ControlsFreak
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User ID: 1422
ControlsFreak
2hr ago
That's a different problem, though. That's part of the awful adversarial game they play. But that doesn't change the fact that they have negotiated prices, and they both had a say in what those prices are. They (either one) can still just tell you the negotiated price, even if there may still be a fight over whether the insurance is actually going to pay. One problem at a time. Don't let the existence of the harder problem stop you from making the trivial solution to the easier problem. Nothing about this trivial solution to the easier problem makes the harder problem any harder.
ControlsFreak
2hr ago
Oof, yes. Fixed.
ControlsFreak
3hr ago
You're misunderstanding. No one is asking for their internal treatment costs/margins/etc. They keep that hidden. Then they sign an agreement. That agreement has numbers in it. Different numbers from their internal treatment costs/margins/etc. Those numbers are known to both parties. They both signed a document with those numbers in it! They are not keeping those numbers hidden. Those numbers are the ones that they can give to patients.
I'm definitely wanting LaTeX support, because even though it's just a derivative, it would look soooo much prettier.
I've found it interesting to think about it marginally. What's the time savings of each marginal additional mph? A derivative gives a very good approximation of this, and particularly for highway speeds, it's a good enough approximation to be reasonable over at least a handful of individual mph changes without recalculating.
Governing equation, which everyone should know from high school: d = rt, distance = rate*time.
We care about time. t = d/r.
dt/dr = -d/r^2
(Yes, this would be a nice place for LaTeX, because the d's for the derivative should be visually different from the d for distance.)
One has to be careful with units, because we're often talking about changes in time in terms of minutes, but we have rates in terms of hours. What we ultimately want is something mixed, like minutes/mph.
We're starting with [miles]/[mph]^2, so we need to correct by [60min]/[1hr], meaning if we just plug miles and mph into our formula, we need to multiply the result by 60 to get the units we want.
The obvious mental math version to just get your bearings on the magnitudes of things is to consider r=60mph, because then one of our denominator terms will cancel with our unit correction. It's also not too far off from the nominal speed of many state highways. This case gives us that a quick approximation, with inputs in terms of miles and mph and output in terms of minutes/mph is -d/r. That is, again, kind of assuming r=60, then if your trip is, say, 150 miles, you're saving (note that it's negative, because this is a reduction in time spent) about 2.5 minutes per mph you increase.
Some things to note. Time savings is linear in distance. I personally don't think it matters much until we're getting to pretty significant distance trips (I think trying to speed a bunch to save time on your 20mile commute is kinda dumb). It's also a 1/r^2 in rate. That is nasty in terms of diminishing returns. It's also why I'm kinda fine with the nominal 60mph mental math to make the unit change "free"; yes, I'm slightly overestimating the value of speeding if the nominal speed limit is 70, but it's probably not huge error. I haven't bothered actually quantifying the error; this is all just to quickly get into a ballpark.
I think the economist would probably want to slap a utility on this derivative and set it equal to something representing your estimation of the likelihood of getting pulled over. I think it's easy enough to handwave that a little bit and just think a little about the trip you're planning and this marginal rate of improvement and come to some approximation that you're comfortable with.
ControlsFreak
9hr ago
but they have to hide what they know to negotiate with insurers and the government.
They don't have to hide the terms of the agreement that they signed with said insurers. The insurers already have this! They both signed the agreement!
Sure, they can continue hiding their internal costs, but those were never something that the patient cared about anyway. The patient cares about what they're going to get billed, which is a number in an agreement that both the provider and the insurance company have.
In the auto mechanic example, this is like saying that the shop owner hides how he compensates his employees, pays for consumables/times/equipment/etc. That's all perfectly fine. I don't care to know that. Just tell me what number you're planning on putting on my bill.
ControlsFreak
9hr ago
Thank you for the correction. I do appreciate that.
I stand by everything else I said, though. I don't appreciate you lying about what I had asked for, claiming that I had asked to litigate each and every post, when it is unmistakable that, from the very beginning, I had consistently asked for one specific thing.
I will make one final note that your excuse at the time was that you didn't want to "relitigate" the ban, but the factual reality is that there was no prior litigation to relitigate. It was just a ban, and well, when you're banned, you're banned, and no litigation can occur. That beginning comment, where I asked for one specific thing was the first.
This is just the factual history, and for this one (unlike my reporting behavior), everyone can just go read the public links.
ControlsFreak
9hr ago
In this case you unfortunately need to go to your insurance to find out the prices, as the clinics and doctors kind of have no say in the matter.
This is not true. It's a lie perpetuated by providers who want to remain price opaque.
Providers and insurance companies sign agreements, where they agree to a list of negotiated prices. They both sign this agreement. They both have a copy of this agreement that they signed. They both have a copy of the negotiated prices. Either party is perfectly capable of looking at their copy of the prices and telling you the number they've agreed to.
