This article is easy reading exploring some the differences and why people may choose one plan over the other plan. Attached is also a Commonwealth Fund article with more detail.

Medicare Plan Commissions May Steer Beneficiaries to Wrong Coverage, MedPage Today, Cheryl Clark.

Agents and brokers selling Medicare plan coverage often steer their clients to a Medicare Advantage (MA) plan because it earns them a higher commission compared with a Medigap supplemental plan with traditional Medicare that might better serve the beneficiary’s needs.

What role do financial incentives play for healthcare planning agents and brokers in the advice they give to their clients?

One incentive for agents and brokers steering clients to a Medicare Advantage

In 2018. I made a similar argument without the detail Skanda Amarnath provides today. My points were not accepted. I went to a “we shall see” mode. And we did see banks taking risks because they could do so because Congress (which included Democrats) gave them the slack to do so too soon.

In 2018, a decade after Wall Street and Banks blew up main street with their gambling, I felt it was too soon to give banks slack of this nature. It was only 7-8 years from the point of when things started to improve domestically amongst the population. Participation Rate never returned to what it was pre-2008 as one example. Rather than stimulate the economy, a Republican Congress started to cut back on unemployment and other areas.

This is a good commentary

A different viewpoint by the Physicians for a National Health Program. Mainly speaking as advocates for a universal national health program which would be as cost-effective as possible. They are proposing the plan could be constructed as an improved form of Traditional Medicare. They do too find similar issues as what Gilfillan and Berwick extensively discussed in the commentary Medicare ‘Money Machine, Part One and Part Two.

Comments on CY 2024 Advance Notice of Methodological Changes for Medicare AdvantageCapitation Rates and Part C and Part D Payment Policies, PNHP, Physicians for a National Health Program

PNHP welcomes CMS’ efforts to begin to rein in abuse of the payment system by Medicare Advantage (MA) plans and rampant overpayments to

Quick two weeks went by and have been pretty busy. Starting to warm-up in Arizona. Been spending more time outside while I can and before it gets hot.

Environment, Consumerism, Technology

Micro-Apartment Makeover Includes Mini-Loft and Space-Saving Furniture, treehugger.com, Kimberley Mok. The comfort and livability of a 300-square-foot apartment are beautifully improved in this smart renovation.

What changes after the Norfolk Southern train incident in Ohio, qz.com, Ananya Bhattacharya. Transport secretary Pete Buttigieg proposed that railway companies join the Federal Railroad Administration’s Confidential Close Call Reporting System (C3), which was first piloted in 2007. 

Your car may not be as safe as you think. Here’s why,

For some reason, I did not release this one on the 13th. Not sure why. I was at the eye doctor for sure and he was removing membrane from the retina. Never felt a thing. So far so good. It might just be me thinking it improved my right eye vision. I was able to read the chart which the NP said was positive. I was told many people could not after surgery.

Anyway, there are any number of good posts on different blogs you can read. This one by Dean Baker gets right to the point. Once again, the same as 2008, it is all about rescuing the big guys who have political pull. The rest of us were along for the ride.

SVB Was Donald Trump’s Bailout, Center for Economic and Policy Research (cepr.net), Dean Baker

There are two key points that people should

“The very men who were arguing the government should protect all the depositors’ money, not just that protected under the FDIC, have been vocal in opposing both government regulation of their industry and government relief for student loan debt, suggesting that they hate government action…except for themselves.”

March 12, 2023, Letters from an American, Professor Heather Cox Richardson

At 6:15 this evening, Secretary of the Treasury Janet L. Yellen, Federal Reserve Board Chair Jerome H. Powell, and Federal Deposit Insurance Corporation (FDIC) Chairman Martin J. Gruenberg announced that Secretary Yellen has signed off on measures to enable the FDIC to fully protect everyone who had money in Silicon Valley Bank, Santa Clara, California, and

Traditional USPS supporter at Save the Post Office, Steve Hutkins presents the latest information about the reorganization of the USPS. We had let off where President Joe Biden has/had a chance to replace two commissioners whose terms were at an end. Everyone wants two new Commissioners, but Biden has not made a move yet on their replacement.

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“The USPS Eagle spins S&DCs to postal employees,” Save the Post Office, Steve Hutkins

The cover story of the new issue of the Postal Service’s Eagle Magazine is “Re-Thinking Local Delivery.”  It’s all about the big, new, modern Sorting and Delivery Centers replacing carrier operations at your local post office. Acting like a mouthpiece for Louis Dejoy, the Eagle proffers a different story

Part Two explores where Medicare should be going forward as determined by doctors Richard Gilfillan and Donald M. Berwick. It is an endorsement of the ACO model with changes to it creating greater efficiency. I am not so sure Kip Sullivan would endorse this approach as opposed to Single Payer. Ultimately Single Payer is less costly when we consider the elimination of much of the administration effort. There is another post I will be putting up when I am sure I can see appropriately again. It may touch upon this area of cost saves.

