Logbook: Health

White Paper 13: The 1:500 Parity Ratio Modeling Preventative Footwear as Durable Medical Equipment to Mitigate Acute Trauma Liabilities

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Title: Biomechanical Footwear as Essential Durable Medical Equipment: A Cost-Benefit Analysis of Preventative Orthopedic Coverage in Mitigating Falls, Emergency Admissions, and Catastrophic Healthcare Expenditure
Target Audience: Centers for Medicare & Services (CMS), Private Payer Actuarial Committees, State Medicaid Directors, Value-Based Care Policy Analysts
Domain: Health Economics, Biomechanics, Injury Epidemiology, Health Policy

1. Executive Summary

Falls among older adults and individuals with neurological, musculoskeletal, and sensory impairments constitute an under-managed financial and structural liability within the United States healthcare apparatus. Current national health expenditures attributable to falls exceed $50 billion to $80 billion annually, with more than 70% of those costs absorbed by public payers (Medicare and Medicaid).

A critical structural defect in current healthcare reimbursement policy is the statutory exclusion of non-diabetic therapeutic footwear. While Medicare and commercial payers comprehensively fund high-cost rigid bracing (such as Ankle-Foot Orthoses / AFOs) and post-traumatic acute surgical reconstructions, they categorize the foundational mechanical interface—the shoe—as a non-covered “personal convenience item,” unless tied exclusively to a diabetic metabolic diagnosis (HCPCS A5500 series).

This white paper models the actuarial and clinical outcomes of introducing a standardized, restricted Durable Medical Equipment (DME) Footwear Formulary offering a $200 annual allocation for verified, functional, torsionally stable footwear. Assuming an empirical 25% self-selected utilization rate among an insured cohort of 1,000,000 lives and a conservative 10% reduction in mechanical fall incidence, the policy generates:

  • Gross Preventative Capital Outlay: $50,000,000 annually.
  • Direct Acute Care and ER Savings: $125,000,000 annually.
  • Net Annual Liquidity Dividend: $75,000,000 per 1,000,000 covered lives (a 2.5:1 Return on Investment in Year 1).
  • The “One-for-500” Parity Ratio: The avoided direct surgical and post-acute cost of a single catastrophic trimalleolar or femoral fracture ($100,000) fully underwrites the preventative footwear allocation for 500 vulnerable individuals.

2. Problem Statement & Regulatory Defect

2.1 The Actuarial Cost of Acute Falls and Emergency Over-Utilization

Falls represent the leading cause of non-fatal and fatal injury among adults aged 65 and older, as well as the primary driver of preventable trauma admissions across populations with hereditary motor-sensory neuropathies (e.g., Charcot-Marie-Tooth disease, Hereditary Neuropathy with Liability to Pressure Palsies [HNPP]), spinal cord pathologies, and post-arthrodesis balance deficits.

  • Emergency Department (ED) Volume: Over 3.0 million older adults are treated in hospital emergency departments annually for fall-related injuries.
  • Inpatient Escalation: Roughly 800,000 fall patients per year require emergent inpatient admission, overwhelmingly driven by hip fractures (ICD-10 S72), traumatic brain injuries (ICD-10 S06), and complex trimalleolar/bimalleolar ankle fracture dislocations (ICD-10 S82).
  • The ED Diversion Failure: When an individual with distal lower-extremity sensory loss or foot drop experiences sudden lateral instability, the lack of structural torsional resistance leads directly to mechanical failure. The emergency department is routinely utilized as an expensive, low-efficiency triage mechanism for balance-loss trauma that proper mechanical ground-coupling systematically prevents.

2.2 The Statutory Anomaly: The Diabetic Footwear Silo

The Medicare Therapeutic Shoe Bill (enacted under OBRA 1993) created HCPCS billing codes A5500 through A5514 (extra-depth, custom-molded shoes and inserts). However, the statutory language strictly limits reimbursement to patients with a primary diagnosis of Diabetes Mellitus (ICD-10 E08-E13) exhibiting specific secondary criteria (ulceration, callus, or diabetic neuropathy).

The pathway illustrates the coverage breakdown for patients experiencing peripheral neuropathy and loss of sensation:

  • Metabolic Origin (Type 2 Diabetes): Falls under HCPCS A5500, with 100% of therapeutic depth shoes and custom inserts fully covered and reimbursed.
  • Genomic Origin (HNPP / CMT / Spine): Deemed Non-Covered, resulting in a categorical exclusion and 100% out-of-pocket costs for the patient.

The Clinical Absurdity: A patient with hereditary neuropathy (such as PMP22 haploinsufficiency) or adjacent segment spinal biomechanical instability presents with identical or superior tissue fragility, mechanical shear vulnerability, and fall probability compared to a patient with diabetic neuropathy. Yet, because their neuropathy is genomic rather than metabolic, the claim is rejected at the electronic data interchange (EDI) clearinghouse level.

2.3 The “Brace Without an Enclosure” Disconnect

Insurers routinely authorize $1,500 to $5,000 for custom carbon-fiber or thermoplastic Ankle-Foot Orthoses (HCPCS L1900 series). However, standard commercial off-the-shelf footwear cannot accommodate the volumetric displacement of an AFO calf shell, footplate, and strut without creating severe focal pressure points. When patients are forced to purchase cheap, non-depth retail footwear, the brace compresses cutaneous nerves against rigid seams, precipitating secondary pressure-induced palsies, skin necrosis, or intentional abandonment of the brace-re-establishing catastrophic fall risk.

