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ageitgey

7,101 karma · joined September 11, 2013

Founder at https://turquoise.health/. See https://www.adamgeitgey.com/.

Feel free to email me with any non-spam questions or replies. My email address is easy to find.

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ageitgey··on The road to electric in charts and data
No, they are 3.5kW - 5kW standard EV chargers. But it's probably easy to install them using the existing power run.

But you are right that standard wall charging is much more viable in a 230V system here than in the US. Some people just run a cable from inside to their car if they don't have a 'real' charger yet.

ageitgey··on The road to electric in charts and data
It's improving.

There might not be much of a market for true EV supercars, but that market is so small as to be inconsequential anyway, with many models selling 10s of units and many of these cars never actually being driven significantly.

In the 'high performance but actually driveable' toy zone, there are plenty of Porsche Taycan 'company cars' around London. But sports cars are niche. Lots of rich people drive SUVs, and there are plenty of Porsche / Audi / BMW, etc, SUV EVs around outer London.

EVs will keep getting cheaper as China puts pressure on the market and as the number of EVs on the roads increases. In the UK, you can already get a second-hand VW ID.3, a great EV, for well under £15. And new cars from BYD and MG are available at ever more reasonable prices.

ageitgey··on The road to electric in charts and data
In my (generally affluent) zone 4 neighborhood in London, the number of green plate EVs had multiplied like rabbits over the past few years, but few houses have off-street parking. A huge percentage of the cars parked on street are EVs.

But since you can plug in to charge at many street lamp posts and since most people don't drive their cars much on a day to day basis, it all works fine even without off-street parking. There are also several reserved medium-speed charging spots around the neighborhood and lots of fast chargers at the local large grocery store.

ageitgey··on The truth that haunts the Ramones: 'They sold more T-shirts than records'
It's very smart of them to recognize that.

The world is full of these weird business cases where people aren't aware of the actual product, like how Starbucks US morphed from a coffee shop into an iced dessert drinks company that also incidentally sells hot coffee.

Edit:

Other fun examples -

In the mid-2000s, Porsche was an incredibly successful hedge fund that also sold cars who tried to acquire VW using a short squeeze.

Most US airlines are profitable frequently flier points companies that also operate airplanes to justify the program.

Target US is a real estate company that operates also (profitable) stores.

ageitgey··on I quit editing photos
The dark truth no one wants to say out loud is that 'real' cameras are dying to cell phones not just because phones are more convenient to carry, but because phones take 'better' photos for 99% of people than they can manage with any other camera - and that's without any editing. It's all software.

Yes, enthusiasts here are spending hours editing RAW files and most think cell phone pics are over-HDRed messes. But phone software is so advanced now that it takes real talent and skill to replicate the perceived quality of what users get with their cell phone's software automatically. Most people are at a disadvantage with a DLSR/mirror less, not an advantage. That leads to ever-declining sales.

Why can't someone make a traditional camera with modern software instead of something that looks like it is out of 1994? The software on a Sony DLSR, for example, looks like the on-screen menu of a VHS player, but is somehow slower and dumber to use. The number of overlapping, incompatible picture adjustments on a Fuji is just as ridiculous.

ageitgey··on Padel Chess – tactical simulator for padel
Yes, or pickleball is American padel.

They are similar games and have similar advantages making them popular. But in general, padel is slightly more athletic/intense than pickleball.

ageitgey··on Review: Samsung Galaxy S26 Ultra
I'm posting this with my S26 Ultra.

Is it just a lame rehash of the same phone from the last 4 years with a faster CPU and a screen privacy feature? Yes. But man, the screen privacy feature is so good. I expect that everyone will copy it. Once you have it, it seems irresponsible to not have it. Having it auto-enabled on an app-by-app basis is so nice.

Also, yes, it is absurdly expensive. But whenever Samsung launches a new phone, they offer large preorder bonuses and generous trade-in rates for 2-3 year old phones. So don't believe the price. I think they have to do this to keep growth going, but you get them much cheaper than the stated price if you pre-order. I paid less than 50% of the list price after trading in my near identical S24 and got a free bump to the 512GB model.

ageitgey··on Ask HN: What do you look for in your first 10 hires?
People who make (mostly good) decisions and ship stuff as quickly as possible. Ideally while being nice people to work with.

