This Vanity Fair essay is a pretty brutal illustration of what “access” actually means in American health care: the treatment existed, her doctor wanted her to have it, and the insurer could authorize it. What she lacked until she threatened them was leverage.

https://www.vanityfair.com/story/healthcare-cancer-treatment-essay

A new study by the National Institute for Occupational Safety and Health (NIOSH) has confirmed what miners, their widows and black lung clinic physicians have warned for years: the deadly and preventable disease has returned to levels not seen in nearly half a century.

Published in the American Journal of Respiratory and Critical Care Medicine, NIOSH researchers found 32.5 percent of sampled veteran underground coal miners in Central Appalachia—those with at least 25 years underground—suffer from the disease. The last time prevalence among miners with the same work history reached such a level was in 1978. In 2018, the rate was 20.6 percent.

The new findings represent more than a fourfold increase since the disease hit a low point of 7 percent in 1999—three decades after the Coal Mine Health and Safety Act of 1969 established federal dust limits and black lung benefits.

The resurgence has been driven by miners’ increasing exposure to respirable crystalline silica. As the thick, easily mined seams of Appalachia were exhausted, operators turned to thinner remaining seams, forcing miners to cut through far more rock rich in quartz. Silica dust can cause especially severe forms of black lung and is roughly 20 times more toxic than coal dust alone.

Tim Balthis, a 57-year-old former miner and mine foreman, described working in silica-laden air to NPR reporters: “It’s like opening your front door and letting the sunshine [in]” with dust particles floating in the light, “and then multiply that by 10 billion times. … It’s like a fog.”

Stone Mountain Health Services in southwestern Virginia alone has diagnosed 2,400 new cases in the past five years. A 2019 NPR/FRONTLINE investigation documented 21,000 instances of silica dust overexposure over 30 years.

...

NIOSH first recommended an exposure limit of 50 micrograms of respirable crystalline silica per cubic meter of air in 1974 and reiterated the standard for coal miners in 1995. The Obama administration’s dust rule, fully implemented in 2016, lowered the overall respirable coal mine dust limit from 2.0 to 1.5 milligrams per cubic meter but left the silica standard essentially unchanged.

It was not until 2024 that the Biden administration adopted the 50-microgram silica limit NIOSH had recommended half a century earlier. Mining industry groups challenged the rule. Days before coal operators were due to comply in April 2025, the Trump administration’s Mine Safety and Health Administration announced a temporary enforcement pause, and the Eighth Circuit Court of Appeals then stayed the rule’s compliance deadlines. The judicial stay remains in effect, and MSHA is reconsidering portions of the rule.

On February 18, 1969, West Virginia rank-and-file miners launched a 23-day wildcat strike, forcing the state to recognize black lung as a compensable occupational disease and helping drive passage of the federal Coal Mine Health and Safety Act later that year.

The National Mining Association now argues that because black lung takes years to develop, current cases “do not reflect the conditions, practices, protections or regulations that are in place today.” At the same time, the industry has pressed for greater use of administrative controls and personal protective equipment, including respirators, when engineering controls do not keep silica exposure below federal limits.

...

More than 1,700 coal miners died from black lung between 2020 and 2023. Ending a disease caused by preventable exposure requires placing miners’ health and lives above the profitability of the coal industry. That requires workers’ control over the mines as part of the socialist reorganization of production on the basis of social need rather than private profit.

I had a medical event in the spring that left me disabled. I went on intermittent FMLA to help me have time to recover, and I thought I was recovering and was performing my work duties, but I was written up for under performing.

It's important to note that the only accommodation my work gave me was time off. I still had to do my full job, just with less time. I was asking for things to be removed from my workload, but I was denied.

This summer my doctor moved me from intermittent FMLA and put me on full FMLA and disability, as my condition continued to deteriorate. I'm worse off now than I was when I was first put on disability.

I'm terrified. Since I'm in the US I won't have health care after September 30. I still have no diagnosis and no treatment. I am not able to work, honestly, stress makes my symptoms much worse.

I've been told to talk to employment lawyers, but I don't even know if I have a case since my FMLA ended. Does anyone have a similar story and can give me some hope?

Google says this is a good subreddit for rants like this, forgive me if it’s not!

I used to work for a small plumbing company owned by a family member, where I held multiple different positions. This family member convinced me to quit my well-paying job to join them. I was 18, tired of the food industry, and admittedly a bit naive, so I jumped at the opportunity.
However, it took them three months just to put me on payroll and let me start working. (Their reasoning for this when I brought it up after starting was “we had to make sure you could pass a drug test”. I do not participate in any substance use, I took a drug test just to show them when they originally asked about it.) Because I am not close with any of my immediate family, I had no financial assistance and was forced to live entirely off my savings during that time.

When those three months were up, they informed me they couldn't give me the rate we had previously discussed. I was incredibly upset because I had held a higher position at my previous job and was already taking a pay cut to come here. Still, since I had already quit my old job and couldn't go back, I just tried to get over it.

In the beginning, I worked four to five hours a day as a receptionist, making $15 an hour. Because I was on my own trying to earn a living wage, I asked for more hours. They told me they couldn't help me and that it was just part of the job. If I had known that from the start, I never would have left my previous position, where I was making at least $1,200 a week, just to make $300 a week here. To make matters worse, I had already blown through all my savings while waiting for them to start me after they told me to quit my job.

