[AtlasBarfed]

The CT scan reminds me of someone that was trying to optimize welders.

They said they were at their maximum, but welders would move parts and plates and then weld.

Efficiency expert realize that welding was maximized if the welders were welding the entire time.

Other people could bring them the metal parts that needed to be welded.

So the normal process where the CT person wouldn't move the person in and out of the CT scan in between CTS was a classic example of that.

The CT tech and the CT machine needed to be running as much as possible. Other people without the skills he's juggling the patients

[DowagerDave]

The balance here is what I think is really impressive. They both built assembly lines AND rely on deep, adhoc experience & skill in applicable places. Efficiency in narrower, skill-specialized areas and an "artisanal" approach to initial triage.

[somat]

Makes me think of the apocryphal story that the genius behind Sears Roebuck & co, the thing that enabled them to change from being "just another mail order company" to "The mail order company" was to invert the fulfillment process. this changed the cost of assembling an order from n to log(n)

I don't think it was Mr Sears or Mr Roebuck that came up with the idea, One of their warehouse managers I expect. I always sort of wonder why Sears did not become what amazon is, They already had the infrastructure for it. my best guess, unable to shift mediums fast enough?

While looking for sources to this story(I could not find any, sorry) I did find a claim that bezos was pivotal for a 1992 ruling that no sales tax was due for orders that originated outside the state. and this was critical for amazons early success. I worked for a mail-order company when that ruling was overturned. And it was a mess, I was not in accounting so I have no idea what it did financially, but all of a sudden all the software went from having to handle (in state collect tax, out of state no tax) to (every state, county, city and their dog charges a different tax and now you have to try to figure out what this is and collect it).

[trustinmenowpls]

I thought that law only required you to collect state tax, if you were out of state, local taxes were still exempt unless you had an actual business in that state.

[somat]

It was South Dakota v. Wayfair, Inc. I was a sysadmin so only tangentially involved, but the programmers were having a hard time because the situation was basically unknowable, That is, there was no primary source of information, I think they ended up buying a service that specialized in keeping track of what address charged what taxes.

https://en.wikipedia.org/wiki/South_Dakota_v._Wayfair%2C_Inc.

The basic idea is that some localities charge a use tax, which is a sales tax applied to items bought outside their jurisdiction. The citizens if the jurisdiction are required to self report and pay this tax. The problem(or beneficent depending of what side of the transaction you were on) is that this is very nearly unenforceable, just too large an attack surface. The standard way to enforce tax payment is to move it a rung up the ladder. The store collects collects the sales tax before you get the item, your employer collects the income tax before you see the money etc. now there are exponentially fewer collection points. the collection points are hidden, out of the voter base and each point has far more to loose if they rebel keeping them in line.

[ted_dunning]

What do you mean by "invert the fulfillment process"?

[somat]

I think it is that instead of sending a boy around the store to assemble the stationary order, the assembler stays still, only responsible for what is in reach and the order moves on conveyor between assemblers.