Tuesday, April 4, 2017

Picking up on the self-driving thread

Following up on Joseph's earlier post, Timothy B. Lee displayed a devotion to the standard narrative on autonomous vehicles that bordered on Procrustean. Consequently, he got lots of the story wrong. Unfortunately, that is pretty much the going style when reporting on the topic. I don't want to get sucked into a point by point response, but there is one aspect I'd like to hit because it's ubiquitous in technology reporting and it's been bothering me for a long time. With only isolated exceptions, journalists covering technology have no grasp of how implementation works.

Consider the following from Lee:
It seems inevitable that lax regulation of self-driving cars will lead to some preventable deaths. Still, there’s a good argument that today’s permissive regulatory environment is the best approach.

The reason: While self-driving cars are potentially dangerous, human drivers are definitely dangerous.

“It's so easy to immediately focus on self-driving cars as the new and the scary and forget that every day 100 people die on the road,” Smith said. He says that about 90 percent of those fatalities are caused by human error — errors that self-driving cars could avoid some day.

The trouble with this line of reasoning is that autonomy is not a yes/no proposition; it's a scalar. Here is the standard metric:
A classification system based on six different levels (ranging from none to fully automated systems) was published in 2014 by SAE International, an automotive standardization body, as J3016, Taxonomy and Definitions for Terms Related to On-Road Motor Vehicle Automated Driving Systems.[22][23] This classification system is based on the amount of driver intervention and attentiveness required, rather than the vehicle capabilities, although these are very closely related. In the United States in 2013, the National Highway Traffic Safety Administration (NHTSA) released a formal classification system,[24] but abandoned this system when it adopted the SAE standard in September 2016.

SAE automated vehicle classifications:

    Level 0: Automated system has no vehicle control, but may issue warnings.
    Level 1: Driver must be ready to take control at any time. Automated system may include features such as Adaptive Cruise Control (ACC), Parking Assistance with automated steering, and Lane Keeping Assistance (LKA) Type II in any combination.
    Level 2: The driver is obliged to detect objects and events and respond if the automated system fails to respond properly. The automated system executes accelerating, braking, and steering. The automated system can deactivate immediately upon takeover by the driver.
    Level 3: Within known, limited environments (such as freeways), the driver can safely turn their attention away from driving tasks, but must still be prepared to take control when needed.
    Level 4: The automated system can control the vehicle in all but a few environments such as severe weather. The driver must enable the automated system only when it is safe to do so. When enabled, driver attention is not required.
    Level 5: Other than setting the destination and starting the system, no human intervention is required. The automatic system can drive to any location where it is legal to drive and make its own decisions.

 Lee is jumping from one end of the scale to the other mid-argument. The improvements in safety start at level 1 and, if anything, tend to flatten out as you approach level 4.  If your car takes control of the wheel when you start to drift out of a lane and applies the brakes when you are about to hit something or someone, then you have already achieved most of your gains in this area.

With regulation, the situation is just the opposite. It isn't till around Level 4 that the serious legal concerns start kicking in, and not until you get to the stage of readily available driverless (as compared to self-driving) vehicles that the issues become truly daunting. Strictly from a technological standpoint, we still have quite a ways to go.

For the record, there are still any number of compelling reasons to fully develop this functionality – – for example, Uber's widely hyped plan to use autonomous vehicles to alleviate labor costs makes no sense if the cars still have to have licensed drivers behind the wheel – – but Lee's safety argument simply doesn't hold water.

Monday, April 3, 2017

On the plus side, "red teams" do sound cool

We'll need to come back and dig into this story more later. It is simply too big and hits too many issues to manage in one pass. Lots of long-running thread converge on this one: the dangerous decline in scientific standards; the war on data; the conservative movement's failure to control the misinformation flow;  the way that the movement's social engineering experiment has cultivated a conspiracy mindset.

In the meantime, check out Chelsea Harvey's account in the Washington Post:

Prominent scientists operating outside the scientific consensus on climate change urged Congress on Wednesday to fund “red teams” to investigate “natural” causes of global warming and challenge the findings of the United Nations’ climate science panel.

The suggestion for a counter-investigative science force — or red team approach — was  presented in prepared testimony by scientists known for questioning the influence of human activity on global warming. It comes at a time when President Trump and other members of the administration have expressed doubt about the accepted science of climate change, and are considering drastic cuts to  federal funding for scientific research.

