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It turns out, it's very hard to determine "legit" or not. Standard of care has not permeated much of the AA/NA [edit: treatment] culture. This is a heavily stigmatized group of people who frequently do not have the response reactions you or I might.

Insurance companies like scans from MRI tests, not reports written from mental health consultants.

These are some of our most vulnerable people. We need to take care of them. It's less competitive as a business to do so.

[edit - like much of mental health issues, 'success' is difficult to define, so outcome based measurement is difficult.]


Thank you for the response.

In your opinion, in the facilities such as those discussed in the article and ones like them, would physical inspections address the more egregious cases? Are run down facilities, lack of sanitation, etc., enough to add a location (and operators) to an interstate "do not process insurance claims" blacklist? More regulation isn't the answer for everything, certainly, but as you stated, we are talking about exceptionally vulnerable people.

Or is the stigma of addiction and mental health issues the root cause? Would this type of regulatory pressure be DOA because regulators, as people themselves, often believe addiction is a moral failing and not a health consideration?


Who would do the inspecting? How do you qualify them? Who pays for it? How do you prevent bribes/payoffs?


I agree with you. But there are competitive advantages in a cutthroat industry to being unethical, so over time, it's mostly the bad actors that have the fattest margins and can make plenty of money before getting caught.

Just like any industry, people accept it because it's just what happens. So busy being a business owner that you cannot afford to be Sheriff.


You can make this argument for a lot of crimes: bank robberies are lucrative so over time more and more bad actors will become bank robbers. Except that doesn't happen because bank robbers are pursued vigorously.

If there's a zero tolerance policy against drugs there should be a zero tolerance policy against people providing bogus care for drug addicts. Just like you can judge a society by how it treats its weak, you can judge it by which crimes it pursues vigorously and which ones it lets slide.


>If there's a zero tolerance policy against drugs there should be a zero tolerance policy against people providing bogus care for drug addicts.

Unlike the bank robbery case, it gets difficult to tell the difference between incompetence and intentionally crappy care. Nobody accidentally robs a bank because they were poorly trained.

This makes it harder to have a government policy of charging everyone with a felony that provided poor care.


Also, unlike bank robbery which is usually committed by poor folks, insurance fraud of this type is a white collar crime committed by (typically white) wealthy folks.

I was watching an old George Carlin video on the death penalty yesterday. He was ranting about how folks want to expand the death penalty for drug dealers. His bit was that you should expand the death penalty for the bankers who launder the money and the drug trade would pretty much stop immediately.


The US spends tens of billions of dollars a year on substance abuse treatment. In that context $58 million of fraud could be taken as evidence of fairly vigorous pursuit.


It doesn't happen because bank robberies are not lucrative. The expected outcome is negative, since the chance of getting caught is too high, or the loot is too low. You can change either of those things, and it's much easier to change the second one, especially in an era when most money isn't physically present in the bank anyway.


This has always existed. We call it bureaucracy.


Bureaucracies are staffed with humans who have the capacity to make a judgement call on how to interpret the rules, and bend their letter to serve their spirit, or the interests of pubic relations, or just common sense.


Do we know how much YouTube involves humans in the process? I wouldn't be surprised if appeals go to a human which clicks the "yeah, nope" button.


I disagree. Have you ever been to the CA DMV with a photo of your license (that you lost/had stolen)? I have. They told me I needed a copy of my lost license to get a new one, or else the man couldn't validate my identity.

Bureaucratic hell, as defined by Harry Harrison in the Stainless Steel Rat series, is the definition of humans as automata.


Some sites still monetize (minimally / part of the time) with impression based schemes.


$120k in SF probably amounts to take home just under $6k/mo. $4k goes to rent, so you have $2k for everything else.

That's not a great QOL. For comparison, I ran the Mexico City / SF cost of living on Numbeo[0]. $38k in Mexico City would need to be $140k in SF for comparable quality of life.

(side note -- this COL calculator is super neat! anyone have any evidence of the accuracy?)

[0] https://www.numbeo.com/cost-of-living/compare_cities.jsp?cou...


I have. it grossly underestimates.

a while ago, this and other sites said I needed 120k in LA and 140k in SF to maintain my south america 40k.

turns out I moved making more than the SF salary in LA. and it still falls short on what I have money to do on short trips and night life.

I guess it is acurate if you dont go out every friday and saturday and never, ever leave the city for the longer holidays.


$2k/month is what many people I know take home after tax and before rent.


Where did they make that statement? All I'm hearing GP say is if the only way to know your worth to the market is to test it. There is no other way to measure what your employment is worth.


It was phrased that way above, read carefully. If all they meant was "if you aren't paid fairly, leave and find a better place", that's OK, but that's not how it was phrased (which was quite improper).


Usability will always beat security. This is why usability is one of the 2 most important concerns in security.


Security is like Safety: if it is put on a holy pedestal then everything else suffers.

I always say "Safety Third."


in general, but with just a $10k angel, the odds of becoming a $100k company are pretty decent.


A $100k company could only be a 10x return for a $10k investment if that investment was for 100% of the company.


Some people believe that a lower bar is more achievable, and will provide learning, feedback, and encouragement to surpass a higher bar.


I am naive in this area, but if the creditors freak out, what does that mean? Seems like a "freak out" would mean higher interest rates, and when those rates cross the return from the cash stockpile, they just would stay paying down the debt more aggressively?


Sure; it's just that we're talking about spending the cash stockpile. Microsoft has $126b "in the bank" but that doesn't mean they could actually spend all $126b on some moonshot, because by the time they'd spent half of it it would affect their interest rates and they'd have to start doing something about their debt.


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