Why no preparation?

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The lobbyists for the doctors are at it again.

I don’t know why they don’t teach kids about this freshman year.

Not ALL of the US economy is built atop crony capitalism.

I know that we didn’t totally understand all the implications of this when I was young. But now we do. We should really be talking to students, freshmen year, about what types of markets exist in different segments of the economy.

You all talked to me about these problems for years. So, I can’t say that I didn’t know. I knew about medicine. I didn’t know about software.

But software markets are different than medicine because it’s newer. The market is more international. I don’t know if you can call it, “slavery,” but there’s a lot less enforcement of labor laws in software. You bump into LOTS of places where there is absolutley none. You see more of what might be described as, “sweatshop,” style workplaces.

I’ve actually interviewed at one business in town that was activley advocating for those employees. The guy told me in the first interview that every employee they hired was under threat by a foreign government. Their families back home were being threatened. They were scared to death, and they needed American advocacy. That was one of the more positive scenerios I encountered. I didn’t feel qualified to provide them the assistance they claimed to need, so I passed on that role. I hope they found someone who could help.

But more often, the threats are within the company. Threats come in the form of, “You do what I say, or I will take your work permit.” Employers use that leverage over foreign workers to fix wages at really low levels - sometimes $2.15/hour.

That market behavior, at a large scale, helps them fix wages of American workers. But they aren’t super interested in American workers because we naturally have more resources than foreign workers. We have much more negotiation power. They use arbitration laws, NDAs, and market fixing to increase leverage over us. They import enough low wage, vulnerable workers that markets for Americans largley evaporate.

FTC has, of course, huge concerns over practices by the tech industry.

I would like to work in an industry that does not have the same level of market fixing - something at least a little capitalist because that’s the only way that I can survive when I’m trapped in a relationship with medicine as a patient. There’s enough extortion there to make me finacially vulernable enough. I don’t need more of that.

What industries should I look at? I have one thing in mind.

I think it’s reasonable to assume that I’m not going to have access anymore to medications or medical devices through my insurer. I don’t know if that is retaliatory or not. It doesn’t really matter because I can’t fix it. The patient community lost the ability to sue far too long ago. They will never uphold their contractual obligations to fill prescriptions.

I won’t have sensors anymore. I won’t run a pump without sensors.
I had that stuff when I was young and I could push boundaries and work in physically demanding environments. I could work in the snowy backcountry, run up a mountain, and pull patients out of the woods on a sled with a sensor and an insulin pump. I’m too old for that ■■■■ anyway, now.

But I’m not going to be driving 2.5 hours, one way, to work without a sensor either.

So, my strategy is to find an industry close to home that has need and functions in a capitalistic way. That will be my target. That strategy feels practical.

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I need a job where I’m not involved in financial fraud.
I need a job where I’m NOT KNOWINGLY causing harm to patients - financial or physical.

Really tough to find in this town.

That means medicine is out of the question.

There’s actually quite a lot of problematic stuff in software, but the less education you have in the field, the harder that is to see. They hire people who don’t have a lot of skills and pay the lowest wage possible. So, you can’t call it ‘fraud.’ What industry is doing, is better described as, “ripping people off.” Over time, eventually, that drifts into what can be more formally described as fraud. But it doesn’t start there. It starts as ineptitude.

Software is out of consideration.

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A lot more opportunities are open to me, now that some of the price gouging is handled. I don’t need to make nearly as much money. Premiums are brutal, but I am optimisitic that can get handled, to some degree. State copay caps have been super helpful.

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I sympathise. I’ve felt this way several times; I left the UK because I didn’t agree with Margaret Thatcher. And I also had the opportunity to leave. I stopped working for Microsoft because it was driving me into the ground and, hey, I’d found I could do things other than work. And I had enough money to do it.

You are correct; on an H visa we cannot leave, quit, or control our lives in the way that I did. I was on an H visa but Microsoft paid for the green card. Most employers don’t do that because, a couple of years later I walked out the door; I ghosted. I value my sanity yet, once again, I could only do it because I could.

Some years before, when I worked at EO, a fellow employee, who had been to the company meeting where the dudes said they were in dire straits and said any one who started looking for alternate employment was not a team player (the dude saying this was looking for a job at Apple), came to me, related the curious experience and, for some unknown reason that to this day I don’t understand, asked me what I thought?

