Footnote: Cost Plus drugs is evolutionary - not revolutionary.

The margin collapse on generics (w/ resulting shortages) really started in 2006 w/ Walmart's $4 drug list. Cost Plus has a $5 shipping fee (+15% markup) that makes many generics higher priced to start.

It's not zero-sum technically, but it is practically b/c if margins (already thin for generics) falls too low - a manufacturer will simply stop making a low-margin generic Rx for one that's higher margin.

So yea - shortages will result.

... doesn't *seem* pointless ... until you realize that while SOME will benefit from cash-priced Rx - other's are likely to see higher prices - and when you siphon margins in one direction - there will be consequences ...

#Medsky

“I don’t think there is any way to regain that trust [in science] other than have the viruses do the education, and the bacteria do the education, and then people will realize they paid way too high a cost."

~ Dr. Paul Offit

... at some point (not in our lifetime perhaps) I'd like to think we can eliminate the insanity of "open enrollment" altogether.

I see no headlines from other wealthy countries on this topic - but my subscription to TIHT has elapsed so maybe there are recent examples? ;-)

... or perhaps it's just easier for oligarchs to find the right adulation, reverence, and worship on other platforms?

Disagreement is healthy. It's not an exorcism.

Not pointless b/c it isn't hate. If it were, I’d use a much louder font ;-)

Very "other worldly ... " ;-)

“A nation of sheep will beget a government of wolves.”

~ Edward R. Murrow

... and right up there w/ my other favorite quote:

"Campaign finance reform isn't the biggest problem facing the country - but it's the first." @lessig.bsky.social

Making money - the old-fashioned way ...

I don't want to jump to any hasty conclusions here, but this email exchange from 2011 between Jeff Epstein and Ghislaine Maxwell about Donald Trump having spent hours alone with an underage girl does seem like it might be bad for him.

i mean c’mon. the president’s best friend was the most notorious pedo in the country’s history who ran a massive child trafficking ring. every bit of circumstantial evidence we have says that trump was a participant. if this were a criminal trial we’d have enough evidence to compel a plea deal.