3. The Preventative Footwear Formulary (PFF) Model

To prevent cosmetic consumer leakage (subsidizing fashion athletic shoes or unsupportive footwear), the benefit must not function as an unrestricted open-retail cash stipend. Instead, it must be structured as a Vetted Biomechanical Formulary, modeled after a standardized Pharmacy & Therapeutics (P&T) formulary.

3.1 Closed Technical Specifications (Eligibility Matrix)

Footwear eligible for the $200 annual DME allowance must satisfy strict structural criteria verified by independent biomechanical testing:

  • Torsional Rigidity: Must require longitudinal and midfoot torsional resistance; presence of a composite, steel, or high-modulus thermoplastic shank. This prevents midfoot collapse and high-energy lateral inversion rolling during mid-stance.
  • Heel Counter Rigidity: Minimum Shore A hardness (>70) reinforced thermoplastic or multi-layer leather heel counter; zero medial/lateral collapse under 25 lbs force. This centers the calcaneus, stabilizes subtalar joint pronation/supination, and controls hindfoot sway.
  • Volumetric Clearance: Minimum 3/8-inch to 1/2-inch internal extra-depth throughout the footbed; removable dual-layer spacer system. This accommodates internal AFO footplates and custom orthoses without dorsal or malleolar nerve compression.
  • Outsole Architecture: Flared heel base with beveled or rockered heel strike; slip-resistant rubber compound (ASTM F2913 / F1677 coefficient of friction >0.5). This reduces initial ground-strike trip risk, promotes smooth sagittal roll-through, and stabilizes stance.
  • Seamless Interior: Padded, seamless inner lining across dorsal, medial, and lateral metatarsal zones. This prevents cutaneous friction blisters, pressure palsies, and skin ulceration in insensate/demyelinated tissue.

3.2 Manufacturer Certification & Commercial Access

  • Core Formulary (Tier 1): Pre-screened manufacturers whose dedicated stability/work/hiking lines natively meet the mechanical requirements (e.g., Brooks Addiction/Beast motion-control series, Merrell rigid-chassis Moab/Jungle Moc work series, Timberland PRO rigid-shank boots, Orthofeet/Drew medical depth shoes).
  • Tier 2 (Commercial Evaluation): Consumer lifestyle manufacturers (Nike, Skechers, Reebok) may only enter the formulary if specific SKUs undergo accredited independent lab certification proving torsional stiffness and non-slip metrics.
  • Point-of-Sale Execution: Claims clear via dedicated medical OTC flex debit cards or directly at in-network orthotics suppliers through restricted Universal Product Codes (UPCs) and National Drug Code (NDC)-equivalent product registries.

4. Health Economic & Actuarial Model

4.1 Cohort Architecture & The Breakage Principle

  • Base Risk Pool: 1,000,000 covered commercial / Medicare Advantage / Managed Medicaid lives.
  • Benefit Amount: Up to $200.00 per member per calendar year.
  • Benefit Utilization Factor (Breakage): 25% (250,000 active participants; 750,000 non-participants).

In health plan design, preventative voluntary benefits exhibit a high breakage rate (unclaimed funds). The 25% of subscribers who actively navigate benefit portals to acquire rigid-shank, motion-control footwear represent a self-selected, risk-weighted demographic: individuals with active foot pain, balance instability, occupational concrete exposure, or neuro-spinal deficits. The program naturally concentrates its resources on the highest-yield segment of the population.

Total Population breakdown: Out of 1,000,000 covered lives, 75% (750,000) are non-users, resulting in $0 outlay. The remaining 25% (250,000) represent high-risk, self-selected users, receiving a $200 allocation for a total of $50,000,000 in program investment.

4.2 Acute Injury Costs (The Cost of Inaction)

When an individual without stable footing experiences a lateral inversion failure or sudden slip, the resulting acute medical pathway generates catastrophic claims:

  • Emergency Medical Transport (Ambulance): $1,500 – $2,500
  • Emergency Department Level 5 Facility Fee: $3,500 – $6,000
  • Diagnostic Imaging (CT / Bi-Planar X-Ray): $2,000 – $4,500
  • Surgical Intervention (ORIF Ankle/Femur): $45,000 – $65,000
  • Anesthesia & Inpatient Surgical Suite Fees: $12,000 – $18,000
  • Inpatient Recovery (3-5 Days Acute Bed): $15,000 – $25,000
  • Post-Acute Skilled Nursing Facility (SNF): $10,000 – $20,000
  • Outpatient Physical/Occupational Therapy: $3,000 – $6,000
  • TOTAL DIRECT EPISODE CLAIMS COST: $92,000 – $147,000 (Median: ~$100,000)

5. Cost-to-Savings Analysis

5.1 The 1-to-500 Parity Ratio

The economic viability of preventative footwear rests on an unprecedented asymmetric capital ratio:

  • Single Catastrophic Fall Cost: $100,000
  • Footwear DME Allocation: $200
  • Parity Ratio: $100,000 / $200 = 500 : 1

The 1:500 Axiom: Preventing exactly one catastrophic surgical trauma admission fully amortizes the hardware subsidy for five hundred individuals.

5.2 Population Ledger (1 Million Covered Lives)

To achieve break-even on a $50,000,000 gross program expenditure across 250,000 active participants:

  • Break-Even Calculation: $50,000,000 / $100,000 = 500 Catastrophic Events

Across 250,000 high-risk individuals, avoiding 500 catastrophic fractures requires an incidence reduction of merely 0.2% (2 per 1,000 members per year). Epidemiological studies demonstrate that stabilizing footwear with rigid heel counters and high-traction outsoles reduces fall-related biomechanical failure by 10% to 24%.

