Transmogrifier

Who are the next generation of Republican politicians and voters? Identifying the future of the Democratic party is easy but the Republicans…not so much. @JoeGruters @GOP

Da Walmart flat iron steaks in this recipe andrewgruel.substack.com/p/a…

Trump put out a statement today recognizing Reformation Day. That doesn’t sound like a big deal until you realize almost no president has ever done it. The only other time a sitting president publicly acknowledged it was Herbert Hoover back in 1930, and even then it was just a short greeting he sent to a Lutheran group. Nothing formal, nothing broad, and nothing like what came out of the White House today. What Trump actually said is the interesting part. He didn’t just say “happy Reformation Day.” He connected Martin Luther, the emphasis on Scripture, and people like William Tyndale straight to the ideas of God-given rights and liberty that shaped the founding. And he did it while the country’s in the middle of its 250th anniversary. Most presidents will issue a proclamation for Thanksgiving or Christmas without thinking twice. Reformation Day, though? That’s specific. And for whatever reason, it’s basically never been something the White House has bothered to mark. So yeah, it’s a small thing on paper. But in practice it’s one of those moments where a president is openly tying America’s story to the Reformation instead of treating that history like something that doesn’t matter. Whether you like him or not, that part is new.

farmers don't need bailouts. Stop subsidizing inefficient, single row crop operations that take 3 weeks of work a year!!! Incentivize grazed cover crop, new crops, and denser production per acre.

Friends, in just two days, Christians were murdered on two continents. On Friday, gunmen opened fire on a funeral at St. George’s Greek Orthodox Church in Karak, Jordan, and killed nine people. On Saturday, armed men attacked Orthodox churches and homes in Oromia, Ethiopia, and killed more than forty. These are not statistics. They are our brothers and sisters, members of the mystical Body of Christ. When Saul set out to destroy the Church, the risen Jesus asked him, “Why are you persecuting me?” The Lord is still being persecuted in these victims of anti-Christian violence. Christianity is by far the most persecuted religion in the world today. Those of us who worship in comfort have to ask what the deaths of these martyrs demand of us. At the very least, they demand that we pray for them, learn their names, press our leaders to act, and refuse to look away. The blood of the martyrs is the seed of the Church.

Look, if you wanted to make healthcare more expensive, you would pay non-profit hospitals to buy competitors and make it harder to build new ones. The United States Government does both. Our government rewards acquisitions and restricts new entrants, incumbent hospitals gain bargaining power. Employers and patients have fewer alternatives, making higher prices easier to sustain. The average annual premium for employer-sponsored family coverage has reached $28,303. Employers and employees pay that together, before deductibles and copays. Medicare encourages consolidation. A hospital acquires an independent physician practice, qualifies it for hospital outpatient billing, and collects higher payments. The physician can remain in the same examination room. The acquisition creates a financial return without requiring better care. As the system acquires more practices, insurers have fewer alternatives. Rejecting its prices becomes harder when excluding it means excluding much of the care local employees need. Congress restricts the physicians who could compete with it. Section 6001 of the Affordable Care Act largely closed the Medicare pathway for new physician-owned hospitals and restricted expansion at existing ones. An independent surgeon can recruit colleagues, raise capital, and design a better facility. Congress still stands between that investment and the Medicare participation needed to make it viable. The hospital buying his practice gets a growth opportunity. The physician building a competing hospital gets a federal restriction. Certificate-of-need laws add another obstacle. Opening or expanding certain facilities requires state permission, and incumbent hospitals use that process to oppose competitors. The business collecting the money gets to argue that the community has no need for another business offering the same service. Governors and legislators who preserve those laws protect incumbent hospitals from competition. Employers and families finance that protection, even though it never appears in the state budget. Many protected institutions also receive substantial public support through tax exemption. With little competitive pressure, scrutiny of that support becomes more important. State attorneys general oversee charitable organizations, including tax-exempt health systems. Their authority varies, but protecting charitable assets and enforcing charitable obligations are part of the job. AGs have ignored those responsibilities for too long. Academic medical centers and tax-exempt health systems operate with far too little accountability for the public benefits they receive. A nonprofit designation does not establish that prices are reasonable, financial assistance is adequate, or acquisitions benefit patients. A hospital’s annual report is no substitute for an attorney general examining its conduct. Federal oversight has failed, too. GAO and the Treasury Inspector General have documented weaknesses in how the IRS evaluates hospital community benefits and the standards used to justify tax exemption. Employers absorb higher costs, charge employees more, reduce benefits, or cut elsewhere. Healthcare consumes money otherwise available for wages, hiring, and investment. Congress can repeal physician-owned hospital restrictions and expand site-neutral payments. Governors and legislators can repeal certificate-of-need barriers. Attorneys general and federal tax officials can enforce the obligations attached to charitable status and tax exemption. Premiums would be lower if lawmakers removed the payment advantages and entry restrictions protecting incumbent hospitals. The bill arrives with an insurance company’s logo. The lawmakers’ names belong on it, too. Can I watch football now? My team is losing, maybe il keep posting…

