“Now, if asked to name the last truly popular and incisive tech satire, I’d go with the TV show Black Mirror, which premiered, guess what, 14 years ago.”
Black Mirror is a great one for sure (along with Infinite Jest and most of DeLillo’s oeuvre). I would add a few more recent ones to the list:
- Mike Judge’s Silicon Valley skewered the myopic and lightly sociopathic Tech Bro archetype *years* before we collectively soured on Elon, Zuck, and Bezos
- DEVS on Hulu is a wonderfully cerebral meditation on AI, simulated worlds, and trying to use technology to fill a hole left by grief and tragedy
- The entire canon of Neal Stephenson. Snow Crash is the GOAT that introduced the concept of a metaverse used to cope with a dystopian reality. More recently, “Fall” has an entire section where the internet in the near future becomes an unusable mess of AI slop: those with money pay minimum wage workers to curate their own personal, “cleaned” version of the web while everyone has their brains melted by porn, propaganda, and spam. There is also a subplot about a 9/11-style terrorist event that never happened but everyone THINKS did because fabricated images and data spread on social networks
- Super Sad True Love Story by Gary Shteyngart describes a disturbingly plausible near future NYC where everyone uses drugs and supplements to stay young forever and kids are so desensitized to sex that fashionable women walk around in transparent OnionSkin brand jeans that are translucent
- Honorable mention: It’s old now, but Idiocracy (also Mike Judge, who might be a time traveling wizard) has more or less come true. I wouldn’t be surprised to see a movie like “Ass” released in the next decade
Some people get up in arms about "stop saying Idiocracy is a documentary!", based largely on mild classism and using a eugenics-light plot device, but it really was a precient satire, and becomes more relevant every day. Even the best criticism of it, that it ignores the sins of willfully corporate evil and focuses too much on government incompetence, are becoming less true as corporations increasingly trade willfull malevolence for willfull stupidity.
If anyone thinks Idiocracy went TOO EASY on corporate America, that would be news to corporate America. They HATED how they were portrayed and pressured Fox to bury the movie, doing virtually no marketing. Some theaters where it played didn't even have it listed on their schedule or marquee:
"Throughout Idiocracy, corporate America is framed as the main antagonist and the primary reason for the anti-intellectual culture that ruined the world. The movie takes some pretty vicious swings at companies like Starbucks.
In the future, Starbucks has stopped serving coffee and has started serving blowjobs. Costco is now its own city-state.
[...]
In a 2018 interview with GQ, Terry Crews admitted that real-life advertisers poured money into the movie, thinking that they would receive a positive portrayal. They were shocked when they realized that Idiocracy turned their businesses into full-release massage parlors and then blamed them for destroying the entire world."
Relevant to this article: I’m currently seeking funding to build the Torment Nexus as featured in legendary sci-Fi novel, ‘Do Not Build The Torment Nexus’. Anyone interested in investing, DM me.
The Distractotron was developed in the 60s by researchers at the Carnegie Corporation (and known then as The Distractor) and was used in part to develop shows like Sesame Street. I’m amazed the NYT article doesn’t seem to mention that.
DeLillo's TV-centric vision is out of date and reads a little flat but, on the other hand, my experience in the classroom has been that there are plenty of people (and not just young ones) who are reduced to a state of hostile, unfocused, anxiety the moment you separate them from their smartphone. More or less all they can do is worry about what's happening on their phone.
I’m all in favor of sophisticated cultural commentary, and in addition to your literary examples, I’d add protest music: we hear very little of it these days. But methinks you ascribe a bit too much power to artists and critics. Even your favorite tech critique, “Black Mirror,” has done little to bend the arc of history. Going back further, all the protest rock and art of the ’60s didn’t get the U.S. to pull out of Vietnam.
> Going back further, all the protest rock and art of the ’60s didn’t get the U.S. to pull out of Vietnam.
Are you sure? The US did, in fact, pull out of Vietnam, and for purely internal/political reasons that had little and less to do with battlefield realities. Obviously that wasn't a sole cause, but seems to me like a plausible factor...
The protests dropped a lot after Nixon got rid of the draft...
Arguably the artists did help create a cultural climate that made the war untenable, as you say. I know the culture war means they're more likely to do harm than good (at least from the point of view of electing politicians they like), but the 60s had a culture war too. So why were artists so ineffectual at removing Bush or Trump?
