Australia's high-speed rail dream leaves a bitter taste - <AUTHOR> https://www.theguardian.com/australia-news/2019/aug/05/too-good-to-be-true-australias-high-speed-rail-dream-leaves-a-bitter-taste <comment><USER2> Sydney <-> Melbourne (705km) is the second busiest domestic air route in the world, with 9 million passengers in 2017 [0]. It definitely deserves a high speed rail link. Here's hoping it doesn't get caught up in some sort of greasy land/water buy back scam [1].

0: [https://en.m.wikipedia.org/wiki/List_of_busiest_passenger_ai...](https://en.m.wikipedia.org/wiki/List_of_busiest_passenger_air_routes) 1: [https://www.smh.com.au/politics/federal/what-are-water- buyba...](https://www.smh.com.au/politics/federal/what-are-water-buybacks-and- how-did-we-get-here-20190423-p51gla.html)

<comment><USER3> A high speed rail line doesn't even recoup its carbon footprint (I.e. the carbon output from construction outweighs the savings from fewer airplane trips) until 10 million passengers per year: [https://www.citylab.com/transportation/2011/11/how-green- hig...](https://www.citylab.com/transportation/2011/11/how-green-high-speed- rail/492/)

<comment><USER4> That references a study on a scenario where 10% of the distance is in tunnels. That's a lot of tunnel boring. Is the Sydney-Melbourne flat or hilly?

</comment></comment></comment><comment><USER5> Well, aside from any dramas with the financing history of this Sydney- Melbourne link, the distance is not the most favorable. People (those who would pay / support such a service when it comes down to it) will generally choose rail versus air based on the time city center to city center.

Sydney-Melbourne is 900 km. This is beyond the outer edge of where rail versus air is highly competitive. By several hours.

Paris-London (500km) is about break even for the air/rail time tradeoff, and there rail takes about 50% share. Barcelona-Madrid is a bit further (600km), and has done really well also although that's a bit of a special case.

San Francisco-Los Angeles is 600km and you can see how poorly that project is going -- which by the way is what this Australian project has the similar feeling of.

So by the time you get to Sydney-Melbourne, you're talking 900 km and > 3 hours difference between the air/rail options and really not favored. Maybe Canberra in the middle helps a little, but the volume of traffic of people choosing this option is just not there.

<comment><USER6> Beijing to Shanghai is 1200km and and the high-speed link there seems to thrive just fine

<comment><USER7> I imagine it depends on the number and scale of existing intermediate cities. The proposed route in Australia passes through nothing of note.

<comment><USER8> The Beijing to Shanghai HSR is direct. But the same tracks support other lines that stop at other cities along the way.

</comment></comment></comment></comment><comment><USER9> Episode 3 of Utopia?

[https://en.wikipedia.org/wiki/Utopia_(Australian_TV_series)#...](https://en.wikipedia.org/wiki/Utopia_\(Australian_TV_series\)#Season_1_\(2014\))

<comment><USER10> One of the best TV shows I've ever watched. It was available on Netflix as "Dreamland" but seems it's been removed.

<comment><USER11> next season will be broadcast in two weeks, I never saw it on Netflix. I did consume it off ABC as soon as it was online though

<comment><USER12> Awsome. Also of the opinion it is one of the best series in recent times and I thought there wouldn't be a next season. I wonder why it was released under a different name on Netflix.

Although I must say I like the ending of the series very much. Do you know where it will air?

<comment><USER13> _I wonder why it was released under a different name on Netflix._

There already existed a UK show called Utopia, so it was renamed for its initial UK release. The new name was then subsequently used for all its international releases.

<comment><USER12> Hm, maybe that explains why so many people didn't know what I was talking about when I mentioned the series. I think the series was a bit of a niche, but outside those I watched the series with, nobody seems to have ever heard of it. Already thought of a conspiracy...

</comment></comment></comment></comment></comment></comment><comment><USER14> I read this article as a promise of an utopian future. The good guy comes, builds high-speed railroad and cities on the side without government's money. Might be good chapter for some modern bible. It is just too good to be true. There is longer Forbes reading about building new cities and it's not going to happen without will and government's resources: [https://www.forbes.com/sites/wadeshepard/2017/12/12/why- hund...](https://www.forbes.com/sites/wadeshepard/2017/12/12/why-hundreds-of- completely-new-cities-are-being-built-around-the-world/)

<comment><USER15> Did you read the same article as me? I read, that the good guy failed to mention his bankruptcy, while promising everybody, everything. So best case, someone with a vision, but no cash and crossing the line, worst case, serious scam to draw investment money.

</comment></comment><comment><USER16> As long as you get local firms, local people and local resources to build your new railway it doesn't matter what it costs. It's net free too the country. Look at the massive high speed rail network China has built in the last decade. Yet politicians will outsource such projects to other countries to "save costs".

<comment><USER17> What are the opportunity costs though? At the extreme you could have 100% of your citizenry building houses, you can't then grow food, or build cars, etc, etc.

Second, unless your economy is completely cut off from the outside world you're going to get leakage away. The builder you're paying to build houses is eventually going to want to show off his wealth by buying an iphone, or some champagne, or a Ferrari.

To look at a more practical example lets look at the wood industry, and lets say that Australia's wood industry is already large enough to actually absorb this increase. The wood industry has the option of selling around the world, but this development _has_ to buy from you. So you can sell them all the rubbish stuff that can't be sold internationally. So what then? The government doesn't want shoddy Australian houses being built so restricts exports of wood. But now the supply of wood products doesn't really match the supply and you've got teak being made into OSB, and your houses are made with high quality Australian wood, but your wood industry has gone down the toilet because the prices paid for OSB are nowhere near the prices paid for solid lumps of teak.

Trade is good. It makes everyone _on balance_ better off, what you propose is cutting off trade from the rest of the world, it's never going to end well.

</comment></comment><comment><USER18> Apart from anything else, they're going to need a lot more water from somewhere.

</comment><comment> Pete-Codes Seems dodgy if Clara has no offices etc.

I didn't realise the plan was to build new cities though to fund it. The trains in Oz are terrible so hopefully they come up with some high speed rail project down the east coast.

<comment><USER19> It's not so much the trains that are terrible as the 1800s-era track geometry that is terrible. There are mountains all the way down the east coast; any high-speed line is going to be (a) necessarily built inland and separate from any existing line and (b) phenomenally expensive.

</comment></comment><comment><USER20> The finance model invites speculation on land. Then future rateable income attracts government which wants the outcome and needs the money. It's really hard to resist calls for "if you build it they will come" especially with skyrocketing house costs in the big cities. Thing is.. it's a bit of a shell game and I cannot stop thinking about ghost towers in China

<comment><USER21> A few too many buildings is not a serious issue.

</comment></comment><comment><USER22> Conan O'Brien argued that what they really need is a Monorail.</comment>


Show HN: launching photosite next week, please give us cruel feedback - <AUTHOR>

We're launching http://getgush.com next week. We've been working on this for 6 months, and we'd LOVE to get your feedback before we launch. Please be cruel.
It's a photo site for ALL your photos: every single photo you've ever taken. We still have a long way to go, but trying to launch really early.
You can create an account (hacker news members only) here:
http://getgush.com/i/17p6
Cruel feedback > nice feedback > no feedback. <comment><USER2> I didn't sign up.

I've already signed up for Snapjoy, and a slue of other photo apps. I went to your page and couldn't figure out what your product actually was—what the value add was.

