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Welcome to Our Modern Hospital Where If You Want to Know a Price You Can Go Fuck Yourself

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Welcome to America General Hospital! Seems you have an oozing head injury there. Let’s check your insurance. Okay, quick “heads up” — ha! — that your plan may not cover everything today. What’s that? You want a reasonable price quote, upfront, for our services? Sorry, let me explain a hospital to you: we give you medical care, then we charge whatever the hell we want for it.

If you don’t like that, go fuck yourself and die.

Honestly, there’s no telling what you’ll pay today. Maybe $700. Maybe $70,000. It’s a fun surprise! Maybe you’ll go to the ER for five minutes, get no treatment, then we’ll charge you $5,000 for an ice pack and a bandage. Then your insurance company will be like, “This is nuts. We’re not paying this.” Who knows how hard you’ll get screwed? You will, in three months.

Fun story: This one time we charged two parents $18,000 for some baby formula. LOL! We pull that shit all the time. Don’t like it? Don’t bring a baby, asshole.

Oh, I get it: you’re used to knowing a clear price for products and services. The difference is that medicine is complicated and scary — unlike, say, flying hundreds of people in a steel tube across an ocean, or selling them a six-ounce hand-held computer that plays movies and talks to satellites. Anyway, no need to think this through rationally while you’re vulnerable, right? Your head is really gushing, ma’am.

Sure we could start posting prices and discussing our costs, but then it turns into a public debate about transparency, and people get all huffy and self-righteous about $15 pills of Tylenol, $93 to turn on a single goddamned light, or $5,000 worth of sanitary gloves. We’d rather just mail you a bill later for $97,000, full of obscure medical codes you can’t understand. Oh, you like understanding things? Here, maybe this will help:

Hit your head, and talk to a doctor for one minute? $2,500, you idiot.

Want your pesky appendix out? That’ll probably be $33,611. Or it could be $180,000. Shrug. Don’t know. Don’t care.

Need an hour in the ER? How does $15,000-$50,000, sound? Hint: we don’t give a piss how it sounds you stupid fucking helpless human wallet.

Our medical system strikes you as “insane?” Well, you can’t do much about that now. Except of course to go fuck yourself. Yes, ma’am, as a matter of fact, we do have a special room where you can go fuck yourself. Yes, it does cost money to use the room, and no I cannot tell you how much. Want a hint? It’s between $1 and $35,000 per minute. Will you be reserving the go fuck yourself room?

Oh, you think you think we’re cruel and illogical? Well, no one forced you to come here. It’s your decision, you head-injured meatball. Feel free to go out into the parking lot and just die. I suggest you do that out in section F. Try to lean your corpse against a light pole. Our dead body disposal fee is $3.75 and is not covered by your shitty, confusing, out-of-network medical plan.

So, will you be dying in our parking lot today, you pathetic, impotent, walking insurance code? Okay, great! Your husband will get a bill for that soon, and if he doesn’t like it, he can fuck himself too.

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vitormazzi
11 days ago
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Brasil
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11 days ago
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5 public comments
sarcozona
10 days ago
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I am never ever going back
BLueSS
10 days ago
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Thankfully, dental procedures are the opposite, in my experience. I usually get provided my out of pocket expenses when I'm being told about the work that should be done.

If only medical could catch up to what's done on the dental side...
ChrisDL
11 days ago
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number one reason i might move away from the US.
New York
freeAgent
10 days ago
My wife is having a procedure done that isn't covered by insurance. She was referred to a place that was going to charge $1,600. She shopped around and found a different place that will do it for $4-500. She had to go back to her referring physician to have a second referral for the procedure sent to the other location. On top of that, my wife and her referring physician are coworkers, so it is not as though her doctor was trying to screw her over. Doctors just aren't aware of the costs for procedures or the differences in cost between facilities. That there can be a 3x cost difference between providers, even in the same region, for the exact same procedure is ridiculous.
ChrisDL
10 days ago
thanks for sharing that. I feel like we all have some version of these stories at this point. a dentist that gives you a bunch of care you don't really need. Or an insurance company rep that says something is covered but then it isn't, and there just doesn't seem to be any real recourse unless you feel like litigating. The other thing that surprised me is that it seems a lot of americans don't realize it doesn't have to be like this, plenty (arguably most?) other countries don't have these issues.
diannemharris
11 days ago
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The only thing that is wrong about this piece is that a lot of the time people don't have a choice and are taken against thier will, unconscious or not, and they still get the bill.
deezil
11 days ago
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Yet again, McSweeney's hits it on the head. (no pun intended)
Louisville, Kentucky
jhamill
11 days ago
That'll be $150 or $15,000. Don't know. Don't care.