I could be cynical and say the art sucks. I'm guessing the trend away from creating generally enjoyable or at least appreciable art had something to do with it. You'll note that generally positive portrayals of gay people in TV and movies are, as far as I can tell, thought by all sides on the issue to have helped allow gay marriage. So, the art sucks?
To Pimp a Butterfly was the last great protest record that had any real mainstream cultural impact . Theres a lot of artists making culturally conscious music outside the mainstream. The thing is that the album format isn’t as relevant as it used to be.
Funny thing is, the very readers themselves have beaten the writers/producers of AI slop to the punch: I noticed that an increasing number of people are reading AI summaries of the things I send them, and then offer thoughts on that (the summaries strip away so much information and nuance that they are effectively responding to something that was not written).
So while I used to fear that administrators of content-factories would do exactly what they are trying to do, I now fear that actual writers are going to have to contort their own writing so that it "summarizes correctly" through an LLM (because otherwise people will simply believe that the writer wrote something they did not -- and this can be dangerous or even fatal (see Rushdie and others)).
I also wonder if writing with redundancies/noise will "summarize correctly" (because of the redundancies), but writing that is actually information-dense will "summarize poorly", because there is no noise to remove, so you have to remove information that is actually load bearing.
Alternatively, we might have to make our writing shorter, so as to make summaries "unnecessary" -- which is basically an arms-race towards micro-blogging.
I thought it is was bad enough when search-engines and feeds mediated which of your writing would reach new readers, but we now have to worry about LLMs deciding which _blurred and transmuted concepts_ **from** your writing will reach the reader.
This will also likely carry over into programming (i.e. the LLM turns your good code into crap code, and the time-starved person evaluating your work believes that you are a crap coder).
It seems that Silicon Valley is deliberately (desperately?) trying to stack one brain-melting technology on top of another, recursively.
Yeah, I was looking at it and thinking, "Is THIS what we liked?" It seems different. Not at all funny either. Or maybe we're the ones who've changed? But...somehow I don't think that's it. Maybe it was never belly-laugh funny, but didn't it used to be somewhat amusing at least? I remember the covers being shocking, arresting, too.
I watched exactly two episodes of The Black Mirror and had to stop, it was too painfully probable. And I think about those two episodes all the time now... Those and basically all of Star Trek: TNG, especially the one where the whole ship almost got taken over when everyone got addicted to those headset game things.
The funny thing was, everyone mocked that episode at the time about being too alarmist about video games. Especially when you consider the core audience of video games and Star Trek (nerdy young men) are pretty similar.
Critics especially of the fiction writing kind look at trends that the majority of people don’t see yet. What you describe here has already happened. The dystopias preoccupying writers today are of a different kind involving the future of humanity on a burning planet. As always, nobody wants to listen until it’s too late.
Writing off Delillo based on an undercooked scene from a book he published when he was 84 seems like a bit much. White Noise is one of the great novels of the 20th century. Agree with the rest though.
You're right that the fear of being on the wrong side of history prevents people from criticizing 'progress,' which becomes a self-fulfilling prophecy.
I think we're at a unique moment of reversal. Moldbug was early to elucidate this with politics (the left is always right retrospectively based on the course of history, so who'd want to bet against that trend?). The issue being our lens on modern history is like 1-200 years, maybe up to 1000. But once you really step back, it's actually the reversal that's more inevitable than the 'progress,' especially if that progress acquires a uniquely suboptimal character for most people subject to it.
The Whig view of history - that the arc of history inexorably bends towards progress - has been outdated for a while now. And no wonder! Looking just at England, can we truly say that the working life of a servant in a middle class household circa 1760 was worse than a cotton mill worker’s circa 1860, or an Amazon warehouse worker in 2025?
Is a Taylor Swift song better than a Schubert song? Do we write better books and create more compelling visual art? On the other hand, medicine is a lot better now than at any other time in history, which has to count for something. When that Amazon worker injures himself through overwork, he’s repaired faster and better.