This was compounded by the fact that your "handwritten" font choice is impossible to read : "hackers pet invites faster" is what it looks like at the bottom.

Your "Sign In" button is below the fold—this is going to hurt user engagement and confuse users who come back. When I load up the page, fullscreen, on my MacBook Pro, I don't see a "Sign In" button at all. <http://cl.ly/2j1S1n1V0Z1f3G0K2D3j>

Finally, the "Free with no Limits" thing is scary—especially because, as I mentioned above, I don't know what your product is. The biggest issue and worry with services like these is that you put in all your photos, expecting them to be maintained forever, and then the service goes down in a week. Lots of similar worries were flagged when Snapjoy launched—it might be worthwhile to read their HN thread: <http://news.ycombinator.com/item?id=2861515>

<comment><AUTHOR> Thanks for the feedback, we'll try to make stuff more clear on that page. Clear writing is hard. Thanks for the pointer to Snapjoy discussion too :)

(Gush founder here)

</comment></comment><comment><USER3> "Free with no limits"

That right there is why I won't go anywhere near your site. Sorry, but why would I invest my time and energy, and photos, and inviting friends etc if you've got no visible means of supporting yourself? There's a reason I pay good money to Smugmug.

That aside, I have no idea why I would want all my photos on the one site. Is this the "one ring to rule them all"? Do you expect me to point friends, family, clients etc to your site? Is there realtime sync'ing from my computer? I don't understand who this is aimed at and what pain you're solving.

I also find the name a little odd (Gush?!) and the url particularly so. "Gush", in the traditional sense, suggests flow, water, emotional outpouring (ok, good) but you might want to watch out for the colloquial definition: <http://www.urbandictionary.com/define.php?term=gush> The name also says nothing about photography, nothing about the app and the "get" is awkward (yes, I know other startups have used it but that only makes sense if I'm visiting the site to sign-up. Could you direct your grandmother to "Get Gush"?)

Sorry to be cruel -- I'm not being deliberately mean but you asked for criticism.

<comment><AUTHOR> I can explain the free with no limits here. We put no limits on the amount of photos that you can upload. We do put limits on the amount of pixels per photo that we'll store. So we may not store your full-size photo (although we'll store a pretty good version), and that lets us offer this for free (storage is really cheap).

</comment></comment><comment><USER4> Two things:

1\. This confused me: "Choose a username: (use your real name)". My username is typically different from my real name. Thus, if I should use my real name, just make the field: "What is your name?" Perhaps add ability in settings to change the username/name.

2\. Ability to upload photos from the web.

I think the concept is excellent.

<comment><AUTHOR> Good points both, 1. I'll change for next week, 2. we'll put on the roadmap. Thanks!!

</comment></comment><comment><USER5> I'm friend of one of your developers. I've had alpha access for like a month or so. I've chatted him a bit about the project, but I'll give you some feedback directly.

In short, I think your project is cool but I don't think it is for me. As far as I can tell, you're trying to do a sort of dropbox-style thing, except with images. That's pretty cool (especially the unlimited free storage), but for me I am not really interested. I just don't see the purpose of putting things into the cloud, just because. I have a lot of local storage, and the local storage is faster, and (usually) larger, and not very expensive at all. Sure I run the risk of losing my pictures to a hardware failure, but I mean, oh well, guess I won't have my curated 4chan content anymore.

Overall I think this is pretty cool.

<comment><AUTHOR> Hey, thanks for the feedback :) If it's not for you, that's fine, such is life. I think it's more for people with pictures of their kids and stuff, they tend to care more about not losing them and having them all in one place etc. Thanks again for the comment!

</comment></comment><comment><USER6> It went to Facebook for permission and pressed "Don't Allow", it returned me back to your website with this message:

"Okay. The Gushbot will be gathering your Facebook photos while we prepare your invite."

I don't have many pictures on Facebook, more on trekearth and flickr. It would be good to bring support to old not so well maintained sites like trekearth. More value, at least for me.

<comment><USER7> One of the devs here, Flickr is high up on our priority list - most of us have used flickr pretty heavily and want this feature for ourselves.

</comment></comment><comment><USER8> You want cruel? I hate private signup/invite sites. It's either ready or it's not and if it's not I'm probably not coming back, ever, no matter what the excuse.

<comment><AUTHOR> That's one customer less then :) That's ok. I think there are arguments for being in closed beta though. (founder here)

</comment></comment><comment><USER9> Scammy to ask me to link to FB, give you access to everything, then make me "wait for an invite" or try to get 3 friends to advance my spot.

<comment><AUTHOR> (founder here) We're not trying to be scammy, it's more so that when you do finally log in, your photos will already be there. But yes, it's definitely something we should work on.

You can easily skip that step though, no harm done.

<comment><USER9> Also, after receiving an invite, I am urged to create an account and then there is "One last step!"?!???! What's the step? Download a tiny program that watches my computer and uploads photos that it finds. REALLY? Yes, I will be skipping that step.

In the app, it seems to have lost my album structure.

On the upside, the app is FAST.

Now, where is the account delete function?

<comment><USER10> Hi, gush dev here. I'm curious, why did you so quickly discard the idea of downloading the 'tiny program that watches your computer'? Does the way we present it sound sketchy? Do you use dropbox? Thanks for the feedback :)

<comment><USER9> Hi gush - Definitely the way things are written and presented can use a bit of polishing and help adoption. I sent an email to your notifier along the same lines. I do have a dropbox account and don't use it very much.

I think overall the concept is very sound, however the details need work and perhaps slowly on boarding the user by proving utility before (seemingly) forcing another step.

</comment></comment></comment></comment></comment><comment><AUTHOR> Clicky <http://getgush.com/i/17p6>

</comment><comment><USER11> How can I show my photos to other friends? I don't see any public url</comment>


Interview with Rob Rhinehart about Soylent - <AUTHOR> http://www.vice.com/read/rob-rhinehart-interview-soylent-never-eat-again?utm_source=vicetwitterus

<comment><USER2> On one hand, I really really want Soylent to be successful; it would solve so many problems if we had a ubiquitous, cheap, and above all else _effective_ meal replacement option.

On the other hand, I can't shake the feeling that it's not going to. Even reading this article, my suspicions flared up a few times (I thought invoking McDonalds was strange, and most of his points about nutrition and consumption seemed off-base.) Maybe it's years and years of pseudoscience taking its toll on me, I dunno.

At the very least, I'm interested to see where things are headed.

<comment><USER3> I think it is an interesting product idea if the market is either:

a) People who are starving. If the price is right and it has the right properties as far as shelf life and nutrition, sure, it would make an excellent ration for feeding populations in food emergencies or natural disasters.

b) People for whom eating and food preparation is an undesirable chore. A good example would be combat soldiers who need to eat something and don't care what it is as long as it satisfies hunger and provides nutrition.

For many (most?) other people food is intimately tied in with culture and epicurean tradition. This product won't go over well in places like Italy and France, for example.

<comment><USER4> b) is interesting. In 2008/2009 I spent a year in Iraq on a small military advisor team. We went out in teams of 6-9 and lived with the Iraqis. Most of our MREs were expired (they expire quickly in 100+ degree heat) so we ate a lot of Iraqi food. I also brought tubs of True-Mass to mix with water. It worked pretty well, even over 1-2 weeks ops.

