The hottest Public Policy Substack posts right now

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UnitedHealth, CVS/Aetna, Cigna pulled in close to a trillion dollars last year, mostly as drug middlemen

HEALTH CARE un-covered • 279 implied HN points • 09 Feb 23
🏥 Health Politics Public Policy
  1. Three major companies, UnitedHealth, CVS/Aetna, and Cigna, are now making most of their money from being middlemen in the prescription drug market rather than from selling health insurance. This means they control a big part of how much patients pay for their medications.
  2. In 2022, these companies earned over $492 billion from their pharmacy benefit management (PBM) services, showing that this part of their business is growing much faster than their health insurance offerings.
  3. These companies are expanding into primary care services, like buying healthcare centers, as they face slower growth in their health insurance segments. This shift suggests they are looking for new ways to make profits amid tougher competition.

Daft Spunk

Heterodox STEM • 206 implied HN points • 03 Nov 24
🇺🇸 U.S. Politics Public Policy
  1. Many men are avoiding university because they feel outnumbered by women and see fewer opportunities for relationships. This trend reflects a change in the gender dynamics at schools.
  2. The university environment is increasingly seen as accommodating to women while being less appealing to men. This might lead men to pursue different paths for their careers.
  3. There are concerns about how the current educational focus on diversity and inclusion is affecting the overall representation of men in universities, possibly impacting future relationships and social dynamics.

China’s Ivory Tower in Lockdown: Top Universities Hide Behind Gates

Pekingnology • 64 implied HN points • 04 Jul 25
🇺🇸 U.S. Politics Public Policy
  1. Top universities in China, like Tsinghua and Peking University, have strict campus entry rules, making them less accessible to the public. This creates a sense of exclusion that goes against their purpose as public institutions.
  2. Many global universities are open and welcoming, which contrasts sharply with the restrictive policies of these Chinese institutions. This difference raises concerns about how these universities view their public role.
  3. Keeping campuses closed teaches students to favor isolation and exclusivity over openness. This could influence their future decisions and perspectives in negative ways, perpetuating a cycle of separation from broader society.

Rounding up Rats

Diane Francis • 499 implied HN points • 09 May 22
🇺🇸 U.S. Politics Public Policy
  1. Putin did not escalate his war in a recent speech, which might suggest a more cautious approach.
  2. Jill Biden's visit to Ukraine on Mother's Day was a gesture of support for the country amid the conflict.
  3. Alina Kabaeva, who is linked to Putin, may face sanctions in Europe and has been forced to leave her home in Switzerland.
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China's Frankenstein

Diane Francis • 899 implied HN points • 31 May 21
🇺🇸 U.S. Politics Public Policy
  1. There are debates about whether COVID-19 came from a lab in China or from animals. Some experts believe it was created through risky experiments in a lab rather than naturally from a wet market.
  2. China may have covered up the origins of the virus and the World Health Organization faced criticism for its investigation into the situation. Many countries want a clearer understanding of what happened.
  3. The pandemic shows the need for stricter rules and safety measures in science. There's a growing concern that dangerous experiments with viruses need better oversight to prevent future outbreaks.

Saturday Commentary and Review #178

Fisted by Foucault • 187 implied HN points • 02 Nov 24
🇺🇸 U.S. Politics Public Policy
  1. Elections in the USA are more complicated and possibly rigged than people think. There's a lot of doubt about whether they are truly fair and free, especially after events surrounding the 2020 election.
  2. Government agencies can sometimes act in ways that contradict their original missions, such as the case with ICE and drug trafficking operations. This shows a lack of coordination and oversight within government bodies.
  3. The idea of BRICS as a powerful alternative to Western financial systems isn't as strong as it seems. Current economic ties with the US make it hard for developing nations to shift away from the dollar.

Saturday Commentary and Review #181

Fisted by Foucault • 154 implied HN points • 23 Dec 24
🇺🇸 U.S. Politics Public Policy
  1. The collapse of the Syrian government has surprising global effects, especially concerning China's security. The presence of Uyghur militants fighting in Syria poses a potential threat to China's Xinjiang region.
  2. In many Western societies, the traditional separation between government and private interests has blurred. This post-liberal shift often sees political agendas influencing both public opinion and private actions.
  3. European nations are currently facing significant challenges, including economic passivity and loss of sovereignty. This has led to a sense of pessimism and isolation among many Europeans as they perceive a decline in their collective influence.

