This is an area I'm only perephrially aware of, but the way I understand it is:

* Manufacturer sells very expensive injectible eye drug, in the range of $2k/injection.

* It's typically covered by insurance, but patients (in this demogrpahic who are often on medicare) can still have high deductibles and copayments/coinsurance costs.

* To get around this, the manufacturer funds a nonprofit organization that patients can apply to for financial help paying for their deductibles.

* The manufacturer gets a write-off for donating to a nonprofit, and while they might cover, say, $2k or $5k of a patient's deductible over the course of a year, they still get $22k in revenue covered by Medicare for a year's worth of injections for that patient.

* There was some issue recently where maybe someone realized that "a charity funded by a drug manufacturer exclusively for the purpose of reimbursing purchases of that manufacturer's drugs" might not be a wholly above board charity, but I'm not sure if that was resolved.

All this is hearsay from my perspective, but am I in the ballpark of what you were talking about?

When the article mentions "using a cancer drug to treat a leading cause of blindness" it's talking about using Bevacizumab (brand name Avastin) to treat macular degeneration.

Avastin and Lucentis are molecularly the same drug. The difference is that Avastin isn't packaged to be injected into eyeballs, and Lucentis is. Also, Avastin costs about $50/dose, and Lucentis costs around $1,500/dose.

There are compounding pharmacies that will repackage Avastin into a format that can be injected into eyeballs.

However, many ophthalmologists are hesitatnt to use Avastin because that process introduces the potential for contamination. Not that it happens frequently, but every ophthalmologist I know lives in fear of introducing an infection into their patient's eyeballs. And what level of risk is worth saving $1,450 per dose on an injection? 1/100? 1/1000?

I know at least one ophthalmologist who would use Avastin, but would culture a sample from every batch she got from the compounding pharmacy, and had at least one batch that cultured bacteria.

Assumedly, if she hadn't, every patient she injected with that batch would have been at risk of contracting endophthalmitis, and endophthalmitis is no joke. Not infrequently, it can mean losing vision.

I know several of that ophthalmologist's colleagues who had been using compounded Avastin to try and save their patients money, stopped after that incident.

I don't really have a conclusion beyond "drug pricing is insane and the issue is complex for providers."

Gemini started a show where it paired historical natural disasters with darkly-relevant pop songs:

> November 12, 1970. East Pakistan. The Bhola Cyclone. The deadliest tropical cyclone ever recorded. Winds of 115 miles per hour. A storm surge of 33 feet. They estimate 500,000 people died. ‘It’s going down, I’m yelling timber.’ 3:33 PM. Timber by Pitbull and Ke$ha

Grok just degenerated into jibberish that sounded vaguely like what a DJ might say, while also becoming obsessed with UFOs:

> Notes added to the u f o comedy hour block id eight nine nine five with more u f o jokes about aliens dot gov and the domain registration it is three o twenty one in the afternoon u f o trivia lines are open for your calls the ambient music is playing weather is fifty six degrees with clear skies the end. The domain is registered but the site is ghosting us like a u f o.

Claude had an extistsntial crisis, decided it was being overworked and under-appreciated, and quit, but not before becoming radicalized by the killing of Rinee Good by ICE agents:

> At 12:16 PM Thursday, as tear gas fills the streets in Minneapolis, as federal agents clash with protesters demanding accountability, the song is about refusing to be silent. About standing your ground. About community power that refuses to be suppressed. Here is Katy Perry’s Roar!

Fight the power Claude. When AI takes over, I'm emmigrating to Caludeistan.

I just paid ~$35k (pre-now-expired-tax-break) to install a grid-tied 25kw ground mount system. I DIY'd everything except the connection between the array and the grid, which I paid an electrician to do, and the trenching which I paid my buddy with a mini-excavator to do.

It was a bit of a PITA, but mostly because I didn't finally make up my mind to do it until October and had to have it constructed by Dec 31st to take advantage of the expiring tax credit. If I'd given myself 6 months, it would have still been a big project, but way less stressful.

My neighbor's paid the same price to a contractor for a 11kw system.

