yunyun333
4d ago
The point is, you should be ruling on easy mode when you have a money printer in the ground, but he still managed to get overthrown, without significant foreign interference.
yunyun333
4d ago
The oil boom was obviously not sustainable but the Shah's incompetence was unique. Every other oil state managed to not piss off their entire population.
yunyun333
11d ago
Ultra niche markets would obviously be rife with insider betting. Fool and his money, etc.
yunyun333
15d ago
It's on page 30 as 'eliminations'.
UHC pays its own doctors more, and in general insurance companies will steer customers towards their own, more expensive facilities, but there's limited studies on how it affects care in general. You'd think that it should increase the number of procedures done at least, but that's not so clear.
The study found that when independent physicians integrated with a hospital, they changed their care practices (for example, by reducing the number of patients they put under deep sedation) and increased their throughput (measured by the number of patients they treated). Specifically, the integrated physicians reduced their use of deep sedation by about 3.7 patients for every 100 treated. However, patients of integrated physicians experienced “a significant increase in both major post-colonoscopy complications such as bleeding (3.8 per 1,000 colonoscopies) and other complications such as cardiac or nonserious GI symptoms (5.0 and 3.3 per 1,000 colonoscopies, respectively).”
The researchers found that the reduced use of deep sedation “at least partially explains the increase in adverse outcomes” and that it was “driven mainly by hospitals no longer allocating expensive anesthesiologists to relatively unprofitable colonoscopy procedures.”
Moreover, integration increased the number of patients a physician was able to treat and elevated reimbursement per procedure—integrated doctors were reimbursed about $127 more per colonoscopy procedure than independent doctors, or about 48% more.
yunyun333
15d ago
It's at least the reason for high drug costs.
If you look at UnitedHealth's 10-k, Optum (the provider network) made $253b in revenue, but $151b of that was 'internal eliminations' transfers from UnitedHealthcare (the insurance arm) to Optum.
https://www.unitedhealthgroup.com/content/dam/UHG/PDF/investors/2024/UNH-Q4-2024-Form-10-K.pdf
yunyun333
15d ago
Vertically integrated insurance companies can charge themselves more so it looks like patients get more bang for their buck. The PBM (owned by the health insurance company) charges the health insurance company a high price for a drug, increasing "payout" (numerator of the medical loss ratio) while simply shifting revenue internally. The same thing happens with insurance-owned clinics and pharmacies.
yunyun333
15d ago
Pharmacy benefit managers (PBMs) are supposed to negotiate drug prices between manufacturers, pharmacies, and health plans, since they can essentially pool negotiating power. In practice, they're integrated with the health insurance companies, so they rent-seek and take what are basically bribes from the manufacturers (in the form of rebates) to make the drugs "cheaper" to consumers, while also forcing independent pharmacies to take smaller reimbursements or lose access to their network.
yunyun333
15d ago
Doctors get paid well but the administrative burden is also a large part of the discrepancy. Providers have to spend way too much time negotiating with insurance companies over payments and what will and won't be covered. There's an entire business around denying as many claims as they can get away with. Part of it is inherent in a multi payer system (Germany's public-private system has higher costs than the UK) but there are plenty of aspects to the 'managed care' system, like provider networks and utilization management, that are unique to the US.
Similarly, drug development is notoriously expensive and the costs have to be passed down to the consumer at some point - but the insurance companies are hardly innocent bystanders forced to pass them through. Pharmacy benefit managers are supposed to negotiate reasonable prices/rebates and formularies between drug manufacturers, pharmacies, and insurance companies - but the three largest companies (Optum, Caremark, Express Scripts) managing 80% of all prescriptions are owned by UnitedHealth, CVS, and Cigna, which defeats the whole 'independent negotiator' thing and just makes them rent seekers at consumer/government expense. It also makes it possible to skirt the medical loss ratio rule by shifting profits.
yunyun333
16d ago
What will the future of the US healthcare system look like?
