I’ve started doing Google reviews of these “fee” places, giving an honest opinion of food/services received and adding a simple statement of any fees added to menu prices. At least it makes it a little more visible.
The reimbursement rates for therapists is insane. When I look at my EOB, my psychiatrist gets paid just under $100 for a 25 minute medication maintenance session.
According to insurance rules, this includes any administrative work like filing the claim, booking appointments, office staff, etc. And if I email my doctor, that’s covered under that $100.
I’d have to double check this but I don’t think his reimbursement rate has gone up since I started seeing him 5 years ago.
And this is for a medical doctor. I imagine a talk therapist the reimbursement rate is lower.
I’ve seen therapists both in and out of network and the ones out of network are more attentive. I don’t feel as rushed to get out the door and they don’t overbook. It sucks that this basically means only rich people can see them.
We really need to reform healthcare in this country.
I am a therapist. I take insurance but it’s a goddamn nightmare
You either join a group practice (goodbye at least 40% of earnings) or you try to go it alone
If you go it alone: hello navigating the maze of bureaucracy that is insurance credentialing and billing. Good luck! No real guidance here. There are some “tutorials” online but they’re super generalized because everything is very different on a regional level. Aetna in Atlanta is entirely different from Aetna in New Jersey. Then you can also play the game of “guess how much money I will make?” Because none of them tell you until you’re about to sign the contract (and some don’t tell you until after!). Or you can pay someone to do all this for you for like $1000. Also it takes months. Then you have to figure it all out again to figure out how to bill. Then you have to figure it all out again to figure out how to bill electronically because you bill on paper the first few times to get payments and then use the payment numbers to set up accounts to actually bill the normal way. Or again you can pay someone to bill for you for like 5-10% of your earnings.
And all of this is while you’re a 1099 worker so no health insurance, paid time off, retirement, etc
Alternatively you can in some places join a hospital system. These will sometimes pay you a salary and benefits but will usually pay a shit salary, crappy benefits, and give you a nightmare quota and ask you to supervise interns. Or work someplace like an IOP and run groups but again you’ll make like 40-50k tops with crappy benefits (and the student loan debt of someone with a masters degree). Plus a lot of those places will still keep you as a 1099, at least around here.
So then the community mental health/medicaid agencies cry about why they can’t keep staff and the mental health crisis facing low ses communities (hint: it’s because you pay $30/hr as contract workers to people with 100k+ student loan debt)
Then people run from those places to group practices and stay there for a bit but eventually bail because they take 40% of earnings
Then they go independent and panel with insurers and it’s okay but also a fucking headache. They work 25 hours a week seeing clients and 15 hours a week unpaid doing paperwork to bill for said clients. All well and good except what the article wrote is all true, eventually you get a clawback where an insurance company is like “you wrote 90847 and you meant 90837, you could just correct and resubmit but we won’t allow that. You did it 15 times so we are demanding you return $8,000 thanks” also your quarterly tax payment is due tomorrow. Oh and your insurance billing has to be submitted timely but Aetna is 3 months late in paying you and owes you 6k. It will come, eventually, probably
Also all that admin stuff they refuse to pay you to do? They pay grow and headway and alma and all those other vc backed tech bro companies that started during Covid to “revolutionize mental health” lmao. They pay them $30-40 a session to do it. Shoulda made a website milking off other therapists with a sob story about how you were depressed and had trouble finding a therapist bro, you could’ve been a multimillionaire instead of some dipshit making 65k with no retirement savings
It’s hard to have a nuanced discussion because the article is so vague. It’s not clear what he’s specifically been charged with (beyond “obscenity,” not a specific child abuse statute?). Because any simulated CSAM laws have been, to my knowledge, all struck down when challenged.
I completely get the “lock them all up and throw away the key” visceral reaction - I feel that too, for sure - but this is a much more difficult question. There are porn actors over 18 who look younger, do the laws outlaw them from work that would be legal for others who just look older? If AI was trained exclusively on those over-18 people, would outputs then not be CSAM even if the images produced features that looked under 18?
I’m at least all for a “fruit of the poisoned tree” theory - if AI model training data sets include actual CSAM then they can and should be made illegal. Deepfaking intentionally real under 18 people is also not black and white (looking again to the harm factor), but also I think it can be justifiably prohibited. I also think distribution of completely fake CSAM can be arguably outlawed (the situation here), since it’s going to be impossible to tell AI from real imagery soon and allowing that would undermine enforcement of vital anti-real-CSAM laws.
