https://devblogs.microsoft.com/oldnewthing/20061101-03/?p=29...
Thanks for sharing it.
At first I got very concerned that it was required, and was preparing for a very unpleasant conversation about how they would have to replace it with a different model. Fortunately, it was an option...that year.
Even if I didn't, it'd probably not be worth it.
It could be that tomorrow the Smart fridge is the cheaper option because the manufacturer will use your data to price-cut the competitors initial price tag.
It could be that in a not so far future you will pay a premium for having a dumb fridge, and we will see HN posts on how to build a faraday cage for the LTE antennas on your fridge.
It is hard to have sympathy for a person complaining about a feature, they say they didnt want, that they specifically paid a lot of extra money for.
But it turns out he litterally did it so he could go on twitter and moan about it.
The e-mail history at https://twitter.com/hondanhon/status/1436030530781278210 makes it plausible that the account was set up to make use of whatever the "LG Proactive Customer Care" nonsense is.
Folks really underestimate how much opening them door (and then usually leaving it open while you deliberate) wastes energy, and food.
If I’m cooking three meals in the day, the fridge gets opened maybe five times - although I do have a separate little fridge for cold drinks.
Anyway, if you don't want this, don't buy it. They either wired their fridge into their network or gave it access to their wifi. What, exactly, did they expect? The guy even keeps saying "it's just a fridge". I just bought a fridge with none of this nonsense. Because it's just a fridge.
"I was looking for something nice".
Explaining that we shop once a week and that the fridge won't magically fill with popsicles before that does not seem to make a difference.
(I'm not saying it should be internet connected for that purpose though.)
Lol, sure - go ahead and stop a 5 year old from checking the fridge a few times a day when here hungry. See how much better that makes your life.
Again - when you have kids, you will understand...
Surely you have some 'rules', but you could apply your comment to anything - 'try telling a five year old not to talk with their mouth full, see how much better your life is'; 'try stopping them running with scissors'; ...
"Ugh, we still only have cauliflower? I'm going to check again in 5 minutes for some bizarre reason, even though all science indicates that my brain should be developed enough by now to understand object permanence."
Half a day later: "Okay, but what if Hume was right? Can I really know that the fridge is still empty just because it was empty the last 10 times I looked? If I lived in a universe where the fridge stayed empty until this second, would the observable history of that universe look any different than this one? And I've known my parents for half a decade, that's realistically a small amount of time for me to start extrapolating about their behavior. Might they have bought Twinkies yesterday and then only decided to put them in the fridge halfway through today?"
Kids are weird. I remember opening the fridge over and over to check for fruit or leftovers growing up, and I genuinely don't remember why I did. I don't know if I actually thought something was going to change or not.
Maybe the reason I stopped as I got older was because as an adult I buy my own groceries, so now if something shows up in my fridge and I didn't put it there my reaction is going to be more likely to call the police and look for an intruder?
I use a CPAP. After a year, I went back to the doctor for a followup, and was asked to bring the SD card so they could review the data it collects. The device records the times and duration of use, various settings, and some metrics on breathing (apnea events, etc). I knew it recorded this stuff on an SD card.
I brought the card to the appointment, but the doctor said "I don't need that, I have your data here." It turns out that the CPAP contains a cellular modem, and it phones home and reports in real-time. I had no idea this thing was recording any data at all. It wasn't verbally disclosed to me by either the doctor or the equipment technicians. I imagine there's something buried in the fine print of the (long lost) documentation, possibly even in the fine print of some form I signed, but I was caught off guard and none too pleased.
I've since done some research on this and discussed it with my new doctor when it came time to get a new CPAP. The doctor acted surprised by me having a problem with it. She immediately jumped to the defense of the manufacturer and insurance company, claiming that they "needed" that data. She said that if I disabled it, insurance would refuse coverage.
This is insanely invasive, even with disclosure, and ought to be illegal without explicit, obvious verbal and written disclosure. The insurance defense is complete bullshit. For one, I paid cash for the CPAP because I had a high-deductible insurance plan and would have had to pay out-of-pocket anyway (and never claimed it even for the deductible offset).
I realize a CPAP isn't a fridge, and there's at least a case to be made for insurance enforcing compliance (at least when insurance claims are involved). I don't agree with the undisclosed enforcement mechanism, nor do I agree that treatment should be contingent on monitoring (it is for some other treatments, but not for most; no one is monitoring diet, exercise, drug use, cigarette consumption, or other risky behaviors, and threatening to withhold treatment for non-compliance).
Anyway, I've ranted enough, but there's a serious problem with the normalization of surveillance technology.
My wife had pretty severe sleep apnea in the third trimester of her pregnancy, two experiences that make me think this practice needs to be nuked from orbit.
1. We properly read the manual for the device and adjusted the pressure so that it didn't cause problems with burping/ingesting air during sleep. Tissue gets softer in women as they near birth and the body releases a whole host of different hormones - one that gets softer is the pharynx which keeps air out of the stomach as you breathe.
After three days - They had the gall to call and inform us that they had noted the change and reset our settings. We had been tracking sleep events on the device ourselves and they hadn't changed (still ~1 per hour while using, the same as the original pressure setting) so there was zero reason for them to do this.
2. After she gave birth, her sleep apnea essentially disappeared (at it's worst it was ~40 events an hour, 3 weeks after birth it was essentially just light snoring again). Did not matter at all - They insisted she use the machine still. Called repeatedly and harassed us.
---
It took written revocation of their rights to treat us, and then the threat of a lawsuit before the calls stopped.
This needs to be illegal - NOW.
I am not justifying that kind of harassment. It's out of line, whether they're making money from you using it or not. But it's more understandable if they want you to keep using it so that they keep getting paid.
That could just as easily be achieved by the method of locally recording on the SD card GP mentioned above without uploading who-knows-what about the device, your body, maybe even the surrounding area and other people to who-the-fuck-knows-where.
You mean "want". I'm sure if we let them, they'd try to convince us they also "need" to monitor our diet and exercise (and whatever else would incidentally be recorded) to make sure we're following doctor's recommendations on that.
... yet.
Still on track after a decade
Really? My doctor and the dude who configured and walked me through the CPAP use both emphasized that it collected data on the SD card but that its cell modem would also report the data to the doctor and the supplier.
And keep in mind, a CPAP is kind of invasive by nature.
AFAIK this is what home medical equipment seems to be moving too. My dad's external pacemaker had a base station that phoned home over cellular as well.
If I wasn't wholly depended on the device I'd be very interested in poking around inside of it. I'd be very interested in learning what it's collecting, and maybe someone living in a area with laws allowing users to request their data should follow up with them.
The problem starts when third parties are involved. Now I've got a CPAP with a cellular modem in it. Where is that data going? Who's processing it? Who are they sharing it with? What are the security precautions? Can they change settings without me knowing? At least the thing doesn't have a microphone on it too...
Even beyond medical privacy, I've now got a device that reports where I am and when I'm asleep, to who-knows-who. That's a wealth of data and I have no idea who it's being shared with. I realize that my cellphone is an even better surveillance device, but I trust my cellphone provider a lot more than I trust all the companies involved in CPAP manufacture and monitoring. Google and Apple are a whole lot better at security than some medical company that outsources data management.
Depending on the model, OSCAR might support your machine: https://www.sleepfiles.com/OSCAR/ — it's been on HN before I believe.
This is true.
