#so it really makes no sense for healthcare to be insurance based

[thatmartiangirl]

Working in the insurance industry and getting a better idea of how it works and it's becoming clearer and clearer how bonkers it is that the healthcare system in this country is insurance based

[live-from-flaturn]

Number 25: Wrapping arms around them when they make breakfast. Bonus points if whoever's cooking is terrible at it.

somehow this thing started off with vaguely horny vibes and then, as per usual, veered directly into character study territory and got sickeningly soft. thanks for the lovely prompt, darlin'!

tw: references to Korn in passing

wordcount: approx. 700

Title: "Tasting Sunrise"

Chay slips his arms around Kim’s waist and hooks his chin over his boyfriend’s shoulder. He watches as Thailand’s current indie sweetheart and rising star stirs wayyyyyy too much chili paste into the soup he’s making. “Whatcha doing, Phi?”

“What does it look like?” Kim sniffs. “I’m making us breakfast.”

“Are you secretly trying to kill me and collect my hefty life insurance policy?” 

“Wh– Why would you ask that?!” Kim spins around in his arms, looking so completely horrified that, for a split-second, Porchay feels kinda bad… 

Then he takes in the ‘Fuck You, it’s MY Kitchen’ apron (which Tankhun had special-ordered when Kim nearly burned down the house last summer making grilled cheese), Kim’s untouched bedhead, and his own rumpled Wik tee covering Kim’s chest. A smile blooms softly across his face. There’s no urgency in the gesture, no driving need to ease Kim’s worry – because Kim is already calm again. One look is all it takes now that they’ve learned how real communication works.

“That’s a lot of chili, P’Kim.” Chay noses along the hinge of Kim’s jaw until Kim finally relaxes back against him and exposes his neck for more. “Are you feeling congested, or did I snore last night and you’re trying to fix the problem with folk medicine?”

“Is it really that much?” Kim blinks at him innocently. Chay still can't believe that for all his ferality, all his killing and maiming and committing violent crimes on a near-weekly basis, Kim has no fucking clue how to read recipes. Something about cooking simply doesn't click; and that's fine with Chay, because cooking is his happy place. 

Therapy rocks and he’ll always be grateful for his access to solid mental healthcare – but sometimes, in the quiet of their kitchen, nothing soothes him faster or better than slicing up vegetables and mixing the correct ratio of seasonings into his broth base. He makes Kim a variety of healthy food and takes great pride in doing so.

“I love you so much, P’Kim… But there’s a reason I make breakfast when we have the time to eat together.” 

Kim pouts cutely up at him in disappointment so Chay smacks a kiss to his forehead. Totally fair compensation, in his opinion. “How about we go out for food, instead? There’s a new crepe place down the block that looks awesome and the reviews are good.”

“I like crepes.”

“Precisely my point.”

“Alright,” Kim smiles and turns off the stove. Chay follows him into the bedroom, pinching at his hips to keep them from getting distracted on the way. 

“Thank you for taking care of me,” Chay whispers, just before they leave the apartment. He takes one of Kim’s hands in both of his and presses several kisses along the ridge of Kim's knuckles. “But please don’t push yourself to do things that make you uncomfortable for my sake. We both make up each other’s slack, right?”

Kim looks apprehensive at this request. Wary. Almost as if he's been cornered. 

Chay wonders darkly if he’s been to visit Korn in the last twenty-four hours.  

“I make us healthy, tasty dinners and sometimes breakfast. You check the deadbolts every night and keep a holster under your bedside table,” Chay ticks the items off on his fingers as if he’s making a numbered list. Mostly he wants Kim to understand his point. Kim nods along, so he continues:

“I keep track of our toiletries and resupply when we’re at the store. You have a cool sixth sense about when we’re low on coffee beans, so we never run out. Cats come up to me on the street so we can both pet them. Your fans take candids of us petting cats together on the street and post them online for me to collect. We’re symbiotic, Kim. Not like Venom, I mean, but like two separate people who fit very well together.”

Kim pops onto his toes in order to bestow a pleased kiss to Chay’s lips. Chay can feel Kim's smile beneath the pressure of skin meeting skin and it makes him smile right back. 

When they pull back for air, Kim gasps, “I love you, sunshine.”

“I love you, too, Phi.”

“Breakfast?”

“Breakfast.”

The crepes, while delicious, don't hold a candle to the taste of Kim's early morning smile.

[mermaidfantasy05]

Ninjago #1: Ninjago's Potrayal In Webseries

I've actually deliberated over this for a while. Since in the webseries, instead of people sized Lego people, all the characters would be portrayed as human (both because that's always how I've seen them in my head and maybe hopefully Lego Team would consider the change different enough where they won't try and DMCA me) and I was putting Ninjago in the real world instead of its own realm as its portrayed in canon (again, to hopefully dissuade Lego Team from wanting to sue the brakes off my ass and also just because I think it'd be interesting), I thought of just portraying Ninjago City. But well, I've always been a sucker for fantasy, especially urban fantasy. This also gives me a great excuse to learn more about Asia's mythology and how all the different regions and the countries in those regions interpret it! So yay, silver linings!

So, in the webseries, Ninjago would be its own country. I recently got into Ace Attorney (I have the Phoenix Wright trilogy on my Switch and i'm on Bridge to Turnabout) and while looking over the TVTropes page (I do that for all the media i'm into) and watching YouTube videos about Ace Attorney, learned all about the localizations and Japanifornia. So, that's what i'm basing Ninjago off of, which makes sense since, in canon, Ninjago also has western inspiration in addition to the Japanese inspiration. Which brings me to the first fun fact I learned while researching Japan (since Ninjago has a lot of japanese inspiration), I learned that Japan has free healthcare! Well, mostly free, they have to pay 30% of their medical bills themselves, but hey, considering that I live in a capitalist hell state, I'll take it! Also, according to the websites I've looked at for more information, the insurance is provided by the state.

(I now lowkey wonder what kind of insurance the ninja have. It can't be SHI because that's for everyone that's employed full-time by a large or medium company. And last time I checked, none of the ninja work for a medium or large company. Unless Cyrus Borg has them on his payroll and just lies to the government every year that he employs the ninja).

I really loved the realm merge in Dragons Rising and the fact that there were all these different.... races? Species? now in Ninjago because of it and how they had a whole place where all these different cultures could gather and hang out and sell wares and food and clothes and stuff from their home realms and they have contests and events and I just.... I really loved it. Like LOVED it. I just love when they have blended societies in media. Which brings me right back to my love of urban fantasy. I love love LOVE Rise of the Teenage Mutant Ninja Turtles and the whole mystical yokai city under New York they had in the show and how there were hidden hangout places for the yokai up in New York. So, taking elements from ROTTNMT and Dragons Rising, instead of a realm merge, Yokai have been part of Ninjago's history from the start and by modern day have completely integrated into regular society. So, there's shops run by yokai that sell all kinds of mystic stuff as well as restaurants that sell yokai cuisine. Also, dragons have also been part of Ninjago's history since the start and yes, it's pretty much like how Berk from the How To Train Your Dragon Franchise would have been if it was set in the modern day instead of viking times.

There's so much more I want to talk about: how machines and AI like Zane and P.I.X.A.L are viewed, Yokai shops and cuisine, what daily life is like in Ninjago City (Ninjago in general) with dragons flying around, passing through or even just setting up roost there, the Yokai that live in Ninjago and Ninjago City, the gangs that have sprung up over the years (since the webseries would focus on the Ninja's children), how the Serpentine are doing, ect, but this post is already quite long so I'll have to talk about these things in separate posts.

Since I think I've covered all the basics of how I would portray Ninjago in my hypothetical webseries, i'm going to end this post here and share future thoughts I have on Ninjago's portrayal in said hypothetical webseries in future posts. I hope you all enjoyed this post!

[weabooweedwitch]

to that prior anon: what makes something a disability is how it impacts the life of the person who has it. for example, you use arthritis as an example of smth being "just a medical condition" but without medication that would cost more than $12k/month if I didn't have insurance, I am in constant pain and literally cannot walk or use my hands. my arthritis is disabling, while for others it's just constant low level pain and they may not consider it a disability.

please remember it's up to the person with the medical condition to determine if it disables them, and it varies person to person even with the same condition.

In their defense i think they were just asking a question because it is definitely like, a weird gray area? It honestly brings up a good discussion about, when do you you start calling something a disability, and how, I think, the broken health care system really, uh, falsely categorizes a lot of people based on what insurance is up to. Also different countries apparently have different guidelines, like for example my Canadian friend gets disability benefits literally just for being autistic despite being very "high functioning", putting that in quotes just because I know that can be kind of a controversial term.

But also, I'm so sorry you deal with that, I dont quite have arthritis but I can totally empathize wirh chronic physical pain 🥺 its actually horrifying reading the prices of some of these treatments sometimes and im really glad you have your medicine taken csre of. I often think about what would've happened to me if I hadn't been on state insurance when I was diagnosed with my equinus, I think it was literally like at least 5k per leg (i actually barely remember tbh, it couldve been higher or lower), which, I guess ultimately isn't a lot, but on my income and my moms income would have been so significant I would've felt actual guilt seeking treatment. Like, there was a legitimate possibility that the mere price could have kept me from... walking normally? And like my mom is 58 and she's been told she qualifies for knee replacements but she's literally scared of even getting them because of how long the recovery period can be and the financial loss and also just the price? So my mom could end up in legitimately worse health, although I guess that also has to do with like, America not having good workers rights where she could've taken off laid leave for surgery or something

It's that whole expression about "disability is defined by the environment" or something like that. Sort of like that whole controversy with Mr Beast where he paid for a bunch of people to get their sight or hearing back. Those people had treatable conditions and were stuck living in a way that negatively impacted their lives simply because they couldn't afford it? Like I can't even imagine not being able to use one of my five senses just because I couldn't afford it, but I know that's um already a reality for like, people who can't afford hearing aids and stuff like that

I think I'm starting to ramble here but like, I wish people had more sympathy for the disabled (and im talking about like society, not the last ask just to be clear, I feel like they were legitimately just curious). Like sometimes when you see people like violently hating the homeless, sometimes those people are literally people who got into horrible accidents or had some sort of injury and they wound up addicted to painkillers and had to turn to drugs when they can't afford prescription pain meds or those prescriptions get them addicted. I had a manager who was in a car accident and the painkillers made her eventually switch to straight up heroin. Even our disabled vets don't get good healthcare half the time

But yeah, as for me, I guess consider myself kind of straddling the line between disabled and able bodied, leaning more towards able bodied, but I can still have issues, like my knees are still kinda jacked up and even though i can stand and walk great now, stairs can be really tough sometimes, especially when I'm coming home from work and my body aches. and I still get pains in my back sometimes when I'm bending and leaning to the point I use a menthol roll-on gel for pain relief. Part of me kind of likes that I, I dunno, overcame the challenge and all that, but like, I think I would've preferred a body that didn't hurt lol 😅

[termlifeguy]

How Much Do Medicare Supplements Generally Cost? | Chris Antrim Insurance

Understanding the True Cost of Medicare Supplements | Chris Antrim Discuss The Factors Affecting The Cost Of Your Plan

We've all been there: chatting with friends, family, or coworkers about healthcare costs when the topic of Medicare supplements arises. You know they're important, but how much do they really cost?

