rebootthesystem

If someone's train of thought is interrupted by the difference in code entry time between vim and a good IDE or code editor --which is milliseconds-- they have a real problem requiring medical attention.

Forget IDE's for a moment. Look at an editor like Atom. It's fantastic. You type "for" and it expands the for loop automatically for you and it understands languages. And, more importantly, you have to spend exactly zero minutes configuring that behavior.

Let professionals make great IDE's and tools. Focus on the real job in software development, which is not being a text entry machine.

vi wasn't designed to efficiently edit text. It was designed to deal with shitty keyboards of the time. And now it is a cult.

I challenge anyone to prove that a non-trivial project, say, a year of work for a team of five developers, would get done any faster, better and with less bugs because of the single act of adopting vim vs. a top grade IDE.

That is precisely my point. To devote any effort at all optimizing this is to go after the wrong optimization target. Just buy or use a good IDE that helps you with tasks beyond text entry and move on. There is no value to be gained doing anything else.

In all of the discussions on HN about vi/m this is probably the most intelligent question I've received after posting my opinion.

I've been coding for 16 hours straight and have at least another four in front of me (have to deliver tomorrow AM) so I don't have a ton of time to answer this.

I'll use today as my example of how irrelevant (and counterproductive) vi/m can be.

I'm working on a large Django project and cranking out apps like there's no tomorrow. I use PyCharm for this.

Here's a case where experts are making it their business to deliver a superior tool that allows me to get my work done. It has myriad tools configured and configurable to help me. I don't have to futz around with weird custom stuff. It is intelligent about Python, Django, JS, jQuery, databases, HTML, packages, Git, Python console, Django console, etc. It can even talk to my servers. PyCharm is, in my opinion, a nearly unmatched productivity tool.

I lied. I am working on two large Django projects simultaneously because some of the work for the new project entails porting from an old one. So, two PyCharm windows on two 24 inch monitors and two browser instances side-by-side on the third monitor.

Can you setup vim to do some/all of the above. To some extent, yes. I haven't used it at this level in quite some time so I can't answer the question. What's the question? Can you setup vim to match PyCharm feature for feature? I don't think you can, and, if you could, it'd be a nightmare.

A lot of the vim "religion" centers around keeping your hands on the keyboard, not using the mouse, carpal tunnel and speed.

Keeping your hands on the keyboard is irrelevant unless you are a data entry clerk. If you are a software developer you are far more likely to spend more time doing things other than typing. Designing data structures, diagramming databases, researching approaches to solving a problem. Thinking.

The above is also used hand-in-hand with "vim is faster". Yeah, again, if you are a data entry clerk entering tax return records this might have some value. Software development? Nah. The time one could save by only having to move a finger a few centimeters is but a rounding error in the context of any non-trivial software development project. It's silly, really. Take the entirety of a project and multiply typing time by, I don't know, 1.25. It would still be insignificant when compared to the overall project time. Debugging alone takes orders of magnitude more time than anyone could save by typing faster.

Not using the mouse. You know, those of us who grew up using, designing, building and programming computers that did not have a mouse were ecstatic when the mouse arrived. It's just plain silly to malign the mouse. I will say that I switched to a thumb operated trackball a long time ago. I don't go looking for a mouse. My trackball is always there, quite literally touching the right edge of the keyboard. And I don't have to move it all over the place to use it.

Carpal tunnel. Serious problem. I suffered from this about fifteen years ago. Doing 18 hour days in front of the keyboard was red-hot painful. I tried different ideas. I knew people who had to have surgery on both wrists and were never again the same. I wanted to avoid that scenario.

I ultimately did two things: First, I switched to a thumb operated trackball. Mice are not designed right and you have to move all over the place all the time. This is very repetitive and not good. Second, I designed and built my own desk. I welded a steel framework that supported a surface for the monitors at 29 inches off the floor. The framework also had a full length shelf in the front with the surface dropped down about three inches. The front of that shelf had a 2 inch raised lip. So, my forearms rested on this lip and my keyboard and trackball were two inches below that. My hands naturally drooped into that cavity. No more carpal tunnel. Being in front of the computer doing everything from mechanical to electrical to software engineering using various interfaces for 16+ hours is normal for me. I have not had any issues in 15 years or so. None.

All of the arguments for vim are simply irrelevant. The only argument I could find for knowing how to use it at a basic to mid level is this: If you find yourself having to access a remote system with a computer that dates back to the stone age you might have no choice but to have to edit files remotely and you know that vim/vi will be on that system. Personally, I have never in over thirty years had that problem. These days I'll use something like CuteFTP if I have to or, as I said above, PyCharm and other IDE's (PHPStorm, etc.) know how to talk to servers and allow remote editing "in comfort". I mean, you can buy a $200 PC laptop with a large 17 inch screen, full keyboard, etc. these days. No more excuses.

