I think you responded to the wrong post, but I'll bite anyway -- sure, it's easy to self-diagnose incorrectly. I'm guilty of it myself. But the ability to get labwork done (on my own dime) is super valuable to me, because (anecdotally) doctors follow their traditional protocols, which are generalized for the population and (often, it seems to me) rely on prescribing a magic pill.

I was diagnosed by my doctor with hypothryoidism based on a high (but not astronomical) TSH. My doctor would have NEVER ordered a lab for free triiodothyronine - she just rx'ed synthroid and was done with me. I did more research on my own, decided I really wanted to track FT3 & FT4 because I suspected my symptoms strongly correlated with those levels rather than TSH. And I discovered low/normal FT3/FT4 is NOT good for me - despite it being within the reference range.

For patients that are willing to take charge of their health, having more access to tests is a good thing. Doesn't mean patients shouldn't have conversations with their doctors - I'm meeting with mine in 3 weeks - but those can now be much more fruitful conversations.

Which I don't get with today's system.

I've been feeling really fatigued lately so I had an iron test done. I have low iron-binding capacity, and yet high serum iron. Is that normal for me? I have no idea - I'm 33 years old and I've NEVER had my iron checked before, because my doctor(s) have never ordered it. At least today, I can go online to order tests (paid out of pocket, drawn at local service centers for LabCorp or Quest) that I think might be useful, irregardless of if my doctor would order it or not, and start to look at some of those things pro-actively.

Exactly where I'm at right now - diagnosed with hypothyroidism about 2-3 years ago, given the standard synthetic thyroid hormone and sent on my way. Many dosage changes & roller-coasters of symptoms, now I'm ordering all my own tests online at sites like truehealthlabs.com & directlabs.com & anylabtestnow.com (not affiliated, just a satisfied customer) -- they just requisition orders for labwork to be done at LabCorps or Quest.

I order online, go to a local LabCorbs or Quest patient service center, have the blood drawn, and 3-5 business days later get emailed the results. I get exactly the labs I want, when I want them -- not on my primary doc's schedule or whim. And yeah, I'm paying for these labs out of pocket, but like the GGP posted - I care a lot more about my health & specific condition than my dr does, and if I'm willing to put in the extra time & effort for additional testing, why shouldn't I be able to?

I do still need my doc's guidance (or probably a specialist, given some of my recent confusing results), to help figure out what the results mean in combination with each other, and what additional tests may be useful to run to shed more light on what's going on, but it makes my occasional 15 minute office visit more valuable by discussing lab results, not just deciding we need to run some basic labs.

I think the question of whether or not something should be government-run (or at least involved) vs free market is: Are we, as a society, okay if some people don't get this service?

If the answer to that is 'yes', then free market is probably the way to go.
But if the answer to that is 'no', then free market won't work -- free market requires the voluntary participation of buyers AND sellers.

Don't care if some people don't have health care or education because they can't afford it? Free market is the way to go.

Think health care & education are important for a civilized, well-functioning society? Probably need to have government involvement then -- which is not to say our current systems are perfect (far from it!) but "free market" is not the solitary answer.

Because people want automated off-site backups (a good idea), and not everyone has the knowledge to administer a remote hosted server?

Wait, what? So when an insurance company denies you a service, you can "attempt to get funding elsewhere"? Like where, pray-tell? You basically have 4 options:
1. Appeal the denial & hope you can get them to cover it anyway
2. Pay the cost of the procedure in full and figure out how to cover it (debt, fundraiser, etc)
3. Negotiate with the hospital for a self-pay discount or charity care
4. Don't get the procedure.

Those are the same 4 options you have if your plan is provided by the government, and that gov't plan doesn't cover the procedure.

The simple fact of health care is, we can't afford to do all the procedures, for all the people, all the time. We have finite resources - so they HAVE to be allocated. And someone HAS to decide HOW they are allocated, which means someone has to say "we will pay for this" and "we won't pay for that". That's the reality - no getting around it. What "this" and "that" are -- plenty of room for reasonable debate there, with parameters for profitability, ethics & morality, etc.

Personally, the biggest problem that I see with our current system (which is starting to change), is we don't have "health care", we have "disease care". Your doctor is paid to do services for you, not for keeping you healthy. And the impression I get is that many patients are not "partners" in their own health -- they have a problem, they want to go to a doctor and have that problem fixed, and not have to change themselves. "I don't want to change my diet & lifestyle - just give me a pill to pop to make it all better." I think if doctors were reimbursed for keeping you healthy, and patients had a shared stake in that (besides the obvious benefit of living longer, healthier lives), we would have a very different healthcare system (and probably much, much more effective & economical).

another plug for join.me -- we use it for screen-sharing for work (such as virtual meetings, conference calls, etc). I paid for the professional account ($79/yr, I think?) because I get a conference phone line with that, and it was a simple, easy-to-use service that I felt was worth it.

