#i know insurance sucks and our health care system sucks

[juanabaloo]

Please take it one step further. If you are lethargic get your vitamin D and iron levels checked. Spinach and OTC (over the counter) supplements might help. They also might not be anywhere close to enough. (Imagine you need like 20 gallons of water and you take one glass and hope it will be enough.) At different times in my life I've needed prescription vitamin D AND iron infusions.

You deserve a life with energy! I get my levels regularly checked now and if they fall below a certain level then I need more. I currently take a daily OTC Vitamin D pill, and need iron infusions roughly once every 1-2 years. (I live in the US, still have periods, and I'm lucky enough to have good insurance, for the US.)

There was a TikTok post about an advertisement for “blood-making pills for weak women” someone found in a newspaper from the 1890s and everybody seemed to think it was just an example of the weird misogyny of the day and age but no. Anemia was a massive public health concern. It always has been through history but part of the reason we have this idea of old timey women thought history being physical weak, chronically cold and pale and fainting is because they often they were. Anemia was also a massive problem for men in that day but even now it disproportionally affects people who menstruate. So tonics full of stimulants and “healthful vitamins” were marketed at young women in pages upon pages of advertisements in every newspaper. People generally felt like shit all the time back then.

[garmanarnarr]

Rickorty Week Day 3: Caught

1.2k | secretly married | warning for language

@rickortyweek

“Jesus Christ, Jerry, go get the accountant, would you?” 

Beth’s hands shake around the tax filer. She taps the sheaf of papers against the desk to try and straighten them but it ends up just making things worse, sheets fumbling out into her lap. W-2s. Proof of health insurance. Unemployment papers for Jerry. And that’s just last year’s; she’s pulled their last seven returns, which she keeps in big binders in a filing cabinet in the home office, like they always suggest. 

She can tell her husband is making a face without even looking at him. 

“He said he charged,” Jerry pauses, “what, two thousand flurbos an—”

“FILING ERROR. FILING ERROR,” the big stone head in the middle of the office says, again, thumping the ground for emphasis. 

“I don’t care. Call him,” Beth says. 

“We don’t know the conversion rate!” 

“I know that if we don’t file these correctly beyond a shadow of a doubt, our bodies, and our children’s, are going to get repo’d. That’s what I know, Jerry.” 

“Alright,” Jerry says. “Fine.” Shoulders slumped, he shuffles out of the room. The intergalactic equivalent of the IRS manages to be equally drab as its US counterpart– or maybe worse. Beth had no idea there even was an intergalactic equivalent of the IRS you could be audited by until she was pulled right out of her living room and into space like how cows got sucked up into flying saucers in movies. She’d had a nasty looking gun pointed in her face by an alien and ten minutes to gather ‘the needed tax-related materials’ to ‘rectify a filing error.” She didn’t even have time to finish her glass of wine. 

Now she’s stuck in this office under threat of losing her own bodily autonomy. With a lot of paperwork. And a big stone head in the middle of the floor thundering “FILING ERROR. FILING ERROR.” as it pounds on the ground like the Easter Island equivalent of a Turbotax fuckup. 

She has no clue what’s wrong. Maybe something lingering from the divorce? Unless Jerry has some bank accounts in Turks and Caicos he hasn’t told her about, she’s pretty much fresh out of ideas. She leans over in her chair, twisting her hands in her hair, wishing she had a glass of wine. Perhaps several. 

As she stares at her bare feet (she hadn’t had time to grab shoes) she hears Jerry come into the room, followed by small, light footsteps. When she looks up, a nerdy alien in a polo shirt and khakis is sitting down across the desk from her. He has weakly wavering gray antennae, like everyone else that works here, and a laptop under his arm. 

“Hello, Mrs. Smith. Sounds like there’s a problem you’d like my help with?”

“FILING ERROR. FILING ERROR,” agrees the stone head, loudly. Beth is starting to get a really bad headache and she knows it isn’t from the Cab Sav. 

“I think something is wrong with my previous tax returns? Or something?” she says, pushing her stack of papers towards the accountant, which the accountant eyes, twirling one of his antennae between his fingers. 

“What planet?”

“Uh. Earth?”

“Ah, I see. Earth tends to be a particularly tricky one. You humans can never make up your minds. Makes keeping accurate records a pain.”

“Frankly, sir, I have no fucking clue what’s going on. Pardon my language. This has never been a problem for us before.” 

“Well, Mrs. Smith, if you’re willing to go line by line with me…”

“For the last seven years?”

“I’m paid to be thorough.” 

Beth’s going to pull her hair out. 

“Isn’t there anything you can do to just, like, make it faster? Please.” 

The accountant does some sort of equivalent of pursing his lips that might translate more clearly with different mouth anatomy. 

“Alright. Let me check my system for any inconsistencies.” 

He opens up his laptop and begins typing away. 

Gingerly, Jerry rests a hand on Beth’s back. “See, honey? Look at him go. I knew he was worth it.” 

Her phone rings, inexplicably. But of course, anything is explicable, considering what her father is capable of. She picks up on the second ring. 

“Beth.”

“Dad?” she asks, as if it could be anyone else. She watches as the accountant pulls a small device out of his pants pocket and starts scanning some of the papers with it, seemingly at random. 

“B-Beth, sweetie, tell me something. Are your personal taxes being audited by the intergalactic equivalent of the IRS right now?”

“How do you know?” she asks, instantly, then winces, then hates herself for wincing. This is obviously some Dad shit. There are antennas and strange electronic devices and angry space bureaucrats, which means it has Rick Sanchez written all over it. 

“Ah, jeez, fuck, okay.” Her father sounds oddly panicked, voice strained.  “L-listen, don’t. Don’t tell those squares anything, just wait until I get there–”

The accountant looks up. “I’ve found something, Mrs. Smith.”

“Ooooh, he’s found something, Beth!” Jerry echoes excitedly. 

Beth takes her phone away from her ear and rests it against her shoulder. 

“Yeah?’ 

“You seem to have some kind of error with the status of a family member’s filing.”

“What do you mean?” Faintly, she can hear her father saying Beth? Sweetie? on the other end of the line. 

“Mortimer Smith is listed as a dependent, here.” He points at a line on his laptop screen that’s highlighted in red. 

“Yes, of his mother.” She shoots a look at Jerry, who’s gone quiet.  

“Hmmm,” says the accountant, squinting at his screen. Beth’s stomach feels strange. 

“He’s seventeen. He’s my son.” 

“According to our records, he’s been filing with Rick Sanchez since 2016.”

Two years ago. Beth’s stomach drops. “You mean, he’s like, what, Rick’s dependent now? Like Rick fucking adopted him?”  

Suddenly scenarios of Rick whisking Morty away for real, forever, without her knowing, are flashing through her head. Taking him away on an adventure that he’d never come back from, far away from her. Who knew what he could do. How he could make her sign papers and forget she’d ever done it. Her forehead and armpits start to break out in clammy sweat and she wipes her suddenly damp hands on her pant legs. 

“No, jointly filing,” the accountant says coolly, as if it is nothing. As if it is the most normal thing in the world. “As a spouse.” 

In a flash, a slimy green disk opens in the middle of the room. Beth watches as one long, long, knobby leg steps through, then another. The ratty edge of a lab coat and one gray hand holding a portal gun. 

“First of fucking all,” her father says, as soon as his head bursts through, “let it be known, I didn’t– I didn’t want you to find out like this, Beth . This is pretty m-messed up, even by my standards. Second of all, fuck the government and all the little snitching bitch peons that work for it. Third of all, before you aAAUGGHsk, it’s not, it’s not legal on Earth. So don’t worry about that, sweetie.” 

Beth is very still. 

“CORRECTION ACCEPTED,” says the head, mouth clacking. It had stopped shaking the table with its movement. It seems smug, in fact. 

“See, Beth? Not legal on earth,” Jerry echoes, cheerfully. His face falls.  

“Wait. What?”

