Proximate vs. Root Causes: Why You Should Keep Digging to Find the Answer (2017) - <AUTHOR> https://fs.blog/2017/05/proximate-vs-root-causes/ <comment><USER2> _Post-accident attribution to a 'root cause' is fundamentally wrong._ \- Richard I. Cook, MD. 'How Complex Systems Fail'.

 _In the complex world, the notion of 'cause' itself is suspect; it is either nearly impossible to detect or not really defined - another reason to ignore newspapers, with their constant supply of causes for things._ \- Nassim Taleb

... via [https://github.com/globalcitizen/taoup](https://github.com/globalcitizen/taoup)

<comment><USER3> It's true that in a complex world, there isn't going to be a single cause for anything significant; there will be multiple causes and there can be complex relationships between them. The article recognizes that very point:

 _" The issue with root cause analysis is that it can lead to oversimplification and it is rare for there to be one single root cause."_

But that is not at all the same as the notion of cause itself being suspect. Taleb on that point is simply wrong.

<comment><USER4> >> "The issue with root cause analysis is that it can lead to oversimplification and it is rare for there to be one single root cause."

Root cause analysis is a complex and varied topic, discounting it so easily is an oversimplification.

</comment></comment></comment><comment><USER5> I tend to prefer to frame it slightly differently as "given this same situation again in the future, how do i ensure that the outcome ends up favorably for me instead?" or "how do i enure that i don't encounter such situations in the future?"

The root cause to me is only useful in that it might provide insight in how to improve my life going forward.

<comment><USER6> I think included in that framework is also, "thing over which I have the most control or could be controlled".

We don't say the root cause is that time flows forward. Or that gravity can't be stopped or shielded. Or that I can't directly copy my ideas into your head w/o playing out a story. Direct teleportation of knowledge, feelings, thoughts, arguments and truths. Root causes are like the free variables. The universe is the fixed.

</comment></comment><comment><USER7> Is it just me, or does this look more like a propaganda piece to confuse and guilt trip employees into learning in their free time than an attempt to explain anything? Seriously, who comes up with these examples?

Every action has consequences (also commonly called karma) and every effect has its causes. And that's about it. Picking an arbitrary cause and insisting it's special doesn't look very constructive from here.

<comment><USER8> I often read the comments section before reading the article because it gives me an indication if I want to read the article. In this case, your comment made me very curious. Keep in mind that my point of view is coloured by the fact that I was _looking_ for something out of the ordinary.

I found the examples fairly innocuous. It makes me wonder if you have been recently getting criticism that you consider unfair. It's easy to have your mind latch on to that kind of thing. I think it is especially easy if you consider the advice given to be unsound.

In this case the situation is that the person is laid off from their job and they are considering the causes. It is interesting that all of the causes listed are their _own fault_. While it is not discussed in any detail in the article, I think this is actually a big part of doing root causes analysis. It is not useful to spend a lot of time doing analysis on things that you can do nothing about. I think this is why the author is focusing on "what could I do differently".

I found your comment of "propaganda piece to confuse and guild trip employees into learning in their free time" to be interesting. Now, again, keep in mind that I'm an older guy who is much nearer retirement than starting out and that my biggest fault at work is that I work too hard (especially these days because my body can't handle it and I end up less productive than I could be). However, I have found that the sentiment you seem to endorse is often quite counter productive for software developers. If you are not a software developer, then maybe this won't apply, but it might be interesting anyway.

I don't know if you are young or old, experienced or relatively new at this stuff. However, if I could only give young developers a single piece of advice it's that you can't stop learning and that your boss probably won't pay for all the learning you need to do. I'm still able to code professionally, despite my white hair, _because_ I spend an inordinate amount of time learning both on and off the job. I can do remote development from rural Japan _because_ I can pick up new fashion and become proficient with it as fast as my employer needs me to be.

When I first started, the good jobs I had available to me required me to know JCL, APL, COBOL and DB2. And while you can probably make a decent wage doing this kind of work now, you aren't going to have any choices about where you live (or probably even what colour of tie to wear...).

It sucks in many ways. I wish any of my previous employers had decided that they wanted to allow me to spend a big chunk of my work day using technology and techniques that they didn't need yet. But... There are like 10x more programmers now than there were when I first started. It's _much_ easier to simply lay off the previous ones and bring on the new ones. First, they'll be trained on the new technology. Second, they'll be eager to use it. Third, they'll be half the price.

Just going to say it again to let it sink in. I compete against people who already know the new technology, have more energy than me and who cost half my salary. Saying, "But I'm old", just doesn't cut it for keeping your job ;-)

It's not that I don't understand what you are saying, but I think your conclusions are in many ways dangerously naive. If it's the case that you've got 30-40 years of experience and it's all worked out for you with that kind of attitude, then I will rush to your side to learn your secret. If not, I hope you will consider a more pragmatic view of navigating through your career.

And, yes, I think the kind of thinking promoted by this article can be helpful.

<comment><USER7> Not much, no.

I can think of several causes that are more likely in the described scenarios. The fact that younger employees often are easier and cheaper to exploit is fairly well known, as is the fact that plenty of employers don't mind playing that game in the name of awesome profits. The total disregard for experience goes a long way to explaining why nothing works very well these days.

To me it sounds more like you have a horse in this race yourself, like you wouldn't mind guilt tripping employees in the name of profit.

<comment><USER8> If profit was a motive for me, then I would not keep doing this job for so long ;-) Good luck, anyway. I occasionally try to reach out if I think it might be useful to the person writing. It seems like I wasn't successful this time.</comment></comment></comment></comment>


Y Combinator Challenge #11 - Office Competitor - <AUTHOR> http://astartupaday.wordpress.com/2008/08/04/y-combinator-challenge-11-office-competitor/ <comment><USER2> Assignment incomplete:

"Before you try to start a startup doing this, however, you should be prepared to explain why existing web-based Office alternatives haven't taken the world by storm, and how you're going to beat that."

The author needs to deal with this head-on.

To some extent he addresses it implicitly by talking about gaining traction the same way Facebook did. This implies that the author thinks that existing web Office tools haven't gained traction because they're too diffusely targeted. The author seems to think that if a web Office tool had a clustered communities of users, this would somehow drive adoption of a web Office replacement. This is an interesting idea, but I think it's inadequately motivated in the writeup. Do college students comprise the right population for these sorts of clusters? I don't think so. I think college students collaborate too infrequently for them to bother adopting such a tool, especially on projects requiring Office-like functionality. If they need to collaborate in this way (once or twice in their career?) they'll just email each other Office documents, or _maybe_ use Google Docs.

<comment><USER3> You caught me, man! I actually did have a few paragraphs tackling this but to be perfectly honest A) it was really boring and B) given my status as an MS employee I do need to be a little careful with what I say around this. Not even so much around pro-Microsoft stuff, but more around stuff that is against efforts that our competitors are doing. In other words, to fully address this I'd have to talk smack on Google docs, which could be seen as what we like to call in the consulting world as a CLM (career limiting move) :)

That being said, anyone who has been using web-based Office alternatives and wants to address this, I'd love to hear thoughts either here or within the comments in the original post.

<comment><USER2> It's a huge market, and it's uncracked despite user pain. Why?

It's a boring question in terms of technology, but not in terms of thinking about user needs and behavior. And it's pretty interesting in terms of the amount of money that could flow if the market were cracked, too.

I think the two big reasons the Office market remains uncracked are:

1) incompatibility fears

2) opportunity cost

Incompatibility fear is a big one. A good friend refuses to use MS Office for Mac because she is afraid of incompatibilities. This is rational. The documents she's sending out impinge on multimillion dollar deals, some of which get finalized at the 11th hour. She can't tolerate additional risk in her workflow.

Continuing to use her, and Office for Mac, as an example, "opportunity cost" means that she can bill to her clients at a pretty good hourly rate, or she can spend her time learning about and deploying Parallels and Bootcamp so she could enjoy OS X and still be confident that her Office documents will be viewable and editable by her colleagues. This just isn't a good use of her time, unless she happens to enjoy technical puttering (she doesn't).

