So much of what I know from women in my life is that the human element of medicine is almost a strict negative for them. As a guy it hasn't been much better, but at least doctors listen to me when I say something.
Now replace some / all of those humans with... A machine whose function also needs insurance approval.
It's gonna end badly.
I still think healthcare needs to be reformed, and I hope that insurance will someday be a thing of a past, but I've hung up my chain saw for now.
Things were ruined slowly. They unfortunately will need to be fixed very slowly too.
You have to engage with the specific historical events/factors that led to the direction and the pace in order to change either. Broad statements like "society is big so change has to be slow" are just as unwarranted as "slow change results in decline".
There's a correct answer to "how quickly can change in a new direction be achieved". It will probably only become known after the fact. It will certainly not be model-able as a function with variables for "progressive or not" and "speed of change".
I grant that whether that winds up being fast or slow even if the attempt is intended to be fast is out of my or anyone's hands for the most part as the system dampens that barring total collapse and chaos :P
> They unfortunately will need to be fixed very slowly too.
When the wrong targets get destroyed, everyone suffers. When parasitic forces are destroyed, the system functions better. It's the difference between defense and friendly fire.
What’s going to be different now than in 2010?
You mean the one based on Mitt Romney's approach?
We should have stacked the courts ourselves, brandished executive orders etc, had some spine.
Edit: I think I need to make clear my thinking that the right has selectively destroyed institutions and levied them in other areas where it makes sense for their agenda. It's not been wanton. So when I say leverage the playbook it's not a one sided act of destruction.
The latter might notice the former having an easier time, but "hey, it works for them" is the wrong takeaway. Commit to the hard work of building resilient institutions; don't join in the destruction because it's easier.
There's also an element of "Never (...), they will drag you down to their level and beat you with experience."
You are yet another person upset that Democrats cannot overcome the purposeful design of our government that you need a lot of power to build, and little power to destroy.
People who want to fix things need dramatically more power than people who want to stymie and break things. Democrats only rarely get that power, and usually only by one or two votes from people who strictly do not care about fixing things. You want this country to fix things? You need to vote significantly more for a party who will push to fix things.
The minority party in congress has no power by design.
All of you talking about the right destroying things are wrong they’re just building things and enshrining things you wont like.
- Some executive orders are always flipped as soon as the opposition takes office, but some unilateral changes are much harder for a cyclical/pendulum-swing opposition season to reverse than they are to emplace. We don't know which are which yet. The return-to-office mandate for Federal workers is probably one that'll have a lasting effect--even if un-done in the future, the average prospective Federal worker will consider the job as something that has a significant likelihood of requiring in-person work if the political winds change and that EO is restored.
- Some things really do get permanently addressed within an electoral season, if you have the guts to shotgun through enacting a solution to them. The withdrawal of most U.S. troops from Afghanistan under Biden is a good example of this. So is the "Fork"/RIF/firing wave of Federal employees under Trump. I'm not saying those are both good things, but they aren't "reversible" in the sense that, say, the Global Gag Rule was endlessly reversible.
- Success follows success, as well. Part of the reason that momentum holds such a sacred place in electoral planning is the same reason that Trump's "flood the zone" strategy was effective (again--not good, but undeniably effective): capitalizing on/marketing early unilateral wins of any size results in the public and Congress being more likely to support larger, more durable changes. This is complicated by many factors (media landscape, districting, money), but is broadly true.
And I graciously waited and allowed them to do things that will take decades if not more to repair before deciding they were irredeemable. I had hoped a middle ground and bipartisan ship would be reached, but it's clear to me it won't be. We do not inhabit the same universe at this point, the disdain is mutual.
You’re acting like I’ve always thought about them like this or like I haven't spent years observing and thinking about this to come to my conclusion. You'd do well to listen to your own words about theory of mind. I was raised conservative I voted for Romney. I'm a fan of many of the political platforms they run on now (minus originalism, removing bodily rights, religion), but in practice they do not walk their own talk. The wars, the spending, abandoning neo-liberalism except in word the blatant corruption and disdain for the positions they hold and how they appear on the world stage.
No, I’ve watched their actions for 15 years and moved ever closer to the position that I have nothing in common with them even being ideologically close to a version of their party from 20-30 years ago and they do so blatantly want to destroy the middle class, health, and wealth for anyone outside a small oligarchic class.
