#cow scam

[newspatron]

Shocked by the Shubham Gupta Cow Scam? Share your thoughts and join the conversation below! Let's fight corruption together! 💪🇮🇳

The Never-Ending Saga of Scams Just when we thought the dust had settled on the IAS Pooja Khedkar controversy, another scandal has reared its ugly head in India’s administrative circles. This time, it’s the “Shubham Gupta Cow Scam,” and it’s got everyone talking. 🐄💰 The Never-Ending Saga of ScamsUnraveling the Milch Cow Distribution Scam 🐄🔍Accusations GaloreModus Operandi: The Art of the…

[silverlistenstothings]

i hope theyre gossiping and having so much fun together

[doomed-to-gloom]

What the fuck do you do if a vampire is having you arrested for attempted murder because you somehow fucked up trying to kill it and you can't exactly get proof they're a vampire so you just kinda look like a guy who was planning a whole murder on some recluse in your area

[zanstealstrashcans]

https://play.google.com/store/apps/details?id=com.infinitycow.eplay

Dude, NGL, this looks like a scam, I looked up infinitycow.eplay, and nothing is coming up except for other tumblr users being confused.

Also your link is broken.

Also also, comtext????

[wabble-dee]

How can I sue a local cow shop for scamming me?

Recently, as stated in a previous post, I purchased a herd of cattle from my local cow shop and the issues that I had then are still persisting.

For one, they have now shrunk to be about 7ft tall now, a far cry from their original 11ft. Also, they have completely stopped moving. Any attempts to get them into a different room or anything have been fruitless, they don't even breathe anymore from what I can tell, this makes my apartment really hard to navigate as there's about 2 or 3 cows in every room.

So I'm just wondering if there's a way a civilian like me could sue the people who sold me these cows, maybe even run them out of business? I don't want anyone else to be scammed by them so I'd just like some advice on what to do thanks.

[charlesreeza]

Saint Rosalia, Alabaster marble, 18th century, unknown sculptor - from the Monastery of St. Mary of the Greek in Vizzini, and now at the Museo di Palazzo Bellomo, Syracuse, Sicily

Interesting story: The legend of St. Rosalia claims she was born in 1130 in Palermo, Sicily, to a noble family descended from Charlemagne. Devoutly religious, she chose to live as a hermit in a cave on Mount Pellegrino. Tradition says that she was led to the cave by two angels. On the cave wall she wrote "I, Rosalia, daughter of Sinibald, Lord of Monte delle Rose and Quisquina, have taken the resolution to live in this cave for the love of my Lord, Jesus Christ." She supposedly died alone in the cave in 1166.  Apparently, no one missed her for 458 years.

In 1624, a plague beset Palermo. During this hardship, Rosalia reportedly appeared to a hunter (or a soap seller) and indicated where her remains could be found. She ordered him to bring her bones to Palermo and have them carried in procession through the city. He climbed the mountain and found her bones in the cave as described. He did what she had asked, and after her remains were carried around the city three times, the plague ceased. From then on Rosalia was venerated as the patron saint of Palermo, and a sanctuary was built in the cave.

The Flemish painter Anthony van Dyck was trapped in the city during the 1624–1625 quarantine. He used the time to paint five paintings of Rosalia. In 1629 he also produced Saint Rosalia Interceding for the City of Palermo and Coronation of Saint Rosalia to assist Jesuit efforts to spread devotion to her beyond Sicily.

This turned out to be quite lucrative for Palermo (accidentally, I’m sure) because the shrine built on the mountain has been drawing pilgrims and tourists for centuries. The Festino di Santa Rosalia or ‘the Great Festival” is held on July 14th and 15th in Palermo. It is the biggest celebration of the year, drawing thousands of tourists (and their money, but that’s irrelevant).

In 1825, geologist William Buckland was in Palermo during his honeymoon and asked to see the bones of Rosalia. After an examination of the relics the geologist declared the relics were actually the bones of a goat. Buckland later said the priests claimed Rosalia would not let him see her actual remains because he was not a Catholic Christian. Then they locked the relics away.