From this experience, I've always been interested to see how soylent turns out. Even back here in the rear nutrition is a chore. I eat to stay alive, not for the experience. Heck, I go to Costco and pay $3.77 for a slice of pizza, hotdog, and a drink whenever I can.

My major question about soylent is its nutritional value. I work out 2x a day, 5-6 days a week. I have a Syntha-6 protein shake after each workout with some fruit and orange juice. I'm curious if soylent will provide the same level of nutrition I currently get.

If it does, it'd be excellent under demanding physical conditions like combat operations and high performance athletes. I'd eventually like to see different mixes, i.e.: weight loss, weight-gain, distance athlete, etc. Hell, I'd pay a premium for it. My wife pays around $200/wk. for Bistro M.D. meals because she doesn't have time to cook. I'd pay something similar if I could get a high performance meal replacement that I could eat every day, for every meal (maybe different flavors to mix it up), and didn't taste like shit.

So how long until we see the ultra-lean startup that forgoes the in-house gourmet chef for a soylent dispenser?

</comment></comment></comment><comment><USER5> _Sounds pretty wild. What 's next for the smoothie that Gawker said "looks just like semen"?_

The color is a bit problematic in that respect. He should just put in a little coloring. I suggest green.

<comment><USER6> Blue maybe, but probably not green which is often associated with algae growth in fluids.

One of the most interesting thing about this whole campaign is seeing who is afraid of it. Now _that_ provides some interesting insights.

<comment><USER7> I'm scared of it.

Well let me qualify that. I wouldn't trust my health to eating primarily an engineered food solution as he is doing. In the grand scheme of things it's a lot less scary than the majority of "food" that you see for sale everywhere in the developed world. At least he is trying to create a healthy food rather than something that addicts people and maximizes margins. So I think it's better than the status quo, far less scary than Coca Cola for instance.

But the part that scares me is the idea that a healthy diet can be engineered. As far as I've seen, our understanding of diet and human metabolism is in the dark ages. I wouldn't trust a nutritionist to engineer a diet any more than I would trust a medieval "doctor" to cure me by bloodletting.

So what insight does that provide about me?

<comment><USER8> But you do trust your health to the distracted 16 year old flipping burgers at McDonalds?

<comment><USER9> This line of reasoning drives me crazy. Who cares if it's _maybe_ healthier than just about the shittiest food available for consumption? Honestly, can you think of anything that wouldn't pass the test of "healthier than McDonalds"?

Beyond that, the distracted 16 year old is not suggesting that you consume McDonalds as your sole source of nutrition (in fact, he doesn't care at all what you eat); pretty much everyone agrees that eating only McDonalds is a terrible idea, how that gets twisted into a defense of Soylent is just baffling.

</comment></comment></comment></comment></comment><comment><USER10> An overlooked consequence of long-term replacement of solids with liquids for nutrition is the fact that dentition is going to most likely change, I'm referring especially to teeth position.

Daily chewing is applying pressure to teeth and keeping them 'set' in the position you're familiar with.

While researching some wisdom tooth extraction possible long-term side effects, I was surprised to find out how much can teeth migrate, start receding etc. if one is not able to chew on both sides for example.

I don't remember the source(s), but I saw real pictures of people with this problem. There were multiple causes too, not just as a consequence of extractions gone wrong.

A lot of people are focusing on the issue of meeting nutritional requirements, but I'm curious on seeing a real dentist's opinion on the possible long-term effects of such a diet as well.

</comment><comment><USER11> There is a big gap between "all the ingredients are safe to eat" and "the ingredients comprise everything your body requires".

<comment><USER6> True, one does not imply the other. But if you've read Rob's blog and other material you see that his process was identify "the ingredients your body requires" and then "find _those_ ingredients in safe to eat form." So in this case the list of ingredients is a dependent variable on what your body requires.

</comment></comment><comment><USER12> Doesn't someone already own the trademark for Soylent? Here is Rob's trademark application dated February 21, 2013: [http://www.markhound.com/trademark/search/sBxK5WeM7](http://www.markhound.com/trademark/search/sBxK5WeM7) It seems (to me) incredibly unlikely that someone hasn't already at least tried to trademark it for use in protein shakes or other foodstuffs. And whoever owns the rights to the movie Soylent Green might want to have a word with him if his food supplement ever becomes popular.

</comment><comment><USER13> It's interesting to see an industry traditionally dominated by marketing/advertising being taken on from the perspective of engineering. I have a strong suspicion that the management team isn't right for the long term and if they really hope to compete in the food industry or supplement industry they will have to get bought out.

I was a bit surprised when I tracked down the price - $65-$75 for a weeks supply means $10+ per day. Although I cannot imagine replacing my entire diet with this I could see supplementing or replacing the occasional individual meal. IMO, the price would have to come down from $10 for that to be reasonable.

</comment><comment><USER14> I think the digestive track adapts to what you eat. If you eat only this for a while you may have issues digesting other things down the road. At least this is my anecdotal experience with eating the same damn thing as a student.

</comment><comment><USER15> I don't get the appeal to those of us w/ easy access to a wide variety of inexpensive, high-quality foods stuffs. Eating a varied diet is one of life's great joys, not a problem that needs to be solved.

Even if you want to avoid the joy of eating, isn't Ensure Complete Vanilla already a sufficient meal-replacement-that-looks-like-seminal-fluid drink?

</comment><comment><USER16> Nobody noticed this but Soylent actually made its debut in the matrix. [http://www.youtube.com/watch?v=2oEnJfZ9joY](http://www.youtube.com/watch?v=2oEnJfZ9joY)

Truly the food of the future. (controlled by machines.)

</comment><comment><USER17> I'm sure this stuff will be just as successful as baby formula. And I mean that in the most sarcastic way possible.

</comment><comment><USER18> Another up and coming Oakland based company!

</comment><comment><USER19> soy causes man boobs

<comment><USER20> I'm not sure if you are serious, or trying to make a joke... But last I heard, consuming the Phytoestrogens in soy were found to have no measurable effect on a human male's estrogen/testosterone levels, or otherwise make them appear/act more feminine.

<comment><USER21> Sure, but I'm pretty sure the reason xenoestrogens are "bad" is because they affect the same cellular receptors as naturally occurring hormones, not because they affect estrogen/testosterone levels. Just because we've measured that something isn't the case, doesn't necessarily mean something (else) isn't happening. It could be doing something we just can't measure yet. Who knows what the long-term effects of greater phytoestrogen intake is for an individual? Or for their future offspring?

As others in this thread have alluded to, we're far from having a correct model that we can believe in with high confidence when it comes to nutrition.</comment></comment></comment>


Buzz Aldrin thesis: Line-of-sight guidance for manned orbital rendezvous (1963) - <AUTHOR> https://dspace.mit.edu/handle/1721.1/12652 <comment><USER2> Dr. Aldrin's intellectual contributions to manned spaceflight are unfortunately overlooked. He was known as "Doctor Rendezvous", and he didn't just fly orbital rendezvous missions, he actually helped invent the techniques and then got to demonstrate them on orbit.

Buzz is my hero. He does not deserve to be in Neil Armstrong's shadow.

<comment><AUTHOR> Indeed - the early astronauts' stick-and-rudder flying skills and physical and mental stamina get a lot of appreciation, less than their MIT rocket science PhD's that led to practical conclusions e.g.: "From the above conclusions, the first guiding rule for initiating the transition from the waiting orbit to the intercept trajectory can be formulated: Simply stay in the waiting orbit until the target reaches the angle 3 from the local vertical, then apply the nominal deltaV in the direction a."