[dr-jingles]

Art is hard when Life is Happening but we persist- That's to say I've had a Big Life event happen recently, and a series other things to keep the punches coming. Some context below [ CW death, pet death, uh tooth issues ?]. I want to get back into drawing a bit more regularly- to get back some normalcy in my life. I might start up streaming again, or I might just start posting more whatever doodles here to help keep me on track. But thanks to everyone who has stuck around, and for all the love you've given me and especially my silly little characters.

On July 20th my father passed away. I still don't really know how to cope with it- or process it. I can't rightly put to words how important he was to me, just like the rest of my family. He was always supportive in his own way- encouraging of my art- and was the one who introduced me to the wonders of video games and MUCH more. Then August 3rd, two weeks later, our family dog passed away. I know it will get easier with time, but it's still hard. It all sucks a lot. I've got great friends and a good support system to help me through it, and I'm so thankful for that. So then of course I have to get some dental work done [root canal babeyyy] which was not cheap even with insurance [love that American health care system] and it will need a crown sooner rather than later just to add the cherry on top of this Sundae. I swear it better start going up from here cos I'm starting to run out of pegs to get knocked down from. [ I will be alright, just using a bit of some good ol humor to help cope].

[begitalarcos]

Hey Guys

Wow it's been quite some time. In regards to my last life post (that I don't remember making) but did happen and was very difficult to deal with all the fall out for like... more than a month after.

I'm sorry I left you all with that and then just disappeared again. Things have been weird the last couple months... to put it in simple words... shit sucks

The falling out with my daughter caused a huge rift between several people who (were not involved but still had a very loud opinion about things) and quite a few uncomfortable conversations.

I unfortunately started drinking as a way to deal with not dealing with things (I'm good now but I had about 3 weeks of just being smashed on the regular) and during that time I suffered an awful fall which resulted in me slipping a disc in my back. Possibly 2 of them but I've had such a hard time dealing with doctors lately that no one in the medical field has been particularly helpful. So I've been living off a cocktail of painkillers for almost 2 months now (which I hate), I was going to physio but then my insurance decided not to cover my sessions until I could PROVE I was actually hurt.

Tomorrow I go for an assessment with a new doctor to try and get my insurance to cover treatment again, my MRI isn't even until August of next f*cking year. -_-

Our healthcare system is an absolute joke right now.

On top of being in CONSTANT pain (not being able to sit or lie down for very long either cuz I lose feeling in my legs) my daughters disability/mental health program has decided to just... not help anymore until she gets a new assessment. Even though its been almost 3 years and she's still on a waiting list for an adult psychiatrist.

So the last week or so now everyone is coming back to me to try and fix/smooth things out again (after I was basically pushed out of her life because I was "making shit up" and "didn't actually care" and apparently was just being a control freak) and no one has apologized for the way they treated me or forced me out of helping my own kid. Nope. They just expect that now that she has no financial coverage that I should be the one to speak for her again cause they have no idea what to do. -_-

My husband has been solid thankfully, even though his relationship with Sassy has suffered so much because of the people around her who have influenced her... not always for the better. But I at least have maintained a sense of control in a way that's worked for me.

I told everyone who has given me grief for the past couple years about Sassy (including Sassy) that if I am going to advocate for her and get this stuff sorted out that I'm doing it my way, and if I get any push back or flack from anyone - then I'm done. They can figure it out themselves and I wash my hands of it all.

My husband thinks I shouldn't have gotten involved again at all, but I know (and I knew things were gonna blow up eventually) if I don't fix this... its gonna become my problem again anyways.

This past month or so I've had some really good breakthroughs with my therapist about my toxic coping skills, people pleasing and lack of boundaries with family members.

I feel better about things though than I ever have and now that I am standing firm with my boundaries and my convictions its been much easier for me to deal with any gaslighting or potential drama that people have tried to start up with me.

I know this got super long winded and I didn't intend for it to be as rambling and trauma dumpy as it was but - it is good to get things out and clear the air. As I feel like I sort of left an air of weirdness here for quite sometime.

Working on getting back to the things that I enjoy and stop becoming immersed in other peoples drama and things that I can't change.

I've missed you guys and crikey has Tumblr changed since I've been away. But I'm hopeful and I look forward to getting back into fandoms and gif sets and all those things I loved so much again <3

much love to you all

B

[sabaramonds]

if anyone is wondering if im going to do an analysis of double & mikoto i uhhh need to find more stuff to read in english about psychiatric care and dissociative disorder patients in japan but given what ive found so far im like. well this is what i expected from milgram ill be honest having read the voice drama tl and watched the mv 8573485 times (omg hanae natsukis vocals) i do have a few thoughts. mentions of CSA and childhood abuse below as well as medical abuse - mikoto2 ("john" LMFAOOOO) claims he was born from mikotos workplace stress and implies that mikoto did not have DID prior to that; DID is only developed in childhood, but its common to live your life without knowing about it until adulthood (the average age at diagnosis is 29-35 years as of a 2007 paper on sciencedirect i just double checked; according to a 2009 piece from the national library of medicine, the average patient for a diagnosis is a woman of about 30 years old and a retroactive view of the patients medical history and symptoms tend to reveal a lifetime of DID symptoms) so basically im saying that its equally possible deco and yamanaka are unaware of this or mikoto2 is lying his ass off because why would he want to tell some amnesiac teenage prison warden btw the reason i exist is because mikoto was abused as a child. why do you think our mom divorced our dad. even if es likely researched it themself and is probably aware of the statistical likelihood that mikoto experienced long term childhood abuse, why would mikoto2 say it...especially if that abuse was sexual in nature - according to this video recorded by a japanese man (a recovering hikkikomori who experienced forced hospitalization in the past), the 2017 statistics for mental hospital inpatients was that there were 280,000 patients at the time, and 170,000 of those were hospitalized for over a year. 90,000 had been in hospital care for more than 5 years and 26,000 had been in care for 20 years. he also references that most psychiatric care facilities are private in nature, not government-run, so they prioritize the amount of patients they receive in a short period of time because it earns them more profits (another video i watched compared this practice to a mcdonalds burger vs a proper restaurant; make more at a cheaper cost). likewise, long term care facilities dont want to let their patients go easily, because even if families or the patient cant afford to cover the cost, insurance or the government social security system will cover it. a combination of the psychiatric business as its run and the broader cultural attitude towards mental health (in some cases, families do not want their shame to be public, and actively do not want their mentally ill relative to be released from the hospital; if this is the case, its more likely for a patient to be forcibly hospitalized long term without anyone outside to advocate for their release) so im kind of like. hm. (see saw motion with my hand) as far as rep goes i think its kinda middling, especially because mikoto2 is the Alter Who Kills People For Some Reason trope, which always sucks and basically every journal, article, or vlog ive looked into from people with DID has said "god please stop with the murder alter trope please please", but considering the source material i think its...well, its honestly better than what i was expecting. but milgram is designed to be abstract to a certain extent and were still missing information, so who knows. maybe yamanaka and deco have something else up their sleeve regarding mikoto. but yeah i couldnt find anything specifically regarding patients with DID (or related disorders) but i did only poke around for like 2 hours in the middle of the night soooo ill come back to it and that concludes my findings on this topic for today. stay tuned for my next mikoto fic installment or whatever

[gatekeeper-watchman]

The Purpose of a Business 

          I’m usually open–minded to all arguments, but one argument upon which I refuse to bend is the purpose of a business. That is, a business exists for one purpose and one purpose only, to provide a service or product to the people or their representatives, the government for one example–no other. When there is no further need for a business’s product or service, the reason(s) notwithstanding, it ceases to exist. Its purpose is not profit; its purpose is not to provide jobs; and, most certainly, its purpose is not to fill the Christmas stockings of politicians. Its purpose, once again, is to provide a product or service, directly or indirectly, to man.

          I was viewing a speech on C-span earlier today by Senator Mitch McConnell, the Senate Minority Leader of the Senate in which he presented a defense of the coal industry in light of that industry’s current problems with the EPA–he called it “our war on coal”–not. In his presentation he used the testimony of a young ex-coal miner who wrote a song about coal mining, to the effect, saying coal mining is a “way of life”, and we should not decrease our coal consumption so as not to take away that “way of life” (I suppose the ecology notwithstanding). I submit to you, no business is or should ever become a “way of life”. Just as they have always done throughout history, businesses cease to exist when they are no longer needed, become obsolete, or a detriment to the lives of those whom they serve.

