verucanacl (u/verucanacl)

verucanacl commented on How McKinsey helps companies avoid responsibility slate.com/business/2020/0... · Posted by u/yarapavan

rmrfstar · 6 years ago

GDP growth comes from productivity growth. Productivity growth comes from research and development.

Michael Pearson [1], a 23 year McKinsey veteran pharma CEO, claimed that R&D was "inefficient". It is just mind blowing that people see this and don't panic.

We are allowing ourselves to be ruled by mediocre spreadsheet jockeys.

[1] https://en.wikipedia.org/wiki/J._Michael_Pearson

[2] https://dealbook.nytimes.com/2013/09/02/in-a-new-book-mckins...

verucanacl · 6 years ago

The idea that r&d is inefficient is not unreasonable. the reality behind valeant's demise is more complex. valeant initially began its strategy of buying cheap, cash flow generating assets. But as time went on, they ran out of low hanging fruit as asset prices rose and deals became harder to find. to generate revenue growth and support their growing debt balance, they resorted to unethical, and illegal, tactics such as raising prices and defrauding insurance companies into reimbursing their products.

verucanacl commented on The Hertz Story Isn’t What You Think epsilontheory.com/the-her... · Posted by u/erentz

rrrrrrrrrrrryan · 6 years ago

For others: it's legal, and it's basically all Icahn does - he's probably the most famous corporate raider. He obtains a minority stake in a company, gets a seat or two on the board, bullies the management into taking on tremendous amounts of debt, and uses the cash to pay himself and the other investors, calling it "unlocking value for shareholders." The once-healthy company is eventually sucked dry and he moves on to his next target.

verucanacl · 6 years ago

you fool - icahn is a shareholder with mostly his own fortune

verucanacl commented on Eating Too Much Rice Almost Doomed Japan's Imperial Navy nationalinterest.org/blog... · Posted by u/onetimemanytime

bad_user · 7 years ago

I would add more ... when it comes to chronic diseases, modern medicine is about treatment after the fact, after the damage has occurred and not about prevention.

And while it’s incredibly efficient at treating acute conditions, it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes.

And sometimes those symptoms might actually be part of the body’s defenses against inflammation, which doctors suppress with pills.

The perfect example is elevated LDL cholesterol. This is a marker for heart disease, however it can be high due to hypothyroidism or due to inflammation. LDL cells are actually part of the body’s immune system and by suppressing their synthesis or by accelerating their clearance, the body could be less effective at fighting infections or at repairing arterial walls that have been damaged. Plus pills are a blunt tool with many unintended side effects.

It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia.

Also the DASH diet, the one that is supposed to prevent CVD, is effectively poison as it’s encouraging people to eat ultra-processed food and oils high in omega-6, due to encouraging a big chunk of energy to come from “whole grains” (i.e. products which are often a lesson in chemistry and that might not even contain whole grains due to weak regulation), plus the phobia for saturated fat.

verucanacl · 7 years ago

I do, however, agree with you that much of modern medicine is focused on treatment as opposed to prevention. Type 2 diabetes is probably the best example, which is largely preventable with a good diet and exercise. Unfortunately, it's much easier for patients to take a pill after they start feeling symptoms than it is to adhere to a healthy lifestyle when they are asymptomatic..

verucanacl commented on Eating Too Much Rice Almost Doomed Japan's Imperial Navy nationalinterest.org/blog... · Posted by u/onetimemanytime

refurb · 7 years ago

Yet one of the most profitable drug launches ever was a cure for hepatitis C.

verucanacl · 7 years ago

For good reason. Curing Hep C was a breakthrough medical innovation, which ultimately will save the healthcare system tens of billions of dollars (preventing end stage liver disease, liver transplants, etc)

verucanacl commented on Eating Too Much Rice Almost Doomed Japan's Imperial Navy nationalinterest.org/blog... · Posted by u/onetimemanytime

bad_user · 7 years ago

I would add more ... when it comes to chronic diseases, modern medicine is about treatment after the fact, after the damage has occurred and not about prevention.

And while it’s incredibly efficient at treating acute conditions, it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes.

And sometimes those symptoms might actually be part of the body’s defenses against inflammation, which doctors suppress with pills.

The perfect example is elevated LDL cholesterol. This is a marker for heart disease, however it can be high due to hypothyroidism or due to inflammation. LDL cells are actually part of the body’s immune system and by suppressing their synthesis or by accelerating their clearance, the body could be less effective at fighting infections or at repairing arterial walls that have been damaged. Plus pills are a blunt tool with many unintended side effects.

It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia.

Also the DASH diet, the one that is supposed to prevent CVD, is effectively poison as it’s encouraging people to eat ultra-processed food and oils high in omega-6, due to encouraging a big chunk of energy to come from “whole grains” (i.e. products which are often a lesson in chemistry and that might not even contain whole grains due to weak regulation), plus the phobia for saturated fat.

verucanacl · 7 years ago

Several of your claims are inaccurate, which I'll attempt to correct.

tl;dr - its way more complicated

LDL particles are not (at least directly) a part of the immune system. They are lipoproteins, generated primarily in the liver, that are implicated in the pathogenesis of atherosclerosis (buildup of plaques in the blood vessels).

The immune system, however, plays an important role in atherosclerosis, as it is thought that inflammation in the vasculature contributes to atherosclerosis.

Statins (contrary to your assertion) have in fact been conclusively shown to improve mortality from cardiovascular events. You can find many studies in the last 20 years that have demonstrated this with high statistical significance (do a pubmed search or look for articles in the New England Journal of Medicine).

Perhaps most interestingly, the latest research suggests that statins may improve cardiovascular outcomes not solely from LDL reduction (which has been the classically accepted hypothesis, as statins target the enzyme in the liver that regulates LDL reuptake), but also through anti-inflammatory mechanisms. This idea has been further strengthened by research suggesting that LDL reduction alone (as with a newer agent of drugs called anti PCSK9) may not provide as strong of a mortality benefit, weakening what is known as the "LDL hypothesis". In addition, another recent trial (called CANTOS) found that an anti-inflammatory agent targeting IL-1, an inflammatory cytokine, improved cardiovascular outcomes (such as heart attacks), further strengthening the notion that the immune system plays a key role in cardiovascular disease.