The annual actuarial ledger for 1,000,000 covered lives at 25% utilization is structured as follows:

  • PROGRAM DEBITS (EXPENDITURE):
    • 250,000 members x $200.00 DME Voucher Allocation: ($50,000,000)
    • Administrative clearinghouse / formulary management overhead (5%): ($2,500,000)
    • TOTAL GROSS PROGRAM INVESTMENT: ($52,500,000)
  • PROGRAM CREDITS (SAVINGS REALIZED):
    • Avoided Inpatient Trauma (1,250 prevented fractures @ $100,000): +$125,000,000
    • Avoided Emergency Department Fall Presentations (Uncomplicated): +$4,500,000 (3,000 avoided ED visits @ $1,500 facility/triage cost)
    • Avoided Outpatient Imaging & Soft-Tissue Rehab Claims: +$3,000,000
    • TOTAL GROSS AVOIDED CLAIMS OFFSET: +$132,500,000
  • NET ANNUAL BALANCE SHEET DIVIDEND: +$80,000,000
  • NET RETURN ON INVESTMENT (ROI): 2.52 : 1

6. Downstream Hospitalization & ED Decongestion (The Systemic Bonus)

Beyond the balance sheet of the individual health insurer, implementing a preventative footwear DME benefit addresses critical structural bottlenecks across the American hospital infrastructure:

  • Emergency Department Diversion: Fall-related presentations frequently require Level 4 and Level 5 trauma bay triage, comprehensive multi-slice CT scans (cervical spine, head, and pelvis), and prolonged nursing observation. Decongesting non-emergent, preventable lower-extremity balance trauma directly reduces hospital bed-hold hours, relieves boarding crises in emergency departments, and shortens emergency ambulance turnaround intervals.
  • Elimination of Secondary Iatrogenic Complications: In elderly and neuropathic patients, emergent surgical admission for fracture fixation carries severe secondary clinical risks: hospital-acquired infections (MRSA/C. diff), delirium, rapid muscle deconditioning, and pressure injuries. By eliminating the primary trauma event, the system circumvents the catastrophic functional spiral that so often transitions a community-dwelling individual into a long-term, state-subsidized skilled nursing facility.
  • Preserving Workplace Productivity: For working-age individuals with physical disabilities, spinal fusions, or hereditary neuropathies, proper footwear preserves the ability to maintain active employment, reducing disability claims (SSDI) and stabilizing tax bases.

7. Policy Recommendations & Implementation Roadmap

  • Phase 1: Regulatory Reclassification
    • Remove “for diabetics only” statutory prefix from HCPCS A5500.
    • Establish generic qualifying criteria: ICD-10 G60.0, M43.1, R26.81.
  • Phase 2: Formulary Construction
    • Partner with clinical biomechanics labs to define rigid testing specs.
    • Publish approved manufacturer list (Merrell, Brooks, Timberland, etc.).
  • Phase 3: Point-of-Sale Integration
    • Route funds through restricted medical OTC/DME clearinghouse cards.
    • Enforce SKU-level verification to prevent cosmetic retail leakage.

7.1 Federal Action (CMS & Congress)

  • Modernize Title XVIII of the Social Security Act: Amend the Therapeutic Shoe Bill to remove the etiological restriction on Diabetes Mellitus. Re-title the statutory benefit: “Therapeutic and Biomechanical Footwear for Loss of Protective Sensation and Structural Mobility Impairments.”
  • HCPCS Code Descriptors: Revise HCPCS codes A5500-A5514 by replacing the phrase “For diabetics only” with “For individuals with metabolic, genomic, or biomechanical neurological deficit.”
  • Recognize Hereditary Neuropathies: Explicitly list Hereditary Motor and Sensory Neuropathies (ICD-10 G60.0), post-fusion cervical/lumbar adjacent segment instability (M99.8 series), and cerebellar ataxia (G11 series) as automatic qualifying diagnostic prerequisites.

7.2 Private Payer & Medicare Advantage Execution

  • Special Supplemental Benefits for the Chronically Ill (SSBCI): Managed care organizations (MA-PD and D-SNP plans) should immediately deploy preventative footwear allowances under existing SSBCI authority, capturing immediate medical loss ratio (MLR) savings.
  • Closed-Loop Retail Integrations: Insurers should partner directly with medical supply distributors, certified pedorthic facilities, and approved retail suppliers utilizing barcode-level clearinghouses to verify that funds cannot be applied to unapproved lifestyle footwear.

8. Conclusion

The exclusion of protective, biomechanically vetted footwear from standard healthcare coverage represents an unsustainable actuarial paradox. The modern healthcare enterprise routinely expends $100,000 to surgically reconstruct an ankle or pelvis shattered on the pavement, yet denies a $200 investment that maintains the patient’s ground stability.

The arithmetic of preventative footwear is incontrovertible:

  • Preventing one catastrophic injury finances the defensive footwear of five hundred vulnerable citizens.
  • Capturing a modest 10% reduction in fall incidence across an insured pool recovers billions of dollars in preventable acute trauma expenses, decongests hospital emergency rooms, and protects human autonomy.

Transitioning footwear from an uninsured consumer commodity to a certified, formulary-controlled DME asset is a fiscally conservative, clinically rigorous imperative. The healthcare system must stop allocating unlimited capital to sweep up the broken pieces of human machinery when it can keep the machine upright for the price of a pair of shoes.

It’s Always Sunny in Georgia: The Teacher Gang Tries To Solve The Gas Crisis.

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Apparently in Georgia a teacher has created a gas surplus in the foul winds of teaching.

