WHAT TRUMP’S ELECTION WIN COULD MEAN FOR HEALTH CARE

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. Bertalan Meskó, MD PhD

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Regarding AI, the emphasis will shift away from the regulatory environment towards technology companies making their own decisions. Trump also promised to repeal Biden’s executive order on AI because it “hinders AI Innovation”.

Regarding health care, Trump said he would let Robert F. Kennedy “go wild” on health. Being a vaccine doubter and having made many unscientific claims about health, this could be a huge risk to digital health and the FDA’s job on regulating technologies. READ MORE

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DAILY UPDATE: All About the Stock Markets

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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  • Stocks ended the day mixed, with the Dow sinking into the red while the S&P 500 and NASDAQ kicked off the week on a positive note thanks to gains from tech stocks.
  • Oil popped on a double-whammy of news: Long-range, US-made ballistic missiles launched from Ukraine into Russia might disrupt oil supply, while the shutdown of Norway’s Johan Sverdrup oil field due to a power outage will definitely disrupt oil supply.
  • Crypto continued its hot streak today: Bitcoin popped back above $90,000, giving other cryptocurrencies a boost.
  • Bitcoin’s boom has certainly helped MicroStrategy, which announced today that it purchased 51,780 bitcoins for approximately $4.6 billion in cash, or roughly $88,627 per bitcoin, in the last week alone.

CITE: https://www.r2library.com/Resource

STOCKS UP

The new Trump Trade continues: The president-elect’s selection of Liberty Energy CEO Chris Wright to lead the Department of Energy gave Liberty a 4.85% boost today. Wright is also on the board of nuclear company Oklo, which popped 14.83%.

  • Speaking of Trump, Trump Media & Technology Group soared 16.65% on the news that it may purchase crypto trading firm Bakkt.
  • Netflix disappointed viewers with its glitchy showing of Jake Paul vs. Mike Tyson, but shareholders forgave the company after it announced record viewership of the fight. Shares climbed 2.80%.
  • CVS Health gained 5.41% on news that it struck a deal with activist investor Glenview Capital Management to add four new seats to its board.
  • Robinhood jumped 8.29% to a new all-time high thanks to an upgrade from Needham analysts giving the investing app a “buy” rating due to its crypto offerings under a pro-crypto Trump presidency.
  • Warner Bros. Discovery rose 2.71% on a Wall Street Journal report that it has settled its legal dispute with the NBA, guaranteeing broadcast rights for the next decade.

STOCKS DOWN

  • Nvidia isn’t often in this section of the newsletter, but the semiconductor leader sank 1.29% today on a report from The Information that its new Blackwell chips are prone to overheating.
  • Palantir popped after moving over to the Nasdaq last week, but the red-hot software stock dropped 6.86% as investors collected profits.
  • Redfin may help you buy a house, but the online real estate brokerage is a “sell,” according to Goldman Sachs. The Wall Street firm cited low home sales, low affordability, and low chances of success in a competitive market. Shares fell 4.42%.
  • Uber dropped 5.35% to a new 52-week low on the threat of Tesla’s robotaxis ruling the road thanks to a Trump administration that seems keen on cutting self-driving regulations.

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Here’s where the major benchmarks ended:

  •  The SPX was up 23.00 points (0.4%) to 5893.62; the Dow Jones Industrial Average® ($DJI) fell 55.39 points (0.1%) to 43,389.6; and the NASDAQ Composite® ($COMP) was up 111.69 points (0.6%) to 18,791.81.
  • The 10-year Treasury note yield fell one basis point to 4.41%.
  • The CBOE Volatility Index® (VIX) eased to 15.57.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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The Decline Bias [Declinism]

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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You may have heard the complaint that the internet, blogs, vlogs and social media will be the downfall of information dissemination; but, Socrates reportedly said the same thing about the written word.

Declinism refers to a bias in favor of the past over and above “how things are going.” Similarly, you might know a member of an older generation who prefaces grievances with, “Well, back in my day” before following up with how things are supposedly getting worse.

The decline bias may result from something before — we just don’t like change. People like their worlds to make sense, they like things wrapped up in nice, neat little packages.

Our world is easier to engage in when things make sense to us. When things change, so must the way in which we think about them; and because we are cognitively lazy (Kahenman, 2011; Simon, 1957), we try our best to avoid changing our thought processes.

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GAMIFICATION: Motivation and Achievement

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Gamification is the application of game-design elements in non-game contexts to motivate and engage people. It’s like turning life into a video game with points, badges, and leader boards. This approach leverages our love for games and competition, making mundane tasks more enjoyable.

According to Dan Ariely PhD, whether it’s a fitness app tracking your steps or a learning platform rewarding your progress, gamification taps into our natural desire for achievement and recognition.

So, the next time you find yourself hooked on a task, thank the power of gamification for making it fun.

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DAILY UPDATE: Spirit Airlines in Chapter 11 as Nvidia Rises and Target, Lowes & Walmart Highlight Stock Earnings Week

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Spirit Airlines said Monday it has filed for Chapter 11 bankruptcy protection after struggling with losses, growing debt and a failed merger during the post-pandemic travel lull. The company said in a stock market statement that it had secured a prearranged deal with bondholders that includes £300 million in financing to keep it afloat, with the business planning to end its bankruptcy in the first quarter of 2025.

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Analysts are expecting Nvidia, the world’s largest publicly traded company, to show quarterly sales of ~$33 billion, up 10% from the previous quarter and 83% year over year, but they also warn the mind-blowing growth of the chip maker could begin to slow.

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And, reports this week from Walmart, Target, Lowe’s, and other retailers will offer a peek at consumer health.

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STOCK POSITION SIZING: How to Construct Investment Portfolios That Protect You

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelson CFA
For a while in the value investing community the number of positions you held was akin to bragging on your manhood– the fewer positions you owned the more macho an investor you were. 

I remember meeting two investors at a value conference. At the time they had both had “walk on water” streaks of returns. One had a seven-stock portfolio, the other held three stocks. Sadly, the financial crisis humbled both – the three-stock guy suffered irreparable losses and went out of business (losing most of his clients’ money). The other, after living through a few incredibly difficult years and an investor exodus, is running a more diversified portfolio today.

Under-diversification is dangerous, because a few mistakes or a visit from Bad Luck may prove to be fatal to the portfolio.

On the other extreme, you have a mutual fund industry where it is common to see portfolios with hundreds of stocks (I am generalizing). There are many reasons for that. Mutual funds have an army of analysts who need to be kept busy; their voices need to be heard; and thus their stock picks need to find their way into the portfolio (there are a lot of internal politics in this portfolio). 

These portfolios are run against benchmarks; thus their construction starts to resemble Noah’s Ark, bringing on board a few animals (stocks) from each industry. Also, the size of the fund may limit its ability to buy large positions in small companies.