Enthusiasts vs. Pragmatists: two types of programmers and how they fail

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Do you love programming for its own sake, or do you do for the outcomes it allows? Depending on which describes you best you will face different problems in your career as a software developer.

Enthusiasts code out of love. If you’re an enthusiast you’d write software just for fun, but one day you discovered your hobby could also be your career, and now you get paid to do what you love.

Pragmatists may enjoy coding, but they do it for the outcomes. If you’re a pragmatist, you write software because it’s a good career, or for what it enables you to do and build.

There’s nothing inherently good or bad about either, and this is just a simplification. But understanding your own starting point can help you understand and avoid some of the problems you might encounter in your career.

In this post I will cover:

  1. Why many companies prefer to hire enthusiasts.
  2. The career problems facing enthusiasts, and how they can solve them.
  3. The career problems facing pragmatists, and how they can solve them.

Why companies prefer hiring enthusiasts

Before we move on to specific career problems you might face, it’s worth looking at the bigger picture: the hiring and work environment.

Many companies prefer to hire enthusiast programmers: from the way they screen candidates to the way they advertise jobs, they try to hire people who care about the technology for its own sake. From an employer’s point of view, enthusiasts have a number of advantages:

  1. In a rapidly changing environment, they’re more likely to keep up with the latest technologies. Even better, they’re more likely to do so in their free time, which means the company can spend less on training.
  2. Since they’d write software for free, it’s easier to pay enthusiasts less money.
  3. It’s also easier to get enthusiasts to work long hours.
  4. Finally, since enthusiasts care more about the technical challenge than the goals of the product, they’re less likely to choose their work based on ethical or moral judgments.

But while many companies prefer enthusiasts, this isn’t always in the best interest of either side, as we’ll see next.

The career problems facing enthusiasts

So let’s say you’re an enthusiast. Here are some of the career problems you might face; not everyone will have all these problems, but it’s worth paying attention to see if you’re suffering from one or more of them.

1. Exploitation

As I alluded to above, companies like enthusiasts because they’re worse negotiators.

If you love what you do you’ll accept less money, you’ll work long hours, and you’ll ask less questions. This can cause you problems in the long run:

So even if you code for fun, you should still learn how to negotiate, if only out of self-defense.

2. Being less effective as an employee

Matt Dupree has an excellent writeup about why being an enthusiast can make you a worse worker; I don’t want to repeat his well-stated points here. Here are some additional ways in which enthusiasm can make you worse at your job:

  • Shiny Object Syndrome: As an enthusiast it’s easy to choose a trendy technology or technique for your work because you want to play with it, not because it’s actually necessary in your situation. The most egregious example I’ve seen in recent years is microservices, where an organizational pattern designed for products with hundreds of programmers is being applied by teams with just a handful of developers.
  • Writing code instead of solving problems: If you enjoy writing code for its own sake, it’s tempting to write more code just because it’s fun. Productivity as a programmer, however, comes from solving problems with as little work as needed.

3. Work vs. art

Finally, as an enthusiast you might face a constant sense of frustration. As an enthusiast, you want to write software for fun: solve interesting problems, write quality code, fine-tune your work until it’s beautiful.

But a work environment is all about outcomes, not about craft. And that means a constant pressure to compromise your artistic standards, a constant need to work on things that aren’t fun, and a constant need to finish things on time, rather than when you’re ready.

