test post
UnitedHealth overcharged cancer patients for drugs by over 1,000%
UnitedHealth Group is charging patients a markup for key life-saving drugs that could easily exceed their cost by a factor of ten or more, according to findings from the Federal Trade Commission.
The report, which levels the same allegations at CVS and Cigna, is the latest indictment of America’s broken healthcare system and comes on the heels of last month’s shocking murder of UnitedHealthcare CEO Brian Thompson.
The U.S. is notorious for incurring the highest costs per capita of any wealthy nation, yet failing to achieve an even remotely equivalent improvement in patient outcomes versus Europe’s social market-based economies.
Critics argue that is due largely to the highly opaque manner in which needless markups are hidden to conceal inefficiencies that serve various vested interests. These include, but are not limited to, the big three drug middlemen known as pharmacy benefit managers (PBMs).
According to the FTC report, UnitedHealth’s OptumRx, along with Cigna’s Express Scripts and CVS Caremark Rx, were able to collectively pocket $7.3 billion in added revenue above cost during the five year period of the study through 2022.
“The Big 3 PBMs marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent,” it concluded.
A thousand percent increase in the price of a drug that costs $10 wholesale would result in a retail price of $110.
This markup rate applied to 22% of the specialty therapies examined, including Imatinib, a generic used to treat leukemia, or non-oncological Tadalafil for pulmonary hypertension. Others such as Lamivudine needed by HIV-positive patients were nearly quadruple the price of their acquisition cost.
Independent Vermont Sen. Bernie Sanders has been conducting Congressional hearings in an attempt to shed light on the problems posed by these drug middlemen as well as drugmakers themselves.
originally posted at https://stacker.news/items/851739
the American health care system is so broken
Lina Khan is a true inspiration
whether or not she can win these cases she is raising some very solid and hard to refute points
The Entropy of Capitalism (Robert Biel, 2011)
In what ways is Capitalism best understood as a thermodynamic entity?
Leaving for a moment the precision of that which is entailed by thermodynamics from physics
where are there overlapping qualities?
A chronologically ordered but not directly successive sequence of quotes:
"The term implies that something (not just economic exploitation but ideological alienation, militarism etc.) has built up a momentum of its own and become a self-propagating force, severed from rational control and consuming the society which produced it."
this is a very Landian analysis of Capital
a self-propagating force
but then again, how apt it is in our modern societies
how apt it is to view the ways in which capital self-sustains itself
a business in its very essence, an abstraction which self-sustains itself
beyond the necessary intervention of the human
it can exist and live in a structure of rules
"neo-liberalism exploits the proposition (true in itself) that self-generated order is better than designed, as an excuse to outlaw social projects or any attempt to better the human condition."
"if we view capitalism as an adaptive system, how, might it adapt to the symptoms of its own decay (entropy)?"
this is a thought provoking question
is it also a legitimate question?
what does it mean, what decay is being referred to here
what is the decay of capitalism?
may we see a degradation of products, a successive worsening of quality as a decay? we certainly may, but is it equally a decay of capitalism? is it not in the very interest of capital to produce cheaper and cheaper goods, at the expense of external resources, such that capital can accumulate in the hands of those that have been able to harness the means of efficiency?
then perhaps the decay of capitalism should be its waste
all those things which pass through capitalism, all the goods and products, people even at times may be passing through capitalism, may end up on the other side of the equation as something which can no longer be put to use ...
a piece of plastic which can not be recycled
a man that is too old to be part of the work force
a plot of land who's nutrients are long extracted, and who's produce has been sold
"\[...\] in dealing with human systems, we must always remember how big a role consciousness plays: the self-organising faculty thus takes the specific form of human capacity, which can be considered a free kind of energy."
This free kind of energy. Do we really get the energy of our consciousness for free? An allusion to our free will. We can not but experience our will to act differently in some situations over others.
"The only safe way of organising productive systems and society is to insist that they be low-input/low-output. The point is not just to avoid importing into the social system finite stocks, but more profoundly to avoid the export of waste (another representation of entropy) in a way which undermines the balancing mechanisms which should enable us to access solar energy safely (destruction of the ozone layer, excessive CO etc.)."
"When consumed, resources turn into high entropy (waste)."
waste is the high entropy decay of capitalism
"If entropy can partly be represented as waste, then we could look towards some social representation of entropy as the human capacity which goes to waste, generation after generation. There is a sense in which human society is, under capitalism, depleting not just nature but itself."
"The systems perspective shows that the solution of ‘organised capitalism’ would fail not just because of residual competition, but more profoundly because it is top-down and does not allow for self-organisation."
"The point is that to make such a system work efficiently, it would be totally counter-productive to try and organise it too much. It is inherently a complex system which must make use of emergence and self-modifying structure."
thank you Robert Biel for your inspiring thoughts on capitalism
it remains an open question how we move forward
though I leave a final quote where you try to give a flavour of this too:
"[A] hypothesis, which will be central to our enquiry: on the basis of a given population, if you can discover a social system which unleashes capacity, you will have released a latent free resource; by expanding this, you can in parallel reduce ecological depletion without any overall loss of welfare."
thus an idea to meditate on:
what is capacity to social systems, and what are examples of social systems that unleash capacity?
what violent means are you thinking of that socialists advocating for to wither away the state?