It's a question that lingers in our minds as we strive to ensure we're making the best choices for ourselves and our loved ones. After all, no one wants to be left out when it comes to securing financial stability during those golden years.

During the time when people can sign up for the Idaho Medigap Plan, the monthly premiums range from $113 to $257 . Please be aware that the prices of these plans will change based on the insurer and your premium rating.

Types Of Medicare Supplement Plans

If you're thinking about buying a Medicare supplement plan, it's important to know that there are ten different kinds of plans, labeled A through N, from which to choose. Each plan has different levels of coverage, so it's important to know how they vary so you can choose the one that will best meet your health needs. The different kinds of Medicare supplement plans are:

Plan A: Plan A is the most basic Medicare supplement plan. It covers Medicare Part A fees and hospital costs for up to 365 days after Medicare benefits run out. It also pays for the share or copayment for Medicare Part B.

Plan B: Plan B covers the same things as Plan A, plus the Medicare Part A payment.

Plan C: Plan C covers everything Plans A and B do, plus skilled nursing home care, Medicare Part B excess charges, and emergencies that happen while traveling abroad.

Plan D: Plan D covers everything that Plans A and B cover, plus care in a skilled nursing home and emergencies while traveling outside the country. But it doesn't cover the extra costs for Medicare Part B.

Plan F: Plan F is one of the most complete Medicare supplement plans. It covers everything that Plans A, B, C, and D cover, plus the Medicare Part B payment.

Plan G: Plan G covers everything that Plans A, B, C, and D cover, plus the Medicare Part B deductible and Medicare Part B extra charges.

Plan K: The monthly premiums for Plan K are cheaper, but the out-of-pocket costs are higher. It covers the same things as Plans A and B, but to a lesser extent.

Plan L: Plan L covers the same things as Plan K, but the premiums are a little higher and the out-of-pocket costs are cheaper.

Plan M: Plan M covers everything that Plan A covers, plus 50% of the Medicare Part A deductible and 100% of the Medicare Part B payment.

Plan N covers everything that Plan A covers, plus the Medicare Part B coinsurance or copayment, as well as a $20 copayment for office visits and a $50 copayment for trips to the emergency room.

Factors That Affecting The Costs Of Each Plans

Age, location, and coverage are just some of the things that affect the cost of Medicare supplement plans. It's essential to understand these variables in order to find a plan that fits both your healthcare needs and budget.

Age: As you grow older, premiums for Medicare supplements often increase due to higher health risks associated with aging.

Location: Costs can vary significantly by state or region, as different areas have distinct healthcare costs and regulations.

Coverage: Plans with more comprehensive benefits and lower deductibles typically cost more than those offering basic coverage.

By understanding these key points, you'll be better able to find your way through the world of Medicare supplement options and choose a plan that gives you a sense of security in your healthcare journey.

What To Consider When Shopping For A Medicare Supplement Plan

As we've seen, there can be a significant variation in the cost of Medicare supplement plans depending on factors like location and coverage level. To ensure you find the best fit for your needs and budget, it's essential to consider a few key aspects when shopping around.

Your healthcare needs: Think about your present and future health care needs, such as the medicines you take and any procedures you may need in the near future. This will help you choose a plan that gives you the benefits you need.

Types of Plans: There are ten types of Medicare supplement plans, which are named A through N. Each type of plan has different amounts of coverage, so it's important to compare them and figure out which one meets your needs best.

Cost: There is a monthly premium for Medicare supplement plans, so it's important to check costs between plans and providers to find one that fits your budget.

Provider networks: Medicare Advantage plans have provider networks, but Medicare Supplement plans do not. This means you can go to any doctor or hospital that takes Medicare. Still, it's a good idea to find out if the health care providers you like accept Medicare.

Enrollment periods: There are specific times to sign up for Medicare supplement plans. If you miss these times, your costs may go up or you may not get coverage at all. Make sure to sign up during the right time period to avoid problems.

Insurance providers: Private insurance companies offer Medicare supplement plans, so it's important to do research on the insurance companies you're thinking about to make sure they have a good image for customer service and claims processing. You an also check out Your Health Idaho for more insurance quotes comparisons.

Guaranteed issue rights: If you have a guaranteed issue right, you can sign up for a Medicare supplement plan without having to go through medical screening. Before you sign up, make sure you know what your guaranteed issue rights are.

Check internet reviews and ratings of the Medicare supplement plans and insurance companies you're thinking about to see what other customers have to say about their experiences.

Consult With Licensed Insurance Broker Chris Antrim Insurance Agency

In the end, Medicare Supplement Plans are an important safety net for seniors who want full coverage for their health care. It might seem like a maze to find your way through the complex web of available plans, but with careful research and attention to your own needs, you can find the perfect plan to add to your original Medicare benefits.

It's crucial to weigh factors such as age, health status, and financial resources when selecting a plan that fits your unique requirements. Remember that no two situations are identical—what works best for one person may not be suitable for another. The key is striking the right balance between cost and the desired level of coverage.

By learning about these things and doing thorough comparison shopping, it's easier to make good decisions about health insurance later in life. Putting in time and effort now will pay off in the long run by giving you peace of mind and protecting you from unexpected costs in retirement.

To make your life easier when considering Medicare Supplement, Chris Antrim Insurance Agency can help you narrow down all your options. We have a licensed Health and Medicare Broker who can help you get the best deals for your healthcare needs. Contact us today!

Originally published here: https://www.goidahoinsurance.com/how-much-do-medicare-supplements-generally-cost

[mostlysignssomeportents]

Democrats, health care monopolies, and market failures

As the US health care system reels under shortages and capacity issues, Matt Stoller reminds us that the brittleness of the US health care supply chain predates covid, and is directly attributable to monopolization, and its handmaiden, corruption.

https://mattstoller.substack.com/p/the-villains-behind-our-medical-supply

As Stoller writes, the last decade has seen the health care industry plagued by shortages of basics: “from saline to epinephrine to chemotherapeutic agents to antibiotics, to sterilized water.”

The FDA has maintained a drug shortages advisory page for years, long before covid hit, with doctors prescribing less-familiar, more error-prone meds to patients because the standard-of-care drugs were unavailable.

https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages

Now, obviously covid exacerbated this situation, and in response, a lot of manufacturing has shifted back onshore — but it’s not really helping. It turns out that the same system that created the brittleness in health supplies is now maintaining it.

Stoller identifies Group Purchasing Organizations (GPOs) as a key culprit. GPOs originated as hospital buying clubs, consolidated catalogs of medical supplies available at discount prices. But as the buyers and the sellers grew more monopolized, GPOs took on a sinister role.

It started in 1987, when lobbyists convinced Congress to weaken the anti-kickback laws that had kept GPOs honest. Freed from a prohibition on taking bribes, GPO buyers began to source hospital supplies based on the size of the “commission” rather than value for money.

This is chokepoint capitalism at its finest. The GPOs were the only way to reach the majority of the market for health supplies, and they would only carry your merchandise if you paid them commissions.

This is what Amazon does: charge “advertising fees” and “fulfillment by Amazon” surcharges from sellers on its platform to appear higher in search results, which can climb to over 50%.

Likewise, it’s how Spotify operates, extracting high fees from labels to be featured on playlists and in “radio” streams.

It’s what monopolistic grocers do to food manufacturers, too.

This is one of the dynamics by which monopolism spreads. In order to keep prices low while bribing GPOs, medical manufacturers had to merge (eliminating competition), outsource (lowering labor costs), lower quality, and eliminate buffers and other slack in the system.

Amazon wins over its customers by promising them low prices and free shipping. GPOs win over hospitals by sharing their bribes with top administrators. Monopoly produces monopoly, and monopoly begets corruption.

https://www.wsj.com/articles/where-does-the-law-against-kickbacks-not-apply-your-hospital-1525731707

Which is why covid’s onshoring of manufacturing has not alleviated the supply-chain problems in the health sector. We can make stuff onshore, sure, but hospitals will only buy it through GPOs.

But GPOs will only carry it if it is priced competitively with stuff from Asian sweatshops, and if the bribes are also competitive. It’s not like onshore manufacturers can shop around, either.

GPOs underwent a wave of mergers in the 1990s, so four companies control 90% of US hospitals’ $300b in annual spending. Monopoly begets monopoly.

What’s more, by spreading bribes to hospital administrators, GPOs eliminated the need to keep prices down.

Instead, the final price represents an equilibrium between hospital administrators’ greed for kickbacks and hospital management’s willingness to pay.

Like all corruption, GPOs are a way to concentrate gains (bribes to GPOs and hospital buyers) and diffuse losses (lower quality goods at higher prices made by workers earning lower wages in a system that periodically seizes up due to shortages).

The worst is yet to come. Because this system concentrates production in facilities where maintenance, redundancy and fail-safes are neglected in order to maximize the funds available for bribes, it is vulnerable to even mild shocks.

This is how America ran out of saline (AKA salt water!): Baxter cornered the market for it, shut down production everywhere except Puerto Rico where labor was cheap, and then had no contingency plans for when a hurricane hit the island.

https://www.wsj.com/articles/where-does-the-law-against-kickbacks-not-apply-your-hospital-1525731707

There are more shocks to come, and America is systemically vulnerable to them. Its lawmakers and regulators have not reined in this dangerous corruption — instead, they’ve abetted it. Take Obama’s FTC chairman Jon Leibowitz — he now lobbies for GPOs!

https://www.ftc.gov/system/files/documents/public_comments/2017/12/00222-142618.pdf

That may finally be changing — the Biden admin has specifically targeted single-source goods and GPO monopolies in its analysis of America’s resiliency problems.

https://www.whitehouse.gov/wp-content/uploads/2021/06/100-day-supply-chain-review-report.pdf

But before you get too optimistic, recall that centrist Dems are masters of snatching victory from the jaws of defeat. Take the issue of dental care, a dysfunctional area even by US standards.