A main mission of red teams would be to challenge the scientific consensus on climate change, including the work of the United Nations’ Intergovernmental Panel on Climate Change, whose reports are widely considered the authority on climate science.

“One way to aid Congress in understanding more of the climate issue than what is produced by biased ‘official’ panels of the climate establishment is to organize and fund credible ‘red teams’ that look at issues such as natural variability, the failure of climate models and the huge benefits to society from affordable energy, carbon-based and otherwise,” said witness John Christy, an atmospheric scientist at the University of Alabama in Huntsville, in his prepared testimony. “I would expect such a team would offer to Congress some very different conclusions regarding the human impacts on climate.”

Wednesday’s hearing, which focused on “the scientific method and process as it relates to climate change” is the latest in a series of recent House science committee hearings to challenge the existence or seriousness of climate change. In their prepared testimonies Wednesday, witnesses called by the committee’s Republican majority suggested that organizations like the IPCC present a biased view of climate change, and do not represent the views of the entire scientific community.

...

But climate scientist Michael Mann of Pennsylvania State University, called as a witness at Wednesday’s hearing by the committee’s Democratic minority, said such bias claims are “hogwash.” Policymakers who suggest a need for alternative views on climate change are cherry-picking the science they choose to trust, Mann said.

“These folks start out with their ideology and then work backwards to decide which science they like and which they don’t,” he said in an emailed comment to The Washington Post. “But that’s not how scientific research works. It’s not a buffet where you get to selectively pick and choose what to believe. It’s not about belief. It’s about evidence.”


Friday, March 31, 2017

It's been too long since we've watched a video of a railgun test

Jalopnik's Kristen Lee catches us up.





Of course, I'm still holding out for something a bit more ambitious.












Thursday, March 30, 2017

Jon Chait and game theory

This is Joseph

Jon Chait:
If Republicans are telling Democrats that any attempt to filibuster the Republican nominee will lead to the Republicans abolishing the filibuster, it stands to reason that the filibuster is not worth keeping around. What value is there in a weapon one’s adversary can disarm at any time?
This is absolutely correct.  Leaving the filibuster in place under these conditions is silly.  After all, the next supreme court nomination could also have the filibuster removed if the Democrats objected.  And, say what you will about the specifics of the Merrick Garland episode, but it really does seem to create a situation where the opposing party has the moral authority to object to the nominee.

So if it is left in place but never used then what is its purpose?  At this point it seems to be to maximize the chance that Democrats suffer the odium of removing the filibuster.  Now, it might be that the current nominee should be confirmed on the merits -- that is a very different question.   It is fine to not filibuster Neil Gorsuch because one finds him to be within the acceptable parameters of a supreme court nominee.  Of course you shouldn't filibuster for no reason.

But the idea that you would avoid filibustering just so that you can avoid filibustering in the future seems like a poor strategy.  That there is even a discussion of this I find odd.  If the method can be removed by a majority vote, and the opposition party has already signaled that they are willing to do so, then the only chance of saving it is to use it and have members of the opposition decide not to repeal it.

It is odd that this issue is even being discussed.

US Healthcare reform

This is Joseph.

I want to highlight a couple of issues about free market health care

But in health care, the cheapest, highest-performing systems all do the same thing — they let government set prices centrally. That’s true in the UK’s absurdly inexpensive, and fully socialized, health care system; but it’s also true in the Singaporean system, which conservatives often hold up as a model. 
Hell, it’s even true in the American system! Medicare and Medicaid pay much less for health services than private insurers. That’s one reason Obamacare relied so heavily on the Medicaid expansion — Democrats couldn’t afford to subsidize private insurance for everyone who needed it, and so they turned to the cheaper insurance Medicaid offered. Even now, the part of Obamacare that needs more money is the part based on conservative ideas — the regulated marketplaces where people buy private insurance.
 Now it is true that we cannot presume all government run systems will be inexpensive and high functioning.  But it is a tough problem for the free marketeers that they are, unless price isn't also an object.

