#so no medicare coverage. at all.

[lunarflare64]

AUSTRALIA'S ME/CFS CLINICAL GUIDELINES ARE BEING UPDATED! THE GOVERNMENT APPROVED FUNDING FOR THE RESEARCH! FUCK YEAH!

[yrrtyrrtwhenihrrthrrt]

In light of Brian Thompson being shot dead on my birthday (🎉🥳🎂) I'd like to share a personal story about UnitedHealthcare.

During the peak of COVID, my family all got sick. I couldn't be on my parents' insurance because they were both older and on Medicare. So, I had insurance through my University: UnitedHealthcare.

For some reason, rather than roll-over each year, I got a new plan each year that ended after May and didn't start until August, so I was uninsured for the summer months, but it was a weird situation that the university denied, and told us we were supposed to be insured year-round, it was messy.

Both of my parents went to the hospital, and I got sick too. I had to take care of my pets, and myself, and try to stay alive and keep my pets alive when I was so weak I could hardly move. When my parents came home, my condition got dramatically worse (I think my body knew it couldn't give out, because there was nobody to take care of me, so once my parents were okay, it completely crashed and failed.)

I started experiencing emergency symptoms. It was a bit hard to breathe, my chest hurt, and I was extremely delirious. I wanted to call my insurance to see if I was covered (this was during the summer) and I was connected to some nice person, probably making minimum wage, who told me with caution in her voice that my plan was expired. I had no active insurance, but she urged me to go to an emergency room. I remember saying something to the effect of "You just told me I don't have insurance, I can't go to the hospital, I can't afford it."

She sounded so genuinely worried and scared. I remember she said "You really don't sound good, you sound really sick, please call 9-1-1" and I think I just said "I can't afford it without insurance, don't worry, I think I'll be okay."

And she paused and said "I don't want to hang up the phone with you like this." And it sounded like she was holding back tears. And I don't remember what I said, I think that I would be okay, and I hung up.

I still think about her. I wonder if that phone call haunted her, or if she had dozens of calls like that a day. I wonder if she thinks about it at all, if she wonders if I died after she told me I didn't have insurance and therefore couldn't go to the hospital without incurring a tremendous financial burden. I wonder if she feels guilt or blame-- of course she shouldn't, it wouldn't have been her fault if anything had happened to me. Maybe it's self-centered to wonder if she thinks about it. I'm not the main character and it was just her job. But, still.

I think about how evil it was that we were put in that situation. Because offering year-long continuous coverage through the university plan would maybe cut into profits, maybe not benefit shareholders enough, maybe cut into Thompson's $10 million salary. While his minimum wage administrators have to feel afraid to hang up the phone, because on the other line someone might be dying, and they wouldn't know. While his patients hang up and decide to take their chances rather than put their family through that trauma.

This is UnitedHealthcare. This is Brian Thompson's legacy. This is why, understandably, an entire nation is jubilant that he was gunned down like the vermin he was. I don't care about his widow. I feel pity for his children, despite the fact that they will inherit millions, but I feel more pity for the children of his victims patients who are gone because they didn't want THEIR children to inherit crippling debt. Brian Thompson got what he fucking deserved. I pray that he not be the only one. I pray for continued safety, peace , and anonymity for his killer.

American healthcare is a disease.

[sidras-tak]

Accessibility takes too goddamn fucking long.

My brother was paralyzed in October 2023. We got him home from the hospital (in Texas, when we live in Iowa) in a clunky old hospital chair. He hated it. He was scared and angry and in pain and his life had just changed forever and he couldn’t do anything for himself in that wheelchair. His first goal (aside from learning how to transfer) was to get a wheelchair. My family was lucky enough to afford one so we thought it would be easy enough. Nope.

We couldn’t buy him a wheelchair. He needed a prescription. For a wheelchair. A doctor had to examine him and declare him in need of a wheelchair. It wasn’t good enough that he had scans and tests showing tumors cutting off his spinal cord. He needed his primary care doctor to examine him during a physical and write a prescription. He was making 2-4 transfers a day, tops. He had no energy to get to a doctor. Home health was in and out every day. He had no time to get to a doctor. He didn’t get a prescription for almost a month. Then it had to go through insurance.

We asked if we could skip insurance and just buy a wheelchair for him. Nope. They wouldn’t sell us one, not even at full sticker price. It needed to be approved by Medicare. We ordered a wheelchair, a nice one, a good shade of green, sporty, small. It would let him move around the house. He would be able to cook, to reach drawers and get stuff from the fridge and brush his teeth and put his contacts in at a sink. We were told it would take awhile, maybe two months. Silently we all hoped he would be around to see two more months.

He went on hospice care on a Saturday in March. On Monday, I was calling his friends to come see him before he died. I got a call on his phone. It was the wheelchair company. They were about to order his wheelchair, she said, but there was an issue with insurance— had he stopped being covered by Medicare? Well, yes. When he started hospice care, he got kicked off Medicare. The very nice woman I talked to told me to call her if he resumed Medicare coverage so she could order his wheelchair. He died less than 12 hours later.

We ordered that chair for him in early December. Medicare didn’t approve the order until March. He was dead before they got around to it. He wanted that fucking wheelchair so badly. The only reason he had any semblance of independence and any quality of life for the last five months of his life was because the wheelchair company lent him an old beater chair, a very used model of the chair he ordered. If I could go back and change one thing about his end-of-life, I would get him his dream wheelchair. He told me again and again he couldn’t wait to get it, so that he could feel like a person again. He made the best of what he had with that old beater chair, but it still makes me mad to this day. He was paralyzed. He needed a chair that afforded him dignity. We had the money for it. And yet, we were left waiting for five months, for a chair that wouldn’t even get ordered until the day he died.