          Looking at the subject from another angle or perspective, in fulfilling its purpose stated above, a business should do so in the spirit of the function to be performed as well as in its execution, ethically and responsibly with the ultimate wellbeing of those whom they are supposed to serve in mind. Anything less is immoral and a farce. I’m sure all of you, by now, know that, under the Affordable Care Act, i.e. Obama Care, people with a pre-existing condition cannot be turned down for health insurance. It was reported that United Health Care has found a way around that law by dropping your preferred physician from their coverage. So, what is one to do–especially when your condition is serious and your preferred doctor is critical? What else? You either change doctors (to someone you don’t know and, worse yet, who doesn’t know you) or change insurance carriers, in which case you very possibly will be charged higher insurance premiums. Such action is not within the purpose of a business and is morally reprehensible. I may be idealistic, but I feel a business should not be allowed to exist if it cannot perform in a moral and socially responsible manner. We desperately need to able to trust those with whom we deal.

          Folks, this is just another reason why we need to adopt a single-payer healthcare system, i.e. Medicare for everyone–no confusion, minimal decisions, no muss, no fuss, and, for the people, no bother. I should also add that our proceeding to that end will go a long way toward eliminating our deficit, assuming we establish the same rules governing the negotiations of prescription drug prices as those of the Veterans Administration. This just one example illustrated by United Health Care clearly shows the road ahead for the Affordable Care Act. More United Health Cares will come out of the woodwork every other day. You can count on it. Those who have been blood sucking our people for these many years need to be put in their place, and a single-payer healthcare system modeled after Medicare is the way to do it. Relatively speaking, it’s easy; it’s simple; and it’s doable. Let’s do it. Write your representative in Congress. The Republicans don’t have an alternative plan to the Affordable Care Act.

[thalassarche]

This is kind of long and it's me getting things out. Scroll past if you don't want to read about medical stuff, or declining health of aging parents, or failures of the medical system, or the feeling of personal failures in the face of all of this.

My mom isn't doing well.

I've been living with her for three years now, after losing my job during the pandemic. She had recently been diagnosed with end stage renal failure and needed dialysis three days a week, which really tired her out, so she needed help, and I didn't have a job. So I've been her caregiver for that time. Helping with shopping and meals and appointments and so on. August 1st, she had a stroke, primarily affecting the language centers of her brain, and making speech difficult. She seemed okay when I got up that day but by the time I did my morning routine (teeth brushing etc) she wasn't talking properly and we went to the nearest ER. Since then she's been in neuro ICU, post-stroke rehab, and a short-term care center, for therapy and recovery. Except she was fighting some terrible lower back pain that was making it very difficult for her to do her PT, then getting to the point she was bedridden.

Myself, and her brother and sister-in-law (who are our neighbors), agitated for diagnostics of what was going on with her back pain. They did an xray with "no significant findings" and prescribed oxycodone for pain management. We tried to get a CT scan or MRI or something like that for her and nothing happened, as she was transferred from rehabilitation to short-term care, and short-term care just kept up the narcotics. Well. Now she's in ICU again. CT scan, MRI, and bloodwork revealed that she has osteomyelitis of the lumbar vertebrae -- an infection in the bone/bone marrow of her lower back. There's actually an abcess there in her spine. That's what was causing the hideous pain. Osteomyelitis in the spine has a roughly 20% mortality rate. And Mom just isn't very healthy to begin with. She's a breast cancer survivor with osteoporosis as a result of her treatment. She has diabetes, with that effect on wound healing. She has the aforementioned end stage renal failure, so her kidneys don't work and her blood has to be filtered artificially three times a week. She has atherosclerosis (which may have caused the stroke) and has a stent in her heart, plus an artificial heart valve.

The doctors have said they don't like the look of the infection, and they don't feel she's a candidate for surgery to remove it, so it's going to be treated via antibiotics delivered via PICC for the next 6 weeks. But, it's sort of hanging there, that there's a solid chance she doesn't make it through this. And I just can't stop feeling as if I failed her, by not following through with the additional diagnostics, by not making myself such a pain in the ass that they did it to get me to shut up, and maybe found it sooner. Or that maybe I didn't even catch the stroke soon enough. Or who knows, maybe insurance denied the CT scan, or something like that. Just, that I'm supposed to be her caregiver, and yet, look. I don't know what I'm saying here other than just getting all of this out somewhere. But it sucks. The healthcare system sucks, insurance sucks, all of this sucks, and I just want my Mom.

[decodedlvr]

I’m venting so if you don’t like it get the hell over it. And don’t bother sending me hate, bc I’m not gonna post it for your satisfaction. That would be you “attention seeking” so careful. I’m NOT the one. 

Hearing your doctors use the same excuse that “you’re too young” for this and that is honestly the most heartbreaking thing you could hear

Because when there’s something that could help you live a better life that they CAN do but WONT because you’re not “old enough to deal with these problems” it’s like saying

I can’t have a Better life because you won’t help me GET THERE

It’s not fair it’s not fair it’s not FUCKING FAIR

you’re supposed to be the one HELP me have a better life and help me get there but bc I’m too young to have something my grandma would have, so I can’t have it right? I can’t have a PROCEDURE THAT COULD HELP ME HAVE A BETTER LIFE AND MAYBE EVEN A BETTER MENTAL STATE BECAUSE OF MY AGE!??? so if you’re young fuck you, come back when you’re 50 when your problems are 10x worse. Nice.

ITS NOT EVEN ABOUT “our health care system sucks” it’s literally

: “hey doc I have this problem, I did everything you told me to do for months and now I’m back but the problems worse, I looked into this, maybe this could help?”

: “We usually do this for people who are older or senior citizens, your insurance probably won’t approve because of your age”

: “ I’ve done MY CRITERIA of shit IM SUPPOSED to do so that’s it??? Go home and just suffer some more because I’m not old?”

See how fucked that is. I just wonder how the SUICIDE rates are from lack of giving a FUCK in the field is

Would you tell a kid from St Jude’s they’re too young to have cancer? Would you tell my friend Julia who’s had three back surgeries and major health issues that she’s too young given the proof that HEALTH HAS NOTHING ON AGE???

I can’t get better IF YOU WONT HAVE EMPATHY TO HELP.

GO A STEP AHEAD TO HELP YOUR PATIENT. GODDAMN YOURE GETTING PAID SO WHY NOT? GO A STEP AHEAD YOU COULD SAVE SOMEONE. LITERALLY

Goddamn you can’t go a step further in helping me because you’re told not to right?

Fuck your EGO. Fuck your degree, you may have went to school for this shit but that doesn’t mean you KNOW everything. You aren’t me , you don’t see or feel what I feel so don’t INVALIDATE what I go thru just because you studied this shit and I didn’t. Half of people have to self diagnose themselves and FIND THEIR OWN PROBLEMS WHEN ITS YOUR JOB TO!???

So “young” folk out there if you’re dealing with anything chronically be ready to never get better because you’re too young to get better.

Like I’ve told many people before. When they say “it gets better” no actually it doesn’t. Not for people like me. I can’t get better when I GET NO HELP IN ORDER TO HELP ME GET BETTER. THERES NO POINT. So no it will NEVER get better only WORSE. It’ll only get better when I’m dead and fucking gone. It’s the sad fucking truth.

I’ve cried and hyperventilated too much today I juts I just can’t do it anymore it’s too much. There’s no hope for me to thrive. I don’t deserve to have a better or even tolerable life. Clearly. So thanks doc(s) thank you for adding one more person to that list of nothing than better off disposed. Thanks for not allowing me to have something that could help me live a better life.

What a fucking day..

