Why am I Such a Douchebag? [or] Am I a Troll?

[DooDiligence]

So I'm trying to figure out why nobody here seems interested in pharma supply chain (including payers)

 

Is it me?

 

Are my thoughts regarding the industry & players valueless?

 

Maybe I just don't deserve the time you'd all have to spend commenting?

 

Anywho...

 

(stay needy my friend)

[Liberty]

No idea where the insecurity is coming from, I feel like I missed a thread somewhere. Personally, I'm just not interested in pharma supply chain right now, so that's why I haven't really commented on anything in that field.

[Jurgis]

Mostly what Liberty said.

 

Your thoughts might be useful, but I haven't looked at that sector in depth, so I can't say if they are or they are not.

 

My very superficial thinking is that this area depends on govt politics and then depends on the big cos (pharmas, PBMs, insurers, ???) fighting out for margins. So on one hand, you may end up with quasimonopoly with fat margins and great stock returns. On the other hand, you may end up with cancelled/shifted contracts (to possibly captive divisions), infighting, govt hits, etc. I don't think I am interested, so I don't think I'm gonna comment on these topics.

 

There is a potential for large returns though.

[DooDiligence]

No idea where the insecurity is coming from, I feel like I missed a thread somewhere. Personally, I'm just not interested in pharma supply chain right now, so that's why I haven't really commented on anything in that field.

 

Thanks, the silence was deafening.

 

It's a little bit about insecurity (that part's more the hook 4 responses) & it's a lot about hearing from a bunch of people I've come to respect for sharp analysis & insights.

[Jurgis]

Another thing is that some deep-DD people have left CoBF or just don't post much anymore.

[DooDiligence]

Oh, and another part of the insecurity is probably me seeking confirmation (but it was really about getting some clicks.)

[DooDiligence]

Mostly what Liberty said.

 

Your thoughts might be useful, but I haven't looked at that sector in depth, so I can't say if they are or they are not.

 

My very superficial thinking is that this area depends on govt politics and then depends on the big cos (pharmas, PBMs, insurers, ???) fighting out for margins. So on one hand, you may end up with quasimonopoly with fat margins and great stock returns. On the other hand, you may end up with cancelled/shifted contracts (to possibly captive divisions), infighting, govt hits, etc. I don't think I am interested, so I don't think I'm gonna comment on these topics.

 

There is a potential for large returns though.

 

So can I put you both down for "I'd have a drink with you but stay away from my wallet?"

[Jurgis]

So can I put you both down for "I'd have a drink with you but stay away from my wallet?"

 

I don't think that's what I am saying.

 

You can put me down for "I read what you write and I comment if I have something to say".

[DooDiligence]

So can I put you both down for "I'd have a drink with you but stay away from my wallet?"

 

I don't think that's what I am saying.

 

You can put me down for "I read what you write and I comment if I have something to say".

 

I love you man!

[maybe4less]

Mostly what Liberty said.

 

Your thoughts might be useful, but I haven't looked at that sector in depth, so I can't say if they are or they are not.

 

My very superficial thinking is that this area depends on govt politics and then depends on the big cos (pharmas, PBMs, insurers, ???) fighting out for margins. So on one hand, you may end up with quasimonopoly with fat margins and great stock returns. On the other hand, you may end up with cancelled/shifted contracts (to possibly captive divisions), infighting, govt hits, etc. I don't think I am interested, so I don't think I'm gonna comment on these topics.

 

There is a potential for large returns though.

 

Yeah, it's the too hard pile for me at the moment.

[no_free_lunch]

I keep thinking about Aimia.  Stock down 65% after air canada dropped them.  Okay, radically different business but at a very high level they are kind of middle-men, just facilitating a process.  They both had major customers drop them.  Okay it's not a done deal with esrx yet but still.  I just don't like businesses that can disappear based on their customers deciding to do it themselves.  I could very well be wrong, in fact I am probably wrong since the industry has been around awhile but I am not sure how much value they add relative to other companies in the same space.  Why couldn't a tech company come in and destroy them.  When they talk about their edge a lot of it is data.  Amazon has a lot of smart people and given their existing businesses it doesn't seem like that much of a stretch for them to go here.  End of the day it is just too hard.

