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I have many of these same issues. I actually think ublock is causing some of them; removing and reinstalling fixed some of the hangs for a while, but they eventually came back. I think I also switched from Firefox to chrome version or vice versa.

The general “chrome” of the app is unfortunately a buggy mess regardless of extension config.

I still think it’s easily worth it because for some critical sites it adds so much value. I just accept I’ll have to force quit a few times a day.

Also, PSA, extensions don’t automatically update on desktop.


> Also, PSA, extensions don’t automatically update on desktop.

I see an "automatic updates" checkbox now in the extensions management window


I’ll never forget overhearing this quote from a fellow sophomore in the comp sci lab in college: “if I have to sit in front of a computer every day for the rest of my life I’ll kill myself.” Computer science is an interesting career choice for someone who hates computers and being with computers.

I think the “get rich easy” reputation that software engineering gained somewhere around the 2010s really hurt the industry and a lot of people who are chasing the dollar.

I’m an unhinged lunatic who loves productivity software and user experiences. The type of kid who was setting up Outlook betas in 6th grade to try the new features. Watching videos about how the Ribbon was designed. Reading C++ for dummies even though I had untreated ADHD and couldn’t sit still long enough to get much past std::cout. Eventually daydreaming about walking into the office, tired from a hard sprint, getting coffee in corporate-sponsored coffee cups.

I wake up and reflect how profoundly lucky I am to have my dream job. Not just having the career I have, but having a dream at all and having a dream I could love in practice.


I was still in middle school in the early 2010’s and I remember thinking how lucky I am to want to be a computer programmer for a career AND it happens to pay a lot of money.

Unfortunately many people today got into for the money and not the passion (or at least the passion and the money). Those people look for shortcuts and are generally unpleasant to work with, in my opinion.


Those are the exact people who are most excited about AI today.

They just want the code but they don't enjoy the coding, so they're trying to find something that will give them the former while sparing them the latter.


I don't think that's true at all. I think people who enjoy coding, but don't like AI, like to believe that's true, because it makes it easy to write off AI as useless, and to look down on people who use it ("they're not real programmers anyway. Not like me."). But my experience is that there's a ton of talented people who love programming who also find AI super exciting and useful.

For a hobby I'm writing a little videogame in C using Raylib. I write a lot of the code myself, but sometimes there's an annoying refactor that won't be any fun. I have limited time and motivation for hobby programming, so if an AI can save me 10 minutes of joyless drudgery when I only have 30 mins to work on my project, that's fantastic. Then I get 10 more minutes to work on coding the stuff that's actually interesting.

Not to mention it's an invaluable source of information for how to do certain things. Asking Claude to give me guidance on how to accomplish something, without it writing the code explicitly, is a big part of what I use it for.


Really? That hasn't been my experience at all. There are a lot of brilliant developers who love programming and are excited about AI. (Just read Simon Willison's blog, or any number of other people.) Conversely, my sense is that a lot of the people who are just in it for the money don't want AI to change the industry because they don't like learning new things and they feel it threatens the six-figure salaries they get for churning out boilerplate code without having a deep understanding of architecture or systems.

And they may be right to be worried! If you are in the game out of love and you like learning new things about computers you are well-positioned to do well in the AI era. If you just want to get paid forever to do the same thing that you learned to do in your bootcamp in 2018 when the job market was hot, not so much.


Saying those people are only there for the money is a little bit reductive IMHO.

I like computers but I actually don't like programming that much as an action.

Programming is just a tool I use and try to master because it allows me to do what I like and that's building things.

I'm happy that AI is there to help me reduce the friction in building things.

I'd also argue that people who sees programming as an end and not as a mean are also going to either don't like working in most software companies or to be pretty negative contributors despite their mastering because, in my experience, those people tends to solve inexistant problems while having a hard time understanding that what pays their salary are boring CRUDs calling tangled ORM queries.


I said absolutely nothing about money.

> I actually don't like programming

Right, that's my point exactly.

> in my experience, those people tends to solve inexistant problems

Yes, that's definitely a risk with people who really just love writing code. Fortunately, most people who like to write code also like to have useful code written, so in my experience, the folks who will go off an yak shave a thing no one needs for months are fairly rare.