There are several problems with this approach. First, and this is the important one, it breeds indifference: If a 0.5% position doubles or gets halved, it will have little impact on the portfolio. The second problem is that it is difficult to maintain research on all these positions. Yes, a mutual fund will have an army of analysts following each industry, but the portfolio manager is the one making the final buy and sell decisions. Third, the 75th idea is probably not as good as the 30th, especially in an overvalued market where good ideas are scarce.

Then you have index funds. On the surface they are over-diversified, but they don’t suffer from the over-diversification headaches of managed funds. In fact, index funds are both over-diversified and under-diversified. Let’s take the S&P 500 – the most popular of the bunch. It owns the 500 largest companies in the US. You’d think it was a diversified portfolio, right? Well, kind of. The top eight companies account for more than 25% of the index. Also, the construction of the index favors stocks that are usually more expensive or that have recently appreciated (it is market-cap-weighted); thus you are “diversified” across a lot of overvalued stocks.

If you own hundreds of securities that are exposed to the same idiosyncratic risk, then are you really diversified?

Our portfolio construction process is built from a first-principles perspective. If a Martian visited Earth and decided to try his hand at value investing, knowing nothing about common (usually academic) conventions, how would he construct a portfolio?

We want to have a portfolio where we own not too many stocks, so that every decision we make matters – we have both skin and soul in the game in each decision. But we don’t want to own so few that a small number of stocks slipping on a banana will send us into financial ruin.

In our portfolio construction, we are trying to maximize both our IQ and our EQ (emotional quotient). Too few stocks will decapitate our EQ – we won’t be able to sleep well at night, as the relatively large impact of a low-probability risk could have a devastating impact on the portfolio. I wrote about the importance of good sleep before (link here). It’s something we take seriously at IMA.

Holding too many stocks will result in both a low EQ and low IQ. It is very difficult to follow and understand the drivers of the business of hundreds of stocks, therefore a low IQ about individual positions will eventually lead to lower portfolio EQ. When things turn bad, a constant in investing, you won’t intimately know your portfolio – you’ll be surrounded by a lot of (tiny-position) strangers.

Portfolio construction is a very intimate process. It is unique to one’s EQ and IQ. Our typical portfolios have 20–30 stocks. Our “focused” portfolios have 12–15 stocks (they are designed for clients where we represent only a small part of their total wealth). There is nothing magical about these numbers – they are just the Goldilocks levels for us, for our team and our clients. They allow room for bad luck, but at the same time every decision we make matters.

Now let’s discuss position sizing. We determine position sizing through a well-defined quantitative process. The goals of this process are to achieve the following: Shift the portfolio towards higher-quality companies with higher returns. Take emotion out of the portfolio construction process. And finally, insure healthy diversification.

Our research process is very qualitative: We read annual reports, talk to competitors and ex-employees, build financial models, and debate stocks among ourselves and our research network. In our valuation analysis we try to kill the business – come up with worst-case fair value (where a company slips on multiple bananas) and reasonable fair value. 

We also assign a quality rating to each company in the portfolio. Quality is absolute for us – we don’t allow low-quality companies in, no matter how attractive the valuation is (though that doesn’t mean we don’t occasionally misjudge a company’s quality).

The same company, at different stock prices, will merit a higher or lower position size. In other words, if company A is worth (fair value) $100, at $60 it will be a 3% position and at $40 it will be a 5% position. Company B, of a lower quality than A but also worth $100, will be a 2% position at $60 and a 4% position at $40 (I just made up these numbers for illustration purposes). 

In other words, if there are two companies that have similar expected returns, but one is of higher quality than the other, our system will automatically allocate a larger percentage of the portfolio to the higher-quality company. If you repeat this exercise on a large number of stocks, you cannot but help to shift your portfolio to higher-quality, higher-return stocks. It’s a system of meritocracy where we marry quality and return.

Let’s talk about diversification. We don’t go out of our way to diversify the portfolio. At least, not in a traditional sense. We are not going to allocate 7% to mining stocks because that is the allocation in the index or they are negatively correlated to soft drink companies. (We don’t own either and are not sure if the above statement is even true, but you get the point.) 

We try to assemble a portfolio of high-quality companies that are attractively priced, whose businesses march to different drummers and are not impacted by the same risks. Just as bank robbers rob banks because that is where the money is, value investors gravitate towards sectors where the value is. To keep our excitement (our emotions) in check, and to make sure we are not overexposed to a single industry, we set hard limits of industry exposure. These limits range from 10%–20%. We also set limits of country exposure, ranging from 7%–30% (ex-US).

In portfolio construction, our goal is not to limit the volatility of the portfolio but to reduce true risk – the permanent loss of capital. We are constantly thinking about the types of risks we are taking. Do we have too much exposure to a weaker or stronger dollar? To higher or lower interest rates? Do we have too much exposure to federal government spending? I know, risk is a four-letter word that has lost its meaning. But not to us. Low interest rates may have time-shifted risk into the future, but they haven’t cured it.

READ: Position Sizing: How to Construct Portfolios That Protect You

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NOVEMBER: National Alzheimer’s Awareness Month

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.

November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.

You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.

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BOOLEAN: Logic & Search Engine

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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George Boole, an English mathematician from the 19th century, developed an algebraic method that he first described in his 1847 book, The Mathematical Analysis of Logic and expounded upon in his An Investigation of the Laws of Thought (1854).

Boolean algebra is fundamental to modern computing, and all major programming languages include it. It also figures heavily in statistical methods and set theory.

Today’s database searches are largely based on Boolean logic, which allows us to specify parameters in detail — for example, combining terms to include while excluding others. A Boolean search, in the context of a search engine, is a type of search where you can use special words or symbols to limit, widen, or define your search.

This is possible through Boolean operators such as AND, OR, and NOT, plus symbols like + (add) and – (subtract).

When you include an operator in a Boolean search, you’re either introducing flexibility to get a wider range of results, or you’re defining limitations to reduce the number of unrelated results.

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DEDICATED: Short Stock Bias Strategies

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Dedicated short bias strategies short stocks expected to depreciate as a result of company-specific catalysts or falling markets. These strategies maintain a net short exposure to the equity market, seeking to reduce equity portfolio volatility and offer the potential to earn returns in falling equity markets. Of course, they may be challenged in periods of rising equity markets.

From Shorting to a Short Bias

Prior to the long-term bull market for U.S. equities that took place in the 1980s and 1990s, many hedge funds used a dedicated short strategy, rather than a dedicated short bias strategy.

The dedicated short strategy was one that exclusively took short positions. The dedicated short funds were virtually destroyed during the bull market, so the dedicated short bias fund emerged and took a more balanced approach. The long holdings are enough to keep losses manageable, although funds can still run into problems with leverage and capital flight if losses continue for too long.

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VARIETY: Insensitivity

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Variety Insensitivity is the tendency to under appreciate the value of variety in choices.

