Whistling, I Be......
The Market Ticker - Commentary on The Capital Markets
2017-11-28 21:07 by Karl Denninger
in Personal Health , 434 references Ignore this thread
Whistling, I Be......
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Ready to lynch both your doctor and the government?

No?

After you read this..... you will be.

Back to here if you're tired of the bull**** -- and when your energy level returns, go find your pitchfork and torch.  This was written by an actual endocrinologist in..... 1999.

We are all being robbed of $400 billion a year via Medicare and Medicaid and hundreds of billions more in private "insurance" due to this scam that not only makes people sick and results in them spending billions on unnecessary pills, doctors and procedures it literally gets their feet amputated, they go blind, they wind up on dialysis and die.

The claimed "inevitability progressive" nature of said disorder is an intentional and knowing lie and it not only bankrupting the nation while enriching hospitals, doctors, pharmaceutical companies and politicians it has killed millions.

smiley

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Pika-steph
Posts: 56874
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Also, for women in particular, this endocrinologist has a few things to say about menopause. I wish I had known this doctor's information when my mother was literally losing her brain function before my eyes and completely incapacitated by the time she was 52 - due to a complete hysterectomy (surgical menopause) at age 32 without ANY hormonal intervention. It literally destroyed her brain. She suffered through nearly 20 more years of being completely brain dead after that.

So, this is information that is critical to ALL women whether going through menopause naturally or having it surgically imposed. Menopause is not something that doesn't need to be addressed (and I don't mean with drugs/big pharma), but it DOES need to be addressed in ALL women if they want quality of life. Here's why:
http://www.menopausepower.com/treat-the-....

More articles and information here: http://www.menopausepower.com/article-li....





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"Obama is the dark-center of the anal fissure of a chancre infested, hemorrhoid laden ******* preparing to pucker and spew endless jets of diarrhea."--Chthonic inline

Tsherry
Posts: 957
Incept: 2008-12-09

Spokane WA
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I walked out of my cardiologists office several years ago with a prescription for BP meds. Got the prescription, took it for about a week, was destroyed in terms of energy.

No mention about diet or exercise.

Re-read Karl's info on diet and exercise and lifestyle. Nuked about 80% of the carb intake, started exercising. Lost 20 lbs, dropped my BP back into what passed for 'normal' range. More energy, more muscle pain (that happens when you have lots of energy and then you attack all kinds of things around the house and car and barn and volunteer to do stuff that you couldn't do five years ago!). Still have beer on occasion, and wine, and maybe a bourbon or a Scotch. Still have a pizza on occasion, but nearly no processed foods, very little in the way of breads and grains and starches.

Wouldn't change a thing.

Have not been back to the cardiologist since, nor will I ever go again. **** them all.

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Omne mendacium est.
Hstella
Posts: 712
Incept: 2009-08-18

Colorado
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Thanks Pika! Id heard of bio identical hormones but not of equivalent dosing. It makes sense, though. Im not near menopause, but I think that approach makes sense. So often a youthful hormonal cycle is treated as being its own disease (like the original meaning of hysteria), with post menopause being described as a return to a male-like pattern of stability . Yeah, not helpful .
Eleua
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Pika,

Are you aware of any reputable study linking insulin resistance in younger women and the incidence of autism in their children?

IOW, do overweight/obese mothers tend to have autistic children more often than healthier mothers?

smiley

I've wanted to do a diet/health video for my HS volleyball team (girls), telling them and their parents to lay off the carbohydrates in lieu of some modest protein and higher naturally occurring fats (no veggie or canola fats).

The longer term bennies are obvious, as explained in this article. My short term motivator is that they can jump higher, hit harder, last longer, and recover quicker, with fewer injuries.

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"My object in life is to dethrone God and destroy capitalism." - Karl Marx
"Destroy the family, you destroy the country." - Lenin
"Education is a weapon whose effects depend on who holds it in his hands and at whom it is aimed." - Stalin
Oregoncactus
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Eleua wrote..
Are you aware of any reputable study linking insulin resistance in younger women and the incidence of autism in their children?