I'm pissed because they wear a lot of my ideology as cheap dress to fuck someone.
My preferences, while possibly futile, are least an attempt to not just accomplish short term goals but to fix the broken dynamics of the system. That is, in my opinion, far more important than literally any particular policy goal. Policy progress is pointless in a broken system, so fix the system first.
It's possible that my view of focusing on fixing the system, restoring institutions, erecting new guide-rails in places we have observed that the old ones don't work, etc. won't work. But at least it has a chance of producing a good outcome. A good outcome literally can't come from the kind of political behavior you describe. You want your side to seize as much power as it possibly can when it wins, enact as much "good" as it possibly can in however long it can maintain it's grip before the political tides inevitably swing and you lose power again. You don't seem to realize that this is what we have been doing for at least several cycles now. And what we have seen is that the next administration just tears up the progress, does the same thing except in the opposite direction and even harder, and does what they view as "the good thing" and which your side views as nothing but unmitigated evil (the same way they viewed you and yours when you were in power), and so the both sides have accomplished nothing but pushing the pendulum a little bit further, giving it a little more momentum, and shredding up the social fabric a little bit more.
I'm not so naive as to believe that it is possible for just one side to say "no we won't do that, we will unilaterally disarm". But I am of the belief that, if one wants to pretend that one is "on the side of good", that the only rational action is to, when granted power, to spend as much political capital as is possible to slow down the pendulum, tear back power from the bloated executive and the federal branch more broadly. Stop trying to enact your political project and instead make your political project nothing other than the restoration of the norms and principles of the constitution.
This is not something that has been tried and failed. it's the opposite of the past 50 years of federal political dynamics. What has been tried is your plan of "fuck the other side, they are evil, just do what our base wants and ignore consensus and norms".
It doesn't work, it won't work, and it can't work. It's destroying the country.
From my perspective, you are no better than the side you hate. You may want different policy goals, but both you and your polar opposites are collaborating on a shared project: the destruction of the country.
Edit: And coming back to this later I need to be clear the left also needs to be swept out. I think our institutions in general need to be reworked. Not replaced entirely, but it's clear they don't survive contact with people who would abuse them for their own ends nearly as well as we had hoped.
There is an intermediary between customers and seller and it's allowed to take percentage of the sale. No such entity will ever work in the interest of the consumer. It has every incentive to inflate prices. Intermediary is needed but it should be financed by buyers with flat fee (possibly for additional incentives that reinforce the desired behavior). The tragedy here is that initially it was. But it was deemed too expensive for the buyers and got privatized which made it vastly more expensive in the long run.
Insurance is also wrong. Insurance is gambling and gambling needs restrictions. You are allowed to take people's money without providing any service most of the time, so you shouldn't be allowed to refuse legal service for that privilege.
https://my.clevelandclinic.org/health/symptoms/10880-fever
https://www.mayoclinic.org/diseases-conditions/fever/symptom...
https://www.osfhealthcare.org/blog/whats-considered-a-fever-...
https://www.brownhealth.org/be-well/fever-and-body-temperatu...
https://www.childrensmercy.org/siteassets/media-documents-fo...
I can keep going if you'd like. Google has a lot of results and every single one says a fever is around that range (sometimes 100, sometimes 100.4).
A fever is 38c, great. What the parents said was that you may have misheard because a fever isn't serious until 104. Which is line's up with the language you used.
> and they said it's not a concern until...
Parent is not suggesting that a fever isn't at 100F, they're suggesting that it's not "a concern" until 104F, a number strangely similar to 100.4 that you claim you heard, presumably, while you had a fever.
You didn't say the doctor disputed you had a fever. You said the doctor told you the fever wasn't concern until 100.4. Which I'm guessing is your fault for misinterpreting. If you google around, it's very easy to see the fever thresholds.
Here, I'll even paste a summary for you, and I can keep going if you like:
Key Temperature Thresholds
- 100.4°F : The standard definition of a fever.
- 103°F : Contact a healthcare provider
- 104°F : Seek medical attention, particularly if it does not come down with - treatment.
- 105°F : Emergency; seek immediate care.
In one of your own links (clevelandclinic.org), here's an excerpt for you:
When should a fever be treated by a healthcare provider? In adults, fevers less than 103 degrees F (39.4 degrees C) typically aren’t dangerous and aren’t a cause for concern. If your fever rises above that level, make a call to your healthcare provider for treatment.
