Annoying Questions I'd Like Answered...

[Starmaker]

1. Gender = D&D alignment. No one agrees on what it is, but you can point at Killfuck Soulshitter and say "this doesn't look Lawful Good" and have people agree.
2. If your Dad dies and you're sad, you'll grow up gay, because Freud.
3. It's relevant if you're looking to get a master's in gender studies or similar bullshit.

[Longes]

What do you guys think about nuclear energy and powerplants?

IMHO, they are very important, and Europe is making a mistake by stopping them at its territory.

[Koumei]

Radioactive materials are not actually in huge supply. They're needed for things that don't have other alternatives (aspects of medicine, for instance). Furthermore, if you already have a nuclear reactor, then sure, I can see the benefits of continued use, but actually building a new one (and then mining uranium and transporting it) has a bigger carbon footprint than simply shovelling coal into existing powerplants.

[Stahlseele]

Thorium Reactors could work a bit better maybe.
Not much, mind you, but a bit at least.

[Maj]

Can someone here sum up the theory of "Gender Performativity" in English instead of the insular academic jargon used on wikipedia? Bonus points if you can explain how it's actually relevant instead of just a prime topic for thesisifcation via academicism jargonization across Erikson's eight spectra of normative and psuedo-subjective strata of implied societal differentiation as an internalized facade.

From what I understand (and quite possibly I don't), Gender Performativity is the theory that we create our gender by continually pretending to be a gender. We essentially are going through the motions over and over and over again, impersonating the [unattainable] societal construct of our gender until we trick ourselves into believing it.

Why it's relevant...? I have no idea, but if the theory can be demonstrated to be true, then I suppose we could start looking at societal constructs of gender and start breaking them down (hopefully after we answered the question of , "It this actually a bad thing?").

[Longes]

How do people treat themself in different countries? I mean illnesses - cold, flu, etc. Can medicine be bought in stores? Is self-treatment practiced?

In Russia you can buy most non-narcotic medicines without a receipt from the doctor. Usually, people wait for 1-7 days, depending on condition, and then visit a doctor. Cold and flu are practically never taken to hospital, unless you need an official paper for your job. It's easy to get a free full check up (blood, urine, surgeon, ophthalmologist, dentist, etc.). Actual treatment is also free, except for dentistry, where you pay for materials. Hospital food sucks. Quality of treatment and diagnostics widely varies from hospital to hospital, and it's usually better to get dental procedures at private clinics. I've recently gotten full tooth treatment - root canal treatment, filling, anasthetics. It cost me 50 euro. In state clinic they said that my toothache was just my wisdom teeth growing (facepalm).

[erik]

Sounds pretty similar on the cold and flu. Self treatment with over the counter meds, keep hydrated, eat simple things you can keep down. Try not to spread it around.

Cold and flu rarely go to the hospital. Usually only when it gets bad like pneumonia (difficulty breathing), very long-lasting fevers, inability to keep anything down (dehydration) and such.

If you actually have to go to a doctor or heaven-forbid get admitted to a hospital, it will depend upon your insurance and be refuckingdiculously expensive for the latter.

[Josh_Kablack]

Yeah, most of the time cold and flu are self-treated, however here in the USA we have crazy employment laws and a completely-off-the-rails-pants-on-fire-on-head crazy medical system that results far less reasonable circumstances.

If you are in a job that interacts with the general public (foodservice, retail, etc) you are unlikely to get paid sick leave at all, so you will usually go to work sick and help spread the flu around. If you are one rung up, you may get paid sick leave, but you get crazy policies like my current employer's:,

• You require a written statement from a doctor for missing 3 days in a row. Note that seeing non-emergency doctors here often requires appointments to be made weeks in advance.
• Sick days will not be paid if taken immediately before or after holidays. Regardless of whether you have a doctor's note.
• You receive written warnings (enough of which result in termination) for using more than 6 sick days in a year -- regardless of how many unused sick days you have.
• You receive written warnings for calling off "in a pattern", so do not repeatedly get sick on Mondays.

