Doctors want ban on prescription drug, device advertisements - <AUTHOR> http://arstechnica.com/science/2015/11/doctors-want-ban-on-prescription-drug-device-advertisements/ <comment><USER3> These ads are one of the main reasons I became a cord cutter. I'm very happy they have not yet followed me onto any of the streaming services I use.

They are the creepiest thing ever on television. The actors sit around dinner tables with family members speaking unnatural, FDA manipulated dialog ("Oh, I'm doing great, I've been taking Pradaxa for my afib, not caused by a heart valve problem!") Then you get the unending list of side effects read aloud ("death" almost always one) while the actors smile and stare off into space.

Occasionally, one of these ads will come in a 2 minute and 30 second variety that fills the entire commercial break.

A regulation I'd like to see is that all the side effects must be acted out in the commercial as they are read. Show the peacefully sleeping woman suddenly awakened, choking on her swelling tongue. Or a man running around with an actual 4+ hour erection.

<comment><USER4> The irony of wanting to ban Rx drug ads because they are creepy, is that it was regulations that made them creepy to begin with. (You seem aware of this already)

There is an argument to be made for consumer advertising for a drug like Viagra. Without awareness that an effective treatment exists, patients with ED or another embarrassing condition are not likely to bring it up with their doctor on their own, thus resulting in unnecessary suffering.

Another argument is that for various reasons some patients are unlikely to seek a second opinion, even when one is warranted. Consumer advertising is a way to present alternative treatment options to a patient whose doctor will not.

<comment><USER5> What if you allow basically the same ad but disallow mention of any brand names - only the generic name or condition to be treated?

<comment><USER6> Then we have a tragedy of the commons, where Pfizer and Lilly (the makers of Viagra and Cialis respectively) will wait for the other to create generic ED ads that they will both benefit from.

<comment><USER7> Or they would, you know, work together for exactly this reason, like how dairy farmers supported Got Milk? together

<comment><USER6> "Got Milk?" was originally commissioned by the California Milk Processor Board, which is administered by the California Department of Food and Agriculture (i.e. the government) [1]. Also note that milk lacks much in the way of strong brand identity or distinguishing features, unlike Viagra and Cialis which are very different medications.

[1]: [https://en.wikipedia.org/wiki/Got_Milk%3F](https://en.wikipedia.org/wiki/Got_Milk%3F)

</comment></comment></comment></comment></comment></comment><comment><USER8> I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker. You can't buy prescription drugs without a doctor's authorization, so basically the ads are asking people to go beg their doctors for medicine they may, or may not, need. The doctor, in turn, may give in to the patient's emotional pleas, since they are, in effect, in a customer service business. This would be an ethical violation. This rule would remove the ethical temptation of doctors

Further, it will be nice not to hear about an erection lasting over 4 hours, and not being too old for sex, in front of my 11 year old daughter while watching the news after dinner.

From a policy perspective, since the patients are not usually paying for the meds (you and I do), it makes sense to keep demand and prices low, as the doctors assert.

As for the free market, we do not have a free market in medicine. It is highly regulated through insurance and government regulation. So, I don't see a problem there.

<comment><USER9> "I've never understood the logic behind prescription drug ads. The first rule of sales is to pitch the decision maker."

Plenty of logic is there.

Part of the purpose is to make the Doctor pay attention to the advertising that they see in a journal. [1]

How?

Patient goes in and "asks their doctor" about a drug.

Then another patient. And another.

So now when the doctor sees an ad (or the detail man comes in) the doctor pays more attention and perks up. Similar I guess to the way once you buy a particular car model (or a friend buys one) you start to notice them all over the place. Same reason Pepsi puts ads in football stadiums. Builds general awareness and adds to reinforcement of the product as being "current".

HN works in a similar way for YC by the way. Repetition and current relevance very important in advertising.

[1] Edit: And of course Physicians also watch TV and read mainstream magazines and an ad is likely to stand out and get noticed just for that. (As a tech person imagine if you saw an ad for some software or SAAS that wasn't mainstream on the nightly news. It would certainly get your attention and stand out (more than if you saw it on Techmeme)).

<comment><USER10> _Patient goes in and "asks their doctor" about a drug._

I wonder if this really ever happens. I mean, for many of the ads, it's hard to tell even what the drug does, so going to your doctor and asking for that med would amount to a random question.

<comment><USER11> Oh hell yes. The main one peaople ask me about right now is Marcumar/Warfarin, a drug many patients with atrial fibrillation have to take for the entire rest of their life, despite the fact that it has awful side effects and requires them to go to their doctor every two to four week to have a blood test done. Many patients are quite excited to hear that there's now new alternative drugs (NOAKs) that let you skip the biweekly blood draw. I get asked about Pradaxa, Eliquis and Xarelto so often, my standard Marcumar pitch now includes a whole paragraph about how those alternatives are just as bad. This is getting harder to sell as new studies are coming in and my arguments against the new drugs are steadily being reduced to "They're a lot more expensive." Patients really do NOT want to hear about how they have to get stuck with needles every two weeks so their doctor can save a few Euro a month in the prescription budget.

The whole NOAK advertising scheme seems like a huge win for the pharma companies to me. (Possibly also for the patients. Not so much for the affordability of our medical system.)

<comment><USER12> As an ICU physician, I hate the NOAKs. The data may say that they bleed less. However, when they do bleed, I've got nothing that really reverses the bleeding.

Of course, novel reversal agents are coming and each one will likely only reverse one drug... and each one will cost an arm and a leg.

I understand why patients do it. I just don't like bleeding that I often can't directly control.

<comment><USER13> I will never stop being impressed at the breadth and depth of the HN audience. Thanks, you two, for your comments.

</comment></comment></comment></comment></comment></comment><comment><USER14> I'm a doctor, and I think this is a good idea.

The information provided to both doctors and patients by drug companies is marketing material. The best source of information is peer-reviewed publications, and even those are subject to some bias. Still, that's the best source we have, and should be the primary way all of us get health care information. If you, as a patient, do not understand what the reasearch articles are about, bring them with you to your appointment.

In my clinic, I do not accept visits or items from drug reps (including glossy marketing materials, pens, etc); the only thing they can leave me is a copy of a peer-reviewed article.

<comment><USER15> That's a great approach.

However ... when I was unemployed, I was very happy that my doctor had free samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had free samples for some of the things our kid needed.

<comment><USER16> > However ... when I was unemployed, I was very happy that my doctor had free > samples from her rep of $DRUG_THAT_KEEPS_ME_ALIVE. Our pediatrician also had > free samples for some of the things our kid needed.

Just remember, public health care is _communist!_ Better dead than red.

<comment><USER15> I wonder how long it's going to take to get our heads out of our asses, calm the fuck down, and really exploit civilization's gifts to take care of ourselves and our brothers.

</comment></comment></comment></comment><comment><USER17> I live in the UK, and I love that there are no Rx TV commercials here. Then again, I live in Scotland, and I get my prescriptions for free. The NHS is an incredible service, and it surprises me that most Americans don't want publicly funded healthcare. Even those darn Canadian guys north of your boarder have a good public healthcare system.

BTW, the UK economy spends almost half in, relative terms, at 9.6% of the UK GDP vs the Americans spend of 17.9% of GDP, on healthcare. In real terms (2012 dollars), the UK spends $3480 per person vs the US spending $8362 per person. And we have a health care system free at the point of delivery.

