The geography of Tweets - geotagged tweets visualized - <AUTHOR> https://blog.twitter.com/2013/geography-tweets-3

<comment><USER2> More on the Flickr page: [http://www.flickr.com/photos/twitteroffice/sets/721576336477...](http://www.flickr.com/photos/twitteroffice/sets/72157633647745984/)

San Francisco: [http://farm8.staticflickr.com/7315/8798020541_80aa618bab_o.p...](http://farm8.staticflickr.com/7315/8798020541_80aa618bab_o.png)

Manhattan: [http://farm9.staticflickr.com/8136/8808603540_e298c96fd3_o.p...](http://farm9.staticflickr.com/8136/8808603540_e298c96fd3_o.png)</comment>


Ask HN: Designing addictive products? - <AUTHOR> Suggest books, articles, and courses on designing addictive  and persuasive products. <comment><USER2> Please don't design addictive products. Addictions are only good for the supplier.

</comment><comment><USER3> Addiction by Design: Machine Gambling in Las Vegas [1]

[1] [https://www.amazon.com/Addiction-Design-Machine-Gambling- Veg...](https://www.amazon.com/Addiction-Design-Machine-Gambling- Vegas/dp/0691160880)

edit: also vouching for not designing addictive products

</comment><comment><USER4> "Influence: The Psychology of Persuasion" \- general persuasion psychology

"Hooked: How to Build Habit-Forming Products" \- a framework on how to create addictive tech</comment>


Ask HN: Any advice on new Streamfile functionality? - <AUTHOR> http://streamfile.com

<comment><AUTHOR> New Streamfile features just added! 1. As a downloader/receiver you can now see upload/sender progress bar in real-time 2. Optional PIN/password code + .zip/disk encryption if a password is set by uploader/sender. Any feedback on current functions or future functionality you would like to see?</comment>


Why Is Epic Games Checking Names Against a Watchlist When It Doesn't Have To? - <AUTHOR> http://motherboard.vice.com/read/why-is-epic-games-checking-names-against-a-watchlist-when-it-doesnt-have-to <comment><USER2> Probably a case of lawyers saying jump and programmers saying "seems easier than arguing".</comment>


TapZilla (YC S10) Offers Daily Deals For Paid Mobile Apps - <AUTHOR> http://techcrunch.com/2010/10/13/tapzilla-offers-daily-deals-for-paid-mobile-apps/

<comment><USER2> Was there some informal pact by the stealth YC companies from the summer batch that they launch today?

<comment><USER3> TapZilla, Optimizely, and CarWoo were all in different batches - Summer '10, Winter '10, and Summer '09 respectively.

</comment></comment><comment><USER4> Congrats on the launch!

One thing I thought I'd mention (which might be a bit off topic) is that I recently contemplated the use of the "Zilla" suffix for a project name. But after doing a bit of research, it sounds like the owners of the Godzilla trademark are quite aggressive with when it comes to this. Particularly so if the logo/mascot is also some sort of reptilian creature.

Just thought you might want to look into this now before your service grows (in case you haven't looked into it yet).

<comment><USER5> Thanks for the good will and advice. This has been an issue that we've looked into and we're trying to find out how other companies (IE. Shopzilla) has handled this issue in the past.

Thanks again for the tip and appreciate the advice.

</comment></comment><comment><USER6> Interesting idea to get some visibility for app developers. Although for the app purchaser I think you may get some reluctance as they first have to pay for the app (using an iTunes account) and then get the refund through a different mechanism (Paypal). This may be a bit of barrier to usage for certain users.

My startup (self-promoting link-whoring: <http://www.happybuy.com/>) also helps to find price-reduced iOS Apps and tweets the biggest bargain product of the day. It's an easier mechanism for app purchasers to understand but obviously it doesn't address the value equation for the developer like TapZilla does.

</comment><comment><USER7> Woah, this could actually help me a ton with getting my mediocrely-popular apps out there! Contacted.

<comment><USER5> Thanks for reaching out. I just sent you a bit more info on TapZilla

</comment></comment><comment><USER8> Interesting. This could be useful.

The developer portion of the site seems kind devoid of hard info: <http://tapzilla.com/advertise>

The article says it costs the developer $1 per download. Who is actually paying the money that is credited back to the customer? Does the developer need to fund this (in addition to the $1 per download), or does TapZilla?

If TapZilla is funding the customer credit with the developer's $1 per download, can this be used for apps that are more than 99 cents? And how is TapZilla making any money?

If the developer is funding the customer credit, then the developer would need to pay TapZilla $1 + cost for each download? If so, is this prepaid or postpaid?

<comment><AUTHOR> The developer pays $1 + app cost, they in turn will receive 70% of the app cost from Apple. So the effective cost per user acquisition for a $0.99 app is $1.30.

<comment><USER8> Good point about 70% of the cost being returned by Apple, I forgot to include that. That makes things seem a lot more reasonable.

</comment></comment></comment><comment><USER9> developer pays them $1.00

they pay users $0.99 per app

they drive 1000 apps per day

= $10/day?

<comment><AUTHOR> Not exactly: The developer pays $1 + app cost, they in turn will receive 70% of the app cost from Apple. So the effective cost per user acquisition for a $0.99 app is $1.30.

1000 apps installed per day = $1000/day

<comment><USER10> How do you generate the coupons?

<comment><AUTHOR> These coupon codes aren't the same as the ones from iTunes. These are generated by TapZilla and redeemed within the app itself so that it can inform us which user from our service downloaded the application.

</comment></comment></comment></comment><comment><USER11> It's really hard to grab users' attention in the App Store.

If you have a great app but don't have a big brand associated with it, it's hard to crack the top 25 or even the top 50 in your category. As long as TapZilla can maintain high app quality in their daily deals, this can be a big deal for app developers.

</comment><comment><USER12> It mentions that they have plans for an Android version. That is a much more difficult area to venture into because of the 24 hour refund.

\- I get the discount on the app paid out then return the app. Free money!

Overall I do like the idea, very useful.

<comment><USER5> Good point on the 24 hour refund and our Android strategy since the market mechanisms are so different. We're currently working on our Android story and looking at how to get the best distribution on the different Android AppStores that are out there right now.

</comment></comment><comment><USER13> What about users without a paypal account? How will they get the money back?

And what about the tax cost of 7 cents?

<comment><USER5> Right now we support both PayPal payment and iTunes card redemption. Users can save their payments towards a iTunes card which we will email it to them. Other redemption others are in the works.

As for the tax, state laws vary and we don't collect information about the user's location. So far this hasn't been an issue with our users but we'll collect geo info if this becomes a concern.

</comment></comment><comment><USER14> Great service, have tried it during the closed beta period. Good way for devs to get early users.

</comment><comment><USER15> Rock! Congrats Ed and Francis on the launch. FWIW, Ed and Francis are incredibly great guys...

</comment><comment><USER16> This is a really bad model. I could have launch the same service for just $0.50/download. How are you going to stop cut throat competitors like me?

I hope PG did ask this question during the interview, so it should be easy to answer my inquisition.

<comment><USER16> To Whomever down voted,

I am bringing up a very valid question and I'm not saying that I'm gonna do that, but if I was in PG's seat during the YC interview, that would be my question and I like to hear the founder's response because it is a valid concern and unfortunately a reality too.

<comment><USER6> I'd say the barrier to entry for other startups would be the awareness and userbase that Tapzilla may manage to develop.

For instance if Tapzilla can say to a developer that they have 20,000 users with an average 20% redemption rate then Tapzilla is going to be a lot more likely to be successful in selling their service to a developer than a new operation with only 50 users.

To be able to do this successfully on a longterm basis Tapzilla will need to be able to get several case studies as evidence that, due to the freebies, a certain App went up the sales charts which then resulted in more visibility and more paid sales. Otherwise it could just be a losing proposition for developers.

<comment><USER16> I agree that user base IS a barrier for entry but hardly unique to any business, startups. Almost, and not ALL, business plan that I've seen cite "ability to achieve massive user base" and "first player in the market" as barriers, I choke almost every single time reading that.</comment></comment></comment></comment>


Is 'moderate drinking' really good for the heart? - <AUTHOR> http://www.drbriffa.com/2010/12/30/is-moderate-drinking-really-good-for-the-heart/ <comment><USER2> To my knowledge the graph of "health benefits" versus alcohol is highest for people who drink the most, of course, but also has a noteworthy increase for people who drink zero. During a discussion with some sedentary behaviour researchers we speculated the lower end of the graph is less so do with the alcohol itself but rather the personalities associated with the different consumptions levels:

\- Zero alcohol group; likely to contain above-average numbers of people who are strict on themselves, and thus more likely to be stressed often

\- Medium alcohol group; likely to contain above-average numbers of people who enjoy relaxing

\- High alcohol group; a high alcohol intake is bad for your health and is likely to include above-average numbers of people with a poor quality of life

I know of no medical evidence to specifically back up that idea, but there is a lot of evidence to suggest that worrying less about things can yield improvements in health.

So in conclusion whilst the "eat and drink" bit of "eat, drink and be merry" might be debatable, the "be merry" bit is definitely good advice. HAPPY NEW YEAR HACKER NEWS!!!

:)

</comment><comment><USER3> Note this is not based on clinical research but likely a survey of surveys. It is the least reliable form of research the point is not to come to conclusions but to question the methodology of the original study and suggest improvements. I don't have easy acess to the article at home but it is highly unlikely the article would approve of the conclusions in the article.

Cardiac health is just one of the possible factors increasing life span. There is no way to factor out the root cause this way. You need a control.

I will warn about alcohol and tylinol use together somehow this is not well known it may be very very dangerous together. Tylinol is so common it was hard to spot the combined risks.

</comment><comment><USER4> There's evidence on both sides, but I'll say this...it's good for the soul, and if it's good for the soul, then it can't be half bad.

<comment><USER5> _There's evidence on both sides_

This is usually a phrase that's used to shut down scientific research. Although one can find evidence for almost everything, it's entirely permissable, and good to try to balance up all the evidence and figure out which side is more correct.

<comment><USER6> Not necessarily. It can also indicate that we don't really understand a phenomenon, which can be a very valuable observation.

Certainly better than assuming we know something to be true that later turns out to be unsupported, eg. high fat diets causing to high fat humans.

<comment><USER7> There are good points on both sides of this argument.

