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Saved by @ThomassRichards

Whatever the other merits of this proposal, funneling another ~$30B to hospitals is the antithesis of "targeted relief."

A dozen hospital chains just presented at #JPM21, two weeks ago.

General theme: Financially speaking, hospitals are doing quite well. 1/n

 We have, for example, Community Health Systems, which operates 89 hospitals in 16 states, many of them in smaller towns / metro areas.

Through the pandemic, CHS's EBITDA margin never even fell into single digits, and profitability actually *increased* in 2020.
Meanwhile, Lifepoint Health (84 hospitals, 30 states) also saw profits increase in 2020, while its cash-to-debt ratio fell. Pretty solid year.
ProMedica Health (non-profit, 13 Midwestern hospitals) actually saw profits increase even in *the first half of 2020,* when hospitals were supposedly facing catastrophe.

They finished the year with ~$440M of EBITDA, and $2.3B of cash on hand.
Baylor Scott & White (52 hospitals) saw its profit margin *more than double* during the pandemic year, and ended September with $7.8 billion of cash and portfolio investments.

That's about $600M more than they had pre-pandemic.
Mass General Brigham's cash pile is now over $11 billion, which is roughly twice what Congress proposes to allocate to all rural hospitals in this proposal.

That number is *up* by ~$2B from the start of the pandemic, which is quite something.
Head down the Atlantic coast to NY, and we find that (non-profit) Northwell Health's EBITDA margin did dip a bit in 2020, but not dramatically.

And, like every other chain in this thread, Northwell ended up with a healthier balance sheet than at the beginning of the crisis.
If we turn back to the Midwest, we might look to OhioHealth, a highly profitable "not-for-profit" with 12 hospitals.

Not clear why they need $6.2 billion of cash on hand (4x their total debt), but they have it, which must be nice.
While we're in the neighborhood, we may want to look north, toward Michigan, home to Henry Ford (5 hospitals) and Spectrum Health (14 hospitals).

And...yup! Cash upon cash. Spectrum's cash pile increased by a quarter (~$1B) in the year to September.

Why?
We could also take a look around Illinois, Missouri, Oklahoma and Wisconsin, perhaps through the lens of SSM Health's 23 hospitals in those states.

SSM enjoyed revenue growth in 2020, and currently sits on a tidy pile of $4.4 billion.
Let's keep heading west. We'll make a stop in Utah, where local giant Intermountain is giving Mass General a run for its money. As a...portfolio manager.

Another hospital chain, with $11B of cash on hand, and a nice healthy profit margin.
And now, to the Pacific Coast. Providence is a good example - 51 hospitals from California to Alaska, along with a few facilities in MT, NM and TX.

EBITDA margins were down a smidge, but cash was up by $2B to an eye-popping $14.5B.

Is that a lot? It seems like a lot.
We can keep going, though I am not sure we need to.

There's Tenet, with its 40% EBITDA margin on surgical facilities. Or UHS, where free cash flow more than doubled in 2020...

But, at this point, I think the picture is clear. Congress is wasting your money. /n

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Noah Smith
Noah Smith
@Noahpinion
1/People I know on the Right tend to be obsessed with the idea of "crimethink", taboos, and the (supposedly) oppressive, omnipresent enforcement of liberal cultural norms.

Why?

My new theory: A lot of it is guilt.

2/It's true that in some circles - the media, universities, many big corporations - liberal norms *are* enforced to some degree, and the enforcement has probably gotten stronger in recent years.

But I don't think this explains all of the Right's obsession.

3/The stereotype is that people on the Right tend to be more threat-sensitive. That would help explain the perception that liberal norm-enforcers are lurking everywhere, ready to pounce and anathematize anyone who makes a misstep.

But I don't think that's all of it either.

4/And of course, it's always fun - whether you're on the Right or the Left, or playing a video game, or whatever - to style yourself as the brave iconoclastic rebel fighting against the oppressive forces of blah blah blah.

But I don't think this is all of it, either.

5/The reason I think it's more than these things is that even *in private*, people on the Right express their "crimethink" ideas very gingerly and hesitantly.

I get the sense that they're not just afraid of external censure, but have also internalized liberal norms.
SOCIETY
Kelly Ellis
Kelly Ellis
@justkelly_ok
So, I want to talk about how sexual harassment and fair pay are linked at Google (and beyond), because I think that's an angle that isn't being highlighted enough in the coverage of these walk-outs. I'm going to frame it largely around my personal experience there. Thread.