Weekend Update #142

Phillips’s Newsletter • 52 implied HN points • 20 Jul 25
🇺🇸 U.S. Politics Public Policy
  1. There were big technical problems while trying to send out the weekend update. It's frustrating when technology doesn't work as expected.
  2. To fix the issue, the text from last week's update was reused and combined with new content. This shows a commitment to keeping readers informed.
  3. Readers can support the newsletter by subscribing, whether for free or paid options. Supporting creators helps them continue their work.

The Unluckiness of Jimmy Carter

Common Sense with Bari Weiss • 148 implied HN points • 30 Dec 24
🇺🇸 U.S. Politics Public Policy
  1. Jimmy Carter faced a lot of challenges during his presidency, like high inflation and the Iran hostage crisis. These tough situations made his time in office very difficult.
  2. After leaving the presidency, Carter did many good things like building homes for people and helping to fight diseases. He even won a Nobel Prize for his work in promoting peace and democracy.
  3. Despite the struggles he faced, Carter also accomplished significant things, like making peace between Egypt and Israel and focusing on human rights. Many people believe he was just unlucky during his presidency.

Links to Consider, 10/23/2024

In My Tribe • 182 implied HN points • 23 Oct 24
🇺🇸 U.S. Politics Public Policy
  1. American politics has been stuck in a deadlock because both parties are close in power, leading to constant fighting for control. This makes elections contentious and the political environment very tense.
  2. Public-private partnerships can lead to problems like corruption and a focus on global interests over national ones. This disconnect can happen when these partnerships are not accountable to the public.
  3. In India, excessive regulations and government control hinder economic growth and worsen poverty. Many people work informally because the rules are so strict that it limits job opportunities.

Kamala Harris, Crayon Candidate

eugyppius: a plague chronicle • 192 implied HN points • 18 Oct 24
🇺🇸 U.S. Politics Public Policy
  1. Kamala Harris often relies on scripted lines and rarely shows her own thoughts when interviewed. This makes it hard for her to respond to tougher, unexpected questions.
  2. During a recent debate, she struggled to explain key issues like immigration and her differences from Biden. It seemed like she was stuck on talking points against Trump rather than offering her own ideas.
  3. Harris appears to have multiple personalities when speaking, shifting between different styles but not genuinely expressing her stance. This raises questions about her readiness for the role she seeks.

The NIMBYs strike back

Odds and Ends of History • 67 implied HN points • 09 Jun 25
🇺🇸 U.S. Politics Public Policy
  1. NIMBYs, or 'Not In My Backyard' groups, are causing issues for the Planning and Infrastructure Bill in Parliament. They often oppose new developments near their homes, which can hinder progress.
  2. Criticism is directed at major media and environmental organizations like The Guardian and Natural England for their views on housing and development. This shows a clash of opinions on how to manage land use and development needs.
  3. A former Conservative cabinet minister, Sir Simon Clarke, argues that his party must focus on building and development to stay relevant. This highlights the need for political parties to adapt their policies to current societal demands.

How to Fix America in One Week

PashaNomics • 2 implied HN points • 04 Feb 26
🇺🇸 U.S. Politics Public Policy
  1. The United States functions more as a state-driven economy than a pure market one, with large flows of taxpayer money ending up with “state oligarchs” who effectively own and profit from the system.
  2. Money is used to fund propaganda that hides that ownership and justifies continued spending, using narratives that either ignore the state’s role or worship it as necessary.
  3. The first step to fixing this is clear shared understanding: collect data, track money and propaganda, and negotiate realistic deals or reforms to interrupt the regressive feedback loop instead of just chasing fraud.

When Kellie-Jay Keen comes to New Zealand, we women will be looking out for each other.

A B’Old Woman • 219 implied HN points • 05 Feb 23
🇺🇸 U.S. Politics Public Policy
  1. Kellie-Jay Keen is coming to New Zealand for her 'Let Women Speak' tour, and women plan to support each other during the events. It's important to be united and look out for one another.
  2. There have been incidents of harassment from activists during similar events in other countries, which raises concerns about safety. Women, especially the elderly and disabled, need protection from intimidation.
  3. Past experiences show that activisting groups can be aggressive, making it crucial for women to be prepared and aware of each other when attending such events. Safety in numbers and awareness can help prevent harassment.

