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The US in particular has taken the pursuit of convenience to extremes and the abuse of plastics is one of the clearest examples of that. Most packaging should be glass, paper, or metal. Fewer things should be so disposable.

One thing I wish we could find a solution to is our oil subsidy problem. I get that the US gov wants to subsidize oil for the sake of national security but those subsidies have all sorts of crazy unintended consequences. One of those consequences was that oil found a way to make itself the primary component of packaging.


Having consulted for a major glass manufacturer I can assure you that recycled glass is a coveted resource. It's easier to work with and it's less energy intensive. I wasn't involved much in that side of the business so I don't know the details but I was given tours and cullet (recycled) glass was a BIG deal.


I've been talking to as many companies as I can during all of this. The surge is not evenly distributed but a lot of companies are seeing surprising upticks in online traffic and sales.

The big question though is how long will this last? I think the general population has not yet appreciated the possible severity of the ensuing economic downturn.

A lot of trade publications are already starting to sound the alarms on how ugly this could get. A return to 2008 era aggressive discounting is likely going to happen. Retail partners may be crippled by the quarantine. A lot of brands are going to be assailed from many directions simultaneously, it's going to hurt.


> I think the general population has not yet appreciated the possible severity of the ensuing economic downturn.

My fear as well. The swiftness and ferocity of this downturn is like nothing ever, AFAIK. 22 million out of work in 4 weeks. Many are unlikely to get their jobs back. So while certain companies are seeing upticks due to logistics of the lockdown, I don't think it's safe to assume it would continue long after SIP ends.


> Many are unlikely to get their jobs back.

Their original job? Sounds plausible. Any job? Surely that would be a political choice for their respective governments? Unless there’s a reason we can’t repeat the famous infrastructure jobs programs from a century ago - I’m no economist, so I genuinely don’t know, but Hoover Dam Mark 2 sounds good to me.


> Hoover Dam Mark 2

Is this like the Hoover dam but with 100x longer environmental reviews and 10x more expensive due to special interest grifts that then cripple the investment before it fails 10yrs later? And the only people who made money were a bunch of private consultants hired by the government to do the reviews and executive staff the pseudo-market company behind it?

I haven't heard of a single major infrastructure project that hasn't followed that trajectory. Reading about Obama's two solar projects are a good starting point. But nothing beats Keystone XL.

It's no wonder it hasn't happened and it's not for lack of trying or tax dollars being spent. Even here in Canada it's the same story every time and we have a far more receptive political base for spending the tax money. So I'll never be convinced that's the real hurdle.


If the point is to be a jobs program, wasting money and massive overspend are a feature.


That was my point. It won’t end up in workers hands unless they actually start work on the project. Otherwise it will go to a small group of consultants, gov connected executives, and most importantly endless amounts of lawyers and activism groups.


> Unless there’s a reason we can’t repeat the famous infrastructure jobs programs from a century ago

That had positive effects in the USA, but in Europe the economic woes of the 1930s led to WWII.


Did anyone in Europe do a jobs program at that point? My GCSE history only covered the economic impact of forcing Germany to pay reparations for WW1, and treated The New Deal as unconnected.

GCSEs are not great.


> Unless there’s a reason we can’t repeat the famous infrastructure jobs programs from a century ago

Right now we can't for a very similar reason that we couldn't prior to 1933.

But there's an election this year, so that can change.

> Hoover Dam Mark 2 sounds good to me.

Hoover Dam actually wasn't an infrastructure jobs program to counteract the downturn, it was planned and approved before the 1929 crash and subsequent Depression.


> I think the general population has not yet appreciated the possible severity of the ensuing economic downturn.

I think the general public has not yet appreciated the current severity of the present economic downturn, much less the future possibility.


i saw a lot of brewers move to the shopify platform but the revenues are just not the same as when attached with the restaurants and taprooms. Many are expected to fail which means they will drop off shopify. I think overall, shopify will still be up since this is a wonderful acceleration of a change that was already in progress. But yes, this curve will flatten too as small retail starts failing and wallets dry up.