Telling an AI to implement CRUDs calling tangled ORM queries sure sounds like an exciting profession!

..but but... I've never had the opportunity or helpful environment to focus on learning languages and focused on other skillsets.

Other efforts to try and coordinate the time, finances and a team to accomplish the projects that I have in mind also failed miserably..

Am I (for example) so bad to believe that I could possibly accomplish some of my dreams with the help of LLMs as another attempt to be an accomplished human being?

(partly /s but partly not)


I made no moral claims about whether it's bad to want to have code without wanting to go through the experience of writing it.

I want a nice lawn, but I don't want to mow it myself. I pay a landscaper. I don't think that makes me a bad person.

But it does make me a different person from someone who enjoys the process of manicuring a lawn.


The more powerful the tool, the more responsible its wielder should behave.

Ideally. In reality, that's impossible to enforce.


  >The more powerful the tool, the more responsible its wielder should behave.
I will argue that this is a false pretense, in part that you say it's impossible to enforce, but also for the fact that it does not happen in reality.

Anyone with a will to an objective will utilize any tools at their disposal, only the observer from another perspective will judge that this is 'good or not'. To the beholder, this has become the only way to achieve their goals.

An anecdote goes by the lady who was using a ww2 era hand grenade to crush spices in her kitchen for decades without anything happening. Goals were met and nothing bad happened but general consensus states that this is bad for many reasons, to which nothing happened.

Maybe it's not only responsibility, but the capability for one to understand the situation one is in and what is at their disposal. ..and a hint of 'don't be evil' that leads to good outcomes despite what everyone thinks.


> Maybe it's not only responsibility, but the capability for one to understand the situation one is in and what is at their disposal. ..and a hint of 'don't be evil' that leads to good outcomes despite what everyone thinks.

This understanding, and hint of broader/benevolent perspective, is what I meant by responsibility.

I'm not so naive as to expect it in general but I have known it to exist, that there are people who respect the responsibility implicit in proper use of their tools. The world is a labyrinth of prisoners' dilemmas so I get that there's a reasonable argument for being "irresponsible" whatever that means in the context.


For the greater good, would you go as far as saying that the act of responsibility comes from the top, the people who lead, and those in the public spotlight? Or would this ideology need to be indoctrinated in educational systems? Or do we have to hope and pray that each and every human born would need to go through the same process of learning and understanding to reach this level of responsibility?

I've taken to having a hobby car, and I'm pretty sure I could have been solving automotive problems for a living rather than computer problems; these days, automotive problems are computer problems, but my hobby car is my age and only has one computer in it, but it's not servicable ... it just works and runs the fuel injectors, or it stops working and I'll get a used replacement or a megasquirt. Computer problems are nicer, cause I don't smell like car for 2 days afterwards, but if there was no money in computer problems, I might have been redirected into car problems or other similar things.

Incredibly lucky, honestly. It's a rare thing to have a passion line up with a healthy income.

I went through that in the late 90s and saw the writing on the wall of the 2010s. Hoping it's not too cyclic

Right - there are two types of people working as developers.

1) People who love programming, do it as a hobby, and love being in front of a computer all day.

2) People who doing it because it's a decent paying job, but have no passion (and probably therefore not much skill) for it, and the last thing they want when they clock off their job is to be back on a computer.

If you are from group 1) - getting paid to do your hobby, then being a developer is a great job, but if you are from group 2) I imagine it can be pretty miserable, especially if trying to debug complex problems, or faced with tasks pushing your capability.


As someone who does this because it's a decent paying job, I don't think this comment is fair. I think I'm quite skilled, and I've been told so consistently. I don't have passion; I have discipline and professionalism. I take my job seriously. It pays well, and I make sure that I deserve that paycheck.

Passion for me is a nasty world, in the mouth of bosses. It's almost always a way to ask people to work unhealthy hours, and it results in bad work being done, which I have to fix later. If people talk live their own passion, it's fine, but whenever I hear someone appeal to the passion of someone else, it's to sell them into doing something that's not in their best interest.


I find it hard to believe that your discipline and professionalism doesn't come from, or go hand in hand with passion. Or maybe you are passionate about being disciplined on itself?

Sure. I'm passionate about turning off my computer at 18:00. And I'm passionate about not hurting our customers. These two go hand in hand: I work very hard to avoid prevent doing things that are likely to cause incidents, as those hurt customers who are not at fault, and they often mean I have to stay late.

