> Force hospitals to expose API's with transparent pricing.
Unless you're uninsured (which is a whole separate clusterfuck), the hospitals aren't the ones who decide how much you pay for any service - the insurance companies are. The sticker price that hospitals charge is almost meaningless and is intentionally high because it's used as the starting point for negotiations, which always bring the price down (never up). There isn't any expectation that any insurer is actually going to pay the billed amount as-is.
That's how virtually all industries work though. The computer you are typing on right now probably costs a different amount depending on which retailer you bought it from, even though it's the same manufacturer.
The fact that it's already common doesn't mean it shouldn't be illegal.
And I'm talking more specifically about a single entity selling to multiple customers. If two different retailers want to charge two different prices of course that's fine.
Hospitals shouldn't have to negotiate with insurers. It should be illegal for an insurer to not pay for a necessary procedure at the hospital's standard rate.
> But this went out of the window when some genius decided that usernames were too complicated, so Passkeys had to be discoverable, which means they have to be fully stored token-side. Which of course has the nice side benefit of essentially killing hardware tokens and forcing people into using their Android/iOS/Windows device for it.
This part of your comment is incorrect. Discoverable Webauthn absolutely can be used with hardware tokens like Yubikeys.
> See, that’s just flat-out lying. What’s this mythical circumstance where playing audio A at the same volume as audio B on one device will magically make A louder than Bon another?
Regarding your second point: as any audio engineer or electronic musician knows, the same exact audio absolutely will sound very different on different speakers, depending on how well they replicate various sounds, what level of gain is being applied, and the volume (which is different from gain, although people confuse the two).
That's even before you get into the fact that many modern devices, like smartphones, will apply their own compression or sound processing before playing the sound, sometimes to compensate for those deficiencies and make them less noticeable, and sometimes to "enhance" the sound.
Loudness/volume (technically different things but let's conflate them here) are also unintuitive because human ears don't have a flat frequency response curve, and some things will be perceived as louder despite being the same volume, or vice versa.
Advertisers actually can (and do) take advantage of this, by using sound engineering to make things feel louder while staying within the desired volume, by targeting the way humans perceive the sound.
This isn't a defense of the advertising/streaming companies here, because it is a solvable problem. But it is true that this is a problem that they need to solve.
All that’s true, but those factors affect all the audio similarly. The article specifically talks about server-side ad insertion, so it’s not like the case where it somehow uses the device’s .mov codec to play the content and an MP3 codec to play the ad. All ffmpeg (most likely) knows is that it’s decoding one long stream, and doesn’t switch audio pipelines mid-stream when it thinks it might be playing an ad at that moment.
Regarding the perceptual volume differences: while true, that’s also a solvable problem. Output volumes can be calculated using standard curves. In any case, TV broadcasters have had to figure all this out years ago.
> those factors affect all the audio similarly... Output volumes can be calculated using standard curves... TV broadcasters have had to figure all this out years ago.
Sorry, but all of that is obtuse. The fact that some digital audio can be perceived as much louder than others –– yet it's all limited to the same digital range –– proves they aren't similar at all.
There is no such thing as a standard curve for compression. Source levels vary almost infinitely. Accurately separating and reducing sound after the fact, without turning the whole thing to mud, is considered to be an impossible technical challenge.
Next, TV broadcasters worked on a predetermined schedule with predetermined advertising. This gave them time to inspect and approve ads in advance.
Streaming ads are generally served just in time from third-party services to the streaming host. FFMPEG gets the output from the stream host, but the host has to combine content together from multiple sources (entertainment + multiple ad servers) into that single stream. Currently, sound-level is completely at the whim of each ad server, as well as each ad producer. Meanwhile, the final output is at the whim of the streaming host: 24-hour-news streaming sites probably have different audio standards than Apple TV+.
Ultimately, AI could potentially be used to solve it, since it can generate / make-up new sounds as part of reverse-compression. But it would still have to be done in advance by the third-party ad servers.
None of this is true. There are standard curves for human hearing frequency response and you can use these to compare sound A’s volume to sound B. And since sound compression is in DCT space, you can calculate those numbers very quickly with something similar to sum(vol(f) * curve(f) for f in encoded_frequencies).
I read the article. It specifically talks about server-side ad embedding, i.e. where the service is inserting ad content into the streams, and therefore, by definition, has access to the ad content. They can do the calculations on their end during the embedding process and normalize volumes there before transmitting the result. To make things even easier, they don’t have to calculate the ad volume each time one’s streamed, just once per ad they’re going to serve.
And finally, all of this is a solved problem for TV broadcasters. They face the same problems: advertisers send them content to air, then the broadcasters are legally required to normalize the ad vs content volume, and they do. If this is an insurmountable problem that the streaming services face, they can drive over to their nearest TV station and ask them how they manage to pull off this technological feat.
Conflating DCT-based compression of audio data (like MP3) to dynamic-range compression of an audio signal (as done on an audio compressor during production) shows how little your grasping the problem.
