Astronomers have found the stars responsible for an explosion recorded in 1437 - <AUTHOR> https://www.theatlantic.com/science/archive/2017/08/a-cosmic-whodunit/538482/?single_page=true <comment><USER2> My first reaction was "it shone for 14 days and only Korean astronomers noticed it?" Then I googled for that nova and eventually found this interesting article [https://academic.oup.com/astrogeo/article/47/1/1.29/258488/W...](https://academic.oup.com/astrogeo/article/47/1/1.29/258488/Where- have-all-the-novae-gone)

It seems that Koreans were particularly keen at looking for novae. Cloudy skys, lack of fast global communications, the small number of people looking for faint new stars could explain why nobody else noticed it. For example, about the supernova of 1604 which was visible during the day:

> "On the 30th [of September], the sudden breaking of the clouds afforded one > of Kepler's friends an opportunity of having a very short view of it… On the > 2nd, 3rd, 4th and 6th of October, it was seen by several persons in > different places. On account of cloudy weather at Prague, where Kepler > resided, he did not see it until the 8th of that month."

If that's happened to a supernova, I can imagine a nova could slip away unnoticed.

<comment><USER3> This nova would also have been rather low in the sky. From Seoul's latitude, the maximum altitude of the nova would have been about 7.5 degrees above the southern horizon, and not visible at all from much of Europe.

</comment></comment><comment><USER4> It always saddens me to remember that with the arrival of electricity & technology we've truly lost the fascinating view of the cloudless night sky. I assume that in 15th century Korea it was much easier to notice changes in the night sky than it would be today.

 _(edit: typo)_

<comment><USER5> There are still several dark sky preserves ([https://en.wikipedia.org/wiki/Dark- sky_preserve](https://en.wikipedia.org/wiki/Dark-sky_preserve)) in the world, where the view will be just as good as 15th Century Korea.

Having spend several nights around Tekapo, which is one of the largest in the world. I would definitely say that it's worth trying to spend a night in one. The view of the night sky is stunning. You can see the Milky Way with the naked eye, and the sheer number of stars is magnificent.

<comment><USER6> You don't have to go too far to find dark skies.

My wife and I rented a cottage at Sheep Dung just outside Boonville, CA, a few years ago. Ukiah was on the far side of the hills to the east, another range blocked the coast to the west, and the next closest big city was Santa Rosa -- far enough away not to cause light pollution. I got lucky because the Labor Day wildfires were east of Clear Lake and blowing smoke east toward I-5. It was the first time in my life I got to actually see the Milky Way with my own eyes.

<comment><USER7> I am in Bolinas right now, it's close to midnight, and I am going to close my laptop in a few seconds, and go out to look at the night Sky - which I did yesterday, and it was quite magnificent.

<comment><USER8> Since you posted that 20 hours ago, I'm sure you're done by now. But don't forget it can take 20 minutes to an hour to get your eyes fully adapted to the dark.

So don't go out for just a short time, plan to spend a while in the dark before fully enjoying the stars.

</comment></comment></comment></comment></comment><comment><USER9> I got to say I am always astonished at astronomical discoveries. Finding a wrecked ship in ocean is really really difficult, but correlate and finding what is out there in the open space, hundreds or even more light years away is like finding a dust particle in the open sea. Let's pause for a moment and appreicate these discoveries....

<comment><USER10> And yet the average investment banker or lawyer gets 10x the salary. Priorities...

<comment><USER11> Astonishment factor is not worth much in terms of money.

</comment></comment></comment><comment><USER12> "Michael Shara and his researcher colleagues have spent the last nearly 30 years looking for the star responsible for this nova." that's what you call dedication :D

</comment><comment><USER13> This headline is a little funny if you choose to read it as a legal verdict.

<comment><USER14> Good eye 11

<comment><USER13> 30

</comment></comment></comment><comment><USER15> It's grating to see a major publication quote a date as "1437 AD". It's either "1437 CE" or "AD 1437".

<comment><USER16> It may be a house style, and/or it may not be as important as you think.

For example, the Wikipedia house style, at [https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Date...](https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers) , "says: AD may appear before or after a year (AD 106, 106 AD); the other abbreviations appear only after (106 CE, 3700 BCE, 3700 BC)."

The Atlantic is at least consistent.

"Pre-Islamic Iranian history is believed to range from about 4000 BC to 651 AD." \- [https://www.theatlantic.com/international/archive/2012/04/ir...](https://www.theatlantic.com/international/archive/2012/04/iran- before-islam-challenging-stereotypes-through-art/255503/)

"But earlier sand blows found underground have been dated—thanks in part to the native pottery shards and charcoal that sandwich them—to 1450 AD, 900 AD and 2350 BC." \- [https://www.theatlantic.com/science/archive/2016/06/the- grea...](https://www.theatlantic.com/science/archive/2016/06/the-great-middle- american-earthquake/486623/)

"The dawn of the "Neolithic revolution" around 8,000 BC marks man's transition from hunter-gatherer to food producer. Life" \- [https://www.theatlantic.com/health/archive/2013/01/the- iron-...](https://www.theatlantic.com/health/archive/2013/01/the-iron-in-our- blood-that-keeps-and-kills-us/266936/)

"...which killed about 50 million people in Europe and the Byzantine Empire between 600 and 800 A.D..." \- [https://www.theatlantic.com/health/archive/2015/09/disease-p...](https://www.theatlantic.com/health/archive/2015/09/disease- plague-of-athens-ebola/403561/)

The one exception I found (I only looked at the first few matches) is due to a book titled "EUROPE BETWEEN THE OCEANS: 9000 BC to AD 1000 " \- [https://www.theatlantic.com/magazine/archive/2008/12/books-o...](https://www.theatlantic.com/magazine/archive/2008/12/books- of-the-year/307162/)

</comment></comment><comment><USER17> "One the one hand" \- do these publications proofread their stuff?

<comment><USER18> Did you get a refund?

<comment><USER17> I did not, but I did swallow the ads they sent me so maybe I should.

<comment><USER19> So keep your adblocker and scriptblockers running.

<comment><USER20> Except for the subjectively well written articles of course

<comment><USER19> What? No. Well-written or not, if they try to put ads and javascript in my face, I block it.

</comment></comment></comment></comment></comment></comment><comment><USER21> >"According to their calculations, the star was right in the center of the nova shell on the day the Koreans saw a mystery star, which means it caused the cosmic explosion."

Hmm, or it was in a different plane and is many light years from the nova and some other star, which died, or is too faint to see, or isn't charted, was the cause of that particular nova.

Isn't this classic "correlation is not causation" stuff?

I was expecting to find how they showed the Koreans recorded the position so accurately it could be matched - to the day - with a projected location of a star for which we have 3 data points?

The conclusion (in the abstract) sounds more like a postulate. It seems perfectly reasonable, but does it really follow logically from this single instance?

Presumably, if the conclusion is sound, there are enough records of novae that one can now draw _many_ star trajectories through groups of novae each caused by a single star?

<comment><USER22> _Isn 't this classic "correlation is not causation" stuff?_

It isn't. There are only a few dozen intragalactic novas per year. They've been looking for this one for a while and so far this is the only candidate anyone's found.

 _one can now draw _many_ star trajectories through groups of novae each caused by a single star?_

That's a bit like saying you can draw many trajectories of cars that could have been in a crash while the smoldering wreckage is sitting by the side of the road.

<comment><USER21> We're looking at 600 years back, so are you saying there's 18000 novas to examine (30 per year) across that period?

Their conclusion in the OP was AIUI that _many_ stars produce novae serially. So we should surely be able to match series of novae (along a stars trajectory).

Do you know are English language details of the historic Korean record available (are they in the paper)?

[http://www.cbat.eps.harvard.edu/nova_list.html](http://www.cbat.eps.harvard.edu/nova_list.html) shows very few recorded novae, is this a listing including the dozens per annum you mention?

<comment><USER23> [https://arxiv.org/abs/astro-ph/0501331](https://arxiv.org/abs/astro- ph/0501331) includes a table (as far as I know, exhaustive) of historical Korean nova records.

