Seth Borman

@uriahz @mcuban @StrikeDebt No, there aren't. When you can come up with a country in which you'd rather have cancer or a heart attack, be sure to let me know. People travel from all around the world to be treated here.

@SethBorman @mcuban @StrikeDebt Ain't no unregulated health care system that has better outcomes, but there's lots of nationalized systems that have better outcomes.

See, when you make a very strong argument like "Medicare For All saves lives" or "Medicare For All saves money," it's so unbelievably hard to combat the net positive benefits of M4A that the only lasting retort is to respond with something silly like this. It's to distract.

@bklynfletchIV @mcuban @StrikeDebt Government policy is to have fewer doctors and fewer beds, so if you get M4A expect less of each.

@mcuban @StrikeDebt M4A seems like even more crowded hospitals and longer waits for doctor. When do we get more doctors ans hospital beds to cover the 'A' part?

@uriahz @mcuban @StrikeDebt Health care has been a train wreck at least since the 1960s and arguably since the 1940s when the government first inserted themselves into it.

@mcuban @StrikeDebt We spent most of the last century successfully putting very competent non-partisan leaders in charge of all sorts of things. Just because Trump made the federal government an absolute train wreck doesn't mean it's impossible to have good governance ever again.

@MVargo6 @gatnerd 5.56x30 MARS would be a better starting point. I would expect a 55 grain bullet at 3,000 FPS from a 10" barrel.

@gatnerd I wonder what 85KPsi on a 40gr 5.7 out of a 10" looks like. (Assuming you upgrade everything to handle the increased pressures.)

Knox High Efficiency Cartridge = 5.56 Using High Pressure, they were able to duplicate 5.56 ballistics in a much smaller round, allowing for 50rd magazines and 30% less ammo weight. A much more interesting option than making legacy calibers more powerful.

@jldobrinsky The big question is why insurance companies are so price insensitive. They pay $60 to an independent primary care doctor that can direct patients to a $300 MRI, and they pay $400 to an HOPD that directs them to the HOPD MRI at $2,000. Why?

Last week I shared this article. The author argues that health insurers are not the source of every problem in American healthcare. I do not agree with every argument it makes, but I shared it for this: its financial analysis of insurers. Here it is again. If UnitedHealth gave every dollar of its profit back to patients, it would only cover about 9% more care than it does now. Even if you added executive salaries, the impact would be almost unchanged. This is not to excuse insurers. They are far from blameless. Insurers deny claims, restrict networks, and force patients to fight for coverage they have already paid for. Some of these practices cross the line into predatory behavior. But the amount you owe is not set by the company that sends you the bill. Insurers deliver the bill, but the price was determined long before, by whoever holds the power to set it. In much of West Virginia, that power rests with hospital systems that face little or no competition. On average, only about two cents of every dollar a hospital receives comes directly from a patient’s pocket. Patients rarely see the price before they need care, and those setting the price have little reason to keep it within reach. When a hospital acquires a clinic or outpatient facility, the cost of appointments can rise almost overnight. Medicare pays higher rates for care delivered inside a hospital than for the same service in an independent clinic. In West Virginia, the lack of competition makes this even clearer. Imagine the only gas station for fifty miles. With no rivals, there is no reason to lower the price. Hospitals shielded from competition in West Virginia operate much the same way. The regulation that can prevent a second hospital from opening is called the Certificate of Need. Read about a case going on right now: jessicadobrinsky.substack.com/p/stuck-in-the… It is just as important to see who is not responsible. Your doctor does not set the price, and neither does your nurse. In West Virginia, the labor of caring for patients at the bedside is only about a quarter of what hospitals spend. Nationally, two-thirds of hospital spending goes to things other than direct patient care. Much of that money is spent on administration, overhead, and executive pay. At tax-exempt hospitals, median executive compensation rose by more than 23% in just four years. The nurse starting your IV did not make that decision, and she does not see your bill any more than you do. So when you come across an article urging readers to stop blaming insurers, it is half right. Do not expect insurer profits to solve the problem. There is not enough money there, and the bill was set before the insurer ever saw it.

@brklynmind @thebiggest1500 @arpitrage Call them and ask. All this stuff is real, I'm not making any of it up.

@SethBorman @thebiggest1500 @arpitrage Lol thats where I go ... You arent actually getting out of there for less than 3k...and btw, they are great.

I actually think a more evenly distributed wealth distribution would result in more “pro business” political influence because a larger section of voters views it in their interest

@brklynmind @thebiggest1500 @arpitrage Here is one near you, the consult and follow up are $125. I can do this for radiology as well if you'd like to talk about $300 MRIs, and labs if you want to discuss $4 labs

@SethBorman @thebiggest1500 @arpitrage Lol yeah $950... Where at the animal clinic? Its more like 2k for just the procedure plus the prep plus the anesthesia. . Add the consult, etc its easily over $3k, if its perfectly clean. Like I said , you are completely out of touch

@HumeralO My wife had our first during PGY-1 year, the baby was a pretty minor impediment to sleep compared to the residency.