China is 2x the emitter that the US is and it's going to get worse. China has more than doubled their per capita emissions in the last 20 years. Many other countries will follow suit.

The US and other more developed economies are plateauing in terms of emissions per capita. While there's ample opportunity to begin to claw back those numbers, it is not where the problem lies moving forward.


China: 6.4 metric tons of CO2 per capita

United States: 16.5 metric tons of CO2 per capita

--

Other developed countries:

Germany: 8.9 metric tons of CO2 per capita

France: 4.6 metric tons of CO2 per capita

UK: 6.5 metric tons of CO2 per capita

Spain: 5 metric tons of CO2 per capita

--

This is 2014 data (for comparability), but in 2018 China still had half (7.95 metric tons per capita) the CO2 per capita than the US


I don't understand the whataboutism happening in response to this article. Countries do bad thing sometimes, the US most certainly does. But can we not just be happy that there's some visibility being created about bad acts/actors regardless of who's reporting on it?

These camps have been going on for too long and are still under-reported. Most of the people I've talked to about it still have no idea this is going on at all.


The US was researching comparable systems (and smaller) back in the mid 2000s. I knew a few people involved in those programs and seriously considered joining. Things went very quiet on that front, I've heard no news on those programs in years. I don't know if that means they continued behind closed doors or were put on indefinite pause.

This is the best article I could find on the subject which gives some background as to what derailed the program. http://strangehorizons.com/non-fiction/articles/what-killed-...


I cannot wait for the day that the US seriously revisits the farming subsidies and agricultural practices we've adopted. Everytime I read about modern, large scale farming I'm a little more disturbed by the norms we're establishing. Surely there are better, healthier ways to grow food that are still economically viable.

I say the US specifically because unfortunately we seem to be the origin for almost all of the modern, disturbing practices that have become ubiquitous. We've been setting the standard and hopefully we'll make a 180 and start raising the bar.


> I cannot wait for the day that the US seriously revisits the farming subsidies and agricultural practices we've adopted.

As someone that grew up on a farm, can you explain why? And also explain why the practices, aka fallow fields, are incorrect? A lot of the subidies and practices we have in place today are direct results of things like the dust bowl.

> Surely there are better, healthier ways to grow food that are still economically viable.

Have you validated such assumptions? I can guarantee that large scale farming is a lot more nuanced than one can assume in an arm chair style.

Until you've seen what pests can do to a field that hasn't been treated with fertilizer or say herbicide, its really hard to understand why they get used. It is the difference between having a crop to sell, and going out of business and selling off your farm.

This black and white thinking that comes from people that haven't any experience in the chosen field is honestly more annoying. Should we improve? Sure, no farmer would disagree, but would you be ok with increasing your food costs by 5x? 10x? even more? These are the things you ultimately have to consider when you knock modern practices.

There is no free lunch (pun intended) if you ban modern practices. There is a good chance that requiring the things you want makes large scale farming impossible, and results in more people without food at all. I'm not sure that is an overall net positive.


I've never worked in the industry but I've been casually studying about it for the last 10 years or so. I'm well aware of the roots of our current agriculture system stemming from the dust bowl. I've spent a good amount of time trying to understand the history of the subsidies that shaped the Ag industry.

The fact of the matter is that our modern farming practices are way too short sighted. Topsoil erosion is the easiest thing to point to to identify that something needs to change. Things like monoculture issues, herbicide issues, pollinator health, are all things we should take more seriously but nothing is as concrete as the argument that we need to maintain our soil better.

Small scale forest farming practices have shown that there's alternative methods to produce high yields off the same land with better practices. There's a multitude of simple techniques like hugelkultur that seem like amazingly efficient ways to improve yields. Salatin's work has highlighted some potential ways to incorporate more biodiversity on the farm to maintain a healthier long term ecosystem. There's been meaningful traction with hydroponic and vertical farming practices.

