Fun fact: it mostly does now (varies by market, but the big players have mostly adopted it). It hasn't changed much. As others have observed, the underlying reality is that the mega-acts are inherently supply-constrained, and (enough) people are in fact willing to pay those prices.
Not to derail to an unrelated complaint about Fi, but it's absolutely wild that if you want to do a 3-way call from your Google Pixel phone using Google Fi service, you can't do it from WiFi (or rather, if you don't turn off WiFi before you start the call, then you'll be muted).
Apparently it's a sort-of-known issue, the workaround is to turn off WiFi before starting your call (wtf?) or use another carrier.
Active Frequency | activefrequency.com | Boston (REMOTE)
We're a custom dev agency, specializing (but not exclusively) in Django. We work with a diverse roster of interesting clients, across different industries (everything from healthcare to rock'n'roll).
We've been in business for 12 years, and the company is profitable. We're currently three full-time developers, looking to add an additional developer and our first in-house full time designer to the crew.
Taking that at face value, I'd say that "limit drivers doing it 'for fun' in exchange for better pay/protections for drivers doing it to eke out a living" seems like a reasonable trade-off...
It gets into some (though hardly all) of the issues of why EHR software is the way it is, and why (some) doctors hate it. (Among my friends who are doctors, some hate Epic, and some absolutely love it - depends on specialty, age, institution, how it's configured, etc.)
Among some interesting issues:
- As others in this thread have noted, the buyer (administrator concerned with maximizing billing) is not the user. That's the easy one that's common to a lot of enterprises.
- Epic makes it easier for medical directors to track population health and impose standard protocols of care. Individual practitioners don't always like that! I am not expert enough in those fields to say who's right, and I suspect there's not always an obviously correct answer.
- A lot of doctors dislike the underlying mechanic - being forced to actually write down everything they're doing and why - on top of sub-par UIs. The goals of the system conflict with the goals of the practitioner.
- Interoperability sucks, but it's true that standards aren't really there, and it's hard to get consensus... plus everything you put in prod needs to be back-compatible approximately forever. A lot of institutions got burned by maintaining internal software built over decades that you can't turn off because lives depend on it, and Epic/etc. are part of trying to avoid repeating that mistake.
There's more. I only have a toehold in that world now, but love to chat about it. Email in profile.
To some degree, yes - Massachusetts did that, in fact, and the plan there (that was signed, somewhat ironically, by Mitt Romney) is very very similar to the ACA.
There are a lot of details, though, that make this complicated and not necessarily viable for all states (MA is both relatively wealthy, has relatively wealthy neighboring states, and has a somewhat unusual healthcare market).
Here's a common scenario: you maintain more than one project, and you can't just simultaneously upgrade e.g. Django for all of them (or literally any library where an upgrade may be non-trivial).
Yes, eventually you'll (hopefully) upgrade all your projects to the newest and shiniest versions of all your dependencies, but if you need to maintain some semblance of stability, that's not always immediately possible/practical.
The feasibility of buying 292 million tickets (as you mention) is a key barrier: many lotteries (Powerball included) explicitly and deliberately require that tickets must be bought in person. So, just as a matter of time constraints, you'd need a (nontrivial) army.
Rough ballpark: 300 million combos - let's say you buy 6000 tickets/hour (which I think is actually optimistic probably by a full order of magnitude), for 25 hours a day (assume shifts and magic days), you're still looking at 2,000 person-days.
Most of these are for chronic conditions, where people are seeing their doctor on a fairly regular (once every few months) basis. And yeah, at least some patients absolutely do ask, "hey, I heard about X, is that good for me?"
There are of course also the extreme cases of specifically asking for a given prescription, but like the parent mentioned, just having a few patients persistently ask the doc about X is enough of a motivator to get the doctor to pay [marginally] more attention to the doctor-facing literature/ads/sales force.
My understanding is that PLM very much translates to useable knowledge - just for the pharma and PHM folks who mine the backend (which is how they make money). Notably, this is all quite above-board: it's not a "secretly mine people's private medical details" situation, it's "overtly mine people's private medical details in order to help find treatments for their rare disease"...
I like ZP (now Gusto), I really do, but their support over time has been lacking (and it feels like it's degrading), and as a customer I'm growing increasingly concerned that they're growing too fast to keep up.
Granted - I'm a tiny account (3 employees). That said, it's frustrating that it takes weeks to get answers to questions (some simple, some less so). When I finally do get someone's attention, the resolution is generally a good one, but it just feels like they're flat-out understaffed on the support side - which is disconcerting when dealing with things like payroll, taxes, etc.
I certainly wish ZP all the best, and perhaps this expansion into new lines of business will help them hire more support staff... but a part of me feels like, "guys, get your house in order first before your start expanding."
Channeling patio11 here, but CHARGE MORE! Or, more to the point, have some ways to price-discriminate. Maybe on # of employees; maybe on features; maybe integrations or SSO or whatever.
Obviously you're not (currently) targeting Big Enterprise, but even within your present target market there's got to be a difference in how much value you're delivering for different clients... price based on that!
Global Entry is for immigration/customs, not TSA security.
The trade-off is: they do a background check and take some biometrics, and in exchange you can skip the conversation with an immigration agent where they ask you where you're been, etc. - you just answer the usual customs-form questions at a kiosk.
It's actually a pretty reasonable trade-off, and speeds the process of going through Customs - which, unlike some of the TSA stuff, is in no way unique to the US (having gone through immigration/customs in 20+ countries, I can say with some experience that the US is far from the worst...)