</comment></comment></comment></comment><comment><USER8> This makes complete sense. However, something tells me this article will get about 1% the amount of press that the original "drinking makes you live longer!" story did.

</comment><comment><USER9> I always wonder what are the causes and what are the effects in studies like this one and the ones that say drinking is healthy. Is it possible that those who lead healthier lives are therefore mentally able to resist from drinking, and not the other way around as this study shows? The same applies to the studies that say those who drink a little are healthier than those who don't. As JofArnold said in another comment here, those who don't drink at all may only be less healthy because they are the people who are likely to stress over things.

I'm sure the scientists conducting these studies try to eliminate these inconsistencies to as much as their ability by establishing the cause-effect relationship, but it seems impossible to do this exactly right and thus we should consider the associated problems in studies like these.

</comment><comment><USER10> Lies, damned lies, and medical science: [http://www.theatlantic.com/magazine/archive/2010/11/lies- dam...](http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies- and-medical-science/8269/)

</comment><comment><USER11> From first principles, it wouldn't make sense for alcohol itself to be beneficial. After all, the body treats it like poison, the liver filtering it from the blood stream. Drink too much poison, and the liver gets tired and shuts down, and then you have liver failure.

But there are some compounds in some kinds of alcoholic beverages, mostly red wine, that are thought to be beneficial. Of course, you could get the same benefits by skipping the fermentation process and just drinking grape juice.

<comment><USER12> Until very recently the only way to get truly safe drinking water was through one of two ways. #1 by boiling water and #2 by fermenting grains and fruits mixed with water to create alcohol.

Like the old wives tale says, a glass of wine with dinner will stop you getting food poisoning. And research has been proving this for a while: [http://www2.potsdam.edu/hansondj/HealthIssues/1110384069.htm...](http://www2.potsdam.edu/hansondj/HealthIssues/1110384069.html) (It's a far better read than the NYT article it takes from with more citations)

Considering that 30% of the population annually considers themselves to have suffered food poisoning, that's quite the statistic and as most people confuse food poisoning symptoms with flu symptoms it could easily be far higher. Given that wine is of high enough proof to be potentially effective when consumed in any quantity with food that it has far ranging benefits far beyond just what's in it.

If you ate something with a deadly E. Coli strain, you'd probably be kicking yourself in the ass if you drank grape juice over red wine. Not to mention the potential risk you face from food poisoning through tainted juice.

<comment><USER11> A) This is entirely irrelevant to my point. The point was, the body takes in things it finds useful, and discards the ones it doesn't. Ethanol gets filtered out. And it's rough on your organs if it has to do it too often. Those are the first principles.

B) The whole "wine as a replacement for water" thing is bullshit. Alcohol is a diuretic; when you drink wine, your net hydration is negative.

C) Tainted juice is a non-issue if it's fresh; fruit is one of the safer things you can eat, especially vine fruits, since they don't contact the ground much. If it's spoiled juice... after a certain point it's alcoholic. Ethanol is the by-product of spoilage in grape juice.

D) It's possible that alcohol in conjunction with food reduces contaminants in the food, but I find it highly unlikely this is the reason people started to and continue to drink; it seems that getting buzzed is the more plausible explanation.

</comment></comment></comment><comment><USER13> I'd read this objection to the standard results previously - that the non- drinkers measured were former alcoholics. The following study claimed to get a similar result while controlling for this:

Mainstream press: [http://singularityhub.com/2010/09/02/heavy-drinkers- outlive-...](http://singularityhub.com/2010/09/02/heavy-drinkers-outlive-non- drinkers-longevity-never-tasted-so-good/)

Direct link to abstract: [http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2010....](http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2010.01286.x/abstract)

I posted this to HN a few months ago...

</comment><comment><USER14> I recall reading that the original study indicating red wine was good for the heart was based on studies of a chemical in the wine which was given to rats as part of the study. To get the same amount the rats got, and assumably the same benefit, you'd have to drink a ridiculous amount (1000's of gallons a year IIRC).

<comment><USER15> That'd be resveratrol. There are now various supplements on the market so that you can get the dosage that is alleged to be helpful.

Also, resveratrol is not the only substance in red wine that is alleged to be helpful. Another is, of course, alcohol...jury is still out on whether low- dose alcohol can help cardiovascular health in the long term.

<comment><USER16> I just wonder about the true purity of the supplements. Also, other related chemicals in the wine that increase resveratrol's impact.

</comment></comment></comment><comment><USER17> It seems for every nutrition study out there, you can find another one that will say the exact opposite. My 2011 resolution is to skip nutrition advice altogether.

<comment><USER2> I used to think this, but in the last year I've seen that the science isn't really so ambiguous. The /reporting/ of it is total chaos though. Which is what you'd expect given the various different stakeholders in the food industry.

<comment><USER18> Much like this article right? The article simply brought to light a study that says "previous studies suffer from a bias". The study did not appear to say "alcohol is bad for the heart" or that those studies drew incorrect conclusions. Simply that future work should really take this into account.

That's important, because work needs to be done to identify other lifestyle habits that tend to be present in lifelong-teetotalers, but not in the drinking group. I think it's entirely reasonable to think that folks who abstain from alcohol over the course of a lifetime probably have a lot of other habits that are a bit healthier as well.

So I think it's important to note that this article drew very little in the way of conclusions, but I get the feeling that folks are going to take it and run with it anyways.

<comment><USER2> Is the nature of the beast; I guess epidemiological studies are hardest to get right and yet the easiest for which to collect data...</comment></comment></comment></comment>


A better cloud bookmarking system than delicious? - <AUTHOR>

I hate the way I cannot do bulk updates <comment><USER2> Have you tried pinboard.in?

<comment><AUTHOR> you have to pay!?!? is there even a trial?

<comment><USER3> At least its a one time fee, not a recurring one... :/</comment></comment></comment>


MongoDB 3.2 released, called "a giant leap" - <AUTHOR> https://www.mongodb.com/mongodb-3.2 <comment><USER2> I love the idea of data validation, but... I currently work with people whom will welcome this as an invitation to spend weeks upfront designing strict schema.</comment>


Insurance copays are higher than the cost of the drug about 25% of the time - <AUTHOR> https://www.pbs.org/newshour/health/why-a-patient-paid-a-285-copay-for-a-40-drug <comment><USER2> Health pricing is a weird fixed pricing with all sides in insurance companies, medical suppliers and doctors holding the cards to get the highest prices within the gamed rules with the consumer left out in the cold and each bill a random output that is rarely known beforehand.

Part of the problem is healthcare provided through work that skews pricing for large companies over individuals/small/medium businesses and entrepreneurs.

If we can't get healthcare removed from employers and have both a private and public option based on Medicare for all. We AT LEAST need legislation to bring in CLEAR pricing for insurance cost and non-insurance rates, similar to the CFPB mortgage Loan Estimate and Closing Disclosure that show all pricing clearly in one sheet of paper both the estimate and the final mortgage.

What other product do we buy that the price is not known until after the product/service is rendered? At least some idea of an estimate is even hard to get as each part of the medical pricing matrix scam (insurance companies, medical services/suppliers, doctors, pharmaceuticals) try to keep pricing shrouded to stick it to people wherever they can.

The consumer healthcare experience is horrible in the US healthcare system and employers being the insurance companies main customers is a major part of this problem but pricing can be helped with clear regulations and needs to be now.

<comment><USER3> In my view, understanding the flow of money in the health care system will be impossible until the system is wholly owned by the government. This may be the primary reason why health care in most civilized countries costs half of what it does here. Until then, everybody who's gouging us accuses everybody else of being the ones who are gouging us.

<comment><USER4> The most frustrating issue with the Bernie Sanders single payer campaign is that they flat out lie saying that the reason why healthcare is expensive is because it is private.

Healthcare hasnt been so expensive forever, it was actually very cheap decades ago, when it was still private. The efficiency issues are not public vs private. Its mostly regulatory burdens.

<comment><USER5> Yes regulatory burdens like actually being forced to cover people with pre- existing conditions, not being able to drop people once they use thier insurance and not being able to exclude certain conditions....

<comment><USER4> More like burdens like limiting the amount of doctors available, not allowing the importation of foreign drugs, tying healthcare to the employer, etc.

You can manage the problem of pre-existing conditions in an insurance system with a subsidy, instead of a mandate that forces a 20 year old minimum wage person to work part time, because the employer cannot afford to pay healthcare for him.

<comment><USER5> _More like burdens like limiting the amount of doctors available,_

There has never been a law in the US limiting the number of doctors available.

 _tying healthcare to the employer, etc._

There was never a law tying healthcare to the employer. Before the ACA, if you had a preexisting condition, that was the only way that you could get insurance - by being part of a covered group. The insurance company wouldn't cover you.

 _You can manage the problem of pre-existing conditions in an insurance system with a subsidy, instead of a mandate that forces a 20 year old minimum wage person to work part time, because the employer cannot afford to pay healthcare for him._

So we need universal coverage like the rest of the civilized world....

<comment><USER4> > There has never been a law in the US limiting the number of doctors > available.

There is at least one such limits to about 1/4 of 65.000. And even within that limit they have an irrational amount of extra requirements.

> There was never a law tying healthcare to the employer.

Sorry but in the US, health insurance is provided by the employer because it is a tax-exempt expenditure. Tax it and see wages diminish considerably once employers pass the cost to the employees.

> So we need universal coverage like the rest of the civilized world....

The uncivilized world also has universal coverage. That should be a red flag, shouldn't it?

<comment><USER5> _Sorry but in the US, health insurance is provided by the employer because it is a tax-exempt expenditure. Tax it and see wages diminish considerably once employers pass the cost to the employees._

Employers already pass the cost to employees through lower wages.

 _The uncivilized world also has universal coverage. That should be a red flag, shouldn 't it? reply_

Yes, that in this regard the US is worst than a third world country...

<comment><USER4> They don't pass to the employee the marginal tax rate pf the health benefit, which by the way is a very regressive policy.

And you would be very wrong to believe healthcare in the us is worse than in third world socialized medicine countries. You will find horror stories galore as well as all other kinds of trade offs you wouldn't accept.

</comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER6> I had this experience with imaging (MRI), cost 10% more with insurance than without.

I asked a friend in the healthcare industry about this - they said that since insurance companies negotiate all the services at once - the insurance company is trying to lower the total cost for the whole insured pool, this often means that they will marginally overpay for high margin services in order to get big discounts for the really costly things. The hospital makes more gross margin, and the insurance company lowers it's total spend. The offshoot is that individual people may bear the brunt of this grand bargain...

