The UHC CEO thing has brought up a ton of stuff for me, both as a professional and a person living with 2 "pre-existing conditions", 1 of these since before the ACA. I read an article yesterday that attributed the mass "gee, that's terrible" reaction of Americans to this event being due to an increasing trend of nihilism. While there may be some nihilists out there, I disagree wholeheartedly. Below is why, if you decide to read my long winded reasoning.

Before being involved in a lawsuit against UHC, I knew the healthcare landscape was bad. But it's way worse than you can probably imagine. MAGA types have to work, and I could see them being drawn to jobs with health insurance companies because of the fundamental lack of empathy necessary to do what they do. Good people leave because they can't take it, and you have this toxic cesspool that I suspect exists now in a lot of these companies.

We focus our attention on the insurance companies, but it's not just them. It's the consolidation of hospitals under private equity. I worked for an academic medical center from 2005-2023 and watched the enshittification. The "suits" reproduced like a gremlin thrown in a swimming pool. They shifted to an RVU system, which basically turned medicine into a factory with MDs being paid based on productivity metrics. In direct correlation was the increasing burnout and cynicism amongst the physicians, nurses, and staff. Then COVID hit, and any cracks were just blown wide open and we are where we are today.

Seeking healthcare if you have anything remotely complex going on has never been easy, and I recognize this isn't unique to the U.S., but I'd estimate at least half of the mental health work I do is trying to help people manage the anxiety related to engaging with the system and then dealing with insurance hassles. I try not to add to the gaslighting they've likely experienced already by trying to "reframe their thinking" (a common psychological tool) because their perceptions are 100% accurate. So it's a lot of "yeah...I know. It's terrible." while trying to instill some sense of meaning and hope in other areas of their life.

I also accept about 7 major insurance plans in my mental health practice, which I've run since 2012. The bullshit insurance pulls regarding reimbursement has gotten exponentially worse. They all mess with you, delaying payment by making arbitrary changes to coding what seems to happen every 6 months now. But UHC is definitely a major offender. Today, I have about $10,000 in outstanding claims with UHC plans across 15 patients. For a small operation like mine, that's a lot of coin. And now going into 2025, we face a repeal of the ACA.

Personally, I've lived with Crohn's disease since 2002 and I picked up another awesome diagnosis, Eosinophilic Esophagitis, in 2016. Both require really expensive medications (at least in the US) that eventually stop working for around half of people who take them. So then you have to switch, which puts you into prior authorization hell. Or you have to do some combination of expensive treatments and insurance is like absolutely not. At present, I'm waiting on prior authorization for an iron infusion, which is ridiculously expensive. This is something I've had about 3 times now and was always quickly approved, but I've never gotten one under my current insurance plan. My guess is they're taking their time so I'll have to get it in January when my deductible resets and it'll be on my tab. But I kind of understand why insurance is balking at these treatments, which have been driven up by hospital consolidation and private equity nonsense. With the return of the Orange Shitler administration, I expect my medications to eventually be denied even though they've been covered thus far.

So my indifference to the UHC CEO being murdered has nothing to do with nihilism. I desperately want it to be different. Abject cynicism based on a decade of these experiences? Absolutely.

Some receipts, because academic me just won't die 😂 :

propublica.org/topics/health-i…

journals.lww.com/academicmedic…

jpeds.com/article/S0022-3476(2…

Effects of Performance-based Compensation and Faculty Track ... : Academic Medicine

and testing of a performance-based compensation plan in a department of medicine that is closely linked to the faculty appointment track.

^LWW

Hi there! After a bit of time and lots of work we are near to the release of Tusky 27, but we want it to be perfect, and we need your help.

➡️ Tusky 27 Beta will be out in 2-3 days adn we need as many testers as possible.

