I take issue with the claim that in order to say something is too expensive that you must be able to precisely propose an alternative price.
I have no idea what the correct margin for essential cancer drugs is. I don’t think it should be a 10x markup. Intuitively, it seems that there’s something wrong with price gouging dying cancer patients. If you have an argument why my intuition is wrong, please share it.
> I take issue with the claim that in order to say something is too expensive that you must be able to precisely propose an alternative price.
If you want to be quantitative of course you do. How hard is it? Margin of error is allowed. If you want to be qualitative, vague and wishy washy, that has its place too, but at some point someone is going to ask for a quantitative assertion, otherwise you get nowhere.
To use a software development analogy, the average person is a user of health care, not a health care project manager or designer.
Just as the user of an App doesn't need to provide an alternative design when they say "this App sucks", the average user of healthcare likewise has no obligation to redesign the healthcare system when they say "this healthcare system sucks."
Really apples and oranges comparison. But even so, if a certain App user is motivated to have the hostile App developer make a change that doesn't server their interest, they'll need to do better than cry "this app sucks".
yes. But the more likely action is that they download another app and delete yours. Most apps are "free", so the competition is fierce to keep that market happy. The dev is always beholden to the volatile audience.
It is apples and oranges, though. Because 1) apps are hardly a critical need for the populace and 2) software margins are even more difficult to find that "line" to than physical resources.
I'm sure that medicine needs some higher than average markup in order to make up for R&D, ingredients, and various regulations to get it approved for human patients. But very unlikely 1000%. And only 1000% because of questionable vertical integration that lets UHC charge UHC however much it wants to itself.
It's even worse than you're saying actually, because health care has no price transparency, very little consumer choice, no negotiating power on the part of the user and even the services provided are extremely opaque.
To be honest, I'm quite surprised you're siding with the provider here. Are you personally satisfied with healthcare pricing in the United States? Do you not share my intuition that in general, healthcare is too expensive and inefficient?
Health care now has significant price transparency, although there are still some major gaps and it can be challenging to shop for the best option. Many consumers are still unaware of the tools available.
Your missing the point. No one expects consumers to download the MRFs. Humana plan members can just log in to their web portal to search for the treatment they need and see prices across all the local network providers.
"overcharge" is a qualitative source. If you're not working in the economics, I don't see much worth in finding the exact line between such a qualitative word. The market has some intuitiveness and know that charging 30$ for an item that costs $3 to make is highway robbery. Doesn't matter when or if we start to agree that $5, $6, or even $10 is reasonable (and yes, these are all pretty high markups to begin with compared to typical markups for stores).
We don't need to find the touchdown line when we're already outside of the stadium and the parking lot anyway.
> I have no idea what the correct margin for essential cancer drugs is.
So let's talk about it and think about it and form an idea. There's no universally right or wrong answer, but you should at least be able to decide what answer is right to you.
> I don’t think it should be a 10x markup.
What about 1x markup?
> Intuitively, it seems that there’s something wrong with price gouging
There is, but you're relying on the word "gouging", and without identifying what price you think is gouging vs reasonable profit, stopping at the point where you express that "too much is too much" doesn't get us any closer to having actionable goals.
So, important question: What problem are we trying to solve here? Is there any benefit to the overall populace for us in HN to debate what we feel is "overcharged"?
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But to go along with your exercise, I take a look at current market dynamics and compare it from there. Apparently, the typical wholesale markup is 20-40%, and stores will typically markup another 20-50% on top of that. So we're talking roughly a 125% markup on the higher ends from the factory into the consumer's hands as a very rough average (VERY rough, markups vary a lot per product and industry).
That's with two chains of markup, so clearly 1000% feels absurd from one part of such a chain. Outside of factors like drinks (which are easy to scale and can have markups well into the hundreds), it's pretty hard to find any part of the chain as not "overcharged" once we go past 100% markups in any given place.
on the most generous side, Costco famously has markups limited to 14% (albeit they rely on bulk purchases to mitigate that). and subsidized vehicles used to generally be a 10-15% markup price. So I'd say 15% is about the bare bottom of what to expect markups without some kind of twist. e.g. printers selling at a loss, making up for it with high markups for ink (another product that's easy to scale and marked up into the hundreds). or previously, a video game console in order to sell games (software, whose markup is hard to really determine since it's infinitely scalable and costs are more to make up for R&D).
I perceive that one of the reasons that people who want change in the devastatingly perverted system are repeatedly plowed over, cheated, and ignored when it comes to making actual policy is that as a group those with the most reason to be upset are easily swindled into engaging only vague moans about some miniscule ignorable example being bad but not being ready to articulate what should be done instead as a set of categorical rules. And it happens over and over again until the voting public are bred into helplessness, and the way out is to talk about things in actionable ways instead of in vague handwavy ways. And the path to collective dialogue shift has to start somewhere, so it can start with us. Was it painful?