I'm certainly no expert in what the actual solution is but whatever we're doing now is unsustainable. Much of it originates from the abused and malformed subsidies that over-emphasize food security over health or environmental issues. High Fructose corn syrup and ethanol being perfect examples of the stupidity of our current strategy around agricultural subsidies.

The government already pumps a tremendous amount of money into the agriculture industry. We should just do it more deliberately and thoughtfully.

Sure, prices or taxes will likely go up. By how much is the real debate but ultimately I'd say whatever the change is it's probably going to be worth it. Modern farming practices is right up there with climate change as an existential threat that we should not neglect and saddle future generations with.


I agree with much of what you're saying.

It feels like part of the problem is one of wording. 'Modern farming' sounds very positive -- who doesn't like modern things? I suggest that 'industrial farming' would be a better description, and invoke a more realistic mental image of what it involves.

Holmgren & Mollison formulated a more recent answer to the problems of sustainable food production than Haber & Bosch. So perhaps a system that doesn't rapidly render the land unproductive, and does not requiring an energy input roughly the same as the (food) energy output, could be considered more 'modern'.


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Industry insiders cannot always be relied on to dictate good policy. I won't profess to know more about ag, but I know that in any industry insiders can get too close to a problem and lose the big picture. Ag's totally insatiable appetite for water strikes me as one example, and disregard for long term pollinator health strikes me as another.

The point being, you don't have to be a farmer or rancher to have valid concerns, and the outcome affects all of us so we all have a stake.


Monocropping field corn to feed cattle has always stood out to me as a big one. Monocrops are inherently vulnerable, beef is a luxury good not a necessity, and the total input for a pound of beef is extremely high compared to most other food items. I haven't personally done the math, but I understand beef production enjoys significant subsidies at multiple steps.

Another topic, a common desire among ecologists is to incentivize more natural habitat at the margins to support native plants, insects, and birds. It's fairly simple, easy to measure the cost & implementation, and the goal would be it would ultimately be better for everyone, with healthy predator populations and so forth.


Edit: just wanted to add, the vast majority of all corn grown in the US is field corn for cattle, we're not talking some small portion of US agriculture.


Indeed--for example around 70% of the corn grown in Illinois, one of the top corn-producing states, goes directly to Illinois hogs.


Ranching is way better for natural habitat than cropping. Cattle in the North American prairies graze on native grasses where on cultivated land (in Saskatchewan, for peas, wheat and canola) all native grasses are ripped up for crop and riparian and wetland areas are destroyed to increase acreage.


Yes, however last I heard, ranched cattle represents something like 1% of the beef market.


Exactly. Meat produced from grazing animals is not neccesarily a bad thing -- many fields are simply not suited for farming, and grazing animals may be able to produce more food per square metre compared to withering crops.

Problem is that most meat simply isn't produced that way.


>Until you've seen what pests can do to a field that hasn't been treated with fertilizer or say herbicide, its really hard to understand why they get used. It is the difference between having a crop to sell, and going out of business and selling off your farm.

In my meager attempts at a backyard garden, I have lost entire "crops" of vegetables due to insects. From the slugs eating the young/new growth, grasshoppers eating the leafy plants, birds/insects eating the fruit, and just neighborhood stray cats using the loose soil as litter box digging up the plants. Then there's the squirrels and possums or raccoons that come along digging up plants looking for food. I just want to nuke the whole place from orbit. It's the only way to be sure.

With all of that, it's just a hobby to "keep me off the streets", but damn those pesky pests. I have often said that I'm really lucky/thankful that my livelihood does not depend on me being able to successfully grow food. Oh, and before you get to the stage of pests, it has to rain just the right amount. Not enough, and nothing grows. Too much, and everything drowns and rots. None of these things are in the farmer's control.