[cleolinda]

Phone scam gothic

So my mom sits down and starts telling me about two weird-ass phone calls she had today—she was returning a missed call, and the woman who answered just… sobbed for a minute. I’m sitting here asking, like, a whole minute? Nothing else, just sobbing? Who did you THINK you were calling back?

“United Healthcare, they have my Medicare plan. They’ve been calling me for weeks without leaving any voicemail.”

(Are you sure it was United Healthcare? “It was the same number that’s on my card, I checked, and that’s who the caller ID said it was.”)

Are you sure it was a whole minute? Did YOU say anything?

“Yes, like sixty seconds while I kept going ‘Hello? Hello?’ It sounded like she was having a nervous breakdown, I kept waiting to see if she’d tell me what was even wrong. Finally I just hung up.”

And then my mom turned right around and called back again, because she was gonna get to the bottom of this.

This time she got a different woman, perfectly calm, who wanted to set up “your in-home direct patient care home health visit.”

At this point (at this point?) I’m staring, because no one here currently has anyone coming to the house to help with any kind of medical care. My mom might honestly be the healthiest member of the household, but even I don’t use any home services, herniated discs and all. “Did they have you… confused with someone else?”

“No, she repeated my full name and phone number back to me.”

This lady then started ARGUING with my mother. Why don’t you want us to come to your house to manage your direct patient care? Don’t you need home health care to be managed? Why don’t you need home health care? Why would you not want home health care? “I JUST KIND OF HAVE HIGH CHOLESTEROL?” But don’t you want us to manage your home health care? “WHY DO YOU NEED TO COME TO MY HOUSE TO MANAGE HEALTH CARE I DON’T USE?”

My mom finally hung up on this lady as well, without giving her any real information.

The more we talked about it, the more things we started to notice:

I was incredibly creeped out by the unsolicited use of the word “manage,” for some reason. Very sinister “write me into your will” vibes for some reason—I don’t know what these people want, but they’re gonna get you to sign something over.

My mom got especially stuck on “WHY DO YOU NEED TO COME TO MY HOUSE?!”

My mom has used home health services before… years ago, before she was on Medicare. But this company wouldn’t know about that. However, if you’re on Medicare, you’re over 65. Having not ever dealt with my mother before, someone calling a Medicare user might be playing the odds that a person over 65 is 1) in frail health and 2) old enough to get easily confused.

Fair play to my mom, she’s the one who thought of number spoofing. I’m so busy not answering the phone ever and arranging all my medical communications to happen through passworded portals that I didn’t think of it.

Hey, are you guys, like… holding someone hostage…?

So at this point, I google “United Healthcare scam.”

The “health insurance counselor”

This fraudster will offer help navigating the health insurance marketplace for a fee, capitalizing on people’s confusion about the state-based health exchanges created through the Affordable Care Act.

What to know

This sort of assistance is indeed available and is legitimate, but the people who offer it – also known as “navigators” – aren’t allowed to charge for their services. Also, remember that people with Medicare coverage don’t need to use the state health exchanges. The exchanges are for people under the age of 65, who are looking to enroll in an individual health plan.

Change “navigate” to “manage,” and I think this is it, although the lady on the phone never mentioned any fees. Either my mom didn’t let her get that far, or this is the point of actually getting into someone’s house: persuading them face-to-face to pay something, and potentially refusing to leave until the scammer has worn their target down.

Medicare does not make unsolicited phone calls.

Okay, so it was a scam no matter what it was about. As far as I’m concerned, my mom should contact Actual United Healthcare about it, and I’m here to spread the good word of Never Believing Anyone on the Phone 2k24. I don’t know what to tell you about the lady having the nervous breakdown though.

[tedcruzhasastupidface]

This is class warfare. The ruling class is really freaking out that someone will come for them next, as they should in the natural order of things. You can see this on the cable news channels. So much “manhunt” style coverage and very little time spent asking the bigger questions. Why do insurance companies get to play god for a profit? Why don’t we have Medicare for all? Why are they covering the gallows humor of the reaction the way they are? NYPD and cable news pundits taking full advantage of the copiganda opportunity to find and catch the “bad guy”. We all know this was a righteous act. The media elites are trying hard to make us think otherwise but take a look at social media and you can see the public sentiment.

[unsolicited-opinions]

I used to run a doctor's office. If your doctor's office hasn't explained this to you, let me do it for them.

You probably don't know how much time your doctor and their staff spend fighting with insurance companies for routine, ordinary things. The stories you see online might leave you thinking that these fights are, if not rare, maybe occasional. A sometimes sort of challenge.

Nope.

It's every day. It's all day. Your doctor's office has employees who fight with insurance companies as a full time job.

This isn't an accident or a side effect of other market forces at work - this is the deliberate, calculated plan the insurance companies have chosen to implement. They know very well it is hurting patients and providers, and they're okay with that because their priority is to maximize ROI for investors and other stakeholders. They're in the business of business, and they don't give a single fuck about human beings or health care.

They've lowered reimbursements in primary care so effectively that primary care has only survived in many parts of the US by becoming a loss leader for larger health systems. You know how the local retail store gets you in the building by selling something at slightly below cost because they know you're likely to buy more once you're inside? It's like that, a loss leader.

The health system where you get your primary care often loses money when you see your PCP, but since your PCP refers you to speciality care inside their own organization, the system makes up the money when your doctor sends you to see their own systems' surgeons, endocrinologists, dermatologists, etc.

Smaller primary care practices literally can't survive. That's why there are almost no independent family doctors any longer. That's why it is so hard to see the same provider with consistency, someone with whom you can develop trust over time, who knows you and knows your challenges. United Healthcare and it's private healthcare insurance competitors have nearly finished killing off that kind of primary care.