<comment><USER18> We're 'MURICANS! We don't need no stinking gubmint telling us what doctor we can see! Now let me get down to Walmart on my Medicare provided scooter because I'm too obese to walk... [https://www.medicare.gov/Pubs/pdf/11046.pdf](https://www.medicare.gov/Pubs/pdf/11046.pdf)

<comment><USER17> Just so we're absolutely clear, I can choose my own doctors. GP's, specialists, dentists, and even a Homeopath!; if I don't like 'em, I can find another, and all on the NHS. I think, in fact, I have more choice than Americans--don't you have to go to whomever your HMO tells you to use? Also, your Canadian neighbours to the north get to choose their doctors.

<comment><USER19> Most medical plans create doctor pools and aggressively recruit doctors for those pools. I've never found a doctor that didn't accept my insurance.

<comment><USER17> I am saying three things:

1.) There is a very common assumptions in the USA that because a State funds healthcare, the individual is not allowed choice of doctor, which is incorrect in every public healthcare system I have used.

2.) That public or state run health care system is not substandard or less efficient to the American private system, but actually generally better for just about everyone.

3.) That if every American paid a flat 18% tax for healthcare (instead of any healthcare insurance premiums, whether paid directly by you, or by your employer), then the American government nationalised all American healthcare, every American should then receive at least a $4000 tax rebate. Then again your government could use that money fund better schools and universities.

[EDIT] And by-the-way, the UK Government still spends less than the American Government on every citizen, on healthcare. The American government spends $4437 per every single American citizen every year on healthcare. By contrast, the UK spends $2919 per person, every year. You tell me which tax payer is getting better value for money.

[http://www.theguardian.com/news/datablog/2012/jun/30/healthc...](http://www.theguardian.com/news/datablog/2012/jun/30/healthcare- spending-world-country)

<comment><USER19> I'm suspicious of govt-run healthcare. Look at Canada - their system is in collapse.

<comment><USER17> Is it? BTW, provision of healthcare in Canada is a provincial matter, so there are 13 separate healthcare systems in Canada. Which one is in collapse? Or are all the provinces facing severe budgetary constraints imposed by the previous Conservative, let's not tax the rich, government.

There are some very powerful, vested interests, namely the insurance and drug companies, that do not want public healthcare.

I am completely suspicious of private, for profit healthcare.

Are you seriously telling me that private healthcare is better? (Okay, private healthcare is better for the maybe the top 1% who can pay for their healthcare out of pocket, but if that is not you, the public system is better.) If I change employer, and therefore insurance policy and/or provider, I will never have to think about previous conditions that may not be covered with my new employer, for instance.

</comment></comment></comment></comment></comment></comment></comment><comment><USER12> See how much money your physician takes from drug companies.

[https://www.cms.gov/openpayments/](https://www.cms.gov/openpayments/)

As a physician I can tell you that this type of public reporting has radically decreased the amount of stuff that doctors take from drug companies.

Removing advertising from the TV will do the same. It is much easier for a physician to give a patient the most correct medication without these biases. Remember that in the US, we spend about 2-3X as much as anybody else for less length and quality of life.

[http://qz.com/553181/americans-spend-nearly-three-times- as-m...](http://qz.com/553181/americans-spend-nearly-three-times-as-much-on- healthcare-as-other-wealthy-countries-and-die-earlier/)

<comment><USER20> I would argue the opposite. By creating a separate class of individual that receives information about medicines we obfuscate what the options are. Under the current model a doctor could say "You should take <x>" and I would have little to no exposure to alternatives" .

IMO the real issue is that advertising (not just pharmaceutical) is not very informative anymore, we need a return to fact based ads. No more "sexy" women draped over whatever, no more saccharine smily women glowing after their husband took <y> ... Ads today are propaganda.

<comment><USER21> > _information about medicines_

TV ads are not "information about medicines", that's just ridiculous. They are mind-games the advertisers play with potential customers in hope of squeezing more cash out of them.

You want true information? Read peer-review studies.

> _Under the current model a doctor could say "You should take <x>" and I > would have little to no exposure to alternatives_

Right, 'cause doctors are evil like that. I just saw an ad revealing what doctors don't want me to know, I am totally going to believe it!

<comment><USER22> You could say similar things about political ads. They're mind-games. Do we want to get rid of them too?

<comment><USER23> ABSOLUTELY YES.

That we, as a society, allow people deceive us and to lie in our faces, and not only that - we've turned it into an respected occupation - still boggles my mind.

<comment><USER24> In order to ban lies, you need to entrust power in someone else to discern the lies from truth. But that someone else lies too.

It is simply intractable. Like the halting problem.

<comment><USER22> Exactly. That's why we opt for free speech. We allow people to lie and attempt to deceive and spin because we know that it's better for citizens to be accustomed to the marketing and somewhat robust against it than to trust some other higher power that can betray the unprotected and unaware masses.

<comment><USER23> I don't buy it. I think "we" didn't allow a thing, it's just that lying makes money, money gives power, and power can be used to keep your lying legal (and money can be used to make it be perceived as socially acceptable occupation).

<comment><USER22> And how do you get around the problem of who watches the watchers?

[edit add: Because I actually don't disagree with anything you said, but the solution you propose never seems to work]

</comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER25> I guess I'll be the one to go against the grain here. I've seen a lot of doctors over the years, primarily for mental illness, but my experience has served me well generalizing to normal, physical health. The model of a doctor as a paternal guardian who knows better than you so you should just do as he says is a very bad model. They're as flawed human beings as anyone else and the only person qualified to fight for your best interests is you. Doctors get complacent, lazy and fail to keep up with the latest information unless you press them to do so. You HAVE to stay informed and aware to get the best treatment. Ads can serve an important function of informing patients of new treatment options and if doctors could truely be entrusted with your health without question then there wouldn't be a need to regulate these ads at all since doctors would only be perscribing the best treatments anyway. Medicine works best when it's a two-way, active dialog. In my personal experience anyway.

<comment><USER26> As someone who also has mental health issues, I want to say I agree. However, I don't think ads are the optimal way for a populace to stay educated. Personally, every medication I've been prescribed has been followed by my own research as to how the medication is designed to work.

I will agree though that the relationship between me and my doctor should be a two-way one. I am completely open with my doctor and make it known what i expect out of them, and they are the same with me.

<comment><USER25> It's not the best solution, but I don't think banning them will do any good. I'm more rebutting the attitude in this thread that medical information is only for your doctor and not you. I don't think you'll get better health outcomes by focusing all of your medical advertising budget on influencing doctors behind the backs of patients. And advertising does serve a legitimate purpose; I knew a woman with restless leg syndrome who had suffered from it for all her life, but a treatment wasn't developed until something like 5 or 10 years ago. She'd have never asked her doctor about it had she not seen the advertising since she had gone without medication for 50 or 60 years at that point.

<comment><USER27> We should just ban profit seeking in health care. It removes the incentive to cheat.

</comment></comment></comment></comment><comment><USER28> This is an issue for both doctors and pharmaceutical companies. Doctors hate it because patients may want a drug that's not optimal for them (but I saw if on TV) and it's bad for pharmaceuticals because they've had to become marketing machines, investing massive amounts of money into advertising and sales apps.

The biggest issue with an outright ban is consumer education. Someone, something, or some organization needs to be responsible for properly communicating and educating consumers on a drug, its benefits, and its negatives. It needs to be educational, supplemental, and neutral.

Stuff like this does exist for cancer drugs but should spread to other drug areas as well.

<comment><USER29> > Someone, something, or some organization needs to be responsible for > properly communicating and educating consumers on a drug

Why shouldn't this just be their doctor?

<comment><USER30> The best reason, in my opinion, is that there are new drugs all the time. The FDA approves on the order of 20 or so drugs per year (that's new drugs, not including new generic versions of old drugs). So physicians have to learn 2 new drugs per month in enough depth to consider how it should change their current prescribing habits.