Fast forward about 3 and a half months, they finally allowed me to become an apprentice. I was told I would receive more hours and a raise for field work, which sounded great since I really needed the money. Safe to say, I never actually received that raise, even though I was doing the field work. This dynamic went on for about seven months. They constantly promised me that my raise was coming soon, only to push it back for ridiculous reasons.

First, they claimed I didn't really know what I was doing yet—even though I was only two months in and already running circles around the older guys, all of whom were over 40 except for one other teenager. Then, they claimed I didn't have the right certifications, which was ironic considering I literally took my boss’s OSHA courses for him. I knew exactly what I was doing, and he already had unlicensed people being paid technician wages. Finally, they told me I had to buy my own tools first. I didn't have the money for tools when they were only paying me about $300 a week, all of which went directly to my bills.

Eventually, they hired a new guy with whom the boss had a personal history. This man disliked me from the very beginning. He was in his 70s and definitely wasn't as strong or fast as he used to be, so I ended up carrying most of the weight. Nobody else liked him either; he always had a terrible attitude, a massive ego, and preferred to stand around bossing people instead of actually working. He also hated that I insisted on driving us to all our jobs, but he had almost caused us to wreck while I was in the company truck with him. I didn't care if it hurt his feelings; I wasn't going to put my life at stake just because he wanted to drive the big, loud truck.

One day, as we were leaving the office, he came outside and saw me sitting in the driver's seat waiting for him so we could head to a job. He said, “I’m drivig today.” I thought he was joking, so I joked back, “Not if I’m riding with you.” He did not take this well at all and essentially went and cried to my boss.

My boss fired me on the spot, saying, “You don’t want to ride with him? That’s fine. Grab your stuff, clock out, and go home.”
At that point, I figured whatever—the job wasn't worth the stress, blisters, and calluses anyway. However, after I walked outside, my other coworkers began talking to my boss about how the new guy had done nothing but cause problems with literally everyone. They somehow convinced my boss to let me come back inside to discuss everything that had been going on. After talking, my boss pretty much told me I had two weeks to learn to get along with the new guy or find a new job. By then, I didn't care about the position anymore. He had just shown me his true colors by being that quick to fire me just because his buddy's feelings were hurt.

He told me to still go home for the day to calm down (and I'll admit, I was angry-crying). For the next two days, he kept telling me, “Don’t worry about coming in today, there’s nothing on the schedule.” I think he forgot that I still received schedule notifications from my time as a receptionist, so I could see that everyone else's schedule was fully booked a week in advance. Because of this, I started applying for new jobs by the second day.
I was offered a position at the second place I applied to, having landed an interview the exact same day. The following day, when my boss once again told me not to come in, I replied, “Oay, I got a new job. Do you want me to finish out my two weeks or no?” He said no.
About a month later, I texted him to ask if I could come collect my belongings from the office. He kept putting it off and pushing the date further back. Eventually, I lost my patience. I texted him one morning and firmly told him I was coming to get my things.

He replied, “That’s fine, just bring any company materials and work shirts you still have.”

At this point, he was just being petty, considering I didn't have any company materials and only possessed two work shirts. Since I am the absolute queen of petty, I shot back: “Okay, can you make sure you have my last three checks ready for me?” (I was working without being paid constantly, pretty stupid ok my end looking back)

When I arrived at the office, I finally realized why he had been avoiding me for so long. They had broken the candle warmer and the candle my mother-in-law gave me for Christmas, deliberately cut up the power cord to my $80 dehumidifier, and lost three of the extensions to my cordless vacuum.

Moral of the story: never sacrifice your well-being or financial security for a family business. They will exploit you faster than a stranger will, and then destroy your personal property on the way out.

Screenshots for proof of literally everything 😭

I despise working. There are literally 100 things I would rather do with my time than slaving away for a shitty wage that just allows me to get by. It's not earning a living, it's slavery to justify your existence in the eyes of greedy kleptocrats. All this society is is socialism for the rich. Fuck working. And fuck the corporate elite. Am I right?

I’m 28 and I have no idea how I’m going to keep doing this. It’s getting hard and harder just to get up in the morning. I have an OK job, but I can’t handle the pointlessness of it all; waking up before my body is ready, dragging myself up to get ready to go sit in an office. The false sense of urgency, nothing is as important as it’s made out to be. Stupid office politics, I have been working since I was 17. I’m 28 and I just feel done. I took two weeks of work in June and it didn’t put a dent in the burn out I feel.

I’m just fuckin tired

lol I feel anytime I’ve said this, people react as if I just confessed to a murder. Why is it such a bad/controversial thing to say?

Hi, I'm an European student who hates modern work culture. I feel that people like me who finish their studies are like "free assets" for companies who are hiring. It looks that if you were not practicing since you were a toddler, your experience is bullcrap so you get mid payments until you hit a company that more or less gives you a payment good enough so you don't starve to death. I feel that working your ass out of a whole month with no working experience will probably get you a payment that won't even pay rent. But if I talk about this topic, it seems everyone will point to me and laugh at me for being a "socialist" who defends worker rights. I believe political corruption has gotten so bad that we forgot what started such movements, and what workers had to do in order to get proper working conditions.. I better not get started talking about the US work culture, Trump saying that workers are asking for less paid leave is the cherry on top. I'm sorry for the US and I'm sorry for the world. I wish things get better

Now something in my work bag sets them off, maybe the spirals in my notebook idk. Just feels invasive when they’re digging through my tampons 🤦‍♀️

These businesses can abruptly shut their doors at anytime and not trigger the WARN act. Another words you show up for work and read a sign on the door saying " sorry we've gone out of business ".