Denying dental care is a cruel and senseless policy. And yet all forms of US health insurance either under-cover dental work, or fail to cover it at all. 65% of Medicare recipients don’t have any dental coverage.

Even people who do have dental coverage find it woefully inadequate. Getting two crowns under our family’s dental coverage — the “gold-plated” coverage offered by a blue-chip employer — costs $2,500 over the insurance maximum.

No wonder Americans wryly call their teeth “luxury bones” — the part of your body that health-care treats as optional, despite the serious consequences for health, wellbeing, employment and self-esteem caused by poor dentistry.

It’s a particularly American disease: one of Luke O’Neil’s readers describes being reduced to tears by the realization that his Taiwanese dentristry bill would only come to $20 — for “3 visits + surgery + medication + 3D x-rays”.

https://luke.substack.com/p/the-american-healthcare-system-damages

It’s not like the Dems don’t know this. They’re even promising to do something about it. They’ve proposed extending dental coverage to Medicare…in seven years.

As O’Neil says, “This is almost the platonic ideal of Some Democrat Shit. These people need help. Our plan is to give it to them well over half a decade from now. It makes no sense. They don’t even seem to want to reap the immediate political benefits of such a move!”

Centrism destroys politicians’ time-sense as Harold Meyerson writes for The American Prospect: “Child care subsidies are set to phase in over six years. Medicare negotiation with pharmaceutical companies over prescription drug prices won’t begin until 2025.”

https://prospect.org/politics/liberalism-and-time/

“As to the bipartisan infrastructure legislation, one admittedly conservative estimate has it that no more than $20 billion will be spent by the end of 2022.”

This is a party that is hoping to win midterms in 2022, remember.

There was a time when progressivism was impatient: Medicare was up and running in less than a year, in 1965. Today, we are faced with urgent crises — a looming irreversible climate emergency among them — and we have no time for this foot-dragging.

Neither do the families who’ll lose teeth or suffer debilitating chronic infections — to say nothing of the patients who will suffer needlessly or even die as a result of monopolistic shortages. The best time to act on this was a decade ago. The second best time is now.

Image: Nitram242 (modified) https://www.flickr.com/photos/25165196@N08/7082538687/

CC BY: https://creativecommons.org/licenses/by/2.0/

[whitehotharlots]

Privilege Theory is popular because it is conservative

Privilege theory, as a formal academic thing, has been around at least since 1989, when Peggy McIntosh published the now-seminal essay “White Privilege: Unpacking the Invisible Knapsack.” Even within academic cultural studies, however, privilege theory was pretty niche until about a decade ago--it’s not what you’d call intellectually sound (McIntosh’s essay contains zero citations), and its limitations as an analytical frame are pretty obvious. I went through a cultural studies-heavy PhD program in the early twenty teens and I only heard it mentioned a handful of times. If you didn’t get a humanities degree, odds are it didn’t enter your purview until 2015 or thereabouts.

This poses an obvious question: how could an obscure and not particularly groundbreaking academic concept become so ubiquitous so quickly? How did such a niche (and, frankly, weird and alienating) understanding of racial relations become so de rigeur that companies that still utilize slave labor and still produce skin whitening cream are now all but mandated to release statements denouncing it? 

Simply put, the rapid ascent of privilege theory is due to the fact that privilege theory is fundamentally conservative. Not in cultural sense, no. But if we understand conservatism as an approach to politics that seeks first and foremost to maintain existing power structures, then privilege theory is the cultural studies equivalent of phrenology or Austrian economics. 

This realization poses a second, much darker question: how did a concept as regressive and unhelpful as privilege become the foundational worldview among people who style themselves as progressives, people whose basic self-understanding is grounded in a belief that they are working to address injustice? Let’s dig into this:

First, let’s go down a well-worn path and establish the worthlessness of privilege as an analytical lens. We’ll start with two basic observations: 1) on the whole, white people have an easier time existing within these United States than non-white people, and 2) systemic racism exists, at least to the extent that non-white people face hurdles that make it harder for them to achieve safety and material success.

I think a large majority of Americans would agree with both of these statements--somewhere in the ballpark of 80%, including many people you and I would agree are straight-up racists. They are obvious and undeniable, the equivalent to saying “politicians are corrupt” or “good things are good and bad things are bad.” Nothing about them is difficult or groundbreaking.

As simplistic as these statements may be, privilege theory attempts to make them the primary foreground of all understandings of social systems and human interaction. Hence the focus on an acknowledgement of privilege as the ends and means of social justice. We must keep admitting to privilege, keep announcing our awareness, again and again and again, vigilance is everything, there is nothing beyond awareness.

Of course, acknowledging the existence of inequities does nothing to actually address those inequities. Awareness can serve as an important (though not necessarily indispensable) precondition for change, but does not lead to change in and of itself. 

I’ve been saying this for years but the point still stands: those who advocate for privilege theory almost never articulate how awareness by itself will bring about change. Even in the most generous hypothetical situation, where all human interaction is prefaced by a formal enunciation of the raced-based power dynamics presently at play, this acknowledgement doesn’t actually change anything. There is never a Step Two. 

Now, some people have suggested Step Twos. But suggestions are usually ignored, and on the rare occasions they are addressed they are dismissed without fail, often on grounds that are incredibly specious and dishonest. To hit upon another well-worn point, let’s look at the presidential campaign of Bernie Sanders. The majority of Sanders’ liberal critics admit that the senator’s record on racial justice is impeccable, and that his platform would have done substantially more to materially address racial inequities than that being proffered by any of his opponents. That’s all agreed upon, yet we are told that none of that actually matters. 

Sanders dropped out of the race nearly 3 months ago, yet just this past week The New York Times published yet another hit piece explaining that while his policies would have benefitted black people, the fact that he strayed from arbitrarily invoked rhetorical standards meant he was just too problematic to support.  

The piece was written by Sidney Ember, a Wall Street hack who cites anonymous finance and health insurance lobbyists to argue that financial regulation is racist. Ember, like most other neoliberals, has been struggling to reconcile her vague support for recent protests with the fact that she is paid to lie about people who have tried to fix things. Now that people are forcefully demanding change, the Times have re-deployed her to explain why change is actually bad even though it’s good.  

How does one pivot from celebrating the fact that black people will not be receiving universal healthcare to mourning racially disproportionate COVID death rates? They equivocate. They lean even harder on rhetorical purity, dismissing a focus on policy as a priori blind to race. Bernie never said “white privilege.” Well, okay, he did, but he didn’t say it in the right tone or often enough, and that’s what the problem was. Citing Ember:

Yet amid a national movement for racial justice that took hold after high-profile killings of black men and women, there is also an acknowledgment among some progressives that their discussion of racism, including from their standard-bearer, did not seem to meet or anticipate the forcefulness of these protests.

Kimberlé Crenshaw, the legal scholar who pioneered the concept of intersectionality to describe how various forms of discrimination can overlap, said that Mr. Sanders struggled with the reality that talking forcefully about racial injustice has traditionally alienated white voters — especially the working-class white voters he was aiming to win over. But that is where thinking of class as a “colorblind experience” limits white progressives. “Class cannot help you see the specific contours of race disparity,” she said.

Many other institutions, she noted, have now gone further faster than the party that is the political base of most African-American voters. “You basically have a moment where every corporation worth its salt is saying something about structural racism and anti-blackness, and that stuff is even outdistancing what candidates in the Democratic Party were actually saying,” she said.

Crenshaw’s point here is that the empty, utterly immaterial statements of support coming from multinational corporations are more substantial and important than policy proposals that would have actually addressed racial inequities. This is astounding. A full throated embrace of entropy as praxis. 

Crenshaw started out the primary as a Warren supporter but threw her endorsement to Bernie once the race had narrowed to two viable candidates. This fact is not mentioned, nor does Ember feel the need to touch upon any of Biden’s dozens of rhetorical missteps regarding race (you might remember that he kicked off his presidential run with a rambling story about the time he toughed it out with a black ne'er do well named Corn Pop, or his more recent assertion that if you don’t vote for him, “you ain’t black.”). The statement here--not the implication: the direct and undeniable statement--is that tone and posturing are more important than material proposals, and that concerns regarding tone and posturing should only be raised in order to delegitimize those who have dared to proffer proposals that might actually change things for the better. 

The ascendence of privilege theory marks the triumph of selective indignation, the ruling class and their media lackeys having been granted the power to dismiss any and all proposals for material change according to standards that are too nonsensical to be enforced in any fair or consistent manner. The concept has immense utility for those who wish to perpetuate the status quo. And that, more than anything, is why it’s gotten so successful so quickly. But still… why have people fallen for something so obviously craven and regressive? Why are so few decent people able to summon even the smallest critique against it? 

We can answer this by taking a clear look at what privilege actually entails. And this is where things get really, really grim:

What are the material effects of privilege, at least as they are imagined by those who believe the concept to be something that must be sussed out and eradicated? A privileged person gets to live their life with the expectation that they will face no undue hurdles to success and fulfillment because of their identity markers, that they will not be subject to constant surveillance and/or made to suffer grave consequences for minor or arbitrary offenses, and that police will not be able to murder them at will. The effects of “privilege” are what we might have once called “freedom” or “dignity.” Until very recently, progressives regarded these effects not as problematic, but as a humane baseline, a standard that all decent people should fight to provide to all of our fellow citizens. 

Here we find the utility in the use of the specific term “privilege.” Similar to how austerity-minded politicians refer to social security as an “entitlement,” conflating dignity and privilege gives it the sense of something undeserved and unearned--things that no one, let alone members of racially advantaged groups, could expect for themselves unless they were blinded by selfishness and coddled by an insufficiently cruel social structure. The problem isn’t therefore that humans are being selectively brutalized. Brutality is the baseline, the natural order, the unavoidable constant that has not been engineered into our society but simply is what society is and will always be. The problem, instead, is that some people are being exempted from some forms of brutalization. The problem is that pain does not stretch far enough.

We are a nation that worships cruelty and authority. All Americans, regardless of gender or race, are united in being litigious tattletales who take joy in hurting one another, who will never run out of ways to rationalize their own cruelty even as they decry the cruelty of others. We are taught from birth that human life has no value, that material success is morally self-validating, and that those who suffer deserve to suffer. This is our real cultural brokenness: a deep, foundational hatred of one another and of ourselves. It transcends all identity markers. It stains us all. And it’s why we’ve all run headlong into a regressive and idiotic understanding of race at a time when we desperately need to unite and help one another. 

