Good concept in theory but consolidation of streaming services to a handful of providers in an $88 billion dollar industry means the reality for most is that you can culturally isolate yourself by not consuming or seek illegal means of getting your entertainment.
Voting with your dollars works for mom and pop shops, but a loss in viewership due to changes in fees was calculated and note in the ledger.
It’s the difference between single-payer systems run by the government and private, for-profit commercial plans. I’m happy to see this carried out on an executive level since an actual law regulating private insurance would be a shit storm in congress. Remove the profit motive from insurers and the shift quickly moves towards real-world evidence and health outcomes rather than profit margins.
Obviously the insurance company actually dictates your healthcare and the prescriptions you receive, not your doctor. If you have great insurance, more physicians and treatments will be covered. Under insured is just having insurance that doesn’t cover your treatment.
Anytime a drug comes to market, manufacturers need to make sure drugs are covered by insurers. So, pharma companies go out to the “payers” (it’s what’s we call them at work) and vie to get a good position on the payer’s “formulary” (the list of drugs covered by insurance).
In this negotiation, you have things like “prior authorization” where the prescriber needs to make a case to the insurance company before a drug can be prescribed. There’s also different tiers for a class of drugs. This means the payers allow certain drugs to be covered only after a patient steps through other (cheaper) treatments. If it’s not covered, you can pay out of pocket but none of this shit is priced for an individual.
There’s a cold calculus on both sides where the pharma company has sunk $300 million to $5 billion dollars to bring a drug to market that can sometimes take a decade to go through clinical trials and receive FDA approval — they need to charge a lot to recoup their investment and hopefully become profitable. Meanwhile, insurers have a population they need to cover and a set pool of money and they don’t need a new $50,000 therapy when there’s a generic that will treat 80% of patients. The other 20% can jump through the hoops or get stuffed…
PSA from someone who works in the industry. Drug manufacturers offer “patient assistance programs” where people who are under insured or uninsured can receive treatments at a discount or sometimes free. They are not broadly advertised and I had no idea they existed until I started working in the space. Just search the drug + patient assistance or financial assistance.
Also to state the obvious… The US healthcare system is fucked — mostly insurance companies but also pharmaceutical companies and hospital systems in the US are all doing everything they can to increase their profits at your expense.
Yep, I spent a month refactoring a few thousand lines of code using GPT4 and I felt like I was working with the best senior developer with infinite patience and availability.
I could vaguely describe what I was after and it would identify the established programming patterns and provide examples based on all the code snippets I fed it. It was amazing and a little terrifying what an LLM is capable of. It didn’t write the code for me but it increased my productivity 2 fold… I’m a developer now a getting rusty being 5 years into management rather than delivering functional code, so just having that copilot was invaluable.
Then one day it just stopped. It lost all context for my project. I asked what it thought what we were working on and it replied with something to do with TCP relays instead of my little Lua pet project dealing with music sequencing and MIDI processing… not even close to the fucking ballpark’s overflow lot.
It’s like my trusty senior developer got smashed in the head with a brick. And as described, would just give me nonsense hand wavy answers.
The point is not to say all is lost so fuck it, but to highlight that maybe there are systemic issues with an unregulated free markets. Networks have consolidated into a handful of streaming services to a point where there are really no other options for consumers.
What are you going to do? Read a book? Go back to DVDs? They can afford the relatively few people willing to take an all or nothing proposition to squeeze consumers for all they got. They are also really good at lobbying to keep the law on their side to keep it that way.