[dreamlandsystem]

it sucks to be disabled with no “marketable skills.”

our bank account overdrafted by almost $70 because we had to pay the trash bill. we are drowning and desperate to make some extra income.

but we have no skill or talent that we can market or sell. we can’t keep up with working part-time, continuing therapy, and taking care of the house, let alone adopting hobbies that create tangible items to sell. we’re disabled, but because our disabilities make it difficult to talk on the phone, we’ve been denied government aid.

we’ve been feeling incredibly hopeless. again. i genuinely don’t know how much longer we can survive like this.

i feel like we’re letting our wife down. it’s been hard for us to work steadily due to our mental illness and chronic pain. she has bottom surgery in june, and the way things are going for us….. i’m not sure we’ll be able to afford for her to have the procedure. it’s so heartbreaking, because this is the only opportunity she will have to get this surgery (since she will lose her mom’s insurance in august). and because we haven’t been able to work steadily, not only will we be unable to pay our bills, we won’t be able to pay the out of pocket cost for the surgery.

it’s all just so overwhelming. i’m at a complete loss for what to do. i’ve let my system down and our wife down too. we’ve reached a point where we can’t afford to survive anymore :(

sorry for the vent. if anyone has some advice on how to make money as a disabled person with severe mental health issues and chronic hand/joint pain, please reach out. like i said, we are absolutely desperate. at this point idk how we’re going to avoid being evicted.

[cherryblossomshadow]

The Employer-Based Social Safety Is a Disaster. We Can End It.

Hamilton Nolan

Companies can do math … Classic defined benefit pensions are the single most costly benefit that employers traditionally provided, when you add up their total cost over the lifetime of workers. So, for more than 40 years, unionized companies have been absolutely cutthroat at the bargaining table in their determination to shift their workers into 401(k)s. Over the decades, in the private sector, pension after pension has fallen, each a lost battle in an economic war.

Even the man who invented the 401(k) now acknowledges that this process has been a financial catastrophe for workers.

.

I am not bringing this up just to bemoan the fact that companies are greedy. Yes, companies are greedy, but that is because they are in essence machines programmed to maximize profits, so cursing them for being greedy is like yelling at a beaver for making a dam. That is what they do.

What the fuck are we doing? This is all very dumb.

If America were a rational nation we would have sat down after WW2 and said, “Well, we rule the world and we are about to be so, so rich, we’d better just pass a sensible piece of legislation providing for health care and retirement and child care and other basic necessities for all, like a normal and reasonable country.” Of course we did not do that. Instead, deep in Cold War psychosis, we evolved our way into a system that provided health insurance for most people from the employers, which may be a crazy way to do it but is definitely NOT COMMUNIST. Then later we kind of grafted on Medicare to try to plug the hole for people left out of this system. The evolution of employer-provided benefits has continued for generations. But our original sin was allowing ourselves to be drawn into this plainly inferior system in the first place.

.

Not to get super technical here but, because private companies are constantly trying to maximize profits, they have an ENORMOUS and NEVER-ENDING incentive to chip away at the cost of employee benefits. So it is unsurprising that, over time, such benefits will be jettisoned by employers at the first possible opportunity. I know I am speaking in generalities here, but this pretty much captures the trap we have gotten into: 1) Tie necessary life-sustaining benefits to employment, rather than building a universal public government-funded safety net. 2) Erode the unions which are the only force that prevent companies from engaging in a race to the bottom on the quality of these benefits. 3) The benefits go away and people die. In a mature and serious country, “workplace benefits” would be things like, you know, “a variety of free bagels.” Not stuff like “your health insurance” or “your ability to avoid poverty in your old age.” Remarkably stupid system. Really idiotic.

.

The “gig economy” is, in aggregate, an attempt by capital to build a system of employment with no employees. Companies have realized that if you can turn every full-time employee into an independent contractor and every job into a gig, then you can escape the responsibility of paying benefits (and enjoy a work force that is legally unable to unionize). The gig economy is the arbitraging away of the employer-based social safety net. The savings go to the investment class. The model, as you can see, expands to the entire economy, sucking in not just Uber drivers but also adjunct professors. The root cause of this is that we have created an enormous financial incentive for companies to get out of playing the role of Real Employer, which comes with a host of demands for employee benefits. The people who designed this system should have seen this all coming. If they did, they didn’t care.

.

You can write books on this topic, of course, and many people have. (One I read recently is “Over Work” by Brigid Schulte, an interesting exploration of various often stymied attempts to make workplace benefits more humane.)

.

Today, all I want to do is point out the fact that there is an escape route from all of this. This is an issue that presents the opportunity to create a natural alliance of convenience between business and workers. Not because business “cares” about human quality of life, but because business cares about itself.

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If you open an ice cream shop, you want to sell ice cream. Do you want to be a health insurance provider? No. Do you want to be a life insurance provider? No. Do you want to be a retirement investment account provider? No. You want to be an ice cream provider. The absurd burden of making businesses into benefit providers weighs most heavily on small businesses, which are forced to pay to outsource this stuff to large firms. The system is predatory and confusing for employers and employees alike. Unfortunately, the logic of capitalism is simply for employers to try to escape their obligations to provide benefits, which leaves employees with nothing.

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What needs to change is simply the calculation that employers make about what the path of least resistance is for their own operations. The rise of the gig economy is what happens when employers believe that their best option is just to pretend like none of this is their problem. Yet it is—in the long run, employers need a stable society that creates healthy working people who can survive and are not so desperate that they steal from their employer and also chop up the CEO and throw him in a river.

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Employer-based health insurance, a system hated by everyone that benefits nobody except health insurance companies, is probably the single most obvious issue upon which the AFL-CIO and the Chamber of Commerce should be on the same side. Business should be demanding Medicare For All as loudly as Bernie Sanders is! They don’t want to deal with this shit either! All of this is, by definition, a distraction from an employer’s core business, and a financial burden. The same goes for providing retirement benefits to workers. Adequate public health care and adequate Social Security that obviates the need for private health insurance and private retirement plans would be great for American business. It would leave them to just do the thing that they are in business to do.

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I don’t want to sound like a naive moron here. In order for the business world writ large to come to this conclusion, the first thing we must do is to close off the easier possibility they now prefer, which is to escape their responsibilities altogether through subcontracting and pushing full time jobs off their books, or whittling down benefit costs to the smallest possible number by eradicating union power. That means that we need to regulate the gig economy out of existence, at least in the sense of requiring gig economy companies to treat their workers like employees rather than independent contractors.

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Building a public safety net would mean more taxes for businesses.

But a government system would be more efficient, meaning the long term cost would be lower, and

employers would also get the invaluable gift of never having to think about this shit again.

Providing a necessary social safety net to all citizens is properly the role of the state, not of private business. The very idea of outsourcing this role to private employers is plainly ludicrous.

[natashalie-lumley]

Ok. This is something that maybe doesn't apply to everybody but I don't care because literally Nothing applies to Everybody. And I need to write some of this down before going to bed and having to get up for work again tomorrow

Some context: I answer phones for the Medicare department of a national health insurance agency. That means I'm mostly dealing with older people or younger people with disabilities. It also means a lot of calls about heavy topics. Which is a great lead in to my first point.

1) your member services rep is NOT your trauma dumping ground. I don't want or need to know about your shitty life, past present or future. I get so many people every day telling me they don't have any family or friends and they don't like their lives and honey I'm sorry because that does suck but I AM NOT A COUNSELOR. I'm here to answer your health insurance questions and get you off the phone.

2) similar point, WE ARE NOT MEDICALLY TRAINED PROFESSIONALS!! the number of times I've been asked "what medication should I be on" or "should I have this procedure" is higher than you think. And yes there are some people who are asking "what medications are covered" (which is a little easier to answer) and "is this procedure covered", but that's not what they Ask. Also leads in to point 3

3) we don't need to know your symptoms! We can't do anything with that information! Even if you're calling because something got denied and you want to appeal it, telling us about how you need the chemo because you're losing bodily functions or something is Not Helpful and in fact is very stressful. And no, me adding that to the appeal does not increase the chances of it getting a positive result.

4) don't ask super broad questions. A common one is "am I on the best plan" and they always seem confused when I can't just say "yes/no" to it. Each plan is just slightly different from the other, be it in the amount of dental work it covers or the medications it includes. I need to know what factors matter to you before I can tell you whether there's a plan that would work better.

