The manufacturing operations-ization of hospitals is both good and bad. Good because that means we have standard care (as desired by regulators and single-payer advocates) but bad because doctors lose the ability to perform customized care solutions.
I’m in favor of single-payer but we have to guard against turning healthcare into a manufacturing operation while also bouncing out bad actors and poo-quality physicians.
The issue with hospitals controlling healthcare is that they are the group with the least incentive to lower the cost of care
Hospitals account for the largest chunk of healthcare spend (30%). Hospitals make money by increasing inpatient admissions, particularly for profitable surgeries. The standardization of care in hospitals is intended to maximize profit under the constraints of various regulations around readmissions penalties, reimbursement limited length of stay, etc. If you look at the financials of public hospital companies like HCA and Community Health and Tenet, their major metrics are growth in admissions and surgeries. Even non profit hospitals are driven by this
The expansion of hospitals into owning tons of formerly independent specialist and generalist physicians is scary. Once in a hospital's system, these physicians act as loss leaders funneling patients into the hospitals profit center
Having hospitals in charge of the healthcare system is like having a fox in charge of the proverbial chicken coop
Intuitively do you believe it's easier to govern a group of people with very different opinions and very different backgrounds and socioeconomic status, or easier?
>Female dominated jobs have less flexibility on average then male dominated jobs. It is mostly that primary caregivers after they have children need more flexibility, but original choice of occupation does not reflect this later need.
Source? In finance I don't see my boss making my female colleagues skip going to the dentist while letting male colleagues go. I do see the lady that sits near me leave all the time for appointments or what have you for her kids. I don't really mind, I think it's good that we have flexibility, especially with all the top-down directive to make sure women (not men obviously just women) have more scheduling freedom. Personally, I'd take the scheduling freedom and work half time and stay at home with my kids instead of being stuck in a high-pressure career - but I don't have that option.
>That would be unusal, nurses I know have to be on the job on time and at schedule
True to some extent. When you're actually scheduled you have to be on there on schedule, obviously, but if you don't like your schedule then you can just jump to another hospital, at least in any mid-sized city with a few different hospitals and clinics. I don't see men working at Ford or something complaining that they can't just come in whenever is convenient for their family. I was actually having this discussion with a pharmacist (obviously not a nurse but a nurse on my team was listening in) and she was lamenting about her schedule - really likes her job but doesn't like the schedule - so I was giving her advice (mansplaining and placing an emotional burden on her and others if you live in SF) on how to handle having this conversation with her manager. Ultimately though you don't get everything you want and you have to be willing to quit the job if it doesn't fit your schedule - some people just aren't because of the money or whatever (not unique to women either, obviously). If you're a nurse (because that was the example) and your kids demand more time than your job allows, you should find a new job - it's not your employers responsibility to pay you for not being there or not doing work. They can accommodate you if they can - tech is easier to do that in, but otherwise it's your life and those are your decisions. Be an adult.
> it's not your employers responsibility to pay you for not being there
While this is perhaps true in principle, in practice employers pay you not to be at work all the time. If an employer didn't pay you to be sick or take a vacation you'd probably quit.
Setting expectations about what is an acceptable work load is an ongoing conversation between employees and employers.
> I'd take the scheduling freedom and work half time and stay at home with my kids instead of being stuck in a high-pressure career - but I don't have that option.
> you should find a new job
I firmly believe that if you are not happy then you should either make life changes to meet your acceptable happiness criteria, or rethink your expectations and acquiesce. Whichever is easier. The main thing is to get happy. The only thing in life worth anything is happiness, pursue it at all costs.
Sorry but this is completely ridiculous and disingenuously undermines the OP's very good point.
First, even if some Americans don't support universal healthcare, that doesn't mean that all Americans don't support it. Even if they do, there are arguments to be made both for and against universal healthcare. I happen to fall on the pro-universal healthcare side, but it's certainly not without drawbacks.
Second, the OP wasn't suggesting that we should have privately funded militaries and private roads, but that one possible government outcome is the government paying for such things while leaving other items (maybe donations to scientific foundations as an example) up to private sector interests. If you're Dropbox, and you strongly believe in a cause and you want to support that cause, it makes far more sense to withhold taxes (so far as it is legal to do so) that you have no control over and set up a foundation to pursue the cause that you're aiming for. Not only can you ensure that money goes toward that cause, but you're nearly guaranteed to do a better job than the government which is, by it's very nature, subject to the whims and opinions of people who may not share your view on the use of your money and less efficient in the handling of your money.
I have a big problem with American companies not paying their fair share of taxes, and even more so with the obscene wealth inequality that has come to dominate the last few decades, but your post here is a drive-by at a reasonable discussion point, followed by a trite comment about Americans for no reason other than to stir up trouble.
What does the author gain from this statement? Now, if I were to be interested in this book, I would now be not interested and would encourage others to avoid it.
On the contrary, I like that the author spells out clear guidance on what is necessary preparation for the material. It lets me know right away if I should keep reading or look for more introductory material.
I didn't read it as rude. Rather a "hey you better know what you're signing up for here".
I don't think the author gains anything. On the contrary, as a reader I gain something from this statement. It's not "now would be an excellent time to leave and you should feel bad you stupid person", it's "now would be an excellent time to leave so that you don't waste your time trying to build a house on a junk foundation". If anything, it's courteous.
The author doesn’t gain anything, it’s entirely to help the reader understand their own readiness for the material. It’s not rude, it’s straightforward and matter of fact.
If you don’t meet the prerequisites, you should avoid the material. Not because the author has stated the obvious, but because you’re not prepared for it. If you’d like you can interpret it as rudeness, but really it’s intended to help people save time instead of waste it.