Farmers irrigate heavily. That's why groundwater is in crisis around the globe.


On average, Dutch farmers tend to use the least water per mass of product sold.


Depends strongly on location. In the western US farmers irrigate heavily. The eastern US doesn't irrigate at all.

Farmers who irrigate are very concerned about ground water because they know when it is gone so is their profits.


> It is the difference between having a crop to sell, and going out of business and selling off your farm.

Thinking outside of the box, I think this is the problem we should aim to fix.


A simple out of the box solution is intercropping. The loss of a single crop in a multi-crop system is not a ruinous loss compared to monocropping. It also reduces the requirements for pesticides and fertilizers if done well.


Yep. See Sepp Holzer's mountain farm for an egregious example of this.


I'm not a native speaker, but generally "egregious" means "particularly bad", is that what you meant?


Is this solution compatible with contemporary mechanized agriculture ? Seeding, spraying, harvesting by machines ?

Otherwise, it's like finding an automobile manufacturing improvement that can only be used with hand assembly. Besides Rolls-Royce, it won't help anyone.


Yes, depending on the particular intercrop. It's an area that could benefit from the application of robotics.


Somewhat, but 180 bushels of corn at $3.50/bushel is worth more than 60 bushels soybeans at $10/bushel. Farmers only grow soybeans because they are a source of fertilizer for their corn and so it works out in the long run.


This is why farmers spend so much money on insurance.


I’m no subject matter expert, but I think what brd was saying is that farm subsidies are hugely distorting to the agricultural commodities market, and that leads to inefficient capital and resource allocation, which in turn causes misalignments between overall consumer wealfare beyond monitary means and spills over to hurting the health of the general public.

How much of this is true I do not know, but based on economic theory such negative externalities are possible.

You can’t ignore at the fact that the US is much more libertarian than Canada and the EU when it comes to business regulations. And we all know what happens when governments are too business friendly and not addressing market failures or safeguarding public interest.

Ask yourself this, what percentage of your operational best practices are invented/peddled by the industry vs truly independent research?


> what percentage of your operational best practices are invented/peddled by the industry vs truly independent research?

It would be helpful to define “independent” because there is an “industry” of anti-GMO advocates that produce research to support their views and, compared to a Cargill-sponsored study, they’d be viewed as “independent.”

I think we ascribe too much credibility to non-profit corporations. As an example, we routinely dismiss an Exxon climate study as “biased” or “corrupt” but a Greenpeace study is somehow more noble or accurate? Greenpeace lives and dies from donations — donations that would disappear if the threats they purport to care about are diminished. Greenpeace type organizations have just as much at relative stake as “industry” and thus studies they sponsor ought to be held to similar levels of skepticism as “industry” studies. Climate change is an industry with just as much as stake as fossil fuels. Al Gore, as an example, became a billionaire from the climate change issue. It would be difficult to argue that research promoted by a guy like him are independent considering he has gotten ultra wealthy from peddling climate alarmism just as Exxon gets rich from promoting studies rife with skepticism. Truly independent studies are extremely rare — everyone has an agenda.

We don’t necessarily need more independent studies because even independent studies are funded by someone with an agenda, what we need are more reproducible studies that can be analyzed objectively. A reproducible Exxon study is more valid than an in-reproducible study from the Sierra Club (and vice-versa

The problem is that an Cargill study is immediately dismissed as corrupt, but some non-profit study is given the benefit of the doubt.. I propose that all studies should be viewed with skepticism until their results are reproduced and corroborated.


Canada, EU and the U.S. all have massive agriculture subsidies. This article was actually about Canada, you realize?

The EU subsidies for Iberian fisherman to allow them to catch and catch regardless of economics have been the prime mover in destroying fisheries up and down the North American and African coasts. It was, and is, one of the worst environmental crimes of the last century, perhaps only matched by the EU subsidies for diesel vehicles that have contributed so much to climate change and point-source pollution.