Hmmm.

Photos by Charles Reeza

[saintpallis]

🔀 for the ask game

🔀 How canon-divergent vs. canon-compliant are you?

See my timeline starts out pretty damn canon compliant (other than we actually aged during it) but then once we get to the teenage years it starts going off the rails a little because we were growing up and stuff, some of the canon bullshit still happened for me in highschool but there was also a lot of other stuff going on that has absolutely no relation to canon, just because the people around me were changing and so was I. I also dated people! For more than 2 days!! Which is definitely canon divergent cus canon kyle can not keep a girlfriend to save his life (not that I could either, I settled down with stan, boys and what not 🏳️‍🌈.) Generally I'd describe my tl as very a very teen au type thing even though I also have memories of being an adult and lots of being a kid, so more canon divergent than canon compliant.

[indigo-villin]

just got some "infinity cow" link ask... blocked the user cause nah I'm not dealing with that.

[kaosanddestruction]

https://play.google.com/store/apps/details?id=com.infinitycow.eplay

oh shit bro my first ask! ...oh shit bro my first ask is a scam bot :[ anyhow! i do not know what a cow is, nor do I know why i'd want to have infinity of them. go somewhere else now, scam bot. explore the world and find something else to do with your life!

[fruityangel999]

what is a infinity cow..is this a scam or not?? idk

[zarya-zaryanitsa]

Today I learned that in fifteenth century Polish dudes would sometimes pretend to be werewolves in a scam to get some free meat.

They’d attach wolf tails to their backsides, walk around the village howling and occasionally bite a random cow so that folks would donate meat to them to ensure they don’t „lose control” and attack somebody.

I just thought you guys might wanna know.

[tiredlez]

I was about to watch Unsolved Mysteries on Netflix, but immediately before that, I received a message that my account had been "suspended".

WHAT ARE THEY TRYING TO HIDE FROM US!????!?????

[greencheekconure27]

hey what's your beef with peta? if it's that they operate "kill shelters" you might want to read the newsweek fact check https://www.newsweek.com/fact-check-peta-responsible-deaths-thousands-animals-1565532 (tldr: "Just as a hospice has a high mortality rate, so does a shelter that takes in those near end-of-life, feral, aggressive, dying and discarded animals." "Cherry-picking animals to only allow in the most adoptable at shelters with limited admission (otherwise known as 'no-kill') policies doesn't help and often leads to people dumping animals, or neglecting them in other ways,")

Oh no it's so much more than that.Constant spreading of pseudoscience and misinformation, ableist campaigns (such as "drinking milk causes autism", racist and antisemitic campaigns (comparing pig farming to the Holocaust for instance), sexist campaigns under the guise of feminism (veganism is feminist because cows have a womb they are women too) more misinformation and pseudoscience, financial scams, at least one instance of abducting someone's beloved and cared for pet to euthanize it, harassment, using emotional manipulation on children ("your mommy is a murderer because she eats meat" etc), harassing and breaking into zoos and research labs , frequently killing the wild animals they rescue, that one bullshit monkey photograph lawsuit, being against ALL animal agriculture and hunting EVERYWHERE, being opposed to pets (yes cats and dogs too), actually paying people to abuse farm animals for staged videos, cultish behavior,absolutely insane ideas, and oh, misinformation and pseudoscience.

As to kill shelters, it's the lies and the hypocrisy that bothers me, because these are the same fucking people who will insist they're doing good by keeping animals alive when they have no quality of life to speak of anymore. One moment they're gushing over some poor piglet born without trotters or blind legless bird being kept alive and miserable for months, the next they're all pro euthanizing healthy animals en masse, all while they collect donations for both.

I know a lot of people donate to them in good faith but don't. Even if you are vegan. They're not doing anything good with that money.

