Typical to focus on the pipeline, the Economist is culturally conditioned not to question the context of the system.
A lot the distribution, efficiency, and particularly the burnout are due to corporatization and over regulation. The "medical" system is a self-licking ice cream cone of non normal demand curves being served by inefficient systems the generate reasons to intermediate money between the end players of patient and doctor.
So typical to focus on the "doctor" as the problem.
We had a much more robust distributed national system before the"smart" people made it "efficient".
Yes, this sort of solipsism thrives on the coasts where people are So Very Sure how Very Smart and Very Correct they are. Not that all US coastal people and cultures are like that, far from it, but the level of population and prosperity that breeds the resulting insularity comes along with it.
Seems very entitled to me. I wonder if the author ever considered how people who have lived in a small town feel about someone who insists on showing up, being catered to, and not assimilating?
Realize there is some level of resentment of servicemen as well. I was a dependent in the 80s abroad.
I am also an American and so sensitive to small unfriendlinesses, but I find them no worse in visiting a far city like Chicago than in most countries.
Have not been to Germany in a while. It used to feel quite straightforward to me and much friendlier than I expected with a modicum of effort. Perhaps more jaded now in the post internet era but who knows.
Still this feels like the snowflake version of the Ugly American viewpoint.
- among many thoughtful comments, a search for "fun" yields mostly comments about functions and expressivity; I think this is a key aspect that isn't as apparent to many experienced people here. The fond recollections of ZX80/81's captures some of that idea, though.
- Scratch is blessedly non-commercial and immensely approachable. It's educational mission is not top-down, but bottom-up.
- The mix of 3GL expressivity with enough constraint to get a person started is great. Kind of reminds me of the generativity I see in kids playing Minecraft.
- The pure old-schoolness of it all keeps you from being mugged in a dark semantic alley by a gang of monad-botherers.
That sounds somewhat resonant. I'd be really curious as to what insights you had or choices you made; considering the same type of switch. Did you ever write anything up on the journey or find any particular resources useful?
Not really. I've played it safe by buying a Linux desktop box in addition to my MacBook. elementary OS was fun (esp. the Daily build) because so many things can be fixed on an evening by sending a small PR, and they also receive support from the Touchégg developer now for better trackpad gestures. But I never managed to treat Linux as more than a thin shell around my IntelliJ IDE.
I'm just happy that critical discussion around SARS-nCoV-2 and related politics isn't instantly being flagged on Hacker News anymore ;)
There is a lot of brainpower and a surprising variety of experience on this list.
One of the things that had most annoyed me in medicine since 1995,a slavish dedication to what I've come to call "evidence based nihilism". And a lot of the people who are most rigid do not treat patients but get promoted out of useful work.
The space of actual practice is far more complex and some applied science is actually called for.
What's worse, this kind of sanctimonious stringency (large industry/govt funded placebo DB RCT etc) is selectively applied to only certain practices, never to received wisdom or pet projects.
Good points about engaging in this work has changed the ways the author both thinks and feels about the landscape and ecosystem.
We've been learning about permaculture (old school Holzer, Mollison, Hemenway style) and small-scale homesteading for about 8 yrs now. Started from nearly scratch, in terms of practical gardening.
Every bit of work I've done with bees (solitary mason bees) and other permaculture (garden, orchard, efficient irrigation solutions, swaling, synergistic plantings, etc) has been fascinating.
The permaculture philosophy itself is more broadly-applicable than agriculture, in terms of a systems based view, but a lot of the practical instantiations are in ag, heating, irrigation, animal husbandry, etc. There's a lot on offer for many people who would be attracted to HN. E.g. looking at the thermodynamic aspects of siting water tanks, passive solar, masonry stoves, etc (physics and biomed background b4 software). Cost-wise and energetically a lot more scalable than widely existing solutions.
Also improved my perceptive ability and appreciation for natural surroundings and different human landscapes.
Anyhow, I'll get down off my soapbox now, but it's been a surprisingly rich vein of practical innovation and fun.
If you're curious, check out "Gaia's Garden" by Hemenway or one of Bill Mollison's books (former in Portland, so small yards, latter doing more wide-reaching stuff in Australia and developing nations).
A lot the distribution, efficiency, and particularly the burnout are due to corporatization and over regulation. The "medical" system is a self-licking ice cream cone of non normal demand curves being served by inefficient systems the generate reasons to intermediate money between the end players of patient and doctor.
So typical to focus on the "doctor" as the problem.
We had a much more robust distributed national system before the"smart" people made it "efficient".