I also want to highlight a practical problem:
The loophole that makes our system the enormous clusterbang that it is results from Republicans not having the courage to back up their tough talk on people who can't afford health care. As long as the law requires Emergency Rooms to take people irrespective of ability to pay, the system we use today is guaranteed to be an expensive mess. A system that requires people to buy insurance from a for-profit insurance industry or face a penalty is going to leave some people uncovered. Those people are going to get sick and get in car accidents just like everyone else. When they do, they end up getting services they have no intention of or ability to pay for. The costs get passed on to everyone else. This is why health care in the U.S. has been such a disaster – because we treat it like an industry rather than a social service.
The logical solution is to have a single-payer system in which people don't have to go to the ER when they have the flu because it's the only service provider they have access to that can't reject them for being uninsured and poor. The alternative, though, is for the Republicans to sack up and change the law that requires ERs to take uninsured patients. If they really are committed to the idea of health care as a product, the provision of which is governed by the invisible hand, then go all the way. Tell people, "If you don't have insurance, the ER will leave you outside on the sidewalk and lock the door. Hospitals don't have to treat you anymore, even if you're comatose, until they determine what you can afford."
 This is just one more of the series of information problems that accompany private health care transactions.  The classic one is trying to get prices or estimates for the cost of medical care.  Now I strong disagree with the author above that it would ever be ethical to cut people off of emergency care, but it is a logical outcome of fully free market care.

But you also providers being unsure of just how much care a patient can afford.  Just imagine having a heart attack and having forgot one's wallet.  No care for a rapidly fatal medical condition because you can't get anyone to get your wallet to the hospital in time.  Or imagine having equity in your house but it being too long of a process to free it up to pay for cancer treatment.  To some extent a very carefully regulated insurance market can help.  But surely everyone can see how easily rescission of medical insurance could be a problem -- even the debate could make the costs moot (as the patient has expired).

Furthermore, what does a fully private market think about "self-educated" doctors?  Is not the AMA a government regulation reducing free market activity?  But who would want the system that produces incredibly proficient providers and really sets a floor on quality to go away?

These sorts of deep structural problems (high cost) and information issues (price and so forth) make the provision of fully private medical care unlikely.  Given that, the real question is what results do we want to have.  If we want inexpensive and effective than one has to look much more closely at expanding Medicare and Medicaid, which are the current options with these features.

And a more expensive system is fine, but we should own up to that and accept that we are going to spending more on health care.  And given the high levels of cost, at some level a lot of that has to be sourced from public funds.

Wednesday, March 29, 2017

Without precedent, beyond analogy

Sometimes, the best examples come after the post has run. Last month  we made the following point about attempts to draw analogies between Trump and a couple of 20th Century Republicans.
There's already been lots of discussion about the Trump/Goldwater analogy and a fair amount, more recently, about the Trump/Nixon analogy. Both of these provide some interesting points to explore, but what strikes me is most important here is where the analogies fail. At the risk of oversimplifying, the extremism of Barry Goldwater and the corruption and abuse of power of the Nixon administration both qualified as comparable threats to the Republican Party. The GOP was able to weather these threats with no lasting damage in large part because it successfully distanced itself from both men.


Along these lines, check out the following from Carl Bernstein of Woodward and Bernstein fame:
Bernstein called back to President Nixon's Watergate scandal, and said the "heroes" of the scandal were the Republicans in Congress. "The heroes of Watergate were really Republicans, they were Republicans in the House and the Senate who wanted this investigated to the bottom: What did the president know and when did he know it," he said. "That's what we're not seeing here. We're not seeing it from the Republicans on the Hill who are consumed by supposedly looking for leaks."

We can go back and forth as to whether or not Bernstein is overstating the heroism here, but what matters for this discussion is perception, and clearly the GOP was able to create a perceived distance between its legislators and the Nixon White House. If Russia does end up playing a significant role in the end of the Trump administration, it is fairly safe to assume that future Bernsteins will not describe Devin Nunes as a hero of the process.

Tuesday, March 28, 2017

Maybe Paltrow and Tom Brady* could go into business together

In journalism, as in all things, there is no such thing as an original sin. Press-release pseudo-reporting and publicist ghostwriters have been around as long as newspapers have. That does not mean, however, that things are not getting worse. Not only does the previously mentioned flack-to-hack ratio continue to grow, but we have started down the dangerous road of legitimizing these behaviors.

Even if this "interview" was with a qualified expert offering products of real value, this would still cross numerous ethical lines. In this case, those lines are way past the horizon.

Kristen V. Brown writing for Gizmodo:

Gwyneth Paltrow, high priestess of sex-dust smoothies and $66 jade vagina eggs, is back with some more pseudoscientific health advice that you should definitely never follow.

