You can buy prepaid SIM cards with cash, and without hassle, in the US as well.
You can do this in many countries, I believe, as well as online through services offered in exchange for crypto.
You didn't define where "here" is for you. Mexico is a better option than the US because the retail price of a SIM card with a number and service is around 50 pesos (maybe lower).
> Is this actually a problem you see? I'm going on 15 years in the industry and haven't seen any issues training people up on a new language in just a couple months.
Some years ago the largest company using Elixir in the US, or at least on the west coast, abandoned Elixir because they couldn't find enough developers.
Yes. The adoption is poor despite the loud voices.
That's so disappointing to hear. I have an intern who hadn't touched Elixir 4 weeks ago who is already making meaningful PRs. She's done the PragProg courses and leans a bit on Copilot/Claude, but she's proving how quickly one can get up to speed on the language and contribute. To hear that a major company couldn't bring resources up to speed, to me, shows a failure of the organization, not the language or ecosystem.
Would be interesting to know how much data leaks on a new iPhone with some of the iOS privacy settings enabled and a handful of popular apps installed (WhatsApp, Instagram, Google Maps, Uber, etc).
And then if you use a commercial VPN with DNS ad-blocking enabled, how much more does this help?
Marc Andreessen mentioned what's called "Operation Chokepoint 2.0" in relation to many tech founders being debanked. In the crypto industry you can find many examples of this, however they're often not so public. Here's an instance from the entrepreneur Sam Hamidi-Kazemian:
'Kept quiet about this for almost a year out of fear but since I'm in good company with @tyler @cameron @brian_armstrong @elonmusk now.. Last December, I got a call from JPM saying "we have to close anyone's account that we know their primary source of income/wealth is crypto. This is directly from the top from Jamie. I'm really sorry."
I had a close relationship with my banker so I assume 99% of people wouldn't even get that kind of transparency/explanation. Wanted to add my own name to the debanked OCP list @nic__carter. It's real. It happened. Hopefully now it will soon be over.' -- https://x.com/samkazemian/status/1861956394079101391
Furthermore, this phenomenon affects not only founders but is common to retail investors. Try cashing out seven figures to your bank via a crypto payment rail and see how the bank reacts. If you get close to a successful crypto investors you can find many cases. However, this crowd often stays quiet: revealing that you're a high net worth individual, particularly in crypto, can be a security risk so these stories are shared in private chats amongst individuals of the same status.
Tailscale is not a good option for this (hiding your geo-location from work). As the article states,
'Additionally, in the case of a DERP-relayed connection, if one were to run a “traceroute” on your connection, they would see the public DERP relay server IP address, since it is routing your traffic in the middle. This IP obviously belongs to a commercial/enterprise IP block, but it’s only visible by running a traceroute which is able to see every “hop” your traffic makes. Whether or not your employer’s telemetry would pick up on this is what would determine whether this method would still work for you or not.'
Tailscale is not built for anonymity and contains strange surprises.
Not according to Marc Andreessen & Ben Horowitz [1], Chamath Palihapitiya & David Sacks [2], possibly Zuckerberg [3], and others. And of course Elon, Thiel. Many such cases.
These videos would fit very nicely into an undergraduate course segment on motivated reasoning. As viewers, it's incumbent upon us to determine whether the Musks and the Thiels of the world have our best interests in mind and, if not, whether their support for any particular candidate might reflect that.
As Trump said in his recent speech in Michigan "We have to make life good for our smart people." These are executives and investors who have created trillions in value with their technology based products and services. Their interests align with mine.
You're entitled to believe that. But you might want to consider whether this is (1) uniformly true for HN's readership demographic, and (2) uniformly true for the American electorate.
Hmm why should they consider those things? They stated their opinion and priorities, which will likely influence their voting decision. The views of HN or the American electorate play no role in the statement of that individual's priorities, no?
I think the simplest answer here is “almost everyone’s revealed preference is for living in a deliberative democracy, not a demagogic one.”
In other words: GP probably wants, in an ordinary setting, to have their views understood (why bother responding at all if not?). In which case they should similarly set aside some space for understanding why others don’t share them.
I'm not sure I follow that logic. Nothing about justinhj's statement implied "we should do this regardless of what anyone else thinks". They just stated something which is a priority to them. They're taking part in a deliberative democracy by engaging in a public discussion of their priorities. Am I misunderstanding something? Are you maybe responding to something another comment insinuated?
Downvoting isn't really a mechanism to censor, flagging is. The intent of downvoting is usually just disagreement. My guess would be you're being downvoted for a few reasons:
- A few of the people you mentioned are somewhat polarising, so folks who dislike them, might downvote
- in a measure of a president's efficacy, mentioning people who think a president is ineffective isn't as convincing as say mentioning actions of the president that were ineffective. You will, for any president, be able to find a large number of people who will passionately argue for/against that president's effectiveness.