[DooDiligence]

I keep thinking about Aimia.  Stock down 65% after air canada dropped them.  Okay, radically different business but at a very high level they are kind of middle-men, just facilitating a process.  They both had major customers drop them.  Okay it's not a done deal with esrx yet but still.  I just don't like businesses that can disappear based on their customers deciding to do it themselves.  I could very well be wrong, in fact I am probably wrong since the industry has been around awhile but I am not sure how much value they add relative to other companies in the same space.  Why couldn't a tech company come in and destroy them.  When they talk about their edge a lot of it is data.  Amazon has a lot of smart people and given their existing businesses it doesn't seem like that much of a stretch for them to go here.  End of the day it is just too hard.

 

Their past opaque practices & pricing have put them in the too hard pile for many.

 

Consumers hate them because their job is to save payers money by not allowing a prescription or making the patient bear more of the burden.

 

They're an easy target in this environment.

 

The recent earnings call really added a lot of color to the business & more transparency into pricing.

 

I believe they perform a useful service & are removing the target from their backs.

 

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I agree that Amazon is a huge threat.

 

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Amazon vs CVS & WBA

 

 

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On free EHR with Amazon Healthcare Solutions Partner

 

 

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Direct link to Amazon Cloud Computing in Healthcare

 

https://aws.amazon.com/health/

 

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more in my tweets about MyMatrixx purchase & changes in corporate culture towards altruism (these guys have to become great content marketers in addition to performing pharma logistics services for manufacturers, payers, patients & distributors.)

 

Efforts towards culture shift for consumer facing end

 

https://www.goodrx.com

 

http://www.mobihealthnews.com/content/mango-health-express-scripts-announce-strategic-investment-longterm-partnership

 

M2c

[LC]

I think you might need to get over yourself...people care about themselves (and their portfolio) way more than personalities on an internet message board :)

 

Otherwise, pharma is not really my wheelhouse. I don't quite understand all the industry dynamics...but I think there is value in the distributors (CVS, Walgreens, etc.) that is easier to understand than the insurance side.

 

The insurance part is so damn complicated. There must be value there, just because it is such a huge part of the entire "value chain", but I don't quite know how to identify it. I'd definitely be interested in learning more, though. Don't really know where to start.

[DooDiligence]

I think you might need to get over yourself...people care about themselves (and their portfolio) way more than personalities on an internet message board :)

 

Otherwise, pharma is not really my wheelhouse. I don't quite understand all the industry dynamics...but I think there is value in the distributors (CVS, Walgreens, etc.) that is easier to understand than the insurance side.

 

The insurance part is so damn complicated. There must be value there, just because it is such a huge part of the entire "value chain", but I don't quite know how to identify it. I'd definitely be interested in learning more, though. Don't really know where to start.

 

OK, I'm over myself now.

 

Learn how you 2 can banish solipsism...

 

http://www.cracked.com/blog/5-mental-tricks-getting-over-yourself/

[DooDiligence]

Full Disclosure: the only vote for “I like your take on pharma supply chain” came from me.

 

Thanks 4 all the lovely drink offers!

 

Sanjeev, may I change my username to DewshDilligence?

[Cigarbutt]

Reviving this thread.

Realize that health insurers, pharma industry dynamics and workers compensation insurance may not the most popular topics here.

“To get something you never had, you have to do something you never did.”

So, planting a seed.

For some reason, find these topics fascinating.

 

Here's a link discussing some specific dynamic aspects of certain corners of the market, including the "managed" parts.

https://www.insurancejournal.com/news/national/2017/11/27/472190.htm

 

So what?

 

Am reading "Grinding it out" describing how the business model of fast food met the American Dream.

Looking for the new generation Ray Kroc to come around.

They are at the gates.

 

[DooDiligence]

Sweet jesus, thanks for reminding me that I'm capable of being like Donald Trump if he ever became self aware.

 

Not quite as needy now & more importantly no longer celebrating getting laid off by being high 24/7.

 

Yay?

 

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Oh and death to non-innovators & pure profiteers with no real function in healthcare?

 

CVS could become the 1st healthcare superstore (besides all the hospitals, that is.)

[doughishere]

i voted clueless douche. that is all i have to add to this topic.

[DooDiligence]

Voting will remain open until we reach a landslide decision on clueless douche.