[berniesrevolution]

There is a debate right now among the 2020 candidates about whether and how to provide “free college.” Peter Buttigieg, the much-hyped mayor of South Bend, Indiana, says that public college tuition should be free only for those whose families earn under a certain income threshold. He has criticized those who believe in free college “for all,” regardless of family income, saying that this would be a handout to the children of millionaires and billionaires. My colleague Sparky Abraham has written an excellent essay on why “free college for all” is so important and what Buttigieg doesn’t understand. Of course, Buttigieg is just plain wrong on the math: There’s no reason free college needs to be a “handout” to the rich, if free college is funded through progressive taxation. But Sparky also shows some less-discussed problems with “income-based” free college schemes: They’re more complicated and require subjecting poor people to humiliating bureaucratic requirements.

The problem with having “free X for the poor,” and only for the poor, is that in practice you need to have an apparatus to determine who counts as poor. You have to set a standard for how much people can have before they become ineligible, and then you need a way of reliably assessing that eligibility. This is difficult, and it means that no matter what, a “means tested” program is going to make accessing a given service more of a headache for poor people (who must fill out forms and prove eligibility) than it is for rich people (who can just hand over money and get it). Weirdly, even though “what it looks like in practice” should be central to discussions about means testing, advocate of means-tested programs seem frequently to ignore what the lived experience of constantly having to be means-tested is like. (Actually, advocates for many kinds of policy changes ignore what enforcement looks like on the ground, which is why France has debates about “banning” burkas when it is really debating “whether or not to have cops drag Muslim women away for their choice of swimsuit,” and Americans debate “legalizing” drugs rather than “whether or not to cage people for what they put in their mouths.”)

So, one good reason to provide free college to all is that it eliminates the need to check whether a person “deserves” or is “entitled” to free college. We know in advance that they’re entitled to it, because they’re a person. This certainly cuts down on paperwork. And that makes people’s lives better: If public high schools were means-tested, and there was a standard tuition fee, but you could have it waived if you met a series of requirements, it would not seem more fair or egalitarian. Currently, we do something strange where even though public schools are free, public school lunches are not, meaning that you have to apply to eat lunch for free or at a discount and have your income reviewed by the school district before they will give your child so much as a hot dog or a plate of baked beans. Predictably, this has led to the ugly widespread phenomenon of “school lunch debt.” This is not the case everywhere: Since 1948, Finland has just given children lunch, just as it gives them schoolbooks and instruction and playgrounds, which makes complete sense if you think of lunch as just as important a part of the school day.

Yes, there is a “fairness” element to universal giveaways like this, in that they treat everyone as equal. But it also just makes everybody’s life easier. As Sparky notes, we could pay for public parks by charging admission and offering income-based tax credits for park admission to anyone below a certain threshold. But isn’t it nicer when anyone can just walk in the park? I have written before about what an incredible mental relief it is not to have to think about money. The “commons” are wonderful: places where you can go without buying anything or paying for access. Public libraries, public beaches, public parks, public schools: They are held in common and everyone can use them as much as they please.

The leftist vision for how institutions should operate frequently involves taking money out of the picture, not just because we find it grubby but because it gets in the way of what we really want out of life. This is important to understanding the left vision for how healthcare ought to operate. Why is Medicare For All so important to us? In part because every other scheme makes your experience of healthcare much more complicated! We want you to be able to go to the doctor and not have to think about money. We don’t want you to have to think about premiums, co-pays, and deductibles. You should just be thinking about your health. And this isn’t utopian. In countries that pay for health services using taxes, when you want to go to the doctor you just go, get treated, and leave. As my U.K.-based colleague Aisling McCrea has noted, this is liberatory: It just makes you feel far more free, it makes life easier. (The downside, Aisling notes, is that you feel less grown up: “American: when I need a doctor I fill in forms A29-B0072, call the provider four times, and set up a payment plan with my accountant. [UK]: I go to the doctor and she makes me better. then I buy a Twix.” Descriptions like this from Europeans sound like they live in a children’s book about how a town operates.)

One of the big criticisms of “Medicare for All” is that it “eliminates private insurance.” Thank God! I hate having to deal with insurance. I just want to deal with a doctor! Nobody likes having to have insurance. Saying that it “eliminates private insurance” is like saying that having free college “eliminates your school loan providers.” And the people trying to tell you that you love your insurance and don’t want to lose it are like people in that scenario telling you that because you’ve found a financing provider that’s kind of better than the others, the whole financing structure makes sense and you like. But we need to ask simple questions like: Does this really make sense as a system? Can’t we do better? Is this amount of paperwork really required?

(Continue Reading)

[anyu-blue]

~

Medical stuffs below the cut. Nothing graphic.. just me lamenting how our system is failing and possibly killing me more than it was before.

So aside from the mid-apocalyptic headline in the newspaper this morning about how our state isn't getting the number of covid-19 vaccines it was promised, the government blaming low supply, and the supplier blaming the government's refusal to give orders to distribute supply that is very much there.... I had hope today would be helpful.

Turns out the doctor I've been bugging with my ailments REALLY did not want to see me and kept calling instead. Then he told me that I was too impatient and if I really really wanted answers I needed to go to the hospital... Oh but he didn't mean the hospital.. he meant the emergency department of the hospital, and based on my insurance it was going to be extremely expensive and he'd rather i tough it out for another week waiting for blood results to come back, and THEN refer me for any scans that might be necessary (another week minimum after the results until they could get me in after the results are back)...

It's been nearly a month.. or has it been longer than a month? Tough it out tough it out tough it out.

I've HAD to call off work because I couldn't see straight or hardly move!! I couldn't drive in that condition!! Let alone be by myself for 8 hours!! I might have to again in the time I'm kept waiting!! I CAN'T afford that!!!

So.. go to the ER... Where it's literally (seriously I'm not kidding, I have Medicaid which usually covers all deemed-necessary expenses) $1000 to walk in right now due to limited supplies, low staff, and limited capacity. That's BEFORE any work to help is done.

??? What?

I... I can't.... I can't afford that...

I'm not going to lie and say my eyes are dry.... Right now... Because they're not... Even though crying is probably only hurting me.

Lol

Doc thinks I've got a major infection (as do I!!!) In my abdomen. Doesn't know which of two (possibly 3) specific organs... And therefore will not and cannot prescribe treatment.... Even though they all have the same starting treatment of antibiotics/penicillin. Nope. Can't prescribe without knowing- which through his office will take a minimum of 3 weeks. Kaaay....

I just... I just... I'm so sick.. more than my normal sick... And idk what to do. I cannot convey how scared and desperate I am through this text... How the thought makes my vision blur streaks and grabs my throat so tightly I can't breathe...

I'm scared. I'm hurting. I might also be dying from an easily curable sickness... And I don't have the money- NO ONE I know has the money- to get the help I'm asking for. Wait.. the help I NEED. I was told to tough it out as long as I could.. I did. Told to call my doctor if I didn't get better. I did (and she's too busy even to take a phonecall from me or call me back). So I took it into my own hands and begged to be seen. Was given a Covid test which was negative and 2 H Pylori tests- immediate one was negative and the one that took nearly a week to get back- SURPRISE also negative.... And told to discuss my symptoms again over the phone.. which didn't help the first time. How.. how does that make sense?

I can barely pay my bills right now... Especially with missing two days of work this month... Thank the Gods for my amazing boss pulling some strings for me and adding the $1 differential to my paychecks even though I'm the temp... Or I wouldn't be able to at all. $1000 and more... CT scans too alone are $3000 and that's what he told me to ask for up there... After rapid testing labs... Some of which I know from being a phlebotomist a few years ago were $150 a pop THEN... Gods what are they NOW?

I'm not the only one suffering. I know I'm not. I will not be the first nor the last death from our corrupted healthcare system if it comes to that either... Lol... Nor will I be the first or last who keeps waiting and waiting and ends up in the ER anyway... Racking up even MORE bills than if I had just gone in right away....

I'm so distraught and lost (gotta save gotta save gotta save!!! So sick so sick so sick!!! ????????) I had to call my sister.... I'm so lost that even with all my experience I need someone who has none to tell me what to do out of my options...

I am toughing it out until Monday.... Going in to a different clinic ASAP where they see people from $10-$100 up front (medicaid is usually free but at this rate I don't trust that)... If they can't help me or won't like this other doctor... I'm to go straight to the ER... And we'll figure out the thousands of dollars in expenses however we can....

I hate this.. so much... I understand it's not perfect in other countries either.... But I don't really know of many more 1st world countries (can we even be called that any more?) where people are literally dying and drowning in medical debt... And are dying Because of their fear of the costs... And are dying because they choose the cheaper options... And are dying because they can't get help in time due mostly to costs and also to our fucked up referral system ....

[maryellencarter]

So for about ten days now I've been playing around with the budgeting app Mint (along with a Google Sheets yearly budget template and a lot of manual work with a calculator, a calendar, and a succession of blank Google Docs because that's just the kind of person I am), and so obviously I have some Thoughts.

* I picked Mint because it's the budgeting app all the financial reviewers talk about, because it's run by Intuit who also own TurboTax so I knew their security and interface would be good, and because it does not come with built-in shaming over any of your ~unnecessary~ purchases.

* Mint is a free app which makes its money by offering you sponsored ads for financial products it thinks you might like, and getting paid by the advertisers when you accept one of the ads. The most intrusive location for these ads is on your dashboard, feed, whatever you want to call it, where the ad tile is required to be the third tile down and cannot be shuffled to the bottom or turned off.

* (There is also a desktop browser version, Mint.com. I have poked it very slightly but couldn't get it to do anything useful. More on that later. I don't remember noticing how the ads are arranged there.)

* The app's general design is very sleek and intuitive, what I'd expect from the parent company of QuickBooks and TurboTax. Other than the intrusive ad tile, it lets you rearrange everything however you want.

* Mint is designed around importing transactions from your bank account for you to do budgetary stuff at, so obviously security is really important, which gives Intuit an edge up on the competition because I'm already used to trusting them with my tax returns. It only seems to sync new transactions during banking hours, which for someone like me who does most of their shopping on Sunday is kind of frustrating. It also won't let you edit or recategorize a transaction till it's finished "processing" a day or two down the line. I don't know if these pitfalls are common to all budget apps but it would probably make sense if they are.

