As long as they don't set the copy-once flag cablecard is another option. I got a cablecard tuner and I can record 3 shows in HD simultaneously on any channel except for the premiums, which I don't subscribe to.
The video is just mpeg - no DRM/etc, and the metadata is just stored in a DB. If I want I can back it up or whatever. Maybe once a year something really bizarre happens and I get a somewhat corrupt show, in which case mplayer can play must about anything when it isn't encrypted - they're just mpeg files.
Oh, and I have about 1TB of storage space, and I can expand that without limit. Unlimited front-ends, back-ends, tuners, storage, etc - just whatever you're willing to pay for. It plays files downloaded over the internet just fine as well (granted, via a different UI).
Only thing I wish was that the android front-end was better (they're working on it - admittedly I haven't tested it in a few months).
Face it, Google just isn't getting what they wanted out of the platform.
Or they got exactly what they wanted: market penetration. The majority of happy Android users will have no problem upgrading to a closed Chrome Mobile as long as they get keep their apps (which will then be emulated in an Android VM, a VM within a VM if you will). And Google dropping old, smelly, and open Android means they won't keep their apps on future Android devices.
ChromeOS isn't closed - well, no more than Android is. ChromeOS is actually based on Gentoo, believe it or not, so if anything the foundation is even more open.
However, in general everything in ChromeOS is web-based, and web-based apps in general don't have touchscreen UIs. I'm not sure that we'll ever see full Android-ChromeOS convergence. If we do, the result will be a platform that is actually much closer to the traditional Linux distro.
People with zero knowledge in a field can sit at as reverse editors on pages where professors enhance and fix subject, only for a the same pillock come back and delete everything done since they took unofficial ownership of the pages. Admins themselves are in a clique that circle the wagons as soon as anti-edits and overzealous deletionists are flagged.
The thing is that this kind of behavior tends to be self-reinforcing. Experts already tend to be skeptical about WP. If one goes in and finds themselves in a revert war on their first contribution chances are they'll just walk away. They're not going to round up a cadre of support for their edits and have a showdown on the talk page with some long-time editor and his 47 friends.
The same applies to article deletion. If somebody takes the time to write up an article, about the most certain way to discourage them from doing it is to call up a council of 10 people to publicly argue that the work is worthless, and then delete it.
Have any of you ever considered that if we figured out a way to make synthetic meat that tastes as good as the real thing for cheaper that there would be no more cows, apart from in zoos?
So? Is having a bazillion cows walking around in pens some kind of ecological virtue?
There will be cows in the wild - just not very many.
Yup. Maybe if dissent weren't so effectively squashed on wikimedia-owned sites, there wouldn't be nearly so much expression of it on sites that they have no control over. I think there was actually a policy on WP to discourage discussion of policy outside of WP sites, usually using terms like "attack sites" to describe them.
Just another example of the Internet treating censorship as damage and routing around it. If you censor Talk:whatever then you'll just find talk about whatever elsewhere.
I think we can make a fair near-objective distinction between printed-at-kinkos, and published to an academic journal. There are only a few edge cases that would really raise doubt about that.
How about printed to a local newspaper? Those aren't exactly printed at kinkos, but such references are almost impossible to verify.
Please don't misunderstand, I like meat and I eat it.
But I'm not so abstracted from my food that I forget that it used to be a living thing, and that it's life was taken so that I could have nutrition (and useful byproducts like bone meal, glycerin, leather, etc). If we ever reach a level of technology where there are no health or taste reasons why a synthetic meat would be undesirable, I simply wouldn't ever buy meat that used to be alive.
I agree. I completely support the right to eat meat or experiment on animals because both are essential to human health. The moral harm from banning such practices would be far greater than allowing them to continue.
However, as technology advanced that could change. If you can produce food economically without endangering animals, then raising animals simply to use them for food becomes unjustifiable. Other uses for animals might still be justified (like animal testing), but anytime a technology reduces the need for animal-based testing that is a good thing in my mind. Life has some value - even primitive life. That doesn't mean that i'm going to cry everytime I step on an ant, but on the other hand I'm not going to breed ants just so that I can step on them.
suspect the real reason they don not want to release this information to law enforcement agencies is to prevent it from being used in a court of law. It will be very difficult to raise the domestic spying issue as a violation of the 4th amendment if there is no one who can claim standing in a civil or criminal procedure. So I definitely think you misunderstand the NSA's motive in this.