Imagine that this lie were actually true, and clinics/doctors truly had "no say in the matter". Well, then the insurance company could just magically decide that the price is $1, right? There's nothing the clinics/doctors could do about it, if they "have no say in the matter". But in reality, they do have a say in the matter, and it happens when they negotiate an agreement on a list of prices. If, prior to signing an agreement on a list of prices, the insurance company were to say, "If you sign this agreement, we'll pay you $1 for services," the provider simply won't sign the agreement; it's not worth it to them to be "in-network" if it only pays $1. If, on the other hand, after signing an agreement on a list of prices, the insurance company were to say, "Lol, whatevs about that whole 'price list' BS, we're gonna only pay you $1, because you have no say in the matter," then the provider will simply point to the agreement that they signed, in writing, with the threat of obviously winning lawsuits.
I would be over the moon thrilled if doctors were as transparent as auto mechanics. They tell you what they're planning on doing, they give you a (usually pretty good) estimated price, and then if they get in there and find something that's going to change their plan/cost, they tell you, give a revised estimate, and get your approval before proceeding.
No one is asking for doctors to be clairvoyant. Just that they do basic communication of what they know, when they know, to whatever extent possible.
Obviously, there could be cases where a patient is under anesthesia, they find something genuinely unexpected, whatever. I think a simple rule for this is to just follow normal informed consent principles. If you'd be comfortable proceeding without getting specific informed consent for the medical costs/benefits, then you probably don't need to give them a price, either. But to use an example based on what one of the doctors here said before, he said that they might know that a surgery typically costs $X, but 1% of the time there's a thing that makes it cost $[Stupid]x[X]. Simple: you know this, so just communicate it to the patient. Sure, it's probably not going to change much in that particular case, but at least they've gotten a heads up that there's about a 1% chance that they'll wake up on the hook for their entire OOPM. [EDIT: I'm pretty sure this is concordant with medical informed consent procedures. If you know there's a 1% chance that there will be a major shift in what you're going to do in a surgery, I'm pretty sure you're kinda supposed to tell the patient, "Hey, so this is a small chance, but it is known to be about a 1% chance."]
It's honestly just basic human decency in business practice.
ControlsFreak
22hr ago
a lot of it is having armies of staff disputing every charge at the insurance company, who in turn pays the hospital to have armies of staff fighting the disputed charges.
I don't really have a dog in this adversarial fight; it's a total cluster. I did see an interesting one recently, though. Some folks discovered a "hack" if you have a patient with BCBS who travels across state lines before getting care. They've found it financially viable to contract with third-party vendors to maximize their payout. Sounds like eventually BCBS will shut it down, but yeah, the extent to which this adversarial game is played is wild. They've let the whole thing get so complex that it pays to play the game hard... and there's certainly not anyone out there trying to play these games on behalf of patients' pocketbooks. They just fight each other, and some number of patients randomly get screwed in the process.
ControlsFreak
23hr ago
Whelp, I just got screwed again by the lack of price transparency in the American Healthcare System. feelsbad.man.jpg
Thankfully, it's not a huge dollar figure, but it's the sheer stupidity of clinging to price opacity, which inevitably finds some way to reach into my pocket and pull out more money, that annoys me.
It was not a situation where the provider didn't have the necessary information to understand why the price ended up being what it was. When I called them to ask WTH, it took all of three minutes for them to just go through the steps of verifying the process and then explaining it to me. But that's three minutes that they should have spent going through the steps in order to give me a price before they performed the service, rather than blindsiding me with a bill after the fact.
Yes, yes, I know, they don't want to spend three minutes per patient; that adds up! And of course they don't want to; it's not only their time being spent; it's not in any way in their favor to spend those three minutes. It's my pocket that it comes out of, after all.
Moreover, it was a situation where, had they spent the three minutes and we could have then had a conversation about the price, in hindsight, I am extremely confident about how I would have made a different choice as to the way that I arranged the services that I would have liked to acquire. I literally, actually, could have personally made a different choice if I had had price information, and it's a choice that I would have preferred in terms of my personal cost/benefit analysis.
Of course, it must be remarked on that had I had this information and had I made the choice that I would have preferred, the provider would have made slightly less money. I don't think they were doing this on purpose; it's just convenient for them to not spend three minutes and also probably make more money. They just have near zero incentive to even consider doing things in a way that may be in my own interest. The only danger that they run is that if folks like me eventually get pissed off enough at these shenanigans, we'll either search desperately for a different provider who will bother spending three minutes or simply get so fed up with the constant nonsense that we just eschew that sort of service altogether. Man, it's tempting to do that, because it's just... so... constant a problem. I'm already pretty cynical for how they're going to find a way to screw me over, and apparently even that was not enough cynicism.
