𝕽𝖚𝖆𝖎𝖉𝖍𝖗𝖎𝖌𝖍

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 𝕽𝖚𝖆𝖎𝖉𝖍𝖗𝖎𝖌𝖍 𝖋𝖊𝖆𝖙𝖍𝖊𝖗𝖘𝖙𝖔𝖓𝖊𝖍𝖆𝖚𝖌𝖍 
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Cake day: August 26th, 2022

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  • I would love to hear the author’s justification and examples. And then I’ll repeatedly slap them in the head with Player of Games, where one of the characters changes genders every couple of decades and it’s unclear whether anyone remembers what they started out as because it’s utterly irrelevant to everyone.

    Also, seriously yeah, WTF? Several of The Culture’s major operatives - their James Bonds, their spies, counter-spies, and black ops - are women, and to my recollection the only agent that used sex as a manipulation tool was a man.

    Of all the terms you could try to insult Banks with, “mysogynist” utterly misses the mark.











  • I can’t answer why you’re getting calls, but I’d be suspicious.

    It’s where your primary care physician goes independent and stops accepting insurance. You pay them a flat fee a couple of times a year, and get their service for free. That is, you’re obviously paying them whether you use them or not, but you don’t pay them every time you see them.

    You still need insurance, to cover things like specialists, and many tests the doctor performs - blood work, etc - can still be billed to insurance. But you go to a flat fee for your doctor.

    My wife and I did it because our primary care physician, who we’ve been with for years and like, went concierge; we decided to stay with her despite it costing more than to switch to a different doctor.

    Many things changed, mostly for the better.

    • It is more expensive
    • We get appointments with her often the same day - no more scheduling three weeks out
    • We have an instant messaging app, and message her any time, and get a response within minutes up to a half hour. I’ve messaged her on the weekend and gotten an immediate response. She’s not the only one who answers - her PAs field some stuff, like appointments, but getting the immediate response is fantastic
    • We no longer worry about co-pay or getting bills from her. Unless there’s lab work, all we pay is the bi-yearly fee. The emotional value of feeling free to contact her any time about anything can not be undervalued
    • She loves it because, apparently, working in a clinic is hell for physicians. Shitty records systems, slow information responses, bureaucracy, crammed scheduling. She’s happier.
    • I have yet to have to wait to see her. If I have an appointment, any time of the day, I show up and she’s ready. No sitting in the waiting room for a half hour.
    • We’re able to hold cheaper insurance, because we’re paying for the GP out of pocket.

    There is really the only one downside: insurance does not cover concierge, and it is not cheap. It’s within reason for middle class, but it’d be utterly unaffordable for lower or lower-middle class. It’s totally entitled. OTOH, if we had a single payer universal healthcare system, or if every provider were concierge, healthcare would be cheaper all around and maybe it’d be affordable.

    Anyway, we did it because we followed a doctor. I don’t know that I’d jump into it with a provider I didn’t know. In our doctor’s case, she only offered it to her existing patients and doesn’t take on new ones (or, not often), and keeps her work load more manageable; I’d expect this to be common.

    If insurance is trying to get you to do this, there’s an angle and I’d be suspicious. Either because they have to pay less (because concierge fees aren’t paid by insurance); or some company has figured out a way to “give you insurance” where you pay them and they pay the concierge fee, in which case they’re just a middleman skimming money and you’re paying more.

    We are extremely happy with our concierge service, but we love our doctor, we can afford it, and it’s been a massively better experience for us. But that’s us. YMMV.