u/tkpwaeub

1. Retro pay doesn't accrue interest when it comes late. By contrast, every bill you pay does.

2. Side letters are a thing. They can be added at any time by mutual agreement between the state and your union.

3. Political action is a thing. All public sector unions in NY have statewide and regional PACs that advocate for legislation that benefits their members.

Today, SCOTUS ruled that the White House can exert direct control over administrative agencies; heads and acting heads are now at will employees.

Why does this matter for S&P ratings?

S&P, Fitch, and Moody's are nationally registered statistical rating organizations - NRSRO's. That's what gives their ratings "official" status. Without that - it's all talk. We trust these entities because we have been able to assume, until today, that their practices have been carefully evaluated by an impartial, apolitical arbiter - the SEC, which for all intents and purposes, is now synonymous with "Trump."

But there's more. In addition to the SEC, Trump now controls the Library of Congress, directly. A huge part of S&P's value is its intellectual property - and Trump can now weaponize copyrights.

Finally, there's non-profit status. S&P is a 501(c)(3). They are now at the mercy of Trump if they want that status to continue.

Can states do anything about it? Like giving S&P their "imprimatur" if the feds don't? Nope. State and local government websites are at the mercy of CISA - aka Trump - if they wish to continue using ".gov" in their websites.

We are royally screwed. As of today, there's no longer an objective, publicly accessible way of assessing whether a company is worth investing in.

And this will persist even after our current POTUS is gone. S&P ratings will be permanently politicized, going forward. If a left-wing President thinks a company isn't "green" enough or has ties to Israel - it can say bye-bye to its S&P ratings. Ratings will no longer indicate objective reality, but the whims of whatever President is in office.

So that will be my answer next time someone asks how I lost 70 lb in 6 months

Section 9.1 (m):

>Pediatric vaccines shall be administered consistent with the guidance provided by the Centers for Disease Control (CDC) and Prevention Advisory Committee on Immunization Practices (ACIP) or other federal or State entity. The Plan may also follow the recommendations of the American College of Pediatrics, American Academy of Family Physicians, and American College of Obstetrics and Gynecology.

And

Section 9.1(w)

>The Plan may also follow the recommended guidelines for adult and pediatric vaccines set forth by other medical professional organizations.

Phew

We don't know yet whether CSEA's contract has similar language (LLM's won't help you here, since this is a black hole right now - there's literally no official published info so you'll get pessimistic hallucinations)

I should add that this is post is in no way meant to advocate that you should or shouldn't vote for the contract. It's a specific aspect of the contract that I happen to like, and that's the extent of it.

Friendly reminder: take a look at the difference between what you'll be contributing under the new Tier 6 and what you would be contributing under the old Tier 6, and put the difference in deferred comp.

www.nysdcp.com

The ACA sets MLR at 80%.

States could set it at

0.8 + 0.2 * P/(P + 5 billion)

​

To start with: I'm largely pro-single payer. Medicare for All is the right idea. Here's why I can't get on board with it, in its current form.

One of the big talking points in advocating for single payer in the US is that other countries do it. That's true - there are seventeen other countries that have single payer models, where everyone is automatically enrolled in a government health plan covering medically necessary health care.

Here's where the M4A bill, introduced in every Congress, loses me. It comes down to one section:

>(a) In General.—It shall be unlawful for—

(1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or

(2) an employer to provide benefits an employee duplicates the benefits provided under this Act.

Remember those seventeen countries that we like to hold up as role models? Guess how many of them have strict prohibitions on duplicate coverage?

....zero

We can't have it both ways, folks. If we're gonna argue for M4A based on precedent, then you gotta check whether those supposed precedents are actually valid. And the simple fact is they aren't. The country that comes closest to strictly prohibiting duplication is Canada, but:

(1) the bans are provincial, not federal

(2) Canada's single payer system isn't comprehensive (for instance, dental isn't included)

(3) Canada has a population that's barely a tenth of ours

I'm not sure if this section persists because of a significant overlap between M4A and "eat the rich", but whatever the reason, it sucks. If it's about keeping the CBO score down, there are better ways - like making private health insurance post-tax to the extent that it duplicates single payer.

Maybe the concern is that having a parallel track would allow a few privileged folks to jump the line - but there's nothing to stop that in the bill anyway, since people can always pay out of pocket. And all single payer countries allow that, too.

Allowing duplicate coverage allows people with moderate incomes to set aside some money in case they might need services a little faster. They aren't rich, they're just risk averse and would rather toss some of their discretionary income at health insurance.

Last summer I ruptured my Achilles tendon. I was fortunate that I was able to get surgery within a week. It's considered medically necessary care, which is why it's covered by most public and private plans. It's also time sensitive - the sooner you get the surgery, the better. That goes for a lot of surgeries.

Or, my grandfather, a village policeman in the north of England. Modest, working class. Late in life he developed Depuytren's Contracture, an excruciatingly painful condition that causes one's fingers to curl inwards. It's covered by NHS, but the wait times were too long, so he used his pension plan's health benefit.

Under M4A, in its current form, *only rich people get to do that.* A ban on duplicate coverage fails to account for nuances like:

- Different pain tolerances

- Different levels of risk aversion

- Different lifestyles

In other words, a failure to look at the "whole person"

Let's get rid of this section already.

To start with: I'm largely pro-single payer. Medicare for All is the right idea. Here's why I can't get on board with it, in its current form.