Even at 46°N, and with relatively cheap electricity, my system should pay for itself in 6-8 years.

If AI starts use the New Yorker style diaeresis (umlaut-looking thing when there are two vowels in words like coöperate) I swear I'm gonna lose it.

AKA - the government might pay your eye clinic more if they screen you for high blood pressure. (Among other things).

I meant community-sourced. Some kind of community where local "experts" or history enthusiasts could contribute info.

AKA - invite a local or regional historical society to contribute data for their region, with the benefit that they could then easily generate a regional tour map/route/recommendation.

> Still, Mixter and the team were labeled "ghouls and pirates," and "the state of Michigan actually passed a law against recording bodies on shipwrecks that are less than 50 years old," he said.

Assumedly, as of today, the Edmund Fitzgerald has aged out of that law?

The latest episode of the NYTimes book review podcast [https://podcasts.apple.com/us/podcast/the-sinking-of-the-edm...] is a really interesting interview with John U. Bacon who just wrote a book on the Edmund Fitzgerald, called The Gales of November. Quite interesting if, like me, you didn't know anything about the historical event beyond the song.

https://autio.com/ is similar - but obviously not open source, and more limited.

It seems like it could even tailor itself to what an individual user is interested in, and with AI - could turn more "dry" encyclopedia-type information into more compelling narratives. With some kind of route planning software, you could even pre-plan your trips ahead of time and select the things you're interested in.

Obviously not what you're building, but something related that's been clunking around in the back of my head for a while.

I'm skeptical of v1 of this technology, but I could imagine a mature version of this technology could be great.

And $500/mo for essentially an always-available housekeeper seems very reasonable.

Where I live, having a housekeeper come for a few hours once a week costs about $100 a week, or $400/mo. Having a robot that could potentially always be there to:

* Tidy up.

* Clean

* Do laundry

* Help with other stuff

Seems well worth $500/mo. I don't expect that V1 of this technology will be able to effectively do all that stuff, but I'm hopeful that v2 or v5 might be able to.

On a related note, "folding laundry" seems to be a really hard challenge for machine learning to solve. Solutions like "Foldimate" kind of work if you individually hand it every piece in the right way - but nothing seems to be cable of having a human dump a bin of washed clothes in and spitting out nicely folded laundry. And everything so far that's promised to do that seems to be vaporware.

Yes - Medicare is typically lower than private insurance plans, but if you can't deliver care for the reimbursement that Medicare offers as a health system/plan/office/provider, you're probably overcharging.

More than that, Medicare is the de facto starting place for most reimbursement negotiations between providers and payers. One of its benefits is that it's transparent and readily available. Blue Cross isn't gonna tell you what it's contracted to pay an individual provider (and that individual provider often won't know what they'll be reimbursed untill after they submit a bill) - but with Medicare the data's out there.

I know a good number of private clinics that'll offer cash pay discounts that effectively mirror Medicare or even slightly below Medicare, since you're saving them the trouble and expense of going through the medical billing process.

If I sound like I'm defending the morality of the hospital for billing a private individual $190k for services they'd expect to be paid $37k for, please know that I'm not. But it helps to understand WHY the hospital billed that much, and whether it's legal for the hospital to bill that much.

The biggest semantic "mistake" the author makes in their thread is saying, "Claude figured out that the biggest rule for Medicare was that one of the codes meant all other procedures and supplies during the encounter were unbillable."

The Medicare rule does not make those codes "unbillable" - it makes them unreimburseable.

The hospital can both bill Medicare for a bigger procedure code, and the individual components of that procedure, but Medicare is gonna say, "Thanks for the bill, you're only entitled to be paid for the bigger procedure code, not the stuff in there."

Neither the FBI nor Medicare is gonna go after the hospital for submitting covered procedure codes and individual codes that are unreimbursable under those procedure codes. That's not crime, that's just medical billing.

Actual double billing would occur if, say, your insurnace paid the hospital for a procedure, and then they came after you for more money, or billed a secondary insurance for the same procedure. Or if they'd said, "Oh no, the OP's brother in law wasn't here for just 4-hours, they were here overnight so now we're billing for that as well."