It doesn’t work very well for TV in my opinion. Ads still sound louder as they are mastered differently.
I’ve no skin in this game, and no desire to ever see or hear ads. I just hope we don’t kick off a “loudness war” for TV/Movie audio by mandating the average volume across entire programs has to hit some high level like modern music or ads have.
I’ve built my own synthesizer. It is likely I know much more about this subject than you suspect, even if you wish to misread what I’m talking about.
Given how audio codec compression, eg MP3 files, work it’s easy to efficiently calculate the perceived human ear loudness of a sound. The hard work’s already been done. While of course there are intricacies and edge cases, it’s not impossibly hard to match the volume level of an ad to the volume level of the content immediately preceding it. TV stations already do this, by law.
There’s also a weird undercurrent in this thread conflating audio dynamic compression with loudness. Level compression does not imply loudness. It implies a constant volume, at whatever level the engineer picks. Compress the heck out of ads if you want, then match their starting volume to the preceding volume of the streamed content, and you’re golden.
It definitely isn’t simple, but it’s a pretty well trod path. If the FCC or state equivalent doesn’t have folks who can write the spec that’s a huge problem. I would be surprised if an existing spec doesn’t already exist that just needs to be applied to this scenario.
The streamers should be responsible for the signal. If the device front end has crazy frequency response or the backend does weird DSP tricks, that’s on the device manufacturers.
> The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses
This is incorrect. The HBV vaccine is one of the most effective vaccines available for any pathogen, providing full immunity to over 95% of healthy infants, children, and young adults, and with that immunity typical lasting for at least 30 years (and likely for life).
If someone is one of the rare exception, tthat's easy to detect with blood titers, and the response is either to give them additional doses or to deliver an adjuvanted version (which is the same thing regularly done for other vaccines which are either less effective or primarily targeted at the elderly, who have weaker immune responses).
I work in healthcare. As a requirement for employment, I had to get tested for immunity to HBV. Even though I got the vaccine as is generally recommended for everyone, the test says I'm not immue. So now I have to get 3 additional doses, and apparently even with that it's not guaranteed sufficient for full immunity. And I know my case is not unusual at all
One 20 is not unusual. That said, that does not mean that the vaccine is not effective at being a vaccine. A vaccine isnt just about your immunity, but about herd immunity. When you create an inability for a virus to spread among the herd, you protect those who are unable to acquire immunity by inhibiting the viruses ability to move between hosts and persist in a population.
Vaccines are not 100% effective for each individual.
> Yes, there is an effective vaccine but not everyone has access to it for tons of reasons.
Also, about 3.5% of the world's population already has it. That's about 300 million people for whom a vaccine is pointless, and who are at dramatically higher risk of liver cancer (somewhere between 15-50% lifetime risk of an extremely deadly type of cancer), and for whom a cure would literally be life-changing, if available.
It's estimated that 300 million people have HBV. HBV is currently incurable once acquired, at which point the vaccine is irrelevant.
The HBV virus is also carcinogenic, which makes it unique[0] among the three big hepatitis viruses. Liver cancer is extremely aggressive and fast-killing, often reaching terminal stages before it is even detectable at all. It is one of the top three causes of cancer deaths worldwide.
Aside from the sheer number of people affected by this, it is also a horrible thing to experience. I have watched someone die from liver cancer, and I would not wish it on anyone.
Contrast to HSV, which is widespread (approximately half the population has at least one HSV latent infection) and causes very few problems beyond occasional irritation in virtually all cases that do not involve other comorbidities or immunocompromised status. HSV is also suppressible through antiviral treatment, making it generally untransmittable (if treated and suppressed) and unlikely to cause symptoms. Most people with HSV do not even bother to do this, which is if anything a testament to how little HSV affects their lives (most don't even know they have it, and there is no clinical justification for routine testing in otherwise healthy patients).
Of all infections pathogens for which I could wish a cure into existence, HSV would be extremely low on my list.
[0] While HCV can cause cancer if left untreated for a long time and if it causes cirrhosis, approximately one third of people clear HCV infection in the acute stages without any lasting ill effect. Of the remainder, it takes a long time for cirrhosis to develop, leaving plenty of time for treatment. First-line treatments are approximately 95-99% effective. So there is no clinical reason HCV needs to increase a person's risk for cancer, as long as they have access to medical care. The same is not true for HBV.
Yep — if this is properly verified it means HSV is one of the most consequential virus families in public health.
For the same reason we should be hoping for a treatment that can rid the body of VZV (chickenpox/shingles) because it is absolutely clear that the shingles vaccine has some protective effect against dementia.
First, while you're correct that most people who have HSV have few symptoms (if any), you're discounting the fact that, because so many people are infected, there are millions upon millions who have highly-visible and highly-painful infections. Many of these people struggle with relationships and mental health as a result.
Second, HSV is associated with higher risk of HIV infection for obvious reasons.