Fair enough, but at least the constitution is providing us a little protection either way. Industries that police themselves usually are only doing so to prevent being subject to expensive regulation, but the end result is that at least some kind of policing is taking place.
Not a surprise at all. This is the problem with the nation of a bazillion laws that we live in. Selective enforcement of laws that everybody violates can be used to easily justify any raid/seizure/etc.
Suppose a police vehicle uses listening equipment without a warrant to listen in on random houses to find evidence of drug manufacture. Any data they collect would be thrown out of court, as well as any follow-on evidence (fruit of the poisonous tree and all that). So, when the police find a home engaged in drug use using such methods they don't document it in any way.
They then setup surveillance of the home, completely off the books. They figure out when the drugs go in and out and all that. Maybe they just go up the chain for bigger fish and never bust the house. If they do want to bust the house, they send an officer down the street right when something is going on, and they happen to notice some suspicious behavior (could be a car parked more than 6" from the curb, grass that is too tall, whatever - with so many laws on the books you can ALWAYS find something to be an excuse for an investigation). When they knock on the door they happen to notice through the window something suspicious, so they act. The official story is that the police got lucky but everything that is presented to the court is legal.
The act of spying & collecting this data didn't already pass this threshold?
While I tend to agree, I can at least commend the NSA for trying to limit the use of this data where there isn't an overriding purpose.
The problem is that once databases like these are compiled there will be constant pressure to expand their use. First national security letters are used to find out who is reading bomb-making books at the local library. Later national security letters are used to find out who is reading communist/cryptography/whatever books at the library.
The next problem is that these are secret databases whose existence isn't generally admitted to in the first place. How do these other agencies even know (prior to Snowden) that this data is out there to begin with? If they were obtaining data from these databases, how would we even find out about it?
Better to not collect this kind of data in the first place, unless it is in reaction to a specific threat (and if there is a specific threat, you should be able to obtain a warrant which makes it completely legal). When this kind of data is collected, it should only be used for the original intended purpose.
I almost never watch youtube videos in the browser. On my ISP at least they buffer all the time (on a 30Mbps connection). So I just queue a bunch up for downloading and watch them when they're done.
Yup. I don't think I own a single bluetooth device that DOESN'T have a hardcoded PIN. My phone/PC/laptop/etc support pairing to devices that don't, but everything I'd want to attach them to just hardcodes 1234 or 0000.
Or use Tails, a Linux distro specifically designed for paranoia. You burn it on a CD (or USB stick) and boot from it into a Linux desktop environment specially crafted for privacy and security. All internet traffic is routed through Tor (sic), so after rebooting you should be fine.
The only problem with this sort of approach is that if you run some program that doesn't route all its traffic through tor you could be in trouble.
If I were concerned about privacy I'd run tor on a proxy, then run all my browsers/etc on some VM that was completely firewalled from everything but the proxy. That means that if for any reason it was exploited or buggy it couldn't phone home anyway, and any locally-running code can't really obtain any useful information about where it might be located. It has no access to hardware, and it has some private IP address that doesn't mean anything to anybody.
Now if Tails actually accomplishes all that, great, but I have no idea how you block software from finding out your IP address on Linux if it isn't virtualized.
Right now the NIH does the early research, but doesn't spend the boatload of money needed to actually test the stuff they come up with. They usually abandon research when it gets to the point where this article is at.
Not really - what actually happens is typically that the universities patent the discovery and license it to a company which performs the development work.
Really two ways of saying the same thing. I realize that university labs often patent the stuff they come up with (something I don't have a problem with - the part I don't like is that the license fees that result don't predominantly go to the US Government). The bottom line is that they don't spend the huge sums of money that happen after an initial lead is developed.
Among these is the drug/pharmaceutical industry because only they can afford the R&D needed to make important things happen.
They're not the only ones who can afford it, but right now they're about the only ones willing to spend it.
The research in this article did NOT develop a new drug. It only discovered a compound that has biological activity. That is the very first step in drug research, and usually it takes about 5 years and $100M to prove conclusively that it won't work in the real world. Maybe 5% of the time it will take 5 years and $100M to prove that it actually does work.
I'm all for expanding the publish research model instead of relying on patented drugs. The problem is that this will require a HUGE increase in public funding. Duplicating what the pharmaceutical industry is already doing would probably require tripling the funding of the NIH (perhaps with a few first world nations pitching in). The resulting drugs would be cheap, but taxpayers would pay for them. Oh, and in the industry model the public only pays for drugs that work (granted at a substantial premium). In the publicly funded model the public pays for every drug with no real accountability for failures.
