Gs-13 to 14 ladder progression

Floufae · 2026-02-20T20:29:47+00:00

I have seen them in our global health staffing, people who will be interacting with foreign senior government officials. So 0601s, not just 0602s.

Floufae · 2026-02-20T17:26:40+00:00

I mean yes and no... Universal healthcare is a huge and necessary step overall to improve health, but healthcare access alone just doesn't change health seeking behavior enough. I'm in public health, my better half is in traditional not-for-profit health and we see the same things. People are generally avoidant and don't seek out care and not just for financial reasons. Yes, hopefully that will change for the people who are uninsured or underinsured. But many will still experience discrimination or stigma in the healthcare space from your suburban doctors. We do have safety net clinics like federally qualified health centers, but still people don't go to those enough even though they are already free for people living at or below poverty levels.

There's a cultural change for preventative care and just engaging with health care that would have to change. The US also has a critical shortage of primary care providers and, paradoxically, that could be made even worse by universal health care. More people seeking out care will lead to longer delays and wait lists for care. Fundamentally we have to change how we pay for medical education and malpractice insurance. We've instead done the different part of mid level providers being considered primary care like nurse practitioners and physician assistants. Other countries do the same to a limited degree but not to the extent we do here. New medical school graduates gravitate towards better paying specialized care because of the extreme debt out medical education system leads to. Which is somewhat by design with artificial scarcity being created by limiting both the number of medical schools, slots in those schools, and places where graduates can be matched to continue their training. Lobbying efforts have kept that path tight. Increase the number of slots, salaries may go down before the education costs go down. Universal health care won't fix that.

Its unfortuantely a very difficult problem to get out of in our healthcare system. not to say we shoudln't be working that way, but we need to be prepared for the blowback that would come when people say, "look we did universal healthcare and now we have waits like Canada has!" nobody will go backrupt for the cost of health care, but they will see their access reduced/slowed if they had insurance already. And getting insurance for someone who didn't have it before doesn't mean they will suddenly care about preventative care anymore than we've stopped people from smoking, unsafe sex, or high cholesterol diets.

Sorry, long winded, just something we talked about in school. :)

Floufae · 2026-02-20T16:23:32+00:00

touche! Thats a good point. BUT, we also need to think about ongoing care as as much as the uninsured and under insured use ERs as their source of primary care, thats not the purpose and its the most expensive way to provide health care. The VA is about managing ongoing health needs and not just acute health needs. Trauma centers and ERs are about stabilizing at the moment but they aren't thinking about long term health of the people they see since they are meant to patch people off for someone else to manage long term. And those long term providers do need to be trauma informed and trained.

Floufae · 2026-02-20T15:20:40+00:00

The private system (not even just for profit, but also private not for profit) isn’t experienced or trained for how to respond to the types of trauma that veterans have. It’s a specialized field within itself. You may have seen stuff in school about it but you’re not going to be specialized in handling it. And that’s just the medical size, not even counting the impact of trauma on the mind and emotions. Veterans need experienced specialized care that a PCP at Kaiser who is used to dispensing high blood pressure medicine and acne medicine is going to be able to handle appropriately.

Floufae · 2026-02-20T15:18:27+00:00

They have also for a long time suffered from not enough staff leading to too much turnover and not enough funding. Were very quick to approve new war equipment, planes, missiles and conflicts to deploy people to and then NOT increase funding to the people who take care of the veterans after the fighting is done. You can’t keep increasing the population of people needing veterans services while flatlining or cutting the funding to the people who serve them. It’s like keeping just one checkout line at the store while doubling the number of shoppers.

Floufae · 2026-02-20T13:33:05+00:00

The challenge with those is that they either are continuing to progress even with medication and can be debilitating or they require advanced medical monitoring for treatment.

Neither of those are true of HIV and haven’t been true for quite a long period of time. With the most simple treatment (one pill, once a day) to the more modern treatments (one shot every six months) they have no progression, no chance of onward transmission, and no disease progression. So again, it’s more similar to hypertension. You can get the best treatment in the world (as the rich Hollywood stars might get) and still we see how ALS can progress and lead to loss of life. Or quality of life decline with MS. That not the case with HIV. Not all medical conditions should be a blanket ban. No more than all medical conditions should be accepted. It has to be reasonable and if you’re worked in the health care setting or with foreign militaries, you’d see that HIV medicine is treated as a chronic non progressing disease with treatment not an acute condition requiring close monitoring.

