And the US didn't bomb Saudi Arabia when a bunch of Saudi nationals destroyed the twin towers.
The US hasn't generally retalliated against nations simply for having terrorists inside them. The US attacks nations that harbor terrorists and give them aid.
Look, I'm not a big fan of US interventionism. However, the US reponse in Afganistan was pretty good policy - and internationally it was fairly well supported. Iraq was an entirely different mess. In fact, Iraq tended to blur US policy which damaged the effectiveness of real retaliations.
US policy should be simple - attack the US and the US will attack you. Sponsor a bunch of nuts, give them guns, and have them attack the US, and the US will attack you. If you happen to have nuts living in your country that you don't support, and which you try to keep under control, and which you punish when you catch them, then the US won't attack you even if those nuts attack the US. Maybe the US would ask to help you catch them, and even request extradition (something that might be open for negotiation as long as the terrorists get punished one way or another).
Most nations would support this kind of foreign policy, and it would certainly deter attacks.
I'm not usually the conspiracy-theory type, but I suspect that the USAF already is flying an SR-71 replacement and this is why they have been retired.
Spy Satellites and UAVs certainly cover parts of the SR-71 mission profile. However, what about battlefield survailence of a major military adversary? Current UAVs cannot survive in combat. Sure, they can loiter over Basra all day when nobody has anything other than a rifle to shoot at them with. Try to get footage of downtown Tehran with a UAV and you'll just have UAV-parts raining all over the place. Satellites certainly work better, but they're very limited in coverage and have no loiter capability. They're also very vulnerable if somebody is determined enough to actually start shooting them down.
I'm not saying you couldn't do the job with a UAV with SR-71-like capabilities. That is certainly an option. Perhaps one already exists. However, neither satellites or the currently public UAV options make the SR-71 completely obsolete. Either the US doesn't think it needs ariel recon of hot areas, or it has some other way of doing it that nobody knows about.
I think it would be the same as it always has been. We would provide millions of dollars in aide for them, there would be peace rallies and movements to bring them supplies, but ultimately we (The US) would leave it to them to resolve the problem on their own.
Of course the US would leave them to resolve the problem on their own - the US wasn't attacked in the parent's hypothetical scenario. Why would the US care if somebody killed a few thousand Chinese citizens?
The Chinese (or Russians), on the other hand, would have almost certainly launched an invasion of some kind. Why do you think nobody messes with them?
Now, they might or might not have launched a full-scale takeover of Afganistan. I suspect that their style would be more along the lines of doing covert operations. Then again, the Chinese at least might look forward to an internationally-sanctioned opportunity to get some field practice for their army.
The point was that the US did what any other country in a similar position would have done. The Chinese or the Russians certainly wouldn't have given them a slap on the wrist.
Going back to the original point of this thread - I doubt any major nation would launch a knee-jerk nuclear strike in response to a terrorist attack. If the terrorists were state-sponsored they would almost certainly retalliate at least conventionally, but if the terrorists were wackos from Kansas I doubt they'd wipe Kansas off the map.
Yup, same experience here. I was looking for an automotive GPS, and decided to stop by (having already heard about the ripoff "markdowns" - but since the closeouts were being subcontracted I figured maybe I'd get lucky). Well, I didn't get lucky. EVERYTHING was much more expensive than even the Best Buy across the street. I wasn't sure how they thought they'd get away with it. Plus they had "all sales final" signs all over the place.
Now, why would I want to spend $250 for a GPS with no returns when I could spend $200 and get it at Best Buy with a returns policy, or $120 online (still with a return policy, but a little more hassle)?
As it is I almost never shop in Best Buy due to the ripoff prices. Forget CC...
There is not an absence of data. Read The God Delusion.
Uh, how can you have data supporting the non-existence of God? At best you could have data to indicate that everything makes sense without the existence of God. You might even have data to disprove specific accounts about somebody's specific assertion as to how God has intervened in the world. However, unless one is claiming to be God one can certainly not claim to have evidence as to whether God does or does not exist.
I don't need to pay $9.95 for a book to tell me this much...:)
Of course, if you give everybody a $40 coupon (or whatever) they end up just paying $50 more in taxes or their grandkids get the equivalent in debt. It isn't like "the government" has no relationship to the people who live and breathe within the country. As an added bonus you get to pay a premium on the cost of the converter which is able to be sold for a higher cost since consumers will be willing to pay more on top of their subsidies.
Sure, the money might "come from" the spectrum sales, but that is just $40 + distribution costs less revenue for the government to operate on, which again, is just higher taxes. There is just one big pile of government money out there - cut off one input and another grows to take its place.
You give god too much credit to suppose that denial of his existence is a fundamental belief rather than a mere consequence of a belief in logical positivism.
Any belief can stand on its own, and also can be a consequence of another belief. Belief isn't logical, and no laws of logic need apply.
For example, one can deny the existance of God, and hold a belief in the Tooth Fairy. Such a person is clearly not a logical positivist.
And a belief in logical positivism is also a belief - so the point isn't really any different. Absence of evidence isn't evidence of absence. One can choose to regard it as such nonetheless, but that is a matter of philosophy. Actually, science itself is a philosophy - a very successful one, but it is as fallible as anything else made by men. It just has the virtue of not being falsifiable - falsifying a theory as an attack upon science is really just a reinforcement of the scientific method.:)
Look, I'm not knocking Dawkins, or athiests, or anything like that. All I'm saying is that philisophically the denial of God is no more a privileged position than the belief in God. The two positions are more fashionable among various culture groups, but the only way one position or the other can be privileged except by convention is if some source of omnscience exists, and somehow I don't think that such a source would be an athiest unless the source also holds to its own non-existence.
He never, ever says that there is absolutely 100% no god. In fact, he usually puts the possibility that there is no god somewhere within 90-98%.
Uh, how can you estimate the possibility of a completely untestable assertion being true as having ANY value at all short of simply holding a belief? How does he know the true probability isn't in fact 99.99% and that he is being needlessly uncertain of his convictins? Perhaps the true probability is 84.5%. Then again, there is no such thing as probability in the absence of data. Probability is a mathematical concept, and all it does it allows one to formally state the level of certainty in an outcome given a well-defined scenario. Unless you can come up with a mathematical model for the existance of a hypothetical God, how can you begin to calculate probabilities.
