The most honest sentence I've read about American healthcare came from Goldman Sachs.
In 2018, one of their analysts asked: "Is curing patients a sustainable business model?"
That one question explains most of our medical system. It isn't broken. It's working exactly the way it's paid to, and that's the problem. The system isn't paid to make you healthy. It's paid when you're not. This isn't a conspiracy. Every player is simply responding to how it gets paid.
1. Food companies are paid to sell more, not to keep you healthy.
Big food engineers products to be as craveable as possible, because the more you eat, the more they sell. Your health doesn't show up anywhere on the balance sheet.
Example: Nearly 3 out of 4 packaged foods Americans buy contain added sugar, including many breads, ketchups and pasta sauces. The industry even has a name for the exact amount of sugar that makes a product taste best: the bliss point. And food, drink and restaurant companies spent almost $14 billion on US advertising in 2017, with more than 80% of it promoting fast food, sugary drinks, candy and unhealthy snacks.
2. Insurers make more when healthcare costs more.
Insurers keep a fixed slice of what they collect, so their profit grows when total spending grows. Lowering the cost of care doesn't make them richer, because the law makes them refund the difference.
Example: The ACA lets insurers keep up to 20% of premiums for admin and profit. On $1,000 in premiums, that's $200. On $2,000, it's $400. It works like a waiter paid on tips: the bigger the bill, the bigger the tip.
3. Media makes billions from drug ads.
Media is paid by whoever buys your attention, and in health, the biggest buyer is the drug industry.
Example: Drug companies spent over $10 billion on ads in 2024. In early 2025, nearly 1 in 4 ad minutes on the evening news were for drugs, and the US is one of only two countries that allows these ads at all. So the loudest health message on TV isn't "find the cause." It's "ask your doctor if it's right for you."
4. Pharma makes the most from drugs you never stop taking.
A cure is sold once. A drug you take every day for the rest of your life is sold forever, and that's where the money is.
Example: Many of the most prescribed drugs in America treat cholesterol, blood pressure and blood sugar, and people usually take them for years, often for life. Now compare hepatitis C. A cure came out that works in over 95% of cases, and it cured so many people that its US sales were expected to fall from $12.5 billion in 2015 to under $4 billion by 2018. That drop is what led Goldman to ask whether curing patients is a sustainable business model.
5. Doctors are paid per visit, not per result.
Most doctors are good people with too little time. In a short visit, the fastest complete answer is to follow the guideline and write a prescription. Looking for the cause takes longer and pays the same or less.
Example: A primary care visit gives your doctor about 15 to 20 minutes to cover your history, your symptoms, your labs and a plan. Four years of medical school include, on average, under 20 hours of nutrition training. Insurers and Medicare also pay practices bonuses based on how many eligible patients are on certain medications.
6. Nobody fixes it, because prevention pays off too late.
The cost of being sick is paid today. The savings from staying healthy arrive years later, usually for someone else, so nobody wants to pay for them.
Example: About 90% of US healthcare spending goes to people with chronic and mental health conditions. Roughly 3% goes to public health and prevention.
Put the chain together. The food sets up the problem, the ads sell the treatment, the treatment is built to last a lifetime, the visit is too short to look for the cause, and the insurer takes a cut of every step. Each piece makes sense on its own. Together, they add up to one thing:
Nobody in this system is paid to look out for your long-term health.
The food isn't made to keep you well, the ads aren't there to inform you, and the system that treats you isn't paid to find the cause and fix it for good. Every one of them gets paid while you're sick, and the money stops when you're not.
That's how America spends more on healthcare than any other wealthy country, and Americans still die younger.
So go back to that question. Is curing patients a sustainable business model? For the system, maybe not. But there's one person in this whole chain who wins when you get healthy.
You.
If you look closely, you might notice subtle framing choices from CNN reporting on these two cases:
Illegal aliens charged with murder (and later with rape) of a 12 yo American girl. That case spurred "immigration debate."
Frat guys investigated for allegedly raping a woman two years later. This case is fueling "national outrage."
This is how the media narrative machine operates.
🫚They put the spice in one arm of the trial and the drug in the other.
Same patients. Same scoring. Peer-reviewed.
The spice won. Over and over.