Bottom line: vi/vim don't make sense because they do not provide any advantages when compared to state of the art IDE's.

Wow, I ended up typing more than I wanted to. Oh well.

Most people have no idea why vi made sense way back when (and, in my opinion, does not today).

I used VT100 terminals for years on both mainframe and CP/M systems. Keyboards were not very standardized before then, the mouse did not exist and most text editors had to use all sorts of convoluted commands to allow you to do anything.

http://www.vintagecomputer.net/digital/VT100/DEC_VT100_SYSBO...

I ran the first version of AutoCAD back then on a CP/M system with 64K of RAM, an S-100 RAMDISK card, an 8087 math co-processor on yet another S-100 card, another card with a graphics co-processor and a 1K x 1K CRT-based analog display. This is the reason AutoCAD has the console. You would type the commands on your VT-100 terminal and the graphics would happen on the stand-alone display. You had to load and unload modules based on what you were doing in order to control memory consumption. AutoLISP, the version of LISP included with AutoCAD, was invaluable.

Oh, yeah, 8 inch floppies and no hard drives.

Everything worked.

All they had to say is "use this SKU kitty litter ONLY, nothing else. Here's the link. Do not buy anything else or you can cause a massive disaster. Here's a picture of the bag. Any deviation from this must be approved by a domain expert."

In other words, when failure is not an option you have to engineer out failure vectors. This was stupid simple to prevent. I don't see it as a failure of the workers, they don't know any better.

As an example, in aerospace you vet and qualify every single material through Material's Engineers. Only materials that have been approved for a particular use are designed into an assembly. It would be inconceivable for an assembly technician to order an alternative adhesive from a random catalog. This is proper engineering.

It sounds like the folks running the nuclear waste installation had no idea how to manage a mission critical process.

Part of me keeps waiting for someone with the right clout and means to attack the elephant in the room:

Change the rules of the road.

Our roads can move far more cars per unit time than they do now. This is easy to see if you drive around Los Angeles for a fair amount of time. I drive the 405 corridor with some frequency and I can say it has gotten worst over the last few years.

Yet, the one common theme you see every day consists of these characteristics:

  - Cars driving everywhere at whatever speed they want
  - Cars driving slowly on the left
  - "Synchronized" driving, where two cars drive equally slow side-by-side
  - People who can and want to drive faster have to zig-zag through traffic
  - The carpool lane is inhabited by people who do nor carpool
    Just because a car has more than one person it doesn't mean they are
    carpooling.
  - The carpool lane has buses going slow and sometimes (often) empty
  - No penalty for slowing down when going uphill and causing backup

It's insane, there are no penalties for going slow and causing backups that trigger massive oscillations that lead to the entire freeway going through these nodes where speed grinds down to zero. This wave travels backwards and it can be triggered by slow or insecure drivers. I've seen in time and time again.

If I were to generalize, the rules of the road are not designed or evolved to optimize flow. You can't even say they are optimized for safety because there is nothing safe about a moron going 55 on the fast lane while people are swerving all over the place to get around him.

What we need is a new mentality: Caltrans and CHP need to work together to optimize flow, not get in the way of it. The carpool lane is a disgrace. It takes-up 20 to 25 percent of the road's capacity for no gains whatsoever. We need a layered system where slow drivers get out of the way and don't impede others. I am not saying go full autobahn but there's merit to the idea that slow drivers should not be allowed to impede others. I've watched the 405 grind to a halt because of a few (two or three) drivers who manage to lock-up an area. It always gets worst before it gets better.

Tunnels? Sure. But first fix the real problem.

This is where self driving cars might do an amazing job. We will be able to extract far more capacity out of the existing infrastructure by increasing speeds and layering them from right to left.

Oh, I know what it means. That was a public service.

Acronym soup can be maddening. Sure, one can look up every acronym but this can reach the point of jarring the reader out of a story. It is often a better idea to help the reader retain the desired mental state by taking a second to clarify acronyms.

Anyone who's read legal documents know just how easy it is to do this. The first time you use the acronym you define it, just like this (JLT). Any time after that the reader knows what it means without having to run a separate search and change mental states, JLT.

Can someone with Windows Server experience please explain how this might make any sense at all?

I've never uses Windows Server or any of the MS server technologies. The closest I've gotten to this was using Exchange in the context of being just another user in a corporate environment.

If you need Windows Server, why would you want any part of Linux?

And, if you need Linux server, why would you pile gigabytes (?) of MS Server code onto your server?

I can see (and I like) the utility of WSL on the desktop for development. As this evolves it will become more and more useful. But on the server? Not sure I see the point.

>The only thing worse are the windows computers, which are in such bad shape that they just stopped using them.

Sounds like they are old and haven't been maintained properly.

I have experience with small (~200) and large (~6,000) professionally maintained Windows installations. They operate like a finely tuned engine, allowing you to focus on your core work.