He does not merely not believe in a God. He BELIEVES there is no God.
Define atheism as you will. The point is that Dawkins certainly advances a religious belief - one which cannot in any way be proven one way or another.
Merely not holding an opinion on the subject of God is not a belief - that is an attitude and not an intellectual position.
As an analogy. I am convinced a company will go up in value - I buy the stock. I am convinced a company will go down in value - I short the stock. I don't care about the company - I go to the beach and buy ice cream instead. Dawkins clearly is shorting the stock. I'm not criticising that decision - however clearly he isn't just eating ice cream...
Of course, if the insurance denies them you might still not be liable. Most likely your doctor signed a contract with your insurance company in which they agreed to hold you harmless for any fees incurred not in accordance with the plan.
So now we have a contract with A and B, a contract with B and C, and a contract with A and C that all disagree. You also have a doctor that isn't eager to lose their contract with B and EVERY other company like B. They'll certainly bug you but most likely the charges wouldn't stand up in court.
Of course, they can still put a complaint in your credit history. Credit reporting agencies need a bit more regulation. Companies shouldn't be able to simply lodge complaints without some kind of judgment against you. Courts are the forum for weighing liability - not credit reporting agencies (who are paid by the people who have a complaint against you).
A me-too drug by definition has the same mechanism of action. For example, even though insulin and metformin both lower blood sugar one is not considered a "me-too" of the other since they have completely different mechanisms and potential uses.
Most me-too drugs usually aren't trivial variations on existing drugs. Sometimes antibiotics fall into this category (often to defeat some resistance mechanism).
I would think that a drug that is only a trivial variation of an existing drug would be risky from a patent perspective. Why spend hundreds of millions of dollars developing a drug that might be open to a challenge to its novelty? If you have the processes worked out for screening drug leads for a particular activity you might as well develop a more novel molecule if it is going to cost about the same either way.
If you have any examples of truly trivial changes in me-too drugs I'd be interested in seeing them. The only one that I can think of is Nexium/Prilosec. I think that granting a patent on that is a bit of a stretch - anybody skilled in the art would predict that a purified enantiomer would be likely to have double the activity of a racemic mixture. On the other hand, while lots of people get up in arms over that one I don't see much harm in it - people can always take double the dose of the generic racemic mixture and get the same effect for far less cost. If people want to pay 10X the cost for essentially the same clinical effect more power to them.
Drug research isn't actually all that expensive (as in generating concepts). What is expensive is drug development - which is working a concept into a drug candidate and then putting it through trials.
I suspect that what will happen is that drug companies will look at the breakthroughs in these open consortiums and then develop candidates and patent them and run them through trials.
Example - the "open source" consortium discovers that inhibiting enzyme A cures cancer. Now, you can't patent the idea of inhibiting enzyme A. However, you can patent molecule 123 as an inhibitor of enzyme A. Somebody else could of course come up with molecule 456 which does the same thing but is a different molecule entirely. That's what we call a me-too drug and it is the reason why people with drug allergies don't die of diseases (they can take a me-too drug instead), and the reason for marginal improvements in classes over time (maybe molecue 456 is slightly better than 123).
However, once the company proves 123 is safe, they own the market until soembody else comes out with another drug. 123 is after all patent protected.
Consumers still win because maybe 456 comes along a year later and prices drop as they compete.
The issue at big drug companies is that they're having trouble coming up with breakthrough ideas for new drugs. The market doesn't need another statin that works 3% better than the 14 that are already on the market. However, something novel would certainly be both profitable and beneficial to the public. So, drug companies are trying to fund more novel R&D. Once some concepts worth developing come out the big pharma companies are experts at running molecules through the process, and after a few hundred million dollars spent getting something on the market.
This is also smart as the expensive part of drug development is the development part. You're not going to find poorly-funded researchers contributing much to that part of the puzzle. However, the blue sky research component needs ingenuity more than money - and that is what things like this are good at.
It is an interesting concept - I wonder how it will work out...
The average medical school costs a fortune to attend. The average Ph.D. program in the sciences PAYS you to attend (granted, really only enough to get by - maybe going into a tiny amount of debt). You're probably talking about $200k in cost to get that MD vs a Ph.D. in the sciences (which are the most prolific area they are awareded - probably because they're about the only area where it really impacts earnings).
Society also needs a lot more doctors than it needs Ph.D.s. I know I see a lot more "MDs" on signs on my way to work than Ph.D.s at work (and I work in a science-based company).
I'd like to see more merit-based scholarships for medicine to reduce the cost of entry, and then a drop of wages in the field. However, it isn't realistic to expect interest in medicine to be high if pay is mediocre - the hours are lousy, the liability is lousy, the eductional costs are lousy, and if you just want to feel good about helping people you could volunteer at a homeless shelter.
Thank you for your comments. I'd love to have a doctor like you (in fact I do - your attitudes are the sorts of things I look for if I need to find a new doctor). I also realize that if your practice depended solely on finding patients like me then you would be out of a practice...
I've thought about the ethics of placebos. If we're talking about an actual drug or a test, then you're exposing your patients to risks, and at the very least to cost. You're also directing their care without divulging your reasoning to your patient, which I think is also questionable. On the other hand, the placebo effect clearly works - there is a far greater difference between no treatment and placebo than there is between placebo and active ingredient in many classes of drugs.
I think the danger of placebos isn't that they're not effective - but rather that they're a step in the wrong direction. People need to get MORE involved in their health. I'd rather see a patient harmed because they interfered with their own care than see a patient "coerced" into a line of therapy they would rather not take part in. If it were up to me you wouldn't be required to have a prescription to take any drug (though I can see there being validity in insurers requireing them for reimbursement).
