Anyone have any opinions on how self-insured employers consider innovative healthcare offerings to pass on to their employees?

As I understand it, by shouldering the financial risk, self-insured employers can curate a list of more relevant benefits ... (1/10)

ATROCIOUS big pharma price gouging of insulin:

This crying mother can’t afford the $1000 for her son’s insulin.

📌yet, it only costs pharma $5 to produce.

📌Insulin was invented 100 years ago by Fred Banting—who donated patent for $1 to make it free for all.

Let that sink in.

2) Insulin is one of the most disgusting cases of price gouging ever.

America has long taken a free market approach to pharmaceuticals.
Drug companies haggle separately over drug prices with a variety of private insurers across the

3) “Meanwhile, Medicare, the government health program for those over age 65 — it’s also the nation’s largest buyer of drugs—is barred from negotiating drug prices. That gives pharma more leverage, and it leads to the kind of price surges of EpiPens, opioid antidotes, & insulin.”

4) In 2018:
Johnson & Johnson CEO made $30M
Pfizer CEO made $28M
Merck CEO made $18M
Eli Lilly CEO made $16M
Gilead CEO made $16M

Meanwhile:

📌Americans spent $535B on Rx drugs

📌1/4 of diabetics rationed insulin to survive

📌500K Americans went bankrupt from medical bills.

5) What’s the right price patients should pay for medications? ZERO dollars, because no copay ==> more patients get their medicine ==> saves lives and saves money. Copays decrease adherence, and copays hurt patients who actually need them.

1/

Get a cup of coffee.

In this thread, we'll cover *State Quantities* and *Flow Quantities*.

This mental model can help us analyze many different entities -- from complex engineering systems to publicly traded companies.

2/

A "State Quantity" is something that's associated with a *specific point in time*.

For example, the number of followers a Twitter account has is a state quantity. This number can go up and down over time. But at any one *specific* time point, it's fixed.

3/

Similarly, the amount of cash a company has is a state quantity.

This cash balance can also rise and fall over time.

But pick any one *specific* time point -- and the company can only have one *specific* cash balance at that time point.

4/

By contrast, a "Flow Quantity" is something that's associated with a time *interval* rather than a time *point*.

For example, the number of followers gained by a Twitter account is a flow quantity. It's meaningful only when we specify a time interval (eg, the last 30 days).

5/

A simple analogy is that a State Quantity is like a photo -- a snapshot at a particular *point* in time.

But a Flow Quantity is like a video -- a record of events that take place during a particular time *interval*.

A potential problem is looming, and the media are pursuing a new story that builds on the following chain of reasoning: 1) higher inflation is coming;2) if CBs increase interest rates debts will explode and recession may ensue; 3) CBs are caught in an impossible dilemma 1/12

It´s perhaps too complex for some tweets, but.. Registered inflation this year is bound to be higher than present forecasts, resulting from one-off price spikes and base effects That will not start a sustained high inflation process, but temporary higher inflation is possible 2/

For example, Euro Area inflation increased suddenly from several months at -0.3% to +0.9% in Jan. This jump resulted mostly from several base effects, especially the change to German VAT. Inflation expectations increasing but higher in the US than in the EA 3/

The major one-off base effect will come from oil prices that decreased abysmally in March 2020 and have recovered. Some estimates put US inflation in April reaching 4%! After vaccinations, later in the year, pent-up consumer demand will also increase prices.4/

Despite the increased spending of accumulated savings, the savings rate will remain higher than before Covid for precautionary reasons (Fig 1). No permanent spending spree will materialise. Wages will remain subdued for a while (Fig2). Higher but not high inflation is coming.5/

I devoured 50 years of Warren Buffett shareholder letters.

The result?

12 timeless principles from the greatest investor in the world.

Here are the golden nuggets🧵

The Orangutan Effect

"If you sit down with an orangutan and carefully explain to it one of your cherished ideas, you may leave behind a puzzled primate, but will exit thinking more clearly yourself."

Teaching others actually teaches yourself.

2022

The Faulty Premise Framework

“A horse that can count to ten is a remarkable horse - not a remarkable mathematician.”

Beware your comparison set.

Are you judging crappy relative performance or absolute results?

1985

Pick the Right Business Boat

The business boat you get into is more important than how effectively you row.

“When a brilliant management team tackles a business with a reputation for poor fundamental economics, the reputation of the business usually stays intact.”

1985

A Rising Tide Doesn't Lift All Bonuses

"Good performance should be rewarded whether Berkshire stock rises or falls.
Average performance should earn no special rewards even if our stock soars."

Judge for individual performance or risk free riding on group success.

1986