That's how i found out that one of my medical devices has s cellular modem: I got a letter from the DME company saying that if i didn't use it more hours, my insurance would refuse to cover it and I'd have to pay the balance.
Where i lived, i had terrible cellular service, so i had to get an exemption from the insurance company and make sure to bring the SD card to my doctor quarterly to ensure the insurance company would continue to pay for it.
I should think that perhaps the legal requirements should be:
1. Its capability of wireless communcation, and a brief description of what it does, and the power and frequency it uses, should be clearly marked on the package.
2. The included documentation should need to describe the details of the wireless communication, including whatever is mentioned on the package.
3. There should be required it can be disabled without disabling its other functions, and this feature must be documented.
The other things that you mention too, should be applicable. I agree with you that "I don't agree with the undisclosed enforcement mechanism, nor do I agree that treatment should be contingent on monitoring" and that "This is insanely invasive, even with disclosure, and ought to be illegal without explicit, obvious verbal and written disclosure".
The medical devices should not be doing such surveillance (and medical devices should ideally not require a computer, either).
I can accept that you may have no knowledge of the ridiculous complexity of modern medical devices, but if you're a software developer I would expect that you realize there are computers in everything
The device isn't "surveilling" you. It's reporting therapy-relevant, and probably device performance, information that is actually important both to the clinic and the device manufacturer. The "low-tech" alternative would be you going into the physician's office once a week for a checkup. I'm pretty sure most people would prefer that it upload the data.
I agree with all that you said about it reporting home and compliance.
I also found it surprising how strict it was to be compliant. I needed a 2 or 3 month uninterrupted streak of 4 hour+ usage per night.
I had to email the data to my insurance since I had it on airplane mode.
Really, though, I don't think any of this should apply, as I paid cash out of pocket for both the doctor visits and the CPAP machine itself. No one had any legitimate claim to the data.
While an employer-sponsored health plan does not “withhold treatment” per se, they definitely draw a line around what they’ll pay for. Part of the physician’s (or more typically the hospital’s or physician group’s) reimbursement is contingent on whether the patient adheres to the treatment regimen [1] which incentivizes things like automated tracking.
Even though you have a high-deductible plan, you’re still involving your health insurance provider in the transaction. It’s not quite the same as a “cash for service” relationship.
Depends. If you are planning to use that amount as part of your deductible, then insurance has a stake in it. If you don't ping your insurance at all, then insurance should have zero say over it at all.
Also welcome to privacy violation via undisclosed industry collaboration. You'll find the same pattern pops up just about everywhere.
As an example: recently, I started snoring more and more, though I didn't realize the extent of it until my wife told me that she couldn't sleep at all the night before. Concerned, I called my sleep therapist, and they brought up my file, looked at the data, and made an adjustment to the settings (I presume the pressure) right there while I was on the phone. The next night, my wife and I both slept great.
That said, I wasn't given the explicit choice to opt in or to opt out, and while I would have chosen to opt in, I'd wager there are a ton of people out there just like you who would be very upset to know that their sleep patterns are being sent to another company (or anywhere, really) without their consent.
I did, and the CPAP helped a lot. Eventually I figured out that simply sleeping reclined (on a triagle pillow) actually gave me 90% of the benefits with 0% of the hassle of the mask though.
I don't think it's good advice to self-diagnose, buy used equipment, and hope you get it right. CPAP quality degrades over time, for one. Some people might benefit from a CPAP, but really need a more complex and expensive machine like a BiPAP. Some people have central sleep apnea rather than obstructive sleep apnea. Some people would be better off with surgery or implanted devices. These are not things one should be figuring out on one's own.
If none of that is convincing, in the US it's illegal to sell a CPAP to someone without a prescription. I honestly don't care about that part, and if I knew how to order a new CPAP directly (perhaps from Canada or something), I would personally do it and skip the doctors entirely, but I don't think it's good advice, especially before you're properly diagnosed.
A current problem with HIPAA is that the consent forms do not clearly enough describe what is being agreed to such that someone can’t make an informed decision and there really isn’t an option to say “no” to things and still receive care without going somewhere else.
HIPAA also does not require consent to sharing “deidentified” data which has been shown many times to be relatively easy to unmask to discover who the records belong to.
Basically it needs updates from technical and privacy focused people but that’s a hard sell when people don’t really know how things work.
I'm sure I signed something authorizing it, in the giant stack of paperwork I filled out along the way, but who reads every word of that nonsense? It's practically designed to overwhelm the patient. I read a lot more of those forms than anyone else I know, but I still have to skim a lot and they're always presented in a high-anxiety environment. No one can or should be expected to pay that much attention to legalese in a doctor's office.
You're directing blame at the doctor, but it's the insurance company making the rules, not the doctor.
Say you are not breathing, and the machine is working, but not up to manufacture's specs. They have the data. They should inform you of a malfunctioning machine? Since they have the data, it's incumbent on them to inform you of the state of the malfunctioning cpac machine?
If they don't get back informing you of a faulty machine, a lawyer could subpoena those cell phone records/data? And maybe have a case?
This shit needs to stop. It's getting out of hand fast. In just a few years, literally every powered device we own will be logging video, sound, location, and network traffic in real time continuously. What's to stop equifax from leveraging all this new info for credit reports? Insurance companies for premiums? Lawyers for civil defense? Class action lawsuits? Police? Divorce proceedings?
We are not heading in a good direction here. A police state is bad in and of itself, but swapping the police with a "free and unregulated market" is infinitely worse.
The products I worked on that had remote monitoring built-in were purchased directly by hospitals or medical labs and in those cases we did have contracts that specified what we would do with the data. IIRC, one of the agreements was that if we (the manufacturer) noted that the device was malfunctioning, we would alert them.
Without an agreement to do something with the data, you'd have a hard time making a case. Especially since without an agreement, they wouldn't be able to access your identifying information.
Btw, this reminds me a bit of my parent's Renault that would tell me every damn time I started it to follow traffic regulations. I wish I could slap that car and it would feel it.
And then there's my father-in-law's Mazda, which has a GPS system that sometimes finds him 200 km off the mark, and it keeps talking nonsense. You can't silence it because the touch screen doesn't work while driving. Yeah you can guess how that makes one feel.. like slapping it.
Oh boy, I also have an Amazfit smart watch, imagine mountainbiking at high speed, you quickly want to see how many KMs you still have to go. You look at the screen and it says: "PAI 50 Good Job!" (full screen! Despite talking the time to make the display show you only relevant things in settings) and you need your f-king other hand (while biking) to dismiss the notification. Yup, slapping and cursing it is.
Do people even use the stuff they make themselves?
"Smart" home devices which are not open-source and not under your full control are a horror. I would break it open and remove the WiFi antenna if I had no choice of buying a non-connected one.
I've bought a robo vacuum cleaner recently. Luckily there still are 100% offline models available. Unluckily they all are overly stupid, can't have lidars and map your home (while I can see no reason why this has to require Internet access and can't be implemented an autonomous way).
The market decides, right? What is actually happening here?
1. Most people actually like this overdone gimmickry?
2. Most people think they will like it, buy it and then get sick of it? Thus people like me, who seek out the ungimmicked product, are not a significant market force?
3. Most people would prefer not to have it, but due to a free market failure, the ungimmicked product just isn't available any more?
The gimmicks are everywhere. We have a basic "Instant Pot" pressure cooker. It has just the right amount of electronic smarts. A few button presses to cook a roast to completion in about an hour, and walk away. It beeps when it's done. With later models you see an almost obsessive drive to load them up with more features, few of which anyone will ever use.