I think it is an experiment worth trying, perhaps on a small scale at first. However, this kind of early research (which happens all the time) shouldn't be confused the cost of coming up with new drugs.
Yup - this is just discovery work. This kind of research often happens in university and other open settings.
The problem is that 95% of the cost comes in during the boring and expensive process of testing the drug.
That's a good FOSS analogy as well. Notice how few FOSS projects REALLY test their products? Now consider that testing a piece of software just consists of people or scripts spending a few hours rigorously exercising the software on commodity hardware. In the drug research world you have to get thousands of volunteers, give them all an experimental medication THAT COULD KILL THEM, and then do a variety of medical tests over a period of months or years to see how it works out. Oh, and the failure rate is over 90% (usually resulting in starting over from scratch, not patching a few lines of code).
I think that this stuff could be done without patents, but until I actually see that happening I'm not going to jump on the kill patents bandwagon. There is no reason the NIH and similar bodies worldwide couldn't just do the end-to-end R&D on a few drugs as an experiment and see how it works out. They could file the patents (defensively) and license out the drugs free of charge. If it works out well, then you won't even have to abolish patents - there is no way that branded medications could compete against free ones anyway. Right now the NIH does the early research, but doesn't spend the boatload of money needed to actually test the stuff they come up with. They usually abandon research when it gets to the point where this article is at.
Much easier to do today - still not cheap, but many of the components can actually be bought (USB interfaces), and companies now sell software to fully emulate many of the systems.
One thing this system is missing is a collimated display. That adds a lot of realism from what I've heard. Those are expensive if you want to buy them, but people are starting to DIY them.
In the former case you beat and perhaps permanently scar or injure someone who was innocent.
Since the whole point of my post was to focus on rehabilitation and not punishment, the last thing I'm suggesting is doing anything that is likely to cause permanent injury.
Frankly I think ex-convicts should be always viewed as innocent - the whole point of the sentence should be to re-integrate them into society and any kind of taint/record only compromises that.
As far as them being innocent goes - that is always a risk in any justice system. In my version of the justice system though the innocent person gets back to being innocent as quickly as possible with no lasting harm. In the status quo they lose most of their money, years of time, and they're forever branded as a convict and find it difficult to get a job/etc. If you were innocent which would you choose? But hey, I'm also all for reforming the adversarial criminal justice system where DAs are always out for blood and use plea bargains to beat everybody into taking a deal.
I'm not suggesting that we should be using corporal punishment - I'm just suggesting that if we do anything punitive at all that corporal punishment is a better solution than just locking people up in a cell for a decade.
How can a truly civilized race possibly take us as anything other than animals when we still do things like this?
Which - the mode of punishment, or the "crime" that was being punished? I think the latter is the far greater problem, even if the former is what tends to make headlines. It would hardly be better if he were sentenced to spend two years in a US-style prison, with the US-style criminal background check ensuring he never is able to get a decent job again.
Sometimes I wonder if corporal punishment isn't actually a good idea. It still punishes and deters crime, but it does so without ruining the life of the offender and wasting huge amounts of resources housing them in close proximity to other criminals who will likely just reinforce his bad behavior. If a criminal justice system must be punitive in nature, corporal punishment actually seems like a better punishment than most. All that said, I'd really prefer to see the criminal justice system be rehabilitative in nature first and foremost. The current US design seems to make any kind of rehabilitation happen almost by accident, and the highly punitive nature of the system tends to just drive a wedge between criminals and society.
If I were designing a criminal justice system from scratch I'd start by designing it solely to maximize the rehabilitative properties of the system with no regard to punitive value. I suspect that just the compulsory nature of the system would have sufficient punitive value on its own. However, if people start killing each other just to get a free education then I'd probably add in enough punishment to remove the incentive. Corporal punishment seems like a better option than most.
Just think about raising a kid. When they do something wrong do you issue a swift but short punishment (a harsh rebuke, a slap, a brief denial of privileges), or do you tell them that you'll take a year or two to figure out how to handle it and then tell them that you've decided to cancel their college savings fund?
Re:And when are the Hellfire missles coming?
