But yeah, double is insane. When I saw prices for COBRA from Facebook, it was $3300 a month, and that was god-tier insurance - the insurance benefits were so good they had a custom list of what was covered that was probably way better than anything available on the market (e.g. you want brand name drugs? no problem. You don't want to try both ambien and trazadone before taking a sleep medication doctors actually recommend? No problem - etc.) - but for my needs it was barely better than COBRA costing way less than half. $3300/mo, or even $1200/mo for an entry level ops worker is a lot of their salary, and probably where the double comes from. At SWE compensation most of it ceases to scale.
The fully loaded costs including proportional management costs isn't relevant to the true marginal engineer, but estimates I've gotten from higher-ups definitely factor into engineering decisions about "should we spend engineering time to save money/make more money - how much will doing this thing cost the company" (opportunity costs are also relevant, but usually less grounded, since most projects don't have concrete benefits like "we will save $x/yr in infra costs")
It's kind of like neuroscientists found the trigger to tell your brain "we're going to do a clean shutdown now, trigger transition to runlevel 0".
Quiviviq, Dayvigo, Belsomra. All still on-patent, so they don't have generics and are pretty expensive (like $1000/mo if your insurance doesn't cover them). A lot of doctors won't recommend them in practice because most of their patients won't yet be able to get them covered.