"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices." - Adam Smith
It really irks me for some reason that American Medical Association (one of the top spenders in lobbying) is doing the lobbying. I did a quick Gemini/Google search and these are the topics they lobby for.
```
Core Legislative PrioritiesMedicare Reform:
Fighting to fix stagnant physician payment formulas and account for inflation.
Prior Authorization: Pushing to reduce administrative roadblocks and delays enforced by insurance companies.
Scope of Practice: Opposing laws that expand independent clinical roles for non-physicians like nurse practitioners and pharmacists.
Burnout Reduction: Supporting federal and organizational relief to help doctors manage workplace stress and administrative tasks.
--
Public Health and Science
Public Health Crises: Supporting science-based policies on vaccinations, gun violence prevention, and chronic disease reduction.
Digital Health: Guiding regulations for artificial intelligence and telehealth integration in medical practices
```
Most of these are about keeping the gate (i.e., doctor's compensation high). The US doctors are the highest paid in the world (among developed countries like UK, Canada, France, Germany, Italy, etc.) by a long shot. Kind of mad if you think about it.
Disclaimer: My spouse is a specialist doctor. You can say I have selfish interest in keeping doctor's salaries high in the US. But I can't help highlighting that doctor's guilds (like AMA) are part of the reasons why the healthcare expenses are so high in the US.
One of the ways that the AMA gatekeeps is to limit the number of medical school seats and residency slots in the US (residency is run by Medicare).
Quality of life (at work) for many physicians is arguably pretty bad due to long hours, administrative requirements, and insurance requirements / prior auth. Physicians should lobby to get some of these things fixed by regulation, because it's likely the only way they will get fixed! However, a physicians lobby of any kind is going to have a tough time reducing healthcare costs because they have a significant financial incentive to gatekeep and their members can pay high dues to spend a lot on lobbying.
I wonder if the AI meant PAs instead of pharmacists -- as I understand it, a pharmacist's scope of practice is quite distinct from a physician.
Yeah, doctors have been wilding and it's curious how completely they have been able to avoid public backlash for it. Probably some combination of knowing your doctor and more strongly associating billing/insurance with the financial pain even though providers are a big part of the cost spiral.
I already pay for my government in taxes (which ironically these big cos don't pay).
Besides, if I were to gather up 4 million to lobby, the opposition would simply spend 8 million instead which they could come up with just as easily. They don't have to outrun the bear, the just have to outrun you.
j/k, but then again, it's not like we have other means to "help make good governance decisions" that we haven't already tried before. Maybe except the failed cybernetics experiments that came a little before their time and in the wrong political regime, but then those are effectively replicated by any large multinational internally to some extent.
Right. That's what actually buys you the politician. Being able to promise "Pass this regulation for us and we'll make sure you are set up for life, since we know it's politically unfavorable"
the ~$2M just gets your foot in the door, that's it.
That's the real evil. Once a super PAC has enough money, they don't even have to spend it. The threat alone is enough to get most Congress people back in line.
This is what a PAC is. Political Action Committee.
They primarily only get headlines for outrage topics when people don’t like what they’re pushing toward. Many of the top PACs are from groups like realtors or sheet metal workers lobbying for their interests.
Most people skip PACs and donate straight to political candidates instead. Individual donations to candidates outweigh anything the AI companies are spending by a huge number.
> Letting mega-billionaires spend mega-millions to buy the conversation around elections isn't my definition of freedom.
Spell out the details: Exactly who will not be permitted to speak under your definition of "freedom"?
If you say that only people with a billion dollars can be punished for speaking: Do you think the limit won't be lowered over time?
If the issue is that no person should be able to spend more than N million dollars in one "conversation", how do you allocate broadcast licenses when the price in an auction would be more than N million?
America wasn't a democracy before the 2010 Citizens United ruling allowed corporations and wealthy donors to spend unlimited money on elections? That's news to me.