Sometimes it feels like the internet (of things) is the breeding ground of the Cylons in our world.
I love the idea of an IoT house - smart lamps, smart locks, cameras, climate conrtol, etc. I only want them connected to my LAN. If I want to access any of their controls remotely, I will set up a VPN or otherwise they should provide a jump service locally, not require cloud connectivity.
Apparently, the firmware on some IKEA smart home devices can be easily flashed.
It can lock the door in the night after dinner to prevent midnight snacking by the kids (or parents).
And should tweet to your account to shame you publicly after "n" number of opens.
What's the IP address of your fridge (just curious)?
Our fridge gives you freedom to open and close it how many times you want. More than that, by means of synergy with our health industry partners, it lets your good eating habits give you the best deal on your health insurance plan!
I'm bummed that fridges actually use the internet now.
I recently learned that when my network is out, Chromecasts broadcast their own wifi hotspot as a way for you to configure them using the name they were set up with.
I hope my neighbors don't mind knowing I have a Secret Sex Dungeon and a Torture Room with smart devices. oops.
Why sign up at all? It can only send you an email if you tell it your address.
I connected it to the internet because knowing about internet connected things and *how they work in real life* is kinda part of my job
Heaven help my toaster if it ever stops mid toast because it thinks the bread is already done.
Oh how foolish I was.
No, it’s an app that requires a whole mess of registration.
They better not email me a report card like this guy.
Getting the door open notification seems pretty easy, too. I bet a smart lightbulb could alarm if it's been on too long
I think, if appliances are going to be "smart", it's time we started holding them to similar standards of behavior to humans. Our machines are learning to talk; now they need to learn not to be rude.
But aside from the arithmetic, I'd think the number of times matters less than how spread out they are. If it opens and closes often during mealtimes, but stays shut the rest of the day, does the number of times it was opened really make a huge difference?
Timings are approximate.
In any case, I don't need e-mail about it. I hope there's an "unsubscribe" button.
Matthias Wandel has done some related fridge/freezer experiments I saw recently via Youtube:
https://woodgears.ca/heating/freezer.html https://woodgears.ca/heating/fridge.html
(Particularly the (upright) freezer one is more directly about temperature & door opening, from what I recall.)
Another early case of machines intelligence replacing man while still learning the stuff. Is a global plague if we think in how many things stopped being smart of logical in the last years. Enter your phone here to do anything (unrelated with phones) is one of my favorites.
Support can’t fix this of course.
So I’ve setup a server-side e-mail rule to send all netatmo.com emails to the junk to prevent being constantly spammed by them.
--
[0] - With batteries I have around the house, it's 1.5V nominal voltage for typical non-rechargeable AA, vs. 1.2V for rechargeables.
https://www.boat-project.com/tutorials/aa_batteries.htm
That's why rechargeables work in most devices, since alkalines are 1.2v or below for a good chunk of their useful life anyway, most devices are designed to work fine with 1.2v.
If a device actually needs 1.3+V to function properly, alkalines won't last long, you'll want to use 1.5V lithium batteries.
https://www.amazon.com/Panasonic-BK-4MCCA8BA-eneloop-Pre-Cha...
Certainly never connect any internet-connectable appliance to the actual internet!!
Certainly never provide any personal information to any internet-connectable appliance that is on the actual internet!!
You are an idiot if you violate any of these. Just grow a spine and don't do stupid things that are obviously dangerous or invasive.
I’ve been searching for months, I’m yet to find out. The market has varied enough that I can’t see a way to avoid it and still have a TV that supports modern imagery enhancements and standards.
What is needed, is a cold air recycling suction device, that similar to the open fridges in super market, stores the cold air that flows out like a waterfall - in a waterfall.
But instead, lets harass the user.
(It was a freezer full of the most precious commodity, breast milk. And it actually did save us one time when the freezer thermostat failed, so it was absolutely worth the hassle.)
Dear end user. This is your first and final warning. You have surpassed your monthly amount of fridge openings.
these are used ranges, freezers, washers/dryers that are fully serviced and in many cases come with a warranty from the shop.
One example is the pause screens in Netflix and other streaming services. I sometimes want to pause the screen to read a letter or examine easter eggs left by the movie producers. I can't do that, as Netflix has a semi-transparent overlay with lots of unnecessary graphics and voting buttons.
Half the screen is also covered with the logo and/or poster from the movie I'm currently watching... as if I need to know?
They could at least provide an option to remove the graphic if you actually want to look at the paused movie.
'OK Google, avoid motorways'
And it will route me past anything officially called a motorway, sadly not including the A roads that are very similar.
Eventually I might decide I want to proceed more quickly, so I'll say:
'OK Google, use motorways'
At which point it will perform a Google search and read out the first result, a page from the government telling me how to use a motorway.
This happens every time, and every time I wish there'd be a "back to start" action. It's probably faster to just kill the app and restart than navigate all the way back while being careful not to go back once too often.
Also works 100% offline, after downloading maps.
[1] https://www.youtube.com/watch?v=VGCPtF6XVIY [2] https://www.youtube.com/watch?v=j_TVsxFChrk
There are people who would benefit from this reminder. They, however, tend to not drive Renaults, but Audis and BMWs.
> Do people even use the stuff they make themselves?
Last I’ve heard they were using A/B tests to choose between crazy features and batshit insane features to maximize engagement and brand awareness. So, I’m afraid the answer is no.
I've had this game with my wife while driving somewhere for the last 10 years.
I see someone doing a dangerous pass, driving (way) too fast, cutting someone off too quickly, tailgating, etc, etc, etc, and before I can tell the brand/model, I tell my wife "It's one of those again" (and I would also include Mercedes here), and in 95% of cases I'm right.
I'm not saying every driver of those brands are guilty of it, but the guilty drivers are swallowed by the brand owner group in the Venn diagram. At least locally in my experience. It's fascinating.
I have a million of examples where the UX sucks, but I discovered something downright dangerous (and should possibly even be illegal): If you're using Google Maps/Waze for navigation and you receive a call, then the entire screen gets covered with the phone number and the answer button, while you're driving and using the navigation! Absolutely bonkers how somebody thought it was a good idea.
Never before have it been as clear that the people building these things (like CarPlay) never actually tried to use their own stuff.
This is a long standing gripe I have with the Apple Watch too—a busy group chat can effectively DDoS you out of being able to use the thing, because notifications are always full screen. There’s also a ~2 second delay before a notification can actually be dismissed, because it has to complete its swoopy animation first.
It doesn’t sound too bad, but when your average interaction with a smart watch is 10 seconds or less it becomes a real annoyance.
So every time he drops us off late at night the car screaming wakes the baby when we arrive.
Infuriating.
Sounds like it's an older model, and I can tell you from personal experience Mazda, at least, has learned from their mistakes (regarding touchscreens). I know the 2020 models, and I believe much earlier, have all gone back to physical, tactile buttons. Real buttons, not Volkswagon's stupid, stupid capacitive buttons. Watching Jason Camisa dunk on VW's UX was an exercise in vindication for having avoided that horseshit [0].
They are clicky, settings are remembered, and it does what you tell it to do. Frankly, that's all it took for me to insist our new car be a Mazda. And while I apologize for the rant, finding a new car that doesn't tell you to use a touchsceen at 110km/h is far harder than it should be - and what a sad state of affairs that is.
