#coverage levels for health insurance

[naukrisambad]

Navigating the Maze of Health Insurance Coverage

Health Insurance Coverage: In today’s uncertain world, having comprehensive health insurance coverage is not just a luxury; it’s a necessity. With the ever-increasing costs of medical care, understanding the intricacies of health insurance coverage is paramount for individuals and families alike. In this guide, we will delve deep into the world of health insurance coverage, unravelling its…

[wellhealthhub]

Type 2 Diabetes Once-a-Week Injection: A Revolutionary Breakthrough in Diabetes Management

Introduction Welcome, esteemed readers, to this all-encompassing and profound guide, a magnum opus exploring the groundbreaking, once-a-week injection for the management of Type 2 Diabetes. For those grappling with the pervasive impact of Type 2 Diabetes or those intimately associated with someone affected by this condition, the present article ardently endeavors to bestow upon you invaluable…

[batboyblog]

Things the Biden-Harris Administration Did This Week #35

Sep 20-27 2024

President Biden and Vice-President Harris announced new actions to curb gun violence at the one year anniversary of the White House Office of Gun Violence Prevention. The Office is the first ever White House office to deal with the issue of guns and has been overseen by the Vice-President. President Biden signed a new Executive Order aimed at combatting the emerging threat of machinegun conversion devices. These devices allow the conversion of semi-automatic firearms to a rate of fire that can match military machineguns, up to 20 bullets in one second. The EO also targets the threat of 3-D printed guns. The EO also addresses active schooler drills at schools. While almost every school conducts them there is little uniformity in how they are carried out, and no consensus on the most effective version of a drill. President Biden's EO directions the development of a research based active shooter drills, which maximize both student physical and mental safety.

President Biden celebrated the one year anniversary of the American Climate Corps and announced new Climate Corp programs. The Climate Corps has seen 15,000 young people connected to well paid jobs in clean energy and climate resilience jobs across America. The EPA and AmeriCorps announced a new Environmental Justice Climate Corps program which will connect 250 American Climate Corps members with local communities and over the next 3 help them achieve environmental justice projects. In addition HUD announced it will be the 8th federal agency to partner with the Climate Corp, opening the door to its involvement in Housing. Since its launch the American Climate Corp has inspired 14 states to launch their own state level version of the program, most recently just this week the New Jersey Climate Corps.

The Biden-Harris Administration announced that 4.2 million small business owners and self-employed people get their health insurance through the ACA marketplace. Up from 1.4 million ten years ago when President Obama and then Vice-President Biden rolled out the marketplaces. The self-employed are 3 times as likely as other Americans to use the marketplaces for their insurance, one out of every 5 getting coverage there. The ACA passed by President Obama, defended and expanded by President Biden, has freed millions of Americans to start their own businesses without fear of losing health coverage for them and their families.

The Departments of Transportation and Labor pressed freight railroad companies to close the gap and offer paid sick time to all their employees. Since 2022 under President Biden's leadership the number of Class I freight railroad employees who have access to paid sick days increased from 5% to 90%. Now the Biden-Harris Administration is pushing to finish the job and get coverage to the last 10%.

The EPA announced $965 million to help school districts buy clean energy buses. This comes on top of the 3 billion the EPA has already spent to bring clean energy buses to America's schools. So far the EPA has helped replace 8,700 school buses, across 1,300 school districts in all 50 states, DC, tribal nations, and US Territories. 95% of these buses are zero-emission, battery-electric. The clean bus program is responsible for over 2/3rds of the electric school buses on the road today.

The Biden-Harris Administration took another step forward in its historic efforts to protect the Colorado River System by signing 5 water conservation agreements with local water authorities in California and Arizona. The two short term agreements will conserve over 717,000 acre-feet of water by 2026. Collectively adding 10 feet to Lake Mead’s elevation by 2026. The Colorado River Basin provides water for more than 40 million people and fuels hydropower resources in seven U.S. states.

The Department of The Interior announced $254 million to help support local parks, the largest such investment in history. The money will go to 54 projects across 24 states hoping to redevelopment or create new parks.

HHS announced $1.5 billion to help combat opioid addiction and prevent opioid overdose deaths. The money will support state and tribal governments and help pay for mobile clinics, naloxone kits, and treatment centers. This comes as nationwide overdose rates drop for the first time since 2020, thanks to strong investment in harm reduction efforts by the Biden-Harris team.

The Department of Agriculture announced it'll spend $466.5 million in food assistance and development worldwide this year. Through its McGovern-Dole Program, the United States is the largest donor to global school feeding programs. The USDA will help feed 1.2 million children in Angola, Bangladesh, El Salvador, Ethiopia, Guatemala, Guinea-Bissau, Laos, Malawi and Rwanda. Through its Food for Progress the USDA will help support 200,000 farmers in Benin, Cambodia, Madagascar, Rwanda, Sri Lanka, Tanzania and Tunisia shift to climate-smart agriculture boosting food security in those nations and the wider region.

At a meeting at the UN First Lady Jill Biden announced a partnership between USAID and UNICEF to end childhood exposer to lead worldwide. Lead exposure kills 1.5 million people each year, mostly in the developing world.

The Senate approved the appointment of Byron Conway to a federal judgeship in Wisconsin. This makes the 213th federal judge that President Biden has appointed.

[tomorrowusa]

Don't risk a rerun of the 2000 election.

In the first presidential election of the 21st century many deluded progressives voted for Green Party candidate Ralph Nader.