The real hard case is producing and retaining fully fake people and without real CSAM in training data, solely locally (possession crimes). That’s really tough. Because not only does it not directly hurt anyone in its creation, there’s a possible benefit in that it diminishes the market for real CSAM (potentially saving unrelated children from the abuse flowing from that demand), and could also divert the impulse of the producer from preying on children around them due to unfulfilled desire.
Could, because I don’t think there’s studies that answers whether those are true.
Downloading and possession of CSAM seems to be a common first step in a person initiating communication with a minor with the intent to meet up and abuse them. I’ve read many articles over the years about men getting arrested for trying to meet up with minors, and one thing that shows up pretty often in these articles is the perpetrator admitting to downloading CSAM for years until deciding the fantasy wasn’t enough anymore. They become comfortable enough with it that it loses its taboo and they feel emboldened to take the next step.
CSAM possession is illegal because possession directly supports creation, and creation is inherently abusive and exploitative of real people, and generating it from a model that was trained on non-abusive content probably isn’t exploitative, but there’s a legitimate question as to whether we as a society decide it’s associated closely enough with real world harms that it should be banned.
Not an easy question for sure, and it’s one that deserves to be answered using empirical data, but I imagine the vast majority of Americans would flatly reject a nuanced view on this issue.
The problem is empirical data cannot be morally or ethically found. You can’t show a bunch of people porn and then make a statistical observation of whether those shown child porn are more likely to assault children. So we have to go forward without that data.
I will anecdotally observe anal sex, oral sex, and facials have gone up between partners as prevalence in porn has gone up. That suggests but does not prove a direct statistical harm caused by even “ethically produced CSAM.”
True, it wouldn’t be ethical to conduct an experiment, but we can (and probably do) collect lots of observational data that can provide meaningful insight. People are arrested at all stages of CSAM related offenses from just possession, distribution, solicitation, and active abuse.
While observation and correlations are inherently weaker than experimental data, they can at least provide some insight. For example, “what percentage of those only in possession of artificially generated CSAM for at least one year go on to solicit minors” vs. “real” CSAM.
If it seems that artificial CSAM is associated with a lower rate of solicitation, or if it ends up decreasing overall demand for “real” CSAM, then keeping it legal might provide a real net benefit to society and its most vulnerable even if it’s pretty icky.
That said, I have a nagging suspicion that the thing many abusers like most about CSAM is that it’s a real person and that the artificial stuff won’t do it for them at all. There’s also the risk that artificial CSAM reduces the taboo of CSAM and can be an on-ramp to more harmful materials for those with pedophilic tendencies that they otherwise are able to suppress. But it’s still way too early to know either way.
Even worse, you don’t need CSAM to start with. If a learning model has regular porn and nude reference model photography of people under 18 that are used for drawing anatomy, then they have enough information to combine the two. Hell, it probably doesn’t even need the people under 18 to actually be nude.
Hell, society tends to assume any nudity inder 18 to be CSAM anyway, because someone could see it that way.
Reuters - News Source Context (Click to view Full Report)Information for Reuters:
> MBFC: Least Biased - Credibility: High - Factual Reporting: Very High - United Kingdom
> Wikipedia about this source
Reuters - News Source Context (Click to view Full Report)Information for Reuters:
> MBFC: Least Biased - Credibility: High - Factual Reporting: Very High - United Kingdom
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This is bad, why? Because our problem is plastic production, any reuse that does not reduce production is meaningless at it would all still break down into microplastics and new plasticts would still be produced.
Nor recycling, no reuse, just abolishing the wode spread use of plastic. Plastic should be kept for tasks that are not convinced based, but rather exclusive to plastic (like medical usage, not like saving costs cause it’s cheap)
Associated Press - News Source Context (Click to view Full Report)Information for Associated Press:
> MBFC: Left-Center - Credibility: High - Factual Reporting: High - United States of America
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ABC7chicago.com - News Source Context (Click to view Full Report)Information for ABC7chicago.com:
> MBFC: Least Biased - Credibility: High - Factual Reporting: High - United States of America
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