I think she's pretty emblematic of this problem. If you can't get her to use an web-based Office substitute, I submit that you haven't cracked the Office market.

I think that this problem is harder, and in some ways more interesting, than the technical problem of how to make a nifty Office-like web app.

</comment></comment></comment><comment><USER4> I don't see this as that much different from Google Docs.

A little bit more social features and an emphasis on the college crowd but that's all.

<comment><USER3> Same thing could have been said about Facebook re: MySpace. :)

Seriously though, this is a good point. Any time you go up against a competitor with a product in market, billions in the bank, and a huge incentive to make there product succeed at all costs, you better have a pretty frickin' solid differentiation story before you start down this path...even then, good luck...

</comment></comment><comment><USER5> He has the idea down to perfection. Somebody start making this!

<comment><USER3> Thanks Jim! I gotta say, out of all the ideas I've posted so far, this one is probably my favorite. If anyone does want to pick this up, shoot me a mail at firstname.lastname@example.com and I can offer some additional thoughts and features that I didn't have time to detail out in the post (free of charge + no strings attached, as always).

</comment></comment><comment> a-priori I think university students would also like an easy way to make documents that follow the guidelines of various journals.

For example, when I need to follow APA style, I use the LaTeX "apa.cls" document class. However, I think the average psych student manually formats their documents in Word.

</comment><comment><USER6> I'm not sure about this idea.

I think the problem with existing web-based Office substitutes isn't a problem of segmenting the market -- the problem is that they're just not as good as Office. In particular, they're slower, uglier and always seem to be missing some of everyone's favourite features. Office isn't perfect, but it's almost always fast, and it has a _lot_ of features.

Get the implementation right, and you've got a great Office competitor. But given the limitations on the speed of a web-based application I'm not convinced it's possible (but keen to be proven wrong!)

</comment><comment><USER7> College kids have DC++, Demonoid, ThePiratebay, and very little sense of ethics.

Not gonna work.

In fact, I feel as if this will never really take off for the simple reason that people don't want to have to be connected just to edit their word documents. They want to do that anywhere, connection or not, and as such office apps wont be ported to the internet on a wide scale unless they have something else to offer.

<comment><USER5> They could just add in Gears support with some sort of merging rules for when the changes are posted back online.

Also, I believe that this idea has a lot to offer. The added value to the college student is the easy collaboration and especially social networking. I could see freshmen students using this because it both helps with their schoolwork and also connects them with other students for homework and projects.

</comment></comment><comment><USER8> Beware Microsoft employees bearing startup ideas.

<comment><USER3> Startup ideas are just the beginning of my plot. These ideas are really just my way of getting some attention prior to the release of my new site: ClubbingBabySeals.com. Once that IPOs, I should have enough money to buy a really, really, really big laser that I can use to etch the Windows logo into the moon.

<comment><USER8> Don't leak tomorrow's '#12 fix advertising' idea about the moon laser early!

</comment></comment></comment><comment><USER9> scribd should do this. they have a big opportunity if they do it right.</comment>


Toothache anyone? It's time for a vacation - <AUTHOR> http://startupgrind.com/2012/04/dental-departures-is-bootstrapped-disruptive-oh-plus-they-made-500k-last-month/ <comment><USER2> Can't wait to see the response and the PR campaign launched by American Dental Association (or whatever it is called).

"<fade in> <sad marimba music playing> <black and white scene> some guy is on the floor in fetal position, in some dirty antiquated medical office, he is alone, holding his jaw with his hand. Camera slowly zooms out, out of the windows, we see he is in Bangkok. Voice over "thinking of trying dental tourism? Think again!" < fade out >"

On a related topic. I've been practicing medical tourism for 15 years now. Had 1 surgery, dental work, regular comprehensive full panel tests and saved lots of money. (I went to Eastern Europe). What can I say. I go and also visit friends and I have connections there to know which doctors are good. Can't imagine just going there without knowing the doctors or knowing the country. Corruption is rampant. Imagine it is the same in Thailand or South America. Once this takes off, there will be lots of opportunity there to prey on American "health" tourists. I would have to really trust the whole chain of connections : company that manages this, people they employ locally, local doctors, nurses.

<comment><USER3> I can't vouch for anywhere else in South America, but private clinics in Brazil are pretty much safe, well equiped and pristine (public healthcare is a whoole different story). We also have leading research in many medical fields, can't imagine Thailand (no disrespect) being anywhere near.

</comment></comment><comment><USER4> I am currently in Nicaragua. I am from the USA and don't have health insurance. I had a toothache that was periodically dehabilitating, mostly in high altitudes.

Having an irrational fear of the dentist and a rational fear of dental bills, I put it off for longer than I should have, and only last week got my work done in Managua.

A root canal, 3 cavities, a half a dozen or so xrays and a teeth cleaning was about $600; and included 3 visits and xanax for 2 of the 3 visits.

The last root canal I had in the USA was in 2002, and cost 1100 with insurance.

I went to one of the most expensive dentists in Managua because he was recommended highly and spoke perfect english, and I didn't really trust my spanish.

Really interesting to wrap this phenomenon in a profitable venture; but I found it easy to get the information myself.

I would 100% absolutely do it again.

<comment><USER5> Interesting. How much was the flight + living expenses by comparison?

<comment><USER4> I have been traveling around for a while so I can't comment on flight as I came via bus from Costa Rica.

Living expenses are extremely cheap. A nice apt on a short term lease in a nice part of Managua is 300-400 a month. A very nice restaurant is like 7 dollars a person; food on the street is <$2 a meal.

For comparison, day labor outside of Managua costs 150 cordoba a day; or about 7 dollars.

</comment></comment></comment><comment><USER6> My Wife is a Dentist with a specialty in prosthodontics. One of the more complicated cases you can do in Dentistry is a full mouth reconstruction where you basically are fixing all the teeth and likely fixing the bite. These treatment plans can easily cost $30K or greater. Sure, you can go overseas and get this kind of treatment. However, if they are doing implants the only way to do it in a timely basis is immediate placement (stick the implant in the bone and put a crown on) instead of installing the implant and waiting for the bone to heal. Additionally, good luck in getting a stateside dentist to support foreign dental work. The statement that dentistry has been around since Roman times is laughable; certainly not modern dentistry and definitely not implant dentistry.

Here's a brief overview of the economics:

230K student loans, 6K / month business loan for office, 2K / month rent (fairly cheap IMO), salaries for staff, malpractice, lab fees, etc. So there is clearly a lot of shit to pay for. We aren't driving a Bentley yet.

One of the big issues driving cost is the same thing as medical costs: fee for service payment. The nature of the beast forces Dentist to optimize specific procedures or more of the expensive procedures. Additonally, armies of consultants out there train dentists (and their staff) to optimize "coding" against Dental insurance rules to optimize the payouts from the insurance companies.

<comment><USER7> There are basically 4 things driving up medical costs in this country. (Education, Malpractice, R&D, and Insurance) Unfortunately, I don't see any fundamental change happening in any of those areas any time soon. Just think what it would mean if you banned say, advertising the name of any prescription drug to private citizens.

I mean I can understand advertising that there are prescription treatments for ED which hey people might not know about. But, when these things have significant side effects and can't be sold over the counter you need actual medical advice not just people dancing around with smiles on their faces. Not that I think there is a chance in hell of this actually changing, but many country's actually do something like this.

<comment><USER8> Malpractice insurance is something like 2% of the overall medical costs in the US, and at least some states have caps on liability lawsuits. Looking now, it seems malpractice insurance premiums have stayed pretty constant over the last couple of years.

Are you sure that malpractice is one of the major factors "driving up medical costs in this country", and if so, do you have a pointer to something which reinforces that statement?

Personally I thought the big increases in liability insurance coverage 5 or so years ago were because the insurance companies were so invested in the market, that after the market crash they needed to hike rates to build back their reserves. Those hikes were then used as justification in advocating liability caps.