<comment><USER3> I find this interesting, >Simply stay in the waiting orbit until the target reaches the angle 3 from the local vertical [...]

On terrestrial flight (airplanes) the standard approach to landing glidepath is 3°, while the standard rate turn is 3°/sec (a "two minute turn") — I wonder if 3 degrees is some magic value in flight dynamics, perhaps determined by our local (Eatths's) gravitational force (G).

/Acey

Disclaimer: I haven't read Buzz's thesis, so this is purely an off the cuff observation.

</comment></comment></comment><comment> one-small-step Under DEDICATION:

      In the hopes that this work may in some way contribute to their exploration of space, this is dedicated to the crew members of this country' s present and future manned space programs.
      If only I could join them in their exciting endeavors.

<comment><USER4> Wow! It is either an intentional sarcasm or Mr.Buzz is a 'know-it-all' like it was portrayed in the First Man movie.

<comment><USER5> Year of publication of this paper: 1963, as a result of work done in the Gemmy-nee program.

Apollo 7 (first crewed Apollo mission): 1968

Apollo 11 landing on the moon: 1969

I would suggest that Buzz was being quite sincere in this statement, with some hint of confidence that he actually would participate in the Apollo missions. The Gemini and Apollo programs were expected to be dangerous. There was no guarantee that people who participated in Gemini would even be alive for the Moon missions, much less physically capable of participating, much less the best people for the job.

<comment><USER4> My bad, since he joined NASA in 1963; I assumed he wrote it while trainin.

</comment></comment></comment></comment><comment><USER6> Off-topic, but if you were like me and confused why clicking the PDF link on that page downloaded the PDF instead of opening it in the browser, the problem is the "Content-Disposition: attachment" header which tells the browser to do this. As a result, I now have this add-on which gives users the option to ignore that header by file type: [https://addons.mozilla.org/en- US/firefox/addon/open-in-brows...](https://addons.mozilla.org/en- US/firefox/addon/open-in-browser/)

</comment><comment><USER7> Who stole page 69?

<comment><USER8> My old boss who had some spooky jobs in the past (NSA, CIA) gave me a copy of a public paper from a researcher at one of those places. I noticed a page was missing from the body of the text. We were supposed to read parts of this paper to understand how to implement something but it felt like my boss was surprised I had noticed, as if he didn't expect us to read fully. When I asked about the missing page he gave me a knowing smile and said "it's not available" and contorted his mouth into an exaggerated mouth-clamped-shut position, all the time holding my eye for several seconds and smiling this very final "that's all folks" look. I think sometime pages just go missing. And we may never know why.</comment></comment>


As Suicides Rise, Insurers Find Ways to Deny Mental Health Coverage - <AUTHOR> https://www.bloomberg.com/news/features/2019-05-16/insurance-covers-mental-health-but-good-luck-using-it <comment><USER2> Even before the insurance denies, it is basically impossible to get someone that is delusional/psychotic mental health care in the US, unless they go in voluntarily, which they won't, by the nature of the illness.

A friend that has been certified mentally ill stopped taking his meds and was fantasizing about killing himself, a family member and shooting up religious organizations. His doctor, family, employer and friends all called the police, talked to lawyers, mental health professionals, etc.

The end result was that he was facing sleeping in a car that was about to repossessed, and eating in homeless shelters. At that point he decided to accept free housing in exchange for seeking help.

His family's only other recourse would have been to pay tens of thousands of dollars in legal fees to petition the court to force the police to uphold the law. This would have had a medium to low chance of succeeding.

Of course, during the months this dragged on, he missed an insurance payment or two (he had also been fired, divorced and evicted), so it lapsed.

There is a 12 (6?) month wait to get government disability insurance to kick in for this sort of thing, and the clock starts after the mentally ill person goes in for scary interviews with the government to establish they're actually crazy.

The law used to handle this sort of thing properly in California, but Regan repealed the lions share of it as governor, and loopholes that accidentally allowed people like my friend to get health care have been progressively closed since them.

Nurses at the intake office of the appropriate mental health facility in Santa Cruz told me that most of the homeless people in the Boardwalk area there are in exactly the same situation as my friend was in, except they've been trapped in it for years.

<comment><USER3> > it is basically impossible to get someone that is delusional/psychotic > mental health care in the US, unless they go in voluntarily

I'm not sure I see a better solution to this that doesn't come with its own set of risks and downsides (involuntary commitment or counseling of someone against their will is not something to be taken lightly in any event, even if their reality diverges from your own).

<comment><USER4> Things which would have helped here:

\- healthcare not linked to employment

\- a housing-first homeless policy

\- a compassionate aid policy that presumes that people who are asking for help need help, and starts providing help as soon as it is asked for rather than after a year or more.

Those don't seem like they have any major risks other than monetary.

<comment><USER2> I strongly disagree with the housing first policy. I tried paying for temporary housing for my friend, and things spiraled. The housing has to be conditioned on some sort of recovery plan.

Threat of homelessness is basically the only remaining lever the law allows in these situations.

The other two points are spot on.

<comment><USER5> I don't know your circumstances, and first of all that is a great and generous thing you did for your friend.

The one place I know of where a housing-first policy has been implemented, Salt Lake City (or maybe all of Utah?), doesn't just give homeless people a set of keys. They do assign everyone a social worker at the same time. The goal is to minimize the risk of what happened to your friend; that isn't good for anyone, including the person spiraling.

It's key, though, to start with a home (and a social worker). The wealthiest country in the world can do that for its people -- and it shouldn't be on private citizens, though that was generous of you.

<comment><USER6> A big advantage of institutions is to collect the long term learning and lessons into more effective actions. Trying to handle it individually is admirable, but it's at a huge disadvantage and without experience with multiple cases to know what might work better or worse for various people.

</comment></comment></comment></comment></comment></comment><comment><USER7> I've lost three friends over the years to psychotic episodes or schizophrenic breakdowns so I've seen several examples of what happens to people and it all comes down to financial means. The friend born to a wealthy family had a safety net to fall back on. Same for the friend born to a very religious family.

As for the friend from a poor family, it was horrible to watch what everyone involved had to go through. He was a happily married man in his mid 20's. Decided to go off his meds and not tell anyone. It didn't help that he had never told us about his mental illness, but that was his choice. He snapped, left his wife and vanished for a while. When he was brought home his parents could not keep him in their house as he was prone to threaten violence. He even threatened me once during this period. Since they had no insurance they could not house him at a facility. The only thing they could do was pay for him to live in a motel, one within their abilities which meant the cheapest motel they could find, one known for drug users. My friend had previously had a problem with drugs, had to go to court mandated Narcotics Anonymous, even had a mentor to help him. Despite having cleaned up for over 10 years, here he was in a motel full of drug dealers and users while in the midst of a psychotic breakdown.

The last time I ever saw him he was having a fit in a field near a mall. I stopped to help him, he was in a fugue state thinking he was in World War 3. he smelled of urine and his clothes were a mess. I drove him to a local YMCA because I had no idea what else to do. They told me there was nothing they could do, but agreed to take him in for the day and see if they could clean him up. Knowing he was prone to violent behavior I figured that wouldn't work out.

I never saw him again. A friend of five years just evaporated. But what I saw is that if you are poor and have a mental breakdown, and your family has no means to help you, you are screwed and have no choice but to live on the street.

