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How many times will you hear crap coming out of your Tee Vee and various reps and senators before you drop everything you're doing, get off your ass, show up in DC and refuse to leave until everyone involved in this garbage goes to prison?

The EpiPen isn’t new; it has been in use since 1977. Research and development costs were recouped long ago. Nine years ago, it was bought by the pharmaceutical company Mylan, which then began to sell the device. When Mylan bought it, EpiPens cost about $57 each.

Few competitors existed, and for various reasons, that has remained the case. The device actually worked and saved lives. People needed it. Mylan raised the price. It also began to raise awareness.

"Raise the price" is sure a decent description... if you consider a 500% increase a "raise"...

Why?

No competition.

Or is there?

Yes, there is.  You can buy these over the counter virtually anywhere in Europe for about $20 each.  You can buy insulin over the counter in France for about the same price for a month's worth of supply.

And yet if you bring just one of either back over said border with you then you are breaking the law.  Bring a whole suitcase back and you're going to prison.

Yet if you did exactly that, were not put in prison and sold them, how many $600 (for a pack of two) pens would be sold in America?  Zero, because even if you charged $50 each (a $30, or 150% profit) you could make a hell of a business out of flying back and forth between any EU country and the United States doing exactly this.

How long would Mylan sell them for $300 each ($600 for a 2-pack) if you started doing this?  15 seconds, which is how long it would take them to figure out that they'd sell zero of them if they didn't drop the price back to about $50.

Now note very carefully that absent government force it is blatantly illegal under 15 USC, with a ten year per count felony prison term, to attempt to monopolize, restrain trade or price-fix.  Therefore it is only because of the explicit, intentional and outrageous conduct of your own government that you are getting raped like this on a literal daily basis, and this issue, as I've repeatedly pointed out is not limited to EpiPens -- in fact, Mylan has raised prices on dozens of off-patent, generic medications by about the same 500% in the last few years and the only reason they get away with any of it is the above use of government force.

Note that while the law may prohibit you from bringing said things back from Europe under penalty of imprisonment nowhere in that same law does it exempt the makers from 15 United States Code -- in other words, said law and regulation prohibiting your reimportation doesn't grant them an exemption to 15 USC prohibiting restraint of trade or pricing-fixing.  If that law were ever to be enforced those executives would still go to prison and their firms would still be bankrupted by ruinous fines, in short.

That is exactly where they, and all of Congress, damn well ought to be facing right here, right now.

If you want to know why medical care is so expensive and you need the fraud called "insurance", if you want to know why Obamacare was "sold" to people and is now going to collapse, if you want to know why Medicare and Medicaid were sold as "necessary" and yet continue to bankrupt the nation the answer is right here.

You are paying roughly five times what virtually everything ought to cost when it comes to medicine, and the reason you are paying it is because every firm and person in the business either is wantonly violating the law (and nobody ever gets indicted or goes to prison despite doing so) or even worse they've conspired with the government so they can enforce what is an otherwise-illegal act of restraint of trade under penalty of throwing your ass in jail instead of theirs and yet the're still quite-arguably violating the law themselves!

Let me know when you're ready to cut the crap, America, because until you do en-masse and descend on Washington DC to demand and enforce that this garbage stop right here and now, with every one of the co-conspirators drawing 20+ years of hard felony federal time along with each and every one of the involved firms being dismantled from the millions of dollars of fines per count, with each person harmed being a separate count, you deserve to be screwed, blued, tattooed and finally dead as you continue, each and every day, to give your consent to exactly that.

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2016-08-21 15:23 by Karl Denninger
in Small Business , 290 references
 

If you're wondering why this isn't on the market (note that nice $35 computer it runs on), read here.  After all, why would I do the remaining (relatively minor) work of turning this into a formal product (yes, I have filed a copyright on the code) when any one of the big firms could simply steal it and nobody would go to jail?

BTW, the code is kinda cool.  It not only can lock and unlock and knows whenever the state of the lock changes (and why), it can change the user codes (add or remove them) and, surprisingly, turn on and off the keypad entirely.  The latter is quite cool since it enables capabilities like "we're all home and going to bed; shut off the keypads so even if a jackass has a working code it doesn't do him crap worth of good."