Larger primary care practices (30-40 providers) might still be able to make ends meet independently through economies of scale and/or what they earn by doing their own lab/testing/imaging services in-house, but that won't work much longer if current trends continue. We're headed in the direction of just a handful of vertically integrated businesses running healthcare, and they are in the business of business, not health care.

The insurance companies deliberately create administrative barriers which make it expensive for your doctor's office to advocate for you because it moves administrative costs away from the insurance company and onto your doctor's office. This results in fewer paid claims when your doctor's office can't afford to hire another full time position whose only job is to argue with insurance companies and jump through their deliberately obstructive hoops. They want your PCP to be struggling to stay open. They want your PCP unable to afford the cost of overcoming the administrative burdens they have deliberately created for the purpose of denying you the health care your doctor thinks you need.

There are other words for this, but the most appropriate one is "evil."

I don't want to glorify murder or lionize Luigi Mangione, but Brian Thompson was a ghoul, his senior team are ghouls, and the for-profit health insurance industry is a disaster for Americans, even those Americans who don't yet see the problem affecting themselves. They will.

We need universal, single-payer health coverage, just like every other wealthy nation.

We're not going to get it any time soon, and things are about to get worse for healthcare in the US.

Set aside the damage RFK Jr is likely to do to an already patchwork public health system by attacking regulations and spreading misinformation. Let's look at other ways Trump and the GOP plan to worsen health care.

1. They're going to go after Medicare and Medicaid benefits. They'll seek to lower them and raise the bar which must be cleared to receive them.

2. They're going to seek to raise the age for social security benefits (above 70!), and reduce benefits paid, so the most financially vulnerable seniors will have greater out-of-pocket costs. Those seniors are going to struggle harder with out-of-pocket costs.

3. They're going to attempt to cripple the Affordable Care Act (AKA 'Obamacare'), despite the fact that the ACA has been a HUGE money maker for the private insurance companies.

4. This administration will be run by hyper capitalist billionaires. It will seek to deregulate wherever possible and promote supply-side economics (tax breaks for the rich and large corporations) at every opportunity. United Healthcare and its competitors, which already weild an obscene, horrific amount of control over US Healthcare, are about to get substantially more power.

It's bad, folks. It's a very bad time to be sick and it's going to get worse.

Alan Grayson was right in 2009. The Republican health care plan has been and remains:

* Don't get sick

* If you do get sick, die quickly.

[mush-dooms]

MISSOURI VOTERS!!!

ABORTION RIGHTS ARE OFFICIALLY ON THE MO BALLOT THIS NOVEMBER 5

I know tumblr dot com doesn't give a shit about rural, deep red states, but this is HUGE. Missouri has one of the most restrictive abortion bans in the US, allowing exceptions only "to save the pregnant person's life" or "to prevent serious risk to the pregnant person's physical health," and even these have stipulations requiring a mandatory 72-hour waiting period and counseling, parental consent for minors, as well as banning Medicare and insurance from providing abortion coverage

WE CAN CHANGE THIS

Ammendment 3 would change the Missouri constitution, effectively reestablishing reproductive freedom. More specifically, this includes "the right to make and carry out decisions about all matters relating to reproductive health care, including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions."

Ammendment 3 also only allows for future legislation restricting abortion access after fetal viability. While this is less than ideal, you have to understand that this is Missouri we're talking about, a state where Trump won in 2020 by a 15% margin. Republicans have already tried (and failed!!!) to have Ammendment 3 removed from the ballot-- they're scared, but we HAVE TO SHOW UP.

A "Yes" vote on Ammendment 3 is in favor of amending the MO constitution and restoring the right to choose what happens to OUR bodies.

WE HAVE A CHANCE TO FIX THINGS

- - - - -

Voter Resources:

October 9 is the deadline to register to vote, and you can do so here: https://www.sos.mo.gov/elections/goVoteMissouri/register

Find a polling place: https://voteroutreach.sos.mo.gov/portal

Register for absentee voting:

Online: https://www.vote.org/absentee-ballot/missouri/

By Mail: https://www.sos.mo.gov/elections/goVoteMissouri/howtovote

Confirm your registration status: https://voteroutreach.sos.mo.gov/portal/

Accepted Forms of Voter ID (required in MO): https://www.sos.mo.gov/voterid

REBLOG TO SPREAD AWARENESS

[thatdiabolicalfeminist]

If they don't fix the debt ceiling problem by June 1st—and it looks like that's a real possibility—it's not clear if people will be getting their social security checks or Medicare coverage. This is so bad, I'm not sure if any of you are following this but we all probably should be.

I'm not gonna do a writeup myself because I'm brainfogged to hell and don't want to risk accidentally sharing inaccurate information but you should look for news articles on this.

[justinspoliticalcorner]

Qasim Rashid at Let's Address This:

On May 20, 1962, JFK delivered an impassioned speech at Madison Square Garden in favor of universal healthcare. Then, decades later in 2006 nearly 7 in 10 Americans believed the government should fund healthcare. And now, a new Gallop Poll reports that 62% of Americans believe in guaranteed universal healthcare. And despite this decades of support, not a single Presidential candidate this cycle had the courage to run on this wildly popular platform. Over the last week I’ve written in detail about America’s Violent Health System, and likewise, shared a deeply personal story about When Insurance Rejects Life Saving Care about our daughter Hannah Noor.