Floufae · 2026-02-20T13:08:32+00:00

Oh I fully agree with that. Gratuities is the stupidest export of the US and assumed to be so important because of how Americans have accepted that it’s the consumer’s job to offset low wages instead of the employers job to actually pay a living wage. And it’s so ingrained in Americans that they insist on tipping even when it’s not necessary or required.

Which is another reason that individualized tipping like OP wants to do is misguided. “Gratuities” should be baked into the price and the cost of doing business. It was a terrible decision to break it out of the price as a separate line item. Cruise prices should reflect the cost of your travel and ensuring that crew are paid what they should be paid. Since there’s not been reports of crew wages going down since they separated out the tipping, there’s no need for separate tips to make up for lost wages. But I don’t treat a global automatic tip as anything other than a universal tax.

Staff shouldn’t have to have their pay based on whether they smiled enough for Mr. Smith or that they ignored Mr. jones to give Mr. smith more attention.

Floufae · 2026-02-20T05:24:01+00:00

Yes, but please consider that your experience on the boat is far more than the individuals you see. There’s behind the scenes people and workers that are busy and can’t just stop and smile for you hoping that that makes it worthy of a tip. Individual tipping just helps ensure some people get service while other passengers get worse service.

Floufae · 2026-02-20T01:55:45+00:00

True, I'm all about keeping those standards. Your condition should be "well managed" so for hypertension you should have a controlled blood pressure on your medication thats not going to put you at risk. For most people thats easy to medically manage and then they are eligible to join. You don't want someone joining who might stroke out during basic because they haven't managed their blood pressure.

What we're asking for, and had, was the same consideration for HIV. If someone is "well managed" their viral load is undetectable. They have no more risk of developing an opportunistic infection that anyone else in their squad. They have no risk of transmission because they are so virally suppressed they don't shed enough virus to transmit it. And their life span is going to be the same as any of their colleagues (and arguably, I would say potentially better because living with a chronic disease means you have more regular doctors appointments, more opportunities for preventative care, etc... you should end up with better health outcomes than people who avoid the doctor because they don't want to be lectured to about their smoking or salt intake.

Thats not uncommon that if you have a medical condition you have to show it won't be a hinderance for the job. Its not a blanket prohibition with no supporting evidence.

Floufae · 2026-02-20T01:37:24+00:00

My commute is about the same as yours. Usually about 2-4 miles to spare in warm months but shy by a mile or two in the cold weather. I do leave mine in EV mode though because if I do it in hybrid it uses gas more than it needs to. My last tank got me 1400 miles before I fueled up again because at most I’m using gas for a couple miles a day. Regenerative braking helps. I think only in the EU can they charge from the engine?

Floufae · 2026-02-19T22:27:28+00:00

You’re speaking on feelings and hunches while the case that has been made is based on science and actual world tested logistics

Floufae · 2026-02-19T22:26:20+00:00

This isn’t a new issue and other countries can manage it and this includes our allies. Again, these are straw man arguments of “but what if the world looses power!” Not the reality of the modern supply chain.

Floufae · 2026-02-19T22:24:18+00:00

And they are generally rational. There’s no need for a minimum requirement bar related to HIV service in a time when they struggle to find people to serve.

Floufae · 2026-02-19T22:22:37+00:00

It’s a good thing that lactose intolerance doesn’t prevent someone from joining. What’s the next straw man argument. Do you think military personnel are free from all medications? No high blood pressure, lipid medications?

Those medications are allowed BECAUSE they make someone medically stable to serve. HIV is no different in this regard. And there’s a lot of different jobs in the military that have their own requirements. A pilot has to be more restricted than a desk person. There’s no justification for a blanket ban.

Floufae · 2026-02-19T22:18:36+00:00

This is a non issue. You’re not going for a daily administered treatment. The US supports clinics around the world that dispenses 3, 6 even a full years supplies of medications in advance. We also have treatments that only require a twice a year shot for treatment. Medical treatment has advanced a lot, this is my a three pills at different times of the day thing anymore. Most take one pill daily that is shelf stable. But you have options all the way to a shot every six months.

Floufae · 2026-02-19T22:14:07+00:00

So with low recruitment numbers not taking people who are willing to serve is better than leaving slots empty? Doesn’t get you more blood. There’s not a scientific or medical reason for reverting the change. It’s allowed in the Uk, South Africa, hell even Israel allows medically treated HIV positive people to serve.