I completely agree that the reality is far more nuanced.

Have you questioned your assumptions yourself that food cost has to go up using alternative approaches? There is research out there painting a different picture[1].

[1] https://rodaleinstitute.org/wp-content/uploads/RI-FST-Brochu...


> As someone that grew up on a farm, can you explain why?

One reason is sheer hypocrisy of the country to force developing or under-developed countries to stop subsidizing _their own_ farming.


I think subsidies are a good thing, however our current application of them is definitely backwards. Corn is one of the worst crops to subsidize, the whole reason we grow corn is because how absolutely robust and resilient it is as staple crop. However the trade off for being such a strong crop is poor input-output efficiency. I think subsidies need to be applied to more vulnerable crops, some should go to staple crops other than corn, but I think the larger portion of it should go to fruit and vegetable production. I would also like to see some of it given to more sustainable farming practices, with an emphasis in reducing artificial irrigation, reducing artificial fertilizer usage, and maintaining or increasing topsoil depth and soil health, although I have no idea how to properly implement those practice.


When you grow a crop that takes nutrients out of the soil they must be replaced. When you eat the crop in the same location (substance farming) there isn't a problem as your excrement is fertilizer.

When you live in the city that doesn't happen - nobody transports sewage back to the fields. It isn't necessarily a good idea to try: the energy to transport sewage back to the fields needs to come from somewhere; sewage needs to not have harmful chemicals/heavy metals from other processes mixed in.


Unfortunately I think this will only arise if/when we have a major crisis that results in a large amount of Americans being poisoned. We're really, really bad at preventative measures instead opting for short term profit over long term stability and health.

The amount that farms end up poisoning local rivers, streams etc I thought would be enough of a wake up call but I guess I was too optimistic. Organic foods aren't the answer either sadly, since a lot of the time that's the result from unfounded fears.


The poisoning is happening. It's just not yet happening to humans, it's happening to our rivers and streams and oceans that are receiving all the phosphorous runoff, and to the wild herbaceous plants that are caught in the drift of dicamba, glyphosate or 2-4,d.

(p.s. I live rural, have a hobby orchard/vineyard, and live next to two cash crop farms)


> It's just not yet happening to humans.

It isn't?

https://pubs.acs.org/doi/abs/10.1021/acs.jafc.5b05852


Not according to the abstract in your link.

"In none of the investigated samples were glyphosate residues above the limit of detection found."


One cynical/cute view is that farming subsidies will start disappearing when Iowa is no longer the first primary state.


However that theory was challenged when Ted Cruz opposes ethanol subsidies and still won the state. The problem is that most politicians aren’t as courageous to fight for what is right (in their view) as opposed to what they think Iowa voters want.

But you are correct: Iowa’s status as the first caucus state has a lot to do with the state of farm policy.


I'm hoping for a single solid study establishing either A) alternative farming practices that are reasonably efficient and profitable to highlight a way for smaller scale farmers to thrive. B) the negative health effects of some of these choices in our food supply that causes people to actually get up in arms about it and force some regulation with real teeth.

I can only hope you're wrong and that we don't hit a point of mass poisonings before we do anything but I can very easily see that coming to fruition.



the question is, though, whether the slow mass poisoning isn't already happening since a couple of years and the symptoms are just misattributed to other factors?


The rapid rise of self-diagnosed "gluten intolerance" for instance.


I don't know what you would consider a "large amount", but 32 people were recently poisoned by what authorities suspect was contaminated lettuce.

https://www.cdc.gov/ecoli/2018/o157h7-11-18/index.html


I have read somewhere, and i agree with the argument, that the subsidies given to farming in the US is partly in place in order to secure food in case of imported foods not being an option due to sanctions, war or any other reason.

So as long as the farms in the US fulfills this criteria there is no urgent reason for the government to restructure the subsidy criteria, incentives and payouts.