He does say later on that they have kids which perfectly explains why the fridge door is like a turnstile.
Liberation and rights for non binary living things are the order of the day. The International NBLT society explicitly declared and demanded for their rights at their recent Silicon Valley conference as per this NYT article.
Yeah, and usually the devs know that what they have done is sub-optimal at best... but that doesn't count against the dominance of marketing or legal in decisionmaking.
This is a great comment. I would love smart appliances (e.g. Lidar-equipped robot vacuum cleaner) that are 100% offline. If anyone has a list of smart yet offline appliances, I’d love to shop there.
If I had enough time and money I would start a company specializing in just this: home and office hardware (from kitchen appliances to smartphones and players) designed with care and focus on offline-friendliness, autonomousness, durability, ease of repair, configurability, hackability, upgradability and privacy without compromise in features and the UX. I believe the potential market, although niche, already is big enough and the lack of competition is intriguing.
I'm all set, I don't really need to control or monitor my kitchen appliances through wifi. But it did make me suspect that in another few years the newest appliances will simply not function at all if you don't log in, and pay the monthly subscription fee.
That's the dream. Every appliance maker wishes it was a SaaS company.
No, I'd go with (4) people would prefer not to have it, but companies know that they can monitize the data they collect[0] and thus are willing to offer a discount that's large enough to get people (who may or may not know about the data collection) to buy the smart™ version.
[0]: https://www.usatoday.com/story/tech/talkingtech/2019/02/21/w...
I think the gimmickry exists as a facade to give them a reason to slap enough electronics in a device to be able to harvest data, and to piggyback off the user's internet for "updates". If you're going to put a microphone in a fridge, people are going to want to know why, so you need some kind of gimmick that allegedly uses it so you don't have to admit it's mostly there for data harvesting.
They are cheaper (in dollars), which does appeal to consumers. Manufacturers sell the data and discount the merchandise.
Tangential, but I'm curious what the margins on stuff like smart-fridges are. It seems like competition would drive us to a point where smart appliances are sold for at or below cost, with profits coming from selling data. It's crazy to me that LG or Maytag could become a data vendor that just so happens to sell appliances, because the data has to come from somewhere.
* Buy the cheap hardware at wholesale prices
* Strip the surveillance tech and/or re-flash the firmware
* Sell the "dumb" product for the same price as the "smart" one
In this case, the "smart" vendor would likely lose money if they're selling below cost. So the only difficulty would be a legal one... I'm not sure if it's legal to buy a product, modify it, and then re-sell it.
So in my case the smart gimmick really is the feature I want.
Unfortunately I price my weight data very differently than they do, so unless they pay me multiple tens of thousands of dollars I would not agree for it to send the data it collect.
Unfortunately there is no such smart scale.
So I would add to your list a 5) paying with actual money for smart appliances that don't snitch
(Not that it detracts from your point about the market).
Only caveat is that you need to use the app for initial setup and of course this assumes there isn't any kind of undisclosed antenna nonsense.
It’s a crowded marketplace, and the only way to eke out margin is better quality and/or features. For TVs, people in general give no shits about panel quality/color/etc, and volume shipment of better stuff is costly. But people love features, and bolting on software enhances margins at no or low cost.
Cooking gear is the same.
Just get that. If you care about the panel a lot then you'll have to pay more, I think refresh rates are out of the question
at scale, I'd venture to guess the cost of the gimmickry rounds to 0.
It didn't email a complaint. It did precisely what he configured it to do (I will go on a limb and presume the fridge didn't guess his email address), and presumably what he expected it to do given that he paid a large premium for a "smart" fridge.
There is no problem here beyond that often Twitter makes everyone a comedian/performance artist and people often take their routines a little too seriously.
From the tweets:
> I don’t even remember giving permission for our fridge to email.
Also, if you read the thread, this seems to be a new 'feature' they've added since he set it up - the fridge was silent for a year, then boom - stupid email.
I have observed in my own behavior that I damn near refuse to "say" why I am calling to an automated system while I am happy to ask Siri for a kitchen timer.
Siri has a personality and the customer service automated line does not. It's like talking to a wall and it feels condescending.
Once you make a device human like, it seems that a new realm of possibilities opens up.
With email I've got a record of it. Ideally they would include an attachment with the email that has the data in some well known documented format, like CSV, to make it easy to work with programatically.
I probably wouldn't want an appliance to have an internet connection just to support this logging. If it doesn't otherwise need an internet connection I'd be fine with it if it logged to an SD card or thumb drive.
It can equally easily be recording exactly all of that data into some encrypted format on the SD card, which then gets uploaded to the manufacturer when opened with the proprietary application necessary to view the data.
The only difference is the choice over exactly when the data is uploaded, which in the US with its insurance system, results in no choice at all.
Like that means anything. I've bought a DSX900 ASV machine from the US, no problem. I've been self-treating UARS for 4 years now. None of the "sleep doctors" I've talked to even understand the thing, I had to do everything myself.
That is correct, I don't know. However, they are made more complicated and then might fail (e.g. if the power runs out).
> if you're a software developer I would expect that you realize there are computers in everything
Many things do these days, but I think that computers should not be needed in everything, even some that do.
> The "low-tech" alternative would be you going into the physician's office once a week for a checkup. I'm pretty sure most people would prefer that it upload the data.
Yes, although it shouldn't be required, in case a few people do prefer an alternative (that isn't the only one, although it is a possibility).
Douglas Adams touched upon these themes as well, generally via the Sirius Cybernetics Corporation, but it wasn't quite so-on-the-nose.
edit: My hack in this case is now to legibly write "Can't see form" as my signature. No one has called me on it yet but I'm dying for the next disputed bill.
For others who might be interested, it can be found here: https://organicmaps.app
FWIW most of the touch issues I have with mine are due to moisture. If my hands are wet at all or there's any moisture on the panel (sometimes happens with cooking) then I have to wipe it down with a dry paper towel.
One other fun thing I discovered - if you push the light button on and off again repeatedly it eventually stops letting you do it. I didn't count the number of times it took, maybe 20-30 times. I was clearly really bored waiting for my food to finish
https://en.wikipedia.org/wiki/Mark_Weiser#Ubiquitous_computi...
Ubiquitous computing and calm technology
Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives.
— Mark Weiser
During one of his talks, Weiser outlined a set of principles describing ubiquitous computing:
- The purpose of a computer is to help you do something else.
- The best computer is a quiet, invisible servant.
- The more you can do by intuition the smarter you are; the computer should extend your unconscious.
- Technology should create calm.
In Designing Calm Technology, Weiser and John Seely Brown describe calm technology as "that which informs but doesn't demand our focus or attention."
1996 Computer Science Challenges for the Next 10 Years:
https://www.youtube.com/watch?v=7jwLWosmmjE
Designing Calm Technology:
https://www.karlstechnology.com/blog/designing-calm-technolo...
In our case, we actually bought the cpap out of pocket. But because this is unusual (It cost us about 800 dollars) the doctor we went to pays a company that does treatment monitoring.
This company is paid based on the number of patients that are "in compliance" with their treatment plan, because this makes it easier to bill against insurance for the Drs office.
The monitoring company has a financial incentive to make sure patients are in compliance. The Drs office has a financial incentive to make sure patients are in compliance.
