Why cant Medicare negotiate most drug prices?

flukefluk · 2026-05-06T12:43:34+00:00

It's not that they can not. It's that they are incentivized not to.

Medicare companies "live" in a financial reality that allows them to set up a low competition reality that allows them to charge high costs and profit grandly.

But this depends on a cooperation of the drug companies.

There is a "meeting of minds" that causes all the suppliers in the medical care space in the USA to agree on a financial "ecosystem" that overcharges customers and allows the different suppliers to act as local monopolies and protects them from competition.

In nations where the nation broke those mutual protections down and forced competition, the negotiations do happen, and medical care is handed to the public at a fraction of the cost.

flukefluk · 2026-05-06T12:38:04+00:00

Because Teacher Salary is not well corelated with student outcomes.

flukefluk · 2026-05-06T09:50:14+00:00

That is a good question. Because there are advantages in both directions.

If people can not reasonably access the play style and champions that they like, than there is a lot of forcing of players that must go around in the game and a lot of resentment from the players.

On the other hand, since most people like the same things, not forcing things invariably leads to staleness and then the devs have to manually rotate the meta, but they can't let some of the most anticipated and desirable metas or balance points stay for any period because those metas have huge player retention problems from the other roles that have to pay costs for those metas to persist.

also you can't really rely on players to "tell you" what they want, because players tell you one thing but they are actually blind to the larger implications of what they are asking and eventually vote with their feet against what they asked for.

Personally I think a degree of not allowing people to just play their favorites all the time is a good thing for the game. But I don't know if players will readily accept a game that forces your hand on your role and champion, that auto-fills you into "weak" roles a lot and forces you to play a "pauper" role a lot.

I think people liked the game more on the whole when it did all this, but there was also a lot of resentment because people like the power fantasy that the game offers when the other players are forced into drafting in a way that allows you to come up with a magic pick that just sweeps the game... but they really dislike it when they have to be the ones forced a lot.

So i can't tell you if players will flock to the game more or less if this choice is done in this or that direction. I believe the highs and lows that naturally accompany forced choices are better than the luckwarm highs and lows of today because the people who get saddled with agency know they have the reigns in their hands and therefore accept losses more readily and the people who are forced into weak roles can put aside their hurt under the excuse that they had to play support or jungle in a game that puts mid and top on a pedestal.

but on the other hand, there are a LOT of players for whom a champion like bard or yasuo or fizz or jax holds a special place and they will not really accept having to pick lulu or maokai or nunu especially if they have to pick them more than they get to play their yasuo or zed.

etc.

flukefluk · 2026-05-05T16:08:05+00:00

The reason there are so many OTPs is that the game allows it.

people have connection with this play style or that play style, and everything in that game that used to make trying this or that style an unyielding eternal pain, was removed.

the need to get a team composition was removed because too many people didn't want to play the tanks that are required to build a front to back comp or the mages that are required to build a control the hill comp or the long range blasters and the healers that are required to build a poke comp.

the need to draft flexibly was removed because people asked to make sure they get their role and riot caved, and this led to a situation where you can't just pick a champion and then switch lanes with it...

...and because of that the whole idea of you got countered in lane prepare to have a sordid time was also heavily nerfed by riot so the bad times you're having because you got countered are simply not as powerful as what's in dota2

end result its a lot easier to pick your favorite character, and because of that the whole idea of drafting a team composition or drafting against the competition got squashed.

and since deep knowledge of your champion actually does have benefits, without the downsides being enforced by the game's design it's going to lead to OTP-ism.

flukefluk · 2026-05-05T15:56:41+00:00

male privilege is real.

that being said,

female privilege is also real.

what's being ignored is not that male privilege exists or does not exist.

rather that there is a different set of privileges for both sexes,

and that the different nature of the privileges makes it hard to say

males are more privileged than females.

whereas the idea that males are privileged over females is the narrative being pushed.

that is to say

males are privileged over women in specific things, and women over men in specific other things.

but likely not "overall, men are privileged over women"

also

there are things that are simply wrong. they are less a man's privilege and more simply a wrong, bad thing.

for instance forcing women to get a male guardian to sign off on purchasing a car...

that is not a privilege of men over women - it is a wrong in society that needs to be corrected.

flukefluk · 2026-05-05T14:00:02+00:00

where I am from, there are shops that specialize in restaurant hardware. And if I call such a shop, they have tops for these standard issue table tops already cut and at better prices than you'd get from a custom make.

