Why are we still facing shortages of masks and medicine a year and a half after the start of the pandemic? Because a buying cartel controls medical supplies, and has for 25 years.
Philip Zweig has been (is) such a fierce outspoken advocate against these kickbacks but faces a David vs. Goliath situation in a purposefully obscured area of healthcare policy and decision-making. It is more than shortages and the harm from not having the right product at the right time. The game-playing and anti-competitive behavior makes hospitals less safe - the best (whatever criteria - mix of price and quality - a consumer of healthcare goods would use to judge "best") products don't win out. Adam Smith himself understood the danger of monopolies, right?
The game-playing in the hospital supply chain can result in products being switched out for no reason other than a backroom deal; that change increases risk as staff need to adjust. I worked in hospitals in patient safety and risk; this happens.
I think we need much more transparency into the books of all companies that work in healthcare - profit or non-profit - to see what is hidden. I don't see that happening so long as our economy is captured by big business or - in healthcare - what is sometimes called the medical-industrial complex (which, in my view, includes the AMA).
I also don't think most hospital staff know leadership has a financial stake in decisions made to choose/reject products and supplies. It is bizarre but it is almost like hospitals need internal air-tight bans on voting/weighing in on decisions where one has a financial conflict-of-interest (disclosure being wholly inadequate) - including at the Board level.
Indicting Zuckerberg, then trying, convicting, and sentencing him to time in prison would go a long way toward restoring the faith of the American people in the American justice system. Doing the same to the former guy would go even further.
Couldn’t we do something like charge a significant excise tax on all M&A activity, and give that money to the FTC? That way the agency resources will scale with their responsibilities
Yesterday, while I was being wheeled into the CT donut, the CT nurse asked the CT tech where all the vials were. Her response, “supply chain problems or something.”
Having worked for decades in a hospital, I have intuitively understood what you've written here but now I have the explanation that makes sense of it all. Thankyou.
I wouldn't underestimate the intent to which government plays in all of this- you guys seem to have regulations governing everything other than product safety itself. In effect American Government has become the East India Company, with corporate monopolies its individual fiefdoms. Adam Smith would turn in his grave given just how opposed he was to the original monstrosity.
'Regulation is this disease of which it pretends to be the cure.'
One thing you could do is switch to the pay-as-you-earn (PAYE) systems which most other countries akready operate. Some of Internal Revenues freed time could be used to go after the top 10% for non-payment of taxes, but far more time could be invested in auditing government itself and anti-competition research with a view to congressional action.
If mergers lead to fewer (bigger) corporations and less competition, what will be the effect on the number of lobbyists in Washington and the size and quantity of the bribes (I mean campaign contributions) that are paid to politicians? I'm thinking there will be less competition among lobbyists, fewer visits, smaller suitcases filled with cash and less extravagant junkets. Washington must act swiftly prevent this dangerous and preventable tragedy. Break up the cartels now.
Independent hospitals are enticed to join a Premier like GPO provider to secure the commissions off of the direct and indirect spends of the hospital. Some years ago while still working with a large integrated carrier, I recall the fee back to the GPO was 3% of the value of the goods or service.
ANY Hospital should try to be a "health intervention for local citizens": i.e. it should be an intervention that is humanistic-hippocratic, i.e. fulfilling all 5 conditions:
safe, efficient, effective, cheap, and TRANSPARENT.
The availability and affordability can only be provided, if it is comprehended as some infrastructure we like to have and pay all for like the streets, the power grid, etc..
We do not shut down streets just because no one drives on one for a month.
Well, you can adopt to demand, but we have to plan with foresight, and no manager under pressure to throw revenues from shares can do this.
Transparent means protected from structural and normal corruption by open and hidden humanistic-hippocratic interventions. Best done by caring citizens.
You can apply the 5 to ALL crisis, personal, local, or global.
If you want to end conflicts, lock-up the anrcissictic empathy-deprived leaders of both Quarrels into a soft padded cell with something to write on: the peace treaty. Only water till signed.
If you want to end hunger, plant EVERY wall with a lot of pots with something to eat.
If you want to end women and weak ones being mis-treated, make your local community strong and empathic and caring and looking after each other.
If you want to end imbalances and unfair trade, FIRST do protect your local businesses, and ask them, when they are ready for the onslaught of global trade, and open gradually. Trade and undistorted markets are like Gaia: they are good.
Only if (structural!) corruption comes in play, we do have a problem.