* One thing Mint does that's incredibly handy for me is it lets you put all your recurring bills in one place and even sync them with your phone calendar. I actually had to turn off the phone calendar sync because it was alerting me constantly on the day before payday when I couldn't do anything about the bill that was due on payday, but if you can find the setting to change the alert frequency it might be useful. And having a nice chronological list of what the fuck is due when, is extremely helpful to my brain, because previously I was trying to remember everything in my head and I kept losing bills.

* Going down my tiles as I have them sorted in the app, I don't have much to say about that list of transactions itself, except that you can recategorize them and split them into different categories -- which is handy if the rent included $105 late fees which you don't want befuckening your future averages, or if you bought groceries and also a barbecue lighter at Walmart, to take two recent examples.

* You cannot, unfortunately, rename or edit categories. On desktop only, you can supposedly add categories, but you cannot then use those categories in any of Mint's other functions, which really defeats the purpose. And their ideas of what categories you might need are pretty... idiosyncratic, not to say WASPy, so e.g. I'm currently categorizing Patreon income under "Reimbursement" because the other options were things like "Investment Income" and "Returned Purchase". And transfers to my savings account can either be "Credit Card Payment" or "Transfer for Cash Spending".

* (I suppose I could put my savings under "Investment: Deposit" or something similarly grandiose, but that seems like... a lot for the 31 cents rounded up from getting a pizza at Little Caesars.)

* Anyways. So then, after the obligatory ad tile, comes a nice colorful pie chart of my spending for the month, which I can open up and tab through to look at all the categories. I saw one finance blogger saying you should use the Miscellaneous category for some things rather than getting too granular, but I like seeing the little individual entries for my haircut and my cloth mask and my pharmacy copay. (That last one's going to be a more substantial pie slice now that I can actually afford to start taking most of my meds again. Turns out my prescription for diabetic test strips expired, though, so I have to get ahold of my doctor and get a new one sent over, and I'm looking skeptically at the copays. :P I've been ignoring my diabetes since January, it can wait a little longer till I'm financially caught up from COVID.)

* I can see list-style breakdowns by category and merchant, too. This is one of the few places in the mobile app that my income shows up, other than the actual paycheck transactions. The desktop version has some more places to budget projected income, but the handling is clunky as hell.

* Next up is the tile where I've been spending a lot of my time, Budgets. This is your basic "envelope method" where you create, say, a budget for haircuts and another one for groceries. Each budget has to be for one of Mint's pre-created categories, and when you have a spending transaction in that category, it puts the expense against that Budget. The desktop version has you also creating a line item for expected income in Budgets, and then becoming stroppy when you attempt to adjust parts in the wrong order, so I prefer the app which simply tells you e.g. that you have spent $900 of an allocated $1000 with an airy unconcern for whether the $1000 has arrived in your bank account yet.

* My single biggest frustration with Mint is that you cannot create Budgets based on user-created categories, nor can you delete, rename, or even collapse categories in the list. So if I go to create a new Budget for, say, "Housewares" to account for the $1 barbecue lighter I finally bought (I have large hands and a tall jar candle that has burned down farther than I can reach, okay, it was a necessity), then I'm stuck scrolling all the way up and down past "Investment: Capital Gains" and "Kids: Child Support" before finally settling on "Home Supplies" because it doesn't really seem like a "Home Furnishings".

* After Budgets comes Accounts, which just shows me my current net worth across all my accounts. I actually unlinked my savings account because it was confusing the hell out of me to see a 31-cent transfer out of checking paired with the same 31-cent transfer into savings, so this doesn't show me anything I can't get through my bank app, but if I had current credit card debt or non-retirement investment accounts it might be more useful.

* (I have not linked my 401(k) to Mint. I haven't even figured out how to get into my 401(k), either before or after it transferred to a different handler a couple months back. I feel like those are problems for a later time than "okay how much groceries can I buy and still pay the rent".)

* On the desktop version of Mint, you can also put things like your car in under your net worth as Property. I tried that, found that I both did not believe their Kelly Blue Book valuation at all (it didn't have any option to take into account "was totaled two years ago and looks it but still mostly runs") and that I find it extremely stressful to have non-liquid property listed as part of my net worth. Interesting to know. You learn all sorts of shit about yourself when you try to manage money.

* Next there's a tile that attempts to break down my "cash flow" by month. It doesn't seem to have noticed the Paypal transfers on which I was largely subsisting for the three months it was able to pull from my bank account, even though they show up fine in Transactions, so it's deeply confused about whether my cash flow is Healthy or Unhealthy. For now, with my acquisition of a second paycheck for August, it seems to have settled on Healthy. I might turn that tile off though. It doesn't really... offer much, I guess?

* I have turned off the tile that shows me my free credit score. That's a problem for a much later me. Right now I have more urgent problems, like catching up on my deferred car insurance and my deferred cell phone bill and my deferred healthcare deductions.

* You also can't turn off the tile for the Mint "Life Blog" or the one asking you to rate the app, but at least they sit at the bottom of the app as you scroll down.

* The desktop version also has an entire segment not found in the app, for "Goals", where you can supposedly put in your outstanding debts and figure out payment schedules for them. It sounds really good in principle, but I found that section of the site unworkably glitchy, on both laptop and iPad; I couldn't even get past the screen where you try to first enter one of your debts, as it required me to choose answers from two dropdowns neither of which would actually do anything. I was able to get an estimate from the "saving for a rainy day" goal, anyway, by putting in the amount of a debt and telling it I'd like to save up that much money in a year, but that's nothing I couldn't have done with a calculator and a bit of mental effort.

* Jumping back up to the top of the app, one other thing that does intermittently drive me bananas about the app is, when you put in a bill you get a dropdown where you select how often it should recur, but then it... doesn't recur. You have to manually put in the next occurrence. It's still a handy list of upcoming bills, but I actually had to resort to my phone calendar (which properly handles recurring events) to get a good visual on future months' bills.

* And because there is nowhere to put in your projected income and get a nice projection of "On X date you will have $XX in your bank account", or even better a daily graph of your expected cash flow so that you can see "yeah don't put that $300 in savings you'll need it for rent in two weeks", I've been reduced to, as mentioned above, manual daily projections through the end of the year using my phone calculator, phone calendar, Google Docs, and eventually my damn iPad drawing app (came with a Bluetooth stylus I never got working) because I couldn't find any physical graph paper.

* So. Um. Summary. I guess it's a good app? It's very sleek, it has nice charts and graphs and a good interface. But it thinks you can do a lot more with it than you can actually do. Its main uses for me are probably going to boil down to "stop forgetting bills" (the rolling list format works a lot better for my brain than the phone calendar format, even if I do have to re-enter data every time I mark a bill paid) and "finally figure out how much I spend on food really".

[dreaminginthedeepsouth]

* * * *

LETTERS FROM AN AMERICAN

September 25, 2020

Heather Cox Richardson

Trump’s refusal Wednesday to commit to accepting a loss in the November election with a peaceful transfer of power continues to make waves. Today the New York Times reported that military officers are worried that Trump will try to drag them into a contested election. But while people are rightly frightened about Trump’s increasing authoritarianism, it’s important to understand that he is deploying these particular threats about the election to create an impression that he has the option to control the outcome in November. He does not have that option.

Trump and his cronies are trying to create their own reality. They are trying to make people believe that the coronavirus is not real, that it has not killed more than 200,000 of our neighbors, that the economy is fine, that our cities are in flames, that Black Lives Matter protesters are anarchists, and that putting Democrats in office will usher in radical socialism. None of these things is true. Similarly, Trump is trying to convince people that he can deploy the power of the government to remain in power even if we want him to leave, creating uncertainly and fear. By talking about it, he is willing that situation into existence. It is a lie, and we do not have to accept it.

For his part, Democratic presidential nominee Joe Biden recognizes that Trump’s repeated threats not to leave office are both letting him convince us that leaving is his choice, rather than ours, and keeping the media focused on him when we should, in fact, be talking about real issues. Biden is refusing to give the idea oxygen, reminding reporters that it is a “typical Trump distraction.” “I just think the people in the country are going to be heard on November 3,” he told them. “Every vote in this country is going to be heard and they will not be stopped. I'm confident that all of the irresponsible, outrageous attacks on voting, we’ll have an election in this country as we always have had, and he'll leave.” He said: “I don’t think he’s going to get the FBI to follow him or get anybody else to enforce something that’s not real.”

While the Senate voted unanimously yesterday to commit to the peaceful transfer of power in January, it was actually Massachusetts Governor Charlie Baker, a Republican, who gave Trump’s refusal to commit to a peaceful transfer of power the dripping disdain it deserved. Speaking to reporters, Baker defended the mail-in ballots that Trump is saying will invalidate the election, and called Trump’s suggestion that he wouldn’t leave office peacefully “appalling and outrageous.” Baker said he would to do everything in his power to defend the results of the election.

“A huge part of this nation’s glory, to the extent it exists as a beacon to others, is the peaceful transfer of power based on the vote of the people of this country,” he said.

Trump responded with an insulting tweet, but one that suggested he was deliberately stoking the story to try to get free media coverage.

This makes sense, because there are signs that Trump and the Republicans have a real money problem. We know that the Trump campaign has run through close to a billion dollars, leaving him and other Republican candidates short of cash for the last weeks of the campaign. At the same time, Democratic fundraising in the wake of Justice Ruth Bader Ginsburg’s death has been unprecedented. The squeeze showed clearly in three highly unusual appearances by Senator Lindsey Graham (R-SC) on the Fox News Channel begging for donations.

Two new ploys to advance Trump’s reelection, one claiming to address healthcare concerns and one claiming to address coronavirus concerns, reveal both the campaign’s attempts to construct their own reality and to do it on someone else’s dime.

The president has repeatedly promised his own healthcare bill to replace the Affordable Care Act that his administration is currently trying to kill. Under criticism for trying to end the law that protects people with preexisting health conditions from discrimination in buying insurance—the ACA will come before the Supreme Court a week after the November 3 election-- Trump on Thursday abruptly signed an Executive Order affirming that “it is the official policy of the United States government to protect patients with preexisting conditions.” The Executive Order is toothless; if the Supreme Court overturns the ACA, the Executive Order will mean nothing.

But Trump also suggested that he might be willing simply to keep the law and call it his own. “Obamacare is no longer Obamacare, as we worked on it and managed it very well,” Trump said of the law that continues to provide coverage for more than 20 million Americans. “What we have now is a much better plan. It is no longer Obamacare because we got rid of the worse part of it — the individual mandate.” “We’ve really become the health-care party — the Republican Party,” he said.

