[Winstonm]

thepossum, on 2021-August-18, 05:40, said:

According to Twitter over the last 12-18 months PhD was equivalent to being a Doctor

So I have been taking all their advice accordingly

I would take the mathematical advice of our good Dr. Ken Berg but not so much his advice about pancreatitis.

[Winstonm]

This is a step toward rationality:

Quote

Delta Air Lines employees who have not been vaccinated will soon have to pay a $200 monthly surcharge and take a weekly COVID-19 test.

The new monthly charge will begin on Nov. 1 for all employees enrolled in Delta’s health care plan, Chief Executive Officer Ed Bastian announced Wednesday.

[pilowsky]

So in America, employers are permitted to dock wages if they are unhappy with a particular behaviour?
I happen to agree wrt coronavirus, but what if the employee drove a car that the Boss (yes Massa) thought was environmentally unfriendly - can they put a surcharge on that?
This is how deeply the Master-slave culture is embedded in the American workplace.

Here's a sign that I'm told comes from Australia.

[Winstonm]

pilowsky, on 2021-August-25, 15:19, said:

So in America, employers are permitted to dock wages if they are unhappy with a particular behaviour?
I happen to agree wrt coronavirus, but what if the employee drove a car that the Boss (yes Massa) thought was environmentally unfriendly - can they put a surcharge on that?
This is how deeply the Master-slave culture is embedded in the American workplace.

Here's a sign that I'm told comes from Australia.

If the employee drove a car that data showed to cost everyone else more for insurance and increased health risks for everyone else then sure.

[barmar]

pilowsky, on 2021-August-25, 15:19, said:

So in America, employers are permitted to dock wages if they are unhappy with a particular behaviour?

They're not docking wages, they're increasing the employee's health insurance premium (which the employer is still paying the bulk of).

It has long been considered acceptable for insurers to do this type of thing. For instance, smokers pay higher premiums in many plans because they're more likely to get lung cancer.

[pilowsky]

barmar, on 2021-August-26, 09:30, said:

They're not docking wages, they're increasing the employee's health insurance premium (which the employer is still paying the bulk of).

It has long been considered acceptable for insurers to do this type of thing. For instance, smokers pay higher premiums in many plans because they're more likely to get lung cancer.

The reason that this seems bizarre to a non-American living in other first world countries is that Australia, UK etc. have community-rating; basic minimum health care (up to and including all cancer treatment etc) is included in this package which every single citizen in the country is entitled to - working or not. You are not under the thumb of your employer.
I read in several places that one reason people didn't report Trump's bad behaviour when he was a reality TV actor was that they couldn't afford to lose their job.
Because if they lost their job, they would lose inter alia the health care that their children might need. In Australia, your children's health does not depend on the whim of your employer.


Yes, people smoke and overeat, and some people might think they should pay extra, but this does not happen.
Cost the health system a fortune because you didn't wear a motorcycle helmet, some complain, but this emotion is overwhelmed by the but for the grace of, there go I.

In America, your employer determines it: "they're increasing the employee's health insurance premium (which the employer is still paying the bulk of)".
Effectively they are decreasing the amount of $$ in your pocket.

Other countries with a similar level of wealth (and quite a few with less) don't do this.

[awm]

Yes, the US system of healthcare is very strange by international standards. It’s hard to change though — the system is such that insurance is very expensive, but most Americans don’t realize what they currently pay because it’s paid by the employer (effectively reducing their wages but who knows by how much).

Thus many Americans (especially those who are reasonably well off) have pretty good health care that they don’t see the price for. They are thus terrified of being thrown into the (visibly very expensive) individual market or otherwise losing their insurance. And since they have pretty good health care (and it’s unclear how much income they are effectively losing to pay for it) they are leery of a big reform plans that might replace it with a system like what other countries have.

To illustrate this:

When we lived in the US, our monthly cost for health insurance was about $300. The policy had no deductible and basically covered everything, but who knows how much my employer was pitching in (and probably reducing my wages)?

If we had to purchase health care on the individual market in the US, a similar plan would be around $1500/month and a lower-quality plan with a $2500 yearly deductible would be around $1000 per month.

This looks like a pretty big premium for leaving a job (easily around $10k/year) and could definitely deter people from starting their own business or quitting a job without having another lined up.

For comparison, in Switzerland we are on the individual market (everyone is) and we pay about $600/month for a plan with a $2500 deductible. This is the second most expensive health care country in the world but still much cheaper than the US. However, it "looks" quite a bit more expensive than the insurance we had through my employer in the US (again, hidden costs -- presumably my employer was kicking in about $1200/month for insurance that would've otherwise been added to my salary).

[y66]

It's weird to hear people who say they put a high value on individual freedom oppose healthcare reforms aimed at making it easier for people to change jobs and move from one place to another.

[kenberg]

If anything, Adam's "very strange" understates the matter. In the 1940s our family doctor made house calls, no one had insurance, prices for the everyday medical needs were modest. This was hardly perfect. I ell while climbing, hurt my back, my father took me to the hospital, they refused to treat me until my father proved he could pay for it. So it's better but make that sorta better, and much better for some of us than for others.

