USPS is late to the party for worshipping health care providers

I was shopping for stamps back in December in order to send out our family’s Christmas/New Year’s/Kwanzakkuh cards. I discovered that the USPS is about 4.5 years late with the health care provider worship:

(The Greenspun Version of this stamp would be large enough for the following legend: “Thank you for hoovering up 20 percent of our GDP and can we please work two days per week instead of just one in order to fund you?”)

What else is going on in the USPS stamp design mill?

Compare the following holidays for fun factor:

(No mention of Maulana Karenga a.k.a. Ronald Everett on the Kwanzaa stamp?)

Perhaps because of the fun discrepancy, the Kwanzaa stamps were sold out at both post offices that I visited.

We’re invited to “celebrate the universal experience of love” with a Keith Haring design. (Haring’s experience of love was having sex with a lot of different guys and then dying of HIV/AIDS in 1990.)

(The USPS didn’t want to use Haring’s mural or a work from the Bad Boys series?)

If we’re done with love we can celebrate a typical migrant and remind the native-born that there would be no entertainment without open borders:

The 8×10 view camera has its moment in the unionized sun:

Separately, I had some difficulty convincing USPS workers on December 23, 2024 to handle a letter to a friend in Canada. They said that the Canadians weren’t accepting mail from the U.S. The Tequesta, Florida Post Office was more accommodating. The lady behind the counter there said that letters were okay, but packages wouldn’t be accepted. The unionized government workers who handle mail in Canada went on strike from November 15, 2024-December 17, 2024. Wikipedia says “On November 29, Canada Post asked the mail services of all other countries to stop accepting or sending mail to Canada, leaving all mail unprocessed in secure containers from November 15. This mail could not be delivered or even scanned due to the strike.”

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Working class taxpayers buy a laptop class Coloradan a free electric car

“How I Leased a New EV for $0 Down and $0 per Month” (Car and Driver, December 2024):

During my morning scroll, I came upon news of a Denver dealer offering a Fiat 500e lease for $0 down and $0 a month. The minimal fine print said lessees had to be Colorado residents, which I am, and just had to cover the tax on this wee EV. I had to check it out.

The magic of this deal comes down to incentives. Because it’s a leased EV with an MSRP below $55,000, the car qualifies for the full $7500 federal tax credit regardless of battery mineral content or origin. Or rather, the leasing company qualifies for that credit, so the lessee’s personal income is irrelevant. This is the so-called leasing loophole. Colorado adds its own spiffs in the form of $5000 for a new EV, plug-in, or hydrogen-fuel-cell vehicle, plus $600 if the vehicle is being financed or leased and an additional $2500 for cars with a sub-$35,000 MSRP. (The model eligible for this deal limbos under that bar at $34,095.) The $5000 state tax break ratchets down to $3500 on January 1, which is why the deal has a deadline of December 31, 2024. Uncertainty about the next administration’s stance on (non-Tesla) EVs provides a push, too.

All together, that’s $16,100 in credits, knocking the capitalized cost of the lease down to $17,995. I’d be on the hook for 4.5 percent tax on the original $34,095, but additional dealer-side coupons from Stellantis brought that down to $1205.50. If I choose to buy the car at the end of the term, it will cost me $17,388.45. I don’t expect that to happen.

Our family is in the laptop class. Could we get the working class to buy us a free car for use in Florida? No.

Because of Colorado’s unique tax-credit situation, the store rounded up as many unsold 2024s as it could find from across the country and slapped the deal on them. The car I ended up with was, coincidentally, originally delivered to the Fiat dealer down the road from C/D HQ in Ann Arbor, Michigan, where I used to live.

Maybe a working class person behind on his/her/zir/their rent could get this deal too? No. It’s restricted to the “reasonably elite”:

A funny formality: They still had to run a credit check to confirm my ability to (not) pay.

Was that the end of the river of cash for the happy journalist?

I get my choice between a free Level 2 home charging station or $600 in charging credits, either of which will offset about half of my initial outlay. I opted for the hardware since I don’t plan to stray too far from home with this little Italian job. There’s also the incremental cost of adding a car to insurance as well as registration and plates, but you can’t get around those. So all in all, I’m paying less than $50 per month in taxes. Not bad.

