Health Insurers Are Vacuuming Up Details About Customers - <AUTHOR> https://www.propublica.org/article/health-insurers-are-vacuuming-up-details-about-you-and-it-could-raise-your-rates <comment><USER4> Whenever someone says that AI and IoT would automate insurance underwriting, I start to fret — because it very quickly starts to imply more and more data collection. This is like pre-crime but for your health. Meaning, you start paying high premiums right away because later in life you might be at a high risk for a specific condition. (I know this already happens for smoking, but that is declared on a form — not by a company sending a drone to spy on you)

Since this is a startup forum — I believe health insurance to be so dark and morbid (with things like companies haggling with living relatives about ventilator care) — there is got to be a better way! (I realize this is more of a lament than a constructive suggestion)

<comment><USER5> "there is(sic) got to be a better way!"

There are _two_ better ways - each at a different end of the spectrum.

You can give up entirely on government intervention in health insurance and social "goods" being pursued - everyone is on their own and "healthcare" is a private, personal matter. You can play these agency/incentive games with insurers for better or for worse and you're on your own.

OR

We declare "healthcare" to be a public, common good and completely socialize it. Like roads and fire departments.

What these two different strategies have in common is that _both of them_ are intelligible, reasonable and give people a framework for planning and making long term decisions.

Anything between these two points on the spectrum is unintelligible and unsustainable. You would probably be better off with (the option above that you like the least) than any option between them.

<comment><USER6> > You can give up entirely on government intervention in health insurance and > social "goods" being pursued - everyone is on their own and "healthcare" is > a private, personal matter.

Except Kenneth Arrow showed market based health care doesn't work. That was in 1963. Since then the US has pursued market based heath insurance for ideological reasons and... that doesn't work without vast government subsidies. The government pays enough subsidies to cover a socialized system.

[http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf](http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf)

<comment><USER7> > Except Kenneth Arrow showed market based health care doesn't work.

That is a really disingenuous reading of Arrow's work. Even if you ignore the myriad of ways in which the global heathcare market has changed in the last 55 years and how those affect the US (which is the largest player in the global system), that's still an unjustifiably broad interpretation of his research.

<comment><USER6> > That is a really disingenuous reading of Arrow's work

You say so, but provide no examples. So your argument is an unsupported conclusory one.

</comment></comment></comment></comment></comment><comment><USER8> While its called its called Health Insurance, it should be called health care costs.

The US is the only 1st world country without universal healthcare. The thing is most of us already subsidize the healthcare industry. The hospital has to treat someone in an emergency if they take medicare or medicaid. A lot of times people are using the emergency room as their primary care since they can't afford primary care. The hospital increases the rates it charges everyone else to cover this.

You can use data to predict who is going to be more sick and charge them more. However do you want them to die or suffer. I wouldn't. So why not try to fix the big problem instead of all these little ones about data misuse and just cover everyone since you are paying for them anyway.

<comment><USER7> > The thing is most of us already subsidize the healthcare industry. The > hospital has to treat someone in an emergency if they take medicare or > medicaid.

The "subsidies" run the other way. Medicare reimbursements do not cover COGS, which means that providers cannot sustain themselves solely on Medicare reimbursement rates; they need to take privately-insured patients (whom they charge dramatically more) in order to stay afloat[0].

These costs get passed on to privately-insured patients in the form of higher premiums.

[0] Medicare acknowledges this, and in fact, Medicare even runs multiple stipend programs to essentially pay extra to hospitals who don't see enough privately-insured patients that they can make up the difference. If they didn't, those hospitals would close, because you can't lose money on a per- patient basis and still run a practice, even if you managed to recruit doctors, nurses, and staff who agreed to work for free as volunteers.

</comment></comment><comment><USER9> > Insurers contend they use the information to spot health issues in their > clients — and flag them so they get services they need.

Horse shit. And I say that as someone who writes claims management software for the healthcare industry.

I challenge ANY health insurer to provide examples of this. Of course, they won't, because they'll cite "patient confidentiality", but that just doesn't happen.

They've wanted to do this for years, though, and try to. Requests to be able mine claim data for familial predispositions to diseases was one that we fended off multiple times.

<comment><USER10> You may have fended it off but I assure you there is a whole industry devoted to using claims and other health data to manage care and costs. Insurers are primary partners of these companies and act as both providers and consumers of the data.

Not just insurers, but big hospitals and provider networks, too.

<comment><USER11> We're going down some kind of bizarre path. Insurance is ultimately about risk sharing. If every risk is modeled then there is no insurance, just expensive prepayment.

<comment><USER12> This is the core problem of health insurance as currently structured in the US -- everyone will make a claim eventually so it's effectively a whole life insurance policy except the payout is sporadic and involves tons of bureaucratic crap. I personally would be fine with either universal healthcare or regulating the marketing to outlaw non-catastrophic health "insurance" thereby forcing routine care to be a direct payment relationship with your doctor.

<comment><USER13> The major problem with that is there is no price transparency. If I go see a doctor, I have no idea if I will end up with a $40, $400, $4000, or $40,000 bill until the bill comes months later and I have to pay it.

I'm relying on insurance because going to the doctor is such a financially risky gamble.

<comment><USER14> > If I go see a doctor, I have no idea if I will end up with a $40, $400, > $4000, or $40,000 bill until the bill comes months later and I have to pay > it. NO IDEA.

This is what's really strange about the American healthcare system. For everything else in America you can either get a price up front or an estimate of total costs up front. Why should going to the doctor be any different than going to a mechanic? Pay advertised flat rates for issue diagnosis, and get estimates for the problem.

Yes, in cases of emergency you can't really shop around too much, but the majority of the time you're going to a doctor, you could at least call and get estimates of how much things will cost. It's not even possible to do this with most healthcare organizations. If you call your doctor's reception and ask "how much will it cost for this visit?" they'll tell you they don't do billing and they won't know until it's processed by insurance.

Price transparency in the healthcare market - or at least some decent estimate of it - would be a great thing to see. American healthcare is ridiculously inefficient because it appears wholly designed to be byzantine.

<comment><USER15> Or we could just have universal healthcare with government-set price controls, just like Japan does. The ultimate in price transparency. Everyone is healthier, lives longer, and it's far cheaper.

<comment><USER12> I'd be fine with that, but I'm acutely aware living in the deep south that _MANY_ people would not be happy with that. If we're talking about what's politically feasible within the US, "universal" healthcare is only really an option at the state level, or maybe with some federal maneuvering, as a multi- state regional coordination. It's simply not going to be accepted anywhere in the near-future on a national level.

For the parts of the country that are rabidly anti-universal healthcare, a more free market solution would be a nice consolation prize.

<comment><USER15> There's already tons of people on Medicare and Medicaid in red states and there hasn't been an armed insurrection.

I think that working class people in these regions wouldn't be adverse to Medicare being expanded to include them. I'm sure the Republican Party base of upper middle income and wealthy whites would be, but again, not so much everyone else there. It's a matter of how and what constituencies you recruit and activate.

<comment><USER13> > I think that working class people in these regions wouldn't be adverse to > the program being expanded to include them

It's so strange, the people who would most benefit from universal healthcare (and those that currently do, like Medicare beneficiaries) tend to be the strongest objectors to it, citing hard-to-understand ideological reasons.

<comment><USER7> > It's so strange, the people who would most benefit from universal healthcare > (and those that currently do, like Medicare beneficiaries) tend to be the > strongest objectors to it, citing hard-to-understand ideological reasons.

It's not so strange if you allow yourself to question the assumption that they'd benefit from it in the first place.

Medicare is a great example. Patients can opt to receive their Medicare inpatient and outpatient coverage through a private plan instead of through the government-managed plan. Since this program was introduced, it's gained popularity rapidly, over a third of Medicare beneficiaries receive their benefits from private plans. Many private plans are the same price as Medicare or cheaper.

From the data, the private plans beat government-managed plans on the three major metrics: medical outcomes, cost, and patient satisfaction. On the last one, the difference isn't even close: the _worst_ of the major private plans (by patient satisfaction scores) still manages higher scores than Original Medicare does.

