There are published human and animal Studies showing that piperine enhances serum concentration, extent of absorption and bioavailability of curcumin by 2,000%.
7,879 karma · joined December 3, 2012
No and you don’t need to be a monopoly to violate antitrust laws and engage in anti competitive behavior.
Believe it or not vitamins and minerals are nutrients.
In nutrition science vitamins and minerals are generally referred to as micronutrients whereas fats, sugars, proteins are referred to as macronutrients.
And no macros are not all absorbed the same. As a general rule the longer someone’s intestines the more macro absorption they will have than someone with a shorter intestinal track. As I have already suggested digestive enzymes play a role, so if someone ate black pepper as I suggested before, that will secrete more digestive enzymes allowing for more absorption of calories and macros. There is also gut bacteria (microbiome) take for example the study of African twins where one is healthy and the other malnourished, where it was determined the malnourished twin with the same diet wasn’t absorbing the same amount of nutrients as the healthy twin because of the difference in their microbiome.
Not even close, especially when it comes to vitamins, nutrients and minerals. For example, take turmeric which is praised for its anti-inflammatory and anti-oxidant benefits...we will usually not readily absorb the active ingredients unless taken together with black pepper.
Black pepper will also improve nutrient availability in general, because it helps digestive enzyme secretion.
Another example is iron, which generally we readily absorb from meat but not plants, however, consuming iron rich plants together with vitamin c improves our iron absorption up to 6x.
When in deep ketosis I was experimenting with various types of protein supplements and (surprisingly) found whey would spike my insulin. Of course this seemed odd as my supplement was pure and contained no sugar/no carbs.
After researching come to find out this is well known and in fact whey has a bigger impact on insulin levels than pure glucose. Apparently the amino acids in whey trigger insulin secretion directly in pancreatic beta cells.
Edit:
I thought it kind of funny doughnuts made its way into your fat/protein list and not the carb list.
These traditional forms of media are scrambling for likes/comments just as much as the next influencer.
Or you can un-ironically google “google lobbying” and find more detailed articles about Google’s lobbying published by time, fortune, Bloomberg, etc...
Lobbying is tracked and google spent over 33% more than Comcast - in your own words - bribing members of Congress.
The bulk of Google’s lobbying expenditure was for immigration, tax reform and antitrust. I’d say Google’s far better “at playing the game” after all no one is randomly sticking up for Comcast.
I think amazon : amazon basics is a great example of antitrust/unfair monopoly the same as google search : almost all consumer facing google products.
Both amazon and google search are the dominate online market leaders in their respective categories. In amazons case they unfairly use their market position to begin offering amazon private label products on their platform. They know what users are looking for, spend the most on, and they can give their own products dominate positions in the UI. In the case of google they too unfairly use their position as a market leader against their own customers (advertisers), so say you are a hotel booking platform and spend $x with google, google knows the market (searches, clicks, etc...) so google launches their own hotel booking, gives their in-house service priority in search results over existing market incumbents and self bids on google search advertising for key industry terms to drive up costs of advertisers to keep in business.
It’s kind of like standard oil buying up the railroads so they owned the supply chain and no other oil could be moved. It’s unfairly using your market position, not to compete, but to be anti competitive to the detriment of consumers.
I’d like to see the tech giants prevented from unfairly using their market dominance to stifle competition. As we saw with the break up of standard oil...competition is good for consumers.
Should the insurers costs be a factor in patient care? No.
Should pharmacists be paid by insurers to contra to cold call patients and interfere with the doctor patient relationship? No.
Should the pharmacists be financially incentivized to get patients to consent changes to therapies on the basis those changes lower insurers costs? No.
Should pharmacists be forced to do the bidding of the insurers under threat of being dropped from the insurance network? No.
Should doctors be forced to accept the insurers recommendations for changes to patient therapies under threat of being dropped from the insurers network? No.
It’s great to lower patient costs...and that’s what insurers and pharmacists on hanging their hat on, as I said almost no one knows the reality of how and why it’s being done. It’s no secret insurance companies are dropping pharmacies and doctors who don’t play ball (it’s worse for a patient to lose their network of doctors than pay for name brand drugs if the doctor feels that’s in their best interest). It’s also no secret that insurance companies are consolidating the market (buying pharmacies, buys hospitals and buying doctor offices) and forcing thei patients to the insurance owned doctors/pharmacies.
It can’t be ignored that patients are now often seeing a doctor owned by the insurer, filling their drugs at an insurance owned pharmacy...and decisions about patient care are made by the insurance company to lower their cost, not patient costs.
Then he said outcomesMTM is a pharmacy patient management software having nothing to with insurance, but it’s a software for insurers to pay pharmacies to provide mtm to the insurers patients and I quoted from their website. It’s really above and beyond ridiculous like me saying google is a search engine and someone say no it’s not give me a cite.
But this is more of the pharmacist interfering with your relationship with the patient...