In response, I’ve received overwhelming empathy and compassion from conservatives and liberals alike, Republicans and Democrats, from those who self-identify as “Ultra MAGA” to those who label themselves as “Bernie Social Democrats.” Americans get it. Healthcare needs to be a human right. Sadly, politicians, Republicans and too many Democrats alike, don’t get it. They worship at the altar of corporate donations. The health insurance industry annually spends a harrowing $700,000,000 on lobbying politicians to do their bidding. And that doesn’t even include what they spend on SuperPACs to block out candidates who dare run on a platform of guaranteed universal healthcare. Those same healthcare corporations then engage in a mass media blitz of misinformation and disinformation to convince people to vote against their own self-interests. In reality, guaranteed universal healthcare is a proven model adopted by every single developed nation on Earth (and many lower income developing nations). And while I do not have $700,000,000 to counter the lobbying propaganda health insurance corporations infuse into our politics, I do have access to the facts that health insurance corporations hope the American people don’t realize.

Myth 1: We Can’t Afford Universal Healthcare

Fact: The opposite is true. Dozens of studies prove that universal healthcare will save Americans billions of dollars annually. In fact, 22 studies reviewed all concluded that universal healthcare would save approximately $450 billion a year. And this is a universal conclusion. For example, “Even the Mercatus Center, a right-wing think tank, recently found about $2 trillion in net savings over 10 years from a single-payer Medicare for All system. Most importantly, everyone in America would have high-quality health care coverage.” Moreover, we cannot forget that right now approximately 73 million Americans are on Medicaid, 68 million Americans are on Medicare, and 10 million Americans are on Tricare. That means that of our nation’s 335 million people, approximately 151 million are already on a universal (or near universal) healthcare model. And guess what? These programs each cost significantly less than the exploitative for-profit healthcare model. The overhead on these programs is 2-3%, while the overhead on for profit healthcare is 20%, plus a near unlimited mark up on prescription drugs. In this we have a side by side comparison of access to the exact same doctors and medications, except one has a nominal mark up and the other has a 10X markup. It doesn’t take an MBA in finance to understand that the same product or service without the massive markup is the smarter path to take. The only thing we cannot afford is for the current exploitative for profit model to continue.

Myth 2: If Costs Go Down, So Does Quality of Care

Fact: This is simply not true. It is important to understand why costs decrease, because contrary to the myth, every single one of the above studies found that quality of care would not decrease with universal healthcare. 

[...]

Myth 3: Universal Healthcare Puts Millions Out of Work

Fact: What would happen to the roughly 1.8 million Americans who work in medical billing? This is a great question and has a robust answer that I break down in three parts. First, remember that about 40% of these jobs are already in the Medicaid and Medicare and Tricare industries—which is essentially universal healthcare for a portion of society. Therefore, we’re talk about roughly 1 million jobs, which admittedly is still a large number. What to do with those? Well, hence the second point. Expanding Medicare to accommodate another 175 million people will necessarily require medical billing professionals and administrators to do those jobs. Therefore, the question is not about eliminating jobs, but about transitioning workers from the for profit exploitative system, to a non for profit system that prioritizes access to healthcare. Likewise, remember that ending the for profit system saves us at least $450 billion annually. These resources give us options. For example, these are excellent resources that could be spent on a lengthy 2-year salary severance to those in medical billing who do lose their jobs, plus adequate funding and training to allow them to become proficient in a new job. Indeed, at $70 billion annually, four-year-public college costs a fraction of what would be saved by shifting from an exploitative for profit model, to a universal healthcare model. We cannot afford not to make the shift.

[...]

Myth 5: Universal Healthcare Causes Long Wait Lines

Fact: For primary physician appointments, Americans already wait longer under our exploitative for profit model than do people in nations with universal healthcare. Frankly, I marvel at this allegation as I reflect over the fact that it took us more than two years to get our daughter the critical life saving medication she needed, only because our exploitative for profit health insurance company refused to accept our doctor’s medical instruction. In reality, wait times in the United States are shorter only for elective surgery, but for primary care or for critical care, the United States is the worst out of any nation with universal healthcare.

Qasim Rashid wrote a solid piece debunking anti-universal healthcare lies propped up by for-profit health shills.

[macgyvermedical]

I'm in the middle of a career change and a tentative asthma diagnosis (ie. no tests yet but it's on my record and my doctor is approaching it as such). What was healthcare like before protections were in place for people with pre-existing conditions? What should I do if I can't get health insurance? Should I try to get undiagnosed or something??? My symptoms are sporadic and usually mild so I can get through it without the inhaler if I had to, I'm just worried about losing access to all healthcare (also afab 😓) and want to be prepared to navigate things since I know it was way worse for chronic illnesses before the ACA.

The ACA was gigantic and it would be hard to talk about every aspect in this post.

Generally speaking, prior to the ACA, you essentially had three options. You could get health insurance through an employer, you could get health insurance through the state (medicaid), and you could get health insurance through an individual plan.

Seems pretty similar to today, right?

Nope.

See, the easiest way to get health insurance would be through a job. But if you had a pre-existing condition, including pregnancy or even simply being AFAB, in most states nobody legally had to cover you- including your employer. And if they did, they could say "you have health insurance for everything except the treatment of your chronic condition(s)" or make you pay significantly more for your premiums. Or, y'know, both (the idea being- if you sought medical care for one thing, you might do it again, and that would cost the insurance company profit*).

When you applied for health coverage through an employer, you had to disclose every medical problem you had ever had, including one-off problems like ear infections or broken bones. Anything could be grounds for not covering you at the outset. BUT if you didn't list a problem, and it was discovered (and they really went hard to find things), that could be grounds for rescission- the process of kicking you off insurance and forcing you to pay back money that the insurance had previously paid out for you.