<comment><USER7> It's not a major direct cost, however due to inefficiencies in the system your paying for that 2% in several additional ways. Doctors do a lot of tests to cover their ass. People without insurance tack their get their costs shifted to other people. Then Insurance company's tack on their profit margin above that 2% that's already been compounded a few times. And many of those unnecessary tests can cause further complications down the road due to things like false positives.

<comment><USER8> I believe that 2% includes defensive medicine. Ahh, here's one of the relevant papers: <http://content.healthaffairs.org/content/29/9/1569.abstract>

"Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending."

I really don't see 2.4% as one of the major things "driving up medical costs in this country."

Here's another from [http://www.factcheck.org/2009/10/malpractice-savings- reconsi...](http://www.factcheck.org/2009/10/malpractice-savings- reconsidered/) "In an Oct. 9 letter to Republican Sen. Orrin Hatch of Utah, CBO Director Douglas Elmendorf said that a package of changes including limits on malpractice awards 'would reduce total national health care spending by about 0.5 percent (about $11 billion in 2009).'" "That figure includes a 0.2 percent reduction just from lower premiums for malpractice insurance paid by medical professionals. And it includes an additional 0.3 percent in reduced costs of medical tests, imaging and other medical services. "

This would imply that the malpractice overhead isn't more than a couple percent.

Personally, I think the major perception regarding malpractice is based on propaganda by people who want to put caps on all lawsuits. See, of all things, a Cracked article on the major examples of 'outrageous' judgements where the actual facts are at odds with the perceptions: [http://www.cracked.com/article_19150_6-famous-frivolous- laws...](http://www.cracked.com/article_19150_6-famous-frivolous-lawsuit- stories-that-are-total-b.s..html) .

Civil lawsuits are one of the few ways that individuals can take on large companies with bad business practices. Caps mean those companies are more free to make decisions in favor of cost-cutting over quality.

Of course it's hard to justify it that way. It's much easier to say "idiotic medical lawsuits are one of the major reasons for increases in medical costs, so lets cap all lawsuits."

Where do you get your idea that medical malpractice costs are a major contributor to increasing medical costs, either direct or indirect?

<comment><USER7> _Where do you get your idea that medical malpractice costs are a major contributor to increasing medical costs, either direct or indirect?_ edit: I am not predicting future costs just describing things as they are right now.

I know a few doctors paying well over 100k / year in personal malpractice insurance. Though it looks vary regional. <http://www.ama- assn.org/amednews/2003/11/10/prl11110.htm>

Obstetrician-gynecologists Florida (Dade County) $201,376 (2002) $249,196(2003) South Dakota $13,325(2002) $14,662(2003)

I agree that on it's own it's not the single top issue. But, don't forget those cost estimates 2.4% get multiplied by all the other inefficiency's in the system. I don't think putting cap's on all lawsuits is the best idea, but neither are lawsuits an efficient processes. Still, if you eliminate 5 different 2 percent inefficiency's your talking about a 10% drop in healthcare spending and around 220 billion dollars a year.

There is no single bullet solution to healthcare. And a lot of people make their living directly from those inefficiency's, but you can't provide everyone the 'perfect' care that everyone seems to expect. Nor does 'perfect' care mean everyone get's to live forever.

<comment><USER8> Yes, I saw that article as well. It is now 9 years old, and out of date. Quoting from <http://www.medscape.com/viewarticle/751009> : "Premiums indeed rose dramatically in the early part of the new century, but in 2011, they declined for the fourth straight year for 3 representative medical specialties, according to a publication called Medical Liability Monitor (MLM). Its annual rate survey, highly regarded in the field, was published this week."

You first said the 2% doesn't include the impact of defensive medicine. I pointed out that it did include defensive medicine, so now you say it's magnified by other inefficiencies in the system. I don't believe you, because your arguments sound very hand-wavy, and don't change in the presence of contrary data. Do you have any evidence to strengthen your statement?

I could be even more hand-wavy and argue that the increase number of medical malpractice payouts is due to the medical system in the US getting worse. As <http://content.healthaffairs.org/content/29/9/1565.full> points out, "One way to attack the medical liability crisis is to make health care better and safer in the first place" and "Another key to limiting medical malpractice suits is to improve communication with patients immediately after an injury" and "Most health policy experts, he says, believe that "caps on damages [are] tangential to the real problems with the malpractice system, which involve excessive numbers of medical errors, inaccessible compensation for most avoidable injuries, and a slow, expensive process of dispute resolution that is inhumane to both plaintiffs and defendants"."

You pointed out that you know doctors paying over $100K/year in personal malpractice insurance. According to <http://content.healthaffairs.org/content/29/9/1585.abstract> "We found high levels of malpractice concern among both generalists and specialists in states where objective measures of malpractice risk were low. We also found relatively modest differences in physicians' concerns across states with and without common tort reforms. These results suggest that many policies aimed at controlling malpractice costs may have a limited effect on physicians' malpractice concerns." or as stated in <http://content.healthaffairs.org/content/29/9/1565.full> "Emily Carrier and colleagues find that physicians' perceptions of the threat of being sued are out of step with their actual risk of being the target of a malpractice lawsuit."

In other words, those doctors might not be needing the $100K+ coverage which they are paying for.

According to [http://www.kaiseredu.org/Issue-Modules/US-Health-Care- Costs/...](http://www.kaiseredu.org/Issue-Modules/US-Health-Care- Costs/Background-Brief.aspx) , "health care costs for chronic disease treatment account for over 75% of national health expenditures" and "At least 7% of health care expenditures are estimated to go toward for the administrative costs of government health care programs and the net cost of private insurance."

Those two factors - which you didn't mention in your list of four things affecting the increase in medical rates - are both larger than the 2.4% we're talking about related to malpractice.

<comment><USER7> 2.4% is 20% larger than 2%. That .4% represents something like 8 billion a year which is ya know a lot of money. I have also seen numbers close to 3% from a few sources.

If you want a less hand wavy answer why 2.4 was still to low insurance is inefficient. Here is a link to one company lowering it's rates after the recent change in how inefficient they can be: [http://www.ctmirror.org/story/12550/aetna-seeks-cut- health-i...](http://www.ctmirror.org/story/12550/aetna-seeks-cut-health- insurance-rates) _Beginning this year, the federal health reform law requires insurance companies to spend at least 80 percent of the money they collect in premiums on health care costs for individual and small-group plans, and 85 percent for large-group plans._ Several company's where over that limit. Anyway, going from the direct cost of 2.4% though an 80% efficient insurance company means .024 / .8 = 3% of someones insurance premiums go to paying that 2.4% direct cost. It's a little worse than that because insurance also requires the provider to create the bill and that time is then indirectly billed back to the insurance company's.

But, still all of this is really nitpickey. It's not really sometime I care about, I just used the word as one of several inefficient part's of the system we have now. I am fine suggesting the dead weight is somewhere between .5% and 3.5% of total healthcare spending, but that's still something like 100,000 _or more_ million dollars every 10 years.

<comment><USER8> Oh come on, I first said "something like 2%" and after a short bit of research found the number was 2.4%. Not bad for a several year old memory, I think.

Neither you nor I have read that paper which gives the 2.4% value. It may have included the insurance overhead already.

In any case, the health reform law you linked to covers medical insurance for patients, while the 2.4% we're talking about is malpractice insurance for doctors. You can't apply the numbers from one system directly to the other.

The US is the third most populous country. Of course any numbers related to health care are going to be huge. We spend 2.6 trillion or so on health care in a year. You can do as you did and use 100 trillion over 10 years, or you can say that $10 billion per year / population of the US, is $32 per year, or under 0.10 cents per day per person. Note that 2.6 trillion / population of the US => $8,387 per person per year, and 2.4% of that is $201 per person per year or $23 and $0.55 per person per day, respectively.