I think the real problem with EBM, or any kind of medicine, is that there is so little evidence out there. Real clinical data is hard to come by, and it is often in conflict. I think this just reflects the difficulty in working with humans. If we were talking about rats we could feed them bacon and count how many die of heart attacks, and then take those bacon-fed rats, give half of them bypass surgery, and then chop them all up and see the results a year later. Medical ethics (though clearly ESSENTIAL) really does tend to harm scientific progress. Ironically we might be able to save more people (statistically) if we just treated people like lab rats and sacrificed them for science from time to time. However, when you're talking about real human beings the needs of the individual clearly are at least as important as the needs of the statistical population.
As for my attitude - I'm going to die some day. It might be in 10 years, might be in 50 years, or even 200 years if somebody comes up with some fountain of youth. For me quality of life is certainly as important a consideration as quantity of life. I'd rather see people treated with dignity even if it does lower the average life expectancy a little.
You sound like a really good doctor - genuinely concerned about your patients well being. I wish you the best of luck!
A big problem is collective bargaining. I have a familiy member with some serious medical problems and they get large bills all the time.
When there aren't catastrophic surgeries involved the bills usually amount to tens of thousands of dollars a year, and the insurance company will pay maybe $1000-2000 per year to settle those claims.
Now, I could certainly budget on my own to pay the $1-2k and just get some catastrophic coverage to cover major expenses. However, I don't have that option. If I don't get a general goverage plan of some kind I have to pay the $10-20k per year at list price and not the negotiated rate of $1-2k per year.
If Jiffy Lube worked such that you just dropped off your car without even a mention of cost, and then you picked it up, and then a month later you got a bill for whatever they wanted to charge you, then chances are car maintenance would cost about as much as health care. Throw in making it illegal to change oil without a board certification and you'll really drive up prices. Make it illegal to distribute oil or filters to anybody without a certification and you get rid of the do-it-yourself option as well.
Keep in mind that antidepressants are really messy in terms of gauging effectiveness and side-effects. The placebo effect is significant.
When a side-effect is reported in fewer than 1% of patients there is a clinical trial somewhere backing it up. Sure, it is possible the actual incidence rate is higher, but the only way to be sure is to do another trial.
For all you know the doctor who sees those problems "all the time" would see them just as often if her patients were taking placebos. That is why trials are double-blind - neither the doctor nor the patient know what is in the pills.
I'm not knocking either you or your doctor. The placebo effect is a very real phenomenon. There is no way for ANY doctor or patient to tell if a clinical effect is a placebo effect or a real one. In fact, for most antidepressants if the drug company started selling sugar pills without telling anybody about it chances are the public health impacts wouldn't be all that different from selling the active ingredient. Of course, if people KNEW they were sugar pills it wouldn't work at all. Of course, ethical issues prevent placebos from being used in actual therapeutic care.
The other big issue with depression is that it is a fairly non-specific problem. I was talking to a psychiatrist about it and he pointed out that often different patients will respond differently to various drugs. He felt that the problem is that depression is a general description of what is likely many different biological problems. If you took a random population of people with congested breathing and gave them an antibiotic you'd find a portion of them making amazing recoveries and a portion not being helped at all. However, if you screened the population for the cause of the problem and only gave the antibiotic to those with bacterial infections likely to be susceptible to the antibiotic then the success rate would go way up. In the same way we often stumble in the darkness treating patients generically when if we only understood the underlying biology better we could give more effective care.
Sure, the profit motive certainly creates certain trends and pressures in the medical industry (particularly with drugs, but it certainly isn't limited to drugs). However, in my experiences there isn't really any grand conspiracy out there to take advantage of patients. Instead there is a confluence of issues that tend to result in the problems we see today. The solution is to fix the systemic problems - not to go around looking for people to lynch...
Yup - a big problem is supply/demand. The demand for doctors is huge. The supply is very limited. I think that a triage system of some sort would probably help - why should "House" be treating average cases.
I have a family member with some serious medical problems and I had similar experiences with doctors. The thing that amazes me is that a doctor will blow in with the breeze for 30 seconds to see a patient, and then spend an hour at the desk pouring over charts and test results. It seems like care just isn't very patient-centric.
Diabetes management is also a big problem. I've found that nurses fall into two camps. One camp tends to defer to the patient when it is clear the patient has experience with managing a particular problem - they offer advice and support but the patient is in charge. The other camp is "the chart says you get 5 units of insulin - so that's what you're getting unless you refuse treatment, and no, we won't give you what you actually want - take it or leave it." Is it a wonder that I've come in to visit this person and found them recovering from serious hypoglycemia in the morning, or that they're more in fear of their care team then the serious medical problem they're battling? Sure, sepsis or whatever feels REALLY lousy, but at least the disease doesn't put you in your place any time you dare to speak up.
Then, combine that with the legal system and doctors aren't so much interested in curing the patient as they are in not getting sued. Who can blame them?
And of course we also have the problem of imperfect knowledge. The fact is that even decades-old drugs are poorly known - good data takes well designed trials with tens of thousands of patients and that doesn't happen often. Often we have conflicting results from what would appear to be well-designed trials. Since we can't control clinical trials the way we can control animal studies we'll just have to accept that from time to time our best standards of care will turn out to be wrong. Independent studies to gather more data are of course beneficial.
Yeah, but still, $400M seems kind of steep. Wonder what it is like in constant dollars...
According to wikipedia an F-15E cost only $30M in 1998. I can't imagine that a helicoptier needs to cost the same as a squadron of F-15s. Even though they're becoming slightly dated the F15 is still superior to almost every other fighter on the planet - although the very best European and Russian designs are probably becoming close to on-par.
Just what capability will a new HELICOPTER give the president? These things are really just used to ferry people from point A to B. I could see a military attack helicopter being very expensive - those things actually serve combat missions that other aircraft can't. However, Marine One is just a transport. Sure, you can put some fancy anti-missile and communications gear in it, but the fact is that if it actually ends up being targetted in combat we're probably going to be flying flags at half mast.
Yes, but the point is that the worm shouldn't be able to "phone home" with data - there is no route from one of these classified computers back to the internet. The GP is basically describing a system of VPNs that might be used to link classified networks, but there shouldn't be any routes that lead to an unclassified network.