If you're a company looking to pick this up on a "lock, stock and barrel" basis (in other words, despite the above you're still in the game to "make a go of it"), then feel free to contact me.....

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I tire of people who are too damned ignorant to be bothered with 30 seconds of research.

For example, one of the memes going around is how "evil" Aetna is because their CEO gets paid a lot of money.  The meme, of course, is that Aetna the company (and other health "insurers") is screwing Americans out of huge amounts of money because they are refusing to continue selling "health insurance" at a loss through Obamacare exchanges, and told the government in advance that adverse action by them against a merger they wanted to conduct would lead them to not have the economy of scale required to defray those losses.

The government sued anyway, and Aetna kept their promise.  For this they're evil, you see, as opposed to not telling anyone in advance what their calculations said the only logical decision was should they be sued.

Never mind that "health insurance" is a fraud in the first place since insurance is something you buy to cover you against financial ruin should you suffer an unexpected and unlikely calamity.  If you attempt to buy "fire insurance" while your house is on fire (or deliberately set it on fire) you will find that nobody will sell it to you, and if you deceive an insurer about the pre-existence of the fire or your intentions to set one you go to prison.  Ditto if you buy "auto insurance" while intending to deliberately crash your car or have someone steal it.  Therefore, buying "health insurance" to cover either routine, suspected, expected or already-existing medical needs is in fact not insurance; it is simply a scheme to force someone else to pay some of your ordinary and expected expenses, and for this service the "insurance" company is certainly entitled to some percentage of the money, since nobody works for free.

This, of course, belies the truth behind such "insurance"; nobody would ever sell it or buy it voluntarily since by definition it isn't insurance; it's a cost-shifting scheme in which nobody would participate if they were paying more than they were getting since (1) you wouldn't voluntarily do so unless you were deceived or (2) you were forced at gunpoint by some law.  Therefore, by definition the present "health insurance" system is a fraud and since it is arguably organized for the purpose of theft by either deception or force along with being a fraud it is also quite-arguably an organized criminal enterprise -- that is, racketeering.

But leaving that outright scam of so-called "health insurance" (and the fact that everyone in the industry who uses that term with knowledge of its falsehood ought to be under indictment or in prison) aside the criticism would be fine and it might even be defensible, but for one tiny problem.

Aetna is $61 billion company (in revenue.)

The Federal Government alone, which is about one third of health spending in total, has spent just over $1 trillion dollars (that is, $1,000 billion) thus far this fiscal year, and has three months left to go.  It will thus probably spend somewhere north of $1,300 billion this year, and combined health spending in the nation will be about $4,000 billion this fiscal year.

Humana, by the way (the company they proposed to acquire) has $54 billion in annual revenue; in other words, the two combined would be about a $115 billion company.

Their revenue would amount to about three whole percent of the total, and in fact Humana has about a 1.8% (!!) profit margin and a 4.17 operating margin.  Their gross margin is about 19%.

Aetna has a 5% profit margin and a 27% gross profit margin.  In other words Aetna is the more-efficient company; Humana, the one Aetna wishes to take over, is the worse of the two.

But this belies the real issue because if you took all of Aetna's and Humana's gross profit -- that is, you paid nobody in either company anything nor did you spend anything on investment or even the light bill you'd drop the cost of medical care in the United States by...... about 1%.

Did you get that folks?  All of this strum, furor and hatred if you could completely eliminate these firms "profiteering" from the picture (oh, and they do profiteer!) would result in a cost reduction of...... one percent.

In other words, statistically zero.

But heh, it's popular to bash people like this.

Now tell me why you're not instead advocating for jailing all of the medical industry folks from the local hospital administrator to doctors to pharma companies and more?  It's not like there isn't plenty of existing law to jail them with either, because there is.

See, if you went after all of those folks for what facially appear to be rank violations of 15 USC -- Federal Law that has stood for more than 100 years -- you would drop the cost of health care to somewhere between one tenth and one fifth of what it is now.

Instead of a 1% reduction predicated on completely destroying two companies you'd get an 80% reduction which would eliminate the need for Obamacare and most medical "insurance" entirely, premiums would drop to less than your car insurance payment and thus would require no subsidies at all and federal, state and local government budgetary deficits and funding problems would all disappear.

But to do that you have to think.