Stupid-simple to use -- user just visits a simple URL (join.me/my-url-here) to observer. If you pass presenter control to them, the browser will prompt to download an executable that runs to host. No install necessary, just download & run.

I think you are missing the author's points in your rebuttal.

Testing server -- maybe it's not ALWAYS possible with expensive enterprise-y server software, but just about anyone can spin up a VM on their dev machine to simulate (with varying degrees of accuracy) a production environment.

Secret logins & back doors -- you mean you've never created a "god" or "super admin" account (or "secret URL") that could access all kinds of technical / debugging info that regular admins/users shouldn't see? Having such an account means your application has additional logic & code paths to support -- code that's probably not being adequately (if at all) tested and probably has bugs, some of which may be security-related.

Test data in production - yeah, I've worked on systems (such as health care IT systems), where project team puts test data in the system. It sucks for operational users. "What, you mean Dr. Smith doesn't have a 2pm appt w/ TEST, DUMMY today?" "The compliance dept just got a call about a six-figure insurance claim to Medicare for a pregnancy-related hospitalization for a DUMBASS, JOE -- anyone know about that?" Test data belongs in a test database.

Frameworks -- in my humble opinion (and I'm not exactly alone) there are very few situations where run-time performance is actually "absolutely critical". More often (in my experience) time-to-develop "performance" is a bigger factor, and rolling-your-own (to get alleged better run-time performance) will cost you development time, bug-fix time, QA & testing-time -- which, for the vast majority of applications, will cost more than simply buying faster hardware (the happy medium way is to optimize just the critical slow parts in your application that the framework handles sub-optimally).

Choice of languages -- again, I think you missed the point. Any language is fine. His point is to keep your project consistent. If you've developed a hair-brained solution that involves Perl, cgi-bin, bash, PHP, and chunks of C -- it probably works great and flawlessly, like you said. Until that programmer (1) retires or (2) gets hit by a bus. Then the junior programming intern they hire to take his place is screwed. And that's the author's point -- write maintainable code. A mismash of languages & bindings "because they are cool" may function, but it's not maintainable. If your star programmer has this Perl/bash/PHP/C contraption and it's well-documented and logical, then maybe that junior intern will take it over and, with a bit of a learning curve, master it. But if your programmer used 4 different languages because "it's cool to make it complicated" -- well, good luck.

Not too mention, the horse still retains full autonomy and can, at its discretion, ignore you.

"Lower", huh? How would you like to qualify that?

I've lived with animals before. Sometimes I wonder if we really are "smarter" then they are.

Besides, I'm positive that I've had pets that were smarter than many members of Congress.

Simple - commitment to non-violence is a choice to avoid conscious killing. Microorganisms killed in the course of normal bodily functions is not conscious activity.

Yeah, sometimes it's just obnoxious. I splurged on the Bose noise-canceling headphones, so I can actually hear the flight attendants BETTER when my headphones are on! Not that I pay attention to the safety briefing anyway - I'm often asleep already :-)

Most of the time they just let it go, but everyone once in awhile someone decides to exert their authority.

Or get a 120GB SSD (around $100 right now), which is big enough to install Windows + pretty much all your apps (Visual Studio, Office, Photoshop, etc), and still have plenty enough left-over space that your SSD can move blocks around for years to come.

And then you can avoid worrying about junctions :-)

It all depends on your priorities & values.

I find the 120-250GB SSDs a really good value right now. For $100-$200, I get plenty of fast storage to install my OS and all applications on. It definitely makes the system feel zippier; I have an SSD as the system drive in all 4 systems I have. I keep most of my data (documents, photos, videos, download archives) on my HDD, not necessarily because it's more reliable but because that data is typically not frequently accessed, any millisecond delay won't be noticed anyway, and I don't want to have to worry about managing the size of my personal data store vs free space on the SSD.

On the issue of reliability, all drives fail. Maybe statistically SSDs will fail sooner than HDDs (although I'm not even sure if that's true), but that means very little on an individual drive basis. If all of your data is on a single drive, you are definitely at risk. Anecdotally, I've had more HDDs fail on me in the last 15 years (3-4) than SSDs (0). (although I did have some SSDs with undesirable behavior that needed a firmware upgrade).

I work in the healthcare IT field (formerly at an IT vendor). The reality is -- health care organizations are becoming IT shops. And that's expensive. Big iron servers, expensive SAN storage, workstations in every clinic office / nursing unit, and certified trained staff to run it all... It adds up.

There's definitely some research that suggests it results in better care -- warnings for med interactions, doing the right procedure on the right patient, etc. But it's really being driven in the name of compliance (and CYA). Document & audit trail EVERYTHING, so you can justify the charges if Medicare comes knocking for an audit. Or in case there's a lawsuit. It's complicated, and expensive. And Medicare (and the insurance companies) just make it more complicated & expensive by increasing complexity of the billing rules.