10 head-to-head studies pharma hopes you never read — all from the 1.4M-study @GreenMedInfo archive 🧵👇
Every study above sits in the National Library of Medicine. None is hidden. It's just unfindable — in 2021 PubMed deleted the alt-medicine filter.
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In 2020 they tried to take it away. It's still yours.
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The official verdict is absolute Crap!
I'm a Commercial pilot (Complex piston singles) and I have followed this story from the beginning. The official story is pathetic. This will go down in history as one best examples of aviation bravery.
For this story to have the happy ending that it did, 3 things had to happen perfectly:
First, Cpt. Smit who while on the floor (being attacked with an axe!!!) thought "these are my last moments, but I cant let these people die" and somehow opened the cockpit door. Without his bravery and determination, Everybody dies no question.
Second the passengers Yaniv and Yitzhack rushed the cockpit the minute they heard screams. Dont minimize this. Most people in a situation like this would freeze in their seats. Not to mention getting the the front of the plane in a zero G nose over. I'm assuming IDF training (mandatory for all Israelis) but even then excellent reactions under pressure. By rushing to the front immediately, they were on the other side of the door the second that Cpt Smit opened it. The IDF training also probably had a hand in their ability to rapidly neutralize the co-pilot.
Yaniv taking the stick and pulling out of the dive is critical simply because there was no time otherwise. At the rate of decent by that point there is maybe 30s to impact if they keep diving (and they were already past Vne)
However, contrary to popular male ego, a non pilot successfully recovering the plane has odds near zero. Commercial aircraft are huge and have massive momentum. Even in a small plane, if you are too heavy on the controls nothing happens for ten seconds, then next thing you know you are upside down. The most likely outcome after a non-pilot pulling out of a dive would be overcontrolling and triggering a stall. Fortunately (according to Yaniv's interview) the relief pilot took over just as he leveled the plane.
The relief pilots being on board was fortunate, the relief pilot managing to take over the controls before Yaniv could trigger a stall was perfect timing. The pilots were not just random pilots or random airline pilots, they were the relief crew which meant they had hundreds if not thousands of hours in that exact model. Why is this important? Because the co-pilot had smashed the instruments (once again from Yaniv's interview) and the rudder was damaged from exceeding Vne. The relief pilots could handle this as a routine emergency, for a pilot unfamiliar with that airplane and instruments smashed it would be a insurmountable challenge.
Finally the Pilot who thought he was going to die was in luck because on board was a dentist. A dental surgeon no less. Not quite the same an ER doc, but enough to stop major arterial bleeding from multiple wounds.
If somebody doesnt make a great movie out of this it would be a crime. This is aviation history being made.
Am I wrong about this?
If "govt" delivers to everybody a "dignified" certain equal level of housing, salary, lifestyle, cars, phones, food, child care, clothes, computers, etc...as Mamdani and others advocate for...
That actually means "taxpayers" deliver on all that. Government is staffed and funded by us.
That means you're expected to work your hardest, but not to gain anything.
You're expected to sacrifice your time and energy for people you don't know, from illegal immigrants to criminals and ordinary folks who simply choose not to work themselves.
How many people will innovate and be motivated to strive and achieve if everything they earn is taken from them? Maybe some will, but I suspect most would not.
Meantime, a larger proportion of people will figure that if they get all their needs fulfilled without having to do anything, then they won't do anything.
This is the opposite of dignity.
There would be more people sitting in the @DineshDSouza "wagon" and almost nobody left to pull the wagon.
It seems we would grind to a halt as a modern society.
There are quite a few people though who advocate for this very thing so -- what am I missing?
Here are two career politicians who have never built a business that had to survive on its own. Their entire adult lives have been spent inside politics - drawing salaries, climbing political ladders, and spending other people’s money - without ever running a business, making a payroll, or answering to a customer who could simply walk away.
A bank laundered money for terrorists and drug cartels and paid a fine. A restaurant gave me a job and sent me home with dinner.
Guess which one I think about more.
After I blew the whistle at @HSBC, every door in my industry closed. Not slowly. All at once. I had a degree, a record of being right, and no one who would return a call. I was sleeping on a camping cot in a studio apartment and I needed to eat.
@PFChangs hired me.
They did not ask about the bank. They did not treat me like a liability. They handed me an apron and a section and let me earn an honest dollar on a day when nobody else in America would. On the nights money was tightest, the kitchen sent me home with lo mein so I would have something to eat. Nobody made a speech about it. They just did it.