<comment><USER21> Fascinating, I was expecting it to be in hanguls rather than Chinese characters - never really considered astronomy as having an overlap with history quite so much as this before. Thanks for the link.</comment></comment></comment></comment></comment>


What I learned from reading a thousand emergency room bills - <AUTHOR> https://www.vox.com/health-care/2018/12/18/18134825/emergency-room-bills-health-care-costs-america <comment><USER3> Exhibit A for why "free market healthcare" is an oxymoron.

I have yet to hear a coherent explanation for how anyone can reasonably expect for price discovery to even pretend to function in a market where the consumers can't even guess the prices until after they've already purchased and frequently couldn't reasonably be expected to refuse service even if they did believe it was overpriced.

<comment><USER4> Exactly. It's the same reason we don't have free market police and fire services. You simply don't get to "shop around" for emergency services, which includes privatized ambulance services (which are outrageously expensive, on the order of $12,000 for the ride I took when I had to take one, and it was a relatively benign one... thank god I had insurance). EMS is covered, but that's the Fire Department. After that, it's all privatized. If it's cosmetic, then I could see the argument. But when it comes to emergency services, and for ambulances especially, the "free market" argument just doesn't hold water.

<comment><USER5> The history of private firefighting is a particularly dirty one.

In the past, fire companies would show up and demand payment before putting out fires. If a payment couldn't be made, the company might negotiate the purchase of the burning property at a steep discount.

Later, insurance companies hired brigades to only put out fires on insured properties. Fire companies might have fought or sabotaged one another in order to win the right to put out a fire and get paid for it.

While it isn't perfect, and it's often underfunded, I definitely prefer the system we have now.

<comment><USER6> Not everywhere, though. In Denmark, private operators have been handling emergency services since 1926; currently one company (Falck) is handling 65 percent of municipal fire brigades and 85 percent of ambulance services. No particular nastiness has been reported afaik.

<comment><USER7> The US has lots services that are provided by regulated monopolies. My garbage company, power company are all regulated monopolies. A key thing is you're required to have garbage and power service but the rates are negotiated by a public utilities commission or the city or county.

However Healthcare in the US isn't a regulated monopoly like that.

<comment><USER8> And there was an entire thread about how those regulated monopolies are not working well. In particular PG&E in California.

I think it was this one

[https://news.ycombinator.com/item?id=18690916](https://news.ycombinator.com/item?id=18690916)

<comment><USER7> My point was just we do have regulated monopolies in the US. But healthcare in the US isn't a fully regulated monopoly.

I'll argue whatever PG&E problems are they don't rise at all to the level of healthcare. And their problems are due to poor regulation and the US's current terrible management culture.

</comment></comment></comment></comment></comment></comment></comment><comment> y-c-o-m-b I was a victim of the surprise out of network bill in the Portland, OR area. I did all my research before hand: hospital in network, surgeon in network, etc. but ONE person in that operating room was not in network and SURPRISE i'm out thousands of dollars. The worst part about this is my state passed a bill to stop this prior to my surgery, but the bill's effective date was roughly 3 months later. Talk about bad timing.

<comment><USER9> I'm at a loss as to why the US is still dead set to have no meaningful health coverage.

I got burned by this in California a decade ago. A dentist charged me $4,500 to fix a broken tooth (panic!) and fill in a cavity on a Sunday.

Had I known then what it might have cost I'd have simply flown back to Europe in the next flight ($600-800 at the time) and get the same thing done for under $100-200 with a full refund from my local social security.

Adding insult to injury I had a very expensive international health insurance policy owing to my traveling around the world back then. And they didn't cover dental with my plan. I knew they wouldn't. But it was still mind boggling to me in that I never expected a casual procedure that would have cost me €150 at most anywhere in Europe - most of which would have gotten refunded at that - to cost me a whopping $4,500 in the US.

<comment><USER10> USA dentists don't work on Sunday. If you had waited until Monday you would have had many more options. Besides what could she have possibly done to "fix a broken tooth" in one day? Nobody was milling crowns in the office a decade ago. If it was really just a filling, wow.

Do dentists in Europe work on Sunday? In my experience the grocery stores aren't even open...

<comment><USER11> I've had emergency dental treatment in an NHS hospital in the UK for an extremely painful dental abscess - was treated first thing on a Sunday morning.

<comment><USER12> > I've had emergency dental treatment in an NHS hospital in the UK for an > extremely painful dental abscess - was treated first thing on a Sunday > morning.

Emergency dental care is provided in the US as well. Filling a cavity is not considered an emergency.

<comment><USER10> Very few oral problems are emergent. GP's abscess would have been visible on examination for months, and certainly was uncomfortable before it was extremely painful. In many cases the first treatment is a course of antibiotics, which any USA ER could administer perfectly well.

<comment><USER11> "certainly was uncomfortable before it was extremely painful"

Actually it wasn't - went from nothing to blinding pain as if someone threw a switch. I'd have 10-15 minutes of agony then it turned off for the same time and it repeated at that frequency all of the Saturday until a GP came out on the Saturday evening and gave me painkillers and told me to go to the emergency dental clinic the next day.

It was right in the middle of my 3 years exams at University - which was a bit of bad timing!

</comment></comment></comment></comment></comment></comment></comment><comment><USER13> I'm not an advocate of government paid health care, but hospitals and medical providers should see that this train is coming and if they don't become more transparent it's going to be forced upon them.

I don't have a problem with ER care being more expensive -- that isn't necessarily unreasonable when you are getting care in an expensive facility open 24x7, fitted out with equipment to handle any possible medical emergency, and staffed with highly educated people who make a lot of money. But it is unfair to have no idea what costs you are facing and whether any of those costs are out of network on your insurance.

<comment><USER14> > But it is unfair to have no idea what costs you are facing and whether any > of those costs are out of network on your insurance.

It's practically impossible to make an informed economic decision about truly emergency medical care without heavy regulation. It's not uncommon to be _literally unconscious_ while all the care decisions for you are being made by others.

See this article for an example: some uninsured woman had a brain hemorrhage and woke up with $357,000 in medical bills:

[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><USER15> Considering she was unconscious she could not possibly have consented to those transactions. What laws exist that allow these companies to unilaterally create these transactions, and what limitations do they have?

<comment><USER16> They have literally no limitations. The reason that an advil at the hospital costs $200 is because they were afraid if they made it cost $20000 people would burn down the hospital.

<comment><USER17> Considering how many people have had their lives ruined by absurd hospital bills I'm honestly surprised nobody's shot one up yet.

<comment><USER18> Really, the only surprise is that you didn't Google "hospital shooting", the following hit from Google lists 15 hospital shootings in 2018 alone:

[https://www.campussafetymagazine.com/tag/hospital_shootings/](https://www.campussafetymagazine.com/tag/hospital_shootings/)

I guess you can go look for the motivation, most shootings probably isn't financially motivated thought.

</comment></comment></comment></comment></comment></comment><comment><USER19> Despite the fact that in my opinion this could be fixed by Universal Healthcare I'm left wondering: how is it legal to be billed these insane amounts of money without even getting a quote beforehand? Like just waiting in the ER is worth more than buying a first class airplane ticket and getting treated in another country.

<comment><USER20> > without even getting a quote beforehand

Reminds me of this really good article. TLDR: Man tried to call a number of hospitals to find out how much childbirth is going to cost him and received no answers.

[https://www.vox.com/2016/5/5/11591592/birth-cost-hospital- bi...](https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bills)

<comment><USER21> Realistically, no hospital is going to give out a price. They don't know what unexpected complication may arise that requires additional services.

<comment><USER22> Realistically, no airline is going to give you a price for transit to a destination. They don't know if there will be a terrorist attack or if the baggage handlers on the other end will jack up their rates.

<comment><USER21> A terrorist attack is an extremely low frequency event to the point is being nearly non-existent. The same cannot be said of birth complications. Baggage handler rates don't change on a dime. Labor rates do affect ticket prices, but they're drastically more predictable.

<comment><USER22> Yes, but the same logic applies: you either negotiate prices out with a network in advance, or insure against the major complications. None of that is different for a health care operation.