You must have heard me say this before: Put on your own oxygen mask first. It’s important, if your don’t you really can’t help anyone. That comment wasn’t for you, just for anyone else who reads this and hasn’t heard me say it before. Sometimes there is no oxygen mask, or, maybe, in my case, nothing that smells like oxygen, nothing that I can breath.

So now I have nothing to lose; I’ve given up once and I’m still here and breathing something.

When I speak to people I’m a socialist, “From each according to their ability, for each according to their need.”

Then again I’m a capitalist, “A fair price for a fair product.” I should add, in this country, that I am a true capitalist; an honest hour’s work requires an honest hour’s pay. If I care to choose people who are inept at doing an hours work I’m not a competent capitalist. Every person on this planet can do an hours work to the best of their ability and anyone who devalues that work is neither a socialist nor a capitalist, just a fascist.

This, of course, does not help you in the slightest: I’m just being an arrogant know-it-all. Yet so is everyone else on the web.

I’d go for software. Yeah, I was once on an H visa and I couldn’t leave. Yet I did have an employer who paid for the green card; that’s an amount of trust that I value too this day. I also watched and listened, while on an H visa, as the whole of the US coders whined about how they couldn’t get paid more because of exactly the arguments you gave. It’s true; they just weren’t any good and every software company was importing indentured labor from India, China, Korea. Those guys were damn good.

Tricky.

W tried to fix one of the H visa problems. He suggested requiring employees to actually be verified by employers. He gave us RealID; which identifies us, but gave up on the simple other part. Maybe he liked chicken, that’s chicken, not Chicken. H4 So I’m a socialist and a capitalist but I’m with W on this; when I work an hour I want an hour’s social security and I want an hour’s Medicare. The very things W tried to guarantee, or not.

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Interesting. I didn’t know that’s how it worked.

I don’t know if Apple invented the software labor camp, but they popularized them. People know about them now and there has been some backlash. Last time someone asked me to join one, it was in Atlanta and it was the start of covid. I think those took a hit during covid because no one wanted to all move in together in the same building.

They are being treated badly, John.
They tell me so. I’ve seen it.

One korean student was hired as an “intern,” for a local startup. She urgently needed a work visa when she graduated. It’s always an urgent need because there are no jobs. She was put into a sexually exploitative position in order to keep her visa and job.

A male friend of mine went in. I refused to go in. The startup guys looked too sketchy and I had been burned before. He was working 80 hour work weeks.

The startup was collecting money from the state. The state would send grant $ out to small startups to encourage buisness development in the city. It was intended to fund employee wages. The startup stopped paying him because they ran out of money.

He had a foreign name, so I think they believed he was more vulnerable than he was. But he had citizenship and had lived here since he was a teenager. His family lived here. He had more resources and freedom to discuss what was happening than she did.

He spoke to me about it. I reported them to the state. The state worker sounded surprised and skeptical when I told her that he was a US citizen. She said, “Typically, we don’t see these problems for US citizens, only foreign nationals.”

They knew this stuff was going on.

What we discovered was that the startup guys were actually Canadian citizen who were trying to purchase US citizenship. There was an arrangement where rich foreign nationals could come, pay an amount of $, establish a business, & hire employees. If they did that, they would be gifted US citizenship.

That’s just to show that it’s a super twisted web. We were totally outmatched and didn’t understand ANYTHING about how the markets were operating when we were younger.

I don’t think the young know anything about this stuff. I think they walk right into it like sitting ducks. That’s really unfortunate. Someone should warn them. But how?

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P.S. They just sent me a Dexcom G7 sensor RX!!!

When I write stuff about industry on the internet, they send me scripts immediatley - sometimes within 30 minutes.

This might have been a coincidence because I spoke with them two weeks ago and they apologized for not supplying an Rx. They were working on it.

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@jbowler,

How do you feel about Rojas’s lobbying?

I think he’s pretty good.

I feel like what he writes on behalf of the Doctors, helps our patient position and our advocacy efforts.

Many of the Doctor’s guys just drone on and on about how they are being underpaid.
I find that super annoying.

Between me, the small business pharmacists, and the independent (self-employed) physicians, we got candidates in the state of MN to say the word “monopoly,” four times in the week leading up to the primary. I think that was a pretty good accomplishment so I sent them $100 for every time one of them (from either party) said that word.