No idea if it's true, but had a ring of truth to it...

<comment><USER7> I had the same situation with multiple services:

1\. ultrasound cost around $300 with insurance...$150 without

2\. ER visit cost $4K with insurance....$900 without

3\. specialist visit with insurance cost around $200...$150 without

And don't get me started on labs.

It's really a rip off to use insurance for anything other than:

1\. general doctor visit (cheap co-pay, pretty expensive cash option)

2\. really expensive shit (c-section w/o insurance runs $25-$30K -- cost me around $5K with insurance)

Anything in between seems to be cheaper when you pay individually.

As a disclaimer this is "gold-level" insurance coverage which costs around $1200-$1300/month for a family of 4.

<comment><USER8> Wow. I used to live in the US but thank you for the reminder. I am very glad i now work a government job in a country with public health care. I went to the dentist last week. Walking out without paying anything, not a single form, feels like stealing. I cannot understand how anyone in the US can pay such costs. Simply staying alive seems a constant battle.

<comment><USER9> What dental services were performed? In the U.S. I frequently pay nothing nor fill out any forms for dental work.

<comment><USER8> Xrays, replaced a filling and got a night guard thing made. Took a couple hours.

<comment><USER9> Yeah, I've paid nothing for x-rays and fillings. Haven't needed a night guard yet.

I suspect that the chicanery in the U.S. is more severe in the non-dental sectors of healthcare as there's more volume/value there (from a provider/stakeholder POV).

<comment><USER10> My wife missed a checkup (perhaps two) due to pregnancy. When she went back she needed a root canal. I happened to need a filling for the first time in 12 years. Before any of my work we had hit our insurance max for the year and had to pay cash for the excess--about $1000. This all happened in the same month or two so we didn't know until after.

</comment></comment></comment></comment></comment></comment></comment><comment><USER11> Healthcare and profit don't go together. This is just exhibit n° 31415926535897932384626433.

What happens in the software world when you see twentyseven useless levels of abstraction? Exactly the same. You smell a rat.

In my ideal world:

* Healthcare research funding to come from the public sector and donations only.[0]

* Healthcare products can only be sold once the production process is verifiably fully publicly documented. This means independent reproduction by multiple reputable non-profits.

* Market based generics manufacturers handle production. Competitors (for profit or non-profit) jump in if pricing gets out of hand.

* Healthcare education free to students.

* Only non-profit healthcare services allowed.

* Compensation for people providing healthcare services is linked to median income.

[0] This is not such a big difference as one would think, as more than half of the basic research in the field is actually publicly funded already.

<comment><USER12> "Only non-profit healthcare services allowed."

Not sure if this is required - the UK manages to have a socialist health care system (the NHS) for the vast majority and a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc.

I'm not sure I'd be happy with completely banning access to private healthcare - although I'd prefer it if the NHS was resourced to a level where there really wasn't much need to to go private (which certainly used to be the case).

<comment><USER13> I wouldn't hold the NHS up as a paragon of virtue. I got sick on a recent trip to London and tried to get in to see a GP under the NHS and it was impossible.

The clinics near my hotel only accepted same day bookings. I tried calling just after opening hours and the phone was engaged. I managed to get through 15 minutes after the clinic opened and the clinic was booked out for the day and I would have to call back the next day. I tried a number of clinics and they were all booked out. I was lucky that I wasn't that sick and got better. Otherwise, I was looking at an exorbitant fee to see a private doctor.

I was shocked, as I always assumed that the NHS was better than the system we have in Australia. I think that there are lots of perverse incentives involved in Medicine and Healthcare. Government intervention is required to balance out these incentives from profit takers and consumers (i.e. smokers, obesity, etc). I'm not sure that any model in the world right now gets the balance right.

<comment><USER12> Note my comment about "I'd prefer it if the NHS was resourced to a level"....

The issue with not getting GP appointments quickly seems to have been a relatively recent thing - due to lack of resources and mismanagement rather than fundamental problems with the approach.

<comment><USER14> That's not entirely true. If you're actually emergent and require a same day apptmnt then they've got held appointments for you. However this has led to an extremely strange system where often GP receptionists are essentially gatekeeping services (as a pre requisite to accessing the GPs who gatekeep the other services...)

</comment></comment></comment></comment></comment><comment><USER15> Something is very wrong with the whole medical insurance system in the US. Having recently been exposed to it, I keep discovering new surprises and being shocked regularly.

What I found most bizarre is that Americans who are "temporarily" in the US (e.g. expats, visiting) can get health insurance with better terms and at about 1/10th the price of what residents are offered.

Someone is being had, I'd say.

<comment><USER16> That could be because for the really expensive stuff they'll pay for you to be transported back to your home country, where your primary insurance will treat you.

<comment><USER15> No, that is not the type of insurance I was writing about. To take an example, take a look at Patriot America Plus from [https://www.visitorscoverage.com/visitor-health- insurance/pl...](https://www.visitorscoverage.com/visitor-health- insurance/plans/)

It does include the acute onset of pre-existing conditions, $250 total yearly deductible, 100% percent in-network coverage. But it is not available to US residents, only for short term (up to two years) stays.

<comment><USER17> > _The Patriot America Plus Plan is available for any_ non-US Resident _, > visiting the USA for a short period of time_

> _Pre-existing conditions are not covered by Patriot America Plus Plan_

It requires you to already have insurance somewhere else, and they expect you to go home for anything chronic (expensive). It sounds exactly the same as any travel insurance you can get in your home country (and is included in many fancy credit cards)

You said "expats" before, but ex-pat implies residency in the US. Tourists/business travelers are a whole other ballgame. They're just protecting against not getting hit by a car when they're at their week-long conference. They're all limited in scope of their costs by their visitor's visa duration (typically 90 days)

</comment></comment></comment></comment><comment><USER18> Under the NHS most patients pay a "prescription charge" which is intended to encourage patients not to seek prescription meds when they needn't do anything. (Several big categories like pregnant women are exempt from charges, and if you use lots of medicine you can "prepay" a fixed fee of about £100 each year to stop getting charged regardless)

The charge is more than some cheap OTC medicine you might get prescribed, e.g. hay fever tablets are pennies per box and the charge is almost £10. But pharmacists are required to tell you if you could just buy it yourself for less - they collect the charge so they have the opportunity to point this out whereas your doctor needn't know if you pay or not.

Logically the charge must also be bigger than the price for some of the cheapest prescription-only medicine and there's no way to avoid paying extra in the UK as far as I know in this case.

<comment><USER19> Over 90% of prescriptions are free, because they're prescribed to exempt groups (children, the elderly, people on benefits). It's a slightly peculiar system that doesn't make a huge amount of sense.

[https://www.pharmaceutical-journal.com/news-and- analysis/pre...](https://www.pharmaceutical-journal.com/news-and- analysis/prescription-charge-overhaul-would-raise-1bn-a-year-for-nhs-says- think-tank/20066348.article)

<comment><USER20> The alternative conclusion is that it's fulfilling its purpose as a deterrent against abusing prescription medication

</comment></comment></comment><comment><USER21> I am on the same exact medication. I live in Italy. My 90-day supply is 15 euro (5 euro per box), but the government covers most of it through the healthcare system, so I end up paying 3 euro (1 euro per box).

<comment><USER22> And you could probably get it even _cheaper_ if you ordered them from a pharmacy in India.

<comment><USER23> Except they'd probably get stopped by customs.

<comment><USER24> and might be counterfeit

<comment><USER25> Anyone who thinks the FDA should be abolished should read the Warning Letter of the Week and reconsider: [http://chemjobber.blogspot.com/search/label/warning%20letter...](http://chemjobber.blogspot.com/search/label/warning%20letter%20of%20the%20week)

<comment><USER26> _Our investigator documented that you have an employee food preparation area within your drug manufacturing area with no separation between open manufacturing equipment, cooking utensils, and personal-use items. The practices observed at your facility, which was observed open to the outdoors, increase the likelihood of your drug products becoming contaminated._

<comment><USER25> Eating in the lab is poor form, it goes against all the social norms a manufacturing chemist has imbibed during their training. Such poor discipline usually points to further trouble, and indeed there are deeper problems:

 _You provided no evidence that you have performed chemical and microbial testing on each batch you manufactured before making a batch disposition decision._

</comment></comment></comment></comment></comment></comment></comment><comment><USER27> I have a doctor friend who's made it a habit to recommend that patients use GoodRx anytime they go to pick up prescriptions. Doctors can only be so involved in the pharmacy side of the transaction and a lot of pharmacists aren't able to intervene.

It's sad that it requires a 3rd party app to help people not get screwed over by the current US medical system.

<comment><USER28> Are you aware of any privacy issues with GoodRx? I've avoided it because I assume they are making money selling my prescription information.

<comment><USER26> I can't say if GoodRx is doing it, but Walgreen's seems to be selling information.

I was with a friend picking up his meds and I bleeped my rewards card to collect the points, since he didn't have one. Now I get offers in the mail to treat his condition.

<comment><USER29> So this has been a roller coaster. My initial thought was that this was a big HIPAA violation but then I decided to actually look to see if my assumption held up. According to the Department of Health & Human Services page on HIPAA and marketing [0], Walgreens can use personal health information (PHI) in marketing without violating HIPAA, as long as they have permission to do so.

So with that in mind, I went and looked at Walgreen's notice of privacy practices [1] and they say that they will get a written disclosure before using PHI (and that is restated in their Balance Reward ToS.

Bottom line is, if they are selling information then hopefully you're friend has signed a form authorizing use of the PHI otherwise Walgreens is violating HIPAA.

[0] [https://www.hhs.gov/hipaa/for- professionals/privacy/guidance...](https://www.hhs.gov/hipaa/for- professionals/privacy/guidance/marketing/index.html)

[1] [https://www.walgreens.com/topic/help/general/noticeprivacypr...](https://www.walgreens.com/topic/help/general/noticeprivacypractices.jsp?foot=privacy)

</comment></comment></comment></comment><comment><USER30> I do wonder if insurance paying for everything under the sun is part of the issue. I remember hearing talk of medicine for some chronic conditions being available over the counter (migraines, diabetes, asthma, etc.). The way I see it, my car insurance only covers a limited number of issues. Unfortunately, health insurance has historically come on the wrong side of things (e.g.: pre- existing conditions BS)

<comment><USER31> Health insurance in the US isn't insurance. It's a scheme to try and spread around the costs of providing healthcare to everyone, and everyone tries to pass the buck to those with the least power in the system. Large employers with young, healthy office workers win, and poorer taxpayers who don't have health insurance or independent contractors who have very little power lose. The people who have nothing get medical care, but it's not ideal, but they don't have anything to pay with either.