<comment><USER21> No. The same logic does not apply, as the two situations are drastically different. The regularity of airline costs is drastically greater than the regularity of healthcare costs. Airlines can set ticket prices upfront because they predict their expenses on a given flight with a reasonable degree of accuracy. Hospitals, subject to extreme and frequent irregularities between what patients may need, cannot. At least not with individual patients. Insurance companies are very different types of customers as compared to individuals. Because the negotiated price applies to a large group of people, the question isn't "how much do we have to charge to break even on X procedure?" The question becomes, "How much do I have to charge for X procedure, *averaged over hundreds or thousands of patients?". Each patient is effectively a slot machine for the hospital. Insurance companies negotiate on behalf of a large number of patients so that the aggregate cost becomes something that is predictable enough to negotiate.

</comment></comment></comment></comment></comment></comment></comment><comment><USER23> Health care is the only industry where the felony laws regarding up front pricing aren't enforced. It was allowed to become a twisted regulatory nightmare where the laws were written by the industry itself utilizing kneejerk methods to obtain profit at the cost of systemic corruption.

<comment><USER24> And yet it is by far the most regulated industry in the US. Almost as if the more invasive the regulations the more invasive the corruption.

<comment><USER23> It takes a while to realize nearly every law is anti-competition protectionism. I didn't realize it until I was working for a multinational food company and the managers were bragging about how the company lobbied for a safety bill that exactly regulated their own industry in a way that cost their competitors billions in compliance fees. They were proud of it. I was disgusted.

<comment><USER25> Disgusting, but know that there are good regulations—like environmental protections—that are frequently combatted by industry groups and tend to get weakened by the Republicans before they pass into law. Regulation can be abused by industry and corrupt politicians for anticompetitive reasons, but most of the time, it's to force companies from doing highly profitable things that aren't good for people or the planet; its much cheaper to just dump all your hazardous waste into the river, after all.

</comment></comment></comment></comment><comment><USER26> "The prices are high — even for things you can buy in a drugstore"

Reminds me of the brief hospital visit I had in Paraguay where I needed to have a friend or relative always with me because the hospital didn't stock anything. If ibuprofen, bandages, syringes, antibiotics, etc were needed, the hospital staff would tell me and I would have my friend or relative run across the street to buy the necessary supplies from one of the pharmacies so the doctor or nurse could treat me.

Cheap hospital bill, cheap pharmacy bill, pain in the butt for my friends and relatives.

</comment><comment><USER27> I know $60 Ibuprofen can seem like a lot, but is anyone arguing that you're literally paying for only the pill(s) with that $60? Aren't you paying for the instant availability, the insurance that it's not expired (do they even expire? I really don't know), and confidence that your healthcare provider has signed off that XXX mg of Ibuprofen is a.) OK to have with your current medications and conditions and b.) sufficient to do the job? Isn't some of that cost the healthcare provider's expertise and service? Would it be better if they prescribed morphine and charged you a magnitude more when ibuprofen would have done the job?

I charge clients similarly. I overbid projects that I don't really want to do. If you want me to setup Wordpress for you, I'll charge you out the nose. Granted, you get to accept my fees before I ever send you a bill. It's not a perfect analogy.

> This is all due to the key fee I've been investigating this year: the ER > facility fee. This is the fee that ERs charge for walking in the door and > seeking care, something akin to a cover charge at a bar.

This seems absolutely reasonable to me, I wish I could charge a 'fill my email with RFPs' type fees. Walking into a waiting room, signing in and waiting is not nothing. You and your symptoms get evaluated and triaged. That takes expertise and know-how. The prices vary wildly because different hospitals experience different levels of demand, I imagine.

<comment><USER28> > I know $60 Ibuprofen can seem like a lot, but is anyone arguing that you're > literally paying for only the pill(s) with that $60? Aren't you paying for > the instant availability, the insurance that it's not expired (do they even > expire? I really don't know), and confidence that your healthcare provider > has signed off that XXX mg of Ibuprofen is a.) OK to have with your current > medications and conditions and b.) sufficient to do the job? Isn't some of > that cost the healthcare provider's expertise and service? Would it be > better if they prescribed morphine and charged you a magnitude more when > ibuprofen would have done the job?

It's hard to argue the 600x markup is there to cover overhead when they literally have a facility charge there to cover overhead.

You also have separate line items for each of the things you mentioned -- doctors, nurses, staff, etc. You are paying for that expertise, often many times over, in addition to a $60 pill that retails for $0.10 at the local Walgreens (who also manages to make sure that it's not expired).

<comment><USER29> You also have to cover uncompensated care, which is a significant chunk of change at any hospital in a major metro area. Besides, nobody actually pays the charges. Insurance companies don't, CMS doesn't, and even the uninsured can typically negotiate a bill down with a quick phone call. That's why the charges are all made up bullshit. It doesn't matter so why bother?

Most hospitals in the US are non-profits. You can go look at their financial statements yourself. They're not exactly raking in the dough. Running a hospital is enormously expensive, and if somebody comes in needing $1 million worth of care, then you're required by law to give it even if they can't pay.

That money has to come from somewhere. That's why Ibuprofen is $60.

<comment><USER30> This just isn't true. The costs of the uninsured are not driving ibuprofen up to $60.

The % of people who are uninsured has halved in the last decade, and this hasn't changed a thing for insurance billing.

</comment></comment></comment></comment><comment><USER31> Great article. I think the narrative around health care is often around who has access to good insurance and who doesn't, and as the cost has skyrocketed we have doubled down on that debate. The real problem is that health care providers won't or even _can 't_ tell you how much something costs. This has set up this situation where, since money is not part of the decision making process, they just keep raising costs. Imagine a grocery store where prices are not labelled, and you get a complex bill a month afterwards. And every grocery store does this. What are the chances prices for groceries are going to be competitive? Zero.

If we can find a way to bring market forces to bear, it will pressure healthcare organizations to reorganize themselves to provide services in a more affordable way. And before anyone gets sanctimonious about putting money over quality care, consider the actual harmful effects of these crazy bills on people's lives. I used to do title work, and I became familiar with a pattern of people quietly paying their mortgage on their house for a couple decades, no liens, and then all of a sudden a lien from a hospital bill shows up. And then everything starts to crumble, other liens accrue, and I'm doing the title search for the foreclosure. A family just got moved from middle class to living in poverty. Our healthcare system is becoming a vehicle to impoverish people.

<comment><USER32> > If we can find a way to bring market forces to bear

I think the problem (also outlined in other comments) is that there are no market forces in the US health services market. There is no pressure to provide less expensive services, no pressure to reorganize, and no reason not to do what is being done now: build a non-transparent system where people get charged arbitrary amounts and prices are not known beforehand.

</comment></comment><comment><USER33> Let's be careful to not look at one type of health care, emergency care, and generalize to all types of health care. Right now we all (Americans at least) don't really have insurance. We are part of pre-paid health clubs and we try to use the health club membership to pay for everything. For true time- sensitive emergencies we should all have traditional insurance, and yes, the services should probably be supplied, like fire fighting, by non-profit organizations.

Health care that is not time critical should not work like the fire department. In fact, emergency rooms, once they diagnose something as not being an emergency should be able to say, "sorry, this isn't the right place for this, go to a doctors office."

With non-emergency care we should all be able to get price quotes up front, we should be completely aware of our choices and the be able to shop around. We could maybe outsource that to health care clubs like Aetna and UHC if we choose to (knowing that we are getting less choice and that we'll have to deal with those bureaucracies as a trade-off), but there shouldn't be any tax breaks or employee incentives for using those health clubs.

I recently had surgery to have my vision corrected with no "insurance" (or health care club) involved and it was so nice. I shopped around, the doctors all competed for my business and treated me like royalty, there was absolutely no confusion over price, there were financing options available, the technology was cutting edge (or I could have chosen to go less cutting edge and paid less), it was incredibly refreshing. I'd _love_ if most of my health care could be like that.

<comment><USER3> This works reasonably well for things like vision care because they're entirely opt-in. Patients who aren't satisfied with the prices they're being quoted can realistically choose to keep wearing glasses instead.

No one in their right mind is going to decide that the going rate for chemotherapy is a little steep right now so they're going to sit with the cancer for a year or two and see if the prices come down.

<comment><USER33> So think of it in terms of food then. We don't have "food insurance," yet food is a short-term need and it works pretty darn well as a free market.

<comment><USER3> A) We do have socialized food insurance. That's literally what EBT is.