It helps to lead a boring life.

I started my college job in 1967 and retired in 2004. All that time at the same job entitled me to a very good insurance package in my retirement for the rest of my life. So was clever, or responsible, or something like that? Not really. I did not, in my 20s, plan my career so I would have good insurance in my 80s. I know people of various incomes, for example we have someone come around to do some house cleaning. She is reasonably young and healthy, that's good in itself, but it also might be essential financially. She is a very responsible person with a couple of kids and a husband with (modest) health problems. She tries to keep up with the changing rules about insurance but it ain't easy. And she is far from the only such example I know of.

Getting a good deal seems to depend more on good karma than on good planning.

As to prices, good grief. I take pills. For some I pay $5, for some I pay $20, ( once asked about how the amount was determined, the pharmacist had no more of an idea than I did), for some I pay nothing, I occasionally look at the actual cost. $500 is not rare. If I were to get into health details, I'll spare you, I could find considerably more extreme examples.

Well, here is one example for amusement. This was maybe 14 years ago. I woke up in the middle of the night with extreme pain in my back and chest. We called for an ambulance, they took me to the hospital, I stayed for a couple of days and then went to another hospital for further checks before going home. Not all that long after I was first admitted, the pain in my chest subsided but my back still hurt. It must have been some weird muscle seizure since they never found out what it was and it never came back. However, despite me telling them that my chest was no longer bothering me, it was just my back, all of the write-ups emphasized my chest pain. I speculate that they figured insurance might be more willing to pay for further examinations if the complaint involved an area associated with my heart. Even if this is just my over-active imagination, I think insurance issues distort choices.

Short version: Our medical system is seriously screwed up.

[Winstonm]

kenberg, on 2021-August-28, 06:48, said:

If anything, Adam's "very strange" understates the matter. In the 1940s our family doctor made house calls, no one had insurance, prices for the everyday medical needs were modest. This was hardly perfect. I ell while climbing, hurt my back, my father took me to the hospital, they refused to treat me until my father proved he could pay for it. So it's better but make that sorta better, and much better for some of us than for others.

It helps to lead a boring life.

I started my college job in 1967 and retired in 2004. All that time at the same job entitled me to a very good insurance package in my retirement for the rest of my life. So was clever, or responsible, or something like that? Not really. I did not, in my 20s, plan my career so I would have good insurance in my 80s. I know people of various incomes, for example we have someone come around to do some house cleaning. She is reasonably young and healthy, that's good in itself, but it also might be essential financially. She is a very responsible person with a couple of kids and a husband with (modest) health problems. She tries to keep up with the changing rules about insurance but it ain't easy. And she is far from the only such example I know of.

Getting a good deal seems to depend more on good karma than on good planning.

As to prices, good grief. I take pills. For some I pay $5, for some I pay $20, ( once asked about how the amount was determined, the pharmacist had no more of an idea than I did), for some I pay nothing, I occasionally look at the actual cost. $500 is not rare. If I were to get into health details, I'll spare you, I could find considerably more extreme examples.

Well, here is one example for amusement. This was maybe 14 years ago. I woke up in the middle of the night with extreme pain in my back and chest. We called for an ambulance, they took me to the hospital, I stayed for a couple of days and then went to another hospital for further checks before going home. Not all that long after I was first admitted, the pain in my chest subsided but my back still hurt. It must have been some weird muscle seizure since they never found out what it was and it never came back. However, despite me telling them that my chest was no longer bothering me, it was just my back, all of the write-ups emphasized my chest pain. I speculate that they figured insurance might be more willing to pay for further examinations if the complaint involved an area associated with my heart. Even if this is just my over-active imagination, I think insurance issues distort choices.

Short version: Our medical system is seriously screwed up.

Healthcare stems from our culture of profits over person.

[cherdano]

Ken, I would think they were just worried more about the chest pain? Back pain is usually muscular, but chest pain could be something serious that needs treatment even after it resolves itself?

[pilowsky]

cherdano, on 2021-August-28, 19:15, said:

Ken, I would think they were just worried more about the chest pain? Back pain is usually muscular, but chest pain could be something serious that needs treatment even after it resolves itself?

Pain radiating from the Chest through to the back could be a symptom of many things.
The term "Chest" in the notes is typically code for heart-related or at least vascular.
Something that would spark alarm in any Doctor hearing, "I have chest pain that is now going through to my back", is the possibility of an aortic aneurysm.

Much more dangerous than 'musculoskeletal pain'.

Particularly in a person with a known history of high blood pressure, a condition known to damage the heart and blood vessels.

[kenberg]

cherdano, on 2021-August-28, 19:15, said:

Ken, I would think they were just worried more about the chest pain? Back pain is usually muscular, but chest pain could be something serious that needs treatment even after it resolves itself?

Yes, that is probably correct. I had not thought it through all that well. The chest pain, although after a day or maybe less it no longer amounted to much, had been a reality and so I can see why they might want to check it out thoroughly. So this isn't the best example.

