#then why do people go bankrupt paying for cancer treatment

[katy-books]

My first conversation of the morning -

Mum - I've got bad news.

Me - Is the world over?

Mum - Yeah, pretty much.

Me - We're all going to die.

I wasn't kidding. You guys could have made history with the first female president (who has a long political career and knows how things work - like her of hate her you can't deny she'd be competent) - instead you go for a guy who loves Putin and once blackmailed Zelensky in order to try and gain an advantage over a political opponent - REALLY!? What the fuck America!? (Obviously that doesn't count for everyone who voted Harris)

I'm going to start considering becoming a prepper and anyone who voted Trump can go fuck themselves 😡

*edit*

Could have sworn I posted this around 10am but it's fine to out now - I'm no longer yelling but my sentiments are exactly the same - I've felt a little dizzy all day - this is honestly terrifying

For the record - I don't care if you don't like Harris - neither do I - it's not about whether you like her - it's about how she's not very likely to cause WW3 compared to the guy who thinks bombs are cool (like a fucking 6 year old)

[arcticfox007]

Suptober Day 1: Harvest

This is my first time doing Suptober and I probably won’t do every day (and am already a day late) but I thought it would be a good creativity boost and looking through all the other work it seemed like a lot of fun! Thanks to @winchester-reload for organizing this :)

Check it out on AO3!

Castiel hadn’t meant to overhear the conversation. He was supposed to be on break, but had volunteered to reset room 5 for the next patient because he knew his friend Alex had been in dire need of a break. Cas was only a volunteer, spending his junior year of college shadowing various medical professionals to get a better idea of what a career in medicine would really be like. When Alex had suggested shadowing one of the doctors she worked with, he’d readily agreed, knowing that his friend spoke highly of both Dr. Barnes and Dr. Fitzgerald.

He’d already spent the past few hours shadowing Dr. Fitzgerald (or Garth as he insisted on being called) and had seen enough to realize that Family Medicine was understaffed and struggling to do the best they could for their patients given the absurd constraints on their time. Garth was currently seeing a patient who didn’t want a stranger in the room, so the doctor had told Cas to grab some lunch. Cas had intended to do just that when he saw Alex making frantic phone calls at the front desk. When she’d hung up, she’d looked at the end of her rope, explaining to Can that one of the other nurses called out and she couldn’t find anyone to cover for them.

Which is how Cas ended up in room 5 wiping down the surfaces and pulling a new paper cover over the bed. Cas knew all about patient privacy, but really, the conversation easily carried into the room when the man who must be one of Dr. Barnes patients had decided to continue talking to her out in the hallway. The man had a compelling voice and by the time Cas realized he was eavesdropping it was too late to avoid it as leaving room 5 now would have only made the unsuspecting patient realize he’d been overheard.

“Um, and, I’m really sorry about this doc, but I probably can’t afford the bill for today’s services right away.”

“Dean, just call Meg like I told you. Our pharmacy here is amazing at finding co-pay cards for these types of medications.”

“I will talk to her, I swear. It’s just when we had to switch insurance plans the new one says the co-pay for that grade of medicine is $100 a dose. I’m honestly not sure I can make that work Dr. Barnes.”

“I understand, but you need this medicine Dean. Your RA will flare right back up without it. If that happens you eventually won’t be able to work at all. Even skipping doses is ill-advised, letting the inflammation persist could eventually cause permanent damage to your joints.”

“I get it doc, I do, but $400 a month? It’s basically choosing between eating and my ability to move without pain.”

“Dean, just talk to Meg. We will figure something out. At least promise me you’ll take the Humira every other week. I know it didn’t manage your symptoms well at the lower dose before, but it was still better than letting the RA go untreated.”

Dean must have responded to Dr. Barnes in some way Castiel couldn’t hear, because after a few moments the sound of footsteps echoed down the hallway, fading as they moved towards the front desk. Cas hurried out of room 5, the trash bag hanging unnoticed from his wrist. His heartbeat sped up as he worried that he wouldn’t catch a glimpse of “Dean” before he left the office. Cas didn’t really know what he was planning on doing, just that he couldn’t stand the thought of this man resigning himself to pain all because the healthcare industry was such an awful mess that it would burden someone with choosing food over medicine. Something about the way Dean had sounded reminded him so much of his sister, Anna, right before she had left Castiel forever. That feeling drew Cas forward to meet a man he didn’t know. Cas couldn’t solve Dean’s money problems, Cas couldn’t force the government to change how healthcare was run in the country, Cas couldn’t even make Dean’s medical issues any better – but he could meet this man and maybe make him smile for a moment. Maybe, if he was brave enough, he could offer him some sort of friendship so maybe he would have one more person to help him through his struggles. Cas had been too young to understand how alone Anna must have felt but he knew more about it now. Helping people like Anna was what had drawn Cas to medicine in the first place.

Turning the corner Cas was startled to see what could only be a 6-foot flannel-wearing freckled god. The man was Hollywood beautiful and for a moment Cas forgot what had brought him rushing around the corner in the first place. The sound of Alex pointedly snapping her fingers brought Castiel back to reality as he broke of his inappropriate staring. He felt his skin heat up rapidly as he blushed.

“Did you finish room 5, Castiel?” Alex stared at him expectantly. Silently, Cas handed over the trash bag and muttered something about taking his lunch break outside. Too embarrassed by his very obvious admiration of the man that must have been Dean, Cas didn’t think he could talk to him in front of Alex. He rushed out the front door in the hopes that the autumn air would help him pull himself together. He didn’t know why he’d felt so compelled to talk to a man who’s private and very personal conversation he’d overheard. He was almost glad that his humiliating gawking had saved him from speaking to the guy. After all, what would he have said anyway? The air alone wasn’t helping Castiel’s composure, so he began pacing in front of the building.

“I mean how do you go up to a stranger and tell them they aren’t alone and that good things do happen? It’s not like it wouldn’t embarrass the guy to know I overheard him talking about his money problems…” Cas froze as he heard someone clear their throat behind him.

“Uh, hey man. I actually came out to ask you something else, but I think this just got awkward.” Cas took a deep breath already knowing it was Dean standing behind him. Cas’ habit of muttering to himself when anxious had gotten him into trouble on more than one occasion, but never quite as badly as this felt. Sadly, his fervent wish to turn invisible on the spot was being ignored by the universe and he found himself staring into striking green eyes while wondering how he could possibly salvage this situation.

“H-hello Dean. I’m Castiel, and I can’t apologize enough for overhearing your conversation with Dr. Barnes. I swear it wasn’t intentional, I was cleaning out the room you were standing near and – “

“Whoa, hold up buddy. I’m not mad or anything. I mean, it wouldn’t be my topic of choice to start chatting up the hot new guy at my doctor’s office, but you clearly work in healthcare, I’m sure you’ve heard the same thing from lots of folks.” Cas’ brain froze a bit when Dean referred to him as hot, but then it caught up with what he was actually saying.

“Er, actually I’m just shadowing Dr. Garth for the day, but yes, I have heard stories like yours. My sister, Anna, went through something similar. That’s why I wanted to say something to you but wasn’t sure what. Then I actually saw you and, well, you saw. I’m not really good with subtlety. I apologize if I made you uncomfortable.” Dean threw his head back with a barking laugh and Cas found himself staring at the beautiful man yet again.

“Having someone like you checking me out definitely doesn’t make me uncomfortable. If it makes you feel better, I came out hoping to ask if you’d be interested in going to the Harvest Festival tonight. I have to work for a bit at my store’s booth but if you were free around 7, I’d love to talk with you more. Even if it’s just whatever you wanted to talk to me about before.” Dean smiled flirtatiously at Cas, and there was no way to resist that.

“Yes, I’d love to! Where should I meet you?”

They exchanged information quickly, and parted ways with matching smiles. Cas would get his chance to tell Dean how his sister gave up her fight with cancer because she knew her treatments were bankrupting the family. He’d tell him how he’d was hoping to be a doctor himself one day to maybe help someone else like Anna win their fight despite the shitty healthcare system. He’d also tell Dean that he’d chased him down the hall because he’d desperately wanted to tell him that maybe they were strangers, but that he hoped Dean didn’t give up and that he’d be willing to be there for him if having a friend would help.

Now though, Cas thought maybe he’d already made Dean’s day a bit brighter, and he looked forward to getting to know the handsome man better. Maybe his impulse to offer his friendship to a stranger wasn’t as insane as it first seemed, and if Castiel was reading things right perhaps friendship wasn’t the only thing they had to offer one another.

[whitehotharlots]

Anything changed yet?

The "2020 UGGGHH" discourse is insufferable. It boggles my mind that so many people think an arbitrary temporal distinction is the cause of our nation's collapse. They believe, in all earnestness, that 2021 is going to be better simply by virtue of it being different.

There's a very good chance--better than 50/50--that 2020 is going to be the best of our remaining years, that every year and month and day from now until the sun explodes is going to be progressively worse than the one that preceded it.  