[720am]

M A S T E R L I S T

for losing as much as possible in a short amount of time (cuz we are all desperate), from me - a biotechnologist, who relapsed (the demons never leave)

the tips i am about to share with all my girliepops are all based on science and work; if you have any other tips, feel free to share in the comments, so we can have all the tips in one place!

• eat your meals from smaller sized plates, to trick your brain you are eating more

• cut up your food into small pieces

• chew every bite at least 10-15 times, until it is a purée consistency; this way you will be eating slower and give your brain more time to realise you are full

• sip water with a lemon slice between your bites

• focus on eating vegetables and protein, limit carbs

• drink a lot of water, and I mean a lot

• add lemon slices to your water to make it have some flavour; also the lemon juice in water before your meals will help reduce the glucose spike => less insulin released from liver => less absorbed glucose from carbs/sugars/starches => less fat on your body

• move for 10 mins right after eating - walk, do calf raises, some light movement so all the glucose can be used before getting stored as fat on your body

• drink tea - green tea, detox tea, whatever tea, without a sweetener

• do not drink diet sodas/colas - or any kind of liquid that is not water/tea - these are useless calories, why would you do that to yourselves?! even if it says 0 cals - this s#it is so bad for you, and the carbonation makes you feel bloated like a god damn whale! ditch the diet sodas girliepops

• implement some kind of movement every day - walking, pilates, yoga, dance workouts, resistance bands workouts or stretching

• do not weigh yourself everyday - due to hormones our weigh fluctuates every day and this will just make you feel bad if you lose and gain 1-2 legs everyday depending on your menstrual cycle, water weight and so on.. weigh yourself every 2 weeks.

• do not drink fruit juice - this is such a scam; hear me out: how many oranges does it take to make 1 glass of orange juice? around 3. can you eat three whole oranges in one sitting? i bet no. then why would you drink 3 oranges? when you make fruit juice, all the fibre and the pulp is removed, leaving you with just the juice with all the sugar in it (in the form of glucose and fructose) so you are basically drinking pure sugar, which turns into fat… just eat your damned fruit, instead of drinking a bunch of empty calories

• take red cranberry supplements - they are usually taken for UTIs, but the red cranberry has diuretic effect, and will make you pee your water weight out; please do not take more than 2 pills and remember to drink plenty of water so you don’t damage your kidneys!!!!

• take probiotics - this will ensure your gut health stays good while restricting foods, so you don’t end up constipated and bloated

• i personally do not eat dairy products (i am lactose intolerant) - they are full of hormones from the cows, give you acne and inflammation, and the protein in it is not worth it considering the amount of fat these products have; skip the dairy if you can

• if you drink a lot of coffee, remember to drink plenty of water! coffee has a diuretic effect and if you are not drinking more water, it will make you retain whatever water is in your body, leading to water weight gain

• if you end up binging, do so mindfully - do not give in to all the food, just have a piece of chocolate, not the whole chocolate bar; have a piece of cake, not the whole cake; then get back on track and try to exercise as much as possible to burn the excess calories

• i think this is obvious but let me say it just in case - in order to lose weight, you have to be on a calorie deficit - meaning you burn/use more calories than you consume; but!! here is the trick - you have to maintain low calorie diet, do not ⭐️ve for more than 2 days, as this will f#ck up your metabolism - your body goes into fight or flight response, meaning everything you eat after f4sting will remain on your body as a reserve of food, in case you end up ⭐️ving again; so have your veggies and protein (chicken breasts, white fish)

• keep yourself busy so you don’t think about f0od - study, work, read books, journal, whatever it is, your day has to be full of activities do you can forget to e4t

• reject offered food - say you already ate / yr not hungry / you are allergic to some ingredient / you have a bad migraine and this will make it worse / or take the food and say you will have it later and just give it to someone else (pls don’t throw in trash, do not waste food)

• when eating with family / boyfriend - place food in a smaller plate, cut up food into very small pieces and eat very slowly and chew every bite for a long time, sip water between every few bites, then say you are full and cannot eat anymore / that you ate a bit earlier and yr full

• when eating, eat your veggies first, then your protein and eat the smallest amount of carbs - always leave leftover carbs in your plate

• do not eat any snacks - no cereal bars, no cereal, no chips, no crisps, no crackers, no salty sticks, just do not eat snacks!