So unless you want to become a pragmatist, you might want to get back more time for yourself, time where you can write code however you like. You could, for example, negotiate a 3-day weekend.

The career problems facing pragmatists

Pragmatists face the opposite set of problems; again, not all pragmatists will have all of these problems, but you should keep your eye out to see if they’re affecting you.

1. It’s harder to find a job

Since many companies actively seek out enthusiasts, finding a job as a pragmatist can be somewhat harder. Here are some things you can do to work around this:

  • Actively seek out companies that talk about work/life balance.
  • When interviewing, amplify your enthusiasm for technology beyond what it actually is. After all, you will learn what you need to to get the results you want, right?
  • Demonstrate the ways in which pragmatism actually makes you a more valuable employee.

2. You need to actively keep your skills up

Since you don’t care about technology for technology’s sake, it can be easy to let your skills get out of date, especially if you work for a company that doesn’t invest in training. To avoid this:

3. Pressure to work long hours

Finally, you will often encounter pressure both from management and—indirectly—from enthusiast peers to work long hours. Just remember that working long hours is bad for you and your boss (even if they don’t realize it).

Programmer, know thyself

So are you an enthusiast or a pragmatist?

These are not exclusive categories, nor will they stay frozen with time—these days I’m more of a pragmatist, but I used to be more of an enthusiast—but there is a difference in attitudes. And that difference will lead to different choices, and different problems.

Once you know who you are, you can figure out what you want—and avoid the inevitable obstacles along the way.



It’s Friday afternoon. You just can’t write another line of code—but you’re still stuck at the office...

What if every weekend could be a 3-day weekend?

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vitormazzi
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Earth, Sol system, Western spiral arm
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How I got an Unsponsored UK Work Visa as a Software Developer

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A stroll through the process of getting a UK Tier 1 Visa

I’m an American. I’ve lived in several different countries in my career, but never in Europe. But like many Americans, I’ve had visions of living in Europe for a while - particularly in London.

Visiting London with my wife and son

For years, I thought my dream of living in London would never happen. As an American, I can’t move to the UK without getting a full-time job at a company that will sponsor me for a UK work visa. But since I’ve been running my own consulting business for the past couple of years, I wasn’t in a situation where I could go work for another company. It seemed like a stalemate unless I discovered a forgotten grandparent with UK citizenship (spoiler: I didn’t).

I gave up on ever living in the UK — until one of my friends sent me a link to a special visa for people working in the tech industry that made it possible. The visa process was intimidating, but it all worked out. I wanted to share my experience in case it helps out someone else or encourages someone else to apply.

Note: Keep in mind that I’m neither a barrister nor a solicitor (and I’d be hard-pressed to even tell you the difference between the two), so this is definitely not any kind of official advice. I’m just sharing what happened to me in case it is helpful to you.

The Tier 1 Exceptional Talent Visa

If you are a tech worker with a strong track record, the UK wants you! They offer a visa targeted at you called the Tier 1 Exceptional Talent visa. It is a great deal as far as visas go:

  1. The visa lasts for 5 years and can be extended.
  2. You are free to work for anyone (as a consultant, employee, whatever) and switch jobs at will. You can even start your own company and hire employees.
  3. The rest of your immediate family also gets a visa through you. You can sponsor your spouse/partner and they can also work legally. That’s huge for people with families and two-income households.
  4. It’s a path to permanent residence and potentially citizenship. You can apply to become a permanent resident (a.k.a. Indefinite Leave to Remain) after staying in the UK for only three years.

Who can get this visa?

This visa is for anyone who is “an established as a leader in the field of digital technology” or “demonstrates the potential to become a leader in the field of digital technology.”

Before we go further, keep in mind that everything I’m going to say only applies to people with backgrounds in software engineering or tech start-ups. There are different flavors of this visa available to people who work in science, engineering, fashion, art or medicine, but it is a different process for each industry with different qualification standards. So if you work in one of those other fields, you’ll want to search out a different source of advice.