Uh, data like this shouldn't even be on a computer with a physical link to the internet at all. Classified data should stay on classified networks. Period.
I know a guy at a defense contractor. They isolate their networks containing classified data. If they need to remove a file from the room they reimage a desktop with a known safe image, copy the file onto that PC from a CD burned from a classified PC. They then scrub the files with software that does stuff like wipe unallocated space, check for word versions, PDF comments, etc. Then that desktop is used to burn a new CD with just the intended files. Then they securely wipe the desktop. That one CD that was created in this fashion is then allowed to leave the room. Note that this is the gist of how it works - some details may be less than accurate (obviously I'm not privy to the exact procedures, but this is the general level of rigor involved).
Even if somebody installed Kazaa or its like on one of the computers in that room it wouldn't be able to leak data - there are no network connections that are attached to the internet. If somebody needs to check email or browse the web they leave the room (carrying nothing with them) and go to another desk in a regular office area, which has a fairly secure network but something more akin to what you'd find in any decently secured corporate network. Of course, installing kazaa in the first place would be difficult since you're not supposed to carry anything into or out of the classified areas - I don't know if they get searched at the door but you would certainly be fired and potentially prosecuted if you were caught doing it intentionally.
Important datacenters like those found in stock exchanges / etc are similar. The datacenter is secured, network access is very carefully controlled, and to do anything important you need to have physical access to a room with cameras pointed everywhere and every task involves two people at the keyboard at all times.
There is no excuse for these kinds of breaches. Strong security isn't actually hard. It is certainly expensive, and it is certainly inconvenient. However, it really isn't hard - you just need to be methodical.
You haven't digested the "what we have does not work, and an interesting idea that might fail is better than what we have now, which is already failing or failed" realities of the situation yet.
Not only have I digested that, but I agree with it.
This whole system is going to crumble to ashes and dust, and a new social order is going to take its place
That is what I don't agree with.
and most people aren't ready to stop pretending things are ok just yet...
And this is why I don't agree with it.:)
I was pointing out why that idea wouldn't happen. I wasn't trying to say that it wouldn't work in some theoretical world where companies weren't run by self-interested short-sighted managers. When the followers of Plato rise up and their their place as philosopher-kings I'm sure the world will look different!:)
Any application can be pirated on any platform. PERIOD! You can make it easier or harder, but you can't prevent it as long as users have physical access to the hardware that the program runs on. All DRM shares this fundamental flaw. Now, with a phone you could assume connectivity at all times and run the bulk of the software on your own servers, and that would prevent copying of the software (consider MMORPGs as an example).
In the case of the G1 you can just buy the app using a non-dev phone with a root exploit installed, then copy the files off and install them on your dev phone. Viola - DRM bypassed. Sure, they could make it harder, but you could always patch the app. You could make the phone require signed apps, but then you could patch the firmware. There is always an expoit - even if it involves an electron microscope. The device is implemented in actual physical hardware, and if you have the means to take it apart you can do so. The only thing you can do is make it so hard that it isn't worth it for some $5 application.
However, half the attraction of android is its openness. If you lock the whole thing down like Fort Knox, what is the point? And if devs can't buy apps from other devs, then that just makes open source that much more competitive on the platform.:)
The big issue is leadership. You need it to make good software.
When 10 guys decide to live on hot dogs for three years to make a software product, that is leadership. If what they make does well they all end up owning islands, otherwise they end up having to get regular jobs.
When Google decides to take over the mobile phone OS market with an open source offering, writes 95% of it themselves, and then uses it as a platform to make money on value-adds, that is leadership.
When some guy in his spare time invents an application, and gets a few friends to join in, that is also leadership.
This kind of stuff doesn't tend to come out of consortiums of equals. I can think of a few initiatives like that in my industry and none of them have gone anywhere. The problem is that software isn't core to these industries. Their CEOs don't talk about software in their shareholder meetings. Software leaders don't become company leaders - they go to other companies if they have those kinds of ambitions.
Most companies want somebody else to solve the problem for them and then pay big money for the product. They line up for outsourcing opportunities for this reason - even if with proper focus they could do the same job cheaper in-house. The key word is "proper focus" - if IT is considered just a distraction then it won't get the leadership needed to be successful - you just need to buy stuff.
So, while I agree that what you suggest could work in theory, it won't work in practice. Companies would rather spend $100M buying products than $10M trying to do it themselves.
You'd be amazed by how much industry-specific software is out there. This kind of software has 25 customers, with 100 users each, and each of them pay $1-2M for the licenses. It is the polar opposite of Microsoft Office. And therein lies the problem...
Like any industry we use a ton of this stuff at work. I've always found that you're better off finding a successful vendor that specializes in this kind of work than buying something like this from a big software house. When you go with the specialized vendor the product probably makes up 30-100% of their revenue. With the major software house the product makes up 0.001% of their revenue and their main focus is on stuff that comes in boxes on the shelf of Best Buy or wherever. Usually this kind of stuff starts out in small companies and gets bought out by a big company. They invest minimally (nothing truly innovative - mainly support for database/OS upgrades), and milk the maintenance contracts. Eventually everybody abandons them and they drop the product entirely.
Sure, you also take a gamble with a small company. However, with small companies I can sit down and talk to their development team and they actually have a vision for where their product will be in five years. They actually come up with new ideas. If you get in early you can actually build goodwill and form a partnership and get discounted rates. Or, you can pay full retail by waiting until they're already popular, but then most of the risk of being abandoned goes away. Just make sure the core development team isn't about to sell out - it helps to get to know them and their motivations a little.
Sure, if you're talking commodity software (software used in ANY industry - webservers, email, development platforms, etc) just go open source. However, you'll find this isn't much of an option when you get to industry-specific stuff (with some exceptions).
Well, there is always mother nature. Or you can pay for the 2032 technique. Or you can live with 2009.
With the latest pendulum swing in prescribing nobody wants to put their patients on anything less than 15 years old anyway. Who knows what the fad will be in 2032 though...