Their foolishness gave us eight years of George W. Bush who plagued the country with two recessions (including the Great Recession) and two wars (one totally unnecessary and one which could have been avoided if he heeded an intelligence brief 5 weeks before 9/11).

Oh yeah, Dubya also appointed one conservative and one batshit crazy reactionary to the US Supreme Court. Roberts and Alito are still there.

Paul Waldman of the Washington Post offers some thoughts.

Why leftists should work their hearts out for Biden in 2024

Ask a Democrat with a long memory what the numbers 97,488 and 537 represent, and their face will twist into a grimace. The first is the number of votes Ralph Nader received in Florida in 2000 as the nominee of the Green Party; the second is the margin by which George W. Bush was eventually certified the winner of the state, handing him the White House. Now, with President Biden gearing up for reelection, talk of a spoiler candidate from the left is again in the air. That’s unfortunate, because here’s the truth: The past 2½ years under Biden have been a triumph for progressivism, even if it’s not in most people’s interest to admit it. This was not what most people expected from Biden, who ran as a relative moderate in the 2020 Democratic primary. His nomination was a victory for pragmatism with its eyes directed toward the center. But today, no one can honestly deny that Biden is the most progressive president since at least Lyndon B. Johnson. His judicial appointments are more diverse than those of any of his predecessors. He has directed more resources to combating climate change than any other president. Notwithstanding the opposition from the Supreme Court, his administration has moved aggressively to forgive and restructure student loans.

Three years ago the economy was in horrible shape because of Trump's mishandling of the pandemic. Now unemployment is steadily below 4%, job creation continues to exceed expectations, and wages are rising as unions gain strength. The post-pandemic, post-Afghan War inflation rate has receded to near normal levels; people in the 1970s would have sold their souls for a 3.2% (and dropping) inflation rate. And many of the effects of "Bidenomics" have yet to kick in.

And in a story that is criminally underappreciated, his administration’s policy reaction to the covid-induced recession of 2020 was revolutionary in precisely the ways any good leftist should favor. It embraced massive government intervention to stave off the worst economic impacts, including handing millions of families monthly checks (by expanding the child tax credit), giving all kids in public schools free meals, boosting unemployment insurance and extending health coverage to millions.

It worked. While inflation rose (as it did worldwide), the economy’s recovery has been blisteringly fast. It took more than six years for employment rates to return to what they were before the Great Recession hit in 2008, but we surpassed January 2020 jobs levels by the spring of 2022 — and have kept adding jobs ever since. To the idealistic leftist, that might feel like both old news and a partial victory at best. What about everything supporters of Bernie Sanders have found so thrilling about the Vermont senator’s vision of the future, from universal health care to free college? It’s true Biden was never going to deliver that, but to be honest, neither would Sanders had he been elected president. And that brings me to the heart of how people on the left ought to think about Biden and his reelection.

Biden has gotten things done. The US economy is doing better than those of almost every other advanced industrialized country.

Our rivals China and Russia are both worse off than they were three years ago. And NATO is not just united, it's growing.

Sadly, we still need to deal with a far right MAGA cult at home who would wreck the country just to get its own way.

Biden may be elderly and unexciting, but that is one of the reasons he won in 2020. Many people just wanted an end to the daily drama of Trump's capricious and incompetent rule by tweet. And a good portion of those people live in places that count greatly in elections – suburbs and exurbs.

Superhero films seem to be slipping in popularity. Hopefully that's a sign that voters are less likely to embrace self-appointed political messiahs to save them from themselves.

Good governance is a steady process – not a collection of magic tricks. Experienced and competent individuals who are not too far removed from the lives of the people they represent are the best people to have in government.

Paul Waldman concludes his column speaking from the heart as a liberal...

I’ve been in and around politics for many years, and even among liberals, I’ve almost always been one of the most liberal people in the room. Yet only since Biden’s election have I realized that I will probably never see a president as liberal as I’d like. It’s not an easy idea to make peace with. But it suggests a different way of thinking about elections — as one necessary step in a long, difficult process. The further you are to the left, the more important Biden’s reelection ought to be to you. It might require emotional (and policy) compromise, but for now, it’s also the most important tool you have to achieve progressive ends.

Exactly. Rightwingers take the long view. It took them 49 years but they eventually got Roe v. Wade overturned. To succeed, we need to look upon politics as an extended marathon rather as one short sprint.

Republicans may currently be bickering, but they will most likely unite behind whichever anti-abortion extremist they nominate.

It's necessary to get the word out now that the only way to defeat climate-denying, abortion-restricting, assault weapon-loving, race-baiting, homophobic Republicans is to vote Democratic.

[afrenomes]

It is very unlikely to have anything to do with the assassination, especially given that they’re two DIFFERENT insurance companies, and since afaik authorities haven’t caught the assassin yet, they likely have no idea what his motives were. Could’ve been a personal vendetta or something else entirely for all we know. Regardless, an assassination is unlikely to change any policy ever because that would set an extremely dangerous precedent for the people who work at these companies: that killing them will get the change that people want and need in healthcare. And anyways, fatal violence almost never gets people to be like: “hey, let’s be better people so that others won’t kill us!” That’s not how morality, corporations, nor human nature work. It’s STILL not smart nor productive, as well as not moral, to kill people. I can’t believe I have to say this.

Please stop sending me hate mail for saying vigilante justice/murder of/against Insurence ceos isn’t smart or productive or moral.

