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Cake day: June 12th, 2023

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  • Only the first one can be fixed by competition, the rest aren’t impacted by that at all. There are too many moving parts for it all to magically go away by just saying “make them compete”. For instance what happens when insurance companies compete to offer the best deals on group rates to employers but then charge exorbitant premiums to employees? Or what if insurance premiums all magically came down but pharmaceutical prices kept skyrocketing?

    Medical costs are an inelastic demand as well as a non-discretionary expense. That’s an absolutely terrible combination which means they’re almost entirely isolated from market forces.

    Consider for instance a situation I find myself in. I need a certain medication for a permanent medical condition. Fortunately there are multiple medications available (often due to patents there’s only a single option). Unfortunately I’m allergic to all but one of them. That means it doesn’t matter if the pharmaceutical company is charging $5 or $5000 I’m paying for it. I literally have no choice. Whether my insurance pays for 100% of that or 0% doesn’t change what the pharmaceutical company is charging. Further for insurance I was offered a choice of about 5 different plans through my employer (which is a lot by most standards, often employers only offer one or two plans). My insurance is by all metrics terrible, I pay thousands of dollars every year in deductibles, but once I hit those deductibles it covers everything at 90% which with my medical expenses save me tens of thousands of dollars a year. There are cheaper plans of course, but then the tradeoff is that I’m restricted to a tiny handful of doctors who are all terrible and every single medical decision has to be pre-approved by the insurance company or they don’t cover it and I’d rather pay the extra thousand dollars a year to keep those decisions between me and my doctors.

    The US medical system is a hydra and fixing any one part doesn’t actually solve anything. The entire system needs to be overhauled top to bottom. Switching to a single payer system is just the first step in that process but it’s a necessary one because otherwise the problem is intractable. It’s likely the patent system is going to need to be overhauled at least with regards to medications before it’s fixed as well.


  • Mostly because:

    A) Insurance companies collude with each other

    B) are only half the problem (the other half being hospitals and pharmaceutical companies cranking prices up)

    C) Most Americans get their insurance through their employer

    and

    D) Healthcare costs are complicated because they’re split between insurance premiums and out of pocket expenses and typically raising one lowers the other and vice versa

    Insurance was always a terrible way to handle healthcare expenses because healthcare costs are generally non-discretionary and have far too many moving parts and payers.




  • That’s why I specifically said non-Republicans.

    Edit: here, I’ll walk you through the math. The article says 70% of Republicans approved of him and 33% of everyone approved of him. Republicans make up ~30% of the population. 70% of 30% is 21%. That leaves 12% unaccounted for (33-21). So 12% out of everyone both approves of him and doesn’t identify as a Republican, while 21% out of everyone both approves of him and identifies as Republican. The remaining 67% of everyone doesn’t approve of him whether or not they identify as a Republican.







  • So I saw a pretty believable breakdown that would absolutely explain this. It’s basically because they had a messy falling out over Trump being a spoiled brat. The timeline is as follows.

    The inciting incident was Epstein putting in what he thought was a winning bid on a new mansion. Confident in his bid he then showed the property off to his good buddy Trump and asked some advice on some renovations he was planning. Trump then went to his Russian buddies, got a “loan” and put in a higher bid on the property ultimately winning it. This pissed Epstein off who was further confused because he knew Trump had been having financial problems and didn’t have enough money to cover the bid he put in. Six months later Trump sold the property to the same Russian who had given him the money in the first place for twice what Trump paid for it laundering millions of dollars in the process. Epstein correctly realized that Trump just used his property that he swiped from him to launder Russian money which pissed him off even more. Enraged he called Trump and threatened to expose the money laundering. In retaliation Trump then informed the FBI about what Epstein had been up to on his island which is what ultimately led to his arrest. Whether Trump and/or the Russians then silenced Epstein and whether that was about Trumps participation in Epstein’s crimes or about the money laundering who knows, but it definitely makes some pieces fit.

    Edit: Dug up the video the claim was made in: https://www.youtube.com/watch?v=JTz6X5Bh_lw