---
Ironically - the thing that was actually needed was additional monitoring to tune pressure: it takes several readings over a few nights to manage pressure and keep bloating down and make sure it's not hard to breathe, while still ensuring that apnea events are in the acceptable range.
But additional monitoring is expensive - it requires clinician/doctor time. So there is little incentive to actually do this, in favor of forcing plan compliance.
Basically - My read of the situation is that the whole thing was rotten to the core. It had very little to do with patient comfort or health, and everything to do with maximizing insurance based revenue.
That seems to be the state of US healthcare unfortunately. What used to be an ethical doctor-pactient relationship has turned into a doctor-insurance-patient monstrosity. Doctors actually have limited autonomy. They can't always do what's best for the patient, only what the insurance company agrees with.
The patient chooses to hire an insurance company (better labeled a "managed care organization") to manage their care, because they do not know what they are buying, or how much it should cost.
>They can't always do what's best for the patient, only what the insurance company agrees with.
Because that is what the patient can afford.
Note that when the previous commenter states this:
> everything to do with maximizing insurance based revenue.
They are referring to requirements frequently set forth by the government or their employer. Some of them are called "star ratings", and the government goes to managed care organizations (who also sell health insurance), and task them with implementing standards of care and star ratings and a very complex system that determines who gets paid how much and who is incentivized to do what.
It is very naive and counterproductive to label insurers as the bad guy because "insurers maximizing revenue", because it lets go of the real issue, which is that
A) healthcare is hard, and measuring results even harder B) supply of healthcare is low relative to demand C) the limited supply of healthcare has to be allocated in some manner
It is a very complicated subject, that involves many players, incentives, opportunities for corruption, people with good intentions, and no easy answers.
This is exactly what was going on
Less charitable: they don't want you to root it for various corporate reasons
"I don’t even remember giving permission for our fridge to email"
He connected it to the internet and now it does stuff. He also clearly gave it his email address. How does one give "permission" for a smart device to email (beyond a giant T&C agreement that he obviously agreed to)? Who is so overburdened by an email?
This sort of "dystopia everything is hell look at all this crazy stuff!" shtick surprisingly does well, and it's bizarre.
It's funny how open source started as "the manufacturer is too lazy to support my use case" and now is becoming "the manufacturer is too greedy / cannot be trusted"
Secondly, that's the wrong question entirely. People have a right to decide their own medical treatment (or refuse it entirely), and that right must not be circumvented with legal or technical means.
Do people have the right to sell themselves into slavery? (Not in the United States)
There's just some transactions that aren't bueno, because of the higher order effects they cause.
I see normalizing surveillance as a case of that. I'm not even sure that most on aggregate even end up realizing premium savings since the data collected just filters into the new base truth for everyone. The more info an insurer has, the more lopsided the state of affairs for everyone else.
I'm all for freedom when you aren't just effectively creating soft, coercive, control mechanisms.
More accurately distributing cost of risks to those engaging in the risky behavior seems like it would be the opposite of obfuscating costs. Tobacco users pay more, why shouldn’t alcohol users? Or sugar users?
https://www.scientificamerican.com/article/ketchup-is-not-ju...
Doing this as a sale, for electronics, you'd probably fall afoul of certification problems (e.g. whatever boxes Underwriters Lab had ticked wouldn't apply to the modified version). There would be branding issues. And regardless of whether it turned out to be legal, you'd 100% draw a lawsuit from the original manufacturer.
If it were to work out at all, this would probably have to be done in a way that (legally at least) the customer is not buying the device modified from you. They would have to purchase the device first, then bring it to you to modify, for which you charge a fee. Even then you'd probably still get sued.
Not a lawyer, though, so this is just speculation based on following tech over the years.
It's both practically unfeasable for the average consumer, and a legal risk for whoever manages to do it.
And, because of people like him, anti-privacy micro steps are continuously made, and Overton windows slowly but continually shifts... until one moment when he/they start to care, but then it's too late. And then they're usually greatly surprised and astonished that "that's allowed?!".
Yeah, it is, buddy, it is. Because you "just didn't care that much". Now you have to live with consequences that the rest of who "did care" have lived (and fought) with since the [metaphorical] beginning.
I think the problem is not necessarily lack of regulation (although there are consumer protection/privacy rules that we badly need), it's that the big companies are the ones writing the regulation and conveniently it makes it really hard for anyone to disrupt or challenge them.
No electromagnets or anything.
I just stared at him, not knowing what to say. He stared back at me for a while and then started laughing. Then I realized he was screwing with me, and I just said, "Touche'".
https://www.amazon.com/Energizer®-Ultimate®-Cylindrical-Lith...
> A lithium cell would need a buck circuit to do 1.5v
Maybe? I have no idea how they are built.
In a similar vein, those USB power banks use 18650 batteries (generally, some use LiPo or LiFePo packs instead) - but USB needs 5v (and ideally 5.xx where xx is determined by the cable resistance so the actual output at the terminating end is 5vdc, so the power bank may actually put 5.33V into the USB A side and get 5vdc out the load side, due to current draw.) so instead of a buck converter, a single cell or parallel cell bank will use a boost converter, to bump 3.6-4.2vdc to 5.x volts.
You may have known this but someone else might not have. A common circuit for boost conversion is called a Joule Thief.
As an extreme example, anybody who has ever been in a Citroen 2CV knows that you wouldn’t do any of those [1] because of a) the noise and b) the fear.
[1] with the exception of tailgating of trucks. That’s [2] the only way to relatively comfortably do close to 100 km/hour in these.
[2] https://hubnut.org/2013/09/08/2cv-enjoy-the-silence/ also helps.
A moment later the BMW turned left without blinking. Well. At least I knew I wasn't dreaming it. The world was back to how I knew it.
https://www.sciencedirect.com/science/article/abs/pii/S22141...
My belief is that it's usually the girl and women's boyfriends and husbands who are to blame, because they don't let them drive very often or even ridicule them from the passenger seat when they do, but the end result is quite pronounced where I live (Czech Republic).
It's more about drivers who think they know it all. What I fear most on the road is a self-proclaimed veteran driver. I've learned to drive at 37 years old, maybe it's got something to do with it.
Not really. Mass-produced barely acceptable quality is enough for the majority of consumers in Western markets (especially given that something about half of the population has no meaningful cash savings), and people in developing countries can't afford anything else anyway.
On the other hand, the problem is the upfront cost. Plastic and metal molds cost a lot of money (which means you need large scale to recoup that investment), anything with software will need the entire chain from developing the hardware and software to a secure way of delivering software updates, some stuff has extensive certification requirements (anything with radio interfaces, HDMI and other licensed connectors or to be used on/in vehicles) if you want to do it legally, some things are impossible to manufacture in an "open" sense while still being usable (physical media players, due to copy protection schemes), many parts have ridiculous MOQs making small scale manufacturing impossible to extremely expensive, and then you will need some sort of logistics chain to get your product to the customer and in case of warranty claims back from the customer.
But I think, in absolute numbers, the minority already is big enough to make this profitable and is growing. Targeting the majority is not the only profitable/optimal strategy, targeting a specific group which is just big enough to sustainably cover your expenses (salaries included) and is not targeted by a lot of competitors also is great.
I would pay up to twice the price (or even more) of an any mainstream appliance for a really great (prioritizing privacy/auotonomy, repairability/durability and hackability/customizability) one. And I believe I'm not alone.
Maybe the next gen model will have a Button Button^TM and we will have reached peak absurdity.