B) I'm not going to wake up in the morning to discover that my expected annual food costs have suddenly increased by four or five orders of magnitude. There is no budget-conscious version of a lot of non-emergency, but still lifesaving, medical care.

<comment><USER33> A) we do not have universal single payer food. Some welfare for the poor yes.

B) that's because food is a free market

<comment><USER3> A) Right. We have universal single payer food _insurance_ , also known as taxpayer funded welfare for the poor. We're in essence covered by, and paying premiums to, a mandatory State-run insurance policy such that if we ever can't afford the minimum necessary food to survive the State will (at least in theory) step in and buy it for us from the open market.

B) Let me rephrase. I'm not going to wake up one day to find that my required daily calorie intake has increased by multiple orders of magnitude. There are very few household budgets that could reasonably be expected to absorb such a shock, no matter how efficiently the market for those calories functions.

<comment><USER33> A) and it works like insurance in that most of us don't ever need it, but it's there just in case. Also, it does not regulate prices, providers, etc.

B) Again, yes, we need health insurance for rare surprises just like we get fire insurance, auto collision insurance, etc. in case of those rare occurrences. We do not need insurance for medical treatments that _everyone_ gets. We just need to plan ahead financially for those, just like we do for food, clothing, housing, etc. Preparing ahead of time for known expenses is not insurance. If everyone's house burned down a few times each year fire insurance would not work, you would instead just factor that in to the cost of living.

<comment><USER3> As I understand it, we have a relatively small number of people with serious or chronic illnesses whose normal, predictable healthcare expenses will drastically and permanently outstrip their realistic ability to pay. The only way they will ever be able to receive treatment is on someone else's dime, one way or another. And because everyone involved knows they're going to cost more to treat than they can pay then no sane insurer will willingly cover them if they have a choice in the matter.

As far as I can tell the main difference between the socialized food insurance we already have and the socialized medical insurance I'd like us to have is that subsistence level food costs are uniformly low for everyone whereas subsistence level medical costs vary wildly from person to person.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER34> Last year my 1 year old baby had an accident in Germany. She fell off of a bed. I took her to an ER and after the examination I paid approx. 100€ = ~100usd. I assume in USA I would have paid 10kUSD or more..

<comment><USER35> $10K? That's ridiculous, I really wouldn't expect any kind of trauma visit to be that cheap, the ambulance ride alone could be over $2000 and the hospital could charge a "trauma activation" fee of $5,000 - $15,000 which doesn't include any treatment at all, that's just the price to have access to the ER facilities.

</comment></comment><comment><USER27> I wonder what healthcare bills would look like if they were itemized so that things like Ibuprofen were literally billed at cost ($0.25 per?) and there were line items for services/labor that captured the real cost of being a medical professional:

\- Emergency room wait: $0.10 for lights

\- OTC eyedrops (4 drops): $0.20

\- Triage by on-duty nurse: $100 (@ $300/hr)

\- Consult by on-duty physician: $220 (@ $600/hr)

\- Late-night convenience fee: $100 (between 7pm and 7am)

etc. I made up all the numbers, I have no idea how healthcare professionals calculate their hourly rate.

<comment><USER36> Isn't there something like generally accepted accounting principles in healthcare ? Genuine question if anyone knows the answer.

<comment><USER37> IIUC, much of healthcare billing in the US is governed by discrete codes for services performed. I suspect this allows big customers like Federal Gov't & insurers to audit bills easier. In order to either be more specific about the bills or allow less wiggle room, they made these codes remarkably more specific recently (ICD-10 [1]). IMO the descriptions of the items in these codes are humorously specific. Imagine if your auto mechanic got $650/hr for labor, I suppose you would get much more specific invoices for their work too.

[1] [https://en.wikipedia.org/wiki/ICD-10](https://en.wikipedia.org/wiki/ICD-10)

<comment><USER36> Interesting. Well the thing is if people really are motivated enough they will always find a way to skirt certain types of regulations.

</comment></comment></comment></comment><comment><USER38> I'm surprised to see lots of people in the comments talking about line items. Line Items are irrelevant. They could include line items for oxygen and toilet paper if they wanted to. The hospital charges whatever the market (and where applicable, regulations) allow. The configuration of the line item is pretty much a customer service problem: 'how do we show what we've done in a way that will get the customer to pay it.'

<comment><USER39> > The hospital charges whatever the market [...] will allow.

Except that in this case, the market is paying before being told the cost. So, what is enforcing the upper limit on price in this type of bizarro market?

</comment></comment><comment><USER40> It makes me sad that there are places in the world where people have to pay to go to an emergency doctor. I know it's a political hot topic but all that aside doesn't most people deep down inside think that every fellow human should have the right to free doctor?

<comment><USER41> Okay, sure, I agree in general, but how far do we go with this?

Does every other human have the right to extraordinarily expensive, often unproven cancer treatments only available at research institutions in the United States? Are we willing to start making cost based decisions on who should die (i.e. should we really be spending hundreds of thousands of dollars keeping those above 90 alive for age related illnesses?)

Everyone will want everything free, but for this to work you have to make uncomfortable decisions. If you put nothing into the system, how much should you get out? Should others with more resources then be able to then buy private insurance for access to better care even though that sounds "unfair"?

Everyone always glosses over these fun questions when they talk about universal health-care systems.

<comment><USER32> Those are red herrings. Many (if not most) countries somehow figured it out without having to deal with absolutes and black/white decisions. You can (and should) draw a line somewhere, and this can be done reasonably.

As a European living in the US I find it mind-boggling that the richest country in the world does not consider universal healthcare to be a fundamental right of its citizens.

</comment></comment></comment><comment><USER42> I'm patiently waiting to have injuries and sudden symptoms until ER bills become more reasonable and transparent. Until then, if something happens, I guess I'll just die.

-youth of today

</comment><comment><USER43> This is outrageous because the regulation wouldn't even have to be complicated. In the EU there is a directive that you have the rights to know the retail prices of things before you make a purchase and in some countries, retailers have to honor the lowest posted price and we are talking about baguettes!

I don't see why that same thing couldn't apply for healthcare. 1\. ERs should publish prices in a public database. If a price is not published for an item/procedure, the customer can pay the lowest price she/he can find for the same procedure from an other provider. 2\. The same price must be charged from everyone (regardless of insurance).

Even if only a small fraction of people shop around it might push down the prices. Even if the above is too naive, I am sure someone smarter can come up with a less naive version of it.

<comment><USER44> "1\. ERs should publish prices in a public database. If a price is not published for an item/procedure, the customer can pay the lowest price she/he can find for the same procedure from an other provider. 2. The same price must be charged from everyone (regardless of insurance)."

this would bring a lot of sanity into the system.

</comment></comment><comment><USER45> Brit here, thank God for the NHS

<comment><USER46> +1. Moved from UK to Australia and it is very similar here too in that most medical care is free.

One difference is that the ambulance service charges for residents, and usually it is reasonable priced (but not cheap) but if it turns out you need a helicopter the bill can be quite large! But insurance covers it. For most professionals insurance is very cheap because of the tax saving you get.

<comment><USER36> any idea how is it in NZ ?

<comment><USER47> It's fantastic here too. I had a scare recently and called the ambulance, was at the hospital pretty quickly, got an x-ray, stayed overnight, turned out not to be a serious thing but finally figured out what was causing it. No drama and no crazy $100,000 bills. Just healthcare of an acceptable quality when you need it.

There is just no way that any perceived marginal improvement in the quality of care on an individual basis warrants an off chance of maybe being bankrupted. I can't say I've ever found the quality of care of be poor or unacceptable. It's always been available and served me well.

I kind of liken it to being forced to drive an $80,000 BMW as opposed to being provided with a reasonable Toyota that does the job.

The economic experiment has been tried and the US is on the wrong side of it.

<comment><USER36> Indeed. I am surprised though because the income taxes in NZ seem to be lower than the quality of healthcare then. Wondering what the catch is.

<comment><USER48> I've sadly been to hospital via ambulance quite a lot for seizure activity and that kinda carrying on. The biggest bill was when I received my $54 bill for the ambulance! Oh no. (St John is a volunteer ambulance service). So, I went and paid it and _then_ paid them $80 for an annual househould membership - meaning if anyone in my house ever needs an ambulance, it's free!