But all those are reasonable compared to our insurance system and medical costs. We believe in having high end training, equipment and diagnostics and then erecting massive barriers of cost and red tape to keep the riffraff from having access to them.

If you don't have health insurance (which is like 1-in-6 of americans or about 50 million people), you are generally looking at well over $100 for even the most basic checkup, and actual stays in the hospital are in the neighborhood of $10,000 per night.

If you do have insurance, you are probably paying $200 a month (individual) or $500 (family) for it and you are still looking at minimum of roughly $50 out of pocket (co-pays and deductibles) anytime you visit anywhere. And that things that are supposed to be covered by your insurance will mysteriously not be and you will receive extra bills in attempts to get both you and your company to pay for it and/or bills that are just barely too low to be worth fight the red tape over (my optometrist last month).

For anecdotal cost comparison purposes:
The dental work I had done last year (4 quadrant oral surgery to correct mid-stage periodontial disease) cost me a bit over $3,000 out of pocket, wtih my employer sponsored insurance kicking in roughly another $6000. The private root canal I had done back in 1993, when I was uninsured cost me roughly $1000 out of pocket.


Now the Affordable Care Act (Obamacare) is an attempt to allow more people access to insurance and to help slow the explosive growth of costs - but it's not in full effect yet so how it changes things will take a few years to see.

[Prak]

And that things that are supposed to be covered by your insurance will mysteriously not be and you will receive extra bills in attempts to get both you and your company to pay for it and/or bills that are just barely too low to be worth fight the red tape over (my optometrist last month).

Has anyone ever sued their hospital over this sort of thing? I know that it happens, and for the reason you say, which is basically blatantly illegal, but has anyone actually tried to bring it to court?

[fectin]

Well, remember that your insurance is between you and your insurer, and your medical services are between you and your doctor. They will often bill for you as a convenience though. So, if you roll up to a doc and get him to whatever crazy thing (or non-crazy, but crazy is clearer), you're on the hook for paying for it. So, say you got your spleen gold-plated. The doc wants his money from you, because he did the galvanizing like you asked. The insurance company is unwilling to pay, because they only cover copper-plated spleens. But the doc doesn't go after the insurance company, any more than he goes after a bank if your checks bounce. He goes after you.

If you end up seeing that a lot, it's probably because your insurance providers are scum-sucking shitweasels, and you may want to consider taking your business elsewhere.

[tussock]

How do people treat themself in different countries? I mean illnesses - cold, flu, etc. Can medicine be bought in stores? Is self-treatment practiced?

In NZ under-5 kids are free, under-18 or unemployed/retired have a nuisance fee (~$20 to see a doctor and ~$5 for any medicine up to three months, any referrals are free from there). Fees for the gainfully employed are capped at about $60 to start that ball rolling.

Getting admitted to hospital for surgery or observation or whatever is free, other than time filling in forms and stuff. If you're in a car crash or have a heart attack or whatever the government sponsors charitable rescue helicopters and ambulances at major hospitals, many of which will ask you for a "donation" of about $250 which almost everyone pays.

Getting put in waiting-to-die facilities for old people costs about $600/wk and the government takes a share in your house and shit if you can't pay, but those places are private for-profit and kick them back to hospital if they get properly sick and stop being worth money. Caring for long-term debilitated people is mostly done in-family with some free trained support staff time, and you can almost get the equivalent of a full-time minimum-wage pay for it if everything checks out (repeatedly, the constant reassessment is pretty stupid).

People mostly go to work with colds, but it depends on employer attitudes, some places suck and some are awesome. Legally your boss can screw you for "suspicious" sickness patterns, but that's new and doesn't seem much used. Takes a couple days to get an appointment for a doctor if non-emergency, and referrals anywhere from immediate to several years (legal limit of six months isn't followed) depending on what's wrong and the local budget blowouts.