The Elizabeth Holmes story doesn’t happen without an enabling media ecosystem that doesn’t actually open a new book to realize the pages inside have a nonsensical / incomplete word salad. Check out this clip from an October 2015 media event that is ostensibly journalism but is clearly just a PR campaign for the new hot thing. Q: “Even though you’re going above and beyond with the FDA approvals how do you answer the critics who aren’t just attack dogs for the lab industry that say you’re being too secretive about the technology ?” The theme that repeats constantly with most science journalists is an inability to even make a passing attempt at interpreting primary data. They need trusted ppl to parse it for them. The lab ppl with questions ? — they’re conflicted so nothing they say can be taken at face value. Ok sure.. but why this default assumption that Holmes with MASSIVE conflicts is trustworthy? But he does mention that there are other non conflicted thoughtful ppl with questions as well about Theranos.. Holmes answers by first saying all the reports and questions in the media are seeded by the lab industry .. and then talks about clearing the FDA approval bar and that the FDA decision memo on her technology is all public. Herper, the journalist, actually interrupts her and looks to the audience and “teaches” the audience about the fact that all decision memos on approved products are public and can be looked up .. he joking says “its hours of fun”. The implication being that he’s a serious journalist who routinely reads these memos and the implication is that he’s read the Theranos memo. But the public FDA decision memo from July 2015 that Herper is ostensibly chuckling about covers ONE Theranos test for herpes simplex virus 1 (HSV-1), along with the Theranos platform as used for that specific test. It was a standard 510(k) clearance. The FDA judged the test substantially equivalent to Focus Diagnostics' HerpeSelect assay, and it described the test as a chemiluminescent immunoassay, which is not a novel technology. This was not a de novo review of a new platform, so nothing the FDA did constituted a verdict on the breakthrough Holmes was selling. A 510(k) is a paper review. The FDA reads data the sponsor generated and decides whether the device is substantially equivalent to an existing approved tech. Theranos tested the samples and sent the results to the CDC to confirm agreement. The CDC supplied the samples and checked the answers, but I’m pretty sure it didn’t run the samples on the Theranos device. The easy pushback in this interview —- actually the FDA approved one of your tests, and the FDA or anyone hasn’t been able to evaluate your propriety box. That follow up never comes. The FDA actually visited some Theranos sites months after the decision letter and rapped the company for marketing an unapproved device. This 483 FDA document came to light in October only in response to a FOIA request. So by the time Herper sat down for this interview the FDA knew there was a wide gap between what Holmes was saying about clearing the FDA bar and what was actually true. As Herper admiringly says in this interview Theranos had a $9billion valuation that put it on par with QUEST. The valuation was based on nothing. The patents she talks about in the interview didn’t describe anything actually new. It was an aspirational diagram of a patch that could monitor and deliver therapeutics. It would be like me having a patent for the Star Trek tricorder. 10 days after this interview by Herper, WSJ reporter John Careyrou wrote a whistleblower sourced story that began the great unraveling. The whole interview is a must watch because you realize how much of what’s happening right now is theater- a movie scripted by firms and their investors.

Now available on all streaming platforms! “Cowpoke” - originally written by Stan Jones in 1951 release.landr.com/9910614850…

🚨🚨THE DEMOCRACY FILES, PART 1: THE PLAN 🚨 I am working on gathering all the documents. Now, here's something to understand about the "democracy" and protest ecosystem: almost nobody knows the 'grand plan' so to speak. They simply agree to play a role. For example, 99% of people breaking stuff on the streets believe they're doing it out of an organic uprising. They don't see that the police have been ordered to stand down. They don't see that legal services have already been arranged for them. They don't see that foundations are paying for their bonds. Similarly here, governors aren't participating in a pact to destroy the Constitution. Governors simply have agreed to push back on the Insurrection Act. The effect is the same: the governors end up playing a role in a grander plan. I call this "shared epistemology" in my book Unelected. Motivations differ, people rarely agree to the big evil supervillain framing, but incentives all converge in the same end goal. No Kings might not agree to explicitly tear down the Constitution, but they nonetheless work with DSA and will turn out millions of people if the right phone call is put in. Here is one articulation of the plan - and crucially, since then, they have put many NGOs in their places to execute their proper role at all levels when the time is right. Many more coming.