I'm aware however, with the rescue helicopters there can sometimes be complications because at the end of the day, someone needs to pay - but as an accident, everything's covered under ACC anyways. (and: [http://www.police.govt.nz/faq/if-i-get-lost-and-need- search-...](http://www.police.govt.nz/faq/if-i-get-lost-and-need-search-and- rescue-will-i-have-to-pay))

<comment><USER36> Wow, the more i read, the more difficult it is for me to believe. At this point i feel that the US healthcare industry is the biggest rent extraction industry in the world and they try to get away with it to the extent they can with every stakeholder blaming someone else.

I have lived here for 9 years and although have paid my insurance diligently i always get anxiety at going to the doctor's office.

<comment><USER47> It is.

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER49> > I started my project focused on one specific charge: the facility fee. I > found this charge for walking through an emergency room's doors could be as > low as $533 or well over $3,000, depending on which hospital a patient > visited and how severe her case was. I also learned that the price of this > charge had skyrocketed in recent years, increasing much faster than other > medical prices for no clear reason.

Is this why my local hospitals are advertising their ER wait times? The arbitrary profit from arbitrary "in the door" fees?

</comment><comment><USER50> I'm curious what percentage of costs were covered by insurance. I recently had some genetic testing done and they were pretty open that they charge one lower price if I paid out of pocket and another higher price if insurance covered it. My hunch is that some of the price variation is just from providers magically increasing prices to match whatever the insurer is willing to pay.

<comment><USER51> Yes, it is called the "chargemaster":

[https://news.ycombinator.com/item?id=18722182](https://news.ycombinator.com/item?id=18722182)

</comment></comment><comment><USER52> >3) You can be charged just for sitting in a waiting room

I once fainted during a comedy show because the comedian was talking about his wife almost dying in surgery in graphic detail and I got nauseous and fainted. I woke up outside the comedy club up against a wall with an ambulance there. They basically took my blood pressure and gave me a bottle of water then asked if I wanted to go to the hospital. I declined. I still received a $3000 emergency services bill later... Apparently they checked my ID/insurance when I passed out and somehow I ended up with a bill even though I declined service.

In contrast, I once hit my head on a train in France and had a huge gash that needed stitches. I took a taxi to an ER, got seen within 20 minutes, left the ER within 90 minutes, then had a $50 Euro bill.

The contrast between "socialized" healthcare in Europe vs privatized healthcare in the US is shocking. We receive far, far, far worse quality and fewer services despite paying a lot more. We're in the worst of all situations.

</comment><comment><USER53> I don't see the situation changing in the US anytime soon. In order for us to have single-payer healthcare, doctors would need to accept drastic pay cuts, pharma companies would get far less for drugs, and insurance companies would go out of business. None of that will happen. Instead we'll have more and more and more regulation until it just stops working.

</comment><comment><USER54> I'm not saying the ER prices are reasonable, but an ER has to keep a lot of expensive staff and equipment sitting around until they are needed. OK, some ER's they are sitting around. But there is a price to have all that service ready for an emergency.

As for high drug prices like the $60 ibuprofen, you are mainly paying for it to be delivered to you by a nurse.

ER's have an average profitability of 7.8%. Higher than Walmart but lower than Apple. So if they became non-profit in some way, they could cut that percentage of costs. That's some, but still very expensive.

[https://www.beckershospitalreview.com/finance/7-things-to- kn...](https://www.beckershospitalreview.com/finance/7-things-to-know-about- emergency-department-profitability.html)

<comment><USER55> The thing is the "paying for it to be delivered by a nurse" is covered by other things.

There will be a line-item for the ibuprofen itself, there will then (generally) be a separate line item for staff time spent helping you, and there will almost always be another line item for the facility fee.

The nurse's overhead is theoretically included in those latter two line items, so shouldn't _also_ be charged in the ibuprofen line item.

Now, there are logistical concerns that will make the ibuprofen marginally more expensive at an ER than at a clinic, but definitely not $60.

I accept the logic of high drug prices including staffing costs when those staffings costs aren't included in other line items. In most hospital bills, it seems, those staffing costs are already included.

</comment></comment><comment><USER56> Reading this article and seeing all the startups sprouting in the field of health care and medicine tells me that there's still a lot more areas to innovate and disrupt in this industry.

One big issue though are that lobbyists who wanted to keep prices high - <USER2> squeeze in as much profit as they can out of these. Drugs, Antibiotics, Procedures, Medical Professionals. I know it would be far-fetched to standardize and at least provide some level of transparency across all facets of operation in this field, but that would be a good start.

Analyze the data, and find ways where things can be improved incrementally.

<comment><USER57> One way to disrupt the industry might be to have everyone be in one giant insurance pool, perhaps paid for via taxes, and then give everyone access to health care via some kind of non-profit entity.

Sounds crazy, right?

It worked well for my family and I during the many years I spent in Italy, which has health care costs that are something like half of what they are in the US in terms of GDP.

<comment><USER58> Yup, it's worked nearly all over the modern world, for years and years. The last thing I want in healthcare is more startup maniacs trying to "disrupt and innovate" when there is a clearly viable alternative.

</comment></comment></comment><comment><USER59> Florida typically comes dead-last consumer protection-wise except that it requires ER physicians to be "in-network" when the hospital is also "in- network".

</comment><comment><USER60> I often find in these discussions that Americans look with undue admiration over to Europe and imagine that the same stuff doesn't happen here.

But it does.

I recently got my wisdom teeth pulled out in Germany, and without my asking, the doctor sent me a pack of 12 Ibuprofen and billed me 24 euro, i.e. €2/pill. I didn't want them because I had 500 of the same at home, which I bought for 25 euro — i.e. €0.05/pill. That's a markup of 40x.

</comment><comment><USER61> There is a documentary on HBO now called Bleed Out. If you want to know how absolutely fucked the US medical system is, watch it. You will probably never want you or anyone you love to ever step foot in a hospital again.

These insurance companies and hospital groups are pure evil. Absolutely disgusted with what a backwards ass country America is.

</comment><comment><USER62> This "ED is too expensive" situation has been going on for decades.

Is it possible the fairly new walk-in clinics could help?

Could there be a big red sign on the ED door saying, "Hey we are very expensive and if your condition isn't serious you will wait a long time! Consider using the walk-in clinic at 123 Main Street."

</comment><comment><USER63> I stopped reading when I saw the minimum charge for walking through the door was USD 500 and that a family was charged USD 18 k for a nap and some formula milk; it was just too depressing.

No amount of analysis of the details is going to fix those things.

</comment><comment><USER64> Profit not service. The system has zero incentive to reduce inefficiencies. Its designed to increase overhead and deliver surprise bills.

The American system is largely a joke where doctors rather collect their co- pays and write prescriptions.

</comment><comment><USER65> It would be interesting to compare prices with countries with free government sponsored medical care. In NZ I know they work out the cost, and if you aren't a resident/citizen you have to pay the bill.

<comment><USER36> Is NZ healthcare decent? Asking because i am trying to decide between NZ and Canada as my future destination for immigration after living in US for 10 years.

</comment></comment><comment><USER66> Nice, now someone do this for legal fees

Even a dot-plot chart from different peoples experience with different practices and needs would be a great improvement to the "it depends" of today

</comment><comment><USER67> Duplicate of: [https://news.ycombinator.com/item?id=18706522](https://news.ycombinator.com/item?id=18706522)

</comment><comment><USER68> This title should be updated to state it is only in regards to the United States and not relevant for Canadians, Australians, etc.

</comment><comment><USER69> I wonder if price gouging laws can be applied in the case of healthcare, especially in the case of emergency care.

</comment><comment><USER51> ctrl-F "chargemaster" gives no results.[1]

This article is BS. I didn't read it, it would be a waste of time.

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

</comment><comment><USER70> Meanwhile in Russia: free ER services, free nationwide health care and no- franchise cheap voluntary insurance for everyone who doesn't want state medicine. Cheap because you have to compete with rather-good and completely free for everyone.

</comment><comment><USER71> American healthcare is basically massive legalized fraud.