It’s really fucked up that I have to defend that position.

[ladyluscinia]

The thing about the UHC shooting is Brian Thompson was killed for being arguably the purest embodiment of the private health insurance system that has caused unfathomable amounts of suffering and death for normal US citizens. He lived that. He encouraged that. He did not give a fuck no matter how many people attest "he was a nice guy." His tenure as CEO was marked by ramping up denials in increasingly shady ways and bringing in lots of blood money to make that profit line go up. And just to really drive home the evil exploitation aspect, we can't ignore the fact that abusive health insurance practices are something that you can't combat on an individual level.

The average American cannot opt out of health insurance, because companies like UHC have made being uninsured into a cruel and unusual punishment. Being insured (especially under UHC) still results in ridiculous medical expenses and lack of care. Most people have basically no say over who their coverage comes from or what kind of plan it is, since it's through their employer. Finding a good doctor who will say "you need this treatment" does not guarantee treatment. Government representatives have broadly abdicated responsibility to try and fix this situation, and half of them in fact would like to make it worse as quickly as possible. You can't vote for a better system, or boycott, or try to find a better option to deny the bad ones your money, or even challenge a blatantly flawed denial without a huge obfuscating headache that you probably lose anyway.

No fucking wonder the general public is responding to the killing with general apathy or discussing how little sympathy they have for a victim who did so much evil.

No fucking wonder someone shot him.

And then almost the entire government and media response to this very valid anger has been tripping over themselves to make it very clear that this is NOT how we deal with these kinds of problems in a civilized society. Murder is bad. He had a family. Which given the way they've gone about it - sparing no expense on their manhunt, balking from discussing how the system has eliminated the "civilized" means of dissent, misquoting people in headlines to pretend no one else is discussing it, overcharging Luigi with terrorism while treating him like the worst criminal to ever exist, treating Briana Boston as a copycat for being angry on a phone call - actually just really efficiently conveys a different but far more honest message:

The lives of people like Brian Thompson are worth infinitely more than the lives of you and me. Get fucked, I guess.

[odinsblog]

Veterans’ health care


A 1996 law set eligibility requirements for military veterans to receive hospital, medical and nursing home care and authorized spending for those services and patient enrollment. That law has not been renewed, but Congress regularly allocates additional Department of Veterans Affairs funding and allows benefits to increase automatically based on inflation. VA provides medical care to more than 9.1 million enrolled veterans, according to the agency.
​

Drug development and opioid addiction treatment

Most of this spending relates to the bipartisan 21st Century Cures Act of 2016. That law provided money to the National Institutes of Health and Food and Drug Administration to modernize pharmaceutical research and medical trials. It funded research for cancer cures and state-level grants for opioid addiction and other substance abuse treatment.


​State Department

In 2003, Congress passed the Foreign Relations Authorization Act, which set policy priorities and created spending authority for the State Department. That law has not been renewed, but Congress every year since has passed annual funding bills for the department, which Trump has announced he’ll nominate Sen. Marco Rubio (R-Florida) to run.


​Housing assistance

President Bill Clinton in 1998 signed the Quality Housing and Work Responsibility Act, which overhauled federal housing assistance policies, including voucher programs and other antipoverty assistance. The Department of Housing and Urban Development and other agencies continue using this law to implement federal housing programs.


​Justice Department

In 1994, Congress passed the landmark Violence Against Women Act and has renewed it multiple times since. In 2006, lawmakers packaged a VAWA renewal with authorizing legislation for the Justice Department. As with the State Department, Congress has not approved new authorizing legislation for the Justice Department since, but it has funded the agency — and even authorized hundreds of millions of dollars more for a new FBI headquarters — every year.


​Education spending

The 2015 Every Student Succeeds Act delegated power to state and local education officials to set primary and secondary education achievement standards. It gives billions of dollars in federal grant money to state and local education officials to fund schools and school districts. Those standards are still used by the Education Department, even though the legislation has not been reauthorized. Trump has suggested he’d like to eliminate the entire department.

NASA

Stripping funding for NASA, which was last reauthorized in 2017, could spell doom for Musk’s commercial spaceflight firm, SpaceX. The company has contracts worth more than $4 billion — including for return trips to the moon and retiring the International Space Station — linked to programs approved in the 2017 law.


​Health-care and student loan programs

What’s known as the Affordable Care Act, or Obamacare, was actually passed in two separate bills in 2010. The Health Care and Education Reconciliation Act represents the second bill, which included some tax revisions and technical changes to the ACA. The law has not been reauthorized since, but the Department of Health and Human Services reported in March that more than 45 million people have health insurance coverage backed by the Affordable Care Act.

The law that made those final tweaks to the ACA also overhauled the Education Department’s student loan program. Where some schools relied on private lenders to issue federally backed loans, with this law, the government itself became the lender. That change has since enabled President Joe Biden to offer student loan debt relief, though many of his most ambitious policies have been blocked by the courts. Student loans are generally funded through mandatory spending — similar to social safety net programs such as Medicare and Social Security — and not subject to annual spending laws.


​International security programs

The 1985 International Security and Development Cooperation Act bundled together authorizations for a number of international security programs, including funding and regulations for arms sales to allies, economic aid for developing countries, airport security, anti-narcotics-trafficking policies, the Peace Corps and more. This Reagan-era law continues to be foundational to congressional funding and federal policy.