If you didn't have a job or made extremely- and I mean extremely- little money, you might qualify for the state-sponsored medicaid, assuming you fell into a category that medicaid covered in your state. These categories included low-income children, some parents of children who lived at or below 64% of the federal poverty line (though in some states the parents had to have income as low as 15% of the FPL (less than $4,000/year for a family of 3)), older adults who had few assets or income, people on disability, and pregnant people up to 60 days post delivery. If you were a childless, able-bodied (at least in the eyes of the government) non-pregnant adult between 19-64, even if you made next to nothing? Pretty much forget about getting medicaid.

As far as I know, there were not a ton of changes made to medicare, the other major government insurance program for people over 65 years of age or who were severely disabled).

So what about individual plans? Well, first off, there was no marketplace (you couldn't compare plans from different companies) and no guaranteed coverage. Similar to plans through an employer, there was nothing protecting you from rescission or denial for even minor medical problems.

Most states, however, allowed something called "high risk pools" i.e. people who had pre-existing conditions and were looking for insurance could pay double what "healthy" people paid in premiums (often literally thousands of dollars per month) in order to have insurance. Even with these exorbitantly expensive plans, it would often be 12 months before they would start covering any pre-existing conditions. This meant that people had to pay their premiums and also out of pocket for their chronic care management for the first year of having insurance.

So what do you do if you're one of the near quarter of Americans who didn't have insurance through their employer, didn't qualify for medicaid, and couldn't afford the private insurance market?

You went into debt, or you died.

No, like, literally. You either agreed to medical care costing 10's or even 100's of thousands of dollars, or you didn't. For yourself or for your kids. Think about that- Would you pay (read, put yourself or your family into debt) half a million dollars for a surgery that saved your life? Your kid's life? These were the kinds of decisions that had to be made.

Back to your question:

Should you try to get un-diagnosed? Well no. That's asking for a rescission if the ACA is overturned. Contact me directly if you want more personal info about planning.

*and it's not like they aren't making a 10s-of-billions profit even with the ACA protections

[mariacallous]

Democrats are charging out of their national convention with enthusiasm and determination ― and in far better shape than seemed possible just a few weeks ago, when then-presumptive nominee President Joe Biden was headed for likely defeat.

Vice President Kamala Harris has wiped out Biden’s deficit in the polls, and now holds small but discernible leads over Donald Trump in both national and swing state surveys. She’s also expanded the electoral map, putting in play states such as North Carolina that seemed lost to Democrats when Biden was leading the ticket. As of this writing, Nate Silver’s predictive model suggests Harris is a 52.8% favorite to win.

It will take a few days for pollsters to figure out whether Harris got the traditional convention bounce, pushing her support even higher, or whether she got a version of it beforehand via the burst of activity and favorable press coverage around her campaign launch.

Either way, it’s hard to look back on the week in Chicago and deem it anything but a smashing political success, from the (still reverberating) call to arms by former first lady Michelle Obama to the (still circulating) sight of Gus Walz, son of vice presidential nominee Minnesota Gov. Tim, tearfully telling the crowd “that’s my dad!”

Harris, for her part, gave what my colleague Jen Bendery’s story called the “speech of her life.” Plenty of other analysts rendered similar judgments.

With a passionate, near-flawless delivery, Harris introduced herself as the daughter of immigrants who valued virtue and hard work, promising to fight for the middle class and vowing to protect democracy. She wrapped herself metaphorically in the flag and what she thinks it represents to the nation’s non-MAGA majority. The laser focus on trying to win over swing voters was impossible to miss, in part because it was such an overriding theme all week ― whether through cultural symbolism (like having the aging veterans of Walz’s championship high school football team appear on stage) or more overt outreach (like having former House Republican Adam Kinzinger give a prime-time address).

But the appeal to the political middle had some telling substantive elements too.

Insofar as Harris and Democrats talked about policy, they focused on causes such as bringing down prescription drug prices, providing paid leave or helping families to pay for child care ― ambitions considerably more modest than the loftier, more progressive “Medicare for All” calls that dominated the last Democratic presidential campaign and to which Harris herself once pledged fealty. Harris also went out of her way to back a bipartisan immigration bill that would tighten security without creating a pathway to citizenship for undocumented immigrants already here, which is a provision progressives have frequently called essential.

The platform evolved, with party leaders scrubbing a call to end the death penalty ― quietly, until my colleague Jessica Schulberg found out about it. They also refused requests to feature a Palestinian speaker on the conflict in Gaza. That part wasn’t so quiet, or unanticipated. In fact, the prospect of protests and disruptions over Biden’s support for Israel had fueled speculation that Chicago 2024 was going to end up as tumultuous as Chicago 1968. But as HuffPost’s Daniel Marans and Jonathan Nicholson observed, the fissures never blew up into 1968-style conflicts ― not over Gaza, or any other issues for that matter. On the contrary, the Democrats seemed improbably and almost impossibly unified, with would-be progressive dissidents like Rep. Alexandria Ocasio-Cortez (D-N.Y.) sounding downright giddy about the Harris-Walz ticket.

What explains this unified enthusiasm? Three likely reasons come to mind. One in particular has a lot to do with how the party has changed in recent years ― and what it might be able to do if Harris manages to win.

Democrats In Array

One of these likely reasons is the threat Trump poses to individual liberties, the rule of law and democracy — threats progressives feel every bit as keenly as the more moderates in the party. These threats almost certainly seem even more menacing now after so many months watching Biden struggle.

Staring into the political abyss this way has been known to focus the mind.

Another possible factor is Harris’ identity. Electing the first woman president, not to mention the first Black woman and the first Asian woman, would have obvious symbolic value. But it would also have more practical effects — namely, bringing a new perspective to the presidency and making it easier for other women, and other nonwhite politicians, to make their own way to the Oval Office.