The first thing to know about this gas station is that it is not a gas station. There are no pumps. No convenience store. No windshield squeegees. And, despite what one might reasonably expect, there is no requirement that anyone actually purchase gas. It is a designated corner of an Atlanta elementary school classroom where students can go when they need to pass … gas.

This may “sound” like a good idea but will never work out to a level that this teacher wants it to. To the class jackasses they are going to make the one man band ripping ass back there. To the shy kids they would rather shit themselves than go to a corner and fart.

“I have a very weak stomach, so I cannot take it,” she tells TODAY.com. “And so I was like, OK, I’m just gonna create this little area over here, and you just get up, you go over there, do your business, come back, and that’s just it.”

Open..a..window.. Also, these kids are in second grade, work out a pattern with them to use the rest room rather than follow the practices of forcing these kids to understand assessments rather than having a learning prompt. Plus with farts, the first moment a sickness starts running in the classroom these kids will have farts that could rechrome a bumper. I give this lady some props for the idea but I think she should come to a better usage of giving these kids time to run to the restroom, A TA(teachers assistant) can run small groups to the rest room and let them have the privacy of using the restroom to relieve themselves.

One commenter wrote, “This is genius and normalizing body functions without disturbing the classroom amazing.” Another asked the question that seems to trouble many adults: “And the rest of the class stays focused while somebody is farting in the corner???” There was also a predictable amount of parental and teacher horror.

This in context is not the way to normalize body functions, How about letting kids go when they need to “go”. The same adults saying its normalizing bodily functions I double dog dare them to fart in a corner at work. Given some children will grow up in “proper” homes and are told to never fart in the room they are in, that is for the bathroom only. You are running so many problems together here trying to fix a fart when the fart problem fix has existed for ages in schools. Its called the bathroom, So even when little sally had taco night the night before doesn’t get embarrassed when she sounds like a nascar stock car revving up won’t be red faced and crying when she is basically told to shit in the corner. This is about as absurd as people believing that classrooms hide secret cat boxes in the corner, no you have Timmy just shitting his pants there because he tried too hard.

The problem here is a fart is only a fart until someone tries to hard, Then it’s a shart.

Attributions From:
Today.com – A ‘Gas Station’ for Farts? This Georgia Teacher Says It’s a Classroom Win-Win

Crows are getting drugged out to the point of needing naloxone

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Of all the weird things one could think about in a given day in the world of AI slop.. sometimes the real world says hold my beer.

An animal welfare group has been administering nasal naloxone to crows that are suspected to have eaten toxic drugs left accessible outside in downtown Prince George, B.C. The Good Caws Crow Rescue Society (GCCRS) has posted multiple videos showing their volunteers giving nasal naloxone to crows that are otherwise unresponsive.

Given these birds are finding opiates is scary. Worse yet, the trend is going up so these crows have a source.

Slayter said they’ve had one or two suspected drug overdoses a year in the past, but said they’ve recorded more than a dozen among crows this year alone, an alarming rise. “Their wings are spread out, their eyes are closed, their heartbeat slows right down. They’re unresponsive but alive,” is how she described the symptoms, adding some have a brown liquid foam coming out of their beaks.

At this point the Mounties need to get in with this group and tag a crow or two because at this point these birds have a source. if a tagged bird shows up again with an overdose they can trace the source. Sometimes people forget that animals other than humans get high, dolphins do it. so does every cat small and large and more animals.

She said she suspects the crows are accessing the drugs as they are mixed in with garbage that is openly available downtown. She said her suggestion for a solution is more covered garbage cans that would prevent crows from accessing disposed materials. “A crow doesn’t know the difference between a sandwich bag and a bag that had something in it. And it takes something the size of like a grain of sand to affect a bird,” she said.

I am going to beg to differ here, some animals enjoy getting high and while its not for everyone sometimes once someone or something starts doing it they don’t stop. It is crazy that when our human world bleeds over into the wild the things that happen. However I am glad that people are out there to help our Corvid friends.

Attributions from:
CBC.ca – Crows are being given naloxone after suspected drug overdoses in Prince George

Student brings coffee to class gets suspended.. Teachers left wanting coffee.

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Some coffee news… A student brought a coffee to school to class on the first day of school only to get suspended from a new policy not known to many

Julie , a senior at Beaver River Central School in Castorland, N.Y., told WWNY that she was stopped by a teacher as she attempted to bring a coffee drink to the first day of school Sept. 3. Kaputa said she was surprised to learn the school had adopted a new policy on outside food and beverages without notifying the public.. Julie, an honor student, was handed an in-school suspension (ISS) for violating a new Code of Conduct regulation that sought to “create a safe, instruction-focused environment for all students.” She accused the Lewis County school district of illegally changing its policy with no public hearing at the school board’s last meeting in August.

In a case of the the left hand not knowing what the right hand was doing the School Board makes new rule, forgets to put it on paper and wonders why they end up in the news. When schools enforce rules they often never go after the students that don’t care. they will just walk past admin with the coffee. So they target mild mannered students and wonder why these students in the end rebel against school policy.

“Julie was put in ISS today for refusing to dump out a ‘banned beverage’ (a latte from moving mountains). I was called down to the school,” Mary Anne wrote on Facebook.

“Meeting minutes from both July and August (where the code may have been discussed) were never published to the website until today when I pointed it out to the District Office, and the district office had no record of a public hearing being conducted,” she continued. “I am certain that the school can not enforce a substantial change to the code of conduct without a public hearing.”

