We are into the fourth year of Biden’s first term as President and some are finally beginning to realize that maybe, just maybe what Joe did was mostly correct. Yeah sure, there were some things he got wrong. However, he did lead us through one of the worst economic calamities the nation has survived, a pandemic. Democrats in Congress did help. In 2008, Obama had two years of Democrat support which went away in 2010.

Recognized Biden’s efforts was Larry Kudlow, Trump’s White House’s Director of the National Economic Council. On Thursday’s Fox’s News Kudlow admitted, “he was wrong about the Biden economy and all the predictions of an economic slowdown and impending recession.”

There is still a hint of a slowdown and New Deal democrat talks about

I am attempting to present a simple way to portray the costs of healthcare in the US. Using pie charts, a bar chart, and a graph gets the measures of cost across and at the same time presents different discussion points. Merrill Goozner presents the same data as did Peterson and draws a different conclusion. Healthcare costs do not appear to be outstripping economic growth. The issue still remains that we can manage our healthcare costs in a more efficient way. The other issue presented here? CMS and CBO reporting has to be accurate as it drives what the government does.

The Nation’s Health Dollar ($4.3 Trillion), Calendar Year 2022: Where It Came from and Where it Went, (cms.gov)

Where Did We Spend the Money for Healthcare?

From Where Did

Abortion is a tough topic to write about as both sides get a bit mean. The one side forbidding it more so then the supporters of reproductive choice. Maybe it has to do with the thought or thinking behind it. Women decide and the males shut up, except for the orange one.

Abortion in the news, GoozNews, Merrill Goozner

There’s only one health care issue that will be on the ballot this November, and that’s abortion.

Health care pundits like myself can tick off a half dozen other issues we would like to see the candidates address this year: prescription drug prices and the Biden program to rein them in; the future of Medicare and Medicare Advantage; how to respond to the next pandemic; how to address the opioid, behavioral health and obesity

In Michigan, we had a feeder about 20 feet from the deck. We would get different species . Flickers, Downey Woodpeckers, Chickadees, Nut Hatches, Wrens, the common sparrows, etc. The Nut Hatches and Chickadees were the acrobats and would hang upside down. When the feeder would empty out the Chickadees would hang around on the feeder hanger and watch me take the feeder down. I would fill it, rehang it, and they would still be looking down or fluttering around. No fear. I put oranges on nails in a piece of wood one time and a set of Orioles came by. Hummingbirds were around so we had a sipping arrangement for them. A lively area and worth watching.

I imagine they will be renaming the Orioles too.

Why dozens of North American bird species are

Mission of Mark Cuban Cost Plus Drugs

The following is Mark Cuban’s pitch on supply drugs. If you do not have healthcare insurance which pays for drugs you more than likely going to pay list unless you have a drug store discount such as GoodRx.

Mark Cuban talking pharmaceuticals and costs: We started Mark Cuban Cost Plus Drug Company because every American should have access to safe, affordable medicines. If you don’t have insurance or have a high deductible plan, you know that even the most basic medications can cost a fortune. Many people are spending crazy amounts of money each month just to stay healthy. No American should have to suffer or worse – because they can’t afford basic prescription medications.

If you are fortunate enough to

Jamie Dimon says lower-income people need more help and he’d ‘pay for it by taxing the wealthy a little bit more’ Fortune

Taxing the Rich?

If he really wants to help the poor? Allow the tax breaks for individuals in the upper 20% sunset. reverse the tax breaks, and tax income from foreign enterprises. A little bit more below.

Didn’t we just have a conversation about Jamie’s beliefs on taxes here at Angry Bear? If you forgot, you can find it here: In Defense of Trump’s Economics by a Billionaire. Jamie is defending trumps economic policies. Such things as leaving the reconciliation tax rate alone for those whose income is 80 percent and below. Allow the taxes under reconciliation sunset for those whose income is in the top 20%. A quick and

A long time ago, I was starting to envision how my wife and I might become a burden to our three children. I hooked up with AARP and took out a plan for Long Term Care which would cover us for four years. At the time, this was said to be the limit of life expectancy for a person entering these homes. And no, I am not advertising for AARP. We dropped the Part D and went with Well Care as we had no majr meds and WellCare did not have a monthly fee tied to its plan.

It could be that long, if the care is good and they do watch over you properly. As it turns out, the care may be not consistent and people wander away from the facilities and get into trouble, suffer injuries, or even die. The Washington Post has an article about it. Kareem Abdul-Jabbar

Trump’s poor showing in New Hampshire, Robert Reich.

Friends,

As I noted earlier today, the mainstream media is falling over itself in seeming awe of Trump’s “powerful” campaign.