Governmental Efficiency: What Can It Possibly Mean?

The Good Science Project • 167 implied HN points • 20 Nov 24
🇺🇸 U.S. Politics Public Policy
  1. Cutting a lot of government jobs might not really save much money. Most spending comes from bigger programs like Social Security and Medicare, not just employee salaries.
  2. Firing workers randomly can hurt important services that people rely on. Instead of cutting jobs, we should focus on fixing how agencies work to make them more efficient.
  3. There are better ways to improve government without just slashing budgets. Setting clear goals and using technology to make processes easier can lead to more meaningful changes.

The Epstein Rerun

The Reactionary • 111 implied HN points • 28 Feb 25
🇺🇸 U.S. Politics Public Policy
  1. The Department of Justice released a 200-page binder related to Jeffrey Epstein, but most of it included old documents and was heavily redacted. It's not the fresh information people were hoping for.
  2. Attorney General Pam Bondi found out that the FBI was hiding thousands of pages of documents on Epstein. This raises concerns about transparency and the effectiveness of the investigation.
  3. The focus on Epstein's case needs to expand beyond the FBI to include the Department of Justice, especially regarding past plea deals and communication with victims.

Germany: The Land of Stuck Politics

eugyppius: a plague chronicle • 133 implied HN points • 18 Jan 25
🇺🇸 U.S. Politics Public Policy
  1. Germany's politics are stuck and slow to change. Other countries are moving forward, but Germany is lagging behind in responding to new challenges.
  2. The current political system in Germany seems to prioritize maintaining the status quo over adapting to citizens' needs. This could lead to poor governance in the future.
  3. There is a sense that Germany wants to set a good example for the world, but this approach may not solve its domestic issues or reflect the changing global landscape.

Reading Thiel's Op-Ed

Unpopular Front • 127 implied HN points • 14 Jan 25
🇺🇸 U.S. Politics Public Policy
  1. Peter Thiel's op-ed suggests a belief in a revolution against the old government system. He thinks exposing the past is necessary for moving forward.
  2. Thiel connects technology and politics, claiming that the internet has the power to reveal hidden truths, but this could also lead to increased paranoia and conspiracy thinking.
  3. There are worries about Thiel's approach to reconciliation, as he hints at the potential for scapegoating and power dynamics, which could lead to authoritarian control disguised as truth-telling.

New event! How AI can (maybe) fix the government!

Odds and Ends of History • 134 implied HN points • 13 Jan 25
🇺🇸 U.S. Politics Public Policy
  1. AI could help the government improve its services. There's a discussion about how it might fix problems when resources are low.
  2. People have mixed feelings about AI. The event encourages both skeptics and enthusiasts to learn more about its potential effects on public services.
  3. The event is a great opportunity to meet others who are interested in technology and government. There will be interesting conversations and some fun giveaways.

Censorship Undermines the Pursuit of Truth

Heterodox STEM • 135 implied HN points • 02 Jan 25
🔬 Science Public Policy
  1. Censorship in academic settings can limit the discussion of important truths. When researchers can't speak freely, society misses out on valuable insights.
  2. There are organizations and conferences focused on addressing and fighting against academic censorship. These groups aim to protect freedom of thought and promote open conversations.
  3. The Journal of Controversial Ideas allows authors to publish under pseudonyms. This encourages debate on sensitive topics while safeguarding individuals' careers and safety.

Will Biden Pardon Fauci?

Vinay Prasad's Observations and Thoughts • 153 implied HN points • 05 Dec 24
🇺🇸 U.S. Politics Public Policy
  1. Biden might pardon Fauci, who is accused of perjury for his statements about gain of function research. This could set a worrying example for future public health leaders.
  2. Fauci's handling of the pandemic included many controversial decisions, like his advice on masks and school closures. Many believe he didn't provide enough scientific backing for these decisions.
  3. Justice isn't just about punishment; it serves to deter future wrong actions. Pardoning Fauci could lead to more reckless behavior in health leadership during crises.