People who haven't ever dealt with Medicare themselves directly (which includes most HN commenters) find this hard to understand, but it really isn't: dealing with Medicare is _awful_. I could give you my personal anecdotes, but they'd overfill the comment length on HN, and again, at the end of the day, the numbers speak for themselves. Medicare beneficiaries themselves are turning to private plans to replace their government-managed plans, so it's really not surprising if they're not the biggest advocates of expanding government-managed plans.

<comment><USER10> The private plans you refer to are mainly either simply administrators (the government pays them to administer the benefits) or supplemental providers or both. And their existence and popularity has more to do with their sponsorship by insurance funded politicians than anything else. Dealing with these administrators isn't generally better or worse than dealing with the government directly. Exceptions exist, but that goes without saying.

<comment><USER7> > The private plans you refer to are mainly either simply administrators (the > government pays them to administer the benefits) or supplemental providers > or both

No, they're much more than that.

> And their existence and popularity has more to do with their sponsorship by > insurance funded politicians than anything else.

The programs are cheaper, provide better medical outcomes, and patients prefer them.

That doesn't mean they're perfect, but you have to bend over pretty far backwards to say that they're inferior and only popular because of "insurance- funded politicians".

> Dealing with these administrators isn't generally better or worse than > dealing with the government directly. Exceptions exist, but that goes > without saying.

It is monumentally easier to deal with private insurers than to deal with an Original Medicare plan.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER16> _" The companies are tracking your race, education level, TV habits, marital status, net worth. They're collecting what you post on social media, whether you're behind on your bills, what you order online."_

The only way they can do this _and_ link it to you as an individual is if we have all been lied to about how everything is "anonymized" data being sent between the data brokers and sold to corporations. I've always assumed that the whole narrative about all this data being anonymized was complete and utter bullshit.

Now we know with certainty.

<comment><USER17> The companies that sell your data non-anonymously to brokers have always (unless they're shady af) said somewhere in their T&C that they will or may do so, and the brokers themselves have never said the data are anonymous (unless you're talking about the ad targeting space).

</comment></comment><comment><USER18> > The company, owned by the massive UnitedHealth Group, has collected the > medical diagnoses, tests, prescriptions, costs and socioeconomic data of 150 > million Americans going back to 1993

I think they just use their point of sales (primary care, etc) to collect data from the client and use it against the client. I know because I used to be in a very similar line of business.

It is easy because clients give you a permanent unique id for payment purposes (ssn), or other unique id (phone numbers) that varies with time (now less with people porting their number). Of course, the point of sale has a list of previous items, even from competitors (medical history) but that has become harder to use, due to laws. Still, most places ask for "emergency contact", which you can use to build a social network. Sick people cluster together. I don't know why, it just happens, and it is a good workaround.

Of course, you need enough data, but it is then a matter of scale (if you have 75% of the market, you have seen everyone in a county at least once) and trade (buy the same data from your competitors).

Personally, due to experience, I prefer to forego insurance and get my healthcare abroad. Better prices than paying deductibles, better services. But I can not recommend that for everyone.

Still this is a dirty business, and I strongly recommend to adopt basic opsec precautions if you get healthcare in the US: never give your ssn, give a phone number that is not used for anything else even better if it is prepaid so not linked to a ssn, never ever give an emergency contact, only list medical conditions that will not cause you legal issues.

<comment><USER19> > Personally, due to experienck, I prefer to forego insurance and get my > healthcare abroad. Better prices than paying deductibles, better services. > But I can not recommend that for everyone.

If you're in the US, that choice could _bankrupt you_ if you ever need major emergency medical care, because of an accident or some condition requiring emergency surgery, like a brain hemorrhage.

[https://www.nytimes.com/2017/03/29/magazine/those- indecipher...](https://www.nytimes.com/2017/03/29/magazine/those- indecipherable-medical-bills-theyre-one-reason-health-care-costs-so-much.html)

<comment><USER20> My father went from having a comfortable nest egg to living on social security alone because he was unable to get insurance before the ACA. All it took was a trip to the emergency room and a heart catheterization, followed by another procedure a couple days later and he was penniless.

<comment><USER18> I wonder: did he go to court at any moment? Or did he just caved in and accepted to cough up the money?

Based on my experience, in the US, people rarely fight their debts. I have had debt go to collection before, I disagreed with it so I sent the collector a friendly letter saying the debt came from a breach of contract by the other party, so I will not pay it, and will be happy to go to court if they want.

It is very rarely worth the time for collectors. The debt will just eventually be resold, penny on the dollar.

In the very unlikely case it ends up in court, based on some friends experience, it can take a long long time for the problem to be resolved - <USER2> ever, because our lifetimes are finite.

</comment></comment></comment></comment><comment><USER21> Exactly why I won't do those genetic-sample tests for "ancestry" or anything else. Eventually, those data will be sold, even if the entire company is sold with it. Eventually, we will be much better at decoding the DNA for predispositions to medical problems like heart disease, diabetes, alzheimers, and so on.

That information will also be used against our kids and maybe our other relatives even if they don't undergo the testing.

<comment><USER22> Data is forever. The Genetic Information Non-Discrimination Act could be repealed in the future. Even governments can change.

</comment></comment><comment><USER23> Heard about this article on NPR this morning. Thought the concern was valid but a little on the alarmist end of things.

Most of the data they need to know if you are going to be an expensive subscriber or a cheap one you're required to give them directly: Your age, your gender, your home address and the list of services you received at your doctor's visits that they were billed for.

Both healthcare providers and insurance providers know that the most efficient way to lower your healthcare costs is to get the patient to go to preventive care visits and keep them out of the ER. It doesn't matter how much money you give them each month, if they can prevent you from going to the doctor all together it's 100% (roughly) profit.

<comment><USER24> I work alongside healthcare informatics and I got to say this is entirely the case from what I have experienced - the less you go to the ER the more the insurance profits. All of our research and data collection revolves around people getting tests and treatment PRIOR to something major happening. Regular bloods tests, proactive bp and a1c monitoring, etc lead to better heart disease and diabetes treatments so you don't go into a crisis. The collection of data allows treatment to be better for the population not to charge a higher rate to specific people. Keeping you out of the hospital is monumentally cheaper than a couple doc visits a year for a couple lab tests.

</comment></comment><comment><USER25> > But patient advocates are skeptical health insurers have altruistic designs > on people's personal information.

It's funny that the article felt this needed to be said. Just how would an altruistic insurance company have survived in such a competitive market?

I think I learned the insurance business model early in life. I lived near a horse race track, and used to collect the programs and assemble giant (paper) spreadsheets with various data on horses and their win/loss records. Does the jockey make a big difference? Does the wetness of the track? I would have used any measure that gave me an edge in betting, with zero "altruistic" regard for the horse, its owners, or anyone else but me. You know, like an insurance company.

It turned out that there was a datum that significantly improved my odds, and converted me from a regular loser to an irregular net winner. And it didn't come from a program. I figured out that I could just watch the horses as they paraded to the starting gate, pick the one that I thought looked like it wanted to win, and could, and ran to place a bet on it before the race started. Far from perfect obviously, and I didn't win big, but I started winning more than losing.

I'd bet that insurance companies wish they could do something similar: Have experienced medical underwriters examine and interview potential customers and then make gut level decisions, then judge more by underwriter stats than patient stats.

But that approach seems to be increasingly prohibited, so they make do with what data they can get. It's hard to find that surprising, unless somehow you've confused "insurance" and "altruism" to be related terms.

</comment><comment><USER26> I think there's something to be said IN FAVOR of the notion that person A's health risks don't trade off against person B's health risks at a 1:1 rate.

The crucial thing however, in a data protection sense, is that there are too many people who don't realize the implications of giving away data about themselves. A shopper signing up for a loyalty card scheme in a grocery store might sign a blanket waiver allowing the scheme operator to pass the data on to whoever they please to be used in whatever way they want, without thinking about the possibility that it may end up in places where it won't serve their best interests.

So there should be something similar here to health warning on cigarettes. Kind of like "Warning: Signing up for this loyalty card may make you uninsurable."

Also, I think there should be legal infrastructure in place to ensure that there are certain rights that you can't sign away as part of a contract that, in practice, you don't have the option not to sign (like Google's general terms & conditions).