According to Dan Ariely PhD, it’s like always ordering the same dish at your favorite restaurant and forgetting how exciting new flavors can be. Our brains love routine, but this can lead to boredom and missed opportunities. Embracing variety can enhance experiences and satisfaction.

So, next time you’re stuck in a rut, shake things up and try something different. Your brain will thank you for the new stimulation.

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IRMAA: Income Related Monthly Adjustment Amount

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The income-related monthly adjustment amount (IRMAA) is a fee you pay on top of your Medicare Part B and Part D premiums if you make a yearly income above the annual thresholds.

READ: https://secure.ssa.gov/poms.nsf/lnx/0601101020

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CURSE of the “Stereotype”

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The Stereotype Curse is the negative impact of stereotypes on an individual’s performance or behavior. It’s like a self-fulfilling prophecy where being aware of a stereotype makes you more likely to conform to it.

For example, if you’re told you’re bad at math because of your gender, that stress can affect your performance. Breaking free from stereotypes requires awareness and effort.

So, next time you feel boxed in by a stereotype, remind yourself: you’re more than a cliché.

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PATTERNICITY: Apophenia vs. Pareidolia

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Patternicity is our brain’s tendency to find patterns in random data. It’s why we see faces in clouds or think the stock market follows our horoscope. According to colleague Dan Ariely PhD, this quirk helped our ancestors survive by recognizing predator shapes in the bushes, but in modern times, it can lead us astray. Our brains love making connections, sometimes too much, seeing patterns where none exist.

So, when you’re convinced that your lucky socks influence your team’s performance, remind yourself: it’s just your brain’s patternicity at work.

Apophenia vs. Pareidolia

Now, “Apophenia is the general term for the human tendency to see patterns in meaningless data that may involve visual, auditory, or other senses,” according to Dr. Harold Hong, a psychiatrist from Raleigh, North Carolina. He points out that pareidolia is a specific form of apophenia that refers to seeing visual patterns in random or ambiguous visual stimuli, such as seeing a face in the clouds.

Apophenia and pareidolia are common occurrences, says Hong, and challenges often only present when someone becomes fixated on specific patterns or details that others perceive as random. “While both phenomena are natural human tendencies, they can become concerning if someone starts to fixate on specific patterns excessively,” he says, noting that apophenia may be prevalent in certain mental health conditions, such as obsessive-compulsive disorder (OCD).

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DAILY UPDATE: 401[k] and Wamco as Stock Markets Crash!

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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The Internal Revenue Service (IRS) ruled that employees at an unnamed company can designate a portion of their employer match to student debt repayments or health reimbursement accounts, in addition to their traditional 401(k).

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STOCKS UP

  • Warren Buffett’s Midas touch gave a boost to Domino’s Pizza and Pool Corp. after Berkshire Hathaway announced it has bought shares of both companies. Domino’s popped to start the day but dropped 1.27%, while Pool climbed just 0.54%.
  • Palantir is jumping ship, moving from the NYSE to the Nasdaq. Shareholders liked the move, pushing the stock up 11.14%.
  • Bloom Energy…bloomed 59.19% on the news that the renewable energy company reached an agreement to provide utility company American Electric Power with 1 gigawatt worth of fuel cells.

STOCKS DOWN

  • What Buffett giveth, Buffett taketh away: Apple sank on the news that Berkshire Hathaway has sold shares of the company, and almost completely eliminated its position in Ulta Beauty. Apple fell 1.41%, while Ulta Beauty dropped 4.60%.
  • Shareholders were expecting the worst from Chinese online retailer Alibaba, and although the company actually beat earnings forecasts, it wasn’t enough—shares still sank 2.20%.
  • Applied Materials tumbled 9.20% after beating both top and bottom line expectations, but shareholders balked at the slowdown in several key businesses.
  • AST SpaceMobile plummeted 9.59% after reporting bigger losses and smaller sales than Wall Street wanted to see.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major stock market benchmarks ended:

  • The SPX fell 78.55 points (–1.32%) to 5,870.62 to end the week down 2.08%; the Dow Jones Industrial Average® ($DJI) lost 305.87 points (–0.70%) to 43,444.99 to end the week down 1.24%; and the NASDAQ Composite® ($COMP) decreased 427.52 points (–2.24%) to 18,680.12 to end the week down 3.15%.
  • The 10-year Treasury note yield rose one basis point to 4.43% but added 12 basis points for the week. Shorter-term yields rose less.
  • The CBOE Volatility Index® (VIX) climbed sharply to 16.11 as stocks fell.

CITE: https://tinyurl.com/tj8smmes

The problems at storied bond manager Western Asset Management keep growing. Clients have pulled about $55 billion from Wamco, as the division is known, since mid-August, representing about 15% of its assets. Franklin Templeton, its 77-year-old parent company and one of the largest asset managers in the U.S., recently reported its steepest quarterly outflows on record.

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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RESPONSE: Flight -OR- Fight?

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Fight or Flight Response is our built-in alarm system, ready to spring into action at the first sign of danger. Whether it’s a charging lion or an impending deadline, our bodies react the same way – heart racing, adrenaline pumping, ready to fight or flee. This ancient survival mechanism is great for escaping predators but less helpful when dealing with modern stressors.

So, the next time you feel your heart racing over a tough email or stock market loss, remember: it’s just your caveman brain doing its thing.

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BIAS: Of “Social Proof” and Influencers

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

INVESTING DEFINITION

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Social Proof is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision. 

This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like doctors, attorneys, financial advisors, teachers and/or people on television.  In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold. 

According to colleague Dan Ariely PhD, when these stressors become extreme, it is of paramount importance that all participants in the financial planning and investing process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals. 

Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media and related influences.

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FATAL: Narcissism

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd

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Imagine if Narcissus had a social media account. Fatal narcissism is what happens when self-love goes off the rails. It’s not just about admiring your reflection; it’s an all-consuming need for admiration and validation. Think endless selfies and humblebrags.

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While a bit of narcissism is normal, fatal narcissism is like a black hole – it sucks in all attention and gives nothing back.

So, if my Instagram looks like a shrine to my own greatness, you might be witnessing fatal narcissism in action.

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Convertible Securities, Bonds and Corporate Securities

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Convertible securities are those that can be converted at the investor’s choice into other investments, normally into shares of the issuer’s underlying common stock. Convertibles are typically issued as bonds or preferred stock.

Convertible bonds, which provide an ongoing stream of income, can be converted into a preset number of shares of the company’s common stock and have a maturity date. Unlike common stock, which pays a variable dividend depending on a corporation’s earnings, convertible preferred stock pays a fixed quarterly dividend. It can be converted into common stock at any time, but often are perpetual.

Corporate securities (corporate bonds and notes) are debt instruments issued by corporations, as distinct from those issued by governments, government agencies, or municipalities.

Corporate securities typically have the following features: 1) they are taxable, 2) they tend to have more credit (default) risk than government or municipal securities, so they tend to have higher yields than comparable-maturity securities in those sectors; and 3) they are traded on major exchanges, with prices published in newspapers.