I guess you could say I'm passionate about testing and observability, though that doesn't really describe how I feel. It just puts me in a sour mood when something breaks and we could have prevented it with better practices from the start.


Is it that hard to believe that certain people simply have the skill to apply themselves? That's what discipline kind of is.

But do you think you wouldn't be more skilled if you had passion for it? Sounds implausible to me.

The amount of times I've seen passionate people make bad technical decisions in the name of trying something exciting is too many to count. I obviously agree that passion is valuable, but not without faults. I think I'm better in some ways and worse in others due to the way I approach the job.

Have you ever met certain singers at talent shows? Even if they'd be better at it than if they wouldn't have the passion, there's also a certain bar one should be able to reach.

I love(d) programming when I was a hobbyist and still get the itch to hack around with stuff now and then.

But even then, I was never interested in doing it as a career. I knew I’d hate it. And lo and behold here we are. I just don’t care about most of the crap products people pay me to work on.

But I was also young and way too broke to go to school so it was really the best financial option at the time. In retrospect, I’d have wasted my time doing something else.


> I just don’t care about most of the crap products people pay me to work on.

I'm a masochist, I like the challenges and pain I have to deal with everyday for a product I don't care about.


Same, same. It was my main hobby since I discovered a little terminal in my dad's 80s videogame that could run BASIC, used my rudimentary 9 years old reading skills to look hard enough to the manual and figure out something about that puzzling black screen.

Discovered I could make it do stuff.

I could make stuff, just by typing some white characters in the black screen.

Fell in love, was my main indoors hobby, bought books, learned enough C/C++ to try to mod games before I was 14.

The web started to be a thing. I asked for HTML books for Christmas. Then learnt about ASP, it had something to do with Visual BASIC, I knew BASIC.

Learnt the web, got a job, worked my ass off. 12 hours day and loving it, I was 18, and lucky. My hobby was my job.

20+ years later, it's a job, programming is a skill I have and I'm extremely grateful for being so lucky that it also made me a career, allowed me to live in other countries, and ultimately settle down in a very different place than what used to be my home.

But still, it's a job now, not my hobby. After working in many different places, seeing the transformation of this industry, me getting older, it's just all a bit jading, I don't aspire to do this for more than a job these days, the only figment left of the old hobby is the odd electronics project for artists.

I have other hobbies that fulfill me in a very different way, I think it's just life :)


I guess it's those two same groups arguing about vibe coding. How many of group 1 say LLMs are too low quality when they really mean that it's diminishing their love of coding? And how many of group 2 say LLMs are the best thing ever when they really mean that they are diminishing their pain of coding?

I'm a hard group 1, and I don't really mind if LLMs take my job, just please don't take my passion.


I’m in group 1 but I do find LLMs to be helpful. I just tend to comb through their output and fix a bunch of issues. Maybe it’s not that much faster that way but it gets over the activation energy of starting a new project/module/ticket.

I do find that they’re pretty much only useful when I already know how I’m going to complete a task. If I can describe the implementation at the stack trace level I’ll do fine with AI. If I’m even a little lost the AI is a total crapshoot.


I want to challenge the statement that a sw dev is "sitting in front of a computer all day". It's like saying a professor is writing on the blackboard all day. If think about what I did today, several hours was spent talking to my manager and peers about work as well as personal stuff.

I was person 1, then I spent 13 years as an engineer, experience severe burnout, and became person 2. I am /very/ skilled, but I no longer enjoy things in the same ways I once did when it comes to computing. I don't despise it, but it no longer fuels me. I prefer to spend my time away from work indulging in other hobbies, like hiking in nature with a camera or playing board games with friends. My experience has been that turning your hobby into a job can kill all the enjoyment of the hobby.

“if I have to sit in front of a computer every day for the rest of my life I’ll kill myself.”

Heh. And then they go become a "real" engineer (mechanical, electrical, whatever), and end up sitting in front of a computer all day, dealing with poor UI and poorly designed SW because a lot of CAD tools are either built in-house or owned by monopolies who have no incentive to improve the experience.

I've lived both worlds.

https://blog.nawaz.org/posts/2016/Jan/code-monkey-or-cad-mon...


