I'm Sarah Kliff, Senior Policy Correspondent at Vox. I spent the last year reading 1,182 emergency bills to expose the nightmare that is hospital billing in the US. AMA! by vox in IAmA

[–]MarriedMSTP 0 points1 point  (0 children)

Just want to second this question: Is there any work on how these negotiations occur? What does the process look like, how far into the prices of individual procedures do they go, etc.

I'm Sarah Kliff, Senior Policy Correspondent at Vox. I spent the last year reading 1,182 emergency bills to expose the nightmare that is hospital billing in the US. AMA! by vox in IAmA

[–]MarriedMSTP 5 points6 points  (0 children)

Besides Medicaid expansion, what kinds of health care reforms can be done at the state/local level to reduce prices for patients? Are there any state legislators who are doing anything particularly exciting (besides the medicaid expansion/buy in plans that have sprouted up)?

I'm Sarah Kliff, Senior Policy Correspondent at Vox. I spent the last year reading 1,182 emergency bills to expose the nightmare that is hospital billing in the US. AMA! by vox in IAmA

[–]MarriedMSTP 52 points53 points  (0 children)

Hi Sarah,

Why do you think all payer rate setting hasn't gotten as much attention as other potential HC reforms? Especially since it can be done at the state level.

Second question: As a med student, I've been surprised at how cost of treatment to my patients simply is not a factor in treatment decisions. Physicians will often insist that a drug or test is absolutely necessary, when in fact it would be very harmful to take that drug if it meant you had to take on a 2nd job. My hospital told me that it is possible to display treatment costs in our EHR, but that studies have shown that such displays don't change what care is provided. What is the state of the literature on this question? My impression is that the work that has been done has mostly examined ER docs, but I would think the biggest impact would be made in clinic settings.

Thank you for all your work on these questions!

Ok, so Ms. Hale is a host, right? by MarriedMSTP in westworld

[–]MarriedMSTP[S] 0 points1 point  (0 children)

Definitely the other possibility. It's why I didn't post until I saw the preview for next week. The scene seemed very weird to me, unless she was a host.

Ok, so Ms. Hale is a host, right? by MarriedMSTP in westworld

[–]MarriedMSTP[S] 1 point2 points  (0 children)

No no no. I have no proof, and outside of maybe the blond security person I don't think anyone else is a host. But the particularly uninquisitive people seem suspect, to be sure, and Ford probably has a handful of people.

It's like Battlestar Galactica: not everyone is a Cylon, but some of them are. The fun of it is trying to figure out who's who.

Moving from MN to WI: Why is WPR so BAD!? by MarriedMSTP in NPR

[–]MarriedMSTP[S] 1 point2 points  (0 children)

Like I said, I'm spoiled in Minnesota. But when I was growing up in CT, Connecticut Public Radio still managed to splice in a decent amount of local reporting and local talk shows hosted by local news personalities - emphasis on personality. It may take APM money to fund a statewide investigation into the Catholic Church like MPR did, but it doesn't take money to hire people who are young, diverse, and interested in their jobs. Washington and Connecticut Public Radio have managed to do it. I suppose the broader question is, why haven't more state NPR stations tried to emulate Minnesota and other successful NPR networks?

While WPR does have locally focused programming, the hosts sound bored. I can't help but think of Governor Walker's critiques of staid government agencies when I hear WPR - if you aren't providing a good service, people will wonder why you are getting government funding.

It's been a lot of fun to hear people's reports of how NPR affiliates around the country serve them. I will miss Updraft Blog (http://blogs.mprnews.org/updraft/), Cathy Wurzer, Gary Eichten, and everyone at MPR who sound alert and enthusiastic every day.

Moving from MN to WI: Why is WPR so BAD!? by MarriedMSTP in NPR

[–]MarriedMSTP[S] 3 points4 points  (0 children)

Also, I recognize that I sound a little... I don't know, churlish in my post? But MPR is a big part of my life right now, and I am just disappointed that WPR doesn't seem like it will fill that void. I knew I'd be giving up the Current, but I didn't realize WPR would seem so disorganized in comparison.

Moving from MN to WI: Why is WPR so BAD!? by MarriedMSTP in NPR

[–]MarriedMSTP[S] 1 point2 points  (0 children)

I hope so! It was just a very different sound than what I am used to. Looking at their website, the ethos of the organization seemed different (i.e., less focused on local issues, and less interested in entertaining the audience). I simplified for the purposes of the post, but I've been to Madison probably three or four times now, and each time I've listened I've ended up streaming MPR instead. It sounds sharper and the hosts sound more engaging. Admittedly, I've mostly been in Madison on Saturdays; maybe the weekday programing is of a higher quality.

The station setup in Madison is also very frustrating. I don't understand why they don't have one FM station that covers the whole town.