I had a sad, drunk epiphany last night about neoliberal management strategies during our collapse. The general consensus is that people like Mitch McConnell and Larry Summers are evil and stupid. But what if they're actually evil and competent? They know that mass displacement is coming, probably very soon, and they intentionally want to immiserate most people beforehand so that we won't have the resources or will to mount any consequential protest as the cities start to flood and burn and trains start herding us into camps.

You might have heard of The Great Reset. Like all other reflections of our horrific future, the political media recently began referring to it as a "conspiracy theory." Indeed, it has been badly misunderstood by paranoid right wingers. But it's real. There was a Davos conference that was literally called "The Great Reset." Transcripts and videos of conference proceedings can be found with a 10 second Google search. These people put their ideology out in the open for everyone to digest, and now simply re-posting the things they said on record makes you a conspiracy theorist.

These types of Rich People Gatherings--Davos, the Aspen Ideas Festival, etc--should not be regarded as a meeting of soothsayers. They're not even really prognosticators. They are, instead, the collected mewlings of the modern clarisy. Their declarations are meant to placate the hyper elite, convince them that their destructive behaviors are moral and the current system is totally sustainable even though the ground is clearly caving in beneath their feet. 

You can think of the visions set forth at these conferences as sort of what the rich think the best case scenario might be.

The Great Reset's best case scenario is terrifying indeed: one of the very first slides announces that by 2030 upwards of a billion people will be displaced by climate change. We won't eat meat anymore (okay, fine, whatever). Oh, also, our economy will be entirely rentier-based. You don't have any possessions. You rent everything you use. You don't draw a steady paycheck. Everyone is a gig worker. There is no retirement, either; you work until you can't, and then you die. 

This is the world both of our wretched political parties want to build. To the people who control our fate, this is idealism.

The weirdest omission is that they all seem to think that the masses are just going to go along with it. India and Pakistan will not exchange nuclear weapons: each side will merely accept that their countries are no longer inhabitable and instead of fighting for water or territory they will simply sit tight and wait for immolation. Eritreans will humbly march themselves into the sea. American homeowners will simply shrug their shoulders and consent to signing all of their earthly possessions over to Citibank in exchange for a weekly allowance of 4 cans of Spam.

Is this naivety, or do they know something we don't? Are they stupid enough to simply believe that no one will fight back, or are they planning some type of mechanisms for the suppression of unrest?

Maybe neither? Because, honestly, I can't see any reform taking place no matter how bad things get. Next year--after Biden eliminates all remaining vestiges of the social safety net and unemployment hits levels never before seen since the dawn of industrialization and the police continue to murder people at will--we could very well see riots that are ten times as destructive as the ones that hit over the past summer.

So what? What will change? The government will act swiftly to ensure that the hyper rich don't suffer a moment of inconvenience. They will give everyone else the choice of either dying quietly or getting mowed down by cops.

Remember the French Yellow Vest riots? Those were morally clear cut: their shitbag neoliberal weasel president eliminated the wealth tax--because omg can you imagine the injustice of a Kardashian only inheriting 80% of their father's money? To pay for this, France instituted a regressive gas tax and incredibly cruel pension cuts. This generated two straight years of violent, disruptive rioting. Macron's approval rating cratered toward near the single-digits. 

What was the result? The wealth tax was not reinstated. The gas tax was not rescinded. The government made a minor concession on the pension reforms, cutting payments on average by 40%, instead of the 50% that was initially approved. 

This is the efficacy of protest. This is the best us non-elites can to do change the future everyone in charge has very explicitly said they want. 

The Democrat adoration for Biden sends a clear message: you get nothing. You will never get anything. You are a bad person for even asking for something.

I’ve mentioned this before, but Endless war, deadly austerity, and environmental destruction simply do not enter the liberal worldview. Anyone who tries bringing them up is a racist sexist bro who cares more about "preventing the oceans from catching fire" when he should be paying attention to something really important, like the newest trans Marvel hero. L-look at this Beefaroni commercial that features a biracial family... you gonna look at that and tell me we're not making progress? You ingrate. You fucking worm. How fucking dare you be upset that we just stole your pension? Your soul is so blighted by privilege you think you just deserve to not go bankrupt to pay for cancer treatment? 

That's the thrust of liberalism post-Obama. No solutions, just excuses. We're not going to help anybody. But we will give relatively well off people a means of justifying, in their tiny brains, why it's good when the leaders they adore act like cruel shitheads.

[gianna1014]

Hidden Truth

Hidden Truth

Hazel’s life has been a mess since her father’s business went bankrupt. They were living a worrie-less life before it happened. But it get worse when her father diagnosed with cancer. They were running out of money. Her father needs medical treatment and she has nothing in her bank account. She discovered too that they don’t have enough money even to pay for their bills.

She has nothing but to sell their ancestral house in Batangas. Then she met Vincent Del Tierra. The ruggedly handsome but lethal looking businessman. He’s rich. A billionaire. And even if she wasn’t willing to sell their last property, she don’t have any other choices. The father’s health was her priority.

Vincent Del Tierra desires Hazel. The first time he saw her, he knew then what he really wants. And he needs her more than having her in his bed.

He will provide her money, her mansion and everything.. if she will be willing to give him a.. child.

Hazel thought he was crazy. But everytime she was looking in his eyes.. there’s something she can’t barely explain.

Will she give in for money? Or will she strip the hidden desires.. along with the truth.. then what is the truth?

***

Chapter 1

Hazel’s POV

I slowly closed the door of my father’s room. He just fell asleep and I don’t want him to be disturbed again. It’s been a long night and he was complaining about his medicines.

I walked out from the hallway. I thought of going to the kitchen and get something to drink but I decided to go to the veranda and stay there for a while before I go to my room.

The cold breeze welcome my exhausted body. I went up here just after I visited my father’s office. I had seen all the unopened letters, documents and other files. I bit my lower lip and suppressed my tears.

What am I going to do now? Who am I going to ask for a help?

I liquidated all our other assets just to fill in our employees last salaries. I paid for the remaining debts and all I have now is our old house and some paper bills in my wallet. My bank account stripped to zero. I’ve decided too to close it down for good rather than having penalties because I can’t maintain the required balance.

I gasped silently. I was a teacher. A Pre-school teacher. I don’t earn that much and I bet if my salary can support my father’s expensive medication. I can’t even afford to hire a private nurse to take care of him when I go to work. Thank, God, I have Nanny Caridad with me. And she waves nothing but to help me, us. She has been working with the family before I was born. She’s almost a family.

But my problem didn’t end just like that. I have to support my father’s health. He was the only family that I have. My mother died when I was a little. She has found dead in the pool. The police said she probably drown. Probably—that’s all I could remember when I asked my father about her.

Relatives? Oh, damn. They were gone since the day my father declared bankruptcy. Even all business partners had gone with the wind. Just like that. That fast.

“Hazel,”

I still startled when I heard Nanny Caridad spoke. I cleared my throat and turned at her. I gave her a weary smile. That’s all I could afford to do.

She walked a few strides at me, “Why are you still awake? You should be in you room in this hour,” she concernly said at me.

I heaved out deep sigh. I blinked my tears back so she can’t see that my status still keep bothering me. “I..can’t sleep, Nanny..” I managed to answer.

She sighed. She’s in her mid fifties and stayed unmarried. I loved her like the way I loved my mother. Because of her, I never felt lonely even growing up without a mother by my side. My father was busy with our business but Nanny Caridad took cared of me.

“I know what’s bothering you, Hazel. You can’t hide it from me.” she said.

I faintedly smiled and stared at the dark night. “Nanny..I’m thinking of..selling this house..” I abruptly felt the pinch of pain right in my chest. There are a bunch of memories with me in this old house. And it's hard to decide and let it go.

She looked at me with surprised eyes. “But..Hazel—“

I shook my head. “I-I have nothing anymore, Nanny. I have to take care of Dad. My savings can’t support us. I can’t even afford to maintain this house, the bills and everything!”

She stared at me. I can feel how bad our situation were.

“If only I can help you..” she sadly uttered.

I held his hands. “You’re already a big help to us, Nanny. You know I can’t pay you anymore but you still chose to be with us and earn nothing. I couldn’t ask for more. If we don’t have you right now..I can’t imagine what will happen to me..”

She squeezed my hand. “The Lord is with us, Hazel. Don’t be discouraged..” she softly said to me.

I didn’t say anything rather than nodding. Yes. I prayed and asked. I know He was challenging me and I won’t give up. It’s just.. this earthly problems are so damn hard to swallow.

***

Tomorrow morning, I volunteered to go to the grocery and buy important goods for us. I have to buy my father’s medicines too.

While looking for the cheaper price of rice, I felt the unknown heat at my back. I turned around but only sees people who’s having their own business too.

I shrugged my shoulders and continued.

I pushed my cart and looked for another cheaper price of meat. I chose the small size of whole chicken. I budgeted my money for one week and it should not exceeded five to six hundred pesos.

When I finished, I lined up to the cashier and waited.

In my mind, I counted how much will it cost so I can save up more for my father’s medicines. I scanned my cart. I sighed and took out the loaf bread. “There you go..” I murmured.