Trump also announced he would give $200 toward the cost of their medicines to 33 million older Americans. That’s $6.6 billion dollars that he will be putting in the pockets of key voters just before the election. Apparently, his plan is to take money from Medicare under a rule that allows the Medicare to test out new programs. Authorization for such a shift in funding usually requires a lengthy approval process, and the new program needs to be cost neutral. Ameet Sarpatwari, assistant director of Harvard Medical School's Program on Regulation, Therapeutics and Law told NPR’s Sydney Lupkin: I think the administration is pushing the envelope in terms of classifying this as a demonstration."

The Trump campaign is also planning a taxpayer-funded advertising blitz, costing at least $300 million, to “defeat despair and inspire hope” about the coronavirus pandemic. According to Politico’s Dan Diamond, the ads will feature interviews between administration officials and celebrities. The ad campaign was conceived and begun by Michael Caputo, the top spokesperson for the Department of Health and Human Services before he stepped down last week for medical leave after an infamous Facebook rant.

Caputo claimed in his video that Trump has personally demanded the advertising campaign. "The Democrats — and, by the way, their conjugal media and the leftist scientists that are working for the government — are dead set against it," Caputo said. "They cannot afford for us to have any good news before November because they're already losing. … They're going to come after me because I'm going to be putting $250 million worth of ads on the air." The White House says it is not accurate that Trump “demanded” the campaign.

To pay for the ads, Caputo requisitioned $300 million from the Centers for Disease Control and Prevention (CDC) and $15 million from the Food and Drug Administration (FDA). But he sidelined the Ad Council, which is a nonprofit consortium of advertising companies that since World War Two has worked on a nonpartisan basis with the government on public health or social issue campaigns. Instead, Caputo hired his own business partner to make the videos.

Josh Peck, the former HHS official who oversaw the Obama administration’s advertising campaign for HealthCare.gov, told Diamond that officials in the Obama administration were never featured in videos, and that the Trump administrations Covid videos sound like they are about more than Americans’ health. He said: "CDC hasn’t yet done an awareness campaign about Covid guidelines — but they are going to pay for a campaign about how to get rid of our despair? Run by political appointees in the press shop? Right before an election? It’s like every red flag I could dream of.”

Trump’s challenge to the outcome of the election is a sign of his desperation, but it is no less dangerous for all that: as they say, a cornered rat will bite the cat. While Democrats and a remarkable number of Republicans are speaking out against Trump, and while teams of lawyers are fighting his lawyers in court, ordinary Americans also have a crucial role to play in this moment. It is up to us to reject Trump's fictions and reclaim the national conversation from the anger and hatred and fear Trump is stoking.

It is time to reassert our core American values so they dominate the public realm, demanding of our representatives a free and fair vote for everyone, a free and fair vote count, and a government of our own choosing.

—-

LETTERS FROM AN AMERICAN

Heather Cox Richardson

[hoganleslie93]

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rental insurance nyc. If you don t have local insurance in a specific city, that is not an insurance company. There are local car insurance companies that specialize in auto insurance. The only company that does not use your address is the same one. Some of them use your mailing address on most auto policies. Another company they are not affiliated with is a third party. Most states where there is a federal agency that is a bit more info on the website than insurance companies that have local locations. Some companies do not use their local location. If you call a number that can help you with your auto insurance, you do not need to tell them that you don t need to have local car insurance until the other person can help you. If you are not getting the coverage that you need to be able to help, you may also have some questions about the cost of insurance. Car insurance is the cheapest way to go. As soon as your insurance bill or policy is paid in full, you can file there. If you. rental insurance nyc. You don t need to have it. You also may have a deductible. But they are not required by law. It s one thing to have them. It s a better approach if you want them to get your business. So, it may be a case if the customer pays for a policy in full coverage. For example, a couple in Texas will be paying $6500 in premiums and it could be a case if the customer has coverage while they use their car to get rides. That s a different story as they could be doing something as well. But for now they ll still see something. So, it s also not an expensive product, so it makes sense to have it. There are things that you can do to save money on car insurance. So, you re not at a loss, it s not too expensive; it works out the best to look for a better deal. The most important thing you can do is to look for ways to save money on the price you. rental insurance nyc_preg and sbod.com. A post on the . A post that gives tips on how I should use health insurance and how i should get it. The whole thing was very informative. You also shared about getting out of your health insurance and how to quit your health insurance with the ACA. Finally, you mentioned the ACA and how its regulations prevent most people from taking it on. How can I know if my health insurance is good or bad? (in the insurance industry I can t help but be a bit confused, and I know people that say they are). After all the information you gave me, I have some insurance company that offers them a discount, which I understand. Now all we need is a small amount of money. Let me know what I should do and I ll give you a small amount of information you can use to get your insurance. Your advice is very clear, and I ll just give you a few examples of how you can see how you can.

Condo Unitowners insurance

Condo Unitowners insurance protects all of your belongings, such as your phone and clothes, and helps pay for the expenses of cleaning them up, including replacement clothing. If your condo is damaged due to something, the condo insurer will go after the person who caused your damage to your condo association and their insurance company. The amount that you pay your insurance company depends on the value of your condo and the amount they charge you. So, if you have a condo and you are paying $950 per year to repair or replace your condo association’s belongings and personal belongings, that’s just under a year of your own car and the condo association isn’t paying anything. Many  Insurance companies do not want the individual who caused the accident to file a claim with the company, so if you cause an accident to your own personal liability insurance – that’s a claim that could lead to the condo association paying the cost when you’re at fault. Insurance experts say that, with the.

Renters Insurance in New York City Overview

Renters Insurance in New York City Overview of the New Jersey home insurance policy is that the coverage is very cheap and the premium is affordable. In addition to being a very cheap policy, it gives good reason to consider a more valuable in the event you need to be with your family or a long-standing family member. We can provide you with a you can find for your specific needs for a quote. This information is designed to help you with your decision-making, and it is not intended to provide advice. Contact a local independent agent in the Trusted Choice network today for assistance concerning the insurance options that are available to you. We are an independent broker serving the insurance needs of the New York Stock Exchange Company for the last 14 years. As a full service broker we are able to provide you with a policy that meets your specific needs and budget. Our professional professionals are committed to protecting the people and businesses in your neighborhood through their insurance companies. To learn more, visit our . The Trusted Choice network allows you to.

What Brokers Need to Know About Insurent

What Brokers Need to Know About Insurently “Insurently” means a specific type of business insurance to cover what they do. What makes Insurently different is this type of business insurance, which isn’t specific to anything in your business, but instead is based on how you perform the job. The insurance that is included with Insurently is called what’s called an “insurance policy.” The is an auto insurance coverage. What follows is the insurance that you pay to the auto insurance. Your Auto Insurance policy is one that allows you to sell and drive your auto insurance policy to your car insurance policy to your car, the policy is called , in this case, your car insurance policy will be referred to upon you owning a vehicle. The  does not have any liability coverage to protect the other party from the person carrying the auto insurance. The state of Tennessee is a not your fault state, so when that person uses a motor vehicle, they will.

Why you need Insurent more than ever in 2017

Why you need Insurent more than ever in 2017…then I don’t recommend you to use Health Insurance to help make it. If you’re looking for health insurance, and need help, call us today. A medical bill must go to pay for treatment you don’t want. There are two kinds of health insurance policies.  An insurance plan is an “information structure,” according to David Schwartz, CEO of the . An insurance plan consists of the cover information, such as a name, policy number and dates of policy. The cover information, information, and date of the policy need to be filled in by all insurers. If you have questions or need a prescription, you can choose your own policy and see its benefits. It’s similar to what you would get from an automobile insurance policy. When using a PPO (Plantinum Health Plan) to provide healthcare for your family or your extended family, you get the financial assistance from the state to pay for your coverage. A large.

The Smart Way To Insure Your Home

The Smart Way To Insure Your Home (Homeowners). To help you with it, we’ve decided to help you with everything you need to know about homeowners insurance, how to save money on it and what kinds of policies are available to protect you. All they do is answer some questions and get you covered for whatever reason you may have. That’s it? For us. It’s the difference between a free and the cheapest car insurance coverage or the one you need. This post is about how to save money on auto insurance for sure or get a different car insurance for that, and if you need to get another car insurance cover, we can give you the answers to the questions you were asking us about auto insurance. What we will cover, and what you need to know to do, is your risk profile, how long you have had a driving ticket, the way you are with the insurance and also the level of coverage you choose. And just remember… it’s insurance. This is what.

How Does Renters Insurance Protect My Personal Property?

How Does Renters Insurance Protect My Personal Property? Renters insurance will also cover against natural disasters, theft and vandalism of your personal (and/or business) property. Learn more about , as well as . For further information on or how to , please . How much does renters insurance really cost? Renters insurance is a one-stop-shop solution to protect your personal belongings from theft, vandalism, insurance theft, and fire. Renters insurance is the easiest way to save on an annual basis for any of your possessions. Many factors go into determining your annual rental insurance payment. While all personal property and bodily injury liability insurance is based on a standard table of numbers, all personal property and bodily injury liability insurance are based on percentages. For example, let’s say your vehicle is worth $1,000, and you want to insure the car of your friend for $4,500. To insure the car.

How Much Does Renters Insurance Cost?

How Much Does Renters Insurance Cost? Renters are likely to receive multiple citations or points against their cars or refuse parking tickets if the car you rent is not safe. They have also reported that of the 1,000 crashes they were involved in, they all reported them for crashes for which they were responsible. In some states, it’s an average or even higher price. Your insurance costs aren’t the only factor, though. The cost of your rental car is also influenced by the type of coverage a rental car covers on a rental while it’s in your wheel. The coverage is generally limited to the rental, although it comes with a deductible, and it’s likely you’ll pay more for that coverage. Some companies offer a percentage of the replacement cost of the insurance if you decide to file a claim with your company. Rental car insurance is only necessary for certain circumstances, such as if you’re going to need the car for a longer period of time or are having trouble.

Most Affordable Cities for Renters Insurance NY

Most Affordable Cities for Renters Insurance NY: Auto Insurance Co. of Buffalo, NY is a financially strong major player in all five major categories listed above. The insurer and company has been in business since 1922. Auto Insurance has two independent, separate entities: Auto Insurance Company of the State of New York (Aetna and Assurance Company) and Assured Commercial Automobile Insurance Company. The latter is the company that insures a large portfolio of companies and is listed (as a third party) on the AIT’s consolidated financial statements. Auto Insurance had $1.8 trillion in assets and $46 Billion in total assets under management under the management of Assured Commercial Automobile Insurance Company—an estimated $10 billion and $10 billion. Assured Commercial Automobile Insurance has a great reputation for being reliable and dependable under the supervision of an extremely knowledgeable company. Aetna also manages a wide range of insurance and investment products. Aetna is an independent insurance company offering home and automobile insurance in New York,.