(The “taxes” described might be more properly considered a user fee for the roads on which the car will be driven.)

What about your range anxiety? Load up on Xanax! From the Fiat USA web site:

I.e., the taxpayer-funded deal makes sense only for those rich enough to already own a long-range electric or gasoline-powered car. It transfers money from people who can barely afford one car to those who can afford to keep at least two. Merry Christmas to the elites, indeed!

Donald Trump, 2014: “I hope we never find life on another planet because if we do there’s no doubt that the United States will start sending them money!”

Related:

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There is no quota and we have not met the quota (US Naval Academy’s race-based admissions system)

“Federal Judge Upholds Racial Preferences in Naval Academy Admissions” (New York Times, December 6, 2024):

A federal judge on Friday denied an effort to stop the U.S. Naval Academy from considering race and ethnicity in admissions, finding that the academy has a distinct interest in using affirmative action to achieve diversity in its student body, and that doing so is a matter of national security.

Judge Bennett said in his decision that 52 percent of enlisted Navy service members belong to racial minority groups, but only 31 percent of officers do. In 2020, only about 17 of the 218 admirals in the Navy were officers of color, he said.

In the Marine Corps, the least diverse branch of the armed services, minority service members make up 35 percent of enlisted Marines, and 29 percent of officers, the judge said.

“There is a significant deficiency in the number of officers of color in the officer corps of the Navy and Marine Corps,” he wrote.

Racial quotas are unconstitutional violations of the 14th Amendment, so there certainly wouldn’t be a quota for “officers of color”. On the other hand, it is clear that the quota hasn’t been met (“significant deficiency in the number”).

Related:

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Can we get a federal law to require call centers to have caller ID?

Here’s one for Brendan Carr, soon to be in charge of the Federal Communications Commission (nytimes)… a regulation that requires call centers to have caller ID so that they don’t hassle Americans with “What is your phone number?” questions. As far as I can tell, customer “service” call centers are the only users of the American telephone system that don’t have caller ID, thus leading to the annoying phenomenon of having to provide one’s phone number, the agent having to type it in, etc.

The worst offender in this regard seems to be General Electric. They have an automated system that has called me about 10 times regarding our fancy Monogram gas range. One of the things that we like about it is that LED rings behind each burner control knob light up to show that a burner is on. Or at least they did until the entire system failed. GE sent out a tech who, predictably, decided that parts were required. GE then began shipping out parts in dribs and drabs. After each shipment, the company’s automated system would tell me to schedule a return visit. Then I would press some buttons to talk to a human who would, after asking for my phone number (keep in mind that GE had actually placed the call and, apparently, no longer had the phone number that it had used) say, “We can’t schedule service until the parts are delivered“.

(I did ask “Why is your system programmed to make calls when a part is shipped and ask me to schedule with a live agent if you can’t schedule anything until after a part is delivered?” and, of course, the agents didn’t agree with me that there was anything suboptimal about GE’s system.)

I recognize that this would seem to be at odds with my general support for smaller government, but telecom is already heavily regulated, purportedly for our benefit.

Separately, I would love to know how roughly a dozen parts are required to fix what, in my humble engineer’s brain, must be attributable to the failure of a single component (none of the six burner controls has a working backlight and I think we have a full set of parts for each of the burner knobs, but I have to believe that the root cause is upstream from the knobs).

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Department of Government Accountability (DOGA): Silicon Valley Bank and the San Francisco Fed, 1.5 years later

Our stroll to the first morning of work in San Francisco included the usual sights, e.g., a homeless encampment in the same frame as a self-driving Waymo:

Also, a smashed office building glass door:

It also took us past a Silicon Valley Bank “Experience Center” and the San Francisco Federal Reserve Bank, notable for supervising SVB right until the bank was seized by regulators in March 2023.

According to ChatGPT, nobody at the San Francisco Fed was fired as a result of this spectacular immolation of taxpayer dollars (somewhere between $15 and $25 billion; the government pretends that didn’t do the bailout with peasant dollars because it made other banks pay, but of course the other banks are where peasants keep their money).