When it was my turned, my bill went up to 565.25php. I smirked and paid the cashier. If I added the bread, the life span of my wallet will shorten.

I carried with the two large plastic bags. I walked to my old jeep and opened the passenger’s door and hop in the grocery bags. I just stop on track when someone called my name, “Yes..?” I turned around. I saw a man smiling at me.

Confusion marred in between my eyesbrows. Well, he was wearing a white longsleeves tucked in his black pants. He probably in his mid thirties or so.

“Do I know you?” I asked.

“You don’t. But my boss knows you and he wants to talk to you.”

I looked around hoping to find other people or bystanders. But I saw nothing. Even the guards. “I’m sorry. But.. I think—“

“You’re Hazel Villanueva, right?” he asked formally.

My lips parted a little. Should I confirm it or not? And I choose the latter. “I’m sorry.” I turned around.

“My boss has a proposal to you, Miss Villanueva..” he added when I opened the driver’s door.

“I’m not interested!” I almost shouted.

“Please see him first. He’s been following you in the grocery..”

I stopped on my track again. I knew it! I was right. There was someone staring at me!

I don’t want to assume but.. “Are.. you a stalker?”

He smirked. “I’m not. Maybe you can ask my boss.. he’s waiting for you in his car..” he cursory nodded the direction where the car was parked.

But I stay stilled. Did he think I will follow him?

I shook my head. “No. I won’t do that. I don’t know you.” I abruptly hop in the jeep and started the engines with my shaking hands. Who are these people?

The man walked at my side and knock on my window. He was urging me to open it.

But I didn’t. The engines finally started and drive the jeep as fast as I could to leave that man. Or men..

[mostlysignssomeportents]

The Nerd Cantina reviews #Radicalized

Megan McCarthy-Biank:

Immigration. Police brutality. Healthcare. Societal Collapse. In a series of novellas, Cory Doctorow isn’t afraid to get political to address these themes in Radicalized. His stories force readers to confront these issues and the frightening familiarity of how these events play out. The main characters in these stories face corporate greed against the most vulnerable, a biased justice system, the corrupt bureaucracy of health insurance, and the end of the world. While our protagonists prevail (for the most part), their successes come at almost-unexpected costs.

The first story, “Unauthorized Bread,” follows Salima in her attempt to navigate a system that seems to actively punish her for being a refugee. She and her fellow-refugee neighbors in their high-rise building have no choice but to use the appliances provided in the low-cost apartment. Unfortunately, these networked appliances will only function for specific products – for example, their toasters will only toast specific (i.e. “approved”) kinds of bread, the dishwasher will only wash specific kinds of dishes, and so on. Even elevator access is determined by how much rent the tenants can afford to pay.

Then one day, Salima’s toaster stops working altogether, due to the company going bankrupt. So she finds a solution to the problem by hacking her broken toaster, and shares this trick with others in the building. Eventually the company is bought out and the network is up and running again – which means that Salima’s efforts could have disastrous consequences for her and everyone she helped to hack into the system and “illegally” use their appliances.

The second story is “Model Minority,” in which readers will recognize the identity of a popular superhero in our modern world. Going by the name of “American Eagle,” our main character witnesses and intervenes in an incident in which police officers are beating an unarmed black man, after allegedly seeing marijuana in the vehicle he is driving. The American Eagle pursues the case and the officer in charge, attempting to ensure that the the justice system works fairly to hold the police accountable. Some readers may be able to guess where the story goes from here.

The American Eagle has spent centuries upholding the law. For decades he thought that police officers worked to do the same. Throw in a well-known journalist/love-interest and billionaire colleague (both recognizable to comic book fans), and he begins to realize the failings of the system and becomes increasingly frustrated that his actions have adverse effects on the victim. The story literally asks the question, “Why did it take you so long?” Why did the American Eagle decide to intervene in police brutality and racial injustice now, when these issues have been around for decades? Would it even make a difference if some sort of supreme being or powerful alien started saying the words “Black Lives Matter,” or would Americans begin to see him as a threat once he confronts the police?

The third novella in the collection, “Radicalized,” will hit home with any reader who has had to deal with the corruption of the American healthcare system. Our main character, Joe, is a father and husband whose wife has cancer. While an experimental treatment can possibly save her life, their insurance company refuses to cover the cost. While fundraising for his wife’s treatment, Joe finds himself diving deep into the dark web and finds a forum/community full of those with similar experiences – people who have lost spouses and children who could have been saved, if not for the insurance policies in place.

In this story, the community members take matters into their own hands by attacking the insurance companies’ headquarters and unleashing their frustration in deadly ways. Eventually the bodies pile up and government officials finally use the word “terrorism” to describe the predominantly armed white male suspects carrying out these attacks. While Joe attempts to help these depressed and angry people and prevent more attacks, he finds himself potentially guilty by association. The question is, how many people have to die for those in power to take action?

The final story, “Masque of the Red Death,” explores how the 1% might handle the end of the world. Our protagonist Martin has spared no expense on his “very cool” bunker (AKA Fort Doom) and survival plan, and seems excited to use them. He invites 30 specific people to join him and spells out explicit instructions to follow, and turns away those who don’t follow them. Not everyone shows up to ride out the collapse of society. Those who do, however, slowly realize taking shelter with Martin may not have been the best course of action, as things begin to go horribly wrong.

Doctorow somehow manages to develop fleshed-out characters in the short time readers spend with them. Each story in Radicalized digs deep into the realities that Americans face today, and gives us new perspectives from the lives directly (and indirectly) impacted. If Doctorow’s goal was to entertain, educate, and make readers realize their potential to fix these problems, then he has succeeded.

https://thenerdcantina.com/radicalized-by-cory-doctorow-book-review/

[that-one-violist]

fuck anyone who says that privatized healthcare that costs this fucking much is good because it makes the healthcare quality.

dont you dare tell me our healthcare system is quality when with so many different doctors and hospitals and at least 3 different health insurance providers it was so fucking bad my mom gave up on going to get any treatment for the last 2 years of her life because she couldnt take the dehumanization, only to be billed thousands of dollars that we didnt have simply because she wanted to be able to walk and live her life and not be bedridden.

they told us years later that they possibly could have managed to switch her cancer diagnoses papers with another patient, and we will never know if the radioactive iodine treatments which, mind you, were 3x as much as a human should have in an entire lifetime in the span of 2 to 3 fucking years, were even necessary. they managed to constantly give her the wrong medication doses and when she complained that they were problematic they told her to get over it. they told her to smoke since her life was meaningless anyways. they told her to lose weight because it was annoying to have to get her a larger size gown. they told her she had to be lying to them about what she was eating, even after logging and taking pictures of every meal and having comfirmation from my dad they told her she was lying. only to find out multiple years too late it was a result of several diseases that she struggled to lose weight. diseases they should have caught and that she asked about and they immediately disregarded her.

dont. fucking. tell me. that the healthcare system works. or that its good. if we had the money, we could have gotten her the surgery for the growth in her abdomen that kept building that prevented her from walking. but we couldnt. you know why? my dads masters degree level 40+ hour work week fucking job didnt pay enough for us to afford that "cosmetic" surgery which meant we had to pay full out of pocket. and we couldnt. we werent even able to take out a loan for it, because we had taken out too many and gone bankrupt twice before.

how ironic, seeing as my father works as a lab technician in a hospital. yet we cant even truly afford to go to one.

all i can do is imagine if she could have gone down the stairs and seen me at graduation or my last concerts or move me into my dorm or live to move me out of it. what if the doctors didnt dismiss her. what if they didnt blatantly disregard her. what if we could have afforded the surgeries. what if we could have afforded the furnature and products that maybe could have made her life easier.

i just. i just cant stop being so fucking mad about it. they dehumanized her for fucking years. and now shes gone. and we dont get any justice. i just. the people who she was supposed to feel safe talking to and who she was supposed to somewhat trust with her life and health disregarded her. and maybe if we could have just afforded the so called "unnecesary cosmetic" surgery because the insurance company had some fine ass fucking print that prevented us from working with them due to the situation, maybe she could have had at least a half decent final 10 years of her life, or maybe she wouldnt have died before i turned fucking 20.

fucking imagine. it cant be real.

maybe im in the wrong to be mad, maybe healthcare here is absolutely fantastic and absolutely it is reasonable for people who dont have the money to die because they cant afford preventable healthcare and when theyre in bad health cant afford to do anything about it. maybe its reasonable that doctors dehumanize their patients consistently because some patients just arent worth their time, right? maybe im in the wrong. so fucking be it. maybe my sitiation is just so particular and non-relatable that this isnt a problem. so fucking be it. but i swear to god im never going to be okay with what happened to her. no one deserves that. no fucking one. regardless of their economic standing.

no. fucking. one.