<comment><USER27> Which is also why you should use a fake phone number, name, etc for those loyalty cards.

Also a neat trick is to just (XYZ)-867-5309 as someone already signed up with the number from that song and it's not a real number.

<comment><USER28> It's a real number in the 401 area code.

[https://www.askgem.com/](https://www.askgem.com/)

See the contact info in the lower left of the page.

</comment></comment></comment><comment><USER29> A recent-ish book that talks a little about this (surprised the article did not mention QuintilesIMS):

"Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records"

[https://www.amazon.com/Our-Bodies-Data-Companies- Billions/dp...](https://www.amazon.com/Our-Bodies-Data-Companies- Billions/dp/0807059021)

</comment><comment><USER30> Isn't this super illegal? Who are the lawyers at these companies who are signing off on these projects?

<comment><USER31> No. Using that data might be. In any case, it's only illegal if the Supreme Court interprets it to be illegal. If you have been following the recent years of Supreme Court decisions/dissents it will not be comforting.

<comment><USER32> Can you point to the cases that concern you? I haven't been following it closely enough.

<comment><USER31> I'm sorry, I can't right now in detail. The general trend started with Citizens United and followed through Masterpiece is a increased set of precedents for corporate personhood, with some harsh dissents from the Alito/Thomas/Gorsuch contingent in cases where that was at issue (but corp. personhood side lost). When Kennedy retires and of Kavanaugh is his replacement, that will give put an awful lot on Robert's judgement as the swing decision. If I'm really getting picky, the lack of consistency in Trump v Hawaii and the Masterpiece case shows a certain amount of prioritizing partisan concerns over logical consistency (imo, ianal).

edit: taking corporate personhood to logical extremes reverses a lot prior precedent and I would have doubted it would have happened until recently.

</comment></comment></comment></comment><comment><USER33> I wouldn't be surprised if people are denied care and left to die due to exorbitant prices based on random, undoubtedly wrong algorithms. Here's where the cost of personal data really becomes huge, at in life or death. Insurers have played god like this since their inception and nothing is going stop them from making more money by shutting out anyone who is a threat to their bottom line. We've only had a law that prevents discrimination on pre-existing conditions for a few years. I'm sure the insurance companies will lobby hard to get rid of it so they can let the very sick suffer and die rather than be forced to pay for their healthcare. This is an end run to that goal in case lobbying to murder people legally fails.

</comment><comment><USER17> I buy data from LexisNexis. AMA.

<comment><USER34> What is the pricing model? (eg per request?) Roughly what is that cost?

Is there an "all-you-can-eat" access level that other organizations have?

How granular are the data fields per record (/person) ?

Do requesters generally cache the retrieved data on their own stores, continually re-retrieve it, do analysis in large batches, or what? Would we expect to see big caches of this data sitting around outside of Lexis's vaults?

<comment><USER17> > What is the pricing model? (eg per request?) Roughly what is that cost?

Across all the products I've used (web, batch, API), the price is per-request (where a batch is multiple requests). The actual price can vary by several orders of magnitude depending on what you're requesting. If we're talking about list pricing, it ranges from about 10 cents to tens of dollars per request. There are significant volume discounts available, of course.

>Is there an "all-you-can-eat" access level that other organizations have?

I have not seen one myself and I doubt they offer one even to their largest enterprise customers. However, I am fairly certain that they offer it to certain government agencies. For example, I have seen federal government RFP's that require it.

>How granular are the data fields per record (/person) ?

It depends on the kind of response/report you're looking at, but as a general matter they are highly granular. For example, provided the data are available, I could itemize a list of every car you've ever owned by make/model/year, infer whether you're in a same-sex relationship, or see what the grounds were for granting your divorce.

>Do requesters generally cache the retrieved data on their own stores, continually re-retrieve it, do analysis in large batches, or what?

Aggressive caching is an absolute requirement for API users. That is proximately because Lexis's server does not "remember" your requests. They are logged and have unique transaction ID's but if you run the same search twice they will not check the request against a log cache to see if it's the same as one you ran recently. Instead they'll just charge you a second time (a very easy way to accidentally run up a big bill when running tests against a production endpoint). In combination with the high price per request, you'd be stupid not to cache the whole response.

>Would we expect to see big caches of this data sitting around outside of their vaults?

Yeah certainly. You can't arbitrarily run requests and store the data (e.g. in order to resell it), but you can store the results of requests you've made.

</comment></comment></comment><comment><USER35> This is complete nonsense and entirely speculative. They admit as much when they inform you they can find no evidence of any individual underwriting decision being made based on this data, which the companies strongly deny, and would be illegal. Insurance is highly regulated, both on a state and federal level. Pricing algorithms and variables are public in most states (albeit obfuscated).

What does seem to be happening is the companies are using third party data providers for marketing and market analysis, as literally every other company from your local HVAC guy to McDonald's does.

</comment><comment><USER26> There are certain dimensions that it makes a lot of sense to discriminate around: For example, if you're a roofing contractor, I really think you SHOULD be paying higher health insurance rates than I do, as an office worker. You'll just price it into whatever you charge to make roofs, which means the price of a house will start getting closer to what it actually costs the economy. Since I rent, I would otherwise end up subsidizing other people to build or buy houses for themselves, and I don't think that's how an economy should work.

<comment><USER36> > For example, if you're a roofing contractor, I really think you SHOULD be > paying higher health insurance rates than I do, as an office worker.

Why? Your sitting eight hours a day is remarkably unhealthy, and roofers (at least where I'm located) are typically separately insured for on-the-job injuries.

<comment><USER26> Don't get unduly bogged down with the example: It works equally well with "horse trainer" or whatever. Clearly some professions have a bearing on your risk profile with regard to certain types of insurance, and there is not always a clear distinction between risks you incur as a private person and risks that your business needs to indemnify you against. -- Like, if you're in a job that involves a lot of travelling and being away from your family for extended periods of time puts you at greater risk of developing mental health conditions etc.

<comment><USER37> I think the numbers may not come out the way you think they will. Sedentary lifestyles are by far the largest medical expense in the country as a whole, so office jobs I would expect to have much higher premiums.

Sure you're not gonna get your sternum crushed by a falling 2000lb pallet - but those situations are already typical covered by workmans comp and other company insurance.

</comment></comment></comment></comment><comment><USER38> Considering how inaccurate some of Fitbit's measurements are( resting heart rate, for example ), I would sue my insurer if I found out they were using that data. My doctor shouldn't be using it either.

RHR is normally measured within the first 30 minutes of waking while lying in bed, which is something Fitbit can determine. What I've noticed is that on days when my RHR that I've measured using their monitor after waking is 54 BPM, they report up to 61 BPM. There's a very long chain on their forum about how inaccurate the measurement is.

<comment><USER39> I work for Fitbit but am speaking only for myself.

I'm guessing that this is the chain you're referring to since it echoes the "30 minutes after waking while lying in bed" claim: [https://community.fitbit.com/t5/Charge-HR/Resting-Heart- Rate...](https://community.fitbit.com/t5/Charge-HR/Resting-Heart-Rate- Inaccuracies/td-p/901287)

Other sources I checked did not echo that claim. As one commenter in the chain pointed out, RHR is not minimum HR.

[http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/G...](http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/GettheFactsAboutHighBloodPressure/All- About-Heart-Rate-Pulse_UCM_438850_Article.jsp#.W04ycdhKhE4)

[https://www.mayoclinic.org/healthy- lifestyle/fitness/expert-...](https://www.mayoclinic.org/healthy- lifestyle/fitness/expert-answers/heart-rate/faq-20057979)

[https://www.health.harvard.edu/blog/resting-heart-rate- can-r...](https://www.health.harvard.edu/blog/resting-heart-rate-can-reflect- current-future-health-201606179806)

Also, one of the critics in the chain thinks Fitbit must be inaccurate after his RHR rose from 68 to 71 after "hiking at altitudes up to 14,200 feet" then fell back to 68. I think this criticism stems from a misunderstanding about how altitude affects oxygen levels and how oxygen levels affect heart rate.

All that being said, even if the devices are generally accurate, there are defects and they aren't designed as medical devices. To the extent you voluntarily share your data with a doctor or insurer (which is the only way they'd get your data), your doctor or insurer should treat it the same way they treat other useful but potentially inaccurate information.

