mwerd

second this. if you stay out of leadership I think it's a lot easier to have a healthy relationship with work. you set your boundaries and stick to them. highly improbable anyone will know any different.

I quit a high pay/low cost of living job to move to a high pay high cost of living job when I was young. The skills, connections, experience I got were great but eventually it was clear I wasn't on a path for long term happiness in that city. I then quit that high pay/high cost of living job to move to a low cost of living area. I bought a house, which was unattainable in hcol area. I ended up getting promoted to comparable pay after a few years. I am now planning to go from leader to individual contributor role soon. I have saved enough in retirement accounts to still retire early, but I'm not in a hurry because my partner wants to work another decade or so and generally be stable while we raise kids.

you might Google and read up on the concept of "coast fire", which is essentially front loading retirement savings then working lower paying jobs while you let your savings compound.

It doesn't really matter how you do it as much as how you talk about it. Like most aspects of a healthy relationship, communication is key.

State law is really important if the relationship fails and you need to split commingled assets. If that's something you're worried about you should speak to an attorney.

To directly answer your question, we both direct deposit into a joint checking account. We spend on cash back credit cards that are auto paid out of the joint checking account each month. Mortgage and car note are out of the joint account. We both maintain access to small spending personal accounts/cards on the side for gifts and misc. stuff we don't want to discuss.

When the checking account gets over our healthy buffer of ~2-3 months spending, we sweep the extra to a taxable brokerage account and invest it in index funds.

We "pay ourselves first" with prediscussed, significant, automatic contributions to retirement savings, college funds for kids, or any key milestones like down payments or big vacations. that way any money that stays in the checking account or misc accounts are relatively guilt free and discretionary.

Of all of the things that I mentioned, contributing to retirement and big milestones before we can "touch" the money has been the most important for our peace of mind. we don't fight over money because we've already aligned on the big stuff.

I spent a week touring Rome and didn't see a single public bathroom.

Every society makes its choices and some of those seem weird when you look on the other side of the fence. The US is unique, sure, but so are other countries.

beautiful. congratulations on this, it's really wonderful.

That's a point of view that would change quickly if you were in one of those management positions.

You get to a point where it's impossible to do the work anymore. There's too much of it. You have to develop teams, processes, structure, etc. that delivers the outcomes you're accountable for with full knowledge that you cannot do them yourself. It's very different than doing the work and experience shows that fewer people are capable of doing it, especially with any repeatability. The working world yearns for effective managers.

I encourage you to compare the productivity of the modern multinational corporation to any commune in history. The people working in collectives are not stupid or lazy. It's not an effective structure.

Nuanced but important distinction: these are ICD-10 diagnosis codes. They are only loosely related to what is billed and would not show up in the pricing data referenced by the OP.

Yes. Unemployment below natural level and inflation still high single digits. They will raise rates. They have no choice. It's literally their dual mandate to do it.

Let's hope not, that would be a disaster. Inflation is far more pernicious than regional bank instability. The fed is acting appropriately in response to a spendthrift Congress, and in the process, stressing the system. There's not a good alternative, especially from the Fed's seat. I'm not trying to make it a political argument, but you're really pointing the finger in the wrong direction. The fed has two mandates when it comes to monetary policy - price and employment stability. That price stability is about market wide inflation, not bank stocks. Banks come and go. If you expect the Fed to prioritize something other than those two mandates, I do believe you're kidding yourself. Rate hikes will continue until the labor market or the inflation data indicate they should stop.

Don’t doxx yourself but can you link to an example, public case? One you weren’t involved in maybe?

I would point to a few key reasons for the complexity.

1) Value based care - It used to be simpler with a model called fee for service. Get paid for what you provide. Insurers, Medicare in particular, aggressively drove the industry away from that because they argued it incentivized unnecessary care. The general approach now is value based care, where the insurers and providers negotiate a rate for each type of procedure or case, usually quoted as a percentage of the Medicare rate. In practice, that means that hospitals don't get paid for what they did, they get paid for the problem they solved, regardless of what it took to solve it. I'm oversimplifying, as this all depends on the setting for the care and the contract specifics, but this is certainly a major factor in how things got so complicated.

2) Supporting documentation - To combat fraud, insurers require that an appropriately licensed clinician provide medical documentation supporting the problem's conclusion. The insurers actually check for compliance, i.e. that the notes support the conclusion, in a significant number of instances. In response, the provider side of the industry has instituted expensive software (Epic, Cerner) and employs an army of clerical workers to be prepared to respond to audits from payers. These audits come in many forms, the most common is a denial where the payer essentially calls bullshit on a single claim, and the providers have to cough up detailed justification to get paid. Many providers find responding to denials so onerous that they don't even try, they just eat the loss. You can't do that in isolation though, that expected loss gets baked into the prices over time. And now you've got your most highly trained, value add people in the industry, doing data entry, by the way.

3) silos of information and decision making - The hospital cannot definitely tell you what you will pay out of pocket. They may be able to tell you the negotiated rate they have with your payer for a specific service, but they do not know if you will have met your annual deductible by the time you are billed. Your insurer has that information, not the hospital or the doctor's office. Your doctor is also not likely to know the complex billing logic, so even if they could tell you what they typically write in their notes for what they intend to do to you, you would still have a few steps before you could figure out what's likely to be billed (because it has to be converted to billing syntax). You may also know things that would affect the billing decisions that your provider doesn't know yet. If you're going to have a procedure and you've got diabetes, for example, your case might be considered complicated and command a higher rate. The list of complicating diagnoses is long. That's one reason you usually get labs done before a procedure. The provider needs to know what they're dealing with and that information can affect how much you and your insurer will ultimately pay.

Each of these factors complicate the billing logic. They all exist for good reasons. You don't want call center workers diagnosing patients and telling them how much things are going to cost. You don't want providers performing unnecessary procedures to drive up billings. Insurers have found that well intentioned providers are often sloppy with their notes or outright unethical with their billing practices. If the insurers can catch those mistakes, they can deny payment, and make more money, some of which will be used to keep premiums lower.

It all exists for a reason but put it together and you've got a damn mess and no one's happy.