When I was sexually harassed by the director of the area I was working in, I was afraid to report it because I was worried that "getting him in trouble" would result in the subtle retaliation of missed leadership opportunities.

I wanted to continue working on the team I was on, because I'd gained a lot of very deep knowledge and expertise in that area, as well as reputation and camaraderie with the other folks working in that area. I didn't want to make the situation more "difficult."

To get promoted at Google, several need to happen: 1. you need opportunities for ownership and leadership above your current level (basically, opportunities to show you're working at the next level you're trying to get promoted to). The work you're "assigned" has a big impact.

2. You need glowing reviews from peers, *at or particularly above the level you're hoping to get promoted to.* Basically, you need people a lot more senior than you to say you're doing awesome work.
TECH , SOCIETY
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It is hoped that you have not forgotten that Svayambhuva Manu had a son named Priyavrata. Priyavrata had ten sons. Their names were Agnidhra, Agnivahu, Vapushmana, Dyutimana, Medha, Medhatithi, Bhavya, Savana, Putra and Jyotishmana.


Medha, Agnivahu and Putra had no desire to rule. They were not interested in material pursuits and became hermits.

Priyavrata divided the earth amongst the remaining seven sons. Thus it was that the earth came to be divided into seven regions or dvipas.


Agnidhra ruled over Jambudvip, Medhatithi over Plakshadvip, Vapushman over Shalmalidvip, Jyotishman over Kushadvip, Dyutimana over Krounchadvip, Bhavya over Shakadvip & Savan over Pushkaradvip


Agnidhra, the ruler of Jambudvipa, had nine sons. Their names were Nabhi Kimpurusha, Hari, Ilavrita, Ramya, Hiranyavana, Kuru, Bhadrashva and Ketumala.

Agnidhra divided Jambudvipa into nine regions (varshas) and gave each of his sons a region to rule over.
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Rob Ford
Rob Ford
@robfordmancs
Two things can be true at once:
1. There is an issue with hostility some academics have faced on some issues
2. Another academic who himself uses threats of legal action to bully colleagues into silence is not a good faith champion of the free speech cause


I have kept quiet about Matthew's recent outpourings on here but as my estwhile co-author has now seen fit to portray me as an enabler of oppression I think I have a right to reply. So I will.

I consider Matthew to be a colleague and a friend, and we had a longstanding agreement not to engage in disputes on twitter. I disagree with much in the article @UOzkirimli wrote on his research in @openDemocracy but I strongly support his right to express such critical views

I therefore find it outrageous that Matthew saw fit to bully @openDemocracy with legal threats, seeking it seems to stifle criticism of his own work. Such behaviour is simply wrong, and completely inconsistent with an academic commitment to free speech.

I am not embroiling myself in the various other cases Matt lists because, unlike him, I think attention to the detail matters and I don't have time to research each of these cases in detail.
SOCIETY
Cory Doctorow #BLM
Cory Doctorow #BLM
@doctorow
When it's railroading time, you get railroads.

When the railroads turn into the personal satrapies of rail-barons, you get trustbusters.

A couple decades ago, it was online service time. We had the users, the telcoms systems, the computers, the modems, so we got platforms.

1/

We had that, but we lacked something important: effective antimonopoly enforcement. Lax merger laws allowed companies with access to capital markets to buy out or neutralize all their competitors, so we got monopolies.

Right on schedule, we're getting digital trustbusters.

2/

Now, some people aren't technically sophisticated, but they do understand a lot about competition law. That's how you get meat-and-taters antitrust proposals like @amyklobuchar's #CALERA, which address the structural problems with antitrust

Klobuchar's bill is hugely important. The reason we have monopolies is that we stopped enforcing anti-monopoly law 40 years ago. Monopoly isn't a tech problem, it's everywhere from sneakers to glass bottles to pro wrestling to candy to

Klobuchar's CALERA doesn't just seek to apply antitrust law to tech - it also explicitly restores the pre-Reagan basis for fighting monopolies: we fight monopolies because they concentrate power and corrupt our politics. All monopolies are guilty unless proven otherwise.

5/
SOCIETY

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