This time, though, Paltrow is peddling a new line of completely unproven nutritional supplements from the cover of Women’s Health magazine. Yes, a magazine with the word ‘health’ in its title actually put a woman who once advocated for vaginal steaming on its cover.

“I think women in modern society don’t feel very well. The number one thing women say is ‘I’m exhausted and I don’t know why!’ I want to get to the bottom of why that is,” Paltrow said in a completely uncritical Q&A published by the magazine, which by the way was not labeled as advertising but was actually written by one of her employees.

Paltrow was gracing the cover to promote Goop Wellness, a new brand of nutritional supplements she is launching to “address the most common health complaints” she hears from women.

* In case you missed the title reference.

Monday, March 27, 2017

Self driving cars

This is Joseph

Over at Vox, Timothy B. Lee makes an argument about self-driving cars:
We don’t have enough data yet to say how today’s self-driving cars compare with today’s human drivers. What does seem likely, however, is that self-driving software will steadily get better over time, while human drivers won’t. And the sooner we reach the point where computers are safer than human drivers, the sooner we can start saving lives.
He talks about this partially in the context of Uber, which has a culture that is very tolerant of risk taking.  However, I think that the idealism in this viewpoint may be too strong.

If we were talking about computer driven trains, where one of the outcomes can be "stop the train and wait for a human" But I think that there are several issues here that should be considered when arguing for self-driving cares being necessarily safer.

1) I would expect there to be a period of transition where human and self-driving cars share the road.  The cars need to be able to handle the human drivers, where tricks like inter-vehicle communication are not going to work

2) Infrastructure is quite varied and tends to break.  How do self-driving cars handle a broken streetlight system or roads without markings, or badly parked cares?  Working 99% of the time is not enough if occasionally there is a disruption.  Right now most adults are very proficient at driving -- what if that skill stops being common among passengers?

3) Is silicon valley reliable enough?  Remember, running on software are vulnerable to issues like bad software updates.  It seems like special pleading to claim that a bad patch should be treated as an exception.  People aren't supposed to drive drunk but they do and the resulting mayhem is laid at the feet of cars (and rightly so).

4) How things work at scale is a whole different issue.  To make a lot of this stuff work we need to have strong regulation.  Look at the bitcoin problems -- fine for a secondary currency but imagine if the hard fork issue hit the US dollar?  What do you do if there are multiple protocols for self-driving cars that don't necessarily play nice with each other?

5) What happens when the car doesn't work?  Your iPhone can become a brick.  Do we really want to be on hold waiting to find out why the software system in the car isn't working?

None of this is to say that I don't like self-driving cars.  Insofar as they can make pubic transit possible for older and sick members of society then it will be a positive good.  It's not impossible to imagine ways that this technology can really help matters (automating parallel parking plays to all of the computer strengths and many drivers dislike it already).  But regulation seems to be the way to go, and it really would make me feel better if the people who spent decades making cars safe (traditional car companies) were more involved.

I would be surprised if Mark didn't have thoughts too.

Friday, March 24, 2017

R.I.P. Chuck Berry

This has always been my favorite,






Thursday, March 23, 2017

Does this solution work at scale? A question we should ask more

This is Joseph

Lawyers, guns, and Money points to this article by Emmie Martin.  It details the journey of a young woman out of student debt.  To make a long story short, it was based on three things: 1) large gifts from family, 2) a high paying job in an inexpensive area, and 3) getting lucky as a small landlord (things go much worse if tenants destroy the rental unit).

But the piece I want to consider is this one:
Back home in Joliet, Illinois, Horton took a job as an operations manager at the nonprofit her mother runs. The salary was comparable to what she made in DC, but the cost of living was drastically less.
Ignoring the family angle (her mother's nonprofit!), the idea here is well understood.  If you can keep the same salary in a less expensive city that is as good as a pay raise.  If that city happens to be the same one as childhood friends and family, that can compensate for the costs of a smaller community (less social contacts, less to do) by becoming engaged in existing social networks.  Now add a job that may well be fulfilling, and the small community can be a lot more appealing.

However, it is almost always the case that one will earn less money in a smaller city or community.  The tricks that let one actually do move to a small town with a full salary (e.g. professor jobs in college towns) almost always do miraculous things to improve personal finances.

But this isn't a solution that can work at scale.  Just like anyone can be a millionaire is not the same as everyone can be a millionaire.  So an interesting note on personal finance, if you can make it work, but it really shows how limited the options to escape a large debt really are, given how much family assistance was needed to make this plan work.