The Amazon workers aren’t repaired at all. That’s just not even a true statement. Surgeons avoid doing surgery, when it is done it’s often a hack job, injured workers languish in workman’s comp hellscapes in which doctors won’t treat them because they don’t want to be involved, doctors can’t treat them because workman’s comp won’t allow the patient to see multiple practitioners at the same time and so everything must move so slowly that nothing can happen, attorneys won’t allow the patient to seek treatment while the case is being battled, and in the meantime not even the patient’s pain can be treated, because we don’t do that anymore. That’s just one category of untreated patient. Patients with complex injuries aren’t treated, because no surgeon wants less than perfect outcomes for their piece of the puzzle, when the one and five year follow-ups come around, and a complex patient may still report pain and disability for the remainder of their injuries or ailments, therefore for the surgeons who did get involved, their outcomes scores will go down. So they punt and try to get the patient to focus on an aspect of their condition that would be some other doctor’s responsibility. Meanwhile medical competency is plummeting, as teach to the test mentalities enter the professions, and doctors now rely on other doctors to read the results of machine tests to them, and offload the responsibility for diagnosis onto the manufacturers of imaging devices and the providers of blood panel services, and make no moves to integrate results with clinical examinations, which at this point barely even happen, and if they happen in some weak form, certainly don’t come close to the rubrics described very clearly in literature as to what constitutes a complete set of tests.
Patients are turned away from ERs with clear and obvious signs of urgent medical emergencies, such as with cauda equina syndrome. I’ve talked with patients on their way to, and then on their way home again from, an ER where they presented with numb genitals, inability to eliminate, numb legs and even falls or inability to walk unassisted, who were told “you’re fine, keep tabs on it and talk to your PCP” when you can get in to see them, being the unspoken remainder of that idiotic dismissal.
Medicine is in the shitter. It’s getting worse, fast. Be very careful crossing the street and even maneuvering around your own house, because unless you can afford concierge medicine—and the best of that, since its spread is going to mean that terrible doctors are found there too—if you are injured, you may well be told, “you’re just going to have to get used to your new normal”.
Medical school has a 97% pass rate, for students who were promoted to be someone else’s problem for their entire academic careers. You do not want most of them anywhere near your patient medical records.
@letterwriter - you make my point for me re: Whig view of history. But I have to correct you: outside the US, we have universal health coverage and the worker is repaired - certainly they are in my example of England.
Sophie, what do you mean? All it takes is going to UK-centric patient forums, or talking to UK patients in open forums, to know that the NHS is failing patients profoundly. Poor care, multi year delays, lack of patient rights to influence who provides care, and so inappropriate specialists are all that’s offered with the patient unable to correct the situation—and the treatments offered for many diseases are not world class. The NHS is still slowly contemplating whether widely available, better outcomes treatments are worth it, or if they even exist, years after they are available to citizens of other countries.
Thanks for one of the very few critiques of "workers compensation" on the web. There's much more to be said, especially about the legal side. It's the singularity of corruption.
*
The purpose of the sysyem is to injure workers at minimum expense to employers, maximum profit to insurance companies and their lawyers with some for the companies that run "industrial medicine" clinics. Compensating workers isn't part of "worker's compensation" at all. It's the nastiest criminal racket besides prison and war.
I’m very interested in the legal side of it. I didn’t know people aren’t talking about this. I’ve heard what are essentially duplicate stories from patients caught in workers comp hell. The system itself turns treatable patients into untreated chronic patients who begin failing in multiple ways from the strain of untreated pain and untreated injuries. Their lives are curtailed both figuratively and literally.
Wow. Thank you. I’m going to be thinking through this and may have more to say, or ask, after that.
A few thoughts in no particular order:
I suspect there are people who’d be very interested in the specifics you mentioned at the end. I’m in some chronic pain / injury groups and that’s where I encounter people caught in the WC meat grinder. I bet that some of your specifics even for heat stroke might translate to other situations, and then the rest certainly would. I’m certainly interested for those reasons and because I’m always trying to give people tools to assert themselves, in these groups.
Also the fact that these cases are allowed to be kept private, and the mismatch in what an employee can be burdened with, are very interesting to me. This is the type of thing that people can, I think, change, and it requires a critical mass of people insisting that things be otherwise. It’s not something solved by mere voting, not even if an individual candidate has some nice or even concrete things to say.