Quoting again from Wikipedia: "In December 2011, the outgoing Administrator of the Centers for Medicare & Medicaid Services, Dr. Donald Berwick, asserted that 20% to 30% of health care spending is waste. He listed five causes for the waste: (1) overtreatment of patients, (2) the failure to coordinate care, (3) the administrative complexity of the health care system, (4) burdensome rules and (5) fraud."

I do not know if (1) is due to defensive medicine or other reasons. For example, when I broke my toe, I asked for extra x-rays even though it wasn't needed. I know friends who got MRIs even though not essential, because it was included in their insurance plans. Or since the doctor gets reimbursed per test, there's a financial incentive to do more tests (so long as cost less than the reimbursement).

Searching now, I found no useful numbers about the overall cost of defensive medicine. Indeed, it seems to be pretty hard to resolve. I came across the statement that "variation in intensity of treatment from one hospital or city to the next has been well documented among the government's veterans hospitals, where there is no financial or business drive for more rather than less treatment", so it's going to be noisy data.

Doctors do commit malpractice. There has to be some system in place to handle that. Our system now is through the courts. Just how bad are 'frivolous' medical lawsuits?

Let's take [http://en.wikipedia.org/wiki/Medical_malpractice#The_case_fo...](http://en.wikipedia.org/wiki/Medical_malpractice#The_case_for_medical_liability_reform) as the source for numbers. This should be biased for the doctors. The AMA says 60% are dropped without payment and do not go to trial, costing $22,000 in fees. ... Sneaky AMA! Notice that it does _not_ list the percentage of payments made without going to trial. This makes that section unusable for what I was going to do.

I had to go to <http://bjs.ojp.usdoj.gov/content/pub/pdf/mmicss04.pdf> and find that in the states where payout and lack of payout is required to be reported (ie, Missouri and Maine), some 1/3rd of claims get a payout. Median payout (using Missouri's numbers since they have 8x more reported cases than Maine) is $110,000 for 2,598 cases out of 8,379 total cases. Of these, under 5% are reached by a trial decision.

So, 65% get no payout, and each costs the doctor (using the AMA numbers) $22,000 in legal fees. 30% gets a payout of $110,000 and costs the doctor $22,000 in legal fees, and 5% are reached by trial, of which 90% is found to have no payment (at $110,00) to defend and 10% is found to have a payment of $342,000 and still needs $110,000 to defend. Further, there are about 17,000 cases per year in the US.

Costs because the doctor was actually negligent: (0.30 * (110+22) + 0.05 * 0.1 * (342+110)) * 17000 = $700 million.

Costs because the doctor was incorrectly accused as being negligent: (0.6 * 110 + 0.05 * 0.9 * 110) * 17000 = $1200 million.

Hence, even if you could magically make all frivolous cases disappear, you could only reduce the payouts+legal expenses by 60%, and you almost certainly wouldn't make defensive medicine practices disappear because there will still be court cases, and some rare ones in the $1,000,000+ range.

This is something I'm nitpickey about because I see liability lawsuits as being the only strong tool individuals have against negligent practices. I don't want to see legislative attempts to curtail that power when the underlying justifications are unfounded. From what I can tell, the cost for overtreatment and liability, while large in aggregate numbers, is simply not one of the major reasons for increasing health care costs in the US. Especially since liability rates haven't gone up the last three years.

<comment><USER7> _This is something I'm nitpickey about because I see liability lawsuits as being the only strong tool individuals have against negligent practices._

Ok, I get where your coming from.

The problem I have is lawsuits is they are expensive AND ineffective. So many things have to happen before _cutting off the wrong leg_ actually get's back to those responsible that losing a 2 million dollar gross negligence lawsuit is less meaningful for a doctor than winning the lawsuit and losing their licence. There are some really bad doctors out there, but because there are still insurable because it's fairly random when someone get's sued so it takes a long list of errors before they need to look for other employment. Moving can also help cover someones medical misdeeds.

The simplest way to cut down on medical errors is to limit how long someone can be on call. Life or death decisions at the end of a 12 or sometimes 16 hour day is just insanity. Yet, it's all to common for someone to end up pulling an 18 hour shift.

As to the awards, you can't just take payouts and say this money ends up in the hands of those who where miss treated. Court cases are expensive and it's not uncommon for someone to receive well below 1/2 the stated award after their legal team get's it's cut. It also tends to take a long time.

My suggesting would be a system with automatic and harsher penalty's where people and institutions are penalized for their average mistakes over time not just the occasional one off case they can buy insurance to cover. And where people who have been mistreated can automatically receive reasonable compensation without the protracted legal battle. Unfortunately, I have no idea of how to implement such a system.

PS: Then again, I am not really a doctor either. Just some random nerd who has really enjoyed this disunion on a late Sunday afternoon. I will even say you win the point if it makes you feel any better.

<comment><USER8> Woo-hoo - I win on the internets! ;)

Yes, that gets back to an issue I highlighted earlier, which is the need to reduce malpractice in the first place. There's a lot of ways to do it. I agree that unfortunately, we've decided that the courts are the right place for feedback.

Doctor review boards, for example, are woefully hesitant to chide doctors who continue to have bad practices. Politicians are equally hesitant to put the nose of "big government" into oversight.

Frankly, one of the reasons I'm in favor of nationalized general health care is that it tightens the feedback between the people who pay for health care and the people who do oversight.

Thanks for the opportunity to do the research on the topic and improve my own understanding.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER9> An amazing idea to disrupt this industry. I can see the same thing for medical and vision. Lasik for 25% of the cost sounds nice (but messing with your eyes is a big risk). What are other players in this market?

<comment><USER10> Medical tourism, from the States to elsewhere, has been a "thing" for some time, maybe a decade(?). I'm sure it's been done individually by out of the box thinkers well before that.

It's great that businesses like in the article are making this a bit more accessible and known, it will put some cost pressure on Stateside providers. Also help people save some money by going outside the States, or even get care that just would not happen otherwise.

</comment></comment><comment><USER11> A guy who used to come to our local tech group used to get dentists from Hungary to come to the UK and set up in inflatable dental surgeries at temporary locations and offer cheap dental care. So that's bringing cheap dentists to us, rather than us heading to the cheap dentists. No idea how it panned out though, as he isn't doing it anymore..

[http://www.dailymail.co.uk/health/article-1051660/Deflated-c...](http://www.dailymail.co.uk/health/article-1051660/Deflated- charges-blow-dental-surgery-Travelling-Hungarians-offer-half-price-treatment- UK.html)

</comment><comment><USER12> I just spent $21,600 on three implants and four crowns. And that was with insurance.

</comment><comment><USER13> Here's an article from 2003 on (the old) Kuro5hin on the same subject, involving dental tourism to Mexico: <http://www.kuro5hin.org/story/2003/12/20/121018/65>

<comment><USER14> I miss the Kuro5hin of yore. It has gone so far downhill as to be unreadable.

</comment></comment><comment><USER15> My parents have been traveling to Costa Rica for their dental work for years (from the US). My dad usually stays with a local family through a language- exchange program, stays for two weeks, and takes Spanish classes at their local university.

He says he's saved tens of thousands of dollars (he doesn't have dental insurance here), and gets awesome, educational vacations out of the deal.

Even my mother, who is not adventurous at all, loves it. The dentists speak perfect English and have top-tier practices.

<comment><USER16> Great to hear that your parents had an excellent experience in Costa Rica!

I really think once people step inside a Costa Rican/Thailand, Mexico dental clinic their concerns of quality fade away.

Full disclosure: I work @ Dental Departures

</comment></comment><comment><USER17> I completely agree with this. I'm doing a... reverse tourism (?) every year by leaving the UK to visit my family in Europe and get my dental issues fixed there. Saves me a lot of money considering cheap flight tickets are around £50 both ways and a standard filling with local anaesthesia costs the same (in a good quality place)...

With local prices of ~£7 per month for basic dental insurance, this is a very simple choice.

</comment><comment><USER18> Is there a site like this for healthcare? I remember seeing something on the news once where people were going to India to get surgery done. When the US treats healthcare like profitable business, what else do expect to happen? Consumers w health issues will go elsewhere if possible, although with emergencies, you are pretty much stuck here.