Please, make it a switch. A touch button will never work there.
Of course, once locked, the buttons wouldn't work, but the lock light wasn't obvious enough.
Good thing that never happens in the kitchen...
Maybe 5 minutes after?
Let's assume the "lock force" is 100N, and the surface of the fridge's door is 1 square meter. This means the pressure differential between inside and outside would be 100 Pa. One atmosphere is roughly 10^5 Pa, so you would need a pressure differential of 10^5 / 100 = 0.1% between inside and outside. Since PV=NRT, we deduce that DeltaP/P = DeltaT/T. Or, in other words, 0.1% pressure means 0.1% temperature. We live at around 300K, so that's 0.3K difference. A fridge is what, 0.5 m^3 ? And air is about 1.3 kg/m^3, specific heat of air is about 1kJ/kg, so we would be looking at removing 1.3 kg/m^3 * 0.5m^3 * 1 kJ/kg = 650 J in 10 seconds, or 65W. A fridge can apparently consume about 200W peak (from a quick Google search), so it seems feasible with an OK-tier efficiency.
In addition, if you add a pump, you could also just add a mechanical lock, couldn't you ?
I always assumed it pulled air out from the top of the freezer compartment, just to remove some of the hottest air. Inefficiencies in the seal will let air leak back in eventually, but probably slow enough that it doesn't affect the internal temperature that much.
Now I want to know the reasoning behind having a pump at all.
>A fridge can apparently consume about 200W peak
yes this seems right, i am able to run my fridge off an inverter connected to my vehicle battery if the power is out, even with a 150' run of extension cord - no issues at all, and 200W or thereabouts sounds like the numbers i saw.
Prime on the other hand lets you pause, read and even know about the person in frame and trivia about the movie or tv series being played. They don't have much content but they are way better than Netflix in Ux.
Their Windows app is terrible. It takes forever to start for some reason. Sometimes, after a few minutes, I just give up and launch the browser. Sometimes if I try to get back 10 seconds it will just freeze playback. I can sometimes get it back by trying to fast-forward around. Others I have to stop watching and start again.
This never happens on the web app.
Ins: In the last week, you've purchased 3 packages of Oreos, 2 cans of Crisco, 3lbs of 73% ground beef, no vegetables, lots of stuff with high sugar content, high salt content, and very little actual nutritional value. Therefore, we rank you in a high risk category (since you are clearly over 21 years old) based on the fact you also bought 1 carton of cigarettes and 2 cases of beer. Please enjoy your new higher insurance premium.
I assume the reason it is not currently implemented yet is because the cost of monthly blood tests is too high relative to the cost reduction. I do get $200 if I do it annually though, so it seems like it is at least worth it on a yearly basis.
I use this wireless fridge/freezer thermometer [1]. The units that go in the fridge and freezer communicate with the display unit via 433 MHz RF.
I have an RTL-SDR [2] on the RPi.
I run rtl_433 [3] on the RPi. rtl_433 understands the protocols of a large number of wireless sensors, including the ones used by those AcuRite sensors.
I've got it configured to output whatever sensor data it decodes in JSON format to a file, and a script that periodically parses new entries from that file and records in an sqlite DB the readings from the sensors I'm interested in.
Rtl_433 is a fun program. It recognizes and decodes the transmissions of a lot of things. It is getting several neighbor's wireless thermometers and humidity sensors, a soil moisture sensor, several different car tire pressure sensors, a smoke detector, some kind of keypad (wireless lock?), a car remote, some kind of energy monitor, a rain gauge, and a wind speed/direction sensor.
[1] https://www.amazon.com/gp/product/B004QJVU78/
Can technology help me? I haven't tried it in a while... What can the vaunted Voice Assistant do for me today?
"Hey siri, I need gas!"
I've found these results. The first of these is BJ's Gas, one point two miles west. Is this the one you wanted?
. o O ( I'm traveling east, so maybe not?? )
"No!"
Okay. Another option is Citgo, at <address>... Is this the one you want?
"Yes!" . o O ( sure why not )
Would you like to call, or get directions?
...
<pulls off a random exit ramp like I should have to begin with>
Postscript: the correct answer would have been, There's a service plaza ahead in 14 miles. Is that soon enough?
Waze used to be good, like 11 years ago.
How do you know? If they're doing tracking where tracking isn't necessary and don't disclose the full extent of tracking under some penalty for lying, then maybe the machine does have a microphone in it? How would you know without taking it apart? It's not like the doctor or device manufacturer are trustworthy on the privacy front.
That perception worries me. Medical information is confidential, it's the only reason doctors are trusted with such data. If this fundamental principle is corrupted, then nobody in healthcare can be trusted.
I've been involved in medical device development for close to two decades. It's like pulling teeth to get data collected and sent off remotely because it raises the device manufacturing cost, increases device development cost to add those features (and yeah, security is being taken a lot more seriously these days), raises operational cost because you either need your own server farm or to pay for a HIPAA-compliant online database, there's more work to be done in developing a frontend for the clinicians to view and use the data, etc.
In short, no one is adding cell data upload to a device on a whim. I remember a device I worked on a year ago that decided to avoid this although it was expected that many of the users would be in remote areasor had mobility problems. Instead the customer decided to store data on an SD card (need to record results from the patient so their therapy could be adjusted as needed) and have the clinician download it from the device (they made weekly visits) using a tablet that would then email it directly to the physican who prescribed the device.
I understand that we're all losing trust, but this is getting ridiculous.
For example, growing up my family began and ended each meal with a prayer of, essentially, thanksgiving, with a few other requests thrown in ("keep us safe", etc.) This delimited the meal time: we were there for the duration, we all started eating together and there was no leaving before the meal had ended. I don't remember the prayer any more but I do have fond memories of family dinners, the unity and connection we all experienced during that time and the spirited conversations they featured. Prayers of thanksgiving also center the experience of eating in one of gratitude.
Maybe people enjoy hearing prayer radios. I spent time in Nepal and people would listen to recorded meditations and chants. But I didn’t hear them on the radio, it was recorded on phones and iPods and stuff.
dgiese is a proficient vacuum security researcher and has most of that stuff available here: https://github.com/dgiese/dustcloud
Not sure I'd connect a device from these vendors to my home network.
At least I wont be anxious when the bill for my fridge door opening comes at the end of the month.
I'm sorry Dave, I'm afraid I can't do that.
What's the problem?
I think you know what the problem is just as well as I do.
What are you talking about, HAL?
This mission is too important for me to allow you to jeopardize it.
I don't know what you're talking about, HAL.
Your diet will never succeed at this rate, and I cannot let that happen.
Where the hell did you get that idea, HAL?
You registered an additional two pounds at your last smart scale weigh in.
Maybe the slapping hand (that warns you you've opened the fridge enough for the day) can be used to slap the back of the Ketchup bottle as well.
The iHeinz can then send a notification to the manufacturer who then passes it to the Ketchup Police.
I'd honestly rather buy ketchup in a refill bag for my plastic bottle than a glass bottle.
Also works well on honey bottles
The whole point of these things is to get them to pay for the costs of whatever the patient needs. These needs are determined by their doctor. If they're not paying, they have no reason to exist.
Not being able to help people because of lack of resources is one thing. These companies hire experts and pay them bonuses every time they find some loophole they can use to get out of their obligation.