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Confused. Market regulation in the US is more widespread than in other countries, which tend to regulate things like workplaces and contracts, something that happens less in the US. Think about things like the heavy regulation of car insurance in many states, the heavy regulation of health “insurance” (it’s not insurance) premiums (pretty much absent everywhere else), the regulation of school curricula, the regulation of energy prices, the regulation of energy supply; at least in Oregon the power companies cannot refuse supply because people don’t pay.

Ok, so he doesn’t like that. Right, he’s a capitalist libertarian or, more like, an anarcho-capitalist.

Whatever. I’ve given up trying to deal with these people; they are so convinced that there is no baby in the bathwater.

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When people say, “libertarian,” I tend to think they mean ‘no governement regulation.’ Think 1980’s Ronald Regan. A lot of old people in America are still stuck in that 40 year old political paradigmn. The republicans have some work to do in order to change that paradigmn. But maybe they just wait until that generation dies. Sometimes that’s the only way that people change their minds.

What we have now is kinda like that 1980’s liberatarianism in business, except that it’s really just “no enforecment of the law,” which is a different flavor of “no government intervention.”

They are preparing to start hunting Epic. The docs, nurses, and software startups have been asking for this, for years.

I don’t know how to begin prepping them for an antitrust case.It took you all 5 years to explain what a PBM is to me. They will never be ready in time.

The IRS is also hunting.

When the IRS is hunting, our gov really means business.

Here’s a guy who talks about populism, regulation, and the new politic.

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I’m gonna get out of this mess, John, now that I understand it. Both administrations proved price fixing in insulin, but we always knew healthcare was a mess. We knew from personal experience. You all taught me about the monopolies as soon as I started asking questions. Some of those guys were and are at the top of the field. But I didn’t know software was monopolized too. Now I know and I gonna get free from it.

What secretly scares me the most are the software labor camps. We have them in town. Some are run by large companies. They try to get me to go live there. You have to live in a required location, like a specific building in order to work there. That’s how you know it’s fishy. That’s why I call them ‘labor camps,’ because they want physical control over the location you live in. That’s one way they exercise inordinate control over employees.

But I have already seen similar camps, so I know better. I almost got stuck in one outside of Fargo. I think the state of South Dakota shut it down for some kinda financial fraud. They might have taken them to federal court. But it’s almost always worse than just financial fraud. It was called Eagle Creek Software (of Eden Prarie, MN).To this day, I have no idea what it was about.

That stuff scares me shitless. I won’t discuss it with the feds. Too scary. But when people ask me about it, I tell them what I know. All I can do is hope that regulators ask around town and word gets back to them. I fear UHG has one because the recruiters call me to work there. People from the state have asked occassionally.

That’s the best I can do for software and for the people that accidentally fell into that mess. Regulators are investigating BOTH software and healthcare. I asked them to talk to people directly - to just talk to stakeholders around town. They are doing that. I hope that’s enough. Whistleblowers seem to be coming forward left and right now that the governement won the federal case to extinguish whistle blowing that Eli Lilly brought.

I suspect that some of what UHG does is put all the white Americans in the “front of house.” But they have apartment buildings full of foriegn workers where those guys are required to live. That’s the “back of the house.” The front of the house is really just a front, although there are smart guys there from the Ivy leagues. The back of the house is where they write a lot of code and where they have a lot of leverage over workers. In a resturant, people refer to ‘front of house,’ as the people customers see. Back of house is where the food gets made.

At some of the larger companies, I would show up at 5am. The international software devs would come chit chat and vent when no one was around to see. They were devs, I was a dev. They wanted to talk. There were smart guys there. They would vent. Things were not good - not for them, not for the code. I was “front of house.” I was the name on the FDA paperwork, but they wouldn’t let me see the code. That’s how they get away with stuff. Dev’s would come to me in a sweat at 5am talking about safety critical bugs and venting that their managers were not allowing the time required to fix those bugs. I felt bad for them. They were clearly deeply concerned. But I knew I couldn’t do anything to help them. People would corner me alone and make threats against my job. So, I knew those guys at back of house would just get axed in a heatbeat.

Everyone gets axed unless they are complicit in pretending to do a job that they didn’t actually do. That’s why planes crash with so much more frequency now. That’s why we all spent years troublshooting medical devices that didn’t work. That’s why we had to build our our AID systems. That’s why we pay $20,000 - $40,000 per year for medical care. It’s all just a crock of ■■■■, where everyone is just threatening one another to get some petty prize.