[thecloserkin]

book review: Mira Grant, Feed (2010)

Genre: Sci-Fi

Is it the main pairing: Yes

Is it canon: No

Is it explicit: No

Is it endgame: Yes

Is it shippable: Hell to the yes

Bottom line: Creepily Codependent Siblings Survive the Zombie Apocalypse! They are adopted but the way they refer to each other as “my brother” and “my sister” when they could have used given names instead? I am here for it. While tight plotting is not one of this book’s strengths, you should slog through the infodumps to the ending which packs one hydrogen bomb of an emotional wallop.

This is the first book in the “Newsflash” trilogy about a pair of journalists, Georgia and Shaun Mason, who begin by blogging out of their parents’ basement and end by uncovering a vast governmental conspiracy subtended by various alphabet-soup agencies. The zombie apocalypse itself happened 23 years ago, and it happened the way these things invariably happen: Scientists try to cure cancer/the common cold, unleash freak virus on humanity, cue end of the world as we know it. Georgia and Shaun are the paradigmic products of this remade world: They, like many children born in and around the chaos of the outbreak, were orphans. On their adoption papers their birthdays are given as the same day—an arbitrary made-up date, but it makes them twins even if George is def a few months older. She acts older too, acting as the business brains of their fledgling journalistic operation while Shaun’s job is to “poke dead things with sticks” and look good while doing it. There is a performative aspect to Shaun’s mugging for the camera and flirting with anything in a skirt. He’s doing it because outrageous behavior garners them more hits, obviously, but he’s also doing it for George who gets a kick out of watching him charm the pants off people. She is bemused but not remotely threatened. George is all-business all the time, emotionally guarded and wary of physical contact, and one time when someone tried to hug her Shaun smoothly stepped up to intercept the hug to spare her the discomfort of enduring it. I SCREAMED. Note that George doesn’t mind being touched if it’s Shaun doing it:

I shuddered. Shaun caught the gesture and put a hand at the small of my back, steadying me. I flashed him a smile.

Shaun put a hand on my knee, steadying me, and I covered it with my own.

These small moments of tenderness punctuate an endearingly banterful sibling rapport. This is them reacting to the news of their big break—they’ve been tapped to cover the presidential campaign of an idealistic Wyoming senator:

Shaun was sure we’d get it. I was sure we wouldn’t. Now, staring at the monitor, Shaun said, “George?” “Yeah?” “You owe me twenty bucks.”

This is George shooing Shaun out of her room so she can change her clothes:

I pointed to the door. “Get out. There’s about to be nudity, and you’ll just complicate things.” “Finally, adult content! Should I turn the webcams on?”

This is big sister Georgia mocking Shaun for his youthful indiscretions:

”Remember how pissed you got when we had to do all that reading about the Rising back in sixth grade? I thought you were going to get us both expelled.”

In conclusion I love them sfm they are perfect.

As an aside, the people tagging this book “horror” on Goodreads have either not read the book (which is legit, TBR piles are a thing) or don’t understand what horror is? It’s like they saw the word “zombies” and just auto-completed the genre. What defines horror is not blood, gore, or violence but the fear and loss of agency engendered by that violence. That’s why so many horror film protagonists are women, who experience loss of agency in large and small ways on a daily basis and must learn to survive in the face of it; it’s cathartic to watch them take back control. The point of this digression is that THIS IS NOT A HORROR NOVEL. It’s not about that kind of fear!!! This is a political thriller so buckle in kids we’re going for a ride.

Twenty-three years ago during the outbreak, Georgia and Shaun’s parents lost their eight-year-old biological son. He was bitten by the neighbors’ dog. This was before it was widely understood that the virus could jump between mammalian species, and that anything surpassing the 40 pound threshold was susceptible to its effects. The dog weighed over 40 pounds. The Masons, who were award-winning reporters in their own right, dealt with their grief by channeling their emotional resources into chasing the news ratings. They continued to be phenomenally successful journalists as well as shitty parents to Shaun and Georgia, whom they seem to have adopted entirely for publicity purposes. The narrative invites us to draw the comparison between George and Shaun, who have chosen to pursue this career out of a thirst for THE TRUTH, and their parents who have less lofty motivations. Not to put too fine a point on it but their parents are mercenary motherfuckers. These kids survived their childhood by building an emotional bunker that they never learned to climb out of. This line from the very first chapter is so telling because they’re out in the field and Shaun is being chased by a zombie right?:

I screamed, images of my inevitable future as an only child filling my mind.

When Shaun’s in mortal peril, Georgia doesn’t think of him as “the center of my universe”— which he is—she thinks of the void that would result in the loss of her brother. That’s how they fit together, that’s what they are to each other, and all the other stuff is layered on top of the shared trauma of their childhood. Ffs they even have a ritual for administering each other’s blood tests—you know that thing at wedding toasts where the bride and groom loop their arms together and tip the champagne flute into the other’s mouth? Like that:

Moving with synchronicity born of long practice, we broke the biohazard seals and popped the plastic lids off our testing units

So the protocol for taking blood tests, which everyone has to do all day long to prove they’re not infected, is to come into the foyer/antechamber/vestibule one at a time and once you test clean you proceed into the building while the next person cycles into the chamber. That way, if anyone is found to be infected, they can be isolated. Georgia and Shaun have never once complied with this rule:

Our next-door-neighbor used to call Child Protective Services every six months because our folks wouldn’t stop us from coming in together. But what’s the point of life if you can’t take risks now and then, like coming into the damn house with your brother?

Implying that if one of them ever got bitten by a zombie the other one would rather spend the rest of their short life trapped in a garage with the shambling corpse of their sibling than die in their sleep at a ripe old age. Talk about ride or die.

I said before that this presidential campaign, this is their big break as much as it is the candidate’s. Up till now George and Shaun have been blogging under the umbrella of news aggregation entities (sort of like how BuzzFeed and HuffPost and Medium are populated by user-generated content that isn’t necessarily making the content creator an appreciable pile of money), but now they’ve finally landed the story that will let them strike out on their own. One of the sharpest things about this book is how it depicts journalism as a job, and a tough one to do right. Nashville does the same thing for the music industry, and as over-the-top as that show is, it shows you the nuts and bolts of success in a profession where practitioners are supposedly driven by “passion” alone. Here the distribution of labor is skewed pretty heavily towards George:

I get the administrative junk that Shaun’s too much of a jerk and Buffy’s too much of a flake to deal with.

Buffy is their business partner and some kind of auteur hacker + tech whiz. Shaun is the public face of their media brand. But make no mistake, George is the heart and soul and brains of this operation. You see her business acumen in drive-by observations like “Replacing that much equipment would kill our operating budget for months,” or when she talks about i n s u r a n c e. And George talks about insurance a lot. She mentions how a certain camera covered in zombie body fluids is an insurance write-off, how being present in designated high-risk zones during certain times of day can triple your insurance premium, how a certain treatment for her chronic vision condition isn’t covered by health insurance. I … just wanna point out that the human race has survived a flippin’ zombie apocalypse, but the United States remains wedded to private for-profit health insurance where who and what are “covered” remains a game of Russian roulette?!! Whoever said it was “easier to imagine the end of the world than the end of capitalism” was onto something. This society is functioning cohesively enough that elections are a thing (thus, nation-states are still a thing). If you want to tell me our fragmented, inefficient, fee-for service model of paying for medical care that routinely bankrupts & kills our citizens has weathered the end of civlization and emerged intact from its ashes, you better look me dead in the eye and bring receipts.

What’s really impressive about Georgia is she’ll rattle off exactly what kind of activities (those forbidden by her journalistic licensing) will invalidate her life insurance if she’s stupid enough to get killed while doing them. From which I surmise that she and Shaun are both covered by pretty hefty policies of which they are each other’s sole beneficiary. Which makes sense, they’re in a dangerous line of work, but I feel like it’s a poor investment since whoever was left behind would be doing their damnedest to climb into the grave next to their sibling lol.

Another little requirement of the household insurance—since we leave safe zones all the time in order to do our jobs, we have to be able to prove we’ve been properly sterilized, and that means logged computer verification of our sterilizations.

George is talking about the AI that is apparently located in her showerhead that douses her with a bleach & antiseptic compound when she comes back from being in the field?? That sounds painful but what concerns me is the breathtaking scope of the Internet of Things’ penetration into her life. The AI is in the bathroom. It knows exactly where she’s been bc ofc her GPS location can be tracked via her phone, and it’s merrily sending packets of information off to …. somewhere, where it will doubtless be aggregated with all the data collected about George from other sources, and combed for patterns to predict future behavior. That’s how surveillance capitalism works. if this sounds chillingly familiar it’s because it’s already happening, it’s what the tech giants are already doing—gobbling up as much data about as many people in as many contexts as possible—and leveraging that data for profit. Privacy is a joke. George is not unaware of this, but what choice does she have? It’s either install the damn AI in her showerhead or get her parents’ homeowners’ insurance policy cancelled for being too “high risk.”

