DOWN: Digital Health Care Funding

By Dr. David Edward Marciniko MBA CMP

SPONSOR: http://www.MarcinkoAssociates.com

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DEFINITION: According to the Food and Drug Administration [FDA], the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, tele-health and tele-medicine, and personalized medicine. From mobile medical apps and software that support the clinical decisions doctors make every day to artificial intelligence and machine learning, digital technology has been driving a revolution in health care. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual. Digital health technologies use computing platforms, connectivity, software, and sensors for health care and related uses. These technologies span a wide range of uses, from applications in general wellness to applications as a medical device. They include technologies intended for use as a medical product, in a medical product, as companion diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They may also be used to develop or study medical products.

Cite: http://tinyurl.com/2jbafuc7

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As many investors predicted, digital health funding took a dive in 2023, according to Rock Health’s year-end funding report. Startups got creative to stay afloat but many digital health founders will have to “face the music” in 2024, the VC firm’s analysts say.

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Editor’s Note: I am on the Advisory Board of Medblob™a start-up based in Boston, MA. The digital mission of Medblob™ is to improve community and national health by allowing patients to better manage their health, providers to better treat their patients, and researchers to have the best information to discover cures to the most prevalent and pernicious diseases.

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HACKED: The SEC’s X Account

By Staff Reporters

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SEC stands for the U.S. Securities and Exchange Commission which is an ...

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Everyone is waiting for the SEC’s decision, expected today, about whether it will allow spot bitcoin ETFs that would make buying the cryptocurrency easier and more accessible. But it seems someone wasn’t willing to wait it out!

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

After the SEC’s account posted to X yesterday that the ETFs had been approved, Chair Gary Gensler said on his own account that there had been no approval and the agency’s account was “compromised.” The false post briefly caused a spike in bitcoin prices.

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PRIVATE HOSPITAL EQUITY: Adverse Events Rise?

By Staff Reporters

DEFINITION: Adverse events are medical errors that healthcare facilities could and should have avoided. The National Quality Forum (NQF) defines these errors, which are also called serious reportable events. There are 29 adverse events listed as reportable errors. The events may result in patient death or serious disability. The department manages aggregate data on adverse events and posts quarterly reports on this website.

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

NEVER EVENTS: https://medicalexecutivepost.com/2007/12/20/new-never-events-policy/

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A hospital’s acquisition by a private equity firm is linked to a rise in adverse events despite the pool of lower-risk patients they tend to admit, according to a Medicare Part A claims analysis just published in the Journal of the American Medical Association [JAMA], and according to Dave Muoio of Fierce Healthcare.

JAMA: https://jamanetwork.com/journals/jama/article-abstract/2813379

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DAILY UPDATE: Stocks Rocket Back for Highest 2024 Close as Key Inflation Updates Loom

By Staff Reporters

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Here is where the major benchmarks ended:

Bond yields and stock prices often move inversely to each other, in part because higher interest rates on virtually risk-free bonds lower the premium investors can expect from riskier assets like stocks, making it less appealing to buy equities. Last week, the 10-year Treasury yield briefly increased to 4.10%, near a three-week high, before dropping back near 4% Monday.

  • The S&P 500 index was up 66.30 points (1.4%) at 4,763.54; the Dow Jones Industrial Average was up 216.90 points (0.6%) at 37,683.01; the NASDAQ Composite was up 319.70 points (2.2%) at 14,843.77.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 4.015%.
  • The CBOE® Volatility Index (VIX) was down 0.28 at 13.07.

Semiconductors shares were among the strongest performers, helped by a surge of 6.4% in Nvdia Corp. (NVDA), the top 2023 performer in the S&P 500 with a gain of 239%. Small-cap stocks were also firm as were consumer discretionary and communication services. The Russell 2000® Index (RUT) gained 1.9% to partly climb back from last week’s 3.7% drop.

Energy shares were soft because crude oil futures sank nearly 4% following reports Saudi Arabia lowered its prices.

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PODCAST: Impact of Education on Employee Health Care

HEALTH INSURANCE DEMOGRAPHICS

By Eric Bricker MD

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DAILY UPDATE: Crypto-Currency, ETFs and the Stock Markets

By Staff Reporters

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The Markets as of 10:00am ET. Here’s what these numbers mean.
Markets: One week into 2024, stocks and bonds are off to their worst start in 21 years as investors maybe got a bit ahead of their skis in anticipating Fed rate cuts.

This week, Wall Street will be focused on fresh inflation data and the beginning of Q4 earnings season.

