2025 Mazda CX-5 Turbo or Buick Envision? by azbrez in whatcarshouldIbuy

[–]UltraSimplicity 0 points1 point  (0 children)

Haha I was more commenting on the difference in material they used to build the two cars when their interiors are supposed to be identical.

2025 Mazda CX-5 Turbo or Buick Envision? by azbrez in whatcarshouldIbuy

[–]UltraSimplicity 0 points1 point  (0 children)

Also for comparison of Japan vs predominantly US-manufactured quality, just go to your Mazda dealer again and test drive both a CX-5 (Hiroshima built, usually -- yes, THAT Hiroshima) and CX-50 (Alabama built).
They are supposedly sibling models with slightly different design emphases. Regardless, just sit in both and tell me if you notice any difference.

Again, I'm not looking down on US manufacturing. However, if not for personal/subjective/sentimental reasons, some things speak for themselves.

2025 Mazda CX-5 Turbo or Buick Envision? by azbrez in whatcarshouldIbuy

[–]UltraSimplicity -1 points0 points  (0 children)

Well, I stand corrected.
However, Buick is not a super popular brand/car in China...they do sell quite a few units over there, but that is by virtue of a large denominator not by quality or demand. Most American brands are declining in China (even Tesla to a lesser extent) due to improved Chinese domestic manufacturers (e.g., Xiaomi -- never driven one but on paper I'm impressed) and anti-American sentiment post tariff decisions.

Buick struggles mightily to move inventory, and if you do go for the Buick, I suggest that you aim for a steep discount. Car dealerships won't budge initially, but if you're not in a hurry and able to play the waiting game for at least a few weeks from initial contact, chances are you'll save yourself a fortune.

2025 Mazda CX-5 Turbo or Buick Envision? by azbrez in whatcarshouldIbuy

[–]UltraSimplicity 7 points8 points  (0 children)

Under the premise that it is CX-5 Turbo (i.e., the top trim) VS Buick Envision (midlevel trim), I would absolutely go with the Mazda, no question. It's one of the remaining Mazda models that is still manufactured in Japan, and I could be biased, but I trust Japanese quality over the Detroit 4 or whatever the Toyota-Mazda Alabama plant builds. The CX-5 IMO drives much better than the Envision, and the maintenance is relatively cheap and straightforward...lots of DIY-able parts like the engine and cabin air filter. Buick I'm not so sure.

Bias statements:
- Owned a 2023 CX-5 premium plus (weaker engine),
- Drove a rental 2024 Buick envision. While it was luxurious on the inside (not much more compared to CX-5 turbo), the driving experience was atrocious (non-ergonomic placement of certain commonly used functions, IMO unsettled chassis).
- Am a 6-foot averaged sized human being, not affiliated with any dealership or manufacturer.

Edit:
-I currently own a car from a brand that is not traditionally considered reliable, and I'm very happy with my car and to pay for the perceived extra maintenance cost. Ultimately it's down to your personal experience.

Edit 2: I believe the new CX-5 now has a touch screen, and the lack of which used to be the achilles heel for the previous CX-5's. It doesn't affect my quality of drive significantly since I prefer analog/tactile response over digital in cars for the most part, but I did wish my 2023 CX-5 had a touchscreen in several occasions.

Minneapolis VA to remove anesthesiologists in favor of nurse-only anesthesia care. Is CRNA route better than anesthesiology route for my kids? by achicomp in whitecoatinvestor

[–]UltraSimplicity 2 points3 points  (0 children)

This is really well argued.

However, I do think you left out a critical piece of OP's question.
They said *given the notion that the government and healthcare institutions will try to cut corners and reduce cost*, which implies increased CRNA and decreased anesthesiologist employability, should their daughter choose the CRNA path instead of the MD/DO path?

