I have an honors minor in medical humanities and took several medical policy courses. We looked at this exact graph from previous years as well as several other huge sets of data/graphs/studies and anything else related to insurance you can imagine. Insurance is not a standard market commodity and does not follow the same trend or logic. The only way you can lower premiums in insurance is by reducing the risk in the pool, or increasing the pool size to dilute the risk. This is either increasing the total pool size by increasing premiums, getting more people, or being selective about who joins the risk pool. The third one was what was called “preexisting conditions” and kept high cost people from entering the risk pool and draining the funds. This got banned and increased premiums. By increasing competition you end up splitting up the pools, making everyone’s premiums go up. This happened multiple times post ACA after the GOP started stripping out the funding and safeguards to prevent this. More and more competition opened up with artificially low premiums being subsidized by federal dollars, but then when the subsidies ended the premiums started jumping. Then when the premiums were jumping, new companies opened up to make more competition advertising lower rates, but then further fractured to pool sizes, leading to premiums skyrocketing. If you look back just 10 years ago there was a 3-5 year stretch of premiums increasing almost 30% year after year. It was due to all the competition opening up every year. This is why single payer systems have the lowest rates. If you have even one private company monopoly with a regulated cap on profits you would still end up with lower premiums. Then, if this single paying company was nationalized to take out the profit making middle man, the premiums are that much lower because your risk is spread across a massive pool. More competition in insurance makes the problem worse. I would agree with your stronger regulation though. There is a lot that can be done there.

Read the book! It was so good as well. Not entirely the same as the movie. The movie was more of the premise with book plus some exerpts, but still amazing in its own way. I really enjoy both. Really easy read because of how it is written, and so much fun as well.

Woosh

Ethiopia DID have a coast. It was what is now known as the country of Eritrea. They were forced to be part of the country after WW2 in 1950, and ignored the wishes of the people to remain independent. Then by 1961 a war for independence started and lasted for 30 years. It ended with the Eritrean forces taking the Ethiopian capital and winning the war capture the flag style, but with guns.

As far as Djibouti, they are probably the best example of American modern imperialism. The country enjoys a stable currency by using an American backed currency. In exchange the US has their Horn of Africa base there. Because the country is so small but the base has so many troops and the US pays to lease the land, the US military ends up making up a little bit over 10% of their entire GDP. This is the base that launches the anti-pirate operations for the region, not only providing security for Djibouti, but security for the entire HoA. Say what you want about the USA and their modern imperialism, but the only thing anyone in that region agrees with is that they love the US troops there and the mission they do.

If Ethiopia wanted to take Djibouti, not only would that piss off literally every other country in the region, they would also have to go through the USA to take it. Good luck with that.

For those who are not familiar with operation praying mantis, here is my favorite video the breaks it down in about 15 minutes.

https://youtu.be/d5v6hlRyeHE?si=qjuaWUv61xe0Y4Xe

Technically it would reach an altitude where it would become ‘null’ due to dividing by zero. You would eventually hit the vacuum of space where there is no speed of sound and any speed is faster than it.

In 2000 the Afghani was worth 75,000 to 1 USD. During ISAF occupation it was fixed at 50 to 1. It is now at 70 to 1 and dropping. Let’s stick to one argument at a time rather than playing the whataboutism game. You said the USA destroyed their economy, yet the evidence strongly says otherwise. Before 2001, Afghanistan was the second poorest country in the world. When ISAF pulled out it was ranked at about 40 (I say ‘about’ because it was still growing and changing faster and the rankings were uptated). In the short time of Taliban rule they have dropped back down to sub 33 with exact number still to be determined. (The sub 33 ranking is important because there are only 33 countries on the UN “least developed countries” list).

I would spend time debating topics like this with educated people and those that are open minded, but you do not seem like you fit either group. Do not expect a reply.

Over the course of 20 years, the US and its coalition allies in Afganistan killed approximately 50,000 civilians and there we calls for war crimes investigations. In the course of one month Israel has killed over 10,000 civilians.

I did two tours in Afghanistan and can tell you now, they are not bending over backwards to minimize it. They are using this as an excuse to indemnify themselves from war crimes prosecution.

Death toll as of yesterday was reported around 8,000. The US/coalition 20-year war in Afghanistan was (rounding UP) 50,000. That puts it at an average of 2,500 civilian deaths per year. Even THAT number was high enough for people to call for war crimes investigations. Now Israel has reached over 3x the yearly average in only 3 weeks. On track to pass 10,000 by the one month mark, too. I’m not saying that Isreal doesn’t have the right to defend its self, or even defense through offense, but there is a point that we need to agree is too far; and I think we are a bit past it.

After rereading this in the morning/afternoon and not late night I realized my mistake. BPPV is normally the posterior, more infrequently the anterior, and to be true up/down vertigo only it would have to be both canals at the same time. The vestibular organ is odd. Either way, this whole scenario doesn’t even sound like bppv (peripheral) and is most likely something up line in the brain (central).

Go see neuro. Get an mri at least.

Unlike the othe comment, this DOES sound like it could be BPPV, where something like the epley maneuver would work. Typically we would use the Semont-plus maneuver (same idea, slightly different). Or there is a fun half somersault maneuver the person could try on their own.

Bppv will be brief but intense episodes lasting seconds with lasting nausea for minutes and exasterbated by head movements. You will also see their eyes jumping or flicking (nystagmus).

The epley maneuver is to treat BPPV- where an otolith becomes dislodged and then finds its way into a semicircular canal (normally the latteral canal). If it was causing vertigo it would have to be the posterior canal. Not to say it isn’t possible, but it is the statistically least common canal to happen in. Not only that, but the epley wouldn’t treat it. Even then, this strongly doesn’t sound like BPPV, whose episodes would last seconds to minutes. If the episodes are lasting minutes to hours it is a short list of other possible things. best case this is vestibular migraine of it was vestibular related. More likely this is central involve ment and the person needs to see a neurologist. I have seen patients like this before for balance accessments. We will do the testing on them(VNG and caloric testing), but then have to tell them to go to a different department because it isn’t part of the vestibular system causing the problem. I would push to see an ENT/neuro/PCP sooner than later because worst case is it is a developing vestibular schwanoma (non cancerous tumor) and the sooner the better to take care of it or at least monitor it.