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On the other hand, considering the Federal Government's track record over the last decade, I wouldn't trust them not to cross the boundary with armed UAS, but they will do it bit by bit so as to not cause a stir until they've come up with a good way to sell it to the public.
When was the last time you saw a government-operated manned aerial vehicle actually fire on something over US soil? I don't really see why unmanned aircraft would be any more likely to be armed. The only time I can think of where law enforcement actually fired on something from an aircraft was this incident. It didn't end well.
Weapons deployed from aircraft are really not a good solution to most problems, especially when you have police stations every few miles anyway. I can see why they are used deep inside enemy territory, or in military campaigns. About the only time they'd make sense domestically is if you happen to have some guy with the trigger to a weapon of mass destruction in your sights and no other way to take him out.
Even a generic may be the wrong approach, if patients have not tried other measures first, such as improving their diets and exercising.
While I tend to be a minimalist when it comes to pills, what you say is often not the case. Any modern pill on the market has demonstrated outcomes. You can argue whether the $5 pill is better than the 30 cent pill, but the 30 cent pill is almost always FAR superior to leaving a condition untreated.
By all means tell the patient to diet and exercise. However, for many conditions it is better to start treating the condition immediately than to play games for a year or two before taking care of the problem. By all means tell the patient to check their BP or do follow-up tests every six months and reduce medication if the patient manages to get things under control on their own.
I've talked to several diabetics now who report having had problems because doctors have taken their sweet time getting things under control. It should probably be considered malpractice to not request weekly appointments (phone, email, in-person, whatever) with any diabetic whose condition is not completely under control. Somebody I know required years to get things under control because they basically met with an endocrinologist quarterly who just tweaked their meds a little at a time while their A1Cs were >10 the whole time - they had a BUNCH of serious complications, and I can assure you that those complications cost FAR more to treat than office visits would.
I do think that diet/etc can be more effective, but it doesn't work out for everybody, and delaying effective treatment costs EVERYBODY more. I think drugs are too often viewed as a last resort.
Now, I say this mainly because your main example was a statin, which have pretty good outcome data. Blood pressure would be another area where weight has a big impact as do drugs. Diabetes is of course another which I brought up. I'll be the first to admit that not all drugs have such solid data backing them, and I'm not a fan of having people pay to basically be test subjects.
You know I am sick and tired of everyone blaming doctors for the cost of healthcare in the US. When in fact, doctors salaries are a miniscule portion of US healthcare, especially compared to drugs and device costs and hospital CEO pay!
Well, looking at this graph, which I'd say looks like most I've seen, for every dollar that gets spent on drugs, two dollars get spent on doctors. In most cases it is the drug that actually has the health benefit, and the doctor just figures out which one is the most appropriate one to prescribe. I'm not sure where this particular breakdown stuck devices - often they're treated as drugs (they're certainly regulated in a similar fashion).
Now, there are certainly plenty of ways to make drugs cheaper, but you can't really pick any part of the US healthcare system and say "hey, this one part is fine - just make everything else cheaper."
As far as schooling/etc goes - the cost of medical school certainly is higher, but that is simply because that is what the market will bear. No idiot is going to spend $250k to get a PhD in Biochemistry, because Biochemists get paid peanuts (despite the fact that they invent half of those drugs, devices, and procedures the doctors end up using).
The whole 12-hour-day thing is a culture thing - there is no need to have doctors working those kinds of hours. Just educate more of them, and have them work more reasonable shifts. If anything those hours probably chase off many who would otherwise want to work in the profession (something the AMA probably counts on). Medical school selects for workaholics and it shouldn't be surprising that workaholics like to work. It isn't some kind of virtue. There is certainly a need for continuity of care which isn't always conducive to a 9-5 M-F schedule, but if individual doctors took on fewer patients they could still give the ones they take better care while spending less time doing it.
Lots of people work hard. Few get paid the kinds of salaries doctors collect.
As far as investment bankers making $500k goes - that is nuts as well. However, you can't point to the 0.001% of workers who make such insane salaries as justification. How about looking at the average US salary of full-time PhD holders of $80k/yr?
Modern society goes out of its way to make it pretty close. The whole concept of health insurance is practically engineered to eliminate most kinds of selective pressure.
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As long as they don't set the copy-once flag cablecard is another option. I got a cablecard tuner and I can record 3 shows in HD simultaneously on any channel except for the premiums, which I don't subscribe to.