And that's the key. There are hacks who call themselves "IT" and there are true IT folks who have the training and knowledge to do things right the first time around.

Prior to my first experience with professionally managed Windows installations I had completely ignored that entire world. We built our own computers --save laptops-- and every installation, save the initial image, was locally managed by the engineer running that machine. Works great. No question about it.

From experience with 20~30 machine installations, I can't remember a single serious issue in, say, 20+ years other than a hard drive failure. No real hardware failures outside of that. No viruses or any such problems in, again, 20+ years and multiple generations of OS and hardware. The key, I'll guess, is to buy good hardware and install good software.

And so, when I read accounts that describe nightmares I have to wonder what people might be doing. I don't understand it at all. I've been using PC's since the very original IBM PC and I can't remember a nightmare scenario, ever.

As for Mac's and iPads. I've had experience with ~200 seat Mac installations. They have the same issues PC's might have. The only "nightmare" I could point out is that, generally speaking, Mac users are utterly clueless. This excludes developers, of course. I saw IT burn time with the dumbest issues, whereas the PC users in the same business (about 200 as well) really only consumed IT time when there were hardware or software installation issues for the most part.

iPad's? I consider them to be useless for but a narrow set of business or educational applications. Cash register? Sure. Authoring documents and doing heavy web work? Nope. In general terms I am pretty down on tablets. I think they've manage to ruin desktop software. The transition of something like Skype from a computer-class application to mobile-first turned the program into a circus act that uses 10x more screen space for everything. Touch, as far as I am concerned, for business and other applications, is bullshit.

Chromebook is a far better choice, one that is easy to manage and deploy.

Rule number one of using acronyms: Do not assume everyone knows what they mean.

NIMBY:

https://en.wikipedia.org/wiki/NIMBY

> Religion isn't math; it's subjective.

No I'm sorry. It is objectively delusional.

I am not going to slice and dice numbers because that's irrelevant. The data I've seen indicates the number of afflicted is far greater than the 25% you are alluding to due to Medicaid expansion.

Yet, let's leave it at that. Let's concede it is only 25% of the folks on Medicaid. We are at 75 million people enrolled right now and firmly headed towards 100 million if nothing changes.

And so, per your number, that means 19 to 25 million people are in debt with the government for their medical care.

You keep calling it "fear mongering". All I did is provide links to source information where the way the program works is clearly laid out. And everything is factually correct.

Here's the part you don't seem to want to concede: If someone is put into Medicaid when they are, say, 40 because they don't qualify for subsidies and can't afford anything else, they are likely to stay there for a long time. And I'd be willing to bet money, they have no clue what's coming.

So, 15 years later they are still on Medicaid only now they shift over to becoming a debtor to the government for aspects of their medical care. And it so happens that after 50 to 55 years of age most people start having greater needs.

Our population is living far longer now, with 90+ not being uncommon. Which means that the 100 million or more that will be on Medicaid over the next decade or two will have a greater component of 55 or older folks. And every single one of them will owe money to the government for health care.

This isn't fear mongering, this is a mathematical reality.

> It's fine if the resources for elder care come from the assets of the people receiving the care.

Ah. OK. Now we understand each other.

I do not agree with this. Not at all. And mostly because most people have no clue they are accumulating debt.

If we did NOT call it medical insurance. If we classified it clearly for what it is. And if we made certain everyone knew what they were walking into it might be a different matter.

I know you are going to say it's right there in the forms. Nobody reads the fucking things. They want healthcare and they are placed between a rock and a hard place. They sign on the dotted line and move on.

-------------------

The fundamental disagreement here is that I am not OK with there being a program that turns people 55 and older into debtors to the government for their medical care.

You don't have a problem with the idea.

That, I think, is the bottom line. Everything else is slicing and dicing numbers. This, to me, is a question about the morality of the thing, not about statistics.

Hmm. OK. You probably haven't spoken to an attorney since Obamacare. I have.

Even so. We are dicing and slicing words here and the whole thing is irrelevant.

> Should society step in and help people who can't afford to pay? Of course.

> Should society work hard so that middle class and wealthy people that need long term care can pass more of their assets to their children? Probably not.

OK, it sounds like we might be coming to an understanding here. Please answer the questions I asked, because everything else is irrelevant.

Here they are again, slightly restated:

-----------------

1- Is estate recovery real?

Can we agree on that point?

Forget age thresholds. Is it real?

-----------------

2- Is this OK?

Should a nation like the US have a healthcare system with programs that place citizens past a certain age --the age where medical needs increase significantly-- in a debtor relationship with the government?

-----------------

I am willing to bet your answers will be:

1: Yes, it's real.

2: No, we should not have a healthcare program that turns medical care recipients into debtors

-----------------

If these are your answers we, then, are 100% in agreement and this back and forth has largely been irrelevant because these two questions are the meat of the objections I have raised.