<comment><USER31> And now, when advertising is allowed, doctors don't have to learn those new drugs?

<comment><USER32> When there's a brand new drug for your semi-rare condition, your family doctor might not yet know such a drug even exists were it not for you seeing the ad and asking about it.

<comment><USER33> Family doctors are not likely to be treating a semi-rare condition.

To put it in programming terms, a front-end web developer would seek advice from a networking expert if her or his application was experiencing a lot of networking difficulties.

</comment></comment></comment></comment></comment></comment><comment><USER34> Even though many commenters here write about how creepy these ads are, I don't think many people realize how _weird_ this looks to the rest of the world. The US and New Zealand are the _only two western nations_ which even allow them to exist.

As I am not residing in the US myself, the only experience I have of this phenomenon is in parody form: Progenitorivox!

[https://www.youtube.com/watch?v=mYodDH4qZQo](https://www.youtube.com/watch?v=mYodDH4qZQo)

(I may or may not have written this comment with the exclusive purpose of linking that video.)

<comment><USER35> See also: Paracetamoxyfrusebendroneomycin, [https://www.youtube.com/watch?v=qWfwNdmK2lA](https://www.youtube.com/watch?v=qWfwNdmK2lA). (Warning: contains some rude words.)

</comment></comment><comment><USER36> One of the arguments I've commonly heard against a ban like this is that pharmaceutical companies need to market their products because of the cost developing new drugs. However, this has turned into a strategy of expanding the medical uses of already approved drugs and then marketing the "new uses".

Tylenol is the perfect example of this. Everyone "knows" that it reduces the risk of heart attacks, because of the marketing campaigns. But what most people don't know is how little of an impact Tylenol actually makes.

<comment><USER37> > _" Tylenol is the perfect example of this. Everyone "knows" that it reduces > the risk of heart attacks, because of the marketing campaigns. But what most > people don't know is how little of an impact Tylenol actually makes."_

Do you mean Aspirin?[1]

[1] [http://www.scq.ubc.ca/should-i-take-tylenol-advil-or- aspirin...](http://www.scq.ubc.ca/should-i-take-tylenol-advil-or-aspirin/)

<comment><USER38> lol

</comment></comment></comment><comment><USER39> Good the fuck luck. Pharmaceuticals are one of the biggest lobbying groups in DC. Advertising firms would be heavily against this as well.

I'm all for this, but it's never going to happen without severe public outcry, and even then...

</comment><comment><USER40> Key question for digital health / biotech startups is whether direct to consumer (D2C) advertising for testing services (e.g. genetic carrier screening; cancer risk screening) would be included.

</comment><comment><USER31> Great news, so pharma companies could focus more on drugs itself and less on marketing. It's huge money waste with mysterious intention - if your drug is the best, doctors should use it anyway, and if it's bad but you can increase its usage with huge marketing campaign, then mankind just gets screwed for own money.

<comment><USER23> > _if your drug is the best, doctors should use it anyway, and if it 's bad > but you can increase its usage with huge marketing campaign, then mankind > just gets screwed for own money._

That's 100% true for everything - just replace "drug" with "product". As soon as an advertisement is leaving the point of informing about product's existence and features, it's starting to trick people into chosing a suboptimal option.

<comment><USER41> If people acted like homo economicus, that would be true. But people are so irrational, that sometimes they need to be convinced to do the right thing for the wrong reason, no?

In other words, a given advertisement might be tricking people into choosing the optimal option.

<comment><USER23> > _In other words, a given advertisement might be tricking people into > choosing the optimal option._

It could be so, in principle, but do you trust people who profit off not having your best interest in mind to do that?

</comment></comment></comment></comment><comment><USER42> While I agree with the idea here, it's important to not take it too far. In Canada "advertising to patients" is interpreted to mean almost any communications at all -- including putting up websites with purely informational content. As a patient who sometimes needs information _about drugs I 'm already taking_, this is not helpful. (Fortunately many such websites allow a "why yes, _of course_ I'm a doctor" checkbox to get access to more medical information. But not all.)

I think disallowing "push" advertising while still allowing companies to make information available to patients who deliberately seek it out would be a good compromise.

</comment><comment><USER43> I'm surprised the AMA, insurance companies or the US government haven't built a simple website that compares the drugs used to treat various conditions to combat the problem of people switching drugs because they are new or are heavily advertised.

While a layman can't be expected to fully understand the benefits/drawbacks/interactions of a drug in detail, it seems like it should be possible to have an easy to understand grid of positives, negatives, retail price, etc. that would make comparing say, the brand new bipolar drug to old generic lithium.

</comment><comment><USER44> There's a part of me that wants to agree completely...and there is another part that has concerns about the messenger.

The end result of that would be that the gatekeeper to knowing about these drugs or devices are the doctor's themselves meaning those companies just have to work harder to advertise to the doctors to recommend their drug/device.

From Last Week Tonight w/ John Oliver: [https://www.youtube.com/watch?v=YQZ2UeOTO3I](https://www.youtube.com/watch?v=YQZ2UeOTO3I)

</comment><comment><USER45> Why not remove a ban on buying whatever you want WITHOUT prescription.

</comment><comment><USER46> When I was in the US for most of last year for business this is the one thing that really perplexed me. In Australia the only advertisements we have are for Nurofen and popular paracetamol product Panadol. In the US, things are ramped up quite substantially, ads for blood pressure medication and erectile dysfunction.

I just stopped turning on the TV in the end. These ads seemingly dominate television over there and some of the side effects for those drugs sound horrible, death is mentioned a lot.

</comment><comment><USER47> One of my parents is a doctor, and I grew up getting a amazing front-row baseball seats courtesy of pharmaceutical sales representatives. Not to mention dinners out at nice restaurants when I tagged along to medical conferences.

I thought that practice was forbidden, but perhaps not: [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811591/)

</comment><comment><USER48> I'm a grumbly old man despite my age, and am rarely in favour of new laws. That said, I find outlawing prescription drug ads entirely reasonable.

</comment><comment><USER49> Relevant slatestarcodex: [http://slatestarcodex.com/2015/04/30/prescriptions- paradoxes...](http://slatestarcodex.com/2015/04/30/prescriptions-paradoxes- and-perversities/)

TL/DR: Doctors like to prescribe new flashy drugs, and patient vs. doctor's ratings of various drugs are negatively correlated.

</comment><comment><USER50> Doctors are very good at keeping tabs on earnings of others but have no limits on the estimates of their own value. We in turned are conditioned to respect doctors as the vessels which carry the whole of healthcare. Nothing could be further from the truth. Talk to a very large percentage of doctors outside the office and you find that money is there bottom line. They're all for tort reform so you can't recover a large settlement when they are negligent. They grouse endlessly about how much they have to pay for malpractice insurance. I recently saw a doctor get into a private chauffeured limousine with a vanity plate outside a major NY hospital. I don't know too many pharma execs that live that high on the hog. Did I mention the chauffeur was armed. I guess you can make people angry when you flaunt wealth like that. My own doctor lamented not making as much money as "those wallstreet guys" just before he forgot I was in the hospital for a week. Oops.

<comment><USER51> Absolutely. US doctors have the highest income in the world. Even our supposedly underpaid GPs have higher salaries than specialists in almost every other country. And the public accepts it, even defends it! Yet our health outcomes aren't any better.

<comment><USER52> Health outcomes are determined by more factors than the quality of medical care. Obesity (and it's bed fellow diabetes), sedentary lifestyles, drinking & drugs, etc. Given current medical knowledge and technology, no medical system can undo the harm caused by those cultural factors. Doctors' advice is just that, advice that you are free to ignore.