Progressives almost by definition care about these things, enough that it can help counterbalance appeal for politicians who see the ticket as less progressive than they might like. Barack Obama in 2008 benefited from just such a dynamic, as The New York Times’ David Leonhardt pointed out on Friday: “He was more moderate than some other Democratic candidates that year, yet he still excited many progressives.”

Harris notably hasn’t talked about herself as groundbreaker, and the campaign hasn’t made that possibility a focus in the way that, say, Hillary Clinton’s did in 2016. But that’s of a piece with Harris’ broader strategy since appeals tied to race or class can alienate some of the swing voters she’s trying to win. The voters who feel otherwise, meanwhile, don’t need reminders.

This brings us to the third, and potentially most important, theory for progressive enthusiasm: Democrats have gotten an awful lot done since Biden took office. An awful lot of it consisted of initiatives or reforms progressives have long championed. And most importantly, it all happened with progressives having a big seat at the table.

The most significant and visible of these accomplishments was the clean green energy investments of the Inflation Reduction Act, which add up (arguably) to the most important climate change legislation in history, plus the law’s health care provisions, which for the first time gave the federal government leverage over the prices of some high-priced drugs in Medicare.

But the list goes beyond that, to the appointment of aggressively pro-consumer and pro-labor officials at key federal agencies, and the burst of spending during the pandemic that (whatever its real or theorized effects on inflation) drove both unemployment and child poverty down to near-record levels.

All of these feel well short of the kinds of transformations progressives would prefer with, say, enactment of “Medicare for All.” But they had, are having or will have tangible, measurable effects on people’s lives — and are examples of the kind of achievements that might be possible if Harris wins and Democrats have control of both congressional houses again.

It so happens that these are also the kinds of achievements that animate up-and-coming party leaders, even if they are not members of the progressive wing — figures like Govs. Josh Shapiro of Pennsylvania and Gretchen Whitmer of Michigan, or Sen. Raphael Warnock of Georgia. Not coincidentally, all gave Harris rousing endorsements in prime- time speeches.

But that too is part of the story about unity: The party’s “moderate” wing today feels pretty strongly about using the federal government to make people’s lives better, just as it does about protecting the freedoms Trump threatens. They may emphasize it differently — focusing more exclusively on the Inflation Reduction Act’s clean energy manufacturing jobs, for example, and a bit less on its environmental impact. They still land in the same place on policy.

Whether these good feelings would carry through enough to enact a legislative agenda is obviously a separate question and one that is very secondary to the question of whether Democrats even get that opportunity.

The presidential race is still a toss-up, or maybe even a bit worse than that for Harris if the polling now is missing Trump votes the way it did in 2016 and again in 2020. Republicans remain by most accounts a slight favorite to hold at least one house of Congress.

But Harris is coming out of Chicago on a roll, with a party behind her as she reaches out to the swing voters she needs to win. That’s a pretty good place to be.

[she-is-ovarit]

I am on government insurance (Medicaid). Out of pocket, my psychologist's rate is $225 an hour. He went through a decade or more of school, obtained a PhD, and graduated with student loan debt. He didn't state how much, but I can imagine it's likely in the hundreds of thousands considering he still has this debt and graduated with his PhD in the early 2000s.

He shared with me that out of that $225 rate, he obtains about $25 from one Medicaid client's insurance company. The insurance company pockets the rest. My friend, another therapist, has a similar story. She makes $75 off of Medicaid clients usually when her rate out of pocket is $200.

Most therapists, psychologists, and psychiatrists are no longer accepting Medicaid/Medicare insurances because of this reason, which people who are poor are on. Over half of mental health professionals are no longer accepting insurance, period. I think we all understand that low-income people and low-income communities struggle the most with mental health issues, and if you are a person of color in the US you are more likely to be low-income. If you are a domestic violence survivor turned homeless because you left your significant other, you are also more likely to be on Medicaid. If you are a first generation student, you are most likely on Medicaid. If you are formerly incarcerated, you are most likely on Medicaid. And so on.

Additionally, if you are a human being of the female sex, you are far more likely to seek out therapy than someone of the male sex. Overwhelmingly men don't seek out therapy unless their female significant partner pleads with them, pressures them, or gives them an ultimatum which influences them to make an appointment. What does this mean when the vast majority of mass shooters, rapists, pedophiles, and domestic violence abusers are male?

Figure 2. Percentage of adults aged 18 and over who had received any mental health treatment, taken medication for their mental health, or received counseling or therapy from a mental health professional in the past 12 months, by sex: United States, 2019

Pair all of these details with the fact that mental health professionals are in such high demand right now, that even with private insurance the wait list is anywhere from three to six months out. Insurance agencies are business, and the corruption inherent. Many focus on prioritizing coverage for acute crisis rather than treating long term underlying conditions (which in turn prevents acute crises), don't provide coverage for co-occurring conditions, are advertising that more providers are accepting their insurance than there actually are, and are solely driven by financial interest.

I wonder how much domestic violence, sexual violence, child abuse, poverty, hate crimes, generational trauma, and overall suffering within individuals and in their societies can be reduced by valuing mental health and holding insurance companies accountable for their financial exploitation.

We talk about the US healthcare crisis without talking about the US mental health crisis.

[scientia-rex]

Good morning! I have a question. When I look up info about vitamin D, I come across many claims that people generally don't get enough of it. In a recent episode of Maintenance Phase, however, the hosts called it a "scam" or overblown, at least (I don't remember the exact wording). So, like, what's the deal with vitamin D? Do Americans get enough of it?

Probably, mostly. At the very least, people should be tested before starting repletion. It probably has a role in osteoporosis treatment and prevention, BUT how much to take and what form and when is HOTLY debated and frequently conclusions are changing.