This here is going to run that school board into legal issues. The its a rule because I said so never ends up well. Because at that point this is running into multiple walls at once. First since its unwritten these students can run the malicious compliance on staff. “Dump your coffee its against policy. I’m a teacher it doesn’t say that. Show me! uhhh… Well you say the policy is policy and it doesn’t specifically name students or teachers so NOCOFFEEFORYOU!” That will be the dialog line going down the school tries to punish for insubordination and it will end up in the news.

Secondly, For the ADA students and they have a sugar crash and the school nurse might be over 10 minutes away and the student end up in the hospital over a drink policy it wont well.

I think there should be a sound policy about drinks, Not a bad but common sense. If there is a problem with the plastic cups that are from take out .. Sure put a policy in place and have admin at school with closed drink containers for 10$ . It helps everyone.

On Thursday, Beaver River Central School District Superintendent Todd Green said updates to the Code of Conduct are posted publicly prior to the August Board of Education meeting where proposed changes are discussed and voted on following public comments.

But if the COC was a result of those meetings were never posted those rules are not rules they are suggestions until formalized by vote. Mr. Green says they were posted.. but where were they posted in the middle of the woods by the 3 oak trees under a rock.. Yes its posted but good luck finding them .

“Recently, an attentive community member brought a procedural technicality to our attention on the very first day of school. While our annual review process mirrors a public hearing in practice, we acknowledge the advance notice did not explicitly contain the phrase ‘Public Hearing,’ and that the public may not have realized they were entitled to speak on the Code of Conduct before action was taken by the board,” Green wrote in a letter to the community.

How to fail at failing. They have made so many mistakes here and they wonder when the news picks up on them over policy that was not posted, Not a publicized meeting, ignores ADA , and policy that is Closer in agency to banning dihydrogen Monoxide in a ironic blast from the past. Again a closed container policy should be in place here and if teachers or admin get all worried ask the students to open the container if they suspect drink tampering is a common sense policy.

According to the New York Post, the new Code of Conduct, which applies to BRCSD middle school and high school students, added a policy barring Food from Outside Vendors. Green told WWNY that the rule aims to promote a safe and distraction-free learning environment.

In a case of stupid rule writing here, The school dept just banned all food, It banned biting nails, Short of shoving a cow and a garden planter in your locker it bans ALL FOOD. The Dept forgets that school lunch is an outside vendor, this is not the 1900 anymore where lunch was made inhouse. So I guess back to eating lead paint and asbestos. Teacher opens a sugar packet.. Call the school dept. Teacher has food in their car .. Call the school department… Principal has crumbs on his tie .. Call the school department. Cannibalism and booger eating is officially compliant. DON’T CALL THE SCHOOL DEPARTMENT!

“The following food and drink guidelines help minimize distractions, protect students with food allergies, and promote a calm, equitable school experience,” the 2026-2027 policy states. “Students arriving with drinks or food will be asked to finish them before entering school.”

This policy is so badly written that a student with a big gulp now will end up in the rest room 5 times trying to urinate 64oz of soda and become a maximum distraction. The student that finishes their Starbucks coffee is not jittering all over the place. The diabetic that uses the drink to keep their sugar stable through the day is now a distraction because s/he is passed out on the floor and class is stopped because a EMS unit is working on them.

“Our family has always promoted transparency in government and proper representation of the people,” Julie wrote on Facebook.” This new policy was overly broad, unenforcible, and open to wide interpretation and inconsistent implementation, which is how abuse of power has always started throughout history. I would hope that this encourages students to pay attention to local politics, read documents before signing them, and get curious about their civic rights and responsibilities.”

Student Julie here is spot on and should be commended for her comments. However the school will likely point out she is against policy and call her insubordinate. However, She will thank the school for giving her pretty much a guarantee of school of choice when she submits this as part of her college entry letter!

Attributions from:
syracuse.com – Upstate NY high school student suspended for bringing coffee to class

Outsourced Idiocy: What Happens When You Let AI Autocomplete Run Your Clinic newsletter..

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I was going through my emails and saw an email and it made me stop and read it.

If you’ve recently had a mammogram screening for breast cancer, well done!

Well now, last time I checked I did not have breast but.. Ok?

Regular screening is the best way to detect breast cancer at an early stage when it is easiest to treat and cure. Yet there’s a chance you may get called back for additional imaging.

This gets a “no shit sherlock” from me but the target audience was massively missed here, I am not part of the Genetics that has a 1 in 8 chance of having this issue. Honestly, if this were done by a real person this would of never hit my email box from the health provider. Instead this feels like it was fed into an AI by a “vibe Manager” and they typed “make me an email about breast cancer month and have it have the maximum outreach.

This can be nerve-wracking but try to remember the vast majority of people we call back do not end up having breast cancer.

The dumb-fuckery here reaches its maximum with the fright call here. Even though it says about calling back this is an afterthought that should be left alone or reworded. The wording could of been more humanized by saying “Some times we call back people to get more clear screening, Have no fear we are hear to help you every step of the way.

Hell… I am all for mammograms for women but blasting this one out to everyone is going to create phone calls to doctors from the wrong gender asking “do I need a mammogram” wasting precious time and PA’s sanity.

This email falls flat and fails completely on raising awareness on women’s issues.

You might be eligible for a refund from your dealer… CVS

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If there is one thing we learn as we age is most people step away from the illegal dealer and end up with the legal dealer of drugs… CVS. But the funnier thing is for the people whom have had a “Dealer” they are likely more secure than CVS.

Many CVS customers may be eligible for money as part of a settlement in a class action lawsuit against the company.
The settlement stems from a lawsuit that alleged CVS violated laws by sharing user data from its website and application with advertising company Criteo.