</comment><comment><USER19> My grandparents have been to Argentina a couple times in the last few years to get their dental work done. They have been extremely happy with the quality service as well as the pricing. Commercializing this is a great idea.

</comment><comment><USER20> I'm a bit confused by the numbers here. They had 400 appointments and made $500,000 in revenue? Does that mean that they're charging over a thousand bucks to set these things up?

<comment><USER21> My first start-up was a medical tourism company.

It's basically an affiliate business model: you get 5-10% of the cost from the doctor, hotel, and airline (depending on your negotiation skills). $500K revenue means $25-50K in true gross revenue for the company. Their net profit is $3-5K on that revenue, depending on how efficient they are.

I put my business on the back burner for 2 reasons:

1) 5-10% of the cost of the package is your true revenue before overheads, so the it's not very profitable once you consider your expenses. 2) It's a high touch customer service experience, so you can't scale it profitably (people will not buy an operation via e-commerce like they would an e-book: there's a lot of personalized contact and questions, examination of records, etc.).</comment></comment>


Blackhat SEO Numbers for 2010 Part 1  - <AUTHOR> http://research.zscaler.com/2011/01/blackhat-seo-numbers-for-december-2010.html and Part II: http://research.zscaler.com/2011/01/blackhat-seo-numbers-for-december-2010_20.html <comment><AUTHOR> Part 2 is also here: [http://research.zscaler.com/2011/01/blackhat-seo- numbers-for...](http://research.zscaler.com/2011/01/blackhat-seo-numbers-for- december-2010_20.html)</comment>


GeoWrite – 5: Copy Protection – pagetable.com - <AUTHOR> https://www.pagetable.com/?p=1449 <comment><USER2> Meta: It is probably too late to edit the title now but in future soon after you submit you can edit the title and the change will be accepted. Probably for historical reasons, of which I'm unaware, the leading 'Inside' is automatically removed on the initial submission. Also, it is unnecessary to include the domain in the title.</comment>


Show HN: Nim in Action – Final eBook Now Available - <AUTHOR> https://book.picheta.me/ <comment><AUTHOR> Author here. It's taken a while but the book is now finalised and being printed. I'd love to hear your thoughts on it!

Also feel free to ask me anything about Nim, publishing a book or anything else.

<comment><USER2> Book looks great, I just started learning nim last week and I think I'll get a copy.

I was intrigued by nim for its transpiling to C/JS (two languages I loathe programming in). I like the syntax and structure of nim and wanted to use it simple programs to upload to arduinos. Your book mentioned embedded systems in the introduction, but there is not a chapter devoted to it. Do you have any resources you can share about using nim on microcontrollers (Arduino or the like)?

<comment><AUTHOR> Unfortunately I don't have anything that isn't immediately searchable via Google (for example: [http://disconnected.systems/blog/nim-on- adruino/](http://disconnected.systems/blog/nim-on-adruino/)). I was indeed planning to write a chapter on this but due to page count constraints I wasn't able to, that said I will do my best to write an article on this at least and post it on nim-lang.org as well as on book.picheta.me :)

I do also know one person that was working on some cool microcontroller stuff in Nim, I keep asking him to write a blog article about this but he's currently busy with other things. Maybe soon it will happen to though. If so I will encourage him to post it on Nim's website and if he doesn't I will definitely tweet about it here: [https://twitter.com/nim_lang](https://twitter.com/nim_lang).

Sorry I can't help more!

</comment></comment></comment><comment><USER3> If you are interested to look into the new generation of system programming languages , this book will open the door to one of the best of the crop. Nim.</comment>


Ask HN: Question about radio waves - <AUTHOR> What frequency would be best for within 1 mile in a city or suburban area?
Follow up, Why are restaurant notification buzzers so limited in distance and how could they improve this.
thanks <comment><USER2> There are four components that effect range. Transmit power, attenuation, receive sensitivity, and interference.

Transmit power is easy, more power more range.

Attenuation depends on frequency in a cluttered environment. Everything being equal lower frequencies work a lot better than high ones. Contrary to what you'll hear or read radio signals in a cluttered environment doesn't follow an inverse square law in practice. It's a lot worse than that.

attenuation = const * distance ^ -k

Where k depends on frequency. For FM/AM radio (important where the tower is on a hill) k = 2.5

900MHZ k is ~3 and for 2.4GHz is ~3.5

So 900MHZ is a lot better than 2.4GHZ. 433 is likely better than either.

Receive sensitivity depends on the antenna and front end design. And modulation type and strongly on the signal bandwidth. And very importantly the presence of interfering signals. Low data rate spread spectrum will give you the highest receive sensitivity.

<comment><USER3> Isn't interference just another way to describe sensitivity? From the classic Salon article, The Myth of Interference: "'Interference is a metaphor that paints an old limitation of technology as a fact of nature.' So says David P. Reed, electrical engineer, computer scientist, and one of the architects of the Internet." [https://www.salon.com/2003/03/12/spectrum/](https://www.salon.com/2003/03/12/spectrum/)

<comment><USER2> Any receiver design, bandwidth and modulation technology will have an ultimate sensitivity. Far as I understand this is due to both noise created by the circuit itself and the thermal noise over the band.

You can't get better than that.

Then you add interference which raises your noise floor both statically and dynamically. Unlicensed bands tend to be polluted with short coherent pulses of RF.

One issue with interference. While attenuation is symmetrical between two transceivers, interference is utterly not symmetric.</comment></comment></comment>


Crack Protection for Spyro: Year of the Dragon - <AUTHOR> http://www.gamecareerguide.com/features/20011017/dodd_01.htm

<comment><USER2> I wouldn't have expected that each game developer had to write their own copy protection on a console. I'd expect that would be something that was provided by the console itself (such as disk/application signing on the 360)

<comment><AUTHOR> It is _now_ (mostly). It wasn't back then.</comment></comment>


Mind Control Will Help People Fly Plane - <AUTHOR> http://yottafire.com/2014/05/mind-control-will-help-people-fly-plane/ <comment><USER2> How about no control? The only way people are doing to adopt the idea of mainstream flying vehicles is if they are full automatic. In a way, they should be easier and safer than self-driving cars, because there are a lot less obstacles to care about.</comment>


Meet one of the world's most groundbreaking scientists. He's 34 - <AUTHOR> https://www.statnews.com/2015/11/06/hollywood-inspired-scientist-rewrite-code-life/ <comment><USER2> I'm all for scientists getting a bit more recognition, though the timing of this with the ongoing court case and the very brief mention of Charpentier and Doudna's work makes it seem a bit suspect.

<comment><USER3> And even if the law suit ends up favorably for him, it isn't as if he thought up the idea of using CRISPR-Cas for gene editing -- he was just (arguably) the first to get it to work in human cells. It's an impressive achievement, but so is winning a marathon -- somebody has to be the first to cross the finish line. To me at least, a "groundbreaking" scientist is somebody who comes up with something nobody else was even thinking about.

<comment><USER4> >who comes up with something nobody else was even thinking about

All the "groundbreaking" things I can think of, when I've looked into them, have always had many people working on it, but we rarely know that as a society.

Relativity, quantum mech, lasers, transistors, superconductors, TV, radio, flight, engines galore....

Do you know of any groundbreaking things done "nobody else was even thinking about" it?

<comment><USER3> Well, a lot of the examples you give deal with technological development, which is different from science as such. For example, as soon as radio was invented, it was obvious that transmitting pictures was the next thing to do, and lots of people went to work on trying to do that. And powered flight was an obvious extension of work on gliders and was likewise very competitive (to the point that some Europeans doubt the Wright brothers' priority to this day).

But groundbreaking science is different. There the next step _isn 't_ obvious. While Einstein certainly benefited from the work of previous scientists like Poincaré and Lorentz, it wasn't as if there was a "race" to discover relativity like there was for TV (or CRISPR-Cas in human cells).