CITE: https://www.r2library.com/Resource/Title/0826102549

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DAILY UPDATE: Healthcare Private Equity Prominent as Stocks Go Down

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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Private equity (PE) dollars have become prominent in the US healthcare industry in recent decades, with PE firms now owning roughly 8% of all private hospitals in the country, according to nonprofit Private Equity Stakeholder Project. But studies have illustrated the financial model’s potential adverse effects, such one published in JAMA in December 2023 that found PE-owned hospitals are 25.4% more likely to report patient complications. Others have found that PE-owned healthcare companies represented more than one-fifth of healthcare company bankruptcies in 2023 and that PE-owned hospitals see their assets drop an average of 24% following an acquisition.

CITE: https://www.r2library.com/Resource

STOCKS UP

Tapestry, parent company of luxury brands like Coach and Kate Spade, and Capri, parent company of luxury brands like Versace and Jimmy Choo, have announced they will mutually terminate their planned merger. Tapestry popped 12.80%, while Capri rose 4.43%.

  • Speaking of luxury brands, Burberry soared 18.04% after its CEO announced a turnaround plan designed to halt the company’s recent decline.
  • Semiconductor maker ASML plummeted last month on a profit warning, but rose 2.90% today on reassurances that it’s still on track to meet its 2030 revenue forecasts.

STOCKS DOWN

  • Super Micro Computer fell yet another 11.41% as it nears the November 16 deadline to report fiscal year earnings or be delisted from the Nasdaq.
  • Trump Media & Technology Group dropped 6.71% as investors digested news that company insiders are shedding shares, as well as in reaction to a number of President-elect Trump’s cabinet appointments.
  • Hims & Hers Health tumbled 24.46% on the news that Amazon is getting into the telehealth game, offering Prime members fixed prices on treatments for hair loss and erectile dysfunction.
  • Ibotta is a cashback rewards company, but its shareholders may want their cash back. The company beat on top and bottom line estimates last quarter, but the win wasn’t good enough, and shares sank 12.55%.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 36.21 points (–0.60%) to 5,949.17; the Dow Jones Industrial Average® ($DJI) lost 207.33 points (–0.47%) to 43,750.86; and the NASDAQ Composite® ($COMP) dropped 123.07 points (–0.64%) to 19,107.65. 
  • The 10-year Treasury note yield fell three basis points to 4.42%.
  • The CBOE Volatility Index® (VIX) edged up to 14.17.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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NOVEMBER: Lung Cancer Awareness Month

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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November is Lung Cancer Awareness Month, which according to the CDC, is the third most common cancer in the US. There are about one in five lung cancer deaths each year across the country, and November is dedicated to increasing screening, reducing smoking, and finding new treatments.

MORE: https://www.lung.org/

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PARADOX: Generosity V. Miserliness

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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According to BC Smith and Hilary Davidson, generosity is paradoxical. Those who give, receive back in turn. By spending ourselves for others’ well-being, we enhance our own standing. In letting go of some of what we own, we better secure our own lives. By giving ourselves away, we ourselves move toward flourishing. This is not only a philosophical or religious teaching; it is a sociological fact.

The the generosity paradox can also be stated in the negative.

By grasping on to what we currently have, we lose out on better goods that we might have gained. In holding onto what we possess, we diminish its long-term value to us. And, by always protecting ourselves against future uncertainties and misfortunes, we are affected in ways that make us more anxious about uncertainties and vulnerable to future misfortunes.

In short, by failing to care for others, we do not properly take care of ourselves. It is no coincidence that the word “miser” is etymologically related to the word “miserable.”

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INVESTMENT STRATEGIES: Market Neutral and Extended Equity

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Equity market neutral strategies seek to eliminate the risks of the equity market by holding up to 100% of net assets in long equity positions and up to 100% of net assets in short equity positions. These strategies attempt to exploit differences in stock prices by being long and short in stocks within the same sector, industry, market capitalization, etc. If successful, these strategies should generate returns independent of the equity market.

Equity market neutral portfolios have two key sources of return: 1) the Treasury Bill return (the interest on proceeds from short sales held in cash as collateral), and 2) the difference (the “spread”) between the return on the long positions and the return on the short positions. Stock picking, rather than broad market moves, should drive most of a market-neutral strategy’s total return (save for any return from the 100% cash position).

CITE: https://www.r2library.com/Resource

Extended Equity Strategies attempt to provide better returns than possible with long-only investments

An example of an extended equity strategy is a 130/30 portfolio, which gets its designation from taking a 130% long position and a 30% short position. In practice, this would mean $100mm invested in stocks that are viewed as attractive.

Next, the manager would borrow and sell short $30mm of unattractive stocks. Then the manager uses the proceeds from the short sale to buy an additional $30mm of attractive stocks. This results in a portfolio that has 130% long and 30% short exposure to stocks, or “extended” exposure to equities relative to a long-only, 100% stock portfolio.

Note: It’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).

CITE: https://www.r2library.com/Resource

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DAILY UPDATE: United Health, Cigna and Inflation as Stock Markets Flatten

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

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Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

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UnitedHealth Group posted nearly $6.1 billion in profit last quarter, edging out Elevance Health with $5.6 billion. Paige Minemyer has more takeaways from third quarter earnings results.

Cigna told investors the company is no longer pursuing a merger with Humana, opting to avoid tricky questions from federal regulators.

CITE: https://www.r2library.com/Resource

STOCKS UP

  • EV startup Rivian popped 13.71% after announcing a new $5.8 billion joint venture with Volkswagen to collaborate on a new line of vehicles that will begin rolling off the assembly line in 2027.
  • Rocket Lab…rocketed 28.44% to a new all-time high after increasing revenue 55% last quarter and announcing the first launch deal for its new Neutron rocket.
  • Charter Communications will purchase Liberty Broadband in an all-stock deal. Charter shares rose 3.63% on the news, while Liberty shares sank 5.05%.
  • Cava reported strong earnings today, including impressive same-store sales growth of 18%. Shares soared on the open, though ended the day up just 1.57%.
  • Flutter Entertainment, parent company of sports betting app FanDuel, rose 6.89% to hit an all-time high thanks to incredibly strong betting on the NFL last quarter.

STOCKS DOWN

  • The problems continue at Super Micro Computer, which announced it will need EVEN MORE time to submit its quarterly 10-Q form to the SEC. That’s on top of the delayed filing of its annual 10-K filing from back in June—and if it doesn’t file that by November 16, the stock will be delisted from the Nasdaq. Shares sank 6.31%.
  • Spirit Airlines really may go bankrupt this time. The beleaguered airline has lost hope of merging with Frontier Airlines, so shares plunged 59.32%.
  • Maplebear, which is the parent company of Instacart, delivered bad news for shareholders: Next quarter will be worse than expected. Shares fell 11.01%.
  • SoundHound AI reported record revenue last quarter, but shares plummeted 17.06% after the voice recognition stock also revealed much lower margins.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 1.39 points (0.02%) to 5,985.38; the Dow Jones Industrial Average® ($DJI) added 47.21 points (0.11%) to 43,958.19; and the NASDAQ Composite® ($COMP) fell 50.66 points (–0.26%) to 19,230.74. 
  • The 10-year Treasury note yield added two basis points to 4.45%, just below last week’s four-month high.
  • The CBOE Volatility Index® (VIX) slid to 14.03, down sharply from above 20 early last week.

