A Striking Concentration of First-born Excess in Neuropsychiatric Conditions – Scary Charts 08.03.26

The study has a number of limitations and…

This study was supported by award no. 1R01MH137646-01 from the National Institute of Mental Health and the National Institutes of Health to S.A.K. and A.R. The funders had no role in study design, data collection or analysis, decision to publish or preparation of the manuscript. Birth order and disease risk across the human phenomehttps://www.nature.com/articles/s44360-026-00177-z#Abs1

I’m a first-born.

YIKES.

Scary Charts (Prescription Drug edition) – 08.02.26

Today, three PBMs, CVS Caremark (34% market share), Express Scripts (23%, owned by Cigna’s Evernorth), and Optum Rx (22%, owned by UnitedHealth Group), control nearly 80% of all U.S. prescription claims. In exchange for placing a manufacturer’s drug on the formulary, or giving it preferred status over competing therapies, the PBM negotiates rebates, administrative fees, and performance payments from the manufacturer. A portion of those payments flows back to the health plan, while the PBM retains part of the negotiated revenue.

One feature of today’s market that surprises many people is how vertically integrated it has become. The largest PBMs are no longer independent middlemen. They sit inside healthcare conglomerates that also own insurers, pharmacies, physician groups, specialty pharmacies, and mail-order pharmacies. For example, CVS Health owns Aetna, CVS Caremark, CVS Pharmacy, MinuteClinic, and Signify Health. UnitedHealth Group owns UnitedHealthcare, Optum Rx, and Optum Health. Cigna owns Express Scripts through Evernorth. This consolidation has fueled ongoing debate about whether these organizations can optimize each part of the supply chain independently or whether incentives increasingly favor the parent company as a whole. Mark Cuban on Breaking the Drug Pricing Cartel: Inside Cost Plus Drugshttps://pearhealthcareplaybook.substack.com/p/mark-cuban-on-breaking-the-drug-pricing

Hat Tip – https://ritholtz.com/2026/08/10-sunday-reads-239/

Yikes.

Scary Charts – 07.30.26

Manhattan led the city with the median asking rent jumping 9% ($427) in a single year to reach $5,117. Brooklyn recorded the second-biggest annual spike of 5.9% ($225), as the median rent rose to $4,054. Queens followed closely with rents rising 5.6% to $3,561 from last year. Fresh College Grads Face NYC’s Toughest Rental Market Yet as Asking Prices Surge to 7-Year Highhttps://www.realtor.com/news/trends/college-grads-toughest-rental-market-nyc-july-2026-rent-report/

Yikes.

This Is Not Your Grandfather’s Weed

So let me be the doctor who says it plainly. This is not the mild plant of the 1970s. Then, cannabis was 1-3% THC. Today’s products run 15-25%, and concentrates — dabs, vapes, wax — hit 70-90%+. When people say “it’s natural, it’s harmless,” they’re defending a product that no longer exists. We didn’t legalize the old plant. We industrialized a far more potent one.

A Danish registry study followed 6,788 people diagnosed with substance-induced psychosis. Overall, 32.2 percent later developed schizophrenia-spectrum or bipolar disorder. Among those with cannabis-induced psychosis, 47.4 percent later received one of those diagnoses.

A large Ontario cohort found that approximately 26 percent of people who presented to an emergency department with cannabis-induced psychosis were diagnosed with a schizophrenia-spectrum disorder within three years. The corresponding rate after alcohol-induced psychosis was approximately 8.9 percent. Among the substances studied, cannabis-induced psychosis carried the highest risk of later transition to schizophrenia-spectrum illness. Is it cannabis-induced psychosis or bipolar disorder? https://kevinmd.com/2026/07/is-it-cannabis-induced-psychosis-or-bipolar-disorder.html

YIKES.

A Brief History of Tiny Houses

​Beyond their versatility, tiny homes typically have multifunctional furniture, including fold-down tables, convertible sofas, and Murphy beds. Because of the small space, tiny homes are commonly built vertically, with sleeping areas accessible by built-in ladders or stairs.

How Tiny Homes Became Big Business—Evolving From DIY Off-Grid Shacks to the Design Darling of Social Mediahttps://www.realtor.com/news/unique-homes/tiny-home-history-evolution-social-media-off-grid-shack/

The verticality is definitely not senior friendly. Where’s the bathroom? But despite the obvious disadvantages for a person of my vintage, serious downsizing remains highly attractive. All I’m trying to do is make our retirement income last as long as we last. Hon, what do you think?

Rejected. Again.

Previous tiny posts here:

https://lifeunderwriter.net/tag/tiny-houses

But Hon, I found one I like…

https://incredibletinyhomes.com/models/black-ace/

Too Tired to Read Your Kid a Bedtime Story?

Meta is testing an app that uses AI to automate bedtime stories for children. The future is here, folks — and boy, is it depressing.

The app, first caught by 9to5Mac, is called “StoryKit.” (It’s not yet available in the US; Meta confirmed to TechCrunch that it’s currently testing StoryKit in pilot countries.) Per a webpage for the app, parents pick a character either by creating one or taking a “photo of their favorite toy or person to bring them to life,” then describe a setting or world for the story to take place in. They can also ask the story to include a specific lesson or moral, which the app says will allow it to “weave in values like kindness, courage, or empathy without it feeling like a lecture.”

Meta Working on Crushingly Sad AI App That Tells Bedtime Stories to Children, for “Tired” Parentshttps://futurism.com/artificial-intelligence/meta-sad-ai-app-stories-children

BULLSHIT!

The Nurse Will See You Now (from the Philippines)

Some U.S. employers use local third-party agencies to hire Filipinos with nursing experience, while others insist on American nursing licenses.But for many virtual healthcare assistants, including telesitters, a degree in any medical field will do. The remote nurses, who usually work the graveyard shift at night from their homes or offices in the Philippines, earn between $5 and $10 per hour, compared to the average pay of more than $45 an hour for registered nurses in the U.S.

The country has grown into a “clinical process outsourcing powerhouse … [and] a premier global hub for supporting over-stressed international healthcare systems,” JL Botor, president of HIMAP, told Rest of World.

U.S. hospitals and clinics can save up to 70% in labor costs by hiring Filipino workers, said Botor, who expects the industry to expand due to the chronic labor shortage, as well as the growing use of AI. Companies will automate easier tasks such as note-taking, and lean more heavily on human oversight for other tasks, he said. He declined to name the U.S. hospitals and clinics that outsource work to the Philippines, citing confidentiality agreements.

Your next nurse may monitor you from the Philippines

https://restofworld.org/2026/u-s-healthcare-philippines-remote-nurses/

Brave New World.