Then, feedback loops making Gaia work are crippled.
And WHO and UN cut more feedback loops than you can count in recent years.
And cut feedback loops are sign for one thing:
Totalitarianism.
See Prof. Matias Desmet: The psychology of totalitarianism. Eg on headwind.tv
IS transparent research done on the role of CO2 in the oceans? Really?
Have we invested 100ths of billions in basic research, before we melt down whole industries burning 10000ths of billions? Or fiddle with Gaia eg by releasing nanotechnology, trying to "engineer" the weather? Instead of adopting to the change (that is too fast, but why?)!?
Have we looked closely who is messing with the weather by sending up protected planes taking probes that are 24/7 supervised against manipulation and look for nanomaterials able to change e.g. reflectivity or melting point that are normally not found in atmosphere, but increasingly so?
NO ONE can detect nanomaterials in a nano world. It is not that it is not possible. Why not?
Fine dust is snow from yesterday. We need to detect nanoplastics and nanodust and do chemistry analysis on it. ESCAR eg.
(low: min. effective dose, high: NOAEL: No observeable Adverse Events Level (of Dosing):
WHICH medication has NO observeable side effects?
Most protocols use 1/3 of NOAEL, in 1/5..1/10 per session.)
B) effectivity against ALL Pathogens one-celled or smaller
C) NEVER will have resistances. Hospital germs and waning efficacy for medication is a solved problem, for >150yrs. The solutions has a big flaw: it is too available and MUCH too cheap.
D) diffuse through bacterial films eg, and get resorbed by mucosa in mouth or stomach, so never affect the biome. Diffusing:= RESET on incubation time for all treated mucosa eg.
E) softly soothe the immune system
F) dissolve blot clots (where again was this the problem? Started in Wuhan? Or Marburg? Well. Don't care, as we have something against it...)
G) reduce viral load to e.g. 1/3rd (so no wonder cure, but useful).
H) also disinfect aerosols in air if dispersed. CIO2 is self-dispersing, effective 0.01-0.1ppm(vol) in air. Just use 10ml CIO2(aq)0.3% (called CDS) per 10m^2 room.
If public building, use in legal terms "drinking water" (up to 20ppm) by pouring it in 1.5L water in a pet bottle, do not close the lid tightly (or punch in holes and place a membrane from old rain jacket in between).
I) are very honest guys. You do not like them, they tell what they are: antiseptics. They smell of swimming bath etc.. But they fulfill every promise I ever read. (Production residues from CDS go to washing machine, smells clean; put on plate in fridge, no mould; in car: disinfect air paths and filter by "circulating" air 1/4 of an hour, but please: stay out; if you ever have to cough, OBEY immideately.
ONLY CIO2 is "self-warning", inhaling the others needs a protocol and dose-finding: rule: NO breathability degradation is tolerable, so mindfully test it by deeply breathing some times before, while and after inhalation session.
(We tolerated well the above stated dosings per session, and inhaled on symptoms as often as we liked. Minimum for prevention is ca. once in he evening, eg., already doing the RESET;)
Here 90% reduction of secondary infections in families having one primary CoV infection case:
For immune system regulating effects, search for hypchlorite eg in animal bite wound care.
It works for ALL pathogens.
ANY study showing "bad marks" eg for H2O2 mostly used PCR. Do not trust any study not telling littly diagrams of dose-related reduction by cell culter measurement ;))
It fits into the picture of "deadly medicine and organized crime" and many more books on that topic.
Next topic would be DMSO, where some shortsightedness in rabbits when 100x overdosing was used as an excuse to NOT giving application by FDA (cite: FDA-boss freaked out as he could not control it, as it is a rechnical solvant AND a medicine). THESE are the medicines to search for - or to create :
For NaHClO: any regulated voltage electrolysis (use lowest voltage possible to avoid Cl2 production) is possible, e.g. use salt pool chlorinators, and attach to a bowl with purified water (demineralised), it gets sterile soon...) and let it run as long as you need to reach 800ppm.
Again, what is available and cheap to have reproduceable Cl concentration? ==>
And whatever you like to do if bad things make terrible symptoms, in the calm of preparation, TRY IT OUT, first one by one to test tolerability and get used to it, then emulate a "treatment run".
up the trees: Literally, see below. And Herbs. And Healing Mushrooms.