Insurance or private funds lets you skip the queues and get whatever surgery you want when you want it at private hospitals. Most of them are tiny and a good deal of the leadup and followup work is covered by public health anyway. Any dangerous complications go public for free.

There's elected health boards for population groups of around 200k+. They dish out their centrally allocated budget as advised by the local senior doctors/administrators and various other beggars, and a lot of places run out of money each year and have to borrow or extend the waiting times on various things because the funding model doesn't account perfectly for differing population needs (old age being a real drag locally).

Sometimes hospitals run targeted fund raising schemes to cover particular shortfalls, and that usually gets enough people embarrassed to increase the central funding.

We had some pretty bad local fraud a few years back that didn't help, because some people really will steal money from sick children. But that guy is never getting out of prison, and is universally hated, so it's not going to be common.


Oh, and there's a centralised employer- and tax-funded no-fault accident insurance scheme (ACC) that technically pays for everything resulting from collisions (accidental or otherwise, including jogging strains and muggings and whatever), including lost wages, and legally prevents people suing each other for all sorts of things.

[name_here]

How do people treat themself in different countries? I mean illnesses - cold, flu, etc. Can medicine be bought in stores? Is self-treatment practiced?

In my region of the US, people generally stay home and only see a doctor if they've been running a high fever for three days or so. Medicine... depends. Firstly, over-the-counter medicine (low-end pain relievers, cough medicine, decongestants, and suchlike) is just on shelves and can be bought at a convience store without any restrictions. There's also some called behind-the-counter, notably certain types of cough syrup, which can be bought but gets tracked because it can be used for making meth or suchlike. High-end painkillers, amphetamines, most ingested antibiotics, and similar require a doctor's prescription and can only be purchased from licensed pharmacists. There's a convience-store chain called CVS that has pharmicists in most of their stores, so everyone I know usually fills prescriptions through them. I also filled prescriptions in a pharmacy located in a hospital on-campus for a while, but then my insurance stopped covering it through them and I could not summon up the will to find out why, so I've been going to a nearby CVS instead.

[Nachtigallerator]

Health insurance in germany is crazy. But let me start with the cold example like everyone else:
If you get a bad case of cold in germany, you probably will go to a doctor - it depends a bit on how tough people consider themselves to be and if they need an attestation for school/work, but it's usually possible to just prop yourself in a general practitioner's waiting room and wait until he has five minutes for you, they expect that kind of thing. Everybody BUT GPs is usually a bit harder to reach - some specialists allow you to take your chances in the waiting room, others want you to make an appointment before showing up at all. How long that takes depends on time of the year and specialty - orthopaedists take notoriously long, and every kind of doctor takes long if you're trying to get in close to the end of a quarter. Reimbursement by insurance for doctors in a practice is fixed at a certain sum for every three months and it would require bureaucratic work to justify larger expenses, so most doctors don't want you to show up when they're not earning anything from your custom.
Now, you've come with a cold, so after some short talk, you'll get your certificate of being to whacked for work with no problem, and if you pester the doctor hard enough, you might even get a prescription for useless antibiotics. Which leads us to medication:

The usual self-medication is available over the counter in pharmacies, and the cities are full of pharmacies, so you can get that Acetaminophen to kill yourself (for the benefit of american readers; it's "Paracetamol" in germany) almost everywhere. Most stuff that's not for trivial conditions requires a written receipt from a doctor just so the pharmacy can legally sell it to you - i.e. pantoprazole against reflux disease needs a new prescription every now and then. Narcotics require a special prescription. Dealing in Marihuana is forbidden under german criminal law like it was heroine, so medical Marihuana requires a super-special one and a new special authorisation every once in a while, so it's not an option for most people.