​Head Start

Head Start provides preschool education for children from low-income families. In the 2023 fiscal year, more than 800,000 children enrolled in Head Start programs, according to the National Head Start Association. The program also helped place more than 530,000 parents in jobs, school or job-training programs. It was last authorized in 2007.

(continue reading)

[paper-mario-wiki]

may i ask why you want to move to japan specifically? wouldn't you be able to find a place to live in america?

tbh the differences in quality of life between countries are so stark that i can give 1 reason at a time and you'd understand why any of them individually would make me want to move.

here's 1 reason: insurance.

in the united states, i pay $450 a month for private health insurance. with that health insurance, i have a yearly deductible, which means that on top of the $5k+ a year I have to pay monthly just to HAVE the insurance, I also have several thousand in medical bills that I've got to pay out of pocket before my insurance begins covering things proper. and after i spend almost $10,000 to actually have my insurance start kicking in (which i have to meet every year, meaning in January I have to start paying the 10k all over again), i also have to pay coinsurance (the percentage of my healthcare that my insurance DOESNT cover), which is a different percentage and base rate based on what specific healthcare service I'm getting. even then, healthcare in the USA is significantly more expensive on a foundational level without insurance than most other countries.

in japan, the amount I could have been paying monthly for the government subsidized National Health Insurance was $5 because I was a student, but I didnt know how to apply for that so I paid the general price of $70 monthly. after that, starting immediately after you begin payment, the national health insurance covers 70%-90% of healthcare costs depending on tax bracket (higher coverage for those earning less). Japanese insurance ALSO has a deductible, which resets monthly instead of yearly, starting at around $150. if the amount that you pay out of pocket exceeds your monthly deductible and you still need healthcare services, you can apply for a reimbursement on all medical expenses for the rest of the month.

that is 1 reason i want to move away from the united states and back to japan.

[mariacallous]

Donald Trump and his fellow Republicans made the high cost of living a major focus of their campaigns in 2024. And for all of their vitriolic attacks on Democrats over issues like crime and immigration, it may have been their promise to reduce everyday prices that allowed them to win control of the White House and Congress.

But governing is harder than campaigning. The president-elect and other Republicans are likely to see this firsthand when their commitment to lower prices runs smack into their opposition to government spending on health care — and, no less important, to their antipathy toward so-called Obamacare. It’s going to happen sometime in the next few months, or maybe even the next few weeks. A finding that the Congressional Budget Office released Thursday shows why.

The finding was about the cost of health insurance for people who buy private coverage through the Affordable Care Act, the landmark legislation that Democrats passed and then-President Barack Obama signed in 2010. The short version of CBO’s conclusion is that insurance for millions of Americans will get more expensive if the Republicans don’t act.

The long version goes like this: These millions are the people who buy insurance directly through the Affordable Care Act marketplaces, HealthCare.gov and its state-run analogues like Covered California, because they make too much money to qualify for government programs like Medicaid and can’t get coverage through their jobs.

When they buy through the marketplaces, they can qualify for tax credits that effectively discount premiums by hundreds and frequently thousands of dollars annually. But in the Affordable Care Act’s early years, those tax credits were smaller than the law’s architects had hoped, because there weren’t enough votes in Congress to fund more generous assistance. It’s a big reason that so many people continued to struggle with high costs, or simply didn’t get insurance at all, in the program’s initial years. All of that changed in 2021, when President Joe Biden and the Democrats temporarily boosted the subsidies with extra money. The initial impetus was the COVID-19 pandemic; doing whatever it took to help people pay medical bills seemed like an especially good idea in the middle of a public health crisis. But there was always a second motive: trying to make insurance available through the Affordable Care Act more affordable.

The effects of the bigger tax credits have been clear. With cheaper insurance at the marketplaces, enrollment has surged to record levels. But the extra subsidies are set to vanish after 2025. And while Democrats have called for extending them, it would be up to Trump and Republicans in Congress to do so.

That’s not the sort of thing they’re inclined to do ― although, with Thursday’s CBO finding, they have a new reason to think about it.

[shadowmaat]

My feeling on what Liz Warren is saying is that violence on an individual level is never the answer, but when you engage in violence at the corporate level in order to increase your profits, then you can't go all surprised pikachu face when people finally snap and dish it back.

Which sounds really good, especially when it's framed as a warning. HOWEVER. The death for dividends policy upheld by health insurance companies in the US has been going on for DECADES, virtually unchecked. No one has successfully stopped it yet, and I'm guessing part of that is because it's good for the economy. And/or good for the senators receiving payouts from the insurance giants.

If Senator Warren and the Dems really want to stop more violence from happening, they'd be working on reforms. Or, y'know, ramming through universal healthcare, like every other country in the world has. The whole "I'm not paying for someone else's insurance" whiners should be shown that they're already paying for it: government subsidies to companies like UHC account for a whopping portion of their profit. And unaligned taxpayers get nothing out of it. At least with universal coverage, if you get polio (surprised pikachu face) at least you won't have to worry about going into irrecoverable medical debt for treatment. And you won't have to worry about some dude in a fancy suit deciding that no, you don't really need this life-saving procedure after all. Just take some Tylenol and you'll be fine.

Of course, given the incoming regime we all know things are only going to get worse. And worse. And worse. Which means that Warren's warning to CEOs is apt. People are going to get increasingly desperate. And desperate people do desperate things. The insurance bros aren't the only ones who should take note.