I’m diffusely thinking about the multitude of courts that exist for different purposes. Some are specific courts ie traffic court, eviction court, etc. Some seem to end up being special courts, or rather a form of court that isn’t run the way people would expect, because the relevant laws are so different from what we’d expect. Look at the difference between what you describe here and divorce court, for example. The difference is much greater than what it seems to be from the outside. I’m thinking of judges up for election: their resume or discussions of their performance, as given by Judicial Watch, or similar non profit organizations dedicated to providing information to the public, does not ever go into the differences in how courts work. An example where this could be done, but isn’t, is Chicago’s two tiered approach to tenant-landlord disputes. Eviction court is handled so differently from regular lawsuit cases that the local law which supposedly protects tenants is divided, and a tenant must pursue two cases to avail themselves of the full remedies stated in law—even though the law is not written that way, so the law in theory and the law in fact are not the same and no tenant can know this in advance of trying to assert their rights under law.
So now I’m aware of two instances of this, and so now I suspect this may happen in other legal situations as well.
Your point that the WC law is rooted in old English common law dating to the time that employees were seen as property (formally, that is) is a powerful point. (In fact it took my breath away to read it). The place to look for these de jure / de facto differences is probably in all the sites of pre-human rights thought. Hence housing court is another place this shows up, in Chicago at least—or at least it’s very visible in that city because of the scale of the system. Divorce court is going to be different yet again—the women’s rights movement has been relatively effective. With the idea women as the property of the husband having been weakened so that it’s not a major wound to the social fabric for a couple to dissolve their marriage, there is not the huge threat to property rights in a divorce, as there is in a tenant asserting that leased property is a true lease ie a form of ownership and not an exploitation enshrined in law, or as there is in an employee asserting that their body isn’t transferred to their employer along with their labor. Anything else you’d like to say about the philosophy underpinning the WC exploitation, and its translation into law or into de facto practice, I’m all ears.
As I am for any and all of the details about these hearings, how they go, and all the rest of that part of the process.
You’re right, in the 90s it was not this way. I had a WC case and got surgery out of it, with a good surgeon and no problems selecting a surgeon, in fact with no problems beyond just a bit of bureaucratic crustiness, or at least that’s how it seemed to me. I can see now, I was extremely lucky. This was in the late 90s, too.
I would have thought that the process is roughly the same now, and I would have assigned the difficulties that I’m seeing others encounter to a general bureaucratic ineptitude or the general refusal to honor social contracts and norms that one sees in almost all businesses and bureaucracies lately—an attitude problem. It seems from what you’re saying, it’s much more deliberate than that, and has been. I mean it’s still an attitude problem, it’s just bigger and deeper than I’d realized.
Thank you again. What an eye opener.
Anything you care to say I’m here for it. If you write a post I’ll restack it.
Cyberpunk 2077 is one very recent example of art criticising many modern developments like the movement to everything online (Braindances in the game) and companies being outright evil. Also the format of a game instead of movie, novel etc. at least to me allows the criticism to be noticeable in every step when you look for it without feeling to "on the nose" as it is just part of the in-game world. I would highly recommend it to everyone as it is truly thought-provoking.
I think video games are one of those 'low arts' that will gain more critical respect as time goes on. They're certainly immersive in a way books or television or movies can't be.
Have you come across any good think pieces on how artists navigate producing satire, or any sharp cultural commentary, when people’s ability to identify and appreciate irony has always been relatively rare? I’m curious how different or similar the sentiments were for people like Bradbury or Vonnegut compared to the points you bring up in this piece.
It's not exactly satire, but the anime Serial Experiments Lain is a decent near-term speculative fiction that deals with social media, internet culture, parasocial relationships, AI, etc in a way that feels pretty on the nose, so much so that half of it seems a bit dated and obvious now 20-some years later.
Also, the movie adaptation of Stanislaw Lem's "The Futurological Congress" where Princess Buttercup gets incepted into an AI download world by studio execs. That's pretty relevant.
“Now, if asked to name the last truly popular and incisive tech satire, I’d go with the TV show Black Mirror, which premiered, guess what, 14 years ago.”