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And the US didn't bomb Saudi Arabia when a bunch of Saudi nationals destroyed the twin towers.
The US hasn't generally retalliated against nations simply for having terrorists inside them. The US attacks nations that harbor terrorists and give them aid.
Look, I'm not a big fan of US interventionism. However, the US reponse in Afganistan was pretty good policy - and internationally it was fairly well supported. Iraq was an entirely different mess. In fact, Iraq tended to blur US policy which damaged the effectiveness of real retaliations.
US policy should be simple - attack the US and the US will attack you. Sponsor a bunch of nuts, give them guns, and have them attack the US, and the US will attack you. If you happen to have nuts living in your country that you don't support, and which you try to keep under control, and which you punish when you catch them, then the US won't attack you even if those nuts attack the US. Maybe the US would ask to help you catch them, and even request extradition (something that might be open for negotiation as long as the terrorists get punished one way or another).
Most nations would support this kind of foreign policy, and it would certainly deter attacks.
I'm not usually the conspiracy-theory type, but I suspect that the USAF already is flying an SR-71 replacement and this is why they have been retired.
Spy Satellites and UAVs certainly cover parts of the SR-71 mission profile. However, what about battlefield survailence of a major military adversary? Current UAVs cannot survive in combat. Sure, they can loiter over Basra all day when nobody has anything other than a rifle to shoot at them with. Try to get footage of downtown Tehran with a UAV and you'll just have UAV-parts raining all over the place. Satellites certainly work better, but they're very limited in coverage and have no loiter capability. They're also very vulnerable if somebody is determined enough to actually start shooting them down.
I'm not saying you couldn't do the job with a UAV with SR-71-like capabilities. That is certainly an option. Perhaps one already exists. However, neither satellites or the currently public UAV options make the SR-71 completely obsolete. Either the US doesn't think it needs ariel recon of hot areas, or it has some other way of doing it that nobody knows about.
I think it would be the same as it always has been. We would provide millions of dollars in aide for them, there would be peace rallies and movements to bring them supplies, but ultimately we (The US) would leave it to them to resolve the problem on their own.
Of course the US would leave them to resolve the problem on their own - the US wasn't attacked in the parent's hypothetical scenario. Why would the US care if somebody killed a few thousand Chinese citizens?
The Chinese (or Russians), on the other hand, would have almost certainly launched an invasion of some kind. Why do you think nobody messes with them?
Now, they might or might not have launched a full-scale takeover of Afganistan. I suspect that their style would be more along the lines of doing covert operations. Then again, the Chinese at least might look forward to an internationally-sanctioned opportunity to get some field practice for their army.
The point was that the US did what any other country in a similar position would have done. The Chinese or the Russians certainly wouldn't have given them a slap on the wrist.
Going back to the original point of this thread - I doubt any major nation would launch a knee-jerk nuclear strike in response to a terrorist attack. If the terrorists were state-sponsored they would almost certainly retalliate at least conventionally, but if the terrorists were wackos from Kansas I doubt they'd wipe Kansas off the map.
Yup, same experience here. I was looking for an automotive GPS, and decided to stop by (having already heard about the ripoff "markdowns" - but since the closeouts were being subcontracted I figured maybe I'd get lucky). Well, I didn't get lucky. EVERYTHING was much more expensive than even the Best Buy across the street. I wasn't sure how they thought they'd get away with it. Plus they had "all sales final" signs all over the place.
Now, why would I want to spend $250 for a GPS with no returns when I could spend $200 and get it at Best Buy with a returns policy, or $120 online (still with a return policy, but a little more hassle)?
As it is I almost never shop in Best Buy due to the ripoff prices. Forget CC...
There is not an absence of data. Read The God Delusion.
Uh, how can you have data supporting the non-existence of God? At best you could have data to indicate that everything makes sense without the existence of God. You might even have data to disprove specific accounts about somebody's specific assertion as to how God has intervened in the world. However, unless one is claiming to be God one can certainly not claim to have evidence as to whether God does or does not exist.
I don't need to pay $9.95 for a book to tell me this much... :)
Of course, if you give everybody a $40 coupon (or whatever) they end up just paying $50 more in taxes or their grandkids get the equivalent in debt. It isn't like "the government" has no relationship to the people who live and breathe within the country. As an added bonus you get to pay a premium on the cost of the converter which is able to be sold for a higher cost since consumers will be willing to pay more on top of their subsidies.
Sure, the money might "come from" the spectrum sales, but that is just $40 + distribution costs less revenue for the government to operate on, which again, is just higher taxes. There is just one big pile of government money out there - cut off one input and another grows to take its place.
You give god too much credit to suppose that denial of his existence is a fundamental belief rather than a mere consequence of a belief in logical positivism.
Any belief can stand on its own, and also can be a consequence of another belief. Belief isn't logical, and no laws of logic need apply.
For example, one can deny the existance of God, and hold a belief in the Tooth Fairy. Such a person is clearly not a logical positivist.
And a belief in logical positivism is also a belief - so the point isn't really any different. Absence of evidence isn't evidence of absence. One can choose to regard it as such nonetheless, but that is a matter of philosophy. Actually, science itself is a philosophy - a very successful one, but it is as fallible as anything else made by men. It just has the virtue of not being falsifiable - falsifying a theory as an attack upon science is really just a reinforcement of the scientific method. :)
Look, I'm not knocking Dawkins, or athiests, or anything like that. All I'm saying is that philisophically the denial of God is no more a privileged position than the belief in God. The two positions are more fashionable among various culture groups, but the only way one position or the other can be privileged except by convention is if some source of omnscience exists, and somehow I don't think that such a source would be an athiest unless the source also holds to its own non-existence.
He never, ever says that there is absolutely 100% no god. In fact, he usually puts the possibility that there is no god somewhere within 90-98%.
Uh, how can you estimate the possibility of a completely untestable assertion being true as having ANY value at all short of simply holding a belief? How does he know the true probability isn't in fact 99.99% and that he is being needlessly uncertain of his convictins? Perhaps the true probability is 84.5%. Then again, there is no such thing as probability in the absence of data. Probability is a mathematical concept, and all it does it allows one to formally state the level of certainty in an outcome given a well-defined scenario. Unless you can come up with a mathematical model for the existance of a hypothetical God, how can you begin to calculate probabilities.