The snafu did, in a minor way, relate to the way the insurance policy is written. I mention this only because I would like to hold open at least some amount of plausible blame for them (it's really kind of hard to in this particular situation, but I'll mention it anyway), but the provider legitimately had 100% of the information necessary to provide me an actual price and discuss tradeoffs/courses of action prior to services being rendered. They just didn't bother.
This feeling really makes me sympathize with all the people who are so outraged. I'm sure there are tons and tons of stories where the insurance company is more to blame, too, so I sympathize with those folks feeling gut anger at them, too. It's just monumentally infuriating to have them over and over again find endless ways to screw you over and see that it's not even malevolence. It's pure apathy toward your interests as a patient combined with an addiction to doing everything possible to remain price opaque.
ControlsFreak
1d ago
Again, "I don't like your explanation" is not the same thing as "You didn't give me an explanation."
Good news! I've said neither of these. Do I need to block quote again? You brought the links.
you'd rather point at where I said you were being obnoxious throughout that thread, and claiming that because I refused your demand to litigate each and every one of those posts
Also something I have not said. Never asked for each and every one. Asked for one. One specific thing. As opposed to, again, the topic of this thread, which is vague, nonspecific accusations.
What you're saying is false and you know it's false. You're just embarrassing yourself, but go on, champ.
ControlsFreak
1d ago
Thank you for providing the links, so people can again just read for themselves. Note the comment that I had actually linked to.
You wrote:
No one post is terrible, but most of them are obnoxious and unnecessarily antagonistic.
Point me to one. Make it something specific. Something real. Something actionable. Something that can actually be put into practice to improve future posting. Without something, the most likely conclusion is, "Atheism is the sacred at The Motte."
Notice that last time, your complaint was that I didn't make it obvious enough that I was riffing off something. [EDIT for appropriate bold:] This time, that is exceedingly obvious. Last time, you complained about me responding to follow-on questions. This time, I have said nothing else up to this point. Give me something real. Something actual. Something actionable.
It's right after the one you linked. We can see from the receipts that you've persistently avoided giving anything specific. Precisely the pattern highlighted here. If I were you, I'd boldly claim that you're just lying. Your own explanation is contradicted by the very links you've provided.
Especially given that you are one of our most irritating serial reporters who reports every post you don't like
ROFL. I can't remember the last time I reported a comment. You're off your rocker. (EDIT: I don't think you can claim with a straight face that there hasn't been even one comment in say, even the last two weeks, that I "didn't like".)
It's clear from your response that you still can't point to anything specific. You have literally nothing. You just have another vague accusation. Pure deflection to an unrelated issue, too. Which is exactly the pattern described by the comment I responded to. You keep a bullshit secret list that you vaguely refer to, conveniently preventing the target from being able to show that any particular item on that list is bullshit.
I am not "seething"; I'm simply responding with a specific example of a particular pattern that was described. That's better than you can do.
ControlsFreak
2d ago
I wish I knew. Crony capitalism is a genuinely hard problem any time the government is allowed to exert such strong power over market actors. Funniest idea I've had that just might work is threatening to abolish the Air Force. This route would be playing the very long game, and is more likely to not work than work anyway, but I'm not sure there is an idea that has a >50% chance of working.
ControlsFreak
2d ago
It seemed to be 'You know what you did, no we aren't going to tell you' as a cover for 'we just don't like you, but don't have any specific rule we can point to'.
Yup, which makes it all the more depressing when this place occasionally pulls that same bullshit.
ControlsFreak
3d ago
The government outsources quality control
I think this is the thing that is being challenged. That they're basically not even doing quality control. It's license control, not quality control.
I'd note from my previous comments regarding the book, they had examples from other industries, too. One that stood out was doctor malpractice that the boards would just kick the can on. "Better to have a bad doctor than no doctor." (But definitely not a foreign doctor!) IIRC, they talked about a case where the board just kept kicking the can and stringing it along, and nothing happened to "control this guy's quality" until he was arrested on criminal charges by the county prosecutor for the utterly obscene stuff he was doing (completely separately from the board's proceedings).
Different industries probably need different changes, because sure, there should be some sort of standards/quality control, and what that looks like can vary. But as it is, it seems to be pretty clear that they're not really doing that.
ControlsFreak
4d ago
So, I wanted to give you an opportunity to suggest your own name and conceptual meaning for the number that Alice puts into the computer in Variant 2 before I gave my own take on it. I think at this point, you've had an opportunity and have not taken it, so here goes.
I cannot think of anything that is appropriate to call this number (the number that Alice puts into the computer in Variant 2) other than some form of "the probability that Bob observes an outcome". Alice has to be reasoning about Bob's observation function when she computes this number. It's pretty obvious, because if we keep everything else the same, but fiddle with Bob's observation function, then we see a corresponding change in Alice's computation and the resulting value of this number (and no other change in Alice's reasoning or behavior, as evidenced by her own bets).