• if you feel like eating - drink water first, then have veggies (cucumbers, carrots, tomatoes, radishes, etc) or fruit (apples, citrus, any kind of berries)

• if you are having breakfast - always eat a savoury breakfast - eggs, avocado, veggies etc; never eat a sweet breakfast - cereal, croissants, pancakes, etc, this will spike up your glucose levels and all that sugar will turn into fat; a sweet breakfast will make you feel tired and exhausted all day, leading you to eat more

• wear a waist trainer - do so for no more than 8hrs a day; this will also help you have smaller portions of food, as it won’t allow your stomach to expand

• do not purge - this is very bad for your teeth and overall health; the stomach acid is very strong and every time you purge, your teeth are getting damaged; just don’t overeat in the first place and have self control!

this is all i have for right now; if i think of anything else, i will add later / make another post; if you have anything to add to this list - go ahead and do so in the comments below

remember, stay safe xx

[takavasen]

Tumblr dashboard in Night Vale simulator

🧪homo-genius

Today's science fact:

Spiders have an open blood circulation system, which means they do not have veins and their blood is different from the blood of mammals. Unfortunately many healthcare professionals do not know this, which can lead to improper methods in...

Read more

🎙️voice_of_night_vale

Spiders are a valuable part of our community and deserve good healthcare.

But more importantly, I want everyone to know that Carlos the Scientist made this post, he is my husband and I love him very much! 💜💜💜💜💜💜💜💜💜

🪬a-thousand-fingernails Follow

Cecil everyone knows you and Carlos are married and most of us are happy for you but you don't need to tell this in every post you make

🎙️voice_of_night_vale

Wait have I mentioned it before?

809 notes

⭐sheriffofallarts

Hah saw some loser (@ marble-eyes) bring the same girl (@ mountainbeliever343 I think, couldn't see her face clearly from the cameras) home for the third time this week lol

cmon just say you are girlfriends already dont be shy

💎marble-eyes Follow

Hey you can't just share private information like that!! And besides that is not true, I haven't brought anyone home for a long time, I don't have time for that anymore!!!

🟡secretly-in-your-home

No. I can confirm that what Sam said is true. I was there. I am always there. Also, I put the rest of your cereal to your washing machine. They have been in the cupboard for a while now, I thought they were getting quite dusty and needed cleaning.

31 notes

🏀basketballpalmer Follow

We had an another great season with @nvwheelchairbasketball team again! Thank you everyone, it's an honor to be the captain of the team! See you guys next season <3

👍wallabyyy Follow

Aaaaa congratulations! I miss you guyssss

43 notes

☀️prophet-of-smiling-god

I just had the most delightful date with the most gorgeous theologist in Desert Bluffs Too!!! We had a lovely dinner at my house (some eyeball salad, mushed tarantulas and fried human fingers), watched some movies and of course made sure to serve our great Smiling God by making each other as happy as possible!! Unfortunately Charles said that it would make him unhappy if I shared the details, but I can confidently say that I have never been more joyful!!

🦷smiling-mayor Follow

Kevin, you missed a service in the Temple of Joy because of this. Surely you would remember doing that for an old friend, wouldn't you? 😊

☀️prophet-of-smiling-god

Oh, Lauren, of course I wouldn't ignore anything like that on purpose, you know how much I love tolerating you!!

98 notes

🪽not-an-angel Follow

Does anyone happen to have 10 bucks?

You can send them here: absolutely-not-a-scam-link

🌟erikaaaaaaa Follow

Does anyone happen to have 10 bucks?

You can send them here: absolutely-not-a-scam-link

💵ex-vanston Follow

Does anyone happen to have 10 bucks?