So what does it mean to be “an established as a leader in the field of digital technology?” An independent group called Tech Nation is tasked with deciding who is and isn’t a leader. Luckily, the UK and Tech Nation provide a fairly detailed list of requirements that you need to satisfy and you only have to qualify for a certain number of them, not all of them.

The requirements are things like “Have made significant technical, commercial, or entrepreneurial contributions in the digital technology sector as either a founder, entrepreneur or employee of a digital technology company.” For each requirement, you get to pick the documents that show that you qualify. It could be anything — a news article, a patent filing, a company blog post, a github repo, visitor stats for your personal tech blog — whatever makes the best case.

But as you read through the official eligibility requirements, it will still be very intimidating (it definitely was for me!). They make it sound like you have to literally be Yann LeCun to qualify. It makes sense that the UK wants to be strict on who is allowed in, but anecdotally it also seems like those very scary-sounding requirements also scare off most people from ever applying. Even though the UK only gives out around 200-400 of these visas per year, supposedly there aren’t actually that many applications relative to the number of visa slots available. You have a fairly decent shot of qualifying if you have a good career track record and can provide good documentation for enough of the requirements.

To hopefully encourage you further, here’s a table from the UK Policy Guidance document that shows examples of the wide range of people they want to apply:

This table is from the UK Policy Guidance Document

They are casting a wide net. Whether you are a UX designer, a hardware engineer, tech salesperson or a product manager, this visa might be an option for you. Just take your time and think through how your past experiences and work might best map to their requirements.

How do I apply for this visa?

First of all, the Gov.uk website is actually great. It’s definitely one of the best government websites that I’ve ever used. Using the website, I was able to figure out the process myself without hiring an immigration attorney. But you do need to be really careful about reading all the requirements fully and making sure you send in exactly what they ask for and nothing else.

Here’s the basic process of applying:

  1. Read the UK’s Visa Guidance document and the Tech Nation Visa Scheme Guidance carefully. The UK makes the final decision, but Tech Nation is the group that actually decides if you qualify as an expert.
  2. You have to qualify in one of two “key” areas and two of four “qualifying” areas to get the visa. Choose which key area and which two qualifying areas you will target based on your experience. Pick the areas for which you have the strongest support.
  3. Collect the required documentation and recommendation letters that best represent you as qualifying in those selected areas. You can only send in 10 two-page documents and two recommendation letters to prove your experience, so give it some thought.
  4. Complete the Stage 1 visa application with the UK.
  5. In parallel, complete the Tech Nation Visa Scheme application. You’ll send in the UK Stage 1 application, the Tech Nation application and all your supporting documents and recommendation letters all together via FedEx to one address.
  6. Wait about a month to see if you qualified. You’ll get the answer via email. This is the most stressful part.
  7. Assuming you qualified, now you need to complete a Stage 2 visa application with the UK. You also need to complete an additional Stage 2 application for each immediate family member that will be going with you. Do them all together — don’t wait to get your visa grant before applying for your family members.
  8. In parallel, you’ll have to visit the closest UK biometric office and get photos and fingerprints taken. If you live in the US, this will actually be a US government immigration office.
  9. Send in a second giant envelope (this time to a different address) with your papers and all the papers for all your family members. You’ll also need to include your passports and extra passport photos. Finally, don’t forget to include proof of relationship for all your immediate family members (marriage certificate, birth certificate or whatever you are using). I nearly missed this in my application.
  10. You’ll get a package back in the mail with your approval letters and your passports. Now you need to fly to the UK on the travel date listed in your application, show the approval letter at the airport and then visit a pre-selected post office to pick up your residence permit card (called a BRP). The catch is that if you don’t show up when you say you will, they can fine you. So don’t put tentative travel plans in your visa application that you can’t actually arrange in time. Make sure to give them the exact dates when you will actually be traveling to the UK.

Congrats, you did it!

Richmond Park in London. I took this picture right after picking up my Residence Permit a few blocks away in Richmond.