So imagine you write a therapy, and the patient gets a call from the pharmacists to the extent:
1. Your Doc Wrote the expensive drug, but if you agree we can save you $x by contacting your doc and encouraging them to change it;
2. Your Doc only wrote a 30 day fill, do you want us to ask for 90 days? (Consider these are your sickest patients, only your patients with chronic diseases, so you probably give them 30 days on purpose to get them back into the office to check their blood).
It may sound reasonable on its face but: 1. Your patient loses faith you are acting in their best interest; 2. It’s framed in a way that the pharmacist knows more than you; 3. It’s not disclosed to the patient or to you as the doc, that the pharmacy getting paid bonuses by the insurance company to do it; and 4. If you disagree with the request for change (it doesn’t matter why, it will harm your rating with the insurer and you will potentially be dropped from the insurance network and lose your patients with that plan/insurer).
>MTM has nothing to do with insurance.
It’s required by law To be provided by insurers/health plans. If you refuse to talk to pharmacists or doctors about it, fine, you can read the law 42 CFR 423.153. In short insurance companies, must provide MTM services to patient covered in their plans.
It is also the single biggest metric in determining an insurers star rating. How could it possibly be unrelated to insurance if insurance companies have to, by law, provide it and it effects their reimbursement/star ratings?
>outcomesMTM is not insurance software, it's pharmacy patient management software.
That’s funny...the software certainly does manage pharmacists...on behalf of the insurance companies.
Right from the outcomes homepage:
“Contracted with more than 50 U.S. health plans, OutcomesMTM provides MTM coverage to 5.5 million patients. The company links more than 100,000 local chain, independent and health-system pharmacy providers with contracted plans across the country.”
Why does outcomesmtm contract with 50 insurance companies? Why does outcomesMTM “link” pharmacies with contracted plans?
“Targeted MTM services are designed to help plan sponsors improve performance for key Star measures, including the triple-weighted adherence measures. Prompted by TIPs in the Connect™ Platform, pharmacists work with patients to impact adherence and optimize medication regimens.”
As to generic substitutions...there are laws from state to state that allow pharmacists to do it, UNLESS the doctor says the name brand must be dispensed. I’m afraid that’s common practice, so permission is required. Plus when it comes to Medicare patients a pharmacist isn’t going to just change the RX to generic because they know they: 1 get paid by the insurer through these MTM portals to make the recommendation and 2 get paid again through the portal if/when the doctor agrees to the change.
Go into any pharmacy and ask the pharmacist about “MTM” and gauge their reaction.
Look at outcomesMTM they are 1 of the 2 dominate insurance software vendors. Again you can ask nearly any pharmacist and they have an outcomesMTM portal that feeds them automated recommendations on behalf of the insurance carrier. Some of the bigger pharmacies, like Wal-Mart, have even removed the MTM portals from the individual stores already and created nationwide MTM centers. I even know of one company who uses pharmacy students (for free) to do this work for the insurers. Here is another tidbit for every recommendation the portal gives the pharmacist the pharmacy gets a “tip” (ie monetary bonus) to forward that to the doctor and if the doctor makes the change the pharmacy gets another tip. The only reason the insurers link up with the pharmacists to do their dirty work instead of the doctors directly is the insurers can’t pay the doctors the way they pay pharmacists to do their work bc of anti kickback laws.
>Pharmacists cannot just ask doctors for prescription modifications.
Again try asking any practicing family physician, ask them how many faxes they get a day from pharmacies requesting they change the patient Rx.
There are many reasons generics, especially in the case of Medicare patients with chronic conditions, are worse for a patient.
Generally if you have a Medicare patientwith chronic conditions such as diabeties and/or high blood pressure, and their physician has successfully been managing their conditions using a name brand therapy, it’s not good practice to switch their therapy to a generic because it helps the insurance company. More importantly, it’s only the active ingredients in name brand drugs and generics that are the same. coloring agents, binders, etc... are different and those can have significant negative side effects. There is no shortage of examples of generics having worse outcomes in the case of chronic conditions.
Also it’s not just the therapy the insurance is changing, they also change the quantity. So again say you are a Medicare patient with type 2 diabetes and your doc prescribed 30 day Rx so you come back for the doc to check your blood work between fills, insurance is demanding the doctor change the Rx from 30 days to 90 days, because they don’t want to pay for the additional doctor appointment/blood work. They are watering down care and interfering with doctor/patient treatments.
Unknown to almost everyone in the US is that if you are a Medicare patient, when you go to fill a Rx before the pharmacist fills the therapy, insurance software suggests cheaper generics to the pharmacist and requires the pharmacist to do the leg work of asking the doctor to change the Rx based on what the insurance company wants (ie the cheaper medication).
So the question might be..why would a pharmacist do what the insurance company software tells them... or why would a doctor second guess their initial Rx at the request of an insurance company trying to minimize their costs? Because if the pharmacist/pharmacy doesn’t do what insurance says or if the doctor doesn’t do what insurance says, they get dropped from the insurance network.
They can call it monism...but it sounds like they are just describing the spatial dimensions.