NYT, 2018:

[Mary C.] Daly, who is openly gay, will become the third woman among the 12 presidents of the Fed’s regional banks. As a senior executive at the San Francisco Fed, she has been a leading voice for addressing what she has described as a “diversity crisis” in the economics profession and at the Federal Reserve. At the San Francisco Fed, she pushed successfully to balance the hiring of male and female research assistants.

Her online biography was updated June 2024 and makes no mention of her role in the SVB collapse.

Incredibly, the bank still operates as SVB, though it is now a division of a North Carolina-based bank. SVB still has its DEI presentation online, updated a few months before the bank failed.

If not for the regulatory seizure they would have put 100 percent of employees through DEI training by now. The 5 percent quota for Black leaders didn’t go into effect until 2025:

Circling back to the life of an expert witness, here’s the view of the Ferry Building from the conference room where I was imprisoned:

In response to a reader question about whether ChatGPT can be trusted, Perplexity.ai’s answer:

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New York Times: FEMA won’t help hurricane victims without documents

The New York Times reminds us that it is misinformation when Donald Trump says that our government spends money on migrants rather than on Americans who have suffered from natural disasters:

One part of the U.S. government welcomes the undocumented, e.g., with a few years of taxpayer-funded hotel rooms in New York City. (NYT, May 2024: “The average hotel room rate in the city is $301 a night, a record. A major reason: One of every five hotels is now a shelter, contributing to a shortage of tourist lodging. … Dozens of hotels, from once-grand facilities to more modest establishments, closed to tourists and began exclusively sheltering migrants, striking multimillion-dollar deals with the city.”)

According to the New York Times, a separate part of the government refuses to help native-born hurricane victims unless they can produce documents:

After the catastrophe, a FEMA official told him they could put him up in a hotel for four days if he could show them his driver’s license. But his license was in the river, along with the rest of his life. So, he moved in with a friend.

So it’s a lie when Donald Trump says that migrants get assistance ahead of native-born Americans and also it is true that native-born Americans can’t get assistance unless they jump through hurdles that migrants aren’t required to clear. Also, the native-born American gets 4 days of taxpayer-funded shelter while the migrant gets a lifetime of taxpayer-funded shelter?

The article overall is interesting. The NYT informs us that existing Americans don’t have enough money to build decent storm-resilient housing for themselves:

The answer to our problems, found elsewhere in the same newspaper, is an open border through which tens of millions of low-skill immigrants will stroll, each one of whom will need housing but won’t earn enough (or anything?) to pay for a house with a standard foundation.

From the FEMA web site, a report on FEMA’s expenditure of $641 million in taxpayer funds on migrant shelters:

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Why not a simple web site or phone app to determine whether one must evacuate?

An American faced with hazardous weather who wants to know whether to evacuate his/her/zir/their house or apartment must first do a web search to find a site that maps flood or evacuation zones, typically A through E. Then the citizen, documented immigrant, temporary protected status migrant, or undocumented migrant must scour various state and county web sites to try to figure out what the latest evacuation orders are by city, county, or state. Here’s part of a story from our local newspaper:

There are many ways for the above process to go wrong. Why not a phone app that gets GPS data from the phone hardware and operating system and does all of the above work reliably? The server just needs to have a database of evacuation and flood zones and a canonical up to date list of evacuation orders. Why is it a human’s job to do something that can be done much more reliably by a computer?

For Floridians during hurricane season the app could run continuously in the background and send alerts as necessary.

One wrinkle is that people who live in mobile homes are often ordered to evacuate even if they aren’t in a surge-prone zone. The ideal app, therefore, would know about trailer parks and maybe get loaded with a database from Zillow or similar regarding the housing type at a given address.

What about people who aren’t competent users of smartphones? Nearly all of them have an app-capable TV and I think those TVs can and do run software when the TV appears to be off. Some code could be built into TVs to connect to the same server that the phone apps connect to. In the event of an applicable evacuation order, the TV would wake up and display/speak “Time to evacuate!”. This would be a little more complex to set up because TVs don’t include GPS receivers and the street address of the TV might have to be entered.

As an added bonus to this app infrastructure, a resident of the U.S. could register his/her/zir/their address and phone/email with the server. The server could then put the registrants into a geospatially indexed database and query to find those affected by a newly issued alert and then email/text the relevant subscribers: “If you’re at 1141 George Perry Floyd Memorial Boulevard right now, which you said was your home address, your county has issued an evacuation order covering your neighborhood. Click here for more information, including a list of county-run shelters.” No matter how fast the U.S. population grows via open borders the computational capability of server CPUs should grow yet faster and, therefore, it would never be impractical to issue personalized alerts to every resident of the U.S.

