Our dumb system

I think we made the right choice last year, going with the bronze plan with the 10K deductible, rather than the silver or gold plan, with 3K deductibles but ~4K and 5K more in premiums for the year, respectively. It is absolutely impossible to know for sure, because of the microscopic fluctuations in charges along the way. Our ~5K out of pocket would have exceeded the 3K deductibles, but various costs would have been subsidized differently along the way, so it's apples and lightbulbs, as an old professor of mine used to say.

However:
1. This is so phenomenally stupid to waste everyone's time scrutinizing endless details that still don't add up to an informed choice.

2. My suspicion is that they've priced these based on a bit of psychology, and that the silver plan is the worst, because it seems like the safe compromise, and thus people are most likely to reach for it when they get overwhelmed with decision fatigue.

Furthermore, I suspect the bronze plan is actually the best value, because they're counting on everyone avoiding the anxiety of paying for everything out of pocket unless necessity dictates the bronze plan.

This is not three actual choices. They're literally in the business of crunching numbers. They have just run the numbers in order to create three ways to wring the most money out of the type of person most likely to reach for each choice.

Bottom line: our open enrollment period ends today, so I guess we're all locked in now.

Guest Post - obsolescence is just a number

Chris Y writes: I find this somewhat comforting. I would have found it more comforting if I'd read it thirty years ago. I'm not a fan of upgrading for the hell of it, but who has been supporting this shit?

Heebie's take:

After over 40 years, the Strategic Automated Command and Control system (SACCS) no longer runs on venerable 8-inch floppy drives from circa 1972. As of this past June, the entire system has moved to a "highly-secure solid-state digital storage solution." That's according to Lt. Col. Jason Rossi, commander of the Air Force's 595th Strategic Communications Squadron. The federal government, for obvious reasons, declined to say much about the exact methods it uses to network the strategic operations center for the ground-based nuclear arsenal.

yowza. I guess they survived Y2K?

Guest Post - Happiness

Chill writes: I can't stop looking at this chart, and in particular the male-female differences.

Boy's Mom's comment: "So you want a divorce?"

There is lots to chew on in this chart - unemployment is much harder to recover from than divorce, widowhood (for either gender) is the most crushing blow by far, nobody should have kids, marital bliss wears off in two years. I don't understand what they mean by "layoff" as opposed to unemployment. But I keep coming back to the gender differences.

It comes from a much much much much much longer article on happiness and life satisfaction here. The article is exhaustive/exhausting; I haven't even skimmed the whole thing much less read it.

I did read this short essay on the "our world in data" project, which I had never heard of before. The essay/history is inspiring if you think of data visualization as a heroic endeavor, which I kind of do.

And I originally got there through this guy's twitter stream (originator of the our world in data project) even though I am not in the twitterverse myself.

Heebie's take: The charts are super interesting, Here's the summary from the long article:

Here is a preview of what the data reveals.

1. Surveys asking people about life satisfaction and happiness do measure subjective well-being with reasonable accuracy.

2. Life satisfaction and happiness vary widely both within and among countries. It only takes a glimpse at the data to see that people are distributed along a wide spectrum of happiness levels.

3. Richer people tend to say they are happier than poorer people; richer countries tend to have higher average happiness levels; and across time, most countries that have experienced sustained economic growth have seen increasing happiness levels. So the evidence suggests that income and life satisfaction tend to go together (which still doesn't mean they are one and the same).

4. Important life events such as marriage or divorce do affect our happiness, but have surprisingly little long-term impact. The evidence suggests that people tend to adapt to changes.

It reminds me a bit of the research on people with disabilities - that people without a given disability fear that it would ruin their life, but the reality is that when a person becomes disabled, it's usually a shortterm hurdle that they adjust to and then return to their baseline happiness.

Without reading the article, my memory on wealth and happiness is that there was a wealth threshhold above which the correlation stops, and happiness ceases to increase as a function of wealth. That notion fits nicely with how I want the world to be, and so I'd be sad if this article challenges it.

Finally: I wonder how this fits into retrospective happiness - ie, looking back over the past ten/twenty/fifty years, and feeling content with how it went. And how much does retrospective happiness matter anyway, if it doesn't ruin the current subjective happiness of the octagenarian looking back? Is it better to be a sourpuss octagenarian who nevertheless feels that they would go back and do it all over again the same way, or the lighthearted octagenarian who made truly terrible choices at every turn and yet happily ‾\_(ツ)_/‾s it all off?

Well, how did I get here?

This can't possibly be as funny as I think it is, so I'm not saying this will have universal appeal. But Kermie's voice is making me laugh and laugh, and I just keep listening to this over and over again:

The way he says "Same as it ever was!" is just the best. (Apparently this aired on The Muppets Tonight, in 1980.)

Never Forget

It's going to be President Kamala

Guest Post - Oxy in China

Mossy writes: From the AP:

representatives from the Sacklers' Chinese affiliate, Mundipharma, tell doctors that time-release painkillers like OxyContin are less addictive than other opioids--the same pitch that Purdue Pharma, the U.S. company owned by the family, admitted was false in court more than a decade ago. [...] As in the U.S., marketing material in China made claims about OxyContin's safety and effectiveness based on company-funded studies and outdated data that has [sic] been debunked. [...] Just as Purdue was accused of doing in the U.S., Mundipharma cultivated doctors with paid speaking gigs, dinners, event sponsorships and expense-paid trips to meetings [...]

Of course Purdue perfidy is by now unsurprising. What I found interesting is that the PRC authorities apparently were no more resistant to this than the American, despite a decade's warning; indeed, enabled it.*

The program was a three-way alliance among the then-Ministry of Health, the Chinese Society of Clinical Oncology and Mundipharma [...] In internal company documents, however, Mundipharma treated the program as part of its marketing strategy and used it to tout the superiority of its own products. "We were definitely talking about OxyContin ninety percent of the time," said a former sales rep [...] By early 2017, OxyContin had captured roughly 60 percent of the cancer pain market in China, up from just over 40 percent in 2014 [...]

And, in addition to the miasma of indifference, ineptitude and corruption one might expect, an odd economy of ideas, mixing colonial cringe and a kind of weaponized ethics of care.

as stories of OxyContin abuse began to circulate in the United States, foreign pharmaceutical companies helped spread a new gospel of pain treatment across China, recasting pain as the fifth vital sign--alongside blood pressure, heart rate, respiratory rate, and temperature--and pain treatment as a human right. [...] Many of his younger colleagues, however, appeared in thrall of these foreign ideas. They believed the best medical practices came from the United States.

*In fairness prescriptions apparently are quite tightly controlled and "The country does not appear to have an opioid crisis anything like in the U.S." Although OTOH "U.S. Centers for Disease Control says that as many as 1 in 4 people prescribed opioids for long-term use struggles with addiction." So.

Heebie's take: Ugh. Hmm. So. This will probably not go well.

Into Hypoxia

Only 23 years after everyone else, we listened to Into Thin Air on the drive home from Denver this weekend. Wow, climbing Everest sure sounds like a miserable experience even before everything goes wrong. Game theory tells us, therefore, that bragging rights must have the very highest utility to entirely rational people.

Unfortunately, nothing has been written on the internet on the topic since 1996, so I have no links for you.