Like Richard Dawkins?
He does not merely not believe in a God. He BELIEVES there is no God.
Define atheism as you will. The point is that Dawkins certainly advances a religious belief - one which cannot in any way be proven one way or another.
Merely not holding an opinion on the subject of God is not a belief - that is an attitude and not an intellectual position.
As an analogy. I am convinced a company will go up in value - I buy the stock. I am convinced a company will go down in value - I short the stock. I don't care about the company - I go to the beach and buy ice cream instead. Dawkins clearly is shorting the stock. I'm not criticising that decision - however clearly he isn't just eating ice cream...
Of course, if the insurance denies them you might still not be liable. Most likely your doctor signed a contract with your insurance company in which they agreed to hold you harmless for any fees incurred not in accordance with the plan.
So now we have a contract with A and B, a contract with B and C, and a contract with A and C that all disagree. You also have a doctor that isn't eager to lose their contract with B and EVERY other company like B. They'll certainly bug you but most likely the charges wouldn't stand up in court.
Of course, they can still put a complaint in your credit history. Credit reporting agencies need a bit more regulation. Companies shouldn't be able to simply lodge complaints without some kind of judgment against you. Courts are the forum for weighing liability - not credit reporting agencies (who are paid by the people who have a complaint against you).
A me-too drug by definition has the same mechanism of action. For example, even though insulin and metformin both lower blood sugar one is not considered a "me-too" of the other since they have completely different mechanisms and potential uses.
Most me-too drugs usually aren't trivial variations on existing drugs. Sometimes antibiotics fall into this category (often to defeat some resistance mechanism).
I would think that a drug that is only a trivial variation of an existing drug would be risky from a patent perspective. Why spend hundreds of millions of dollars developing a drug that might be open to a challenge to its novelty? If you have the processes worked out for screening drug leads for a particular activity you might as well develop a more novel molecule if it is going to cost about the same either way.
If you have any examples of truly trivial changes in me-too drugs I'd be interested in seeing them. The only one that I can think of is Nexium/Prilosec. I think that granting a patent on that is a bit of a stretch - anybody skilled in the art would predict that a purified enantiomer would be likely to have double the activity of a racemic mixture. On the other hand, while lots of people get up in arms over that one I don't see much harm in it - people can always take double the dose of the generic racemic mixture and get the same effect for far less cost. If people want to pay 10X the cost for essentially the same clinical effect more power to them.
Drug research isn't actually all that expensive (as in generating concepts). What is expensive is drug development - which is working a concept into a drug candidate and then putting it through trials.
I suspect that what will happen is that drug companies will look at the breakthroughs in these open consortiums and then develop candidates and patent them and run them through trials.
Example - the "open source" consortium discovers that inhibiting enzyme A cures cancer. Now, you can't patent the idea of inhibiting enzyme A. However, you can patent molecule 123 as an inhibitor of enzyme A. Somebody else could of course come up with molecule 456 which does the same thing but is a different molecule entirely. That's what we call a me-too drug and it is the reason why people with drug allergies don't die of diseases (they can take a me-too drug instead), and the reason for marginal improvements in classes over time (maybe molecue 456 is slightly better than 123).
However, once the company proves 123 is safe, they own the market until soembody else comes out with another drug. 123 is after all patent protected.
Consumers still win because maybe 456 comes along a year later and prices drop as they compete.
The issue at big drug companies is that they're having trouble coming up with breakthrough ideas for new drugs. The market doesn't need another statin that works 3% better than the 14 that are already on the market. However, something novel would certainly be both profitable and beneficial to the public. So, drug companies are trying to fund more novel R&D. Once some concepts worth developing come out the big pharma companies are experts at running molecules through the process, and after a few hundred million dollars spent getting something on the market.
This is also smart as the expensive part of drug development is the development part. You're not going to find poorly-funded researchers contributing much to that part of the puzzle. However, the blue sky research component needs ingenuity more than money - and that is what things like this are good at.
It is an interesting concept - I wonder how it will work out...
The average medical school costs a fortune to attend. The average Ph.D. program in the sciences PAYS you to attend (granted, really only enough to get by - maybe going into a tiny amount of debt). You're probably talking about $200k in cost to get that MD vs a Ph.D. in the sciences (which are the most prolific area they are awareded - probably because they're about the only area where it really impacts earnings).
Society also needs a lot more doctors than it needs Ph.D.s. I know I see a lot more "MDs" on signs on my way to work than Ph.D.s at work (and I work in a science-based company).
I'd like to see more merit-based scholarships for medicine to reduce the cost of entry, and then a drop of wages in the field. However, it isn't realistic to expect interest in medicine to be high if pay is mediocre - the hours are lousy, the liability is lousy, the eductional costs are lousy, and if you just want to feel good about helping people you could volunteer at a homeless shelter.
Thank you for your comments. I'd love to have a doctor like you (in fact I do - your attitudes are the sorts of things I look for if I need to find a new doctor). I also realize that if your practice depended solely on finding patients like me then you would be out of a practice...
I've thought about the ethics of placebos. If we're talking about an actual drug or a test, then you're exposing your patients to risks, and at the very least to cost. You're also directing their care without divulging your reasoning to your patient, which I think is also questionable. On the other hand, the placebo effect clearly works - there is a far greater difference between no treatment and placebo than there is between placebo and active ingredient in many classes of drugs.
I think the danger of placebos isn't that they're not effective - but rather that they're a step in the wrong direction. People need to get MORE involved in their health. I'd rather see a patient harmed because they interfered with their own care than see a patient "coerced" into a line of therapy they would rather not take part in. If it were up to me you wouldn't be required to have a prescription to take any drug (though I can see there being validity in insurers requireing them for reimbursement).
