Also Westinghouse and GE (IIRC), the major suppliers of both nuclear plants and the very expensive fuel rods, have a very strong economic interest in continuing to sell fuel rods. This is analogous to ink jet printers, which are sold at or below cost but the ink is sold at more than 100 times cost. ($5000 per gallon is a typical price.) LTFR reactors threaten their business model. Of course they don't sell the plants at cost, but they do make a lot of money on fuel rods and maintenance contracts.

That's the basis of the problem - it's a systems problem, driven by the separation of cost feedback from price feedback, and exacerbated by the tort environment. Once you've paid your monthly insurance, you feel like "I've paid for it, I should get the service I paid for." Meanwhile, if a hospital were to take it upon itself to even buy that tube from a different supplier (for $125, say), they would almost immediately be subject to class action suits that include everybody who has been served, _even if there were no problems_. And the insurance companies have to go along or they'll get sued, or bad press about how they're abusing their customers. So the lawyers - and healthcare executives - can basically take this boat for a long, fast, ride.

I'll just add that back in the 1980s Arthur Deming (the guy who created the Japanese quality "miracle") came out with a book that showed how to cut medical costs in 1/2. The two big items were tort reform - consider that every item in a hospital, and every component of that item, has a liability insurance load of about 30%. So a kidney machine, for instance, uses about one foot of clear vinyl tubing for the blood pump. It has to be discarded after use, mainly for liability reasons. That's exactly the same tubing you can buy at Ace Hardware for about $1 per foot today. But it's been sanitized, inspected, and packaged in a sterile pack. The hospital has to buy it from the kidney machine maker to avoid liability issues. That piece of tubing, back in 1979, cost $150 each. Of that, the maker of the tubing that the kidney machine buys it from has to include 30% for their liability cost, upping the cost to the kidney machine company. Then the kidney machine maker has to insure on that increased cost. So now their cost is up by about 69%. (This is an actual example I was involved with many year ago.)

Then the hospital is paying 30%. And the doctors and staff are paying 30%. (In the late 1980s I knew a heart surgeon who paid over 30% of his gross pay for liability insurance. He was the 2nd most popular one in Arizona at the time. Others may have paid somewhat less.) So the increased cost of everything is compounded over and over.

The second item was paperwork reform. At that time (and mostly still) each insurance company had different paperwork, none of it was electronic. This is the area that the ACA may actually help with - I don't know for sure.

Deming estimated that fixing each of these would reduce overall costs by about 30%, for a total savings of over 50%.

A very strong contributing item today, that is going to get worse before it gets better, is that the ACA has just dumped a huge new cash cow into the healthcare industry's lap, when it was already floating in cash. Someone I know just went to the HIMSS conference in Orlando. He said he'd never seen such a wealthy business crowd. The parking lot was loaded with Lamborghini, Mercedes, the occasional Bentley. These were not the owners, these were the IT heads! The whole industry has gradually evolved into one of those elite clubs where the money just flows without end, and all the vendors have to do is suck up he cash. There's almost no sense of cost limitation - except for lip service of course! These folks have successfully turned "rent-seeking" into an industry lifestyle.

I had a similar plan when I was an independent consultant in OR in early 2000s, and such plans have been around for decades. The company catered to independents. The cost of my plan in MA to the company actually went up almost 20% per year, starting when RomneyCare kicked in. The company mostly just covered it by paying the higher rate (and switching providers), but finally couldn't do that any more. RomneyCare at least didn't make existing plans illegal AFAIK.

Reminds me of some religious sects.

I forget what it's called, but there's this syndrome. On almost any given issue, it makes a very tiny difference for almost everybody, but it makes a huge difference for a small group of people. That small group are the ones who pay to "get something done", while the vast group of everyone else isn't paying attention to that one thing. So almost all of the information and lobbying that politicians hear is from the small group.

