1/@RANDCorporation just put out a report on drug prices amongst the G7, and the methodology is somewhat appalling. I'm kind of hoping @DrugChannels looks at it because it contains such glaring errors worthy of an Adam Fein Policy Roast.

2/In the introduction of the report (p.viii) they admit that they can't actually compare prices of drugs because US drugs include rebates and many of those aren't public info. So they start out the report by saying they're going to use incorrect numbers....
3/"Although prices net of rebates and other discounts paid by manufacturers after drugs are dispensed are particularly relevant in the United States, these prices are generally not available to researchers."
4/Honestly the report should have stopped right there. How do you honestly proceed after such a whopper of a flaw in your own methodology? What's worse is they buried the useful observation
5/"for unbranded generic drugs (with U.S.
prices at 84 percent of those in comparison countries). Unbranded generics represent 84 percent
of volume in the United States, compared with 35 percent of volume for the other OECD
countries in the study."
6/Get it? 85% of the volume of medicine in the US is also 84% lower in price that the other OECD countries in the study. How you then get a summary point that the real news is that 16% of the medicines dispensed in the US are a higher price should not be the news.
7/The news should be that everyone should be copying the U.S. unbranded generics model and calling the @AccessibleMeds begging them for advice. Another great stat is that the US has an 85% unbranded generic utilization vs. 35% in most other countries.
8/The question is "where did this report come from"? Well, it was commissioned by HHS in 2019, which means it was a political report. How you can get to this conclusion when your report shows such an amazing result is because you know the answers your client wants.
9/Drug pricing is complicated, and health insurers and PBMs have effectively cost-shifted it to consumers while reducing their own bottom lines through rebates they withhold from consumers. Fixing it will be complicated too, and research this bad will hinder fixes for years.
10/My great thanks to my friend, colleague, and advisory board member Dr. Kenneth McCall at @unetweets for making sure I saw this.
@threadreaderapp unroll

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So, as the #MegaMillions jackpot reaches a record $1.6B and #Powerball reaches $620M, here's my advice about how to spend the money in a way that will truly set you, your children and their kids up for life.

Ready?

Create a private foundation and give it all away. 1/

Let's stipulate first that lottery winners often have a hard time. Being publicly identified makes you a target for "friends" and "family" who want your money, as well as for non-family grifters and con men. 2/

The stress can be damaging, even deadly, and Uncle Sam takes his huge cut. Plus, having a big pool of disposable income can be irresistible to people not accustomed to managing wealth.
https://t.co/fiHsuJyZwz 3/

Meanwhile, the private foundation is as close as we come to Downton Abbey and the landed aristocracy in this country. It's a largely untaxed pot of money that grows significantly over time, and those who control them tend to entrench their own privileges and those of their kin. 4

Here's how it works for a big lotto winner:

1. Win the prize.
2. Announce that you are donating it to the YOUR NAME HERE Family Foundation.
3. Receive massive plaudits in the press. You will be a folk hero for this decision.
4. Appoint only trusted friends/family to board. 5/
It is simply not correct to point fingers at wind & solar energy as we try to understand the situation in TX. The system (almost) had a plan for weather (almost) like this. 1/x


It relied on very little wind energy - that was the plan. It relied on a lot of natural gas - that was the plan. It relied on all of its nuclear energy - that was the plan. 2/x

There was enough natural gas, coal and nuclear capacity installed to survive this event - it was NOT "forced out" by the wind energy expansion. It was there. 3/x

Wind, natural gas, coal and nuclear plants all failed to deliver on their expectations for long periods of time. The biggest gap was in natural gas! The generators were there, but they were not able to deliver. 4/x

It may be fair to ask why there is so much wind energy in ERCOT if we do NOT expect it to deliver during weather events like this, but that is an entirely different question - and one with a lot of great answers!! 5/x

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#தினம்_ஒரு_திருவாசகம்
தொல்லை இரும்பிறவிச் சூழும் தளை நீக்கி
அல்லல் அறுத்து ஆனந்தம் ஆக்கியதே – எல்லை
மருவா நெறியளிக்கும் வாதவூர் எங்கோன்
திருவாசகம் என்னும் தேன்

பொருள்:
1.எப்போது ஆரம்பித்தது என அறியப்படமுடியாத தொலை காலமாக (தொல்லை)

2. இருந்து வரும் (இரும்)


3.பிறவிப் பயணத்திலே ஆழ்த்துகின்ற (பிறவி சூழும்)

4.அறியாமையாகிய இடரை (தளை)

5.அகற்றி (நீக்கி),

6.அதன் விளைவால் சுகதுக்கமெனும் துயரங்கள் விலக (அல்லல் அறுத்து),

7.முழுநிறைவாய்த் தன்னுளே இறைவனை உணர்த்துவதே (ஆனந்த மாக்கியதே),

8.பிறந்து இறக்கும் காலவெளிகளில் (எல்லை)

9.பிணைக்காமல் (மருவா)

10.காக்கும் மெய்யறிவினைத் தருகின்ற (நெறியளிக்கும்),

11.என் தலைவனான மாணிக்க வாசகரின் (வாதவூரெங்கோன்)

12.திருவாசகம் எனும் தேன் (திருவா சகமென்னுந் தேன்)

முதல்வரி: பிறவி என்பது முன்வினை விதையால் முளைப்பதோர் பெருமரம். அந்த ‘முன்வினை’ எங்கு ஆரம்பித்தது எனச் சொல்ல இயலாது. ஆனால் ‘அறியாமை’ ஒன்றே ஆசைக்கும்,, அச்சத்துக்கும் காரணம் என்பதால், அவையே வினைகளை விளைவிப்பன என்பதால், தொடர்ந்து வரும் பிறவிகளுக்கு, ‘அறியாமையே’ காரணம்

அறியாமைக்கு ஆரம்பம் கிடையாது. நமக்கு ஒரு பொருளைப் பற்றிய அறிவு எப்போதிருந்து இல்லை? அதைச் சொல்ல முடியாது. அதனாலேதான் முதலடியில், ஆரம்பமில்லாத அஞ்ஞானத்தை பிறவிகளுக்குக் காரணமாகச் சொல்லியது. ஆனால் அறியாமை, அறிவின் எழுச்சியால், அப்போதே முடிந்து விடும்.
Great article from @AsheSchow. I lived thru the 'Satanic Panic' of the 1980's/early 1990's asking myself "Has eveyrbody lost their GODDAMN MINDS?!"


The 3 big things that made the 1980's/early 1990's surreal for me.

1) Satanic Panic - satanism in the day cares ahhhh!

2) "Repressed memory" syndrome

3) Facilitated Communication [FC]

All 3 led to massive abuse.

"Therapists" -and I use the term to describe these quacks loosely - would hypnotize people & convince they they were 'reliving' past memories of Mom & Dad killing babies in Satanic rituals in the basement while they were growing up.

Other 'therapists' would badger kids until they invented stories about watching alligators eat babies dropped into a lake from a hot air balloon. Kids would deny anything happened for hours until the therapist 'broke through' and 'found' the 'truth'.

FC was a movement that started with the claim severely handicapped individuals were able to 'type' legible sentences & communicate if a 'helper' guided their hands over a keyboard.