bonsaii
2hr ago
But who would pay for necessary infrastructure and surgical supplies. Where are the patients going to get the MRI and CT scans necessary for pre-operative planning? The places that already have resources for those things have their own surgeons to train.
bonsaii
16hr ago
I think the problem here is that you often don't know what you're dealing with until you're already knee deep.
If we're keeping with the baseball analogy, the specialist is the guy you call when you already know you're up against the absolute best knuckleballers. The generalists are still out there dealing with most pitchers, who aren't the best at it but do mix in knuckleballs among fasts and curves. I guess the analogy I should have used is:
"If I'm betting my life on a baseball team, I want most of their batters to have at least gone up against a lot of knuckleballs in their life instead of a bunch of guys who've mostly only hit against fasts/curves and are going to be out there winging it for the first time if it turns out the opponent team has many solid knuckleball pitchers." (Sorry if this is bad baseball, I don't actually follow baseball)
bonsaii
16hr ago
Suppose surgery X is only needed by P patients per year per hospital, but surgical residents on average need to do at least C cases under supervision to reach competency. If residency is Y years long and you have R residency spots per hospital, then R is limited to C > Y P R.
bonsaii
17hr ago
Suppose surgery X is only needed by P patients per year per hospital, but surgical residents require C cases to reach competency. If residency is Y years long and you have R residency spots per hospital, then R is limited to C > Y P R.
You'd have to do this exercise for every type of surgery that a competent surgeon should know. Gallbladder is one of the most common (hence, one of the first to come off the top of my head), but you still need your local surgeon to be able to do the less known things as well. If I'm betting my life on a baseball player hitting a home run off a knuckleball pitcher, I want him to have at least gone up against a lot of knuckleballs in his life instead of a guy who's mostly only hit against fastball and curveballs and is going to be out there winging it for the first time.
bonsaii
21hr ago
I have many friends in medicine with whom I talk about these issues fairly often. My understanding based on these conversations is that you can't just go out and increase residency positions because the whole point of residency is to get sufficient exposure to cases. A surgical resident needs to do X gallbladder surgeries, Y appendix surgeries, etc. to reach competence and be able to perform independently. There are only so many patients who actually need those surgeries per year. Also, there are only so many teaching surgeons willing to supervise residents (teaching is almost universally a pay cut in medicine). Freeing the cap on residencies would mean a lot of doctors-in-training who waste time sitting on their hands and come out underprepared.
bonsaii
7d ago
Do you think most C-suite executives are over, under, or appropriately paid relative to the market value of their labor?
Japan had a 20 year modernization head-start over South Korea, which in turn had a 20 year head-start over mainland China. Korea only very recently entered mainstream Western consciousness (only 2 decades ago Hank Hill's "so are you Chinese or Japanese?" was a pretty accurate depiction of the median American conception of East Asia) and mainland China is widely considered an authoritarian enemy-state.
Japan's hold is largely a function of it having been the first, and for a long period of time only, "developed" but "non-Western" place in the world. So it planted its flag as the premiere "exotic" destination that still had all of the first world comforts.
I'd agree that today Japan, South Korea, Taiwan, and certain parts of mainland China all have comparable tourist options to offer Western visitors with incredible safety, transportation, and other conveniences to boot. I often work with videos like this in the background on a second screen and it makes me want to quit my job and spend a year or two just traveling China in particular. But the power of having been the first is a lot to overcome, so I doubt we'll see a "place, China" effect take anywhere as deep of a root.
It's commonly believed that music tastes crystallize around age 13-18. Whatever music you listened to then determines what you'll like for the rest of your life. "Not old" can mean a lot of things, but unless you were born after around 2005 your experience tracks with my own and many others.
Side note: I still have that teenager somewhere in me who wants to act too cool for anything made by a pop artist, but Anti-Hero (both original and its variants) is one I can't help but find genuinely enjoyable.
bonsaii
15d ago
Google summary is the most hallucinatory AI I've ever used. For topics on which I have any familiarity, it seems wrong more often than it is right. It sets off sanity check alarms way too often. I'm frankly shocked they thought it was in a state to put front and center on their primary product.
bonsaii
18d ago
Somewhere out there is an Obama-Obama-Trump-Biden-Trump voter and I genuinely want to know what guided that person's voting pattern.
bonsaii
18d ago
As someone who has watched their youtube uploads since their start, I mostly just look forward to Saagar/Ryan shows these days. Both seem like genuine political obsessives who read a ton and frequently draw connections to political/historical context. Krystal just seems to react without any research as far as I can tell. Of the four, she's the only one where I feel like I can already predict her take on a segment before she speaks. I'm hoping they start having some Saagar/Ryan debates, since the Saagar/Krystal debates feel rather unproductive.
bonsaii
22d ago
as the whole point of them is for the children of uber-elites to network with other children of uber-elites
I've heard this phrased as something like "merit laundering". Harvard et al. reserve part of the class for their primary clientele (uber-elites) and part of the class for the actual best students (IMO medalists, etc.) to maintain their legitimacy. They grade inflate and then everyone's resume line looks roughly the same coming out.