</comment><comment><USER72> the most amazing and unbelievable part of this story is "Congress wants to do something about the issue"

</comment><comment><USER73> Want to do something about it? Regulate it.

Like literally, have some government body write a table:

      1 pill of 400 mg paracetamol ............ $0.50
      1 pill of 800 mg paracetamol ............ $0.60
      prescribing medicine (once per day) ..... $4.32
      base fee for an ER visit .............. $200.00
      5 minutes of work by an ER physician ... $27.43

etc. and impose that as the maximum price that can be charged.

It's not going to happen because "omg socialism", but this is literally how other countries handle it. Possibly with a multiplier that the hospital/doctor can apply within certain limits. If you really need to, maybe even allow deviating from it as long as the patient is conscious, in a position to make that choice (i.e. not emergency care), is explicitly informed that this is above the "official" rate, is informed about the rate, and signs off on it beforehand.

And I'd like to point out that this sort of regulation isn't unprecedented in the US either. Taxi prices are regulated this way in many areas. Apparently, transportation is more important and less suitable to be left to a free market than healthcare...

<comment><USER74> Shouldn't the max price of services (not things like RX of course) be different depending on the cost of living in that area? You'd need different prices in different areas otherwise the prices might be too expensive in some areas and too cheap in others. If the prices set are too cheap, you might see more people using the ER for non-emergency purposes, which would be bad for the people that need to use the ER for actual emergencies.

<comment><USER75> > If the prices set are too cheap, you might see more people using the ER for > non-emergency purposes, which would be bad for the people that need to use > the ER for actual emergencies.

The "long wait times" that Canadians sometimes complain about actually address this problem within public healthcare. If you come into the ER for a non- emergency, fine, but prepare to wait 4-6 hours. Every emergency case coming in the door will get placement ahead of you.

Some provinces (e.g. Ontario) address this with phone triage hotlines that help you make a decision about whether to go to the ER, a walk-in clinic, or wait for a doctor's appointment.

</comment></comment></comment><comment><USER76> Sooo.... It's the hospital's fault healthcare is expensive! (Mostly joking)

</comment><comment><USER77> The idea suggests itself that the problems of the US healthcare system are closely tied to unrestrained capitalism, includings its influence on/over US politics.

</comment><comment><USER78> A question that frequently comes up in healthcare debates is "would you rather be alive now or alive with the medical technology of 1970".

You'd be giving up genetic testing, numerous advances in wound care, a number of advanced antibiotics, leaps in transplant technology, and a whole slew of joint-replacement innovations. Plus cancer treatments, and of course, AIDS therapies. Massive impacts, right?

And if today is better than 1970, 1970 was better than 1950, and 1950 better than 1920, and....

Right?

Not so fast.

New York City have been tracking mortality rates since 1800, and there's a chart I love to pass around in these discussions, with the charming cocktail- party friendly title of "The Conquest of Pestilence in New York City ... as shown by the death rate as recorded in the official records of the Department of Health and Mental Hygiene".

The 20th century has seen a host of medical advances: antibiotics, vaccines, transplants, tailored drugs, implants. High-cost, yes, but huge impacts.

No, not really.

[https://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAA...](https://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAAM/eyirotYDmXo/s1600/2004_01_healthstat.jpg)

The turning point in the chart -- where the _increase_ in mortality as New York as it grew from a town of 60,515 (1800) to a city of 813,669 (1860), _was the formation of the Department of Public Health itself_ , in 1866. Peak mortality hit 50/1,000 in the 1830s, 180s, and 1860s, with a sustained average above 35/1,000, and marked volatility as the city was rocked by epidemics. By the 1890s, it had fallen to 20, and 1920, about 12. The pre-WWII low was actually in 1939-40, at just over 10, and mortality _rose_ through the early 1970s. There _has_ been a further decline, to about 7.5, since 1990.

Analysis elsewhere suggests that this is almost _wholly_ attributable to increased longevity among minority populations -- nonwhites generally, black women, and especially black men. My suspicion (though I've not researched in depth) is that this is _largely_ attributable to _increased access to medical care_ , either through improved socioeconomic status and access to the commercial healthcare market, or through public health programmes. _There is little if any evidence that the gains come from medical technology itself._

This is a topic that's been much studied. Robert J. Gordon's epic assessment of US economic progress, _The Rise and Fall of American Growth_ (2016) looks hard at medical advances, particularly since 1970, and finds them largely absent. Victor Fuchs, healthcare economist (heavily cited by Gordon) has found published similar results for the past few decades.

A personal anecdote is a close friend who'd died of an obscure cancer in the early 1990s. The (brutal) treatments they'd undergone were essentially unchanged since the early 1970s, or even 1960s, as I read the literature, _and have changed little in the ensuing nearly three decades_. Given that one of the questions and agonies we faced at the time was "what if some miracle cure emerges, or we weren't doing enough", this failure-to-advance is in some ways a bit of validation: we really try to do everything we could, and applied the best available knowledge, and no, even now, the outcome is virtually unchanged: four out of five patients with that diagnosis die within five years, often less.

(Other friends _have_ survived their, mostly other, cancer diagnoses. And of the cancer-friends we'd made, some are still alive, others have died, in cases of complications from treatment, including blood- and tissue-donation related infections such as hepatitis. Life is not fair.)

Real healthcare improvement, as with so many other quality-of-life improvements, comes _not_ from heroic measures, _but by assuring adequate access._ And the market is a terrible mechanism for assuring such adequacy.

</comment><comment><USER79> The reason we don't have universal healthcare is mostly racism and male supremacy. Racist white people dont want anyone with dark skin getting a "free ride". And, supporters of patriarchy don't want their stay-at-home wives to be able to get healthcare without going through them because it undermines the husband's power and control. They will use the language of "personal responsibility" or "free markets" to describe it, but the same people who don't want universal healthcare also wave confederate flags and think that a woman's place is in the home.

<comment><USER79> I was expecting to get downvoted for this, but it's still true. In countries where women can get free childcare and free healthcare, they have more _power_. American men deeply fear this. In the end, like everything else, it's all about power- who has it, who doesn't. Big healthcare also makes a killing on the situation, but here in the states conservatives have always been willing to make the devils bargain of allying themselves with the ruling class in order to preserve white supremacy and male supremacy. It's true no matter how many downvotes I get.</comment></comment>


9-5 Is Out. Try the 1-6 Instead - <AUTHOR> https://www.forbes.com/sites/piasilva/2018/01/24/9-5-is-out-try-the-1-6-instead/#e44c5127c87d <comment><USER2> I live in a region where winter days are very short. I go to work and it's dark, I leave work and it's dark. I don't understand why we have decided to go sit in buildings during daylight hours.

Even with a 40-hour week, I would love if the work day was shifted to allow one to get sunlight for a few hours each day.

<comment><USER3> go outside during lunch mang.

<comment><USER4> But it's 14 degrees out there.

<comment><USER5> If that bothers you, you simply aren't wearing proper clothing.

The difference between a refreshing chill and a harrowing cold can just be an extra sweater under your coat and a good attitude. As long as it isn't very windy, it's easy to make 14 comfortable.

<comment><USER6> As someone who lives in Minnesota (and has lived in the upper Midwest for the last 14 years)... no, it's not just "proper clothing ...and a good attitude."

Below a certain temperature, it hurts to be outside for any nontrivial amount of time. That is a strong disincentive to go outside, no matter how many sweaters you're wearing.

<comment><USER7> That is pretty rare though. I live in Sweden (not the northern part) and at my previous job I liked to take walks at lunch and as long as it is not snowing, raining or being too windy it is pretty nice even at colder temperatures.

Now I'm usually talking about over -10C (14F) but a lot of people seem to think even that is too cold but just don't wear proper clothing.

</comment></comment></comment></comment></comment></comment><comment><USER8> This is predicated on the idea that you're only really productive in the afternoon, and that the morning is just wasted time.

I'm most productive in the mornings, and my productivity only takes a dive in the afternoon because that's when all my meetings are.

Turns out, anecdotes about an individual's workflow aren't broadly generalizable!