The general feeling that it is difficult to cope with the various rules is widespread. Here is another example:

It was maybe ten years ago that I was diagnosed with sleep apnea, a diagnosis for which I am very grateful. I doubt I would be alive today had it not been discovered. There are a lot of details in deciding just what needs to be done, I'll skip over them, but at one point there was a question about whether Medicare would or would not pay for a particular choice (an autosv bipap instead of s cpap for those who know about such things). I called Medicare to see what justification was needed, it was tough to get through to a human, when I did it didn't help. So naturally I said "I seem to need it, so I want it, let's do it, I'll pay for it if Medicare doesn't. Medicare did, although it took some further tests and further re-writes before they did. It would not have been hugely expensive but there are people out there who cannot easily say "I'll pay if Medicare won't".

Simple things get complicated fast. We probably agree that some things what cost what for whom needs fixing.

[pilowsky]

You may be familiar with the Irish guy on CNN who interviews people at Trump rallies.
Here is the (sort of) Australian equivalent.

[kenberg]

This is sort of six degrees of separation post. Becky has a friend who has a friend, so call her FOF. FOF has a daughter. The daughter, the daughter's husband, and their three kids all have covid. I know nothing about their vaccinations. But Becky's friend's sister and the sister's husband have both been vaccinated and they both have covid, but in a mild form.

I would love to say that everyone I know, and everyone who knows anyone I know, is being careful but I don't think this is the case. I'm not shy about expressing my hopes for what people will do but I also don't think people get up in the morning and ask themselves "What would Ken do?".

This problem is not at all solved, and I am far from sure it is being solved.

[Gilithin]

kenberg, on 2021-August-31, 06:14, said:

This is sort of six degrees of separation post. Becky has a friend who has a friend, so call her FOF. FOF has a daughter. The daughter, the daughter's husband, and their three kids all have covid. I know nothing about their vaccinations. But Becky's friend's sister and the sister's husband have both been vaccinated and they both have covid, but in a mild form.

Were they fully vaccinated? How long did they have their final dose before contracting it? There seems to be a presumption in some quarters that getting a jab == 100% protection and being able to do anything. This is not how it works. Add to that those who are spreading deliberate misinformation and you have to be very careful and ask a bunch of questions before even thinking about drawing any conclusions from such anecdotes.

[pilowsky]

I suspect that a lot of the problem boils down to the governance structure.
We have the same problem in Australia - albeit not quite so bad.
In the USA, as in Australia, every state elects two senators.
This means that Wyoming has the same political power as California.
A bruise of red runs through the middle of America that illustrates the resulting malapportionment of power.


Senators in the USA have an astonishing amount of power compared to similarly organised upper houses.
As seen in the past 4 years, they get to decide whether or not an appointment is made to the supreme court (where the unelected Kings sit).
This seems to mean that the Senate/Supreme Court and the Prez (elected using a bizarre and incomprehensible 'college' system) get to control all the levers of power.
The people get nothing.
The only truly representative place (HoR) is regarded as a nuisance to be tolerated by the people that have all the power.
William E Ricks referred to America as a totalitarian oligarchy, not a democracy at all.
When viewed in this way, America is similar to Iran or the Soviet state - an arriviste nation concerned only with strengthening the rights of certain individuals with no concern at all for the population as a whole.


If America were a model for parenthood, with the Government running the household, the children would have to compete for food with only the bigger, stronger ones making it through to adulthood.
Sparta redux.


What do the suffering citizens do? They wring their hands and complain that they "don't understand". They talk about their "Founders" as gods and refer to what the "American people" want.
When Hitler invaded Poland, and my relatives were hauled off to their death, they shuffled along to the trains not because they didn't think something bad was happening but because they had no option - they were just regular people who depended on the good behaviour of "the people".


There's nothing new about the problems that America faces.
The new Rockefellers and Carnegies wear t-shirts and fly to space on top of giant phalluses while the people that feed them suffer and die in modern sweatshops, dying and hoping.

[Gilithin]

pilowsky, on 2021-August-31, 16:06, said:

[font="Tahoma"][size="3"]The only truly representative place (HoR)

The HoR is not in the slightest representative. The extreme gerrymandering means that once you have control you only need 40% or so of the vote to keep it. The USA is more or less one Presidential election away from permanent minority government if the GOP chooses to go down that route and Dems fail to take preemptive action during this administration to prevent it.

[Winstonm]

Accidentally responded on Ken's post so deleted and am reposting as I didn't mean this as a response to his comments.

When did we as a nation lose our shame? How is it possible that absolute nonsense is expressed as a reasonable alternative and then reported as bothsideism news? Why do we tolerate senators and congressmen and news organizations spreading and reporting nutcase garbage as if it were valid alternatives to scientific research?

This is McCarthyism II - only this time there is no shame.

[pilowsky]

Gilithin, on 2021-August-31, 16:39, said:

The HoR is not in the slightest representative. The extreme gerrymandering means that once you have control you only need 40% or so of the vote to keep it. The USA is more or less one Presidential election away from permanent minority government if the GOP chooses to go down that route and Dems fail to take preemptive action during this administration to prevent it.

but slightly more than the others