Year: 2014

Have you seen this 4-minute YouTube?

If you’re part of the conference call culture, you’ll chuckle.

If you’re not, you’ll enjoy feeling superior to the rest of us.

Off at TED, having my mind blown.

I cede the rest of my time to Chris Hayes, Rachel Maddow, Jon Stewart, and Stephen Colbert (alphabetically by time slot).

GOOD, BRAVE RUSSIANS

Artyom Matusov:  “Here is full four-hour coverage of the anti-war protests in Moscow, where tens of thousands of people marched, and somehow a stage was allowed to be constructed for speakers to address the rally, openly calling Putin a warmonger who needs to be removed.  It’s a historic moment for several reasons, regardless of what happens.  First, it’s a miracle that so many people showed up, despite the fact that any remaining independent media, including social media outlets have been blocked, and people know there is a good chance they could be sent to prison for a long time for participating. Second, in a world where good triumphs, this rally could be the beginning of Putin’s undoing, and prevent a full scale invasion of Ukraine and other former Soviet states. It’s hard for me to believe that this can happen, but I also didn’t believe that a protest of this scale could happen.  Finally, if the world turns out to be what we’ve become accustomed to, where good often doesn’t triumph, this protest will probably be the last time anything like this can happen in Russia for a very long time — yet I didn’t see it covered in the U.S. anywhere.  Did you?  I’d like to see English captions for some of the more moving speeches, and the Western media showing how big the protest is so that people will feel moved to support them, and so that the protesters feel like the world is with them.  I think those kinds of things matter, and I haven’t found anyone in the western media covering it so far (via a Google news search, at least).”

HOW OTHER RUSSIANS SEE IT

This, from the Moscow Times, gives a sense of what we’re up against:

Russia Must Stop U.S. Expansion in Ukraine
By Sergei Markov / Mar. 14 2014

. . . The Crimean crisis, which began as a power struggle between the ruling authorities in Kiev and opposition forces, transformed into an attempt to overthrow Ukrainian President Viktor Yanukovych by pro-Western and nationalist opposition forces with the support of the U.S. and European Union.

The crisis escalated into a conflict between the U.S. and Russia after the West supported a coup, then lied by violating the Feb. 21 agreement when it recognized the formation of a new and illegitimate government of extremists.

This conflict has the potential of sparking a new Cold War — something I never thought could happen in modern times since I believed it would have to be rooted in ideological differences. Instead, Moscow and Washington have billions of dollars of economic interests at stake, making this a geopolitical rather than an ideological Cold War.

Moscow does not see the revolution in Ukraine as an attempt to create a more democratic or law-based society. Instead, it sees the events in Kiev as an attempt to make Ukraine as anti-Russian as possible. The new government represents a minority of the Ukrainian population. It wants to suppress the Russian-speaking majority and violate their right to representation by holding unfair elections on May 25.

Moreover, U.S. President Barack Obama and German Chancellor Angela Merkel deceived President Vladimir Putin when they persuaded him to convince Yanukovych to refrain from using force to quell the Maidan, and then to sign the Feb. 21 agreement — which they refused to uphold. Instead, they told Russia to accept the new reality in Ukraine. But why should Moscow accept that reality when it is directed against Russia, democracy and human rights?

What did Russia do to become the focus of so much animosity? Is it because it prevented the West from bombing Syria? Because it persuaded Yanukovych not to sign the Association Agreement — a treaty of little real importance to the EU? Those are trivial reasons for starting a new Cold War.

It seems that the West simply does not like Putin. He is a huge obstacle who prevents them from achieving global hegemony. For this reason alone he must be broken. Nobody in Moscow has any doubt that what happened in Ukraine will be repeated in Moscow in two or three years. Without Putin, there will be few world leaders left who have the power or courage to stand up to Washington. When this happens, the entire world will have to quickly accept the new reality.

Russia is not in Crimea to expand its territory but to oppose the immense power of West and its financial institutions in New York and London. Washington wants to characterize this as a conflict between Moscow and Kiev, thereby forcing Russia to negotiate with an illegitimate regime determined to destroy everything Russian in Ukraine.

However, everyone understands that this is a conflict between Moscow and Washington and that these countries should negotiate a solution. The question here is not Crimea but which reality the two sides are prepared to accept.