Dried walnut leaves have one antiviral (anti-*, actually) mechanism of action and even contain human progesterone a bit, helping healing tissue and nerves, and birch tree bark has another (amentoflavone, a 3CL protease inhibitor like in all kitchen herbs, torreya nucifera, black cumin, one yrd mugwort and probably more).
Moringa.
Rock Rose.
So you have 4 different prinicples of action. Use 2, or all, or: Please: Find more.
The more you have, the better the efficacies of a single intervention multiplies if applied with others.
But do not use the dosing used in "clinical trials", especially if paid by 3 letter orgs, take 5x should be safe ;)) (They regularly underdose to show "sadly, no effect", because normally, plants can't be overdosed. (This was done for HCQ, and the WHO directly gave lethal dosings to hospitals doing a "together" trial. Yes, solidarity... 1100 are dead now, just to be able to say: WE can't use HCQ, but heck, it reduced mortality in waves by FACTOR 10, OK, blessing: lvermectin by FACTOR 14, not alone of course. Zinc sufalte or other organic resorbable form and many more interventions patient-symptoms centered are necessary for 99.99..% success, you write down the numbers of "9" after the comma, and then get help to do all the interventions it implies. Effficacy = 1 - (Product(n=1-N)of(Reduction Rate of one orthogonal Intervention(n))).
By the way, Spring 2019, Inthal (Sanofi) was taken down from market. NO ALTERNATIVE.
By autumn 2019, the last dosing aerosol inhaler was sold by some international pharmacy.
Then Covid could start. As Chromolynium acid effectively blocks the chlorine channel of the spike and inhibits infection, and inhibits cytokine storm alas locally (if not solved micellarly, then systemically even if inhaled. Guess what is not existing.)
Guess now, we can't even buy DNCG iso now, run out, not deliverably; the last chance to inhale it.
EVERY allergic asthma patient in DE is now treated by corticoids or aelveoli dilating etc. stuff. Crazy.
So this means, in 1-2 month on we have something nasty coming.
So DON'T PANIC.
But get one inhaler per family, and set on shelf: inorganic antiseptic inhalable, and time-shifted some anti-allergic nasal spray (they are all anti-viral and anti-cytokine storm), xylitol 9%, iota-CArrageenan 0.15% (trickle in stirred water like snow fall, difficult or easy like clump-free thin pudding, salt with Mg++ or Ca++ in (we use dead sea or stone salt as a "base" for mixing inhalation solution; we cook afterwards and close lid like doing marmelade, store in fridge. 1-2/wk we put in 1 drop of NaHCIO or H2O2 or CIO2(aq) 0.3% to keep it sterile).
If you inhale 0.1-2% H2O2 or 0.1-3% PVP-I: most formulations are sour, bad for lungs, lungs like pH 6.5, so trickle in 0.5% baking soda solution "just till not tasting sour any more" for the supply of some days or 1-2 wks if stored in fridge.
Thanks for the article. I don't quite understand why hospitals and HMOs put up with the GPO markups however? Is every executive getting a free car from them? Otherwise, it seems to me they know they're paying more than they should and getting shortages as part of the bargain-- and that they can do better, save money and pay themselves with the savings, by saying 'no' to price gouging and looking for other suppliers?
I think people missed these monopoly power formations because the mergers were for administrative functions and not mergers of the whole entities. The first joint operating agreement that I know of was a merger of the printing and delivery functions for the Seattle Times and the Seattle Post-Intelligence newspapers. That occurred sometime in the early 80s.
The idea of competitors joining together to share expenses for a common overhead function is called co-opetition. cooperation-competition. With this type of joint operating agreement, the "market" becomes the monopoly thereby skirting our laws against monopolies. I first noticed it sometime in the mid 1990s. There was a small software retailer on the internet that I liked to buy software from. At some point, I figured out that the retailer had become simply a web portal to receive and pass through orders to UPS. UPS became the market middleman between the end customer and the wholesaler.
Side Note: Jeff Skilling of Enron was trying to build a market system for all commodities. He bit off more than he could chew.
Philip Zweig has been (is) such a fierce outspoken advocate against these kickbacks but faces a David vs. Goliath situation in a purposefully obscured area of healthcare policy and decision-making. It is more than shortages and the harm from not having the right product at the right time. The game-playing and anti-competitive behavior makes hospitals less safe - the best (whatever criteria - mix of price and quality - a consumer of healthcare goods would use to judge "best") products don't win out. Adam Smith himself understood the danger of monopolies, right?