Even more specific metrics can be misleading. E.g. we know that cancer patients are more likely to be cured in the US than in Europe, but there's enough confounding factors to muddle any conclusions. It could be that earlier detection in the US leads to treatment for a cancer that would have gone into remission on its own and never been detected by doctors in another country. Or it could be that US cancer care is superior.

</comment></comment></comment><comment><USER53> I would support such a ban. But mostly so that watching the nightly news without being able to skip commercials would be more palatable.

<comment><USER54> Get ready for more Draft Kings one day fantasy duel promo code: GambleYourFamilysMoneyAway.

<comment><USER53> There is that. It is interesting to see how television in particular seems to have lost a lot of advertising diversity, excluding advertising for other shows on the same network, these days just drugs, cars, lawyers, and pay-to- play games, with the occasional movie trailer for good measure. Bad news for television networks.

<comment><USER54> Yeah - to the point that I can't stand it. I can't even watch football anymore. I generally end up muting the commercials and forgetting to check back when they're over.

<comment><USER38> Monday night football is like USAA and IBM Watson commercials over and over. With erectile disfunction thrown in.

</comment></comment></comment></comment></comment><comment><USER55> I am from the UK. When I first went to the US in the 90s I was _shocked_ to see adverts on TV for prescription meds. Sure I was used to an ad for some "premium" paracetamol in the UK but drugs to treat depression? nerve pain? Etc.

When I released it was the norm I wasn't surprised the US never established an NHS style system. Way too much money to be lost.

</comment><comment><USER56> As part of the UK's single-payer system, it is illegal to advertise prescription medicines to the public. Seems to work.

<comment><USER57> You mean DTC advertising?

There are still sales reps in the UK, no?

<comment><USER56> Yes, although actual prescribing is supposed to be limited by the government agency NICE.

(see also [https://www.gov.uk/guidance/advertise-your- medicines](https://www.gov.uk/guidance/advertise-your-medicines) )

</comment></comment></comment><comment><USER32> Are family doctors able or willing to keep up on the flood of new medicines available, each of which may only apply to a handful of their patients?

Aren't drug ads, in a way, a good method for matching medicines to the people who need them? As far as I know, your family physician isn't going to call you when a new drug comes out that better treats your semi-rare, non-fatal condition - and patients aren't going to read medical journals to discover new drugs to ask their doctor about.

<comment><USER33> I replied to this comment elsewhere:

Family doctors are not likely to be treating a semi-rare condition.

To put it in programming terms, a front-end web developer would seek advice from a networking expert if her or his application was experiencing a lot of networking difficulties.

Further, even if your family physician is monitoring the progress of your disease, you'll likely also be seeing a specialist who will also be monitoring the progress of your disease.

<comment><USER32> > Family doctors are not likely to be treating a semi-rare condition.

Really?

I have family members with rare conditions - for example diverticul(it/os)is, which affects 0.74% of the population - and they don't see specialists. The family physician monitors it. And this is with a "Cadillac" insurance plan.

I don't think every rare condition automatically gets you in with a specialist.

<comment><USER33> It likely sounds like a rare condition for you and your family members but that particular example happens to be something regularly discussed in first year medical school courses. See [1] for a discussion of how common this is.

Also consider that a family practitioner might easily have 2,000 patients. Thus, she or he will likely have direct experience with diverticulitis.

Further (and this is more inside baseball), your family members would need to be admitted to a hospital if their disease worsens to the point that a standard course of antibiotics won't help.

There might be better examples of 'rare' conditions than this, but the point stands - for any condition where extensive domain knowledge is required, you'll have a specialist involved.

Incidentally, diverticulitis is a very American disorder, likely attributable to our eating habits. You and all other readers should be sure to include fiber in your diet.

[1] [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780269/)

<comment><USER32> > Incidentally, diverticulitis is a very American disorder, likely > attributable to our eating habits. You and all other readers should be sure > to include fiber in your diet.

The family member in question has eaten a near total vegetarian diet for most of their life, so fiber intake is not the problem in this case.

</comment></comment></comment></comment></comment><comment><USER58> only the US and NZ allow direct-to-consumer advertising of prescription drugs.

let that sink in a bit.

from germany to japan to ghana to timor leste - everyone else has disagreed on this approach.

<comment><USER59> Argumentum ad populum is a logical fallacy.

Only Uruguay has legal marijuana, doesn't make illegal marijuana a fantastic public policy.

<comment><USER58> everyone agrees jumping from the roof of a 6 story building will hurt - <USER2> please go ahead, try your debate theory against it.

</comment></comment></comment><comment><USER60> There is one I see advertised regularly, one of the side effects is "suicidal thoughts, or actions", can you believe that, OR ACTIONS. It's one thing when a pill causes my body to fail and I die, it's quite another to have a pill put me in a state of mind where I kill myself.

Also I have seen recently the words, "these are not all the side effects, see our website for a complete list".

It's unbelievable what it has come to.

<comment><USER24> > It's unbelievable what it has come to.

I don't understand your sentiment. Do you think that the drugs you take before do not have this many side effects, including suicidal thoughts or actions? Or do you find it unbelievable these side effects are now required to be spelt out in front of you?

</comment></comment><comment><USER61> I would not mind keeping them provided that they were required to mention the generic if it exist by name in regular sized print and voice.

Most of the drugs I see are ED/PE related and yes you can get prescriptions.

Still in the end, if we are going to allow untested by the FDA and others supplements to be advertised then why would we block drugs which have passed rigid testing from being advertised. Sorry, that would make zero sense.

</comment><comment><USER62> Such a ban would probably be damaging to many publicly traded companies (not just in health care, but also media and related) that are large components of the Health Care index funds and even broader market index funds sitting in Americans' retirement accounts... which might make this difficult to accomplish politically. (Aside from constitutionality issues, etc.)

<comment><USER21> Ah, yes, the "it will hurt the free markets" red herring.

<comment><USER62> How is it a red herring with respect to political feasibility? (Which you'll note is my point; I'm not arguing anything here about the merit of the idea itself on this basis, except insofar as one counts feasibility as in-scope for merit.)

</comment></comment></comment><comment><USER63> I wonder if HN community reaction would have been different if the headline was "Doctors want ban on access to information to general public on prescription drug and device."

This community sees the word "advertisement" and flips out. I guess health insurance and medical special interest groups did their homework on how to phrase the argument in their favor.

</comment><comment><USER64> I'd like to know more about the strategy for disrupting that $4.5 billion gravy train. The pharma industry and consolidated media is going to fight tooth and nail, and our current surgeon general seems too close to the industry to act as the heavy in calling for more regulation, as did his predecessors with tobacco.

</comment><comment><USER65> This is a great idea, so long as you also ban doctors who fail to keep up with advancements in medicine.

</comment><comment><USER66> Glad to see AMA expand their lobbying efforts beyond protecting incompetent doctors from lawsuits.

</comment><comment><USER67> I'm trying to understand, but I'm pretty confused. There must be something I'm missing, because it seems that this is an obvious move to the majority of the world, as well as the majority of Hacker News. Could you all help me out? What am I missing?