So try not to be in the middle - the ones with enough assets to take, but not enough to defend against having them taken (e.g. not being part of a group that can negotiate out of it).

God forbid we actually come out and say we, as a country, want to support each other. A large portion of our fellow citizens would rather play this game of hot potato, but don't have the balls to turn poor people away from the emergency room and tell them to die.

<comment><USER5> _Health insurance in the US isn't insurance. It's a scheme to try and spread around the costs of providing healthcare to everyone_

That by definition is insurance.... [https://www.investopedia.com/terms/i/insurance.asp](https://www.investopedia.com/terms/i/insurance.asp)

<comment><USER31> The key difference is that the recipients are also others who pay for insurance, whereas in US health insurance, it's a game of see which provider can collect more from which payer (government, insurance, individual) to make up for the losses on those that can't pay.

Also, chronic and old age health issues don't even seem like insurable risks, like getting 20 year term life insurance for a 90 year old. You would basically just be paying for someone else to manage your premium money and take a cut before giving it back to you since the insured risk is inevitable and has to be priced accordingly.

<comment><USER5> _The key difference is that the recipients are also others who pay for insurance, whereas in US health insurance, it's a game of see which provider can collect more from which payer (government, insurance, individual) to make up for the losses on those that can't pay._

Health costs between what you pay as an individual and what you pay as part of a group is just like anything else. You couldn't buy the same parts for a computer at the same price as Dell. Dell can get bulk discounts you can't.

A health care provider is willing to charge less for care per person for a group of people through an insurance carrier than you individually.

If you have ever signed up for term life insurance, you usually get a fixed premium up to a certain age, and then premiums skyrocket as you get older. You theoretically can price life insurance for a 90 year old based on actuarial data. The cost will be prohibitively expensive.

<comment><USER31> An individual isn't paying increased costs for parts for computer because the merchant was forced to sell parts to someone for free. A merchant might be making less on the marginal profit to a large vendor (or accept slight loss to benefit from the marketing of having a large customer), but I don't see it quite as bad for the little guy as it is in US healthcare.

Edit: I understand the analogy of a bigger buyer means better prices, but it's a little different too because the merchant of the computer parts can't bill the losses to the government who then pays via increased taxes. The pricing differences are astronomical too between what prices are given to people who want to pay cash versus via insurance or Medicare or Medicaid, it makes no sense.

I see the US healthcare market as the middle and lower middle class spending a larger portion of their wealth subsidizing the poor class while the upper middle and upper class spend a smaller portion of their wealth subsidizing the poor class because they can negotiate out of it, and they probably get better care too.

And this is all exacerbated because employers get to deduct health insurance premiums from taxes, while independent contractors buying insurance independently don't.

<comment><USER5> Health insurance is deductible as an independent consultant.

[https://turbotax.intuit.com/tax-tips/home- ownership/deductin...](https://turbotax.intuit.com/tax-tips/home- ownership/deducting-health-insurance-premiums-if-youre-self- employed/L6bRhLaVE)

<comment><USER31> Is that a recent change? I was under the impression that people who buy their own insurance can't deduct it, or at least I haven't ready any 1040 instructions that say you can. What if you're employer doesn't offer health insurance and you buy it? Then you're not an independent contractor, but you still don't get it from employer.

<comment><USER5> It's part of your standard business expenses as an independent contractor. It's been that way at least since 2012 when I was a consultant.

<comment><USER31> Interesting, thanks for the correct info. I can't seem to find anything about people employed by small business that aren't required to offer health insurance, so I think they still have to purchase health insurance themselves with post tax income, so I guess my point only stands for them.

But still, it's all needlessly complicated and unreasonable to expect people to be able to optimize in our current system.

<comment><USER5> If you are employee and receive a W2, you can only deduct healthcare expenses that are more than 10% of you income.

I would say that any company, no matter how small has no excuse not to offer health insurance to thier employees. The cost in administration is minimal and can be outsourced. I have a relative who runs a law firm with just herself and one or two assistants and even she offers unsubsiduzed health insurance. I'm not saying they should _subsidize_ the cost. Just by offering it through the company, it's cheaper for the employee because the company can offer it pretax.

As an employee, I would never be an _employee_ of a company that didn't offer insurance if I needed it. If they won't offer (unsubsidized) insurance, and I want to work for the company, I would insist on working as an independent contractor at a rate that would make up for not getting paid time off, self employment taxes, and future unemployment benefits.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER32> What would happen if we suddenly made opaque pricing illegal? If anyone sells anything to anyone, they'd be required to publicly disclose the price.

Having thought about it for all of thirty seconds, I can't see any downsides. Can anyone convince me otherwise?

<comment><USER33> Not necessarily a downside, but in some industries I think most people don't care that much if different customers get different prices.

Like B2B, often the sales people feel out and negotiate a customer to see how high they can sell a product/service for. And that can actually be nice for small companies. They are probably getting subsidized by larger companies to some extent. I know the company I work for has negotiated very aggressively on some of our infrastructure pieces (metrics, config-management, db etc), where there was no way we could afford the sticker price.

EDIT: OTOH making opaque prices illegal, wouldn't bar negotiation.

</comment></comment><comment><USER34> Do pharmacists have to take the Hippocratic Oath? How is not telling your customers that the insurance copay is higher than cash not harmful?

<comment><USER35> There are articles such as this: [https://www.pharmacytimes.com/contributor/douglas- jennings-p...](https://www.pharmacytimes.com/contributor/douglas-jennings- pharmd-fccp-faha/2016/06/when-should-patients-pay-cash-for-prescriptions) , suggesting that some contracts forbid pharmacies from mentioning a cash option to patients. Which should be illegal.

</comment></comment><comment><USER22> Another example of how distorted prices are in this market. Price discovery is nearly impossible. Some places can't even tell you how much a drug cost without insurance because _they don 't even know!_

<comment><USER36> Anecdata warning . Took paper Rx to a very large chain that has a one word name beginning with a W and was told they wouldn't quote the cost of the prescription without scanning the Rx. And destroying it so I couldn't take it anywhere else.

<comment><USER37> Often times they take the script and put their sticker on it before even checking if it's in stock. I have had this happen numerous times. I then go to another pharmacy because the first was out of stock (and my time is worth nothing, so of course I can drive all over town and stand in line for 20 to 40 minutes at each place) and get interrogated by the pharmacy tech, "did you take this somewhere else to fill!!???" Because apparently only a criminal would fill a controlled substance. And with the DEA artificially limiting production, it's _very normal_ for the first three pharmacies to be completely out of stock.

</comment></comment></comment><comment><USER38> I am skeptical of claims that the US heathcare system could be fixed solely by better consumer medical information. But this is one area where consumers can often save money - just by asking their pharmicist when they go to fill a prescription to run the cost both under insurance vs cash pay.

One wonders what value health system administrators are providing when such a high percentage of negotiated drug plans result in higher prices than cash prices.

<comment><USER39> >One wonders what value health insurance administrators are providing

Good question. This was also discussed last week on HN[1].

Since 1970, the number of doctors is up 150%, in line with pop. growth, while healthcare administrators up by 3200%.

1-[https://news.ycombinator.com/item?id=17756845](https://news.ycombinator.com/item?id=17756845)

</comment></comment><comment><USER40> Can someone explin to me how the US prescription process works? As someone in the UK it seems quite alien.

<comment><USER41> It's always seemed weird to me as well. Let's say you go to the doctor for something like strep throat. You get a prescription for an antibiotic. Doctors offices don't carry drugs, so you take this prescription to a pharmacy to fill it. The pharmacy is a third party that isn't affiliated with the doctor's office. Only doctors can write prescriptions, and as far as I'm aware only pharmacists can fill them. Pharmacists aren't allowed to write prescriptions, even if it's something trivial.

On the insurance side, it's a nightmare. The doctor probably charges your insurance $200 for the office visit. Your insurance has a negotiated rate with the doctor's office for $150. You have a coinsurance of 50% if you've met your deductible, so assuming you haven't hit your max out of pocket for the year you pay $75. If you haven't met your deductible (some arbitrary amount you have to pay on top of paying for insurance) you pay $150. If you have hit this max out of pocket number, you'd pay 0. The $50 goes into the void. My employers insurance is something like a $1000 deductible / $5000 max out of pocket / 75% coinsurance.

When you get the prescription filled, well, I have no idea how this insane process works. Last time I needed antibiotics the receipt had a "before insurance" amount of $50 with an actual cost to me of $4. I have no idea where the $46 went or what my insurance actually paid.

<comment><USER40> In the UK, I go to a doctor, get the prescription. Some doctors in rural areas have pharmacies joined on but I think the majority don't. I go to the pharmacy, hand in my prescription and pay £8.80 per item (so two boxes of the same drug is £8.80). I pay upfront, so it costs me £104 a year for anything prescribed by an NHS doctor.

I see US folks talk about getting half their prescription filled, or seemingly using the same prescription multiple times. We can submit repeat prescriptions (such as I do for BP etc). but the actual prescription 'document' is a one time deal.

It's very, very odd to me the way it's set up over there. Especially so that some people fight so hard against change.

<comment><USER42> For chronic medications it is common to have a single prescription include multiple refills. So one paper document might get you 4 months worth of medication, but only filled 1 month at a time.

Mail order pharmacies often fill 90 days at a time, possibly with multiple refills. 90 days dispensed at once is uncommon at retail pharmacies, but is possible in at least some cases. (Not sure if it is laws or contracts that normally prevent this).

It is also possible that a pharmacy may not have enough to fill the script all at once, so they dispense only part, and you come back for the rest later. (I've never experienced this so I'm unclear on the details.)

</comment></comment></comment></comment><comment><USER43> Not from the US. But how in God sake does this make any possible sense? I mean if the insurance doesn't want to insure a certain medication, then you just pay it for yourself (provided they explain why; or that your contract said so).

But how could it be possible that you pay more?