We need a healthcare system that takes care of everyone, rich and poor. There should be no distinction when you walk into the doctor's office or hospital. And it should certainly not turn you into a debtor to the government. That's immoral and wrong.

As for the philosophical question of the wealthy passing assets to their children, that's an entirely different discussion. As an advanced and "civilized" nation we should not use the healthcare system as a battering ram to deal with such issues. Healthcare should be about just that, healthcare. Everyone should have access to it and it should not bankrupt anyone or turn them into debtors to the government. We need to achieve that. The issue of inheritance, etc. is a matter for a different kind of legislation and it should be kept separate from medical care. I hope you'll agree to that as well.

-----------------

I'm pretty sick of what politicians have been doing with our healthcare system over the past 20 to 50 years. It is an absolute mess. And I fear it will get worst before it gets better.

What we need is leadership that is able to have an adult conversation with the nation to explain how we need to work together for the greater good. Instead we have politicians in various political camps playing fucking games with our healthcare for political gain, not our benefit.

The right kind of leader would be able to unite the citizenry in understanding that the ONLY way we are going to end-up with a better system is if we accept that we all have the obligation to contribute --obviously based on financial ability-- in order to create a system where anyone, rich or poor, can walk into a hospital and not worry one iota about costs. What we have today is a horrible mess. And Trump, despite what many might think, is very far from the leader we need on this matter. I think we can agree on this as well.

You keep pushing on this. I guess I have to spell it out for you.

To be precise, Medicaid is obligated to recover cost of services provided at or after 55 years of age.

OK. Fine.

So CA enrolls twelve million people. Some young some older.

Do these people not age?

Of course they do. So, presumably, they are going to be on Medicaid for a very long time. Maybe their entire lives.

OK. That's established. People age. They think they have health insurance. Yet, they actually don't.

Out of those 12 million roughly 2.2 million were 45+ years old. One million were 65+.

So that 55+ event horizon, we could say, is very close for millions of people being shoved into Medicaid.

In fact, nationwide, about 14.5 million people 45+ were enrolled. Out of those, about 6.4 million were 65+.

These are not insignificant numbers. Source [1]

BTW, these numbers are for FY2011 when we had about 32 million people enrolled in Medicaid. Due to Obamacare and other factors we now have over 74 million and are well on our way to the 100 million mark. Finding current data seems to require a lot of work. You are welcome to do it if you want to be accurate. For now...let's double the numbers above:

45+ 28 million.

65+ 13 million.

So we are looking at roughly 41 million people at or past the threshold for estate recovery. And, of course, millions more that will eventually get there if they don't pop out of Medicaid or if they are shifted back into it because health insurance becomes too expensive.

41 million and counting. All subject to estate recovery or within a few years of it.

I, quite literally, don't understand what you are arguing about.

This is a real problem. People age and live well beyond 55 years of age. My Dad is 90. He had cancer when he was 70. That was 20 years ago. And, like him, millions of people. And most of them don't have a clue that Medicaid is debt they accumulate with the government, not health insurance.

There's another reality: Older people have greater healthcare needs. I read a report showing that the average need for a healthy older adult is around $10K per year. That being true, had my father not had a serious condition --had he been of average health-- he would have racked-up somewhere around $350,000 in medical debt to the government while on Medicaid. The actual number is closer to a million bucks.

A million dollars of debt to the government. And we call this insurance?

Let's see you face that reality and see how you react.

I'm getting sick of saying this. All of this bullshit still misses the greater point:

-------------------

We should not have a program that is falsely promoted as "health insurance" that actually has the government sink it's hooks into people's estates.

-------------------

That is immoral. It is objectively wrong. It is also fraudulent. Obamacare reports taut "27 million insured". No. It's a lie. You have millions of people shoved into Medicaid, which is not insurance. It is debt. Maybe not for all today. Certainly for millions today, maybe 30+ million. And certainly for millions of others who think they have insurance yet, as they approach the estate recovery threshold are unlikely to realize what "insurance" they actually don't have.

It's really sobering to receive a letter from the government demanding payment of $900K in medical care.

[1] http://kff.org/medicaid/state-indicator/medicaid-enrollment-...

"means testing" refers to something very specific which includes asset valuation.

Obamacare/ACA/Medicaid no longer include means testing. It's a simple income test against FPL.

Where did I say that Medicaid has grave financial results for all recipients?

Again, you continue to ignore the point:

The fact that these hooks exist in Medicaid is objectively wrong. Very wrong.

They (the hooks) are also very real and, yes, they affect millions of people. So real that there are myriad attorneys specializing in complicated asset protection schemes intended to shield people from them.

The trouble is this is only available if you have the money to afford some very expensive and complicated legal work.

In other words, the poor and lower middle class are totally screwed and can't defend against this. This is horrible.

We should not do this to our people.

--

1- Are you saying it is OK for Medicaid to have estate recovery rules?