- Your sources are very long videos, which discourage verifying if folks want to see what they said about him. Eg "Here's why he's in effective: [3 hours of podcasts]"
- One of your sources is a podcast which features Trump himself, which greatly brings into doubt the objectivism of the video
- the Zuckerberg short is very speculative, further weakening this collection of sources
- The FT article includes the following names: Elon Musk, Marc Andreessen, Ben Horowitz, Shervin Pishevar, Keith Rabois, Chamath Palihapitiya, David Sacks, Doug Leone, Shaun Maguire, Joe Lonsdale, Jacob Helberg
Please keep in mind that not too long ago vocal support for Trump could get you fired (and still might). Fighting against censorship is important.
We would disagree on who is promising the deliberative democracy and who is the demagog I expect. However, expressing my opinion does not reduce the space for others to express theirs. In fact downvoting opinions is a form of exclusion.
Ah, yes, just the people I ask for a sensible objective view on the world.
Like “well, this collection of the weirdest Silicon Valley people available took some time out of their busy schedule of hawking bitcoin or metaverses or magic robots or whatever to give a Very Important Opinion” is _not_ the world’s strongest argument.
There are four censored comments in that thread that cannot be read along with a few benign downvoted comments. I'll give you the benefit of the doubt that at least someone behaved poorly, but this is HN -- the thread is not littered.
What sort of qualifications? 99th percentile talent in subjects like organic chemistry, which are actually not used by 99% of doctors in the real world? Willingness to work themselves so long and hard that their judgement is usually substantially impaired?
And does the (my impression) widespread support for oh-so-rigorous qualifications for doctors reflect any real-world data about actual resulting quality of patient care? Or is it a way for prospective patients to vocalize a bunch of anxieties and emotions about medical care, plus a way for the doctors who've had to endure such treatment to say "all the noobs should have to suffer as much as I did"?
We need a range of doctors, who range in price according to quality.
That way for simple stuff, which anyone can get right, we go to a cheap, reasonable doctor.
A similar example would be if we only had uber software engineers. Each one had to have a PhD. There were no cheap and okay developers who could do say web-sites but not write a programming language from scratch.
That is not even remotely viable. There is little or no correlation between price and quality in healthcare. There are no reliable ways to accurately measure quality of individual doctors across the full spectrum of services that they deliver. In particular, it doesn't make sense to just look at outcomes because the doctors who take on more difficult cases will always look worse in the metrics regardless of the quality of care that they deliver.
Your example doesn't even make sense. Having a PhD doesn't make software engineers more productive on average. PhD programs train researchers. Research skills have very little correlation with practical software engineering.
What could actually work is to train more physician assistants and nurse practitioners, then have them deliver the bulk of simple primary care services under the supervision of physicians. This is more cost effective and usually works well enough, although there may be some degradation in service quality for edge cases.
Like air transport, in America Healthcare has its First Class, Business and Steerage tiers of medical care.
ACA (Obamacare)HMOs may have opened healthcare up to a lot of people who until then were going without. But its a faaaar cry from from Employer PPOs. And the ACA PPOs somewhere in between.
An don't forget the Trumpcare policies, with major policy exclusions.
You appear to be mixing up a number of unrelated issues. Employers often offer both HMO and PPO plans. The differences are typically in provider networks and deductibles/co-pays/co-insurance. Employer sponsored PPO plans don't necessarily make it easier to access higher quality providers — especially because most of the metrics for measuring provider quality are unreliable or even misleading. And in practice there is very little difference in networks between most health plans; the majority of major provider organizations accept all the major plans.
If you really want "First Class" health care then you'll have to pay out of pocket for concierge medicine. That isn't directly covered by most insurance plans, although they will reimburse for certain services delivered through concierge medicine practices.
I've heard this before, but I still can't figure out where this first class medical care is hiding. For the regional medical system I'm familiar with, there are two major hospitals, each with a set of associated providers. They both take most "insurances", because they effectively have to. I'm mostly familiar with the "better" one, and my experiences there have not been good. Are they checking the class of a patient's "insurance" plan behind the scenes, and sending different doctors based on that? Do I need to travel to a major 1M+ city (somehow even during an emergency)? Or what else gives? Where are these engaged doctors, who actually give you more than a 10-20 minute slice of their time, actually hiding? Ones who don't simply pass the buck to a different place (often booking many months out), recursively? Because from what I've gathered, I suspect that most people are just not very good at judging the competence of professionals, and are absolutely unable to judge the constructive incompetence of systems.
