ryanackley

There are no "overall" outcomes listed in CONCORD-3 or any other paper. Everything is measured by cancer type.

You're argument that uninsured are included is just as axiomatic. Zero evidence or sources. I guess we'll agree to disagree.

I literally posted a link to the CONCORD-3 paper and made arguments using it and you rebutted it with "start with CONCORD-3".

I'll restate my argument so it's clear: CONCORD-3 does not mention insurance status anywhere in the paper. It does state that the statistics require diagnosis. It's reasonable to assume that if you can't afford healthcare, you're less likely to seek treatment or diagnosis.

You understand that CONCORD-3 is about tracking people who enter the healthcare system. Isn't it reasonable to assume that if healthcare is free or very affordable, there would be higher participation? And on the flipside, if it's outrageously expensive, there would be lower participation?

Again, you cite zero sources. Survival rates for lung cancer in the USA, the most common cancer in the world, are much lower than Japan and South Korea. South Korea is single payer and Japan has strict government regulation of healthcare costs.

The second most common cancer is Breast Cancer. The USA is "top-tier" but so is pretty much every other Western Country. Australia, also famously single-payer is a mere 0.4% behind the USA.

This is the only source of modern survival statistics by country:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5879496/

Compiled into an easier to read format:

https://worldpopulationreview.com/country-rankings/cancer-su...

Take note of two things: First, some states weren't even included in the study and second, there is no mention of insurance. The statistics are only tracking people who were diagnosed with cancer. It's reasonable to assume that some people who had cancer symptoms did not seek treatment because they didn't have insurance and died without being diagnosed.

I'm sure there are qualifiers and rationalizations when comparing cancer survival statistics as well. As someone already pointed out, uninsured Americans aren't necessarily included. They cited sources, you rebutted without sources.

I believe a single payer system is a matter of when not if. It works just fine in other countries. In our country, the healthcare industry has evolved into extracting as many dollars as it can from the economy. This is because when someone is sick and needs treatment, healthcare providers hold all of the cards.

This is a cherry picked statistic. We still have lower life expectancy, high infant mortality rates, and one of the highest rate of preventable and treatable deaths among developed countries

Looks cool. Price is pretty steep. Lucid chart is like $16/month.

I understand you're trying to draw a parallel (no pun intended) between what you did with Rust and the work the author performs as a professional game developer who optimizes game code for a living (it says this in his bio).

Since, I'm assuming you are not a professional game developer, the parallel is speculative and sort of reaching. Therefore, is it feasible to you the author of the blog knows better than you what tools work for his chosen field and that he came to the conclusions he did in good faith?

LLMs work perfectly fine for me but I’m building web app equivalents of binder keepers, like most people. Essentially store data, display data. The novelty is in what/how we’re displaying. LLMs are owning this market.

Unless you yourself are doing commercial game development, calling the author disingenuous puts your own pro-AI bias on display. It’s based on speculation. I prefer to take his very specific examples and experiments at face value.

His experience is completely plausible. He’s in a niche that requires highly performant code and most complex, highly performant games do nit have source available for models to train on. It’s a very common observation that the farther you stray from mainstream, the less effective the LLM models become.

Luckily, accountability does exist in most professional settings so someone accepting moral responsibility is not required.

It doesn't always land on the right person but it's usually a motivating factor for people to make an effort.

What I like is that this is a measurable productivity increase that can be directly linked to AI and they go over their methodology. AI-positive posts skew heavily anecdotal and hyperbolic.

This is a company selling picks and shovels for the AI bubble. Of course they're going to drip feed "AI is so awesome guys!" stories on their blog.

If you strip away the hyperbolic statement about compilers and the Empire State Building, it's an internal success anecdote.

Would be interested to hear how all of the self-directed AI decisions worked out after launch. This is where I run into problems with AI. Sometimes it makes product decisions that aren't immediately visible and make no sense and cause serious problems down the road. Also, an analysis of how much time was actually saved by using AI? since it sounds like there was a lot of guidance and testing to make sure what the AI did was correct.

Don't agree with the hyperbole in the article but I think the broad strokes are there. I'm the same as you, AI has excelled at small tasks and daily chores. Like writing a complex query in seconds that used to take an hour to work out.

Doing feature development seems to take just as long or productivity gains are modest (where I work at least) and I think the reason is touched on in the article. Most orgs are just terminally bad at building software.

The classic arc of internal tooling is generally:

* Person gets angry/frustrated/passionate about some third party tool they could build themselves.

* Person builds that tool. It's not perfect but does what company needs (for now)

* Person gets slaps on the back and congratulations for building such an awesome tool and saving the company loads of money

* Person leaves company

* Nobody else cares anymore and/or wants to bother with the inconvenience of keeping up with bugs and features

* After dealing with this for a period of time, someone says "Hey, why don't we just use third party tool?"

* Company re-subscribes to third party tool

I think it could go either way because what I consider calcification of choices because of AI.

We've all seen people outsourcing their thinking to AI. "Hey Claude, I need bug tracking which product should I use?" Claude then recommends Jira because it's the defacto standard as of 2026. This leads to Jira getting even more popular, leading to subsequent training data keeping it as the defacto standard.

Same issue for development technologies. React/Typescript will never ever go away thanks to coding agents.

This isn't accurate since the main reason I'm using Claude Code instead of these other interesting sounding harnesses is the subscription service with highly discounted token usage. With OpenCode, you're paying the full price.