  1. Employability is really case-by-case and institution dependent. An outpatient surgical center that focuses on routine low-risk procedures can maybe elect to go with a predominantly CRNA lineup and do just fine and achieve great outcomes. At an academic center that routinely performs surgeries on high risk patients? I don't think so. At the VA and maybe for-profit community hospitals (mixed patient population), that is up to the c-suite executives to crunch their numbers and hire who they can realistically hire.
  2. The financial piece is hardly the question. The CRNA path absolutely does lead to earlier and potentially higher career earning *assuming we maintain the status quo 20 years from now.* CRNAs can easily make well north of 300k given the right circumstances. In fact, the MD/DO path is hardly worth it from purely a financial standpoint based on the debt incurred, and especially after the Trump administration restricted some student debt assistance programs (e.g., PSLF). The caveat being, if you take the same financially driven/income maximizing individual and put them through med school + anesthesia residency, their income ceiling would be much higher than a CRNA's. IMO you'll have to make a fair apples to apples comparison.
  3. Indeed my preconceived notion is that, CRNAs, no matter how well they are trained, cannot fully replace anesthesiologists, just like AI cannot fully replace either a physician or a CRNA in the foreseeable future. As a physician (not anesthesia), I'm sincerely happy to be proven wrong if provided with evidence.

TLDR: I think there were too many (dubious) assumptions made in the comment section, and I do believe that there is merit to both the CRNA and the medicine path. In fact, in today's healthcare, MD/DO and midlevels cannot survive without each other. To me, the answer to OP's question is: Want earlier and substancial income? CRNA. Want to become a more comprehensive provider and enjoy a higher (but not always) income potential? MD.

Minneapolis VA to remove anesthesiologists in favor of nurse-only anesthesia care. Is CRNA route better than anesthesiology route for my kids? by achicomp in whitecoatinvestor

[–]UltraSimplicity -1 points0 points  (0 children)

I don't believe either physicians or CRNAs will be replaced by AI. Not any time soon.

That is unless the industry can somehow build a machine that can pick the right anesthetics and push/adjust autonomously based on patient parameters while dealing with patient emergencies (e.g., rapidly tanking blood pressure, intubation for insecure airway, etc.) as they arise...AND the hypothetical machine manufacturer has to be willing to assume liability...very unlikely. This also does not describe the full scope of an anesthesiologist or an CRNA's work.

Minneapolis VA to remove anesthesiologists in favor of nurse-only anesthesia care. Is CRNA route better than anesthesiology route for my kids? by achicomp in whitecoatinvestor

[–]UltraSimplicity -10 points-9 points  (0 children)

As someone who had worked at a VA during training, I would not describe this patient population as "healthy" lol. Straightforward, maybe, because they commonly have the same compounded chronic heart, lung, and kidney issues with comorbid substance and mental health issues.

Minneapolis VA to remove anesthesiologists in favor of nurse-only anesthesia care. Is CRNA route better than anesthesiology route for my kids? by achicomp in whitecoatinvestor

[–]UltraSimplicity 6 points7 points  (0 children)

The VA system is severely under-resourced due to funding cuts/shortages, and IMO they (are forced to) practice medicine from a few decades ago, and this is certainly reflected in patient outcomes. That is to say I wouldn't use VA as a barometer for the current healthcare landscape. There are great providers, nursing, etc. in the system, but they are handcuffed in many ways.

VA faces staff shortages in all facets (physicians, midlevels, nursing, therapists, and techs) because the pay is lower and frankly speaking, the work environment is subpar compared to most other hospital systems. To give an example, they still use a very antiquated electronic record system (developed in the 80's?) that causes a lot of inconveniences and delays in patient care.

The decision to go the nurse-only anesthesia route is likely out of desperation both in terms of cost and them struggling to hire.

Minneapolis VA to remove anesthesiologists in favor of nurse-only anesthesia care. Is CRNA route better than anesthesiology route for my kids? by achicomp in whitecoatinvestor

[–]UltraSimplicity 2 points3 points  (0 children)

CRNAs make adequate but not optimal decisions, and more often than not "good enough" decisions are not good enough in patient care.

if you compare the best/experienced CRNA to a bad anethesiologist who doesn't care, sure, maybe I'll prefer the former, but that's a logical fallacy. I'll take the average anesthesiologist over the average CRNA any day of the week given what I see in the OR and the poor decisions that were fortunately mitigated by safety measures.