I imagine the people who say that would like a more people-facing job (like, I dunno, maybe a DJ) rather than a computer-facing one. They don't necessarily imagine being a "real" engineer as an alternative to being a programmer, they put them both in the same category.

Not the ones I dealt with.

Mechanical Engineer: I build real things that I can touch!

Electrical Engineer: I get to play with oscilloscopes, and do soldering!

You get the idea.

I think this is because as students, a lot of engineering work is either labs, or on paper. They don't realize how much dependent on computers professional engineering work is.


> I’ll never forget overhearing this quote from a fellow sophomore in the comp sci lab in college: “if I have to sit in front of a computer every day for the rest of my life I’ll kill myself.” Computer science is an interesting career choice for someone who hates computers and being with computers.

I went to college in the late 1990s at the height of the dotcom boom. Saw a bunch of people who had this same feeling.

Which made no sense to me b/c I loved programming so much that I would do my homework assignments ahead of time!


> I think the “get rich easy” reputation that software engineering gained somewhere around the 2010s really hurt the industry and a lot of people who are chasing the dollar.

Yup.

Also, "The Company is the Product," where the goal is to sell the company, and the end-users are just food for the prize hog.

Just start talking about improving software quality, or giving end-users more agency, privacy, and freedom, around here, and see the response.


OP is a decent article which just becomes fodder for the usual

1. I love my job because (1) CRUD apps are so immensely satisfying (2) turns out that optimizing ad metrics at FAANG was my innately-sought destiny (3) being acquired by GOOG is bitter-sweet because now my wife will complain that I am not retiring even though I can

2. As opposed to the normies that just have this job because they need a job


I am a mechanical engineer who browses hackernews, if you want to get up and move around get a mechanical engineering degree

Same. Maybe this AI text generator trend will bring salaries back down, the opportunists will leave for greener pastures and us mega-nerds will have the software-writing all to ourselves.

This is me too! Everything about writing code, running it, messing with Github, tinkering with my dotfiles, automations... even as a preschooler, I was always dissatisfied that my drawings didn't do anything. I feel astoundingly lucky to have a job I was born to do.

It's nice to get paid to do what I would be doing anyways.

> The type of kid who was setting up Outlook betas in 6th grade to try the new features.

Oh man, this brings up memories of me being inordinately excited about Office 2007 when it was in beta. I was in elementary school.

And memories of staying up late reading my collection of outdated tech books (Borland C++, UNIX SVR4, HTML 4, and the MS-DOS 6.22 manual were the big ones). Initially learning about programming and UNIX from those books were extremely formative for how I view programming today, and I suspect that's given me quite a different perspective on a lot of things (especially things like HTML & CGI) than a lot of other folks in my age cohort.


> I’ll never forget overhearing this quote from a fellow sophomore in the comp sci lab in college: “if I have to sit in front of a computer every day for the rest of my life I’ll kill myself.” Computer science is an interesting career choice for someone who hates computers and being with computers.

This was a discussion that came up a few times in College. I argued that with hyper-specialization, you can't satisfy a desirable balance of cerebral and manual work, socializing, and being outdoors. Pick your poison. I didn't want to do shift work at the bottom of a mine pit so here I am.

You can have flexibility in your free time to do something else. My father was always tired from shift-work and did basically nothing at leisure even as we grew up.


It depends on your ideal balance. There are jobs that involve field work, thinking, and socializing, but there are always trade offs. I find that being indoors from dawn to dusk with a 30 minute walking commute and a hike once or twice a year is my ideal balance.

Police officer actually has a really good balance of physical exertion, mental/social challenge, and indoor/outdoor exposure. And you get to write A LOT. But there are lots of adjacent roles, and many more not so close; e.g. I know someone who used to do field data collection and data analysis for some conservation nonprofit; lots of nature, physical exercise, and mental stimulation.


You're right. Some with a academic slant I knew took biology and ended up working as park conservationists. That allowed them to be outdoors and do assessments for research.

I'll also concede that some proponents for trades will argue that their work is cerebral, but this probably depends on the job. Dev can be like that too. I knew union guys who would describe their work as pretty rote and dull despite the long hours (even for electrical), and others who'd say it was interesting.


