Garvey Rene, MD

Chairman of Cardiology - Caremount Medical IC. Opinions reflected are my own.

[Garvey Rene, MD @DocReneIII]

@irishroadchild @CMichaelGibson AI will probably start with the non-clinical jobs they all switched to.

[Peter Attia @PeterAttiaMD]

Social media personalities have been challenging conventional wisdom on atherosclerosis, but their evidence doesn’t hold up to scrutiny. Full article linked below.

https://t.co/aM60JEws0o

[Chamath Palihapitiya @chamath]

Unfortunate update as of today:

More calls from friends. The total wealth that has left California is now $1T.

We had $2T of billionaire wealth just a few weeks ago. Now, 50% of that wealth has left - taking their income tax revenue, sales tax revenue, real estate tax revenue and all their staffs (and their salaries and income taxes) with them.

In other words, by starting this ill conceived attempt at an asset tax, the California budget deficit will explode. And we still don’t know if the tax will even make the ballot.

California billionaires were reliable tax payers - 13.3% every year. They were the sheep you could shear forever. Now California will lose this revenue source FOREVER.

Unless this ballot initiative is pulled, we will not stop the billionaire exodus. With no rich people left in California, the middle class will have to foot the bill.

[Chamath Palihapitiya @chamath]

It’s not 1% a year for 5 years.

It’s a one time 5% tax on all assets and it will kill entrepreneurship in California.

Here is an example:

John Doe starts a company. He takes a nominal salary - say $150k for this example - and the rest in equity in the company. Let’s say he owns 20%. He raises VC capital in 2026 from someone that invests $100M into the company and values the company at $6B. This means his 20% is “worth” $1.2B.

I put it in quotes because he can’t actually sell. He has a paper value that putatively says he’s a billionaire. But he actually lives on $150k because that is what his income is. Just because someone decides to make a bet on the business does not mean some bank account in your name magically gets created with $1.2B in it.

Under the proposed tax, however, John Doe would now owe $60M in cash to California in 2027.

How will he pay it?

Is there some buyer you know of, that the rest of the market doesn’t, that will do a deal at the max value when there is a distressed seller like John Doe who needs money he doesn’t have to pay taxes on value he also doesn’t have!

Now imagine that after the tax is assessed, in early 2027, the company takes a write down to $200M. Now his share is $40M. But he still owes $60M. Again, there are no buyers for his shares per se.

He still only makes $150k/yr.

What is this person supposed to do? He now has a “worth” of $40M but owes California $60M.

Should he declare bankruptcy now because he tried to start a business but was retarded enough to do it in California?

So did you really get the billionaires??

No. Because the mega billionaires have already left or are tax structured to minimize the tax or will fight it.

You will, however, drag a bunch of young, energetic folks who want to make things and hire people into bankruptcy court.

Awesome work, Ro. You should be proud.

[Eric Topol @EricTopol]

A new, outstanding review of non-invasive imaging for coronary artery disease
—"Most acute coronary syndromes occur in arterial segments with non-obstructive disease, which can be appreciated on CT coronary angiography but not on functional tests only detecting ischemia."
—"Notably, in a Danish cohort study, up to 14% (725 out of 5043) of patients with flow-limiting stenoses had a CACS (calcium score) of 0"
https://t.co/vDnyTDRcOf
Aligns with my recent GT review of the big shift to non-obstructive coronary atheroma
https://t.co/3GgVhZkSMN

[Jay Giri @jaygirimd]

Now in @JACCJournals, we cover the economics of transcatheter interventions. This includes:

1) mechanics of facility & doc payment
2) rapidly evolving CV financial landscape
3) novel research on hospital margins
4) future health econ policy shifts

https://t.co/e9lm0IM1EA

[Garvey Rene, MD @DocReneIII]

@jaygirimd @PennMedicine @PennCardiology Congrats Paulie!

[Nayib Bukele @nayibbukele]

Crime and GDP:

El crimen y el PIB:

[World Scholar @WorldScholar_]

One of the world's greatest architectural gems has risen again today.

It took 182 years to build, but almost burned down in just one night in 2019.

Here's everything you need to know about Notre-Dame de Paris.... 🧵

[Elon Musk @elonmusk]

The fixed pie fallacy as at the heart of many bad government decisions

[Elon Musk @elonmusk]

This is a beautiful composition

[David @DavidSHolz]

the rocket catch isn't just like an engineering victory, it's a cultural-spiritual one too, it stirs in us a deep yearning for science, physics and the objective truth. once you taste it, you know we must have more and this hunger itself may be the driving force of civilization

[Elon Musk @elonmusk]

Sometimes things do work after all

[Elon Musk @elonmusk]

It is time for the people of Venezuela to have the chance for a better future.

Support Maria Corina!

[ATP Tour @atptour]

The No.1 club called, and the former No.1’s are so glad you answered, Jannik ❤️

Hard work and perseverance got him here, and now the legends of the game unite to welcome their newest member🥇

#S1NNER | #PIF | #ATPRankings | #partner

[Jay Giri @jaygirimd]

Continued efforts at regulatory capture and monopolistic business practices by @ABIMFoundation

Hospital leaders: help us break this monopoly by endorsing @InfoNbpas for maintenance of your credentials.

This is a concrete step to decrease burnout among your workforce

[Allison Dupont, MD @Allison_Dupont]

#MedTwitter Board-certified physicians…As a group, would you be willing to stop enabling the ABIM extortion of physicians by denying them the annual certification fees they charge you for their “MOC”?
#CardioTwitter @MSampleMD @doctorwes

[Nick Mark MD @nickmmark]

Much has been made of the declining life expectancy in the US.

The reality is regional. Think of the US as two countries:

Some blue counties with increasing life-expectancy better than 🇯🇵 (84) & many red counties with plummeting life expectancy worse than 🇷🇺 (71).
1/

[Nayib Bukele @nayibbukele]

Why did we destroy the tombstones on the graves of gang members?

[American Heart Association @American_Heart]

Don’t miss @HamlinIsland’s interview tomorrow at 7 am EST- you don’t want to miss it!!