[justinspoliticalcorner]

Jonathan Cohn at HuffPost:

One of the bigger and more underappreciated policy debates coming to Congress this year will be over whether to extend a Biden-era initiative that’s helping millions of Americans to pay for their health insurance. Some Democrats want to make sure that debate starts now. Sen. Jeanne Shaheen (D-N.H.) and two other Democratic lawmakers are planning to introduce legislation that would keep the Biden-era program going, aides to lawmakers told HuffPost. Most likely, the lawmakers will introduce their bill formally on Thursday. Getting the proposal through Congress won’t be easy now that both houses are under the control of Republicans, who have traditionally opposed government-financed health care programs and have said cutting federal spending is a priority. But there are reasons to think the Democratic proposal, or at least some version of it, could become law. And at the top of the list is the fact that doing nothing ― in other words, allowing the Biden-era program to lapse completely ― would mean higher insurance costs for millions.

How Pandemic Relief Lowered Insurance Costs

The program these Democrats want to extend is a temporary supplement to the Affordable Care Act. It provides extra financial assistance to people who are buying coverage on their own, whether through the federal insurance marketplace (HealthCare.gov) or one of its state-run analogues (Covered California, Minnesota’s MNsure, and so on). The extra assistance can bring down premiums by hundreds, or in some cases thousands, of dollars. That’s enough to allow people to buy better coverage or save meaningfully on premiums ― and, in some cases, to buy insurance when they would otherwise remain uninsured. The effects have been dramatic. Since the extra money first became available in 2021, as part of the Democratic pandemic relief package that President Joe Biden signed into law, the number of people getting coverage on the marketplaces has risen to record highs, contributing almost certainly to a record decline in the number of uninsured Americans. And signups this year are about to hit 24 million, the Biden administration announced Wednesday morning. That’s the highest number yet, with a week still to go before open enrollment ends.

[...]

What Democrats Want To Do Now

Shaheen and her Wisconsin colleague, fellow Democratic Sen. Tammy Baldwin, plan to introduce legislation on Thursday that would make the extra assistance permanent. Rep. Lauren Underwood (D-Ill.) is planning to introduce a companion version in the House. The proposal itself isn’t really new, and neither is the idea. Shaheen and Underwood also championed the original push to make the financial assistance more generous. In early 2023, not long after the temporary assistance was rolled out, they introduced legislation to make that funding permanent. [...]

How The Debate Could Play Out

But Trump campaign statements have never been a reliable indicator of his intentions. And in general, Republicans haven’t had a lot to say on the matter, which may have something to do with the fact that the millions who currently benefit from the extra financial assistance include millions of their own supporters and constituents. Explaining to these people why their premiums suddenly jumped could be especially difficult following an election in which inflation was a top, potentially decisive issue, and in which Republicans up and down the ticket pledged they would bring down the cost of living for average Americans.

The expanded Obamacare subsidies is set to expire this year, and the fight over to keep the extension will be had in Congress.

[dreaminginthedeepsouth]

The Los Angeles Firestorm

January 9, 2025

Robert B. Hubbell

The largest firestorm ever to hit Los Angeles has ravaged the nation’s second-most populous city. Tens of thousands have lost their homes, hundreds of thousands have evacuated, and everyone is dealing with collateral effects, which include widespread power outages, low or no water pressure, and unhealthy air.

Jill and I (and our families) are safe. But we know eight families that have lost their homes. We know many more who fled their homes on Tuesday and do not know whether their homes are still standing. We have opened our home to friends who evacuated from the Eaton Fire (Pasadena / Altadena area).

Widespread power outages have affected traffic lights across broad portions of LA, making driving more dangerous. Many schools were closed, which meant that Jill and I spent the day caring for granddaughters—always a blessing.

Amid a humanitarian crisis, President-elect Donald Trump posted a statement that insulted California’s governor, Gavin Newsom, by claiming the governor was to blame for the wildfires for refusing to sign a fictional “water restoration agreement.” Trump wrote:

Governor Gavin Newscum refused to sign the water restoration declaration put before him that would have allowed millions of gallons of water, from excess rain and snow melt from the North, to flow daily into many parts of California.

Turning a tragedy into a callous, crass political attack is reprehensible. Moreover, Trump’s post demonstrates that he does not understand the nature of the crisis facing Los Angeles. “Lack of water” did not cause the conflagration; climate change did. Although climate change is not entirely responsible for the fires, which are a seasonal feature in Los Angeles, it is responsible for magnifying the intensity and scale of the fires to unprecedented levels.

California experiences seasonal desert winds (called Santa Ana winds) from October through March. But the combined effect of a warmer-than-usual Pacific Ocean, a wobbling jet stream that has wandered into the mid-latitudes of the US, and record-low levels of humidity turned blustery Santa Ana winds into hurricane-force winds that created a blast-furnace effect. See Vox, The unusually strong force behind the apocalyptic fires in Los Angeles

Some observers may argue that single weather events, standing alone, cannot prove that climate change is real. Point taken. But the insurance industry studies trends in weather disasters and draws reasonable inferences about changes in the risk environment.

Fire insurers have recently concluded that the trend of wildfires in California is no longer a risk they can tolerate. Many of those who lost their homes over the last two days have recently lost their fire insurance coverage as insurers have exited the California market. See Business Insider, Insurers Cut California Fire Coverage Months Before LA, Palisades Blaze.