Most Expensive Cities for Renters Insurance NY

Most Expensive Cities for Renters Insurance NYD. Compare Renters Insurance NYD. Learn More » Renters insurance is a necessary coverance to safeguard that you and your belongings when the worst comes. Whether you rent a first-floor apartment, new house, or second-floor condo, renters insurance protects you and your belongings for bodily damage and personal injury caused by your home. Renters insurance is an extremely affordable item, so it’s good for renters because most things in life can be fixed. See if renters insurance is an essential part of your landlord’s home insurance. Renters insurance protects against property damages, but you can add a few more options to make it more predictable. To insure the belongings of your home, you must include supplemental dwelling or condominium insurance or an umbrella. A comprehensive policy covers your dwelling, your belongings and some of ​​your personal property and losses in the event of an accident. When you lease your apartment, a renters insurance policy may only be available for those units that are rented.

Doesn’t The Owner Insure The Building?

Doesn’t The Owner Insure The Building? is an innovative solution designed for small commercial properties.  It covers the structures inside a building and in between those structures for more personal belongings.  For those who can provide an estimate, this “auto liability policy will cover any damages to your vehicle and property that occurs during the business.”  As long as your insurance policy doesn’t pay more than the maximum dollar amount, you may be covered for any or any flood caused by the policy.  These include: A  (B) (C) (3)  (D) (5) (E) (6) (F) A (I) (IV) (3)  (IV) (5) You pay a fee, on a yearly income (or monthly on a monthly payment), in the case of a mortgage.  This is usually.

[insurebetterhealth-blog]

Health Care Fraud - The Perfect Storm

Today, health care fraud is all over the news. There undoubtedly is fraud in health care. The same is true for every business or endeavor touched by human hands, e.g. banking, credit, insurance, politics, etc. There is no question that health care providers who abuse their position and our trust to steal are a problem. So are those from other professions who do the same.

Why does health care fraud appear to get the 'lions-share' of attention? Could it be that it is the perfect vehicle to drive agendas for divergent groups where taxpayers, health care consumers and health care providers are dupes in a health care fraud shell-game operated with 'sleight-of-hand' precision?

Take a closer look and one finds this is no game-of-chance. Taxpayers, consumers and providers always lose because the problem with health care fraud is not just the fraud, but it is that our government and insurers use the fraud problem to further agendas while at the same time fail to be accountable and take responsibility for a fraud problem they facilitate and allow to flourish.

1. Astronomical Cost Estimates

What better way to report on fraud then to tout fraud cost estimates, e.g.

- "Fraud perpetrated against both public and private health plans costs between $72 and $220 billion annually, increasing the cost of medical care and health insurance and undermining public trust in our health care system... It is no longer a secret that fraud represents one of the fastest growing and most costly forms of crime in America today... We pay these costs as taxpayers and through higher health insurance premiums... We must be proactive in combating health care fraud and abuse... We must also ensure that law enforcement has the tools that it needs to deter, detect, and punish health care fraud." [Senator Ted Kaufman (D-DE), 10/28/09 press release]

- The General Accounting Office (GAO) estimates that fraud in healthcare ranges from $60 billion to $600 billion per year - or anywhere between 3% and 10% of the $2 trillion health care budget. [Health Care Finance News reports, 10/2/09] The GAO is the investigative arm of Congress.

- The National Health Care Anti-Fraud Association (NHCAA) reports over $54 billion is stolen every year in scams designed to stick us and our insurance companies with fraudulent and illegal medical charges. [NHCAA, web-site] NHCAA was created and is funded by health insurance companies.

Unfortunately, the reliability of the purported estimates is dubious at best. Insurers, state and federal agencies, and others may gather fraud data related to their own missions, where the kind, quality and volume of data compiled varies widely. David Hyman, professor of Law, University of Maryland, tells us that the widely-disseminated estimates of the incidence of health care fraud and abuse (assumed to be 10% of total spending) lacks any empirical foundation at all, the little we do know about health care fraud and abuse is dwarfed by what we don't know and what we know that is not so. [The Cato Journal, 3/22/02]

2. Health Care Standards

The laws & rules governing health care - vary from state to state and from payor to payor - are extensive and very confusing for providers and others to understand as they are written in legalese and not plain speak.

Providers use specific codes to report conditions treated (ICD-9) and services rendered (CPT-4 and HCPCS). These codes are used when seeking compensation from payors for services rendered to patients. Although created to universally apply to facilitate accurate reporting to reflect providers' services, many insurers instruct providers to report codes based on what the insurer's computer editing programs recognize - not on what the provider rendered. Further, practice building consultants instruct providers on what codes to report to get paid - in some cases codes that do not accurately reflect the provider's service.

Consumers know what services they receive from their doctor or other provider but may not have a clue as to what those billing codes or service descriptors mean on explanation of benefits received from insurers. This lack of understanding may result in consumers moving on without gaining clarification of what the codes mean, or may result in some believing they were improperly billed. The multitude of insurance plans available today, with varying levels of coverage, ad a wild card to the equation when services are denied for non-coverage - especially if it is Medicare that denotes non-covered services as not medically necessary.

3. Proactively addressing the health care fraud problem

The government and insurers do very little to proactively address the problem with tangible activities that will result in detecting inappropriate claims before they are paid. Indeed, payors of health care claims proclaim to operate a payment system based on trust that providers bill accurately for services rendered, as they can not review every claim before payment is made because the reimbursement system would shut down.

They claim to use sophisticated computer programs to look for errors and patterns in claims, have increased pre- and post-payment audits of selected providers to detect fraud, and have created consortiums and task forces consisting of law enforcers and insurance investigators to study the problem and share fraud information. However, this activity, for the most part, is dealing with activity after the claim is paid and has little bearing on the proactive detection of fraud.

4. Exorcise health care fraud with the creation of new laws

The government's reports on the fraud problem are published in earnest in conjunction with efforts to reform our health care system, and our experience shows us that it ultimately results in the government introducing and enacting new laws - presuming new laws will result in more fraud detected, investigated and prosecuted - without establishing how new laws will accomplish this more effectively than existing laws that were not used to their full potential.

With such efforts in 1996, we got the Health Insurance Portability and Accountability Act (HIPAA). It was enacted by Congress to address insurance portability and accountability for patient privacy and health care fraud and abuse. HIPAA purportedly was to equip federal law enforcers and prosecutors with the tools to attack fraud, and resulted in the creation of a number of new health care fraud statutes, including: Health Care Fraud, Theft or Embezzlement in Health Care, Obstructing Criminal Investigation of Health Care, and False Statements Relating to Health Care Fraud Matters.

In 2009, the Health Care Fraud Enforcement Act appeared on the scene. This act has recently been introduced by Congress with promises that it will build on fraud prevention efforts and strengthen the governments' capacity to investigate and prosecute waste, fraud and abuse in both government and private health insurance by sentencing increases; redefining health care fraud offense; improving whistleblower claims; creating common-sense mental state requirement for health care fraud offenses; and increasing funding in federal antifraud spending.

Undoubtedly, law enforcers and prosecutors MUST have the tools to effectively do their jobs. However, these actions alone, without inclusion of some tangible and significant before-the-claim-is-paid actions, will have little impact on reducing the occurrence of the problem.

What's one person's fraud (insurer alleging medically unnecessary services) is another person's savior (provider administering tests to defend against potential lawsuits from legal sharks). Is tort reform a possibility from those pushing for health care reform? Unfortunately, it is not! Support for legislation placing new and onerous requirements on providers in the name of fighting fraud, however, does not appear to be a problem.

If Congress really wants to use its legislative powers to make a difference on the fraud problem they must think outside-the-box of what has already been done in some form or fashion. Focus on some front-end activity that deals with addressing the fraud before it happens. The following are illustrative of steps that could be taken in an effort to stem-the-tide on fraud and abuse:

- DEMAND all payors and providers, suppliers and others only use approved coding systems, where the codes are clearly defined for ALL to know and understand what the specific code means. Prohibit anyone from deviating from the defined meaning when reporting services rendered (providers, suppliers) and adjudicating claims for payment (payors and others). Make violations a strict liability issue.

- REQUIRE that all submitted claims to public and private insurers be signed or annotated in some fashion by the patient (or appropriate representative) affirming they received the reported and billed services. If such affirmation is not present claim isn't paid. If the claim is later determined to be problematic investigators have the ability to talk with both the provider and the patient...

- REQUIRE that all claims-handlers (especially if they have authority to pay claims), consultants retained by insurers to assist on adjudicating claims, and fraud investigators be certified by a national accrediting company under the purview of the government to exhibit that they have the requisite understanding for recognizing health care fraud, and the knowledge to detect and investigate the fraud in health care claims. If such accreditation is not obtained, then neither the employee nor the consultant would be permitted to touch a health care claim or investigate suspected health care fraud.

- PROHIBIT public and private payors from asserting fraud on claims previously paid where it is established that the payor knew or should have known the claim was improper and should not have been paid. And, in those cases where fraud is established in paid claims any monies collected from providers and suppliers for overpayments be deposited into a national account to fund various fraud and abuse education programs for consumers, insurers, law enforcers, prosecutors, legislators and others; fund front-line investigators for state health care regulatory boards to investigate fraud in their respective jurisdictions; as well as funding other health care related activity.

- PROHIBIT insurers from raising premiums of policyholders based on estimates of the occurrence of fraud. Require insurers to establish a factual basis for purported losses attributed to fraud coupled with showing tangible proof of their efforts to detect and investigate fraud, as well as not paying fraudulent claims.

[rjzimmerman]

Faith can be secular. I’ve recently learned personally how critical faith and trust are to us. Segue to politics from healthcare.

Some of you are aware that our son has had a liver transplant. What you may not know, because frankly I don’t remember what I’ve posted recently, is that the transplanted liver failed. He then received almost immediately a second liver, which was transplanted. The procedure went well initially, but then horribly wrong. He was in an uncontrolled bleeding situation, and almost died. But he didn’t. We learned that the cautious and meticulous actions taken by his healthcare providers has worked, and the bleeding was brought under control after three days.