German hospitals are notable in for performing more joint/spinal column operations and hearth catherizations than any other european country. There are some comittee records of how well hospitals do at what kind of treatment, but they're very hard to find and not neccessarily published by the hospitals themselves, so you'll have to dig a little or rely on word of mouth if you want to find the best for a particular procedure. We also have too many hospitals of various financial backgrounds (state-financed, state-financed but run by a church, privately financed) so they're fighting tooth and claw for survival and your surgeon might be a bit more inclined to do the procedure that will pay his hospital the most money.
Note that hospitals used to be paid for every day a patient was occupying their beds and had the tendency to keep people over the weekend with just about everything. Now they get a fixed sum of money depending on a patient's diagnosis; so they're now trying to get it over with as quickly as possible to free up the bed and get paid for the next guy.

German health insurance! Most people have some form of public health insurance, of which there is truly ridonculous number available. Public health insurance is usually quite good: I'm a student and my mother pays fees at the Techniker Krankenkasse, so I get my health insurance completely for free. While they won't pay for everything, we have a state level comittee that decides what things they have to pay for you. Therefore, if you're hospitalized, your exact public health insurance won't matter. Different public insurers differ in the discount agreements they have with pharmaceutical companies and also in whether or not they will pay for fancy and popular nonsense like acupuncture or homeopathy.
Now! There's also private insurance, but to get private health insurance, you have to earn a certain amount of money first, otherwise the german state won't allow you to screw yourself by ditching the public health insurance you most likely had before. However, if you're a civil servant, you basically have to get private insurance (because it was legally made so that public health insurance would be impractical for you as a gift to the private insurance industry). Private insurance works like this: When you're young and healthy, your fees are low, and they still pay for all kinds of expensive stuff, so doctors are more inclined to give you the full MRI experience for back pain and possibly operate on your spine for a dislocated disc. However, the older and sicker you get, the higher your costs are and the LESS stuff they pay for you - and you also can't get back to public insurance because you ditched it!
tl;dr: Private insurance sucks because they can't actually make money by having less patients insured and paying MORE for each of them without billing you hard eventually. Recent legislation forces private insurers to offer some basic stuff to everyone, so it's not quite as bad as it used to be for old and privately insured people.

Any questions left?

[Longes]

German health insurance! Most people have some form of public health insurance, of which there is truly ridonculous number available

I have AOK student insurance. I should probably read what it pays for.

[Orca]

Some small points on NZ's situation; a fair range of drugs are now not available over the counter because they may be used to make illegal drugs, though they aren't illegal themselves. Anything with pseudoephedrine in it, or painkillers that aren't aspirin or paracetamol. They might be available in small amounts if you're willing to wrangle with bureaucracy for a while, but the controls are always getting stricter.

The public system buys most drugs that people take, which is really good for price control and pretty bad if the cheapest drug available for a given condition doesn't help you. I've personal experience with that. Wages are quite a bit lower than in most of the developed world so going outside the system is impractical for most.

[name_here]

Oh yeah, wait times and insurance.

In my experience, usually you can get an appointment with a general practitioner the next weekday. There are also walk-in urgent care places and hospital emergency rooms, in case you want to be tested for strep throat over the weekend or you have suddenly graduated from persistent cough to coughing up blood, but there's the risk of getting stuck in an extremely long line, since severe cases get priority. More specialized stuff takes forever; dentists and eye doctors are booked solid months in advance.

Insurance and pricing is an insane nightmare wherin the companies do their level best to take all your money and then find ways to not spend it on you. There's a crazy pricing race where hospitals set prices via dartboard because the insurance companies have negotiated them down anyways.

[Nachtigallerator]

@longes: As I said, the differences are fairly negligible, because all public insurers recieve money from public health insurance and have to pay anything that the GBA (I failed my english check above, it's a federal comittee) says they have to pay for. A physician would have to tell you specifically before he does something your insurance won't pay for.

Because the actual billing for the doctor's work is done between the doctor and the local assossiciation of statutory health physicians, you're usually not party to the treatment contract at all - if the doctor feels he won't get his money from the association for something, he'll have to make a new contract with you specifically.