Despite the ubiquitous evidence of human-caused climate change, Trump plans to withdraw from the Paris Climate accords and reverse US energy policy favoring renewable energy.

At a press conference on Tuesday, Trump pledged that he would ensure that no new wind turbines would be constructed in the US because—in his addled mind—wind turbines affect the mental health of whales. See Tribune News Service, Trump says Massachusetts wind farms are ‘driving whales crazy’. (Trump pledged on Tuesday that “no windmills will be built when he regains office on Jan. 20.”)

But it is not only scientific illiteracy and general ignorance that is driving Trump's anti-environment stance. Like clockwork, right-wing social media is pushing disinformation and conspiracy theories. See Mother Jones, As Los Angeles Burns, We’re Seeing a Conflagration of Lies and Disinformation.

As noted in the Mother Jones article, right-wing hate mongers are blaming “diversity initiatives” in the Los Angeles Fire Department—a slander provoked by the simple fact that LA Fire Department is led by an LGBTQ woman. Per Mother Jones,

[C]onservative actor and Palisades homeowner James Woods [] denied that climate change played any role in the fires and blamed “diversity,” citing the LAFD chief’s profile [as a lesbian woman].

Others resurrected Trump's old claims that California experienced wildfires because it did not “rake and clean” its forest floors like Finland. Trump's claims are risible for several reasons, including the fact that the federal government owns most of the forest woodland in California—47%. The state owns only 3% of the forests, while the remainder is in private hands. Moreover, California has an aggressive prescribed burn plan designed to reduce fuel load in the areas that California owns.

Los Angeles faces several more agonizing days of wind-driven fires--to be followed by the slow process of containing a dozen wildfires in hilly, dry terrain. And then the victims must begin the long process of rebuilding homes and reclaiming normalcy. That process will require assistance from local, state, and federal government agencies. At a time when too many see the government as the enemy, we are reminded once again that “Government is simply the name we give to the things we choose to do together.”

Coda

Early in the day, a reader recommended an app that provides real-time information about wildfires in an easy to use but comprehensive format. I have been using the app throughout the day to understand what is happening around us. The app is called Watch Duty. It is run by a network of volunteers and is free to download and use. Enhanced versions for professionals and journalists start at $24.99 per year. If you are affected by the fires, I highly recommend this app. The link is here: Watch Duty - Wildfire Maps & Alerts

[Robert B. Hubbell Newsletter]

[midwesttranssurvivalcollective]

midwest states & access to trans care

Illinois: Illinois is a sanctuary state for gender-affirming care, meaning they allow individuals coming from out of state to access gender-affirming care in Illinois regardless of the laws of their home state and will not enforce bans or penalties from other states. In 2023, Illinois passed a law safeguarding abortion and gender-affirming care, protecting providers who provide gender-affirming care, and protecting out-of-state care-seekers. In Illinois, there are no legal restrictions on hormone access for adults. At Planned Parenthood, anyone older than 16 can access hormone treatment without requiring parental consent. People under 16 can access hormones or puberty blockers with parental consent. Insurance providers are not allowed to exclude coverage for trans-related medical care, and Medicaid in Illinois covers trans health care. In Illinois, it is relatively easy to undergo the name change and gender marker change process, only requiring proof of residence for at least 6 months in Illinois. Anyone who has lived in Illinois for at least 6 months can change their legal documents regardless of the state they were born in.

Wisconsin: Wisconsin is not a sanctuary state for gender-affirming care, but right now, there are no state laws prohibiting adults or minors from accessing gender-affirming care. Currently, insurance providers and Medicaid cover trans health care. Wisconsin does not have as many legal protections as Illinois, so there is more of a chance for restrictions on a state level to occur under Trump. Wisconsin also requires proof of sex reassignment surgery to change gender markers. 

Iowa: In Iowa, there are legal restrictions on gender-affirming care for minors (passed in 2023), as well as laws preventing trans students from participating in sports or using bathrooms consistent with their gender identity. There is also no law requiring insurance providers to cover trans healthcare. Currently, trans healthcare is covered by Medicaid, but this may change under Trump. Iowa also requires proof of sex reassignment surgery for gender marker change.

Missouri: In Missouri, there is a ban on gender-affirming care for minors (passed in 2023), and a law restrictring access to gender-affirming care for adults on Medicaid. There is also a ban on trans students participating in sports consistent with their gender identity. However, Kansas City, Missouri, has declared itself a sanctuary city for gender-affirming care, meaning the city will not prosecute any person or organization that helps provide or receive gender-affirming care. Missouri also requires proof of sex reassignment surgery for gender marker change.

Kentucky: In Kentucky, there is a ban on gender-affirming care for minors (passed in 2023), and a law restricting access to gender-affirming care for adults on Medicaid. There are also laws preventing trans students from participating in sports or using bathrooms consistent with their gender identity. Kentucky also requires proof of sex reassignment surgery for gender marker change.

Indiana: In Indiana, there is a ban on gender-affirming care for minors (passed in 2023). There is no law restricting access to gender-affirming care for adults on Medicaid, but there are also no legal protections, meaning it's possible there will be a restriction put in place under Trump. Policies around gender marker changes are also unclear. There is also a ban on trans students participating in sports consistent with their gender identity.

Ohio: In Ohio, there is a ban on gender-affirming care for minors (passed in 2023), and a law restricting access to gender-affirming care for adults on Medicaid. There is also a ban on trans students participating in sports consistent with their gender identity. Ohio is unclear about requirements for changes to gender markers. 