I want to circle back to George’s chronic medical condition for a sec. She’s got a disability—what’s a called a “reservoir condition” where the virus takes up residence in a body organ, in her case the retina—meaning essentially that she has zombie vision; she can see ridiculously well in low light situations but direct sunlight will blind her. She has to wear shades even indoors and is literally incapable of crying since her tear ducts are inoperative. So there’s a testy situation where a federal agent tries to get her to take off her sunglasses so he can verify her identity with a retinal scan right? And because they’re standing outside this is obviously a recipe for permanent blindness, quite aside from the fact you wouldn’t be able to get a valid scan anyway due to the virus over-dilating George pupils. But instead of checking George’s files, where her disability & its effects are prominently listed, this grunt insists on making her remove her glasses because Procedure. It’s a pretty tense moment. Shaun goes ballistic. He doesn’t physically threaten the dude, or insult his mom or anything. No, Shaun understands that he needs to make this pencil-pusher more afraid of the consequences of taking George’s glasses than of Not Following Procedure. And it works. YEET.

On the campaign trail the Senator’s aides arrange for sex-segregated hotel rooms but Shaun and George are having none of it:

On the few occasions when I’ve tried sleeping without Shaun in the next room, well, let’s just say that I can go a long way on a six-pack of Coke.

The ostensible reason the sleeping arrangements need to be reshuffled is, Buffy can’t sleep without a nightlight and George’s eyes can’t tolerate a nightlight. Clearly the real reason is George and Shaun are c l i n g y and codependent as FUCK. One night after a zombie attack and the long grueling hours of cleanup/decontamination that followed it, they actually climb into the same bed—I guess this room only had a double instead of two singles?? The scene the next morning, the two of them having predictably overslept:

“Fuck a duck, Buffy, what are you trying to do, blind her?” … Shaun, clad only in his boxer shorts, staring at an unrepentant Buffy.

So Shaun’s beef with Buffy is not that she barged in on them while they were asleep & half-naked but that she opened the curtains, thereby triggering a painful migraine for George’s sensitive eyes. Buffy explains she didn’t shake them awake because they both sleep armed, lmao. George’s disability and Shaun’s practiced ability to help her maneuver around it (like a trusty prosthetic, he’s an extension of herself) serves to highlight how in this partnership they are one unit and they know each other inside out. This is them after their close shave with the dunce who tried to take George’s glasses:

“Fuck you, too,” I muttered as Shaun got his arm around me and hoisted me away from the barn. “You kiss our mother with that mouth?” “Our mother and you both, dickhead. Give me my sunglasses.”

And this is George waking up in their hotel room, eyes squeezed shut against the glare of multiple computer screens:

He touched my hand with the tips of his fingers before he pressed my sunglasses against my palm.

This is absurdly, spine-tinglingly intimate. First he touches her hand with the tip of his fingers, the most fleeting of touches to let her know it’s him, and then he presses the glasses into her palm to restore her agency so she can, you know, open her eyes. And that earlier scene with him guiding her by the elbow in broad daylight!!! I’M NOT CRYING YOU’RE CRYING

Sometimes I can hardly believe that George and Shaun are twenty-three years old. When I was twenty-three I … was not adulting half so well as these kids. But then, giving their barbarous upbringing, that’s not surprising; my parents loved and nurtured me. When I look at George and Shaun and the successful business they’ve built and the professional relationships they’ve cultivated and their expertise and their bravery I just feel this proud parental glow you know?

I want to say a word about Senator Ryman before we move onto spoiler territory. There’s a big controversy initially about whether the Senator is “genuine” or not (spoiler alert: he is). But what does that even mean, genuine? He’s a good egg, sure, but what are his policies, none of which are explored in depth except his support for horse farms??? I’m not kidding. In a world where any animal weighing over 40 pounds is a zombie outbreak waiting to happen, it’s a controversial position to say people should be able to keep pets in residential zones. Here is how George describes our Candidate:

He’s like a big, friendly Boy Scout who just woke up one day and decided to become the President of the United States of America.

I see two major problems with this: One, they say “Personnel is Policy” so who the hell is he planning to appoint to key Cabinet positions and can he trust them to pursue rather than undermine his objectives (and does he even have a deep enough bench of people to draw on)? Two, the Boy Scouts of America are not exactly, er, unproblematic, and while it’s safe to say our faves are always problematic, I think “Boy Scout” is shorthand here for “no skeletons in his closet,” which again puts the focus squarely on his personal qualities rather than what policies he espouses. It’s great that he hasn’t cheated on his wife or his taxes. But morality and ethics are not the same thing:

Morals are how you treat people you know. Ethics are how you treat people you don’t know. Your morality is what makes you a good spouse/friend … Your ethics are what makes you a good politician … Morality dictates that you take care of your family, friends and even acquaintances first … For a large society—a society where you can’t know everyone—to work, ethics must come before morality, or ethics and morality must have a great deal of overlap. By acting morally, you must be able to act ethically.

I think we can all agree that this does not describe how our society is currently constituted, and it doesn’t describe George and Shaun’s America either. So this narrow fixation on whether individual candidates are “genuine” or corrupt imo kinda misses the point. George says:

I haven’t even been able to find proof that his campaign received funding from the tobacco companies, and everyone’s campaign receives funding from the tobacco companies.

I don’t want to undersell how important it is the guy is not taking tobacco money. But is he also eschewing Wall Street money, Big Pharma money, defense contractor money? How could George possibly have time to investigate all this dark money if she is supposed to be covering the actual campaign? Seems like it would be a lot easier to reform the campaign finance laws than to vet every single single candidate’s funding sources.

I think one reason the Senator is long on identity & personal charisma and short on policy is that he’s up against an opponent whose base of support is millenarian-fundamentalist “the Rapture is here, we’re all going to hell”:

it was either Ryman’s brand of “we should all get along while we’re here,” or Tate’s hellfire and damnation.

If that is the main faultline in society, I guess half the voters don’t really wanna hear how a given politician is planning to make a material difference in their lives, since they’ve already got eyes on the prize aka the next life.

So there you have it. George and Shaun are scrappy independent muckrakers digging for the truth. Time and again their allegiance to that holy grail overrides their concern for trivial aims like idk personal safety. There’s a vast, shady conspiracy afoot, and as our heroes get closer to it they start getting shot at. They lose comrades. None of this deters them because they are after THE TRUTH. Oh wait there is in fact one thing George values more than the truth:

���You’re more interested in your brother than figuring out the truth?” “Shaun’s the only thing that concerns me more than the truth does.”

And later:

The sight of him was enough to make my heart beat faster and my throat get tight. I knew he was wearing Kevlar underneath his clothes, but Kevlar wouldn’t protect him from a headshot.

Her first concern is always, always, for him.

SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS SPOILERS

George gets infected. That’s the denouement. George is infected and Shaun has to shoot her before she turns all the way. Every single person who makes it to this scene is just bawling by the end of it:

His lips brushed the top of my head as he bent forward and pressed them to my hair. I wanted to yell at him to get away from me, but I didn’t. The barrel of the gun remained a cool, constant pressure on the back of my neck. When I turned, when I stopped being me, he would end it. He loved me enough to end it. Has any girl ever been luckier than I am?

The reassuring pressure of the gun on the base of her neck??? Has there been a more romantic moment in cinematic history??? I THINK NOT. Shaun is a crack shot—he’s the kind of guy who caresses his guns, names them after pretty women, causes his sister to grouse about digging through a suitcaseful of his weaponry to find her clothes—and yet here he is using his gun to kill the woman he loves most in the world.

It was supposed to be Shaun. They both took it as a given that Shaun would be the one to die first. Now he has to find a reason to continue living other than the obvious (vengeance). Stay tuned for the next installment, narrated by Shaun!

[ambre-gris]

Warning: personal rant! Omfg things are a mess. My dad died in February, from cancer. He had suffered from a form of leukemia for years but last December, he was diagnosed with prostate cancer. The autopsy results said it had spread even to his bones - he only started seeking treatment when it was too late. I'm not sad. I last spoke with him in 2020. But I have to deal with what he left behind: a literal junkyard. I have not found a will. He had been a hoarder and his house is in utter disrepair, I'd say it's beyond repair.

My mom keeps bugging me about selling the property and house to make profit, because she paid half of it when they got married. Thing is... They divorced in 2017 and being my dad's only child on paper - I have a half-sister who is over 10 years older than me and my dad was in her life long before I was even born but he never adopted her (he always felt insecure about the that my mom had been with someone else - to the point that he let it affect how he treated my sister). So that being the case, I am the sole heir. I wish I wasn't. It's painstaking to do this all alone: to suss out the papers, living far away, having no car, trying to write a thesis and work full time simultaneously.

I went there last month to organize some papers, clean up rotting biowaste, figuring out what to do with the ant-infested parts of house.... Someone had unplugged the freezer and I nearly threw up when I opened it, not knowing what awaited me. I could not stay there longer than two hours, the strong odors triggered a massive migraine later. I wish that freezer would just combust and burn everything down to the ground.