You can send them here: absolutely-not-a-scam-link

💡erika-the-black-one Follow

Does anyone happen to have 10 bucks?

You can send them here: absolutely-not-a-scam-link

3 notes

😎violentfootstool-deactivated20230416

Hey guys, so I just spoke to the new scientist lady and found out I don't actually have three pairs of arms. The lower two were just robot limbs that I tried out when I was seven years old and forgot to take them off. So hows your day ://

🔬janet-lubelle

I am always happy to help with explaining your problems away.

🎀tinfoilforteeth

Hey bitch how is it going under the cow

754 notes

🎙️voice-of-night-vale

Alright, I'm going to say it. Steve Carlsberg does NOT know how to be a basketball coach. He knows nothing about any game structures, and he only allows one ball per game!! He talks too loud, except when you can't hear him. It will be ALL HIS FAULT if we end up losing this season!!!!!

🌠lines-in-the-sky Follow

:(

🎙️voice-of-night-vale

For everyone who finds this post now: I made this many years ago. Things have changed a lot. I'm very sorry, Steve. I couldn't hope for a better brother-in-law. You are my best friend, and I was the irrational one in this situation.

I have changed the way I look at people. I will not treat them the same way I used to treat Steve anymore.

1,642 notes

🎙️voice-of-night-vale

Alright, who let Susan Willman be in charge of anything? She is the absolute worst at making desicions, like, who asks an obelisk its NAME? She had an oppoturnity to ask almost anything, and that's what she chose?? She better stay away from our way for at least seven decades, and keep her "Huntokar"-nonsense with herself!!!

11 notes

[mostlysignssomeportents]

The health industry’s invisible hand is a fist

On June 21, I'm doing an ONLINE READING for the LOCUS AWARDS at 16hPT. On June 22, I'll be in OAKLAND, CA for a panel and a keynote at the LOCUS AWARDS.

The US has the rich world's most expensive health care system, and that system delivers the worst health outcomes of any country in the rich world. Also, the US is unique in relying on market forces as the primary regulator of its health care system. All of these facts are related!

Capitalism's most dogmatic zealots have a mystical belief in the power of markets to "efficiently allocate" goods and services. For them, the process by which goods and services are offered and purchased performs a kind of vast, distributed computation that "discovers the price" of everything. Our decisions to accept or refuse prices are the data that feeds this distributed computer, and the signals these decisions send about our desires triggers investment decisions by sellers, which guides the whole system to "equilibrium" in which we are all better off.

There's some truth to this: when demand for something exceeds the supply, prices tend to go up. These higher prices tempt new sellers into the market, until demand is met and prices fall and production is stabilized at the level that meets demand.

But this elegant, self-regulating system rarely survives contact with reality. It's the kind of simplified model that works when we're hypothesizing about perfectly spherical cows of uniform density on a frictionless surface, but ceases to be useful when it encounters a messy world of imperfect rationality, imperfect information, monopolization, regulatory capture, and other unavoidable properties of reality.

For members of the "efficient market" cult, reality's stubborn refusal to behave the way it does in their thought experiments is a personal affront. Panged by cognitive dissonance, the cult members insist that any market failures in the real world are illusions caused by not doing capitalism hard enough. When deregulation and markets fail, the answer is always more deregulation and more markets.

That's the story of the American health industry in a nutshell. Rather than accepting that people won't shop for the best emergency room while unconscious in an ambulance, or that the "clearing price" of "not dying of cancer" is "infinity," the cult insists that America's worst-in-class, most expensive health system just needs more capitalism to turn it into a world leader.