Michigan: In Michigan, there no ban on gender-affirming care, and state Medicaid policy explicitly covers gender-affirming care. It is possible to change gender markers and names on legal documents without proof of sex reassignment surgery.

Minnesota: In Minnesota, there are no legal restrictions on hormone access, and Minnesota is a state with ‘shield’ laws actively protecting access to trans healthcare. In 2023, Minnesota passed a bill that prevents state courts or officials from complying with child removal requests, extraditions, arrests or subpoenas related to gender-affirming health care that a person receives in Minnesota, regardless of the laws in the person’s home state. Insurance providers are not allowed to exclude coverage for trans-related medical care, and Medicaid in Illinois covers trans health care. There is currently no ban on gender-affirming care for youth. Gender markers and names on birth certificates can be changed without proof of sex reassignment surgery.

more info or important additions for any of these states?? message us!!

most info from Movement Advancement Project (https://www.mapresearch.org/equality-maps/healthcare/trans_shield_laws) so if your state isn’t on here, check them out to find out your state’s status!

[clatterbane]

Early o'clock appointment at the prosthetics place this morning. This was waiting in the office after the initial intake talking to the prosthetist, while he went off for a while to look into using a bigger room where they do casting.

The prosthetist I got was a youngish Indian guy who seemed fine to deal with so far. My shitty Swedish skills did not turn out to be an issue today either, which was a relief. Occasionally I really do need Mr. C to act as interpreter on some things, but that really wasn't needed today. And it's extra important to get clear communication going with a prosthetist, at least if you want to get an actually useful prosthesis.

The initial assessment was pretty encouraging. He was initially concerned that the situation might have been complicated by the delays, and me mostly being stuck in the chair for 4 years and counting now. But, I really do NOT have the troublesome muscle contractures or level of general deconditioning that they were halfway expecting to see. Actually seemed impressed (like the PT people last time) at my leg strength now, after a couple of quick tests.

I am in absolutely terrible shape right now, for myself as an individual. But, I am also NOT upward of 70 and with other serious health issues complicating matters, like the average client they'd be encountering. Kinda makes a difference. Also, being persistently unable to fucking sit still for more than a few minutes at a time has probably actually worked to my advantage in this case.

At any rate, the guy quickly seemed convinced that, with a little practice and reconditioning and all that good stuff? I am likely to be very active, and need to be set up with appropriate equipment to that end.

Thankfully, there that may well include more than one leg setup at a time, to be better for different purposes. Also a higher level ankle and foot than they put most people in especially starting out. ..

(They don't use exactly the same system for classification or criteria here, but it's pretty much the same idea. I haven't actually looked into the specifics. What'll get you around a grocery store fine won't necessarily work so well if you're wanting to hike around uneven terrain, etc. Sounded like I went straight to the equivalent of K4 back in the US, though.)

Gotta say I was a tad concerned about that part, going in. I didn't make it as far as the actual prosthetics clinic dealing with the NHS, but overall I kept getting these mixed messages that I was young and healthy, and should spring back in no time--and also that it was basically only expected for a middle-aged AFAB person to occasionally gimp around the shops, and that it might be unreasonable to expect to ever get back much better mobility than that. Which could easily turn into a bit of a self-fulfilling prophecy, especially with enough pennypinching involved. Again, I never made it to the stage of working with the local "Limb Centre", so may have run into some different attitudes there. It may have been better than I still sorta suspect.

As it stands, though? Nobody's looked at me like I had two heads when I've mentioned wanting to get back on a bike. Very normal daily activity, living in a purposely very bikeable city! Or anything else, really. I do not want to start running marathons now, I just want the ability to get back to some reasonable-for-my-hyper-ass level of activity doing stuff that I actually enjoy.

It sounds like I should at some point get a leg set up for general walking-around purposes including hiking (as one of my explicitly stated goals) and one set up better for cycling (as the other major one), using different attachment systems and slightly different ankle/foot components. May be able to get a swim fin foot in the future to swap on if I want to get back into that. It is evidently (thankfully!) not like some insurance coverage elsewhere or some of the things I hear about experiences with the NHS, where you're necessarily getting one all-purpose leg to last you for 5 years or whatever.

I really don't know what they're intending with the timeframe for both, but it should be 2-3 weeks until the walking-around leg is ready to try on. They may need to do some adjustments before it's ready to start getting up on. It sounded like they're doing the socket building in house, rather than sending it out to some more centralized facility--which is to the good, as long as they know what they're doing. Sounded like my leg guy would be doing the fabrication.

I was a little surprised that they're skipping the temporary socket step and going straight for a final version, but things have had a good while to shrink down on their own by now, and that guy wasn't foreseeing my bony leg shrinking down much more anytime soon so that it needed a new smaller socket to fit. That is a pretty common thing for people who have started the process much sooner after surgery.

(No, he just kept commenting on how knobbly mine is. Which, he's not wrong. That does need some extra fitting accommodation around the potential pressure points, however.)

I did not go home entirely empty handed today, though.

I did get one of the "real" liners made for wear under a socket, as opposed to the compression-only sleeve that PT put me wearing. It is remarkably more comfortable, as I was hoping. We're talking a neoprene sleeve with enough of a silicone gel lining to make a seal on the leg, and it's cut down lower. Not extra bastard heavy duty silicone only.

