I missed you! Welcome back to the land of the public-facing! That was going to be all, but instead:
13. This was surreal commentary to me, because I used to work in health insurance where EVERYONE knows healthcare is scarce, and instead has ideological or pragmatic disagreements about which parts SHOULD be scarce (million dollar gene therapy? drugs that are technically approved but don't really work? convenience drugs that don't technically work better than taking the two meds separately except that they improve adherence by improving convenience? how much do you need to improve adherence before it's worth it?) or how to make parts that are supply-side scarce (rather than unaffordable on the demand side) like rural specialist access less scarce (okay, actually there's an aside to be had there about insurance networks that make all the "preferred" providers with preferential pricing be providers who are in urban areas, so if you have members of the plan who live rurally, well, too bad for them).
There is, yes, also the issue of the inability to discover whether a treatment for your condition exists at any price (I like IncitefulMed as a first pass search, but that's not a solution, just a search engine better than most; OpenEvidence will do too, and is still not a solution, just a tool), and the separate issue of trying to determine what the treatment costs, which there is an entire industry of band-aid solutions for that DO NOT SOLVE THE PROBLEM, which really just tells you how Byzantine the problem is. But I'm skeptical of the idea that unwillingness to admit to scarcity is a root cause of problems with healthcare policy in the US, just because policymakers and insurers explicitly argue about what should be scarce in healthcare and entirely the patient's responsibility to pay for, all the time.
(I'm less sure about other developed countries, but Singapore presents scarcity of total $$ relative to the rising cost of the package of care the government thinks of as normal AS the problem--or rather, American studies of Singaporean healthcare suggest that Singaporean policymakers believe so; take with the usual grains of salt.)
You can claim that the general public refuses to acknowledge scarcity and thinks everything should be paid for, maybe, (I'm not talking about socialized medicine as a concept; I'm talking about what's on the formulary/billing code book of reimbursed medicine, socialized or commercial) but I'm not convinced that has any impact on policy, especially compared to a lobby group like say the AMA, AHIP, or PhRMA.
20. You're probably already reading it because of the social circle you're in, but I strongly recommend Ada Palmer's Inventing the Renaissance if you like history books that are an opinionated girl telling entertaining stories about interesting individuals, and of course, the Italian Renaissance.
11. "why should our ingroup be any different, just because we’re also objectively correct?" - I literally laughed out loud, and since you could not see this, I felt I should interact socially by telling you so. I too am from a port city and grew up in the highly international culture that is natural sciences academia. You would think that hearing so many people speak English as a second language and being delighted to hear about where they came from would make me less afraid to interact in languages that I only kind of speak, but alas, it does not.
Really glad you published this. The premise and the form is inspiring. Makes me wanna shake off the rust and write again, too. Also, Bruce is a boss name.
> The fact is, I’ve been hiding. It feels like “writer’s block” or like I “can’t think of anything to say”, but obviously that’s suspect, and the real thing is that I can’t think of anything to say that’s impeccable and beyond reproach and definitely won’t get criticized.
Extremely relatable. Good luck with the job search! Happy to make a warm intro if helpful somewhere.
Great post - welcome back. Triggered two thoughts and a question:
1. What a great antidote to the idea of "babybrain" - sounds like your thinking is more fertile than ever.
2. On number 17. I am a dad and now a granddad - there will be a period as young adults when they don't listen to you - get over it! Aim is that they have enough common sense by then not to try anything too crazy.
Question: that personal CRM, does it include your linkedin contacts?
yep i gave it read-only access to the gmail API. it took a lot of futzing with the prompts to get the error rate under 5% or so and then i manually corrected the rest.
I love this post! Your miscellanea are always interesting. Congrats on the baby, he's adorable.
16 and 17 are unexpected, my kids aren't school-aged yet so I'm a bit clueless there but what do schools focus on if not the 3 Rs? At least at toddler age it seems like the alphabet and counting are big topics in toddler media.
And why video games > youtube? More active? Social?
whatever database or files backs up your custom todo app and CRM, it's pretty easy to sync them to a cheap cloud server as well.
it's also really easy to vibe code a trivial MCP that just gives Claude read-write access to those files. (took me <1hr to do and it is truly authentically vibe coded, i didn't even read a line of python). claude will tell you how to set this up to run on the server, which was also easy even though i know next to nothing about administering linux systems.
since it's running on a cloud server, you can add it as a custom MCP and then all claude interfaces (web, mobile, desktop) have access.
so the upshot is that the claude chat product now can read all your tasks on request (+ calendar and any other context) and answer questions like "what should i do next" or "help me with my weekly review" or "is there anything i've been letting drop" or "extract all promises i made from this email chain and add them to my list".
