A long term care bed at a nursing home costs anywhere between $5500 to $20000 monthly. There are many rich, retired people who would have their finances depleted in a few years with a cost that high.
The average middle class individual would never be able to afford that so the fall back is usually medicaid.
What you are saying is generally true. The only real oversight in ensuring things are moving forward is us ourselves as patients. It’s our responsibility as patients to take charge of our health.
That being said, P2P is sadly a standard aspect of American medical practice. Essentially anyone in a direct patient contact position position has done them. In the clinic or hospital, it may be your primary clinician handling it but it doesn’t necessarily have to be. It can be handled by other clinical staff or a group of nonclinical doctors also.
You dont have to worry about P2P since it will get taken care of (whether the service will be covered by insurance is another story). Instead I’d focus on keeping disconnected parts of the system abreast of your medical conditions and current list of medications. Because health information is protected there really isn’t a great solution for centralizing this data yet so if you go to a clinic that’s on a different EMR, they’re not going to have all of the necessary information available to them.
This is advice for doctors, not patients.
Usually doctors do the peer to peer and then the patient can appeal once services are denied (which is almost always the case if you’ve reached the peer to peer stage).
I’ve used this before with mild succees. It’s far from reliably effective. You’re more likely to get the decision over turned at the appeal stage, the problem being that precious time is lost while going through that process.
I do like to schedule an appointment so that patients are part of the peer to peer call. That way they can tell the doctor, nurse, PA, NP or whichever other service reimbursement bouncer the insurance company has hired that they’re putting a curse on them and their family.
Early to mid mollenial here with the same experience. It all went downhill when Facebook and flip phones with cameras came out ie. around 2006.
Generally the hospital has checks and balances to prevent fraudulent billing (well not in this case, apparently).
My bigger issue with the RVU system is how it promotes sub sub specialization into procedure based specialties which are the antithesis of preventative medicine. The system valuee family medicine doctors the least despite the massive shortage in their services (especially in rural communities).
So, the surgeon that fixes the broken hip gets paid more than the doctor that gets the bone density scan done and starts meds that support bone health. The cardiologist that opens up the blocked vessel gets more than the PCP who takes the time to counsel on athersclerotic cardiovascular disease and controls risk factors medically and with lifestyle.
I’m not saying the surgeon / proceduralist shouldn’t get paid more. I’m just saying that when your system incentivizes ‘wait for the problem to happen and then fix it’ you’re going to have some bad health outcomes.
Bill Gates’ net worth has grown substantially despite his philanthropy, rising from $126.8 billion in early 2023 to $156 billion in December 2024.
Regarding COVID-19 vaccines, Gates actively opposed patent waivers and influenced Oxford University to privatize its vaccine through AstraZeneca rather than keep it open-source. He pushed for maintaining intellectual property rights through COVAX, despite public funding supporting vaccine development.
Not a good guy by any metric.
I understand now that you are using the communist definition, which is not the definition that’s widely agreed upon but is popular here. Another user clarified that. Thanks and glad we could clear things up.
Ah that explains the response. I was using the modern American definition. Genuinely appreciate the clarification
Defining a phrase is not gatekeeping.
I think you’d be hard pressed convincing anyone that a physician or lawyer acting as an independent contractor and selling their professional services for $200+/hr is working class.
Its a general definition of the phrase. There will always be exceptions. There is still no evidence that anyone considers doctors, engineers, lawyers etc to be part of the working class.
They are generally considered to be part of the professional class. More have become beholden to corporate structures as America descends further into late stage capitalism, but they are still not generally considered part of the working class.
Most Amazon / Walmart workers, Uber drivers, fast food workers etc. would likely scoff at the idea of considering those professions to be working class as they are.
The working class includes those who earn their living through wage-paying (hourly) jobs, typically involving manual labor or service work without poatsecondary education requirements. They tend to have modest property ownership, and make close to minimum wage with limited benefits. Working-class jobs are predominantly in the service sector, including retail sales, clerical work, food industry positions, and manual labor.
Which definition of working class are you using that includes doctors, lawyers and engineers?
According to a Leger poll, 64% of Canadians would vote for Kamala Harris, while 21% would support Donald Trump, with 15% undecided. Conservative voters in Canada were nearly evenly split, with 42% supporting Harris and 45% backing Trump.
Trump would lose the election if Canada were a state, barring any electoral college shenanigans.
American culture magnifies it.
Pickup trucks have evolved from work vehicles into powerful status symbols in American culture. While 75% of truck owners rarely or never use them for towing, they purchase these vehicles as symbols of success, masculinity, and lifestyle choice. In urban and suburban areas, professionals spend $70,000+ on trucks as alternatives to luxury cars, particularly in Southern states where they represent wealth and power. The trend continues growing, with trucks now accounting for 20% of U.S. vehicle sales. Despite minimal towing usage, truck owners display the highest vehicle loyalty rate, with nearly 80% choosing another truck when replacing their current one.
Meanwhile China is slowly working towards global dominance in the EV space which we all know is the future.
The American empire is in that stage of decay where the men are actively lying to themselves about their greatness. The whole manosphere (which originated in the US) is based on that premise.
As they feel themselves sliding further and further into the periphery of relevance, they’ll elect increasingly fascist leaders to try and reassert their dominance, only to be swindled by those they put into power.
It’s all downhill from here.
80% of Latinos are citizens and those that voted must hold citizenship. Expressing shaudenfraude over the possibility of denaturalization is a level of capitulation so profound it makes it feel as if some of our liberal brethren are invertebrates.
White liberals taking joy in the fact that they and their families can have freedom of choice reinforces age old racial hierarchies. Yes, your uncle might be a racist, sexist, narcissist, but no one is going to question their citizenship over it.
Meanwhile, PoC must vote Democrat and if they don’t, their white liberal compatriots will applaud when they’re put in cages and extricated from the country. The racial hierarchy is reinforced when PoC are not granted agency.
They must vote the way I think is right. Otherwise, I will join hands with my regressive conservative kin and shamelessly capitulate as we take glee in the racial purification of America.
Do you all even believe in what you say you believe in? If these are our allies, who needs enemies?
I find that in many cases, if you actually click the link to find the sourced information, it’s not there. I’ve experienced this with nearly every LLM front-end platform.
I mean…yes. But more often through colonial enterprises.
Can I access it via Eternity app? Is it basically another instance?
We generally attribute discoveries to whoever documented it first. It’s almost laughable to attribute it to the French based on a kissing style that was widespread there in 1923. Surely people were doing it before then. Yet, the Americans and British found it so unique they referred to it as French kissing.
Perhaps it was common before ancient India, but then the question is, why didn’t the ancient Babylonians, Egyptians, Chinese, Romans, and Greek document on it then?
Any examples?