I don't understand this logic at all. How can more information be bad? If you see a mass that looks very likely to not be cancer, for which the cost of further investigation is higher than the likely benefit, then the rational patient will agree not to investigate further. I don't see how more information can be bad unless you assume that the patient is an idiot or irrational.
Exactly. You could even have the option of contributing your MRI scans to academic research so that future identification of cancer improves, and set up a happy feedback loop.
The scary truth is modern western medicine is primarily optimized to extract revenue while reducing spending and improving patient outcomes is merely a side effect of that process. Even in places such as the UK NHS it's all about not finding out things we don't want to know so we don't have to spend money dealing with it.
This is why I look forward to when we can replace doctors (not nurses) with AI.
> The scary truth is modern western medicine is primarily optimized to extract revenue
MRI scans are a fantastic source of revenue, as are treatments for things that don't actually need to get treated. Reducing those things are actually doing the opposite of the motivation you're claiming.
Those raise revenue. Actual spending involves effort which cannot be easily industrialized, and is only done to maintain the prestige of the industry.
This is why getting tested for something which results in endless prescriptions is done enthusiastically while a test for something which might find something which requires them doing actual work provokes the sort of self serving concerns expressed elsewhere.
> This is why getting tested for something which results in endless prescriptions is done enthusiastically while a test for something which might find something which requires them doing actual work provokes the sort of self serving concerns expressed elsewhere.
You'll have to be more specific because right now this is just handwaving. What kind of "actual work" are you referring to?
It's generally actual medical researchers, who will neither get revenue or have to do actual work, who are objecting to excessive testing without patient outcome benefits.
> You'll have to be more specific because right now this is just handwaving. What kind of "actual work" are you referring to?
Anything that isn't completely reduced to an industrial process. i.e. we want to have a simple no-effort repeatable billable outcome for this or we won't do it and will claim doing so is counter productive or dangerous.
> It's generally actual medical researchers, who will neither get revenue or have to do actual work, who are objecting to excessive testing without patient outcome benefits.
And they're doing the establishment's dirty work by doing so.
To provide a concrete example, I'm in Canada, and my other half had to pay for private MRI and ultrasound scans to identify a lump that she was laughed out of the room by three successive doctors for claiming she had. The MRI got her finally referred to a surgeon that announced he'd never seen anything like it, removes it, end of story.
That's far from an isolated case. I know people in the UK that literally died from these antics.
At one point I was invited to the opening of some medical simulation centre, and the speeches were enlightening. Two things stay with me: tests in India demonstrated that qualified doctors were no better than unqualified doctors except when the qualified doctors were told some of the patients were faking as part of an experiment and they are being observed, but mainly "I read a study that showed ~5-10% of people in US hospital are there because of a medical mistake from a previous visit, so I laughed and commissioned an equivalent study to show how much better we are in Canada, except for us it was >15%". The person telling that story was rightly disgusted. Those are not numbers for a profession that respects patients in the slightest.
You will forgive people with actual experience on the receiving end of this nonsense for thinking that maybe it's not actually setup to provide the assistance it claims to provide, and is primarily for the aggrandizement of those engaged in the rituals.
Yes.
This to me is the same line of thinking as "in a meta study, wearing a helmet makes bikers more reckless and prone to injury so it's actually safer to be helmetless".
No, actually it's safest to wear a helmet AND not become reckless.
So similar approach here - its safer to get the imaging AND remain rational in evaluating results & next steps.
Because further investigation is dangerous. So you see a mass which has an a posteriori probability of being cancer of 1%, but the investigation causes serious complications in 2% of cases, then the decision to investigate is not clear cut. The additional information has not only not helped but has led to additional stress.
Not all further investigation needs to be surgical.
A mass that is found can be observed in decreasingly frequent ultrasounds or some other imaging and surgically investigated/removed only if found to be growing or passed a concerning size threshold.
A doctor jumping straight to invasive procedures seems to be a mix of poor risk management and rarity of this type of medical imaging.
My doctor for example, pointed out that actually in some East Asian countries, there are routine annual imaging tests done that pick up some of the types of cancer we do no screening for.