But sitting in front of computers isn't what computer science is about, and some of those students might have aspirations to change the HCI status quo.

Software engineering and computer science seem to have two strict criteria to consider and neither of them is the same sort of continuous, analog suffering as wearing large shoes or practicing shooting a basketball. These criteria are

1) can you solve hard problems? 2) do you want to continue solving hard problems?

At least to me it seems that those two things take more effort and willpower than anything else in software. So I don't think challenging a person about whether they would love to sit in front a computer all day is the right approach.


> somewhere around the 2010s

It was there in the 90s


Far less prominently. I'll never forget when a programmer I worked with in 2001 or so said that he had decided to study CS in college for the money, having never written a line of code beforehand. The rest of us looked at him like he had squeezed a second head out of his neck. We had first gotten into it as a hobby and were later surprised to find that we could get paid for it. Only a few of us had CS degrees or had even taken CS coursework in college.

Yeah. I learned programming in high school in the mid-80's and was hooked. I liked electronics too, and got a BSEE. But took a summer job writing code and never looked back... still coding now, professionally.

My analogy is that the 80's and 90's were like the "Golden years" of software jobs... maybe like being in the aircraft industry was in the 30's. Lot's of learning and discovery and fun to be had. Working in software now is probably like I imagine being an aeronautical engineer at Boeing now... you'd better be prepared for being satisfied working on some small part of a much larger and complex system and moving at a glacial pace (compared to the Golden years).

(And yeah, the workplace now is flooded with people who seem to be here because they heard it paid well.)


My Information Systems major in college had 6 graduates in 2006. It had been over a hundred a few years prior.

1) I LOVED computer science school

2) I really love certain aspects of being a software engineer.

3) I have definutely said Ill kill myself if I have to sit in front of a computer for my entire life

4) this job will afford me a future where I can retire at a reasonable age. Whereas a non-computer oriented alternative (the other career available to me was house painting) will not.

Therefore I will bear the monotony of sitting in front of a computer all day for a few decades


True, teamblind.com shows how horrible people have become software engineers. no wonder software quality has become very bad

> Computer science is an interesting career choice for someone who hates computers and being with computers.

Dijkstra famously wasn't exactly keen on computers.


I haven’t heard that, but if it’s true, it’s probably because he enjoyed math more than engineering or programming.

Computer science as a branch of mathematics has a long and fruitful history

Or to be more pithy, nobody accomplishes what Dijkstra did without liking their work. I’d say it’s zero people


> Computer science is an interesting career choice for someone who hates computers and being with computers.

Well, people who do real computer science don't program a lot, it's all theoretical math. Computer science has as much to do with computers as astronomy does with telescopes.


That's why the real term is computing science.

I think I relate with most of the things you've said, even with the ADHD part (not officially diagnosed, however) but what annoys me these days is the amount of work we have to do. The work is rewarding but very often just * too much *. Maybe I'm unlucky or maybe it is the companies I worked for...

For the same reason i chose not to go into computer science, changed to a different degree after 1st year in college, best decision.

What you really need in life is financial independence and then you can choose what you want to do.

Wish you all financial independence.


I think there are a lot of people who liked programming until it became a job.

I actually find i tend to dislike non-programming computer activity. Love programming, but if someone suggests taking notes with a laptop instead of paper, my reaction is ewww computers.

> Computer science is an interesting career choice for someone who hates computers and being with computers.

Sometimes the interest just fades. What stimulated me at age 14 no longer does at age 36.


Yes, and that’s what windows does on touch screens going back a long while.

iOS makes pretty heavy use of right click menus (e.g. on the Home Screen, in Mail). It used to be Force Touch/3D Touch, which is superior, but has more learning curve and doesn’t scale to iPad.


If you have quality news sources you hear about these things all the time (e.g. Economist).

One reason Israel gets so much attention in the US is that US taxpayers are underwriting the war; both by selling arms and by defending attacks on Israel. So in other words, every tax paying US person who works is working hard every day to further genocide. It is a bitter pill to swallow, and highlights the contradictions and hypocrisy of US foreign policy.

My tax dollars are not as clearly implicated in the wars in Sudan, Ethiopia, Syria, Myanmar, or the various other genocides.


They were implicated in Yemen.