With all of the hundreds of billions of dollars spent by the federal government on disaster-related projects over the years, why hasn’t something like this been built by the government? Google, Apple, or Amazon could probably build it pretty easily given that those companies already know our addresses, phone numbers, and email addresses. If the above capabilities were built into Android and iOS that would cover almost everyone. Maybe these big companies wouldn’t want to implement this capability, though, due to fear of liability in case they happen to miss an evacuation order. (Maybe they could be protected from liability as the COVID-19 vaccine manufacturers were?)

Here’s a concrete example from Tampa (wiped out in 1848 and hit badly again in 1921), starting with the “evacuation zone map” for Hillsborough County:

The official evacuation order says “Hillsborough County has issued a mandatory evacuation order for Evacuation Zones A and B…”, but the the legend doesn’t mention “zones”. The legend refers to an “evacuation level” of either A or B:

If we look at a satellite view of the city we can see that a lot of people shouldn’t have to run away:

My favorite steakhouse, Bern’s, is in the center of the city and Zone C. Same deal for Columbia Restaurant in Ybor City. The art museum, on the other hand, is in Zone A. Need to go to the hijab store in Brandon, Florida (suburban Tampa)? That’s not in any evacuation zone (i.e., the hijab inventory should be safe). The Tampa Zoo, on the other hand, seems to be in Zone A, which is not great news for the animals. Busch Gardens is not in any evacuation zone. The big airport? Zone A.

During the Tampa evacuation it seems that some people ran away who didn’t need to and some people stayed despite an order to evacuate because they didn’t know what zone they were in. Once on the road, things got more chaotic with shelters that filled up and traffic jams. Officials were saying “You don’t have to go more than 10 or 20 miles”, but residents didn’t know which shelter was the most sensible destination so some folks might have driven 100+ miles away to a hotel or relative’s house. Ships always have muster stations so that people know where to go in the event that the whistle blows 7 times and then there is a long horn sound. Maybe the app could have a preplanned idea of which shelter people in which blocks of a city should go to first, adjusted for the pet ownership status of the app user (it’s more complex to evacuate with a pet than one might think; only some shelters are pet-friendly and the owner is required to have and bring a crate big enough for the pet and the owner can’t stay with the pet while in the shelter). This could be refined if information is received that a shelter is full and turning people away.

What about after the hurricane arrives? The app/server combo could send an SMS or push notification reminding people to put their phones into low-power mode. The software could then notify people when it was safe to return to their individual neighborhoods (this can be complicated after a hurricane because sometimes bridges to barrier islands are destroyed and/or roads are blocked by trees). Using data from poweroutage.us, the software could include SMS information about whether power was likely to be available at a user’s home (maybe someone would choose to remain with friends or relatives until power was likely back).

Separately, here were our neighbors’ Hurricane Milton preparations as of yesterday, which may or may not meet FEMA standards:

Related:

  • “NY governor slammed for saying black children don’t know what computers are” (BBC). If Democrats don’t think that Black people can use computers and Democrats run the U.S. (which they do right now), why hasn’t the above-described app already been built and released by FEMA?
  • “FEMA Scrambles to Confront Two Storms—and Misinformation” (WSJ): “Instead, federal officials’ efforts to save lives are being complicated by an unusual level of politically charged misinformation, which authorities say risks leading people to disregard evacuation orders…” (the authorities are sure that the problem is that Americans are allowed to speak their minds on Twitter and not that people in a country where IQ is falling might not have the brainpower and diligence to get through the multiple web sites that are required to make an evacuation decision. (If the “authorities” are correct maybe Twitter and Facebook need to be shut down any time that an emergency has been declared? If “misinformation” is killing people and saving lives from COVID-19 justified suspending the First Amendment right to assemble then surely it would make sense to suspend the First Amendment as a hurricane approaches the U.S.)
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NASA at Oshkosh (saving our planet with plastic bags)

From nasa.gov:

The NASA pavilion at EAA AirVenture (“Oshkosh”) 2024:

(These are the plastic bags that are good for the environment?)