CITE: https://tinyurl.com/tj8smmes

The Labor Department on Wednesday reported that consumer prices in October rose 2.6% from a year earlier. That marks a pickup in the pace of inflation from September, when prices were up 2.4% on the year.

A digital token inspired by a Shiba Inu dog meme is now worth more than the company that pioneered the assembly line. Yesterday, dogecoin continued its post-election surge to become more valuable than 121-year-old Ford.

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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PODCAST: Farzad Mostashari MD and “Aledade”Primary Care

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Shahid N Shah

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Our guest on this episode is Dr. Farzad Mostashari. Farzad is the co-founder and CEO of Aledade, a primary care enablement company that partners with independent PCPs to transition to value-based care and, as a result, maintain their independence.

Founded in 2014, Aledade works with 11,000 physicians across 40 states and DC, accounting for 1.7M patients under management in Medicare, Medicare Advantage, Commercial and Medicaid contracts. Farzad previously served as the National Coordinator for Health IT in the Department of Health and Human Services, he completed medical school at the Yale School of Medicine and a Master’s in Population Health from Harvard’s T.H. Chan School of Public Health. Earlier this year, Aledade raised a $123M Series E round of funding led by OMERS Growth Equity.

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In this episode, colleague Shahid N. Shah will discuss with Farzad about (1) his journey to starting Aledade and the role policy expertise and evidence have played in the company’s success (2) why he and the company are betting on independent physicians as the drivers of change in value-based care and (3) how Aledade became the rare profitable health tech company.

-Dr. David Edward Marcinko MBA MEd

PODCAST: https://soundcloud.com/wharton-pulse-podcast/mostashari-aledade

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ORDER: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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ORDER: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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MEDICAL TESTS: The Surprise Paradox

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

THE SURPRISE MEDICAL TEST PARADOX

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Classic Definition:  A doctor announces to her hospitalized patient that there will be a painful medical test sometime during the following week. The patient begins to speculate about when it might occur, until another patient announces that there is no reason to worry because a medical surprise test is impossible.

The test cannot be given on Friday, because by the end of the day on Thursday we would know that the test must be given the next day. Nor can the test be given on Thursday, because, given that we know that the test cannot be given on Friday, by the end of the day on Wednesday we would know that the test must be given the next day. And likewise for Wednesday, Tuesday, and Monday!

Modern Circumstance: The patient spends a restful weekend not worrying about the test, yet is very surprised when it is given on Wednesday. How could this happen?

Paradox Example: There are various versions of this paradox; one of them, called the Hangman, concerns a condemned prisoner who is clever but ultimately overconfident. The implications of the paradox are as yet unclear, and there is virtually no agreement about how it should be solved.

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FINANCIAL YIELDS: All About Fixed Income Securities

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Yield: For bonds and other fixed-income securities, yield is a rate of return on those securities. There are several types of yields and yield calculations. “Yield to maturity” is a common calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity.

Yield curve: A line graph showing the yields of fixed income securities from a single sector (such as Treasuries or municipals), but from a range of different maturities (typically three months to 30 years), at a single point in time (often at month-, quarter- or year-end). Maturities are plotted on the x-axis of the graph, and yields are plotted on the y-axis. The resulting line is a key bond market benchmark and a leading economic indicator.

Yield to maturity [real yield to maturity]: Yield to maturity is a common performance calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity. Real yield to maturity is simply yield to maturity minus any “inflation premium” that had been added/priced in. (See Real yield.)

Yield ratio: A ratio of one yield divided by another. Most often used as a relative value measurement.

Yield spread: A “spread,” in fixed income parlance, is simply a difference. Yield spreads measure yield differences, typically between debt securities with high credit ratings (which typically have lower yields) and those with lower ratings (which typically have higher yields). Yield spreads can also be measured between debt securities with different maturities (shorter-maturity securities typically have lower yields and longer-maturity securities typically have higher yields).

Yield trap: An investment that can lure investors with an attractive yield that may not be fundamentally sustainable, or that may lead to undesired price volatility. Yield traps can lurk in both the equity and fixed income markets. They have a tendency to prey on those who can least afford them, including retirement investors looking for increased relative income and stability, who may have been too focused on their income goals and not enough on stability.

CITE: https://www.r2library.com/Resource/Title/0826102549

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CELEBRATE: World Kindness Day

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

November 13th, 2024

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World Kindness Day is an international holiday first introduced in 1998 by the World Kindness Movement.

The holiday is devoted to promoting kindness throughout the world, understanding the positive potential of large and small acts of kindness, and unifying together as human beings.

WKD: https://worldkindness.org/

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DAILY UPDATE: Bitcoin Fog as Chegg the DJIA and NASDAQ Drop

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

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The operator of the longest-running money laundering machine in dark web history, Bitcoin Fog, has been sentenced to 12 years and six months in US prison. Roman Sterlingov, 36, a Russian-Swedish national, was also ordered to repay more than half a billion dollars accrued from the cryptocurrency mixing service that he ran for a decade between 2011 and 2021.

CITE: https://www.r2library.com/Resource

Stocks Up

  • r Elliott Investment Management is at it again, this time with a $5 billion stake in industrial conglomerate Honeywell. Shares gained 3.87% on the news.
  • Shopify announced its ninth consecutive quarter of beating analyst revenue expectations, pushing shares up 21.04%.
  • Bad news is good news: 40% of the workforce at 23andMe is getting laid off to cut costs. Shareholders cheered, and shares climbed 2.17%.
  • Where’s the beef? Tyson Foods popped 6.55% after announcing strong earnings thanks to higher beef and chicken prices last quarter.
  • Sentinel One climbed 2.01% after Deutsche Bank analysts upgraded the cybersecurity stock from “hold” to “buy,” noting it should profit from CrowdStrike’s outage earlier this year.

Stocks Down

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 17.36 points (–0.29%) to 5,983.99; the Dow Jones Industrial Average® ($DJI) lost 382.15 points (–0.86%) to 43,910.98; and the NASDAQ Composite® ($COMP) decreased 17.36 points (–0.09%) to 19,281.40.
  • The 10-year Treasury note yield added 12 basis points to 4.43%.
  • The CBOE Volatility Index® (VIX) fell to 14.81, unusual on a day when stocks lost ground.

