@EmoryRicks@DrDiGiorgio@mcuban This maybe happening in the auto insurance market as well. Private equity owned Caliber Collision has a significant percentage of body repair biz. Who are the private investors? Auto insurance companies? I smell a rat.
The Animal and Plant Health Inspection Service at USDA helps prevent threats like screwworm from ever reaching US livestock.
In 2025, it lost 1,300 employees due to cuts and firings.
That’s the thing about prevention: you don’t notice it when it works, only when it is gone.
With just the cost of Trump's Iran war so far, we could have: 1.) introduced national day care for all 3- and 4-year-olds; and 2.) introduced free college education for all families earning less than $125,000 a year. Just a reminder of opportunity cost. https://t.co/mYRz3tSpTb
Congressional advisers call to rein in Medicare Advantage spending amid industry pressure
I’ll summarize for you.
EVERY SINGLE FAMILY IN THE USA IS PAYING $800 A YEAR to the big insurance companies because taxpayers pay them more than it costs to support Trad Medicare
That’s insane. And it doesn’t even include the increased premiums trad medicare plan holders have to spend.
Medicare Advantage was meant to cost LESS than trad Medicare. Yet here we are
Support the Break Up Big Medicine bill from @HawleyMO and @SenWarren
If your representative is up for election in Nov and they don’t support this bill. Don’t vote for them. They support higher healthcare costs. To reduce healthcare costs, this bill is the most direct path
https://t.co/GD8rfn0ySy via @statnews
Why do the big drug distributors seem to get a pass when it comes to healthcare cost dysfunction ?
The fact that pharmaceutical wholesalers buy at what is effectively retail price is the foundation of pharmacy pricing dysfunction
The only industry I know that buys at retail price.
As a result
1. Indy pharmacies pay more cash out of pocket then pray they get reimbursed a fair amount.
2. Patients pay this price, full retail, during their deductible phase and a percentage of this inflated number for coinsurance
3. PBMs make a killing because they charge employers, manufacturers and patients fees and apply rebates as a percentage of WAC.
4. You don’t want to look at how this works for specialty drugs. It’s so profitable that these wholesalers are buying clinics to keep the business under their control.
5. This is the flu in the ointment in DTC. Pharm to table ? More like dollars to expensive middlemen charging a fortune that keeps the DTC prices higher than they need be. Fortunately some some manufacturers are realizing that consignment is a better supply chain model than what is currently happening
6. If brand manufacturers went completely to consignment for all brand and specialty drugs, the above might have to come to reality.
Or
If they went to all net pricing then:
Pharmacies would have more cash and less reimbursement risk.
Patients would pay far less during the deductible phase, and less in coinsurance and more
Spread pricing would be less of a problem
Etc.
Can someone explain to me why the big wholesalers get a pass when evaluating why healthcare costs are so horrific ?
January 23, 2026
OPEN
LETTER II
Every Hardworking American Who Wakes Up in the
Morning Asking Themselves What Went Wrong
The Federal Open Market Committee
2051 Constitution Avenue
Washington, DC 20418
Dear Distinguished Members of the Federal Open Market Committee,
Ahead of the contentious 2016 presidential election, Highland Park Presbyterian’s late Right Reverend Bryan Dunagan delivered a stern, succinct, secular message. To paraphrase, “If you don’t vote, you renounce the right to find fault for four years.” Deeply missed as he is, taken from the world at the tender age of 44 due to a fluke twist of medicine, Dunagan’s words are nonetheless directed at you this Wednesday.
By law, 18 of you can still occupy your positions at year-end. By law, you are required to elect the chair and vice chair of the Federal Open Market Committee on Wednesday, as is the case at the conclusion of every first FOMC meeting of the calendar year. By law, your vote counts. And by golly, if you don’t vote, you renounce the right to find fault with whomever President Trump nominates to a different position, that of chair of the Federal Reserve Board.
While you are more than aware, should President Trump choose to have Stephen Miran return to his post as Chair of the Council of Economic Advisors after his abbreviated term ends the last day of this month, the 18 of you who can still occupy your positions at year-end are in full control of your fate. Allow me to repeat myself please. The gentleman or gentlewoman who stands behind the podium at the conclusion of every FOMC meeting to explain, on your behalf, why and how you have made monetary policy is the individual you elect.
Naïve, I am not. I worked inside the Dallas Fed for nine years. I personally bore witness to the deep intransigence against breaking with tradition. My vexation was so acute upon my departure that I wrote a book that immediately branded me persona non grata within the institution that 18 of you lead today. Call me bratty if you must. But two squandered years teaming up with 800 PhDs in economics searching for a better inflation gauge pissed into the wind left me…well, fed up. Why bother with the existential façade of caring for the American people if the solution required to correctly measure price pressures negated the ability to maintain zero interest rate policy (ZIRP) and Quantitative Easing (QE)? As such, as you are all highly cognizant, all staff papers concluding that a new inflation metric was needed to prevent a replay of the Great Financial Crisis were burned. So yes…a clinically hyperactive former markets advisor to Richard Fisher was sufficiently miffed to dedicate 2 ½ years of my life, with four kids under the age of 12, to writing a book explaining why the Fed abandoned the “public” officials are dutybound to serve.
But I don’t digress. The 18 of you can come clean on Wednesday. You can vote into power an FOMC chair who honors the Fed’s raison d’être of safeguarding the buying power of the U.S dollar.
At the risk of being political, which I’ve dedicated my career to avoiding, you have a Fed Chair candidate in your circle who can force the hands of Treasury Secretary Scott Bessent and President Trump.
NATO & Denmark: We will give you the exact same security arrangements you have had for the past 40 years in Greenland.
Trump: Total surrender! Art of the deal!