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Post by messi on Mar 1, 2024 9:42:34 GMT -8
3-3-2-2-1? I thought this was going to be our new defensive alignment. BTW, 3+3+2+2+1=11 (not 12) When I first saw it, I immediately thought soccer formation.
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Post by orangeattack on Mar 1, 2024 10:08:17 GMT -8
Cliff's Notes for everyone who is too lazy to click on the link: Brand Name Prescription Drugs. Insulin pricing with patent engineering is the very worst offender. The same carton of insulin that sells for $20 in Canada goes for $300+ in the US.
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Post by Henry Skrimshander on Mar 1, 2024 10:57:21 GMT -8
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Post by beaver55to7 on Mar 1, 2024 11:17:49 GMT -8
3-3-2-2-1? I thought this was going to be our new defensive alignment. BTW, 3+3+2+2+1=11 (not 12) Notre Dame
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Post by atownbeaver on Mar 1, 2024 12:25:46 GMT -8
Cliff's Notes for everyone who is too lazy to click on the link: Brand Name Prescription Drugs. Insulin pricing with patent engineering is the very worst offender. The same carton of insulin that sells for $20 in Canada goes for $300+ in the US. Pharma is a big part of it, but roughly 17%-20% of everything that drives a year over year cost increase, give or take. Still means 80% of the growth in costs are due to other factors. The real cliff notes is Greed. plan and simple boring old greed. That is your answer at every level. Be it the pharmaceutical companies, be it the health system, be it the specialty doctor clinic, be it the insurance company. Federal rules enable the greed in a lot of ways. Most insurance companies are subject to medical loss ratio laws, meaning they are required to spend at least 80% (sometimes 85, depending on size) of the premiums they collect on payments for medical services. Meaning they, by law, can only hold back 20% for administrative costs and profit. Sounds like a good idea on paper, except when you realize the companies are going to prioritize profits no matter what. So how do you do that when you are limited to 20% of the premiums you collect? you either A. get more paying members (that is hard) or B. you willingly pay out more to providers! So we have a legally incentivized system where the providers can ask for more money without pushback, the insurance company willingly agrees, and then puts out their crocodile tears to state regulators about how their medical spend is through the roof and they have to raise rates. states rubber stamp double digit rate increases every year and insurance companies increase profits by virtue of collecting more in premiums year over year. There isn't actually a real force in the system to restrict cost growth, because the primary way we pay for it is incentivized to pay more, so they earn more. Health care is a broken system in America that capitalism cannot provide the answer to, as the goals of capitalism are antithetical to the goals of health care delivery. Hospitals ain't selling cars, TVs and appliances. Of course I started this tangent in to health care, but I think there are valid parallels. Other forces, external forces that are preoccupied by greed have co-opted a service that historically was about providing opportunity for students, promotion of the school, and entertainment of the student body and alumni. A system rooted in our culture, as a display of pride, tradition and sportsmanship. over time, everything to do with the student and the school itself has fallen further and further out of the picture, just like how in health care everything to do with the ethics of maintaining healthy population for the greater good of society as fallen out of the picture.
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Post by drunkandstoopidbeav on Mar 1, 2024 13:06:14 GMT -8
Cliff's Notes for everyone who is too lazy to click on the link: Brand Name Prescription Drugs. Insulin pricing with patent engineering is the very worst offender. The same carton of insulin that sells for $20 in Canada goes for $300+ in the US. Between this and the "diet" comment, I'm having a tough time holding my tongue. You hit on insulin, and you hit on drug companies, both of which are huge issues, and diet is the other issue. Fix those 3 and US spending on healthcare drops like a rock. I'll touch on some examples of a very small portion of the problems we're facing. 50 some years ago the sugar industry paid Harvard scientists to blame fat for various health issues. In the 70's one of those same 3 scientists was responsible for developing the US "food pyramid", which finally was changed in the last several years, thank goodness we don't have to eat "6-11 servings" of grain everyday anymore. Even though the food recommendations have changed, they're probably not absolutely correct, government recommendations often are often made only after decades of actual science having shown there was an issue. In the late 70's and early 80s, Phillip Morris and RJ Reynolds bought Craft foods, Nabisco and General Foods and got to work on creating "hyper-palatable" highly processed foods. That in itself is a huge issue, people don't eat like they did 60-100 years ago. Today the grocery shelves are loaded with highly processed foods. If a food product has loads of ingredients (call it more than 3 or 4) listed on the label, especially scientificky sounding ones, it may not have existed when my parents grew up, maybe even when I grew up. Trans fats. In the early 1900's a german scientist discovered you could hydrogenate oils and make them stable. By 1911 Crisco became available and the race was on, shortening... margarines, etc. In the late 50's a college student realized that they had found issues with trans fats, he became a researcher and by the 60's and 70's he and others basically proved trans fats to be dangerous. It took the FDA 50 years and a lawsuit to finally react. Remember all the labels on packaged items saying "No Trans fats" a few years ago? Now it's "banned" but is still in products as long as it's less than .5 grams per serving. They don't have to list it as an ingredient if the volume per serving is less than a half a gram, so some/many companies reduce serving sizes on the label enough to get that number down, any product