Red onion shaped like a giant airpod

This is one spud that ain’t a d—

Wait did you say onion?

Some of us really need to be doing “Finish That Fanfic We Haven’t Updated in a Year November” 💀

A reminder of how absolutely bleak it looked in the first few days of election coverage in 2020

From Washington Post [archive link because fuck Jeff]

Thank you, because I feel like crying right now seeing so much red.

2024: the year of growing your hair out

werewolf & vampire?

Epic Systems, a lethal health record monopolist

Epic Systems makes the dominant electronic health record (EHR) system in America; if you're a doctor, chances are you are required to use it, and for every hour a doctor spends with a patient, they have to spend two hours doing clinically useless bureaucratic data-entry on an Epic EHR.

How could a product so manifestly unfit for purpose be the absolute market leader? Simple: as Robert Kuttner describes in an excellent feature in The American Prospect, Epic may be a clinical disaster, but it's a profit-generating miracle:

https://prospect.org/health/2024-10-01-epic-dystopia/

At the core of Epic's value proposition is "upcoding," a form of billing fraud that is beloved of hospital administrators, including the "nonprofit" hospitals that generate vast fortunes that are somehow not characterized as profits. Here's a particularly egregious form of upcoding: back in 2020, the Poudre Valley Hospital in Ft Collins, CO locked all its doors except the ER entrance. Every patient entering the hospital, including those receiving absolutely routine care, was therefore processed as an "emergency."

In April 2020, Caitlin Wells Salerno – a pregnant biologist – drove to Poudre Valley with normal labor pains. She walked herself up to obstetrics, declining the offer of a wheelchair, stopping only to snap a cheeky selfie. Nevertheless, the hospital recorded her normal, uncomplicated birth as a Level 5 emergency – comparable to a major heart-attack – and whacked her with a $2755 bill for emergency care:

https://pluralistic.net/2021/10/27/crossing-a-line/#zero-fucks-given

Upcoding has its origins in the Reagan revolution, when the market-worshipping cultists he'd put in charge of health care created the "Prospective Payment System," which paid a lump sum for care. The idea was to incentivize hospitals to provide efficient care, since they could keep the difference between whatever they spent getting you better and the set PPS amount that Medicare would reimburse them. Hospitals responded by inventing upcoding: a patient with controlled, long-term coronary disease who showed up with a broken leg would get coded for the coronary condition and the cast, and the hospital would pocket both lump sums:

https://pluralistic.net/2024/06/13/a-punch-in-the-guts/#hayek-pilled

The reason hospital administrators love Epic, and pay gigantic sums for systemwide software licenses, is directly connected to the two hours that doctors spent filling in Epic forms for every hour they spend treating patients. Epic collects all that extra information in order to identify potential sources of plausible upcodes, which allows hospitals to bill patients, insurers, and Medicare through the nose for routine care. Epic can automatically recode "diabetes with no complications" from a Hierarchical Condition Category code 19 (worth $894.40) as "diabetes with kidney failure," code 18 and 136, which gooses the reimbursement to $1273.60.

Epic snitches on doctors to their bosses, giving them a dashboard to track doctors' compliance with upcoding suggestions. One of Kuttner's doctor sources says her supervisor contacts her with questions like, "That appointment was a 2. Don’t you think it might be a 3?"

Robert Kuttner is the perfect journalist to unravel the Epic scam. As a journalist who wrote for The New England Journal of Medicine, he's got an insider's knowledge of the health industry, and plenty of sources among health professionals. As he tells it, Epic is a cultlike, insular company that employs 12.500 people in its hometown of Verona, WI.

Oooh. My partner interviewed at Epic a couple years back and the level of bullshit they put him through spoke volumes about the corporate culture. He was interviewing from home for a remote software development position, but they had him take some sort of standardized tests using anti-cheating tech - including a live monitor - that penalized him for the fact that he couldn't completely close off access to an entire area of our home for hours. Even a dog walking through was an issue.

So when zero people I know have ever had a positive experience with Epic, it's not a surprise. That the company is all about this kind of shady behavior is also not a surprise.

I want to comment, but I have nothing further to add.

Ugh, Epic.

It's not functional for the supposed primary user (physicians), because we're not its intended primary user - the c-suite is

God I didn't know I was waiting for Cory to cover Epic but this is everything I ever wanted

there is an old jewish joke/saying from the pale of settlement that i once read as an epigraph to a history book, whose title i forget: if someone says they're right more than half the time, we say he is an educated man; if he's right two thirds of the time, then we praise the lord, he is wise, he is knowledgeable, he is a prophet; if he says he's right any more than that, he is a charlatan, a crook, a cheat, and a swindler

Epigraph for Czeslaw Miłosz, The Captive Mind

whenever i'm trying to talk myself out of buying something i don't need i always hear my old russian professor's voice echoing in my head: "WHAT??? WILL YOU DIE THE RICHEST MAN IN THE GRAVEYARD?" and then i make an unwise financial decision

i'm so glad i happened to see these tags this is the best thing anyone has added to this post so far

i cannot blame cats for using their fangs to put perfect little stapler holes in cardboard bc if i had such fangs you bet your ass id be doing that too

thinking about this

so if plastic cellophane is bad bc of microplastics and aluminium foil is bad bc.of aluminium in the brain, what da hell am i supposed to wrap my cured meats in to keep them fresh in the fridge???? i get acid reflux from dilemmas like these

You would have to consume more than 40 mg per kg of body mass for aluminum to be toxic, which for the average person of c. 62 kg means consuming 2.5 grams of aluminum at a sitting, or the equivalent of a square of foil 23 centimeters on a side. It is not very bioaccumulative; its presence in Alzheimer’s patients has never been shown to be causally linked (i.e. it seems more likely that something about their brain tissues makes aluminum build up, rather than aluminum buildup causing Alzheimer’s).

Microplastics, similarly, aren’t dangerous on their own, but there are toxins that can be trapped in the body by them. And since cellophane is made of dietary fiber (cellulose), it’s not the kind of plastic anyone should be worried about.

There’s also wax paper and silicone parchment paper, the latter another “plastic but not an issue” plastic. (Silicone is basically sand, chemically.)

there have been dozens of idiotic and borderline infuriating replies and tags on this post since it broke containment and this is literally the only worthwhile one. acid reflux resolved

picketing terf conferences is OUT, releasing 6000 live crickets into the audience of a terf conference and watching chaos erupt as everyone scrambles to evacuate is IN

it occurs to me that this sounds like a shitpost if you don't have the context that this is a real thing that actually happened in the uk yesterday

Truly iconic; thank you for sharing this, and for the tags about their donation page!! Here is the link for better access; I'll return to it soon once I'm able to donate :D

I think some of y’all are missing the point reading some of these tags

They’re not saying “wow that’s such a small amount to win.” Cause yeah to every normal person $434M is a life time of money to have.

What they’re pointing out is looking at how much the gov taxed of that $2 billion, makes it glaringly obvious how little actually billionaires are paying in taxes comparatively.