The truth is just the opposite. Last week, he won fewer than 7 percent of registered voters in Iowa.

Trump’s success in last week’s Iowa caucuses wasn’t a “stunning show of strength.” It was a display of remarkable weakness. He got just 56,260 votes. Hello? There are 2,083,979 registered voters in Iowa. Fewer than 3 percent of Iowans voted for him.

“Why the mainstream media’s awestruck coverage of Trump’s campaign is deceptive and dangerous,” Robert Reich

AB: Other sites posted a 15% turnout. trump received 52% of the 110,000 turnout voters of ~750,000

Kind of hard to keep track of this these days. In 1968, I left for the Corps, Boot Camp and then over to Fort Monmouth to be trained as a Crypto Tech. I was sent back to California and the to Camp LeJeune, North Carolina. Back and forth out of Cuba.

Times are changing; but not fast enough for people who have been subjugated to a lifetime of discrimination. Can’t be many of those left who marched in this Memphis strike and then experienced the murder of Reverend Martin Luther King at the Lorraine Motel. Good read – enjoy and think about time passing and what has occurred since then.

~~~~~~~~

Elmore Nickleberry, a Memphis sanitation worker who marched with Martin Luther King, has died at 92 – WABE, Associated Press.

I read this article “MAGA warning to Dems is right on target.” An OpEd by the NY Post. Others may disagree, I believe it to be nonsensical. Just some rich guy saying, I like it like this. Don’t change it. There is a lot saying he is wrong. Adding the detail in brevity. You can always click on a link to get more detail.

Here is Jamie Dimon comping trump and Biden on the economy. What do you think he is worried about over the next four years? First, what is Jamie Dimon saying “Jamie Dimon’s MAGA warning to Dems is right on target,” msn.com, NYP Editorial Opinion.

A fisking (thanks Joel) we will go . . .

“’Just take a step back and be honest,” urged Dimon in a CNBC interview at the World Economic Forum confab:

Jamie: “He (trump) was kind of

January 17, 2023, Letters from an American, Prof, Heather Cox Richardson

Texas attorney general Ken Paxton responded this evening to the federal government’s demand that state troops give U.S. Border Patrol agents access to Shelby Park in Eagle Pass, Texas, the site where three migrants died last week as they tried to cross the Rio Grande. 

Aarón Torres and Joseph Morton of The Dallas Morning News reported that Paxton’s letter acknowledged that by law the federal government’s Border Patrol officers are allowed  “warrantless access to land within 25 miles of the border, but only ‘for the purpose of patrolling the border to prevent the illegal entry of aliens into the United States.’” Paxton claimed that this law doesn’t apply because the current

It appears like someone is waking up to a reality. When they can, corporations will take advantage of an economic event to increase margins resulting in increasing profits. They will call up and say they are increasing prices, take it or leave it. When your customer is one of the big three, you take it. And, you will not be able to pass along the pricing increase. One scenario, I experienced.

Prices are simply the sum of costs and corporate profits. While rising costs of inputs can drive up what Americans pay at the gas pump or the grocery store, corporate profits can just as easily.

GWC Corporate Profits Report, ground work collaborative, Liz Pancotti and Lindsay Owens

Another scenario is the backed-up container ships on the West Coast.

A key factor in many manufacturing companies is the outsourcing of the manufacturing of components which the parent company has become expert in creating, manufacturing, and quality control of components. Unless a company’s employee is to be on site, it is difficult to ensure the quality of manufacture. The outsourced company does not have the innate ownership of the sourcing company.

Been at this too long. I was reading on Linked-In how a bunch of Purchasing managers and executives would manage on time delivery of critical parts to their companies. It was all about control of the purchasing process. I was in purchasing, planning, consulting, supply chain, etc. at the plant and corporate levels. If you do not know how the part, etc., is made

Most state laws back the company when it comes to employment. Plus, you don’t have the cash to make a fight out of it. So move on to something better, forget them, do something great, chalk it up to experience, learn from it, and ask the right questions the next go around.

Being let-go happens. Reasons could be because of the economy, job is transferred, boss does not like you, or maybe you are just to slow at acclimating to the company environment. I have run into some real idiots during my time of being an employee. This is kind of an interesting take as a “fired” employee turns the tables on the company. At the company, the head muck-amuck is astounded this occurred under his watch.

Lest we forget, the head person creates the company

This article is kinda long and also along the lines of what I have done since the mid-seventies. I consulted in throughput for a while. Did not much like it as compared to actually doing it. It is a good piece though. This report is twenty years old and things have changed in China. Modernization has changed its cities and is having an impact outside of them. Been there and seen it multiple times over the years. However, the topic is different than modernization. It is about the costs of manufacturing and understanding them.