The first thing I do when I open a new textbook is flip to the preface material to see what the prerequisites are and how firm they are. Sometimes “passing familiarity” is enough, sometimes “mathematical maturity” is enough. But there are many treatments where that is not the case, and it’s better for everyone who’s serious about the material to be upfront about it.
Then the correct approach is "you are likely not ready for this material, I recommend you do XYZ and come back".
There's no problem with telling a reader they are not ready for a text - in fact, it can save them time. The way in which you do it though can encourage or discourage a student.
From the title, I'm very interested in the topic since a portion of my job is some form of data analysis and aggregation.
However, it's been 15 years since my Linear Algebra course and I haven't done Multivariate Calculus since high school, which even then was just a very basic introduction to the topic. I'm too far removed from that level of math at this point in my life. Further, the data I'm looking at doesn't often lend itself toward linear regressions or mathematical analysis. At least, not in a meaningful sense. It's rare that even a simple standard deviation is even particularly useful.
I appreciate that the author tells me up front the type of paper being presented isn't the type of paper I'm interested in reading even though.
> What does the author gain from this statement? Now, if I were to be interested in this book, I would now be not interested and would encourage others to avoid it.
That's not very rational. That your feelings are hurt has no impact on how good or bad the book is.
Don't need to be rational. Human beings aren't rational.
> That your feelings are hurt has no impact on how good or bad the book is.
It could be a great book, but if somebody is rude then (some are suggesting that the comment is tongue-in-cheek but meh) I don't really need to engage with that person. There are plenty of great books that cover this material so I would just suggest others to look elsewhere instead. Ultimately - I don't reward poor behavior. There are very few people who could make a significant enough contribution that I would give a pass on rude behavior towards others, particularly if they are condescending or mean for no reason.
I also found it peculiar that you would believe that my feelings would be hurt. Why would they be? I just found out about this particular book and have no emotional attachment to it, nor the author whatsoever. Maybe you're defensive because you believe the book is good and worthy of being read despite the author's rudeness? That would certainly better explain your need to attempt to attack my "rationality" and suggest that my "feelings were hurt" alongside posting a link that wasn't worth reading.
> Don't need to be rational. Human beings aren't rational.
Some are more than others.
> Why would they be?
I don't know why they would be, but the fact that you say "that's so rude I'm not reading your book" is clear indication that they are.
> Maybe you're defensive because (blablabla)
What the hell are you talking about? I was just pointing out that you were letting your emotions interfering with making good decisions. I was doing this for your benefit. If you don't care about that fact, I don't either. Now, have a nice life!
The commenter isn’t trolling, you’re just being incredibly literal in your interpretation and responses, so much so that you’re being obtuse. He said “your feelings were hurt” because you said it’s rude - you don’t need to start a diatribe litigating the commenter for assuming your feelings were hurt. If you find something rude, you took offense to it in some sense, and if you take offense to something, reasonable people could say your feelings were hurt in some sense.
On a similar note, when the commenter said what you’re saying isn’t rational, you took the opportunity to point out that humans as a species aren’t rational. That feels like you’re deliberately missing the point, but in case you’re not, here’s that point restated: It doesn’t make sense for you to call an author rude when the author is matter of factly informing the reader of the necessary prerequisites.
For what it’s worth, it’s apparent that the other commenters who responded to you, myself included, agree with the substantive meaning you’re attacking so literally.
For whatever it’s worth, he seems to be a dedicated teacher who posts self criticisms of his courses publicly online. The course this book is based on has grown quite successful as well.
I’m not sure if you’re just trolling, but encouraging others to avoid this book might be a mistake. It’s quite good.
Well, because they want to have their cake and eat it too. "Everybody has a voice, we're accepting of all cultures, everybody is welcome" etc.. until they aren't.
And believe it or not, people in the south have to (from their point of view) put up with "the liberals" too - similar to people in SF or wherever.
Frankly, what is interesting here is that instead of the United States becoming more culturally similar with the advent of planes, mobile phones, and what have you it would appear, at least on the surface, that we're becoming more different. I live in the Midwest and when I hear somebody from Vancouver saying that explaining something to someone automatically is "mansplaining" and "placing an emotional burden" on that person I find that just as idiotic and incompatible with my way of life as some bible-thumping anti-climate change person from Mississippi. Now, both of these are of course generalizations, but the most pervasive noise, if you will, is this instead of the most likely interaction I would have with most people which is just a hey how are you, thanks, yes I like XYZ as well.
What we need to do is police the most radical people if we want the United States to be a united country. If we'd rather break it up or something then that's a different story.
Which could be a fine solution, except one or more groups still are making rules which affect the lives of all of the other groups. So disengaging means letting other groups you may disagree with dictate parts of your life.
It's also in your nature to murder other humans, steal things, and participate in all sorts of mischief. If you're of a certain disposition it's in your nature to rape children, maybe hang cats, or try to destroy the lives of other people in other ways. I personally do not eat meat but I also don't shun those who do - my goal is only to do my best to reduce suffering as much as I can - but I think that to argue that it's in your nature to do something is a very poor argument. Being human means we can largely overcome our nature, or at least make rational choices about it.
Agreed, though we will all need to pray that GPU costs come down - I saw 1080s on Amazon going for $1400 the other day, granted it was just a spot check and I’m sure it’s cheaper elsewhere.
The manufacturing operations-ization of hospitals is both good and bad. Good because that means we have standard care (as desired by regulators and single-payer advocates) but bad because doctors lose the ability to perform customized care solutions.
I’m in favor of single-payer but we have to guard against turning healthcare into a manufacturing operation while also bouncing out bad actors and poo-quality physicians.