First, implicit in most of the comments here is the idea that whether you _need_ or _don 't need_ a drug is a simple, black-and-white thing. The idea seems to be: if you truly had a need for a drug you'd be going to the doctor for it already, and if you were going to the doctor for it already you'd get the medication. It seems to me there's a lot more nuance. There are many, many classes of drugs that solve problems that aren't obviously "go to the doctor!" kinds of problems. I take a prescription medicine sometimes when I do public speaking. It never occurred to me to talk to a doctor about that problem, because it just seemed like a "problem" some people have and others don't. I happened to find out that this situation is easily treatable online, but I easily could have found out by watching a commercial. And this medicine makes my life significantly better, so that commercial would have been of enormous benefit to me, the consumer.

Secondly, it seems obvious that commercials which increase demand would inflate price. For the class of drugs like above -- drugs that make people's lives better but aren't saving lives or addressing significant medical problems -- why should that not be the case? I pay zero dollars for this drug because I have good benefits. Why should that be? I make plenty of money, and I can survive just fine without this drug. Why should I pay zero dollars for it? Why shouldn't the free market be in play in that situation? If we pretend my insurance didn't pay for this drug, I would be happy to pay a bunch of money for it -- or choose not to pay a bunch of money for it because it's too expensive. It's exactly the same decision I make about food at the store, or a new TV.

I understand that there are many prescription drugs that aren't "casual" in this way. I think it's good for society to do everything it can to grant to citizens a certain level of health, and therefore I'm all for restrictions on how these kinds of drugs are priced. And therefore it makes sense to have restrictions about how these kinds of drugs are advertised. But Viagra? Why shouldn't Viagra be subject to the free market? I'm an ultra-progressive (though rational) liberal here, so I don't really understand what I'm missing. Clue me in!

</comment><comment><USER68> The doctor has to write a prescription for the drug based on his knowledge and experience the tv add therefore is superfluous and solicitous and Unnessary the add is an attempt push the new expensive drug on the patient and their doctor

</comment><comment><USER69> 1) Please, please, please... 2) There goes TV.

"May Cause Death." That's some good advertisin' right there.

Of course, it's interleaved with the ads from law firms trolling for the victims of the stuff advertised from five years ago...

</comment><comment><USER70> Color me surprised and happy... I hope this become a reality.

</comment><comment><USER71> They're banned in Australia, I've never actually seen one before just heard about them from American comedians. I find the practice very strange

</comment><comment><USER72> Yes, please do. Completely agreed.

I find these ADS very highly disturbing, and I'm old enough to remember times before these ADS too.

</comment><comment><USER73> I agree the ads suck.

Banning things rarely makes things better.

</comment><comment><USER74> What rubbish! Let speech be free, and let people make up their own minds about things.

<comment><USER75> I'm a doctor, and very into free speech, but the problem here is that in healthcare, patients' choices are paid with other people money.

<comment><USER76> As a healthy, single, white male who hasn't had a threatening reason to visit a doctor, This. I probably wouldn't have health insurance right now if it weren't for the Affordable Care Act (even though my employer pays most of it). Sure that could bite me in the ass if something were to happen to me, but I'm comfortable with that risk and have family to help me out. There's no good reason for me to "outsource" my healthcare options.

<comment><USER77> > Sure that could bite me in the ass if something were to happen to me, but > I'm comfortable with that risk

Has it ever occurred to you don't have much control over that risk, and that you are a human being that like every other can become sick for no reason at all?

> and have family to help me out

Has it ever occurred to you that many people in the United States do not have family to help them out?

<comment><USER38> That's ok because the emergency room has to treat you if you don't have insurance but don't mention single payer or those same people will flip out. Even though those costs are being passed on to the insured int he current setup.

<comment><USER78> Uncompensated care in the US for 2013 was $85 billion ([http://kff.org/uninsured/report/uncompensated-care-for- the-u...](http://kff.org/uninsured/report/uncompensated-care-for-the- uninsured-in-2013-a-detailed-examination/)). Which may seem like a lot, but it's a drop in the bucket compared to the total health care spending of $3.8 trillion ([http://www.forbes.com/sites/danmunro/2014/02/02/annual-u- s-h...](http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare- spending-hits-3-8-trillion/)). The alleged problem of people deliberately not buying health insurance and then freeloading when they get sent to the emergency room just isn't a significant factor. But the ACA cleverly uses that as a pretense to force young and healthy people to pay far more than the fair market value for insurance policies, as a way to disguise subsidies to others.

</comment></comment></comment></comment></comment></comment><comment><USER79> "Patients want ban on doctors taking money from prescription drug companies"

</comment><comment><USER80> How about banning reps from visiting doctors and pushing their products?

</comment><comment><USER81> Medical advertisements aren't the problem. The problem is that consumers aren't spending their own money and don't know how much things cost because medical providers can't/won't tell them.

Let's fix _that_ problem.

</comment><comment><USER82> Yay! I was thinking they should be unable to use actors and only be able to use people with the conditions they treat.

</comment><comment><USER83> Can't a free market sort out the problems with drug use?

<comment><USER84> As it is, there are too many distortions. You don't pay for your drugs, your insurance company does. You don't even pay for your insurance, your employer does. So once a year, maybe, you grumble that your insurance premiums (the part you pay, at least) are going up, then the next day ask your doctor about Scrotium.

<comment><USER85> Also, tying health insurance to employment is a direct result of the Feds wage and price controls of the past. Business couldn't compete in cash, so they went for the next biggest benefit.

</comment></comment></comment><comment><USER86> Over and over people on HN come to the defense of advertising. Doctors tend to be Republican and free-market adherents. So why would they be against drug advertising?

 _" It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"_ _\- Upton Sinclair_

<comment><USER87> > Doctors tend to be Republican and free-market adherents.

Where did you get this idea from?

<comment><USER23> Not to mention this idea:

> _Over and over people on HN come to the defense of advertising._

<comment><USER86> > _Doctors tend to be Republican and free-market adherents._

This was based on an outdated[1][2] understanding and personal experience (my father is a physician and nearly every physician I knew supported Reagan). I retract.

> _Over and over people on HN come to the defense of advertising._

I know this because in my comments here I frequently criticize the role of advertising on the internet and society in general. The downvotes are many. Not everyone defends ads, but many do, and my comment is directed at them.

Here's one thread[3]. I can't spend more time on this, so if you guys still don't believe me, you win (for the moment). I'd rather you were right anyway. -

[1] "In the mid-90s, 72% physicians' campaign donations went to Republicans." [https://www.advisory.com/daily-briefing/2015/04/30/how- docto...](https://www.advisory.com/daily-briefing/2015/04/30/how-doctors- political-affiliations-have-changed)

[2] "The percentage of contributions that doctors have given to Republicans has mostly declined since 1996. It dipped below 50 percent in 2008 before rebounding in 2010." "The study attributed the partisan shift to an increase in female physicians and the shrinking number of doctors running their own solo and small practices." [http://www.nytimes.com/2014/06/03/upshot/doctors- arent-stron...](http://www.nytimes.com/2014/06/03/upshot/doctors-arent- strongly-republican-anymore.html)

[3] [https://news.ycombinator.com/item?id=10398290](https://news.ycombinator.com/item?id=10398290)

<comment><USER23> > _my father is a physician and nearly every physician I knew supported > Reagan_

Reminds me of a pretty interesting post by Yvain[0]. The relevant quote:

"There are certain theories of dark matter where it barely interacts with the regular world at all, such that we could have a dark matter planet exactly co- incident with Earth and never know. Maybe dark matter people are walking all around us and through us, maybe my house is in the Times Square of a great dark matter city, maybe a few meters away from me a dark matter blogger is writing on his dark matter computer about how weird it would be if there was a light matter person he couldn't see right next to him.

This is sort of how I feel about conservatives.

(...)

What I mean is – well, take creationists. According to Gallup polls, about 46% of Americans are creationists. Not just in the sense of believing God helped guide evolution. I mean they think evolution is a vile atheist lie and God created humans exactly as they exist right now. That's half the country.