I think the real problem with EBM, or any kind of medicine, is that there is so little evidence out there. Real clinical data is hard to come by, and it is often in conflict. I think this just reflects the difficulty in working with humans. If we were talking about rats we could feed them bacon and count how many die of heart attacks, and then take those bacon-fed rats, give half of them bypass surgery, and then chop them all up and see the results a year later. Medical ethics (though clearly ESSENTIAL) really does tend to harm scientific progress. Ironically we might be able to save more people (statistically) if we just treated people like lab rats and sacrificed them for science from time to time. However, when you're talking about real human beings the needs of the individual clearly are at least as important as the needs of the statistical population.
As for my attitude - I'm going to die some day. It might be in 10 years, might be in 50 years, or even 200 years if somebody comes up with some fountain of youth. For me quality of life is certainly as important a consideration as quantity of life. I'd rather see people treated with dignity even if it does lower the average life expectancy a little.
You sound like a really good doctor - genuinely concerned about your patients well being. I wish you the best of luck!
A big problem is collective bargaining. I have a familiy member with some serious medical problems and they get large bills all the time.
When there aren't catastrophic surgeries involved the bills usually amount to tens of thousands of dollars a year, and the insurance company will pay maybe $1000-2000 per year to settle those claims.
Now, I could certainly budget on my own to pay the $1-2k and just get some catastrophic coverage to cover major expenses. However, I don't have that option. If I don't get a general goverage plan of some kind I have to pay the $10-20k per year at list price and not the negotiated rate of $1-2k per year.
If Jiffy Lube worked such that you just dropped off your car without even a mention of cost, and then you picked it up, and then a month later you got a bill for whatever they wanted to charge you, then chances are car maintenance would cost about as much as health care. Throw in making it illegal to change oil without a board certification and you'll really drive up prices. Make it illegal to distribute oil or filters to anybody without a certification and you get rid of the do-it-yourself option as well.
Keep in mind that antidepressants are really messy in terms of gauging effectiveness and side-effects. The placebo effect is significant.
When a side-effect is reported in fewer than 1% of patients there is a clinical trial somewhere backing it up. Sure, it is possible the actual incidence rate is higher, but the only way to be sure is to do another trial.
For all you know the doctor who sees those problems "all the time" would see them just as often if her patients were taking placebos. That is why trials are double-blind - neither the doctor nor the patient know what is in the pills.
I'm not knocking either you or your doctor. The placebo effect is a very real phenomenon. There is no way for ANY doctor or patient to tell if a clinical effect is a placebo effect or a real one. In fact, for most antidepressants if the drug company started selling sugar pills without telling anybody about it chances are the public health impacts wouldn't be all that different from selling the active ingredient. Of course, if people KNEW they were sugar pills it wouldn't work at all. Of course, ethical issues prevent placebos from being used in actual therapeutic care.
The other big issue with depression is that it is a fairly non-specific problem. I was talking to a psychiatrist about it and he pointed out that often different patients will respond differently to various drugs. He felt that the problem is that depression is a general description of what is likely many different biological problems. If you took a random population of people with congested breathing and gave them an antibiotic you'd find a portion of them making amazing recoveries and a portion not being helped at all. However, if you screened the population for the cause of the problem and only gave the antibiotic to those with bacterial infections likely to be susceptible to the antibiotic then the success rate would go way up. In the same way we often stumble in the darkness treating patients generically when if we only understood the underlying biology better we could give more effective care.
Sure, the profit motive certainly creates certain trends and pressures in the medical industry (particularly with drugs, but it certainly isn't limited to drugs). However, in my experiences there isn't really any grand conspiracy out there to take advantage of patients. Instead there is a confluence of issues that tend to result in the problems we see today. The solution is to fix the systemic problems - not to go around looking for people to lynch...
Yup - a big problem is supply/demand. The demand for doctors is huge. The supply is very limited. I think that a triage system of some sort would probably help - why should "House" be treating average cases.
I have a family member with some serious medical problems and I had similar experiences with doctors. The thing that amazes me is that a doctor will blow in with the breeze for 30 seconds to see a patient, and then spend an hour at the desk pouring over charts and test results. It seems like care just isn't very patient-centric.
Diabetes management is also a big problem. I've found that nurses fall into two camps. One camp tends to defer to the patient when it is clear the patient has experience with managing a particular problem - they offer advice and support but the patient is in charge. The other camp is "the chart says you get 5 units of insulin - so that's what you're getting unless you refuse treatment, and no, we won't give you what you actually want - take it or leave it." Is it a wonder that I've come in to visit this person and found them recovering from serious hypoglycemia in the morning, or that they're more in fear of their care team then the serious medical problem they're battling? Sure, sepsis or whatever feels REALLY lousy, but at least the disease doesn't put you in your place any time you dare to speak up.
Then, combine that with the legal system and doctors aren't so much interested in curing the patient as they are in not getting sued. Who can blame them?
And of course we also have the problem of imperfect knowledge. The fact is that even decades-old drugs are poorly known - good data takes well designed trials with tens of thousands of patients and that doesn't happen often. Often we have conflicting results from what would appear to be well-designed trials. Since we can't control clinical trials the way we can control animal studies we'll just have to accept that from time to time our best standards of care will turn out to be wrong. Independent studies to gather more data are of course beneficial.
Yeah, but still, $400M seems kind of steep. Wonder what it is like in constant dollars...
According to wikipedia an F-15E cost only $30M in 1998. I can't imagine that a helicoptier needs to cost the same as a squadron of F-15s. Even though they're becoming slightly dated the F15 is still superior to almost every other fighter on the planet - although the very best European and Russian designs are probably becoming close to on-par.
Just what capability will a new HELICOPTER give the president? These things are really just used to ferry people from point A to B. I could see a military attack helicopter being very expensive - those things actually serve combat missions that other aircraft can't. However, Marine One is just a transport. Sure, you can put some fancy anti-missile and communications gear in it, but the fact is that if it actually ends up being targetted in combat we're probably going to be flying flags at half mast.
Yes, but the point is that the worm shouldn't be able to "phone home" with data - there is no route from one of these classified computers back to the internet. The GP is basically describing a system of VPNs that might be used to link classified networks, but there shouldn't be any routes that lead to an unclassified network.