It was such a pleasant surprise to me that this worked as well as it did, i've been very excited about it. also saved me from exposure to the OpenClaw community.
25 very interesting! Are there concrete predictions this would make? E.g. do clinical trials have a higher success rate when targeting older versus more recently evolved things? I'd take the other side of this bet I think but either way I'm curious what the answer is.
> “Healthcare abundance”, as an agenda of building more hospitals, licensing more healthcare practitioners, producing more drugs and supplies so we’re not in shortage all the time, etc, is very important, but it is harder to communicate than housing abundance, in part because most people don’t know healthcare scarcity is a thing. And people don’t know about healthcare scarcity because we hide it.
Uh, uh, I can already see people angrily opposing anything that increases the amount of health care available, on the grounds that it’ll be luxury health care, and therefore also racist and so on; you know, health-care gentrification. Existing health-care practitioners will happily go along with this, as it protects their health-care values. Now that the shortage is entrenched and politically impossible to do anything about, it’s time to divide and conquer: boo tourists, boo digital nomads, no health care for you.
So most games require active success in the form of the player learning to do something better (like reflexes or strategy). RPGs move the burden of improvement to the character, who just gets XP and improved skills for grinding at the same task (especially the classic "grind for XP" type - in fairness some creative ones have different focused).
It's why I've mostly stopped playing them (even when I have time for gaming) despite having used to like them. I don't like the incentives they give me (empty improvement of my character instead of doing something interesting), it feels like a secret form of passive entertainment.
I missed you! Welcome back to the land of the public-facing! That was going to be all, but instead:
13. This was surreal commentary to me, because I used to work in health insurance where EVERYONE knows healthcare is scarce, and instead has ideological or pragmatic disagreements about which parts SHOULD be scarce (million dollar gene therapy? drugs that are technically approved but don't really work? convenience drugs that don't technically work better than taking the two meds separately except that they improve adherence by improving convenience? how much do you need to improve adherence before it's worth it?) or how to make parts that are supply-side scarce (rather than unaffordable on the demand side) like rural specialist access less scarce (okay, actually there's an aside to be had there about insurance networks that make all the "preferred" providers with preferential pricing be providers who are in urban areas, so if you have members of the plan who live rurally, well, too bad for them).
There is, yes, also the issue of the inability to discover whether a treatment for your condition exists at any price (I like IncitefulMed as a first pass search, but that's not a solution, just a search engine better than most; OpenEvidence will do too, and is still not a solution, just a tool), and the separate issue of trying to determine what the treatment costs, which there is an entire industry of band-aid solutions for that DO NOT SOLVE THE PROBLEM, which really just tells you how Byzantine the problem is. But I'm skeptical of the idea that unwillingness to admit to scarcity is a root cause of problems with healthcare policy in the US, just because policymakers and insurers explicitly argue about what should be scarce in healthcare and entirely the patient's responsibility to pay for, all the time.
(I'm less sure about other developed countries, but Singapore presents scarcity of total $$ relative to the rising cost of the package of care the government thinks of as normal AS the problem--or rather, American studies of Singaporean healthcare suggest that Singaporean policymakers believe so; take with the usual grains of salt.)
You can claim that the general public refuses to acknowledge scarcity and thinks everything should be paid for, maybe, (I'm not talking about socialized medicine as a concept; I'm talking about what's on the formulary/billing code book of reimbursed medicine, socialized or commercial) but I'm not convinced that has any impact on policy, especially compared to a lobby group like say the AMA, AHIP, or PhRMA.
20. You're probably already reading it because of the social circle you're in, but I strongly recommend Ada Palmer's Inventing the Renaissance if you like history books that are an opinionated girl telling entertaining stories about interesting individuals, and of course, the Italian Renaissance.
11. "why should our ingroup be any different, just because we’re also objectively correct?" - I literally laughed out loud, and since you could not see this, I felt I should interact socially by telling you so. I too am from a port city and grew up in the highly international culture that is natural sciences academia. You would think that hearing so many people speak English as a second language and being delighted to hear about where they came from would make me less afraid to interact in languages that I only kind of speak, but alas, it does not.
PS: Your baby is cute!
Really glad you published this. The premise and the form is inspiring. Makes me wanna shake off the rust and write again, too. Also, Bruce is a boss name.