In the other half of this post, you will notice I italicized some sentences and then used unitalicized wording. The Italicized sentences are a subject with the normal wording being an explanation. Other than using

Hey look, this is an interesting C&P from Hullabaloo. Why is it that those who attack others who appear to be different actually do similar things or are similar? You typically find this out years later. I don’t know . . .

“He just doesn’t like people,” Digby’s Hullabaloo, (digbysblog.net)

He’s Nixon in high heels . . .

He’s very weird:

Suzy Barker, a native Iowan dressed in an orange-and-blue University of Florida hoodie, waited in a crowd of fellow Republicans on Friday morning to meet Gov. Ron DeSantis of Florida.

She smiled widely and pointed to her hoodie as she told the governor that her son attended college in his home state. Mr. DeSantis — dressed in a dark blue suit with a light blue, open-collar shirt and black boots —

What Every Conservative Needs to Know about Student Loans, Alan Collinge, Medium.

Conservatives have been tricked into defending the worst big-government loan scam in U.S. History; a slight majority of the borrowers identify as either republican, or independent.

The 2020 election was a huge loss for the republicans. Even so, Conservatives buoyed by recent election wins, and the current unpopularity of the President. There is one issue that made many of those statewide elections even close in the first place. It is growing quickly and will easily be the largest  untethered voting block in the country this November: Student loans.

There are 60 million voters in the country- including millions of veterans– who hold either federal or private

Japan, The U.S., The Moon And More, Weldon Berger, Bad Crow Review

Links are at the end, with the steam trains.

The train station had a 7-11 outside the platforms. The station was near my hotel and I went there for evening snacks a few times—bentos and musubi and azuki bean pastries and the like. Good food, really, in context.

I miss trains, as regular readers will know. Trains and crows, neither of which I got any good shots, the latter because they wouldn’t fucking stand still and the former, I don’t know, just because. Japanese train platforms aren’t really designed for dawdling.

You have to watch the Jenny Lewis and the Watson Twins video linked below. It will leave you questioning everything you think you know. Also I’ve

Infidel753: Cultural vandalism

As soon as all the corrections which happened to be necessary in any particular number of ‘The Times’ had been assembled and collated, that number would be reprinted, the original copy destroyed, and the corrected copy placed on the files in its stead.  This process of continuous alteration was applied not only to newspapers, but to books, periodicals, pamphlets, posters, leaflets, films, sound-tracks, cartoons, photographs — to every kind of literature or documentation which might conceivably hold any political or ideological significance.  Day by day and almost minute by minute the past was brought up to date.Every record has been destroyed or falsified, every book rewritten, every picture has been repainted,

This is Part One covering Medicare Advantage, Direct Contracting, and the MA Money Machine of which the Risk Scores drive the payout. If the Risk Scoring methodology was eliminated, ~$355 billion over the next eight years if just the risk-score related overpayments were eliminated.

This is a pretty good read if you have the patience to cover all of it. I have added acronym and other definitions at the bottom. I have also added some additional reading on HCC coding which determines risk. The Part Two site is listed also if you wish to get ahead of me. I will try to have Part Two completed by Sunday evening.

I have done some editing of parts of the commentary, added some commentary/explanation and generally tried to make it more understandable.

Hey, if you have not noticed, I have been doing most of the posting at Angry Bear, for myself, others, and for NDd on Angry Bear on various topics. NDd’s commentary I consider to be important and timely reporting on housing, jobs, Covid, the economy, etc. He is on the money each time.

It is amazing to me, how the FED keeps trying to blow the economy up and it keeps on ticking. There are a lot of reasons for such a great economy, none of which involve Republicans. Think back to 2007/8 through 2010 and how bad it was. Inflation is a problem; but, we are also short Labor (amazing that this is occurring) and business has been manipulating the supply chain (not so amazing).

Back to my topic, I am tired. I also have an eye operation coming up next

Parts of this Covid Vaccine Story came via the Daily Beast;

Just hours after Sen. Bernie Sanders (I-VT) swore to question Moderna’s chief executive in a Senate hearing next month about plans to quadruple the price of its COVID-19 vaccine, the company abruptly reversed course, announcing in a statement that the vaccine would remain free to all consumers “regardless of their ability to pay.”

The pharmaceutical giant was widely denounced last month in the wake of reports it was considering jacking up the price of its jabs more than 400 percent–to $130 per dose. The Biden administration also unveiled the expected end of a public health emergency in May, which would have left uninsured Americans paying out of pocket.