Should Moscow allow Washington to force it into humiliating submission and accept the possibility of a violent overthrow of the Putin regime? Or should Washington acknowledge that it can no longer impose its will on others? Both sides are unwilling to admit their weakness, thus making a geopolitical Cold War likely.

The West will hit Russia with economic sanctions to pressure Russian oligarchs into forming a fifth column, just as it did in Ukraine. To avoid this, Moscow will have to force oligarchs to bring their overseas assets back to Russia.

If Washington wins this geopolitical Cold War, it will install a pro-Western government in Moscow which could lead to the breakup of Russia. Siberia, the Caucasus and the Far East will demand autonomy, and the country’s oil and gas resources will be transferred from the government to multinational corporations.

However, it is possible that Russia can resist, thereby fulfilling its historical mission of foiling the designs of those who long for world domination. Just as Russia stopped Hitler in the 20th century, Napoleon in the 19th century and Frederick the Great in the 18th century, it will stop Washington in the 21st century. This is nothing personal, just business. Russia has its historical mission to fulfill.

If a geopolitical Cold War erupts, it very well may morph into an ideological one since a Western attack would force Putin to rely heavily on conservative forces in the country’s so-called “moral majority” in order to bolster his support. Additionally, Moscow will attempt to relieve pressure and find support abroad by stepping up its information campaign among the hundreds of millions of EU residents who sympathize not only with Putin’s stance against Washington, but also his support of the traditional values that have been rejected by the EU elite.

Recent polls show that 80 percent of Germany’s population sympathizes with Russian policy in Ukraine and only 8 percent favor sanctions. The online social networks in the West constitute an intellectual revolt against the bias of the mainstream media — all of which demonize Putin without any objectivity. Social network users clearly sympathize with Putin and their support will only grow.

Washington once transformed Cesar Chavez from a minor U.S. activist into a major political figure. Now Washington will transform Putin from his role as the man that lifted Russia off its knees into a global leader in the struggle against the global domination of Washington and the new values of postmodernism.

However, I would like to believe that the current crisis will not develop into a full-fledged geopolitical Cold War. After all, Obama thinks in 21st century terms, not 19th century. For his part, Putin holds many Western convictions. What’s more, a geopolitical Cold War would hit Europe the hardest, robbing it of the balanced economic growth it needs and preventing it from consolidating its resources for something more useful. It is now the time for every responsible European leader to speak out against a new Cold War since they have the most to lose.

The way to end this standoff is clear: Ukraine must become a neutral state with a democratic government. It must grant full equality to both its Ukrainian and Russian-speaking citizens, adopt the policy of federalism and make both Ukrainian and Russian official state languages.

Sergei Markov is director of the Institute of Political Studies.

A rather different perspective from ours.  It’s nuts, but it seems to have a great deal of traction in Russia.  After all, in any country it is easy for “the people” to be misled.  Look how many of them elected a certain German eighty years ago . . . how many North Koreans wept at the death of Kim Jong-Il . . . how many of our own well-intentioned compatriots believed, when they reelected George W. Bush, that Iraq had had a hand in 9/11 (or how many believe our current president is a Kenyan-born Muslim).

Russia is in a scary place.  On top of which, it is a kleptocracy.

Some say Putin may be the richest man in the world.  For all I can prove, he has but one shirt which, photographs show, is frequently in the wash.  But did you see this, in The Nation, about dirty money in Miami real estate?

In February, a member of Russia’s ruling party, Vladimir Pekhtin, was forced to resign from the Duma when a blogger published documents showing that he owned three Miami properties worth more than a combined $2 million.  Pekhtin’s holdings were especially embarrassing because he had not disclosed his overseas properties in his annual financial disclosure filing, as is legally required under a bill he had written as chairman of the Duma’s ethics committee.  In Russia, which saw illegal capital outflows of more than $200 billion from 1994 to 2011, charges of corruption and lavish spending overseas have become major political issues.  

I’m so glad I live here and not there.  

Monday, I linked to that New York Magazine story on over-priced drugs of marginal utility.

For me, it raises two questions:

First, of course: In a world of limited resources, how do we get to a better balance of cost and results for our healthcare system?  Does it make sense to spend a fortune on drugs that add little or nothing in terms of efficacy?  That’s the important question.  And it leads to questions like: should Medicare be allowed to negotiate drug prices?  Are our pharmaceutical companies swinging for the fences in search of breakthrough treatments — or, as suggested, in New York Magazine piece, are they now largely incentivised to make minor differentiations that will allow them to charge — and receive — a fortune for something that already basically exists?