I had asked the author if there was an update to this report. Unfortunately, there is not. I would have enjoyed seeing the differences. And yes, some of the parts here have changed dramatically. The concept is still the same

As taken from “In ‘wild western Licking County,’ rogue builders meeting permit enforcers bent on upholding laws,” msn.com, as written by Alan Miller. The Angry Bear writer has added his own experiences to the article. There are modifications to the original article.

With the rapid pace of growth in western Licking County, some commercial builders and business owners have taken the law into their own hands by moving ahead with construction projects before they have all of the proper permits and inspections. Or as Linda Nicodemus calls it “the wild western Licking County.”

Those builders are learning Linda Nicodemus and a posse of other county officials are not standing for those who go rogue.

AB: I sat on a Planning Commission for a number of

Texas took it upon themselves to guard the border and not allow the Border Patrol entry to Shelby Park, a 47-acre Texas public park. The Border Patrol typically apprehends people crossing the river at that point. Texas/US military soldiers were sent to the area to block any migrants from crossing the river. A group of six had trouble crossing the river. One woman and two children drown in the presence of the National Guard. The Border Patrol was blocked from giving aid and assistance to them.

There is a certain point where you have to count yourself in as a human being and not just a robot taking orders. You aid people in trouble. This is murder in Texas by Texas.

A letter from President Andrew Jackson to Vice President Martin Van Buren

On

What Charles is telling us is the 21+ million new ACA enrollees is a record. What he also adds at the end of his commentary is this is not the final number. There are more uncounted enrollees to be added to this number from after Christmas. Record year for healthcare coverage. This is good news.

BOOM: Biden-Harris Admin announces over 21.6M ACA enrollees thru 12/23, record high w/a week or more left to #GetCovered!, ACA Signups, Charles Gaba

Breaking via the Centers for Medicare & Medicaid Services (CMS):

Under the Biden-Harris Administration, Over 20 Million Selected Affordable Health Coverage in ACA Marketplace Since Start of Open Enrollment Period, a Record High

As January 16 coverage deadline approaches, Biden-Harris

Thank you for your comments.

Bill

Good commentary by Merrill Goozner. I subscribe to his site. He, I and other have gotten together and talked. I did ask the Lown Institute if I can publish their top ten examples of profiteering and dysfunction in health care.

This group make my spidery senses tingle. Rather ask than get a reprimand. Got that one time and I knew who did it. It backfired on them and they were dropped by their host. Good writer and I was posting their commentaries on Angry Bear for a good while. A win-win.

Martin Shkreli’s legacy, GoozNews, Merrill Goozner.

The Lown Institute “honors” the top ten examples of profiteering and dysfunction in health care with an award in his name. Plus a few other items that caught my eye.

Remember Martin Shkreli, the “Pharma

It is bad enough with high healthcare costs for doctors, hospitals, medicines, care, insurance, etc. But when all of them start to allow you credit so they can collect their moneys leaving you to fend for yourself, it becomes outrageous.

A common interest rate for payment plans is 16% to 19% with private equity. It is a rip off of those who are ill and the families who are willing to sacrifice all. It is unfortunate banks, etc., are willing to feed off those who are ill or even dying. Picking off the meat from their bones.

“Consolidate your healthcare expenses” is a call to financial ruin. Single Payer for all . . .

How Banks and Private Equity Cash in When Patients Can’t Pay Their Medical Bills, KFF Health News, Noam N. Levey and Aneri

We have been needing more people, people of some importance, to say something about the economy besides how bad it is. Mind you, no matter how good the recovery is; the negatives will still flow from the other side of the room. If you have been reading New Deal democrat’s commentary at Angry Bear each day, you already have a pretty good idea of where we will land.

NDd: “Real retails sales stopped deteriorating YoY last spring, and have been more or less flat YoY since summer. This tells us that the unemployment rate should stop deteriorating as well over the next few months.”
“Scenes from the jobs report 2: unemployment rate and consumption: weak, but not recessionary,” Angry Bear , NDd.

Coming up? Economist Krugman talks politics as related

Some light reading. I subscribe to it (The Atlantic) and have done so since the Civil War for a decade. Thought I would post one from The Atlantic’s News Letter (I think). Just an interesting read about something they discovered happening or maybe not-happening. People locked into something they do not like, have to stay, and when the opportunity arises, they leave. Especially if there is money to be made or less time at work or less work.