The game-playing in the hospital supply chain can result in products being switched out for no reason other than a backroom deal; that change increases risk as staff need to adjust. I worked in hospitals in patient safety and risk; this happens.
I think we need much more transparency into the books of all companies that work in healthcare - profit or non-profit - to see what is hidden. I don't see that happening so long as our economy is captured by big business or - in healthcare - what is sometimes called the medical-industrial complex (which, in my view, includes the AMA).
I also don't think most hospital staff know leadership has a financial stake in decisions made to choose/reject products and supplies. It is bizarre but it is almost like hospitals need internal air-tight bans on voting/weighing in on decisions where one has a financial conflict-of-interest (disclosure being wholly inadequate) - including at the Board level.
Indicting Zuckerberg, then trying, convicting, and sentencing him to time in prison would go a long way toward restoring the faith of the American people in the American justice system. Doing the same to the former guy would go even further.
A phrase from one of the quotes in this article, "perverse incentives," really explains a lot about where we find ourselves as a society today.
Add to this the consolidation of hospitals. Hospitals are merging in to regional monopolies that have absolute control.
Couldn’t we do something like charge a significant excise tax on all M&A activity, and give that money to the FTC? That way the agency resources will scale with their responsibilities
Yesterday, while I was being wheeled into the CT donut, the CT nurse asked the CT tech where all the vials were. Her response, “supply chain problems or something.”
Having worked for decades in a hospital, I have intuitively understood what you've written here but now I have the explanation that makes sense of it all. Thankyou.
I wouldn't underestimate the intent to which government plays in all of this- you guys seem to have regulations governing everything other than product safety itself. In effect American Government has become the East India Company, with corporate monopolies its individual fiefdoms. Adam Smith would turn in his grave given just how opposed he was to the original monstrosity.
'Regulation is this disease of which it pretends to be the cure.'
One thing you could do is switch to the pay-as-you-earn (PAYE) systems which most other countries akready operate. Some of Internal Revenues freed time could be used to go after the top 10% for non-payment of taxes, but far more time could be invested in auditing government itself and anti-competition research with a view to congressional action.
If mergers lead to fewer (bigger) corporations and less competition, what will be the effect on the number of lobbyists in Washington and the size and quantity of the bribes (I mean campaign contributions) that are paid to politicians? I'm thinking there will be less competition among lobbyists, fewer visits, smaller suitcases filled with cash and less extravagant junkets. Washington must act swiftly prevent this dangerous and preventable tragedy. Break up the cartels now.
Independent hospitals are enticed to join a Premier like GPO provider to secure the commissions off of the direct and indirect spends of the hospital. Some years ago while still working with a large integrated carrier, I recall the fee back to the GPO was 3% of the value of the goods or service.
ANY Hospital should try to be a "health intervention for local citizens": i.e. it should be an intervention that is humanistic-hippocratic, i.e. fulfilling all 5 conditions:
safe, efficient, effective, cheap, and TRANSPARENT.
The availability and affordability can only be provided, if it is comprehended as some infrastructure we like to have and pay all for like the streets, the power grid, etc..
We do not shut down streets just because no one drives on one for a month.
Well, you can adopt to demand, but we have to plan with foresight, and no manager under pressure to throw revenues from shares can do this.
Transparent means protected from structural and normal corruption by open and hidden humanistic-hippocratic interventions. Best done by caring citizens.
You can apply the 5 to ALL crisis, personal, local, or global.
If you want to end conflicts, lock-up the anrcissictic empathy-deprived leaders of both Quarrels into a soft padded cell with something to write on: the peace treaty. Only water till signed.
If you want to end hunger, plant EVERY wall with a lot of pots with something to eat.
If you want to end women and weak ones being mis-treated, make your local community strong and empathic and caring and looking after each other.
If you want to end imbalances and unfair trade, FIRST do protect your local businesses, and ask them, when they are ready for the onslaught of global trade, and open gradually. Trade and undistorted markets are like Gaia: they are good.
Only if (structural!) corruption comes in play, we do have a problem.
Then, feedback loops making Gaia work are crippled.
And WHO and UN cut more feedback loops than you can count in recent years.
And cut feedback loops are sign for one thing:
Totalitarianism.
See Prof. Matias Desmet: The psychology of totalitarianism. Eg on headwind.tv
IS transparent research done on the role of CO2 in the oceans? Really?