<comment><USER8> That's heart breaking. When was that last time you saw him?

<comment><USER7> It's been about 20 years now. No idea what ever happened to him sadly.

</comment></comment></comment><comment><USER9> In my experience a related obstacle to obtaining mental health services is that the insurance companies require that the records from therapy must be available to the insurance company so they can verify the services they are paying for. Meaning, the notes from deeply personal discussions with your therapist and any resulting diagnosis can end up in the hands of your insurance company. Once this information has left your therapist's office it can end up any number of places. While that might be a risk I am willing to take with my social security number or other personal information the deeply personal topics discussed in therapy are not worth risking.

I don't see how this gets any better with single-payer/government funded funding routes. I don't want anyone to know what I discuss with my therapist much less a soulless corporation or the government. The avenues this could open up for oppression from corporations and/or the government sends a shiver down my spine.

<comment><USER10> >The avenues this could open up for oppression from corporations and/or the government sends a shiver down my spine.

Tons of vets already avoid mental health services because it's a black mark on their career and can hinder their ability to bear arms in civilian life.

<comment><USER11> It's a huge problem in the firearms community - most of us are scared to seek even minimal mental health assistance because of the stigma associated with it.

I faced my own issues with depression in my late teens and early twenties. Gun rights are very important to me, and I was extremely hesitant to speak to any mental health professional due to the potential future restrictions it might place on me. I did see someone, and over the course of a few years recovered to the point that I was able to get my life back on track - but even then, it was difficult to find a therapist that wouldn't immediately demand that I dispose of all of my firearms. I ended up asking around and basically "interviewing" several providers before I chose one. I wasn't suicidal and didn't have anything resembling an urge to harm myself or others, for what it's worth.

I still believe that seeking help may come back to haunt me one day. It's something I've come to terms with and I believe I made the right decision, but I think my ability to introspect and make a rational decision in the face of my illness is... atypical.

I think it's a consequence of the "do you have firearms in your home" questions during routine checkups. The current push for so-called "red flag" laws seems to validate the concern.

<comment><USER12> On the other hand, in the US it happens that a disaffected fellow has a dissociative episode and shoots up his former workplace or school. It's a culture-bound syndrome. You need to defend society against it.

When you taught at college and had to deal with a deranged individual who eventually got himself expelled for stalking and attempted rape your opinion about gun rights changes.

<comment><USER10> Your first and second sentences seem to strongly contradict each other.

</comment></comment></comment></comment></comment><comment><USER13> The core problem of mental health and insurance is:

1) resource utilization 2) long term cost-effective value

A therapist can induce infinite demand on a patient, by just doing follow-up sessions ad-infinitum. In argentina for example, people go to the same therapist for decades!!

This means that the insurance model doesn't work well, because you can't do actuarial analysis on how much therapy someone might need and how to distribute that in the population.

The second part is that as a patient, if the insurance covers your cost, you might as well go to the most expensive therapist you can find, and consume the infinitely. Also, you know more than the insurance company if you plan on using or needing this care, thus you have a very strong adverse-selection situation going on with any plan that is generous on mental health.

Economically speaking, mental health should not be part of an insurance scheme. It should be cash pay. To help people that could not afford mental health and they need it, you would do better to provide state-run service, that is low-cost high-effective-value and cover the lower side of the population.

<comment><USER14> > A therapist can induce infinite demand on a patient, by just doing follow-up > sessions ad-infinitum. In argentina for example, people go to the same > therapist for decades!!

You know people who take insulin are on it for the rest of their lives, but that doesn't make it the fault of their doctors.

Therapy actually works. "Hundreds of studies have found that psychotherapy is an effective way to help people make positive changes in their lives," Nordal says. "Compared with medication, psychotherapy has fewer side effects and lower instances of relapse when discontinued." [1]

> The second part is that as a patient, if the insurance covers your cost, you > might as well go to the most expensive therapist you can find, and consume > the infinitely. Also, you know more than the insurance company if you plan > on using or needing this care, thus you have a very strong adverse-selection > situation going on with any plan that is generous on mental health.

This is a very strange American perspective on health care. If it was suddenly available to everyone, there's a perception that we'd all be like kids in the candy store getting 1 of everything at the doctors office. That's just not how it works. Nobody in Canada goes to their GP and asks for the immunotherapy and a few casts. People go to doctors because they're sick, and they need treatment and would rather be literally anywhere else.

It's not as though we're socializing the electronics section at Best Buy.

> Economically speaking, mental health should not be part of an insurance > scheme. It should be cash pay. To help people that could not afford mental > health and they need it, you would do better to provide state-run service, > that is low-cost high-effective-value and cover the lower side of the > population.

Sold, but it should cover everyone.

[1] [https://www.apa.org/monitor/2013/02/therapist](https://www.apa.org/monitor/2013/02/therapist)

<comment><USER13> > You know people who take insulin are on it for the rest of their lives, but > that doesn't make it the fault of their doctors.

The bet on diabetes has to happen before it is diagnosed to make actuarial analysis. If you want to guarantee that all diabetes patients get access to insulin, what you want is charity, not insurance.

Insurance is risk pooling.

> This is a very strange American perspective on health care. If it was > suddenly available to everyone, there's a perception that we'd all be like > kids in the candy store getting 1 of everything at the doctors office

The science has already shown that is true. Over and underutilization of healthcare are studied effects, ones insurance companies pay very close attention to because if they don't, they will go bust. That is also why countries with free healthcare also have copays.

> People go to doctors because they're sick, and they need treatment and would > rather be literally anywhere else.

I think you are have an outsider's view on how healthcare provision works. No doctor i met would ever agree with this statement.

<comment><USER14> > The bet on diabetes has to happen before it is diagnosed to make actuarial > analysis. If you want to guarantee that all diabetes patients get access to > insulin, what you want is charity, not insurance. Insurance is risk pooling.

Yep! That's why health _insurance_ is a misnomer. There's no guarantee my house will catch fire, so I insure against it. There is a 100% chance each and every human will catch a terminal illness. That makes it at best a structured payout program. The amount of the payout can be reduced through preventative care, and yes, maintenance drugs like insulin. That's the best case for why it should be socialized.

It's not insurance, and it's not charity, it's a service in the public interest. And of course people should have access to the medication they need to live, we're not savages.

> The science has already shown that is true. Over and underutilization of > healthcare are studied effects, ones insurance companies pay very close > attention to because if they don't, they will go bust. That is also why > countries with free healthcare also have copays.

Insurance companies get paid in advance, and their goal is not to provide the best care but to return the largest amount possible to their shareholders. Co- pays keep people out of hospital, especially lower-income folks, which allows insurance companies to make more money. Same with high deductibles. Their goal is not care, it's profit.

The UK and Canada (the systems I know best) don't really have co-payments, certainly not like in the US. The vast majority of services are co-payment free [1] (UK: "Out-of-pocket payments for general practice are limited to some services, such as examinations for employment or insurance purposes and the provision of certificates for travel or insurance", in Ontario going to the hospital you only pay for parking or 'upgrades' like private rooms - [2], [3] is the entire fee schedule). Same with Australia [4] who in 2015 rebelled over an AU$7 co-pay. You get sick, you go to the doctor, they take care of it.

Think about it, if you could access any procedure right now, what would you get done? Nothing, because it's not fun, it's not rewarding. If it's medically necessary, you'll get it done one way or the other, if it's not, literally why are you at the hospital? Yes, use goes up a bit. IMO, that can be offset by creating clinics and guiding people to them for minor ailments as in the UK.