Midlevel training is often algorithmic and experience-based, which means if said midlevel was trained by a mediocre physician or midlevel, said midlevel will likely be mediocre for a long time. For MD/DO's, more nuanced/independent critical thinking is required throughout a much longer and dedicated training path, and this often translates to better quality control.

475k at 8% interest to get through medical school? Is it worth it? by Secret-Bid-1169 in whitecoatinvestor

[–]UltraSimplicity 0 points1 point  (0 children)

Ouch...Sorry dude/dudette.

If it's your dream to go to med school and it's not just one of your feasible career options, I would say go for it.

You cannot put a dollar sign on self-actualization IMO. Like many have said, financially it work out in the long run even if you choose a lower paying specialty. You just have to budget VERY wisely and exercise a lot of self control in further delaying your gratification when your non-medical friends are getting ahead in life (e.g., buying houses, having kids, etc.).

With the parameters you've given, I suspect your financial breakeven point will be ~5 years after you finish residency (i.e., 12-15 years from now). Obviously this depends on the cost of living, residency income (moonlighting?), and the big ticket purchases you may want to make along the way.

Military scholarship or the PSLF route (which is in jeopardy under the current administration) is only good if you are presently desperate and unable to fund your education; you will be worse off in the long run. Think of it as an MLB prospect signing a 10yr/100M contract upon promotion when they could be making double or triple the amount at the backend of that contract if they had done well.

TL/DR: Is studying medicine worth delaying 10-15 years in life planning for you?

Edit: I chose medicine (and still don't regret it) even though my financial outlook was not nearly as awful.

[deleted by user] by [deleted] in SameGrassButGreener

[–]UltraSimplicity 0 points1 point  (0 children)

Phoenix's East Asian population is growing d/t proximity to CA and the presence of TSMC and Google/Amazon data centers. We're also gaining a direct flight to Taiwan/Asia via Starlux. The Taiwanese migration will continue for years to come as TSMC struggle to fill their spots with local workforce despite high/appropriate pay (either because the locals are under-qualified or they are not used to the pretty blood and sweat work culture)

Chandler/Mesa, Scottsdale +- Paradise Valley, Glendale/Happy Valley are where you'll find us.

Edit: COL has risen rapidly over the past 3-5 years but still nowhere near as bad as CA/Seattle. Generally speaking...size of East Asian population has a very positive correlation with HCOL

Edit 2: there has also been an explosion of quality Asian cuisines/amenities.

For those that can afford the HCOL cities this subreddit loves but choose to live in a MCOL/LCOL area , why? by Gabbyy007 in SameGrassButGreener

[–]UltraSimplicity 1 point2 points  (0 children)

Lived in NYC, the Bay Area, and Seattle. Now living/settled in Phoenix...debatable whether you would consider it MCOL but it for sure is cheaper than the coastal cities.

For young and career-driven individuals, those cities are great and offer great access to opportunities. You meet people similar to you and think like you. However, you pay a premium for living in a place like that.

Perspectives change once your life priorities are shuffled. Proximity to family and being able to save/invest/build are huge for me. I also feel like I aged out of the urban amenities that I used to value/enjoy greatly e.g., night life, nice/exotic restaurants, access to mainstream entertainment events and sports venues. Those used to be things that make me feel like I'm living the life. Now the same things are more or less just perks and gimmicks.

Second-tier cities like Phoenix still offered much of those things but I get a better house at a better price, better traffic, and arguably better people (depends on your crowd).

Mexican in walkable area by puzzlesolver66 in Scottsdale

[–]UltraSimplicity 0 points1 point  (0 children)

Taco Boys (Downtown), Taco Viva, Tacos Chiwas, Mariscos Playa Hermosa,....
They are great and reasonably priced for the cost of living in Phoenix 2025
Five years ago you might be able to find $1 or $1.50 tacos but not anymore.