<comment><USER38> Thanks! This is way more informative than any of the responses I've seen from your support team in that chain.

</comment></comment></comment><comment><USER40> Most people who work for medium or large sized companies in the US are working for companies that are self-insured, meaning your company is taking on all the risk, so if anything your own employer is incentivized to do this and not the insurance company itself.

When I first heard of the Amazon/JP Morgan/BH heathcare initiative my thought on what that company would actually do is surveillance on their collective millions of employees to better predict if they are prone to disease and use predictive analytics to lower their own claims cost.

<comment><USER41> > meaning your company is taking on all the risk

While I wouldn't say there aren't any companies out there that are absorbing the entire cost of insurance premiums, most are splitting this in some proportion with the employee.

<comment><USER40> by risk I mean that the company is liable for all claims cost, but right premiums can come from the employee, employer, or both.

</comment></comment></comment><comment><USER42> As a college student I work taking phone calls for a biz that attends entirely US customer base, my colleague asked why our clients were often leery about sharing things like their photo ID with us, despite being customers with us for many years.

As one of the few who lived in the US amongst us I'd have to say it might have to do with how much companies involved in risk assessment really know about you and how much of it goes to the government -- they have no interest in having us show up in their credit or what have you.

</comment><comment><USER43> That's ok with me? I wish it were like life insurance where they can ask you anything and then you get that rate locked down for the term.

I also actually liked the proposal in Congress that got rejected: allow people to make their own groups. So if you are a person who likes to work out and get your fat levels tested once a year, you could join a group of like minded individuals and insurance companies would bid to insure your group.

<comment><USER36> > That's ok with me? I wish it were like life insurance where they can ask you > anything and then you get that rate locked down for the term.

That's an understandable attitude for a healthy person.

What is the person born with a disability or a gene making cancer, Alzheimers, heart disease, etc. likely supposed to do?

"Your insurance premium is $25k/month. We take checks!"

<comment><USER44> If they can't afford to pay anyone enough to insure them, they should ask for charity, because that's what they need.

<comment><USER36> Shockingly, it turns out that most charities don't have the financial resources to dedicate a hundred thousand dollars for a single heat transplant.

<comment><USER44> Also shockingly, if you already know you need a heart transplant, you're well beyond the point where any market-based risk pool is going to offer to pay for your transplant in exchange for a premium that's below the cost of your transplant.

You need charity, not a market.

<comment><USER36> > Also shockingly, if you already know you need a heart transplant, you're > well beyond the point where any market-based risk pool is going to offer to > pay for your transplant in exchange for a premium that's below the cost of > your transplant.

 _Everyone_ is at potential risk for needing something like a transplant eventually. Making the pool large enough allows reasonable premiums, just as I can pay a couple hundred bucks a year to replace my entire house if it burns down.

The rest of the developed world defines the risk pool as "everyone", and the end result is healthcare costs half of ours (including the tax component) and similar outcomes.

> You need charity, not a market.

You need government, not a charity.

<comment><USER44> >Everyone is at potential risk for needing something like a transplant eventually.

Not everyone is at equal risk, and many choices people make can have an impact on that risk. That's the point of this thread.

>Making the pool large enough allows reasonable premiums, just as I can pay a couple hundred bucks a year to replace my entire house if it burns down.

What is 'large enough'? The populations of many entire European countries are dwarfed by the number of subscribers to several health insurance companies in the US. Of course we don't know how large health insurance companies would get in a market without heavy government interference, but do you have some reason to believe the size of pools in a market with less interference would result in unreasonable premiums?

>The rest of the developed world defines the risk pool as "everyone", and the end result is healthcare costs half of ours (including the tax component) and similar outcomes.

And our health care system requires subscribers to insurance companies to pay those insurance companies to A) provide charity to people who wouldn't be able to afford to buy insurance in real market and B) pay for routine care (i.e. care where there is no risk to insure against - you know you're going to need it). And of course the health insurance company is going to collect its cut of the money that the government has forced subscribers to funnel through those companies. Is it really any surprise that system gets expensive?

>You need government, not a charity.

You need charity, whether it's administered by a public organization or a private organization or funded by private individuals or taxpayers.

<comment><USER36> > do you have some reason to believe the size of pools in a market with less > interference would result in unreasonable premiums?

Demonstrably so. Just look at pre-Obamacare "high risk pools" for concrete examples. [https://www.kff.org/health-reform/issue-brief/high-risk- pool...](https://www.kff.org/health-reform/issue-brief/high-risk-pools-for- uninsurable-individuals/)

You'll also see it in other insurance markets, like life, house, car, malpractice, etc. - many people are largely uninsurable in these markets.

> What is 'large enough'? The populations of many entire European countries > are dwarfed by the number of subscribers to several health insurance > companies in the US.

It's not so much raw population as how much you're allowed to slice it up. A decent sized city is big enough - many corporations of a few thousand people self-insure as it's cheaper.

The problem is when you allow insurance to pick their customers. They just pick the healthy ones, if allowed.

> And our health care system requires subscribers to insurance companies to > pay those insurance companies to A) provide charity to people who wouldn't > be able to afford to buy insurance in real market...

You are using some _very_ weird definitions of "charity".

Obamacare's subsidized premiums aren't shouldered by the insurance companies, they're provided by the government. Those insurance companies are making bank, not providing charity.

Single-payer or income-based subsidized healthcare isn't "charity". Insurance paying out more than premiums taken in for a particular subscriber isn't "charity", it's how insurance works.

> Is it really any surprise that system gets expensive?

Oh, not at all, but that's because we've picked the _least_ cost-effective bits of both private and public healthcare systems to combine into a monstrosity.

<comment><USER44> >Demonstrably so. Just look at pre-Obamacare "high risk pools" for concrete examples.

I'm obviously not talking about individuals who are so expensive to profitably insure that they can't afford the premiums. I've already stated that the market isn't going to work for them. It's not the size of the pool that's causing problems here; the contents of the pool are the problem.

>They just pick the healthy ones, if allowed.

They also pick the less healthy ones that are able to afford to pay the higher premiums it takes to make it worth it for the insurance company to cover them, assuming the insurance company is allowed to charge such premiums. There is plenty of money to be made there. Where there isn't any money to be made is in people who know they have high expenses and can't afford to pay them.

>You are using some very weird definitions of "charity".

Are you taking issue with my characterization of government welfare as charity? Why should it be excluded from such a broad category?

>Obamacare's subsidized premiums aren't shouldered by the insurance companies, they're provided by the government.

That's not what I'm talking about. I'm talking about people who have pre- existing conditions, who are definitely going to cost the insurance company more than they're going to be paying in, regardless of subsidies, who the health insurance company can't charge more money to and can't deny coverage to.

>Insurance paying out more than premiums taken in for a particular subscriber isn't "charity", it's how insurance works.

Actually that hinges on whether it's known before the agreement is made that the particular subscriber is going to have more paid out on his behalf than he is going to pay in. If it is known, then that's not insurance. It's charity.

</comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER45> My employer used to provide additional funding in employees' HSAs (Health Savings Accounts) if they participated in a health screening. The health screening involved measuring height, weight, blood sugar, cholesterol and other lipids. There was also a questionnaire about lifestyle choices related to health in terms of how physically active you were, smoking, drinking, etc.

</comment><comment><USER46> I've been saying this for years. That discount card you use at the grocery store tells your insurance company how much bacon you eat.

</comment><comment><USER47> LexisNexis said there is no web page to submit a request for info. I tried their chat option and that person said I had to call. 888.497.0011 After 30 min on hold I spoke to someone. They wanted my personal info including SS# and Drivers license# They saifd they would mail out the info in 10 days.

I guess this 'personal touch' is a security measure.

</comment><comment><USER48> In WA state to price out insurance all you need to provide is your age, gender, and smoking status. I don't see how insurance companies can use any other information in setting the price?

</comment><comment><USER19> Has anyone done any research to map out the relationships between the different data brokers? E.g. who has what data to sell, and who's selling what data to who?

<comment><USER17> I could tell you who is selling what, and a little bit of who is selling what to who, but I don't think any one person has a complete picture.