Black Mirror is a great one for sure (along with Infinite Jest and most of DeLillo’s oeuvre). I would add a few more recent ones to the list:
- Mike Judge’s Silicon Valley skewered the myopic and lightly sociopathic Tech Bro archetype *years* before we collectively soured on Elon, Zuck, and Bezos
- DEVS on Hulu is a wonderfully cerebral meditation on AI, simulated worlds, and trying to use technology to fill a hole left by grief and tragedy
- The entire canon of Neal Stephenson. Snow Crash is the GOAT that introduced the concept of a metaverse used to cope with a dystopian reality. More recently, “Fall” has an entire section where the internet in the near future becomes an unusable mess of AI slop: those with money pay minimum wage workers to curate their own personal, “cleaned” version of the web while everyone has their brains melted by porn, propaganda, and spam. There is also a subplot about a 9/11-style terrorist event that never happened but everyone THINKS did because fabricated images and data spread on social networks
- Super Sad True Love Story by Gary Shteyngart describes a disturbingly plausible near future NYC where everyone uses drugs and supplements to stay young forever and kids are so desensitized to sex that fashionable women walk around in transparent OnionSkin brand jeans that are translucent
- Honorable mention: It’s old now, but Idiocracy (also Mike Judge, who might be a time traveling wizard) has more or less come true. I wouldn’t be surprised to see a movie like “Ass” released in the next decade
Some people get up in arms about "stop saying Idiocracy is a documentary!", based largely on mild classism and using a eugenics-light plot device, but it really was a precient satire, and becomes more relevant every day. Even the best criticism of it, that it ignores the sins of willfully corporate evil and focuses too much on government incompetence, are becoming less true as corporations increasingly trade willfull malevolence for willfull stupidity.
If anyone thinks Idiocracy went TOO EASY on corporate America, that would be news to corporate America. They HATED how they were portrayed and pressured Fox to bury the movie, doing virtually no marketing. Some theaters where it played didn't even have it listed on their schedule or marquee:
"Throughout Idiocracy, corporate America is framed as the main antagonist and the primary reason for the anti-intellectual culture that ruined the world. The movie takes some pretty vicious swings at companies like Starbucks.
In the future, Starbucks has stopped serving coffee and has started serving blowjobs. Costco is now its own city-state.
[...]
In a 2018 interview with GQ, Terry Crews admitted that real-life advertisers poured money into the movie, thinking that they would receive a positive portrayal. They were shocked when they realized that Idiocracy turned their businesses into full-release massage parlors and then blamed them for destroying the entire world."
https://www.giantfreakinrobot.com/ent/independent-idiocracy.html
Mike Judge is the GenX'er we were promised (OK, so he's not technically GenX but whatever). Would that there were more of him.
Relevant to this article: I’m currently seeking funding to build the Torment Nexus as featured in legendary sci-Fi novel, ‘Do Not Build The Torment Nexus’. Anyone interested in investing, DM me.
The Distractotron was developed in the 60s by researchers at the Carnegie Corporation (and known then as The Distractor) and was used in part to develop shows like Sesame Street. I’m amazed the NYT article doesn’t seem to mention that.
Thank you for this pointer. Really interesting how often what seems newly concerning has in retrospect been present in force since the Cold War.
DeLillo's TV-centric vision is out of date and reads a little flat but, on the other hand, my experience in the classroom has been that there are plenty of people (and not just young ones) who are reduced to a state of hostile, unfocused, anxiety the moment you separate them from their smartphone. More or less all they can do is worry about what's happening on their phone.
It's where all their friends are.
I’m all in favor of sophisticated cultural commentary, and in addition to your literary examples, I’d add protest music: we hear very little of it these days. But methinks you ascribe a bit too much power to artists and critics. Even your favorite tech critique, “Black Mirror,” has done little to bend the arc of history. Going back further, all the protest rock and art of the ’60s didn’t get the U.S. to pull out of Vietnam.
> Going back further, all the protest rock and art of the ’60s didn’t get the U.S. to pull out of Vietnam.
Are you sure? The US did, in fact, pull out of Vietnam, and for purely internal/political reasons that had little and less to do with battlefield realities. Obviously that wasn't a sole cause, but seems to me like a plausible factor...
The protests dropped a lot after Nixon got rid of the draft...
Arguably the artists did help create a cultural climate that made the war untenable, as you say. I know the culture war means they're more likely to do harm than good (at least from the point of view of electing politicians they like), but the 60s had a culture war too. So why were artists so ineffectual at removing Bush or Trump?