>And the path to collective dialogue shift has to start somewhere, so it can start with us.
I suppose so. But I have no insight of these concepts outside of the 30 minutes I spent studying various markup strategies. And I have no interest in trying to personally influence policy (especially in something I studied for 30 minutes ". I don't know how many qualified people in this community can influence such stuff (or any that will read HN specifically) , so I simply question the tactic's effectiveness.
If you think this is bad, wait until you move physical addresses and don’t notify all your creditors!
Literally ANYONE who moves into your old house will have access to your bank statements, credit card bills, tax forms, auto registration and who knows what else. And it will all come plaintext and unencrypted!
Phone numbers too. Ah, but it's illegal to open mail addressed to someone else. (Although what if you change your legal name to match???!) Perhaps we need an electronic messaging service backed by the USPS.
It's effectively mass subsidization for bad behavior at the expense of people who are altruistic. I don't see how it can be a winning strategy in the long run.
For just a second, let's set aside our hopes and idealism, because I do realize how distasteful this world view may be.
If the best hope for the environment is that altruistic people suffer a disadvantage so that everyone (including defectors who don't want to help anyone and only help themselves) can win, how is that not a strong long term advantage for anti-social behavior?
"Great, don't take that plane ride, stop burning fossil fuels. More for me until we run out! I can even afford to have more kids because I don't care how impactful they are, while you responsibly go extinct."
Feels like a losing battle, and not a fun way to lose either. I suspect that we all know, despite our hopes, that eight billion people will not decide to collectively give up their own happiness for the betterment of billions of strangers they aren't related to.
I thought it had more to do with the fact that plastic recycling is largely a scam - i.e., recycling logos are printed on nearly all plastics, less than half of which are actually recyclable. Yet, there's been no crackdown on such brazen fraud. I'm sure the assumption by most is that's due to lobbying.
They're all recyclable. Just not into grades of plastic anyone wants to manufacture things out of.
Recycled plastic are used heavily in things that people touch and need a lot of chonk to them relative to their strength to feel substantial and high quality or stuff that'll almost purely be loaded in compression (like bolt on plastic pads that prevent metal to metal contact or allow nice sliding).
I think recycling, or reuse, could be made to be cheaper or more effective with better policy. This has to come from the top down. For example, by regulation on product design, or better incentives for consumer recycling (like deposits).
It's possible you're underestimating the open source community.
If there's a competing platform that hobbyists can tinker with, the ecosystem can improve quite rapidly, especially when the competing platform is completely closed and hobbyists basically are locked out and have no alternative.
> It's possible you're underestimating the open source community.
On the contrary. You really don't know how I love and prefer open source and love a more leveling playing field.
> If there's a competing platform that hobbyists can tinker with...
AMD's cards are better from hardware and software architecture standpoint, but the performance is not there yet. Plus, ROCm libraries are not that mature, but they're getting there. Developing high performance, high quality code is deceivingly expensive, because it's very heavy in theory, and you fly very close to the metal. I did that in my Ph.D., so I know what it entails. So it requires more than a couple (hundred) hobbyists to pull off (see the development of Eigen linear algebra library, or any high end math library).
Some big guns are pouring money into AMD to implement good ROCm libraries, and it started paying off (Debian has a ton of ROCm packages now, too). However, you need to be able to pull it off in the datacenter to be able to pull it off on the desktop.
AMD also needs to be able to enable ROCm on desktop properly, so people can start hacking it at home.
> especially when the competing platform is completely closed...
NVIDIA gives a lot of support to universities, researchers and institutions who play with their cards. Big cards may not be free, but know-how, support and first steps are always within reach. Plus, their researchers dogfood their own cards, and write papers with them.
So, as long as papers got published, researchers do their research, and something got invented, many people don't care about how open source the ecosystem is. This upsets me a ton, but when closed source AI companies and researchers who forget to add crucial details to their papers so what they did can't be reproduced don't care about open source, because they think like NVIDIA. "My research, my secrets, my fame, my money".
It's not about sharing. It's about winning, and it's ugly in some aspects.
That said, for hobbyist inference on large pretrained models, I think there is an interesting set of possibilities here: maybe a number of operations aren't optimized, and it takes 10x as long to load the model into memory... but all that might not matter if AMD were to be the first to market for 128GB+ VRAM cards that are the only things that can run next-generation open-weight models in a desktop environment, particularly those generating video and images. The hobbyists don't need to optimize all the linear algebra operations that researchers need to be able to experiment with when training; they just need to implement the ones used by the open-weight models.
But of course this is all just wishful thinking, because as others have pointed out, any developments in this direction would require a level of foresight that AMD simply hasn't historically shown.