It's easier to hate the big executive instead of pointing the finger where it belongs -- at the monopolists who have driven EpiPen prices from $100 to $400 while the actual cost of the drug is literal pennies.  In anything approaching an actual market where competition was both protected and those seeking to block it imprisoned as the law directs those pens would cost $20 and available over the counter.  By the way this applies to doctors, hospitals and medical device makers too including so-called "competitive" areas of the market such as dentistry, all of whom resist mightily the most-simple of requirement for a competitive and fair market (not to mention the basic requirements for a lawful and enforceable contract; offer, acceptance and performance): making it easy or even possible to know what the price will be before goods and services are provided.

PS: Socializing medicine will not fix any of this; it will simply shift all of it to the federal government which will be driven into either fiscal insolvency or cut off services to tens of millions of Americans who will then, as a consequence, die.

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The Democrat and Republican party -- both sides of the aisle -- are liars.

So are their "spokespersons" when it comes to the issues related to health care.

The most-recent component, that of Aetna deciding to exit nearly all of the ACA exchanges, is just one example.

This is what I said in 2009:

It is my opinion that we should be treating those in the health-insurance lobby, including hospitals, physicians and health-insurance providers, as co-conspirators in a racketeering scheme that effectively trades on the fear of disease and imminent bankruptcy to bamboozle and screw the population, while waving around their "hippocratic oath" - something better described as the "hypocritic oath."

Well?

The talking heads have been out claiming that Medicare and Medicaid spending has "gone down" -- some of them have claimed this on a "per-capita" basis, others just generally.

That's a lie, it's a documented lie, and yet no member of the media has challenged these bald-faced lies despite the numerical facts being available to literally anyone with no more than 30 seconds of effort.

In the most-recent Treasury Statement (which is canonically correct when it comes to government spending) this fiscal year to date Medicare and Medicaid have spent $1,034,867 (millions); that is, $1.035 trillion.  The entire government spent $2,869,374, so this amounts to more than one-third of the total, 36% to be exact.

Last year to the same point in the fiscal year these two programs consumed $950,861.

That is, this fiscal year spending increased 8.83% on a comparable period basis.

Last full fiscal year (September 2014-2015) said spending rose 9.25%.

The prior fiscal (September 2013-2014) said spending rose 6.63% and the year prior to that it rose 5.74%.

There has been no "decrease"; in point of fact it has accelerated by approximately one third in the last two years over the previous two!

This could have been determined in literally 30 seconds by any "journalist" that cared to look.

Nobody cared from either side of the political and media aisle.

This rate of acceleration will, as I have repeatedly pointed out, bankrupt the Federal Government within the next administration's term.  It will in fact exceed all current federal spending within the next 10 years.  Neither of these events will actually come to pass because you cannot have a government when you can't pay the light bill in Washington DC.

There is exactly one way to stop this from happening and that is to start prosecuting and imprisoning, right now, each and every instance of price-fixing (Sherman/Clayton), attempts to monopolize markets (Sherman/Clayton again), pricing discrimination of like kind and quantity for goods (forbidden under Robinson-Patman) and failure or even refusal to provide a price before services and goods are rendered (various consumer protection laws within the states, as well as unfair business practice regulations within the FTC), including such facially-outrageous practices as setting price based on the GDP or "ability to pay" (extort) within a given nation while enforcing same through the passage of laws that are facially unlawful as said practices violate 15 USC.

Until and unless that action is taken the outcome is certain.  Worse, by sitting on our butts as a body politic for the last seven years we have doubled the economic damage we must absorb when, not if, this action occurs and if we wait for the inevitable collapse in a few years instead of dealing with it now the economic damage that must be absorbed will have doubled again.

This is the issue that will first "get us" and yet it is just one of literally thousands of examples where the Rule of Law is ignored with impunity by not only politically-connected people but also those in the corporate world who have economic power.

There is simply no point to either entrepreneurship or for that matter making any sort of effort at all beyond enjoying what little time we have left in this nation under what we consider "reasonable and ordinary" economic and social conditions until and unless the people of this nation rise and demand that this crap stop, for if we do not, as a body politic, our government and social order will collapse.

This is a matter of arithmetic, not politics.