With limited wear so far, the less rigid material is indeed NOT trapping and pinching the hell out of any flesh on the back of my leg. I did take it off after we got home because my skin there does need a little rest break to heal after what the first one has been doing to it. I do not really intend to put the white one on again. Will be happy to give that thing back to PT whenever I see them again.

But yeah, there is no doubt an awful lot of work in my near future. I am extremely relieved to finally have an aftermarket leg this close in sight, though. It almost felt like a "when I win the lottery" type prospect, there for a while. (And I am trying not to place similarly unrealistic expectations on the whole process, tbqh.)

[shannendoherty-fans]

Shannen Doherty’s Untimely Death Sparks Important Conversations About Healthcare Access And Equity

By Janice Gassam Asare

Shannen Doherty, the actress best known for her roles in Beverly Hills, 90210 and Charmed has died after a long battle with cancer, at the age of 53. In a 2015 statement to People magazine, the actress revealed her breast cancer diagnosis, stating that she was “undergoing treatment” and that she was suing a firm and its former business manager for causing her to lose her health insurance due to a failure to pay the insurance premiums. According to reports, in a lawsuit Doherty shared that she hired a firm for tax, accounting, and investment services, among other things, and that part of their role was to make her health insurance premium payments to the Screen Actors Guild; Doherty claimed that their failure to make the premium payments in 2014 caused her health insurance to lapse until the re-enrollment period in 2015. When Doherty went in for a checkup in March of 2015, the cancer was discovered, at which time it had spread. In the lawsuit, Doherty indicated that if she had insurance, she would have been able to get the checkup sooner—the cancer would have been discovered, and she could have avoided chemotherapy and a mastectomy.

Under the IRS, actors are often classified as independent contractors, which comes with its own set of challenges. Although it is unclear what Doherty’s situation was, for many independent contractors, obtaining health insurance can be difficult. Trying to get health insurance as an independent contractor can be a costly and convoluted process. A 2020 Actors’ Equity Association survey indicated that “more than 80% of nonunion actors and stage managers in California have been misclassified as independent contractors.” A 2021 research study revealed that self-employment (which is what independent contractors are considered to be) was associated with a higher likelihood of being uninsured.

Doherty’s tragic situation invites a larger conversation about healthcare access and equity in the United States. According to the Center on Budget and Policy Priorities, the Affordable Care Act (ACA), also known as “Obamacare,” was signed into law in 2010 and revolutionized healthcare access in two distinct ways: “creating health insurance marketplaces with federal financial assistance that reduces premiums and deductibles and by allowing states to expand Medicaid to adults with household incomes up to 138 percent of the federal poverty level.” The ACA helped reduce the number of uninsured Americans and expanded healthcare access to those most in need. It also helped close gaps in coverage for different populations, including those with pre-existing health conditions, lower-income individuals, part-time workers, and those from historically excluded and marginalized populations.

Despite strides made through the ACA, healthcare access and equity are still persistent issues, especially within marginalized communities. Research from the Henry J. Kaiser Family Foundation (KFF) examining 2010-2022 data indicated that in 2022, non-elderly American Indian and Alaska Natives (AIAN) and Hispanic people had the greatest uninsured rates (19.1% and 18% respectively). When compared with their white counterparts, Native Hawaiian and Other Pacific Islanders (NHOPI) and Black people also had higher uninsured rates at 12.7% and 10%, respectively. The Commonwealth Fund reported that between 2013 and 2021, “states that expanded Medicaid eligibility had higher rates of insurance coverage and health care access, with smaller disparities between racial/ethnic groups and larger improvements, than states that didn’t expand Medicaid.” It’s important to note that if a Republican president is elected, Project 2025, the far-right policy proposal document, seeks to upend Medicaid as we know it by introducing limits on the amount of time that a person can receive Medicaid.

When peeling back the layers to examine these racial and ethnic differences in more detail, the Brookings Institute noted in 2020 that the refusal of several states to expand Medicaid could be one contributing factor. One 2017 research study found that some underrepresented racial groups were more likely to experience insurance loss than their white counterparts. The study indicated that for Black and Hispanic populations, specific trigger events were more likely, as well as “socioeconomic characteristics” that were linked to more insurance loss and slower insurance gain. The study also noted that in the U.S., health insurance access was associated with employment and and marriage and that Black and Hispanic populations were “disadvantaged in both areas.”

Equity in and access to healthcare is fundamental, but bias is omnipresent. Age bias, for example, is a pervasive issue in breast cancer treatment. Research also indicates that racial bias is a prevalent issue—because the current guidelines in breast cancer screenings are based on white populations, this can lead to a delayed diagnosis for women from non-white communities. Our health is one of our greatest assets and healthcare should be a basic human right, no matter what state or country you live in. As a society, we must ensure that healthcare is available, affordable and accessible to all citizens. After all, how can a country call itself great if so many of its citizens, especially those most marginalized and vulnerable, don’t have access to healthcare?

[jacquesthepigeon]

Fascinating the deep levels of BS involved in health insurance and how companies change pricing for each payor

At my clinic we have a couple of common medications that the patient can buy in cash for 10-25 bucks but when those same meds are dispensed via worker’s comp, their prices suddenly change to 100+

So basically healthcare companies charge depending entirely on whatever agreement they have with the payor instead of having a flat rate cost for each goods and services provided and that just makes the fact that they still charge inflated prices to people without insurance instead of setting up a reasonably equitable system for deciding how much to charge based on factors like income and insurance coverage that much more disgusting