tinokid's comments

And that is the claim I was contesting. You seem to have an odd intuition that a line of argument that does not reduce to a computing problem is "emotional". Even if one does not believe in retributive justice at all, an adequate deterrent is still going to be in proportion to the seriousness of the crime. It's not something that admits of a resolution by facts and figures alone.

Well you yourself said it reflected the same kind of "emotional thinking" that led to millennia of "torture and abuse". What I am trying to show is that there are plenty of good reasons for this kind of punishment (whether or not one accepts a retributive component to justice). It is not simply a knee jerk insensitive reaction.

You're missing the point because you don't understand the gravity of the crime.

A minimum wage fast food worker is constantly observed by a phalanx of cameras that will incriminate her should she attempt to steal five dollars from the till, but a surgeon in an operating room performs an infinitely more consequential task with nary a recording device in sight. Why? The immense trust and responsibility invested by society in medical doctors.

There is a common misconception that a medical license is basically just a reward for a demonstration of technical mastery, much as a developer job flows from passing a coding interview. But in reality the technical aspect is only secondary; the primary purpose of all those years of training is to ensure that the student understands the fullness of the obligations associated with the profession and is properly disposed to accept them.

In a case like this, the person understood and accepted those grave obligations, as well as all the privileges that came with them, only to toss them out the window when the opportunity arose to make a few extra dollars. That is what is being punished here. Four years is hardly too long, or cruelly retributive.

This is absolutely correct and should not have been downvoted.

It is the abuse of a position of trust that aggravates this crime relative to that of a simple outlaw street dealer.

Commenters who are concerned with the effect on the convict's reputation and future employability are simply not in touch with reality....this was a grave breach of the basic ethics of the medical profession and seriously harmed the innocent patients involved. There is no return to work after something like this...any more than with a scientist who falsifies data, a teacher who sleeps with minor students, a lawyer who steals from escrow, etc.

I find it highly disturbing that there is more discussion in this thread as to the effect on the doctor's return on investment from his medical degree rather than on the individuals who bodies were damaged by someone they were supposed to be able to trust.

Right, it's not easy and there are adverse selection issues when you start incentivizing doctors to avoid complex cases that are more likely to involve complications. And the scientific basis for a given procedure is likely more important than minor variations in doctors' technical competence levels.

That said, insurers have better insight into this than almost anyone else. If they see a young person with almost no medical claims go in for an elective foot surgery with Doctor Lexus, and then all of a sudden that person is attending physical therapy and filling opioid prescriptions every month, that's a bad sign. If it happens more than once, insurers should feel empowered to go ahead and shut the good doctor down. But this does not happen.

"Not all that much" is not how I would describe a chart like this: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanag...

And lung cancer is not the only cancer caused by smoking.

In any case, cancer death rates and changes in risk factors do not speak directly to the claim about treatment effectiveness. If you are diagnosed with cancer, you are basically every bit as f'ed today as you were 50 years ago, except in the special case that your cancer happens to be one of those that never would have been noticed back then.

> Even beyond that the absolute rate of cancer deaths in the US peaked in 1990 216 per 100k vs 2015 at 158 per 100k. Which is a massive drop even over 1950's pre screening and younger population numbers of 193 per 100k.

Hmmm... Apply a 25 year lag. https://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m4843a2f1....

>PS: Stomach cancer is flat out much less common because we understand a major cause now. Cervical cancer rates will similarly drop from the HPV vaccine.

Yes...lots of progress in infectious disease treatment, very little with cancer treatment.

Treating infectious disease than can cause cancer (H. pylori, HPV) has nothing to do with cancer treatment.

Treating, for example, thyroid or prostate cancers that would not have killed the person improves cancer survival statistics but nothing else.

"People cared" maybe plays a bigger role than you realize here. There were stronger social norms back then about the role of medical care in society. Most hospitals were community or religious owned, physicians were content with merely above average professional salaries, and you never saw any kind of advertisement that ended with "ask your doctor about X".