<comment><USER4> >it wasn't as if there was a "race" to discover relativity

Yes, there was. They didn't call it relativity, which is a later name, but probably dozens to hundreds of scientists were working on exactly what Einstein is credited for.

Hilbert was close (published equivalent first?), Poincare was working on it (which is why the symmetries of special relativity are Poincare symmetries), Lorenz was working on it (which is why special relativity focuses on Lorenz transforms) , and many, many people were going to do it within a year or less if Einstein did not do it. There were so many people doing the same thing that there is an entire field devoted to sorting relativity priority out. Einstein is simply the one most people associate with it. See [1] for a huge list of people (and likely not all) that were on the same track at the same time.

And this is also exactly my point. Many things people think were isolated inventions, because history loses most of those who were going to do it at the same time (and often did do it sooner, but just lost credit).

[1] [https://en.wikipedia.org/wiki/Relativity_priority_dispute](https://en.wikipedia.org/wiki/Relativity_priority_dispute)

</comment></comment></comment></comment></comment><comment><USER5> Feng Zhang is a cool dude. Cool enough that his name should be in the title.

</comment><comment><USER6> Scientists agree that Doudna/Charpentier deserve the lion's share of credit for the CRISPR work - if only the Broad institute could agree.

</comment><comment><USER7> Feng Zhang is a genius. He has done some earth-shattering work.

<comment><USER8> Like patenting the work of others?

</comment></comment><comment><USER9> I find it a bit odd that we now consider 34 being young for scientists.

Newton was 23 when he developed the theory of gravitation, Einstein submitted his 4 famous papers at 26.

<comment><USER10> Conceptually it kind of makes sense. As time progresses and science advances, the amount of knowledge scientists are expected to understand expands. A decent student of science today must know much more than a student in the 17th Century. That extra learning takes time.

</comment></comment><comment><USER11> Dude might do impressive stuff, but the video provides little insight except that trivial regular expressions are supposed to be applicable to the DNA.</comment>


Ask HN: Do you stumble into design while coding or do you design and then code? - <AUTHOR> Recently I realised that I start coding and then a design evolves from that effort. Effectively I stumble on the design while coding rather than design first and then code. What is the right way, first to design and then code, or to start coding and then let the design emerge? <comment><USER2> If it's a well understood domain, up front design is nice. A simple drawing that fits on a sheet of paper.

If it's new territory, up front design is worthless. You've never attempted to create a facial recognition program before. Not too long ago, no one else had either so there wasn't a lot of useful content to study. Your best bet is to try making 1 small useful unit of work, iterate, try again. Fit the pieces you create to achieve a goal. A design is grown from the bottom up. Now you have a better understanding of the problem and may be able to do some design.

</comment><comment><USER3> I've noticed that the more time I spend with pen and paper before starting to type, the better the resulting program is. It's more natural to me, and maybe everyone, to just start typing feverishly with the end goal in mind, hoping to roughly get it working quickly before the ball of spaghetti gets too complicated. That's fun, but I've learnt not to do that. Unless it's a one- liner, every minute spent on paper first saves an hour or day later.

Also I refactor as I go (which I learnt about decades later than I should have), striving to get the naturally emerging structure as clear as possible, in every way – data structures, single-purpose functions, variable names etc. That's apart from the general structure I plan initially, but planning things first makes the refactoring infinitely easier. So, for me it's kind of a combination of the two.

</comment><comment><USER4> There is no single answer that is going to be universally applicable (surprise, surprise :-)). Oftentimes, the right design is going to be informed by some view of the practicalities of actually trying to implement it. Equally, there will be many problems where starting to fill the buffer of your text editor as the only way of designing the code will result in kludgey solutions to many cases that weren't immediately apparent when one started thinking about the problem.

To combat the fact that there's no right answer here, the teams that I work in have adopted a couple of strategies.

1\. Start out with a reasonable sketch of the high-level design of the system and/or library that is being written. Thinking through this high-level approach lets everyone start with a reasonable shared mental model of how things will look as development proceeds. It also means that some of the complexities of "which of the more complex cases that we're going to come across are we going to solve, and which can be a TODO" be decided up-front.

2\. After this initial design exercise, do design is small chunks, iteratively. Take the smallest possible set of functionality, and have a developer in the team (not just the tech lead...) determine the options for design, and propose one as the solution. These small units of design can be informed as the developer wishes -- i.e., they can do prototyping if it makes sense.

3\. At all costs, avoid development approaches and team dynamics where refactoring is not considered an option, or discouraged. As you observe in your question, getting the design right might involve understanding more of the problem, or the requirements, and that might need the "oh ____, we should have solved this like that! " moment that only comes from having implemented something, or watching your users try and use the solution you built entirely differently to how you expected. Ensure that there's a team culture, or an openness to the idea that you definitely won't be right the first time. Perfect is the enemy of "done" or "shipped".

Personally, I prefer to start to think about the problem in an abstract form before coding, because this allows me to separate the consideration of the best way to write maintainable, testable code from the problem of the system, library or application design. Of course, YMMV, but this is what works for me :-)

</comment><comment><USER5> For me an MVP and feedback (even if just my own feedback) greatly dictates what the design will be. I don't feel like I'm good enough / it makes sense to just dictate design right off the bat.

I could imagine someone with a good feel for the context could do that, I just haven't been able to do so / don't find it helpful to do so.

</comment><comment><USER6> Both. However, I end up iteratively developing and refactoring.

> What is the right way? I would like to know too. I suspect experience gives > you insight into a design that will likely work.

</comment><comment><USER7> Both. I go into coding with a design in mind (a class diagram/db schema etc.), but I've found after I start coding the design always mutates.</comment>


Ask HN: Idea Sunday - <AUTHOR>

First week of May edition. <comment><USER2> Already posted [0] and was killed [1].

I'd love to see this thread albeit less frequent (once or maybe twice in a month). Let people give crazy ideas, and let other be motivated to build maybe one of those. I found interesting and intellectually stimulating discussions happening around some of the ideas posted on these threads which IMO alighn with the core vision of HN.

0\. [https://news.ycombinator.com/item?id=7693262](https://news.ycombinator.com/item?id=7693262)

1\. [https://news.ycombinator.com/item?id=7693640](https://news.ycombinator.com/item?id=7693640)

<comment><USER3> I would really like a specific account to post one of these threads once per month.

I am surprised that people post them themselves, and don't appear to be checking for other threads posted the same day.

<comment><AUTHOR> I did check. Just didn't see it. My bad.

</comment></comment></comment><comment><USER4> I`m starting to work on a marketing tool which will be a combination of displaying popups like Bounce Exchange([http://bounceexchange.com/](http://bounceexchange.com/)) and Tweetganic([http://www.tweetganic.com/](http://www.tweetganic.com/)) or [http://snip.ly/](http://snip.ly/).

Currently Social Media Management tools like Hootsuite provide a link shortner so it's relatively easier for them to integrate a service like [http://snip.ly/](http://snip.ly/) however they don't.

The product I'm thinking to create will allow anyone to manage, split test their pop ups and promote themselves using a service like snip.ly. An analytics module will accompany the product so all the data can be meaningfully used to enhance the campaigns.

Hope I was able to clearly explain my idea. Would detail out some more if anyone is interested.

</comment><comment><USER5> Earlier today: [https://news.ycombinator.com/item?id=7693262](https://news.ycombinator.com/item?id=7693262)

Last month: [https://news.ycombinator.com/item?id=7541601](https://news.ycombinator.com/item?id=7541601)

</comment><comment><USER6> VRCoin. It's a blockchain that simultaneously doubles as storage for items a decentralized virtual space. You require the coin to store/remove items from the space [namecoin for coordinates essentially].

I think once VR takes off there's going to be a desire for a virtual world that's not owned by any one specific entity. The blockchain acts as decentralized storage as well as spam control, so people don't just place dicks everywhere (or rather it would be costly to do so).

</comment><comment><USER7> Burying as dupe. Please see [https://news.ycombinator.com/item?id=7693640](https://news.ycombinator.com/item?id=7693640).

