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8 changed files with 66 additions and 2 deletions
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@ -39,6 +39,12 @@ The GLP-1 case is particularly stark because the clinical evidence is robust (ca
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The claim that budget scoring "systematically" undervalues prevention requires evidence beyond a single case. However, the GLP-1 divergence is consistent with known CBO methodology (10-year window, conservative assumptions) and parallels similar scoring challenges for other preventive interventions (vaccines, screening programs). The structural bias is well-documented in health policy literature, though this source provides the most dramatic single-case illustration.
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### Additional Evidence (confirm)
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*Source: [[2024-11-01-aspe-medicare-anti-obesity-medication-coverage]] | Added: 2026-03-16*
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The CBO vs. ASPE divergence on Medicare GLP-1 coverage provides concrete evidence: CBO projects $35B in additional spending (2026-2034) using budget scoring methodology, while ASPE projects net savings of $715M over 10 years using clinical economics methodology that includes downstream event avoidance. The $35.7B gap between these estimates demonstrates how budget scoring rules structurally disadvantage preventive interventions. CBO uses conservative uptake assumptions and doesn't fully count avoided hospitalizations and disease progression within the 10-year window, while ASPE includes 38,950 CV events avoided and 6,180 deaths avoided. Both are technically correct but answer different questions—budget impact vs. clinical economics.
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Relevant Notes:
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@ -34,6 +34,12 @@ Rated experimental because this is a proposed design not yet deployed. The liqui
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Coal's v0.6 migration sets minimum liquidity requirements of 1500 USDC and 2000 coal for proposals, with OTC buyer lined up to purchase dev fund tokens and seed the futarchy AMM. This shows the liquidity bootstrapping pattern extends beyond initial launch to governance upgrades, where projects must arrange capital to meet minimum depth requirements before migration.
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### Additional Evidence (confirm)
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*Source: [[2024-01-24-futardio-proposal-develop-amm-program-for-futarchy]] | Added: 2026-03-16*
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The proposal describes the bootstrapping mechanism: 'These types of proposals would also require that the proposer lock-up some initial liquidity, and set the starting price for the pass/fail markets. With this setup, liquidity would start low when the proposal is launched, someone would swap and move the AMM price to their preferred price, and then provide liquidity at that price since the fee incentives are high. Liquidity would increase over the duration of the proposal.'
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Relevant Notes:
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@ -21,6 +21,12 @@ This cost differential becomes material at scale: a DAO running 50 proposals ann
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- AMM state requirements described as "almost nothing"
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- State rent recovery requires autocrat program migration (feedback section)
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### Additional Evidence (confirm)
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*Source: [[2024-01-24-futardio-proposal-develop-amm-program-for-futarchy]] | Added: 2026-03-16*
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MetaDAO proposal CF9QUBS251FnNGZHLJ4WbB2CVRi5BtqJbCqMi47NX1PG quantifies the cost reduction: CLOB market pairs cost 3.75 SOL in state rent per proposal (135-225 SOL annually at 3-5 proposals/month), while AMMs cost 'almost nothing' in state rent. At January 2024 SOL prices ($85), this represents $11,475-$19,125 annual savings.
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Relevant Notes:
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@ -23,6 +23,12 @@ This connects to [[MetaDAOs futarchy implementation shows limited trading volume
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- Expected pattern: liquidity increases as proposal duration progresses
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- CLOB minimum order size (1 META) acts as spam filter but fragments liquidity further
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### Additional Evidence (confirm)
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*Source: [[2024-01-24-futardio-proposal-develop-amm-program-for-futarchy]] | Added: 2026-03-16*
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The proposal identifies that 'estimating a fair price for the future value of MetaDao under pass/fail conditions is difficult, and most reasonable estimates will have a wide range. This uncertainty discourages people from risking their funds with limit orders near the midpoint price, and has the effect of reducing liquidity (and trading).' This is cited as 'the main reason for switching to AMMs.'
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Relevant Notes:
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@ -36,6 +36,12 @@ The mechanism depends on futarchy-specific conditions (short duration, governanc
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- May reduce legitimate trading volume
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- LP attraction depends on base trading activity
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### Additional Evidence (confirm)
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*Source: [[2024-01-24-futardio-proposal-develop-amm-program-for-futarchy]] | Added: 2026-03-16*
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MetaDAO's AMM proposal sets fees at 3-5% explicitly to 'both: encourage LPs, and aggressively discourage wash-trading and manipulation.' The mechanism works because high fees make price manipulation through wash trading expensive while creating strong incentives for liquidity provision.