If I were a residency program director, everyone would have to spend a month raising a newborn before starting residency. If you can survive the sleep deprivation of a newborn, you can survive the sleep deprivation of residency.

@BladeDoc @asymmetricinfo They'll get it. One way or another.

@SethBorman @asymmetricinfo They need to get the laws changed first. Even in those places where NPs have independent practice they can't practice radiology independently.

It's worth noting that there are regulatory and liability hurdles to replacing radiologists. No one has yet cleared those hurdles, but that doesn't mean they never will.

@DylanMalyasov How does it reload? I don't see a crane in the LLM.

Lockheed Martin unveils HIMARS FLEX at Eurosatory 2026: dual-pod config doubles munitions load, adds PAC-3/IFPC air defense roles, optional autonomy via FLEXFires ecosystem. Compatible with GMLRS, ER GMLRS, PrSM, ATACMS. defence-blog.com/lockheed-marti…

@bobbyfijan I think it makes sense for the SFR scale, there is a developer doing scattered site affordable with SFR in South Bend, IN using the zoning code and pre-approved houses that the city commissioned. But that's not a production builder in a place where they are doing big projects.

Yes "time is money" when it comes to lowering housing costs ... but it's a portion of the budget. The biggest part of the budget is construction costs And infill vertical development is significantly more expensive to build than detached single family

@brian_blase If you think health insurers should be agents of or fiduciaries to anyone other than their shareholders, the setup we have isn't the one you might want.

@brian_blase An insurance company is not an agent of a plan sponsor or member. They have no responsibility to save anyone money, and they often aren't incentivized to do so financially either. This was the great innovation when we went from mutuals to publicly traded insurers.

My expectation was for this outcome. Here's one reason. Providers have much clearer incentives to win than insurers. Providers clearly benefit financially when they win. Insurers are somewhere between imperfect and terrible agents for the principal (the plan sponsor). They have much less financial incentive to win in arbitration.

@brklynmind @thebiggest1500 @arpitrage Colonoscopy w/o insurance is generally between $950 and $1,300. Works out to about a month of insurance premiums for most people.

@SethBorman @thebiggest1500 @arpitrage You are so out of touch its embarrassing . Do you know how much the avg American has saved in their bank account , do you knkw how much a colonoscopy costs w/o ins. Im done with this debate. You dont have a clue what you are talking about

@yorkshire_lewis @2805662 Abrams has had so many engine programs over the years that you can pick a different engine pretty easily, I think the MTU 883 and 890 were prototyped, the LV 100-5 was never finished, there's an opposed cylinder project and a Caterpillar diesel.

@2805662 Abrams is such a bad option for the UK. Leopard II, if it's an off the shelf purchase. The UK evaluated Abrams and the economics of it, and that crazy expensive turbine engine is no good for UK spending or needs.

Challenger 2.5 - new turret on an unmodified hull - isn’t doing the job. Time for the UK to join the majority of AUKUS & go all in on Abrams.

@WAHealthEnroll There's no mechanism besides competition that can get them to change their management practices. The management they have today reflects the management systems in place to deal with CMS and private insurance already.

@SethBorman UH, I was actually pointing to the opposite when I used the term "management heavy" but do go on if you have something worthwhile to add.

If we want to drive down cost then how hospitals conduct business will have to be evaluated and possibly changed. Are they over using travel nurses? Are they upcharging private insurance? Are they management heavy? Are patients getting their money's worth?

@edwards183 @kharyp $25k is the average for a family. I didn't make that number up. Regardless, either way they'd be taxed on it.

@SethBorman @kharyp They wouldn’t get that 25K in their pockets because the companies who employ 67% (self-funded plans) don’t pay anywhere near that amount. A better idea would be ending/limiting employer/employee tax deductibility in addition to limiting some of the ACA mandated benefits.

Tie health care to the job and you trap people in jobs they hate, afraid to start a business or change careers because a diagnosis would bankrupt them. We built a leash and called it a benefit. Cut it loose.

@smithbob_ @scandlenjosh How old were you?

@scandlenjosh Kids today demand much more home. Our 1st mortgage was at 10% interest, on a $100K balance, largely due to us 1st saving up a very large down payment. Delayed gratification, another foreign concept these days. BTW, we still live in that home several decades later.

Going through my mom's stuff and found an old mortgage statement from 1977. 25 year term at 8.75% for the $15,500 house on Peaks Island, Maine. The idea that "kids today" are so much worse off than previous generations is silly. Yes, housing costs are more expensive today than 10 years ago. But come on, today isn't extreme. This higher you are on this graph the more affordable housing is. @texasrunnerDFW

@tonyannett Yes, lets be like China, Venezuela, and Vietnam.

Capital controls would fix this.