IDK, I found a post that's 2 years old that has links to doing llama and SD on an Arc [0] (although might be linux only), I feel like a cheap huge ram card would create a 'critical mass' as far as being able to start optimizing, and then from a longer term Intel could promise and deliver on 'scale up' improvements.
It would be a huge shift for them. To go from preferring some (sometimes not quite reached) metric, to, perhaps rightly play the 'reformed underdog'. Commoditize Big-Memory ML Capable GPUs, even if they aren't quite as competitive as the top players at first.
Will the other players respond? Yes. But ruin their margin. I know that sounds cutthroat[1] but hey I'm trying to hypothetically sell this to whomever is taking the reigns after Pat G.
> NVIDIA gives a lot of support to universities, researchers and institutions who play with their cards. Big cards may not be free, but know-how, support and first steps are always within reach. Plus, their researchers dogfood their own cards, and write papers with them.
Ideally they need to do that too. Ideally they have some 'high powered' prototypes (e.x. lets say they decide a 2-gpu per card design with an interlink is feasible for some reason) to share as well. This may not be be entirely ethical[1] in this example of how a corp could play it out, again it's a thought experiment since intel has NOT announced or hinted at a larger memory card anyway.
> AMD also needs to be able to enable ROCm on desktop properly, so people can start hacking it at home
AMD's driver story has always been a hot mess, My desktop won't behave with both my onboard video and 4060 enabled, every AMD card I've had winds up with some weird firmware quirk one way or another... I guess I'm saying their general level of driver quality doesn't lend to hope they'll fix dev tools that soon...
ROCm doesn't really matter when the hardware is almost the same as Nvidia cards. AMD is not selling "cheaper" card with a lot of RAM, what the original poster was asking. (and a reason why people who like to tinker with large model are using Macs).
You're writing as if AMD cares about open source. If they would only actually open source their driver the community would have made their cards better than nvidia ones long ago.
I'm one of those academics. You've got it all wrong. So many people care about open source. So many people carefully release their code and make everything reproducible.
We desperately just want AMD to open up. They just refuse. There's nothing secret going on and there's no conspiracy. There's just a company that for some inexplicable reason doesn't want to make boatloads of money for free.
AMD is the worst possible situation. They're hostile to us and they refuse to invest to make their stuff work.
> If they would only actually open source their driver the community would have made their cards better than nvidia ones long ago.
Software wise, maybe. But you can't change AMD's hardware with a magic wand, and that's where a lot of CUDA's optimizations come from. AMD's GPU architecture is optimized for raster compute, and it's been that way for decades.
I can assure you that AMD does not have a magic button to press that would make their systems competitive for AI. If that was possible it would have been done years ago, with or without their consent. The problem is deeper and extends to design decisions and disagreement over the complexity of GPU designs. If you compare AMD's cards to Nvidia on "fair ground" (eg. no CUDA, only OpenCL) the GPGPU performance still leans in Nvidia's favor.
That would require competently produced documentation. Intel can't do that for any of their side projects because their MBAs don't get a bonus if the tech writers are treated as a valuable asset.
They're building coal peaker plants to complement the massive amount of solar they're building. The capacity factor of their coal plants has halved at the same time the number of plants has doubled -- those coal plants just run at night.
Up until this year coal has been cheaper than batteries for this task. That changed this year and they're now building some very large battery farms and i invasive their coal builds will drop.
> That changed this year and they're now building some very large battery farms and i invasive their coal builds will drop.
This is an under-considered point: just because energy sources like coal or solar, etc. are being installed NOW doesn't mean they will be there forever. Here in the UK, there is often a lot of opposition to solar and wind farms. But I would expect those eventually to be phased out in the same way as coal once better/cheaper forms of generation come along.
With all of the AI demands for electricity, as well as the strategic importance of 24/7 power production, you should not hold your breath for coal plants to be decommissioned.
If everyone who was soliciting was like Doctors without Borders, there wouldn't be a problem. That's a worthy cause.
The problem is the scammers, not DWB. The fact that you think it's legitimate causes trying to get support that are the problem and not the scammers makes my head spin.
The fact that cold calling was expensive was a signal that the caller was legitimate.
In the era where calling someone on the phone is cheap and highly optimized, getting a phone call is not a signal for quality.
But back in the 1980s that wouldn’t have been the case. If a human being picked up the phone and called you, you would be more inclined to listen to them, simply because you knew it was expensive for them to call and it happened infrequently. Phone spam didn’t become a thing until much later.
I have no idea what the correct margin for essential cancer drugs is. I don’t think it should be a 10x markup. Intuitively, it seems that there’s something wrong with price gouging dying cancer patients. If you have an argument why my intuition is wrong, please share it.