> I think you are have an outsider's view on how healthcare provision works. > No doctor i met would ever agree with this statement.

Respectfully disagree. Both my parents are doctors, and I grew up in numerous medical systems all over the world. I've benefitted hugely from socialized medical systems and not having one right now is downright terrifying even though I'm well 'insured'.

My dad refused to work in the US because he felt the healthcare system here was inhumane. He wanted to provide people care based on their needs not what they could afford. It took me until I lived here to understand he was exactly right. There's a lot of this apologist: "there must be _some_ reason the American system is better" \-- sorry, it's just not better.

[1] [https://international.commonwealthfund.org/countries/england...](https://international.commonwealthfund.org/countries/england/)

[2] [https://www.qch.on.ca/hospitalcharges](https://www.qch.on.ca/hospitalcharges)

[3] [https://www.qch.on.ca/uploads/Finance/Hospital%20fees%20Webs...](https://www.qch.on.ca/uploads/Finance/Hospital%20fees%20Website%20version%20for%20Insured%20Res%20April%201%202019%20NewLogo.pdf)

[4] [https://transferwise.com/au/blog/healthcare-system-in- austra...](https://transferwise.com/au/blog/healthcare-system-in-australia)

<comment><USER13> > That makes it at best a structured payout program.

This is what prepay's are, and HMO's. You have 2 opinions on HMO: they love it because pricing is transparent, they dislike it because they ration service. An example of that with Kaiser: they put severe barriers on their own mental health services. An industry gossip for you: one of the biggest consumer of mental health services at Kaiser is Kaiser doctors.

> Insurance companies get paid in advance, and their goal is not to provide > the best care but to return the largest amount possible to their > shareholders...

At the same time, insurance has an interest in controlling how much the insurance is used, something governments can fail at pretty hard. Remember Medicare insurance already costs 1k per person per month. That's the socialized system america has now, and it won't be more efficient by being bigger.

> Think about it, if you could access any procedure right now, what would you > get done? Nothing, because it's not fun, it's not rewarding.

This is just not the reality. It's a well studied effect, denying it is depriving the science behind policy analysis from any legitimacy.

> Respectfully disagree. Both my parents are doctors, and I grew up in > numerous medical systems all over the world. I've benefitted hugely from > socialized medical systems and not having one right now is downright > terrifying even though I'm well 'insured'.

They told you that patients never go to the doctor for superfluous reasons? I won't believe it. I am in the industry and I can see every case imaginable.

We have had this argument before. The U.S. socializing healthcare will not bring out-of-us healthcare results. It will get something else, because what makes healthcare suck is not private vs public, it's the regulatory framework.

<comment><USER14> > This is just not the reality. It's a well studied effect, denying it is > depriving the science behind policy analysis from any legitimacy.

You are correct. People do go more often, and to counter it programs exist in the UK which drive people with less severe issues to local centers where they can get looked at without taxing the hospital system to the same extent. [1] It's not that big an issue. All that and they still deliver better health outcomes for a much lower price.

FWIW the NHS actually offers free mental health services with no co-pays too [2]. It looks like it's managed via GP which is a good middle ground IMO between co-pays and unlimited fee-free access. Canada does not as a rule, though it's an active conversation [3] and has been for years -- and it enjoys a (razor thin) majority of support with 51% in favor. Psychiatry is covered today, therapy is not.

> They told you that patients never go to the doctor for superfluous reasons? > I won't believe it. I am in the industry and I can see every case > imaginable.

No, they told me the US healthcare system is inhumane. I may have misread your post if I wasn't replying to the right section :)

> We have had this argument before. The U.S. socializing healthcare will not > bring out-of-us healthcare results. It will get something else, because what > makes healthcare suck is not private vs public, it's the regulatory > framework.

The US is already at the bottom of the OECD, do you have reason to believe it'll get worse? We've got a lot of models that show it'll be better and really nothing to point to that shows it'll get worse. Socialized systems are cheaper and control costs better, even here.

[1] [https://www.newdevonccg.nhs.uk/file/?rid=109734](https://www.newdevonccg.nhs.uk/file/?rid=109734)

[2] [https://www.nhs.uk/using-the-nhs/nhs-services/mental- health-...](https://www.nhs.uk/using-the-nhs/nhs-services/mental-health- services/how-to-access-mental-health-services/)

[3] [https://globalnews.ca/news/5276022/canadians-mental- health-s...](https://globalnews.ca/news/5276022/canadians-mental-health- services-provincial-health-plans-ipsos-poll/)

</comment></comment></comment></comment></comment></comment><comment><USER15> That's the business though. Kill, maim, and let people suffer to make more money. That's the core of every single health insurance company with every single patient for every single problem. To claim otherwise is lunacy. So why don't we have nationalized, single-payer health care? People are still claiming that they don't think the government can do a good job despite the existence of Medicare and Medicaid. People are worried about government "death squads" when private insurance "death squads" have been killing people for decades. Frankly it's fucking ridiculous at this time. Can one even call the US a "developed" country anymore with this kind of healthcare? Certainly not in my mind.

</comment><comment><USER16> Having seems the guts of a lot of different insurance technology stacks, it's possible to see how the nature of the commercial business biases the behavior of the systems. In the simplest cases, health care providers have systems that take enough time to just get going that someone who becomes very sick and after a small amount of expensive intervention dies doesn't become a cost, because that system operates as if they had recovered....leading to the sad mantra at one 'Death is proof of recovery' . Same case here effectively. If it isn't treated it can kill, if it isn't treated then costs don't accrue, if it isn't treated then other potential costs don't materialize. I have never met anyone in the technology side of insurance evil enough to do that, but have met plenty horrified by the fact that it is what their systems keep evolving to do. The goal of profit is inversely related to the goal of care, plain and simple.

<comment><USER17> I guess why have it at all then? If their goal is profit and profit means to skip care, which is the main reason of healthcare, why even go about trying to pretend then? Skip right to the fact, take my money and leave me to die. I know this isn't a real answer and isn't how it truly works but the system just seems to defy the whole idea behind healthcare.

Edit: missed a word.

</comment></comment><comment><USER18> While this might shooting from the hip...If health care insurance came bundled with life insurance, perhaps the providers would have an incentive that would be good for everyone?

Again, this is simply a "what if", please don't go all HN on me. tia

</comment><comment><USER19> _"...Some practitioners who want to join networks are turned away. Melissa Davies, a psychologist in Defiance County, Ohio, was part of Anthem's network for years when she worked in a larger medical group. But the insurer refused to contract with her after she started a solo practice in 2012, saying the area was saturated, even though Davies is one of only three psychologists in the county. When Davies examined Anthem's directory, "I found a great number of their providers were no longer practicing, or were dead," she says..."_

This is damning.

<comment><USER20> It's really, really hard to find a good therapist. I've heard so many stories from friends and have direct experience with employees who've had trouble. Kaiser completely screwed over an employee of mine, which led to him being homeless for more than 6 months and abandoning his job. It took him more than a year to get back on track.

IMO, it's criminal what these insurers are doing.

Also, there was a post here, I believe, about a successful therapist (in Australia, I believe) that was quitting because of the BS he was putting up with from the insurers. It was a youtube video where he laid out all the reasons. It was just heartbreaking to watch.

<comment><USER21> If you're comfortable, I would like to hear more about the Kaiser-related incident.