--

2- Are you saying estate recovery isn't real?

--

Please clarify because I truly don't understand where you are coming from.

> Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaagh

So, you don't think it is immoral to have this estate recovery thing?

I don't know why you are focusing on this age business. It does affect a large number of people. And it is objectively wrong.

It is wrong because it is immoral and fraudulent to present it as insurance when it is not.

It is wrong because it is immoral and fraudulent to deceive people.

It is wrong for a country like the US to have a law that results in the government sinking it's hooks into a large percentage of the people on that program.

We should not have such provisions in any healthcare program at all. Period.

You are missing that one point. The most important of all.

Again.

We should not have such provisions in any healthcare program at all.

We should have programs that help people and provide healthcare for all with no such conditions or stipulations.

We should help the poor without having them give up whatever property they have or may have for the sake of having health care.

We need to be a better society and we can't claim to be that when we have a law that allows government to place a lien on someone's property because they had the misfortune of needing medical care.

As for all the means testing BS you continue to sling around. That went out the window with Obamacare. The only thing that matters now is a percentage of the Federal Poverty Level. It varies per State. In CA it's 138%, which means about $22K for an older couple who's kids have left the nest. Over ten million people have been shoved into Medicaid in CA (called Medical here) in 2016.

It turns out to be that a lot of fixed income older couples who own homes of significant value can easily fall under this FPL requirement. Hence, again, the over ten million people shoved into the program last year in CA alone.

You are sadly misinformed. I urge you to read the links I've provided in this thread so you can get a real picture of what's going on and how things work. I get the sense that you've had exactly zero contact with this system from any imaginable angle. I and my family have, from both the professional angle --my wife being a Doctor-- and the patient angle, with my parents and her parents.

Here's yet another link:

https://www.healthinsurance.org/california-medicaid/

And here's a quote from that article:

"This has become more of a problem since the ACA’s Medicaid expansion took effect in 2014, as people are now funneled into the Medi-Cal system in much greater numbers than they used to be. Covered California enrollees with income up to 138 percent of the poverty level are directed to Medi-Cal, regardless of the value of their assets (there’s no asset test for subsidy eligibility or Medicaid coverage under the ACA).

As a result, some families have been receiving bills from Medi-Cal after their loved ones pass away, including bills to cover the cost of payments that the state makes to managed care plans, even if the deceased didn’t use any medical services."

Let that last line sink in: "EVEN IF THE DECEASED DIDN'T USE ANY MEDICAL SERVICES"

The famous line from The Matrix applies here:

"You take the blue pill, the story ends. You wake up in your bed and believe whatever you want to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes."

I've shown you where the rabbit hole goes, yet you continue to believe whatever you want to believe despite overwhelming factual evidence. I can't fix that. Enjoy that steak.

You really need to do a bunch of research and reading.

Here's a tid-bit:

Quote: "Does Medicare Pay For Long Term Care?

NO. After a 3 day hospital stay, Medicare pays 100% of the cost, but only for the first 20 days of skilled nursing care. For days 21 through 100, you are responsible for a co-payment. As of this date, the daily co-pay rate is $148 per day.

But it gets worse: After 100 days of care in a nursing home, Medicare stops paying altogether, and you are responsible for all future costs, unless there is a new 3 day qualifying hospital stay (which then re-sets the 100 day clock).

You also need to be aware that Medicare does not pay for “custodial care.” If you or a loved one are in need of custodial care, it must be paid for either by writing a check, by private long-term care insurance, or by Medi-Cal."

I am not going to bother providing you with links because you are obviously not reading anything. If you are truly interested in understanding the issues you need to spend half a day googling around to build a better image of what reality looks like.

Also, my wife is a doctor. She, among other things, has dealt with precisely the segment "served" by all of these programs for at least ten years. She has left that practice. And so have tons of doctors. This is the other side of the equation.

These programs work for some but, on the aggregate, they are a disaster. It is impossible for doctors to provide good care. Patients are getting screwed right and left. My wife would easily see a dozen patients a week for free because there was no possible way to justify doing it under these programs.

The vast majority of people are extremely ignorant of the realities in US health care.

Anyhow, that's the end of it. Thanks.

No, I got it right. You can click on a radio button and get a head count instead of the percentage. Both pieces of information are useful. What it does say is that the overwhelming majority of people on Medicaid are what I would term as "young", say, somewhere around 50 or younger.

And, before you say 50 is old. I know plenty of people who have started businesses and entire new careers in their 40's and 50's. This ain't the 1920's.

Everything I said is accurate. Yet, you insist in missing my greater point:

This issue shouldn't even exist.

We, as a society, should revolt at having such clauses in a medical program that is supposed to help people.

The US healthcare system should take care of every single US resident. Period. Rich, poor, healthy and ill. And it should do this without the kind of thing I have highlighted regarding Medicaid.