True story: A dermatology practice gave me two contracts when I first showed up. The first was for sharing patient information with other providers (which I signed) the second was to oblige me to pay, cash or EC, immediately whenever they would use a specific diagnostic microscope for skin lesions that the GBA has, so far, not decided to include in the master list of stuff public insurers have to cover.

I didn't sign that, because it's sure as hell not needed for acne and I won't be needing a skin cancer checkup for a few years to come.

[name_here]

Private insurance in the US works similarly, except the negotiation is between the insurance company and the hospital. Most insurance companies have a "network" of doctors and hospitals they cover and have negotiated rates with, and cover less if you go out of the network for treatment. Individuals are on the hook for paying for any medical procedure they receive if they can't get their insurance to pay for it. At least at present, most people get their insurance through their employer, but the Affordable Care Act made a ton of changes to make it easier to purchase health insurance on an individual basis.

As I alluded to before, costs for everything are a byzantine nightmare. Firstly, payment is for procedures performed instead of outcomes, and some procedures are much more profitable than others. And hospitals don't like to talk about how much they cost, and last year information about the costs they reported to Medicare for a given procedure was publically released and it turned out prices for a given procedure could vary by three hundred percent between hospitals for no reason whatsoever. Also, apparently when they bill people they stick in wildly implausible charges like 60$ for a gauze pad. But that's okay for people with insurance because the companies point out that's obviously bullshit. Instead they must contend with insurance company pricing.

If people get insurance through their employer, then it's a fairly simple matter, but direct individual purchases calculate premiums in an obscure and non-uniform manner. But then there are co-pays and deductibles which are apparently assigned in a completely random manner. But more significantly, random crap might or might not be covered. Psychiatric treatment, contraceptives (until recently), and cosmetic surgery (which can be rather loosely defined) were commonly left uncovered, but basically anything might be left out or a given location might not be covered. Which is a serious problem because the direct prices for things are much higher; when I had insurance coverage from the hospital pharmacy my copay was... something less than twenty dollars, I'm not entirely sure it was the same each time. The prescription's direct cost there was more like two hundred dollars.

Oh, end of life care. People who are given six months or less to live can be admitted to a hospice care facility, which is supposed to be comfortable way to spend your last days instead of repeatedly undergoing invasive and probably futile surgery. However, there was a fuckup with price incentives. Medicare pays hospices at a fixed rate per patient per day regardless of treatment. Thing is, taking care of hospice patients is most expensive near the beginning while things are getting sorted out and near the end when people are constantly dosed with painkillers and final arrangements need to be made. So hospices have been making an effort to get lots of patients who live longer than six months or indeed are not actually terminally ill.

[Koumei]

Compared to the same amount of soft drink (say, Coke), how fattening is cider?

[Username17]

Compared to the same amount of soft drink (say, Coke), how fattening is cider?

Alcohol calories are pretty much exactly the same as sugar calories in terms of what goes on your belly. Coke and Strongbow are both about 400 Calories per liter, so it really doesn't matter which you're drinking only how much.

-Username17

[Koumei]

Ah cool. In that case, I shouldn't expect to gain much weight, as I'm basically changing from Coke to Somersby, and it wasn't in vast amounts to begin with.

[Blade]

Alcohol (especially in large quantities) can mess with your digestive system, though. Since your liver is busy with alcohol it won't necessarily process the rest of the food as well as it does without alcohol, which can lead to weight gain.

[Koumei]

Eh, it's not like I've decided to pursue alcoholism as a career, I'm just changing my poison for a little while.

[Prak]

I hear that's popular with people who work at schools.

[Starmaker]

It's -25 C outside, drier than dust inside, and I have atopic dermatitis. I know from past experience IV drips are good, but the "free" doctors are pandering to their corporate overlords and prescribe anti-aging creams, and I can't afford to pay out of pocket. Halp.