Finally, discovering effective treatments for such a difficult virus would probably produce insights that have implications for other difficult-to-target viruses.
So I don't think we should dismiss HSV on the basis that it's so common and doesn't cause life-threatening symptoms. Medicine should pay adequate attention to infections that affect quality of life for large numbers of people.
Billions are spent on treatments for super rare diseases, many of which are terminal, and in the best cases the end result is often that pharmaceutical companies have drugs costing tens or hundreds of thousands of dollars that extend life by months (often with dubious quality of life).
Yeah HSV on its own would be awesome to find a good vaccine for but the insights it would give for vaccinations against the broader human herpes virus family would be massively impactful.
A successful HSV vaccine would also almost certainly lead to a vaccine for epstein-barr, cytomegalovirus, and roseolovirus.
Even ignoring the thousands of connections HSV is suspected to have to other diseases, getting insight towards the other 3 big "uncured" HHVs would be a massive deal.
EBV/mono is a silent but debilitating disease that infects a near majority of the population even in "developed countries" and is all but confirmed as a requirement for developing multiple sclerosis. EBV is also directly connected to a long list of cancers as well.
cytomegalovirus and roseolovirus while less common in the developed world are still far too common and globally are major sources of harm for infants and young children.
Any steps towards effective vaccination against the broader family of HHVs would be monumental.
I don't have any sort of HSV infection (that I'm aware of) but I subscribe to this subreddit and check on it every month or so:
www.reddit.com/r/HerpesCureResearch/
It's interesting seeing what's going on in that field, and seeing how much effort afflicted people put into tracking possible treatments and cures.
From my reading it appears that there are many promising treatments in the pipeline with some of thek already available through official/unofficial means.
Ive been subscribed there for many years - progress is vanishingly slow. It has sped up since the alzheimers research cabal got busted up and it has become clearer that HSV is a very large contributor to dementia.
> That's certainly not true in many European countries
This suprised me. I’ve hunted for polling and can find plenty showing a plummeting opinion on Israel, but little on internal polling about a Palestinian state.
Polls are interesting. They depend exclusively on people willing to respond. Let me give you an example of how they don't tell the whole story:
In the USA, there are many, many firearms. And there's also a small but very vocal cadre of people who would like to disarm the people. In light of this, if a pollster calls and asks for your opinion on guns, and/or inquires if you have any, a common response is to hang up without answering the questions, due to the possibility that the information will be used against them.
The result? They call someone else, and don't count "declined to answer" in their results. So the poll simply is the prevailing opinion of those who wished to answer, and thus is skewed one direction. (BTW, this is why everyone says there are "at least XXX hundred million guns in America; the best they can get is a low estimate)
This happens quite a lot with controversial topics.
> wait, how many workers fall outside the 16-65 range??
A little less than 10% of the workforce.
GP is correct - basically there was a report making that claim about the decline in employment rates of US-born workers over a certain time period. It was almost immediately debunked because it excluded workers older than 65, who are almost exclusively US-born, and excluding them heavily skews the average. Many of these workers also aged out of that bucket during that time period, which makes the comparison misleading, since the actual size of the studied workforce varied, and the workers who were excluded from the studied cohort were strongly correlated with the effect they were trying to demonstrate.
Furthermore, that effect is also exacerbated because of the uneven distribution of baby boomers.
> This is wrong. There is no minimum time in the country for a green card. You are thinking of citizenship. That is different.
You are incorrect. What you said is technically true in that there is no statute that requires it, but in practice, OP is correct.
It varies depending on the country of origin, but in the case of immigrants who hold citizenship from India, which is the country OP mentioned, you can likely expect to have to wait that period or even much longer before becoming eligible, unless you have a way to otherwise jump the queue.
You absolutely have to wait several years, but the point they were making is, there is no requirement to have ever worked IN the US or held any nonimmigrant visa to get a green card. The way the law was originally written, both the employment and family green card categories are standalone. They require work/research accomplishments, but there is zero requirement that that work was ever done in the US or for a US company.
Because it takes so long, in practice the issue is that for anyone to sponsor you, they want you working for them during that time, and so that's why it often looks like someone gets an H1B and then "graduates" to a green card.
> This is not true, India has something called “Overseas Citizenship of India” which is technically not a citizenship even though the name says, but its a life time visa available for US citizens of Indian origin. And you don’t have to give up US citizenship
The OCI card is better thought of as a green card that you have to reapply for once at the age of 65.
It provides the ability to live and work, with some minor restrictions, but none of the typical benefits of citizenship that wouldn't come with permanent residency in the US.
Unless you're uninsured (which is a whole separate clusterfuck), the hospitals aren't the ones who decide how much you pay for any service - the insurance companies are. The sticker price that hospitals charge is almost meaningless and is intentionally high because it's used as the starting point for negotiations, which always bring the price down (never up). There isn't any expectation that any insurer is actually going to pay the billed amount as-is.