boss charles

My last account got suspended because I tweeted mean stuff at a food hall that got rid of their buffet

[Sanat Dixit MD FACS @sdixitmd]

The ACA was projected to save $120B from the federal budget deficit from 2010-2019. Healthcare related deficit spending actually INCREASED by over $440B over that same 10 year period, and almost doubled over the subsequent 5 years.

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

One of the worst takes in US healthcare policy discussions is: "Medicare has low administrative costs."

Medicare has narrowly measured administrative costs, unusually expensive beneficiaries, and a large hidden bureaucracy that is offloaded to entities outside of CMS.

First, Medicare beneficiaries are older and sicker than the average privately insured person, so Medicare spends far more in medical claims per enrollee. When administrative costs are presented as a percentage of total spending, a program that pays very large medical bills will naturally look administratively leaner.

Second, Medicare offloads collection of premiums to other branches of the government. Where a private insurance company has to spend money on premium collection, Medicare relies on the IRS to collect the taxes to pay for its services. No cost to CMS there.

Additionally, Medicare offloads the work of describing and valuing the billing units for physicians. Much of this happens through the CPT and RUC machinery, maintained outside CMS by the AMA and specialty societies. There are millions of dollars worth of time from physicians and staff for which Medicare never pays. Meanwhile, private insurance companies are responsible for negotiating their own distinct contracts with numerous provider groups.

Then the compliance costs. Doctors and hosptials spend billions of dollars on quality metric reporting, conditions of participation, joint commission compliance, and other regulations.

There is also a deeper point: low administrative spending is not automatically good. A trillion-dollar public program needs oversight. CMS loses billions to waste, fraud, and abuse every year. Some more administration to reel that in might be helpful.

Learn more in my latest, link below:

[Handre @Handre]

Two countries split from the same colonial body in 1965. One picked economic freedom. The other picked handouts and racial spoils. You already know how this ended.

Singapore had no oil, no farmland, no hinterland. Just a swamp and a port. Lee Kuan Yew looked at that and trusted trade, low taxes, and hard money. Central planners hate what he did.

Malaysia went the other way. In 1971 Kuala Lumpur launched the New Economic Policy, a state program handing quotas, contracts, and university seats to ethnic Malays. Politicians decided who got what. A commissar fantasy dressed in liberal language.

Now let's look at the numbers. In 1965 both places sat around $500 per capita. Today Singapore clears $84,000. Malaysia sits near $13,000. Same climate, same starting line, one sixth the result.

The Singapore dollar holds its value because the Monetary Authority of Singapore manages it against a currency basket and refuses to print its way out of trouble. The ringgit has lost roughly two thirds of its value against the Singapore dollar since 1981.

You cannot subsidize your way to wealth. You cannot redistribute what you never let people produce. Every ringgit funneled through a quota is a ringgit some bureaucrat spent on his own vision instead of a customer's.

Malaysia bet on planners deciding outcomes. Singapore bet on people deciding for themselves. The gap between $84,000 and $13,000 is your answer.

[boss charles @rockstopher2]

@NotSonnyFaz Lmao

[boss charles @rockstopher2]

@raghu_venugopal You do understand what average means right?

[boss charles @rockstopher2]

@BFW Indiana not interesting? With Hoover ?

[Richard Hanania @RichardHanania]

The intellectual debate over universal healthcare is dead, right? I don’t see people claiming the UK or Canada has a better system any more.

Is this going to go on forever? Capitalism constantly proving itself superior, and then people forgetting that lesson for the next thing?

[david morris @dmorris345]

@DrDiGiorgio My wife’s old small town doctor could see 50-70 patients if needed using paper charts…. This was in 80s-90s.

He knew each patient, as he was the only doc in town. Brilliant doc. He had a great lifestyle…no admin jacking his practice up. Great $$.

Used to be typical situation

[Kurt Schlichter @KurtSchlichter]

Remember, the United States of America, and our 250th anniversary would not be possible, if the American citizens did not own modern firearms sufficient to annihilate tyrants.

Nothing has changed in a quarter millennium.

Buy guns and ammunition.

[boss charles @rockstopher2]

@CNN Sucks

[Tunku Varadarajan @tunkuv]

What Mamdani doesn't get, & will never get, is that America's greatness lies in the fact that people like him--who revile America, detest its values, & strive to destroy its economy--are not herded into jails or gulags or frogmarched to face shooting squads but get, instead, to run for and win elections. America's greatness lies in its limitless tolerance of obnoxious, ungrateful wretches who spit in its face. America is wasted on Mamdani. Think of the many millions of people the world over who would trade places with him in a heartbeat--and actually be thankful to be in America.

[Konstantin Kisin @KonstantinKisin]

This is because the anti-capitalist left is not actually against people being crazy rich. They're against certain types of people being crazy rich.

Artists and athletes make sense to them because they've played music and sports and because their success can be explained by "luck" and "talent". Messi's wealth is not offensive to them because they understand Messi is much better at football than they are.

But when it comes to business, the anti-capitalist leftist has no framework for understanding why Jeff Bezos might be super rich since 99% of them have never ever created a product, business or service that was of value to other people. They've never taken entrepreneurial risk. They've never employed people and felt the burden of responsibility that comes with that. They've never pick up a business and given it a play in the way they've picked up a ball or a guitar.

They *literally* don't understand wealth creation. They think there is a fixed amount of money and the only thing a business does is split it unfairly.

It's why they rage at Elon and other successful business leaders. Because they genuinely don't understand why they're wealthy.

Also, and this is just as important, athletes and artists are disproportionately young, attractive, "diverse", left wing etc. Business leaders are "evil" middle aged white men whose success offends the average anti-capitalist leftist because they don't understand a) what it is they do and b) that Elon Musk has the same talent advantage on them as Messi does, it's just harder to measure.

[Real Doc Speaks @realdocspeaks]

This is ironic coming from someone at Harvard Medical School. The Harvard hospitals lead the way in the Fair Share Deficit, according to the Lown Institute.

This means that, according to the Lown Institute, these hospitals provide hundreds of millions less in charity care than they receive from their tax-exempt status.

Then you have to add in the enormous windfall from the 340B program!

There is also the facility fee markup that hospitals enjoy.

And of course there are the enormous indirect research fees charged by Harvard that are as high as 69%.

Harvard is masterful at soaking up taxpayer money, and you want to claim the moral high ground.

[Anish Koka, MD @anish_koka]

On June 30, 2026, the NEJM retracted the clinical trial that got a drug approved by the FDA, triggering a $3.7B acquisition by Amgen.

The reason: the primary endpoint data was manipulated.

Here's how it happened, how it came to light, and who paid the price. 🧵

[boss charles @rockstopher2]

@joshmcgoo @DrDiGiorgio It happens all the time, including epic chats asking for clarity on orders other doctors have placed

[boss charles @rockstopher2]

@FrenchResponse You can’t be serious

[boss charles @rockstopher2]

@paulg 100%, and I’m on board . Why have a nation at all if our jobs are open to anyone?

[boss charles @rockstopher2]

@DrJuniorM1 @anish_koka Literally never happens in America

[boss charles @rockstopher2]

@litcapital They also do t have a monopoly on computers or phones