The thing is as much as someone purports that it is alleged. My opinion is they are a bank vault with a screen door. The CVS registers tell you to put in your full name and birthdate. I made an objection to the CVS manager and they claimed “oh it has a privacy screen!” I said no it has a polarized filter pretending to be security, anyone that is lingering 10 feet behind you see you typing all of your information in as long as they stay in 20 to 30 degrees of the CVS kiosk.

CVS and Criteo denied any wrongdoing. In a statement, Amy Thibault, a CVS spokesperson, said: “We stand by our privacy practices and believe they comply with applicable laws. The settlement resolves claims based on legal theories that challenge common online industry practices.”

CVS and Criteo denied any wrongdoing. YET they changed their entire terms of service, Took more rights away from the consumer and now hold a INSANE right to hold your personal information in perpetuity

The statement also said CVS agreed to the settlement to “avoid expense and distraction of prolonged litigation.” While the settlement is still awaiting final court approval, affected customers can submit their claims through Nov. 16.

This statement is so contradictory its not even funny, Corporations love prolonged litigation. There is no way in hell they would want to “settle” if they can hang up in court for 10 years and keep that going its less than what is at hand. They threw out a number and said go away we are likely doomed if this goes to court.

I asked myself who the hell is Criteo, it would seem its a back end to CVS and it likely resides on those machines well that say “check your coupons here” , at a guess CVS was wholesale giving the purchases to them so every time you walked into CVS to get your drugs and purchased something Criteo got a copy. The problem here is recently CVS changed their terms of service to give Criteo a hole into your meds and other PII. If you buy plan B they know, if you buy condoms they know. If you buy those and a week later you buy monostat it will try to put that together that you are unclean or you had an issue during intercourse. If you buy pads every 24 days it becomes your unofficial period tracker. So that day you walk in on day 23 and go to the savings center the machine happily prints a Tampax coupon.

Yet, Criteo takes this information, sell its on a second market, and CVS claims they protect your information! Just from my last paragraph alone think about how much information they can take from you. Your period time, Plan B (you make mistakes), Condoms (sexually active), Monostat (Maybe doesn’t take care of themself if repeated purchase.) . Even for the males the same purchases will let the company figure out that a male purchasing the same items and come up with through metrics Male buys these items and the timings and will happily add “Male buying for female” and use all the same metrics.

For machines like this a little malicious compliance to the retail machine never hurts, Buy three things that never should go together in a purchase and put it on your card.. Say Cucumbers, Condoms, and Petroleum jelly.. Let the prediction machine do the rest. After awhile of crossing 3 item purchases together you will offset the machine so badly it will not how to accurately measure you. Vinegar, Tampons and Baking powder. the list goes on. Plan B, a turkey baster, and Cake mix and a fleet enema. Even if you are not needing these things such as the plan B or Tampons.. donate them to a shelter they always need the things..

The $10 dollars that CVS is offering is a bad joke, they want you to go away for the price of a medium tier Starbucks coffee..

Attributions from:
USA TODAY – CVS customers may be eligible for money from settlement

Attack of the Christmas 2026 edition.

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Every year Christmas for retail comes earlier and earlier.

ed note- Christmas the holiday will be properly capitalized while retail christmas will not.

We are not even through the first month of school for kids and now store are decorating for christmas. The thing is when I was young seeing christmas decorations before thanksgiving was borderline blasphemy. Always the day after Thanksgiving would be the first time stores would decorated for the holiday

Now Stores push christmas in july, christmas in September , christmas because we say so.. and so on. Retailers need to stop this. Retailers think buy stuffing this holiday in our face we are going to buy more… the reality is we buy less. What corporations miss is the time that makes or breaks for a quarter for the holidays gets so diluted that the black friday sales and cyber monday sales just get looked over as another day of retail manipulating customers.

For the most part those two days are a joke because if you eye something you want for Christmas, Go to that store starting in October and take a photo of the price of the item you want you will see a very interesting trend. About October 7th that price will start going up. By November that price will be about 15 to 20% higher than the price throughout the year, BUT!, you will see “BLACK FRIDAY DEAL 18% Off new low Price! “. So that cool thing you have been eyeballing most of the year goes from $100 to $120 down to $102 in price with a grand savings of negative $2 dollars.

Stores need to get their heads out of there asses, they are making Grinches of everyone. Because its about this time now we start getting yelled at DO YOUR CHRISTMAS SHOPPING!, uhh fuck no, I have bills to pay. year after year for the last 15 years the christmas shopping black Friday and cyber Monday days are so diluted that they don’t understand it.

I have a recommendation to all retail stores out there. Let people have their holidays, Let people have Columbus day, Give the kids Halloween without the parents worrying if they have enough for Christmas, let them have Veterans day, and lastly lets have Thanksgiving without worrying until 11:59:59pm of not having to deal with christmas shopping.

Give people a break, Allow them to swing into Christmas rather than smashing them in the face with unending christmas sales… Let people start to decorate without the guillotine of christmas sales being thrown into them every place they go. What retail doesn’t want to acknowledge is happy people will spend more money rather than depressed stressed out people. Depressed stressed people will buy 20 shitty little things just to get christmas shopping out of the way vs the happy person putting in thoughts to what people want and buying 20 well thought gifts out for Christmas.

The last few years I asked my SO if we could make the week after Christmas the time to shop for christmas because 9 times out of 10 you get deals that are pre-October prices and summer slump deals.

Dumb: Climbing a mountain with no experience. Dumber: asking someone who has never climbed a Mountain to do it. Darwin dumb: It was AI

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Every time I am thinking about AI, there is a fatal concept that comes to mind with AI, it has never done anything but, it can explain it in concept it but not much else.