In addition to all this, I've been meaning to search for a therapist. I have been writing emails to potential therapists for TWO YEARS. I'm at my wit's end at this point. I don't have the energy to write a hearfelt request to 20 therapists each month (most of whom aren't even the type of therapist I should be seeing), for them to just say no, no one is available. I thought I was ready to fight for this but I guess I'm not. This is too rough on the soul right now. I am going to deal with this situation, somehow, but there's no way that rotten shack can bring any profit to my mom, or me. She doesn't understand how things work - my dad did all the work for her, even after the divorce. I have to explain things to her, and she gets angry if things don't work how she thinks "they should". My mom keeps offering to pay half of the bills but she wants the money back, so I'll just pay the bills from my own pocket and hope to get tax deductions later. I don't care anymore. I have a job that pays ok, so I'm not going to be bankrupt from doing this. What's wonky is that I wasn't even on good terms with my dad. The last text he sent me was over a year ago, and he asked me if Covid had killed me yet? Why am I even bothering with this? Even though my dad can't physically or verbally hurt me anymore, what he left behind still weighs on my shoulders. At one point, I felt guilty I had not attempted to reconcile. But you know what? I sure as hell don't anymore. Everything around me, everything that falls apart just proves he was a toxic person inside out, drove everyone away from him, cared more about alcohol than people. My mom says she keeps visiting his grave but she cannot bear to go to his house. I don't understand why she even cares. He was rotten towards her, and only showed her kindness when he was dying. I wanted to respect his wishes and I chose to have him buried in a coffin, not cremated, because I remembered him being against it. Now I'm just angry about it, about caring. I always gave him the benefit of the doubt in the end. Even after the hurtful things he said and never apologized for, never truly understanding how hurtful they were, refusing to listen to me, because he was uncomfortable with taking responsibility for his words and actions. The therapist I saw for a year, told me during one session: "If your parents were able to own up to their actions and objectively reflect on them, you would have been able to discuss your problems years ago." That opened my eyes and I was able to forgive myself for no longer wanting to try so hard.

Full disclosure: I miss my dog way more than I miss him. I'm not sure I even miss him. She was my angel, and I never felt that I wanted to do something else or be somewhere else when we were together. Staying at home, going on a walk on a rainy night, didn't matter. Every moment with her was valuable in itself.

That doesn't mean no one should mourn their parents. It doesn't mean anything except that at best, I have ambiguous feelings toward my dad. Everything he ever did for me was transactional. Same for my mom. At least I hope I will be able to cut loose more from all this after it's over. My bio family won't ever be "home" for me. I've made my home with my friends, and maybe one day I'll start my own, independent from my birth family. Such is life for some folks. Not all of us get great cards dealt at birth. What matters is what you make of your life, try to make it the best you can, the kind you can live without regrets.

[myurlusedtobemyname]

Hi a Canadian here!

About a year and a half ago I had a very bad pregnancy scare so I looked into my rights because I was 20 and I was going to terminate it if it ended up that I was pregnant. Canadian doctors can refuse you treatment, but they are required by law to refer you to a medical professional that will not refuse you treatment.

I went to my university hospital with a uti and was in and out in an hour, I went back with another; in and out in three, went back with yet another and the lead shift ER doctor took me aside to figure out why I was having so many, I was in about out in four hours because they were interested in making it so I stopped needing to go on heavy antibiotics week after week.

I’m 22 and I won’t pay a cent of my medications until I’m 25 because all residents under 25 get free prescription meds without issue or question.

My parents walked out of a three day stay at the hospital with me bundled in their arms paying a ten dollar phone pill because they used a pay phone to call my extended family to tell them that I was born.

Americans have this ridiculous notion that they are the best at everything. Is Canada perfect? Fuck no. Do I have to worry about bankrupting myself when I need to go to the hospital for a uti or when I sliced my hand open when a glass broke? Not even a little

Pimento is right, do we have long non emergent wait times in ERs? Hell ya we do, I waited six hours for my hand to get stitched up, you know what I did? I brought work with me and I sat in the waiting room reading my course work. But my Nana was diagnosed with stage three stomach cancer in the winter of 2014 and she waited about three days to see a specialist, according to @odinsravendutchess this wait should have been closer to months instead of a long weekend.

See the thing is if you are waiting you aren’t top priority and you know what that means? That means that somewhere behind that sliding door those doctors who would be stitching your hand or taking your blood or whatever are saving a woman who fell after a heart attack. Saving a kid who’s gone into their first diabetic shock episode. A man who is about to have a stroke. A teenage boy who came in with his mom, both of them in tears, and he’s being seen by an intake nurse who’s going to send him to the psychologist.

I’d rather fucking wait than have it be that any one of those people end up not getting the help they need. You aren’t the centre of the universe no matter what you think. Sometimes people are more in need of help than you are.

Universal health care means that when I was 6 months old and I got a lung infection I wouldn’t die, that when I was having chronic ear infections as a 2-4 year old I wouldn’t end up with meningitis or hearing loss or facial paralysis, that when I was 11 and I got H1N1 my parents didn’t need to worry that I was going to die from it, that when my brother called them sitting in his car they could get him to the hospital for a 24 hour stay and save him from doing something irreversible without worrying that they couldn’t make the mortgage payment or buy groceries or take us to the movies or a baseball game or or or or or. My parents couldn’t have imagined the hell that would befall their three kids. Alone I would have bankrupted us before I was in the first grade if we lived in America.

No system is 100% perfect but America’s is broken beyond understanding. You shouldn’t have to pay extra to hold your baby after it’s been born. Insulin shouldn’t cost the same as rent. Doctors shouldn’t push medications (especially when there are better/ more suited/ more effective medications) because pharma wants to make some money. None of that is normal. None of that is okay. Understand that America isn’t the utopia you were taught it was (yes I’m mostly talking to other white people now) I hope you never have to experience it first hand but damn take some time to imagine what it’s like at least.

And just btw your casual racism is showing big time Odin. Maybe learn a thing or two about health care in other countries (especially neighbouring countries) before you go spewing this America’s number one bullshit. It’s tiring and stupid. Don’t forget Americans are biiiig fans of healthcare tourism bc your system is so broken, but you don’t see us bemoaning that. (I’m on mobile so I can’t link but if you google medical tourism among Americans you’ll see that in 2017 more than 1.4 million Americans sought care abroad, a figure up significantly from a decade prior (2007) when the number of Americans leaving the country for care was at 750,000)

Oh and if anyone’s about to come for me almost getting an abortion or my parents for giving us all those life saving drugs or anything I mentioned in this kindly fuck off

[keanuweeps]

At the end of the day, I am extremely doubtful we will ever get free healthcare.  Not because we can afford it-- we could afford it, we're one of the wealthiest countries in the world, the money is here if it's anywhere.  Not because it is impractical-- other countries have and do do it.  The state of Connecticut offers it to people in poverty here through the Husky Health program, and we're one of only 10 states that pay more to the federal government in taxes than we get back.  I'm on that Husky Health program, and it has worked wonders in my life. We won't get free healthcare not because it is impossible, but because too much wealth in this country is made through the exorbitant costs of the dysfunctions in our current system.

So many people are bankrupted and hackneyed by medical debt.  Someone OWNS that debt.  Someone is collecting the interest on that debt.  The reason many medications and treatments are expensive is not because hospitals are really that expensive to run, or because doctors are all living in hilltop mansions, it is because someone is making their cut on it, and their cut on it is massive.  There are hundreds, if not thousands, of Martin Shkrelis out there, and the reason they aren't in the media is because they're smart enough not to brag about it on twitter.

And we don't talk about this part of the issue why?  Because the people who profit off of the ruins of our lives use their cut to make sure we don't.  To pay lobbyists, to pay media companies, to make "donations" to candidates who say things like "well, free medical care would be great, but are all you poor people going to pay for it? You can't afford your own cancer treatment, do you really think your taxes can pay for someone else's?" when the people who would get the free health care by and large would save a significant amount of money, and everyone that isn't rich enough to buy the patent for a medication and raise the price a thousand and fifty percent would save a significant amount of money, including hospitals and doctors and so on. Or they'll say "Our current healthcare system already barely works-- and you want to bring in a new one, with a new host of problems?"  because no one is talking about why ours doesn't work, because the lot of us like to assume it is due to human error, and not the profitability of those dysfunctions.

[payprosalaska]

HHS Secretary Azar Wants Employers to Help Control Health Care Costs

To help rein in health care costs, employers can avoid plans with “backdoor rebates” on prescription drugs, contract directly with hospitals, and guide employees to high-quality, competitively priced doctors, Health and Human Services (HHS) Secretary Alex Azar said last week.

While people often look to the government to drive changes in U.S. health care, employers “represent a hugely important force, in many ways as important or more important than the federal government” because of the 180 million people in the U.S. who receive job-based health coverage, Azar said April 11 at the National Business Group on Health’s (NBGH’s) Business Health Agenda 2019 in Washington, D.C.

“No American should be going bankrupt due to the cost of health care services,” Azar told the group representing large U.S. employers. The cost of health services and prescription drugs “should be accessible, transparent and, to the extent possible, predictable,” he said. “We need new levels of competition in health care so that market forces can increase quality and drive down costs, just like they do throughout the rest of our economy. We need transparency around price and quality so that individual consumers and, in some cases, third-party payers can drive that transformation.”