The video is just mpeg - no DRM/etc, and the metadata is just stored in a DB. If I want I can back it up or whatever. Maybe once a year something really bizarre happens and I get a somewhat corrupt show, in which case mplayer can play must about anything when it isn't encrypted - they're just mpeg files.
Oh, and I have about 1TB of storage space, and I can expand that without limit. Unlimited front-ends, back-ends, tuners, storage, etc - just whatever you're willing to pay for. It plays files downloaded over the internet just fine as well (granted, via a different UI).
Only thing I wish was that the android front-end was better (they're working on it - admittedly I haven't tested it in a few months).
Face it, Google just isn't getting what they wanted out of the platform.
Or they got exactly what they wanted: market penetration. The majority of happy Android users will have no problem upgrading to a closed Chrome Mobile as long as they get keep their apps (which will then be emulated in an Android VM, a VM within a VM if you will). And Google dropping old, smelly, and open Android means they won't keep their apps on future Android devices.
ChromeOS isn't closed - well, no more than Android is. ChromeOS is actually based on Gentoo, believe it or not, so if anything the foundation is even more open.
However, in general everything in ChromeOS is web-based, and web-based apps in general don't have touchscreen UIs. I'm not sure that we'll ever see full Android-ChromeOS convergence. If we do, the result will be a platform that is actually much closer to the traditional Linux distro.
People with zero knowledge in a field can sit at as reverse editors on pages where professors enhance and fix subject, only for a the same pillock come back and delete everything done since they took unofficial ownership of the pages. Admins themselves are in a clique that circle the wagons as soon as anti-edits and overzealous deletionists are flagged.
The thing is that this kind of behavior tends to be self-reinforcing. Experts already tend to be skeptical about WP. If one goes in and finds themselves in a revert war on their first contribution chances are they'll just walk away. They're not going to round up a cadre of support for their edits and have a showdown on the talk page with some long-time editor and his 47 friends.
The same applies to article deletion. If somebody takes the time to write up an article, about the most certain way to discourage them from doing it is to call up a council of 10 people to publicly argue that the work is worthless, and then delete it.
Have any of you ever considered that if we figured out a way to make synthetic meat that tastes as good as the real thing for cheaper that there would be no more cows, apart from in zoos?
So? Is having a bazillion cows walking around in pens some kind of ecological virtue?
There will be cows in the wild - just not very many.
Yup. Maybe if dissent weren't so effectively squashed on wikimedia-owned sites, there wouldn't be nearly so much expression of it on sites that they have no control over. I think there was actually a policy on WP to discourage discussion of policy outside of WP sites, usually using terms like "attack sites" to describe them.
Just another example of the Internet treating censorship as damage and routing around it. If you censor Talk:whatever then you'll just find talk about whatever elsewhere.
I think we can make a fair near-objective distinction between printed-at-kinkos, and published to an academic journal. There are only a few edge cases that would really raise doubt about that.
How about printed to a local newspaper? Those aren't exactly printed at kinkos, but such references are almost impossible to verify.
There are many things American don't do well, but we are pretty good about not burning our steaks.
You obviously grew up with a different mother than I did.
Please don't misunderstand, I like meat and I eat it.
But I'm not so abstracted from my food that I forget that it used to be a living thing, and that it's life was taken so that I could have nutrition (and useful byproducts like bone meal, glycerin, leather, etc). If we ever reach a level of technology where there are no health or taste reasons why a synthetic meat would be undesirable, I simply wouldn't ever buy meat that used to be alive.
I agree. I completely support the right to eat meat or experiment on animals because both are essential to human health. The moral harm from banning such practices would be far greater than allowing them to continue.
However, as technology advanced that could change. If you can produce food economically without endangering animals, then raising animals simply to use them for food becomes unjustifiable. Other uses for animals might still be justified (like animal testing), but anytime a technology reduces the need for animal-based testing that is a good thing in my mind. Life has some value - even primitive life. That doesn't mean that i'm going to cry everytime I step on an ant, but on the other hand I'm not going to breed ants just so that I can step on them.
suspect the real reason they don not want to release this information to law enforcement agencies is to prevent it from being used in a court of law. It will be very difficult to raise the domestic spying issue as a violation of the 4th amendment if there is no one who can claim standing in a civil or criminal procedure. So I definitely think you misunderstand the NSA's motive in this.