</comment></comment></comment><comment><USER22> This is what I don't get about the Stephen Pinker argument that "everything's getting better." To a country experiencing something like a collective mental breakdown, how does the claim that the bad parts are "all in your head" help anything at all?

Mental health is getting worse because the economy is getting worse, simply.

<comment><USER23> I don't normally go for Marxist or populist analyses of the world, and indeed spend a lot of effort arguing against them, but Stephen Pinker made a lot more sense when someone pointed out that he's basically a shill for globalism, or neoliberalism, or whatever your word for "that thing" is. His whole shtick is going, "Everything's fine! Getting better in fact! No need to examine the current system and all the ways it might be flawed, or change it at all!", since that kind of thinking could hurt entrenched interests immensely.

<comment><USER24> Your characterization better fits someone like Thomas Friedman, not Pinker. Pinker absolutely acknowledges the many problems of the current system and the need to devise solutions to these problems. His argument is that things have, on the whole, been improving, we've solved big problems in the past, and we can solve current problems so long as we hold with Enlightenment and humanist / liberal values and put the effort in. He's arguing against those who want to throw away liberalism and replace it with some form of mystical authoritarianism, whether that be socialist, fascist, or whatever. And there are many such people, who take the benefits brought from liberalism for granted and would throw them all away for some romantic wishful thinking. His argument reminds me of essays written by Albert Camus defending liberalism against fascism during WWII and against the communism that was en vogue in France after the war among Sartre and others that Stalin referred to as his "useful idiots".

By liberalism here, I mean the original (and only sensible) meaning of a system of individual freedom in social, religious, and economic spheres, equality before the law, and democratic representation, not the New Left's utter misappropriation of the term to represent tribal resentment and mob justice.

</comment></comment></comment><comment><USER25> Fundamentally the actuaries have figured out that the cost of treating someone with mental illness is greater than the value of the premiums.

<comment><USER13> Correct. Mental health does not really fit insurance models.

To be fair, most healthcare doesn't. Primary care being part of insurance is ridicolous.

<comment><USER25> > Primary care being part of insurance is ridicolous.

It's the cheapest to provide and saves a lot of "downstream" costs

<comment><USER13> Not related to cost itself, but how the utilization is decided. You can go to the primary doctor for a cold it's just a pure waste of resources.

It is also bad for the pcp to be so transactional with insurance: it should be a relationship, which is proven to give better medical outcomes..

</comment></comment></comment></comment><comment><USER26> Of course they are. They're incentivized to make money, not pay it out. I'm completely baffled that people would rather this system than a universal healthcare system simply because they don't want a poor person to have insurance because they're "not pulling their weight". And that's the reason. "Hard working, red blooded Amerikans don't need anything taken away from them by them poor folk that don't wanna work!". ugh.

<comment><USER27> Yeah, this system needs to be refactored for sure. But the counter argument to universal healthcare isn't as basic as you outline. It really comes down to how do we pay for it. Healthcare costs are ridiculous, and so is our deficit. The counter argument is more in that realm, and you painting it as "they don't want a poor person to have insurance" is not helping the discussion.

<comment><USER26> >... and you painting it as "they don't want a poor person to have insurance" is not helping the discussion.

Then I sure wish people didn't say that if they don't mean it.

</comment></comment></comment><comment><USER28> I'd imagine the 'customer service' people at insurances companies would also need mental health care after breaking the news to their clients...must take a toll

</comment><comment><USER29> What we need to do is turn the procedures on their head--you can demand the insurance company find you an appointment with <any specialty>, they have say 30 days (to the appointment, not to respond). If they don't come up with one you can go out of network and pay no more than you would in network. Exception: If you're in a smaller place and there's only one such doc in town you're expected to go to the bigger city instead. (So you can't have one specialist setting up in an area without any such and charging an arm and a leg.) It's not the insurance company's fault if there are no providers, it is their fault if there are no in-network providers.

</comment><comment><USER30> Hasn't suicide rates increased along with mental health coverage/therapist usage?

It seems like everyone is seeing a therapist nowadays. Why are suicide rates still increasing?

Is there any real scientific proof that therapy or mental health coverage does anything?

Why was suicide lower when nobody was using therapist? Why is it increasing now that so many people see therapist?

What's with the neverending drive to get people to take more drugs, spend more on counseling, etc? Every week there is an article about how depressed we are or how lonely we are and all the pharmaceutical or therapy that can help.

</comment><comment><USER31> I am suicidal and have been off and on for years due to disability/pain from medical mistakes that cut my life short at 30. I am 45 now. That led to immediate loss of quality of life, career, financial security...and a slow painful loss of relationships and self worth. I was told to "get help", and did when I could afford it, but the problem is the root issues were never addressed. All mental health care has for most people is superficial bandaids. You cannot live an entire and healthy life drugged while things fester. You cannot cope every minute of every day. Life also isn't static or always improving and we have to deal with new issues like added health problems, aging, financial pressure weighing us down further. Bail one bucket of water out, two more pour in.

I had to ask family for help and one by one after a time they began to resent me and abandon me. I was denied SSDI. I was denied nearly everything I applied for and buried in bureacracy. I lived abroad for a time and had a much better quality of life and access to healthcare, but I couldn't legitimize permanently (still a fantasy at times) and had to come back to the USA. I now live, and who knows for how long they will allow it, with resentful family, isolated in rural Murica with no transport or access without much more expense and effort. No insurance. Limited income based medical care. Living on 600 dollars a month from a partial pension I was fortunate to have. Hearing every day how it simply has to be my fault and treated as if I am a loser who chose and continues to choose this. I am the same person I was when I was a public servant and seen as doing good in the world, but now that I have lost my autonomy I am lower class and shamed.

There was a time when my root issues would have been addressable and I could have had a decent life, but there was no help and things got worse. There was a time I though if I could just find someone to give me the "right" job that would work around my issues I could have a survivable life, and finally a kind and caring soul did that after years of nothing, but those two buckets I mentioned above poured in and things got worse and I wasn't able to do it. Now I have no idea what if anything can save me. How is one supposed to survive since "suicide is never the answer" when you have a miserable, painful life and no realistic way to dig yourself out? I cannot magically become a citizen of a nation with social support and healthcare. I don't have the bootstraps to pull on and rebuild. I cannot endure decades more of this yet anytime I discuss it I hear "seek help" or other shallow pearls of wisdom. Hotlines and calling the police seems the default response if someone brings up the topic. Everyone feels good like they did something and pats themselves on the back. The patient might get sent to hospital and that results in tens of thousands in medical debt and a worse problem. So it goes. No real solutions happening.

In cases like mine, which are a majority of suicidal people in my experience professionally and personally, it's rooted, situational stuff (often from multiple angles) and not some primary mental illness that Prozac and CBT mitigates. It's not simply about insurance (or the lackthereof) and what it will and will not pay for. I have been to a lot of doctors in my day and not a single one has improved my quality of life, most in fact the opposite. It's about there being no willingness to solve root causes and the eventual response being victim blaming and turning a blind eye when the bandaids don't work. Until society addresses the fact that many people end up in bad situations through no fault of their own (and honestly even those to blame somehow are still human beings who deserve help and not some abstract calculations on a moral or financial ledger) and provides a safety net and path to rebuild as much life as possible (something friends have accomplished in nations with such support), you will find more and more people choosing to quit living. We don't want to...we have no options...most especially not in America where all the things we need to stabilize and rebuild are even more costly and unattainable...where the only places we can afford are isolated with no services...where we are further and further cut off. Everything that would give me a chance is the opposite to where and what I am living now. Can't win.