Art of the Next Best

Diane Francis • 499 implied HN points • 17 Jan 22
🇺🇸 U.S. Politics Public Policy
  1. The recent actions by activists like Stacey Abrams show a tough moment for democracy in America. Their rejection of President Biden's speech highlights growing divides.
  2. Biden was trying to support voting rights with the Freedom to Vote Act but faced backlash. This makes it harder to reach agreements with those who oppose the bill.
  3. Criticism from both sides can block potential compromises. It's important for leaders to find common ground to move forward.

Jake Tapper's Unoriginal Sin

Unreported Truths • 61 implied HN points • 04 Jun 25
🇺🇸 U.S. Politics Public Policy
  1. Jake Tapper and Alex Thompson's book 'Original Sin' lacks new and important information about Joe Biden's mental decline. It mostly restates what many already knew.
  2. The media has praised the book as groundbreaking, but it does not address its own failures in covering Biden's issues during his presidency.
  3. Good journalism should question authority and seek the truth, rather than just echoing popular opinions or the status quo.

I scream, you scream, we all scream for exit liquidity!

Alex's Personal Blog • 98 implied HN points • 03 Mar 25
🇺🇸 U.S. Politics Public Policy
  1. Ramp is growing really quickly, now valued at $13 billion with strong revenue. It's impressively outperforming competitors and still chooses to stay private for now.
  2. There's concern about the U.S. government’s crypto plans under Trump, suggesting it might favor investors over the general public. This move seems to help the crypto wealthy rather than promoting financial access for everyone.
  3. Apple is falling behind in the AI race. While they still have loyal users, their lack of advancements could hurt their market share in the long run.

The Audit: 2024

Comment is Freed • 132 implied HN points • 21 Dec 24
🇺🇸 U.S. Politics Public Policy
  1. It's important to review past predictions to see what worked and what didn't. This practice helps improve future insights and keeps one accountable.
  2. Analyzing elections at a detailed level, like looking at specific councils or seats, can provide more accurate predictions. This method shows the need to understand local issues better.
  3. Finding positive trends in difficult situations can be tough but necessary. It's good to challenge a negative mindset and look for hope in the community.

The New Zealand birth certificate will soon be just a vanity document.

A B’Old Woman • 199 implied HN points • 21 Jan 23
🇺🇸 U.S. Politics Public Policy
  1. In New Zealand, people will soon be able to buy a birth certificate online with any sex on it for just $10, making it less about actual birth details and more about personal choice.
  2. There are concerns about fraud as individuals could legally hold two different birth certificates with different sexes, which might confuse identity verification.
  3. Single-sex spaces can still be legally protected in New Zealand, even after the sex self-ID law passes, but confusion about the law may lead some services to include individuals who identify differently.

The Problem of Cooperation Costs

Economic Forces • 6 implied HN points • 01 Jan 26
💼 Business Public Policy
  1. High cooperation costs — the costs of communicating, coordinating, and committing — can stop profitable sequential investments because early actors fear later expropriation, creating development traps.
  2. Because bargaining and coordination are costly, policymakers often use rules like zoning or quantity limits instead of taxes to prevent expropriation and avoid expensive negotiations.
  3. Institutions like imprisonment, juries, and bans on leasing prison labor raise the cost of corrupt cooperation among officials, which reduces incentives to extort, over-enforce, or unfairly extract resources via the justice system.

Frequently Asked Questions About US Government Funding for R&D

New Things Under the Sun • 96 implied HN points • 19 Feb 25
🇺🇸 U.S. Politics Public Policy
  1. The US government spent about $160 billion on research and development (R&D) in 2022, but this is a declining share of overall GDP. In contrast, the private sector spends significantly more on R&D.
  2. Averaging across sectors, every dollar spent on R&D can generate about $5.50 in economic growth, with some estimates suggesting even higher benefits when considering broader impacts.
  3. Government funding is important because it explores research areas that might be overlooked by private companies, ensuring that valuable scientific knowledge is developed for public benefit.

Kamala Harris and the Rise of Progressive Nothing Politics

eugyppius: a plague chronicle • 146 implied HN points • 03 Nov 24
🇺🇸 U.S. Politics Public Policy
  1. Kamala Harris's speeches often lack substance and fail to inspire listeners. People are noticing that she repeats the same ideas without offering new insights.
  2. The idea of 'Progressive Nothing Politics' suggests a decline in meaningful political discourse, especially within the progressive left.
  3. This shift in politics could lead to a tough future for candidates like Harris, as voters may be looking for more engaging and concrete proposals.