Your first hires need to be people who make the company faster, not slower. A single bad hire can sink the ship. Someone who is great in a large corporation can ruin an early start-up.

Personally, I'm hoping for low-ego high achievers. But that's up to you. This is where you get to define what the company culture will be.

ageitgey··on You Want to Visit the UK? You Better Have a Google Play or App Store Account
It's 100% illegal to present a non-US passport at the US border if you are US citizen.

The law is 8 U.S.C. 1185 - "it shall be unlawful for any citizen of the United States to depart from or enter, or attempt to depart from or enter, the United States unless he bears a valid United States passport."

In the past, the penalty for violating this has generally just been "a stern talking to," like you said. But no guarantees on that.

ageitgey··on You Want to Visit the UK? You Better Have a Google Play or App Store Account
> There should always be web fallbacks for those opposed to smartphones or unable to use them.

And there is a web fallback. And it's right there on the page. Honestly, I think they did a pretty good job.

ageitgey··on You Want to Visit the UK? You Better Have a Google Play or App Store Account
Yeah, I really don't get this complaint either.

I'm a dual US/UK citizen, and the US has always required citizens to present their US passport to enter the US. The UK is doing the same. It's not a big ask.

ageitgey··on Americans Are Leaving the U.S. in Record Numbers
It's very hard to get a UK work visa normally (and getting a lot harder each year, like in the US), but if you are a HN type with a good tech, start-up, investor, or researcher career, they roll out the red carpet for you.

https://www.gov.uk/global-talent

If you qualify, you get a 'Tier 1' visa where you can work at any company without sponsorship, change jobs at any time just like a citizen, or start your own company with no fear of your visa being tied to a job. You can become a citizen yourself in 5 years.

Source: Am now UK citizen

Various other European countries have similar programs with different requirements. Netherlands, Portugal, and Spain are common places that a lot of US people go depending on what options they have to qualify and where they want to be. Spain has a digital nomad visa right now that is easy to get.

ageitgey··on Pebble Production: February Update
Thanks for providing such a great service. I use it in a totally different free, OSS project, and it's really great to have this option available!
ageitgey··on "Hate brings views": Confessions of a London fake news TikToker
As a sidenote, Jim Waterson is doing amazing work at London Centric, single-handedly doing the kind of investigative journalism week after week via Substack funding that traditional media has abandoned. I highly recommend subscribing if you are in the London area.
ageitgey··on English professors double down on requiring printed copies of readings
> “Over the years I’ve found that when students read on paper they're more likely to read carefully, and less likely in a pinch to read on their phones or rely on chatbot summaries,” Shirkhani wrote to the News. “This improves the quality of class time by orders of magnitude.”

This is the key part. I'm doing a part-time graduate degree at a major university right now, and it's fascinating to watch the week-to-week pressure AI is putting on the education establishment. When your job as a student is to read case studies and think about them, but Google Drive says "here's an automatic summary of the key points" before you even open the file, it takes a very determined student to ignore that and actually read the material. And if no one reads the original material, the class discussion is a complete waste of time, with everyone bringing up the same trite points, and the whole exercise becomes a facade.

Schools are struggling to figure out how to let students use AI tools to be more productive while still learning how to think. The students (especially undergrads) are incredibly good at doing as little work as possible. And until you get to the end-of-PhD level, there's basically nothing you encounter in your learning journey that ChatGPT can't perfectly summarize and analyze in 1 second, removing the requirement for you to do anything.

This isn't even about AI being "good" or "bad". We still teach children how to add numbers before we give them calculators because it's a useful skill. But now these AI thinking-calculators are injecting themselves into every text box and screen, making them impossible to avoid. If the answer pops up in the sidebar before you even ask the question, what kind of masochist is going to bother learning how to read and think?

ageitgey··on Elevated error rates on Opus 4.5
Kinda sad because I thought of a great, practical use of Cowork to demo to the company today to demonstrate how useful I thought it could be across a range of user types. Such is life.
ageitgey··on Why AI works better on existing codebases
This reads like a ChatGPT response
ageitgey··on UK police chief admits policy relied on CoPilot hallucination
Many offices (public sector, commercial, etc) are full of people who write reports that no one reads.

