I think this analysis has little to say.
What would be important to know how those $ are being spent, not where they are collected from. We do not know how those $ are being spent.
1. Doctors, Nurses, Administration (management and field administration), other. We need to know total employment and total salaries (including private practices).
2. OTC, prescription and hospital administered drugs (separated for acute, such as ER, and chronic, such as inpatient and elective surgery). We need to know how much is being spent on these, which is _potentially_ one of the culprits of large discrepancy between US healthcare vs European healthcare. What would be great to have these by large cohorts of population (<20; 20-65; 66-85; 85<) and maybe the top 5 buckets (i am guessing: cardiovascular - chronic; diabetes; accidents; hospice; dialysis)
3. Facility expenses (rent, maintenance, utilities, other contractor)
4. Other
Without these, very hard to opine reasonably on the state of affairs. And to be fair, I suspect there is a reason why proper expense breakdowns are not available.
They sign the purchase order on 1/1/26. AMD issues invoice to be paid in 30 days, that is 2/1/26. OpenAI triggers warrant and informs AMD on 1/2/26. OpenAI receives shares on 1/4/26. On 1/5/26 OpenAI and AMD announce the GPU purchase deal. On 1/30/26 OpenAI sells its shares in AMD. From proceeds, OpenAI pays AMD on 2/1/26. Thus, AMD financed OpenAI's GPU purchase via AMD's shares.
translated, AMD buys GPU from itself and gives them to OpenAI for free. OpenAI gets GPUs for free, AMD hopes the market will reward the deal enough to increase its valuation by more than the dilution cost.
I have to ask - is this even legal? I understand it can be, but somehow it feels wrong. I guess AMD would report revenue of those GPU sale and equity issuance / dilution as part of payment terms, and OpenAI would record hardware purchase expense as well as investment income or maybe capital gain when selling those shares. What makes it legal is probably it all needs to be transparently communicated in time?
I did a calculation once. US spends $4.9T on healthcare: $2T on personnel, $500B on non-acute drugs (ie OTC + prescribed) and $2.4T on something else.
Germany spends $550B on healthcare: $430B on personnel, $80B on non-acute drugs and $31B on something else.
My guess is that the "something else", which is non transparent, is actually private insurance jacking prices up.
There is no need. The personnel cost multiplier is 3.6x, the non-acute drug multiplier is 6.25x and the "something else" multiplier 77x. So we can debate that there are ~4x more people in the US and CoL is higher maybe by 0.5x turns, but there is no debate that the 77x shows something is awfully wrong.
My bet is the private insurance because we dont have transparent data on how much does the same procedure (broken down by personnel (doctor, nurse, admin), implied equipment amortization, rent, drugs) cost with and without insurance.
I could totally imagine that there are plus personnel expenses buried within the "something else", or acute drug prices, which are administered during an emergency at a hospital. But we don't know, because healthcare spending is a black box in the US.
>That something else could also be stuff like malpractice insurance, legal settlements, etc.
This claim is regularly brought forth as why US healthcare is expensive and it just doesn't work.
First of all, are you aware Texas has fairly rigorous limits to rewards for Medical Malpractice suits? You can only get half a million dollars above what the malpractice cost you. There's also a two year statute of limitations from when you found out about the malpractice, and if you find out that your surgeon willfully fucked up your treatment more than 10 years after it happened, too bad, no case for you period.
Does Texas have cheaper healthcare than the rest of the country?
Nope.
Second, the primary cost of a medical malpractice suit is fixing the medical problem which is only a large number because medical care in the US is stupid expensive. Blaming the cost of healthcare on malpractice suits and insurance is putting the cart before the horse.
Meanwhile, most medical lawsuits never even come close to large sums.
When my sister was being born, the doctor broke her shoulder to get her unstuck. There is a correct way to do this, but he did it wrong and permanently disabled her. Turns out, he was literally not allowed to practice medicine in some states for doing exactly that to several other babies, and ended up doing exactly the same thing to another baby a few years later in the same town.
We got $10k. Permanent, life altering disability with no treatment or fix for outright malicious incompetence. My sister isn't supposed to be left handed, but she is.
$10k
If you've ever gotten upset about the McDonalds "hot coffee" lawsuit for example, you should be aware that the plaintiff originally was only asking for $20k to treat her fused labia and permanent damage. The court awarded significant damages because it was discovered that McDonalds had done this to multiple people and was purposefully keeping their coffee hotter than they were supposed to despite how it had directly harmed multiple people. They also ran a literal propaganda campaign to libel this woman that it was somehow her fault for not knowing the coffee was hot or something. You can bet they spent more than $20k on that. Oh, and the $2.7 million she got in punitive damages for McDonalds willfully contravening safety and helping melt her lady parts? It was specifically equal to 2 days of coffee sales. And then the judge said "no" and only gave her $600k. Then McDonalds appealed the case and settled privately.
I mean, to be fair, Google's scam of how much GBs you have is very annoying and downright scandalous.
I had 16.5GB or so used up so it was flashing red. When paid for Gemini, my total space jumped to 2TB and my usage dropped to 12GB. Disgusting. So might as well switch to fastmail. Not sure.
Likely not true re adoption. According to McKinsey November 2024 12% of employees in the US used AI for >30% of their daily tasks. I saw another research early this summer, it said that 40% of employees use AI.
Adoption is already pretty relevant. The real question is: number of people x token requirement of their daily tasks equals how many tokens, and where are we there. Based on McK, we possibly around 17% unless remaining 50% of tasks requires just way more complexity, because then that would obviously mean the incremental tasks require maybe exponentially more tokens and then penetration will be indeed low. But for this we need to know total token need of daily tasks of average office worker.
I just heard a thesis that there is no bubble unless there is debt in it. Currently mostly internal funds were used for increasing capex. More recently started we seeing circularity (NVDA -> OpenAI -> MSFT -> NVDA), thus this is less relevant so far yet. Especially as around ~70% of data center is viewed to be GPU, so NVDA putting down $100B, that essentially funds "only" $140B of data center capex.
META is spending 45% of their _sales_ of capex. So I wonder when are they going to up their game with a little debt sprinkled on.
There is a book called "Talent is overrated" it essentially says, you need to 1) invest time, 2) do targeted practice, and 3) have a mentor, who helps you in targeted practice. Practice alone is not enough, it must be targeted at 1) what is relevant and/or 2) where your biggest weakness is at the moment.
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