What else was going on? NASA arranged to have a Boeing Starliner parked in front:

The NISAR mission was featured. This was supposed to be launched in January 2022 and will supposedly be able to measure displacements of parts of Earth’s surface as small as 3.5 mm. I’m not sure if this includes vertical displacement, e.g., to see whether sea levels are indeed rising to the point that owners of multi-$billion lower Manhattan and Boston real estate portfolios need to be bailed out by taxpayers in the Midwest. The satellite will supposedly be able to watch glaciers and ice sheets moving. I don’t think that it can measure sea level directly because the Science Users’ Handbook says “Provide observations of relative sea level rise from melting land ice and land subsidence.” How many migrants could have been housed for the cost of this mission? “NISAR launch slips to 2025” (July 29, 2024) says “with NASA alone spending more than $1 billion in formulation and development of the mission”. Taxpayers spend about $200,000 per year per migrant family welcomed in New York ($140k/year for food and housing and then let’s assume another $60,000/year for health care and other benefits). So if we hadn’t spent money on NISAR we could have supported 1,000 additional migrant families for five years.

NASA was also featuring the X-66, a collaboration with Boeing on an airliner that could possibly cut fuel burn by 30 percent, mostly via high aspect ratio wings (as you might see on a glider). We’re in a “climate crisis” according to our ablest minds, e.g., Kamala Harris, and “communities of color are often the hardest hit”. When will communities of color see some relief from the X-66? NASA says that if everything goes perfect the X-66 might get into the air as soon as 2028 and then, in the year 2050, we’ll be in a net-zero phase for aviation. The United Nations forecasts that world population will grow to approximately 10 billion by 2050. So we’ll have more people taking more trips, mostly in planes that were built to current designs, and the result will be much less environmental impact.

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Unrealized capital gains are already taxed by the federal government…

… for those who renounce U.S. citizenship.

There has been a bit of an uproar regarding the Democrats’ plan to tax unrealized capital gains and Republicans are complaining that it is an unprecedented new area for the federal government. But this isn’t a new area, at least when it comes to Americans who decide that they’re never going to pay U.S. taxes again. The IRS web page regarding the expatriation tax:

IRC 877A imposes a mark-to-market regime, which generally means that all property of a covered expatriate is deemed sold for its fair market value on the day before the expatriation date. Any gain arising from the deemed sale is taken into account for the tax year of the deemed sale notwithstanding any other provisions of the Code. Any loss from the deemed sale is taken into account for the tax year of the deemed sale to the extent otherwise provided in the Code, except that the wash sale rules of IRC 1091 do not apply.

And a detail page:

Section 877A(a) generally imposes a mark-to-market regime on expatriates who are covered by section 877A, providing that all property of a covered expatriate is treated as sold on the day before the expatriation date for its fair market value.

For purposes of the mark-to-market regime, the covered expatriate is deemed to have sold any interest in property that he or she is considered to own under the rules of this paragraph other than property described in section 877A(c). For purposes of computing the tax liability under the mark-to-market regime, a covered expatriate is considered to own any interest in property that would be taxable as part of his or her gross estate for Federal estate tax purposes under Chapter 11 of Subtitle B of the Code as if he or she had died on the day before the expatriation date as a citizen or resident of the United States.

In computing the tax liability under the mark-to-market regime, a covered expatriate must use the fair market value of each interest in property as of the day before the expatriation date in accordance with the valuation principles applicable for purposes of the Federal estate tax, except as otherwise provided in this paragraph.

How often does this happen? “IRS steps up enforcement of the individual expatriation tax” (KPMG partner; June 2024):

The number of individuals who renounce their U.S. citizenship or terminate their green card status has increased significantly since the enactment of the current expatriation tax regime in 2008. Lists of these individuals published quarterly by the IRS in the Federal Register show that the number of individuals expatriating has increased from 312 in 2008 to 3,260 in 2023, with a peak of 6,705 in 2020.