5) if we say something is a Medicare rule, it means WE CANT CHANGE IT. the biggest one is the Coverage Gap, sometimes called the donut hole. (Tl;Dr is that after so much money gets spent on your meds you end up paying 25% of the cost instead of flat co-pays, which on like a handful of meds actually does save people money but usually it raises the price into the triple digits for a month supply.) Look, we know it sucks. We know that the whole system of stages is fucked. And we would LOVE to find a way for you to get your meds for free or super cheap. But as I mentioned before, we are not social workers and our resources for that are basically Google. So if we say "ok looks like the issue is [Medicare policy x]", telling us how much you need x is not going to change the fact that Medicare gets to do what they want.

6) HIPAA is a big ass deal and unfortunately it can mean making things difficult. Oh, your grandma has dementia and can't talk on the phone? Well unless you're authorized on her account or filed as her POA then grandma has to verbally come on the recorded line and say I can talk to you. Thankfully we're told that the caller can coach the member but like. It's still difficult and sometimes they're not in the same place let alone same state, and we have to say "ok so I can share certain information with you but I can't answer all your questions". If that happens, getting pissy at the rep isn't going to change THE LAW.

7) I'm sorry if you've been transferred a million times but if I can't help you because you need the dental dept, asking me questions is just prolonging both of our suffering. And yelling at me for it does nothing.

8) I don't know why other people do things. One of my absolute least favorite questions is "why did the last person I talked to tell me x and you're saying y??". Dude I don't fucking know I barely know why I DO THINGS and you want me to explain somebody else? (Also half the time the answer is "they didn't want to deal with you getting mad so they said what you wanted to hear" but I can't say that on the recording but it's true.)

9) technology sucks. I have 2 monitors and a laptop for work and I consistently want to introduce at least one of them to the business end of a mallet. Pages load slow or not at all and it's not on me so getting mad at me for taking some time helps exactly nobody.

10) those surveys at the end do have a result- bad reviews get coaching and good reviews go towards getting a raise. So even if you don't think it's worth it, if it's three questions or less maybe just take the dang thing.

11) if we're having trouble explaining something, it doesn't automatically mean we don't understand it. I get insulted at least once a day by someone intimating that if I were smarter there wouldn't be any issues and let me tell you, half the time is me remembering all of the non-advanced terms for things so I can try and break something down for you but the other half of those long pauses are me going "how to better explain the concept of co-pays when I can't break it down any further than "you have to pay for medical services".

12) if you say "well I'm going to change my plan" because we couldn't help you or something wasn't covered, please know that we are seconds from going "fine don't let the door hit your ass on the way out". We don't care, we can't care, because there are hundreds of you and it adds so much to the pile.

13) yes, a lot of us are working from home. Yes, a lot of the employees are from overseas. Yes, the costs of things suck. But if you try and engage us in any of those topics, the best you're getting is a non-committal response because and I can't stress this enough, we NEVER KNOW WHO IS LISTENING. So stop trying to get that agreement tell me what you wanted and go away.

14) if it sounds like a script it probably is. I get graded on my opening AND my closing and if I miss even a beat of it I get points off. So please. Don't hang up. Don't try and "uh-huh" every 2 seconds so we stop. Just listen and deal. Oh and please for the love of heaven, don't tell us "no I'm not taking the survey". What am I going to say to that, huh? Esp when, again, those do affect our jobs. Just say good day and hang up.

15) answer the question you were asked! This applies in both simple things (I end my greeting with "who do I get to help today" and the number of times people skip their name entirely or only give me their first name drives me up a wall) and in more complex questions. If I'm asking a clarifying question about a story you just told me, I don't need the whole story again! I just need that piece of information! You might think you're helping but really I'm sitting there glaring at the screen biting a hole through my lip in the effort to not punch you.

16) speaking of thinking you're helping, STOP INTERRUPTING. If you have something to clarify or think we missed something, keep your mouth shut and be respectful and wait until we stop talking. I hate being interrupted and so often it's something completely useless and I've actually started to very pointedly say "as I was saying" or just altogether interrupt back and say "please don't interrupt me" because "I'm sorry to interrupt but I could answer that question if you let me" was getting me nowhere.

There's probably more but I'm actually getting tired for once so I'm off to bed. The long and short of it- please remember that the person on the other end does not make the rules, does not make the decisions, and is doing their best. And also no their supervisor can't do those either because all of that is back of house and according to the internal phone book they don't exist. Sometimes you get a negative result on something and that's just life.

[gatekeeper-watchman]

The Purpose of a Business 

          I’m usually open–minded to all arguments, but one argument upon which I refuse to bend is the purpose of a business. That is, a business exists for one purpose and one purpose only, to provide a service or product to the people or their representatives, the government for one example–no other. When there is no further need for a business’s product or service, the reason(s) notwithstanding, it ceases to exist. Its purpose is not profit; its purpose is not to provide jobs; and, most certainly, its purpose is not to fill the Christmas stockings of politicians. Its purpose, once again, is to provide a product or service, directly or indirectly, to man.

          I was viewing a speech on C-span earlier today by Senator Mitch McConnell, the Senate Minority Leader of the Senate in which he presented a defense of the coal industry in light of that industry’s current problems with the EPA–he called it “our war on coal”–not. In his presentation he used the testimony of a young ex-coal miner who wrote a song about coal mining, to the effect, saying coal mining is a “way of life”, and we should not decrease our coal consumption so as not to take away that “way of life” (I suppose the ecology notwithstanding). I submit to you, no business is or should ever become a “way of life”. Just as they have always done throughout history, businesses cease to exist when they are no longer needed, become obsolete, or a detriment to the lives of those whom they serve.

          Looking at the subject from another angle or perspective, in fulfilling its purpose stated above, a business should do so in the spirit of the function to be performed as well as in its execution, ethically and responsibly with the ultimate wellbeing of those whom they are supposed to serve in mind. Anything less is immoral and a farce. I’m sure all of you, by now, know that, under the Affordable Care Act, i.e. Obama Care, people with a pre-existing condition cannot be turned down for health insurance. Guess what, 0n CNN, it was reported that United Health Care has found a way around that law by dropping your preferred physician from their coverage. So, what is one to do–especially when your condition is serious and your preferred doctor is critical? What else? You either change doctors (to someone you don’t know and, worse yet, who doesn’t know you) or change insurance carriers, in which case you very possibly will be charged higher insurance premiums. Such action is not within the purpose of a business and is morally reprehensible. I may be idealistic, but I feel a business should not be allowed to exist if it cannot perform in a moral and socially responsible manner. We desperately need to able to trust those with whom we deal.

          Folks, this is just another reason why we need to adopt a single-payer healthcare system, i.e. Medicare for everyone–no confusion, minimal decisions, no muss, no fuss, and, for the people, no bother. I should also add that our proceeding to that end will go a long way toward eliminating our deficit, assuming we establish the same rules governing the negotiations of prescription drug prices as those of the Veterans Administration. This just one example illustrated by United Health Care clearly shows the road ahead for the Affordable Care Act. More United Health Cares will come out of the woodwork every other day. You can count on it. Those who have been blood sucking our people for these many years need to be put in their place, and a single-payer healthcare system modeled after Medicare is the way to do it. Relatively speaking, it’s easy; it’s simple; and it’s doable. Let’s do it. Write your representative in Congress. The Republicans don’t have an alternative plan to the Affordable Care Act. Here’s one for you. From: Steven P. Miller @ParkermillerQ,  gatekeeperwatchman.org Tuesday, June 18, 2024, Jacksonville, Florida., USA. Founder and Administrator of Gatekeeper-Watchman International Groups: Https://gatekeeperwatchman.org/post/751889961062744064/daily-devotionals-for-may-30-2024-proverbs-gods? X/Twitter ... @ParkermillerQ   #GWIG, #GWIN, #GWINGO FACEBOOK/META GROUP: Founder and Creator… Steven P. Miller/ Gatekeeper-Watchman International Group Https://www.facebook.com/groups/Sparkermiller.JAX.FL.USA Timeline: https://www.facebook.com/gatekeeperwatchnan TAGS:  #GWIG, #GWIN, #GWINGO, #IAM, #Sparkermiller, #Eldermiller1981

[ms-demeanor]

Reminder that I was in the exact age cohort that got kicked off my parents' insurance before the ACA kicked in so for my last two years of college the only medical care I had was through the health center at my school OR what I could afford out of pocket so the only treatment available to me when i injured my back was to go and see the chiropractor who broke my spine because I injured myself while school was shut down for winter break.