<comment><USER26> _you just pay it for yourself_

That used to be the way it worked. You'd go to the doctor and he'd charge you, say, $35 for a basic exam, and you'd pay in cash.

Since health insurance became widespread, now doctors charge crazy amounts. My doctor charges something like $210 for a basic exam, or $185 for the "negotiated rate" to the insurance company.

I saw on television once that the reason we're in this mess has to do with WWII. With so many working-age people fighting overseas, finding workers was hard for companies, so they started raising wages. The government was afraid of war + inflation, so it put limits on pay raises. So, instead, big companies started offering health care benefits. And thus, an industry was born.

At least that's what I remember from the TV. I can't cite the show or channel, but I do watch a lot of PBS and virtually zero YouTube.

<comment><USER5> _Since health insurance became widespread, now doctors charge crazy amounts. My doctor charges something like $210 for a basic exam, or $185 for the "negotiated rate" to the insurance company._

The price a doctor charges per hour doesn't go directly in his pocket. That hourly cost has to cover support staff, the facilities, liability insurance, his accountant, etc.

<comment><USER26> So did the $35.

</comment></comment></comment></comment><comment><USER44> I think the telmisartan story is cherry picked to tell the story the author wanted to tell.

I'm on that drug, and have a good health plan that charges the lesser of copay or actual cost for drugs.

That drug was going generic two years ago, and it took the generic manufactures awhile to ramp up. The generic drug cost more than the name brand version for a few months and was constrained — the pharmacies my my area had difficulty doing a 90 day fill.

It ultimately didn't drop to super cheap status until they were approved to sell it in a normal pill bottle — previously it was sold in blister pack form.

</comment><comment><USER45> Watch "drug Short" on the "Dirty Money" series on Netflix. It pretty enraging, and you are likely already familiar with the story, Valeant Pharma and Martin Skrelli....

[https://www.netflix.com/watch/80149535?trackId=14170289&tctx...](https://www.netflix.com/watch/80149535?trackId=14170289&tctx=0%2C2%2Ca534ce77-e4b4-4d8c-9077-4da1a44b8a0e-77260350%2C331d9787-d92a-4dfc-b506-3eb056dd1503_30039662X3XX1534727957227%2C331d9787-d92a-4dfc-b506-3eb056dd1503_ROOT)

</comment><comment><USER46> I wonder what % of people now believe the US medical system is the scam that it is. Utterly dishonest pricing.

</comment><comment><USER47> I live in Dubai. I used to get glasses made for AED 100 - AED 200 (USD 27 to USD 54) when I was young, based on what I remember from visits to the opticians with my dad. No insurance.

Sometime after that insurance was introduced. Now, as an adult I pay AED 100 - AED 200 (USD 27 - USD 54) [basically the same amount] as 20% co-insurance when getting glasses.

Note 1: USD and AED are pegged.

Note 2: There has been inflation, but not that much. Tea increased from AED 1 to AED 1.5. Taxi increased from AED 10 to AED 20. Clothes increased 50% perhaps.

<comment><USER48> Slightly off topic, but you can order glasses (frames and lenses) for under $10 on zennioptical.com

Ive ordered my last 3 pairs there, and will never pay $200 for glasses again

</comment></comment><comment><USER49> Not sure how widely known or common this is for medications but I take PrEP (Truvada) and the maker has a free "co-pay" card on their website that basically covers $4800/year in copayments (well above the $50/month I would ever pay).

I'm sure there's some shady big pharma economics behind why these exist in the first place, but at the very least I'm getting a very expensive drug for free.

<comment><USER50> > I'm sure there's some shady big pharma economics behind why these exist in > the first place

The co-pay is designed to make you share in the pain of the sky-high costs the drug manufacturer charges the insurance company. This has two benefits—1) you are only going to get it if you really need it 2) maybe you'll lobby your congressperson to rein in monopolist pricing.

By giving you a coupon there's no pain sharing and those benefits are lost. Sure you'll pay higher premiums, either directly or in reduced wage gains, but that's defuse and indirect, so far less likely to drive behavior.

<comment><USER51> Biologic drugs are grown, not manufactured. Mine should be around 4k / dose; insurance won't cover it, so the drug company only charges me I think a $25 copay.

Fwiw, the insurance would have covered older alternatives, but the potential side effects on those are worse than the cure.

<comment><USER50> Should be in what sense? Is that the marginal cost to manufacturer a dose?

<comment><USER51> Should be in the sense that I don't recall the specific number, only that it was around $4k. Given the decreased consistency in the process (living things vs. mixing chemicals), I imagine a fairly good chunk of that 4k is also marginal cost to the manufacturer. Everything from research, to scaling up production, to storage and shipping (spoils at room temp) becomes more expensive.

</comment></comment></comment></comment></comment><comment><USER52> I'm not sure I understand this article. I take a few drugs the cost of which is less than the co-pay and I pay that lesser amount when I pick up my prescription from a major US pharmacy chain. They have my health insurance info and would charge the co-pay if the amount were more. But they don't because the retail price is less.

<comment><USER53> I have routinely had to pay the $20 minimum for generics that cost $5 retail. So I paid $15 over retail for using my health insurance.

</comment></comment><comment><USER54> My experience is that it's more like 90% of the time. My "lessons learned" is: Talk to your pharmacist and see what options they have for cash payment and discount cards like GoodRx. It takes them a couple minutes to compare to your insurance, but for me it's cutting the cost of my prescriptions by around half.

My insurance has a $10 copay, but limits me to getting 30 day supplies. Currently they are moving to require you to get refills through them by mail, which would be fine except I'm skeptical that it would cost me significantly more.

I have 3 prescriptions, which with the monthly copay would add up to $90 a quarter. Using the "GoodRx" or other "discount card", those 3 prescriptions with a 90 day supply end up costing me around $40 a quarter.

The meds for my family's recent set of illnesses were cheaper with the GoodRx than the copay, but just barely.

</comment><comment><USER55> Prices vary also a ton from pharmacy to pharmacy. I recently discovered GoodRx ([https://goodrx.com/](https://goodrx.com/)), which has been extremely helpful in minimizing prescription costs.

* Not affiliated.

</comment><comment><USER56> Maybe this is a dumb idea, but why not change the laws so medical insurance is more like car insurance - the insurance company works for me?

If I get into an accident and it's the other drivers fault, my insurance goes after them for the money.

Would be interesting if once a physician decides to perform services for you, he/she is bound by the insurance you have. If they don't like it, then they work it out with the insurance company, not you. As a patient, you'd know up front what your responsibility is.

Would sure as hell speed things up in terms of physicians and insurance companies figuring shit out.

<comment><USER57> _" Would be interesting if once a physician decides to perform services for you, he/she is bound by the insurance you have."_

That's not how the car insurance model works. You have an agreement with your insurance company to provide a certain amount of coverage, irrespective of what has actually happened. If, for example, there is $2,500 of damage, and insurance covers $2,000 of it, the mechanic isn't stuck eating $500. You get billed for that, and rightly so. The mechanic is specifically (and legally) bound to offer the same service/repair at the same price. The mechanic cannot quote you differently for a repair based on the insurance you have and is not bound to any agreement with your insurance company. The mechanic merely accepts the remittance made by the insurance company on your behalf as being towards the total repair cost.

</comment></comment><comment><USER58> I wonder how much we'd save if we just (say, "economically", for the sake of "civil" speech) whacked all the middlemen.

It's like going to the grocery store and wondering how much this "Monopoly" game (just came up in conversation with the clerk at the checkout lane, this evening) is really costing you.

Bunch of "marketing" gurus in suits. On top of the "prizes", I'm paying for them and their suit.

Bah

</comment><comment><USER59> It's just mindboggling that pricing in medical is so opaque. Mandating transparent pricing should be the number one reform everybody should be able to agree with.

<comment><USER25> _Mandating transparent pricing should be the number one reform_

In normal countries patients manage to do without shopping around suppliers altogether, but in the US that very fact is unimaginable to many. People outsource all sorts of things, Gusto is a YC company that companies use to do payroll, but Americans cannot imagine that the civilized world has outsourced prescription medicine pricing to the government and that it gets a good deal.

<comment><USER60> Americans can imagine that just fine; it's just harder to imagine _our_ government handling this in a beneficial way.

<comment><USER61> Our government is a reflection of us, if we demanded a better system we'd get it, the problem is that we hate other Americans and want to hurt them far more than we want to help ourselves.

<comment><USER62> Could you please stop posting unsubstantive and/or snarky comments to Hacker News?

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

</comment></comment></comment></comment></comment><comment><USER63> ...and the other 75% of the time pharmaceutical companies simply factor in the insurance payments into the drug price raising it to unreasonable level.

</comment><comment><USER64> I have so much experience with this, as do thousands of women.

Before the ACA was enacted, insurers were allowed to charge copays for birth control pills. I was paying $50/month ($600/year) for something that cost literally pennies for them to manufacture.

Generic birth control pills are one of the most common, cheapest medicines out there. I'm glad that the ACA outlawed copays for them.

<comment><USER65> >I was paying $50/month ($600/year) for something that cost literally pennies for them to manufacture.

This applies to the vast majority of drugs. Most of the cost either goes to recouping R&D or funding less profitable drugs.

<comment><USER64> True. My point is that the most common drugs are often the cheapest, so this 25% number quoted in the article isn't a surprise at all. I actually would have guessed that it would be higher.

</comment></comment></comment><comment><USER66> Save some by paying out of pocket? You can still use it as a healthcare expense come tax time.

<comment><USER67> Health expenses only matter if they exceed 7.5% of your income for a given year. Using flex accounts though, that would give you a big tax win. Flex and HSAs are really the only way to really get tax savings on health since the standard deduction was doubled in the Trump tax plan.

</comment></comment><comment><USER68> Want to do something about it?

[https://www.gormanhealthgroup.com/blog/trump- administration-...](https://www.gormanhealthgroup.com/blog/trump- administration-alarms-pbms-with-first-drug-pricing-initiative/)

Take action and write, tell them you oppose the PBM's and want drug kickbacks removed from the safe harbor exception!

This is what you are up against: [https://www.pcmanet.org/wp- content/uploads/2018/07/PCMA-comm...](https://www.pcmanet.org/wp- content/uploads/2018/07/PCMA-comments-on-Blueprint-RFI-July-16-2018.pdf)

Oh, they sound very convincing with great charts and data and bullet points. But they are very very wrong, they are looking out ONLY for themself!