CITE: https://tinyurl.com/tj8smmes

Chegg is on the verge of collapse. Its stock is down 99% since 2021, the Wall Street Journal reported, wiping out nearly $15 billion in market value.

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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PHYSICIAN: Pay Cuts in 2025

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Doctors, Facing Another Pay Cut, Call for Permanent Medicare Payment Reform

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. CMS has finalized the calendar year 2025 Medicare Physician Fee Schedule rule that sets payment rates for next year and also outlines new policies focused on primary care, preserved telehealth flexibilities, and a strengthened Medicare Shared Savings Program (MSSP). 

But, provider groups were quick to condemn CMS’ decision to go ahead with the pay cut, which was proposed in the draft rule released in July. In a statement, Bruce Scott, MD, president of the American Medical Association (AMA), pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation, Medicare reimbursement to physicians has decreased 29% since 2001, the AMA says.

Source: Heather Landi, Fierce Healthcare [11/2/24]

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Take the Physician-Focused FINANCIAL PLAN “Challenge”

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Do You Have “What it Takes”?

Book Marcinko

DEM 2

By Professor David E. Marcinko MBBS DPM MBA MEd CMP®

Institute of Medical Business Advisors, Inc.

mba

www.CertifiedMedicalPlanner.org

cmp-logo16

My History

More than 20 years ago I crafted a comprehensive holistic financial plan for a young doctor colleague who was born in 1959. In fact, he was not even a medical student at the time; so “canned off-the-shelf plans”, computer generated software or generic spread sheets were not a viable creation option. It was all a granular, detailed, specific and cognitive work-product. Today, he is a board-certified internist.

So, in 2023, it is right and just to take a look back and see how well, or poorly, we’ve fared.

Now, I appreciate more than most how financial planning is a “process”; and not an isolated event. Yet, all sorts of “advisors” and “consultants” create and charge hefty fees for same, and on-going monitoring, every day.

The ME-P Challenge

Nevertheless, I challenge all you mid-career or senior financial planners /advisors to this competition; regardless of degree, certification or designation.

“Show me your financial plan” – AND – “I’ll show you my financial plan”

Here Comes the Judge

Then, our community of ME-P readers, subscribers, visitors and “judges” will decide the winner.

The contest is open to any financial advisor, planner, consultant, wealth manager, CFP®, CFA, insurance agent, CPA or CLU, ChFC, or stock-broker, etc., who is not afraid of transparency in his or her work product and purported expertise.

Of Financial Certifications and Designations

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Assessment

So, just send in a copy of any “blinded” physician-focused financial plan that is about 21 years old. We will post for all to see and review …. warts and all … including my own; three part mega-plan!

The winner will receive bragging rights, academic swagger, and expert promotion to our entire ME-P ecosystem and network of medical, business, law and graduate school communities; as well as physicians, nurses, healthcare executives and allied health care professionals.

An informed sought-after and lucrative sector – indeed!

IOW: Free publicity and positive “new-wave” PR – PRICELESS!

Of course, as an educator and professor of health economics and finance, we are pleased to present you with the deep medical business knowledge and detailed financial,managerial and accounting techniques used, with some real-life “tips and pearls” developed over the last two decades of R&D, right here:

MORE: Comprehensive Financial Planning Strategies for Doctors …[Best Practices from Leading Consultants and Certified Medical Planners™]

MORE: Risk Management Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™           8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PART 1: My Sample Financial Plan I [Data gathering, goals and objectives]

PART 2: My Sample Financial Plan II [Data Analytics, Creation and Crafting]

PART 3: Request here: MarcinkoAdvisors@msn.com [Stress Testing and Completion]

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BONDS: Zero Coupon [Pros & Cons]

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Zero-coupon securities (aka zeros) are debt securities [bonds] that, unlike most of their debt security counterparts, make no periodic interest payments to investors. Instead, they are sold at a deep discount (with an imputed interest rate priced into the discount), then redeemed for their full face value at maturity.

CITE: https://www.r2library.com/Resource/Title/0826102549

When held to maturity, a zero’s entire return comes from the difference between its purchase price and its value at maturity.

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ANGUS DEATON’S: Paradox

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Angus Deaton’s 1980s studies, including one called “Why is consumption so smooth?” gave birth to a concept called the Deaton Paradox — in short, sharp shocks to income didn’t seem to cause similarly large shocks to consumption.

IOW: Consumption varies surprisingly smoothly despite sharp variations in income.

CITE: https://www.r2library.com/Resource/Title/0826102549

According to David Henderson, this was an important development in understanding the actions of consumers, causing economists to rethink the “permanent income hypothesis” developed by Milton Friedman, which suggested that people spend based on their lifetime income.

And, Mike Bird wrote a good article on Deaton the highlighted the Nobel Prize in Economics Committee.

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DAILY UPDATE: About the Markets

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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The S&P 500 closed above 6,000 for the first time. Chips fell on China trade tension. The US dollar rose. Treasuries were closed.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  •  The SPX rose 5.81 points (0.10%) to 6,001.35; the Dow Jones Industrial Average® ($DJI) added 304.14 points (0.69%) to 44,293.13, a new all-time closing high; and the NASDAQ Composite® ($COMP) gained 11.99 points (0.06%) to 19,298.76.
  • The 10-year Treasury note yield (TNX) didn’t trade today due to the Veterans Day holiday.
  • The CBOE Volatility Index® (VIX) inched up to 15.05. 

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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ECONOMIC: Paradoxes all Financial Advisors Should Know

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A paradox is a logic and self-contradictory statement or a statement that runs contrary to one’s expectation. It is a statement that, despite apparently valid reasoning from true or apparently true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in “persistent contradiction between interdependent elements” leading to a lasting “unity of opposites”.

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And so, as we plan for our financial future thru a New Year Resolution for 2025, it’s helpful to be cognizant of these paradoxes. While there’s nothing we can do to control or change them, there is great value in being aware of them, so we can approach them with the right tools and the right mindset.

According to Adam Grossman, here are seven [7] of the paradoxes that can bedevil financial decision-making, clients and financial advisors, alike:

  1. There’s the paradox that all of the greatest fortunes—Carnegie, Rockefeller, Buffett, Gates—have been made by owning just one stock. And yet the best advice for individual investors is to do the opposite: to own broadly diversified index funds. More: https://tinyurl.com/285vftx4
  2. There’s the paradox that the stock market may appear over valued and yet it could become even more overvalued before it eventually declines. And when it does decline, it may be to a level that is even higher than where it is today.
  3. There’s the paradox that we make plans based on our understanding of the rules—and yet Congress can change the rules on us at any time, as the recent 2024 election results attest.
  4. There’s the paradox that we base our plans on historical averages—average stock market returns, average interest rates, average inflation rates and so on—and yet we only lead one life, so none of us will experience the average.
  5. There’s the paradox that we continue to be attracted to the prestige of high-cost colleges, even though rational analysis that looks at return on investment tells us that lower-cost state schools are usually the better bet.
  6. There’s the paradox that early retirement seems so appealing—and has even turned into a movement—and yet the reality of early retirement suggests that we might be better off staying at our desks.
  7. There’s the paradox that retirees’ worst fear is outliving their money and yet few choose the financial product that is purpose-built to solve that problem: the single-premium immediate annuity.