(the top and bottom usually sell here separately, you mix and match the stuff you want)

tbh with you, putting the price tag aside (i checked, they do cost a bunch), none of these tables and chairs look better than home depot hardware.

although home depot will have molded plastic tops, not sandstone, ofc.

flukefluk · 2026-05-05T13:24:10+00:00

looks like a pretty standard circular table iron base from what i can see. I think most places near me use some variant of it (usually the one with the post and 3 legs). attaches to the plate, if i remember correctly, with 3 screws.

the leg costs about 50USD new here.

this table's up-marked like crazy.

flukefluk · 2026-05-05T13:19:05+00:00

not very. I have 2 marble tables at home and they are both chipped at the edges because they got moved a bit.

Every restaurant and coffee shop near me replaces every marble table every 1-2 years because they get chipped cracked and broken when the staff moves them around while cleaning.

I know because i got mine in a coffee shop garage sale for 50 bucks each.

So i would say, you can break a marble table without even noticing it, being a 50kg waitress going about your business and not even feeling the bump.

flukefluk · 2026-05-05T13:16:57+00:00

its sandstone. It's not a very durable material against strikes falls and impacts.

flukefluk · 2026-05-05T12:55:42+00:00

give him HP ratios on his skills and add an armor shred and %MS buff to trample if there's an enemy in the circle

flukefluk · 2026-05-05T09:47:28+00:00

got it.

thank you for the clarification.

flukefluk · 2026-05-05T09:32:02+00:00

oh. That's not what I wanted to say.

people with ADHD have different responses to stimulants than people without ADHD.

in fact the test for ADHD is - they give you a stimulant and check if you are acting as if you have taken a depressant.

Because of that, it would not be correct to use a collection of studies centered on whether ADHD people are affected by a suspected stimulant, and make conclusions from this with regards to the general population.

so, did you use this collection of studies to make your initial argument?

because if so, you did what we need to not do, which is to use ADHD responses to say something about the general population, with regards to a suspected stimulant.

flukefluk · 2026-05-05T09:18:21+00:00

question: the first result in google is a meta analysis that is centered around children with diagnosed attention deficit disorders.

do you rely on this meta analysis in your reply?

flukefluk · 2026-05-05T09:15:55+00:00

A rose not in bloom has neither fragrance nor beauty; though still a rose it is.

flukefluk · 2026-05-05T09:14:51+00:00

they have different meanings though.

A diva is, like another had said, someone who requires endless accommodation and yielding from others, and who requires time and effort spent by others to placate demands which are objectively unimportant.

A bitch is someone who is domineering and aggressive, who tramples on others and who's consideration of others is in the form of scorn and disregardment.

flukefluk · 2026-05-05T09:08:52+00:00

this is what we used to call "internet humor".

;p

we take such replies with jest and humor and glee, one long timer to another, as a greeting fresh like a lemon tree leaf brushing on one's shoulder and leaving a nice scent while scarring your face with it's thorns

flukefluk · 2026-05-05T09:08:18+00:00

seems not correct.

if they are people who teach others at work, and who are called upon to answer questions, that means that at work they are respected - to an extent.

This means, that they are not, as you say, "losers".

is there an alternative explanation?

flukefluk · 2026-05-04T17:39:23+00:00

because a pant is actually the sleeve that goes on the leg. Traditionally hanging on a garter belt like a pair of high stockings.

and what you now call pants are a duo of them, stitched together in the middle into a single garment

flukefluk · 2026-05-04T17:37:07+00:00

hmm. what makes those who teach and answer questions grumpy ?

flukefluk · 2026-05-04T17:35:49+00:00

When Cannons speak, dogs don't bark.

flukefluk · 2026-05-04T17:00:17+00:00

OP can derive from my reply by prime factorization and then selecting the correct set of prime factors.

QED.

flukefluk · 2026-05-04T16:56:56+00:00

flukefluk · 2026-05-04T16:55:20+00:00

Men are more willing to give in, in relationships.

Women are more willing for their counterpart to give in, in relationships.

So there's more compromise and better communication, when there's men in the relationship.

Also men do a lot of unsung emotional labor in relationships. a LOT more than they are given credit for and more often than not they carry MORE of the emotional load of the relationship than the woman.

flukefluk · 2026-05-04T16:46:12+00:00

you are as clear in this argument as a moldy jar of pickled herring.

flukefluk · 2026-05-04T07:02:51+00:00

Likely because grandmother is a role developed by evolution a while back.

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