$100 per month for a high deductible single person is not out of the ballpark, or at least wasn't until ACA. These have been popular among independents for a long time. I had one at my company last year. In high-cost MA, my cost was about $110-120, plus I paid some more for dental. And the company paid another $100+ IIRC. I 'only' had a $1500 deductible so the insurance carrier had to cover a lot of things that the parent's plan wouldn't. The reason these plans work is that by far the largest part by far of that "$8895" cost is for all those doctor visits, labs, etc. for non-catastrophic (non-Major Medical) expenses. When I went to the doctor I got a discount due to being in the insurance program, but paid the entire cost myslf until the $1500 was covered. So most years my out-of-pocket for monthly plus actual medical was probably more in the $2500-$3000 range, plus what the company covered. And, like most people on these plans, I didnt/don't go to the doctor as much so the overall cost to the insurer is less. That $8895 mean is undoubtedly skewed by the Cadillac plans - I suspect the median is closer to $4000.

Interestingly for a few months in 2014 I was uninsured. One Rx I take had a co-pay of $100 per month under my insurance and the supposed "cost" was over $300. But when I paid for it out of pocket, I paid only $120. And most of my doctors gave me bigger discounts for paying cash so it was often cheaper than using the insurance. (Of course I didn't have Major Medical coverage, so that could have been a problem if anything had happened.)

My now ex-wife had surgery back in 2001. It was covered by insurance. The doctor billed $9000 (which was the amount right out of the "code" book), and after two years of going back and forth with letters, threats, haggling, he finally got paid about $4500. They "lost" the paperwork twice. They rejcted it several times for supposed errors. This was all delaying tactics - I found out later that the insurance company was having cash flow problems and was doing this to thousands of patients and doctors - just delay until the end of the fiscal year, and the books look much better!

His office person told us that if she had just gone in with her VISA and said, "I want this" and paid cash, he would have billed us $1200. This one-doctor office had two full time staff people who did nothing but deal with insurance companies so his costs are much higher for anything covered by insurane.

It is unlikely to pass, but I'm watching with interest the proposed ballot measure to split CA into multiple pieces. The state is apparently ungovernable as it is now, and (like many states, even MA) the urban areas tend to drive the politics and leave the rest of the state to grumble. Looking at many 'blue' states, the actual areas that are blue are often less than 1/10 of the area and less than 1/2 the population but election districts tend to be drawn to increase the influence of the more urban parts. Splitting the state would bring government a bit closer to the people in all areas.

Among other things, this would also make the 9th Circuit Court of Appeals much happier. At present the 9th Circuit spends almost all of its time on CA cases and the case load is already much too large. But there's no precedent nor logic to splitting the Court - and its precedents - to cover only part of a state. Imagine if the precedents set for San Francisco did not apply to LA! Splitting CA would allow at least one, possibly two new Circuit Courts to be established.

Splitting states has been done before, but not for about 150 years. I think the last ones were around the time of the Civil War - West Virginia split from Virginia to go with the North.

One small thing you can do - put the various versions of facebook.com in your /etc/hosts file (there's a Windows file that does the same thing). Use 127.0.0.1 or some other non-tracking web server IP for the IP address. This supercedes the DNS request and the browser just thinks that this IP address is facebook.com so sends the request there. It never even goes onto the LAN or WiFi.

On my laptop I have a webserver the serves a blank page so I am not plagued with "can't find website" or 404 errors. This completely prevents any facebook scripts from being loaded, much less talking to facebook.

The only disadvantage I've found is that a few websites seem to implement the facebook scriptlet in such a way that when it isn't loaded, it opens an iframe the size of the entire browser window instead of the little facebook icon. I don't recall which ones. Otherwise, all facebookisms completely disappear. I might do that for a bunch of other beacon sites.

Now I think of it, this would make a good plug-in - more extreme than AdBlock. I wouldn't use it for anything but beacons and tracking. It means you are completely unable to access those domains from that machine.

Ah, I stand corrected. I did a quick google+wikipedia as well, but mistakenly read housing units as population. There are 1350 housing units per sq. mi. in Houston. (I picked Houston because when I lived there it had the lowest density of any US city.) As you pointed out, the population density is closer to 3500.