With AI, there is a strong incentive for the employee to churn out the report quickly and take Friday off, since no one is going to read it anyway. Maybe they still skim the report and make sure it looks reasonable, but they don't catch the smaller details that are wrong, and more importantly, they don't think deeply or critically about the issue at hand since the report looks reasonable at a glance.

"Show me the incentive, and I'll show you the outcome" - Charlie Munger

My guess is that reporting processes will change and adapt once everyone realizes how useless the old system is in an AI world. A long report used to signal "we thought about this, so rest easy". Now, a long report doesn't signal that. It no longer serves the function it once did.

ageitgey··on I stayed in a $40 capsule hotel (London)
I love that you were living in a hostel while having a £300+/month premium gym membership.
ageitgey··on Gimp Source Code
I've used GIMP and Photoshop for a very long time (close to 30 years).

In ~1998, GIMP was not quite as good as Photoshop 5 and was more awkward to use, but you could see how it could close the gap. It had impressive underlying tech that could handle large images on computers at the time. There was an expansive library of weird and neat plug-ins and scripts. It felt like we were at the start of a great shift in which OSS software would "catch up" and eventually replace desktop power tools, just as Linux had done with web servers. It was... the year of Linux on the Desktop!

By ~2005, GIMP was starting to really catch up to where Photoshop was in 1998, but Photoshop had added lots of quality of line features like adjustment layers and layer effects, way better text rendering, and amazing new features like spot healing brushes, vanishing point warping, etc. The gap was widening. But GIMP still did all the core stuff, and Photoshop was annoying users by shoving Adobe Bridge down their throat, etc. So people were still hopeful for a replacement.

By ~2012, GIMP was adding.. an awkward single window mode? It lacked tons of by-now-basic features that made it totally impractical for professional use. Photoshop, meanwhile, was adding amazing time-saving features like Content-Aware Patch and Move that seemed "magic" at the time. The tech gap was widening, but Adobe was also pushing subscriptions down users' throats, which was very unpopular, so GIMP still had a chance to make a come back.

By ~2018, GIMP was finally adding.. basic CMYK support for printing, something which literally no one uses GIMP for professionally and was a dying need? Meanwhile, Photoshop was demoing an AI object selection tool that could magically select objects without needing to trace them, which came out in 2019. Using GIMP felt like using software from a decade previous.

The last 5 years have been the worst for GIMP. Photoshop has been improving at an astonishing rate. Now it's literally what photo editing looked like in 90's movies - you just open an image, click "select object" and it perfectly selects it, and lets you move/drag/add elements with AI, etc. You can do edits in seconds now that used to take hours, and the results are really good.

None of this is a complaint about GIMP or all the people who contributed to it. It's impossible for a few volunteers to complete with infinite money and hundreds of full-time employees. But Photoshop and GIMP are no longer in the same league. And Adobe knows this, which is why it can get away with punitive subscription-only pricing.

ageitgey··on 8-bit Boléro
This guy's other video where he covers Clowncore's 'Computers' on computers is one of the most impressive, incredibly niche things I've ever seen on YouTube. He's a serious talent.
ageitgey··on The World of OCR (C. 1960) [video]
The most interesting part of this video to me is the editing. It feels like someone just watched Breathless by Goddard and really wanted to make a French new wave movie, but had a day job making films for IBM.
ageitgey··on English vocabulary test – how many words do you know?
It's a test measuring outlier knowledge. By definition, most of the words will be words that never come up in common usage (and thus words of limited utility outside of reading classic literature). You shouldn't feel bad if you don't know 90% of them.
ageitgey··on Roomba maker goes bankrupt, Chinese owner emerges
Sure, but a simple address database seems like a lot easier way to get there than robots roving around houses with LIDAR?
ageitgey··on A fork of Calibre called Clbre, because the AI is stripped out
Calibre has had a comically obtuse and amateur UI for over a decade. I don't think anyone working on it is spending time on a grand beautiful UI redesign (which would be really hard, both in effort and in politics). So I don't think it's fair to complain that anytime someone adds a feature you don't use that is taking time away from UI work.
ageitgey··on Jack Ma's family shifted wealth to UK after years-long 'disappearance'
> New land is created all the time. The netherlands has created an entire new province.