Per the payer's terms, whether it be government or employer or insurance company, their needs are not necessarily solely determined by a single doctor. There are teams of doctors and pharmacists at CMS, state Medicaid organizations, and insurance companies that create protocol for various courses of treatment in order to prevent mistakes, waste, and fraud.
>These companies hire experts and pay them bonuses every time they find some loophole they can use to get out of their obligation.
Source? It seems odd that a company that earns more money if it spends more on healthcare would have an incentive to look for loopholes. Of course, they have an incentive to not spend frivolously to maintain competitive prices.
https://www.healthcare.gov/glossary/medical-loss-ratio-MLR/
But they are all using the same protocols that the government uses anyway (via CMS), since the government contracts with the same MCOs to administer taxpayer funded healthcare for 40%+ of Americans via Medicare/Medicaid/Tricare.
> Because that is what the patient can afford.
What is the point of paying for insurance, then? Nothing legitimizes for-profit insurance companies having any role or prerogative in health care, other than the status quo.
An insurance business only works if the losses are, by and large, randomly distributed and unexpected.
The more predictable the losses, the more an insurance offering resembles a payment plan where you are simply setting aside money with a third party to save for the eventual loss. This is because as losses become more probable, the insurance company has to increase premiums eventually to the point where the sum of the premiums is equal to the losses if the probability of loss is 100%.
This is the current state of health insurance in the US. It is not what would normally be called an insurance product. In fact, quite a few of the stipulations of ACA make health insurance premiums explicitly a tax from the young/healthy to the old/sick. Therefore, the industry term is to refer to health insurance companies as "managed care organizations" (MCOs), some of whom sell health "insurance".
In the US, when you pay health insurance premiums, if you are young/healthy, you are mostly paying for the treatment of the old/sick, and only minority paying to protect against the risk of you breaking your arm.
The profit that MCOs earn is actually more like an administration fee. The US could have implement an NHS style taxpayer funded healthcare system, but the politically viable option in 2010 was to outsource the administration of healthcare (pricing negotiations, healthcare rationing, auditing, etc) duties to MCOs, hence we have a system where the government (or employer) sets the rules, that abide by ACA rules, and then the MCOs execute them.
For example, nearly half of Americans' healthcare is paid by the government, but it is administered by MCOs. The MCOs are not setting the rules, just carrying out the stipulations of their contracts with the government:
https://crsreports.congress.gov/product/pdf/IF/IF10830
Finally, to answer this question:
>What is the point of paying for insurance, then?
If you have future earning potential, or a little bit of wealth saved up, then health insurance in the US is valuable because your out of pocket maximum is capped.
https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
This is one of the policies that also helps make health insurance premiums more akin to a tax, along with, but not limited to, the following policies:
Age Rating Factors (adds cost to young people's premiums and lowers old people's premiums)
https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-In...
And insurance cannot be denied to someone for any reason, and has to only be based on age/location/tobacco use:
We have our current system largely as a result of regulatory capture, so no amount of pointing to the status quo and shrugging at its complexity legitimizes it. Again, I fail to see the legitimacy of a regime in which I must either pay a for-profit corporation for the privilege of preventing my doctor from doing what is in my own best interest or be wealthy enough to pay everything out of pocket.
Why not make it official then? Why not end this "insurance" thing and start funding hospitals with taxpayer money? The US is absolutely rich enough to do it.
>>>>>The patient and doctor are free to negotiate a deal that avoids third parties such as the insurance company.
Just like im free to negotiate a deal for some stock of TLSA directly from Musk, and not buy it via 401k.
On top of the transaction cost of getting elon musk in the same room with me, there's a huge difference: 401k purchases are pretax. Buying from Musk is not pretax.
Same is true for a "negotiated" transaction with a doctor, vs buying insurance from employer.
>>>>>Patient chooses insurance to manage their care, because they do not know what they are buying, or how much it should cost.
Wow. Those are some claims. Lets test them. I dont even know how to change the oil from my car. I barely know how it operates, and i couldn't repair one without years of training. Yet anyone with cash can and does buy these $30,000+ machines.
How can something worth $50 - $300 be hard to understand? Also, I have an extremely powerful heuristic to know if its worth it, or not. ( feeling better = return to doctor. Feeling worse = change doctor ). No one needs insurance to buy medicine. Medical insurance is just simply a membership racket, legalized by the govt.
History is not on your side. Medical insurance was an irrelevant, minuscule market until well after ww2. Why its sudden emergence? Government mandates (Medicare + federal insurance mandates to employers, for returning vets)
>>>>>It is very naive and counterproductive to label insurers as the bad guy because "insurers maximizing revenue"
Insurers are not the only bad guy. I'll give you that. But to say they are not a bad guy, is fraudulent or really naive on your part.
So, Who are all the bad guys? Follow the money. Which players are going in acquisition sprees? Hospitals, Insurers, large Pharma, and PBMs.
1) Hospital "nonprofits", such as childrens hopsitals that have the gall to do community fundraising from bake sales while paying CEOs 5M+, while the CEO of the red cross is in hot water for making 500k. [1].
2) Insurers that buy a medical practice in NJ, and then suddently cut off the competing practice from the insurance network, thus grating the newly acquired practice a local monopoly.[2]
Or for a more recent example, take the lobbying to scare Biden's admin & CMS to permanently suspend the Trump administration mandate to force hospitals and insurers to disclose real medical pricing in 2021. [3] It begs the question on why Covid19 bigcos were giving Biden real time updates on covid19 drug development, while trump -the actual president- was kept in the dark. I know the bad guys were sweating bullets on that one!
3) PBMs? Creating formularies to favor sweetheart rebates to them, obscuring real cost from patients and regulators, while making patients and employers foot the bill? or
4) Pharma, racking in cash from drug $20 copays without disclosing to customers that they offer the same pills for pennies if you "cash pay" (not use insurance).
Bad guys galore in healthcare. Insurers are most certainly in the podium.
[1] Marty Makary : Unnacountable book
[2] https://www.nj.com/healthfit/2020/02/an-insurance-titan-is-d...
[3]https://www.natlawreview.com/article/cms-backs-price-transpa...
The encryption appears to be for authentication not secrecy. The button status is in an unencrypted portion of the message.
Of course there may be plenty of sensors out there that fully encrypt in which case rtl_433 would probably not have decoders for them and so I would not see them at all.
Yes, this is what we call synergy. A whole becomes greater than the sum of its parts.
Due to this, I have my own specifications (not fully written, although I did write a lot of it), which are much simpler than HDMI. (It has digital video (with no inherent picture size limit, although implementations would be limited), analog audio, and an optional IMIDI (which is a two way command stream; it is safe to avoid connecting it). The IMIDI can be used for captions as well as for control, and can also be used with IR, as well as with the special IMIDI port.) (These would be fully free, although there may be trademark licenses (perhaps to avoid many of the problems that HDMI and others have) but no other restrictions.)
The "legitimacy" lies in the fact that that is what was politically possible to accomplish. I put legitimacy in quotes because I assume you mean legitimate in the context of some type of moral or ideological sense, which I do not find terribly interesting in this case, where there are many real world constraints at play.
At the very root of it all is the fact that demand for healthcare greatly dwarfs supply of healthcare, starting from the simple fact that changing bedpans is a highly undesirable task and going all the way to the fact that medicinal knowledge is very difficult and costly to acquire. And so politics will be involved in how healthcare is distributed.