Fair enough, but at least the constitution is providing us a little protection either way. Industries that police themselves usually are only doing so to prevent being subject to expensive regulation, but the end result is that at least some kind of policing is taking place.
Not a surprise at all. This is the problem with the nation of a bazillion laws that we live in. Selective enforcement of laws that everybody violates can be used to easily justify any raid/seizure/etc.
Suppose a police vehicle uses listening equipment without a warrant to listen in on random houses to find evidence of drug manufacture. Any data they collect would be thrown out of court, as well as any follow-on evidence (fruit of the poisonous tree and all that). So, when the police find a home engaged in drug use using such methods they don't document it in any way.
They then setup surveillance of the home, completely off the books. They figure out when the drugs go in and out and all that. Maybe they just go up the chain for bigger fish and never bust the house. If they do want to bust the house, they send an officer down the street right when something is going on, and they happen to notice some suspicious behavior (could be a car parked more than 6" from the curb, grass that is too tall, whatever - with so many laws on the books you can ALWAYS find something to be an excuse for an investigation). When they knock on the door they happen to notice through the window something suspicious, so they act. The official story is that the police got lucky but everything that is presented to the court is legal.
The act of spying & collecting this data didn't already pass this threshold?
While I tend to agree, I can at least commend the NSA for trying to limit the use of this data where there isn't an overriding purpose.
The problem is that once databases like these are compiled there will be constant pressure to expand their use. First national security letters are used to find out who is reading bomb-making books at the local library. Later national security letters are used to find out who is reading communist/cryptography/whatever books at the library.
The next problem is that these are secret databases whose existence isn't generally admitted to in the first place. How do these other agencies even know (prior to Snowden) that this data is out there to begin with? If they were obtaining data from these databases, how would we even find out about it?
Better to not collect this kind of data in the first place, unless it is in reaction to a specific threat (and if there is a specific threat, you should be able to obtain a warrant which makes it completely legal). When this kind of data is collected, it should only be used for the original intended purpose.
As opposed to just using youtube-dl...
I almost never watch youtube videos in the browser. On my ISP at least they buffer all the time (on a 30Mbps connection). So I just queue a bunch up for downloading and watch them when they're done.
Yup. I don't think I own a single bluetooth device that DOESN'T have a hardcoded PIN. My phone/PC/laptop/etc support pairing to devices that don't, but everything I'd want to attach them to just hardcodes 1234 or 0000.
Or use Tails, a Linux distro specifically designed for paranoia. You burn it on a CD (or USB stick) and boot from it into a Linux desktop environment specially crafted for privacy and security. All internet traffic is routed through Tor (sic), so after rebooting you should be fine.
The only problem with this sort of approach is that if you run some program that doesn't route all its traffic through tor you could be in trouble.
If I were concerned about privacy I'd run tor on a proxy, then run all my browsers/etc on some VM that was completely firewalled from everything but the proxy. That means that if for any reason it was exploited or buggy it couldn't phone home anyway, and any locally-running code can't really obtain any useful information about where it might be located. It has no access to hardware, and it has some private IP address that doesn't mean anything to anybody.
Now if Tails actually accomplishes all that, great, but I have no idea how you block software from finding out your IP address on Linux if it isn't virtualized.
Right now the NIH does the early research, but doesn't spend the boatload of money needed to actually test the stuff they come up with. They usually abandon research when it gets to the point where this article is at.
Not really - what actually happens is typically that the universities patent the discovery and license it to a company which performs the development work.
Really two ways of saying the same thing. I realize that university labs often patent the stuff they come up with (something I don't have a problem with - the part I don't like is that the license fees that result don't predominantly go to the US Government). The bottom line is that they don't spend the huge sums of money that happen after an initial lead is developed.
Among these is the drug/pharmaceutical industry because only they can afford the R&D needed to make important things happen.
They're not the only ones who can afford it, but right now they're about the only ones willing to spend it.
The research in this article did NOT develop a new drug. It only discovered a compound that has biological activity. That is the very first step in drug research, and usually it takes about 5 years and $100M to prove conclusively that it won't work in the real world. Maybe 5% of the time it will take 5 years and $100M to prove that it actually does work.
I'm all for expanding the publish research model instead of relying on patented drugs. The problem is that this will require a HUGE increase in public funding. Duplicating what the pharmaceutical industry is already doing would probably require tripling the funding of the NIH (perhaps with a few first world nations pitching in). The resulting drugs would be cheap, but taxpayers would pay for them. Oh, and in the industry model the public only pays for drugs that work (granted at a substantial premium). In the publicly funded model the public pays for every drug with no real accountability for failures.