CITE: https://www.r2library.com/Resource/Title/0826102549

How should you respond to these paradoxes? As you plan for your financial future, embrace the concept of “loosely held views.”

In other words, make financial plans, but continuously update your views, question your assumptions and rethink your priorities.

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PRIMARY MEDICAL CARE: The Paradox

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP™

Sponsor: http://www.CertifiedMedicalPlanner.org

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Classic Definition: Despite rising costs, health care often is of poor quality. Evidence from a classic medical improvement outcomes study assessed care of patients with several chronic diseases. This study found that patients’ functional health status outcomes are similar to care rendered by specialists and generalists but that generalists use far fewer resources. Similar outcome at lower cost represents higher value.

Modern Circumstance: Current solutions to improving care quality may do more harm than good if they focus more on diseases than on people. Efforts to improve the parts (evidence-based care of specific diseases) may not necessarily improve the whole (the health of people and populations).

Expanding access to specialty care, for example, has been proposed as both a source of and a solution for deficiencies in quality of care. Primary care is touted as an essential building block of a high-value health care system even as it is undermined by systems attempting to improve the quality, effectiveness, and value of their health care..

Paradox Example: The above contradictions plague improvement efforts in health care systems around the world, particularly the United States The paradox is that compared with specialty care or with systems dominated by specialty medical care, primary care is associated with the following: (1) poorer quality care for individual diseases, yet (2) similar functional health status at lower cost for people with chronic disease, and (3) better quality, better health, greater health  equity and lower costs for whole peoples and populations.

And so, this contradiction plagues improvement efforts in health care systems around the world, particularly the United States.

Cite: Kurt Stange MD PhD and Robert Ferrer MD MPH

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GIBSON’S PARADOX: Inaccurate Economic Observations

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Why were interest rates and prices correlated?

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Gibson’s paradox is based on an economic observation made by British economist Alfred Herbert Gibson regarding the positive correlation between interest rates and wholesale price levels. John Maynard Keynes later called this relationship a paradox because he claimed that it could not be explained by existing economic theories.

CITE: https://www.r2library.com/Resource/Title/0826102549

There have been possible explanations raised by economists to solve Gibson’s paradox over the decades. But as long as the relationship between interest rates and prices remains artificially de-linked, there may not be enough interest by today’s macro-economists to pursue it any further.

In the end, Gibson’s paradox was neither Gibson’s (having been previously discovered by others) nor a true paradox (as plausible explanations already existed at the time of Keynes’s writing and more have been explored since) and is of little interest beyond being a historical footnote to the gold standard era.

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California Passes Bill Regulating Private Equity Deals

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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On September 28th, 2024, California Governor Gavin Newsom vetoed Assembly Bill (AB) 3129, which sought to regulate private equity (PE) transactions involving healthcare organizations by requiring certain transactions to be reviewed by, and to receive approval from, the California Attorney General (AG).

In his veto message, Governor Newsom stated that the state’s Office of Health Care Affordability (OHCA), established in 2022, has the power to review and evaluate healthcare transactions (including the ones at issue in AB 3129). While OHCA does not have the power to block proposed transactions, as the AG would have had under AB 3129, it can refer transactions to the AG for further examination. Put simply, the governor’s veto seems to stem from concern that taking power away from the newly-created OHCA could muddy the waters in healthcare transaction regulation.

While there is a possibility that the California legislature could override Governor Newsom’s veto, it appears unlikely as of the publication of this Alert. However, the overall popularity of this bill in the legislature (as evidenced by the fairly wide margins with which it passed) indicates that PE groups looking to transact in the healthcare space – both in California and across the U.S. – should be on high alert, as regulators are increasingly turning their focus on the role of PE in healthcare.

CITE: https://www.r2library.com/Resource/Title/0826102549

For more information on AB 3129, as well as the status of state and federal regulation of PE, see the September 2024 Health Capital Topics article entitled, “California Passes Bill Regulating Private Equity Deals.”

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BRICS: Economics Defined

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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BRIC is an acronym for the economies of Brazil, Russia, India, China and South Africa,combined.

CITE: https://www.r2library.com/Resource/Title/0826102549

These are considered to be large developing economies that are part of a global, twenty-first century shift in economic power and influence away from the more established, traditional developed economies of the twentieth century.

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SORTINO: A Financial Risk Ratio

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINED

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The Sortino Ratio is similar to the Sharpe Ratio, it is a measure of risk-adjusted performance which looks at returns through the lens of the risk taken to achieve that performance, but instead of volatility of return, it uses downside variance as its measure of risk.

SHARP RATIO: https://medicalexecutivepost.com/2021/11/08/introducing-the-sharp-index/

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VETERAN’S DAY: 2024

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

GENERATIONS OF VALOR

By Dr. David Edward Marcinko MBA MEd

On Veterans Day, we want to express our deep gratitude to all those who have served in the US military.

  • Here’s one quick factoid: Gulf War-era veterans now make up the largest share of US veterans, having passed Vietnam-era veterans in 2016.
  • And another: The share of veterans who are women is projected to increase significantly, from 11% currently to 18% in 2046.
Veteran's Day 2012

THANK YOU

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MEMORY: Fallibility

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Memory is Fallible. Think you have a great memory? Think again.

According to psychologist and colleague Dan Ariely PhD, memory is more like a game of telephone than a recording device. Each time you recall an event, your brain makes tiny edits, adding some flair or skipping the boring parts. It’s why you can’t remember where you left your keys but can vividly recall an embarrassing moment from high school.

So, the next time someone says, “I remember it like it was yesterday,” know that yesterday might be a heavily edited rerun.

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DAILY UPDATE: Election Week Wrap-Up

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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  • Stocks ended a record-breaking election week by breaking records: The Dow rose above 44,000 for the first time ever, the S&P 500 rose above 6,000 for the first time ever, and the NASDAQ hit its own all-time high.
  • Tesla in particular had an excellent week, rising to a market cap of $1 trillion on a post-election surge.
  • Treasury yields fell and ended the week lower than where they began as investors hedged their bets and bought bonds.

CITE: https://tinyurl.com/2h47urt5

  • Oil rose a bit this week on fears that Hurricane Rafael would disrupt supply in the Gulf Coast, but new projections show the storm losing steam, which meant oil did as well.
  • One investment that didn’t go down this week: bitcoin. The crypto king soared to a new all-time high as traders bought into a friendlier regulatory environment under Donald Trump.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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REO versus REIT

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Real Estate Operating Company (REOC)

A company that invests in real estate and whose shares trade on a public exchange.