I don't feel more free at all on account of that ruling. Maybe if you said "freedom" one or two more times, that would do the trick.
"The political action committee emerged from the labor movement of 1943. The first PAC was the CIO-PAC, formed in July 1943 under CIO president Philip Murray and headed by Sidney Hillman. It was established after the U.S. Congress prohibited unions from giving direct contributions to political candidates."
The above from Wikipedia.
But I'm wasting my time talking to you, you are just raging and putting words into other people's mouths, because you are too high on your own supply of resentment to want to have a good discussion.
I'll put my opinion clearly: Everybody should have the freedom of association and be able to get together with likeminded to work for any political cause they want to advance, as long as they do it within the limits of just law.
Political donations by large groups of special interests aren't unique to America. Many countries have very strong labour union super-PACs.
I think of that Netflix series on FIFA and its rampant corruption. The bribes in question are laughable, considering that FIFA is a multi-billion dollar operation, and it's always some round number like $1M. At least add some cents to it so it's not glaringly obvious in the bank accounts.
Are the bribes round, or is it just usual bullshit journalism practice of fudging the numbers and rounding them in the process (usually made apparent when there are multiple reports for the same number, each using different units of currency or measure).
The estimated spending on the 2026 election season is $11.6 billion [1]. One primary has had an estimated $60 million spent on it (ie the Michigan Democratic primary). Thomas Massie's primary had an estimated $35 million spent on it. A GOP Super PAC has earmarked $342 million for 8 Senate races [2].
Over $5 billion was spent on lobbying in 2025 [3].
To truly move policy you need to get pliable representatives first and that's not just money. There is a pipeline here. First, you get the right connections. That could be coming from a wealth family, be the nephew or grandson of some politician, do your time as a staffer or whatever. Going up through the ranks acts as a giant filter to make sure you will maintain the status quo. So you have to find candidates to run for these offices who have been weeded out by the existing processes. And if you don't have enough of them, the DNC or RNC will spend selectively against you in the primary and general election. And an increasing number of races have over $100 million spent on them.
Buying back democracy would be very, very expensive.
And then after all that there's the income and jobs pipeline. Your children get six-figure jobs with think tanks and interested companies. You leave office and get placed on boards of large companies. You can't compete with that.
It seems to me that there's really nothing at that store that "normal people" want to buy.
Everything that we want to do can be done through ordinary collaboration with no need for the state. The special services which the state provides (violence and threats of violence, imperialism, inhibition of movement of people and goods across imaginary lines, etc) are the kinds of things that are really only interesting to the kinds of people who are already spending their money on lobbying.
It would not surprise me that the cost of lobbying rises exponentially as the policy moves left on the political spectrum. That pro-business, pro-austerity, neo-liberal policy is orders of magnitude cheaper to lobby for, then pro-worker, pro-democracy, pro-consumer policy.
Many of the groups that spend the most on lobbying are composed of "normal" people who have banded together for some common interest. For example:
- The AARP ($21M annual spend) has 38M members
- The National Association of Realtors ($54M annual spend) has 1.5M members
- The American Medical Association ($24M annual spend) has 300K members
Of course that doesn't mean that their interests necessarily align with your interests.
Also if they want my money then their interests align.
"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices." - Adam Smith
A curious choice of quote on a tech forum attached to a VC firm :P
You know what would be cool? A national startup accelerator!
It really irks me for some reason that American Medical Association (one of the top spenders in lobbying) is doing the lobbying. I did a quick Gemini/Google search and these are the topics they lobby for.
``` Core Legislative PrioritiesMedicare Reform:
Fighting to fix stagnant physician payment formulas and account for inflation.
Prior Authorization: Pushing to reduce administrative roadblocks and delays enforced by insurance companies.
Scope of Practice: Opposing laws that expand independent clinical roles for non-physicians like nurse practitioners and pharmacists.
Burnout Reduction: Supporting federal and organizational relief to help doctors manage workplace stress and administrative tasks.