you buy that says hydrogenated (or partially hydrogenated) oil on the label will likely contain at least some trans fats. I cannot remember access to sugary drinks (other than maybe apple juice and orange juice on occasion) and highly processed foods, in school growing up. Now it's a regular thing, some states are banning sodas at school, but not necessarily other sources of sugar. Type 2 diabetes used to be practically unheard of or very rare in kids, now the CDC says 1 in 5 adolescents and 1 in 4 young adults are living with pre-diabetes or diabetes. They are even finding kids with fatty liver disease, which used to be only found in heavy drinking alcoholics. While I love doctors, I was raised by a MD (I'm married to a Doctor of Pharmacy as well), they generally have little to no nutritional training in medical school. The study I just linked says they average less that 20 contact hours of nutritional courses - contact hours are not credit hours, it's actual hours of sitting in a classroom getting taught, the equivalent of a single 2 credit hour 10 week course. I believe nearly ALL doctors mean well, but nutrition is not necessarily in their training history unless they have sought it over and beyond their regular medical training. Maybe something should change in the regards of nutritional training, I don't know. I won't even get into the drug companies, other than to say they really play off the fact that for the most part the US healthcare system is more developed around diagnosing a problem and dispensing a drug to help combat the problem rather than doing preventative non-drug maintenance to reduce or eliminate the likelihood of becoming ill. On the maintenance issue (this goes back to doctors and insulin) type 2 diabetes is just about entirely preventable without drugs just by making some dietary changes. Luckily I haven't got there yet, but I had to ask my doc to get an A1C test after years of having pre-diabetic blood glucose levels. I've never even been suggested to get a resting insulin test. This is only my opinion, but every overweight adult, maybe even kids now, should get a fasting insulin level test added onto whatever blood work they're having done for a few bucks - at that point you can figure out your HOMA-IR ratio in seconds and get potentially years of notice that type 2 diabetes or fatty liver disease is likely in your future and have time to make a few minor diet changes. Probably wouldn't even have to do that test regularly, just every several years. Guess I get more easily triggered as I get older and actually have started reading up on health information. Probably should have started years ago. Rant over, for now at least.
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Post by NativeBeav on Mar 1, 2024 13:29:59 GMT -8
I cannot improve much on what Atown and drunkandstoopid already have said, but to tell a true story from roughly 10 years ago. Was at a brew pub in Ashland, having a cold one, and met a guy at the bar, who worked for one of the few corporations that now own the lion's share of the hospitals nationwide. He was a "hotshot" for the company, traveling around the country putting out fires. He said the reason the quality of care at the hospitals was dropping, and nurses are so overworked in these hospitals, is because the corporations that own them are continually cutting overhead, to increase profits. I said it didn't sound good for someone who is hospitalized. His response? "From someone on the inside, all I can tell you is, whatever you do, do not get sick and need to be hospitalized".
And this was well before the medical "events" of recent years. Events that made big pharma insane amounts of money. And what is coming next? (referencing drunkandstoopid's graphic) - Ozempic. You know, for those who refuse to modify their diet, including too many sugary drinks. Made by a Danish company, and not allowed to be sold in the country it is made in. SMH
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Angus
Freshman
Posts: 187
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Post by Angus on Mar 1, 2024 13:59:07 GMT -8
Whatever the reason, the fact is, the US spends approximately twice as much on healthcare as a percentage of GDP as any other country in the world. Probably has nothing to do with funding drug research and insurance companies who have year on year record profits that go to stock holders. I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days)
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Post by drunkandstoopidbeav on Mar 1, 2024 14:30:28 GMT -8
Probably has nothing to do with funding drug research and insurance companies who have year on year record profits that go to stock holders. I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days) I won't call drug companies evil, if anything, they are a necessary evil and do a lot of good. They deserve to make a profit as much as the next business. They spend billions on product development, it's gotta be paid for somehow. I probably get most bothered by many of their lobbying efforts, but moreso by those who are influenced by lobbyists and take monetary or other reimbursement from it (politicians and other organizations? ).
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Post by orangeattack on Mar 1, 2024 14:30:48 GMT -8
Probably has nothing to do with funding drug research and insurance companies who have year on year record profits that go to stock holders. I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days) You know what's funny is that it's really difficult to find numbers on immigration and how many successful illegal entries there actually are. The data that is out there is for "contacts with immigrants" which includes surrendering to authorities and even those who were granted asylum. Not a good metric for understanding how much immigration has spiked, which is what I wanted. Everybody says it's bad but nobody can say exactly how bad it is. Anyway. I work in the medical industry, my company operates globally. It's interesting to see it from the sales and infrastructure side how different the institutional approaches are. The US Healthcare market is in some ways both the best and the worst of them all. The ceiling is no doubt the highest in the US, but also the floor seems to be one of the lowest for patient care/experiences, of the developed nations.
