INtroTUITION

[INtroTUITION @DiFFn_fun]

@angertab @JMK4USA You’re assuming he set a limit on purchases… 😈

[Forest Park Pharmacy @ForestParkPharm]

My wife and I own a pharmacy. Last month we spent days trying to pry one prescription loose from a company that did everything it could to hold onto it.

The drug was everolimus. A generic. It treats cancer and protects transplant patients from rejecting their new organ. Not exotic. Not rare. A pill.

The patient wanted it filled with us because we're cash-pay and cost-plus. No insurance. No PBM. No secret markups, no games. Our price was $318. That's not cheap by our standards — most of what we fill runs under $20 — but it was honest.

Here's what that same prescription looked like on the other side of the counter.

In 2023, Medicare was paying about $6,645 for it. That's roughly 21 times our price for the identical medication. Medicare spent around $240 million on everolimus alone that year. If they'd paid our price, they'd have saved roughly $230 million. On one generic drug.

So how does an insurance company profit off a drug that expensive? Don't they pay for it?

No. You pay for it. In your premiums. Their job isn't to spend less — it's to keep your healthcare dollars circulating inside their own companies. And the tool they use is called spread pricing.

Spread pricing works like this: the middleman bills the health plan one price, pays the pharmacy a lower one, and keeps the difference. You never see it. On TRICARE, they pay an independent pharmacy like mine about $311 to fill everolimus. That barely covers our cost of the drug. Meanwhile the plan gets billed thousands. That gap — north of $6,000 on a single fill — is pure margin the middleman pockets.

Now here's the part they'd rather you not think about.

The pharmacy we were fighting was Accredo. Accredo is owned by Express Scripts. Express Scripts is the pharmacy benefit manager owned by Cigna. Same company, three masks. That nesting-doll structure isn't an accident — it's the whole design. When the pharmacy, the PBM, and the insurer are all one entity, they can shuffle money between their own pockets and call it whatever they want. The confusion is the product.

And this isn't a story about one weird drug. It's the business model.

The FTC has been digging into exactly this. In its January 2025 report on the three biggest PBMs — CVS Caremark, Express Scripts, and OptumRx — staff found those companies marked up specialty generic drugs by hundreds and thousands of percent when dispensing through their own affiliated pharmacies. Just those markups generated more than $7.3 billion above what the drugs actually cost to acquire, from 2017 to 2022. One in five of the specialty generics they studied was marked up over 1,000%. Some cancer generics: over 3,000%. On top of that, the FTC pegged spread pricing on those same drugs at another $1.4 billion.

One example straight from the FTC's files: dimethyl fumarate, a multiple sclerosis drug. Costs about $177 to acquire. The PBMs paid their own pharmacies close to $4,000 for a 30-day supply. Same trick. Different drug.

And they steer the profitable ones to themselves on purpose. Pharmacies affiliated with the big three took in 68% of specialty dispensing revenue in 2023 — up from 54% in 2016. The prescriptions marked up more than $1,000 disproportionately end up at their own pharmacies, not independents like mine.

So when we called to transfer this patient's everolimus to be filled without insurance, it landed like we were asking them to set $6,000 on fire. Of course they stonewalled us.

That's why we fired them.

No insurance means no invisible $6,000 charge buried in a premium you can't itemize. It means the price you see is the price. Ours was $318. Theirs was thousands. Same pill.

[Travis Hawley @talk2trav]

I spent all week putting together a powerful narrative intelligence piece in response to the UN's report that Israel allegedly *deliberately targeted* children in Gaza. I traced the spread, the amplification and the escalation of language as it hopped across accounts and time.

It is VERY in depth (maybe too much) but most will appreciate the first half without a doubt.

https://t.co/k3lHxXRuV8

[INtroTUITION @DiFFn_fun]

If every bad call is 'his staff misleading him' and every backstab is 5D chess, you’re not defending a president, you’re running quality control for a cult.
At some point, if the same guy keeps hiring snakes, kneecapping allies, and somehow landing on backdoor deals that shower benefits on himself and his buddies like we’ve never seen, the simpler story isn’t cosmic genius.
You’re just reverse engineering a halo around anything he does.

@StealthMedical1 Are you seeing the patterns you’re always talking about, or does this little conflict of interest actually increase your confidence in his purity?
This is a textbook definition of conflict of interest.

@StealthMedical1 You’ve drifted so far from analysis you’re basically doing theological exegesis. Whatever happens is righteous by definition, and if it looks corrupt, well that’s just narrative shaping and we all haven’t been briefed on the op yet, am I right??

@StealthMedical1 You don’t see the patterns, you retrofit them. Anything that contradicts the faith becomes more proof of the faith!

Oh, and I can help you write the next line in advance:
“When Trump’s Turkey deal looks bad, that only proves how good it secretly was… once you understand the op and see the patterns, of course.”