At that point, you couldn't stay on your parents' insurance after you were 24 and there wasn't any kind of subsidy for the insurance so either you got insurance through work or you paid through the nose; I know it seems expensive to pay insurance premiums now but here's an excerpt from a story from 2009:

That lady's premium *started* at $240 ($364 adjusted for inflation), then went up to $315 (478), and went up AGAIN to $484 ($734).

A health care plan in California right now would cost the same person (45 year old woman with relatively low use and an average individual wage) $422 out of pocket with a $58 dollar rebate for at total cost of $363, so nearly exactly the same price as her starting insurance. (NGL, it's weird the way that worked out; you can do the numbers if you want, I estimated her at 55k a year in the 91105 zip code at 45 years old with median use and went with the blue shield silver hmo)

The system we have now is *not good* but it is a FUCK of a lot better than what we were dealing with fifteen years ago. Because it sucks, we should continue fighting to make it better. (And it does suck; there are still plenty of people with gaps in coverage and we're paying more than 20% of our household income to insurance in spite of also paying taxes for a perfectly functional medicaid system; these things could be combined and would cost less and provide coverage for more people!)

On insurance: I still live with my parents and don't know a lot yet about the sorts of things adults usually have to spend money on. I've always been skeptical of things like insurance and credit cards because it seems to me they wouldn't be selling that if they didn't expect to make money from it. I talked to my cousin a while ago about credit cards and basically came to the conclusion that they do that because they're betting on the customer getting sloppy and letting their debts stack up, and the way you beat that and get money from credit card companies is just by being careful.

I'm a little more confused about insurance though because it seems much more straightforwardly like a gamble they will simply not take if it won't pay off for them. Like, you don't go to a casino because every game they play at a casino is one they've done the math on and have determined that statistically most people will lose money on most of the time. Is insurance not kinda the same? Where they estimate the risk and then charge you an amount calculated to make sure it probably won't be worth it for you?

I know if you have a car you legally need car insurance so everyone knows you can pay for another car if you crash into someone, and I gather that here in the US at least health insurance companies have some kinda deal with hospitals so that the prices go down or something, and there's a reason I don't fully understand why not having health insurance is Really Bad. But we get to pet insurance, or like when I buy a concert ticket and it offers ticket insurance in case I can't make it to the show, and surely if they thought they were gonna lose money on that they just wouldn't sell it, right? Or they'd raise the price of it until it became worth the risk that something bad actually will happen? Wouldn't it only be worth it to buy insurance if you know something the insurance company doesn't?

So the deal is that most people don't use their insurance much, and often insurance companies will incentivize doing things that will make you use your insurance less.

So, for example, you can get a discount on car insurance if you have multiple cars because people who insure multiple cars are more likely to be responsible drivers (the ability to pay for multiple cars stands in as a representation of responsibility here). The longer you go without an accident, the lower your premiums get because that means that you are not costing your insurance company anything but you are paying into the system. The car insurance company's goal is to have the most responsible, safest drivers who never get into car accidents because they can predict (roughly) how much they're going to have to pay out to their customers and they want the number they pay out to be lower than what's paid in. So they try to discourage irresponsible drivers by raising their rates and encourage responsible drivers by giving them discounts.

Health insurance companies often do the same thing: I recently got a gift card from my health insurance company because I had a visit from a nurse who interviewed me about my overall health and made sure I had stable blood pressure and access to medications. It is literally cheaper for my insurance company to give me a $100 giftcard and hire a nurse to visit me than it is for me to go to my doctor's office a couple of times, so they try to make sure that their customers are getting preventative care and are seeing inexpensive medical professionals regularly so that they don't have to suddenly see very expensive professionals after a long time without care.

Insurance in the US has many, many, many problems and should be replaced with socialized healthcare for a huge number of reasons but right now, because it is an insurance-based system, you need to have insurance.

We're going to use Large Bastard as an example.

Large Bastard had insurance when he had his heart attack and when he needed multiple organs transplanted. He didn't *want* to be paying for insurance, because he thought he was healthy enough to get by, but I insisted. His premium is four hundred dollars a month, and his out of pocket maximum is eight thousand dollars a year. That means that every year, he pays about $5000 whether he uses his insurance or not, and if he DOES need to use the insurance, he pays the first $8k worth of care, so every year his insurance has the possibility of costing him thirteen thousand dollars.

The bill for his bypass surgery was a quarter million dollars.

The bill for his transplant was over one and a half million dollars.

His medication each month is around six hundred dollars. He needs to have multiple biopsies - which are surgeries - each year, and each one costs about twenty thousand dollars.

Without health insurance, he would very likely be dead, or we would be *even more* incapable of paying for his healthcare than we are right now. He almost ditched his insurance because he was a healthy-seeming 40-year-old and he didn't think he'd get sick. And then he proceeded to be the sickest human being I've ever known personally who did not actually die.

Health insurance costs a lot of money. It costs less money for people who are young and who are expected to be healthy. But the thing is, everybody pays into health insurance, and very, very few people end up using as much money for their medical expenses as Large Bastard did. There are a few thousand transplants in the US ever year, but there are hundreds of millions of people paying for insurance.

This ends up balancing out (sort of) so that people who pay for insurance get a much lower cost on care if they need it, hospitals get paid for the care they provide, and the insurance company makes enough money to continue to exist. Part of the reason that people don't like this scheme is because "insurance company" could feasibly be replaced by "government" and it would cost less and provide a better standard of care, but again, with things as they are now, you need to have insurance. Insurance companies are large entities that are able to negotiate down costs with the providers they work with, you are not. If you get hit by a car you may be able to get your medical bills significantly reduced through a number of means, but you're very unlikely to get your bills lower than the cost of insurance and a copay.

Because of the Affordable Care Act, which is flawed but which did a LOT of good, medical insurance companies cannot refuse to treat you because of preexisting conditions and also cannot jack up your premiums to intolerable rates - since Large Bastard got sick, he has had the standard price increases you'd expect from aging, but nothing like the gouging you might expect from an insurance company deciding you're not worth it.

Pet insurance works on the same model. Millions of people pay for the insurance, thousands of people end up needing it, a few hundred end up needing a LOT of it, and the insurance companies are able to make more money than they hand out, so they continue to exist. This is part of why it's less expensive to get pet insurance for younger animals - people who sign up puppies and kittens are likely to be paying for a very long time and are likely to provide a lot of preventative care for their animals, so they're a good bet for the insurer. Animals signed up when they are older are more likely to have health problems (and pet insurance CAN turn animals away for preexisting conditions) and are going to cost the insurance companies more, so they cost more to enroll (and animals over a certain age or with certain conditions may be denied entirely).

This weighing risk/reward is called actuarial science, and the insurance industry is built on it.

But yeah it's kind of betting. The insurance company says "I'll insure ten thousand dogs and I'm going to bet that only a hundred of them will need surgery at some point in the next year" and if they're correct, they make money and the dogs who need surgery get their surgery paid for out of the premiums from the nine thousand nine hundred dogs who didn't need surgery.

Your assessment of credit is correct: credit card companies expect that you will end up carrying a balance, and that balance will accrue interest, and the interest is how they make the money.

And it is EASY to fuck up financially as an adult. REALLY EASY. But you are still likely to need a good credit score so you will need a credit history. That means that the correct way to use a credit card is to have a card, but not carry a balance.

To do this, never buy anything on the card that you can't afford. In order to avoid needing the card for emergencies, start an emergency fund that is at least 3 months of your total pay *before* you get a credit card. That seems like a *lot* of savings to have, but from the perspective of someone who has had plenty of mess-ups, it's a lot easier to build up a $10k emergency fund than it is to pay off a $10k credit card debt.

If you don't understand how interest works on credit cards, or why a 10k savings is different than a 10k debt, here are some examples working with $10k of debt, 23% interest (an average-ish rate for people with average credit), and various payments.