How much does it cost?

It cost me £1,708 to get the visa for myself (£456 for Stage 1, £152 for Stage 2 and a £1,100 healthcare surcharge). In addition, it cost an extra £1,708 for each additional person in my immediate family that would also be coming. So all in, it cost £5,124 for the three of us.

Basically, immigration is going to be expensive, so plan ahead for these costs. And keep in mind that this total doesn’t include incidental costs like Fedex charges to send in the applications and it doesn’t include the cost of actually getting to the UK. I also ended up paying about $900 in expedited processing fees because of a flight scheduling issue where I needed my passport back more quickly for a business trip, but that won’t apply to everyone.

Most of the fees are fixed, but the healthcare surcharge is pro-rated based on how long you want to stay in the UK. It’s less if you don’t want to stay the entire 5 years, but it seems crazy to me to go through the whole visa process and opt for less time to save a few hundred pounds. But I’ve also heard that the healthcare surcharge will be doubling in the near future, so it may be an additional £1,100 per person for a 5-year visa in the near future. In any case, it is still way less than most Americans pay for private health insurance, so you might actually save money in that area.

How long does it take to get the visa?

It took me about three months to get the visa from start to finish (which is fast in the world of visas). That breaks down like this:

  • Prep: About a month to gather the required documentation and get recommendation letters.
  • Visa Stage 1: About a month waiting to be endorsed as an expert after applying.
  • Visa Stage 2: About two-four weeks to get approved for the visa itself after being endorsed. This is the step where you will be without your passport since you have to send it in to get stamped. You can pay extra here for faster processing which I did because I needed my passport back for another trip. But I don’t think it would have taken that much longer if I hadn’t paid.
  • Biometrics: About a week to get an appointment to get my biometric data collected and then about an hour to do it. They partner with US Immigration for this, so the nearest biometric collection office was only a few miles away.
  • Pick-up: After you are awarded the visa, you have to physically fly to a pre-arranged post office in the UK to collect your residence permit in person on the day it says on your acceptance letter. The actual process at the post office only took about five minutes and was painless.

Your own timing is going to vary. This is just what I experienced when I applied in Spring/Summer 2018.

If you feel like this visa is something you want to try, I hope this information was helpful and I hope it all works out for you! If you have questions about your own visa process, I’m not really qualified to help you but I’ve had a great experience reading and posting on Reddit in /r/ukvisa.

Thanks for checking out this article. If you are interested in getting into machine learning, you can check out my new book or consider signing up for my Machine Learning is Fun! newsletter:

You can also follow me on Twitter at @ageitgey, email me directly or find me on linkedin. I’d love to hear from you if I can help you or your team with machine learning.

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vitormazzi
17 days ago
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Distributing Malware By Becoming an Admin on an Open-Source Project

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The module "event-stream" was infected with malware by an anonymous someone who became an admin on the project.

Cory Doctorow points out that this is a clever new attack vector:

Many open source projects attain a level of "maturity" where no one really needs any new features and there aren't a lot of new bugs being found, and the contributors to these projects dwindle, often to a single maintainer who is generally grateful for developers who take an interest in these older projects and offer to share the choresome, intermittent work of keeping the projects alive.

Ironically, these are often projects with millions of users, who trust them specifically because of their stolid, unexciting maturity.

This presents a scary social-engineering vector for malware: A malicious person volunteers to help maintain the project, makes some small, positive contributions, gets commit access to the project, and releases a malicious patch, infecting millions of users and apps.

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19 days ago
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Saturday Morning Breakfast Cereal - Christ

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Click here to go see the bonus panel!

Hovertext:
Wait, does Buddha come from above or sideways or what?


Today's News:
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26 days ago
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Saturday Morning Breakfast Cereal - Median

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Click here to go see the bonus panel!

Hovertext:
What's that gray blobby thing at the bottom, you ask? That's a folded pile of flattened dead plants that once conveyed news from far-away lands.


Today's News:
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