-- Public Health and Science
Public Health Crises: Supporting science-based policies on vaccinations, gun violence prevention, and chronic disease reduction.
Digital Health: Guiding regulations for artificial intelligence and telehealth integration in medical practices ```
Most of these are about keeping the gate (i.e., doctor's compensation high). The US doctors are the highest paid in the world (among developed countries like UK, Canada, France, Germany, Italy, etc.) by a long shot. Kind of mad if you think about it.
Disclaimer: My spouse is a specialist doctor. You can say I have selfish interest in keeping doctor's salaries high in the US. But I can't help highlighting that doctor's guilds (like AMA) are part of the reasons why the healthcare expenses are so high in the US.
One of the ways that the AMA gatekeeps is to limit the number of medical school seats and residency slots in the US (residency is run by Medicare).
Quality of life (at work) for many physicians is arguably pretty bad due to long hours, administrative requirements, and insurance requirements / prior auth. Physicians should lobby to get some of these things fixed by regulation, because it's likely the only way they will get fixed! However, a physicians lobby of any kind is going to have a tough time reducing healthcare costs because they have a significant financial incentive to gatekeep and their members can pay high dues to spend a lot on lobbying.
I wonder if the AI meant PAs instead of pharmacists -- as I understand it, a pharmacist's scope of practice is quite distinct from a physician.
Yeah, doctors have been wilding and it's curious how completely they have been able to avoid public backlash for it. Probably some combination of knowing your doctor and more strongly associating billing/insurance with the financial pain even though providers are a big part of the cost spiral.
It's a "temporarily embarrassed millionaire" variant, I think. "Temporarily embarrassed parent of a future doctor".
I already pay for my government in taxes (which ironically these big cos don't pay).
Besides, if I were to gather up 4 million to lobby, the opposition would simply spend 8 million instead which they could come up with just as easily. They don't have to outrun the bear, the just have to outrun you.
Yeah, I would like my taxes to go to paying for expertise to help make good governance decisions, personally.
Oh so you're aligned with AI lobbying then?
j/k, but then again, it's not like we have other means to "help make good governance decisions" that we haven't already tried before. Maybe except the failed cybernetics experiments that came a little before their time and in the wrong political regime, but then those are effectively replicated by any large multinational internally to some extent.
Normal people can't offer speaking fees, consulting gigs, and other sinecures to politicians and their staffers after they leave the government.
Right. That's what actually buys you the politician. Being able to promise "Pass this regulation for us and we'll make sure you are set up for life, since we know it's politically unfavorable"
the ~$2M just gets your foot in the door, that's it.
And also they can threaten to fund an opponent's PAC.
That's the real evil. Once a super PAC has enough money, they don't even have to spend it. The threat alone is enough to get most Congress people back in line.
Or primary you
Opponents run in primaries too, not just general elections.
[dead]
This is what a PAC is. Political Action Committee.
They primarily only get headlines for outrage topics when people don’t like what they’re pushing toward. Many of the top PACs are from groups like realtors or sheet metal workers lobbying for their interests.
Most people skip PACs and donate straight to political candidates instead. Individual donations to candidates outweigh anything the AI companies are spending by a huge number.
Yes, and it’s trivial to form one! If you look up the documentation necessary you may not believe your eyes.
Why should it be hard? It's something which should be completely unregulated in a free country.
Letting mega-billionaires spend mega-millions to buy the conversation around elections isn't my definition of freedom.
> Letting mega-billionaires spend mega-millions to buy the conversation around elections isn't my definition of freedom.
Spell out the details: Exactly who will not be permitted to speak under your definition of "freedom"?
If you say that only people with a billion dollars can be punished for speaking: Do you think the limit won't be lowered over time?
If the issue is that no person should be able to spend more than N million dollars in one "conversation", how do you allocate broadcast licenses when the price in an auction would be more than N million?
Overturn Citizens United.
Which people do you allow to work together for their political goals then, oh grand hacker?