</comment><comment><USER8> I've been working on a kind of reversed wetransfer. You'll claim a domain, and others can drop files at your personal url. It have been opensourced on github ([https://github.com/dutchcoders/dropit](https://github.com/dutchcoders/dropit)). And running at [https://dropit.io/](https://dropit.io/).

</comment><comment><USER9> Does anyone have any interesting Bitcoin ideas? I have a good Bitcoin domain but I'm not sure what to do with it.

<comment><USER10> I had two ideas, not exactly sure how to get them to work though:

1) Replace the pointless hashing with some actually useful calculation or form of work. Trouble is, I'm not sure what kind of asymmetrically difficult function could be used instead of hashing that would have some value for society.

2) Replace the hashing with some kind of genetic algorithm or other AI solution search. So instead of trying to find the proper hash, you're trying to find the proper algorithm to some currently-posed problem. Miners who find the current-best solution can then be rewarded with some form of bitcoin, which can be traded among themselves as currency, or used to decide what the next problem the network searches for a solution to will be. I figure this would make the entire blockchain into a giant sort of AI/brain, with the problems it tackles being more or less democratically chosen by whoever wants to spend the most of their bitcoin for it. The spent bitcoin then goes to the people who find the best solutions, in addition to whatever small amount of new bitcoin is mined. And replace "bitcoin" with whatever the new name would be, of course.

May be possible, maybe not. There's basically no chance I'll be able to implement some version of either any time soon, so feel free to run with it if anyone thinks they can.

<comment> unix-dude This and similar ideas are often passed around. There are a few cryptocurrencies which try to implement something like this (finding series of primes, for example).

There are a few problems with actually implementing your suggestions. You call hashing "pointless", but it is anything but that. Hashing, specifically SHA256 in bitcoin's case, has a well understood and possibly proven (?) level of difficulty. There is no known way to gain an advantage, other than simply throwing more computational power at the problem. Thus, because the problem being solved is arbitrary, random, and difficult, it takes a huge amount of computational power to make an invalid transaction.

Not only do you have to find initial "acceptable" hashes for your faked block, you have to create hashes of all the following blocks up until the present time, and push this version of the blockchain as legitimate until a majority of the network adopts it as the correct branch. The absolutely ridiculous computational power required to do this is what keeps transactions of cryptocurrencies safe. You don't just have to fake one hash, you have to find and fake an entire chain of them!

Many scientific problems don't have the same kind of guarantees about difficulty. And even if they are really, really hard, what happens when you find the answer? You'd essentially have to hard-fork all the clients. SHA256 and other hash functions used have a search space that is astronomically high, and is guaranteed never to be "completed".

Hashing is a way to make transactions safe, permanent, and unmodifiable because of the cryptographic properties which come with the field. There's very little chance of someone stumbling upon sequential solutions, and essentially impossible for someone to "derail" the blockchain due to those properties. The value that hashing provides are those guarantees.

<comment><USER10> This is why I'm just throwing the idea out there (though, as you say, it's probably not even a very original one). It would take some thought to figure out a way to make it work as well as the current hashing system. Perhaps "pointless" was a careless choice of words, but the incentive is to put all those cycles to a use that had more value for society, apart from the value of creating bitcoin itself. I forget the exact order of magnitude, but iirc it's something like tens of millions of dollars of electricity being used by miners each year, for no other purpose than to verify the blockchain. It'd be convenient if we could still have cryptocurrency, but all the computing power was going into something like BOINC instead. Hashing is used for good reasons, as you point out, but it's a wasteful use of resources, in my opinion. Even if it wasn't the best cryptocurrency, something that would crash and die with new scientific/mathematical advances, I'd still consider it successful if it got all those resources working on more valuable problems for a while.

It's definitely a half-baked idea. I'd like to take a shot at seeing if I could work out those details, but it's not the top priority on my list of projects. Maybe in a few years, if it is possible and no one else has managed it yet.

</comment></comment></comment></comment><comment><USER11> I don't know if it already exist but a password tool that automatically changes your passwords and syncs it with your mobile/desktop every day. (password for example: gmail, twitter facebook etc.)

something like 1Password but automatically changing the passwords every day/week/month

<comment><USER4> Mostly these type of software provide a policy system where you can set a rule so after every x days you'll be forced to change your passwords.

However, automating this process for 3rd party apps would require to connect to the apps in a way that it allows the product to change passwords of your other accounts.

I'm not even sure if 3rd party apps provide you the API to change password etc from another product. If that can be done then this product is very feasible.

</comment></comment><comment><USER12> Current discussion: [https://news.ycombinator.com/item?id=7693262](https://news.ycombinator.com/item?id=7693262) (150 points, 8 hours ago, 160 comments)

</comment><comment><USER13> [https://github.com/topdownburglar/globalu/blob/master/README...](https://github.com/topdownburglar/globalu/blob/master/README.md)

</comment><comment><USER14> What would you like to see in a weight logging Android application?

<comment><USER15> The next steps in fitness are going to come with device integration, not just the app alone. The apps themselves, not coupled to devices, are converging on ideal in my opinion. I can't think of other features that I would like more for apps like MyFitnessPal other than more integration with the world around me through devices.

<comment><USER14> You are right. Device integration is tricky as hardware manufacturers don't play well with standards. And those hardware manufacturers that are ahead of curve are out of reach of general consumers.

There are several apps in the market that do what I want a logger to do but they tend to present the data in a form which is not very effective in motivating me and reminding me the purpose. For example, There are a lot of app that one can use for tracking activities but Moves take the whole paradigm of activity tracking to the next level.

</comment></comment></comment><comment><USER16> Seeing less comments. It appears people are quickly running out of good ideas.

<comment><USER3> This is a duplicate thread.</comment></comment>


DIY face masks with nylon stocking on top can work better than surgical masks - <AUTHOR> https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v1 <comment><AUTHOR> > As has been previously observed by Cooper et al. (1983), adding a layer of > nylon stocking over the masks minimized the flow of air around the edges of > the masks and improved particle filtration efficiency for all masks, > including all commercial products tested. Use of a nylon stocking overlayer > brought the particle filtration efficiency for five of the ten fabric masks > above the 3M surgical mask baseline.

> When compared to commercial baseline masks, the addition of the stocking > layer improved particle removal efficiency of many masks to match or exceed > the baseline; the masks that achieved this level of filtration using the > stocking layer each included a filter layer (organic cotton batting, Pellon, > or loosely-woven cotton muslin) in addition to two layers of cotton fabric.

I think we now have a basic recipe for producing good home-made masks!

Also, some sewers did tests with the same machines used in this article. Their design claimed 50% efficiency without any filtration media. Adding filtration media achieved up to 87%, equivalent to the best results in this study, by using particular brands of blue shop towels. I think their good results are because their design also emphasizes creating a better seal to the face. [https://suayla.com/pages/suay-community-mask- coalition](https://suayla.com/pages/suay-community-mask-coalition)</comment>


Show HN: Eary – the easiest way to listen to audiobooks on Spotify - <AUTHOR> https://apps.apple.com/app/eary/id1451351600 <comment><AUTHOR> Hey HN!

My name ist Fabian, I'm a computer science student from Munich and created an iOS App which allows you to listen to Spotify audiobooks! What are the advantages compared to the normal Spotify App? The playback position is always saved, so no need to remember anything. You can easily start listening where you left.

What are the key features?

* Have your own audiobook library. So no need for creating a playlist on Spotify. * See full length of audiobooks and your current position. * Play downloaded audiobooks with Spotify Mode (make sure you stop the playback in Eary) * See all chapters (tracks of audiobook) and jump directly between them. * Bookmarks * Sleeptimer * Search audiobooks directly in Eary * Dark mode (activate through settings app or swipe with two fingers)

This is my first iOS Application, and I'm quite sure there are still some bugs, therefore I am grateful for any feedback.</comment>


Our Understanding of Giraffes Does Not Measure Up - <AUTHOR> http://www.nytimes.com/2014/10/07/science/our-understanding-of-giraffes-does-not-measure-up.html?hp&action=click&pgtype=Homepage&version=LargeMediaHeadlineSum&module=photo-spot-region&region=top-news&WT.nav=top-news <comment><USER2> I was hoping the article would mention something about their neuroscience, too. From a control systems perspective, it's rather remarkable that they're able to stand upright. They have similar nerve conduction velocities as we do… but have much longer latencies[1]! It'd be interesting to do further studies and simulations of the control system requirements with such a long delay.