And I don't have a single one of those people in my social circle. (...)

I live in a Republican congressional district in a state with a Republican governor. The conservatives are definitely out there. They drive on the same roads as I do, live in the same neighborhoods. But they might as well be made of dark matter. I never meet them."

\--

> _Here 's one thread. I can't spend more time on this, so if you guys still > don't believe me, you win (for the moment). I'd rather you were right > anyway._

Hah. An advertising-bashing thread I missed :<. I post a lot of negative comments about advertising too, and the reactions are... mixed. I have an impression that HN is a bit split on the issue, some believing that it's absolutely necessary and others (like me) who would say "good riddance" if all ad-supported web sites disappeared right now. But I don't feel like there's a HN consensus around ads.

[0] - [http://slatestarcodex.com/2014/09/30/i-can-tolerate- anything...](http://slatestarcodex.com/2014/09/30/i-can-tolerate-anything- except-the-outgroup/)

<comment><USER86> Likewise no one I spend time with are creationists, but the Internet acts as an inter-dimensional gateway, connecting me with creationists with whom I schooled as a child, and the die-hard you-get-what-you-deserve libertarians here.

I'm writing a treatise on advertising and the internet, or at least I'm trying. I might hit you up for feedback. It may be a while.

<comment><USER23> Please do, I'll be happy to give you feedback. I'm also gathering my beliefs on this topic myself.

I find myself repeating so often, and being asked the same questions so often, that I decided to write down and maintain a description of my current beliefs on most frequent topics - to serve both as a FAQ for someone asking and as a collection of points and citations to quote.

I'm in the process of writing stuff down, but I still haven't figured out what would be the best way to publicize it. I'd like something that would show the current state of article, but would also allow to easily view the changes over time (as my beliefs get updated based on evidence). Sort of like more streamlined Wiki, or Wiki meets Github meets Etherpad or sth.</comment></comment></comment></comment></comment></comment></comment>


Show HN: Video streaming for all - <AUTHOR> https://github.com/stoufa88/lawd-desktop <comment><USER2> How is this any different than popcorn time?

<comment><AUTHOR> it is not, but I'm trying to add it a new feature, live chat on movies. Do you think it is worth it? You know the periscope style comments.

</comment></comment><comment><USER3> uh oh...</comment>


Show HN: Redbeard Marketplace. A marketplace of iOS Apps with full source - <AUTHOR> http://redbeard.io/marketplace <comment><AUTHOR> Hi All,

We've just launched the Redbeard Marketplace as a place where customers can purchase complete end to end native (Obj-C/Swift) apps developed exclusively by the Redbeard Team. We'll have clones of some of the biggest brands out there so you get to know how an App like Twitter is developed for example. We're launching with 2 Apps, Taskeedo (Which is totally FREE) and RBnB, our AirBnB inspired clone that's available right now.

Right now we're trying to get a feel for whether there's any demand moving forward with Objective-C or if we should just concentrate all our efforts on Swift only (It's very time consuming having to write each app twice). So it's a decision we're hoping the community can help us with.

<comment><USER2> I think the idea of a marketplace for open source iOS apps is an interesting idea. On the other hand, if all the apps are from one source, it might not be a marketplace in a strong sense. Anyway, it's an interesting start.

Good luck.</comment></comment>


How our new homepage outperformed the old, 2 to 1 - <AUTHOR> http://johnhenrymuller.com/betterhome

<comment><USER2> Add a link to packdog.com so we can see it! I had to scroll to the bottom. Otherwise, great post!</comment>


O'Reilly Cookbook titles for only $9.99 - <AUTHOR> http://oreilly.com/store/ddccc.html

<comment><USER2> On twitter, Tim O'Reilly posts a daily (or almost daily) $9.99 deal of the day.

<http://twitter.com/timoreilly>

He happens to link to stuff that interests me, so I'm happy following him, and there's the bonus of a cheap read every now and again.

<comment><USER3> The ebook deal of the day offers have a dedicated RSS feed:

<http://feeds.feedburner.com/oreilly/ebookdealoftheday>

P.S. Sometimes it appears they don't cut off right at midnight. Weekends would be one example of this, but also on weekdays.

I've yet to see one of their "heavy hitter" titles offered, though. But I haven't been following the feed regularly.

</comment></comment><comment><USER4> Which ones of those would be worth buying?

<comment><USER5> The one you're actually going to read.

P.S. They have this "sale" once a month and the iPhone version of these books is also half the price.

(O'Reilly also provides instructions on how to get to the actual "book" out of the iPhone app:

<http://oreilly.com/ebooks/oreilly_iphone_tips.csp> Check "Extracting the EPUB pearl.")

<comment><USER6> It still amazes me that Amazon bought Stanza (which powers O'Reilly books on iOS). Stanza's still going strong though.

[http://ireaderreview.com/2009/04/27/kindle-vs-stanza- amazon-...](http://ireaderreview.com/2009/04/27/kindle-vs-stanza-amazon-buys- stanza-and-kills-the-contest/)

</comment></comment></comment><comment><USER7> I picked up the JQuery and CSS cookbooks. The CSS one really looked sharp and any solid guide on JQuery is a must have for web developers.

I keep getting suckered with these $9.99 deals. What are you doing to me, O'Reilly?!

</comment><comment><USER8> Or for $20/month (10 books/month) or $40/month (unlimited books/month) you could get a safari.oreilly.com account with access to every O'Reilly book published (and more).

</comment><comment><USER9> This is awesome, thanks for posting it ! I purchased three books: JQuery, Web Security Testing and ADO.NET 3.5

</comment><comment><USER10> Hmm. Python Cookbook release date 2005 and 'updated' for v2.4

I think I'll pass.

</comment><comment><USER11> Just bought some. Lets see how many of them I will really read...

</comment><comment><USER12> Argh, but they won't let me buy them because their website is so poorly programmed. Several attempts to checkout just returned to the "enter credit card info" page without an error. Switched to chrome was able to check out only to get "we were unable to save your information, please try again later"... was my credit card charged? who knows.

So irritating.

</comment><comment><USER13> Or you could save your money, spend a bit more time searching, and not waste valuable real estate on books that get obsolete in a year.</comment>


Something Mysterious Is Killing Captive Gorillas - <AUTHOR> https://www.theatlantic.com/science/archive/2018/03/gorilla-guts/554636/?single_page=true <comment><USER2> No wonder, what with all the health problems us cube monkeys keep getting as well.</comment>


How France Tries to Keep English Out of Public Life - <AUTHOR> https://www.citylab.com/life/2019/08/french-culture-minister-riester-academie-francaise-franglais/595819/ <comment><USER2> I can understand wanting to protect your culture, but the benefits of having a truly global language outweigh personal considerations of cultural pride.

<comment><USER3> It's not pride. It's identity and culture.

If you lose your language you lose your culture, you no longer exist as a people.

<comment><USER2> That's partly true. I've always felt that language is the soil in which culture grows. But different English speaking countries have very different cultures. And culture is more fundamental than language. Language is more of a barrier that leads to isolation, and it's in that isolation that distinct cultures develop.

But my point remains. Your people living today may lament losing their native language, but your children and their children will not, at least not as much. In the long run linguistic unity far outweighs the current generation's unhappiness.

<comment><USER3> OK, I'm sold. Let's all learn Chinese.

> _Your people living today may lament losing their native language, but your > children and their children will not, at least not as much._

I haven't read something that arrogant and condescending in a long time.