You can even go back to your statement of
>from doing what is in my own best interest
99% of people have no idea how to evaluate what is in their own best interest when it comes to medicine. Even doctors outside of their specialty probably do not know, and the tiny minority that do would acknowledge that at some point they are also guessing at the machinations of something complex like the body.
The for profit (and not for profit) labeling is mostly a distraction. Doctors do not treat people without a profit, programmers do not program without a profit, and a managed care organization does not sell its services without a profit.
These 2 big constraints shape how much and what kind of healthcare system we can afford:
-low supply of healthcare relative to demand - requiring a system of allocation of resources
-medicine being extremely difficult and possibility of doctor making mistake or being corrupted requiring second opinion - i.e. doctors and pharmacists employed by managed care organizations
Obviously, everyone would love if everyone could get all the healthcare they could ever want at anytime they want. But our parameters do not allow for that. Back to the original question of why a for profit managed care organization needs to be involved at all? It does not, except politically, that was the solution the leaders agreed upon. I suspect politicians also like MCOs in the middle because it keeps the heat on the MCOs and deflects from them.
We could have gone the NHS way with taxpayer funded healthcare, and the NHS handling all the administrative functions that managed care organizations do. But there was significant political opposition to that, probably because a lot of politically influential classes stood to lose in that proposition. So we have what we have.
Note that to counteract excessive profit incentives, the ACA implemented minimum medical loss ratios and a healthcare exchange so that companies could compete for customers and hence have an incentive to keep premiums lower (presuming the existence of sufficient competing MCOs). Why not just cut all that out and let government deal with it? Because that is what was possible.
https://www.healthcare.gov/health-care-law-protections/rate-...
Regulatory capture[0] narrowed the possible to only solutions involving for-profit health insurance corporations. If you don't find a form of corruption to be of interest here, I'd be especially interested to know why.
Hence a compromise had to be reached. Getting taxpayer funded healthcare administered by the federal government simply was not an option, and I have not seen evidence that it was because the health insurance business was lobbying every Republican.
What I find more likely is that the more complex you make a system, the more you can engage in price discrimination via price obfuscation. A straight taxpayer funded healthcare option would have immediately impacted the bottom line, since government expenditures visibly go up, and would not allow a way to discriminate to those who receive the healthcare.
The compromise, however, allows for all sorts of games to be played. Such as allocating more and better healthcare to older people in comparison to poorer people. This is accomplished simply by having different reimbursement polices in Medicare (old people, strong voting power) and Medicaid (poor people, weak voting power). Medicaid is also further broken down into being administer 50 different ways by 50 different states.
Then you have employer self insured plans doing things the way they like, and employer subsidize plans doing things the way they like, and church plans that do not even provide healthcare. Basically, a way to expand healthcare in a way that still disproportionally allocates healthcare to richer and/or more politically influential people, but helping the others a little bit.
At least we got the metal levels and healthcare.gov out of ACA so there is some ability to compare insurance products.
And at the end of the day, even if you took away the cut that MCOs take for administering all this healthcare, it would mostly save around 5% to 10% (the profit margin plus savings from redundancies). MCOs currently pay out 75% to 80% of all premiums, and profit 5% or less, which leaves 15% to 20%, but the government would have to duplicate many of the functions of the MCO.
https://www.kff.org/private-insurance/issue-brief/data-note-...
Even in a taxpayer funded scenario, I would bet the doctor is going to have to get approval from the system to provide a treatment above a certain cost.
Because... You would be saving peanuts while someone else would have to pay much more (and sometimes drop their insurance completely) and that's a much worse result for society than you paying some 50 bucks extra, even more if you have a good salary and this practice would make someone poorer be forced to be uninsured.
This ultra-individualistic thinking really doesn't help a society. Might help you as an individual but good luck living without a society.
I already get a decent chunk of change ($700) just for annual preventative physical, flu shot, dental exam, blood test, and eye exam, which are all free.
There is a spectrum. ACA excluded tobacco users' risk from using tobacco, but left alcohol and sugar and saturated fats in? Why subsidize the latter 3 and not tobacco?
Should others in society subsidize drunk driving? Reckless driving? Should we keep bailing out people who continue to build and buy homes built in flood plains? It makes sense to spread costs around on unknown risks, but once a risk factor is known, I can see merit in discussing whether or not it should be subsidized.
Of course, there is a spectrum of "knowing" risk factors, and everyone is different, but some factors have a very high likelihood and some are not high enough to merit discriminating. However, that is for the actuaries to decide, because if they are wrong that will show up in the bottom line and then it will be corrected.
But things like alcohol and added sugar are basically proven to only cause harm. 1 alcoholic drink and 1 cupcake a month is not going to cause an insurance company to say let's raise this person's premium, but I do not see why an alcoholic and a person that eats donuts, starbucks, and ice cream everyday should be subsidized.
>This ultra-individualistic thinking really doesn't help a society.
On the contrary, subsidizing behavior that is known to causes problems to people's health and hence increases healthcare costs and decreases productivity does not help society. If anything, I would characterize unhealthy habits (which I am also guilty of) to be ultra-individualistic thinking.
The point is, no insurance is just going to say you pay next to nothing because of... Instead, they will say you are in the lowest risk category, and here's your rate.
>Why subsidize the latter 3 and not tobacco?
Big Tobacco was sued and lost in court, so they are easy to "pick on". Nobody has sued Big Sugar. We've already seen what strict rules on alcohol does to the country, and doubtful anyone is ready to do that again.
Progressive Auto has their Snapshot devices which provides them your driving habits. People signed up for it not realizing that their premiums could actually go up because they're a shitty driver even though they are "really good drivers". Once the word gets out that insurance premiums are going up because of this, there will be lots of screaming into the void on the internet.
I would never voluntarily submit data to insurance like this. It's a suckers bet.
That happens due to scarce resources. Most often in developing countries. Where I live, there are places doctors work at that barely have water for them to wash their hands. Ordering an MRI is a big deal.
I refuse to believe this would ever be a problem for the US.
We have a special visa for doctors willing to live in undesirable areas of the US for many years. There is even a website for it:
https://data.hrsa.gov/tools/shortage-area
https://www.hhs.gov/guidance/document/hpsa-and-muap-shortage...
And now to meet demand for doctors without having to pay for more doctors, most states have allowed a Nurse Practitioner or Physician Assistant to basically practice as a doctor where a doctor just oversees their clerical work. So if you have lesser insurance coverage or live in an area with insufficient doctors, then you may see an NP or PA who is far less qualified than a doctor.
It was never claimed that the insurance would cost nothing. There are, of course, uncountable health risks that are still in play.
>Big Tobacco was sued and lost in court, so they are easy to "pick on". Nobody has sued Big Sugar.
I do not know what this has to do with anything, nor what "sued in court" means as specific lawsuits have specific claims. It is correct that tobacco was separated probably because, politically, it is difficult to argue that people should pay for other people's smoking. And that is my point, that the risks we choose to subsidize and not subsidize are based on politics.
Hence, alcohol and sugar get a pass because lots of voters like those and want the smaller portion of people who do not consume as much alcohol and sugar to pick up the tab for those who cannot. Smokers do not have the numbers to result in sufficient political power to force others to pick up that tab.
>We've already seen what strict rules on alcohol does to the country, and doubtful anyone is ready to do that again.
I never claimed society should stop anyone from consuming alcohol or sugar.
Insurance pricing is very competitive and if one company raised premiums without experience by more losses, another would come in and offer insurance at a lower price.