Second:  Should I sell my drug stocks?  That’s a question of little importance, but it still interests me.  And it leads to questions like: will the government and private insurers eventually drive a harder bargain with the drug companies . . . even as we continue to provide loads of inventive for research and ever better health care?

I’m no expert in this, to say the least.

One of my friends who is an expert, and who has strong feelings he’s shared with me privately over the years, is our very own Guru.

Another is esteemed reader Kevin Knopf.   Let me first hand the mike to him, then to Guru.  (There will be no quiz.)

Kevin:

The drug cost problem is a very complicated one – multifaceted.  The New York Magazine piece touched on some of them, but certainly not all.

I’m a researcher in Cancer Pharmacoeconomics (the economics of cancer drug prices), with a masters of public health degree so I may see it from the liberal perspective.  But let’s consider some defense for the drug companies, to keep it fair.

#1  The US is a capitalist country.  The drug companies are behaving as they should in this system — maximizing profit and ROI.  Other corporations act the same way — Apple, JP Morgan, Goldman Sachs, Bain Capital, etc.

#2  Because all industrialized countries besides the US  have a single-payer system that holds down drug prices, much of the money for R&D ostensibly comes from the higher prices Pharma can charge their US customers.  This means the US health care system is financing other countries’ health care systems.  As a result, our corporations spend more on insurance premiums, which affects their profitability in the global marketplace.

#3 – Very early in the negotiations for Obamacare, President Obama met with Pharma executives and assured them they would not lose profit under Obamacare.
(Here I should point out that we physicians got no such promise.)

#4 – With the drying up of federal funds for medical research, particularly the NIH whose budget has been axed repeatedly by [the Republican] Congress, many drug companies are supporting development of our researchers with post-doc positions, and career tracks that formerly were in academia (via grants).  A whole generation of researchers are having their careers with PHARMA.  And, via partnerships with academic medical centers, they are supporting the careers of many physicians and researchers.

It gets more complicated after that.  If you have the time/inclination, I gave a ten-minute talk on health economics to a group of MIT alums, about how to fund cancer research, including pharmaceutical R&D.  My talk starts about six and a half minutes into this link.

Guru:

In a free market economy, the buyer must experience the full effect of the price and then choose between alternatives.  But in our healthcare system, the game is to ensure that the buyer—the consumer—does not experience the full effect of the price.  And, of course, there often are no alternatives.  Even when there are, the drug makers game the system.

New cancer drugs are now being launched at more than $100,000 a year, even if they add on average 2 months to survival.  Drugs for orphan diseases (those with fewer than 200,000 affected) are usually priced at $250,000 to $400,000 a year.   Once the drug is approved and priced, the company must get it onto an insurance company’s formulary.  The standard approach for most insurance companies is to accept whatever price the company charges, believing it would be a political hot potato to deny kids with rare genetic disorders or cancer patients drugs that could help them. 

The insurance companies create three tiers of reimbursement.  Tier 3 usually means hundreds or a thousand dollars per month out of the consumer’s pocket by way of the co-pay.  But to keep this from deterring sales, the drug maker turns around and sets up a “reimbursement division” that “coupons” — literally sends the patient a check — to cover that out-of-pocket expense.  So the consumer may experience zero price effect.  And the drug companies do fine.  If the list price is $400,000 a year, the net after “couponing” might be $320,000 or $350,000, but even at that, the cost of goods sold is still about 11% — leaving plenty of profit!  Who pays for this?  It goes straight to the rest of the insurance policy purchasers (or the taxpayers):  cost shift to thousands (or millions) of people who have absolutely no say in the process.