That will never happen unless people start voting with their feet. Look into CSAs in your area. The guy that runs mine is fanatical about using traditional practices—“just compost and hard work”. It’s incredibly satisfying.


> I cannot wait for the day that the US seriously revisits the farming subsidies

Like the 2014 Farm Bill? I farm outside of the US, but from an outsider’s perspective that seemed like a huge change.


Absolutely this. We're actively building a system to better monitor effectiveness of social content and it's amazing hearing the relief from people when they're seeing numbers for the first time that look like actual KPIs versus platforms spewing out self serving vanity metrics.

FB and much of the current social marketing scene in general have been handing off best practices that feel highly questionable at best.


I have a doctor friend who's made it a habit to recommend that patients use GoodRx anytime they go to pick up prescriptions. Doctors can only be so involved in the pharmacy side of the transaction and a lot of pharmacists aren't able to intervene.

It's sad that it requires a 3rd party app to help people not get screwed over by the current US medical system.


You don't need a third-party app to use GoodRx. I use it regularly, and you can just have em email or text you the discount info. When you go to the pharmacist, you hand em the printout or phone, and they type it in. I'd definitely suggest people at least compare prices with em before going to pick up their medicine.

Another suggestion, at least for California: always ask for paper prescriptions! Fuck digital prescriptions. With a paper prescription you can go to any pharmacy you want and have it filled (i.e. shop around and find the cheapest)! But with a digital prescription you can't have it transferred to another pharmacy without calling up the doctor, which is completely fucked up. It's especially frustrating when your regular pharmacy is out of your prescription and your refill day happens to land on the weekend. Now you have to wait 2 days for your refill. One situation I've had happen occasionally is that I'll miss my regular pharmacy's closing hours because I was busy, so I'll just drive to my nearest 24-hour pharmacy to have my prescription filled; you can't do that with digital prescriptions!

I've literally saved hundreds of dollars, just by shopping around a bit. And heck, it's not as if driving an extra half a mile is such a big deal, especially when it can end up saving you a few hundred dollars. I'll also note that sometimes even within the same franchise prices can vary greatly, so it's often worth going a little bit further.

I think pharmacists are allowed to point out services like GoodRx, but it might be frowned upon, I'm not sure. At least in my case, I found out about their services thanks to a pharmacist: I was refilling a prescription, and the pharmacist walked out of their sealed off area, pulled me to the side and told me to look up this "GoodRx" thing.


GoodRx /is/ the third party app. The point is that US consumers shouldn't need to worry that their medical insurance is duping them.


I think he was just nitpicking that GoodRX is available through more than a binary you have to install. I've used it through its website quite a bit. Its a wonderful service.


My mother who is a doctor had their business card in her office, you could you the info on it for any prescription. No need to go to a website or download an app.


Not very good advice. Pharmacies can deny paper prescriptions at their discretion. And most people know where they’re picking up scripts ahead if time.

For example, the pharmacist at a CVS decided not to refill my Vyvanse (amphetamine) paper script because I was paying in cash (+ using paper script). Treated me like a criminal. Digital scripts avoid this unpleasant scenario.

The pharmacy system itself needs reform. It’s idiotic that your doctor can write you a prescription that gets denied by someone who puts pills into a bottle. An anti-abuse system that treats everyone like criminals needs a better solution.


It's a little different in my state.

A pharmacist is required to fill any prescription, paper or digital, except if the pharmacist has a religious objection (birth control, morning after pill, etc...). This came out in a recent court case.

It's the state that decides if prescriptions for controlled substances (like your Vyvanse) get rejected through a centralized database that works off of your driver's license/state ID scan* to prevent abuse.

There was much chaos a few months ago when the state imposed tighter restrictions on the number of opioid pain pills that could be dispensed at one time. You might have a prescription from your doctor for a 90-day supply, but you could only pick up five at a time. (Not an exact number, as I'm not on opioids.) For months, the lines at the pharmacy were backed up for hours as thousands of people ran into the new rules and took them out on the pharmacists.