0D Point (quantum/singularity/Planck unit), then 1D line, 2D square, 3D cube...as a direct consequence of nature/math it’s got structure, correlation, and symmetry (aka their definition of beauty). Is there any physicist who doesn’t think dimensions are a key concept of physics?
Really? Because the system itself is fixed guaranteeing Capital of the rich is much more productive than wages of the poor, through taxation. That is an employee of Company abc has their wages taxed to a much greater extent than the company owners profits are taxed.
It’s definately not “hobbling” everyone else if we “fixed” the system such that workers wages were taxed less than the capital profits of business owners. In fact the current system is so unfairly weighted only a small percentage benefit from capital gains taxes whereas the masses of the working class are hobbled by greater taxes on their wages making up the difference. Ever wonder why it’s pretty easy to find CEO’s taking a $1 salary (it’s because they take the rest in capital so they are taxed less than their own workers).
Those who suffer the most don’t need to be more productive, they working class is already more productive than anytime through history it’s time their wages reflect that fact and for good measure it’s time wages become more productive by flipping the wage/capital tax paradigm.
Sure in hindsight it’s a sprained thumb, but likely because of pain thought to be broken or worse...requiring x-ray and being set by a trained professional or maybe even surgery. It is a thumb so it would be less than ideal to lose feeling or mobility or the thumb itself (say there was nerve or circulatory damage).
Seems to me it is a traditional bank offering the banking services...only in authentic Silicon Valley style its being marketed exactly as you describe, a non traditional bank disrupting the status quo.
Unless there is an increase in productivity, which if you read the article, would be apparent.
That is increase the labor supply while simultaneously increasing labor productivity and you will see a real drop in demand for laborers which is naturally going to result in a stagnation of wages. That is the extra demand created by the wave of low wage immigrants is more than made up with the increases in productivity in that same time period. Now you have a macro economy much more efficient at concentrating wealth.
That isn’t the legal standard for release pending trial.
Thus is may look like an algorithm “predicts” crime better than judges, but judges can’t withhold bail/bond because they “predict” a certain defendant will commit another crime (because that’s not exactly judges are doing when determining bond).
After all what is the local market rate for a job that has shown the tendency to trigger PTSD without sufficient benefits to treat said PTSD? You would hope at least enough to cover PTSD treatments...Would you continue to use Facebook or allow your kids to use Facebook if there was a good chance of them developing PTSD symptoms? Would you take a job where there was a good chance you would develop PTSD and the job wouldn’t cover it and didn’t pay enough for you to cover it?
Well for starters he might stop outsourcing the work through a contractor who pays its employees 1/8 what the average Facebook employee is paid. Maybe the powers that be accept and acknowledge these low/underpaid contractors are developing PTSD like symptoms and are clearly not getting services internally much less the financial compensation to get such services externally...not to mention the contractual arrangement which seems to keep the contractors from seeking help externally.
Right which will never occur in the current system because each middleman needs to justify their place to keep their piece of the pie.
Like I said it’s a system with tons of middlemen (who don’t add value) who could be ripped out and replaced with Blockchain.
Dole was “ultimately resolved” only after complex class action litigation that costs millions of dollars and resulted in the party who took dole private having to pay an extra ~$2.50 x ~36.8M shares. It’s clear from any public company that goes private this is a serious issue...Dole is not an edge case.
How about corporate stock?
You know how many third parties are involved with the markets and the added costs of those third parties? Even with a corporation with a stock ledger, stock trusts who own them, banks/brokers who handle all the buying/selling of stock...things don’t work.
Take the Dole case where the corporation had almost double the number of stock issued as actually existed.
Whereas every corporation could memorialize their stock on the Blockchain and each sale of stock would be completed via smart contract. Instant settlement, no stock trusts, no banks, no brokers...a peer to peer market. Stocks are a particular use case because unlike the authors examples of “real world counter parts” (supply chain, authorship, land registry) shares in a company can be represented entirely digitally allowing the peer to peer and trustless system (at least for purposes of transaction settlement).
Generally through measurement. Colors are just differences in electromagnetic wave frequency, change the electromagnetic wave frequency enough and you are out of “visual light rays” and into other types of rays (radio, gamma, x, etc...). Until people start “seeing” those other non visable light rays, we have some indication we are all seeing the same things (light waves).
As to the “colors” of the various frequencies within the visual light wave spectrum, we may receive/interpret them differently (ie color blindness), but the wave frequencies are the same and it is us who work differently.
That’s why we can have other objective factors and measurements (primary colors, mixing of colors, etc...) that suggest for the most part we are all seeing the visual light spectrum waves similarly. In otherwords if you and I saw the visual light wave differently it should be obviously once we start mixing colors to produce new colors (if you saw black and white where I saw blue and yellow, then you couldn’t see green - it would be black). Still your use of “experience” of colors likely is inheriently true we probably all do experience the colors differently (some are my favorites, those don’t need to be your favorites, some may trigger certain emotions in me and not in you) but that doesn’t change the fact that the electromagnetic wave is the same for both observers.