Just to take you on a spin through the most recent Cochrane reviews (THESE ARE NOT SINGLE STUDIES, in case any of the research-naive out there want to get pissy about them; look up what a Cochrane review actually is before trying to shit on it; also note that I did NOT say this will cover every fucking person and every hypothetical they can come up with, jesus CHRIST):

No role for vitamin D in asthma

Insufficient evidence to recommend it in sickle cell

Raising vitamin D levels in cystic fibrosis patients is not beneficial

No evidence of benefit of vitamin D in MS

Supplementing vitamin D in pregnancy may have small benefits but also risk of harms

No clinically significant benefit from vitamin D supplementation in chronic pain

Insufficient data on vitamin D in inflammatory bowel disease, but no evidence of benefit

No evidence of benefit of vitamin D supplementation in liver disease

Vitamin D does not appear to prevent cancer in general population

No evidence for benefit in supplementation of vitamin D in premenopausal women to prevent bone density loss

Possible small mortality benefit of D3, but not D2, in elderly patients, but also increased risk of kidney stones and hypercalcemia

Vitamin D alone ineffective, but combined with calcium may be effective, in preventing bone fractures in older adults

Insufficient evidence for vitamin D improving COVID-19 outcomes

Now, vitamin D plus calcium in people who have post-menopausal bone density loss does seem to prevent fractures. This is why doctors routinely recommend it. However, dosage and formulation are still debated as data are insufficient, and uncertainty still large.

So, do you need to supplement? Probably not. There is some fairly weak evidence that vitamin D supplementation may help with depression, but I would argue that it's going to be most relevant in people with pre-existing deficiencies, which Medicare is just hellbent on not letting me test for anymore. They've narrowed the coverage codes for testing so now even know vitamin D deficiency isn't considered a good enough reason to test. So Medicare has very clearly decided it's not relevant, for whatever that's worth, I spit on their graves, etc. Of course, then you get into the question of what counts as a deficiency, which we also really don't know.

And to be clear, I wasn't looking through the Cochrane review results with an angle--those are most of the first page of search results on their site, with the only one skipped being similar to another one I mentioned, and I stopped when I got bored. These should not be paywalled, as I am not logged into anything and I can read it all, so try clicking the side menu on the right if you have trouble getting into the weeds.

If anything, running through this little exercise has made me less likely to recommend vitamin D supplementation, so do with that what you will.

[simply-ivanka]

Press Failure Inflates the Debate

Coverage of the Harris campaign is biased.

Worse than that, it’s malpractice.

By William McGurn Wall Street Journal

Presidential debates typically don’t determine the outcomes of elections, notwithstanding the large television audiences they draw and the dramatic moments they produce. But Tuesday night’s dustup between Donald Trump and Kamala Harris may be different.

Press failure has inflated it into the seminal event of the Trump-Harris race. Because reporters haven’t insisted that Ms. Harris answer basic questions, the debate, moderated by ABC News, may provide the only moment in the 2024 election when Americans get to see how Ms. Harris performs under pressure.

This failure would be appalling at any time, but the circumstances of Ms. Harris’s campaign turn simple media bias into journalistic malpractice. The vice president secured the top slot on the Democratic ticket without having to contest a single primary—and therefore without having to lay out and defend her record. This leaves her largely unknown to American voters, a situation Ms. Harris is now exploiting to reinvent herself as a moderate challenger rather than a woke incumbent.

In addition, Ms. Harris is a mother lode of unanswered questions on most of the issues that once defined her. This includes her previous support for everything from defunding the police and banning plastic straws to getting rid of Immigration and Customs Enforcement and starting from “scratch,” stances she now apparently disavows.

An appearance by Sen. Tom Cotton (R., Ark.) on ABC’s “This Week” in August shows how the press lets her off the hook. When Mr. Cotton brought up Ms. Harris’s support for eliminating private health insurance, which the Medicare for All policy she espoused in 2019 would do, host Jonathan Karl interjected that Ms. Harris has said she no longer holds that position. Mr. Cotton pushed back. “She has not said that,” he correctly pointed out. “Anonymous aides,” he said, may have said that she no longer holds the position she once did, but we haven’t heard it from the candidate herself.

Ditto the big CNN interview, for which Ms. Harris brought along running mate Tim Walz to cut in to the time she would have to take questions. Moderator Dana Bash did make a show of asking why Ms. Harris flipped on fracking. But she wasn’t pressed on her biggest non-answer of the evening—“My values have not changed.”

It’s unlikely Ms. Bash or CNN would accept such an evasion from Mr. Trump or his running mate, JD Vance. When Mr. Vance did his own interview with Ms. Bash, she rightly grilled him on abortion and comments he made about Mr. Walz’s characterization of his service in the Minnesota National Guard. But it’s worth watching the two interviews to see the very different tones Ms. Bash took toward Mr. Vance and Ms. Harris.

In short, Ms. Harris is getting a pass. Bad enough that 56 days from the election, she still isn’t giving interviews or holding news conferences. The far greater scandal is that a free press isn’t demanding that she do so.

It’s hard to fault Ms. Harris. Her strategy is a sign that she knows her liabilities. Her campaign is trying to get through the next eight weeks avoiding events where she might have to answer an unscripted question or explain details of, say, inflation. Team Harris knows they don’t go very well for her.

Take the recent rollout of her economic platform, most notable for her call for a federal ban on “price gouging.” Even the Washington Post called her plan full of “populist gimmicks.” And former Obama administration economist Jason Furman told the New York Times that it is “not sensible policy.” Message taken: Better to stick to fuzzy, feel-good themes like “joy” or to call Mr. Trump a felon.

