Applies to pre-tenure professors (on the tenure track) as well. They do research/writing during this time if they want to be promoted. But once you reach the highest rank (full professor), there's not much your university can do if you aren't productive.
Many professors are of course still motivated by internal drive, but there aren't strong external controls that can be exerted.
This is a hard one for me. My wife and I want/need a good plan. One that doesn't require us to get referrals, and has good coverage for medication. I would happily pay for this plan, but I can't seem to find one on my own. Nothing is comparable to what I currently have through my employer.
In the US, decent health insurance plans are all corporate. Particularly if you want something non-HMO with reasonable out-of-state coverage.
A few states have laws on the books which compel health insurance companies there to sell corporate health insurance plans to sole proprietors and single member LLCs. Florida is one example.
(Florida also tends to have some of the best health insurance options in general in the US, at least as of several years ago.)
Sadly, just because the state law says health insurers must sell corporate plans to sole proprietors and single member LLCs doesn’t mean those health insurers will happily sell you a corporate plan without a fight. For example, I tried to buy a corporate health insurance plan via a Florida sole proprietorship, per the state law. Every Florida insurer I contacted refused to sell me a corporate plan.
I ended up calling the FL regulators who ensured me Florida law indeed does compel these companies to sell me the plan. They either just didn’t want to sell me the plan, or their corporate division was entirely unfamiliar with working with sole proprietors. I left the US shortly thereafter.
If I were in the US, I’d try for a corporate plan again, maybe even in Florida. Unless something has changed, the alternative is far worse. E.g. paying $600+ per month for a plan with essentially zero out-of-state coverage, a deductible so high it almost makes no sense to even have the insurance plan at all for a healthy young person, and a bunch of weasely out clauses that let them screw you over even if you pay them ludicrous sums of money. Plus if you’re on an individual plan, the health insurers tend to systematically deprioritize you compared to their corporate customers who have far more bargaining power than you do. I would sooner go uninsured, or leave the US entirely.
There are actually tons of studies that show preventive healthcare reduces spend later on. For instance, if you pay for someone's routine checkup you might catch a heart issue or cancer early. Both insurance companies and the government (Medicaid/Medicare) would save money by paying for preventative care.
An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without going into deductible.
I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere.
So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."
What, exactly, is a preventative check, if not a discussion with your GP about your current physiological status? Given the time described (15 minutes), and the lack of immediate diagnostics, it sounds exactly like what I would expect from a check-in with my doctor here in Canada.
The only other option I could see counting as a preventative check is a physical, which would be more involved than what was described.
It’s a matter of billing. A preventive visit does a set of screening and evaluation of results.
If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical.
And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.
So, yes, this is the problem. Healthcare should not be a business. It should be obvious that people who have been denied access before will come in to their first visit with multiple concerns, and the system should be accommodating to that without a massive "onboarding" fee. After all, it's not their fault that previous incarnations of said system did not supply care adequately.
If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked."
My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.
So you’re against how universal care is setup in Canada? Each visit has a billing code for a certain amount of work. If you brought up other issues you’d be told to make another appointment.
Of course not. Canada's healthcare system is not, at the point-of-care, a business. Whatever business arrangement that exists is between the government and providers, not me and my doctor, so the latter relationship is not directly constrained by economic concerns, as is the case here in the US. If that appointment had taken place in Canada - and let's be clear first that it would not have, as I would have been insured unconditionally since birth and able to deal with each issue as it arose - the doctor would have either helped set up a treatment plan then and there, or she would have let me know that it would require another visit or two to go over everything, as here.
The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.
It’s the same issue of billing for the doctor in Canada as the US.
The doctor gets paid $X for a preventive visit. If you start adding things on that will be flagged to ensure doctor get paid more, typically through additional billing codes.
The original comment was “why do I get billed more when I bring up issues during a preventative visit”?
In Alabama you cannot qualify for medicaid unless you are a "needy child, parent, caregiver, pregnant woman, or elderly/disabled resident". Meaning you can't qualify just for being low income.
While Amazon does provide decent health insurance, most lower income jobs do not.
I make good money, and have good health insurance and it would still cost me over $1k to go to the hospital. Imagine doing that with no health insurance while making $10/hr.
EDIT: You updated your comment so I'll add on. Sure, Amazon provides health insurance, but a lot of businesses don't. In 2020, ~31 million Americans didn't have insurance. Even if you have health insurance, premiums and deductibles can be astronomical.
So you learned "there are six continents"? That's really interesting. Growing up in the US, we always learned it as seven. I never really thought about that as something that was taught differently based on location.
(Unfortunately though, I think that ignorance is fairly common for a lot of aspects of life for people raised in the US.)
Side note: I was going to say "aspects of life for Americans", but realized Americans means more than just those in the US. So I propose a new term for "people from the US". USers. :)
No. The beams would overlap, which is fine of they are on different frequencies, but eventually you run out of frequencies to use. Fiber confines the beam to inside the fiber. No overlap between one fiber and another means you can run multiple down the same pipe.
Because a beam in an open medium always diverges due to wavefront errors and diffraction. A very good laser system might possibly have a divergence of only 1 microradians. For reference a typical laser pointer has a divergence angle of 1 to 2 milliradians. With the 2000km or so between satellites for Starlink the laser "spot" on the receiving satellite with the very good laser will be about 2 meter. Not enough to receive multiple beams on one satellite without overlapping.
Thanks for explaining. Would it work if they put receivers on a long pole, spaced 3m apart? Maybe they could mount them on the edge of the solar panel array, which is ~30m long [0].
The link estimates the surface of the panels to be 30m2. Since the panels are 3.1m wide the length would be 9.6 meters. But even at 30 meters it would be very very hard to engineer a system that can keep a laser beam aligned on a moving target with sub microradian precision. I'd guess Starlink laser are more divergent to make hitting the target easier. Keeps the exit pupil a manageable size too (narrower beams need bigger optics).