* Amusingly, one of America's largest supermarket chains, Albertson's, isn't using the computerized driver's license scan. It keeps records in paper binders where the pharmacist writes down your DL# and you sign next to it. They don't even record what it is that you filled, or how much. Good job, Albertson's!


Many states are screwing up Albertson's strategy with mandatory centralized database reporting. The "opioid epidemic" is terrific justification for growing government power and enforcement arms.


It’s worse. Pseudoephedrine is available without prescription but you are limited to 30 day supply in total per month and there is a mandatory state database. All that seems reasonable, until you can’t both buy pills fit yourself and your child without going over.


Oh man, great point. The pseudoephedrine thing is a nightmare. I have several kids so I have to make a note to purchase some every month, because once a sickness ravages the house I won't be able to buy enough. It's insane.


I believe in my state it's not available at all any more.


Could I ask what state you're in? I've been taking amphetamines for a pretty long time now, and the only times I've been turned down was when I went to take my refill in before its due date, and they still let me drop it off, they just wouldn't hand me the medicine until the due date. It's a bit annoying if you have a lot of errands to run on the next day, or if you're going on a trip, but I can sorta understand where they're coming from. Especially since it has such a high potential of abuse.


There are lots of Pharmacies. I always use paper and cash.

I always use smaller, non chain pharmacists too. Msny will compound, they know me and mine, and that relationship is worth a lot.

The cheapest is not too important most of the time. Things being right, and an active pharmacist helping with cost, special programs, and accuracy matters more.


They don’t just put pills in a bottle. They’ve been tasked, by the government, with making sure the correct drugs are dispenses to avoid abuse and other damage.

Obviously if certain behaviors correlate strongly with people who abuse, then it’s their job to use their discretion to demand more proof, or deny.


Odd. Can't they verify the prescription with the prescribing doctor, and verify your state issued ID? I personally haven't had this issue with Walgreens (but I get a lot of medicines through them, and only controlled substances I've filled were small dosage Norco post-surgery)


That's interesting. I'm in Illinois and can only use paper scripts for controlled substances. It is quite annoying to have to physically go into the doctor's office to get my Adderrall prescription because they aren't allowed to use a digital script.


My mother (a doctor) will only give eScripts because of the abuse, it sucks, but sometimes the bad actors ruin it for the rest of us.


In my state most doctors don't have the technology to send digital eScript for controlled substances


Out of curiosity, what state are you in?

Even in Alaska, not generally a very technically advanced state, I never met a doctors that didn't have the ability to send eScripts. I never visited a doc in a remote village however, might be a different story out there.


California, you'd think the handful of doctors I've busted could send an eScript to a national chain (CVS), but I'm denied and made to carry 3 months worth of wonky triplicate paper prescriptions that are prone to being misplaced.


I'm in Illinois and have to get a paper script for my controlled substance prescriptions (Adderall)


My doctor brought in his laptop and showed me this site. I was completely floored that these are cheaper then my co-pay. I now recommend this to everyone. My neighbor who is low income retired senior, was paying more with all these government subsidized prices, then Safeway. He was absolutely livid he could get a $15 that cost him $280. At this point I realized that the entire insurance scheme is a scam. The co-pay is above what the prices you can find on GoodRx. You end up paying MORE with the insurance co-pay then you would if you were to just shop around. This should be felony fraud! From speaking with my friends, nobody knew about GoodRx so I bet a majority of medicine is overpaid with "insurance" -- this should be headlines everywhere.


GoodRx is a pharmacy benefit manager, most insurance companies use a pharmacy benefit manager. What they do is negotiate prices for some certain set of drugs. So 2 insurance companies might have 2 different prices than GoodRx and each of the 3 will offer a slightly different set of drugs.

When you use insurance and pay the co-pay, that counts against your out of pocket maximum on the plan. Prescriptions bought with GoodRx don't.