Eleua, that is a very interesting questions. I am interested in the answer. Both of my children are on the Autism Spectrum. I was not obese/overweight or insulin resistant. I did, however, exactly follow the diet recommendations of my doctors and gained exactly the weight they recommended. I had to drink a lot of milk every day, low fat of course. I wonder if the diet recommendations my doctors gave at the time (my kids are 23 and 18) played into that with all the milk and low fat and high carb recommendations.
Hilandstrata
Posts: 251
Incept: 2008-10-19

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Well, who stands to gain from the disinformation. Hmmmmm...the list is long. I believe the thinking is that there is no shortage of slaves on this earth so it doesn't matter if some die off. They're all just "useless eaters" anyway. In the meantime, let's profit from it also. Two birds with one stone. This is how the satanist's think. Who are these satanist's?
Supertruckertom
Posts: 1548
Incept: 2010-11-07

USA
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My Son is Autistic as well and my ex has certainly become Insulin resistant.
She put on weight that never came off while carrying him.

She was downright bony when she was nursing his older sister.

I still want her healthy for my kids sake.

Same for my wife and soul mate.
I will buy that book for her.

In just 2 weeks she is now into some clothes that haven't been out of the closet in years.




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Preparing to go Hunting.
Londoncat
Posts: 95
Incept: 2012-03-02

Kansas
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Oregoncactus - don't know about the driving factors for autism, but here is a link to a presentation by Dr. Susan Masino addressing the ketogenic diet and its effect on autism (and it's impact on adenosine-stimulating effects). Of course, she can't get funding to expand the research since big pharma can't make any money telling people to cut carbs and eat healthy fats.

I would encourage you to watch the whole thing, but she focuses on autism at the 42 minute mark.

https://www.youtube.com/watch?v=bnvR-_TY....

As for LowCarbHighFat for Athletic Performance - here is a presentation that does a great job covering the maximization of strength and power while minimizing damage and recovery time. It's very nerdy science, but very persuasive.

https://www.youtube.com/watch?v=4eIphrSP....
Londoncat
Posts: 95
Incept: 2012-03-02

Kansas
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Eleua - here is a great 26 minute presentation from Dr. Jeff Volek from Ohio State University (whom I suspect has done the most research on LCHF and its impacts on athletes to date) on enhancing performance, endurance, resistance training, and recovery. If nothing else, there is a side at the 25:30 mark that lists some of the many benefits of a keto-adapted athlete.

https://www.youtube.com/watch?v=9QBWZqDi....
Rollformer
Posts: 78
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I have a friend who works as a regional finance manager for DaVita, the kidney dialysis provider. He had mentioned that he was presenting a business improvement plan a few days ago. I asked him whether he was going to subsidize sugar consumption in his region.

I'm taking a look at the 10-K today. This company cannot survive without more and more people getting sick! They claim to lose money on government jobs, which is 64% of their business. If I assume a 0% gross margin on this business, they are making a 90% gross margin on the commercial insurance business! Which is $3.2 billion in revenues.

The think with end-stage renal disease is that Medicare picks up essentially everyone after 33 months. So margins drop big (probably not to 0% gross, I hope). So most of the SG&A and D&A have to be absorbed by NEW patients. So there is absolutely no incentive for them to prevent, rather than treat the disease.

They disclose the number of treatments provided, and assuming 3 weekly treatment per patient, can estimate the number of patients at around 174,000. So here are some statistics about what a sick person means for Davita:

$52,000 in revenue.
$10,206 in operating profit.
$4,300 in absorbed General & Administrative! Most of this is BILLING. For a company that does essentially one thing.
Oregoncactus
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Thanks Londoncat!
Rollformer
Posts: 78
Incept: 2013-02-13

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I have looked now at the DaVita proxy statement and balance sheet. The executive compensation is entirely discretionary; no goals, just mealy-mouthed nonsense. However, the first listed relates mostly to the expansion of the business. Not earnings, not shareholder return, not return on invested capital. This has resulted in a comical balance sheet.

They have 2,350 dialysis centers. Their corporate functions and 16 of these centers are leased.

$913 million in cash.
$3.2 billion, Property and Equipment (1.35 million per center).
$1.5 billion, Net Intangibles. About 1.6 billion of the gross is "Customer Relationships".
$9.4 billion in goodwill. That works out to $4 million per center, or $50,119 per patient, who earn them $10,000 per year in operating income.

This is supported by:
$9 billion in long-term debt.
$1 billion in a non-controlling interest subject to put provision liability.
$4.8 billion in book equity.

I'm honestly not sure whether they are charging too much, but those intangibles and goodwill beggar belief.
Nadavegan
Posts: 63
Incept: 2017-05-03

The South
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@Rollformer,

Goodwill is probably from acquisitions (a quick internet search shows several, and one article mentions that overseas acquisitions are being made to offset rising costs). Goodwill is basically a purchase premium based on the belief that business will improve tremendously at some point down the road. Gee I wonder how.