Targeting Drug Rebates

Azar encouraged employers to support an HHS proposal to end “backdoor rebates” that drug makers pay to pharmacy benefit managers (PBMs), and require that any rebates be deducted from the cost consumers pay at the pharmacy counter. Although the proposal would apply to privately administered Medicare Part D prescription drug plans and “would not technically extend to the commercial market, we were clear in our proposed rulemaking that enforcement of this rule has to take into account the possibility of negotiations bleeding between the Part D market and the commercial market,” Azar said. “As a policy matter, we believe that the need for upfront discounts is even greater in the employer market than in Part D.”

PBMs receive “tens of billions of dollars in rebates without patients—or the employers who pay a big chunk of the bill—ever knowing where the money goes,” Azar said. Replacing rebates with upfront discounts “will be an immensely positive step for patients, employers and prescription drug markets overall.”

Lower-cost generic drugs and brand drugs that have cut their list price are “struggling to get placement on insurers’ formularies because they have lower rebates they can funnel to the pharmacy benefit manager,” Azar said, and that is “holding back lower-cost options” from the patients who are covered through employer plans.

NBGH’s 2019 Large Employers’ Health Care Strategy and Plan Design survey report, based on responses from 170 large U.S. employers, found that 3 in 4 large employers do not believe drug-manufacturer rebates are an effective tool for helping to drive down pharmaceutical costs, and more than half are concerned that rebates do not benefit consumers at the point of sale.

Azar encouraged employers to press their insurers and third-party administrators to require that manufacturer rebates be passed directly to consumers, a development that, he noted, is already gaining traction.

Contracting Directly with Providers

Along with reforming drug rebates, Azar pointed to other steps employers could take to make health care prices more competitive. For instance, he called it a positive sign that more employers are beginning to contract directly with health systems and providers, such as hospitals and specialized providers (e.g., cancer treatment centers), that are rated as centers of excellence (COEs).

The share of large employers directly contracting with health providers rose from 3 percent in 2018 to 11 percent in 2019, the NBGH survey found.

Also speaking at the conference, Walmart’s senior director of benefits strategy and design, Lisa Woods, discussed how the retailer has contracted with COEs such as the Mayo Clinic, Cleveland Clinic and Emory Healthcare for cost-competitive cancer treatment, organ transplants, knee and hip replacements, spine surgery and cardiac care. To incentivize employees to use these highly rated COE facilities, Walmart covers evaluation and care 100 percent after employees meet their deductibles.

Walmart also pays for travel and lodging and provides an expense allowance for the employee and one caregiver.

Long-term health outcomes for employees in Walmart’s COE program “are far superior” to those of employees outside the program, Woods said. For instance, time off work for spine surgery is 10.6 weeks through the COE program and 13.2 weeks for non-COE care, while hospital readmission rates for spine surgery were 0.3 percent at the COE and 6.5 percent for non-COE care.

A comprehensive look at Walmart’s direct-contracting initiative was published in the March issue of the Harvard Business Review.

[SHRM members-only toolkit: Managing Health Care Costs]

Guiding Employees to Quality Care

Azar also said that employers’ adopting consumer-directed health plans with higher deductibles encourages people to choose care options with more-competitive prices, but only “if patients have the tools they need to shop around and drive value.” Too often, he noted, they lack such tools, so employers could help connect employees with highly rated, competitively priced providers.

In a conference session on health care navigation support, NBGH President and CEO Brian Marcotte likewise called on employers to “rethink consumerism to simplify decision-making.” Benefits that help employees make health care choices include online platforms that show ratings for doctors and hospitals, and staffed “concierge” services that help employees choose providers based on health outcomes and prices. These offerings can also include medical-decision support, in which medical specialists evaluate the appropriateness of diagnoses based on a patient’s submitted records and suggest second-opinion providers when appropriate.

The NGBH survey showed that 71 percent of large employers provide employees with medical-decision support tools, and 39 percent offer full concierge services.

HHS is interested in helping employers use health care navigation services and may incorporate them into federal health care programs. Employers that offer such services report that sizable shares of covered employees are using them.

While many employers are limiting the number of health care providers covered at in-network rates to weed out low-rated doctors and facilities, “narrow networks don’t by themselves help to better educate the consumer” on why quality ratings matter, said Brendon Perkins, vice president for global benefits and mobility at Nielsen, a consumer data company.

Nielsen gave employees access to an independent, third-party navigation service, he said, “because it turns every interaction into an educational opportunity for getting people to better doctors,” which can improve their health and avoid excess costs.

Related SHRM Articles:

HHS Proposes Targeting PBM Rebates for Prescription Drugs, SHRM Online, February 2019

Direct Contracting with Health Providers Can Lower Costs, SHRM Online, October 2018

For 2019, Employers Adjust Health Benefits as Costs Near $15,000 per Employee, SHRM Online, August 2018

Health Plans Shift Toward Paying Doctors for Value Provided, SHRM Online, January 2017

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[stirringwinds]

bigdawge9 replied to your post :the Republican Party has had 6 years to come up...

You obviously are another ill informed loudmouth, the countries you mention have relatively poor healthcare, if they are as good as you say why do so many people from those countries come here to obtain care. I have spent over a decade in several of the countries you listed and I can assure their healthcare pails in comparison to ours.

My dude, I live in the UK right now. I have been treated by the NHS. I am familiar with other European systems because I’ve travelled in the EU. I have family members in Taiwan and Singapore. And none of us would trade our universal healthcare for what my sister is subject to in the United States- which the ACA already attempted to improve. 

One of my family members is on expensive cancer medication and if he were American the medicine would cost easily over $130k year, but fortunately he doesn’t have to pay anything. AND, additionally costs like drug prices are kept lower because the UK government uses its enormous bargaining power as the representative of a single-payer system covering 65 million people to negotiate with the drug company to have the price slashed to a fraction of its American price. American healthcare costs and drug prices are ridiculously inflated and ACA attempted to fix some of that while the GOP is going to make it even worse. That is not ‘good’ healthcare. It’s a damn shame the most powerful country in the world, the linchpin of the global economy and major driver of R & D doesn’t guarantee its citizens the healthcare they deserve.

I’d be the first to point out the NHS isn’t perfect here and we have problems to fix, but in comparison? We spend less per capita on healthcare under the UK’s single-payer NHS and with vastly better outcomes. Here’s the evidence:

Doesn’t seem to be translating into better health, does it? 

Put that disparity next to the spending, who isn’t getting value for their money?Of course there are multiple factors at play but just look at how much more the US spends. There’s something clearly wrong. It shouldn’t be such a big gap.

I don’t know anybody going to the US for health treatment unless they’re wealthy. Because don’t mistake wealthy as fuck foreigners who come over to the US for the most cutting edge expensive treatments developed as representative of the rest of us. The entire problem with the United States isn’t that it doesn’t have technology and innovation. It has some of the best R & D, I’ve said so many times myself. The problem is quality healthcare is often unaffordable unless you’re extremely wealthy. The problem is that the US’ minimum standard of healthcare access is poor. Here, we are happy to have the taxes we pay- from VAT to income tax- to be paid towards providing a safety net that all of us will have to use in our lifetime and to spread the risk amongst 30 million or so taxpayers instead of small, limited high-risk pools. Economies of scale? Efficient risk distribution? Better bargaining power when purchasing in bulk? Creating the correct incentives - i.e encouraging preventive care instead of people waiting till their condition needs costly treatment by providing free checkups? These are basic economic principles. 

Most of all, you don’t judge how well a country does just solely based on how it treats its wealthiest and most connected citizens. It’s way better to be a poor, ill person in our countries whose healthcare you claim is crap than the United States. People here go bankrupt yes, but nobody here goes bankrupt because of an unexpected health emergency. Nobody feels they have to stick to a shitty job they don’t like and where their talents are not maximised instead of moving on to what they like to do or going back to school, or even starting their own business just because they need the health insurance provided by their employer. That’s liberating, you know. It’s an investment made in the citizens of a country. Can you say the same for America? 

But sure, I’m another ‘ill-informed loudmouth’. ¯\_(ツ)_/¯

[alarajrogers]

braveday said:  private insurance companies are the sole (ONLY) reason why people go bankrupt because of medical care. The astronomical price of medicine is entirely due to greedy capitalists. we need to get money out of medicine and M4A is the only plan that will state that process

I don’t disagree with any of that, but I think you’re missing my point.

In a sane country, healthcare run by the government wouldn’t result in women periodically losing coverage for birth control because the politicians that answer to 30% of the electorate have 50% of the control and include a really, really reactionary, misogynist, religious right-wing as part of their coalition. However, that is not our country.

We need to recognize that even if we get control of the Presidency, the House and the Senate, we won’t keep that control; it took a long, long time for the Republicans to achieve the dominance they have and it will take a long, long time for us to win back the kind of control we once had and not have to worry about what happens the next time the Democrats field a flavorless candidate and idiots vote for a Republican who tells pretty lies.