I think it is an experiment worth trying, perhaps on a small scale at first. However, this kind of early research (which happens all the time) shouldn't be confused the cost of coming up with new drugs.
Yup - this is just discovery work. This kind of research often happens in university and other open settings.
The problem is that 95% of the cost comes in during the boring and expensive process of testing the drug.
That's a good FOSS analogy as well. Notice how few FOSS projects REALLY test their products? Now consider that testing a piece of software just consists of people or scripts spending a few hours rigorously exercising the software on commodity hardware. In the drug research world you have to get thousands of volunteers, give them all an experimental medication THAT COULD KILL THEM, and then do a variety of medical tests over a period of months or years to see how it works out. Oh, and the failure rate is over 90% (usually resulting in starting over from scratch, not patching a few lines of code).
I think that this stuff could be done without patents, but until I actually see that happening I'm not going to jump on the kill patents bandwagon. There is no reason the NIH and similar bodies worldwide couldn't just do the end-to-end R&D on a few drugs as an experiment and see how it works out. They could file the patents (defensively) and license out the drugs free of charge. If it works out well, then you won't even have to abolish patents - there is no way that branded medications could compete against free ones anyway. Right now the NIH does the early research, but doesn't spend the boatload of money needed to actually test the stuff they come up with. They usually abandon research when it gets to the point where this article is at.
Much easier to do today - still not cheap, but many of the components can actually be bought (USB interfaces), and companies now sell software to fully emulate many of the systems.
One thing this system is missing is a collimated display. That adds a lot of realism from what I've heard. Those are expensive if you want to buy them, but people are starting to DIY them.
In the former case you beat and perhaps permanently scar or injure someone who was innocent.
Since the whole point of my post was to focus on rehabilitation and not punishment, the last thing I'm suggesting is doing anything that is likely to cause permanent injury.
Frankly I think ex-convicts should be always viewed as innocent - the whole point of the sentence should be to re-integrate them into society and any kind of taint/record only compromises that.
As far as them being innocent goes - that is always a risk in any justice system. In my version of the justice system though the innocent person gets back to being innocent as quickly as possible with no lasting harm. In the status quo they lose most of their money, years of time, and they're forever branded as a convict and find it difficult to get a job/etc. If you were innocent which would you choose? But hey, I'm also all for reforming the adversarial criminal justice system where DAs are always out for blood and use plea bargains to beat everybody into taking a deal.
I'm not suggesting that we should be using corporal punishment - I'm just suggesting that if we do anything punitive at all that corporal punishment is a better solution than just locking people up in a cell for a decade.
How can a truly civilized race possibly take us as anything other than animals when we still do things like this?
Which - the mode of punishment, or the "crime" that was being punished? I think the latter is the far greater problem, even if the former is what tends to make headlines. It would hardly be better if he were sentenced to spend two years in a US-style prison, with the US-style criminal background check ensuring he never is able to get a decent job again.
Sometimes I wonder if corporal punishment isn't actually a good idea. It still punishes and deters crime, but it does so without ruining the life of the offender and wasting huge amounts of resources housing them in close proximity to other criminals who will likely just reinforce his bad behavior. If a criminal justice system must be punitive in nature, corporal punishment actually seems like a better punishment than most. All that said, I'd really prefer to see the criminal justice system be rehabilitative in nature first and foremost. The current US design seems to make any kind of rehabilitation happen almost by accident, and the highly punitive nature of the system tends to just drive a wedge between criminals and society.
If I were designing a criminal justice system from scratch I'd start by designing it solely to maximize the rehabilitative properties of the system with no regard to punitive value. I suspect that just the compulsory nature of the system would have sufficient punitive value on its own. However, if people start killing each other just to get a free education then I'd probably add in enough punishment to remove the incentive. Corporal punishment seems like a better option than most.
Just think about raising a kid. When they do something wrong do you issue a swift but short punishment (a harsh rebuke, a slap, a brief denial of privileges), or do you tell them that you'll take a year or two to figure out how to handle it and then tell them that you've decided to cancel their college savings fund?
On the other hand, considering the Federal Government's track record over the last decade, I wouldn't trust them not to cross the boundary with armed UAS, but they will do it bit by bit so as to not cause a stir until they've come up with a good way to sell it to the public.