The problem with paying ransoms is that even if it actually is the most cost effective solution in any one case, it just creates the incentive for more rapacious behavior.

I think I'd be willing to pay $800 of my time to disincentivize that behavior.


It’s a shakedown scam. IANAL and all that. Gaming it tells me it’s easier to remove the offending focus and ignore them until they send another nastygram. Never directly reply. Dave’s not here, man. Anybody doing this bullshit over an open graph image is looking for a mark. Generally, that’s why there are three strikes policies, etc. Why engage until they initiate? You speak through lawyers and they really have to have a real case or they’re wasting money because this is purely not malicious or profit seeking.

Article does not make the case for why you must keep up.

AFAICT the best strategy would have been to completely tune out AI for the last ~3 years:

- AI has not meaningfully improved productivity (unless you’re doing something super basic like react and were already bad at it). If you are using AI in a transformative way, that looks different today than it did 6 months ago. - AI has not stolen jobs (end of ZIRP did that) - The field changes so fast that you could completely tune out, and at any moment become up-to-date because the news from 3 months ago is irrelevant.

I don’t get where this meme that “you have to keep up” comes from.

You have agency. You can get off the treadmill. You will be fine.


I have been tuning out for the last ~3 years and unfortunately it hasn't been the best strategy because the hype is still running roughshod all over me

It is very likely my employer will use my AI apathy as an excuse to include me in the next round of layoffs, compared to my coworkers that are very AI enthusiastic


Maybe that would even be justified, if you are a software developer? If not now, at least soon.

Imagine a software developer who refuses to use IDEs, or any kind of editor beyond sed, or version control, or some other essential tool. AI is soon similar, except in rare niche cases.


Version control is different since it’s collaboration with the rest of the org.

The rest: if they are just as productive as others, I would not care one bit. Tool use as a metric is just bad.


I've met many people smarter than myself who object to all of those.

One professor thought syntax highlighting was a distraction.

Lots of colleagues used vim/helix instead of IDEs.

I haven't met anyone who refused version control from an intelligent standpoint.

The most reasonable objection to AI from people who don't hate it are:

  I just don't know how it could help me; it's not as skilled as me at my job, and I'm already doing fine.


They're not that hard to learn how to use. If your employer asks you to use one then just learn whatever tool the license you for, it's not that big of a deal. It's like learning how to use your employer's official IDE or email client.


What exactly am I supposed to learn?

Cursor is just VSCode with annoyingly slow intellisense and bad code suggestions, what is there to learn, genuinely?


The article uses "why" in the title, but does not follow through with an answer.

It sort of hints at one reason:

> The most common errors of misunderstanding are either underestimation (“it’s all hype that will blow over”) or overestimation (“I don’t need programmers anymore”). These patterns are rooted in a lack of a solid understanding of the technology and how it is evolving over time.

So if you don't at least find some middle ground between those two poles, you will make uninformed choices.

But I agree: It is safe to ignore AI for now.

I do sense that some people attach to AI because of a fundamental anxiety that it might transform society quickly and detrimentally, because that's part of the hype speech ("it will murder us all, it will make us all unemployed, it will turn us into slaves, maybe you can ride the dragon, and maybe you must").

---

> AI has not meaningfully improved productivity

This is contended.

As the article says, we are in one of the most polluted information environments.

People will say "It's absolutely useless" and "It has fundamentally changed my life."

So neither extreme can be taken at face value as representative; they're samples of a murky picture.

> The field changes so fast that you could completely tune out

It's not that fast, in my opinion. Last big steps:

  - Transformer architecture (2017)
  - Larger models with greater performance (2020-)
  - Chain of thought (research in 2022, commercial breakthrough in 2024)
  - Agents (since forever, but 2022 for GPT-based agentic frameworks)
Other things happened; for example, DeepSeek making an architectural breakthrough and challenging the financial model of open/closed weights.

But most of the hype is just people trying to make commercial success on a few cornerstone breakthroughs.

In one to two years, maybe we can add one more major advancement.


If you have such little regard for formatting that markdown suffices, you also don’t care about the difficult edge cases of docx.


I was wondering the other day about something like this for retro computing hardware, including game consoles.

You can buy a device that looks perfectly good, but has rusty parts, leaking capacitors, shoddy/counterfeit replacement parts, and who knows what else. And if it wasn’t previously opened (they seemingly always are), you don’t know what was done to it.

