What Charles Ponzi’s Scheme and US Entitlement Programs Have in Common

Daniel Kowalski

When Charles Ponzi’s investment opportunity to sell international postage stamps was exposed to be a scam in 1920, its basic premise would forever be associated with the man’s name. A Ponzi Scheme promises investors massive returns on an investment that does not really exist. Instead, unknown to everyone but the person or people running it, old investors are paid with money that comes in from new investors. This set up usually goes undetected until the one day when the well of new investors dries up and the money stops flowing in.

The structure of Ponzi’s scheme must have really impressed the policy makers that were coming to age during this era because they would use the same set up for the nation’s new Social Security system in the 1930s. Starting in 1937, employees and employers needed to fund the system and in 1940, retirees began to draw benefits. The financial amount of these benefits dwarfed what the first retirees put in during their working careers. …

PBMs, the Brokers Who Control Drug Prices, Finally Get Washington’s Attention

by Yves Smith

Yves here. On the one hand, if you read the business press, you encounter enough discussion of the role of pharmacy benefit managers, or PBMs, to work out that they are very large and profitable and wield enormous influence in the pharmaceutical business…but it’a all a bit fuzzy how they do that.

Kaiser Health News, now rebranded as KFF Health News, has a new article on PBMs, with the news hook that the Senate just held hearings on PBMs before a vote on PBM legislation….with the description of what PBMs do, exactly, and what the legislation entails peculiarly hazy.

Matt Stoller, in his post The Red Wedding for Rural Pharmacies, gave the 50,000 foot description of how PBMs work and how they abuse their monopoly position. A key section: …