The insurance isn't doing a great job when they charge a co-pay that is larger than the price GoodRx has negotiated, but it isn't evidence of a scam.


GoodRx is not a Pharmacy Benefit Manager (PBM) actually. A PBM negotiates prices with pharmacies to include them in their network, GoodRx does not do that to my knowledge. Instead, GoodRx offers a service that allows users to compare different coupon and membership prices so that people can chose the best available price/pharmacy combination.


They do it by taking up the role of a PBM. This is for some other discounter, but you get the idea, they process the prescription using GoodRx's system:

https://www.discountdrugnetwork.com/what-rx-bin-and-group-nu...


> Doctors can only be so involved in the pharmacy side of the transaction and a lot of pharmacists aren't able to intervene.

Pharmacists can intervene a lot more than your doctor friend lets on. A good pharmacist will tell the patient there is a generic version of the drug when the doctor wrote a script for a brand name.

A good pharmacist will also tell you not to use your copay when its more than the out of pocket cost.

A bad pharmacist will do neither of those, but they are 2 simple questions anyone can ask when they go to get their prescriptions filled.

Is there a generic? Is it cheaper than my copay?

I learned the hard way after coming home with an Rx that was more expensive than I remembered. Wife found out they gave my brand name "well thats what the doctor wrote!" and chewed her out.

That said, if you are OK with privacy concerns or don't have the time to call yourself, GoodRx is nice to find the lowest cost as they definitely aren't standard and some places even have certain drugs for free.

Source: wife & mother pharmacists :)


Truth.

Source: awesome family pharmacist.


Are you aware of any privacy issues with GoodRx? I’ve avoided it because I assume they are making money selling my prescription information.


I can't say if GoodRx is doing it, but Walgreen's seems to be selling information.

I was with a friend picking up his meds and I bleeped my rewards card to collect the points, since he didn't have one. Now I get offers in the mail to treat his condition.


So this has been a roller coaster. My initial thought was that this was a big HIPAA violation but then I decided to actually look to see if my assumption held up. According to the Department of Health & Human Services page on HIPAA and marketing [0], Walgreens can use personal health information (PHI) in marketing without violating HIPAA, as long as they have permission to do so.

So with that in mind, I went and looked at Walgreen's notice of privacy practices [1] and they say that they will get a written disclosure before using PHI (and that is restated in their Balance Reward ToS.

Bottom line is, if they are selling information then hopefully you're friend has signed a form authorizing use of the PHI otherwise Walgreens is violating HIPAA.

[0] https://www.hhs.gov/hipaa/for-professionals/privacy/guidance...

[1] https://www.walgreens.com/topic/help/general/noticeprivacypr...


GoodRx is strictly against selling personal medical data. Reference. https://support.goodrx.com/hc/en-us/articles/115005228506-Pr...

"GoodRx does not sell information regarding your drug prescriptions and medical conditions that are linked to your name, contact information and other personal data you provide us."


This could just mean pseudoanonymization. I.e. they staple you medical information to your IP, a cookie, or an advertising ID. A buyer can deanonymize that kind of data in many cases.


Would also like an answer to this. This is worrying, just started using them...


I would say this is an argument for free markets.


What's funny is I imagine "Amazon Prescription Drugs", would look like dark-net market websites.

Both sell prescriptions, both use USPS or whomever to ship. Besides I bet it would be easier to track illicit use if it was regulated. Not to mention cheaper, faster and digital. Less prejudice.

Too bad the general consensus is that these jobs are necessary when they aren't.


I always thought Klout was a useless vanity metric. Since starting a company that operates in the social listening space I've had chances to do quick sanity checks against Klout scores and they've proven to be consistently less than useful.

Good riddance indeed.


> social listening

What?


"Big data" analytics pointed specifically at social media data. Netbase and Crimson Hexagon are two good examples of incumbents in the space.


it's like bullshit, but smells worse


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