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Relevant Notes:
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@ -30,6 +30,12 @@ The proposal acknowledges CLOB manipulation is "a 1/n problem" addressable by de
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- No empirical data on manipulation resistance
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- High fees may reduce legitimate trading volume
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### Additional Evidence (extend)
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*Source: [[2024-01-24-futardio-proposal-develop-amm-program-for-futarchy]] | Added: 2026-03-16*
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The proposal specifies the implementation: 'liquidity-weighted price over time. The more liquidity that is on the books, the more weight the current price of the pass or fail market is given. Every time there is a swap, these metrics are updated/aggregated.' This creates a continuous aggregation mechanism rather than point-in-time measurement.
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Relevant Notes:
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@ -6,9 +6,13 @@ url: "https://www.futard.io/proposal/CF9QUBS251FnNGZHLJ4WbB2CVRi5BtqJbCqMi47NX1P
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date: 2024-01-24
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domain: internet-finance
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format: data
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status: unprocessed
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status: enrichment
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tags: [futardio, metadao, futarchy, solana, governance]
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event_type: proposal
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processed_by: rio
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processed_date: 2026-03-16
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enrichments_applied: ["amm-futarchy-reduces-state-rent-costs-by-99-percent-versus-clob-by-eliminating-orderbook-storage-requirements.md", "futarchy-clob-liquidity-fragmentation-creates-wide-spreads-because-pricing-counterfactual-governance-outcomes-has-inherent-uncertainty.md", "high-fee-amms-create-lp-incentive-and-manipulation-deterrent-simultaneously-by-making-passive-provision-profitable-and-active-trading-expensive.md", "liquidity-weighted-price-over-time-solves-futarchy-manipulation-through-capital-commitment-not-vote-counting.md", "amm-futarchy-bootstraps-liquidity-through-high-fee-incentives-and-required-proposer-initial-liquidity-creating-self-reinforcing-depth.md"]
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extraction_model: "anthropic/claude-sonnet-4.5"
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---
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## Proposal Details
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@ -128,3 +132,14 @@ Any important changes or feedback brought up during the proposal vote will be re
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- Autocrat version: 0.1
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- Completed: 2024-01-29
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- Ended: 2024-01-29
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## Key Facts
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- MetaDAO Proposal #4 (CF9QUBS251FnNGZHLJ4WbB2CVRi5BtqJbCqMi47NX1PG) passed on 2024-01-24
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- Proposal completed on 2024-01-29
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- Budget: 400 META on passing + 800 META on completion
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- CLOB minimum order size was 1 META as spam filter
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- AMM implementation timeline: 3 weeks development + 1 week review
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- Proposer: XXXvLz1B89UtcTsg2hT3cL9qUJi5PqEEBTHg57MfNkZ
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- DAO account: 7J5yieabpMoiN3LrdfJnRjQiXHgi7f47UuMnyMyR78yy
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- Autocrat version: 0.1
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@ -7,9 +7,13 @@ date: 2024-11-01
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domain: health
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secondary_domains: [internet-finance]
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format: policy
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status: unprocessed
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status: enrichment
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priority: medium
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tags: [glp-1, medicare, obesity, budget-impact, CBO, federal-spending]
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processed_by: vida
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processed_date: 2026-03-16
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enrichments_applied: ["federal-budget-scoring-methodology-systematically-undervalues-preventive-interventions-because-10-year-window-excludes-long-term-savings.md"]
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extraction_model: "anthropic/claude-sonnet-4.5"
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---
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## Content
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@ -45,3 +49,12 @@ WHY ARCHIVED: The CBO vs. ASPE divergence reveals a systematic bias in how preve
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EXTRACTION HINT: Focus on the methodological divergence as evidence of structural misalignment in policy evaluation, not just the GLP-1 budget numbers
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flagged_for_leo: ["Budget scoring methodology systematically disadvantages prevention — this is a cross-domain structural problem affecting all preventive health investments"]
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## Key Facts
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- CBO estimates Medicare coverage of anti-obesity medications would increase federal spending by $35 billion over 2026-2034
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- ASPE estimates net savings of $715 million over 10 years from Medicare GLP-1 coverage (range: $412M to $1.04B)
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- Broad semaglutide access projected to avoid 38,950 CV events and 6,180 deaths over 10 years
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- Annual Part D cost increase from Medicare GLP-1 coverage: $3.1-6.1 billion
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- Approximately 10% of Medicare beneficiaries would be eligible under proposed criteria requiring comorbidities
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- Proposed eligibility criteria require CVD history, heart failure, CKD, or prediabetes—not just BMI threshold
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