<comment><USER9> I agree that the ideas aren't necessarily generalizable, but what if we shifted to an idea that people's individual schedules reflect when they specifically are most productive. Someone else who replied said they were most productive in the morning. Great! Let them have and earlier start time. For me, I'm completely useless in the morning. Sure, I _can_ be in the office at 8:00am, but you're not getting any meaningful work out of me until late morning or noon-ish. So let me come in at noon and work until 6:00. And for someone else who is super productive in the evening hours, if they want to come in a 8:00pm and work until 2:00am, why not?

I get that there are issues of collaboration or interaction that may be necessary. But in general, it seems like, as long as your job doesn't depend on customer interaction or some other constraint, why not let people work a schedule that suits their lifestyle, and lets them work when they are most productive?

<comment><USER10> _...if they want to come in a 8:00pm and work until 2:00am, why not?_

Part of the "why not" is a deeply ingrained belief in at least American culture that morning people are just "better" than night people. It's so ingrained that we mostly forget to talk about it and it's just assumed. "Early bird catches the worm" and all that.

I once saw a workplace where there were night-person-friendly policies and schedules. Then one insanely morning person joins and wants to leave at 3:30 every day. Suddenly all of his scheduling preferences were presumed valid, and all night-person preferences had to be fought for and justified.

So if you want to reach a world with truly optimal flexible schedules, first you'll need to wrest ownership of the culture from the "morning people are better" people who currently dominate it.

<comment><USER11> > Then one insanely morning person joins and wants to leave at 3:30 every day. > Suddenly all of his scheduling preferences were presumed valid

Why wouldn't their preferences be presumed valid? It's as hard for the morning person to deal with night-person preferences as it's hard for a night person to deal with morning-person preferences.

(Disclaimer: I'm a morning person and I'm not American.)

<comment><USER9> I think it's because people think "morning person" is the default, and correct, way of being. And that not being a morning person makes you odd or lazy. So when someone comes in challenging late-friendly scheduling, they're assumed to be the correct one, and that the workplace has somehow been in error by allowing later schedules.

<comment><USER12> But morning really is the default; it's our biological default. Most people wake up in the morning and go to bed at night naturally. Many people have small children, good luck remaining a night person with a 1 year old in the house. There are real reasons here, it's not just some arbitrary decision.

<comment><USER13> Biologically, don't most people wake up at dawn? That doesn't get you to the office at 7:30 AM in the winter.

That is, our schedule is _not_ a biologically-based schedule. "Morning" (as defined by our society) is not the biological default.

<comment><USER12> Sure, but you're quibbling over an hour here or there. When people use the term "night person" they don't mean someone who wakes up at e.g. 8 instead of 7, we're talking about pushing back work by many hours, which just isn't possible for most people without a much shorter work day (I'm ok with that!)

</comment></comment></comment></comment></comment></comment></comment></comment><comment><USER14> This all sounds good unless you work a "shift" style schedule. Every single person I know works what is considered first shift (approximately 6/7/8/9am to 2/3/4/5pm). Some of them have tried second and third shifts, but they always go back to first shift because "second/third shift don't work for me" they say.

Now for me I work better at night/early morning. Because of this I have worked third shift (midnight to 8am) for over 30 years and it works perfectly for me. If I want to be up while first shift is working I can. Or if I want to sleep during first shift and be awake for second shift I can do that too. It is nice to get off of work and do my errands and such without much traffic or that many people in stores. I get my errands done faster which gives me more free time.

Third shift has the advantage that most of the population is asleep when I am working. So when I drive into work at night the roads are mostly empty and when I leave work in the morning the morning rush traffic is moving in the opposite direction that I am.

Another advantage of third shift is I only spend 20 minutes driving to work and 20 minutes driving home from work each day. All the first shift people I know spend at least double that in traffic each day because dang near everyone works first shift.

<comment><USER15> neat! I'm often a nightowl myself, and often reflect on how life would be different if we spread out the working hours for people more - so most places would be 24-hour, and roads wouldn't be so packed.

<comment><USER14> It would be different if each shift only contained 1/3 of the workforce at a time. Rush hour(s) should contain much less traffic volume this way (since now there are what, 3 of them per day?). Overall there would be a slight increase in continuous traffic volume (as in at any given time of the day/night more people would be out and about).

I do wonder if cities could benefit from a 24 hour schedule. Sure, during first shift the cities near me are bustling with people and activity. Second shift there are still people about and things to do, but after 8pm or so most cities around here start to look barren. Third shift. Shoot, it's me, the police, the newspaper delivery drivers and pretty much no one else.

</comment></comment></comment><comment><USER16> Sounds like #NoKids rather than #SpainBrain.

I'm sure it sounds like I'm being pithy, but you fall into line when your kids get home at 4 and you want to spend time with them before they go to bed at 8.

Maybe his point stands in some sense, but once you add kids into the mix it quickly becomes "9-5" again or "burning the candle at both ends."

<comment><USER17> There's also an argument that's been made that kids go to school too early in the day and school start time should be postponed to later in the morning, because they need more hours of sleep.

<comment><USER18> They need a solid 6-8 hours of sleep, like other humans.

I suspect the problem is that teens just stay awake FAR LONGER than is advisable perhaps to maximize their free unstructured time at night and to minimize the crushing grind of the mornings?

I expect that if the school start time was shifted to 9am, the kids would just stay up until 5AM instead of only 3AM.

<comment><USER19> Most teenagers aren't staying awake til 3am, it turns out. And you can test your theory in several ways - either by checking American teenager sleep habits against those in other countries where school does start later (e.g Australia - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941425/figure/...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941425/figure/F2/)), or by looking for the existing studies that have been done on changing school times (e.g this one in Norway [https://teensneedsleep.files.wordpress.com/2011/05/school- st...](https://teensneedsleep.files.wordpress.com/2011/05/school-start-time- sleepiness-and-functioning-in-norwegian-adolescents.pdf))

Summary: your theory doesn't appear to be supported by data.

</comment></comment></comment></comment><comment><USER20> Article should be titled "Try being a wealthy business owner to work less." Most people don't have the luxury of choosing their hours and only working 4 hours a day, remotely from a cafe or hotel. It's not as if everyone is getting up and going to work for 8 hours because they want to...

<comment><USER21> Obviously it is implied that this article is giving advice for people who set their own schedule and are wondering about how to move time around to feel more productive. Not for people who have their schedule strictly set for them by their employer. You dont have to be a wealthy business owner to fall into the former camp though.

</comment></comment><comment><USER22> It's absolutely great.

Unless you start having kids. Or work in an area where you need to meet customers face to face. Or both.

Just like working from Bali, working from a van, working from a plane, etc.

If you're a SINK or a DINK, go for it, 100%.

<comment><USER23> What do "SINK" and "DINK" mean?

<comment><USER24> single income no kids; dual income no kids

<comment><USER25> my life goal is dink

<comment><USER26> if you will it, it is no dream

</comment></comment></comment></comment></comment><comment><USER27> Working efficiently at your peak working time makes sense. Assuming everyone else shares that same peak working time does not. You either need to set up an organizations where all collaboration can happen via async mechanisms (possible, but difficult)... or you need to have some times where people's work overlaps enough to have discussions and meetings.

I've worked in remote jobs where, in general, people worked whenever they wanted, and we'd get on phone calls at agreed upon times if needed. I've also worked in jobs where we set aside a 2 hour window each day for everyone to be there, not caring if that window was the beginning, middle, or end of your day. Both of those scenarios felt more productive than "9-5".

</comment><comment><USER28> God Forbes' website is awful

<comment><USER29> It is genuinely terrible. I enjoy a lot of their content, but that website is malignant.

</comment></comment><comment><USER30> Yes! A thousand times yes!

I'd also be okay starting at a 1-9 if people are against the idea of working less hours per day.

Now this would only work if everything adapted. Schools, shops, banks, would all need to shift their hours.

Finally we could enjoy daylight. Imagine spending time outside in the sun with your kids and wife during the day!! Everyday!

Imagine not being too tired after your hard day of work to spend quality time with your family, hangout with friends, so household chores, work on that hobby project of yours, exercise!

I don't think its feasible without a King or dictator forcing this change though. I hope we did, the idea of working on the hours that the sun is out is old, everyone works indoors now.

Also, its difficult to gage the health and mental health impact of how little less sunshine we now consume compared to days past when we were outside a lot more during daylight times.