When was the last time you saw a government-operated manned aerial vehicle actually fire on something over US soil? I don't really see why unmanned aircraft would be any more likely to be armed. The only time I can think of where law enforcement actually fired on something from an aircraft was this incident. It didn't end well.
Weapons deployed from aircraft are really not a good solution to most problems, especially when you have police stations every few miles anyway. I can see why they are used deep inside enemy territory, or in military campaigns. About the only time they'd make sense domestically is if you happen to have some guy with the trigger to a weapon of mass destruction in your sights and no other way to take him out.
Even a generic may be the wrong approach, if patients have not tried other measures first, such as improving their diets and exercising.
While I tend to be a minimalist when it comes to pills, what you say is often not the case. Any modern pill on the market has demonstrated outcomes. You can argue whether the $5 pill is better than the 30 cent pill, but the 30 cent pill is almost always FAR superior to leaving a condition untreated.
By all means tell the patient to diet and exercise. However, for many conditions it is better to start treating the condition immediately than to play games for a year or two before taking care of the problem. By all means tell the patient to check their BP or do follow-up tests every six months and reduce medication if the patient manages to get things under control on their own.
I've talked to several diabetics now who report having had problems because doctors have taken their sweet time getting things under control. It should probably be considered malpractice to not request weekly appointments (phone, email, in-person, whatever) with any diabetic whose condition is not completely under control. Somebody I know required years to get things under control because they basically met with an endocrinologist quarterly who just tweaked their meds a little at a time while their A1Cs were >10 the whole time - they had a BUNCH of serious complications, and I can assure you that those complications cost FAR more to treat than office visits would.
I do think that diet/etc can be more effective, but it doesn't work out for everybody, and delaying effective treatment costs EVERYBODY more. I think drugs are too often viewed as a last resort.
Now, I say this mainly because your main example was a statin, which have pretty good outcome data. Blood pressure would be another area where weight has a big impact as do drugs. Diabetes is of course another which I brought up. I'll be the first to admit that not all drugs have such solid data backing them, and I'm not a fan of having people pay to basically be test subjects.
You know I am sick and tired of everyone blaming doctors for the cost of healthcare in the US. When in fact, doctors salaries are a miniscule portion of US healthcare, especially compared to drugs and device costs and hospital CEO pay!
Well, looking at this graph, which I'd say looks like most I've seen, for every dollar that gets spent on drugs, two dollars get spent on doctors. In most cases it is the drug that actually has the health benefit, and the doctor just figures out which one is the most appropriate one to prescribe. I'm not sure where this particular breakdown stuck devices - often they're treated as drugs (they're certainly regulated in a similar fashion).
Now, there are certainly plenty of ways to make drugs cheaper, but you can't really pick any part of the US healthcare system and say "hey, this one part is fine - just make everything else cheaper."
As far as schooling/etc goes - the cost of medical school certainly is higher, but that is simply because that is what the market will bear. No idiot is going to spend $250k to get a PhD in Biochemistry, because Biochemists get paid peanuts (despite the fact that they invent half of those drugs, devices, and procedures the doctors end up using).
The whole 12-hour-day thing is a culture thing - there is no need to have doctors working those kinds of hours. Just educate more of them, and have them work more reasonable shifts. If anything those hours probably chase off many who would otherwise want to work in the profession (something the AMA probably counts on). Medical school selects for workaholics and it shouldn't be surprising that workaholics like to work. It isn't some kind of virtue. There is certainly a need for continuity of care which isn't always conducive to a 9-5 M-F schedule, but if individual doctors took on fewer patients they could still give the ones they take better care while spending less time doing it.
Lots of people work hard. Few get paid the kinds of salaries doctors collect.
As far as investment bankers making $500k goes - that is nuts as well. However, you can't point to the 0.001% of workers who make such insane salaries as justification. How about looking at the average US salary of full-time PhD holders of $80k/yr?
Medicare is generally not covering providers' costs.
Like the aforementioned gastroenterologist making $460k/yr?
The whole healthcare system is incredibly messed up. You get pockets of near-bankruptcy mixed with pockets of largesse.
Perhaps the solution is to just reduce reimbursements every year until the medical school acceptance rate is 90%?
Pregnancy isn't hazard-less...
Modern society goes out of its way to make it pretty close. The whole concept of health insurance is practically engineered to eliminate most kinds of selective pressure.