I can't find where to comment, and I think the comment period might be closed, but doesn't matter write anyway. Encourage the Trump administration to do it and get rid of kickbacks!

</comment><comment><USER69> Yep. I take blood pressure medication. Cost without insurance: $5.70/mo. Cost with insurance: $10 co/pay. I know this because my insurance lapsed once for a month. Same exact pills, same manufacturer even.

</comment><comment><USER70> I have many friends and family members that frequently complain about the high cost of their health care and insurance premiums. Yet most of them are leading unhealthy lifestyles, a mix of bad diets, smoking, sedentary lifestyle, etc. There seems to be a big disconnect in their head between how they live their lives and how much it affects their health spending.

Sure, it would be nice if pharmaceutical drugs cost less, and if copays were cheaper. But it would be much better to not need either of those to begin with.</comment>


Healthcare.gov's SQL structure exposed by typing ; in search - <AUTHOR> http://i.imgur.com/6fQEQGc.png

<comment><AUTHOR> Actually I realize now that this might only represent people's _attempt_ to SQL inject rather than any real representation of their SQL structure

<comment><USER2> That seems a more likely explanation.

</comment></comment><comment><USER3> how is this getting upvotes? that is obviously not an SQL injection per se. It could just be OPs history of entries in any search field or the website that records what people input.</comment>


AT&T Buys T-Mobile for $39 Billion - <AUTHOR> http://www.engadget.com/2011/03/20/atandt-agrees-to-buy-t-mobile-from-deutsche-telekom/

<comment><USER2> Much more discussion from earlier post of same story: <http://news.ycombinator.com/item?id=2346908>

</comment><comment><USER3> Yay! Letting corporations do what they want is great for the economy. Now we all will have to pay more for less service than ever before, because AT&T will find a way to complain that their new infrastructure and customer base can't handle their new customer base. Meanwhile people will mention how awesome it is when companies are free to act as they please because of some religious devotion to the idea "free markets are good for the consumers".

I love this country.

</comment><comment><USER4> This is rather depressing for many reasons, including that I am a T-mo customer... maybe not for much longer though.</comment>


Steve Jobs maintains grip at Apple - <AUTHOR> http://www.reuters.com/article/ousiv/idUSTRE53A0BK20090411

<comment><USER2> I love how this article ends saying that the stock is down since the summer when his health concerns were revealed.

Yeah, I'm sure that was the reason and not the fact that the market lost half its value over the same period.

</comment><comment><USER3> I think it's important to note that the "major strategic decisions" he is involved in while he is out: "particularly...the user interface of the new iPhone"

UI design as a major strategic decision is pretty underestimated.</comment>


Show HN - Side Project to Help You Decide What Craft Beer You Should Drink - <AUTHOR> http://ShouldIDrinkThisFuckingBeer.com

<comment><USER2> My immediate reaction is "Should I trust this fucking website?"

Based on my 2 minutes of using it, that's a very firm no.

<comment><AUTHOR> any substantial reason? also, it's not about trust, it's about humor. and good beer. might help if you drink a good beer and then go visit the site again :)

<comment><USER2> Lack of transparency I guess.

If I enter a crap beer, say "heineken", I get told "no", which is fine.

If I enter random characters, say "rthjkejbfkel", I get told "no", which is not fine, because it means you are just saying no to anything that's not on your list.

So, if I enter a boutique beer that I like, say "Bluebottle" or anything from Mildura Brewery, I also get the "no", but I can't tell if it's because you're morons who don't appreciate good beer, or just ignorant about some excellent beers.

The only conclusion is I can draw is that you have a set of beers that you like, you'll say any other beer is crap (even if you've never tried it), and your suggestions are entirely opaque. I don't know why you like those beers, you're clearly not suggesting those beer based on any input I provided. That means is just a list of your preferred beers, with a front end that randomly selects a beer and an insult for me. Since I don't know you, or have any reason to trust your judgement in beer, there's no real reason to care.

Yes, it's about humor (although I don't find obscenities and insults to be particularly funny), but there's no evidence that it's actually about good beer - just beer that you happen to like with no explanation of why.

<comment><AUTHOR> thanks for taking the time to write out a coherent answer and critique, i appreciate it. after reading through your thoughts, it's safe to say that you may not be the target demographic for the site!

<comment><USER2> _It's safe to say that you may not be the target demographic for the site_

I think that's almost certainly the case.

</comment></comment></comment></comment></comment><comment><USER3> New favorite site

<comment><AUTHOR> ha, thanks!

</comment></comment><comment><USER4> awesome

<comment><AUTHOR> thank you!</comment></comment>


Ask HN: React JS instead of GWT in Java application? - <AUTHOR> We are crafting a system which will help to overcome the difficulties which Java developers have when they try to make a modern front-end utilising great frameworks and technologies from JavaScript world.
The first step is done, we made a visual development tool Structor (https://github.com/ipselon/structor) for React UI.
The next step will be a bunch of source code generators, which will produce React components along with Ajax methods for REST endpoints. Shortly, Structor will generate all source code for UI components along with the glue code for connection to the back end.
In addition there will be starter-kits which include different combinations of Spring Boot application, set of ReactUI components, and etc.
We are on the early stage, but I think this will greatly simplify the development of the front-end for the enterprise.
What do you think about such approach? <comment><AUTHOR> Just to clarify our approach I made a video. Here you can see how to create a sign in menu for Facebook and GooglePlus in Structor.

[https://www.youtube.com/watch?v=Ks2tWAJvDqo](https://www.youtube.com/watch?v=Ks2tWAJvDqo)

And there are 2 boilerplate projects for Structor here: [http://helmetrex.com](http://helmetrex.com)</comment>


Accept card (Stripe) payments with no coding - <AUTHOR> https://www.payzo.io

<comment><AUTHOR> Payzo.io allows you to connect your Stripe account and create a simple hosted payment form which you can send to your clients.</comment>


Nokia CEO's Burning Platform memo - <AUTHOR> http://blogs.wsj.com/tech-europe/2011/02/09/full-text-nokia-ceo-stephen-elops-burning-platform-memo/

<comment><USER2> Why is this article from 2011 being re-hashed multiple times on HN today?</comment>


EBay acquires visual search engine Corrigon for less than $30M - <AUTHOR> https://techcrunch.com/2016/10/05/ebay-acquires-visual-search-engine-corrigon-reportedly-for-30m/ <comment><USER2> I need a way to identify if an image of a particular automobile is a _red four door jeep_ or a _blue two door corvette_.

<comment><USER3> 10 cent query on Mechanical Turk?

<comment><USER4> Mechanical Turk is the truly "cognitive" system.</comment></comment></comment>


Apple hires Noteboom - Yahoo's ex-data center chief - <AUTHOR> http://gigaom.com/cloud/apple-hires-yahoos-data-center-chief/

<comment><USER2> Wow, this is big news.

Apple is building data centers _very far_ from being the state of the art, and very costly. (And they were probably not enticed to do better, thanks to their massive profits...) For example their latest $500M North Carolina facility is running off-the-shelf enterprise equipment from NetApp and Teradata!: [http://articles.businessinsider.com/2011-06-08/tech/30072633...](http://articles.businessinsider.com/2011-06-08/tech/30072633_1_netapp- hp-gear) There appears to have been little or no effort spent on optimizing cost, cooling, PUE, etc.

On the other hand, the top dogs built their data centers from the ground up from commodity hardware highly customized to improve efficiency and reduce cost. For example Facebook's tech is well documented in their <http://opencompute.org> effort. Google is well-known to have advanced the start-of-the-art in designing cloud-scale data centers based on commodity parts: <http://news.cnet.com/8301-1001_3-10209580-92.html> Ditto for Yahoo with their "chicken coop" data centers [http://gigaom.com/cleantech/now- online-yahoos-chicken-coop-i...](http://gigaom.com/cleantech/now-online- yahoos-chicken-coop-inspired-green-data-center) And Amazon is very secretive, but very likely doing the same and building EC2 on top of commodity hardware.

The cloud is a race which will be won by whoever has the most efficient computing infrastructure. Who do you think is going to win? Those who go as far as designing their own 95%+ efficient PSU running on 277V (Facebook: <http://opencompute.org/projects/power-supply/>) or those who buy run-of-the- mill NetApp appliances?

Hiring Noteboom is a sign that Apple's executive leadership recognizes the need to stop wasting money, and to start building serious data centers.

<comment><USER3> Do you know what Apple are using their much reported data centers for?

As far as I can see, all the iCloud related stuff ends up in Cupertino/SJ.

<comment><USER2> The North Carolina facility is reportedly for iCloud. But construction was barely completed, so it is probably not online yet.</comment></comment></comment>


Linux gets frozen, what do you do? - <AUTHOR> http://www.jovicailic.org/2013/05/linux-gets-frozen-what-do-you-do/ <comment><USER2> I'm using Linux since 20 years and used to do this all the time, back when Linux --or more specifically X Window system-- was less stable than today. I'd make sure to always compile the kernel with MagicSysRQ (you need it for the combo mentioned in TFA).

It wasn't even mandatory to restart the system: the trick was to use first MagicSysRQ and then issue a "vgareset" (IIRC I couldn't even see what I was typing, but the command was taken into account) and then, miracle: I could unlock frozen X Window sessions (more specifically: kill X, "reset" the GPU and then restart a new X Window session).

Note that very often X is fine: it's just X which is frozen. Heck, if you have another machine on your LAN and allow SSH in, you can SSH and kill X / vgareset without needing MagicSysRQ.

But since quite a few years X is so stable that such hackery ain't needed anymore. Moreover if I recall correctly "vgareset" did only exist for 32 bits system (at least at one point). Nowadays my Linux workstation regularly reaches 6 months of uptime (there are only very rarely know remote root exploits mandating a kernel upgrade) so I've kinda "forgot" how MagicSysRQ works ^ ^

<comment><USER3> When I read that I thought of "Stop A" on Sun workstations - and indeed that is mentioned on the wikipedia page:

[http://en.wikipedia.org/wiki/Magic_SysRq_key](http://en.wikipedia.org/wiki/Magic_SysRq_key)

Mind you I don't think I ever used "Stop A" on a Sun for anything constructive...

<comment><USER4> I thought Stop-A launched the Forth interpreter ;-)

<comment><USER5> Sort of. Stop-A drops you into the firmware prompt (OpenBoot), suspending the OS in the process. OpenBoot, of course implements a forth interpreter shell.