<comment><USER4> Actually itd be smarter to force everyone to learn a long dead obscure language. That way everyone starts from scratch rather than a group having a leg up.</comment></comment></comment></comment></comment>


Ask HN: Can you reduce New York LLC publication fee by using a registered agent? - <AUTHOR>

I have a question around creating a LLC in New York City centered around the publication requirement of LLC's in New York state. This publication requirement means if your LLC is registered in New York City you pay approx. $1,000-$2,000 in fees to newspapers. The key question is can I use a registered agent to meet the publication requirement in a location outside the city of New York but in New York state thus avoiding the higher newspaper fees of New York city. Then change the address to "real address" of the business to the location in New York city.
I'm looking to use this service: http://www.northwestregisteredagent.com/new-york-llc-publication.html
Is this approach legitimate? Has anyone else used this service?
Situation - Company business will be publishing mobile apps - iOS & Android - 1 person company - no employees - Will not be seeking investment or partners - Lives in New York City (Brooklyn) - Will be writing the software in New York City
Why I've chosen LLC - Not having to publish under my own name in iOS store - Liability protection afforded to me by LLC (realize this is a small risk in app publishing, but I'm risk adverse) - Appears to have the least paperwork for any legal entity providing me with limited liablility
My research shows To setup an LLC in New York (as single member LLC) I need to: - Pick a name not in use for LLC - File articles of organization + operating agreement (online) - $200 - Publish in 2 news papers, one daily, one weekly (desigated by the County Clerk) for 6 weeks in the county where business will be (in my case Brooklyn/Kings County) - approx. $1,000 - $2,000 - File Certificate of publication (received from newspapers) after 6 weeks  - $50
There doesn't appear to be any rule in the law around publishing that says you have to republish if you change address: http://public.leginfo.state.ny.us/LAWSSEAF.cgi?QUERYTYPE=LAWS+&QUERYDATA=$$LLC206$$@TXLLC0206 <comment><USER2> Yes, IANAL, but I have incorporated an LLC a few times in NY myself.

I live in Queens, and the LLC was incorporated in Queens, and our publishing fees ran about $1200.

Best to find a registered agent in Albany or somewhere with cheap newspapers and incorporate there.

But an even better plan is to go over this with your accountant, b/c where you initially incorporate may change your taxes, etc. Plus your accountant will know a heck of alot more about structuring an LLC for taxes, etc, than you.

Or another plan is to just incorporate now, forget about doing the LLC registration (you have 180 days legally), and hopefully make enough money off your app to pay the incorporation costs.

If the app busts, just close down the company and be happy you took advice from some random guy on the internet who was not a lawyer and saved you $1,000-$2,000.

I don't know anything about these northwest registered agent people other than that they are good at SEO.

But seriously, the best thing to do is talk to your accountant.

<comment><AUTHOR> Awesome thanks. In retrospect would you have gone the registered agent route? Do you have a recommendation for an accountant? I don't have one, just moved to NYC. Also what would they charge to answer a question like this (understand you may not be able to answer the $ part)

<comment><USER2> Possibly I would have gone the registered agent account, as long as the price was close to how much it would cost to register it myself, and the registered agent was someone recommended to me personally (not found on the internet).

I've found that many registered agents will also send you a bunch of crap (official letter heads, a seal stamper, binders with your company name) and then charge you $500 more for their service vs. doing it yourself.

For NYC, I would recommend Dmitriy at www.dgatax.com. The consulting fee to sit down and talk won't be very much (I'm thinking $50-$100).

<comment><AUTHOR> Thank you, I was thinking of just using the registered agent to allow me to publish in Albany country instead of Kings county.

According to their website (NorthWest Registered Agents), you can publish in Albany newspapers for a total of approx. $95. That would save me approx. $900.

Their fee for this is $125.

</comment></comment></comment></comment><comment><USER3> From what I know, you can be the registered agent for your own business as well. I recommend talking to a CPA in New York who can discuss your case. These things are complicated and I can tell you being an S-corp owner.

<comment><USER2> +1 for talking to an accountant. If I had talked to my accountant when I started my business, I would have saved myself money and time!

<comment><USER3> definitely. Also it is very important to talk to a good accountant who handles your specific cases. When I incorporated intially, I used an accountant who even though helped with the paperwork, did not advise the right structure etc. for business based on _my_ individual case.

</comment></comment></comment><comment><USER4> Those publishing fees are extortion! I complained when I had to pay $150 (Upstate NY).

Also, IANAL, but I have received indication in the past that an LLC with a single member is at times treated differently when the shit hits the fan than an LLC with two or more members.</comment>


Snopes pulls out of its fact-checking partnership with Facebook - <AUTHOR> https://www.poynter.org/fact-checking/2019/snopes-pulls-out-of-its-fact-checking-partnership-with-facebook/ <comment><USER2> If Facebook was only willing to devote $100,000 to it, it seems like they basically spent the minimum amount possible so that they could claim they were doing something. The expense doesn't remotely match up to the scale of the problem.

<comment><USER3> ...or the value of the work.

<comment><USER4> That's not really a new MO for them - remember, this is a site that uses unpaid content creators to attract other unpaid content creators and then sells access to us and knowledge about us to businesses and political interests among others.

Figuring out how to pay very little and suck out a lot of value is what their business is built on.

<comment><USER3> The mere definition of profit does not excuse Snopes' having got a bad deal.

</comment></comment></comment></comment><comment><USER5> Oddly, it seems that Facebook needs Snopes more than Snopes needed Facebook.

</comment><comment><USER6> it is wild to me how many people are in this thread saying "Snopes is partisan" or "Snopes is biased" or "Snopes is not a real fact checker" and who are also entirely unable to provide any actual evidence.

A link to an article on the Federalist (laughably partisan) is not "evidence" any more than pointing out that they have fact-checked satirical sites is. [https://reddit.com/r/atetheonion](https://reddit.com/r/atetheonion) is a thing for a reason, and in every post about Satire Snopes goes out of their way to highlight that they are responding to Satire.

Your own biases are showing and it's kind of a bad look.

<comment><USER7> This site on ethics routinely deconstructs the problems at Snopes: [https://ethicsalarms.com/?s=snopes](https://ethicsalarms.com/?s=snopes)

<comment><USER8> How surprising, a site with a banner that says "it's okay to be white" and currently has a front-page article about how black people are too stupid to talk in court makes a bunch of nitpicks of snopes' prose.

Presumably so that they can later say "snopes is always wrong and biased" when Snopes contradicts Breitbart's claims that Obama and the UN and Black Lives Matter are planning to burn down Central Park next weekend.

(actual thing a relative told me, actual breitbart story from summer 2015,for those HN users fortunate enough not to be exposed to the worst of the fake news epidemic)

<comment><USER9> Here is an example of a false Snopes article [https://www.snopes.com/fact- check/gop-obamacare-repeal-elect...](https://www.snopes.com/fact-check/gop- obamacare-repeal-election/)

Snopes claims that a meme (showing a picture of people, many of whom have red x over their faces, writing that everyone with a red x has been voted out of office) is true even though they admit

> Although memes are frequently grossly inaccurate, this one got the general > idea and numbers correct (even if the persons actually pictured in the > accompanying photograph are difficult or impossible to identify).

Some of the people with an x were not elected people and some did not get voted out. This meme is clearly false, yet Snopes calls it true.

<comment><USER8> Is the information on the snopes page false or incorrect? No, it isn't.

There's a reason that they write more about each topic than merely the headline.

"snopes occasionally makes editorial decisions I disagree with" is not the same as "snopes is fake and unreliable".