The average cough after a respiratory tract infection lasts 18 days.

Republicans vs dems isn’t the issue, man. It’s people who hate America vs people who love it…that’s what counts. There are people in both parties who have no love for their country. A 3rd party doesn’t fix that. There is no political solution for cultural rot. Stop pretending.

Canada: A wildfire has just broken out in Alberta on the Canadian Forces Base in Wainwright. Both the Prime Minister and Premier have made statements saying a “serious and major incident occurred on the base, with a fast moving fire starting.” Medivac ships are flying into the area, and the official Prime Minister page is calling it a tragedy. The local community is being evacuated, and a large firefighter response is underway. Something big must have happened to cause this fire to get such a reaction from both the Prime Minister and Premier, so quickly. Reports of major explosions. Video from Madison Keller

The craziest thing happened to me in an interview yesterday. I interviewed my first deep fake candidate. It took me a bit to catch on. My coworker noticed his glasses looked off.... there was a second ghost frame smeared across his cheeks. He'd been running a live face filter the whole interview So I asked him to put his hand in front of his face. He put it up right NEXT to his face lol, never in front. Asked again, still wouldn't do it He looked a little different from his linked in and his github (which I wont link here) hiring and interviewing is so ridiculous now. In the days of AI we're going to have to be more careful.. and forced to move to in person interviews.

A serving of Campbell's tomato soup has more sugar than a Krispy Kreme glazed donut. The can lists tomato puree, water, wheat flour and sugar, then under 2% of salt, potassium salt, natural flavoring, citric acid, vitamin C, celery extract and garlic oil. Half a cup of the condensed soup, which is one bowl once you add the water, has 12 grams of total sugar on Campbell's current label, 8 of them added. Krispy Kreme's nutrition sheet puts the Original Glazed at 10 grams. Some of that sugar is the tomato's. A raw tomato runs about 2.6 grams of sugar per 100 grams and the paste concentrates it. The other 8 grams are the sugar on the ingredient list. It's there because tomato puree is sour and flour makes it flat, and the cheapest fix for both at a cannery is sugar. The soup also carries 480 milligrams of sodium a serving, 21% of your day, so you're getting the salt either way.

"Vital signs are stable" can be used to describe a dead person. Please be more specific. - one of my attendings in training.

I brought one of the year's biggest economic stories to the White House podium, and the legacy media didn't bother to show up. 500+ new factory projects across 47 states. So if the networks won’t report it, I will.

Can people not hear me? I am saying this every single day, loudly: It’s not the judges. I spent 14.5 years inside Allegheny County Pretrial Services. We wrote the recommendations. After the MacArthur grant money arrived, the mandate was to reduce the jail population. Recommendations do not include monetary conditions. The magistrate signs the order. Pretrial reviews every case and can move the next day to modify it. Delvin Dobbins walked the day after the Garfield aggravated assault (intestines out, bloody knife) on non-monetary, with an open case already pending and a prior adult shooting charge. The dockets are public. This is the system working as designed. I laid the emails and the incentives out with @colin_dunlap on @KDKARadio: Please hear me. x.com/KDKARadio/status/21046…

Politicians could easily use @grok to fact check thier posts/policies

If you have a kid applying to college with the last name of Patel or Koka or Reddy you may want to know what your kid is up against: (it’s worse than I thought) Tx to @zagrebbi we have an analysis of leaked Columbia data that disaggregates Asian as a group into South East Asian and East Asian. East Asians with a near perfect 1550+ SAT score have about the same rate of acceptance as whites (16-17%) Southeast Asians (Patels/Kokas) with the same near perfect SATs have an 8% acceptance rate. (Sorry to report to white nationalists — there is no mafia of Indians at elite schools in the U.S. that favor Indians) Other notable findings— there are comparatively few self identified black/Hispanics with 1550+ SATs. (Current NYC mayor Zohran Mamdani self identified as black when applying to Columbia). Acceptance rates for black/Hispanic identified individuals is 25-50% Cc @TheBrancaShow

According to @CMSGov, Xarelto will be removed from the Medicare Drug Negotiation Program starting January 1, 2027. Their reason? The availability of generic competition, which disqualifies this drug from negotiated pricing under the Inflation Reduction Act rules. Excuse me, am I missing something? Maybe I’m missing the ACTUAL launch of a generic Xarelto in another strength other than the 2.5mg that’s currently available?!! My next question would be, why is Farxiga still a Medicare Negotiated Drug for 2027 then? It has had a readily available, super inexpensive generic for months now!! Who the fuck at @CMSGov isn’t doing their homework?