It isn’t the first time a Democratic presidential candidate has benefited from a domesticated press. One reason Ms. Harris is her party’s nominee is that the press covered up President Biden’s mental decline. By the time the June 27 debate with Mr. Trump exposed Mr. Biden’s condition for all the American people to see, it was too late for primaries. It was much the same in 2020, when the New York Post broke the story of Hunter Biden’s laptop three weeks before the election. Because the computer contained evidence of Hunter’s sleazy overseas business dealings while his dad was vice president, the press buried it.

Today the received wisdom is that sooner or later Ms. Harris will have to give interviews and press conferences like a normal candidate. Perhaps. But she has a decent shot at winning the White House because her campaign is running out the clock before anyone can ask her a tough question.

On Tuesday night at the National Constitution Center in Philadelphia, Ms. Harris and Mr. Trump will have at it for 90 minutes. Ironically the low expectations for Ms. Harris may be an advantage. All she has to do is not humiliate herself and her performance will be hailed as a triumph.

If the press corps did its job, we’d all know more of what we need to know about Kamala Harris and what kind of president she’d make. But because it won’t, it’s all on Donald Trump to do that job himself.

[batboyblog]

Seeing the post about Jasmine, I can literally feel an ulcer grow within me. Are people actually this fucking stupid? Spreading VERY blatant and easily debunakable misinformation? Are they MALICIOUSLY trying to sabotage shit? Also the antisemitism only grows stronger. You literally have spoken in support of Palestine multiple times and yet these people start to froth at the mouth when they find out you're Jewish, these people have the reading comprehension of a fucking brick!!! And seeing the quote by Malcom X... Literally that's the most disgusting shit to act like you're a white liberal when Jews are not seen as white, are seen as lesser than white, the lack of self-awareness this person has is stunning. Sorry to make such a long post but what the fuck, seriously what the fuck is people's problem.

what the fuck is people's problem is a great question that I really wish I had an answer for.

I mean on the antisemitism front I suspect that the thrill of bullying transcends ideological views, just because you say you're a socialist doesn't mean you're also a good person. Just means you have justify your behavior through a new lens, so its fine to accuse Pete Buttigieg of being a sexual pervert like some conservative Catholic, if you're doing it as a "joke" because he's "Neo-liberal" or whatever, or post snakes at Elizabeth Warren, or or etc etc as long as you come up with an excuse its fine to be horrible as long as you do in the name of leftism! or whatever.

as to the wider question? why blow up chances to make progressive change by supporting nonsense candidates who are just unfunny versions of Vermin Supreme? hm I don't know, but I suspect that for a lot of them, politics aren't really real to them. It's like ideological football for them, the most important thing is to "be right" and "win the argument" over in reality, we have to sometimes work with people we loath, sometimes we have to put up with shitty things to get what we really want, and always always always its slow work. Listen, in 1912 Teddy Roosevelt put forward the idea of a national health service, over 100 years later we're still fighting for universal health care. Now we've made important steps, everyone over 65 those who need it most, have health coverage through Medicare, others have been added to Medicare, we have Obamacare which regulates the health markets and helps people get affordable coverage and more people are covered now than every before. But people like we're talking about would rather than was Nothing for anyone, that everyone was not covered at all, than take an answer that helps people but isn't perfect.

Just isn't my style really, idk I just can't help but think about all the people whose lives got saved by Obamacare and just, what we should have let them die? progress builds it doesn't just appear nothing just happens, so each term you move closer, but each time a Republican gets it, they undermine, undo, go backward. I mean for example, Trump literally wants to get rid of the job in government that advices all the many federal departs on how to be greener and replace it with a guy who's job it'll be to push departments to use more oil and gas.... literally thats a thing, what a perfect example of what a Republican Presidency is about, going backward. Then when we have a Democrat rather than making progress they have to undo all the damage to get to baseline and then start improving.

I also think there's a small group of cynical grifters, when Democrats/liberals/people on the left whatever we want to call them, are scared and frustrated and upset, ie when a Republican is in power and elections are years away, they invest, money, time, energy into things to try to feel like they're making a difference or that they're heard, or validated. Left wing podcasts boom, left wing groups that are good at social media boom, people can become kinda stars and make money. Now many of those people drift off to normal life when there's a safe Democrat not doing horrifying shit every day, the money dries up. So the cynical crowd 1. tries to undermine Democrats to keep that feeling of frustrated hopelessness alive in listeners so they keep toning in and 2. they want Republicans to win! of course! its good for them!

[so-much-for-subtlety]

I just had a shocking moment of clarity when I realized that healthcare in the United States is probably always going to suck - at least for the rest of my life (and probably much much longer).

You can't just build a public health infrastructure for 400 million people in any reasonable amount of time, so even if Medicare for All were somehow magically passed, it's almost certainly going to be administered by a private health insurance company, and use existing networks of for-profit hospitals etc.

It's not like the U.S. government is going to nationalize all of these institutions.

And whatever health insurance companies wins the bid for that contract, yes they will have various obligations to meet under that contract, but underneath this all it will still be operating as a for-profit company looking to squeeze the absolute most it can by providing the absolute bare minimum of coverage.

It would absolutely suck.

It gets worse when you consider how systems like this tend to become entrenched. A massive, nationalized healthcare program would lock in private corporations as permanent players.

Once they’re embedded in the infrastructure, it will be almost impossible to dislodge them, because any failure or upheaval would hurt patients first, not the companies.

That’s an enormous hostage scenario! these companies would argue that any regulation or attempt to cut their profits would harm care.

God that is so disappointing. U.S. healthcare system has so much underlying rot, and there's just no good path out of this mess.