I rebuilt my life between shifts. Everything I have now traces back to a restaurant that decided a whistleblower was worth hiring.
Here is what I learned carrying plates that I never learned at a bank. Dignity does not come from the title on your badge. It comes from doing honest work well, every single shift, when nobody is watching and nobody is impressed. The people I reported kept their bonuses. I kept my self-respect. I would make that trade again.
So I have a small ask.
Eat at @PFChangs this week. Lunch, dinner, whatever works. And tip your server like they might be rebuilding their entire life between tables, because some of them are. I was.
To the @PFChangs team, past and present: you did not just feed me. You gave me a place to stand while I figured out how to fight back. I will never forget it.
War at the Journal
I’ve never seen a greater disconnect from reality in covering the news.
Front page WSJ: the caption calls the stabbing co-pilot “a rogue pilot.” Rogue? No use of the words “high jacking” or “terrorist.” Quite a cad this rogue.
Article says no clear motive but there are “troubling possibilities”
Then comes this doozy of a paragraph:
“Negotiations to end the war that Israel and the U.S. launched against Iran appear stalled, and anger runs high over Israel’s conduct in the war against Hamas in the Gaza Strip.”
No mention here of Oct. 7th, Hamas or Hezbollah or Iran’s link to terrorism in the UK yesterday — clearly the US or Israel must be to blame for this incident.
Contrast the editorial inside at the same moment with the headline about how brave passengers averted a “highjacking” and calling the stabber a “terrorist” and putting it in the context of the Iranian actions, threats and history of terrorism.
It seems if you want the news straight you need to read the Ed page and I’m at a loss as to the game being played on the front page, but there are “troubling possibilities.”
Poor black people are owed 1.) the foundational public good of public safety, without which no other virtues can be cultivated, 2.) the best pedagogy that we have available to teach in safe, orderly environments.
Neither of these goods will equalize outcomes -- it will not be close in any of our lifetimes or our children's lifetimes -- but the adequate provision of both will satisfy a duty that is owed to them. That will be justice.
All other forms of ostensible aid that subvert and corrupt the integrity of these goods under the guise of pursuing "equity" harm the ostensible recipients and corrupt institutions in a manner that inflicts global harm to their functioning.
NEW: RFK Jr. says Medicare spending on wound care patches exploded from $200 million in 2019 to $14 billion last year: "It's all stolen."
Bad actors billed Medicare billions by slapping the most expensive skin grafts on elderly and dying patients who didn't need them.
"The doctors who prescribed them would get 6% of the sales cost. And so, they were incentivized to prescribe more expensive products. In Europe, they spend 35 cents a cubic inch. We were spending $135, and that went up to $2,000 a cubic inch."
"So 2019, we were paying $200 million. Last year we spent 14 billion. All stolen. It's all stolen. And we were on track to spend 23 billion this year."
"We put an end to it, and we now have driven that cost down to somewhere around a billion dollars."
In one Arizona case, the owners of two wound care companies pleaded guilty to more than $1.2 billion in fraudulent claims. Medicare paid over $1 million per patient for grafts slapped on elderly patients who didn't need them, many of them dying in hospice.
In June, DOJ charged 11 more defendants over more than $2 billion in allograft claims, including a company accused of issuing sham invoices to inflate what Medicare paid.
It feels like every week I learn a new way people were ripping off taxpayers for billions.
At the height of its power and prosperity, America lost its capacity to transmit basic numeracy and literacy to a rising generation because it handed over pedagogy to a pseudo-scholarly establishment that paid a credentialed caste handsomely to propagate ruinous errors that conformed to moral vanities that it chose to prioritize over all other values
There are entire fields of scholarly inquiry that destroy knowledge and replace it with pseudo-consensus buttressed by endless citations generated by the field that refer to nothing but self-evident lies that the field exists to prevent anyone from disputing.
Do not underestimate the importance of this — the threat it poses is in fact as existential as any of the more charismatic extinction events. Indeed, its relative slowness prevents us from perceiving its inexorable creep. And it’s no longer slow in many domains.
@StateDept I renewed my passport online
SUPERB
I've commented on the experience to a large number of my friends
The single easiest and most efficient interaction with the USG I've ever had
I actually timed it. It took me NINE MINUTES to complete, and I had the passport in ONE WEEK