(subj: pharmaceuticals)

The prices for generic for one seizure medication are like this:
Membership warehouse (cough, Costco) – $90/month
Walmart – $100
CVS and everywhere else without magic Internet coupon cards – $800, give or take a couple hundred (went down to $350 at CVS with the coupon)

This is why pharmaceutical/health care legislation is so frustrating, because the Yes people say that voting No is gonna let companies charge whatever they want like that Shkreli piece of work, while No people say that voting Yes is gonna make companies just withhold important medical therapies from everyone. I personally think that both sides could plausibly be correct. So you’re damned if you do and damned if you don’t.

And this is “just” a dog we’re talking about. If owners really can’t afford it then there’s no ethical obligation against putting pets “out of their misery”. Which sounds AWFUL and is not an option that I’m willing to consider for my dog but not everyone has Costco membership and not everyone can spare an annual cost of $2K ($10K if you’re going to CVS or Rite Aid without the magic card) on an animal.

But PEOPLE are using the SAME medicines, you know? What happens when somebody has to say, “This medicine works better than the other ones but because it’s not locally available, or because of the prohibitive price, I’m gonna soldier on with a different medicine that doesn’t help as much or gives me more side effects or both”?

As a public sector employee, I have pretty darn good health insurance coverage and basically don’t have to worry about myself but I’m sure many people don’t have that. They’re no less at risk of having to live with lifelong conditions than I am. Some of them are covered through private employers (but the success of private companies, a.k.a. their ability to provide those benefits, can be mercurial even without the risk of sudden termination when like Microsoft decides to prune some branches) but some (like small business owners, the self-employed) have to wrangle it out with insurance companies on their own, like the little old lady in The Incredibles trying to understand how her policy doesn’t cover what she needs. They’re not that much better than a pet with no pet insurance (or a pet with pet insurance, honestly, as many pet insurances only cover accidents).

What do you say to them? Good luck?

I’m trying to understand something.

Some people might call it social anxiety. What I’m trying to plot out is how it’s self-defeating.

So far, I’ve got it compartmentalized to two major modes: reactive and proactive. And the more I think about it, the more I think that it’s one big self-defeating sine curve that cycles through the reactive and proactive modes.

Reactive runs kind of like this:

  1. I can’t tell if people enjoy my company or not, so I will let them decide when to invite me to things.
  2. People who actually like me will continue to spend time with me, indicating that they genuinely enjoy my company. I can avoid forcing people who dislike me to spend time with me out of politeness.
  3. But, they will stop liking me because I’m too passive, or they will come to think that I dislike them.
  4. So, waiting for other people to do all of the reaching out is socially an unsustainable practice.

And so the switch flips to proactive:

  1. People who would enjoy my company may not know that I would also like to hang out and talk to them if I don’t show that I also enjoy their company. I will take some initiative to talk to people.
  2. So, people won’t think that I’m too passive or that I dislike them.
  3. But, because I have trouble reading social cues, I may bother people who dislike me, or people who didn’t mind me at first will start to find me annoying and intrusive on time that they’d rather spend with other people or in solitude.
  4. So, I’d better not be pushy and let others take the lead.

Around and around it goes.

Naturally, normal people will probably find this totally bizarre because obviously, everyone needs to find a balance doing a little of both, read the situation, etc. The problem is that socially anxious people either don’t have confidence in their ability to interpret how other people feel about them accurately (i.e. paranoid that people are just being polite but really trying to get rid of them), or they actually don’t know how to read the situation and are painfully aware of the effect that they have when they make a faux pas but they really struggle with the learning curve. (People who don’t know how to read the situation and are unaware of the effects would be weird but not socially anxious, and people who do know how to read the situation and intentionally cause those effects would be creeps.)

For the first group, they’re the people that a lot of general advice that people hear about social anxiety is geared towards. “You’re OK, it’s the irrational anxiety and the anxiety alone that needs to be fixed.”

For the second group, my guess is that the problem could be that they have trouble thinking outside of black and white. For these guys, it’s super easy when 1 + 1 = 2, but when you’re dealing with “A increases the probability of B, C decreases the probability of B, and A and C are both present in different unquantifiable degrees, now figure out whether we’re leaning towards yes or no on B,” they either get stuck trying to convert it into quantifiable terms that they understand (where normal people kinda just eyeball the situation), or they just get thoroughly confused because it doesn’t even make sense to them because that’s just not the way that their minds think. I don’t know if all that made sense at all, but it’s OK if it doesn’t because it’s just an idea. I mean, any other ideas are welcome, too.

I wasn’t planning to go anywhere with this. I just thought that it’d be worth writing out, because it was kind of swirling around in some squint-inducing mess in my head and I couldn’t think straight. I wonder if that happens to everyone else, where you start thinking about something with no actual goal. Like you have a need to have it all articulated out but you’re not ready to rush to any kind of persuasive conclusion. For whatever reason, K – 12 left me with the strong impression that all serious-er attempts at writing have to turn themselves into a persuasive essay with an intro, body, and conclusion. But I’m just writing to detangle my own head and I don’t think that it makes sense to force myself to yank the detangling threads to the end as long as they’re mostly straightened out for now, and yanking often breaks the string, creating a sloppy or totally wrong conclusion anyway…

But yeah, social anxiety! I couldn’t tell you why I was thinking about it, though.