Wednesday, March 22, 2017

"Nobody told me there would be a test!"

The good people at Gizmodo pass on a clever (although, I suspect, doomed) idea for improving the quality of our online discourse:

From Bryan Menegus:

Over the years, conventional wisdom for how to deal with comment sections has changed a few times as publishers walked the line between promoting open conversation and stemming abuse. Sign-ins, badging, upvotes, paid and unpaid moderators—they’ve all been tried. Now, NRKbeta, the tech-focused arm of Norwegian public broadcaster NRK, has a new idea: a reading comprehension test.

It’s no great secret that comments sections tend to bring out the worst in people. NRKbeta’s solution asks readers to “reply to a quiz” if they’re intent on commenting. “We try to keep the questions easy and as neutral as possible,” StÃ¥le Grut, a journalist with NRKbeta, told Gizmodo. The net result, hopefully, is higher value comments and less bickering.

But these short multiple choice questions do more than ensure commenters actually bothered to read the article they’re commenting on. Taking the time to answer things acts as a sort of mental chill out period to keep people from spewing their immediate gut reaction to headlines. “If we could make sure people at least had read the story before lashing out, the comments might become a bit more valuable for everybody,” Grut said. “The international attention shows that people really are keen on trying to solve problems with the comments section.”

Tuesday, March 21, 2017

It's always reassuring when Josh Marshall agrees with you


We did a post last month on game theory and the relationship between Trump and the GOP [emphasis added]:

However, while the relationship is simple in those terms, it is dauntingly complex in terms of the pros and cons of staying versus going. If the Republicans stand with Trump, he will probably sign any piece of legislation that comes across his desk (with this White House, "probably" is always a necessary qualifier). This comes at the cost of losing their ability to distance themselves from and increasingly unpopular and scandal-ridden administration.

Some of that distance might be clawed back by public criticism of the president and by high-profile hearings, but those steps bring even greater risks. Trump has no interest in the GOP's legislative agenda, no loyalty to the party, and no particular affection for its leaders. Worse still, as Josh Marshall has frequently noted, Trump has the bully's instinctive tendency to go after the vulnerable. There is a limit to the damage he can inflict on the Democrats, but he is in a position to literally destroy the Republican Party.

Last  week, Josh Marshall made a similar point in the excellent post, Ryan Alone:

 That makes the situation volatile and unpredictable. Trump's ideological commitment to this bill? Basically zero. Trump's commitment to being loved and not looking stupid? Incalculable. Trump seems at least temporarily imprinted with the access/freedom Ryan mantra. But there's every reason to think that is just skin deep. Trump may not care in any deep sense about millions of people losing their insurance coverage. But he did say his genius and deal making power would make things awesome for everyone. He wants everyone happy and loving him. This bill is not good for that agenda.


Monday, March 20, 2017

How did the press develop a top quartile worldview?

Admittedly, it is always dangerous going to Business Insider for a representative anecdote, but this is a conversation we've been having for a long time. You can find plenty of examples in this blog, in the Monkey Cage, and in the currently dormant food blog.

Pretty much everywhere you look, journalists tend to describe things from the implicit point of view of the well-off and well-connected. This has been particularly striking when the supposed purpose of the article is advising people on how to get by on a limited budget.

Over at Lawyers Guns and Money, DJ W points out a perfect example from a Business Insider article titled "How one 31-year-old paid off $220,000 in student loans in 3 years." [as excerpted by LGM]

    She had toyed with the idea of moving back in with her parents to save on rent, and when her father had a stroke in 2013, she knew it was time to make the transition.

    Back home in Joliet, Illinois, Horton took a job as an operations manager at the nonprofit her mother runs. 

...

    Horton’s mother gave the couple a condo that she had purchased at an auction for $13,000 as a wedding gift. It became crucial in wiping away the hefty student-loan tab.

    Horton and her husband lived in the condo for three months, but then they decided to move in with her grandparents down the street and started renting out the condo to bring in extra income.
...

    When Horton’s grandparents moved south, she returned to her parents’ house, refusing to live in one of her rental properties because they were bringing in extra income.
...