My big question is how President Kamala Harris will collect long-term money from the targets of her extended (not exactly new, as noted above) unrealized capital gains tax. A person targeted by the tax has two choices:

  1. pay President Harris for unrealized capital gains in 2026 (let’s assume it takes a while for this to be implemented), 2027, 2028, and every subsequent year until death
  2. pay President Harris for unrealized capital gains at long-term rates in 2025 and then never pay income taxes to President Harris, the U.S. government, or any other government again (expatriation)

Why wouldn’t a rational target of the new tax choose Option 2? He/she/ze/they renounces U.S. citizenship, moves his/her/zir/their assets into an offshore Dutch trust (as U2 did) and moves to any country that doesn’t dig into offshore assets/income for computing income tax. Or establish a residence in Italy and pay a flat tax rate of €200,000 a year (recently bumped up from the €100,000/year rate established in 2017, which means it has kept roughly even after adjusting for inflation in the costs of things that rich people buy, but the bump doesn’t affect people who signed up for this prior to August 2024). Or simply move to a country that doesn’t impose any income tax (KMPG on relocation to Monaco). If the expat is nostalgic, he/she/ze/they can return to the US for 30-60 days per year, depending on the employment situation, without becoming subject to U.S. taxation.

There is a lot to like about living in the U.S. (especially here in Florida!), but is it worth paying 100X as much in taxes compared to living in some other part of the world? If there are friends you want to see buy them a first class ticket to Heathrow and push your way through the pro-Hamas rallies to a night of theater. Or, if you’re truly one of those who has taken more than he/she/ze/they needs, send the Gulfstream or Airbus Corporate Jet to pick up the friends.

Here’s a place in northern Italy that costs less than a tract house in Palm Beach County ($2.7 million for a modern house on 22 acres):

If you don’t mind a little maintenance, a castle in Sicily on 7 acres:

Given the tax savings, maybe there isn’t any need for maintenance. Just buy a new house every few years with a fraction of what would have been paid in unrealized capital gains tax and give the old house to a charity.

Separately, why didn’t the Democrats impose their new tax regime during the first two years of the Biden-Harris administration when they had control of both houses of Congress and the White House? How can Kamala Harris simultaneously say that she agrees with everything that Joe Biden did (or read from a teleprompter) and also that she will do completely different stuff starting January 2025?

Related:

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Bad Pharma, 2024 edition

Ten years ago… Book review: Bad Pharma:

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in a drug’s life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all.

The book notes that the British government refuses to pay more for a new drug than the value added by that drug in terms of quality adjusted life years compared to cheap generics or other existing treatments. In the U.S., by contrast, the government and private insurers pay whatever the pharma company asks or, perhaps, a discount off whatever the pharma company asks.

Our ruling elites (I hesitate to say “the Biden administration” because it is unclear what role Joe Biden has been playing) have been touting a recent scheme to pay a little less for some drugs. This scheme is analyzed by Professor Vinay Prasad in “Price negotiation does not save money when keep you paying for drugs that don’t work”:

The Biden Administration saves 6 billion and then loses tens of billions with bad drug policy

They lowered the price of a drug that has no good evidence it is better than older drugs. Consider Entresto (above). Entresto— sacubitril valsartan 160mg BID— beat enalapril 10 mg BID in PARADIGM. Since then it failed in post MI and in HFpEF. It’s one the few drugs that ‘works’ in HFrEF but not post-MI. The dose tested in Paradigm was the MAXIMAL Entresto dose with a dizzying dose of ARB. But few people get this dose in real life. There is NO EVIDENCE that the prescribed doses in the US in 2024 (lower than maximal dose) are better than ace-s, which are dirt cheap.

You can lower the price of drugs, but you lose when you spend billions on covid drugs that have no evidence of efficacy. In recent years the Biden administration approved COVID boosters for toddlers, and spent 10 billion on Paxlovid. There is no evidence either of these interventions work in the current climate. So congrats on your 6 billion in savings, too bad we blew 10 billion on unproven products. (Net impact -4 billion dollars)

For every drug you negotiate prices on, the FDA is approving at least 5x as many new drugs based on poor evidence.

Summary: some things never change!

(The relative cost efficiency of the British health care system combined with the descent into Third World status for Britain is kind of confusing. The U.S. plainly wastes at least 10 percent of GDP via health care (closer to 15 percent if we compare to Singapore). How is it that we’re still so much more prosperous than the UK and most European nations?)

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