<comment><USER19> Would it be too much trouble to share what you know? Even just a list of the players would be helpful.

I'd really like to understand more about this industry, but from a consumer perspective, it's very opaque. It's easy to find people search websites (and articles about them), but much harder to understand how they got your data or what else about you may be getting sold.

<comment><USER17> I'll do my best to explain. I need to start by noting that, as far as I'm aware, there's no generally accepted nomenclature for this stuff. Accordingly, I've invented my own terms (some of them as I write this).

At a high level there are two different kinds of brokers, which I'll call "primary brokers" and "secondary brokers." Primary brokers are companies that primarily aggregate their own data and sell it to other businesses. Secondary brokers are companies that primarily buy data from primary brokers and resell them to other companies or to consumers.

Each broker can further be defined by the kind(s) of data they sell. Generally speaking, there are 5 categories of data:

1\. FCRA records. These are mainly credit records and credit-related data that are permitted to be used in making credit determinations.

2\. Non-FCRA public records. This is stuff like birth, death, marriage, property records, DMV records, criminal records, etc. These are explicitly not to be used for credit and hiring determinations (not sure about renting, off- hand).

3\. Hiring data. Frankly I'm not entirely sure what these are beyond criminal background stuff, but they are allowed to be used for making hiring decisions, where permitted.

4\. Marketing/Lifestyle data. This is stuff like purchase history, magazine subscriptions, hobbies and interests, data sold by companies whose products you sign up for for free, etc.

5\. Insurance underwriting data. These tend not to be explicitly tied to a non-anonymous person. However, given someone's street address, you'd be able to pull some info on their property or something.

Most brokers sell data belonging to multiple of the above categories.

The big primary brokers for FCRA data are, as you might expect, credit agencies (Experian, Equifax, and TransUnion).

The big brokers who deal in mixes of data are LexisNexis (a Reed Elsevier company), Thomson Reuters/WestLaw, and TLO (a TransUnion subsidiary). They are primary brokers of Non-FCRA and hiring data but secondary brokers of FCRA data (I believe they mainly purchase it from the credit agencies). There are a couple small companies that are primary brokers of things like hiring data (e.g. Checkr).

The big primary brokers of marketing/lifestyle data are companies like Acxiom, BlueKai, Epsilon, US Data, and a number of others. I have heard that credit card companies sell certain kinds of data but I am not sure what exactly and have not used their products myself.

The big primary broker of insurance underwriting data (along with a couple other categories) is CoreLogic.

The big secondary brokers of Non-FCRA data are Intelius and Instant Checkmate. I do not think they are primary brokers under my definition because most of what they sell is basically an identical copy of what the primary brokers sell, but for a lot more money. It's hard for me to imagine them taking on the expense of aggregating the bulk of their own primary data when they can run a search against a primary broker DB for a few bucks and resell a pretty version of the response to a consumer for $50. They probably aggregate _some_ of their own data but I'd guess it's low-hanging fruit.

There are also some purely social media-driven secondary brokers, like Pipl.

</comment></comment></comment></comment><comment><USER49> To play devil's advocate, I think data should be used to manage rates for things that a consumer can reasonably change, like diet/exercise. Smokers are already penalized.

e.g. "Our data indicates your average sugar consumption is over Xg per day over the last 6 months. If you commit to reducing this to Yg per day over the next 6 months, your insurance rate will drop by 10%. Otherwise rates will increase by 20% to cover your increased risk for diabetes, heart disease, and stroke."

<comment><USER38> On that note, my insurer helpfully put a note in my file that the doctor should tell me about being more physically active based on my BMI. When I listed everything I do, he turned to his intern and said "this is an example of how BMI doesn't tell the whole story." Then he deleted the note. So it has to be the right data and the doctor needs to be the final arbiter of whether it's meaningful or not.

</comment></comment><comment><USER50> > And it could raise your rates

And it could lower your rates.

<comment><USER51> > And it could lower your rates.

Lack of a national competitive market for healthcare insurance in the US ensures an oligopoly within each state, and thus argues against your reply. Also, keep your eye upon demographic rate _trends_ , not individual rates.

In other words, for the same demographic over time, have rates been going up or down as the insurance market consolidates players over the past few decades? The trend is inarguable [1]; it is a monotonic function. What data do you have that convincingly advocates including data brokering of lifestyle data into insurance actuarial calculations makes a material change in this function or the marketplace?

[1] [https://www.thebalance.com/causes-of-rising-healthcare- costs...](https://www.thebalance.com/causes-of-rising-healthcare- costs-4064878)

</comment></comment><comment><USER52> Aren't there obvious GDPR issues with this unless you're limiting the analysis to US insurers?

</comment><comment><USER53> Just clicked for me why "healthcare" companies spend so much money on hard discs and data storage.

</comment><comment><USER54> We desperately need some privacy legislation in the US, years ago.

</comment><comment><USER55> Free'ish healthcare is the only way...

</comment><comment><USER56> Whelp, just one more reason why we need Medicare for All. There's no need to enable these people whose business is to find ways to deny people healthcare, just eliminate their industry completely and save money in the process too.

</comment><comment><USER57> This will ensure the death of the private healthcare system. It won't happen overnight, but eventually the private/hybrid healthcare system will have _no_ redeeming qualities other than to extract as much profit as possible out of anyone's health issues. That's when no one will support it anymore (except the politicians taking bribes to support it).

<comment><USER58> Why the downvotes? He's right. The thing about insurance is that the only reason it works is because of imperfect information about the future. The more accurately people can be priced, the more pointless private health insurance becomes: the expensive patients (pre-existing conditions, or just people with bad luck) will get accurately priced and have impossible premiums and won't bother, and the cheap patients will realize they probably don't need it, take a gamble and also not bother. Microtargeted health insurance will be its own undoing.

<comment><USER59> It sounds like you're doing something that most people do, despite it being incorrect. That is, conflating "health care" and "health insurance". Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so.

I believe that our goal should be to reduce the cost of health care so that most of it can be afforded _without_ insurance - with insurance then returned to its role as a hedge against the more extreme/unlikely events.

<comment><USER60> >Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so.

Try this experiment. Walk into your doctor's office and ask what a procedure would cost. Ask the doctor, the receptionist, the billing clerk - <USER3> everyone. No one will be able to give you an answer. That's why they are conflated. Fix that (very ripe for disruption) problem and you'll fix health care.

PS: I agree with you, it should generally be affordable without insurance.

<comment><USER61> > _Try this experiment. ...ask everyone. No one will be able to give you an > answer._

Funny you say this. A friend just went through this. Not even the insurance company could say. The calls to everyone got so ridiculous that I had to construct _lawyerly_ questions so that people couldn't default to weaselly answers. The provider billing staff seemed to feel put upon that they were being asked to _coordinate w /the insurer_ to figure out patient out of pocket cost would be. And in the end they still couldn't figure it out.

<comment><USER60> Here's what gets to me as well... providers love to talk about how little they get reimbursed from medicare and from many insurers. But, for example, I'm not going to have a surgery that I would really like to have (and that a doctor agreed I should have) because nobody can tell me what the cost would be. The 15 minute appointment with the doctor who recommended it to me was $700 out of pocket - so I'm unlikely to return if that's the kind of bill I get hit with for having a cup of coffee with them. So, I'd like to believe that at some point, given the current environment in which people are paying for insurance but can't afford to go to the doctor, that we'll see providers realize they are losing out on revenue opportunities by not actually serving their customers.

<comment><USER62> > of bill I get hit with for having a cup of coffee with them. So, I'd like to > believe that at some point, given the current environment in which people > are paying for insurance but can't afford to go to the doctor, that we'll > see providers realize they are losing out on revenue opportunities by not > actually serving their customers.

The customers from which the providers drive revenue are the ones who _can_ afford to go to the doctor. The ones who can't (even if they pay for insurance) are ones providers wouldn't be getting revenue by serving.

<comment><USER60> But you are missing my point and that of joc815 below you - if I knew the cost, then I could determine whether or not to become a customer. In the absence of a clear cost structure, I can't answer the question of whether I can afford the care or not.

<comment><USER62> > But you are missing my point and that of joc815 below you - if I knew the > cost, then I could determine whether or not to become a customer.