1\. [http://jeb.biologists.org/content/216/6/1003.full](http://jeb.biologists.org/content/216/6/1003.full)

<comment><USER3> Remember that a lot of 'standard' movements aren't fully controlled from the brain. Instead, the brain generators modulating signals to structures/systems lower in the spinal - ie increasing or decreasing your rate of walking. There's lots of evidence of these 'Central Pattern Generators' being located below the brain - which would reduce signal lag.

For a somewhat disturbing example of this, here's a 'decerberated' cat on a treadmill.

[https://www.youtube.com/watch?v=wPiLLplofYw](https://www.youtube.com/watch?v=wPiLLplofYw)

That said, the fact that any vertebrae (even our selves) are able to move and react so well is pretty amazing, given that our own neural lag is in the ~100ms range. It's really a testament to the robustment of the multi-tier control that we (animals in general.. but especially large animals) have evolved.

<comment><USER4> Fascinating (if a little hard to stomach) video. This seems to imply that bipedal locomotion is learned, while quadrupeds have the skill hardwired into lower-level structures. (Certainly, having watched my eldest figure it out, it doesn't seem to be an innate ability in humans.)

<comment><USER3> Just because the structure resides below the brain, doesn't mean that it's simply 'innate'. For example, while deer fawn are famously able to start walking right away, a kitten is actually pretty terrible at walking for many weeks - they still have to learn. Perhaps part of the difference between the 'apparent' skill of quadrapedal and bipedal learning is that a) quadrupedal is inherently easier (its more stable, more forgiving of small deficiencies), b) bipedal 'failure' is a lot more drastic (especially when you have the proportions of a child.. you don't have a lot of leg to catch yourself), and c) we're simply more familiar with bipedal motion, and therefore more critical of flaws on observation.

In addition, there is suggestive evidence that human bipedal motion is CPG driven [1]. I think a reasonable analogy to draw is that at birth a CPG is kind of a lower level controller, all hooked up, but not yet programmed. It takes time and practice to tune and program the controller to generate useful output.

[1] [http://brain.oxfordjournals.org/content/117/5/1143.abstract](http://brain.oxfordjournals.org/content/117/5/1143.abstract)

<comment><USER4> Interesting - thanks.

</comment></comment></comment></comment></comment><comment><USER5> "June 21 is World Giraffe Day — the longest day for the tallest animal" :D What animal should be celebrate on Dec 21 then?

<comment><USER6> June 21 is the longest day only for the northern hemisphere. The southern hemisphere would therefore celebrate giraffes on the (or about) the 21st Dec.

Also, from a cursory search, giraffes occur both north and south of the equator in Africa. So neither northern or southern hemisphere could lay sole claim to picking a day.

<comment><USER7> But around the equator, the length of the day barely varies, so the entire idea behind it is lost.

</comment></comment></comment><comment><USER8> Those Voronoi things are fascinating indeed.

</comment><comment><USER9> Giraffes are heartless creatures

<comment><USER10> Perhaps your comment is a reference to something that I don't know about, or a sarcastic quip. However, it is in direct conflict with the substance of the article:

"Female giraffes, for example, have been found to form close friendships with one another that can last for years, while mother giraffes have displayed signs of persistent grief after losing their calves to lions."

In fact, the emotional behavior of giraffes is a focal point of the article.

<comment><USER11> its a reference to this image, btw: [http://viciulgandirii.files.wordpress.com/2012/03/giraffes-a...](http://viciulgandirii.files.wordpress.com/2012/03/giraffes- are-heartless-creatures.jpg)

</comment></comment></comment><comment><USER12> Why are there so many random NY Times articles ending up on the front page lately? Back 6 months ago I never remember seeing these articles and now there seems to be one hitting the front page every day. I could understand if they were relevant technical articles but one about giraffes?

The worst part is they create very poor discussions where most of the comments get down voted because what can one really say about a story about giraffe evolution?

<comment><USER13> Because someone submitted them and others up voted them. Don't compain just flag it or ignore it.

<comment><USER12> So if a group of people wants to change the fundamental focus of this site from technology to animal evolution we're not allowed to say anything about it? Flagging doesn't do anything because too many people take your approach of just ignoring it (or worse down voting any concern as complaining).

There definitely seems to be a growing group of users who are looking to greatly expand the scope of this site and to me that dilutes the quality of the site.

<comment><USER13> 1\. I don't down vote comments like yours because I try not to down vote (I once down voted in anger and felt bad, ever since I've reserved them for the most ignorant comments I come across and rarely even bother then).

2\. If I ignore it, I'm not up voting it. I'm up voting posts that I think have some value.

3\. This site is about whatever people on this site find interesting. If evolution (an interesting subject) happens to come up, it'll likely get up voted and discussed.

4\. We get some slow days when it's mostly fluff here. And then we get days when it's nothing but academic math papers. It comes and goes, deal with it.

</comment></comment></comment></comment><comment><USER14> NYTimes doesn't let you highlight text?

<comment><USER15> I'm able to highlight text using a mouse.</comment></comment>


Linux and Convertible Tablets - <AUTHOR>

I've been following IFA here and there and I've noticed that manufacturers are moving towards this tablet/laptop convertible form factor. I think Windows 8 will make this form factor be the defacto standard in portable computers. What are your thoughts on how Ubuntu (or any other distro) will adjust/adapt to it? <comment><USER2> Ubuntu has already been touch-optimizing Unity for a long time. Ubuntu (actually the credit should go to Gnome and GTK for smooth scrolling, and Linux kernel for touch drivers) now perfectly supports smooth touch scrolling along with certain three-finger gestures to move windows around etc. They might even be ahead of Windows 8 in terms touch-compatibility. What they should do now is to convince more OEMs to ship Ubuntu devices.</comment>


Why we[The helios project] insist on Linux on the desktop - <AUTHOR> http://linuxlock.blogspot.com/2011/01/why-we-insist-on-linux-on-desktop.html

<comment><USER2> I feel that linux has reached parity with other OS's in all ways but these:

1 - Continuity of applications. For example, in updating Ubuntu on a laptop I use for compiling embedded kernels, I lost the swanky power management window that could tell me things about battery charge/discharge rates. No idea where it went. Then the next version changed the interface again. Adding and removing apps between versions causes problems, if only from jarring users from how things used to work. This is the main reason that I don't support Linux on the desktop as much as I could - I can't more than a few versions of "how the GUI works for program X" when X seems to be replaced frequently.

2 - Hardware compatibility at the edges. The core works great - the problem is with weird/proprietary things (binary drivers, etc...). I don't have a solution for this, other than proper hardware choices at purchase, which is harder than you think.

3 - Microsoft specific formats. I'm talking .doc/.xls/etc. These are the biggest reason people "can't" switch - they have too much rolled up in these old crappy formats that don't convert perfectly to OO.org. 90% of those problems are formatting/fonts/printing/interchange related. The BIGGEST win Microsoft ever had was getting their XML formats (.docx/.xlsx/etc.) approved - had the standards bodies and governments rejected them, everyone, on all platforms (Windows included), would be in a much better place now.

</comment><comment><USER3> yes, windows has a lot of virus. ok, we get it. we get it for over ten years. every year i hear "this year linux will be on every desktop". But it never happened. Just be more realistic please.

data source: [http://en.wikipedia.org/wiki/Usage_share_of_operating_system...](http://en.wikipedia.org/wiki/Usage_share_of_operating_systems)

<comment><USER4> The point he's making is that Windows is being kept alive, in large part, by closed-source fanatics.</comment></comment>