To your point, a friend of mine was an analyst for a nationally-known hospital chain, based in an area with decreasing population. All of their projections were based on "beds occupied", and all the planning was based around how to fill more hospital beds. Ghastly stuff indeed.
Rollformer
Posts: 78
Incept: 2013-02-13

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@Nadavegan:

I know what the goodwill is. I was once involved in a 8.4 million dollar purchase, in which we bought about $400K in inventory and capital goods, so we held about $8 million of goodwill on the books. But the capital and the employees were putting about $6m a year in EBITDA. You can justify that. Easily.

In their most recent 10-Q, we get an example of one of their acquisitions:

Centers: 36
Patients: 2,600

Purchase Price: $361,563
Goodwill: $298,358

So they are paying about 7x book. 6x assets. Book assets are probably a bit light of what it would cost to build it yourself, but I think they are a good proxy.

Then I worked proforma financials, from what I talked about above. Apportioned some debt based on sales, and taxes based on what they actually pay (30%, actually). That comes up to almost 30x net income. There are public companies that trade like this, but they are usually software companies with major growth lies/stories, whichever you believe.

This is a mature industry, one where you only have profitable patients for less than three years. It seems to me an incredibly reckless use of the shareholders' money. Managements whose boards do not reward stupidity do not do this. But the bigger they get, the better they get paid, so buy, buy, buy; no price too high.
Tickergroupie
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Incept: 2010-03-24

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Pika,
Great information.
I have to wonder how many menopausal women are following a HCLF diet and harming their brain health in the process.

I had just tip-toed into the bio-identical hormones a few years ago when my doctor of 30 years went 'concierge'...just as hubby retired. Doc was suddenly unaffordable...end of the bio-identicals for me.
Now, I can't decide if I want to go back into 'the system' for them. So far I am resisting. I'm going with her slowing down advice, etc... (and LCHF.)
Rollformer
Posts: 78
Incept: 2013-02-13

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Well, this is probably between Karl and me at this point, but I did some more research on DaVita. They are remarkably transparent in their 10-K disclosures, so I looked a bit more at their pre/post Obamacare financials. Here is what I found for CAGRs (2008 - 2013, 2014 - 2016):

Cost of Service, before: -2.2%; after: +1.5%
Government Patient Revenue per Pt, before: 0.2%, after: -1.1%
Private Patient Revenue per Pt, before: -0.6%. after: 5.7%
SG&A CAGR: before, 6.4%, after 4.9%.

Remarkably, the per patient SG&A charge was declining pre-Obamacare; it has been flat post.

Working a proforma, using those numbers (well, gov't at 0% going forward), the fair value of the acquisition mentioned before is about $400, on a net-of-tax, basis, in perpetuity. Assuming no growth in patients.

Now, these are MBAs buying from doctors. Doctors have seen things grow exponentially in a petri dish, so they understand. I'm not so sure about the MBAs. So they think they are getting a deal; the doctors are laughing all the way to the bank. (If you want to see my work, I will gladly share.)

This got me thinking about Obamacare. What I discovered, I have probably already learned here. But I often need to learn things the hard way. Here is what I found:

Obamacare created the "Minimum Loss Ratio". The big groups cannot be greedy; they have to spend 85% of what they bring in premiums. The individual and small group gets to be MORE greedy: they only have to spend 80%. Then, in Maine, where there was little competition and the insurance companies ahd their say, they only had to spend 65% of what they took in. Serious thieves, these people in Maine.

So, I opened up Excel. I created three, pre-Obamacare insurance firms. All, pre-Obamacare, were bringing in $1 billion in revenue. They all made a 20% gross margin (premiums - medical loss), and all three were spending $50 million on SG&A. Everyone is making $150 million in operating profit.

So I made some assumptions. Everyone's board has said that they want a 7% increase in operating profit. That's 160.5 million. Everyone gets a 3% raise, so everyone's SG&A goes to 51.5 million.

So, what happens?

The big company, who can only make a 15% gross margin, needs to increase its costs by 50%, and its premiums by 41.3%.

The individual and small providers, being allowed to be greedy need to increase their costs by 6%, and their prices by the same.

And the rat bastards who can steal 35% of their premiums? Well, they can reduce their spending by 50% and their premiums by 39%, and still make their $160.5 in profit.

I stand by my numbers, and I know it is a gross simplicity. The really big guys are self-insured. Are they paying a percentage of spend, or are they paying per-head? If it is the former, then they REALLY (ins. companies) don't care what they do.

I've heard it here, from you and the commenters, but I didn't know how bad it was.

God bless us, everyone.
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