Since you won't get off your ass politically and are far more interested in whether Ellen told a racist joke than whether you've been screwed blind by both sides of the political aisle for decades, you ought to read this article -- because when, not if, this part of our economy collapses (and it will in just a few years) if you're dependent on the "health" system you're going to die, and it's not going to be in a pleasant way either.  Your literal only other option is to not need anything from said part of our economy -- and you're running out of time to make that change.

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I was sent this by one of the authors in my email.

It's science-loaded -- and met with extreme resistance to publication.

Note carefully that the cost to the person who is given this path of treatment for metabolic syndrome (which incidentally either is associated with or leads to Type II diabetes!) is zero.

There were no drugs involved.  There is thus no sale of drugs involved, and no profit for the medical industry; indeed, study participants reduced their pre-existing use of pharmaceuticals.

This study was fairly large in size (n = 372) and showed incredible improvement not only in body mass but also in all of the major metabolic markers, including triglyceride levels, increase in HDL, decrease in LDL, lowered HbA1c and more.

What was the maintenance diet?

After reaching their target weight, a high-fat diet was used for weight maintenance. The use of a high-fat diet was predicated on the high prevalence of insulin resistance in the patient population and favourable changes in multiple health indicators in randomised trials of up to 2 years’ duration in such populations.[3] Foods consumed on the maintenance diet included beef, poultry, fish, eggs, oils, moderate amounts of hard cheeses, and small amounts of nuts, nut butters, seeds and berries.

In other words high fat, moderate protein and low carbohydrate.

Their "weight loss" diet consisted of restriction of both refined carbs and dietary fat, but I suspect the latter was not only unnecessary it limited performance in the weight-loss arena.

Nonetheless the results are impressive; average body mass loss was 12.8kg, BMI was down nearly five points (!!) and metabolic syndrome declined from 57.6% of participants to 19.4%!

Folks, that's two out of three of the study participants who began with metabolic syndrome no longer have it.

Oh, and it gets better.  PHQ-9 showed a commensurate reduction with metabolic syndrome.  For the unaware PHQ-9 is a DSM score measuring depression.  That's right -- approximately two out of three of those who scored high for clinical depression at the introduction of the study no longer were depressed either!

For those who say that LDL will "inevitably" go up if you eat high fat, the study says otherwise.  LDL decreased as did triglyceride levels.  Triglycerides decreased by nearly one third and LDL-C decreased by roughly 15%.

In point of fact the study almost-certainly understated the health impact.  Why?

Consistent with the considerable weight loss, participants at S1 showed marked improvements in their cardiometabolic profile. For example, blood triglyceride concentrations, measured among 119 participants at S1, decreased by 34%, probably a reflection of the reduced intake of starches and sugars.[3] Among the 18 individuals with T2DM in the LI at S1, there was a mean decrease in HbA1c of 0.5%, a figure that fails to account for any reductions in pharmacotherapy, which were not documented in this report. The extent of the changes in cardiometabolic indicators that were measured in this study are therefore a conservative estimate of the health improvements, as participants experienced reductions in the use of insulin and oral hypoglycaemic, antihypertensive and cholesterol-lowering agents. To the intervention participants, the reductions in pharmacotherapy were an empowering ‘side-effect’ of the intervention, and for the clinicians administering the intervention, use of this therapeutic approach improved control of hyperglycaemia, hypertension and dyslipidaemias.

Read that bolded section until it sinks in -- the study participants reduced (or eliminated) already-existing pharmaceutical consumption at the same time they improved their metabolic markers and health because said drug therapy no longer "appropriate" (in light of symptoms) at its former rate of use.

In other words the study participants consumption of drugs was not a function of their body's inherent or progressive disorder; rather, the disorder they formerly experienced was caused by their elective choices when it came to what they ate, and when they changed that the "need" for said drugs was either reduced or eliminated.

They stopped poisoning their bodies and thus needed less (or no) "antidote", in short.

Wake up folks; the evidence is right here under your nose: Stop poisoning your body and it will heal.  As a result you will either need fewer or no pharmaceuticals if you do so, which means you never actually needed them at the level you're consuming them now -- and maybe not at all -- in the first place.

What to eat (and NOT)? Here's the list again, in case you missed it, and here is how you can personally measure your metabolic improvement at very little cost, in private, with nobody but you having the data.

You're welcome.

PS: As a "side effect" your pants will probably fall off.

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