How high-speed rail won over the world

Urben Field Notes • 124 implied HN points • 09 Dec 24
🇺🇸 U.S. Politics Public Policy
  1. Many countries around the world are expanding their high-speed rail systems, while the US is falling behind. It's surprising that America doesn't have more fast trains since the technology has been around for a long time.
  2. High-speed rail is benefitting countries with increased passenger numbers and better environmental impact. Rail travel produces far less carbon pollution compared to cars and planes, making it a cleaner option.
  3. To develop high-speed rail in the US, there may be a need to collaborate with countries that have experience in building these systems. Learning from others could help the US catch up in this area.

On Andrew Cuomo's final humiliation

Unreported Truths • 48 implied HN points • 25 Jun 25
🇺🇸 U.S. Politics Public Policy
  1. Andrew Cuomo, once celebrated for his leadership during the COVID pandemic, faced a humiliating political defeat. He lost the Democratic primary for mayor of New York City after a series of scandals.
  2. Cuomo's behavior while in office, including allegations of harassment, tarnished his reputation. What once made him a hero turned him into just another questionable politician in the eyes of voters.
  3. The recent election results suggest that voters want to move on from the COVID panic and the decisions made during that time. Cuomo's loss indicates a shift in how people view leaders and their actions during the pandemic.

Tune in tonight at 7.30pm NZT, to hear me talk about the 'mixed-sex' women's session at Linwood Pool, Christchurch.

A B’Old Woman • 119 implied HN points • 22 May 23
🇺🇸 U.S. Politics Public Policy
  1. There's a mixed-sex women's swimming session at Linwood Pool in Christchurch where men can join if they identify as women. It raises questions about women-only spaces.
  2. People in Invercargill recently gathered to protest against a similar policy allowing men in women's changing rooms. This shows that many are concerned about these changes.
  3. A livestream discussion is happening about these topics, highlighting different viewpoints on women's spaces and gender policies. It's a chance for people to share their thoughts and concerns.

New Zealand's Midwifery Council banishes the words 'mother' and 'woman'.

A B’Old Woman • 219 implied HN points • 12 Nov 22
🇺🇸 U.S. Politics Public Policy
  1. The New Zealand Midwifery Council has decided to stop using the words 'mother' and 'woman' in their guidelines. This change raises concerns since these terms are central to midwifery.
  2. Most people giving birth identify as women, so removing these words could make midwifery less clear and less welcoming for many parents.
  3. The council has invited public feedback on this decision, but it seems odd that they didn’t consult the women and mothers most affected by these changes beforehand.

Gussie Grips rips Scottish Parliament a new a-hole.

A B’Old Woman • 179 implied HN points • 26 Dec 22
🇺🇸 U.S. Politics Public Policy
  1. A recent change in Scottish law makes it easier for people to change their legal gender. This has raised concerns about whether it will affect single-sex spaces.
  2. Elaine Miller protested against these reforms by making a bold statement in Parliament. She used a shock tactic to draw attention to her message.
  3. The protest sparked mixed reactions online. While some supported her boldness, others found it inappropriate, showing the divide on the issue of gender and sex rights.

#MeToo Plus

Diane Francis • 399 implied HN points • 20 Jan 22
🇺🇸 U.S. Politics Public Policy
  1. Ghislaine Maxwell's conviction for aiding Jeffrey Epstein is a big step in the #MeToo movement.
  2. This case is important because it's the first time someone who helped a perpetrator has been held accountable in this way.
  3. It shows that the justice system is starting to recognize and charge enablers of abuse, which could change how similar cases are handled in the future.

2023 National Cybersecurity Strategy

Resilient Cyber • 159 implied HN points • 02 Mar 23
🇺🇸 U.S. Politics Public Policy
  1. The 2023 National Cybersecurity Strategy emphasizes the need for everyone in society to work together to improve cybersecurity. This means technology companies, governments, and individuals all have roles to play.
  2. Critical infrastructure, like power and communication systems, needs stronger protections from cyber threats. The strategy calls for businesses to take responsibility for securing these systems.
  3. The strategy also aims to change market forces to incentivize companies to prioritize cybersecurity in their products. This could lead to safer technology and fewer cyber risks for everyone.