    To anyone who feels overwhelmed by the prospect of taking on student loans — or paying back any debt they’ve incurred — Horton has a simple message: “I just want them to feel empowered that they can pay if off. If I can do it, anybody can.“

Friday, March 17, 2017

Bialystock's Paradox: Paul Ryan, Supergenius edition

Paul Krugman makes an essential point about the press's favorite serious Republican idea man:
Start with Ezra Klein, who speculates that Ryan has advanced this ludicrous plan in the hope and expectation that it won’t pass. His reasoning is that Ryan is too skilled an operator to get caught off-guard as he seems to have:

    Paul Ryan isn’t an amateur. He is, arguably, the most skilled policy entrepreneur of his generation. He is known for winning support from political actors and policy validators who normally reject his brand of conservatism. The backing he’s built for past proposals comes from painstaking work talking to allies, working on plans with them, preparing them for what he’ll release, hearing out their concerns, constructing processes where they feel heard, and so on. He’s good at this kind of thing. But he didn’t put in the work here. And there are consequences to that.

But has Ryan ever put together major legislation with any real chance of passage? Yes, he made a name for himself with big budget proposals that received adoring press coverage. But these were never remotely operational — they were filled not just with magic asterisks — tax loophole closing to be determined later, cost savings to be achieved via means to be determined later — but with elements, like converting Medicare into a voucher system, that would have drawn immense flack if they got anywhere close to actually happening.

In other words, he has never offered real plans for overhauling social insurance, just things that sound like plans but are basically just advertisements for some imaginary plan that might eventually be produced. Actually pulling together a coalition to get stuff done? Has he ever managed that?

What I’d say is that Ryan is not, in fact, a policy entrepreneur. He’s just a self-promoter, someone who has successfully sold a credulous media on a character he plays: Paul Ryan, Serious, Honest Conservative Policy Wonk. This is really his first test at real policymaking, which is a very different process. There’s nothing strange about his inability to pull off the real thing, as opposed to the act.

Picking up the Producers thread again, Ryan's accounting has only slipped by up to this point because he was never involved with a hit. As long as his budgets and proposals had no real chance of passing, they had no real chance of facing serious scrutiny.









Yes, that is a relatively youthful William Hickey.

Thursday, March 16, 2017

iPhones versus health care

This is Joseph.

There was a recent comment to the Jason Chaffetz's comments that people might allocate resources to health care instead of iPhones.  This is such a huge admission of ignorance as to how expensive the United States health care system is that it is hard to know where to start.

For example, Duncan Black argues that smart phones are actually a pretty major part of basic needs in modern America:
A new phone high end phone costs 500-800 bucks. If I could buy health insurance (Real, not bullshit) for my family for that I'd happily give up my new phone. Of course, the two years ago high end model phone costs $200. The somewhat shittier and not quite latest and greatest can probably be had for 50 bucks. Your older brother can probably give you a handmedown for free. So, phones are not really that expensive (service is in the US because of our shitty noncompetitive market and lax regulation, go to Yurp and pay 20 bucks per month max). Also they're the only way lots of people have regular internet access, so they're pretty much necessary. Smartphones are not luxury items, they're required. 
I like this take because it weaves in a second piece to the puzzle -- monthly service costs are high in the United States.  The more marginally housing somebody is, the less they can afford to have things like land-line telephones (that come with expensive connection charges that presume people are not mobile).  If you needed one item to connect to the outside world, the thing that can act as a phone, gives you a stable phone number, allows you to send texts, and allows you to interface with the internet solves a lot of problems all by itself.  And when you consider used phones then the comparison gets even sillier.

But there is another piece to this puzzle.  Health care costs in the United States are opaque, literally to the point that I couldn't imagine a way to parody them.  Look at this video from Vox (youtube here).  At the end of the process of trying to find out how much it would cost to give birth in a hospital (any hospital), spending hours on the phone trying to get this price quote, the final bill was off by a factor of two.  So you can't realistically price shop in the United States for a foreseeable medical expense (let alone an emergency room visit).

It's not really a case of putting "skin in the game".  People often can only find out prices after the service has been provided -- especially since the system is filled with all sorts of little details that are difficult to estimate ahead of time (how many $50 ibuprofen will you need and is there is a reason you can't bring your own supply?).

There is an important conversation about providing health care in the United States.  But it centers around comparative costs, pricing transparency, the inflexibility of moving with current employer sponsored health care, and how to handle people with economic insufficiency.  It's not an accident that "single payer" style systems are brought up a lot -- they directly attack all of the major problems.  Maybe not the only solution, but trading in smart phones isn't looking like a good deal either.