In the 1980s, Reagan's court sorcerers decreed that they could fix health care with something called "Prospective Payment Systems," which would pay hospitals a lump sum for treating conditions, rather than reimbursing them for each procedure, using competition and profit motives to drive "efficiency." The hospital system responded by "upcoding' patients: if you showed up with a broken leg and a history of coronary disease, they would code you as a heart patient and someone who needed a cast. They'd collect both lump sums, slap a cast on you, and wheel you out the door:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195137/

As Robert Kuttner writes for The American Prospect, this kind of abuse was predictable from the outset, especially since Health and Human Services is starved of budget for auditors and can only hand out "slaps on the wrist" when they catch a hospital ripping off the system:

https://prospect.org/economy/2024-06-13-fantasyland-general/

Upcoding isn't limited to Medicare fraud, either. Hospitals and insurers are locked in a death-battle over payments, and hospitals' favorite scam is sending everyone to the ER, even when they don't have emergencies (some hospitals literally lock all the doors except for the ER entrance). That way, a normal, uncomplicated childbirth can be transformed into a "Level 5" emergency treatment (the highest severity of emergency) and generate a surprise bill of over $2,700:

https://pluralistic.net/2021/10/27/crossing-a-line/#zero-fucks-given

The US health industry is bad enough to generate a constant degree of political will for change, but the industry (and its captured politicians and regulators) is also canny enough to dream up an endless procession of useless gimmicks designed to temporarily bleed off the pressure for change. In 2018, HHS passed a rule requiring hospitals to publish their prices.

Hospitals responded to this with a shrewd gambit: they simply ignored the rule. So in 2021, HHS made another rule, creating penalties for ignoring the first rule:

https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals

The theory here was that publishing prices would create "market discipline." Again, this isn't wholly nonsensical. To the extent that patients have nonurgent conditions and the free time to shop around, being able to access prices will help them. Indeed, if the prices are in a standards-defined, machine-readable form, patients and their advocates could automatically import them, create price-comparison sites, leaderboards, etc. None of this addresses the core problem that health-care is a) a human right and b) not a discretionary expense, but it could help at the margins.

But there's another wrinkle here. The same people who claim that prices can solve all of our problems also insist that monopolies are impossible. They've presided over a decades-long assault on antitrust law that has seen hospitals, pharma companies, insurers, and a menagerie of obscure middlemen merge into gigantic companies that are too big to fail and too big to jail. When a single hospital system is responsible for the majority of care in a city or even a county, how much punishment can regulators realistically subject it to?

Not much, as it turns out. Kuttner describes how Mass Gen Brigham cornered the market on health-care in Boston, allowing it to flout the rules on pricing. In addition to standard tricks – like charging self-pay patients vastly more than insured payments (because individuals don't have the bargaining power of insurers), Mass Gen Brigham's price data is a sick joke.

See for yourself! The portal will send you giant, unstructured, ZIPped text files filled with cryptic garbage like:

ADJUSTABLE C TAPER NECK PLUS|1|UNITED HEALTHCARE [1016]|HB CH UNITED HMO / PPO / INDEMNITY [34]|UNITED HEALTHCARE HMO [101604]|75|Inv Loc: 1004203; from OR location 1004203|52.02|Inpatient PAF; 69.36% Billed|75|Inv Loc: 1004203; from OR location 1004203|56.87|Outpatient PAF; 75.83% Billed

https://www.massgeneralbrigham.org/en/patient-care/patient-visitor-information/billing/cms-required-hospital-charge-data

These files have tens of thousands of rows. As a patient, you are meant to parse through these in order to decide whether you're getting ripped off on that HIP STEM 16X203MM SIZE 4 FEMORAL PRESS FIT NEUTRAL REVISION TITANIUM you're in the market for (as it happens, I have two of these in my body).

Kuttner describes the surreal lengths he had to go through to prevent his mother from getting ripped off by Mass Gen through an upcoding hustle. By coding her as "admitted for observation," Mass Gen was able to turn her into an outpatient, with a 20% co-pay (this is down to a GW Bush policy that punishes hospitals that charge Medicare for inpatient care when they could be treated as outpatients – hospitals reflexively game the system to make every patient an outpatient, even if they have overnight hospital stays).

Kuttner's an expert on this: he was national policy correspondent for the New England Journal of Medicine and covers the health beat for the Prospect. Even so, it took him ten hours of phone calls to two doctors' offices and Blue Cross to resolve the discrepancy. The average person is not qualified to do this – indeed, the average person won't even know they've been upcoded.