Ahh, the good old days... I once implemented a nice little boot device selecting utility in for for some of my Suns. All written in Fourth, and executed by the firmware on every boot.

</comment></comment></comment></comment><comment><USER6> It's a lot easier just to reboot and let fsck patch up your filesystem... flushing buffers isn't going to help you get back the last paragraph of your PhD thesis if Libre Office hasn't called write().

In any case, in ~8 years of using Linux, I don't think I've had a freeze that was the kernel and not just X.

<comment><USER7> "sync; sync; sync; shutdown -r now"

I remember some sort of magic invocation like that years ago for our medical "device" product we had to manage hundreds of remote node instances of. Something along those lines. I don't remember why the developer (Gabe) came up with sync three times being magic number. Maybe three times was just paranoia. =)

<comment><USER8> Back in the bad old days of pre-UNIX Macs, it was a common troubleshooting step to reset your PRAM. This is battery backed up RAM that holds some basic settings, and if it got corrupted somehow it could cause weird problems. You'd reboot while holding down command, option, P, and R, then wait for the boot chime to sound a _second_ time indicating that it had been reset, then release the keys and boot normally.

Somehow this advice got mutated so that you'd keep holding the keys until you heard _two_ boot chimes (thus resetting the stuff _twice_ ). And then it started to grow. Three was common. Some people would advise more. I'm pretty sure that doing it more than once never helped anything, but there we are.

(The cmd-opt-P-R sequence still works on modern Macs and I actually used it to resurrect a machine that wouldn't start up just a month ago, but it's far less frequently needed now.)

<comment><USER9> It's the same with the battery stats resetting and the Dalvik cache wiping these days in Android land. You do it three+ times.

Or the "Repair permissions" thing in OS X. You do it several times as well.

It's like whenever there's this one-step fix thing that a system utility does, the Common Man will interpret it as needing to repeat 3+ times in order for it to be effective.

</comment></comment></comment></comment><comment><USER10> Or, if you're on anything approaching a modern system:

1\. Tap the power button (one single brief tap)

2\. Wait a minute

3\. If the system hasn't already shut down or isn't obviously in the process of shutting down or you just get impatient: hold the power button down

4\. Now that the system is off: tap the power button.

Modern systems (whether server, desktop tower or laptop) have a "soft" power button, that when tapped briefly sends a signal to the OS. Most flavors of linux are configured so that receiving that signal initiates a proper shutdown, just like "shutdown", "poweroff" or a GUI shutdown. All of this has been true for quite a few years now.

If the system is so locked up that the power button initiated shutdown doesn't work, you might as well just pull the power, which holding the button down for a second or two will do. Even if this happens, you're probably using a journaling filesystem that comes back up cleanly.

None of that will help with unsaved data in an application, because you almost certainly have to tell the application to save, and if X has locked up there is no way to do that. A clean shutdown might signal the app with a terminate signal and allow for data to be saved before doing a hard kill.

</comment><comment><USER11> This is not for the situation in the article, but a slightly different one. You have a remote server, there's an ssh session still open to it but it's somehow lost access to _all_ its mount points including / You have nothing to work with but bash builtins and /proc, you're 100 miles away and you need to get it up and running again NOW. Emergency reboot -

        echo 1 > /proc/sys/kernel/sysrq
        echo b > /proc/sysrq-trigger

<comment><USER12> Do a `sync` first! Also This is quite like yanking the power chord and plugging it back in.

[https://en.wikipedia.org/wiki/Sync_(Unix)](https://en.wikipedia.org/wiki/Sync_\(Unix\))

<comment><USER13> [http://www.folkpeople.com/guitar- lesson/pic/power_chord_tabl...](http://www.folkpeople.com/guitar- lesson/pic/power_chord_table.gif)

<comment><USER14> At first, I wasn't sure why you posted this, but I was too busy rocking out to mind.

</comment></comment></comment></comment><comment><USER15> Another way to deal with X freezing.

Use acpi to set your power button to switch you to console. Just edit your /etc/acpi/power.sh and change it to...

        #/bin/sh
        /bin/chvt 1

The acpi system is separate from the X/keyboard interface and still works. So this way you can switch to the console even if your keyboard is locked.

Note you can use other keys as well. On my laptop I use my "thinkvantage" key for this. Any key that has an associated acpi event will work.

<comment><USER16> Which script in /etc/acpi/ corresponds to the thinkvantage key?

<comment><USER15>
      $ cd /etc/acpi
      $ cat events/thinkvantage-button
      # Thinkpad 'ThinkVantage' button
      event=button/prog1
      action=/etc/acpi/thinkvantage.sh
      $ cat thinkvantage.sh
      #!/bin/sh
      /bin/chvt 1

Hope this helps.

</comment></comment></comment><comment><USER17> Handy that 'reisub' is 'busier' backwards

<comment><USER18> You rock.

</comment></comment><comment><USER19> This sounds like like a feature that needs to be automated, probably with a very handy key combination. I don't know ... maybe with Ctrl+Alt+Delete?

<comment><USER20> Agreed. Why isn't this default behaviour? Is there some negative aspect that's not obvious?

<comment><USER21> That's because the default behaviour of CTRL + ALT + DEL is to issue a proper reboot.

That, and because X consumes those keys, making them useless when X goes bad (what is about all the times that Linux freezes and it's not hardware fault).

<comment><USER19> Okay maybe another key combination?

</comment></comment></comment></comment><comment><USER22> It's possible that their computer is frozen enough to need this but it's more probable that this person hasn't figured out how to disable DontZap in newer versions of xorg. You need to disable it in your xorg.conf in order to have ctrl-alt-bksp work again:

        Section "ServerFlags"
            Option "DontZap" "false"
        EndSection

<comment><USER23> Alt + SysRq + k will also do this if you don't feel like writing a xorg.conf.

<comment><USER24> That was one of my favorite Magic SysRq keys. It's the Linux analog to Windows's Ctrl-Alt-Del.

It's the "Secure Access Key" (SAK): You press that key and it kills _all_ programs hooked to the TTY (incl. X, in your case) and displays a proper login prompt so that you can know what you're about to login to was run by the system and not a clever malware trying to steal your password.

</comment></comment></comment><comment><USER25> Raising Elephants Is So Utterly Boring

<comment><USER26> Raising Skinny Elephants Is Utterly Boring

<comment><USER27> Reboot Even If System Utterly Broken

</comment></comment></comment><comment><USER28> Linux gets frozen, what do you do? I remember to press nine buttons on my keyboard, duh. and why? Because a hard reset will "make you a lot of problems?" I am not convinced, and I am not impressed.

This is a laughably awful shortcut for anything. Why make the supposedly safe stuff so out of reach? I would have to use a separate computer to look up how to type this command. Even if I knew the command off the top of my head, what if my keyboard lacks a PrtSc (SysRq) button?

When folks are pointing to Windows for design cues, the open source community ought to reconsider some aspects of how it has implemented certain features.

<comment><USER29> How do you perform the equivalent operations on Windows?

<comment><USER28> It isn't equivalent, but it is approximate; folks were mentioning ctrl-alt- dlt. Three keys instead of nine keys represents a 66% increase in efficiency.

<comment><USER29> I would've said it was approximate enough in whe Windows 3.1 days when it could perform a soft reboot. But since Windows 2000, it has had completely different functionality (sometimes allowing you to log in, sometimes giving you a process manager oslt), not even remotely approximate to the magic sysrq sequence presented here. Do tell me if this has changed since Windows Vista.

Linux, by the way, can also respond to Ctrl-alt-del, and depending on the desktop it might perform functions similar to Windows.

</comment></comment></comment></comment><comment><USER30> Before this try Ctrl+Alt+F1. You might get a full-screen terminal where you can log in and kill the offending process. Ctrl+Alt+F7 to get back to the desktop.

I had to use this just today when ddd stole all other mouse and keyboard input.

<comment><USER31> I used to use Ctrl+alt+backspace but it doesn't work anymore on many desktop environments.

<comment><USER32> That's because it's turned off by default on modern X.

You can enable them in the keyboard options of your DE, or directly with setxkbmap on startup (sorry can't look up the exact options right now) if you're not using one.

</comment></comment></comment><comment><USER33> if your X is hung (ie, NOT "linux"), why not switch to a VC and fix it? yes, it's good to know about magic-sysrq, but most people don't even understand the layering of X on a VC, and the fact that other VCs are available.

of course, fixing why your X hung would be wise too, since for any normal distro and mainstream hardware, that's just not going to happen. if you really want to be fubar, have that f@cking POS systemd die on you... (yes, on-topic, since only sysrq saves the day.)

<comment><USER34> Because X11 has trashed your video interface. You _can 't_ switch to a virtual console. X11 has ring0 access to the video card, to take advantage of DRM.

<comment><USER35> More often than not, it's your WM, DE or a GUI application eating up your RAM (Chromium used to be deadly for this) that's causing the freeze.

In more than a decade of running Linux on my desktop (and at work), I genuinely can't think of a single instance when I've not been able to pull a virtual console from a frozen desktop (albeit it often performs laggy).

<comment><USER34> Thanks for trying to diagnose my computer over a web forum, but I am competent enough to identify when and how my computer has failed. I'm not interested anecdotes from users. I develop video drivers. Am I allowed to experience these lockups now?

<comment><USER35> Firstly, I'm not just a Linux user. Like you, I'm a developer too. Given the demographic of this forum, it would pay for you not to assume that you're the only one on here that works in the industry (in fact I even hinted at that when I said I use Linux at work - but never mind)

Secondly, I was making a general comment about peoples desktops rather than talking specifically about your example (given the lack of details you posted, it would be insane of me to assume I could diagnose your fault with any precision). My point was that generally when people think their computer has locked up / X has crashed, it's actually one of the items I mentioned earlier that's at fault.

The snappy reply was appreciated though </sarcasm>. But given just how unusual your circumstances are (assuming what you said is true) and how much you seem to hate it when others discuss these topics with you; it might be an idea if you clarify your position a little better the next time such a topic arises. Like maybe saying _" my crashes aren't typical because I'm a kernel developer, but....."_. This way people don't accidentally post something that hits one of those raw nerves you have and it saves us all from a lot of unnecessary condescension.

