I am in my 40s, I make pretty good money. My life is good.
My mom died last year. The medical system and her medicare "advantage" plan killed her. She had a stroke. However, within a day, she was up and walking around with assistance.
However, the hospital was understaffed so two things happened. She fell going to the bathroom AND after that happened, they did not get her moving enough and she got a huge bed sore.
The huge bed sore would not have happened if her medicare advantage plan hadn't denied denied denied having her moved to get physical, occupation, and speech theray. If she had just good ole medicare, they would have approved it the day of request (it was requested the day after the stroke, I was warned that her plan was going to deny because they always do where medicare always approves). Instead, she rotted in an understaffed wing of the hospital for a week while I fought to get shit approved.
After getting approval to be moved, she was making slow slow progress due to the bed sore. It is hard when your body needs to recover and you have a huge wound on your back.
Once again her medicare "advantage" plan denied giving her more time in therapy. Guess what? Medicare would have just approved. Her advantage plan said the "community" could care for her and she could just get better over time. Do you know what that means? They wanted me to quit working and care for my mom 24/7. That is what they meant by community care. I am an only child with no other family except my wife and kids.
The hospital social worker was great and refused to discharge my mom because she knew I couldn't physically move my mom around or give her the care she required. That started a month battle where her insurance was refusing to pay anymore hospital bills, refused to get her more therapy, and essentially killed my mom. If the social worker had allowed my mom to be discharged, I would have been fucked.
She slowly got worse and died. The american medical system with its private "advantage" plans took what would have been a recoverable bad health incident and allowed it to kill my mom for greed.
BTW, after a month of fighting, emails to the insurance board of directors and CEO, I got more therapy approved for my mom but it was too late by then. She died a few days later.
You can probably guess how I feel about the CEO's murder........
The incentives are pro-social: insurance companies have an incentive to delay payouts, because their profits come from interest (they pay out more money than they take in) so the longer they can hold onto money the better. But that's reversed for this hypothetical loan issuer - they want to make the payout as fast as possible in order to earn as much interest as possible as quickly as possible.
And if there's a systematic tendency for medicaid advantage plans to deny claims that eventually get approved, and if you could predict which ones will get approved 'just' by really understanding what medicaid would approve, then this might be self-sustaining or even profitable?
But is this actually true, or just something that declining economic sentiment in the newspapers has led us to believe? People are consuming more food, more education, more square feet of house, more travel. My sense is that is surprisingly hard to find a quantitative signal that purchasing power has collapsed.
Maybe it is just that positional goods (access to the best neighborhood in the best city) get harder to obtain as the population grows?
Anyway, good thing we all have a wealth of choices. If you don’t like Gnome, there’s a huge universe of choices available to you! Long live OSS.
That stood out to me.
Incidentally this is what I meant above, about the union being out of touch: unlimited sick leave makes staffing unpredictable, which makes work unpredictable and frankly dangerous, which makes guards take more sick leave in a vicious cycle. The union has weaker-than-expected motivations to fix this, because everyone with seniority does not actually work in the housing blocks.
It seems like they are waisting time and resources with dreams while neglecting basic needs.
1. There's a severe shortage of guards. Anything that could make working in the jails more attractive will help, and a 2-hour commute is not attractive.
2. Getting medical service, prisoners with court dates, lawyers, etc. on and off the island is really really slow.
3. The jail has insourced a lot of services (for example they run a large bakery). These get staffed by corrections officers. This both makes staffing harder, and the existence of these plum positions has weird effects on the politics of the corrections union (people with power in the union are not actually working as guards and are out of touch with the reality of the jail)
Moving to a model like the Tombs, with the jail directly above the courthouse, makes way more sense.
In addition, the buildings on the island need a serious revamp (e.g. there is no automatic access control, so every major door needs a guard physically standing there to let people through and climate control is broken). As long as you need to seriously renovate anyway, might as well just build a new jail where it should have been put in the first place.
Source: I read a lot of blogposts.
Taking this specific issue of nuclear. Nuclear Energy is objectively cleaner than other forms of energy generation and is objectively safe if you operate it properly. With that said, it seems like Nuclear Energy would be embraced by the ESG crowd, but that simply wasn't the case.
Now that the rubber met the road, the sentiment has changed. So was nuclear actually bad? Or was it just "bad". Almost seems that everyone was so obsessed with going green and getting rid of "big bad nuclear" that they forgot that they depend on it. Much like a kid quitting his job to pursue the arts and then realizing, he can't make rent without the job they just quit...
Well yeah, it is explicitly intended as a signal that investors can use to select virtuous companies.
(It's not a motte-and-bailey, that's about a particular sort of shifting goalposts)
Of course not “intentionally” but if you manage to have an even slightly complex tax situation and not get tricked and report something wrong, props to you!
(I am not a tax lawyer nor an accountant, but I have done this 4 out of the last 6 years.)
It’s particularly interesting to watch as the company is based in a country that is a very close ally.