In any case, my point was that this was the original parent's perception, as it is for most people in the US.

I'll also note that the density in Bangladesh is about 1150. In most (all?) developed countries most of the people live in 'urbanized areas' - the percentages vary radically according to how that is defined. E.g. 1/2 of US residence live in the top 48 'urbanized areas', and 80% in all of them (which includes towns down to 2500 population.) -http://www.theatlanticcities.com/neighborhoods/2012/03/us-urban-population-what-does-urban-really-mean/1589/

I think perceptions like this are largely based on what we see in the media. For my part, I was surprised when I moved from Oregon to Massachusetts to discover that the whole state wasn't basically a suburb of Boston. I presently live six+ miles from the nearest supermarket. That's about as far as you can get in central MA, of course, but considering that MA is about the same size as Harney County in Oregon which has a total population of 7,000 - about the same as the town in MA that I live in - I expected to be living "downtown". I moved from central Oregon, which is a bit denser than Harney - Harney is about one per sq. mi., Deschutes is about 52. and in the part where I lived probably 5-15.

Interesting surprise! I just learned that the population density in the state of MA is about 840. It's about the same as Japan! But in my part it's only 220 and I'm in the most rural part of the town.

Well, actually they've been freaking out about the Japanese debt problem for a long time - 20 years or so. Most economists that I've read now believe that it would have been better to 'bite the bullet' back then and let the banks fail, then pick up the pieces. Instead they've been slowly bleeding to death for 20 years and dragging down the Japanese economy. See Iceland vs. UK and several other Euro countries. Iceland told the banks (and Europe) to F*-off - no "too big to fail" BS. The country went through some hard times for a few years, now they're doing well. But other countries all over Europe are now in the bleeding to death for 20 years phase. And, IMHO the US is going that way as well but we're doing it by inflationary theft.

I read recently that Japan's 'safe' Postal Savings system had been exposed - it had been systematically and secretly looted by successive governments for the last 20 years, to cover up the financial problems and prop up the banks. It was originally a true savings system, but no longer. The money's not actually there any more. It's now financially more like the US Social Security system, where they're paying the present oldsters with money paid in by youngsters.

Unfortunately nobody has ever come up with an economic model that is stable without growth in both population and economic activity. I expect that Japan's accelerated work on advanced robotics may be an effort to create a new model that replaces those people with robots and allows renewed economic growth with a shrinking but ever wealthier population - at least until SkyNet! :P

I think the parent was arguing that it is so dense (at least apparently - all we know here is what we see on the media) that it might as well be. I just looked. The density of Houston is about 1350 per square mile, Japan is about 750 per square mile, more than 1/2 of an actual US city (albeit one with a lot of territory). So the parent isn't completely off base.

Unlikely on two counts: 1) Governments rarely do that. Viz. Obamacare - they were hiding the problems for two years until it just became too obvious. Most government IT failures are just swept under the rug; 2) A large number of government and other organizations have been using it for years, and the number is increasing so whatever its failings, Drupal continues to meet their needs better than any alternative.

While WordPress runs about 16% of the top 10 million sites on the net while Drupal runs only about 2.6%, the number of user logins actually favors Drupal by far. Sites that actually handle a lot of logged in users are much more likely to be running Drupal. IOW WordPress is popular for personal blogs, but for real enterprise-y sites it is by far the most common 'independent' CMS, by which I mean not running commercial tools like IBM or Oracle. I don't have numbers for those but I'm sure they're big.

There is a burgeoning (maybe that's too strong) module certification effort now happening. Top Shelf Modules is one group; I think CommerceGuys does it for things in their catalog, there's another that I always forget. So, progress occurs.

Realize that there are still lots of vulnerabilities in core C libraries - not to mention that C is inherently unsafe and must be handled with care. Many of the vulnerabilities in Drupal, PHP and other tools are really just exposing the failings of C. But not to start a flame war... :)