I think it's naive to assume the 16.5%-of-GDP octopus we've created wouldn't figure out a way to profit from the removal of all regulations.

>Heath care has gotten vastly better over time. Look at 5 year cancer survival rates for example.

No. These rates are affected by more screening procedures. Some nipped a potentially fatal cancer in the bud, others just found and removed something that wouldn't have killed the person.

To first order there is no change in the effectiveness of cancer treatment as compared to 50 years ago.

>Maybe some sort of system where if the provider states that something is medically necessary then they are on the hook if insurance denies the claim

Not only should a provider be legally prohibited from trying to collect payment for unnecessary treatment, they should be held responsible for complications. Even unnecessary x-rays can cause cancer.

Nice idea, but how realistic is it? Most patients are not scientifically-literate, some are flat out incapacitated.

For all the stories about heartless insurance companies denying to pay for things, perhaps they should actually be more strict. As in, refuse to pay for anything unless there is 1) rock-solid (i.e. double-blind, placebo-controlled) evidence that it helps 2) for a specific, objectively verifiable indication 3) when provided by a doctor whose track record is demonstrably non-inferior to that of other practitioners. But for all three of those things, no $.

I would be interested in buying insurance like that.

But genetics may or may not be the "base truth" in regard to disease risk. It's difficult to tease out the effects of genes as opposed to environment. When your model has thousands or millions of genetic loci this only gets harder.

C'mon people...this is not science, this is fortune telling. They are just doing a bunch of huge multiparameter curve fits, which are going to pick up signal from all sorts of things that have nothing to do with biology no matter how big their sample size is. These people will tell you with a straight face that a bunch of markers that just happen to be associated with "Northeast European ancestry" are also predictive of "Polka dancing ability," and their papers are shuffling and repackaging thousands upon thousands of nonsensical little tidbits exactly like that. Life experience doesn't just "average out." Do better.

>"Increasingly, banks recognized the value of tellers enabled by information technology, not primarily as checkout clerks, but as salespersons, forging relationships with customers and introducing them to additional bank services like credit cards, loans, and investment products."

Was this written before the Wells Fargo scandal came to light?

Hard to be optimistic when the "silver lining" is that people who were once employed to do necessary work have since been reassigned to trawl for opportunities to make easy money at the expense of the gullible and vulnerable.

Sadly this appears to be yet another theme in technological advancement--the proliferation of scams. Just look at how much social media advertising comes from multi-level marketing schemes.

No, no shooting.

They should have just let the market work and the banks go under.

It would have been a financial loss but a moral victory. An important lesson about carefully choosing who you trust.

Really? It's "self-evident" Visa fucked up? Yeah...I'll be waiting for the statement to that effect on visa.com

And then I saw this comment: "Thats weird. I have a mastercard and was charged twice. So how is it Visas fault."

>As I’ve stated multiple times and you keep ignoring, ideal case, it can take under 12hrs

I must have missed where you said that. You said I was likely mistaking ACH for wire transfer because mine were happening that fast.

The point stands that "inherent delays" in the ACH system are negligible, on the order of hours.

I reacted strongly to the person claiming otherwise because it was presented as an excuse for people not having access to their money quickly. If people are being told they can't get their money because of "ACH delays", "check is in the mail", "clogged tubes", or whatever, they should not be afraid to call BS!

No...the claim that ACH takes "3-5 business days", "several days", or whatever, is just flat out wrong. I can do ACH (not wire transfer, not "credit") between my totally unrelated bank accounts--whether those be at big banks or tiny little credit unions--with a total delay to myself, the end user, of about 14 hours and change. And that isn't new, it has been the case for well over a decade.

And using ACH delays as an excuse for why people can't get money out of Bitcoin quickly-- the original context of this thread-- is completely disingenuous.

Again...no, it is not. You are confusing different things here. Even if they just learned about it the night before, your bank cannot withhold your direct deposit without breaking the law. Unless there is some special situation like a new account or they suspect fraud.