"If you have to ask, you can't afford it."

Or, more to the point, medical procedures often have an unbounded upper limit on potential billed costs, without the opportunity to stop work and inform the customer and get new instructions when it is realized that the original estimate will be exceeded, and even getting a reasonable idea of the statistical distribution of charges for a particular procedure under costly comparable conditions by the same provider wouldn't be easy.

Now, providers could adopt a flat fee structure and eat the risk of long-tail costs, but that creates a lot of risk (and some perverse incentives) for providers.

<comment><USER61> > _"If you have to ask, you can 't afford it."_

Unless we're discussing medical care as a _luxury good_ \-- and if that's the way that we really want to approach this, okay, let's just _be honest about that_ \-- this is incorrect. In my experience, med professionals have made assumptions about what I could and couldn't afford based on their mental databases of flawed correlations. _Things they thought I probably couldn 't pay for, not only could I have if necessary, but didn't need to_ because my insurance was willing to cover it any way.

I'm not going to address the rest of what you've written because, quite frankly, I have a difficult time believing that you are being serious, for a number of reasons. If I'm mistaken, then I thank you for sharing an interesting thought pattern and apologize in advance.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER63> There are surely privacy concerns, but it seems like the evolution of all insurance markets trend towards better risk profiling.

This is a good thing IMO. The point of insurance is to _pool_ risk, not get your high risk subsidized by some sap with low risk. The better insurance companies can profile risk, the more fair the pools.

Then if we want subsidies for high risk individuals, we can work on that separately.</comment>


Where do you find ideas? How should I go about finding ideas for software to make? - <AUTHOR>

<comment><USER2> What are your goals?

If your goals are to gain experience and make money going the startup route, you don't HAVE to be the one with the idea if you're capable of implementing the ideas of others. For best results, you just need to be able to RECOGNIZE a good idea that is presented to you and generate enough passion about said idea that you can make it the focus of your life for awhile.

There are people that have the opposite problem that you have...they have tons of good ideas (and maybe contacts and money), but lack the skills to implement them. Find those people. Start a company with them. Rinse. Repeat. Eventually, you'll tend to rub off on each other and you will gain skills in generating good business ideas on your own...

</comment><comment><USER3> I'd recommend to build something YOU need: it's always the best way to make sure you're building something useful.

<comment><USER4> Building for a target market of one is a bit too narrow in many cases to be a good idea for something you hope to sell to a wider audience.

</comment></comment><comment><USER5> Copy an existing market leader, then as you're developing your software, create new features that distinguish you from the competition.

<comment><USER6> Why is this downvoted?

If you copy something that works and then add features or put a spin on it you can end up with something new and cool. Its a good way to start thinking about ideas imo.

Isn't Digg just google news or nytimes with new innovative features?

</comment></comment><comment><USER7> Talk to people. Tell them you're starting a company. Lay out an idea. It doesn't have to be good. It's been my experience that this scenario triggers an irresistible impulse in the other person to tell you _their_ ideas. Sooner or later, you'll hear something interesting. Explore it and refine it.

The biggest mistakes you can make, IMO, are (a.) thinking your idea is too stupid to start with, and (b.) keeping it a secret. The idea you start with almost certainly won't be what you finish with; the important thing is to get started. And if you don't talk about it, you'll never really explore, refine or (as you'll almost certainly need to) abandon it for something better.

Most people have something interesting to say. Find out what it is.

</comment><comment><USER8> Find something you love to do but is being done in a bad way... then, fix it.

Good Luck

</comment><comment><USER4> You find ideas in one of several ways: 1) you bricolage them together from reading a lot in a wide range of topics or 2) you think long and hard about a single problem you want to solve. In the former, you come up with something interesting and new because it's an unexpected and novel recombination of ideas normally not found in the same place (cross-discipline). For the latter, you will cover a large and interesting search space where you hopefully find a number of interesting ideas that each taken by itself gives you just a small part of the solution.

</comment><comment><USER9> Every time you find yourself/someone else disappointed with something, or unable to do something, instead of thinking _"That's just how things are I suppose"_ ask yourself _"Could I fix this situation if I really tried?"_

Write the ideas down. Look over your list. Pick the one that seems the most interesting AND has the best (clearest/easiest) method of distribution.

</comment><comment><USER10> Analyse existing systems. Divide them into subideas, and mash up them.

For instance, Gmail is a MUA with good spam filter, keeping e-mails in threads. So, why not create a blog reader that keeps discussions between bloggers in threads, making it easy to follow?

</comment><comment><USER11> Well, I have a couple of ideas I would like to see implemented and little time to work on all of them. I'm not promising they're great ideas but it's software that I would use if it were available. If you're interested send me an email.

<comment><USER12> I was in your position about a year ago and wrote a post about possible idea sources. You might find it useful

<http://www.pumperknickel.com/?p=7>

</comment></comment><comment><USER13> understand the problems being solved by existing services. Come up with a different/better solution. Key is understanding problem domain - me thinks.

</comment><comment><USER14> generally they come from your head.</comment>


Can Students Have Too Much Tech? - <AUTHOR> http://www.nytimes.com/2015/01/30/opinion/can-students-have-too-much-tech.html <comment><USER2> I've got kids in middle and high school. And I worked in a large county educational computing facility in the early 80's, that had every kind of computer and piece of educational software for teachers to try out. My observations:

1\. The computer is the "distraction machine." It is just vibrating with distractions. Even the supposedly educational websites have things that move, different colors, links, and so forth. Keeping my kids focused on their lessons requires constant supervision. Most of the time spent at the computer is recreational.

2\. I think the content tends to be superficial, possibly because making the underlying mechanics work detracts from actually creating content. A lot of the software that I saw in the early 80's was glorified flash cards, and I'm not sure it's much better today. I'd estimate kids spend twice the time on half the content.

3\. The bright side is, I think there's some tech, that is qualitatively different than a textbook. It tends to resemble "real" software that grown-ups use, such as programming tools, computer algebra systems, and so forth. Schools rarely use this stuff.

<comment><USER3> The computer is the "distraction machine."

Dead on. It's evolved to that point even for those of us that started in the 80s. Nothing but bright shiny things...a click away.

<comment><USER2> I suggested an idea to my son, who struggles greatly with the distraction machine. Even just having Microsoft Word open is bad enough because there are so many fonts, settings, the help system, and so forth. This, compounded by a bit of writers block, and probably the inherent boredom of the work.

I proposed to set up a Linux system with all apps disabled save for a plain text editor. I told him that it's not a punishment, but just a experiment in finding a practical solution to a problem that he acknowledges.

<comment><USER4> Your example of MS Word is interesting. Not only are these "playable" features distracting, they don't help with learning to write non-trivial texts either. I'd like to see them use a simple semantical text editor where they indicate the structure of the text, which then is automatically formatted. Formatting then is not a seemingly integral part of writing anymore, but a separate task.

More importantly, I think, is that a lot of educators and parents seem to value "having fun" as an important characteristic of education. I am doing research on innovative mathematics education in primary school, and, when asking teachers to evaluate the lessons or instructional materials, they always point out how much fun the children had (compared to the usual instruction). If I asked further and inquire about the actual learning of the students, most teachers aren't able to express anything beyond the superficial, either related to class management or to regurgitating parts of the curriculum.

<comment><USER5> FWIW, this is what a LaTeX editor might give you. You write paragraphs of text, with some tags to indicate the semantics of the text, and converting that into 'pretty' text on a page is (generally) a second step.

<comment><USER4> I was more thinking about something like LyX and hide the typesetting engine / markup language for a while. Although when children have experience with an editor like this, supporting them to learn something like HTML (of LaTeX) is probably a lot easier as they understand the concept of structural elements.

</comment></comment></comment></comment></comment></comment><comment><USER6> I think it's most useful to think about these questions in terms of the quality of the technologies involved. Technology does not just include computers and the Internet, but also books, paper, writing utensils, chalkboards/whiteboards, workspaces, etc.

Taken from that perspective, we should then judge each piece of technology on how well it does its job. A high-quality textbook with a good index, good writing, good editing, and good organization is extremely valuable and useful. A poor quality textbook with an incomplete index, errors, and poor organization is not nearly as useful.