Three novice hikers from Roseville were stranded overnight on Mt. Shasta after following Google’s Gemini AI for route and packing advice, turning an expected eight-hour climb into a multi-day ordeal in Mud Creek Canyon.

What.. the fuck.. asking gemini for instructions to climb a mountain is like asking google maps to guide you through a city when you forget its in pedestrian mode. You will go down more than a few one ways backwards and likely end up with mr police officier asking if you are on something.

In what authorities are calling a “critical misstep,” three hikers relied heavily on Google’s Gemini AI to guide them through a Mt. Shasta summit, leaving them stranded on the mountain’s southeastern flank.

A critical misstep is understatement of the century, what is next for our enterprising adventurers climbing Mt Everest and ignoring sherpa’s that have boots on the ground for centuries and going “Nah dude we got this with AI!” .

In a post on Facebook, the Sheriff’s Office said, “The men summited at 7:00 pm that evening, well after the recommended turnaround time of 12:00 pm, and descended in the dark.”
Officials said that, an hour into their descent, the group called the Siskiyou County Sheriff’s Office Dispatch to ask for directions but eventually wandered off route into Mud Creek Canyon.
That evening, one of the hikers fell and suffered a knee injury.

Our heroes here failed in so many ways it’s not funny. AI is not a magic device that makes you superior at doing things it makes you stupider at doing things if you have no concept of how to do it. AI has never climbed a mountain, AI has never gone to work in new york through the subways and over road routes. it has a “concept” of all of this but it has never done it for itself and this makes AI a bad companion when the user does not know how to do things. If you are talking to AI about installing a 240v supply for your washing machine and use the same prompt later for building a PC you never know if the AI will amalgamate the two together and it tries to make you a PC powered at 240V .

If you are clueless and you have no idea how to do something, Start with the basics like “I want to go up Mt Shasta”. Than ask yourself what does it take to go up Mt Shasta , OH YEAH CLIMBING. our heroes were young here and likely from a university, firstly they could of checked at the uni if there was any climbing or hiking groups. Secondly, they could of reached out to any local climbing place and say ” hi, I do not have much climbing experience and want to climb Mt Shasta.” In two tenths of a second the guy at the climbing place is going to do one of two things, If he just answers the question he’d say “NO don’t do it ” Or if the guy is into his craft “no, please don’t do it, our Climbing group goes to Mt Shasta twice a year and its not recommended for novice, How about I offer you an introductory to climbing course at 25% off?”

We need to stop acting like AI is the mastery of anything, if anything the AI is the master of average, It takes the sum of human intelligence and averages it out. That is AI’s ability. It can’t fathom new ideas, It can NOT figure out how much rocks have fallen on Mt Shasta, Microclimates, our Heroes Abilities or disabilities.

At Mushroom Rock (12,800 ft), another climbing party warned them to turn around. They ignored them and kept climbing into the dark. This is class A dumbarrery at an epic level. Because at the simplest of levels walk around your house… Than blackout every window in the house and try that again. You will fail.

Reading further….. what .. oh What the fuck..

The incident occurred days before Google announced its multi-year partnership with Beast Industries, a company founded by YouTube influencer Jimmy Donaldson, also known as his media personality MrBeast, who produces viral spectacles online.
According to the announcement, on Sunday a new MrBeast video will follow Donaldson and his crew as they attempt to survive “some of the most extreme and treacherous climates on Earth.”
Teams will race to navigate the jungle, the desert and the Arctic using Google’s Gemini to help them identify dangers and survive “brutal weather.”

This will end well? But Mr Beast has millions of dollars and some experience here so I guess he will do well, but this idea is fucking horrible because it’s going to cause more heroes for Mt Shasta. Those rescues are not cheap and at times people recieve bills into the tens of thousands of dollars.

The sheriff’s office said hikers should also have multiple methods of wayfinding. “Do not simply rely on your cellphone or Garmin, and stop to verify that you are on the correct route often.”
The Clear Creek Route on Mt. Shasta, which the three hikers wandered onto, is not a technical mountaineering route, but officials say it still requires climbers to be physically fit and prepared for unforeseen circumstances, such as an injury, inclement weather or an unplanned overnight stay.
“Serious accidents and fatalities occur on the Clear Creek route when individuals become lost and wander into more dangerous terrain, such as the Mud Creek drainage,” officials said on Facebook.

My closing here is Mr Sheriff from the office has sage advice “Do not simply rely on your cellphone or Garmin, and stop to verify that you are on the correct route often.” This man is our hero in the adventure because the three guys basically decided to conquer a mountain with a keyboard.

ed note: with the use of generative images as of late it looks like spelling issues is back on the menu. oh well its another perfect example of why not to use one single device as a way to get a result. Im keeping the errors its funny..

Attributions from:
The LA times – Lost in the algorithm: Hikers stranded on Mt. Shasta after following Gemini AI’s plan

WordPress writing prompt-a-ma-bob

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Daily writing prompt
Share a hobby you’ve picked up recently — what got you into it?
View all responses

While not recent, But, recent enough, I would have to say archery. I picked this hobby up by accident. I tried it one day and I thought to myself that I kind of liked it. The first times I did archery however not accurate was therapeutic in the matter of there is always room to improve. After that day it was trials and tribulations of finding equipment and learning about archery.

After a trip to Dicks sporting goods, I had picked up a bow (it was terrible) and I learned a fast lesson in archery, Don’t buy the first thing you see, I had picked up a cheaper 1 piece bow. While it had worked I had my wrist slapped by the string worse than a nun with a ruler and the bruises to show.