I could be cynical and say the art sucks. I'm guessing the trend away from creating generally enjoyable or at least appreciable art had something to do with it. You'll note that generally positive portrayals of gay people in TV and movies are, as far as I can tell, thought by all sides on the issue to have helped allow gay marriage. So, the art sucks?
To Pimp a Butterfly was the last great protest record that had any real mainstream cultural impact . Theres a lot of artists making culturally conscious music outside the mainstream. The thing is that the album format isn’t as relevant as it used to be.
And novelists like Wallace and DeLilo are even less influential (although I like them both, their culture criticism notwithstanding)
Painfully on the nose
Funny thing is, the very readers themselves have beaten the writers/producers of AI slop to the punch: I noticed that an increasing number of people are reading AI summaries of the things I send them, and then offer thoughts on that (the summaries strip away so much information and nuance that they are effectively responding to something that was not written).
So while I used to fear that administrators of content-factories would do exactly what they are trying to do, I now fear that actual writers are going to have to contort their own writing so that it "summarizes correctly" through an LLM (because otherwise people will simply believe that the writer wrote something they did not -- and this can be dangerous or even fatal (see Rushdie and others)).
I also wonder if writing with redundancies/noise will "summarize correctly" (because of the redundancies), but writing that is actually information-dense will "summarize poorly", because there is no noise to remove, so you have to remove information that is actually load bearing.
Alternatively, we might have to make our writing shorter, so as to make summaries "unnecessary" -- which is basically an arms-race towards micro-blogging.
I thought it is was bad enough when search-engines and feeds mediated which of your writing would reach new readers, but we now have to worry about LLMs deciding which _blurred and transmuted concepts_ **from** your writing will reach the reader.
This will also likely carry over into programming (i.e. the LLM turns your good code into crap code, and the time-starved person evaluating your work believes that you are a crap coder).
It seems that Silicon Valley is deliberately (desperately?) trying to stack one brain-melting technology on top of another, recursively.
Thank you for writing this!
This got me reminiscing about Adbusters magazine from my high school and college years. Apparently it still exists!
https://www.adbusters.org/about-us
Love adbusters! Founded in Vancouver. Huh, it seems to have been replaced here with simple minded literalism as well.
Yeah, I was looking at it and thinking, "Is THIS what we liked?" It seems different. Not at all funny either. Or maybe we're the ones who've changed? But...somehow I don't think that's it. Maybe it was never belly-laugh funny, but didn't it used to be somewhat amusing at least? I remember the covers being shocking, arresting, too.
I watched exactly two episodes of The Black Mirror and had to stop, it was too painfully probable. And I think about those two episodes all the time now... Those and basically all of Star Trek: TNG, especially the one where the whole ship almost got taken over when everyone got addicted to those headset game things.
The funny thing was, everyone mocked that episode at the time about being too alarmist about video games. Especially when you consider the core audience of video games and Star Trek (nerdy young men) are pretty similar.
Critics especially of the fiction writing kind look at trends that the majority of people don’t see yet. What you describe here has already happened. The dystopias preoccupying writers today are of a different kind involving the future of humanity on a burning planet. As always, nobody wants to listen until it’s too late.
Writing off Delillo based on an undercooked scene from a book he published when he was 84 seems like a bit much. White Noise is one of the great novels of the 20th century. Agree with the rest though.
You're right that the fear of being on the wrong side of history prevents people from criticizing 'progress,' which becomes a self-fulfilling prophecy.
I think we're at a unique moment of reversal. Moldbug was early to elucidate this with politics (the left is always right retrospectively based on the course of history, so who'd want to bet against that trend?). The issue being our lens on modern history is like 1-200 years, maybe up to 1000. But once you really step back, it's actually the reversal that's more inevitable than the 'progress,' especially if that progress acquires a uniquely suboptimal character for most people subject to it.
The Whig view of history - that the arc of history inexorably bends towards progress - has been outdated for a while now. And no wonder! Looking just at England, can we truly say that the working life of a servant in a middle class household circa 1760 was worse than a cotton mill worker’s circa 1860, or an Amazon warehouse worker in 2025?
Is a Taylor Swift song better than a Schubert song? Do we write better books and create more compelling visual art? On the other hand, medicine is a lot better now than at any other time in history, which has to count for something. When that Amazon worker injures himself through overwork, he’s repaired faster and better.