[randomep]

 

Investors here and elsewhere like to post about what is exciting sexy. For example, Pabrai says he wants to invest in things that can double or triple in a few years. That precludes stocks like managed care organizations such as Aetna.  Everything medical except some blockbuster drug company is ignored here and everywhere else. But MCO's have had a great run lately with all the attention on medical care and medical insurance.

 

It's just a fact of life.......

[Cigarbutt]

MCO's are based on the notion of a network and that certainly appears to be part of the answer going forward.

 

Concept: from recent verified testimonials showing that a simple visit to the emergency room meant a 629$ bill for a band-aid or a 2445$ bill for a prescription to relieve a back pain episode. (all within the deductible part of the "insured")

 

The potential for improvement (value extraction for the capitalist) is lying in wait.

 

I think Mr. Munger said that cognition, misled by tiny changes involving low contrast, will often miss a trend that is destiny.

Industry insiders sometimes fail to feel the wind of disruption.

Maybe more obvious when looking at a shiny red car but very real nonetheless.

 

For those about to think outside the box, I salute you.

[Gregmal]

 

Investors here and elsewhere like to post about what is exciting sexy. For example, Pabrai says he wants to invest in things that can double or triple in a few years. That precludes stocks like managed care organizations such as Aetna.  Everything medical except some blockbuster drug company is ignored here and everywhere else. But MCO's have had a great run lately with all the attention on medical care and medical insurance.

 

It's just a fact of life.......

 

I would say that is true mainly of places like Yahoo message boards, but to a lesser degree here. Basically IMO lower quality sites. VIC is great because real investments are thoroughly discussed. To me it is a trait of gamblers/speculators to fawn over exciting and sexy. Getting rich quick. I am not close enough to the CVS situation, but it broadly falls into a similar category as most stocks I follow and discuss. Boring, undervalued, great long term runway as an investment and little to no discussion on the threads of the sites I read through. To me that is sexy. To me that is exciting. I kind of ignore all the noise of the FNMA type threads where it's really just speculation and get rich quick wishful thinking. That offers me very little as a patient long term investor. And I own FNMA for what its worth. I bought it realizing my investment would either be a multibagger or a complete zero. Therefor, nothing to discuss; discussing it is a waste of time if that is my understanding of the investment. Whereas something like DVA is an evolving situation that is not exactly binary, and a better use of one's time and/or resources. Just my 2c though. I know I can come off as a douche. Not intentionally, but I don't really care either. We're all here to discuss and help each other with investments. Thats what makes the community useful. Differing opinions.

[DooDiligence]

MCO's are based on the notion of a network and that certainly appears to be part of the answer going forward.

 

Concept: from recent verified testimonials showing that a simple visit to the emergency room meant a 629$ bill for a band-aid or a 2445$ bill for a prescription to relieve a back pain episode. (all within the deductible part of the "insured")

 

The potential for improvement (value extraction for the capitalist) is lying in wait.

 

I think Mr. Munger said that cognition, misled by tiny changes involving low contrast, will often miss a trend that is destiny.

Industry insiders sometimes fail to feel the wind of disruption.

Maybe more obvious when looking at a shiny red car but very real nonetheless.

 

For those about to think outside the box, I salute you.

 

 

I would say that is true mainly of places like Yahoo message boards, but to a lesser degree here. Basically IMO lower quality sites. VIC is great because real investments are thoroughly discussed. To me it is a trait of gamblers/speculators to fawn over exciting and sexy. Getting rich quick. I am not close enough to the CVS situation, but it broadly falls into a similar category as most stocks I follow and discuss. Boring, undervalued, great long term runway as an investment and little to no discussion on the threads of the sites I read through. To me that is sexy. To me that is exciting. I kind of ignore all the noise of the FNMA type threads where it's really just speculation and get rich quick wishful thinking. That offers me very little as a patient long term investor. And I own FNMA for what its worth. I bought it realizing my investment would either be a multibagger or a complete zero. Therefor, nothing to discuss; discussing it is a waste of time if that is my understanding of the investment. Whereas something like DVA is an evolving situation that is not exactly binary, and a better use of one's time and/or resources. Just my 2c though. I know I can come off as a douche. Not intentionally, but I don't really care either. We're all here to discuss and help each other with investments. Thats what makes the community useful. Differing opinions.

 

That book on front running by Fritzell is about this very thing.