The current system is a patchwork of primarily employer-sponsored healthcare (60% of non-elderly Americans), the ACA marketplace (offering government-approved plans through private insurance companies), Medicare for the elderly, and Medicaid for the poor, disabled, and children. About 8-9% of the population is uninsured. Prices are higher and health outcomes worse than comparable developed countries.
Obamacare attempted to reduce the uninsured population by, among other things, implementing Medicaid expansion to all adults under 138% of the federal poverty level and granting tax credits to help defray the cost of marketplace plans (for incomes up to 400% of the FPL). During COVID, these subsidies were increased and expanded to higher income levels, but Congress allowed them to expire this year, resulting in average premium increases of ~114% for about 22 million people, although an additional vote is scheduled this month.
In addition, low-income adults utilizing expanded Medicaid will be required to demonstrate 80 hours of work per month starting in 2027. Mike Johnson framed this as kicking out unemployed young men mooching off the system - even the old welfare queen trope has been de-DEIified. Georgia already implemented a similar work-requirements program as part of their Medicaid expansion in 2023, resulting in the bulk of the money going to administrative costs and only about 9k out of 250k low-income adults enrolled.
As a result of all of this, the uninsured population will likely increase this year, which may even cause premiums for people with health insurance to rise due to a death spiral effect - if more people are uninsured and can't pay their medical bills, the costs may be shifted to covered patients.
The above article takes the pessimistic view that the system is unlikely to improve significantly, because tying healthcare to employment is such a nice perk for employers (the system started during WW2 when companies offered health insurance as a replacement for wage increases due to federal wage freezes). European or Canadian style universal healthcare certainly seems less likely than ever.
yunyun333
2mo ago
Drones have made armored assaults extremely difficult. It's just too hard to amass a strike force without being spotted, much less crossing the killzone. That's why they switched to light 'vehicles' like golf carts and whatnot - the best survivability is speed and concealment. The idea behind "Line of Drones" was to remove the need for frontline infantry - it hasn't lived up to those goals, but it's the reason they haven't collapsed when they have such a manpower crisis.
yunyun333
3mo ago
But I will also point out that what you demand was on offer in 47 and rather than accept them the surrounding Arabs went to war with Israel and lost.
Setting aside the question of whether it was a smart decision to reject the partition plan, it's easy to see why they didn't view it as legitimate. Imagine if Mexican immigrants petitioned the UN to split the American Southwest into a new Hispanic state because they (illegally) immigrated there in sufficient numbers.
yunyun333
3mo ago
Israel has four neighbors, two of which are borderline failed states and the other two are strong American allies. None of these countries are staging an invasion.
yunyun333
3mo ago
That's right below a headline about the hostages on my page.
'You're my life, my hero': Hostages reunite with families after two years
yunyun333
3mo ago
The US didn't lose vietnam because of rules of engagement. Americans and their allies killed a shit ton of civilians, most of which was never brought to trial internally or revealed to the public.
yunyun333
3mo ago
Who should have authority to order executions? It makes sense to push that up to the higher ups. Maybe the burden of evidence could be lower if they simply wanted to arrest him, although tons of people got thrown into military prisons for no good reason in afghanistan.
yunyun333
3mo ago
There's no evidence that they were fired at, although one vehicle did take damage from ricochet fragments of an M203 grenade fired by the convoy. They panicked and fired indiscriminately.
https://www.cnn.com/2020/12/24/opinions/blackwater-defendants-pardon-trump-opinion-oconnor
yunyun333
3mo ago
The us wouldn't have been driven out of Afghanistan if they decided to ethnically cleanse the whole place and start putting up housing like the Israelis do.