In an interview with The

“Michigan Supreme Court hearing on automobile no-fault reform: What to know,” Bridge Michigan,

In reading this, I can almost guarantee, the citizens of the state of Michigan had not given any thought to

the screwing over of those who suffered catastrophic injury due to automobile accidents. Indeed, it was business interests who set the pace for the repeal of No-Fault Auto Insurance. Michigan residents lived with the higher insurance costs. It was business which objected to it because they had difficulty attracting candidates to work at their facilities in Detroit. At least it was a convenient excuse to make at the time.

How This All Started

“Detroit businessman Dan Gilbert’s team on a Thursday, May 2019 filed paperwork for a

Thoughts on this commentary?

Marseille: full canal and empty streams, The one-handed economist, Margot . . .

Margot writes*

Despite being located in a dry and warm region, Marseille is described as the “world capital of water” by the World Water Forum. Indeed, Marseille is known for its efficient water management and water infrastructures like the canal of Marseille, the Roquefavour aqueduct, or the Palais Longchamp.

The Marseille Canal diverts water from the Durance river, which takes its source in the Alps, takes it to Marseille and provides the city with two thirds of its drinking water (Webzine Voyage). The canal, the primary water source of the city, is the main reason why taps could keep running last summer, when the city

Unfortunately, this did not include the screening of “Loan Wolves.” The clip is approximately 36 minutes long. It includes Alan Collinge of Student Loan Justice who I have known for over a decade. Alan has been on Angry Bear Blog multiple times. He has not given up his, the crusade seeking relief for student loans. “Loan Wolves” Writer and Director Blake Zeff has written for The Onion and Politico besides doing other things. He is the chief instigator of Loan Wolves. Lisa Ansell is an Associate Director at the USC Casden Institute. She must be good as she caught the attention of anti-student loan forgiveness promoters Akers and Cooper.

Majority Leader Chuck Shumer (D-N.Y.) and USC President Dr. Carol L. Folt laid out the main points of a plan:

Interesting article on why certain industries are not feeling the impact of Artificial Intelligence. I am not sure I agree entirely with Marc. Sixty-five-inch TV is around $2,000 today. Why use TVs in comparison which were always less costly?

“We’re heading into a world where a flat-screen TV that covers your entire wall costs $100 and a 4-year degree costs $1M,” Fortune, Marc Andreessen and MSN.

Marc Andreessen is not worrying about artificial intelligence taking people’s jobs. The way he sees it, technological innovation is not allowed to disrupt much of the economy anyway. I am not sure Marc is entirely correct with this premise. Having worked through much of this era and contributing to the change using computerization, there were major

I am a member of AARP. I am also a part of its MediGap Plan N Program, and Part D Pharmaceutical. Just like to shop at one store. Some do not believe in MediGap. If you are healthy and do not think you will have to pay the Part A $1600(?) deductible and the 20% of costs. Then skip MediGap. Do you feel Lucky? Then toss the dice. You may be lucky, I am not.

With Part D, I use Walgreens and we are having a faceoff. Everything was fine until they started pushing their pharmaceutical mail service. I do not mind calling my release in to the Walgreen’s store and picking up. For some reason they are sizing the containers incorrectly. For a 90-day supply of a 5-mg tablet they are giving me a bottle which can handle 1800 tablets. The store attendant slipped

Weekly Indicators for February 27 – March 3 at Seeking Alpha

 – by New Deal democrat

My Weekly Indicators post is up at Seeking Alpha.

A number of indicators which had been declining have stabilized since the beginning of the year, leading to increased speculation about a “soft” landing or even a “no landing” at all. The bulk of the long and short leading indicators beg to differ.

As usual, clicking over and reading will fill you in on all the details of both the forecasts and the nowcast, and reward me a little bit for putting the information all together in an organized format for you.

New Deal democrat’s Weekly Indicators February 20 – 24, Angry Bear, New Deal democrat

Loans at the Lege

RECEIVED TUE., FEB. 28, 2023

Another Letter to The Editor from a member of Student Loan Justice Org..

“Loans at the Lege – Feedback,” The Austin Chronicle

Dear Editor,

The fact that Texas legislators like Ted Cruz are opposing student loan cancellation makes no sense. The state is crushed under $141 billion in mostly federal debt, most of the people with these loans are either Republican or Independent, and the lending system is truly the most predatory, big-government loan scam in US history.

Nearly $10 billion/year in interest alone on this debt is leaving the state every year, accruing to the Department of Education. For loans that LBJ, in 1965, declared would be “free of interest.” This cannot continue. The

For one, I find it difficult for behavior economics to explain why people are reacting in irrational ways. For example, University of Chicago poses some statements or questions on the issues.