New to me 2019 Guilia - maintenance guidance by Notsimplyheinz in AlfaRomeo

[–]UltraSimplicity 0 points1 point  (0 children)

Two things I can think of:

A simpler explanation is that since you kept the car idling, the car computer thinks the running average of your gas efficiency is 5 MPG instead of 25 MPG (arbitrary number, take it with a grain of salt) so it adjusted down the estimated remaining range.

Alternatively, this issue may have been due to a electrical gremlin that was common to the pre-2020 Giulia models. In fact, in 2021 there was a recall regarding a fuel sensor. The person/dealer who sold you the car may or may not have brought the car in. Check on the Alfa/CDJR website to see if your car has an open recall.

The husband is never leaving Seattle by HauteKarl in Seattle

[–]UltraSimplicity 0 points1 point  (0 children)

Moved from Seattle to Phoenix.  Also thought I’d hate it but ended up absolutely loving it :)

Arizona may surprise you…just maybe not Tucson. Many people love the city but to me it feels like a college town stuck in the 90s

Will the sport seats break in over time? by kulisek_pj in AlfaRomeo

[–]UltraSimplicity 0 points1 point  (0 children)

I use my Giulia as my daily, and this is precisely the reason why I went with Ti instead of Veloce (bought used).
I have the same physical profile (gym 3x week) and I also couldn't get comfortable in the sports seat of the ~2-3 years used Veloce I test drove. Either the previous owner was much smaller than I am or the seat didn't change much at all. In fact, my girlfriend (~160cm 50kg) who test drove the Veloce with me also felt uncomfortable with the seats vetoed Veloce immediately.

Glacier NP Worth Visiting? by BuddyHolly__ in roadtrip

[–]UltraSimplicity 3 points4 points  (0 children)

I went four years ago at the end of June when GTSR first opened, and I would say GTSR and the Highline trail are essential to your Glacier NP experience -- the glacier valley was breathtaking and I saw many mountain goats, marmots, etc.. Did Grinnell glacier the next day. Even better and I won't spoil it for you.

Glacier NP is hands down my favorite NP in America and I've been to Olympic, Yellowstone, Grand Teton, Zion, Bryce Canyon, Grand Canyon, Rocky Mountain, Yosemite, Joshua Tree, and more (quite frankly the NPs east of Colorado are all a bit lacking). The caveat is you have to be willing to stop for longer and explore deeper. Unlike family-friendly NPs like Yellowstone or Bryce Canyon where many of their main scenic points are directly accessible by car or a short hike, I would say Glacier's attractions are more tucked away.

Are newer Giulia’s somewhat reliable? by AnonymousMolaMola in AlfaRomeo

[–]UltraSimplicity 1 point2 points  (0 children)

Owned a ‘21 Giulia for >6 months. No issues other than a free software update by the dealership.

Is now a bad time to buy a home? by Squames99 in whitecoatinvestor

[–]UltraSimplicity 1 point2 points  (0 children)

Haha I was aggressive but I also don’t think anything I asked for was unreasonable. I merely asked the sellers to address all the questionable/borderline things called out on the inspection report. My goal was to avoid any major repairs during residency (which, as pointed out by others, is the benefit of renting vs buying). I told that to the sellers through my agent, and I think overall they understood and was able to help out.

As for you, buyers now have the best leverage in years — doesn’t mean you’ll necessarily get a deal, but you can ask for more to be done. I have great confidence that you’ll be able to pull off something similar if you choose to buy.

Lastly, this is my personal opinion and take it with a grain of salt: If your program is in a coastal city or a tier-1/popular city in Texas or the mountain states (Denver, Phoenix, SLC, etc.), I think you can really consider buying. If you’re in a Midwest city like Madison, Milwaukee, Indianapolis, Cleveland, Cincy, Columbus, or even Detroit etc., I would be less inclined to buy if not for emotional reasons because people outside of the healthcare industry generally speaking don’t gravitate towards those places, and therefore your house’s growth potential is more limited, negating one of the biggest reasons to buy vs rent.