The Amazon workers aren’t repaired at all. That’s just not even a true statement. Surgeons avoid doing surgery, when it is done it’s often a hack job, injured workers languish in workman’s comp hellscapes in which doctors won’t treat them because they don’t want to be involved, doctors can’t treat them because workman’s comp won’t allow the patient to see multiple practitioners at the same time and so everything must move so slowly that nothing can happen, attorneys won’t allow the patient to seek treatment while the case is being battled, and in the meantime not even the patient’s pain can be treated, because we don’t do that anymore. That’s just one category of untreated patient. Patients with complex injuries aren’t treated, because no surgeon wants less than perfect outcomes for their piece of the puzzle, when the one and five year follow-ups come around, and a complex patient may still report pain and disability for the remainder of their injuries or ailments, therefore for the surgeons who did get involved, their outcomes scores will go down. So they punt and try to get the patient to focus on an aspect of their condition that would be some other doctor’s responsibility. Meanwhile medical competency is plummeting, as teach to the test mentalities enter the professions, and doctors now rely on other doctors to read the results of machine tests to them, and offload the responsibility for diagnosis onto the manufacturers of imaging devices and the providers of blood panel services, and make no moves to integrate results with clinical examinations, which at this point barely even happen, and if they happen in some weak form, certainly don’t come close to the rubrics described very clearly in literature as to what constitutes a complete set of tests.
Patients are turned away from ERs with clear and obvious signs of urgent medical emergencies, such as with cauda equina syndrome. I’ve talked with patients on their way to, and then on their way home again from, an ER where they presented with numb genitals, inability to eliminate, numb legs and even falls or inability to walk unassisted, who were told “you’re fine, keep tabs on it and talk to your PCP” when you can get in to see them, being the unspoken remainder of that idiotic dismissal.
Medicine is in the shitter. It’s getting worse, fast. Be very careful crossing the street and even maneuvering around your own house, because unless you can afford concierge medicine—and the best of that, since its spread is going to mean that terrible doctors are found there too—if you are injured, you may well be told, “you’re just going to have to get used to your new normal”.
Medical school has a 97% pass rate, for students who were promoted to be someone else’s problem for their entire academic careers. You do not want most of them anywhere near your patient medical records.
@letterwriter - you make my point for me re: Whig view of history. But I have to correct you: outside the US, we have universal health coverage and the worker is repaired - certainly they are in my example of England.
Sophie, what do you mean? All it takes is going to UK-centric patient forums, or talking to UK patients in open forums, to know that the NHS is failing patients profoundly. Poor care, multi year delays, lack of patient rights to influence who provides care, and so inappropriate specialists are all that’s offered with the patient unable to correct the situation—and the treatments offered for many diseases are not world class. The NHS is still slowly contemplating whether widely available, better outcomes treatments are worth it, or if they even exist, years after they are available to citizens of other countries.
Thanks for one of the very few critiques of "workers compensation" on the web. There's much more to be said, especially about the legal side. It's the singularity of corruption.
*
The purpose of the sysyem is to injure workers at minimum expense to employers, maximum profit to insurance companies and their lawyers with some for the companies that run "industrial medicine" clinics. Compensating workers isn't part of "worker's compensation" at all. It's the nastiest criminal racket besides prison and war.
I’m very interested in the legal side of it. I didn’t know people aren’t talking about this. I’ve heard what are essentially duplicate stories from patients caught in workers comp hell. The system itself turns treatable patients into untreated chronic patients who begin failing in multiple ways from the strain of untreated pain and untreated injuries. Their lives are curtailed both figuratively and literally.
Wow. Thank you. I’m going to be thinking through this and may have more to say, or ask, after that.
A few thoughts in no particular order:
I suspect there are people who’d be very interested in the specifics you mentioned at the end. I’m in some chronic pain / injury groups and that’s where I encounter people caught in the WC meat grinder. I bet that some of your specifics even for heat stroke might translate to other situations, and then the rest certainly would. I’m certainly interested for those reasons and because I’m always trying to give people tools to assert themselves, in these groups.
Also the fact that these cases are allowed to be kept private, and the mismatch in what an employee can be burdened with, are very interesting to me. This is the type of thing that people can, I think, change, and it requires a critical mass of people insisting that things be otherwise. It’s not something solved by mere voting, not even if an individual candidate has some nice or even concrete things to say.
