I am a victim of AI-documentation-slop at work, and the result is that I've become far more "Tuftian" in my preferences than ever before. In the past, I was a fan of beautiful design and sometimes liked nice colors and ornaments. Now, though, I've a fan of sparse design and relevant data (not information -- lots of information is useless slop). I want content that's useful and actionable, and the majority of the documents many of my peers create using Claude, Gemini or ChatGPT are fluffy broadsheets of irrelevant filler, rarely containing insights and calls-to-action.
I don't think so. With state funded healthcare you get rigid rulebooks and policies. In the capitalist-ish US model, if you are a successful advocate then you can get better than average care because there's enough flexibility in the system (in many cases, physicians can individually decide to over-extend for one patient if they choose to) to allow for this. Having a private payer market absolutely helps here.
Having care depend on "being a successful advocate" does not sound like a good thing to me! Albeit it's probably impossible to avoid entirely. We want good care for everyone.
I'm mostly familiar with the UK system, but medical professionals make pretty much all the decisions here, with a large degree of discretion according to their professional judgement (and they never have to adjust or delay their care based on whether you can pay). Except for some particularly expensive treatments (think CAR-T for cancer) which are not available at all in the state funded system. But you can still pay for those privately if you want to.
The data supports this. The AMA's 2024 Prior Authorization survey found 93% of physicians report PA requirements delay medically necessary care. Twenty-nine percent reported a PA delay causing a serious adverse event for a patient. Seven percent reported PA contributed to a patient death.
The requirement that patients fight for care isn't just a frustration. It's a documented cost driver: Health Affairs (2025) puts the total system-wide cost of prior authorization at $93.3B/year, including $35.8B borne directly by patients navigating the process. The persistence required to appeal a denial is unevenly distributed across income, education, and time availability. That is a structural equity problem as well as a cost problem. Issue #5 of this series covers the full mechanism.
> With state funded healthcare you get rigid rulebooks and policies.
We could just not do that. If you change the flow of control certain problems solve themselves. Think about a landscape where government funding multiplies the patient dollar, for example.
This is how I ended up with my first MacBook in >10 years. I'd been a Thinkpad (T series) guy in the early days, the tried a MacBook in 2015... couldn't get used to it and used a Chromebook for the next 8 years. Needed to buy a new laptop in 2023 and ... the entire Windows laptop industry turned me off. Yes, something like System76 is an option, and so is installing Linux on a Windows OEM machine, but then you still have to deal with the hardware. Apple isn't perfect, but MacBooks are consistent and reliable, with minimal telemetry and no advertising or upselling. That's enough for me.
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