Have we invested 100ths of billions in basic research, before we melt down whole industries burning 10000ths of billions? Or fiddle with Gaia eg by releasing nanotechnology, trying to "engineer" the weather? Instead of adopting to the change (that is too fast, but why?)!?
Have we looked closely who is messing with the weather by sending up protected planes taking probes that are 24/7 supervised against manipulation and look for nanomaterials able to change e.g. reflectivity or melting point that are normally not found in atmosphere, but increasingly so?
NO ONE can detect nanomaterials in a nano world. It is not that it is not possible. Why not?
Fine dust is snow from yesterday. We need to detect nanoplastics and nanodust and do chemistry analysis on it. ESCAR eg.
ALL inorganic antiseptics have
A) a wide therapeutic band
(low: min. effective dose, high: NOAEL: No observeable Adverse Events Level (of Dosing):
WHICH medication has NO observeable side effects?
Most protocols use 1/3 of NOAEL, in 1/5..1/10 per session.)
B) effectivity against ALL Pathogens one-celled or smaller
C) NEVER will have resistances. Hospital germs and waning efficacy for medication is a solved problem, for >150yrs. The solutions has a big flaw: it is too available and MUCH too cheap.
D) diffuse through bacterial films eg, and get resorbed by mucosa in mouth or stomach, so never affect the biome. Diffusing:= RESET on incubation time for all treated mucosa eg.
E) softly soothe the immune system
F) dissolve blot clots (where again was this the problem? Started in Wuhan? Or Marburg? Well. Don't care, as we have something against it...)
G) reduce viral load to e.g. 1/3rd (so no wonder cure, but useful).
H) also disinfect aerosols in air if dispersed. CIO2 is self-dispersing, effective 0.01-0.1ppm(vol) in air. Just use 10ml CIO2(aq)0.3% (called CDS) per 10m^2 room.
If public building, use in legal terms "drinking water" (up to 20ppm) by pouring it in 1.5L water in a pet bottle, do not close the lid tightly (or punch in holes and place a membrane from old rain jacket in between).
I) are very honest guys. You do not like them, they tell what they are: antiseptics. They smell of swimming bath etc.. But they fulfill every promise I ever read. (Production residues from CDS go to washing machine, smells clean; put on plate in fridge, no mould; in car: disinfect air paths and filter by "circulating" air 1/4 of an hour, but please: stay out; if you ever have to cough, OBEY immideately.
ONLY CIO2 is "self-warning", inhaling the others needs a protocol and dose-finding: rule: NO breathability degradation is tolerable, so mindfully test it by deeply breathing some times before, while and after inhalation session.
(We tolerated well the above stated dosings per session, and inhaled on symptoms as often as we liked. Minimum for prevention is ca. once in he evening, eg., already doing the RESET;)
Here 90% reduction of secondary infections in families having one primary CoV infection case:
http://www.ijmra.in/v4i8/2.php
Here 2.4-FOLD reduction of absenteism in school children in classes using 0.03ppm(vol) CIO2 dispenser:
https://academicjournals.org/journal/IJMMS/article-abstract/FDB503B428
For immune system regulating effects, search for hypchlorite eg in animal bite wound care.
It works for ALL pathogens.
ANY study showing "bad marks" eg for H2O2 mostly used PCR. Do not trust any study not telling littly diagrams of dose-related reduction by cell culter measurement ;))
It fits into the picture of "deadly medicine and organized crime" and many more books on that topic.
Next topic would be DMSO, where some shortsightedness in rabbits when 100x overdosing was used as an excuse to NOT giving application by FDA (cite: FDA-boss freaked out as he could not control it, as it is a rechnical solvant AND a medicine). THESE are the medicines to search for - or to create :
BY OPEN SOURCE PROTOCOLS.
For vaccination: see RadVac.org
For CDS: see "diffusion" or "jar glass method".
For NaHClO: any regulated voltage electrolysis (use lowest voltage possible to avoid Cl2 production) is possible, e.g. use salt pool chlorinators, and attach to a bowl with purified water (demineralised), it gets sterile soon...) and let it run as long as you need to reach 800ppm.
Again, what is available and cheap to have reproduceable Cl concentration? ==>
See this cool hand-drown free chlorine sensor:
https://pubs.acs.org/doi/abs/10.1021/acs.analchem.6b03211
Use what grows up the trees!!!