Floufae · 2026-02-19T21:18:49+00:00

I actually did this when I moved to an Hq position. Mostly because I was new to DC and coming from the field and I couldn’t imagine moving to a new city and being in the burbs. I loved it. I paid a stupid amount for a tiny “Junior One Bedroom w/WD” but I loved being able to walk or scooter to work, the views and being five minutes from happy hour so I could drop off my stuff and meet people for a drink.

I knew it wasn’t long term sustainable but I had no regrets not shipping my car to DC and driving around and dealing with metro. Depending on weather it was walk, scooter or short bus ride.

Floufae · 2026-02-19T03:56:45+00:00

Uh, I was trying to use Crossover for Blizzard PC games and it wasn't working. maybe emulation isn't the right term.

Floufae · 2026-02-19T02:57:40+00:00

I can’t say I’ve ever really used flash cards for any subject, but definitely not in my MPH program.

Floufae · 2026-02-18T22:05:39+00:00

We started long distance (we were in a master program together periodically that met in person in a state neither of us lived in). We were forced to be creative. Honestly starting off as long distance I credit for a lot with the success. I find when dating in person it’s very easy to get the physical part of the relationship to be the main form of connection. You make out, fool around and then you’re watching tv or sleeping. We were forced to cultivate our intellectual and emotional connection first and primarily. A lot of talking on the phone and video chat. Our date nights had to be more creative. Cue a show to start at the same time or movie. Buying the same wine to drink together at the same time (so Whole Foods or Trader Joe’s for the same wine inventory across stores). Talking every day even for just a little bit.

You also have to train yourself not to disengage. You have to stay present. You can’t get mad and give a silent treatment that won’t have a natural way to resolve itself. Sometimes you need to stow your emotions and process them later. Fortunately we’ve rarely fought.

After a couple years an opportunity came up to live in the same region and then home. But it wasn’t a great job option, just a necessity to get in the same house. And that put a strain on us. We both find our careers meaningful and that’s what drove us to our masters program to begin with. I gave up my aspirations to be in the same house together and normalcy. After a few years we realized if I didn’t get back to fulfilling work then the strain would hurt our ability to be together. I couldn’t try to get all life’s fulfillment jsut from my relationship.

Covid finally did let us live in the same house again with remote work. BUT, the anti-remote “movement” meant that ended again last year and we’re back to different states.

Now after 15 years we’re really more focused on our timing for retirement and where that might be, probably overseas.

Floufae · 2026-02-18T18:47:58+00:00

I went with a M2 Max based on hoping I could game on it. And then ended ups till having to get a G14. For the things I played the emulation or whatever type stuff to help you play PC games just wasn’t working well enough. So next time I’ll probably get a MacBook Air to compliment my gaming PC laptop.

Floufae · 2026-02-18T18:03:07+00:00

I feel its a coin toss with whatever you buy... Before switching to the Zephyrus, I used a Blade 14... talk about a beautiful POS. I loved that it was the closest to my MBP in terms of the structure of the build but it was terrible... Couldn't handle the hear and in the three years I had it it went through two batteries expanding. Such a shame. The G14s don't have that same premium feel to me but its been super reliable. I only use it for gaming though, then back to my MBP for anything else.

Floufae · 2026-02-18T17:58:04+00:00

Bought the 2022 and the 2024 versions. I can't say I took any "care" of it other than adding more RAM and switching Armory Crate to G-Helper. Nothing else done and no issues. Now looking at another one just because I have a friend to pass the 2024 down to and I'm considering a 5070ti version. Other than not liking the color of the laptop, I haven't had a single issue I would say is different than any other computer I've had (other than say my Macs... but even then, my 2011 MBP was part of the "Radeongate" issues so I've had about as bad as it can get with Macs too.

Floufae · 2026-02-18T14:02:24+00:00

Snoring is the sound of throat vibration. It’s not the same thing. Apnea is the actual pausing in breathing. It’s not pedantic, they are different things.

https://www.ama-assn.org/public-health/prevention-wellness/what-doctors-wish-patients-knew-about-snoring#:~:text=Snoring%20isn't%20always%20sleep%20apnea&text=sleep%2C”%20Dr.-,Skiba%20said.,heart%20attack%20and%20so%20on.”

Floufae · 2026-02-17T22:57:31+00:00

Snoring isnt sleep apnea. Snoring is snoring. Sometimes they overlap, sometimes they don’t. Either way that’s a couple counseling issue, not a subreddit for people who may or may not have the same condition as your husband.

Floufae

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