Let’s take some examples:

1.  If a product has been on the market and there are numerous alternatives, you expect the price to go down.  (Take the cost of a cellphone, for example.)  Not in the pharmaceutical business.  Amgen (AMGN) and Abbvie (ABBV) both have antibodies against TNF to treat arthritis.  The big breakthrough is that ABBV’s antibody, Humira, can be taken every two weeks, whereas Amgen’s Enbrel is once a week.  Both products have been on the market for more than ten years and there are several other anti-TNF antibodies also on the market.  Nonetheless, AMGN and ABBV raise price every year more than 10% –that’s about 5 times the CPI—and it sticks.  AMGN has not seen in increase in unit growth of Enbrel for a few years, but sales of Enbrel keep growing double digits purely because of price, and that price increase goes straight to the bottom line, while the policy holders of insurance companies have to see double digit price hikes in their premiums.  Does Enbrel work twice as well as it did when first launched?  No.  Are there fewer alternatives?  No, there are many more.  Yet Enbrel is priced are more than twice its original price.  Why? Because the companies can get away with it.  There is no gatekeeper.  You just cost-shift to the group of people who have least say in the process.  Sure, they could try to switch plans, but all the plans are in on this.

2. Let’s take another example.  JAZZ pharmaceuticals.  Jazz sells Xyrem—GHB.  GHB was available over the counter in the health food stores until 1990 when the FDA figured out that high doses of GHB caused potentially fatal side effects and banned it.  Studies were going on in the 1980s that suggested GHB is useful for sleep disorders.  GHB, after all, is made in your brain—it’s a neurotransmitter.  In any case, a start-up company called Orphan Drug decided to conduct trials in “narcolepsy” patients, defined broadly as those with “excessive daytime sleepiness.”  Yes, there are a tiny number of people with the classic narcolepsy that causes them to fall over asleep in the middle of the day.  On the other hand, “excessive daytime sleepiness” is something probably most Americans have had at one time or another.  Orphan got GHB approved for narcolepsy by the FDA and JAZZ bought Orphan.  Initially, GHB was priced about $3,000 a year—an enormous mark up to the health food store price, but roughly in line with anti-depressants and other neuro-affective drugs.  The idea was to sell a little for narcolepsy and a lot more for a condition called fibromyalgia syndrome that affects millions of people.  The fibromyalgia trials succeeded, but the FDA rejected the application because the risk of fatalities from widespread use of GHB was too high.  In response, JAZZ jacked up the price of GHB to focus solely on the “orphan” indication of narcolepsy.  They currently price GHB at more than $45,000 a year!  In February 2014, they took a 12% price hike—that’s about 6 times the CPI.  How many people in America got 12% salary increases?  Well, JAZZ just took the price hike.  Is GHB patented?  No.  However, Jazz has a “patent” on their system of “limited distribution” to avoid fatalities (oh, there have been fatalities among patients on GHB sold by Jazz—maybe fewer than there would be) and Jazz is fighting the FDA to approve other applicants who want to sell GHB.  Is this capitalism?  No, it is cronyism—where you take an old drug and price it at astronomical levels to make big profits for Henry Kravis (one of JAZZ’s founders) by gaming the system.  It is the opposite of capitalism.

3.  Or let’s look at Horizon (HZNP).  Horizon sells prescription ibuprofen.  Yes.  Prescription ibuprofen. The high dose (800 mg) required by some patients for arthritis comes in a “prescription” tablet so that the doctor can monitor the patient for stomach bleeding side effects.  Can you buy a bottle over the counter and take four 200 mg tablets without a prescription?  Yes, you can.  Still, there is prescription ibuprofen.  There are numerous generic manufacturers.  A bottle for a month is about $6.  To combat the risk of stomach bleeding, you can also take over the counter famotidine or omeprazole.  Again, a month’s supply will cost about $4.  Take both and your cost is $10/month.  Horizon developed a single pill that staples ibuprofen to famotidine.  Does this improve the efficacy?  No.  It slightly decreases the efficacy.  Still, it improves compliance.  It ensures that the patient takes both.  I suppose it is too much to ask the patient to take pills from each bottle.  Still, there is nothing here that can’t be done better by taking the two pills.  Horizon was flogging their prescription ibuprofen-famotidine and making little money until a year ago when they jacked up the price from about $100/month to $500/month and now about $800/month.  Yes, $800/month versus $10/month for medically the same thing.  Again, the plans approve this as a “tier 3,” but Horizon “coupons” the patient so his out of pocket is–$10/month!  Who pays for the rest?  You and I do.  The strategy of Horizon is to troll for doctors who will write prescriptions for their drug combination and to set up a “specialty pharmacy” that ensures that the patient gets the Horizon version and not a generic or over-the-counter equivalent, even though medically speaking, they are all the same.  The result?  Revenue and profits are exploding and HZNP has gone from $2/share to $13/share.  All for gaming the system.The only entity that does not allow itself to be gamed is the government:  Medicare and Medicaid do not allow “couponing.”  Horizon has dropped Medicare patients as a result:  doesn’t even focus on them.  Why do doctors write for this combination when there are generic equivalents?  The doctor does not pay for it—she never sees the price—and the doctor worries that the patient might get a stomach bleed without the famotidine component.  It is an understandable concern, but really, the patient can accept some responsibility, take two pills instead of one, and save the system $790/month.