“Why do people often avoid or delay investing in 401ks or exercising, even if they know that doing those things would benefit them?” And,
“Why do gamblers often risk more after both winning and losing, even though the odds remain the same, regardless of ‘streaks’?”
Delaying on investing in a 401k to save was only because at the time I could not afford to do so even though I could not afford not to do it either. Current expenses left me little to set aside in a 401k.

Never repeatedly gambled because I would also lose. Here again, I was measuring the

Many of you know me from my telling of past experiences. Here is one more to add to the pile. A recent email to me about an employment opportunity in automotive. My return email to the headhunter.

Renaldo:

Thank you for your interest. 

Having been trapped between Engineering and the plants over the years where I was working was an experience. No amount of logic would sway their demands for what they wanted regardless of their being a part of causing it. I would direct you to what has happened most recently with Semiconductors. 

Automotive shut down due to the Covid epidemic and the lack of a 100% vaccine to prevent it. Even with the vaccine, one still had to maintain distance from others and stay out of crowds. Automotive figured it out

I agree with Charles Gaba. Medicare Advantage is not much better than Commercial Healthcare Insurance. To wit, it is Commercial Healthcare Insurance gussied up to look like FFS Medicare. The extra benefits given to enrollees in Medicare Advantage comes from FFS Medicare expenditures. Furthermore, the companies providing healthcare to those on Medicare bid low and are paid high:

“benchmarks and payments remain above FFS spending levels. We estimate that in 2022, MA benchmarks (including quality bonuses)average 108 percent of FFS spending (before adjusting fully for coding intensity; see Table 12-6). Similarly, benchmarks in 2021 averaged 108 percent of FFS (data not shown), while MA plans bid at record low levels.” MedPac Page 427.

Even then MA

“Jawboning, the moral suasion in the context of economics and politics. In action such is the use of authority to persuade various entities to act in certain ways. It can sometimes be underpinned by the implicit threat of future government regulation.”

President Joe Biden uses the bully pulpit during the State of the Union address to call for a universal price cap on insulin for all diabetes patients. The proposal is very unlikely to pass the current Congress.

And it didn’t . . . In this “Letters from an American.”

March 1, 2023, Letters from an American, Prof. Heather Cox Richardson

Drugmaker Eli Lilly announced today that it will cap the cost of insulin at $35 a month, bringing costs for people with private insurance and those without

I am in Arizona these days and watching the state and local area scramble to get developments approved before the Federal Agency in charge of the Colorado River water decides who gets what. I suspect if you have an approved Build, a state will be allowed to build it. The Feds have applied the new restricts and the counties have to show they have a 100-year water supply. Interesting maneuvering in this story.

Outside of Phoenix sits a farm. The farm is owned by Saudi Arabia’s largest dairy. The dairy Almarai uses the land to grow hay or alfalfa for dairy cows back in Arabia.

The dairy company Almarai bought the farm in 2014 and has planted thousands of acres of alfalfa. Alfalfa is a ground water- guzzling crop. Dairy farms like Alfalfa because of

The biggest driver of healthcare cost is simply “pricing” increases reflected in hospitals, pharmaceuticals, and healthcare insurance. It was Dr. Donald Berwick while head of Medicare and Medicaid during the 1st half of the Obama administration has said, repeatedly, that at least 1/3 of Medicare dollars ware wasted on unnecessary tests, procedures and drugs that provide no benefit for the patient.

Here is Dr. Berwick again discussing healthcare costs in the United States. It is a good read. I have included his footnotes and our own commentary.

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“Salve Lucrum: The Existential Threat of Greed in US Health Care” | Health Care Economics, Insurance, Payment, JAMA | JAMA Network, Donald M. Berwick, MD, MPP

In the mosaic floor of the

Trump’s Tax Cuts and Jobs Act (TCJA) made significant changes to the federal tax code. The major changes were the lowering corporate and individual income tax rates, increasing the standard deduction, reforming child tax benefits, and reforming the corporate international tax system.

In an effort to mask its true cost and fit it within cost limits, almost all of the individual and estate tax provisions were set to expire after 2025. Several business tax provisions are set to either expire, go into effect, or become less generous at various points also.

CBO Estimates TCJA Extensions Could Cost Up to $2.7 Trillion, per the Committee for a Responsible Federal Budget, crfb.org.

From where did the $2,7 trillion come? Hopefully, this will give

UE is the United Electrical, Radio & Machine Workers of America issuing a statement by its Executive Board. In case you are wondering, UE is responsible for transporting train crews. The membership is approximately 2,000.

It is interesting to note, their claiming of pricing issues with the transportation of goods across the US. Typically, we see these costs passed along in the form of shortages and/or higher prices. UE is also calling attention to the plight of railroad workers as caused by precision scheduled railroading (PSR).

PSR attempts to combine the best elements of two opposing operating plan strategies. Those being holding a train for tonnage and moving a train adhering to a schedule. The conflict being freight being available before