As such, if I can put it in a pointed way, why would one think that Alice is smart enough and capable of distinguishing between "the probability that Bob observes an outcome" and "the probability of the coin flip, itself"... but is too stupid to distinguish between "the probability that I, Alice, observe an outcome" and "the probability of the coin flip, itself"?
ControlsFreak
4d ago
A while back, I talked about some secondary press on "The Licensing Racket". In that book, the author talked about just showing up to board meetings for various licensing boards and just watching what they do. Her takeaway was that when it came to disciplining bad behavior of their members, it was supreme leniency, but when it came to any sniff of an unlicensed person doing anything, it was knives out. High crimes. Treason.
At that point, I was mostly just taking her account as an account. It certainly seemed plausible, but of course, she may have been motivated to exaggerate things for an agenda or just to sell more books or something.
But someone on the HVAC subreddit just linked to this. It's from North Carolina's board for plumbing, heating, and fire sprinklers. Looks like they publish one of these newsletters every couple months. Front page is the most important bit - PAY YOUR MONEY TO RENEW YOUR LICENSE! Then some information about the board and forms. Finally, the bulk of the newsletter is reporting their disciplinary stuff.
It's all right there. In black and white. From their own pen. You can just read through it and see. The majority of items (~60%) were them going after unlicensed folks. Near as I can tell, in almost all of the examples of discipline against their own, licensed folks, the result was "probation" and maybe taking a class (almost certainly paying the board to take said class). I think the only examples of anything more significant than that were cases where a licensee did something, how shall I phrase it, 'against the integrity of the licensing scheme'? Like, they let someone else use their license number, for example. That's a real crime that will get your license revoked.
Whereas they seem to have quite the scheme for going after unlicensed folks. They may get someone to sign a "consent agreement", promising not to do any unlicensed work. Or they might take it to a court, potentially getting real, big boy penalties. Did you know that they can get you put in jail for 30 days and slap you with a $5,000 fine? I learned that.
They publish this! You don't have to go to their meetings to find out! You don't have to believe what some random author said about them! They just tell you!
ControlsFreak
4d ago
Oh man, I don't know if this is a promise or a threat, but if we got even basic LaTeX support, I can imagine writing so many more math posts here. Hopefully more Friday Fun than Culture War.
ControlsFreak
5d ago
You're being shifty with your language, though. First, you have an underspecified "probability conditional on it being Monday". I'm being a bit picky with this one, but please fully state "probability of ______" even if you think it's "...conditional on it being Monday". Second, you have that she is supposed to bet her "true probability", but what do you mean by "true" probability? This phrase is not defined. "True probability" of what?
Notice further that there are three variants. She doesn't always put the same number in the computer in each variant. How does that work? What name would you call the number that Alice puts into the computer in Variant 2, for example?
ControlsFreak
5d ago
Right, so you've just picked one of the two to call by that name. What name do we give to p_tails? It's "Alice's credence that _______"?
ControlsFreak
5d ago
Are you taking Alice's money or Bob's money? From what I can see, they've got a nice system set up that's not letting you take their money, but it's not the case that the only number involved in their system is 1/3.
ControlsFreak
5d ago
Alice's bets are neutral EV at odds of 2:1, corresponding to p=1/3 for a fair coin, yes.
What do you mean p=1/3? See, you're back to not specifying what you mean anymore. We already had a value for p. It was 1/2. You had called it p_tails, which was clear. We used it to compute a different value ((1-p)/(p+1) = 1/3), which was being used to make Alice's bets. You had called this latter thing P(H|wake), and I slightly quibbled that I thought it was P(O_A(H|wake)), but in either event, it was clear that it was a different thing from p_tails or "p". It seems like you're using the same mathematical symbol to mean two different things.
ControlsFreak
5d ago
Verily, in the Monty Hall problem. There, you actually do have a very very clear moment where information is gained and there is no ambiguity about which question you are being asked. But in this problem, if Alice tells Bob what you seem to want to have her tell him, we would say that she is wrong. We'd even say that she's extra wrong if she said she "updated".
I notice a distinct lack of links this time in your false history. Let's go to the tape, where you said:
Are you saying that you lied then, when you said it was "fine"... or are you lying now, when you're saying that it was not fine and was the reason why I was banned.
For completeness, the reason you gave for why I was banned was:
I could repeat the rest of the history after that, but we've already done that. The entire premise of your current position is just factually false.
I asked for one specific thing to support your claim.
I asked for one specific thing to support your claim.
I did not claim this.
I don't even necessarily think this. I'm not sure "fair" has anything to do with it.
I didn't actually claim this.
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