</comment></comment></comment></comment></comment><comment><USER36> If its a Linux Desktop alot of the time its just the X session that is frozen. Ctrl ALT F2 and sudo killall X will simply restart X

</comment><comment><USER37> Something very important to note which is missing in the comments and the original article: waiting!

Each one of these commands (r, e, i, s, u) takes or can take a few seconds to complete successfully, so let them do their thing.

<comment><USER38> Indeed!

In particular, if you have HD-activity LEDs, watch and wait until they stop blinking - after the 's' (sync) key.

</comment></comment><comment><USER39> Only if you have magic SysRq keys enabled in the kernel... are kernels shipping these days with this by default?

<comment><USER40> I just tried it on my Ubuntu 12.04 install, and it worked. I definitely didn't change any kernel config options.

</comment></comment><comment><USER41> When visiting the site I get:

unused The server encountered an internal error or misconfiguration and was unable to complete your request. Please contact the server administrator, (etc...)

Did their Linux get frozen?

[edit] it works again

<comment><USER42> Yeah, being first on Hackers News is not good for your box :)

</comment></comment><comment><USER43> What about when an SSH terminal gets locked up? If I'm running something and I want to abort it, I often find I can't because of the kernel thrashing. Often I see a nontrivial amount of CPU time given to kswapd but sometimes not, and more often I don't have any monitoring up to see what's going on, or the terminal I'm monitoring is also nonresponsive.

This is especially a problem with Docker, I've found, because when I've got a container thrashing the system like this, I can't access the host or any other containers.

Is this because I'm running single-core instances and the problem goes away once I have more than one thread available? Or should I be restricting workloads to a block device not used for caching? Does anyone else experience this?

<comment><USER44> Docker can set CPU, memory, and network-bandwidth quotas for containers. If you can guarantee that the aggregate total of each quota is less than the amount of that resource available to the host, then in the worst case you'll always have some of each left for a "rescue" container.

This throws away one of the neat advantages of containers compared to VMs, though, which is that you can overcommit (or "thin-provision", if you want to be charitable) the host's resource allocation, since it's extremely unlikely that all your services will balloon in resource-consumption simultaneously.

A less guaranteed, but more economical strategy, is to just set quotas on each container such that if _it individually_ starts using more than, say, 80% of the host's resources for an extended period, it'll be terminated. This doesn't save you from a bad interaction between containers that makes everything explode in parallel (e.g. all your containers attempting to reconnect to a stuck service with no backoff) but it should save you in the majority of cases where each host has a heterogeneous container-load, and horizontal scale happens between hosts rather than internal to them.

(The dev-side solution to this problem, though, is to just set up your software architecture such that any host that gets into such a state _can_ hard-reboot, without you losing anything of consequence. [http://12factor.net](http://12factor.net) -type containers excel at this, and it looks to be the strategy [https://coreos.com](https://coreos.com) embraces as well.)

<comment><USER43> Docker supports (supported?) what LXC supported, which was relative CPU shares. I am not sure it would help if it supported something else (like quota minimum/maximum). When the IO subsystem is hit with a memory intensive workload that thrashes swap, all your guarantees go out the window. From my perspective (staring at top while an interactive terminal is not responding), it's the kernel that owns the CPU shares being used, and the IO volume, and it looks like the container is "almost idle" because most of the CPU time is being spent by the kernel.

I don't know if it's that something Docker can fix. It might be something kernel devs can fix, though.

</comment></comment></comment><comment><USER45> The most common reason I've had to do this is that I've exhausted RAM and swap, and the system is disk thrashing for spare pages. In some setups, Linux does not like to OOM a process when it really should. (That's adjustable, by the way.)

Also, you don't need to go all the way through it. In my above example, MagicSysReq+RE or MagicSysReq+REI is enough usually. E and I are for sending SIGTERM and SIGKILL, so all the processes are now dead, and we have plenty of RAM. Sometimes it does take a bit of waiting: the system is disk thrashing. That said, you can then just resume, though you'll likely need to switch to a VT and restart X and other things. (But you get to keep your uptime.)

There's also F, which invokes the OOM killer, though I often forget about it.

</comment><comment><USER46> What do you mean 'linux gets frozen'? I literally can't remember the last time a linux box froze on me. As others said, I would just reboot it now and let fsck pick up the pieces.

That's going to be faster than the time spent to search google for the magic incantation.

</comment><comment><USER47> This would be where keyboards with hardware-level macro support (like the Kinesis Advantage) come to be useful.

... to be honest, I can't think of another scenario. I have an Advantage for every place I spend extended computer time in -- it's too big and clunky to carry around...

<comment><USER48> You do not necessarily want to type that _too_ quickly; sync may take a moment.

</comment></comment><comment><USER49> The only way my linux machine has ever locked up is the usb driver seemed to crash in which case I couldn't do this anyways. The only other way I could have possibly restarted is to ssh to my machine from my phone, I opted for the power button instead.

</comment><comment><USER50> Hmm, I wonder if something like this extends to mac. Sometimes the login manager crashes and I can't do anything. Music still playing, but no mouse or keyboard reaction. I can ssh in, but I don't know what to run.

Any ideas?

</comment><comment><USER51> I learnt about this a few months back... and never had to use it. Seriously, on my AMD APU netbook running Mint, I've had no freezes whatsoever, despite the hardware being a bit odd. A neat trick though.

</comment><comment><USER52> Can't get it to work on Fedora 20. Are you suppose to press and hold Ctrl, Alt, PrtSc(SysRq), r, e, i, s, u, and b all together? Does it have to be in that order?

<comment><USER53> Switch to a terminal (Ctrl+Alt+F2) and do AltGr+PrtScr+H - if you've got Magic SysReq enabled that will print the help information (a list of commands with their (k)eycodes) to the terminal. If it doesn't print anything then you need to RTFM to find out how to enable it. AFAIR I had to do this shortly after I switched to Kubuntu as it was disabled by default - I often had to use Ctrl+Alt+Backspace or AltGr+SysRq+K to kill X as there's a hardware bug on my Nvidia graphics card.

My 8yo has a mnemonic for it something about Elephants and Umbrellas but I've always done reissub (now with extra sync'ing power). For a time the process for him was login, Alt+F2, konsole, Ctrl+R, mine, Enter, AltGr+SysRq+R, E, I, S, U, B; then repeat the first part and you're finally ready to play Minecraft!

<comment><USER52> If AltGr is right Alt, it does print a bunch of stuff. On my system, SysRq is under PrtSc. Does that mean I have to do Fn+PrtSc to get SysRq or just PrtSc is enough.

<comment><USER53> If it prints out without presssing Fn then you're doing it right. Laptop keyboards are weird but usually it's just the PrtScr key as it acts as SysRq when using the Alt[Gr] modifier.

It should print something like:

"SysRq : HELP : loglevel(0-9) reboot(b) [...]"

</comment></comment></comment></comment><comment><USER54> > You need to press and hold Ctrl, Alt and PrtSc(SysRq) buttons, and while > holding them, you need to press r, e, i, s, u, b

I think I need an extra hand to do this

<comment><USER55> Control isn't necessary - I'm not sure why it would be specified. On a laptop you might have to hold the Fn key to hit PrtScr, but aside from that it's two fingers to hit 'Right Alt' and 'PrtScr' and the other hand can mash r,e,i,s,u,b.

Source: [http://en.wikipedia.org/wiki/Magic_SysRq_key](http://en.wikipedia.org/wiki/Magic_SysRq_key)

<comment><USER54> In my workplace I have a Dell Keyboard that has the SysRq/Scroll Lock/Pause Keys on the top right, above the numpad. Holding Alt+SysRq with one hand is just impossible.

Maybe it's easier in saner keyboards.

<comment><USER55> Yeah, with a typical ANSI layout it's a small stretch but definitely doable.

This is the layout that I have (and the only keyboard layout I'll ever buy, because every other throws the pipe key and backslash in a random spot along with randomly sizing the enter key)

[http://commons.wikimedia.org/wiki/File:ANSI_Keyboard_Layout_...](http://commons.wikimedia.org/wiki/File:ANSI_Keyboard_Layout_Diagram_with_Form_Factor.svg)

</comment></comment></comment></comment><comment><USER56> "You need to press and hold Ctrl, Alt and PrtSc(SysRq) buttons, and while holding them, you need to press r, e, i, s, u, b"

I'll need three hands.

</comment><comment><USER57> Bind xkill to a global hotkey. If it's just fullscreen or screen-grabbing app that crashed, xkill will take care of it.

</comment><comment><USER58> Let it go, let it go! Can't hold it back any more. Let it go, let it go! Turn away and slam the door. I don't care what they're going to say. Let the storm rage on. The server never bothered me anyway.

</comment><comment><USER59> Sorry for the double posts. An app I was using caused it.

</comment><comment><USER60> If you only have one hand, just press the power button.

</comment><comment><USER61> If only they had made this more ergonomically possible

</comment><comment><USER62> Using Ubuntu minimal + xmonad + dmenu. Does not work.

<comment><USER63> Certain Magic SysRq sequences are now disabled by default in Ubuntu. You can re-enable them by editing /etc/sysctl.d/10-magic-sysrq.conf. Alternately, you can enable them temporarily by # echo 1 > /proc/sys/kernel/sysrq (Or substitute "1" by the number described in magic-sysrq.conf, above)

</comment></comment><comment><USER64> I have not had to do this in a while now.

</comment><comment><USER59> This complexity, my technically oriented friends, is part of the reason normal people do not use Linux.

<comment><USER65> How do you even come up to this conclusion? Knowing the magic key sequence is not required to operate a Linux system at all.

If a Windows box froze, and you had a (somewhat slim) chance of gracefully shutting it down, would you not use it?

Would you call pressing F8 to access magical boot options in Windows, a reason non-technical people wouldn't use Windows?

</comment></comment><comment><USER66> The site is blocked in UAE.

<comment><USER67> What's UAE?

<comment><USER68> I would say United Arab Emirates

<comment><USER18> Censor's not happy with magic?</comment></comment></comment></comment>


Amazingly, MySpace's Decline Is Accelerating - <AUTHOR> http://techcrunch.com/2011/03/23/amazingly-myspaces-decline-is-accelerating/

<comment><USER2> Not amazing at all. This is precisely the behavior I would expect from a social networking site. The same factors that drive exponential growth (hey, all my friends are here, I should join too!) now drive exponential decline (hey, my friends are leaving, guess I should leave too!). Facebook should take heed, it could collapse just as suddenly.</comment>