I actually did say that the doctor disputed I had a fever
- You aren’t considered to have a fever until you get to 100.4. Anything less than that isn’t considered a fever, let alone a concerning one
- A fever isn’t considered concerning (ie dangerous) until it reaches about 104. Anything between 100.4 and 104 is just a regular fever and isn’t considered concerning.
It doesn't have opinions, research, direction of its own. Is this a path of codifying the worst elements of human society as we've known it, permanently?
This even translates to the pediatric space. I took all of my kids to the pediatrician because either they don't make comments to me like they do to my wife, or I don't take shit from them. I'm not sure which. Here's an example:
My wife and daughter were there and the doctor asked what kind of milk my daughter was drinking. She said "whole milk" and the doctor made a comment along the lines of "Wow, mom, you really need to switch to 2%". To understand this, though, you need to understand that my daughter was _small_. Like they had to staple a 2nd sheet of paper to the weight chart because she was below the available graph space. It wasn't from lack of food or anything like that, she's just small and didn't have much of an appetite.
So I became the one to take the kids there. Instead of chastising me, they literally prescribed cheeseburgers and fettuccine alfredo.
My daughter is in her 20s now and is still small -- it's just the way she is. When she goes to see her primary, do you know what their first question is? "When was your last period."
Is that supposed to be a problem? How does it connect to the story in your comment?
The question seems to be warranted to me, since being underweight can stop you from menstruating. So if you find someone thin and her last period was off in the distant past, you can conclude that there's a problem and something should be done about it; if it was a couple of weeks ago, you can conclude that she's fine.
(It could also just be something that is automatically assessed as a potential indicator of all kinds of different things. Notably pregnancy. For me, it bothered me that whenever you have an appointment at Kaiser for any reason, part of their checkin procedure is asking you how tall you are. I'd answer, but eventually I started pointing out to them that I wasn't ever measuring my height and they were just getting the same answer from my memory over and over again. [By contrast, they also take your weight every time, but they do that by putting you on a scale and reading it off.] The fact that my height wasn't being remeasured didn't bother them; I'm not sure what that question is for.)
Particularly given the alarming stories of people being prosecuted for having miscarriages, it feels ridiculous.
If anything I hope more automated diagnostics and triage could help women and POC get better care, but only if there’s safeguards against prejudice. There’s studies showing different rates of pain management across races and sexes, for example. A broken bone is a broken bone, regardless of sex or race.
Doesn't this suggest that they don't care what the answer is?
You need to delete your social media accounts and change where you're getting your news from. Nobody is "being prosecuted for having miscarriages". A few people have been investigated for drug abuse during pregnancy which led to the baby's death, which sensationalist news stories twisted into attention-grabbing headlines.
A doctor asking about cycle is just a core piece of diagnostic data like taking blood pressure and temperature, not some conspiracy to harm you.
It's the same reason why the doctor will take your temperature, instead of accepting your word that you took your own temperature and it is normal.
https://www.who.int/publications/m/item/primary-care-checkli...
You are asking how it connects, and it absolutely doesn't. But they keep asking and won't accept "it's regular" as an answer.
She's in her 20s and is seeing her primary for routine things, not because of her weight -- that part of the story was about how they chastised my wife for giving her whole milk but said absolutely nothing to me about it later on.
The weight thing was not the key aspect of my original comment. They chastised my wife for continuing to give my daughter whole milk while being underweight, but did not make similar comments to me. That was the point.
For women, their pains and problems are far too often whisked away by hand waving and "it's hormones and periods" and serious issues are often overlooked. Very little has changed in that area over the last twenty years.
I wonder how many units of their training courses are spent on this and how much is spent on the cultural reinforcement of it.
* https://www.health.harvard.edu/pain/the-dangerous-dismissal-of-womens-pain
* https://pmc.ncbi.nlm.nih.gov/articles/PMC10937548/
However, your argument focuses on the routine intake instead of any listening part. The fact that the doctor measures height, weight, temperature, and blood pressure on intake and then asks about LMP doesn’t surprise me… that’s the part of the script where you just provide the data before you bring up concerns.
Not to say the doctor was not a jerk, just that your argument doesn’t do much for me.