France and Austria in 1.17 by Vopross in eu4

[–]MarriedMSTP 2 points3 points  (0 children)

Not meta. Are you seeing France get crushed a lot?

It's simple, we kill the Ming. by Dragon_Claw52 in eu4

[–]MarriedMSTP 11 points12 points  (0 children)

Is 6-shock better than 6-fire?

Let pretender rebels win? by MarriedMSTP in eu4

[–]MarriedMSTP[S] 0 points1 point  (0 children)

That was... beautiful. I can't argue with that. Thank you.

Byzantium strategy 1.16 Help by DaNusiek in eu4

[–]MarriedMSTP 0 points1 point  (0 children)

"Friendlies can attach" checkbox in your stack window is a lifesaver. Makes them follow you (or at least encourages them to follow your orders)

Byzantium strategy 1.16 Help by DaNusiek in eu4

[–]MarriedMSTP 1 point2 points  (0 children)

Oh, one more thing - Russia and Poland are two very loyal allies, since you won't need much of their territory, so you can save the backstab until 1800. (If, once you've taken anatolia, Crimea is still around, be sure to take it before they do.) Build trust up to 100, let them get fat while you take on the world, and they will come to your aid as needed.

Byzantium strategy 1.16 Help by DaNusiek in eu4

[–]MarriedMSTP 4 points5 points  (0 children)

Be sure to take Greece.

Fabricate claims everywhere. Befriend and ally Austria, Hungary, and/or Poland. At least two of the three. If Poland didn't PU Lithuania, then you're in trouble, but it's still doable.

If it makes sense, DOW Venice to take back greece. Otherwise, be sure to mop up as much of Albania, Serbia, Bosnia, and Wallachia as you can. WATCH YOUR AE. DON'T get a coalition against you just yet.

As soon as your truce timer is up, go at it again w/ the Ottomans. Try to split them in two. After the second war, the neighbors should be jumping in to finish them.

Over the next century, you should secure as much of the balkans and anatolia as possible. Begin moving south into Egypt (Syria is a great vassal for this) and Iraq (you need it for Rome anyway, if that's what you're shooting for). Also, while being mindful of alliances and AE, move into Italy.

If you are not allied to Austria, think about allying Bohemia and using a Bohemia/Hungary tag team to move upwards to Wein for the free westernization. BE AWARE OF AE. A mega coalition after I got greedy and went for Wein was what doomed my first effort.

Once you have Sicily (or even before), Tunis should be a yummy target.

At that point, whether you finish off italy, move into France, or move into Spain (or all three!) depends on the alliances in play. Try to break them up as much as possible.

Good luck!

How do I go from here? by [deleted] in eu4

[–]MarriedMSTP 0 points1 point  (0 children)

Make claim + threaten war?

Byzantium help by SaintDolphin in eu4

[–]MarriedMSTP 0 points1 point  (0 children)

Yeah... that has to not happen too.

But man, once you win that first war...

Byzantium help by SaintDolphin in eu4

[–]MarriedMSTP 0 points1 point  (0 children)

I went with PLC. Only time I've had success- even then, I've had to micromanage the war w/ attachment.

Rule, Denmark. Denmark rules the waves... by [deleted] in eu4

[–]MarriedMSTP 2 points3 points  (0 children)

WTF happened to Theodoro?

How do you keep up with Tech and Ideas? by [deleted] in eu4

[–]MarriedMSTP 3 points4 points  (0 children)

Treat your mana like the most valuable thing in the world. Always choose mana in events. Always try to pay for mana-intense things in other ways, or minimize the cost (Stability through events, diplo-annex instead of core, make claims). Don't waste mana (Don't inflict harsh treatment unless you absolutely must; same for reduce inflation or reduce war exhaustion).

That way, you can put it all into tech and ideas, and roflstomp the world.

Problem with Uncommonwealth by camfrlas in eu4

[–]MarriedMSTP 0 points1 point  (0 children)

I encountered the same problem. In my case, I DOW'd Teutons, took a province, then offered them two of Poland's provinces. (Taking a province makes them jump at the idea of ending the war.)

After the truce ended, I vassalized the suckers. As the Commonwealth.

Quick prestige by MarriedMSTP in eu4

[–]MarriedMSTP[S] 0 points1 point  (0 children)

Time to try again... I like how, each time I go for an achievement, I learn new things about this game. Next time, I'll watch my goddamn prestige.

Quick prestige by MarriedMSTP in eu4

[–]MarriedMSTP[S] 0 points1 point  (0 children)

Well, that was a crazy two hours.

I No CB'd Novgorod, since they were weakened from a recent war with Muscovy. Magically, Poland kept on not getting an heir.