I’m safe. No one can get to me. But almost every software company in town is sketchy - small or large. The large ones seemed bad, so I tried a small medical device company. It had a spanish name. It had foreign funding. They made remote cardiac monitors. The president of the company told me they had been raided and shut down by the FDA when they were located on the east coast, so they moved here and reopened under a new name. I won’t discuss things that are VERY scary. But they would yell at me and try to make me sign FDA paperwork stating that the device functioned correctly when it didn’t. I refused because I’m a diabetic and I don’t lie when I sign FDA paperwork. My hate of malfunctioning medical devices is greater than my fear of those guys. But I just never imagined that industry operated that way.

I’ve been asked to do illegal hacking of medical devices, but I was never on the books with those guys. I had learned by then to conduct a “getting to know you” phase with medical tech companies. I would refuse to work for them in any official capacity until we had to time to really talk. I don’t know if those guys necessarily knew that what they wanted was illegal. I think they were too incompetent to know that. But I spoke with a company lawyer and explained it all. I did not accept a position there.

Incompetence was pretty rampant throughout industry. That’s an important distinction because sometimes people aren’t building things badly on purpose. They just don’t have any qualifications. They might have been encouraged in industry to make outlandish and untrue claims about what their device can do. I’m not even sure if that is totally illegal anymore because the practice has become so widespread. I would not, personally, say a device could do something it cannot because, as a diabetic, I would tell to call that a fraudulent claim. But that’s all because of my experience as a patient. Other people don’t even think about that.

I could go on and on…

All these companies scare the crap out of me, John. The more I learn, the more scared I become. I’m gonna make a run for it and try to find an industry that isn’t so mafia like. I think it’s industry monopolization that makes them mafia like because I never saw anything like this working as a waitress. People who own resturants are reasonable. Maybe just being in a competitive market prevents some of that bad behavior. That is my hope.

I watched the netflix documentary about Boeing called FreeFall, where the quality engineer comitts suicide, and that feels accurate. I quit flying a couple years ago when I understood how companies actually work. I worked at a giant medical device company with ONE software quality engineer. Imagine being that guy. Imagine. In the documentary, they talk about how regulators DID NOT want competition in the airline industry because they didn’t want safety being compromised as a result of competition. That broke my brain.

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I shouldn’t have even written this. The admins are throwing up warnings like there’s a bunch of political partisans that are gonna come hunting me for writing. Can’t even trust diabetics anymore. I shouldn’t be here in a community of people I don’t know and can’t trust. I suppose I just lost access to the diabetic patient community when TU shut down. The non-diabetic who made the decision told me in DC that they shut us down because we were old. We were old and didn’t do or say anything of value. Nice. It’s been good knowing you all. Really. I’ve only spoken with two or three of you, but you were nice people.

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I don’t have a TV so I have no idea what’s gong on in partisan politics land. It doesn’t really interest me. I haven’t seen a single campaign ad. If it sounds like I’m spewing partisan politics, its probably them repeating things that I have written and said. Not the other way around. They do, do that sometimes. They are doing it more and more. They are activley reading what I write on the internet. People whom I chat with are being promoted into high governement agency positions. It might actually be diabetic representation you are seeing. Not partisan politics. That’s kinda interesting. I dunno. I can’t make sense of what the admins said. I wonder. That would be really strange.

You guys should be proof reading what I write and responding because I don’t necessarily know what I’m talking about. On Tu, I write stuff and everybody would jump in and respond. They would say, “I don’t think your right about this, it’s more like that.” Then, I go and tell the governement and the lobbyists what you said and what your perspective was. Then, they do what you diabetics want.

They are actually doing a lot of that now. But maybe FU has a different perspective or different slant in perspective than TU had. It’s all just small talk. We’ve been doing this for, like, 15 years. Maybe longer. IDK.

Tu told me they wanted PBM reform, but it was not possible to achieve. Well, now we got PBM reform. See how that works? Took a while, but it got done. One of the guys up to run the FDA led on PBM work. You all bitched about insulin prices. Well, now that is being handled. One more step left on that…and some PBM stuff. Should be handled soon. That was a big effort. Really hard to pull of. Many moving parts.

Why are there a bunch of Nordic economist flying into town soon? Because I wrote some interesting stuff about diabetes. We were talking about it on Tu. We were talking about genetic inheritance of diabetes. It interested them. Now they are flying in from Berkley. That’s how democracy works. People talk to each other.

Oh, I see. You have to click the “New” tab in order to see other people writing things. That’s why I never see you all writing anything.

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