With that debt and that interest, here's how much it costs and how long it would take to pay off with $200 as the monthly payment:

Fourteen years, and it would cost you about twenty four thousand dollars in interest, for a total amount paid of about thirty four thousand dollars.

To save $10k at $200 a month would take four years and two months.

Here's the same debt at $300 a month:

4.5 Years and it costs about six grand (again, just in interest - sixteen thousand dollars total). Saving ten thousand dollars at three hundred dollars a month would take just under three years.

Here's the same debt at $400 a month:

3 years, about $4000 dollars (fourteen thousand dollars total). Saving ten thousand dollars at $400 a month takes just over two years.

The thing is, with all of these models you're going to end up paying one way or another. Insurance vs out of pocket is you weighing the risk of losing a fair amount of money by signing up but not using the system, or potentially losing a catastrophic amount of money by not signing up.

For credit cards they really only work if you know you're never going to need them for an emergency, because an emergency is what you're not going to be able to pay off right away. I didn't have an emergency fund when Large Bastard had his heart attack and needed surgery, or when we moved between states suddenly, or when we moved between states suddenly AGAIN and needed to pay storage costs, or when Large Bastard needed a transplant, or when Tiny Bastard got in a fight with my MiL's dog, and the fact that I didn't have an emergency fund is still costing me a lot of money.

So, young folks out there: what's the takeaway?

Get insurance. Get the best deal possible, which usually ends up being the one you sign up for early. You may think you can let it ride without insurance, but man in the six months between when I graduate college (and lost my school insurance) and when care kicked in after 90 days at my job I got electrocuted and needed to go to the ER. If that hadn't been a worker's comp payout I would have had thousands of dollars in bills. Something could happen. You could break your leg, you could get hit by a car, you could suddenly find out that you actually have heart disease at twenty, you could develop cancer. Have insurance, you need insurance. You legally need car insurance in the US, and you financially need health insurance. If you have a pet, I think it's a good idea for them to have pet insurance.

Credit cards are not for emergencies, they are not for fun, they are not for buying things that are just ever so slightly out of your budget, they are for taking advantage of the credit card company and managing to get by in a system that demands you have a credit score. ONLY put purchases on your credit card that you already have cash for. Before you get a credit card, build up an emergency savings so that you aren't tempted to put emergency charges on your card.

If you DO end up with an interest-bearing debt, pay it off as fast as possible because letting it linger costs you a LOT of money in the long run.

Stay the fuck away from tobacco and nicotine products they are fucking terrible for you, they are fucking expensive, and they are not worth it put the vapes down put the zyns down put the cigarettes down I will begin manifesting in your house physically i swear to fuck. Knock that shit off and put the cash that you'd be spending on nicotine into a savings account.

Take care, sorry everything sucks, I promise that in some ways it actually sucks less than it did before and we're working on trying to make it suck even less but it's taking a while.

[vaspider]

Transmedicalism is a plague upon all trans people and it must be stopped.

No, really.

Transmedicalism damages the rights and transitions of all trans people, even those who feel protected by it, and its adherents within the trans community do active damage to every single trans person by continuing to push it.

What is transmedicalism?

Transmedicalism is a belief founded upon the pathologizing white cisgender view of transgender/transsexual* existence.

Transmedicalists believe one or more of the following statements:

Without the experience of the medical phenomenon known as gender dysphoria, a person is not "truly transgender."

If one does not wish to medically transition, or to "fully medically transition", including hormone replacement therapy, name changes, and one or more surgeries, that person is not "truly transgender."

Non-binary identities are not transgender identities.

Cultural identities (such as two-spirit, tumtum, and others) are not transgender identities.

Transmedicalists are also known as transmeds or "truscum," a neologism which means "true transsexual scum." There is an unfortunate amount of overlap between the transmed community and the radfem community, with many transmeds believing that they are not "truly" their proper gender and accepting a second-class status within their gender.

So, starting from the understanding that transmedicalism as it is currently defined requires the belief in at least one of the above statements, why is being a transmed harmful even to people who follow the binary paths laid out by transmedicalism's most ardent adherents?

Transmedicalism allows cisgender doctors to define our experience.

Okay, let me start by saying that I understand that under the current health care system in the United States, a diagnosis is required in order for insurance to pay for medication and/or treatments, rather than treating medical interventions as "optional" or "cosmetic." This is a separate issue, to my mind, to seeing the transmedicalist line carried by the community end. Yes, the medical system is set up currently to see us fail; that doesn't mean that we need to carry that water for them.

The current medical view of transgender life is predicated upon the idea that our existence is based in pain. Basically, goes the cis thinking, every trans person would be cisgender if only we could manage it, but we just can't, because it's too painful. It's not that we're happier when our gender identities are confirmed, it's not that we live fuller and more complete lives, and definitely no one would ever choose our lives, because being trans is a shitty, hard life compared to being cis. Transition is a sort of "lifestyle of last resort."

Trans people are not "failed cisgender people", and that is the mindset which transmedicalism adopts. We are not one of many ways in which humanity expresses itself and what we are isn't a normal and natural way of being, says transmedicalism, but an aberrant way of being whose existence can only be tolerated simply because there is no other choice for us.

Uprooting the transmedicalist mindset means uprooting the mindset that we define ourselves by pain and allowing our community to define itself instead by the whole of our experience, including our pain, yes, but also including our joy. Trans liberation means the opportunity for kids to be raised without fear or shame about their gender, and what then? If we are ever to achieve true trans liberation, we cannot define ourselves solely by our pain, because that would mean that if we remove the societal sources of our pain, trans people would cease to meaningfully exist in that definition.

Transmedicalism as a philosophy therefore creates a trap which means trans existence will always be defined by its pain. And that? Sucks.

Transmedicalism means imposing a harmful "single true path" on all trans people.

If you've been around the trans community for more than 5 seconds, you know that there are uncountable different trans experiences. Transmedicalism, however, reinforces and underlines the "born this way" and "always knew" narratives, excluding those of us who didn't "always know" and those of us with fluid, complicated, or non-binary experiences. This is incredibly screwed up, especially for those of us who grew up before the advent of the modern internet, grew up in extremely conservative households, or simply changed or developed as we grew. Transmedicalism views a trans person as a static thing, one who "always knew" and "always suffered" from gender dysphoria, and that mindset forces a lot of us to lie or tell half-truths in order to receive support or medical treatment.

(read the entire thread, please.)

Even for those of us with binary trans experiences, pushing an idea that one must follow a single path which includes a set number of medical interventions means that a trans person may feel that they must receive these medical interventions -- whether or not they want them -- to be "really trans" or accepted by the community. To be clear, this should not be taken as me saying that the trans community is the source of this mindset or this belief: transmedicalism comes from outside the trans community, imposed upon us by the transphobic medical establishment and transphobic cisgender society, who view themselves as the arbiters of who is 'really trans' or not. If fault is to be laid at the feet of anyone for trans individuals who feel that they must receive medical intervention to be viewed as 'really trans', it must be laid at the feet of medical establishments, individual doctors, school systems, governments and other cisgender authorities who push this medical-intervention-necessary-or-else-not-trans model.

The decision on the appropriateness of any given medical intervention should be a decision made between an individual person, their parents if underage, and their doctor(s), and as with all other questions of bodily autonomy, should not be interfered with by governments, UK Twitter users with 10 accounts and the suffragette flag in their handle, or the writers of derivative wizard-school books.

Like, really, these standards are set up in order to diminish us and to "discourage people" from coming out as trans -- the harder it is to be 'really trans,' goes the thinking, the fewer of us will exist. It is an outright trans-exterminatory model which we really need to stop buying into as a community.

Transmedicalism as a philosophy pushes medical intervention which may not be appropriate or safe for a given individual.

Whether it's someone with Ehlers-Danlos Syndrome for whom top surgery is not advisable, someone in a conservative area who can't live 'out' full-time and can't start hormone therapy, or someone who just isn't ready yet for whatever reason, transmedicalism imposes a script on trans people, and that one-size-fits-all approach simply isn't appropriate for anyone.

Let me repeat: nothing I say is or should be misconstrued as an argument for laws restricting transition by age, for interference in transition by outside forces, or any other such bullshit.