I’m diffusely thinking about the multitude of courts that exist for different purposes. Some are specific courts ie traffic court, eviction court, etc. Some seem to end up being special courts, or rather a form of court that isn’t run the way people would expect, because the relevant laws are so different from what we’d expect. Look at the difference between what you describe here and divorce court, for example. The difference is much greater than what it seems to be from the outside. I’m thinking of judges up for election: their resume or discussions of their performance, as given by Judicial Watch, or similar non profit organizations dedicated to providing information to the public, does not ever go into the differences in how courts work. An example where this could be done, but isn’t, is Chicago’s two tiered approach to tenant-landlord disputes. Eviction court is handled so differently from regular lawsuit cases that the local law which supposedly protects tenants is divided, and a tenant must pursue two cases to avail themselves of the full remedies stated in law—even though the law is not written that way, so the law in theory and the law in fact are not the same and no tenant can know this in advance of trying to assert their rights under law.
So now I’m aware of two instances of this, and so now I suspect this may happen in other legal situations as well.
Your point that the WC law is rooted in old English common law dating to the time that employees were seen as property (formally, that is) is a powerful point. (In fact it took my breath away to read it). The place to look for these de jure / de facto differences is probably in all the sites of pre-human rights thought. Hence housing court is another place this shows up, in Chicago at least—or at least it’s very visible in that city because of the scale of the system. Divorce court is going to be different yet again—the women’s rights movement has been relatively effective. With the idea women as the property of the husband having been weakened so that it’s not a major wound to the social fabric for a couple to dissolve their marriage, there is not the huge threat to property rights in a divorce, as there is in a tenant asserting that leased property is a true lease ie a form of ownership and not an exploitation enshrined in law, or as there is in an employee asserting that their body isn’t transferred to their employer along with their labor. Anything else you’d like to say about the philosophy underpinning the WC exploitation, and its translation into law or into de facto practice, I’m all ears.
As I am for any and all of the details about these hearings, how they go, and all the rest of that part of the process.
You’re right, in the 90s it was not this way. I had a WC case and got surgery out of it, with a good surgeon and no problems selecting a surgeon, in fact with no problems beyond just a bit of bureaucratic crustiness, or at least that’s how it seemed to me. I can see now, I was extremely lucky. This was in the late 90s, too.
I would have thought that the process is roughly the same now, and I would have assigned the difficulties that I’m seeing others encounter to a general bureaucratic ineptitude or the general refusal to honor social contracts and norms that one sees in almost all businesses and bureaucracies lately—an attitude problem. It seems from what you’re saying, it’s much more deliberate than that, and has been. I mean it’s still an attitude problem, it’s just bigger and deeper than I’d realized.
Thank you again. What an eye opener.
Anything you care to say I’m here for it. If you write a post I’ll restack it.
Cyberpunk 2077 is one very recent example of art criticising many modern developments like the movement to everything online (Braindances in the game) and companies being outright evil. Also the format of a game instead of movie, novel etc. at least to me allows the criticism to be noticeable in every step when you look for it without feeling to "on the nose" as it is just part of the in-game world. I would highly recommend it to everyone as it is truly thought-provoking.
I think video games are one of those 'low arts' that will gain more critical respect as time goes on. They're certainly immersive in a way books or television or movies can't be.
The bit about Facebook made me smile. I wrote a short story last year about what might happen if such a scenario didn’t quite work out how our tech overlords envisioned. You might enjoy it: https://open.substack.com/pub/dissidentdeliveries/p/margots-women?r=1gmdij&utm_medium=ios
Have you come across any good think pieces on how artists navigate producing satire, or any sharp cultural commentary, when people’s ability to identify and appreciate irony has always been relatively rare? I’m curious how different or similar the sentiments were for people like Bradbury or Vonnegut compared to the points you bring up in this piece.
It's not exactly satire, but the anime Serial Experiments Lain is a decent near-term speculative fiction that deals with social media, internet culture, parasocial relationships, AI, etc in a way that feels pretty on the nose, so much so that half of it seems a bit dated and obvious now 20-some years later.
Also, the movie adaptation of Stanislaw Lem's "The Futurological Congress" where Princess Buttercup gets incepted into an AI download world by studio execs. That's pretty relevant.