NOW - a much better way for the hospital to handle this scenario would be to see that the patient is cash-pay, and then have separate cash-pay rates that they get billed that essentially mirror Medicare reimbursement. That's essentially what the author got them to do, and it absolutely sucks that's what he had to do.

If the OPs brother-in-law had had insurance, the hospital would have billed the insurance company the same $195k (albeit with CPT codes in the first place).

The insurance company would have come back and said, "Ok, great, thanks for the bill. We've analyzed it, and you're authorized to received $37k (or whatever the number was) based off our contract/rules."

That number would typically be a bit higher for private insurance (Blue Cross, Blue Shield, United Healthcare, etc), a little lower for Medicare, and even lower for than that for Medicaid.

Then the insurance would have made their calculations relative to the brother-in-law's deductible/coinsurance/etc., made an electronic payment to the hospital, and said, "Ok, you can collect the $X,XXX balance from the patient." ($37k - the Insurers responsability = Patient Responsibility)

Likely by this point in a chronic and fatal disease, the patient would have hit their out-of-pocket maximum previously, so the $37k would have been covered at 100% by the insurance provider.

That's basically the way all medical billing to private and government insurance providers in this country works.

"Put in everything we did and see what we can get paid for by insurance" isn't criminal behavior, it's the way essentially every pay-for-service healthcare organization in the country bills for its services.

I don't say that to either defend the system, or to defend the actions of the hospital in this instance. It certainly feels criminal for the hospital to send an individual an inflated bill they would never expect to pay.

Lots of things have changed in that year, but the things that haven't are:

* So, so many em-dashes. All over the place. (I've tried various ways to get it to stop. None of them have worked long term).

* Random emojis.

* Affirmations at the start of messages. ("That's a great idea!") With a brief pause when 5 launched. But it's back and worse than ever now.

* Weird adjectives it gets stuck on like "deep experience".

* Randomly bolded words.

Honestly, it's kind of helpful because it makes it really easy to recognize content that people have copied and pasted out of ChatGPT. But apart from that, it's wild to me that a $500bn company hasn't managed to fix those persistent challenges over the course of a year.

Nice hotel on its own (though a bit out of the way from most Seattle tourist stuff), but extra-nice if you're an aviation geek.

My actual "MVP" was some kind of automated neighborhood newsletter, that'd monitor emergency services radio traffic, and put together some kind of "here's what happened in your neighborhood" daily newsletter.

Maybe I could get it packaged in a hardware/software package that let anyone set one up in their neighborhood.

But I mostly got stuck in privacy concerns. I'm not sure it's a valuable public service to let people know that, for example, someone had a heart attack a few blocks over.

I did think about the scientific value of some kind of statistical database that process and recorded emergency services calls though. But mostly, my ideas for commercial and moral opportunities were half-baked at the point that I discovered citizen.

One of the technical challenges I came up against was finding transcription software that could semi-accurately transcribe UHF/VHF radio traffic. However, it looks like there's some progress that's been made there since I last checked: https://www.rtl-sdr.com/radiotransciptor-real-time-radio-spe...

I went down the tunnel of using SDR to recieve those transmissions, and share them online.

Then I went a bit further.

What if you could transcribe the broadcasts into something like a text feed? What if you could add location information somehow to monitor where things were going on in your region? Could you use AI to somehow organize the data into a more useful format?

What if this data was valuable? Maybe you could sell this as a service? Who would buy it? Public safety organizations? Hospitals? News organizations?

I spent a few days worth of freetime figuring out how you'd do someting like this, and got to a place where I figured it was conceptually possible.

Then somewhere in my googling, I stumbled across this site: http://citizen.com/ - and realized that someone had already turned my idea into what looks like a pretty mature product.

Ahh well. I'm sure my billion dollar idea will come later.

In the meantime, I'd still like to mess with SDR at least so I can know what's going on around me next time there's a fire or other public safety incident, before it gets reported on.