Likewise, even if we're just talking about binary trans people, a given intervention may not be appropriate or desired by a particular person. Transmedicalism pushes all manner of surgeries and medications, pushes the idea that if you don't do this, you're not trans, and that's not only simply not true but diametrically opposed to the truth of trans liberation. Trans liberation means the ability to experiment with gender and presentation, to begin or desist transition without fear, shame, or reprisal from within or without the community, and to recognize and focus on our joy as the central piece of our experience.

When you add in non-binary, genderfluid, and culturally-gendered people to the equation, it becomes glaringly obvious that a one-size-fits-all approach simply doesn't work.

Transmedicalism pushes the idea that desistence is a sign of not being "truly trans," or that transition was a "mistake" rather than a step along the way toward self-understanding.

I've seen this more than once -- someone transitions to a binary gender and then realizes that they're actually non-binary, or begins transition and then finds that they're in an unsafe situation for transition. (The majority of desisters/detransitioners stop transition due to lack of support, and retransition when they have better support or are able to move to a friendlier/safer situation.) Not only then do they have to deal with the incredibly complicated business of retransitioning, they have to then deal with people calling them a 'faker' or 'not really trans' or whatever else. It's not too different from the experiences of people who come out as gay or lesbian only later to realize that they're bisexual or pansexual, to be honest, with the same sort of social backlash.

We've got enough on our plates when it comes to dealing with our lives as trans people without trying to push the idea that desistence means you "were never trans" or "aren't truly trans." We don't need to do that to ourselves, to each other, or to someone who truly did experiment with gender and realize they were transgender. Trans liberation means the ability to experiment with gender is available to everyone, including those who later determine themselves to be cisgender.

Transmedicalism can be really tempting to trans people who do not have a lot of social support or who do not have contact with other, especially older, trans people -- look, it's scientific! look, you can't deny me this because otherwise I will die! -- and for a lot of binary trans people, following that single path of stereotypical medical interventions will not only provide relief from gender dysphoria but serve to give gender euphoria a wonderful garden in which to blossom. However, as a view of the community, it's absolute poison.

What is right for you need not be right for me: we understand this when it comes to other choices that people make with their bodies as a core tenet of feminist philosophy. One person's decision to have an abortion does not mean another person's decision to carry an unintended pregnancy to term is the 'wrong decision' and vice versa. We understand that a woman is not defined by motherhood or by carrying a child; we understand that a child-free life does not reflect poorly on those who choose to carry a child or to become a mother in another fashion. We understand that cis women who are unable to or do not want to carry children are not "unwomen," and that a single life path determined by natal biology and circumstance, imposed on women by the machinery of the cishetalloperipatriarchy, makes no sense. We understand that we do not require the approval of professionals for our plans for our body, and that we alone have -- ro should by all rights have, fuck you, Texas -- the sovereign ability to determine what we want our bodies to do.

Why, then, do we accept a philosophy within our communities which mandates a single defined path for transgender people and a single definition of transgender identity contingent upon approval from an often-hostile medical establishment which views our existence as a "life of last resort"?

Kinda bullshit, honestly.

*Sometimes viewed as outdated, the term transsexual is still used by many older trans people and has been recently reclaimed by some younger trans people. I include it in the name of greatest inclusivity of our community; there's no need for me to be exclusive while talking about how philosophies damage us.

[thatbadadvice]

Help! I Could Keep My Brother Alive, But I Don't Like His Wife!

Carolyn Hax, Washington Post, 1 November 2021:

Dear Carolyn: What do I owe my siblings, if anything? My husband has been fortunate enough to make a lot of money, and we agreed long ago that it was for us and our adult sons, not our (many) deadbeat relatives. My older brother pretty much raised me and helped my husband when starting out. Brother had a severe stroke three years ago, and Second Wife claims they have gone through all their savings and are now $140,000 in debt with all the costs. She is trying to guilt me into helping them. I do not feel this is appropriate.

She did quit her job to take care of him, but they were improvident and did not buy long-term care insurance. I ask her why she does not put him in a home or hire a full-time aide and she says they can’t afford it. Brother’s adult children tell me Second Wife is horrible, which is why they choose not to help, either. Second Wife had the nerve to ask me to help buy Brother an oxygen concentrator. It is expensive: $2,500. I think this is pushing it. She comes off as bitter, so we said no.

Now she tells me she will have to launch a GoFundMe, because otherwise they will lose their house. This will be extremely embarrassing to my husband and me, because we are prominent in the community. What do you advise? — Family

Dear Family,

While your problem has, on the surface, a very obvious solution — let the brother who raised you and gave your now-wealthy family its start in the world die a slow, desperate death in poverty because you don't like his wife's attitude — families are complicated. Sometimes it's not as easy as getting what you want from someone financially and emotionally and then abandoning them forever because you don't care whether they live or die — because then the neighbors might talk! What a pickle.

Of course your brother should be forced to forego the medical care he needs because you don't like his wife. That much is clear. It's not about the money — you'd never miss a dime — but you think your brother's wife sucks, so it's just really not worth ensuring he has the medical care and housing he needs. Anyone in your shoes would make the same calculation without a second thought.

However, things get sticky when we start thinking about what really matters: how embarrassing it will look to people you aren't related to, who you've never met and have no responsibility toward, if it comes out that your brother is an irresponsible poor who didn't even get long-term health insurance before deciding to have a stroke in a country with an exploitative, unjust, discriminatory, and deliberately impenetrable medical system that drives millions of people into unimaginable debt every year.

It would be a kindness if the man who raised you and seeded your family's vast financial success could just suffer in silence and die in the streets with his bad wife and leave you out of it. That's an outcome you could be proud of — the kind of comfortable, happy little family story you'd be fine sharing with a few intimate friends at the club. But for your sister-in-law to publicly humiliate you by trying to stay alive and housed in order to fund your brother's medical care, when she knows you simply can't help him because you hate her! That is impudence of the highest order, and your brother's wife is only creating for everyone a self-perpetuating cycle wherein she quits her job to care for her husband and has to beg other people for money to stay alive, and you have to keep not giving her money because you hate her because she's so poor and embarrassing! The one and only solution in this situation is so simple — she shuts up, he dies! — and yet, this self-absorbed couple just can't bring themselves to take the necessary steps.

There's nothing you can do here, since funding your brother's medical care as the most minimum thanks for his support at the most crucial times in your own life will only help him live a longer and more comfortable life without his wife having to make a big public show of their poverty at you. Some people really can't see past their own self-interest! An upside: if your in-laws go forth with their crowdfunding plan, you will see your own visibility in the community grow in some interesting new ways.

[angrypaperearthquake-tbbb-main]

Y'all want to know how messed up the American healthcare system is???

Every 12 weeks I get a birth control shot. This is for several reasons, but most important being exploding cysts on my ovaries (yay). The birth control prescription itself is completely free under the Affordable Care Act.

In 2021, I was charged $4.31 to go to the gynecologist, take a pregnancy test, and get injected. The pregnancy test was not fully covered, which is why I paid $4.31. I find that reasonable.

In 2022, I was a charged a specialist copay of $100 for the same exact services. I broke down crying in the waiting room, because $4 is easier to swing in a budget than $100. I refused to pay the copay and they sent me a bill for $105.

I have been fighting my insurance company, alongside the head of my HR department, for two months. She's awesome and is completely on my side. The insurance company has been jerking us around and not answering our questions.

Yesterday they sent us an email stating I was billed a specialist copay because, I saw a specialist. Then they followed it up with this statement: "Specialist Physician: A physician who has a majority of his or her practice in areas other than general pediatrics, internal medicine, obstetrics/gynecology, family practice or general medicine."

This is American healthcare. THIS. The American healthcare system is not made for sick people. It's a greedy scam that sucks the money out of people who need it the most.

I see 4 specialists a year, sometime more due to my health conditions. I can pay $400 any given year, plus overages. Now they want me to pay an extra $400 a year for a service that is supposed to be covered. That's about $1000 a year that is NOT applied to my deductible or my out-of-pocket maximum.

Welcome to America. Home of the healthy, because if you can't afford healthcare you're basically dead.