To me the reason we don't in US is simply how medical care is paid for - employer provided insurance, and some actuarial calculation that on the insured pool they'd spend more money on imaging than they'd save on high cost stage 4 cancer care. Personally I'm happy to advocate more for myself, even if it costs money.
Both human nature and the legal system can be very hostile to "we didn't investigate anomaly A, B, C, D, E, ... in the patient's scans and test results, because none of them seemed likely to be worth the costs of doing so".
The idea is that if the growth rate of a city is drawn from the same distribution, regardless of the actual city size, we get Zipf's law. To me this is a reasonable explanation why we see Zipf's law in many places in nature.
> Henri Poincaré famously described them as "monsters" and called Weierstrass' work "an outrage against common sense", while Charles Hermite wrote that they were a "lamentable scourge".
I wonder if there is a really long compound German word for "an achievement whose greatness is best measured by the degree to which it disgusts experts in the field."
Not a bad description of the history of analysis. Turns out function spaces are absolutely full of gross things that don't quite fit nicely into your theory.
For strong form efficiency (which requires markets perfectly reflect all available information) -
You would have trouble finding people who still believe in strong form efficiency.
The weak form paper above cites several papers that go into why strong form efficiency is impossible. There are formal proof versions around. In practice, even empirical studies of strong form efficiency haven't supported it either - it's just very easy to find practical counterexamples.
I skimmed this paper and it seems to be exceptionally bad. The proof sketch offered is that a winning strategy can be verified quickly, but finding a winning strategy requires searching over 3^n possible strategies.
But this assumes that brute force is the only possible way to find a winning strategy, and thus proves far too much. A similar argument would prove that sorting is NP hard, if you start by the assumption that the only way to sort data is by trying every possible permutation.
I may be wrong, but I'm pretty sure any time you claim to have a proof that a problem is NP complete, but your proof doesn't include a reduction, you're doing it wrong.
(The paper does offer what it calls a reduction to 3-sat
, but it's completely hand-wavy, and I can't even understand the intuition behind it at all.)
Mortgage rates have moved surprisingly little. They usually trade at around a 2% premium over the 10-year government bonds for a 30-year fixed. Right now that would mean about 2.8% but my local bank quotes 3.5%. My guess is that spread is going to shrink over time but who knows. I'm waiting...
The best running tip I've ever had is "run tall". Most people tend to slouch forward at the hip which prevents some muscle groups from engaging. Made a world of difference for me.
My version of "run tall" is "pretend you're riding a pony". Your hips and legs are the pony, and your torso is riding it, and it works for me as a cue to remember that my torso should stay tall and upright.
Also when I get really tired, it helps me dissociate myself from the feeling in my legs because instead of thinking "ow my legs hurt", I can think "thank you, pony, for being so strong and working so hard for me!"
Yeah, those two words imply a bunch of posture/style fixes. "Run tall" and "steady breathing" are the two simple reminders that I repeat to myself if I'm getting tired.
I've looked at the difference with a few people. It depends on the balances and interest rates, but the difference is smaller than I would have guessed. With tens of thousands of dollars of debt, I've seen the difference be just a couple hundred dollars.
Smallest to largest balance frees up cash flow faster, making it more likely the person won't go into additional debt (and hopefully won't get discouraged and quit the program all together).
Thats OK. Paying the smallest 1st builds psychological momentum. If people have willpower, financially paying the highest rate makes sense. People with less willpower and drive gain confidence by checking off a loan as paid, then moving to the next.
I guess the parent is arguing for a psychological benefit to reducing the number of discrete debts as quickly as possible. But I agree with you. If someone has credit card debt and then some other debts at significantly lower interest rates, in most cases (modulo liquidity) it would make sense to put any extra money towards the high interest credit card debt first.
I agree, you should pay the highest interest rate debt first. But, you should also not miss out on higher returns on your money to pay debt. Specifically in the US, I mean 401k matching from your employer. If they match 50% on your first 6%, then the 50% return on that money is going to be greater than a 22% credit card debt.
Yes, paying the maximum that you can to the highest interest rate debt and paying the minimum to all of the lower interest rate debt is the optimal greedy algorithm.