In this context, their aversion to non-holistic admissions makes sense. The intelligent, motivated, but not particularly exceptional kid with perfect SAT/GPA and a list of strategically selected, exaggerated extracurriculars who goes to Harvard only to eventually settle down as a private practice dermatologist in the suburbs contributes minimally to their true goal.
Then doesn't this turn into what is essentially an effective consumption tax, which is generally considered one of the most regressive forms of taxation, since percentage of income that goes to consumption is negatively correlated with income? Even worse, imported goods are more likely to be the kinds of goods that the average family spends most of their money on: appliances, groceries, cars, electronics, etc. The excess consumption of the wealthy is largely in the form of luxury services (personal cleaners, drivers, chefs, accountants, lawyers, etc.) or housing, which would be far less affected by tariffs, if at all.
My other concern is that the floor due to higher American wages may in fact be higher that the ceiling you talk about, where most people are just unwilling/unable to buy that good any more.
Aren't a huge percentage of greenhouse gases due to shipping? If you make more things closer to where they're meant to end up, there's likely an environmentalist appeal somewhere there as well.
bonsaii
27d ago
(2) attempt to raise the cost of their items. If they do (2), then things made in America can compete against them, which is great for all Americans but the super-wealthy, because your job’s wages are set according to the number of wage-competitive jobs available to you and your peers.
But there is a floor on the price of American-made competitor goods due to the much higher cost of labor. Therefore, at least up to that floor, aren't American consumers (largely the middle class) just paying more for goods?
bonsaii
29d ago
Let's say you wake up tomorrow and you're 400 IQ. For purposes of this question, suppose this means in slightly more concrete terms that you have a near instantaneous ability to process or recall information, as well as a near infinite capacity for information storage and drawing connections across that information.
What do you do with your newfound ability, if anything at all?
One could certainly compare to other developed countries, as this issue seems largely a US-specific phenomenon. As far as I can tell, third spaces are alive and well in much of Europe and East Asia, where the denser urbanization with proper public transit, among other factors, don't keep kids completely dependent on their parents to get anywhere at all. I remember watching anime as a young teenager. The thing that always stood out as most alien to me, more than the monsters or magic or whatever, was the way that kids in Japan could apparently just go out, alone, and see friends without needing parents to give them a ride every time. As a 14 year old who only ever knew life in my typical American suburb, walking distance from almost nowhere (the nearest non-residential building was a single gas station a 40 minute walk through rows of copy-pasted single family houses belonging to complete strangers), I couldn't help but feel envious. As an adult, I get the appeal of suburbs, and there aren't many great choices for walkable cities in the US (maybe someone from NYC or Chicago, etc. can chime in on if their experiences differed), but I don't know if I would ever want to force that kind of isolation on kids of my own.
bonsaii
1mo ago
My position is a rather unsatisfying "there are enough unknowns that I have no idea what the best option is", but I was curious to discuss others' thoughts.
If I were to refine my thoughts, I would say I believe not in an absolute, universal no free lunch, but rather a weaker, "not much free lunch beyond a particular threshold". As you put it, where the tails might tend to come apart.
My concern lies there, at least to the extent that human progress depends on the abilities of the individuals at those tails.
bonsaii
1mo ago
I'm imagining a hypothetical scenario where we can raise the average but reduce the variance. In such a case, it comes down to whether you think it's more important to have smarter mid-level engineers, doctors, etc. vs having more and smarter geniuses. I don't have a strong opinion one way or another, but was curious what others thought.
bonsaii
1mo ago
I don't think they would be negatively correlated, I just think there are enough unknowns that the possibility is far from negligible. My priors are that the "no free lunch" theorem applies to intelligence, so if I had to guess I would expect some degree of tradeoff, particularly at the upper ends of performance (whether in intelligence or athleticism). Hence why we never see people elite in both running and swimming events despite both being strongly, positively correlated with "general athleticism".
This may be true for some very common surgeries, but you still need the surgeons on staff to be trained in less common situations/surgeries as well. Otherwise, you have scenarios where you need a surgery but turns out the surgeon on shift has done that particular surgery once in his life and has to wing it.
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