One of the big talking points in advocating for single payer in the US is that other countries do it. That's true - there are seventeen other countries that have single payer models, where everyone is automatically enrolled in a government health plan covering medically necessary health care.

Here's where the M4A bill, introduced in every Congress, loses me. It comes down to one section:

>(a) In General.—It shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits an employee duplicates the benefits provided under this Act.

Remember those seventeen countries that we like to hold up as role models? Guess how many of them have strict prohibitions on duplicate coverage?

....zero

We can't have it both ways, folks. If we're gonna argue for M4A based on precedent, then you gotta check whether those supposed precedents are actually valid. And the simple fact is they aren't. The country that comes closest to strictly prohibiting duplication is Canada, but:

(1) the bans are provincial, not federal

(2) Canada's single payer system isn't comprehensive (for instance, dental isn't included)

(3) Canada has a population that's barely a tenth of ours

I'm not sure if this section persists because of a significant overlap between M4A and "eat the rich", but whatever the reason, it sucks. If it's about keeping the CBO score down, there are better ways - like making private health insurance post-tax to the extent that it duplicates single payer.

Maybe the concern is that having a parallel track would allow a few privileged folks to jump the line - but there's nothing to stop that in the bill anyway, since people can always pay out of pocket. And all single payer countries allow that, too.

Allowing duplicate coverage allows people with moderate incomes to set aside some money in case they might need services a little faster. They aren't rich, they're just risk averse and would rather toss some of their discretionary income at health insurance.

Last summer I ruptured my Achilles tendon. I was fortunate that I was able to get surgery within a week. It's considered medically necessary care, which is why it's covered by most public and private plans. It's also time sensitive - the sooner you get the surgery, the better. That goes for a lot of surgeries.

Or, my grandfather, a village policeman in the north of England. Modest, working class. Late in life he developed Depuytren's Contracture, an excruciatingly painful condition that causes one's fingers to curl inwards. It's covered by NHS, but the wait times were too long, so he used his pension plan's health benefit.

Under M4A, in its current form, only rich people get to do that. A ban on duplicate coverage fails to account for nuances like:

• Different pain tolerances

• Different levels of risk aversion

• Different lifestyles

In other words, a failure to look at the "whole person"

Let's get rid of this section already.

Anyone else notice that their agency's intranet has become steadily enshittified?

I'm a PEF shop steward and I'm at the point where I think this a legit Labor Management topic.

Look for 421-a apartments in buildings that

- have more than 10 units

- have a certificate of occupancy prior to 2009, or have a certificate of occupancy that turns 30 years old before the 421-a expires

That way you'll at least remain covered by GCEL

The way the statute is written, "preventive care" is defined as

- immunizations recommended by ACIP

- A or B rated recommendations from USPSTF

- recommendations from HRSA for children and pregnant women

That worked fine until RFK Jr came along.

But maybe there's a better way. Currently health insurance companies don't much care about long term health because

- you might not be their customer forever

- if you die, that actually saves them money (sure, they don't get to collect premiums from you, but at that point you're probably a bad risk, and if you croak they get you off their books)

Here's my idea, which could be implemented at the state level: require health insurance companies to price in term life insurance that lasts as long as you hold your policy, plus an additional ten years.

I realize this might need some refinement, but it's a start.

I find I need a day to pretty much fast beforehand, and then I need a day to recover afterwards.

Anyone else?

How are other folks dealing with this? Semaglutide has worked astonishingly well for me (about 70 lb since December) but there's this..."loose" end

The unlikely source is the show Better Call Saul:

>One day, you're gonna wake up, eat your breakfast, brush your teeth, go about your business, and sooner or later you'll realize that you haven't thought about it. And that's the moment you realize you CAN forget. And that's when it gets a whole lot easier.

Obviously the "it" is something completely different. But it works.

A lot of folks have posted about qualifying for various types of disability as a result of this wretched injury. It appears everyone's experience is different, because it varies depending on age, line of work, and jurisdiction. This type of "formal" disability determination has a lot to do with eligibility for various services, reasonable accommodations with one's employer, insurance claims, and, well, money.

But then there's the more informal "disability" concept that's entirely at your discretion. So you shouldn't feel guilty about using a seat in the front of a bus, getting a tag in your car for using a handicapped spot, or using an elevator instead of the stairs. Maybe not every single time, but when you feel like it's warranted. For how long, we don't know. I guess if we get dirty looks, we can flash our scars.

Indeed, this is arguably the responsible choice. You're not doing anyone any favors by trying to be a hero here, by risking becoming more disabled than you already are! Remember that's what "universal design" is all about - improving accessibility options for folks who are already disabled, and helping prevent those of us in this gray area from joining their ranks.

Anyone else having issues? While updating my mobile ID app on my phone I flunked a "liveness" check.

About eight months ago I ruptured my Achilles and had surgery.

Today I did The Great Saunter - a 32 mile walk around the perimeter of Manhattan.

It doesn't make our jobs any easier. I don't want to read three pages of citations regarding a relatively simple issue - often one that's otherwise got a lot of merit. Neither do field reps/LRS's. It makes our jobs harder, not easier.

Write your grievance in your own words. The time for legalese is in the arbitration step, if warranted. And PEF and CSEA have attorneys.

Aside from making our lives harder, it also hurts our feelings. How would you feel if someone did that to you?