[Matt Tardio @angertab]

A message to President Trump from a veteran and one of his voters.

Listen until the end, share if you agree.

[INtroTUITION @DiFFn_fun]

The problem is not that you support Trump.
The problem is that you have been and continue to be incapable of acknowledging a single mistake he makes.
When challenged, you don’t debate, you talk over people, mute them, or kick them off the stage (typically all of the above in sequence).
You don’t politically support him. You worship him.

You like to replay clips. Listen to some of the blood libels he has spewed the past 48 hours.
Yet your instinct is still to defend him, and that’s unconscionable. In fact, it’s the kind of blindness that has historically left Jews exposed. The trusting of a strongman more than the evidence in front of their own eyes echos Europe of nearly 100 years ago.

https://t.co/CaabLdGTFl

[INtroTUITION @DiFFn_fun]

@JoePaddington @Turbinetraveler This was my exact train of thought after hearing the news. Pilots, flight attendants, mechanics and technicians, service ramp and more.
And the customers suffer as well.
The merger should have never been blocked.
A loss for so many.

[INtroTUITION @DiFFn_fun]

@SacksDisa

[INtroTUITION @DiFFn_fun]

@SacksDisa https://t.co/nDzX0DezF3

[Jim James @yamesyim]

@DavidGiglioCA @MaxNordau Trump was still praising on Fauci on Oct 19, 2020.

[Liberty Forge Network @Free_To_Decide]

@visegrad24 Just amazing courage!! I found his GoFundMe.

https://t.co/cZtdQl3fxN

[INtroTUITION @DiFFn_fun]

@dr4liberty @Osinttechnical Doc.
Am I to understand that you can spot a mm sized bleed on a CT and yet you take every comment the chief utters out of the oval as fact (based on the past year)?

[INtroTUITION @DiFFn_fun]

@dougdrvr @aakashgupta @sarahadams ☝️

[INtroTUITION @DiFFn_fun]

@LittleAnn310751 @aakashgupta @sarahadams Agree.
I was simply trying to add context to the original post.
Also, the incident happened after 11p which, at LGA, is a relatively quiet time (typically anything after 10p at LGA is on the lighter side).

[INtroTUITION @DiFFn_fun]

@harryfisherEMTP @peggidinkc I add this perspective as an attempt to ease the pain and burden I discern from your voice.

[INtroTUITION @DiFFn_fun]

Harry, sadly so many are incapable.
To admit there is any semblance of merit to what you’ve encountered being connected would break them.
Many (either consciously or subconsciously) choose blindness over truth, sacrificing reality itself so that the fragile story holding their world together does not disintegrate.

[INtroTUITION @DiFFn_fun]

@cremieuxrecueil It’s not realistically feasible to devote the time required to train both a pit bull and its handler to reliably prevent such incidents.

https://t.co/jGpy137HAa

[INtroTUITION @DiFFn_fun]

@FremenNat @cremieuxrecueil Agreed.
Hence why I support a mandatory certification requirement for legal ownership of the breed.

[INtroTUITION @DiFFn_fun]

Despicable.
This is part of the main issue.
Shelter’s purposefully lie about a dogs breed as well. In doing so, they’re doing both the dog and the new owners a disservice.
Mislabeling such a breed or sugarcoating serious red flags is malpractice to a criminal extent.

https://t.co/5CDzFCzboU

[INtroTUITION @DiFFn_fun]

The pitbull ‘hyper-violent’ label is a result of a combination of genetics as well as environment.
They’re absolutely hard wired to guard and protect by any means necessary. What delineates their guarding responsibilities as well as whether they have been trained to defer to their handler’s commands, is an important aspect of the conversation which is most often neglected.
What tips the scale in the context of the ‘debate’ is not just their upbringing and environment but the core knowledge of the handler on how to form a healthy bond with the breed that will allow it to thrive.

Ultimately, the breed gets their reputation due to genetic predispositions which can manifest in unwanted behaviors due to poor ownership practices (even by those owners who mean well and are simply uninformed/uneducated on the matters).

Legislation should focus on ensuring responsible ownership and education to improve the safety and welfare of humans and the animals (both in the household as well as in the neighborhood).

[INtroTUITION @DiFFn_fun]

@TradableAstro IYKYK

[INtroTUITION @DiFFn_fun]

Oh we’re ready.
Are you??
There’s a reason he had such a high completion percentage.
Spencer’s CAY was a paltry 5.4, the lowest of any QB on the list you provided.
Rattler depended heavily on YAC, and was incapable of generating explosive plays, sustaining drives, or just simply winning.
The @Saints offensive line was awful and the receiving talent thin, but Shough outplayed your boy hand over fist.
Rattler: 1-7 in 8 starts during which the offense averaged 18.4 ppg
Shough: 5-4 in 9 starts where the offense averaged 23.1 ppg