It is my experience that it is extremely difficult to convince people who have a religious attachment to things. So be it. I put the matter on the table. I've done all I could here to raise awareness. And that's the end of the story.

Be well.

In the US it is extremely easy to rack-up hundreds of thousands of dollars in medical bills. A single operation can cost $200K. Be ill for an extended period of time and the idea of millions of dollars in medical care isn't out of the realm of the possible.

And so, imagine selling the family home to try to pay medical bills or provide more favorable circumstances only to get a knock on the door by the Medicaid estate recovery folks who have first dibs on the proceeds of the sale.

Not only that, the sale also means the patient is now kicked off Medicaid because they have money.

I'll repeat it because the shift in perspective is important:

If a private insurance company had exactly the same clauses in their policies people would be up in arms, they would be brought up on charges and some of their management would land in jail. Yet we are willing to accept this from our government? And enroll people by the tens of millions?

This should not be. We should provide care to the needy without any such preconditions. Our government should not sink hooks into them at all.

Readers seem to be confusing passion for fear mongering. This is real and, as far as I am concerned, it is seriously immoral. We should not be in the business of doing this to our own citizens. This isn't health insurance. Not sure what it is, but I know what it is not.

This is the point that is being missed in my exposure of this issue: This is an abomination. The US should not have a program fraudulently presented as insurance that takes people's property at all. Even if the net effect was that this only affected ten people, it would be wrong.

We should take care of those who need care and not set hooks into them or their estate.

Perhaps I am being too idealistic.

I believe that with the right leadership and a conversation with the nation we could converge on a system that was fair, took care of the needy and got government and insurance companies as we know them to day out of the system to the necessary degree.

I don't, for a moment, believe that we can get both government and insurance companies entirely out of the system in the US. In the first instance, government, you would not want to. Oversight and rules are important. In the second instance, insurance companies, there could be an argument of their need in absorbing some of the risk. Admittedly, not an easy problem.

What we have today, this hodge-podge of laws, agencies and programs is a complete disaster. This should be obvious and evident to anyone who takes the time to take a full dive into the absolute mess healthcare is in the US. The ACA did not fix anything, it made it worst, because it isn't a real solution.

I won't claim to have the solution. As I alluded above, this requires leadership that can bring forth a national-level conversation that, over a year or four, can converge on something that can deal with all issues equitably.

One angle is what I might term a to be a moral obligation: We have the moral obligation to take care of each other. What follows, then, is that we all contribute to a fund or a national health insurance policy of some sort that covers absolutely everyone with, perhaps, reasonable co-pay's to take some of the edge off. If one of us needs a million dollars of medical care he or she should be able to get it.

This should also come with some obligations. I think there's nothing wrong with the idea of requiring regular checkups of some sort. This is where it gets complicated. What do we do about people who destroy themselves through substance abuse. I don't know how we deal with that and other matters.

Anyhow, I think we can all agree that we ought to be able to do far, far better than this mess created by our politicians in playing sick partisan games with one of our most basic needs. And this has been true over at least the last 50 years, no political party is devoid of blood (almost literally) on their hands.

We truly need to take this up to a much higher intellectual level in order to converge on a good solution.

It is interesting to see the reaction had on HN when someone like me, who recognizes the emperor has no clothes, comes along to critique a very real problem with one of these programs, Medicaid. The reaction is evidence of the political polarization out there and the disconnect that exists with what politicians have done to our healthcare system. It's a mess and what we have isn't getting any better.

I have. With the aid of an attorney.

And I am 100% certain that most people who get shoved into Medicaid either have no idea or have no choice but to sign on the dotted line. That's the tragedy here. Our government is making people sign onto something almost out of desperation.

Let me make my position 100% clear, because those down-voting my post and attacking it might not have understood this. Actually, no, I failed to communicate it.

Medicaid Estate Recovery is an abomination.

It should NOT be a part of the program.

It should NOT exist.

We should provide medical care to the needy without ANY recovery requirements whatsoever.

If someone needs a million dollars in medical care they should receive it.

They should not have to worry about being on the hook to repay it in any way.

That is what a decent and compassionate society does and how it behaves.

If this estate recovery business were done by a private insurance company they would be destroyed by both public opinion and brought-up on fraud charges. We should demand better from our government. We should demand that estate recovery be completely removed from Medicaid.

Hope that clarifies my position.

I have read all of it and then some. I have even spent money to consult with three different attorneys on the subject as my family became concerned about how this mechanism would affect our parent's estate.

You can find various corner cases where Medicaid estate recovery isn't an issues. Yes. Yet this is NOT reality for the vast majority of those being shoved into the program by the tens of millions.

I am very well informed on this front, having sought the advice of top attorneys in this domain. This is very real. You can choose to study the links I provided and educate yourself or reject it while armed with imperfect information.

In the end reality isn't modified. We'll probably start seeing the effects of this during the next twenty years. Maybe then people will wake up.