Well what we are learning is that we don’t need doctors for the simple stuff. The doctors cap honestly make sense. We have a surplus of generalists who still do not understand the body systematically, so the demand is not there
Seems it comes down to: "budget-minded politicians in Congress"
According to 'studentdoctor.net' from 2017 - there is a cap because there are not enough residencies for graduating med students. The government is the primary payer for residencies: "It was because of the cost of GME funding that this program came under the fire of budget-minded politicians in Congress. This resulted in curbing of funding for residencies under the Balanced Budget Act (BBA) of both 1997 and 1999:" [1]
> The limitation in funding has essentially put a cap on the number of residencies that can take place in the United States – and since a doctor cannot go into practice without a residency, this is essentially a cap on the number of new, American-trained physicians who are allowed to practice in this country. The American Medical Association, in its AMA wire, blames this cap for the record number of students in 2015 who were not matched with a residency program at the end of their four years in medical school: of the 18,025 allopathic seniors and 3,000 osteopathic seniors who participated in the Main Residency Match, the two groups matched at rates of 93.9% and 79.3% respectively, leaving the highest percentage ever unmatched – and also unable to practice on their own.
> There are proponents for keeping the current cap in place, however. This is mostly among budget-minded members of Congress who are wanting to cut spending, but even the Obama administration proposed reducing Medicare expenditure on GME, even halving support for children’s hospitals, which have their own separate sources of funding. People on this side of this issue tend to decry the seriousness of the physician shortage, pointing out that the increase of physician’s assistants and advanced nurse practitioners has helped to mitigate this problem, even with the cap still in place.
The resource [1] is a bit dated. "Congress recently took steps to support several programs supporting GME funding by fixing technical issues that left some rural programs with an inadvertently low cap, expanding eligibility for rural training track funding, and adding 1000 new Medicare-funded positions for the first time since 1997. " [2]
I would say to you that in the normal case, in general, across all fields - bicycles, clothing, tables, chocolate, holidays, houses, butlers, what-have-you - cost is related to outcome, and this is what would be expected.
In the normal case, I would then think that cost in medicine and medical services would be related to outcome.
To the extent this generalization is true, then when cost is not related to outcome, this is not a normal situation, and then the question would be "why?" - what's going on to make a situation which on the face of it is not normal.
Sure, but no doctors is worse than lower skilled doctors as even lower skilled doctors are better than the average patient self-treatment attempt.
We need doctors who are available to treat simple conditions and refer to a more qualified doctor for the complex ones. Such a job doesn't require being a genius, just people who are not complete idiots, and the qualifications required here are genius-level, not idiotproof-level.
I don't know, lower skilled doctors can be quite a pseudo science amplifier at worst. Sometimes it does feel like that no doctor is better lower skilled one, especially when self treatment (or more accurately, remote treatment) is getting better nowadays.
The problem is worse when there is a lack of actual doctors.
It people can't see a doctor, or can't get decent care because doctors are overworked, they will go to the "pseudo doctors". "pseudo doctors" are usually much less regulated, because they don't really practice medicine, can't make prescriptions, are not covered by healthcare subsidies, etc... but they are available, and actually caring, because there is no shortage of them.
This is actually good for the patients, sometimes, all you need to get better is someone who listens to you and points you to a healthier lifestyle something, something that "pseudo doctors" can do well. The problem is when they bring their pseudoscience to "treat" actual medical problems that can't just be solved by eating vegetables and getting some rest.
Now imagine an actual doctor who is available and caring, giving you all the benefits of the "pseudo doctor", but in addition, can actually practice medicine. Maybe not to the highest level, but he would have attended an actual medical school and knows enough not to treat cancer with fruits.
The problem now in many places is that it is not just hard to become a doctor, it is hard to access medical studies.
Being a doctor is not a reliably ultra-high-income job, and many people don’t consider the slog of med school, an internship, a residency, and an eventual possible job at a hospital to be worth any amount of money.
Educating doctors is really expensive. It would really suck to invest all that money in someone (or in yourself) just for them to fail a final test or whatever.
For what it's worth, I do agree we should train more doctors, but I think it's a complicated problem.
> Educating doctors is really expensive. It would really suck to invest all that money in someone (or in yourself) just for them to fail a final test or whatever.
This happens already, today. There are dozens of reasonable questions you can raise based on this fact - but I don't think it's obvious that the failures at the end of training can majoritarily be identified by pre-training metrics.
Some countries allow any student to take the first two years of medical courses, and then impose restrictions on the following years. This seems a relatively fair system; you can imagine someone persevering over many years to attain the requisite knowledge - but this person would not have had the opportunity if there were a pre-medical school filter