</comment><comment><USER31> I work the over way (west side of the Atlantic, most clients in Europe). So I get up, work until lunchtime, and then my 5 hours working day is other if I want.

Of course it's not everyday I don't work in the afternoon, but it's nice that you can spend the afternoon with the kids if you want.

Ok, sometimes duty calls in the middle of my night (last Tuesday I was woke up at 3am for an emergency on a client server) but in the 3 years I've been living this side of the ocean, it happened 7 or 8 tiles max.

<comment><USER13> I once got woken up by a phone call from Europe at 4 AM. The first thing I had to do was remember an 8-digit hex number. It took a bit...

<comment><USER32> I would've thought it would take 32 bits.

</comment></comment></comment><comment><USER33> I'm a Spaniard and I could never do that.

In order to be able to work like that you need a very specific set of circumstances, probably first of all being self-employed.

Since I work by contract for a company, and they force me to put 8 hours a day, I can't do that. However, it is true that I am the most productive in the afternoon. That is why I try to enter and leave work as early as possible, so that I can spend those sweet afternoon hours being productive.

<comment><USER34> Depends if your hourly paid or salaried - in theory salaried jobs its up to you to decide how and when you work within reason.

</comment></comment><comment><USER35> These ideas are interesting but it seems to suggest that if you work less you don't need as many breaks. Motivation for me comes in waves. When I'm inspired I can easily work 12-16 hours with just bathroom breaks. But, I can't induce those experiences, they just come.

My fear of a 5 hour day would be that I'd be running at 80% for 5 hours instead of 80% for 8 hours.

</comment><comment><USER36> I come in at around 11 45 every day and work until 7 with couple of 15 minute breaks for ping pong. No loss in productivity and extremely satisfied with commute(DC metro). But I make sure, I check my emails and respond at around 930 am, if some one needs me.

</comment><comment><USER37> As many have said, there's more to this than just one type or the other. It might be worth considering taking a more intentional look at organizing teams around similar circadian rhythms. Some of the most productive work I've done was with a team that really started gaining momentum in the afternoons and sometimes into the evenings. I think many who deviate far from the "norm" self-select into late-night service industry positions. There are a lot of misconceptions around "early birds" or "late workers" that could be explained by varying sleeping patterns.

</comment><comment><USER38> I'm 1000% in favor of spending fewer hours at work, and making those hours that are spent at work count more. However, I'm guessing that the 1-6 was for the bosses, and not for the workers.

</comment><comment><USER29> I have felt this way for a long time about work, but my schedule demands something close to an 8 hour day. So to stay fresh, I take walks, small breaks, and try and avoid social media, which makes my desk time immensely more productive, oftentimes moreso than if I were to sit and grind for the entire workday.

</comment><comment><USER39> Nice idea but probably not written by someone who writes code or debugs for a living. Activities that imho benefit from long stretches of deep focus. Now perhaps you could work like that -- 16h sessions -- for three days then snowboard for the remainder of the week. That might work.

<comment><USER40> I write code and debug for a living and often work similarly. I even force myself to take a break every hour, deep concentration or not. Necessity makes amazing things happen. I definitely do not do more than 8 hour sessions, ever, and never without multiple breaks anymore. It works out fine, a little slower than before but that's mainly due to lack of communication and has nothing to do with hours worked.

</comment></comment><comment><USER32> I'm most productive in the early morning and late evening. The mid-afternoon is my least productive time, perhaps because of lunch or because I live in a sunny area and I'd like to take advantage of the sunshine in the afternoon. I don't mind working 8 hours in a day, but I'd rather do something like the inverse of this person's schedule and work 7 to 11, both AM and PM.

</comment><comment><USER41> Spending your day in a sales role can be very similar to this. After losing time in client meetings, you often have only 5 hours left in the day to get your things done (frequently less than half that amount).

I have certainly worked my fair share of > 40 hour weeks, but it's safe to say you are forced to learn a way to be very efficient when you don't have all day available to work.

</comment><comment><USER42> This might be a fitting work schedule for people with an inverted cortisol production profile. Perhaps have some tests done before wanting this. You could be in a stressed-out state.

</comment><comment><USER43> Shortening the work day seems like a great idea. Making everyone work the same hours seems like a terrible one. Especially the proposed 1-6. What if you have kids?</comment>


Ask HN: Why is Flash so insecure? - <AUTHOR>

We have kept hearing about security issues on Flash for so many years now, and even now there are many zero-day bugs that are being discovered in this piece of software.
I find it surprising given that Flash has been around for at least a decade and has presumably been worked on by very talented programmers. They have had plenty of time to work on discovering fixing most of the security flaws.
Is there a set of reasons why Flash is insecure, or is it just as insecure as other platforms but highly sensationalized? Are there any lessons to be learned from this for other software devs out there? <comment><USER2> _Ask HN: Why is Flash so vulnerable?_ (2 days ago): [https://news.ycombinator.com/item?id=9901480](https://news.ycombinator.com/item?id=9901480)</comment>


Neuroscience methods tested on Atari 2600 failed, casting doubts on credibility - <AUTHOR> https://www.researchgate.net/blog/post/should-neuroscientists-trust-methods-that-cant-explain-how-donkey-kong-works <comment><USER2> Very interesting, down right thought provoking really if the study holds, much like Godel's incompleteness theorem, in a sense.</comment>


Show HN: Our Equity Crowdfunding Platform Is Officially Live - <AUTHOR> http://www.rockthepost.com

<comment><USER2> They appear to be using the Regulation D exemption to SEC registration, so generally among the other restrictions:

\- no soliciting or advertising the offering to the general public (though state exceptions to this limitation apply for offerings < $1 million)

\- all investors must receive restricted shares (shares which are not publicly tradeable for at least 6 months without registration)

If seeking investment of greater than $1 million, generally...

\- company financial statements must be audited

\- no soliciting or advertising the offering even pursuant to state exceptions

 _Note that Reg D precedes the crowdfunding bill, so the restrictions will probably change/go away when the appropriate federal agencies finally issue regulations promulgating the new crowdfunding rules._

</comment><comment><USER3> So this is completely worthless to the average person on the street, since you have to be an accredited investor in order to participate. This is no more "crowdfunding" than getting on a private jet is "crowdboarding."

</comment><comment><USER4> Why do you need to access my connections, and send messages and invitations as me? <http://d.pr/i/Ikf2>

Not signing up..

<comment><AUTHOR> We don't automatically send anything through LinkedIn. However, we have a feature that allows an entrepreneur to send an invitation to someone else via LinkedIn's API. In order for that to function we need the permissions you are referring to. When we have more time we will probably reduce the number of requested permissions for general users.

</comment></comment><comment><USER5> First: Cool idea.

> Minimum investments from $1,000-$5,000.

Hmm ... imho that's too much for 'casual for the fun investing'. I'd be willing to 'invest' $250 into some cool idea just because I like it. But $1k is over my pain barrier for mindlessly throwing money at stuff and most probably lose it.

Also are there already startups signed up? I can't find a way to browse active projects.

<comment><AUTHOR> We have over 6,000 registered startups and 3 are currently in preview mode before accepting investments in 6 days. One of them won the "Audience Choice Award" at TechCrunch Disrupt NYC.

</comment></comment><comment><USER6> I'm assuming that the accredited investor requirement is still in place (i.e. this isn't the new JOBS investment opportunity)?

<comment><AUTHOR> Correct. We are operating via Regulation D.

<http://www.sec.gov/answers/regd.htm>

</comment></comment><comment><USER7> Hmmm. The video pitch seems to put them in an investment banking/advisory role, whereas their Ts&Cs disclaim everything :

"For investors, you can rest assured that the deals you're seeing on our platform are highly vetted, and they're top-notch. We've done the homework, we've done all the due diligence, we've done the background checks..."

</comment><comment><USER8> There is something jarring about the concept of jewelry designers pulling in mid-six-figures from accredited investors.

</comment><comment><USER9> Why is the maximum amount an individual can invest $5000? Even trying to raise $100,000, that is 20 people. Is this a limit baked into the law?

<comment><AUTHOR> Maximum and minimum amounts are set by the startup. On average $1k-$5k is the lower range of investments.

</comment></comment><comment><USER10> Congrats!</comment>