My doctor doesn’t know as much as they think they do

Doctors are so bad at listening to their patients that my doctors thought I didn’t have migraine or was bad at reporting my symptoms for more than a decade because it didn’t present the way they expected. They convinced me that I wasn’t having migraine and one of the most compelling arguments is that my attacks didn’t seem to follow the right sequence of symptoms. I had the right symptoms, but they were often mixed up together instead of occurring in discrete phases.

But it turns out that’s normal, especially in kids and teenagers. But nobody thought to actually check or listen to patients.

I’m so glad migraine being better researched, but I’m so angry at how long it’s taken.

Source: Frontiers | Pediatric vs. Adult Prodrome and Postdrome: A Window on Migraine Pathophysiology? | Neurology

From each according to their ability, to each according to their needs

I think it’s easy to imagine that quote from Marx as being purely about redistribution. I’ve often read it like that and am down with it – nobody should have a billion dollars when so many people don’t even have one. It’s comforting to think about living in a society where even if you get really sick, you’ll still be taken care of.

But there is comfort as well in the first part – “from each according to their ability.” Your ability is probably not the ability of a billionaire – the ability to live on a lot less money than you’ve got. But you do have other abilities – you really like doing tedious manual labor while listening to podcasts, you’re a good listener, you’re a safe driver, you make people laugh, you can play Christmas carols on the piano, you can clean up people’s poo without being disgusted or making sick folks embarrassed, you can identify invasive species!

In a socialist world, whatever your abilities are, they are good and useful and we value them. In a socialist world, whatever you can do is good enough. In a socialist world, you are good enough.

If you aren’t some kind of socialist, you’re some kind of combination of ignorant and cruel

“A socialist is just someone who is unable to get over his or her astonishment that most people who have lived and died have spent lives of wretched, fruitless, unremitting toil.” That really is the core of it. A socialist is, first and foremost, not just perturbed by injustice, but horrified by it, really truly sickened by it in a way that means they can’t stop thinking about it. It gives you the feeling that “we can’t do anything about that” or “that’s just the way of the world” is not acceptable.

via A Speech on Socialism at Andover | Current Affairs

Pay your goddamn taxes

Republicans have made it so the IRS can’t collect taxes properly, especially from the wealthy, increasing exploitation and further eroding trust in government.

I want Congress to properly fund the IRS and instruct it to make sure wealthy individuals and corporations are paying their fair share. The government’s ability to collect taxes and to do it fairly is absolutely essential to a functioning democracy and to governance.

I was disappointed and angry to read about a series of slow and devastating cuts to the IRS. We’re losing at least $18 billion a year to tax cheats and likely much more. That’s more than enough money to fund the entire CHIP program or make up the difference in the last year’s cuts to TANF!

It is embarrassing and worrying to read about the effects of the cuts:

The cuts are depleting the staff members who help ensure that taxpayers pay what they owe. As of last year, the IRS had 9,510 auditors. That’s down a third from 2010. The last time the IRS had fewer than 10,000 revenue agents was 1953, when the economy was a seventh of its current size. And the IRS is still shrinking. Almost a third of its remaining employees will be eligible to retire in the next year, and with morale plummeting, many of them will.

Without enough staff, the IRS has slashed even basic functions. It has drastically pulled back from pursuing people who don’t bother filing their tax returns. New investigations of “nonfilers,” as they’re called, dropped from 2.4 million in 2011 to 362,000 last year. According to the inspector general for the IRS, the reduction results in at least $3 billion in lost revenue each year. Meanwhile, collections from people who do file but don’t pay have plummeted. Tax obligations expire after 10 years if the IRS doesn’t pursue them. Such expirations were relatively infrequent before the budget cuts began. In 2010, $482 million in tax debts lapsed. By 2017, according to internal IRS collection reports, that figure had risen to $8.3 billion, 17 times as much as in 2010. The IRS’ ability to investigate criminals has atrophied as well. Source: How the IRS Was Gutted — ProPublica

I am especially appalled that while we’ve eroded our ability to collect taxes from the wealthy – who owe the most and who are most likely to cheat – political pressure from Republicans has the IRS scrutinizing the taxes of people who make less than $20,000/year. It doesn’t seem like a good use of limited time or money to go after people with so little.

I am worried about the effect this will have on the future – as people begin to realize how toothless the IRS has become people will begin to cheat more on their taxes.

The effects of an explosion in tax cheating would be dire. The nation’s already soaring budget deficit would surge by hundreds of billions of dollars more, pushing it well past $1 trillion.

The article focuses on the effect on the deficit, but it will further polarize the classes, increase income inequality, and ultimately destabilize the country. Capitalism without effective redistribution will eat a democracy alive.

 

Of course you choose your life’s direction?

Glowing jellyfish float along a cobblestone street in front of wooden buildings

Jellyfish by Qinni

To this bone tambourine
there is repetition but no script

To this bone tambourine lying quietly in
A suit is a dried rind that at one time slid
Underwater it finds a tree that offers directions for
Rest for mimicking arms and legs allows one
To stop all the shaking approximate direction

To this bone tambourine there is repetition but no
Script in a mad hand our intention to render obsolete
All explanations are thin portraits that begin in this
Corner a crawlspace for which senses are awkward and
Unruly this sad scaffold this breathing instrument

from Anthropy by Ray Hsu

For-profit health care will kill at least 50 million Americans over the next 30 years or so

This study estimated that socioeconomically vulnerable Canadians’ chances of receiving better health care were 36% greater than their American counterparts and this estimate was larger than that based on general patient comparisons (9%). One may wonder about the public health significance of such relative risks/protections. Attributions of risk/protection among populations are a function of three factors of which relative risk is only one. The size of the population and the prevalence of exposure to risks are also important. In this instance, the entire USA population is at relatively greater risk of receiving lower quality care, its more prevalent low-income and inadequately insured populations more so. Applying our findings to population parameters and attributable risk formulations we estimated that without reform, over the next generation more than 50 million Americans will be treated less optimally and die earlier than had they enjoyed a single-payer health care system like Canada’s.

 

via Care of acute conditions and chronic diseases in Canada and the United States: Rapid systematic review and meta-analysis | Journal of Public Health Research

It is endured and then it is gone and you wish it had been so much more

Given the ease with which health infuses life with meaning and purpose, it is shocking how swiftly illness steals away those certainties. It was all I could do to get through moment to moment, and each moment felt like an endless hour, yet days slipped silently past. Time unused and only endured still vanishes, as if time itself is starving, and each day is swallowed whole, leaving no crumbs, no memory, no trace at all.

from The Sound of a Wild Snail Eating by Elizabeth Tova Bailey