<comment><USER32> I've heard variants of your story from so many people here in the midwest. There's an entire nation of people in the US hurting, and many who could return as first class citizens if we had some more empathy paired with grit.

Godspeed.

</comment></comment><comment><USER33> How is mental illness not a pre-existing condition?

<comment><USER34> It certainly was when it was the norm for insurers to deny pre-existing condition coverage.

</comment></comment><comment><USER35> Mental health problems are seen as a weakness in this country. It's very anti the American way to:

1\. Have a mental health problem

2\. Seek help for a mental health problem

This leads to insures being able to deny this, and it not seen as a negative, because it's denying something that's weak. And weakness in the USA is the ultimate sin. Homelessness/Joblessness also fall under this same belief system.

<comment><USER36> I'm not from US but I believe this is incorrect. Everytime I visit there, I am always amazed to see how caring the people are. This is a sample size of one though.

<comment><USER37> It's uneven. There are many who are kind just like you say. But if you have ever seen the savagery in the comments on any HN-linked story on homelessness, that perspective is also well-represented in the US.

<comment><USER38> > But if you have ever seen the savagery in the comments on any HN-linked > story on homelessness

And frankly, compared to Facebook posts from Fox News or indeed any other news outlet, the "savagery" on HN is downright pleasant.

</comment></comment></comment></comment><comment><USER39> It's all around you folks. Count your good fortunes if such a situation is foreign to you.

There's no one to catch you if you fall.

It could happen to you, or your loved ones next.

Try to have some empathy, and fucking VOTE

<comment><USER40> Vote for what? Here in San Francisco we just voted to raise hundreds of millions of dollars in additional funds for homeless and related services. Most of this will be funneled to over 40 NGOs/non-profits by our city officials, the same 40+ organizations that have ineffectively applied nearly $500m a year for the past decade. My hope is that some of this money TRICKLES DOWN, but my hope for change is pretty much gone. Simply raising/spending the money gives incumbent politicians plausible deniability that they are "fixing the problem" even though they aren't. It's an homeless-industrial-complex at this point where major players are motivated to sustain it because it gets them paid well.

We could vote to build more housing. Oh wait, SB50 just got rejected by the appropriations committee - which is full of non-elected government officials.

I know, we could completely re-elect all of our local government officials to shake everything up, oh wait that's the promise of our last N mayors who haven't done anything.

I'm disgruntled, if any of these points are incorrect please let me know - it's very frustrating and I feel helpless as a voter (in SF).

<comment><USER6> Vote for Medicare for All to build a more solid foundation for healthcare and health services instead of each of our single cities having to patchwork with yet more bandaids.

<comment><USER41> That only works when there is an effective provider network exists and the main problems are expanding it and removing cost as a barrier to access.

The problem with mental health care is that such providers either don't exist or are very rare, meaning there is little to no effective care to be had for any amount of money. Simply throwing more money at this problem will not do anything to solve it.

<comment><USER42> Providers presumably respond to economic incentives; if there are not enough therapists in your area, enticing more people to become therapists really will help. It's a better problem to have.

<comment><USER41> I don't think my point was clear. I'm arguing that most of the extant providers are at best worthless. Too much of mental health "care" is focused on treating the symptoms, rather than the underlying cause. More money isn't going to fix ineffective treatment; it's just going to multiply the number of practitioners of it.

</comment></comment></comment></comment></comment></comment><comment><USER43> Why do Americans continue to accept this terribly flawed systems for their 'healthcare'.

<comment><USER44> None of the responses to your question seem to hit at what I believe the source: racism. Single payer has met resistance from the right because people have this misguided notion that they will have to pay for "other peoples mistakes", which is just dogwhistle.

<comment><USER45> There are plenty of reasonable "mistakes" people make; smoking, diet, exercise, alcohol, idiocy, stunts, etc, without having play the racist card.

Lots of people don't want to pay for problems they don't have control or influence over. You don't have to be racist, just a bit myopic.

<comment><USER46> The whole insurance system is that your monthly premium is paying for someone else's treatment. Universal healthcare is just a larger insurance pool that brings costs down for everyone in it.

<comment><USER45> Oh, I agree 100%.

I just get tired of bad faith racism interpretations.

</comment></comment></comment></comment></comment><comment><USER47> Anyone who thinks we have a good healthcare system in the USA would learn a lot by reading the replies to to this tweet:

[https://twitter.com/AllOnMedicare/status/1124042436345569286](https://twitter.com/AllOnMedicare/status/1124042436345569286)

Moneyed interests are pulling the levers:

[https://twitter.com/mattb/status/1015270406754713600](https://twitter.com/mattb/status/1015270406754713600)

</comment><comment><USER48> I'm not sure how this all plays out in policy, but outside of the criticism of the gun community and it relates to deaths by firearms - we have half the suicide rate in the United States as Japan - which has almost no access to firearms by its general population.

It's worth noting in relevance, because the politics in Healthcare reflect the policy of public opinion as well as legislation around other tangent issues our country is trying to reconcile what it wants to do (if anything) about it.

<comment><USER49> > we have half the suicide rate in the United States as Japan

What definition for suicide does the US use?

What definition for suicide does Japan use?

EDIT: and you don't have anything like half the rate. Comparing across countries is hard, but Japan has a rate of about 17 per 100,000 while the US has a rate of about 14 per 100,000.</comment></comment>


Show HN: Bullish – Stock market performance stats in your inbox - <AUTHOR> https://bullish.email <comment><USER2> Interesting concept, a few questions right off the bat, though. Where does the data come from? Premarket data can mean very different things with modern buzzwords. What's your ToC and privacy policy? I'm not going to give up my email just because.

<comment><AUTHOR> Hi there, data is coming from Yahoo Finance. I'll add a note regarding privacy, but rest assured your email will only ever be used on Bullish. Thanks for the feedback.

<comment><USER2> Thanks for the clarification. Tried signing up, looks like you have an issue with CORS:

> Access to XMLHttpRequest at '[https://api.sg- > form.com/signup'](https://api.sg-form.com/signup') from origin > '[https://cdn.forms-content.sg-form.com'](https://cdn.forms-content.sg- > form.com') has been blocked by CORS policy: Response to preflight request > doesn't pass access control check: No 'Access-Control-Allow-Origin' header > is present on the requested resource.

<comment><AUTHOR> That's weird. That form is coming from Sendgrid. You can try this direct link instead [https://cdn.forms-content.sg- form.com/ee9b6677-62ea-11ea-9ec...](https://cdn.forms-content.sg- form.com/ee9b6677-62ea-11ea-9ece-ee034bb60b6a)

<comment><USER2> Found the issue, NextDNS seems to be blocking some part of the interaction with the default settings, probably interacting with some intermediary that also does tracking. Got it to work when I turned that off.

</comment></comment></comment></comment></comment><comment><USER3> Nice idea. At the same time, I wonder how this could help me make money. Your claim is buy low, sell high. But how can publicly available futures help me doing that?

<comment><AUTHOR> Actually, if you pay close attention it is "Buy high sell low" just making fun. The idea is to get a feel for where the market is trending on any given day before it opens.

<comment><USER3> Ah. Sorry for not getting the joke then :)</comment></comment></comment>