Therefore, you should include the actual costs associated with the task in API token usage or subscription level. Is there a reasonable way to do apples to apples cost comparison?

Counter-anecdote. Wife had a herniated disc. It took six months to get back surgery. This happened in America in 2022. She was in bed the entire time.

It was literally months of going through various hoops to get approval from the insurance company. When the surgery happened, the surgeon billed $80k for about 2.5 hour surgery. Not sure what the insurance company ultimately paid. That wasn't including the anesthesiologist and the facility fees.

Yep. Costs for healthcare in other countries have a basis in reality. Here it’s about charging as much as they can get away with. No competition or transparency.

Are you Canadian? I ask because I’ve never met someone from a Western country with free healthcare who wishes they had our healthcare system.

I lived in Australia for five years and when I came home to the USA, I realized that most people here in America are indoctrinated to believe our system (for anything not just healthcare) is better than everyone else’s when it just isn’t true

Preventing crime is good but there are tradeoffs that most people find unacceptable.

We could track people’s movements without AI. We could implement curfews and have 24x7 police checkpoints. Would you consider it worth it if it reduced crime? Most people would not I’m guessing

In your new sci fi economy, where technocrats have a closed economy that excludes everyone else, citizens united would be dead. You can’t prevent people and governments from trying to take everything you have by bribing them with AI algorithms that they can’t actually use for anything. Yes, look at trump as the perfect example. The elite are kissing his ass and basically bribing him. That works because there is this entire economy with something called money and millions of people building and staffing airports and resorts and golf courses and private jet factories and pumping oil out of the ground and refining it into jet fuel. What happens when all of that goes away in your fantasy economy? Oh wait right…robots.

The USA wielding military power for the benefit of the wealthy is not new or a sign of the end of the economy as we know it

I was being sarcastic about business class and expensive handbags. You act like we all should be entitled to these completely unnecessary things.

What you’re suggesting is a return to some kind of neo feudalism which means the elites would need to field their own robot army to challenge governments because in that type of society the power of the sword is the only real power. With robot armies that build themselves and mine uranium for their own small nuclear reactors, we’re back in sci-fi territory.

I think the relevant question isn’t what can be built but the amount of effort in comparison to doing this the old fashioned way.

What do you think the productivity gain was from using an LLM? This question assumes you’re already an experienced developer.

>I think this is an extremely critical misconception, and it's sending the world into an increasingly bad place. They really don't, and the assumptions that underpin this statement breaks down when the elite own all the critical assets. If you need proof of this, look at how the working class is being increasingly priced out of almost all luxuries right now.

Huh? What luxuries? Us plebes can't fly business class? We can't buy that expensive handbag? A better argument would be they can't afford to buy a family home in a lot of markets but this has to do with generational wealth and a housing shortage in many parts of the USA.

> More history than sci fi, but a fair criticism. Still, I don't believe there are any "factual" refutations of my concerns, and that should be worrying.

It's economics. There is a tipping point where automation is self-undermining for capitalism. If nobody has a job, demand collapses. i.e. nobody buys the mountain of goods the robots and AI are producing.

If the economy collapses, many wealthy people would no longer be wealthy. Who is maintaining the robots that are doing everything? Other robots? Now we're getting into sci-fi territory.

Even during the industrial revolution, jobs moved from the farm to the factories. There was not a total replacement for human labor like you seem to be suggesting will happen.

You’re just hand waving. No actual facts in your argument.

Sure, if you have a desktop with 175GB of unified memory, you can run deepseek 4 locally. Not completely out of reach but pretty close for almost everyone. There are smaller models but we’re talking about state of the art stuff that can reliably be used to do serious work right?

Also, even in a mad max style dystopian future, the elite need the working class to enjoy their luxuries. There is a long supply chain of experts and workers to build a yacht for example. It’s kind of ridiculous to imagine robots and AI replacing that entire supply chain. It would be extremely fragile. While conceivable, it’s also an unrealistic extrapolation grounded in sci fi instead of reality

The capital outlay is eye watering and it feels like an over extension. Neither of the two major pure AI providers are close to profitable (OpenAI, Anthropic) while having valuations close to a trillion dollars.

Their ROI is paradoxical. If they succeed in disrupting knowledge work. Who will be around to use or buy their product?

AI maximalism is making a lot of assumptions that I think are not a given

* The curve of AI improvement will continue at the current pace

* AI companies will have the capital continue to expand infrastructure

* there will be some kind of functioning economy if all knowledge workers are replaced

There are strong headwinds to all three of these.

Hey it may come to pass but it’s very speculative at this point. I see a lot of tech people simply overlaying the progress curve of previous tech booms which is reductive.

This needs to be read after the article from Turso on how they're retiring their bug bounty program because of being inundated with useless AI slop reports. It's the top story on HN right now.

https://turso.tech/blog/the-wonders-of-ai

Yes, it will take longer but all value comes from labor, so the consumption of the wealthy is literally produced by the working class. The rich can't eat money.

Also, data centers, chips, and energy require massive working-class supply chains, and enterprise AI revenue depends on customers whose own revenue depends on regular consumers.

Yes, it was responding. One of my points was that it has nothing to do with society's expectations but people's lived experiences and observations.

You seem to think I'm advocating for working your entire life. I'm just trying to share my lived experience so please take it easy.

There is some bitterness that's coming across in your response.