First and most importantly, sorry for your loss. That is truly terrible and unimaginable.

This isn't a diatribe, fear mongering or half-truths. The links I provided are real and from government agencies.

If you wish to refute the reality I am presenting you need to do better than your situation because yours is atypical.

Yes, in your case you fell outside the domain of estate recovery.

Of the projected 100 million people who will be on Medicaid, how many do you think will have three year old kids with Cancer?

Your kid's life was invaluable. I would have spent my last dime had I been in your situation and I am sure you likely did. That goes without saying.

You are also wrong in this statement:

> The government seems to have a procedure that attempts to collect money from an estate, in certain circumstances, after a patient dies, if there really was money available.

This is not true. If a Medicaid member owns a home and sells it or takes out a second mortgage or comes into money (inheritance, etc.) the government takes a bite right there and then AND kicks the person out of Medicaid because now they have money.

I hope you take the time to read the various links I provided and come to understand your situation isn't typical and that it is true that Medicaid is not medical insurance.

If an insurance company had estate recovery clauses in their insurance policies they would be brought up on fraud charges instantly and most of their management would end-up in jail. Why do we demand less from our government?

Sorry for your loss. I cannot imagine having to go through that.

I am sorry, you are sadly misinformed. See this chart:

http://kff.org/medicaid/state-indicator/medicaid-enrollment-...

Here are a few examples of people under the age of 26 who are on Medicaid:

California, 57% Colorado, 69% Idaho, 73% Wyoming, 75% etc.

The only way your assertion is true is if these are worthless and will never make anything out of their lives. Which, of course, isn't true at all.

And so, a young person is shoved into Medicaid and convinced they have medical insurance when, in reality, they are accumulating debt with the government.

And, yes, as life goes on they see some success perhaps buy a house and have an investment or two and never realize the hook that got sunk and set into them when they were younger.

In California alone well over six million people under 27 years of age are walking around thinking they have medical insurance.

Even if this wasn't the case, let's turn things around a bit.

Say an insurance company, Nefarious Unlimited, was issuing medical insurance policies --real insurance-- with a hidden clause in them. The minute the insurance buyer signs on the dotted line Nefarious Unlimited is given the right to recover 100% of their costs from the persons estate. As little or as much as they might have.

Of course, Nefarious Unlimited does not inform their customers that the product they are buying is actually a loan rather than real medical insurance. They even go on TV to advertise it and tout the millions of "satisfied customers" they have.

Nefarious Unlimited would be brought-up on fraud charges so fast your head would spin. The entire board and management would probably --and rightly so-- end-up in jail. Nobody would argue with this outcome.

You see, whether or not a person has a large estate this is wrong, fraudulent and immoral. That is the point you are missing in addition to the above.

This is our government engaged in fraud of the worst kind. This should not be OK with anyone.

This isn't about political lines. This is about basic human decency and exists at the most basic levels of right and wrong.

Does everyone here understand that the ACA much promoted "twenty-seven million people now have insurance" is a complete farce? The number keeps expanding, of course, and it is a tragedy of almost unimaginable proportions.

OK, with great claims one must offer solid evidence. No problem, I accept this responsibility. Thankfully this is a rather easy task.

The great majority of these 27 million people are on what's known as Medicaid.

Is Medicaid health insurance?

No, it is not. Medicaid is a loan.

What?

Medicaid is a loan from the government. It is, if one wishes to interpret it this way, no different from taking out a home equity line of credit.

In other words, you must repay what you spent.

Yes, care you receive under Medicaid must --BY LAW-- be repaid. And, when your lender is the government the realities of dealing with the worst possible kind of loan shark --one with overwhelming power-- can and do easily surface.

Medicaid enrollment as of 2016 reached over 70 million people. Here's the requisite chart:

https://www.statista.com/statistics/245347/total-medicaid-en...

Every single one of these people has, effectively, entered into a promissory note with the government. They DO NOT have health insurance, they have a loan.

And here's where it gets ugly: The State, again, by law, is obligated to seek repayment for services offered and can --and does-- attach your property in the process of doing so.

Medicaid is a program that has convinced people they have medical insurance when, in reality, they have a loan. And this loan can and does cost them their estate as the State automatically becomes the first lien holder once you are on Medicaid.

Please don't take my word for it. Here it is from the horse's mouth:

https://www.medicaid.gov/medicaid/eligibility/estate-recover...

Here's another source with a revelation that should terrify anyone:

"if the property is sold while the Medicaid beneficiary is living, not only will the beneficiary cease to be eligible for Medicaid due to the cash from the sale, but the beneficiary would have to satisfy the lien by paying back the state for its coverage of care to date"

They should have added "refinanced" to that statement.

http://www.elderlawanswers.com/medicaids-power-to-recoup-ben...