➡️ If you want to help us you have to become a beta tester. To do it, opt-in to the Tusky beta program on our Google Play page

play.google.com/store/apps/det…

➡️ Check it out and let us know if anything is not working fine, telling us your Android version and Mastodon instance

Tusky for Mastodon - Apps on Google Play

A client for the social network server Mastodon

^{play.google.com}

@FeatherWiki Just sent a PR for a Hungarian translation for FeatherWiki and extensions. The Japanese translation finally made me sit down and do it 😀

codeberg.org/Alamantus/Feather…

Translation to Hungarian

This adds a Hungarian translation to Feather Wiki, along with the extensions that currently needed translating.

^Codeberg.org

After the next #Conversations_im update have a look at our new Chat Bubble Settings. We are now providing a few customization options that, among other things, allow you to render all message bubbles left aligned.

In combination with the setting that turns off the background color, this is relatively close to what Dino or other team messengers look like.

"Australian railway safety advertising doesn’t sugar-coat things"

submitted by u/OmegaGoober
redd.it/1h77erp
#fuckcars

I'm excited about this one - the GNOME Foundation is looking to hire someone to help turn Flathub into a self-sustaining entity.

Many thanks to Endless for funding this work!

discourse.flathub.org/t/reques…

Request for Proposals: Flathub Program Management

The GNOME Foundation is seeking a contractor to help with program management, financial/legal setup, and public outreach to bootstrap Flathub LLC. This work is funded by Endless. Project Overview The GNOME Foundation, in partnership with KDE e.V.

^{Flathub Discourse}

Moquette Fun

I'm always on the hunt for clothing featuring London Transport Moquette designs. The best place to source these are from the Transport museum. But there have also been dresses and jackets by other companies which unfortunately are not in stock anymore.

#photography #london

#technomage in #MonoWinter

analognowhere serialized special

p. 0-3

#unix_surrealism #comic #monochrome #openbsd #vulture

#Homeassistant – erfolgreich, weil die NutzerInnensicht beachtet wird

Herstellerspezifische Lösungen scheitern daran, dass sie an ihren eigenen Systemgrenzen enden.
Was hilft es, wenn die Hue-Leuchten steuerbar sind, aber der Sensor von Aqara, der Regensensor von Netatmo, die Wallbox oder die Außensteckdose von AVM nicht einbinden kann?

Lediglich Homeassistant schafft den Spagat, eine wirklich umfangreiche Funktionsliste mit einer hinreichenden Usability zu verbinden.

thoralf.familie-will.at/homeas…

Homeassistant - erfolgreich, weil die NutzerInnensicht beachtet wird

Ich habe in den letzten Jahren diverse Heimautomatisierungen getestet (FHEM, iobroker, Homey, Philips Hue, Ikea, Magenta Smarthome, etc.)...

^{Dies & Das}

In the Victorian era, there was a disease: climacteric insanity. It was a form of hysteria which specifically *only* affected women aged 40-60. And these were its symptoms, which might sound familiar to a lot of you around that age...

From F. Skrae, 1884.

So the wife ran over the power cable of the vacuum earlier this week.
She had a bit of a shock when winding in the exposed cable, but luckily no harm done.

I sent the image off for a repair quote and of course to a few people.

the interesting thing was, when I read their responses (my brother, for example, said " Hahaha she done a proper job on that!") I naturally heard it in his voice. Ditto for the other few people I showed it to.

Then the response from the LLM comes in, of course,
"The damage visible across these images suggests that the electrical cord of the vacuum cleaner has been compromised, likely due to accidental contact with the vacuum's rotating brush or similar mechanical damage. This cord should not be used in its current state, as it constitutes a significant fire and safety hazard. It is essential to either repair or replace the cord before using the vacuum cleaner again to avoid any potential for harm."

And I hear it in Data's voice from The Next Generation. I don't know why.

limonicos

#mastoart #sketchbook #sketch

Day 6 - #adventOfIOSAccessibility. With regular buttons from UIKit or SwiftUI, you are all set. With complex views, headings, or table/collection view cells that, when selected, bring the user somewhere else in the app or perform an action, you'll have to add the button accessibility trait yourself to convey users that it is an interactive component.

#365DaysIOSAccessibility