Cracklytoes

If you think all we need to do in healthcare is let people shop for prices and they will fall, is ridiculous The number of hospitals and insurance comps walking away from each other, particularly for Med Adv, tell us everything That the entire HC system is designed to make it IMPOSSIBLE to price shop Hospitals don't know their costs and can't set prices to insurance companies  Insurance companies do their best to manipulate transactions (latelq, underpay, deny, etc)  All of MA is an attempt by the carriers at arbitrage   They bet that they can break the law, and never adhere to reporting regs  and the worse that can happen is they might get fined   They bet that hospitals don't know their margins or profits on a per plan or carrier basis and they will make stupid decisions  That is starting to change   Now they are using AI to manipulate prices and costs in real time, knowing providers use consultants for Rev mgt, making them unable to respond in months, let alone real time They bet that by gaming MLR with subsidiaries, they can further break the law and not get caught  Bottom line , it's not an efficient market , due to zero transparency at the transaction level ,and the concept that individuals can shop based on price , when neither hospitals or insurance companies know what their actual costs and prices are , is insane  Carriers manipulate and obfuscate every number they can with the goal of making it impossible to know actual prices Good luck shopping for prices on all bu the simplest, most obvious services

For more than six decades, metformin has been the most widely prescribed drug for type 2 diabetes, primarily known for reducing glucose production in the liver. A groundbreaking new study from Baylor College of Medicine has overturned the traditional view by showing that the drug’s glucose-lowering effects depend heavily on direct action in the brain. Researchers discovered that metformin targets the ventromedial hypothalamus (VMH), where it activates specific neurons by suppressing a small protein called Rap1. This neural pathway proved essential for the drug’s full therapeutic effect at clinically relevant doses. When Rap1 was genetically removed from these neurons in mice, metformin lost its ability to lower blood sugar, even though other diabetes medications continued to work normally. This finding represents a major shift from earlier understandings that focused almost exclusively on metformin’s actions in the gut and liver. The study highlights the brain’s central role in metabolic regulation and explains part of why metformin produces broad health benefits beyond blood sugar control, including potential effects on aging and longevity. By identifying Rap1 as a key mediator, the research opens the door to developing more targeted therapies that could replicate metformin’s benefits while reducing common side effects such as gastrointestinal discomfort. As scientists continue to uncover the brain’s profound influence on whole-body metabolism, this discovery underscores the unexpected complexity of one of medicine’s most established drugs and paves the way for the next generation of precision treatments for metabolic diseases. [Lin HY, et al. Low-dose metformin requires brain Rap1 for its antidiabetic action. Science Advances. 2025;11(30):eadu3700. doi:10.1126/sciadv.adu3700]

The Trump Administration is using nearly $2 billion of your tax dollars to pay foreign companies to walk away from energy projects that would have lowered your electricity bills and powered millions of homes. Today, I introduced an amendment to stop these payouts and give Congress and the American people a chance to evaluate them. No President, Republican or Democrat, should be cutting backdoor deals with foreign companies to drive up your energy costs without any oversight from Congress.