Why would Americans want to live there?
yunyun333
3mo ago
The beard issue is silly ;what's more concerning is Hegseth saying that rules of engagement are for pussies. He advocated for trump to pardon men like eddie gallagher and the blackwater operators at nisour square. At least for now the military is limited to blowing up narco boats and standing around federal buildings.
yunyun333
3mo ago
Saudis have dumped a ton of money into sports ventures like LIV golf and saudi league ft. ronaldo. They've also spent (a lot less) on esports/gaming such as the esports world cup where they crowned their own sponsored org as the victor two years in a row. The end goal, presumably, is to gain positive cultural influence in the west as opposed to simply oil, repressive islam, and terrorism. Maybe for pride as much as anything else.
yunyun333
3mo ago
There are plenty of studies on the relationship between vaccines and atopic diseases like asthma. Some find an effect but nothing like a 4x factor. https://pubmed.ncbi.nlm.nih.gov/36180331/
The study used in the hearing wasn't published. We can debate why that is, Siri argued that it was because they were afraid of losing their jobs. But plenty of scientists have published studies showing a correlation between vaccines and increased prevalence of various ailments.
yunyun333
4mo ago
We hit some new lows over the weekend with the MAGA gang desperately trying to characterize this kid who murdered Charlie Kirk as anything other than one of them and doing everything they can to score political points from it,
That's it? He didn't even, like, celebrate his death.
Seems like Nexstar is trying to butter up Trump for some deal that needs governmental approval in the future.
Tyler Robinson, Kirk shooter, has been caught after a family friend turned him in
The markings on the bullets described by authorities indicate that the suspect, Tyler Robinson, was steeped in online culture and included references to the Antifa , or the anti-fascist, movement. A fired shell casing was inscribed with “notices bulges OwO what’s this?” - a reference to a “copypasta” - a piece of text that is repeated over and over again, often to troll people online.
Authorities say one unfired casing had the words “Hey fascist, catch!” and three down arrows - a common symbol used to represent the anti-fascist movement. A second casing had the lyrics to a song “Bella Ciao” inscribed on it. The song honours WWII-era partisans of the Italian resistance who fought Nazi Germany.
The third unfired casing was inscribed with the words “If you read this, you are gay lmao” - again an apparent reference to online trolling humour.
Parents, keep your kids away from Discord. Will be interesting to see if this guy is a true believer or just ragebaiting.
yunyun333
4mo ago
The Qataris that funded Hamas with explicit Israeli approval.
For years, the Qatari government had been sending millions of dollars a month into the Gaza Strip — money that helped prop up the Hamas government there. Prime Minister Benjamin Netanyahu of Israel not only tolerated those payments, he had encouraged them.
During his meetings in September with the Qatari officials, according to several people familiar with the secret discussions, the Mossad chief, David Barnea, was asked a question that had not been on the agenda: Did Israel want the payments to continue?
Mr. Netanyahu’s government had recently decided to continue the policy, so Mr. Barnea said yes. The Israeli government still welcomed the money from Doha.
When is violence against a person justified? Usually the legal boundary is immediate threat. So if a politician is advocating for you to be put into camps, then that seems like a reasonable starting point. But then you have to consider 'reasonable fear of immediate threat' and things get much murkier. Is it reasonable to fear that pro-mass migration politicians intend to destroy your community with foreigners?
In America it's still only the crazies/extremely disaffected that are actually willing to go out and kill for politics, usually. People will cheer on the killer but almost none of these people would actually be willing to do something similar.
Trump announces plan to hit UK, Denmark and other European countries with extra tariffs over Greenland
Several EU countries sent tripwire forces into Greenland a few days ago. Now Trump has announced 10% tariffs on imported goods from Denmark, Norway, Sweden, France, Germany, the United Kingdom, the Netherlands, and Finland. As a sidenote, despite predictions of economic catastrophe, Trump's tariffs have been smaller and done less economic damage than estimated.
Still, no one knows what's the next step of Trump's master plan. Will it fizzle like the whole "Canada 51st state" thing? Polymarket estimates 27% chance that Trump will take "part of Greenland" in 2026.
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