It took me just a second to get Bruce Springsteen = the Boss. I am ashamed of myself as a musician ;)
> The fact is, I’ve been hiding. It feels like “writer’s block” or like I “can’t think of anything to say”, but obviously that’s suspect, and the real thing is that I can’t think of anything to say that’s impeccable and beyond reproach and definitely won’t get criticized.
Extremely relatable. Good luck with the job search! Happy to make a warm intro if helpful somewhere.
Congrats on your baby! My first is due in April.
Also: my (physicist) brain read "biological HTS" and thought "biological high-temperature superconductor? Hmm..."
Extra-cute baby!
(Also, as an aside: great post!)
Great post - welcome back. Triggered two thoughts and a question:
1. What a great antidote to the idea of "babybrain" - sounds like your thinking is more fertile than ever.
2. On number 17. I am a dad and now a granddad - there will be a period as young adults when they don't listen to you - get over it! Aim is that they have enough common sense by then not to try anything too crazy.
Question: that personal CRM, does it include your linkedin contacts?
You <> https://elicit.com/ should IMO be a great match.
I love thinking about personal crm.
The data you put into your personal crm was your email contacts/ email history? Did you give it Gmail access, or export something and upload?
What sort of error rate has it had?
yep i gave it read-only access to the gmail API. it took a lot of futzing with the prompts to get the error rate under 5% or so and then i manually corrected the rest.
I love this post! Your miscellanea are always interesting. Congrats on the baby, he's adorable.
16 and 17 are unexpected, my kids aren't school-aged yet so I'm a bit clueless there but what do schools focus on if not the 3 Rs? At least at toddler age it seems like the alphabet and counting are big topics in toddler media.
And why video games > youtube? More active? Social?
whatever database or files backs up your custom todo app and CRM, it's pretty easy to sync them to a cheap cloud server as well.
it's also really easy to vibe code a trivial MCP that just gives Claude read-write access to those files. (took me <1hr to do and it is truly authentically vibe coded, i didn't even read a line of python). claude will tell you how to set this up to run on the server, which was also easy even though i know next to nothing about administering linux systems.
since it's running on a cloud server, you can add it as a custom MCP and then all claude interfaces (web, mobile, desktop) have access.
so the upshot is that the claude chat product now can read all your tasks on request (+ calendar and any other context) and answer questions like "what should i do next" or "help me with my weekly review" or "is there anything i've been letting drop" or "extract all promises i made from this email chain and add them to my list".
yep, all of that is what i have done!
It was such a pleasant surprise to me that this worked as well as it did, i've been very excited about it. also saved me from exposure to the OpenClaw community.
25 very interesting! Are there concrete predictions this would make? E.g. do clinical trials have a higher success rate when targeting older versus more recently evolved things? I'd take the other side of this bet I think but either way I'm curious what the answer is.
Great post. Would appreciate a further list of things you want to write.
Hard agree on #18, would love to hear more about #24 (macrophages and more about the complement system too).
> “Healthcare abundance”, as an agenda of building more hospitals, licensing more healthcare practitioners, producing more drugs and supplies so we’re not in shortage all the time, etc, is very important, but it is harder to communicate than housing abundance, in part because most people don’t know healthcare scarcity is a thing. And people don’t know about healthcare scarcity because we hide it.
Uh, uh, I can already see people angrily opposing anything that increases the amount of health care available, on the grounds that it’ll be luxury health care, and therefore also racist and so on; you know, health-care gentrification. Existing health-care practitioners will happily go along with this, as it protects their health-care values. Now that the shortage is entrenched and politically impossible to do anything about, it’s time to divide and conquer: boo tourists, boo digital nomads, no health care for you.
Re 16, a generalization (if I understand your reasons correctly) is that RPGs are worse than other video games
Re 20, this is part of why I enjoyed the LKY memoirs (especially the part about Jimmy Carter).
oh, why? not obvious to me
So most games require active success in the form of the player learning to do something better (like reflexes or strategy). RPGs move the burden of improvement to the character, who just gets XP and improved skills for grinding at the same task (especially the classic "grind for XP" type - in fairness some creative ones have different focused).
It's why I've mostly stopped playing them (even when I have time for gaming) despite having used to like them. I don't like the incentives they give me (empty improvement of my character instead of doing something interesting), it feels like a secret form of passive entertainment.
Oh interesting that is a reason I object to them but not a generalization I would have made from #16.