You're 'technically correct' but the total amount of land being created is so small as to be meaningless in a global sense.

Your arguments are fixated on extreme corner cases. I'm not sure what you are arguing for.

ageitgey··on Some rando turned me into a meme coin
I feel like a narcissist would take the exact opposite approach and pump their namesake meme coin.
ageitgey··on Free software scares normal people
> The problem is that everyone wants a different 20% of the functionality.

I'm not disagreeing with your basic take, but I think this part is a little more subtle.

I'd argue that 80% of users (by raw user count) do want roughly the same 20% of functionality, most of the time.

The problem in FOSS is that average user in the FOSS ecosystem is not remotely close to the profile of that 80%. The average FOSS user is part of the 1% of power users. They actively want something different and don't even understand the mindset of the other 80% of users.

When someone comes along to a FOSS project and honestly tries to rebuild it for the 80% of users, they often end up getting a lot of hate from the established FOSS community because they just have totally different needs. It's like they don't even speak the same language.

ageitgey··on Using AI to negotiate a $195k hospital bill down to $33k
Fun fact:

In the UK, you can pay more (say 30%-40% the cost of a US health insurance plan), get treated like royalty in private care, skip all the lines for specialists, still be covered by the NHS to pay 0 for anything catastrophic, and still never get a bill in the mail from anyone.

It's not an either/or situation. The US has the least efficient healthcare system of any country in the world. It provides less treatment per dollar than anywhere else. You can provide universal basic coverage and still provide luxury insurance plans.

ageitgey··on Using AI to negotiate a $195k hospital bill down to $33k
> I'd be interested to hear from a charge coding expert about Claude's analysis here and if it was accurate or not. There's also some free mixing of "medicare" v.s. "insurance" which often have very different billing rates. The author says they don't want to pay more than insurance would pay - but insurance pays a lot more than medicare in most cases.

I'm a cofounder of Turquoise Health and this is all we do, all day. Our purpose is to make it really easy to know the entire, all-in, upfront cost of a complex healthcare encounter under any insurance plan. You can see upfront bills for many procedures paid by various healthcare plans on our website.

The information posted in the thread is generally correct. Hospitals have fictional list prices and they on average only expect to collect ~30% of that list price from commercial insurance plans. For Medicare patients, they collect around 15%. The amount the user finally settled for was ~15% of the billed amount, so it all checks out.

The reason for fictional list prices (like everything in US healthcare) is historical, but that doesn't make it any more logical. Many hospital insurance contracts are written as "insurer will pay X% of hospital's billed charges for Y treatment" where X% is a number like 30. No one is 'supposed' to pay anywhere near the list price. Yes, this is a terrible way to do things. Yes, there are shenanigans with logging expected price reductions are 'charity' for tax purposes. But there isn't a single bad guy here. The whole system that is a mess on all sides.

Part of the problem is that the US healthcare billing system is incredibly complex. Billing is as granular as possible. It's like paying for a burger at a restaurant by paying for separate line items like the sesame seeds on the bun, the flour in the bun, the employee time to set the bun on the burger, the level of experience of the bun-setter (was it a Dr. Bun Setter or an RN bun setter?), etc. But like the user said, some of these granular charges get rolled up into a fixed rate for the main service.

However, the roll-up rules are different for every insurance contract. So saying the hospital 'billed them twice' is only maybe true. The answer would be different based on the patient's specific insurance plan and how that insurance company negotiated it. Hospitals often have little idea how much they will get paid to do X service before it happens. They just bill the insurance company and see what comes back. When a patient comes in without insurance, they don't know how to estimate the bill since there is no insurance agreement to follow. So they start from the imaginary list prices and send the patient an astronomically high bill, expecting it to be negotiated down. In some areas, there are now laws like 'you can't charge an uninsured patient more than your highest negotiated insurance rate' but these are not universal.

If you find yourself in this situation, there are good charities like 'Dollar For' that can help patients negotiate this bill down for you. We are trying to address this complexity with software and have made a lot of progress, but there is much more to do. The government has legislation (the No Surprises Act) that requires hospitals to provide upfront estimates and enter mediation if the bill varies more than $400 from that amount. But some parts of the law don't have an enforcement date set yet, which we hope changes soon.

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