How does this compare to computer tools for learning? Well, we can't just judge the tablets or laptops as hardware. Computers are only as good as their software and the content available. And how does that fare? In my experience, it's universally terrible.

In general, content on the Internet is poor to counterproductive in terms of quality. Some sources are good, but the general trend towards massively huge variety served up by completely automated tools, not to mention the inevitable spam that shows up in low-barrier-to-entry zones reveals itself across the board. Current search technology is woefully insufficient to make sense of the surfeit of content. This is obvious on Google, but even in narrower cases like Amazon.com or the various mobile app stores, there's just too much content out there, 99% of which is junk.

That doesn't even begin to address the terrible user interfaces. Compared to a book, which is far less flexible but light-years easier to use and interact with, most software fails miserably.

Virtual textbooks, for example, are easier to search, but harder to use in every other way, from just reading to browsing, to perusing indexes or sharing with classmates. And that's assuming the licensing and access issues don't cause you problems. My daughter's online history textbook was taken away a week or so ago because of a mistake somewhere between the school administration and the textbook company in renewing the license. So now the kids just don't have a textbook until someone resolves the problem. This doesn't happen with actual books.

Books and lecturing have had centuries to be perfected. We take it for granted, but it's true. Computers and the Internet are newborn tech by comparison. So long as we fall for snake oil pitches and pour money into this new tech indiscriminately in the hopes it will solve our education problems, we're just encouraging the already horrific state of the technology. Let's focus on the stuff we know works and let the flashbang tech mature a bit more.

</comment><comment><USER7> Can students have too much tech? Probably not. TV didn't ruin kids, and neither will the Internet. But this article is completely correct that more technology is not a panacea. Putting more technology into classrooms does not, by itself, improve learning outcomes.

Science and engineering, at the university level, are still largely taught the same way they have been for 100 years. This has not hampered the ability of engineers to dream up and create amazing and innovative products, nor the ability of mathematicians and scientists to push the boundaries of their respective fields. If (when) an engineering student takes a course on differential equations and doesn't grasp the material well enough to apply it to their future work, that's much more likely to be because:

a) They didn't understand how these concepts would be applied to practical engineering work and thus failed to apply themselves; or b) They found lectures difficult to follow and didn't have any resources to fall back on (e.g. professor office hours; teaching assistants)

not c) There wasn't enough technology in the classroom

Technology is needed for vocational training - whatever technology would be used to do the job needs to be present in the classroom. But in primary/secondary school and university, you need to teach fundamental, abstract skills and a chalkboard is perfectly adequate for that.

</comment><comment><USER8> I feel like the roots of this movement were to make a more computer literate society, when access to technology was a larger hurdle than it is today.

Kids of all economic classes are currently exposed to technology daily, so the aim has to shift. Can we create software that helps children learn faster than a traditional environment? Can we teach them things that are not available without technology?

Slapping a kid in front of a computer to play some stupid vocabulary game might have been useful in 1990, when learning to type, use a mouse, navigate an operating system, was a useful skill. Not so much now.

Can we teach them logic and problem solving skills through coding? Can we create software that makes them eager to learn and explore? Become Critical Thinkers?

The physical devices are only part of the issue. The curriculum has to be targeted and useful.

<comment><USER9> Typing and using a mouse on an operating system are still useful. I work with students aged 16-21. By and large they hardly know how to operate computers. Typing speeds are very low.

A common occurrence. I see them do a search on chrome. The search bar sends them to spam search site "yeblorsk". I ask why it does that. They shrug and say "isn't that what it's supposed to do?"

They don't even know their browser has been hijacks. And these are university or university track students.

</comment></comment><comment><USER10> I suspect that technology can be a great learning tool if:

1) The computing environment encourages kids to practice problem solving, critical thinking, and systematizing.

2) The kids are intrinsically motivated to spend their "screen" time using software that encourages the above, as opposed to any of the myriad distractions on computers.

#1 is a problem of finding and identifying the good software in the haystack of diversions. This was easier in the pre-internet days because computers simply had far fewer consumer-oriented features.

#2 requires that kids actually be interested in and disciplined about thinking deeply about problems. It also really helps if kids have a problem that they personally want to solve, which motivates them.

</comment><comment><USER11> Who cares? Let them figure it out for themselves for once, self control is only learned through binging and gorging on the sweet stuff until it hurts.

I loopholed my way out of school in grade 7, and for two years after that, I did nothing but watch anime, the crudest and sickest misogynist anime you could lay your eyes on; you would assume I learned nothing from that, but you'd be wrong.

Turns out that if you watch enough anime, you start picking up Japanese whether you like it or not. That binge taught me a skill that helped me, in addition to the computational skills required to pirate so much anime on mere ADSL, get a first job at 17, with income competitive to that of both of my legal guardians, and every last one of my contemporaries.

No matter how much you think they're just loitering around with no aim, they have passions, and soon they'll have developed pre-frontal cortices that can bring them closer to what they love.

It won't have anything to do with your strict prohibition of everything they enjoy. What will save them is those precious daylight hours they spend truant from your mind-numbing institutions.

<comment><USER12> Consider substance addiction. Being a heroin addict might actually teach you how to hide things, steal things, and stick needles into yourself without dying. And eventually you might clean up, 'grow' out of it and use what you've learned for good.

And yet I think most people would agree that prohibiting or strongly discouraging heroin use, at least by children, a good thing.

Obviously heroin is an extreme example. My point is that the things we enjoy lie on a continuum, and with some of these things it's good to discourage or even prohibit, and not 'let people figure it out for themselves', especially not at a young age.

Computer use probably covers most of this continuum. Non-stop candy-crush? Probably more on the bad side of things. Games that involve group activity (WoW, etc.)? Probably a lot better. Games that also involve creation and even 'programming' such as Minecraft? Even better.

When you let children do what they want, there's no guarantee that they will gravitate towards the good stuff in the same way that letting children eat what they want is unlikely to turn them into adults with healthy diets.

Finding the balance between letting children discover for themselves and strictly prohibiting their behavior is very tricky. And that's why it's good to care about these things and discuss them.

</comment></comment><comment><USER3> Absolutely. Technology has evolved computing to the least common denominator, as it it supposed to do. This 'easiness' has nothing to do with critical thinking, analysis, and other thinking skills humans need to develop. There is certainly a place for computer-based learning; I learned more about Linear Algebra and Continuous and Discrete Signal Processing from machines than I did from any professor...but expecting to place elementary level kids in front of a machine and expecting them to emerge as Karl Gauss is idiotic.

</comment><comment><USER13> Sure. I've got like 6 different source of calendar info inflows... None of which sync properly. And I'm willing to bet that is fairly modest by Western standards.

It's a complete fkin mess.

And it gets worse once most of the info is confidential...no you can't make a note of that thing on your phone... It would get syncd to an unencrypted cloud. Fk...

<comment><USER14> Can't you delete the connection to the unencrypted cloud?

</comment></comment><comment><USER15> Books, not iPads. That's what I say!

And you know what, students say so too --- see related discussion about the effectiveness of eTexts vs Print books: [https://news.ycombinator.com/item?id=8882481](https://news.ycombinator.com/item?id=8882481)

</comment><comment><USER16> Rediscovering Koblitz (inventor of ECC ) two decades later ?! [http://www.math.washington.edu/~koblitz/mi.html](http://www.math.washington.edu/~koblitz/mi.html)

</comment><comment><USER17> > Never forget that the human race with technology is like an alcoholic with a > barrel of wine.

Dr. Ted Kaczynski (social critic, mathematician)

<comment><USER18> 'Social Critic' is a bit mild.

</comment></comment><comment><USER19> This is Steven Pinker's sister, if anyone was wondering.

</comment><comment><USER20> Well, prior to the writing of this article, the answer was indeed yes, as the article discusses. However, thanks to the magic of Betteridge's Law, which as we all on Hacker News know is UTTERLY UNASSAILABLE, the answer is now "No!"

Thanks for solving this problem so handily, New York Times! May you use your powers only for the force of good.

<comment><USER21> My life goal is to become a journalist and publish an article about Betteridge's Law that is titled _" Is Betteridge's Law Correct?"_.