So this is a big portion of the American drug industry:  set prices anywhere you want . . . raise them yearly at five to six times the CPI . . . “coupon” the person who otherwise would experience the pain of the price and seek cheaper alternatives . . . and shift costs to the rest of us who have absolutely no say in the process and who see the cost of our healthcare go up well in excess of the rises in our compensation.  Stiff the American public and tell them you are doing them a good turn.

Meanwhile, just FYI, the UK has the NICE committee and Germany has the IQWIG committee, both of which do draw the line–a line is always drawn explicitly or implicitly–about how much benefit (in terms of years of quality life saved) is required to get reimbursement in those countries.  The responsible adult thing is to admit limitations of resources and draw some lines (ration).  The infantile approach is to be entirely emotional and insist that no lines ever be drawn.  We all will die, so there’s one big line.  The UK and Germany have made very sensible moves.  I hope we do, too.

I know I was supposed to post “more expensive healthcare” after Monday’s column.  One thing led to another.  Stay tuned.

For now:

Be sure to watch full screen.  These are awesome.  What people and things really looked like.  Tolstoy with his grandchildren.  Darwin, Lincoln, Tesla.  A Civil War battlefield.  The (horse-drawn) cab stand at Madison Square Park.  Boxing before it was regulated.  And so much more.  Even this quote from Albert Einstein, refusing surgery: “I want to go when I want.  It is tasteless to prolong life artificially.   I have done my share, it is time to go.  I will do it elegantly.”*

Nine minutes.  Have a great day.

*The quote appears to be true.  The caption, “pictured with his therapist,” is not.  As best I can Google, Einstein had no therapist.

EXPENSIVE DRUGS

Read this.  I’m months late suggesting it — the flight attendant didn’t even want my New York Magazine, when she saw it was dated October 28 — but the price of many drugs really is insane.  And, yes, we do need a wonderfully profitable drug industry to inspire continued research and the extraordinary expense of human trials . . . but we’ve gone a little crazy.

As noted in the article, if a drug extends a cancer patient’s life by a day and costs $1 million it would be criminal to to ask our fellow insureds to pay for it — while if that same drug extended life a month and cost $1, it would be criminal not to prescribe it.   So there’s got to be some balance.

No one can say where that balance should be in any given instance — reasonable people can differ — but my guess is that when you read the article you will decide we’ve drifted out of the range of reasonableness.

More examples tomorrow.

CHEAP HEALTH CARE

Obamacare works — particularly if you’re a woman.  Behold Planned Parenthood’s infographics.

HE’S OLD – BUT CAN HE PARK!

Enjoy.

EXPENSIVE HEALTH CARE

Don’t miss this Daily Show clip — as Aasif Mandvi explores third-world health care.  Just past the middle, there’s a stretch of “speechlessness” that gives new meaning to the word “pricelessness.”

Listen:

If you’re affluent, the U.S. health care system is #1.  (On average, it’s #37.)

And if you’re really affluent, you should be thrilled that House Republicans just voted for the 50th time to repeal Obamacare.  It takes resources from those like you — now taxed $380,000 more on each $10 million you earn from dividends and capital gains — and gives health care to the poor, who obviously have done nothing to deserve it.  (Other than cleaning your toilets and trimming your hedges.)  (Or raising children.)  (Or being children.)

If you’re lucky, one day — perhaps on the 55th or 60th vote — the Republicans will get you that $380,000 back, and we can restore the cost-saving lifetime caps on people’s insurance policies (cost-saving, because if someone gets one of those nightmare medical issues, the insurer can drop them after the cap is reached) and stop insuring anyone with a preexisting condition (because, really, what kind of insanity is it to insure all comers? the whole point of underwriting is to be able to reject the bad risks).