Today (nine days after the nightmare began), he opened his eyes and communicated with us, through nods and shakes of his head. I was speechless, but I managed an inane, “Tom, I’m here! Hi!” I was in awe. He is now entering into a “normal” transplant recovery and monitoring process. It will be arduous, but not as terrifying or threatening as what he has gone through.

What does this have to do with faith and trust? When the first liver failed, it felt like we were on the precipice of a cliff, looking down into a deep, dark canyon with steep walls. We had no idea what would happen or what to do. We were terrified. We could have been angry, but we weren’t. We were scared, and felt helpless and immobilized. Then, that evening, a second liver was located. We were relieved and grateful, and again thought of the fellow human being who was giving life to our son, and her or his family.

About 24 hours later, when he was in uncontrolled bleeding during the procedure and the lead surgeon told us his prognosis was extremely poor, we were back on that cliff again, but this time the canyon was darker and steeper and had no bottom. The feelings of helplessness, fear and terror were more intense than they had been the day before, and were accompanied by a sense of loss.

In both of these situations, the only thing that kept me going and prevented me from going into uncontrolled despair was faith. I knew that there is a mostly-hidden, but effective organ transplant system out there, functional and mostly successful, and based upon a combination of the private healthcare sector and government partnership. I had faith that the people running that system, or working with or within it, were working hard on locating a second liver. They had to be. I trusted the doctor and the team who told us they were going to find a new liver. Faith in a system and trust in people pulled me through. Then when the death angels were knocking on the door, I watched seven to nine professionals in our son’s room in the ICU, feverishly doing their jobs, running and rushing here and there, poking and prodding, reacting quickly in a controlled chaos, adjusting numbers on digital devices, hearing beeps and whistles and bangs and whoosh noises. At that very intense moment, I had faith in the healthcare system and trust in those women and men working so hard to save our son. And they did, because about 4 or 5 hours after the nightmare starting, the blood loss was reversing.

Looking back now, I realized my faith in social and healthcare systems and their webs and weaved threads and rules and regulations and brilliant people was all I had left at those moments when our son needed a new liver and then later when he was dying. Faith and trust. Now I understand a lot more what faith in the religious context means, and how critically important faith and trust generally are to each of us so that we can live in a complicated and sometimes baffling world.

What does this have to do with “segue to politics?” The politicians in the republican party have for years, since reagan, strived to weaken and then destroy our systems that are our safety nets and sources of comfort and assurance, and have created, intentionally and maliciously, doubts in each of our heads about their need and efficacy, all at the altar of Ayn Rand or whomever else is emerging at the moment as the latest savior of that “old way of life” and rugged individualism. Then came trump and his people, who have accelerated that destruction, and deepened and broadened the destructive impact so that we have reached the point where we doubt if our vote physically counts, because the system is hacked or rigged, or if whom we vote for cares what we think, or if those politicians will redefine disability or poverty to harm millions more, or will change our regulations to tolerate the expulsion of more toxic air or crap into our water, thus making us ill, or whether the Department of Veteran Affairs will fail our veterans or if we will die because our healthcare insurance programs will only cover hangnails, and then only those that weren’t there last week, and so on. We don’t trust much anymore, and are losing faith or have lost faith that the systems embedded within our government to protect our health, environment, safety, savings, children, elderly parents, our kids’ education, and so on will help us, or even acknowledge our existence.

These people must go, and whomever follows has to work really hard to restore whatever can be restored so we can once again have faith in what surrounds us and trust in the people embedded in those systems to help us.

Faith and trust have become my mantra. I now get it, after years of struggling to understand.

[confusedtransguy]

Hey, I’m a confused trans guy. Have a second to help?

I want to preface this by saying I am on the autism spectrum, so consisely and accurately portraying what I mean and what I’m thinking is pretty difficult for me. I might ramble on here and might leave out something that may clarify my point or viewpoint (or whatever). Before you assume I’m trying to offend someone or that I’m choosing to be ignorant, I’d appreciate if you first ask me to clarify in either a reply, a reblog, a pm or an ask and I’ll do my best to clarify.

Continues under the cut: dysphoria, mentions of transphobia, truscum and transmed ideology. The tags are just to hopefuly get the people who might be intrerested in the topic seeing this post!

Secondly, I am a trans guy that experiences both physical and social dysphoria. I’ve been “in transition” for nearly 3 years, but my transitions hasn’t made it as far as I’d like it to have due to disability, lack of accessibility (money, transportation, healthcare, insurance, etc.), and being in the closet for a while. I want to preface the rest by also saying I totally understand any reason why someone wouldn’t mediclaly or socially transition due to any of these reasons (or any other reasons in people’s living circumstances). 

Thirdly, I want you to know that I am in no way trying to challenge or shoot down anyone’s viewpoint or opinion. I’m here timidly asking for help understanding this issue. Everytime I go looking on my own (yes, I’ve done googling and researching on my own for a very long time and haven’t gotten anything that has helped me better understand, sorry!) I get responses that never really answer my question and pose more questions rather than an answer. I’m, in no way, trying to offend anyone. I just figured this would be a good place to ask since it seems to be a pretty popular opinion (and possibly a widely-believed fact! I don’t know! Like I said, I’m here to figure it out!) here on tumblr.

So what am I getting at, you might be wondering. Well, I want to know how someone can be transgender without experiencing gender dysphoria.

Whenever I pose the question, I get called truscum, transmed, transphobe, etc. And I personally don’t want to believe that I am something so horrible. I just don’t know/understand. I have always, before I even knew what it mean to be transgender, separated gender identity and gender expression. I knew that just because someone was feminine, didn’t mean they were a girl. and just because someone is masculine, doesn’t make them a boy, etc etc. So what makes someone transgender if they don’t have gender dysphoria. and I don’t mean the suffering type of dysphoria, but more the disconnect in the brain of “Hey, this identity that I have been assigned doesn’t feel right, I have something else going on inside.”

I personally think it’s dangerous to say anyone is transgender just if they say they are. That’s not me saying I would tell someone they weren’t trans if they didn’t experience dysphoria, and I probably would never even ask someone if they did. I also would never disrespect someone’s pronouns. I never want to invalidate someone’s identiy, I just don’t understand what basis they have to base their identity on, if not gender dysphoria. 

For me, personally, being trans is extremely difficult and has brought me a lot of discomfort and misery in my short life so far. So, I don’t see how or why someone who doesn’t experience gender dysphoria would identify as transgender, let alone transition. 

Again, please please please do not think I’m trying to spread any sort of hate speech or anything. If anything, I’m asking to help me change my point of view. But, from my research, nothing makes sense to me because none of it has been explained to me. I feel like I’m not welcomed in the trans community because of my viewpoint, which is based on my own confusion. And I know that If I want to be a part of this community, I have to agree with the consensus. And please please please believe me when I say I’ve tried.

If you want to block or blacklist this account, feel free. I’m not forcing anyone to take the time to help me out. But if you do want to help, leave a reply, reblog this post with commentary, or send me a PM or an ask and I’d love to hear what you have to say!

[joelbell]

Managed Care

A friend of mine works for a health insurance company, a big one. She is interviewing Mental Health Counselors and Psychotherapists to understand why it is that practitioners avoid working directly with insurance providers and instead elect to remain "Out of Network." She knew I declined taking insurance since the start of my practice. Why would counselors limit their client base, she asked, and lose folks who want to use their benefits? After all, the co-pay is affordable and being an "In-Network" endorses you. Good question.

          What if participating in the current model of healthcare is, in and of itself, problematic for psychotherapy and mental health counseling? From the current point of view, the one implied by insurance providers, clients come to therapy with a problem like depression or anxiety, infidelity or grief, and we "doctor" away those problems. It is not bad image: a person has an ache or unexplained symptoms and the doctor figures out what's wrong and can fix it, make it go away. But what is the correct way to go about it?

          For example, 1000 years ago a depressed person had too much black bile; you'd see it in her stool or spit or coating her tongue. It was a metaphor rooted in a tangible production of the body. Or when we say there's bad stain in someone's family, depression has a similar, genetic mystery expressed as character ("Don't mess with the Smith's because the whole family is crazy.") Or, in America especially, depression was a moral failure, like laziness ("You're not trying hard enough.") About 100 years ago the metaphor for depression became the disease model, a something happened to an otherwise functional person ("He had a bad experience.") About 30 years ago psychiatry became profitable and the neurochemical explanation came of age ("You lack serotonin.") I agree that anti-depressants can help, but that's not the point.

          The point is that from the start I was enlisted to approach my client's suffering differently than the current medical metaphors about mental illness. Symptoms were not "in the way" so much as a map for where we needed to go carefully. It appeared that current model of diagnosis-driven therapy discouraged folk from the necessity of describing their own experience in their own terms. It seemed to me that without the ability to describe one's own experience in one's own words, all that's left is a blanket sense of defeat and helplessness. Which pointed to the other hidden problem with the system: trusting the doctor's description of your experience over your own. If the doctor is in charge of the label, then whose psyche is being treated?

          I told my friend, "Just check how many In-Network Counselors diagnose their client's with "Adjustment Disorder" and you'll get an idea that the system requires any real therapy to take place subversively. Adjustment Disorder doesn't describe anything, really and that's where In-Network practitioners veil their work." The system requires counselors to act as double-agents between the client and the provider in order to protect the work and get paid. I framed my position to my friend that being an "In Network" provider brings with it aspects of our culture that I believe cause suffering. A person needs to be able to:

          •Talk to whomever they want

          •For as long as they want

          •About whatever they want

          •In whichever words they want

          •In total privacy

          All of that is forfeited if one decides to accept insurance. So, not only are we losing the ability describe our suffering--free of the worry about "Statistical norms"and diagnostic categories--but using insurance also means we don't even own our own information anymore. Medical care becomes like social media. There is no diagnosis for this existential condition because it is the new normal. Have you ever asked what happens to all your information the insurance company holds about you?

          Sometimes a diagnosis is useful and necessary and the best description for behaviors that impede and distress a client. But I also work with folk who just cannot function easily and don't know why and there's no easy label. In those cases, all we have is his or her descriptions and stories and the trust that, handled correctly, we will find a way forward. There's no map for that, only a process. If I were a health insurance company I wouldn't want to pay for that either.

          I have stumbled over all these distinctions over the last 15 years because depth psychology treats not only the individual but also the difficult aspects of culture that pain us. What I was describing to my friend was that a real therapy, if one can happen, is always going to run up against culture because we're looking to heal culture, ultimately, one person at a time.