I knew I was out of my element and I knew something was wrong and no matter the amount of youtube or web instructions you find with a bow its not an exact fix. I decided to find my Yoda of archery, I went to a dedicated archery store and the owner looked at my bow and laughed, I said to him I thought so, He offered me a Greatree bow at a fair deal and set me up with a lesson and the bow. Al the owner(bow yoda) looked at my form and complimented me that I had the form but not the bow, with the Greatree bow I did not slap my wrist and I was elated that I had missed and not felt like someone slapped me with a whip. Al corrected my form and I hit the target, the more I did archery the more I realized that archery in itself is an incredibly meditative state where all your problems slip away and the target becomes your problem.

Between dealing with day to day life and the sometimes insanity of things, I found archery to be a stress releaser. When I had issues where I could not fix something I was working on, I could go outside to with my target and use my bow and focus on the art of archery. I felt confidence with my bow, I also felt drawing my bow with the strength I had gained from doing archery I was outgrowing the bow I had. I started looking at better equipment and realized that it was going to get expensive fast..

The archery place I frequented had a customer appreciation day, Went there with no theory in mind other than seeing if arrows were on sale, they had a drawing for archery equipment. I put in my three tickets that they gave me at the door in a drawing thinking to myself I’ll never win anything. Little did I know that day I would walk out of the place with the top prize. I walked away with a Martin Jaguar Takedown bow! This took my new found hobby to the next level as is it introduced me to ILF limbs.

Thankfully with this prize it was a boon, I was accidently overpowering my bow I knew I had to step up my game. The step up in draw weight was a painful but fulfilling hill to climb. This started me down the road of proficiency with archery that even clubs were asking if I wanted to join. I could likely write a small book of my archery adventures.. the factors of what got me into this was the mindset and a bit of luck thankfully. But, I must say in the end archery has much prominence in my life and has helped me through the best and worst of times.

The greatest lesson archery can impart on you is – It’s not hitting a target, nor is it getting a bullseye, it is the pure action of trying and doing the best you can with a bit of humility and perseverance.

META enshitification alert- Paywalling tech with the Meta Glasses.

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I swear every time I turn around, Meta is doing something stupid because they think it will make them money. But this time they are taking an off the shelf tech and paywalling it. Passthrough or active audio.

Owners of Meta’s AI glasses have been told they must pay a monthly fee if they want full access to a feature that was previously free. Users will have to shell out $19.99 every month to use “Conversation Focus”, which uses the microphones on the glasses to make it easier to hear people you’re talking to, for more than three hours a month.

The fact they are attempting this is just a cash grab like charging monthly for heated power seats.

Meta says those who hit the “free monthly usage limit” will have to wait for their free hours to refresh each calendar month unless they subscribe.

As humans we are making steps back in technological advances, We are headed back to the days were we only make calls after 6pm to use “Free Minutes” and it’s fucking stupid. Meta is seeing how much they can deconstruct tech to see how many parts we will pay for and how many parts they can profit from.

Meta’s plans to test “premium” subscription experiments across Instagram, Facebook and WhatsApp were first revealed in January. The firm later confirmed its tests would include trialling paid access to expanded AI features, including those on its smart glasses.

The fact that Meta has fired tens of thousands for their AI experiment and AI engagement features is a dumpster fire everyone saw coming. But on the meta glasses they have the chip built in to handle all of the audio, they just installed a meter on it so they could charge for it. Bose, Beats, Sony, Sennheiser and Apple all have the same damn thing, its called Transparency mode, Aware, active mode!

Meta is just trying to get your hard earned money for an already established technology. If Bose, Beats, Sony, Sennheiser and Apple Paywalled this tech, there would be digital lynch mobs. Even worse is…

The company says subscribers to its Meta One Premium tier will be able to use Conversation Focus for up to 15 hours each month.

What.. the.. fuck.. this is truly back to the old mobile days where you paid through the ass and waited for nighttime to make calls. 15 hours?? Good luck if you depend on these if you are deaf, or autistic. What fucking morons. The fact that this feature started as free than went to Fee could be seen as a violation of the ADA… This is a massive greed maneuver, first put the tech out .. Then pull it away. The people that need this tech will pay up in a moment.

It reminds me of netflix, When they first started they chirped up and down “no ads” , “no ads Ever!” than they started injecting small ads in the beginning of shows, Than the tile ads started, Then they jumped the shark with a paid NO AD tier and the price has been skyrocketing since.

Meta here is doing the same thing except with a piece of tech that lives on your body, and moreover they are messing with people who maybe for the first time in their lives have been able to go into a public environment with this. The neurodivergent folks need someone to speak up for them. The deaf should be enraged over this.

Meta’s Glasses have been problematic enough with people finding video of themselves online without their permission and worse.

Women have complained of being filmed without their knowledge or consent – with some only discovering they have been covertly filmed after seeing videos of themselves online.

The sad thing is META’s ai could be used for good and if a person has found their videos online they could make META AI delete the persons face as soon as its recorded using AI , but they won’t do that they would rather make money off engagement and keep doing stupid shit.

I think of it this way, If these glasses worked for an autistic child at school, than, you rip away a child’s focus after 3 hours meaning less than one day of school a month is covered. You have just destroyed that child. The glasses are noninvasive compared to earbuds… If you try to force someone who is neurodivergent to wear Earbuds, most neurodivergent kids will remove your finger before you shove something directly in their ear. 

My final thoughts here is while META is using AI to do stupid things like making fake engagement should not be removing engagement from the disabled from the world at large. They should focus to make the world a better place and not use the SaaS to enshitify day to day living.

Attributions from:
BBC- Meta glasses wearers hit with paywall to use built-in feature