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Post by wilkyisdashiznit on Mar 1, 2024 14:50:18 GMT -8
I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days) You know what's funny is that it's really difficult to find numbers on immigration and how many successful illegal entries there actually are. The data that is out there is for "contacts with immigrants" which includes surrendering to authorities and even those who were granted asylum. Not a good metric for understanding how much immigration has spiked, which is what I wanted. Everybody says it's bad but nobody can say exactly how bad it is. Anyway. I work in the medical industry, my company operates globally. It's interesting to see it from the sales and infrastructure side how different the institutional approaches are. The US Healthcare market is in some ways both the best and the worst of them all. The ceiling is no doubt the highest in the US, but also the floor seems to be one of the lowest for patient care/experiences, of the developed nations. If you can afford the American medical system, it is the best. Woe to you, though, if you cannot afford it.
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Post by p8nted on Mar 1, 2024 14:53:38 GMT -8
I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days) I won't call drug companies evil, if anything, they are a necessary evil and do a lot of good. They deserve to make a profit as much as the next business. They spend billions on product development, it's gotta be paid for somehow. I probably get most bothered by many of their lobbying efforts, but moreso by those who are influenced by lobbyists and take monetary or other reimbursement from it (politicians and other organizations? ). They actually spend more on advertising then they do on Research. Much of the early research is government supported as well
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Post by atownbeaver on Mar 1, 2024 16:12:23 GMT -8
Probably has nothing to do with funding drug research and insurance companies who have year on year record profits that go to stock holders. I think we need to take a step back here. I would likely not be alive today if it wasn't for these "greedy" drug companies producing basically a miracle drug that I take. And, the insurance companies that we like to bash actually only take in moderate profits. It averaged around 3.5% in 2022 and last year still in the single digits(with our current inflation rates ... pretty modest still). Compare that to high tech companies like google and apple, and many others .. companies many of us here don't bitch about since it is responsible for the growth of our 401Ks. Then look at all the costly modern medical equipment(like all types of body scanners) that run in the millions of dollars, that hospitals have to incur .. and that they didn't years ago. Not to mention all the other electronic equipment that allows better and faster diagnosis. Then there's the cost of free medical care for our flood of immigrants ... costs we never had to this degree 25+ years ago. It all costs money. Lots of it. If we expect the best care, and the best care for those who can't afford it, then this is the price we pay. (oh.. and no argument on the bloating "MBA" middleperson problem. Pretty much prevalent in everything these days) two things (or more) can be true at the same time. I fully reject any conspiracy theory that is rooted around big pharma wanting to purposefully harm you, or create unnecessary drugs, or any idiocy like that. Big Pharma has high interest in making drugs that work and work well, because the fall out when they don't is severe. Research the fall out from Phen-Phen if you are ever bored. Nobody wants that. But, it is indisputable they price gouge. It is indisputable they manipulate the patent system to renew exclusive rights on ages old formularies to extend periods of exclusivity. It is indisputable they aggressively lobbied congress for advantageous rules effectively forbids Medicare from price negotiations. Big Pharma works well and produces life saving drugs... and at the same time, they are indisputably profit driven to the point of "evil", at least in the measure of many people's morality. But then again, I made a s%#tload of money on Moderna in the pandemic. any of us in a large mutual fund, dividend fund or similar type investment in your 401(k) or similar products undoubtedly are invested in Pharma. Big Pharma is a cornerstone of most blended fund products, and countless millions of Americans depend on their profits, for their own profit. Nothing in life is black and white, we all exist in shades of morality.
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Post by atownbeaver on Mar 1, 2024 16:17:30 GMT -8
I cannot improve much on what Atown and drunkandstoopid already have said, but to tell a true story from roughly 10 years ago. Was at a brew pub in Ashland, having a cold one, and met a guy at the bar, who worked for one of the few corporations that now own the lion's share of the hospitals nationwide. He was a "hotshot" for the company, traveling around the country putting out fires. He said the reason the quality of care at the hospitals was dropping, and nurses are so overworked in these hospitals, is because the corporations that own them are continually cutting overhead, to increase profits. I said it didn't sound good for someone who is hospitalized. His response? "From someone on the inside, all I can tell you is, whatever you do, do not get sick and need to be hospitalized".
And this was well before the medical "events" of recent years. Events that made big pharma insane amounts of money. And what is coming next? (referencing drunkandstoopid's graphic) - Ozempic. You know, for those who refuse to modify their diet, including too many sugary drinks. Made by a Danish company, and not allowed to be sold in the country it is made in. SMH If you had to ask me one piece of advise about hospitals, in all my years of working on them, I would say "Never go to a for-profit hospital". That, above all other advice, is the most important advice I can give you. The next, of course, would then be: "try not to go to the hospital", that one is just a little harder and sometime out of your control.
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Post by rgeorge on Mar 1, 2024 17:30:00 GMT -8
So... about the CFP and the 3-3-2-2-1 "formation"
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