Do you understand the basics of a free society, which include freedom of association? You don't have much of a democracy left if you remove that.
America wasn't a democracy before the 2010 Citizens United ruling allowed corporations and wealthy donors to spend unlimited money on elections? That's news to me.
I don't feel more free at all on account of that ruling. Maybe if you said "freedom" one or two more times, that would do the trick.
"The political action committee emerged from the labor movement of 1943. The first PAC was the CIO-PAC, formed in July 1943 under CIO president Philip Murray and headed by Sidney Hillman. It was established after the U.S. Congress prohibited unions from giving direct contributions to political candidates."
The above from Wikipedia.
But I'm wasting my time talking to you, you are just raging and putting words into other people's mouths, because you are too high on your own supply of resentment to want to have a good discussion.
I'll put my opinion clearly: Everybody should have the freedom of association and be able to get together with likeminded to work for any political cause they want to advance, as long as they do it within the limits of just law.
Political donations by large groups of special interests aren't unique to America. Many countries have very strong labour union super-PACs.
https://www.opensecrets.org/political-action-committees-pacs...
No, these do not make me feel free.
I think of that Netflix series on FIFA and its rampant corruption. The bribes in question are laughable, considering that FIFA is a multi-billion dollar operation, and it's always some round number like $1M. At least add some cents to it so it's not glaringly obvious in the bank accounts.
Are the bribes round, or is it just usual bullshit journalism practice of fudging the numbers and rounding them in the process (usually made apparent when there are multiple reports for the same number, each using different units of currency or measure).
Plenty of nice round numbers in this indictment: https://www.justice.gov/archives/opa/file/450211/dl?inline
Search for “Wire transfer of” to jump to them.
Plus a couple of $1,666,667 which stand out in contrast to all the zeroes.
They are usually round so that those who worked on it can get paid.
That's how Groupon originally started.
And you cannot offer the Kushner family OpenAI shares. The 4 million is just the surface.
The estimated spending on the 2026 election season is $11.6 billion [1]. One primary has had an estimated $60 million spent on it (ie the Michigan Democratic primary). Thomas Massie's primary had an estimated $35 million spent on it. A GOP Super PAC has earmarked $342 million for 8 Senate races [2].
Over $5 billion was spent on lobbying in 2025 [3].
To truly move policy you need to get pliable representatives first and that's not just money. There is a pipeline here. First, you get the right connections. That could be coming from a wealth family, be the nephew or grandson of some politician, do your time as a staffer or whatever. Going up through the ranks acts as a giant filter to make sure you will maintain the status quo. So you have to find candidates to run for these offices who have been weeded out by the existing processes. And if you don't have enough of them, the DNC or RNC will spend selectively against you in the primary and general election. And an increasing number of races have over $100 million spent on them.
Buying back democracy would be very, very expensive.
And then after all that there's the income and jobs pipeline. Your children get six-figure jobs with think tanks and interested companies. You leave office and get placed on boards of large companies. You can't compete with that.
[1]: https://finance.yahoo.com/media-advertising/articles/2026-el...
[2]: https://thehill.com/homenews/campaign/5818507-gop-super-pac-...
[3]: https://www.opensecrets.org/federal-lobbying
It seems to me that there's really nothing at that store that "normal people" want to buy.
Everything that we want to do can be done through ordinary collaboration with no need for the state. The special services which the state provides (violence and threats of violence, imperialism, inhibition of movement of people and goods across imaginary lines, etc) are the kinds of things that are really only interesting to the kinds of people who are already spending their money on lobbying.
It would not surprise me that the cost of lobbying rises exponentially as the policy moves left on the political spectrum. That pro-business, pro-austerity, neo-liberal policy is orders of magnitude cheaper to lobby for, then pro-worker, pro-democracy, pro-consumer policy.
Pro business is pro consumer.
Pro business is pro business. That's reality, not a value judgement.
"re-buy democracy"
It says a lot, if you think about it.