Needless to say that people in other countries – countries where health care is cheaper and the outcomes are better – are baffled by this. Canadians, Britons, Australians, Germans, Finns, etc do not have to price-shop for their care. They don't have to hawkishly monitor their admission paperwork for sneaky upcodes. They don't have to spend ten hours on the phone arguing about esoteric billing practices.

In a rational world, we'd compare the American system to the rest of the world and say, "Well, they've figured it out, we should do what they're doing." But in good old U-S-A! U-S-A! U-S-A!, the answer to this is more prices, more commercialization, more market forces. Just rub some capitalism on it!

That's where companies like Multiplan come in: this is a middleman that serves other middlemen. Multiplan negotiates prices on behalf of insurers, and splits the difference between the list price and the negotiated price with them:

https://www.nytimes.com/2024/04/07/us/health-insurance-medical-bills.html

But – as the Arm and a Leg podcast points out – this provides the perverse incentive for Multiplan to drive list prices up. If the list price quintuples, and then Multiplan drives it back down to, say, double the old price, they collect more money. Meanwhile, your insurer sticks you with the bill, over and above your deductible and co-pay:

https://armandalegshow.com/episode/multiplan/

The Multiplan layer doesn't just allow insurers to rip you off (though boy does it allow insurers to rip you off), it also makes it literally impossible to know what the price is going to be before you get your procedure. As with any proposition bet, the added complexity is there to make it impossible for you to calculate the odds and figure out if you're getting robbed:

https://pluralistic.net/2022/05/04/house-always-wins/#are-you-on-drugs

Multiplan is the purest expression of market dynamics brainworms I've yet encountered: solving the inefficiencies created by the complexity of a system with too many middlemen by adding another middle-man who is even more complex.

No matter what the problem is with America's health industry, the answer is always the same: more markets! Are older voters getting pissed off at politicians for slashing Medicare? No problem: just create Medicare Advantage, where old people can surrender their right to government care and place themselves in the loving hands of a giant corporation that makes more money by denying them care.

The US health industry is a perfect parable about the dangers of trusting shareholder accountable markets to do the work of democratically accountable governments. Shareholders love monopolies, so they drove monopolization throughout the health supply chain. As David Dayen writes in his 2020 book Monopolized the pharma industry monopolized first, and put the screws to hospitals:

https://pluralistic.net/2021/01/29/fractal-bullshit/#dayenu

Hospitals formed regional monopolies to counter the seller power of consolidated Big Pharma. That's Mass Gen's story: tapping the capital markets to buy other hospitals in the region until it became too big to fail and too big to jail (and too big to care). Consolidated hospitals, in turn, put the screws to insurers, so they also consolidated, fighting Big Hospital's pricing power.

Monopoly at any point in a supply chain leads to monopoly throughout the supply chain. But patients can't consolidate (that's what governments are for – representing the diffuse interests of people). Neither can health workers (that's what unions are for). So the system screwed everyone: patients paid more for worse care. Health workers put in longer hours under worse conditions and got paid less.

Kuttner describes how his eye doctor races from patient to patient "as if he was on roller skates." When Kuttner wrote him a letter questioning the quality of care, the eye doctor answered that he understood that he was giving his patients short shrift, but explained that he had to, because his pay was half what he needed, relegating him to a small apartment and an old car. The hospital – which skims the payments he gets for care – sets his caseload, and he can't turn down patients.

The answers to this are obvious: get markets out of health care. Unionize health workers. Give regulators the budgets and power to hold health corporations to account.

But for market cultists, all of that can't work. Instead, we have to create more esoteric middlemen like "pharmacy benefit managers" and Multiplan. We need more prices to shovel into the market computer's data-hopper. If we just capitalism hard enough, surely the system will finally work…someday.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/06/13/a-punch-in-the-guts/#hayek-pilled