 _(One answer is seemingly contradictory, but actually consistent. The other answer is paradoxical.)_</comment></comment>


First images of collisions at 13 TeV - <AUTHOR> http://home.web.cern.ch/about/updates/2015/05/first-images-collisions-13-tev <comment><USER2> I followed the links to the CMS, Atlas and other detectors that the images appear to be from but couldn't find any information on what these images actually mean. By reading the layman's descriptions (which I most certainly am) I assume that the images show where along the "surface", if there is such a thing, of the detector various particles were detected and the length of the bars show either how much energy the particle(s) have or the density of particles at that point.

Is there anywhere I can go to get a more detailed description of these without delving into academic papers that I have no hope of understanding?

<comment><USER3> You've got the right general idea. It's a tricky thing to simultaneously display three-dimensional tracks and the amount of energy deposited in each detector system.

I'm surprised that Atlas and CMS don't have a better viewer's guide immediately at hand, but perhaps this article will help:

[http://www.symmetrymagazine.org/breaking/2010/03/18/atlas- ev...](http://www.symmetrymagazine.org/breaking/2010/03/18/atlas-event- display-decoded)

<comment><USER4> I've worked at two accelerator facilities (RHIC and CEBAF) writing software for doing particle tracking and pseudo-data generation, and I always wished that they could divert more time into preparing articles like the one you linked. They're super helpful to laypeople, especially family and friends, but they're also great for getting students at universities interested in maybe coming to pitch in.

Sadly, the lab personnel (especially those coordinating outreach) are generally crazy overworked and don't have a lot of time, and the interns are just too inexperienced and lack the requisite domain knowledge to do it themselves.

<comment><USER5> If you ever feel like writing a paper on this I can highly suggest Ludwik Fleck as a starting point (his writing on thought collectives). At least that's where I started when I needed a concept of marketplace for ideas and why laypeople matter.

</comment></comment></comment></comment><comment><USER6> Here's the LHC dashboard for your projector: [https://op- webtools.web.cern.ch/op-webtools/vistar/vistars.p...](https://op- webtools.web.cern.ch/op-webtools/vistar/vistars.php)

<comment><AUTHOR> Are there others? This is the one I use: [http://meltronx.com/index.html](http://meltronx.com/index.html)

<comment><USER6> Wow, I haven't seen that. As you can see, my link goes straight to cern; you appear to have found someone else's meta-dashboard.

The cern one has the dropdown in the top left that takes you to a lot of other ones too.

</comment></comment></comment><comment><USER7> What does the raw data that generates these renders look like, or do their dashboards literally spit out images that look like that? I'm guessing their instrumentation can roughly figure out what energy/size/charge of particle is where, but the _how_ just seems like magic to me.

<comment><USER8> I highly recommend the "Particle Adventure" for lots of info about basic particles physics that's accessible to the layman

[http://www.particleadventure.org/](http://www.particleadventure.org/)

In particular, starting at this page should give you an idea of how many components there are and what sorts of information come out of them:

[http://www.particleadventure.org/component_detector.html](http://www.particleadventure.org/component_detector.html)

<comment><USER9> +1 for Particle Adventure.

I wish more things were taught that way!

</comment></comment></comment><comment><USER10> Once again, Scientific Linux delivers :P

<comment><USER11> I remember the days when that distribution was put out together. :)

</comment></comment><comment><USER12> A description of the parts of the Large Hadron Collider, in 90's rap form, is here:

[https://www.youtube.com/watch?v=j50ZssEojtM](https://www.youtube.com/watch?v=j50ZssEojtM)

<comment><USER13> Thanks, that was a nice one!

If one had to explain to somebody who has absolutely no clue whatsoever what the LHC does and why, one could do worse than point them to this video. :)

</comment></comment><comment><USER14> "Mr. Singularity, come here. I want to see you."

</comment><comment><USER15> How long will it take the black holes to swallow the earth?

</comment><comment><USER16> Well, there's been some alarmism about AI recently, and in that same vein I'll admit it - even with a physics degree I'm _uneasy_ about the LHC. By definition we don't know what will happen. We are generating kinetic energies that haven't been seen since literally the dawn of time. I would just be a lot more comfortable if these experiments were being done in space, far away from life. It's just that even 99.999% certainty that nothing catastrophic will happen really isn't high enough considering the stakes.

EDIT: add 'kinetic'

<comment><USER17> Re: "We are generating kinetic energies that haven't been seen since literally the dawn of time."

Is 13 TeV really considered a lot of energy in terms of what happens daily with particles hitting our atmosphere? [http://en.wikipedia.org/wiki/Cosmic_ray](http://en.wikipedia.org/wiki/Cosmic_ray) seems to suggest that we've observed naturally occurring 3 × 10^20 eV, which is a lot ( larger than 13 TeV (10^12).

<comment><USER18> You have to look at center of mass energy, the energy actually available for reactions in a collision. The collisions of ultra-high-energy-cosmic-rays (UHECRs) with air occur at hundreds of TeV center of mass energy. And they may be nucleons, in which case this energy is spread over several nuclei. So assuming that Lorentz symmetry holds (probably the safest assumption in modern physics), 13 TeV is in a similar ball park as UHECR collisions.

<comment><USER19> > And they may be nucleons, in which case this energy is spread over several > nuclei.

???</comment></comment></comment></comment>


What is wrong with functional languages - <AUTHOR> http://www.thinkezy.com/blog/?p=135

<comment><USER2> If python was treating it as a text value then int("009") is 9 as you would expect. Even if it wasn't you could do lstrip("0") to remove leading zeroes before converting to an integer.

From reading the post it sounds like the faults lies more with the developers inability to use python than pythons inabilities.

Also, I know python has functional aspects, but is it really classified as a functional language now?

<comment><USER3> Also - even if it was python fault, and if python was a functional language, error described here would be a problem of dynamic typing, not of functional- ness of a language.

</comment></comment><comment><USER4> I'm not sure an article about "functional languages like Python" is going to shed much light on functional languages.

Maybe he was thinking of "procedural"?

<comment><USER2> Python is multi-paradigm, you can certainly write functional code with it.

<comment><USER5> But the article still get's it wrong it has nothing to do with functional vs OO vs procedural and everything to do with type casting. Given the level of confusion on the authors part I suspect this has more to do with mastery of the tools at the authors disposal than the constructs of a languadge.</comment></comment></comment>


Twitter.net: The International Association of Bird Statistics Gatherers - <AUTHOR> http://twitter.net/ <comment><USER2> Studying about birds is a hobby of mine, but why the heck is this posted on hn?

1) There is (literally) no content to the site, thus nothing interesting.

2) The only action is inputting bird stats if you're already a member.

3) The only rationale I can assume is "Hey someone owns a domain that sort of looks like it should belong twitter.com, but it doesn't." If that's the case, the submitter might be shocked to find there are other sites just like that out there (which generally predate the more popular site).

Is this really something the handful of voters find interesting or is it just a boring weekend?

<comment><USER3> Mildly interesting, but eBird[0] by Cornell is far more powerful and popular for collecting bird sightings data.

[0] [http://ebird.org](http://ebird.org)

<comment><USER2> Yep, I use that one sometimes. Also Cornell's project feederwatch[1] and allaboutbirds[2]. Cornell has a lot of love for bird studies.

I've been tempted to apply when their Ornithology Department had web/mobile job openings, but moving to Ithaca for it seems a bit too much for me, even for a hobby I enjoy.

[1] [http://feederwatch.org](http://feederwatch.org)

[2] [http://allaboutbirds.org](http://allaboutbirds.org)

</comment></comment></comment><comment><USER4> I hope they're being compensated for promoting Twitter and boosting Twitter's SEO with that link on their page.

</comment><comment><USER5> this is amazing! light of my day!</comment>


Show HN: For a Good Strftime - <AUTHOR> http://www.foragoodstrftime.com/ <comment><USER2> Ruby invented strftime?

<comment><AUTHOR> No, but because I'm pushing it through ruby's strftime I didn't want to misrepresent it as being 100% compatible with other implementations.

<comment><USER3> Is Ruby's strftime different from C's strftime?

<comment><AUTHOR> Yeah, unfortunately there are small differences in tokens that different systems strftime's represent.</comment></comment></comment></comment>