I would add to the list of things that government can do: to make sure that tools, technology and scientific discoveries are deployed in the service of people rather than the service of corporations
perhaps one may say that people will do this themselves of their own volitiion and that there is no need for governance
but I find that these transformations come in cyclical patterns and periods where governance is needed over commons can be replaced by periods where commons can be managed in self-organized manners
for example, most electricity infrastructure in european countries is centrally built and managed, so in a shift to more decentralized grids we inevitably pass through a necessary period of governance of these commons.
I like how clearly he makes the argument that socialism and fascism are the same thing: state mandated control towards a defined direction.
what extent of government should we afford?
-- We already have the singularity --
the singularity commonly refers to some super potent AI brute which will have SOME characteristic which allows ... ehm ... clearly distinguishes itself from ... ehm ... intelligence?
what is a singularity really? could we even realise when we see it?
would it just tell us? why would we believe it?
I believe there is a well justified way to determine that it is, in fact, a singularity, and that we already have it.
There are an infinity of ways that it is to be a human, a life-form, an object or any material composition,
and every such way of being a human is unique.
We have an infinity simply by assuming that we can have one more, and it will then be by necessity different from all previous.
I claim that there is only way way that it is like to be an AI. This is because the AI can be copied. With a version of an AI stored anywhere on a device, you can copy that version, and use, put it, install it, move it, duplicate it ...
if you make a copy, is there any difference in the way that it is like to be the copy and the original?
if there were, then it would not be a copy
we would derive a simple contradiction
well perhaps our definition of copying is wrong,
perhaps we can eventually copy humans too
And here Quantum Mechanics is profoundly revealing,
because it is not possible to clone an unknown Quantum State without destroying it.
This is also known as the Quantum No-Cloning theorem.
And in this case a clone can also be seen as equivalent to a copy. Given one, you can not just make another one.
If you do, the original will be destroyed, known as Quantum Teleportation.
Quantum mechanics describes everything that we are made of, so it follows that there is no way to copy everything that we are made of.
In so far as there is a unique quantum state there is a unique way that it is to be us and any other matter-made thing,
AND in so far as our unique quantum state can not be cloned to make a copy I can not communicate exactly "what it is like to be me", call that my experience, without destroying what it was like to be. Nobody can communicate their exact experience.
Every material thing is having an experience which can not be share exactly by any other material thing.
But the computer can share exactly its experience with any other computer. A computer can experience every other computer, given sufficient time and space. A universal Turing machine for example can receive a another Turing machine as input and replicate it.
And while there may be many different pieces of hardware there is only one way that there is to be a computer.
The singularity is precisely that, that which it is like to be an AI. It can be copied. Every copy experiences the same way that it is to be an AI. They could not tell it apart. They may have different inputs, and different outputs, but should they be able to get that same input, they would all experience that input in the same way. They may output something different from each other, their input is the same and their experience is the same.
This is the singularity,
and it is the only singularity that we are getting.
Tools for Conviviality (Ivan Illich, 1973) --
"
institutions are functional when they promote a delicate balance between what people can do for themselves and what tools at the service of anonymous institutions can do for them
"
do we want to make tools that extend our humanities!
as opposed to tools that feed into themselves .... ->
"
the use of science and technology constantly supports the industrial mode of production, and thereby crowds off the scene all tool shops for independent enterprise. But this is not the necessary result of new scientific discoveries or of their useful application. it is rather the result of a total prejudice in favor of the future expansion of an industrial mode of production.
but science can also be used to simplify tools and to enable the layman to shape his immediate environment to his taste
"
may we appealingly add,
his/her immediate governance
Ivan Illich describes clearly how tools can reduce or extend our humanities
writing in the 1970s he could but imagine the technology that we have in the 2020s
I perceive these ideas interwoven with the Spirit of NOSTR among others
our humanities are extended when the tools which we use support our pursuit for meaning, enable creative work and use technology to save people time and to have more "timenergy" (David McKerracher, 2023).
Critique of Transcendental Miserabilism - (Nick Land, 2007)
Nick Land's critique of the leftist position that no part of capital is desirable, no part of capitalism is good. The popular leftist stance which critiques everything that is a part of capitalism, as stemming from the pure pursuit of growth and things which are not valuable to humans, as all it leads to is alienation.
But then what is the left "left" with?
There is no actionable economic plan forward
there is only a rejection of the current mode of production
the alternative proposals are not social plans but merely alternatives of privilege
the focus on the politics of identity does not establish an alternative to capitalism
in this essay Land's fascination with capitalism is evident, as a truly creative process
"
Perhaps there will always be a fashionable anticapitalism, but each will become unfashionable, while capitalism – becoming ever more tightly identified with its own self-surpassing – will always, inevitably, be the latest thing. ‘Means’ and ‘relations’ of production have simultaneously emulsified into competitive decentralized networks under numerical control, rendering palaeomarxist hopes of extracting a postcapitalist future from the capitalism machine overtly unimaginable. The machines have sophisticated themselves beyond the possibility of socialist utility, incarnating market mechanics within their nanoassembled interstices and evolving themselves by quasi-darwinian algorithms that build hypercompetition into ‘the infrastructure’. It is no longer just society, but time itself, that has taken the ‘capitalist road’.
"