Master Thread Dance Your Cares Away/Fraggle/Law Abiding Citizens

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An Faggot
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What if reactor technology has improved...?



🇺🇸 TRUMP WANTS 10 REACTORS, WESTINGHOUSE JUST SAID LET’S DO IT

Trump wants a nuclear comeback.

Westinghouse just promised 10 new reactors.

The first shovels hit dirt before 2030.

Each reactor powers three-quarters of a million homes.

That’s a lot of juice.

They pitched it straight to Trump in Pittsburgh.

The plan comes with $75 billion in economic punch and a fresh deal with Google to speed up construction using AI.

Last time, their project nearly bankrupted them.

This time, they’re betting smarter tools will keep it on rails.

Nuclear’s not dead. It’s just getting rewired.

Source: CNBC

Money grab. Westinghouse claimed bankruptcy during the last built reactor in GA. Also the Georgia reactor took like 15 years, and huge cost overruns.
 

 
A few days ago someone was complaining that Dr. salaries were driving up the cost of care. That isn't the case at all, but I also didn't have time to write-up how the healthcare system works. Here is my explanation.

Healthcare consists of 3 primary verticals and functional groups:

1. Providers - healthcare systems that employ Dr's & Nurses and provide care
2. Payers - insurance companies that steward dollars to pay for care (reimbursement)
3. Life Sciences - drug makers

I an ideal & non-corrupt world, people would pool money, it would be invested to earn interest, and distributed as people needed so that providers could focus on delivering care rather than managing a bank. Along the way, the Life Sciences companies realized that Chronic Disease as-a-service was much more profitable than actually curing root cause issues. They started off paying physicians to prescribe medications that caused certain side effects that could be monetized, but then realized is was much easier to simply control the formularies that determine which medicines and individual doc can prescribe, particularly when they are employed by a larger health system.

Fast forward to 2009 and the ACA (Obamacare) a lot of acceleration was brought to this process and some significant policy implications most of the populace has zero idea about:

1. We limited the profit margin of insurance companies to 20%. With many of these companies being publicly traded companies, it gave them 2 levers to pull: A. increase revenue via premium increases. B. Diversify
2. The diversification plays for UnitedHealth, Anthem, etc. all fell into the following strategies: buy-up the Pharmacy Benefit Managers (PBM) & build out Health Savings Accounts. UnitedHealth and Optum are the largestd example and most advanced, but all of them fundamentally did the same thing.

Now you have an entity like UHC, where ~$200B of it's $450B in revenue comes from core business and it's diversification play, Optum, accounts for more than half of its business. The $250B (450-200) breaks down into the following areas:

1. OptumRX (PBM) = ~$130B
2. OptumHealth (HSAs) = ~100B
3. OptumInsights = ~10B)

Optum, controls the formularies through it's PBM, derives more of it's net margin from this business line, and is then incentivizing the Life Science companies to crank up their costs by underwriting and de-risking their entire product development and R&D cycles. This is fundamentally why drugs cost so much.

Optum also used our HSAs as a way to further underwrite the increase in our core insurance premiums :)

This is the game.

Physicians are pawns. Very few I know actually understand the system and are simply regurgitating what they've been taught in Med School, which is subsidized by the PBMs and Life Science companies that are pursuing Chronic Disease Management as a Service as the desired business model to maximize their shareholder value. They are simply doing what they've been taught.

If we had any moral people in those organizations and their boards, they should've asked to stop. I also think breaking these up, particularly the PBMs via anti-trust measures is a necessary step to actually rectifying the entire mess. Medicare is also the largest purchaser of pharma products via CMS and has leverage here if used properly.


Brilliant and spot-on - need to get you connected with another friend of mine that said the exact same thing - he also said they are moving away from PBMs to a new system as people are catching on - can't think of the name right now but I'll follow up with him.

He used to be one of the top guys at a private wealth division of a big bank - does his own thing now. You two together would be an interesting convo to hear.
 

Throws unlit molotov cocktail and I guess hoped for the best


Unlit Molotov cocktail guy also ran like a woman or Obama throwing a baseball.


This isn't far off from accurate.

Notice it's the woman who is the aggressor.


Hey, bitch. There were no fat folks during colonialism because they had to work for a living. There were no government handouts or corner 7-11's for eating junk foods.
 

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