Sorry, I must have missed it the first time, tell me again why you continue to rely on an overtly racist blog to be your arbiter of "ethics"?

<comment><USER9> > Is the information on the snopes page false or incorrect? No, it isn't.

It is both false and incorrect. Saying that "every one with an x has since been voted out of congress" When not every one with an x has since been voted out of congress is false. I mean even the article quotes a tweet listing 10 people who were incorrectly marked. You should see what Snopes does every time a right wing person says something not 100% correct.

> "snopes occasionally makes editorial decisions I disagree with" is not the > same as "snopes is fake and unreliable".

Again, the Snopes article is blatantly false.

> Sorry, I must have missed it the first time, tell me again why you continue > to rely on an overtly racist blog to be your arbiter of "ethics"?

Sorry, I missed why you think that I continue to rely on a racist blog to be my arbiter of ethics.

</comment></comment></comment></comment></comment></comment><comment><USER10> Was the $100K mentioned in this article the total amount Facebook gave Snopes? Because that's, like, one new-grad signing bonus.

<comment><USER11> For a particularly high-demand technical engineering position maybe. For other things… well, Facebook pays folks in the Philippines something like $2/hour to get PTSD while screening posts for the worst content the worst humans are able to generate (beheadings for example). Where would you expect fact-checking to fit in?

</comment></comment><comment><USER12> RealClearPolitics has an interesting guide to the different fact-check providers. In particular, it calls out the difference between fact-checks and opinion-checks.

[https://www.realclearpolitics.com/fact_check_review/](https://www.realclearpolitics.com/fact_check_review/)

</comment><comment><USER13> I can't believe the massive number of HN users here who are willingly throwing critical thinking under the bus just because of political bias. It's maddening that people are making the jump from "Snopes posted something possibly incorrect about soda cans" and "Snopes one time fact checked shitty satire" directly to "Snopes is untrustworthy".

Everything is imperfect, even fact checking groups. If you're going to throw them under the bus for these tiny errors, I sure hope you've already incinerated every computing device you own, because boy do you have some things to learn about them.

<comment><USER14> The problem with a website like Snopes is that, if you want to claim to be an unbiased gatekeeper of the truth, you better be perfect.

Since humans are imperfect, a site like Snopes can not exist.

<comment><USER15> I don't know why this would get downvoted. Seems reasonable, whether it's Snopes or anyone.

Similar to Apple claiming "it just works", you better make sure it works. Or Google proclaiming "don't be evil". Etc.

<comment><USER16> > Similar to Apple claiming "it just works", you better make sure it works.

My Mac got a kernel panic yesterday. My response was not to swear off Apple products forever.

<comment><USER15> > My Mac got a kernel panic yesterday. My response is not to swear off Apple > products forever.

Yet your response is to downvote everything you disagree with?

Not swearing off Apple products forever is your personal choice. Personally I agree with that. But I know plenty of people who DO choose to swear off Apple products when something doesn't work. That's also their choice, and I don't have a problem with that.

<comment><USER17> Did those people flee civilization to go live naked in a cave somewhere?

No? Then no, their reaction to something not working is not to immediately swear off that entire product category forever. Because, sooner or later, _everything_ fails to work correctly in some fashion.

</comment></comment></comment></comment></comment></comment><comment><USER18> fact checking has always been a silly, hopeless attempt to find a technocratic solution to fundamentally political problems.

<comment><USER15> It's a hopeless quest until AI reaches a certain level of objective interpretation.

Regarding humans, most people who are capable of researching truth without any bias, don't have a voice. Human history is riddled with partisan extremists presenting biased information as neutral and factual. Snopes is no exception.

<comment><USER19> Do you trust whoever trained or is controlling the AI?

<comment><USER15> At this point nothing is trustworthy. But I have more faith that AI is going to do a better job in future than humans ever have. We may be 100 years away from that though, or 1000 years. Who knows?

<comment> 52-6F-62 And then this AI is the sole bearer of all ultimate, unarguable truth regardless. Like a god you mean?

<comment><USER15> Is that your interpretation? Mine is the opposite: "At this point nothing is trustworthy".

Just saying that humans have an extremely poor track record at compromising information for political gain. Anything would be better at this point, you can't get any worse.

<comment> 52-6F-62 I think it could get worse but that's just me.

I prefer an aggregate. Then I can derive what I think is the truth.

Trust is learned, anyway. Except for children— they often do as a default until a point in their lives.</comment></comment></comment></comment></comment></comment></comment>


HACKADAY DICTIONARY: USB TYPE C - <AUTHOR> http://hackaday.com/2016/04/22/hackaday-dictionary-usb-type-c/ <comment><USER2> I had no idea that USB type-c had analog audio support. I thought it was about speed, higher current for charging, and reversible connector.

I must say, I've had the Nexus 5X for about a month now and that reversible connector is a huge improvement over USB micro-B.</comment>


Ask HN: Which bookmarking app do you use? - <AUTHOR> Specifically looking for Mac, iOS and I must be able to link to a saved bookmark from .org mode in Mac. Thanks. <comment><USER2> I have written StaticMarks[0], where I manage most of my bookmarks. The bookmarks are stored in yaml files and transformed into a single, shareable HTML file. You get all the flexibility, but on the other hand the additional cost of setting everything up to suit your workflow. Personally, I manage the yaml files in git and create the HTML on my server after every git push.

Where this approach does not work is when you archive a lot of links for later. Then I would suggest something like Pinboard[1].

[0] [https://staticmarks.com/](https://staticmarks.com/)

[1] [https://pinboard.in/](https://pinboard.in/)</comment>


Ask HN: How honestly likely is it to be hired at FAANG from EU? - <AUTHOR> I mean, being hired straight to the Bay Area, Seattle or another North American HQs without working previously in the company's secondary hub (eg. Dublin), no prior visa, just you and your resume. <comment><USER2> If you are good and also pass thr interview where is the problem? I have many friends from Serbia who are working for FAANG companies in the US. Some got acquihired, some applied directly, some got contacted from recruiters working for this companies.</comment>


Ask HN: Investor Animated Video – draft critiques wanted - <AUTHOR> Hi all, the thing I'm building is very complex and I have a difficult time simplifying it for potential investors and customers. Yes, I know a lot of people wouldn't say this is a MVP.  To me this is. The point is to provide a better social network that is ad-free, allows for anonymous use (and free), encrypted group voice chat/messaging, calendaring, mapping and some AI magic for interrupting the social flow (safety and efficiency). It's targeting women in social/sporting clubs that travel together. How can I really grab audience attention with a short pitch on this?
I made a simplified animated video (draft form) to help explain what it is. Any feedback and definitely suggestions for a simple "what it is" line to catch investors' attention would be super helpful. Thanks! And I understand this might be brutal, so please be honest.
https://www.dropbox.com/s/e8zm79m566wnftg/11.mov?dl=0 <comment><AUTHOR> [https://www.dropbox.com/s/b23t3u0l4o4y8eb/13.mov?dl=0](https://www.dropbox.com/s/b23t3u0l4o4y8eb/13.mov?dl=0)

</comment><comment><USER2> Start with a simple question...

Do you want ....? Do you need ....?

Then say with XYZ you can .... , just [Call to Action]

Put that in front of people if people don't bite on it they don't care...find something they do.

<comment><AUTHOR> So in your formatted suggestion:

"Do you want the ability to switch between voice chat, messaging, map directions, and calendars seamlessly with just using your voice while travelling?

Do you need that ability to enhance your awareness while travelling?

With Cavalcade, you can! Just download the app and form a cavalcade with your friends with just your phone number"

\----That works a lot. I'll try that one. Thanks!</comment></comment>