I don’t think you can really solve that through tech, it’s really more of a record keeping issue. Which actually seems to be mostly how carfax works?

I’ve thought about fixing up consoles and selling them (more for cost recovery and to free up space than for profit), but I wonder about how to share information about the work and the risks in a way that the purchaser is likely to understand and appreciate.


I also have one medical, (cheaper if you have Prime), but they don’t do ozempic/wegovy, so you’re still at the mercy of insurance, or paying out of pocket if you want GLP-1s.

They’re still a great option if you have other needs, like Prep or stimulants.


> Regulatory arbitrage disguised as innovation, dressed in the fashionable vocabulary of patient empowerment while serving no master but the quarterly earnings call.

No masters except the patients that are literally being empowered to make choices about their medical care and are paying a substantial premium (in many cases) to do so.

I would happily be empowered by my doctor and UnitedHealthcare instead, but sadly that’s not on the table.

Try getting tretinoin from a real doctor; I’ve been written prescriptions multiple times, never once succeeded in actually getting it, because insurance is a fucking nightmare. And I’m not on a cheap plan.

Also note that the compounded semaglutide is superior because it comes in adjustable dose vials, unlike the pens. But I’m sure the author would claim that taking a smaller dose to reduce side effects is “a dangerous and unproven approach to medicine that puts patient lives on the line purely for profit”.


Tretinoin is easily prescribed by seeing a dermatologist. What do you mean it’s a nightmare to get even with a prescription? I think a tube of cream cost like $10 at Costco. You don’t even need to use your own insurance to buy things from the pharmacy as long as you have a prescription. I never once had a problem filling it before I switched to Accutane.


My doctor keeps prescribing it and the pharmacy keeps not filling it. I’m not really sure what’s going wrong, I haven’t taken the time to debug the situation. I shouldn’t need to, and I’ve never needed to with hims.


So you’re not even willing to look into the issue, or understand what your problem is. You could have resolved this with like two calls to your pharmacy, but whatever keep shilling hims lol


I was able to buy it two times from an Indian website. I have no concerns about its safety profile.

Fuck the AMA gatekeepers. Bodily Autonomy means I should get to buy and use any medicine I decide it worth my personal risk assessment.


I'm confused. An insurance company cannot reject a prescription. They can only reject paying for it.

So if you're paying for it with Hims why wouldn't you be willing to pay for the medication the doctor prescribes to you if the insurance company is refusing to pay for it?


> An insurance company cannot reject a prescription. They can only reject paying for it.

That's a distinction without meaning. Say an insurer won't pay for cancer treatments. Although they're not technically telling you that you can't have the treatment, for all practical purposes they absolutely are (unless you're so rich you can eat the cost).

The article talks about Semaglutide, which is $750/month from a traditional pharmacy after UnitedHealthcare rejects paying for it, or $300/month from Hims. If you believe the medicine's substantially the same between those sources, why wouldn't you take the $5400/year out of pocket discount?


The egregiously heinous thing, in my view, is how a half dozen states still have some kind of health insurance mandate in their laws, and up until 2019 the ACA required all Americans carry it.


Yeah, please don't repeat this. This is the same thing that insurers say to Congress for other things too. "We're not denying care, we're just not going to be the ones paying for it", be it cardiac surgery, or (in the case of United) even Heli EMS from MVAs, because it wasn't "pre-authorized".


I’m not sure what exactly the issue is. The doctor prescribes and the prescription never gets filled. I assume the insurance said no and the pharmacy just decided not to fill it, they’re pretty inconsistent about what information they give out.

Meanwhile with hims I order it and I get it.


> Try getting tretinoin from a real doctor; I’ve been written prescriptions multiple times, never once succeeded in actually getting it, because insurance is a fucking nightmare. And I’m not on a cheap plan.

Deviated septum with 90% occlusion in one nostril, see an ENT, also on a "platinum" plan. "Great, let's schedule surgery." ENT: "Hold fast. First, I'm going to prescribe you these two nasal sprays so you can come back to me in four weeks and tell me that, to our mutual surprise and disappointment, they didn't realign the cartilage, and that way, insurance will pre-authorize the surgery."


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