And whatever you like to do if bad things make terrible symptoms, in the calm of preparation, TRY IT OUT, first one by one to test tolerability and get used to it, then emulate a "treatment run".
up the trees: Literally, see below. And Herbs. And Healing Mushrooms.
Dried walnut leaves have one antiviral (anti-*, actually) mechanism of action and even contain human progesterone a bit, helping healing tissue and nerves, and birch tree bark has another (amentoflavone, a 3CL protease inhibitor like in all kitchen herbs, torreya nucifera, black cumin, one yrd mugwort and probably more).
Moringa.
Rock Rose.
So you have 4 different prinicples of action. Use 2, or all, or: Please: Find more.
The more you have, the better the efficacies of a single intervention multiplies if applied with others.
But do not use the dosing used in "clinical trials", especially if paid by 3 letter orgs, take 5x should be safe ;)) (They regularly underdose to show "sadly, no effect", because normally, plants can't be overdosed. (This was done for HCQ, and the WHO directly gave lethal dosings to hospitals doing a "together" trial. Yes, solidarity... 1100 are dead now, just to be able to say: WE can't use HCQ, but heck, it reduced mortality in waves by FACTOR 10, OK, blessing: lvermectin by FACTOR 14, not alone of course. Zinc sufalte or other organic resorbable form and many more interventions patient-symptoms centered are necessary for 99.99..% success, you write down the numbers of "9" after the comma, and then get help to do all the interventions it implies. Effficacy = 1 - (Product(n=1-N)of(Reduction Rate of one orthogonal Intervention(n))).
By the way, Spring 2019, Inthal (Sanofi) was taken down from market. NO ALTERNATIVE.
By autumn 2019, the last dosing aerosol inhaler was sold by some international pharmacy.
Then Covid could start. As Chromolynium acid effectively blocks the chlorine channel of the spike and inhibits infection, and inhibits cytokine storm alas locally (if not solved micellarly, then systemically even if inhaled. Guess what is not existing.)
Guess now, we can't even buy DNCG iso now, run out, not deliverably; the last chance to inhale it.
EVERY allergic asthma patient in DE is now treated by corticoids or aelveoli dilating etc. stuff. Crazy.
So this means, in 1-2 month on we have something nasty coming.
So DON'T PANIC.
But get one inhaler per family, and set on shelf: inorganic antiseptic inhalable, and time-shifted some anti-allergic nasal spray (they are all anti-viral and anti-cytokine storm), xylitol 9%, iota-CArrageenan 0.15% (trickle in stirred water like snow fall, difficult or easy like clump-free thin pudding, salt with Mg++ or Ca++ in (we use dead sea or stone salt as a "base" for mixing inhalation solution; we cook afterwards and close lid like doing marmelade, store in fridge. 1-2/wk we put in 1 drop of NaHCIO or H2O2 or CIO2(aq) 0.3% to keep it sterile).
If you inhale 0.1-2% H2O2 or 0.1-3% PVP-I: most formulations are sour, bad for lungs, lungs like pH 6.5, so trickle in 0.5% baking soda solution "just till not tasting sour any more" for the supply of some days or 1-2 wks if stored in fridge.
E.g.: see Dr. Thomas Levy's H2O2 "An at home treatment that can cure any virus" https://www.janssendentalclinic.com/wp-content/uploads/2020/03/H2O2-nebulization-therapy-3.19.2020.pdf and his free book.
Thanks for the article. I don't quite understand why hospitals and HMOs put up with the GPO markups however? Is every executive getting a free car from them? Otherwise, it seems to me they know they're paying more than they should and getting shortages as part of the bargain-- and that they can do better, save money and pay themselves with the savings, by saying 'no' to price gouging and looking for other suppliers?
I think people missed these monopoly power formations because the mergers were for administrative functions and not mergers of the whole entities. The first joint operating agreement that I know of was a merger of the printing and delivery functions for the Seattle Times and the Seattle Post-Intelligence newspapers. That occurred sometime in the early 80s.
The idea of competitors joining together to share expenses for a common overhead function is called co-opetition. cooperation-competition. With this type of joint operating agreement, the "market" becomes the monopoly thereby skirting our laws against monopolies. I first noticed it sometime in the mid 1990s. There was a small software retailer on the internet that I liked to buy software from. At some point, I figured out that the retailer had become simply a web portal to receive and pass through orders to UPS. UPS became the market middleman between the end customer and the wholesaler.
Side Note: Jeff Skilling of Enron was trying to build a market system for all commodities. He bit off more than he could chew.