysfunctional partisanship. None the less policy is not reflecting the majority.
What lobbyists are opposed to universal healthcare?
It seems to instead be merely a wedge issue in culture war. Republicans firmly oppose it, Democratic politicians fight for it, and apparently voters don't care enough to advocate for what they say they want in polls.
Life expectancy tells you basically nothing about the quality of health care in the US. It's dominated by car accidents, homicide, and then CVD --- but CVD varies dramatically across the United States (from states in the south with drastically worse CVD outcomes to states in the north with outcomes on par with the Nordics) despite the same health care structure across all those states.
One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $200K hospital bills. US hospitals charge on a sliding scale based on the applicants' families' ability to pay.
(I don’t mean to belittle your comment about universities which is factual and helpful. I’m just pointing out that US education system is just as fucked up as the US healthcare system the OP is talking about.)
Even people in the US don't understand why those $200K hospital bills aren't real.
Insurance providers (including government programs) have a fixed limit for what they pay for procedures. They pay min(billed_amount, allowed_amount) so providers don't want to risk leaving money on the table by having billed_amount < allowed_amount. To ensure this doesn't happen, they bill an arbitrarily high number with the expectation that insurance will lower it down to some much smaller number.
So every time you see posts on the internet where people talk about their "$200K hospital bill" they're always talking about that arbitrarily high value. If you have to pay cash for some reason, they will reduce the value to the cash pay amount which is in line with the insurance paid numbers.
Nobody ever pays those high hospital bill amounts.
That depends a lot on your insurance. For example, our out of pocket for my son's birth was somewhere in the neighborhood of $10k after insurance. I've met tons of people who would be bankrupted by that amount. What you're describing isn't true for people on High Deductible Health Plans, and those plans are a bit of a racket because they're frequently paired with HSAs where the employer gets to pocket anything left in the account at the end of the year. My son was essentially unplanned, in the sense that we gave up on trying to have a kid but weren't using birth control because over the previous 3 years we had not had a successful pregnancy. So an HSA would have been no help for us.
HSA funds are meant to roll over. Your employer generally should not be pocketing whatever's left over in the account. The idea is that many (most?) people are better off with a lower premium and higher deductible given that most years (for most people) aren't characterized by high medical expenditures; HDHP+HSA is closer in nature to actual "insurance", rather than a structured financing plan for health care.
HSAs are triple tax advantaged retirement accounts. Not taxed on contribution, gains, or withdrawals for qualified expenses. In the worst case it becomes like a pretax IRA because after age 65 you will not pay a penalty on non qualified expenses - but qualified expenses tend to increase with age. For many it should be their primary retirement account.
Even for people with certain chronic conditions (not in perfect health), depending on how good/expensive the PPO offered by the employer, it might still work out better to do HDHP/HSA.
You can get as many basically free HSA accounts from Fidelity.
HSA is your money like a retirement account is. It’s one of the most tax advantaged ways to save money.
More or less all high income earners who do not have a chronic health issue are better off choosing a HDHP paired with a HSA - especially if the company provides any sort of matching benefit. Keep that account as an additional retirement account and pay out of pocket for most healthcare needs.
Think of it also as actual insurance vs. a pre-paid health plan.
The math of course changes for folks who are not highly paid, or have expensive chronic health conditions that would result in maxing out the deductible each year.
You are likely thinking of a FSA which is use it or lose it.
FSA is just a 30%-ish discount on medical expenses. It is useful for eye glasses and such. A lot of QoL services qualify for FSA, including weight loss coaches and therapy.
Heck my (prescription) meta ray bans were paid for in part with FSA funds.
You are I are both commenting on a subthread started by a comment that included "What you're describing isn't true for people on High Deductible Health Plans, and those plans are a bit of a racket because they're frequently paired with HSAs where [...]", none of which is true. I don't care about FSAs and am not trying to argue with anybody about them, but that preceding comment is very wrong about HSAs and HDHPs.
Note that another word that straightforwardly describes this behavior is "fraud". Medical bills aren't like a bill from a car mechanic where there is a contract (either written or at least implied because the mechanic will readily give you estimates and quotes).
In the medical context, the only contract in the picture is possibly between the medical provider and the healthcare management organization. It would be fine if providers only sent the fake bills to them as they're both willingly playing this perverse game.
But the problem is when they send their fake numbers to patients as if they're some kind of legitimate bill. Medical bills to patients are presented on a "cost reimbursement" basis - helping you cost them this much, so you are responsible for reimbursing them. By inflating the numbers 3-5x they are straight up lying about the costs they incurred. That's fraud.
Great link, thanks for sharing. This point below stood out to me — put another way, “fixing” a system in response to an incident to make it safer might actually be making it less safe.
>>> Views of ‘cause’ limit the effectiveness of defenses against future events.
>>> Post-accident remedies for “human error” are usually predicated on obstructing activities that can “cause” accidents. These end-of-the-chain measures do little to reduce the likelihood of further accidents. In fact that likelihood of an identical accident is already extraordinarily low because the pattern of latent failures changes constantly. Instead of increasing safety, post-accident remedies usually increase the coupling and complexity of the system. This increases the potential number of latent failures and also makes the detection and blocking of accident trajectories more difficult.
But that sounds like an assertion without evidence and underestimates the competence of everyone involved in designing and maintaining these complex systems.
For example, take airline safety -- are we to believe based on the quoted assertion that every airline accident and resulting remedy that mitigated the causes have made air travel LESS safe? That sounds objectively, demonstrably false.
Truly complex systems like ecosystems and climate might qualify for this assertion where humans have interfered, often with best intentions, but caused unexpected effects that maybe beyond human capacity control.
Airline safety is a special case I think — THE NTSB does incredible work, and their recommendations are always designed to improve total safety, not just reduce the likelihood of a specific failure.
But I can think of lots of examples where the response to an unfortunate, but very rare, incident can make us less safe overall. The response to rare vaccine side effects comes immediately to mind.
iPad OS 26 is just as bad, if not worse. It's the Windows ME of tablet OS's: ugly, near-unusable, and riddled with bugs.
Just one example: I was excited by the idea of having two apps on screen at the same time: there are two I like to look at side-by-side all the time. But one of them (an iPhone app) randomly decides to switch to landscape mode, making the layout unusable. More generally, the window controls keep getting activated unexpectedly by taps when I use full-screen apps like games, resulting in the window reverting to not-full-screen. So I guess I'll just have to turn that feature off until it's actually usable.
Unless it has a huge memory leak that isn't fixed for years and causes it to be virtually unusable for anyone it's probably not the Windows ME of Tablet OS's.
