This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
There was a wild post on r/RealEstate yesterday. It's already been deleted.
There's obviously a good chance that it's a totally fake story. I'd basically assume that it is. I don't even really care if there's even a 0.1% chance that it's actually true; it doesn't really matter.
Part of the reason why people likely believe that it's fake is that it sounds like absolutely outrageous behavior by the contractor. Something that no one would put up with. Something that would shock the conscience if it actually happened and there was a recording of the interaction or something.
So what's weird is that this is the standard modus operandi in the medical industry. It's just the way things are done. Yes, if you have insurance, then instead of telling you to your face that they're charging a ridiculous made up number after the fact, they tell your insurance provider the same thing. But the basic fact pattern is absolutely the same.
I'm definitely not going to go all Kulak and say that since this routinized obscenity shocks the conscious, everyone needs to start going around murderin'. But it absolutely is a routinized obscenity that should shock the conscience. Perhaps my crazy pills are significantly less potent than his, but they appear to still be crazy pills.
Lawyers can debate the legalese of "consent to treat" forms and what they do and do not allow, but it simply cannot be plausible that we will have a functional medical industry when it is the one and only industry that is allowed to simply refuse to provide you a price prior to authorizing work and then go on to just make up whatever the hell inflated price they want after the fact.
I'll once again note that various excuses about how a treating physician probably can't really know what things cost ring hollow for anyone with a decent veterinarian. That end of things is admittedly a newish experience for me, but when I take my dog to the vet and he presents treatment options, I can inquire what they cost and his reply is, "about [$X], but I can get the exact number for you if you want". That physicians cannot do this for much narrower ranges of practice indicates an incentive structure for not knowing what things cost.
I genuinely believe this is the part that triggers so many people to feel the way they do about Luigi. Guys like Brian Thompson make tens of millions of dollars and if anyone has a problem with it, they can get their lawyers to take it up with his lawyers, who will all make a shitload of money arguing with each other, lying for hire and making arguments that no one actually believes and that most laymen can't even understand. I'm surprised that others are surprised that profitable Kafka rituals occasionally trigger rage.
To me, the complaint is very clearly with the doctor (or practice/hospital -whatever), not the executive! So I'm not sure why this would make people admire Luigi.
The doctor doesn't want to fuck you over, neither does the hospital or practice. The health insurance executive however, wants nothing else but to fuck you over.
In my experience, hospitals are more than happy to screw over patients in billing as long as they don't complain too much after the fact. Surprise out-of-network anaesthesiologists used to be common (now prohibited), and I've seen hospitals try to tack on not-covered-by-insurance fees that show up much later and weren't disclosed in advance (not that they ever give straightforward billing answers in advance). Yeah, they'll "kindly" remove or waive those if you call and complain a bunch (probably marking it down as "charity"), but it's really annoying and not always worth my billing rate.
There are scum bags everywhere, for sure, but the perverse incentives start with the insurance companies. You can't pull a surprise out of network anaesthesiologist out of your pocket if there aren't any networks. It's the insurance companies who ban pharmacies and doctors from talking about the price of medication and offering cheaper alternatives. And it was insurance companies who instituted the policy of denying every claim first and forcing patients to pull teeth getting their claim covered.
Can you provide citation/further reading on this? A brief search actually turned up basically the opposite complaint (in multiple articles that were clearly founded on pro-doctor
propagandaadvocacy), so I'm definitely interested if the surface internet has it all wrong and no one has been talking about these secret bans.The insurance companies want cheap alternatives. It's doctors and pharma companies who run advertising for big pharma, patients then demand treatments that are extremely expensive, then insurance has to pay for it.
Hold up, are you saying doctors want patients to spend more money on meds?
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link