Every time Republicans are in charge of the government, the government-sponsored Medicare For All will stop covering anything to do with birth control. Right now, women covered under Medicare don’t generally need birth control because they’re post-menopausal, but if you don’t think the right wing would use the fact that the government is the only source of health insurance to try to punish women for having sex, you aren’t paying attention.

I want private insurance to continue to exist as a supplement to Medicare For All, to make sure that if the government stops covering a thing, we can still buy insurance that covers it. Right now, some private insurance plans will pay for abortion, but it’s the law of the land that no government funding is ever allowed to. They’d happily expand that to birth control itself. I’ve also seen that private insurance run by right-wingers tries to make access to mental health meds very difficult, so I expect government care run by right-wingers would do the same, and the government’s history with overreacting to “abuse” of painkillers by trying to keep people from having them means that people with legit prescriptions may not be able to get their painkillers. 

We need supplemental insurance to protect us from Republicans running the health care system, which they will, approximately every 8 years or so, if all care is paid for by the government. That isn’t a good reason not to have all care paid for by the government. Republicans haven’t stopped elderly people from getting the cancer treatments that Medicare pays for, after all. Medicare for All would still be a better system than what we have. But there’s a glaring weakness in it -- the thought that any system run by the government would stand up to the extremist right wing indefinitely. 

Some countries that have universal health care also have supplemental coverage that can be paid for independently. There’s nothing about allowing private insurance to continue to exist as a supplement to the government-paid care that is inconsistent with universal health care. 

We don't need centrist incrementalism. We don't need to protect private insurance companies. We don't need employers controlling your insurance.

We need #MedicareForAll

[ultimatestudyabroad]

Health Insurance: Adding Insult to Injury

Not only have I been unemployed and homeless since I arrived back in America, but I’ve also not had any health insurance. So, on top of worrying about how long I can make my money stretch and stressing about whether anyone will ever hire me, I’ve had this nagging voice in the back of my head: You’d better not get sick, Mel. You’d better not need a prescription filled, Mel. Don’t go ice skating with your friend, Mel. If you break your ankle, you don’t have health insurance.

I feel the need to pause here and clarify for my Australian friends: no health insurance = no health cover of any kind. This isn’t a “I don’t have private insurance, but Medicare still covers me” situation. (Note: universal health care in Australia is called “Medicare” whereas “Medicare” in the U.S. is primarily for the elderly – this can admittedly get confusing). In the United States, if you don’t have a job, you don’t have health insurance (unless you buy it yourself, but we’ll get to that). There is no automatic social safety net.

When I was younger, I would simply take the risk of not having insurance in between jobs. In retrospect, I was lucky nothing serious happened. But now, I’m older, wiser, and only two years away from the age my mom was when she was diagnosed with breast cancer, so no insurance is no longer a risk I’m willing to take. Before I left Australia, I tried to figure out how to get some insurance until I get a job. I didn’t have much luck. Because here’s another oddity in America: you can only buy/make changes to your health insurance at certain times of year, the “open enrollment period.” There are exceptions to that, of course, for major “life events” like getting married, etc. and it turns out that returning from living abroad is one of them. However, outside the open enrollment period, options are scarce. They are also tied to the state you live in and I wasn’t sure where I was going to live! The only plans I could find were so expensive and so crappy that I decided against buying “real” insurance and instead obtained emergency cover through a travel insurance plan for expats returning from abroad. I figured I just needed something to cover me in case I was in a car accident or I needed an emergency appendectomy or something like that. I figured I’d only need it a few months and then I’d have a job (hahahahaha, joke was on me). I bought the plan and extended it once. Then open enrollment hit and I still didn’t have a job, so I knew I needed to bite the bullet and get some health insurance.

Some of my friends in Australia assumed that Obamacare gave all Americans health insurance and I had to explain to them that it merely required us all to have insurance; it didn’t give us anything. It did add some regulations to make our health insurance plans suck less and it created the marketplace, a website where individuals could go purchase their own health insurance if they didn’t have any through work. And this is where I went to buy my insurance plan, an eye-opening experience. I entered in some demographic information and where I lived so that the system could identify plans I was eligible for. I got to a screen that asked for my anticipated 2020 income. I entered “$0.” I mean, the whole reason I have to go through this is that I’m unemployed! In return, I got the message that, based on my answer, I do not qualify for subsidies to help cover the cost of my insurance. What?! How can someone with no income not qualify for the assistance the law provides for the insurance the law requires people to have? Oh well. I wasn’t terribly surprised by this. I’d already made weak attempts to see if I could qualify for any kind of social welfare program. Unemployment? Nope. Medicaid? Nope. For food stamps, I was at least asked to provide some additional information, but after that, I never got any kind of response…

Anyway, I cursed the heavens and clicked through to see my plan options. Words cannot express how shit these plans were. As I report on this, bear in mind that I am a healthy, non-smoker with no pre-existing conditions. Plans that were affordable – around $250-300 a month – had deductibles upwards of $8,000! Meaning, I would need to utilize $8,000 worth of medical services before my insurance would kick in. Now, I neither intend to need $8,000 worth of medical services nor do I have $8,000 to spend on medical services. Some of the more affordable plans also had no cap to the out-of-pocket expense. For example, if once I had met my $8,000 deductible, I ended up in the emergency room, I’d still be responsible for, say 50%, of the total cost. For other kinds of treatment, insurance might pay 80% and I’d be responsible for 20% (again, this is all after I’ve met my deductible). Two things make these kind of plans a very bad idea. First, as I mentioned, I have a family history of breast cancer. My boobies are most likely going to turn on me one day. I don’t just need insurance; I need cancer-quality insurance. This fact was vividly driven home to me in the month before I went on the marketplace, when two people I care about were diagnosed with breast cancer. Crappy insurance is not an option for me.

Secondly, health care in America is expensive. How expensive, you ask? Check out this thread of responses from when Bernie asked the same question. From personal experience, I’ll give one example. Before I moved  to Australia, I’d been having annual breast MRIs as part of my preventative care.  My GP in Australia wanted me to continue that type of screening, but warned me that my overseas student health cover (basically, the equivalent of Medicare) didn’t cover MRIs. I immediately refused the test and we got in a bit of a spat over why I was refusing her recommendation. I told her I could not possibly afford an MRI out of pocket. We went back and forth a few times before she finally looked up the price: $500. FIVE HUNDRED DOLLARS FOR AN MRI! The total cost of this test in the U.S. is $3,000-4,000. I told her that. She almost fell out of her chair. This kind of experience happened to me several times in Australia. I’d be having a disagreement with someone on health care and there’d be this sense that neither one of us really knew why we were so opposed to each other and the reason turned out to be that we were operating from two completely different frames of reference. To close the story, I had my MRI (and my OSHC surprisingly ended up covering it! This – paying less than what you think you’re going to have to pay -- is something that never happens in America!)

But back to the Marketplace. I ended up choosing a plan that had an out-of-pocket maximum. I’m not interested in going bankrupt because of medical bills. I also chose a plan with $0 deductible because the difference in cost between low-deductible and no-deductible plans was fairly negligible. So, my plan isn’t that bad (or, I should say, it doesn’t seem to be. We’ll find out when I actually try to use it). What’s this costing me, you might be wondering? $580 a month! Please recall that my income is currently $0. I do not have $580 a month, which is only $139 less than what my mortgage was before I sold my house! Americans reading this are most likely thinking, “yeah, that sounds about right” whereas my Australian friends are probably a little shell-shocked.

To give my American friends some context … When I moved to Australia, in order to get my student visa, I had to pay for 46 months (the duration of my visa) worth of health cover up front. At the cost of my new American health insurance plan, that would have amounted to almost $27,000. Instead, I paid $1,893.12! That’s just over $40 a month. And for that, I got amazing health care. I went to my GP all the time because it was so easy and it was free. The only time I ever had to pay was $35 for a blood test that wasn’t fully covered (and I got part of that back from my insurance within a WEEK of submitting a claim!) My OSHC didn’t cover prescriptions or routine dental, but both of those things were cheaper fully out of pocket than they are in America with insurance. I once had to take an American study abroad student (who had no Australian health insurance) to the equivalent of urgent care for strep throat. He waited less than five minutes without an appointment (can’t remember the last time I waited less than 20 minutes in the U.S. even with an appointment). He paid $50 for the visit and $10 for his antibiotic with – I repeat – no insurance.

I listen to the Medicare for All debates in the Democratic primary and my first reaction is to be completely flummoxed that anyone (other than a health insurance executive) could be against it. But upon further reflection, I think that Americans are just so used to being screwed by their health insurance that they find it hard to conceive of an existence in which they are not. We are so conditioned by the structures that run our lives that a functioning system seems fanciful. Once I got to Australia, it took me some time to believe. During pretty much every encounter with the Australian health care system, I was confused/surprised/skeptical that it really was that easy/quick/cheap. Now that I’m back, I’m equal parts a) dreading the reverse culture shock that will occur when I need to go to a doctor and b) pissed off that the “richest country on earth” extracts so much profit from the health of its citizens. So to my fellow Americans I say: support universal, single-payer health care! Trust me, you’ll love it.

[walduissymavelleyq94insuran-blog]

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