Medi-Cal has similar provisions:

http://www.dhcs.ca.gov/services/Pages/TPLRD_ER_cont.aspx

Another reputable source:

http://www.nolo.com/legal-encyclopedia/how-medicaid-recovers...

You might have to pay your parent's Medicaid bill:

https://www.agingcare.com/articles/medicaid-repayment-of-nur...

More detail from HHS:

https://aspe.hhs.gov/basic-report/medicaid-estate-recovery

https://aspe.hhs.gov/basic-report/medicaid-liens

To be clear, estate recovery was not imposed by ACA. No, this has existed since the very start of the program.

What ACA has done is to systematically shove tens of millions of people into Medicaid for, dare I say, political gain. Nothing less than putting lipstick on a pig.

ACA membership numbers look good to the uninformed because tens of millions of people have been hoisted onto Medicaid. If left unchecked these numbers could easily reach into the hundred million plus range.

This is a tragedy. None of these people fully understand that they do not, in fact, have health insurance at all. They are signing on to a loan, with the loan shark being the government.

Think about this for a moment: This is probably the largest grab of personal property from any government anywhere in the world in the history of humanity. And all of this property is being grabbed from the poor and lower middle class.

Soon one hundred million of our citizens will owe the government everything they possess in order to repay their medical bills.

This is theft sold as medical insurance. When you have real insurance of any kind the insurance company doesn't come after your estate to recover their costs. When you have real insurance the insurance company doesn't take a chunk out of the sale of your home while you are alive and, at the same time, kick you out of your insurance policy.

Medicaid is NOT insurance, it's a dystopian reality nobody is talking about.

I think this is absolutely revolting.

Why aren't the idiots burning down business districts during their "demonstrations" up in arms about this shit? Right, it requires critical thinking skills.

EDIT: I failed to add something very important here, which is what my position is on how this should work. I apologize for not making that clear.

Medicaid Estate Recovery should NOT be a part of the program.

It should NOT exist.

We should provide medical care to the needy without ANY recovery requirements whatsoever.

If someone needs a million dollars in medical care they should receive it.

They should not have to worry about being on the hook to repay it in any way.

That is what a decent and compassionate society does and how it behaves, not by sinking it's hooks into people who have no choice but to sign on the dotted line.

If this estate recovery business were done by a private insurance company they would be destroyed by both public opinion and brought-up on fraud charges. We should demand better from our government. We should demand that estate recovery be completely removed from Medicaid.

Hope that clarifies my position.

Not if you know what you are doing.

And, please, it isn't code it is a Hardware Description Language. We all use "code" for short but let's not lose sight of what it is.

Many people come to FPGA design treating the thing as software. It isn't software. It's a hardware design and it is a hardware description language. Maybe it helps that my work in electrical engineering predates FPGA's and even PAL/PLA's. In other words, I spent years designing "raw" electronics.

When typing Verilog I think about circuits not software and I don't make a lot of mistakes because the circuits are designed on paper before typing code. Code is the hardware description, not the design environment.

I find that older hardware engineers are far better at this. Younger engineers treat it like software and go into this crazy type->debug->type->debug cycle that simply isn't the way you design hardware. Decades ago you had to know your shit. You couldn't throw a bunch of chips at a board and have to redesign it due to simple mistakes. Again, it ain't software.

So, no, I have no issues with Verilog debugging. I can't remember any serious debugging events in, say, twenty years.

You seem to be taking this personally. What I described was my reasoning for choosing Verilog. It worked fine for me. I am not going to debate minutiae.

Also, who said Verilog is C? It feels like C but it isn't. It's simply a lot easier to context switch between C and Verilog than between C and VHDL. That's my opinion. You don't have to agree with it. There is no implicit obligation to agree with anything at all.

I have shipped millions of dollars in product very successfully using Verilog. Others have done so using VHDL. In the end it is a choice.

My intent was to give the OP one criteria he or she might be able to use in some way in making a similar choice.

Back many years ago when I had to make a choice between these two I took a very practical approach. I learned both of them to a level adequate enough to implement a few small test projects and then I made my decisions.

How?

As a solo founder CEO/CTO/Electrical, Mechanical, Software and FPGA Engineer and, let's not forget, Janitor at the time there was one thing I valued far above anything else: Time.

VHDL, I found, is very verbose. Verilog not so. To me this meant having to type twice as much to say the same thing. This didn't sit well with me and that was the primary driver in deciding in favor of Verilog.

Another driver was familiarity with C. I had a need to switch contexts with some frequency. I was using C and C++ for embedded and workstation code development. As a mental exercise, switching to VHDL felt, for lack of a better word, violent. Switching between those languages and Verilog felt natural. Again, a time saver.

It also seemed far easier to find and hire a good Verilog engineer when the time came for me to let go of that title and focus on being a better Janitor. To me Verilog was the clear winner on all fronts. At the time it lacked a few constructs that were later added into the language yet I never found that to be a problem and managed to successfully design and manufacture many successful products.