Uh, data like this shouldn't even be on a computer with a physical link to the internet at all. Classified data should stay on classified networks. Period.
I know a guy at a defense contractor. They isolate their networks containing classified data. If they need to remove a file from the room they reimage a desktop with a known safe image, copy the file onto that PC from a CD burned from a classified PC. They then scrub the files with software that does stuff like wipe unallocated space, check for word versions, PDF comments, etc. Then that desktop is used to burn a new CD with just the intended files. Then they securely wipe the desktop. That one CD that was created in this fashion is then allowed to leave the room. Note that this is the gist of how it works - some details may be less than accurate (obviously I'm not privy to the exact procedures, but this is the general level of rigor involved).
Even if somebody installed Kazaa or its like on one of the computers in that room it wouldn't be able to leak data - there are no network connections that are attached to the internet. If somebody needs to check email or browse the web they leave the room (carrying nothing with them) and go to another desk in a regular office area, which has a fairly secure network but something more akin to what you'd find in any decently secured corporate network. Of course, installing kazaa in the first place would be difficult since you're not supposed to carry anything into or out of the classified areas - I don't know if they get searched at the door but you would certainly be fired and potentially prosecuted if you were caught doing it intentionally.
Important datacenters like those found in stock exchanges / etc are similar. The datacenter is secured, network access is very carefully controlled, and to do anything important you need to have physical access to a room with cameras pointed everywhere and every task involves two people at the keyboard at all times.
There is no excuse for these kinds of breaches. Strong security isn't actually hard. It is certainly expensive, and it is certainly inconvenient. However, it really isn't hard - you just need to be methodical.
You haven't digested the "what we have does not work, and an interesting idea that might fail is better than what we have now, which is already failing or failed" realities of the situation yet.
Not only have I digested that, but I agree with it.
This whole system is going to crumble to ashes and dust, and a new social order is going to take its place
That is what I don't agree with.
and most people aren't ready to stop pretending things are ok just yet...
And this is why I don't agree with it. :)
I was pointing out why that idea wouldn't happen. I wasn't trying to say that it wouldn't work in some theoretical world where companies weren't run by self-interested short-sighted managers. When the followers of Plato rise up and their their place as philosopher-kings I'm sure the world will look different! :)
This is a silly reason to ban the dev phone.
Any application can be pirated on any platform. PERIOD! You can make it easier or harder, but you can't prevent it as long as users have physical access to the hardware that the program runs on. All DRM shares this fundamental flaw. Now, with a phone you could assume connectivity at all times and run the bulk of the software on your own servers, and that would prevent copying of the software (consider MMORPGs as an example).
In the case of the G1 you can just buy the app using a non-dev phone with a root exploit installed, then copy the files off and install them on your dev phone. Viola - DRM bypassed. Sure, they could make it harder, but you could always patch the app. You could make the phone require signed apps, but then you could patch the firmware. There is always an expoit - even if it involves an electron microscope. The device is implemented in actual physical hardware, and if you have the means to take it apart you can do so. The only thing you can do is make it so hard that it isn't worth it for some $5 application.
However, half the attraction of android is its openness. If you lock the whole thing down like Fort Knox, what is the point? And if devs can't buy apps from other devs, then that just makes open source that much more competitive on the platform. :)
The big issue is leadership. You need it to make good software.
When 10 guys decide to live on hot dogs for three years to make a software product, that is leadership. If what they make does well they all end up owning islands, otherwise they end up having to get regular jobs.
When Google decides to take over the mobile phone OS market with an open source offering, writes 95% of it themselves, and then uses it as a platform to make money on value-adds, that is leadership.
When some guy in his spare time invents an application, and gets a few friends to join in, that is also leadership.
This kind of stuff doesn't tend to come out of consortiums of equals. I can think of a few initiatives like that in my industry and none of them have gone anywhere. The problem is that software isn't core to these industries. Their CEOs don't talk about software in their shareholder meetings. Software leaders don't become company leaders - they go to other companies if they have those kinds of ambitions.
Most companies want somebody else to solve the problem for them and then pay big money for the product. They line up for outsourcing opportunities for this reason - even if with proper focus they could do the same job cheaper in-house. The key word is "proper focus" - if IT is considered just a distraction then it won't get the leadership needed to be successful - you just need to buy stuff.
So, while I agree that what you suggest could work in theory, it won't work in practice. Companies would rather spend $100M buying products than $10M trying to do it themselves.
You'd be amazed by how much industry-specific software is out there. This kind of software has 25 customers, with 100 users each, and each of them pay $1-2M for the licenses. It is the polar opposite of Microsoft Office. And therein lies the problem...
Like any industry we use a ton of this stuff at work. I've always found that you're better off finding a successful vendor that specializes in this kind of work than buying something like this from a big software house. When you go with the specialized vendor the product probably makes up 30-100% of their revenue. With the major software house the product makes up 0.001% of their revenue and their main focus is on stuff that comes in boxes on the shelf of Best Buy or wherever. Usually this kind of stuff starts out in small companies and gets bought out by a big company. They invest minimally (nothing truly innovative - mainly support for database/OS upgrades), and milk the maintenance contracts. Eventually everybody abandons them and they drop the product entirely.
Sure, you also take a gamble with a small company. However, with small companies I can sit down and talk to their development team and they actually have a vision for where their product will be in five years. They actually come up with new ideas. If you get in early you can actually build goodwill and form a partnership and get discounted rates. Or, you can pay full retail by waiting until they're already popular, but then most of the risk of being abandoned goes away. Just make sure the core development team isn't about to sell out - it helps to get to know them and their motivations a little.
Sure, if you're talking commodity software (software used in ANY industry - webservers, email, development platforms, etc) just go open source. However, you'll find this isn't much of an option when you get to industry-specific stuff (with some exceptions).
Well, there is always mother nature. Or you can pay for the 2032 technique. Or you can live with 2009.
With the latest pendulum swing in prescribing nobody wants to put their patients on anything less than 15 years old anyway. Who knows what the fad will be in 2032 though...