What if I told you the Big Quit wasn’t really about “quitting.” (Blue pill or Red pill? Your choice.)

Three Myths of the Great Resignation, The Atlantic, Derek Thompson.

The “Great Resignation” remains one of the buzziest economic stories of 2021. But the more people talk about it, the more I wonder whether

Another array of emails collecting in my In-Box offering up articles besides junk. Some interesting reads and others not so. Picked what I thought might be the best. Some are hawking subscriptions too. I like to subscribe to newsletters and magazines. The problem being never getting a chance to finish reading them all.

Climate and Environment

U.S. cities are getting rid of parking minimums, NPR, Laurel Wamsley. Cities are throwing out their own parking requirements – hoping to end up with less parking, more affordable housing, better transit, and walkable neighborhoods.

My TMU Sustainable Design students on how to fix the world, Carbon Upfront, Lloyd Alter. Teaching sustainable design is tough; it is constantly changing. Who was teaching

Those who were trying to overthrow the United States Government for personal gain.

“When the Senate reconvened at 8 p.m. and the House of Representatives an hour later on January 6, 2020, the proceedings including the objection debates were continued. Some lawmakers who had previously planned to vote with the objectors stood down following the occupation of the Capitol. Plans to challenge a number of states after Arizona were scrapped, as well — but one other objection, to Pennsylvania’s results, also advanced to a vote. Here are the eight senators and 139 representatives who voted to sustain one or both objections.” The 147 Republicans Who Voted to Overturn Election Results, NYT, Karen Yourish, Larry Buchanan and Denise Lu, January 7, 2021.

An Updating of Medicaid disenrollments in the nation. Clicking on this tab – state data will take you to individual state numeric. Some states attack the issue of disenrollment with a relish even when the federal government is picking up most of the tab to enroll them. In the end, they will still show up at a hospital to be treated.

Andrew Sprung and I exchanged a few comments the other day. My suggestion was to enroll people automatically into the ACA when they are 200% or less in income. Some hospitals are doing such as the insurance is no cost to those who are 200% or less. Anyway here are the death-star states which are kicking people off of Medicaid. Also click on the charts to enlarge to make them more readable.

Medicaid Enrollment and

Strictly a copy and paste of the Senate Finance Committee Chair Senator Ron Wyden Committee Report. I can not add to this other than say, repeal the 2017 Tax Act.

Interim Report: Big Pharma Tax Avoidance

Senate Finance Committee Investigation Reveals Extent to Which Pharma Giant AbbVie Exploits Offshore Subsidiaries to Avoid Paying Taxes on U.S. Drug Sales.

The Provisions in the 2017 trump Republican tax law allows AbbVie to generate most of its sales in the U.S. At the same time, they report no income in the U.S. for tax purposes. Over 75% of AbbVie’s 2020 sales were made to American consumers. From those sales, 1% of AbbVie’s income was reported in the United States for tax purposes.

AbbVie’s ability to exploit subsidiaries in offshore

This casting was up December 29 at Talking Points Memo (TPM). It is about 50 minutes long and a very interesting conversation between John, Kate, and Prof. Heather. Covering the state of democracy in America is the topic and well worth the listen.

Belaboring the Point: What If We’d Been Mean to Robert E Lee? Talking Points Memo, Josh Marshall, Kate Riga, and Prof. Heather Cox Richardson.

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Tags: Professor Heather Cox Richardson

AB: This brief article gets right down to the basics in where costs are added and impacting the prices to the consumer. It is simple and straight to the point of how PBMs impact the prices to the consumer. Very little or nothing was contributed by myself to this article by the authors Inmaculada Hernandez; Nico Gabriel; Anna Kaltenboeck. The table and figure are products of JAMA.

Why is it on Angry Bear? Because of its simplistic approach to identifying the costs impacting pharma prices to the customer. It is a good read and educational of one way prices are impacted. A deeper dive soon.

Reimbursement to Pharmacies for Generic Drugs by Medicare Part D Sponsors, JAMA Network, Inmaculada Hernandez; Nico Gabriel; Anna Kaltenboeck.

The Issue . .

Introduction: “new analysis finds that that MSSP, the oldest and largest Medicare accountable care organization (ACO) program, has lost money for individuals it covers and overall for Medicare it saves just 75¢ per $1000.”

AB: Not much of gain there. What does it do for other programs?

“Largest ACO Program Saves Piddling Amounts for Medicare,” PNHP. As taken from “Estimated Savings From the Medicare Shared Savings Program,” JAMA Network, Andrew M. Ryan and Adam A. Markovitz. December 15, 2023. With a comment by Kip Sullivan, J.D. and Jim Kahn of PNHP.

The Medicare Shared Savings Program (MSSP) was launched in 2012 to improve efficiency and generate financial savings for the Centers for Medicare & Medicaid Services (CMS). Under the program,