Real Estate Investment Trust (REIT)

A real estate operating company (REOC) is similar to a real estate investment trust (REIT), except that an REOC will reinvest its earnings into the business, rather than distributing them to unit holders like REITs do.

Also, REOCs are more flexible than REITs in terms of what types of real estate investments they can make.

CITE: https://www.r2library.com/Resource/Title/0826102549

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FINANCIAL Derivatives

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Derivatives are securities whose performance and/or structure is derived from the performance and/or structure of other assets, interest rates, or indexes. If used moderately and in appropriate situations, derivatives can help stabilize portfolios and/or enhance returns. However, if used in excess and/or in inappropriate circumstances, they can be harmful, potentially causing portfolio instability and/or losses. Derivatives are similar to medicine in their behavior–usually safe when used as directed, potentially toxic when abused.

There are many different types of derivative securities and many different ways to use them. Some derivative securities, such as mortgage-related and other asset-backed securities, are in many respects like any other investment, although they may be more volatile or less liquid than more traditional debt securities.

Futures and options are commonly used for traditional hedging purposes to attempt to protect portfolios from exposure to changing interest rates, securities prices or currency exchange rates, and for cash management purposes as a low-cost method of gaining exposure to a particular securities market without investing directly in those securities.

Certain other derivative securities may be described as structured investments. A structured investment is a security whose value or performance is linked to an underlying index or other security or asset class. Structured investments include collateralized mortgage obligations (CMOs). Structured investments also include securities backed by other types of collateral.

CITE: https://www.r2library.com/Resource/Title/0826102549

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FINANCIAL PLANNING AND ECONOMIC: Mental Health Blocks

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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KENNETH ARROW: Information Paradox

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

To sell information you need to give it away before the sale

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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THE FATHER OF HEALTH ECONOMICS

According to Wikipedia, a fundamental tenet of the paradox is that the customer, i.e. the potential purchaser of the information describing a technology (or other information having some value, such as facts), wants to know the technology and what it does in sufficient detail as to understand its capabilities or have information about the facts or products to decide whether or not to buy it. Once the customer has this detailed knowledge, however, the seller has in effect transferred the technology to the customer without any compensation. This has been argued to show the need for patent protection [HIPPA].

CITE: https://www.r2library.com/Resource/Title/0826102549

If the buyer trusts the seller or is protected via contract, then they only need to know the results that the technology will provide, along with any caveats for its usage in a given context. A problem is that sellers lie, they may be mistaken, one or both sides overlook side consequences for usage in a given context, or some unknown-unknown affects the actual outcome.

MORE :https://www.nobelprize.org/prizes/economic-sciences/1972/arrow/facts/

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DAILY UPDATE: SPX Ends Just Short of 6,000

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
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Stocks up

  • In another daily double-digit swing, Trump Media & Technology Group jumped 15.22% after President-elect Trump announced he has no plans to sell shares of his social media company.
  • Toast isn’t just for breakfast anymore—it’s also a restaurant software company that’s making money hand over fist. Shares popped 14.93% on strong earnings news.
  • Axon Enterprise climbed 28.68% to a new all-time high thanks to an impressive quarter for the law enforcement technology company.
  • Upstart started up and stayed there, soaring 46.02% after the AI lending marketplace beat-and-raised analyst estimates last quarter.
  • Unless you’re a medical professional, you’ve probably never heard of digital platform Doximity, but doctors love it. Shares surged 34.06% on a stronger-than-expected quarter.

Stocks down

  • Pinterest plummeted after the social media site announced slowing user growth combined with lower ad pricing, a one-two combo that sent shares tumbling 14%.
  • Airbnb may have beaten revenue expectations, but shareholders punished it for missing on earnings estimates last quarter. Shares fell 8.66%.
  • Sweetgreen sank 6.01% after the fast casual eatery fell short of analyst estimates last quarter and Goldman Sachs lowered its rating from “buy” to “neutral.”
  • Redfin plunged 15.62% after it announced lower earnings than analysts expected, cut its forecasts, and revealed it’s losing ground to competitors.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The SPX rose 22.44 points (0.38%) to 5,995.54 to end the week up 4.66%; the Dow Jones Industrial Average® ($DJI) added 259.65 points (0.59%) to 43,988.99 to end the week up 4.61%; and the NASDAQ Composite®($COMP) climbed 17.31 points (0.09%) to 19,286.78 to end the week up 5.74%.
  • The 10-year Treasury note yield (TNX) fell four basis points to 4.31%, but the 2-year yield added three basis points to 4.25%. Shorter-term yields, which are more closely connected to near-term rate policy, gained on longer-term ones this week.
  • The CBOE Volatility Index® (VIX) fell to 14.99, near a two-month low.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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ARTIFICIAL Scarcity

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Artificial Scarcity refers to the intentional limitation of the availability of a product or resource to create a sense of rarity, which often drives up its perceived value and price.

Think: surge pricing

And, circumstances with insufficient competition can lead to suppliers exercising enough market power to constrict supply. The clearest example is a monopoly, where a single producer has complete control over supply and can extract a additional price.

By creating a temporary shortage, sellers or producers can increase demand and capitalize on consumers’ fear of missing out, thereby influencing market dynamics to their advantage. This strategy is frequently used in marketing, particularly for limited-edition items or high-demand products.

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RECIPROCITY: Science “Sales” in Action

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

FREE SAMPLES

The Art of Giving – And Receiving – Value!

By Staff Reporters

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Imagine you’re at a party, and someone hands you a drink. Your first instinct? Find something to give back. This is [sales] reciprocity in action – our built-in psychological urge to repay kindness.

According to colleague Dan Ariely PhD, it’s like a cosmic balance sheet in our brains, ensuring we don’t owe anyone a favor. This is why companies give out free samples. They’re not just being nice; they know you’ll feel a pang of guilt if you walk away without buying something.

THINK: Free financial planning dinner seminar and prospecting event. That’s you – the Sales Prospect!

So, next time someone does you a favor, remember: it’s not just seller kindness, it’s science!

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CURRENCY OPTIONS: Hedging and Overlays

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Currency Hedging is a risk-management strategy, as part of a foreign investment strategy, currency hedging is designed to reduce the impact from changes in the relative values of currencies involved in the foreign investment strategy.

CITE: https://www.r2library.com/Resource/Title/0826102549

In any foreign investment strategy, a significant part of the potential risk and return comes from exposure to relative currency value fluctuations. If exposure to those currency fluctuations is minimized, investors can experience more of a “pure play” exposure to the foreign investments. There is a variety of possible currency hedging strategies, ranging from swaps, options, and spot contracts to simply buying foreign currencies.

Currency Overlay is a financial trading strategy used to separate the management of currency risk from other portfolio strategies. A currency overlay manager can seek to hedge the risk from adverse movements in exchange rates, and/or attempt to profit from tactical currency views.

CITE: https://www.r2library.com/Resource/Title/0826102549

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