In general integer division is implemented using a form of long division, in binary. There is no base-10 arithmetic involved. It’s a relatively expensive operation which usually requires multiple clock cycles to complete, whereas dividing by a power of two (“bit shifting”) is trivial and can be done in hardware simply by routing the signals appropriately, without any logic gates.

The metric standard is to measure information in bits.

Bytes are a non-metric unit. Not a power-of-ten multiple of the metric base unit for information, the bit.

If you’re writing “1 million bytes” and not “8 million bits” then you’re not using metric.

If you aren’t using metric then the metric prefix definitions don’t apply.

There is plenty of precedent for the prefixes used in metric to refer to something other than an exact power of 1000 when not combined with a metric base unit. A microcomputer is not one one-thousandth of a computer. One thousand microscopes do not add up to one scope. Megastructures are not exactly one million times the size of ordinary structures. Etc.

Finally: This isn’t primarily about bit shifting, it’s about computers being based on binary representation and the fact that memory addresses are stored and communicated using whole numbers of bits, which naturally leads to memory sizes (for entire memory devices or smaller structures) which are powers of two. Though the fact that no one is going to do something as idiotic as introducing an expensive and completely unnecessary division by a power of ten for every memory access just so you can have 1000-byte MMU pages rather than 4096 also plays a part.

That part is messed up. You shouldn’t be dealing with individual contractors as a patient. All billing should go through the hospital, and be considered in-network provided the hospital is in-network, regardless of what kind of specialist sees you there. Any exception, such as bringing in someone who doesn’t normally work there to treat a rare condition, should require separate and specific authorization from the patient in advance.

When you have an actual functioning competitive market the money you bring in correlates with the value of the service you provide, so it makes perfect sense to be happy about the money the new surgical center is bringing in. That means it’s useful.

The problem is that the health care market is regulated and subsidized in so many ways, many of them conflicting with each other, that competition is very limited and price discovery is reduced to “whatever the patient (and their insurance) can afford to pay” since they can’t go anywhere else. Fix that and there won’t be any reason for hospital owners or employees to feel guilty about making money.

CVS and E*Trade both refused to accept my fairly standard user@mydomain.info address during initial registration, but had no issue changing to that address once the account was created. It would be nice if their internal teams communicated a bit better.