But until then, keep high-dividend stocks in your $100 million IRA and minimize turn-over of the others — “buy and hold” — so your portfolio grows with ZERO capital gains tax until we get Republican control of the government and zero out taxes on wealth and inheritance.*  Thus, for now, I see no reason to take profits in CISG, up 35% since suggested here in December.  My hope is that it might double over the next few years.

*Those tax rates are currently lower than they were when Reagan left office.  But I don’t care: until they’re zero, theyre too high.

CHEAP HEALTH CARE

Have you seen this TED talk?  Manu Prakash shows off his 50-cent microscopes, made out of paper, that will allow users around the world to test for various diseases — just as if they had the heavy, expensive kind.  (The expensive kind must be handled with care.  Watch Manu stomp on his.  “My students hate when I do this,” he says — but his microscopes just shrug off the pain.)

Tomorrow: More Expensive Health Care

ENTIRELY UNNECESSARY DESPAIR AND RAGE

“Old white people are drowning in despair and rage.  Here’s how my father lost his mind — thanks to his cable diet.”  By Edwin Lyngar.  Maybe you know an enraged old white person in whom this could trigger a catharsis of self-recognition?

IRAQ

Guess what: it was all about the oil, after all.  (When we went in the only building we protected — not the museums or anything else — was the Oil  Ministry.)  I love the interviewee who notes that it would have been a lot cheaper — and destroyed far fewer lives (as in . . . none?) — just to buy the oil than to invade and occupy the country for 10 years.

If you have an hour this weekend, watch.  And if you have five minutes:

CELLOS

Jim Burt:  “Thanks for the towel dancers.  A hoot!  In return, I offer you 2Cellos.”

☞ Love this.  Have a great weekend.

FUN!

Oh, those French.  Four minutes of towel dancing.  Don’t say I never gave you anything.

UGH

Guess who appears to be guilty of insider trading?   S.E.C. employees.

HUZZAH!

Microsoft Level II “Pat” called me precisely on time tonight from the Philippines, but by the time he did I had discovered the problem:  Microsoft Outlook 2013 works fine in Miami and Washington, but if you use one of the two main Internet providers in New York, it won’t release outgoing emails until you return to Miami.  (This was not a feature of Microsoft Outlook 2010.)  Yes, Pat explained.  “When you get back to New York, call us again and we’ll help you adjust the settings for your Internet provider.”

BETA

You’re smart and interested in stuff — care to give fledgling IdeaPod a spin?  (Full disclosure: I have a tiny interest.)  It launched in beta February 20.  Early press:

> VentureBeat: “If Upworthy launched a social network, this is what it would look like”

> PSFK: “Visual idea-sharing platform connects people with passions”

> The Culture-Ist: “Like Pinterest, but Better: The New Social Media Platform That’s About to Change the World”

> PandoDaily: “Ideapod is a social network for ideas, not to be confused with those other non-idea social networks”

> InTheCapital: “Meet Ideapod: Upworthy Meets Pinterest in Social Media Platform for Life-Changing Ideas”

Without gossip, edge, and naked boys towel dancing, I don’t really see how this site makes it.  But I didn’t see A Chorus Line making it on Broadway and suggested Google puts when the stock was $150, so with any luck I’ll again be hugely wrong.

I mentioned my hero Mark Plotkin the other day (helping to save millions of acres of Amazon rain forest, without which we would never have had rubber). Well, read him here on shamans and the importance of hallucinogenic frog slime.

At the other extreme from natural herbal medicine is this artificial pericardium that, after another 10 or 15 years of refinement, might keep your heart beating more or less forever.  (So: moisturize.  And fully fund your Roth IRA.  You could be around a long time.)

If this post seems short, thank Microsoft, whose Outlook software has decided not to send my outgoing mail.  Mail comes in fine, but replies get trapped in the Outbox and never leave.  It’s a novel feature that appeared out of the blue.  Because I know somebody, I got right through to tech support — they didn’t even ask for my credit card or serial number (seriously? could this be Microsoft??) and a mere 40 minutes later the technician returned control of my screen, explaining that he would escalate my case to Level II, and that their tech would call me back tomorrow.  I explained that I am an immensely important person — that I actually shook hands with Bill Gates once in 1988 — and that “tomorrow” just wouldn’t do.  So tomorrow between 8pm and 10pm it will be. (I hope.)