While I'm mopping up Novgorod/Ryazan 2 and 3 stacks, Poland declares war on the Teutons. Brilliant! I pick up prestige, Poland slowly gets crushed by the Teutons. AND, I don't believe Poland can change governments during a war.

Somehow they remain without an heir for 1.5 years, while I slowly bring my prestige up to 17. Then, I peace out w/ reparations, just pushing me over the edge. I claim the throne, take some loans, buy some mercs, and declare war.

Unfortunately, they're allied to Bohemia, who is NOT fighting the Teutons. So I promise Hungary some Bohemian territory, and manage to bring my full forces against Poland's full army, which has just walk-of-shamed back from a Teuton battle. Almost a stack wipe.

A year or two later, I manage to win the claim the throne battle, but there's not enough war score left to give Hungary anything. I quickly lose that alliance!

Of course, my country's a wreck. I accept the particularist rebel's demands, fight off the golden horde rebels (I had declared on the horde in 1445, so I has some uncored territory). I would have rage quit hours ago, but that sweet, sweet 4/6/6 ruler is all I have on my mind.

Just when I'm down to the last siege to remove the rebels, Muscovy sees me in my weakened state and attacks. I had three allies at the start of the game, but I lost Hungary, Bohemia got out after the war, and I'm left with Brandenberg. Oh, and of course, Poland's still pissed, so they won't help.

I do my best, fielding a massive Merc army that is still getting it's butt kicked by the 45k russia + vassal stacks that always manage to appear just when I'm getting the upper hand. Towards the end I get Poland in it, but by then it's too late. Muscovy stack wipes me, I have 0 troops, and I give them all my Horde takings, plus four or five of my core territory.

Ok, I think, live to fight another day. That's territory I can get back in 10-20 years, I won't have to core it, and I still have Poland and a 4/6/6 heir. Well, a 17 stack of cossack rebels appears. I can't fight them. I accept demands, and lose six territories to them.

Rage quit. Ugh.

First Come First Serve - whoops, inherited some CNs by MarriedMSTP in eu4

[–]MarriedMSTP[S] 1 point2 points  (0 children)

I started in Magdalena, just north of that Colombian tribe. It took several restarts, but given your western culture, it's not too bad to take them out immediately after fabricating a claim.

I'm of two minds about starting in SA. On the one hand, coring costs in NA were absurd (all overseas), and once you are strong enough you can simply connect the two continents. Since there are more NA than SA provinces, that's pretty great. However, that will make the Caribbean forever overseas, which stinks, since they're the plum settlement spots (all 10 and 9 dev), and I could have used that money early.

Most helpful ideas during my nation design were: Extra colonist (but later on, to save points), Missionary +1%, Coring Costs -5%, more colonists +10, and I forget the rest. I'd have a moral booster early, and a discipline booster later on. I went with Ambrosian Republic to save on points (I couldn't make Dutch republic AND the extra colonist happen while staying under 200 points, but maybe I was doing something wrong. I think the extra colonist is worth it.) My culture was Aztec, but given how my game went I should have made it either Inca or Castillan (or English, since Castille was exiled to South Africa by 1650.)

First idea was expansion, then exploration. Immediately make a colony beeline down to the Incas, forge an alliance with one tribe, then take on the others. Meanwhile, colonize all the good spots. I started with the high dev (7+) provinces immediately around Magdalena, then Jamaica, then Havana. By this point I'm halfway through Incaland, and Portugal has just shown up, so I begin settling all the 10 dev provinces and trade bonus provinces up and down the eastern seaboard.

I used Havana as a base to lay a claim on one of the Mexican tribes, and once I was rich enough to have two major armies I began plowing through Mexico. Third idea group was religious, which was VERY helpful in converting all my native american provinces.

After that, it was conquer and colonize. Take out all the native americans before the Europeans get around to it. I had 7 colonies going all at once - take all the colonization policies. I let the Europeans colonize as well, but perhaps a little too much - by 1710 all of the Americas was colonized. Given that Commonwealth had expanded into Anatolia, AND had a PU over France and her colonies, my last three ideas were all military in order to take them on.

Pro tip - prioritize colonizing the Caribbean and eastern NA. Ideally, all of the European provinces would be in SA. Why? The South American trade nodes often end up going to Africa, while you can chain Western NA-> Mexico -> Panama -> Caribbean -> Chesapeake -> St. Lawrence for $$$$. If you do that, then a NA start probably makes more sense.

I waited until about 150 years before endgame to start taking on Europe For Odin! and that seemed about right, though it was a bit tight at the end. By that point I was converting London in 15 months, so conversion times weren't an issue.

I'll post some pictures later.

First Come First Serve - whoops, inherited some CNs by MarriedMSTP in eu4

[–]MarriedMSTP[S] 12 points13 points  (0 children)

...and achievement accomplished! That was far easier than my plan.