                        

Bitcoin ETF cleared for launch? The first spot bitcoin ETF—could be approved by regulators this week in what would be a watershed moment for Wall Street’s embrace of digital tokens. The hype around these proposed funds, which would allow regular investors to gain exposure to bitcoin without buying it directly, drove bitcoin’s price up 162% over the past year.

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.
  • The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.453%.
  • CBOE’s Volatility Index (VIX) was down 0.60 at 14.16.

The small-cap focused Russell 2000 Index (RUT), which has lagged large-cap benchmarks for most of the year, jumped more than 5% Tuesday. Small-caps are often seen as being more exposed to the economic cycle and had suffered because of concerns that high interest rates could push the economy into recession.

Other interest rate-sensitive sectors, such as real estate, materials, and utilities, also saw outsize gains.

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DAILY UPDATE: “Medical Properties Trust” Tanks, FDA Approves Canadian Drugs and Medicare Advantage Health Plan [Part C] Patient Traps

By Staff Reporters

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Markets: Stocks climbed a bit on Friday as investors took in the news that the US added more jobs than expected in December, capping off an epic 2023 for the labor market. But it wasn’t a bright start to the year, as all three major averages broke a nine-week winning streak. Stock spotlight: The country’s largest hospital landlord, Medical Properties Trust, tanked after revealing that its biggest tenant was $50 million behind on rent.

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Yesterday, the Food and Drug Administration (FDA) approved Florida’s request to import bargain medications from the country. It’s the first state to get permission from the agency to bring in medications from Canada under a law Congress passed 20 years ago to help Americans pay less for drugs. Florida officials say ordering cheaper drugs for conditions like HIV and diabetes from Canadian wholesalers will save Medicaid and other state programs $150 million over the first year.

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Older Americans say they feel trapped in Medicare Advantage plans.

READ HERE: http://tinyurl.com/yck2yb8z

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IMPLICATION OF WITHDRAWALS IN A MODERATE INTEREST RATE ENVIRONMENT

  A SPECIAL ME-P REPORT

A Retrospective Review … and Implications for Modernity

[Copyright Manning & Napier Advisors, Inc.]

Dr. Jeff Coons

By Jeff Coons PhD CFA

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

The general trend of declining interest rates experienced over the last several decades, part of a long-term trend Manning & Napier Advisors, Inc. and others have focused on since the early 1980’s, created new challenges for managing investment portfolios with regular and significant cash withdrawals.

Historical Review

This continuing report, first prepared 25 years ago, will provide an analysis of the investment implications of withdrawals in light of the secular shift in the economic and market conditions today. This analysis and historical review aims to guide decisions as to the appropriate level of withdrawals from an account in the more current moderate interest rate environment of 2014; and estimated thru to 2023.

The Questions

Declining interest rates restrict the ability to generate income from high quality investments, so a greater proportion of a given withdrawal requirement must come from the potential price appreciation of the securities.  Of course, the inherently volatile nature of the financial markets makes price appreciation the less predictable of the sources of total return available to fund withdrawal needs.

The natural questions that arise from this observation include:

  • What withdrawal rate inhibits the ability to pursue long-term capital growth as a primary investment objective?
  • What withdrawal rate may create a significant risk of a sustained deterioration of capital?
  • What is a reasonable range of withdrawal rates given the relatively low interest rate environment that we face? 

The answer to the first question can be derived from interest rates and dividend yields.  With a dividend yield of 1.0%-2.0% on stocks (e.g., the yield on the S&P 500 Index as of December 2000 was 1.2%) and yields on intermediate-term and long-term fixed income securities between 5.0% and 6.0% (e.g., as of December 2000, a one-year Treasury Bill had a yield of 5.4% and a thirty-year Treasury bond had a yield of 5.5%), growth-oriented portfolios should generally produce a level of income adequate to allow 2.5%-3.5% withdrawals on an annual basis.

Thus, rates of withdrawal of less than 3.5% generally should not inhibit the pursuit of long-term capital growth as a primary investment objective.

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Portfolio analysis

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Management Approach

To establish the high end of the achievable withdrawals under a management approach pursuing long-term capital growth, consider some historical evidence.

Assume that withdrawals are taken from each of three portfolios (i.e., 100% stocks, 80% stocks/20% bonds, and 50% stocks/50% bonds using data from Ibbotson Associates, Inc.) starting at the beginning of 1973.  How many years did it take to regain the original capital of the portfolio?

As can be seen in the following table, it took between 4-8 years for these portfolios to recover from the 1973-74 bear market with a 5.0% withdrawal rate.  If withdrawals are at a 7.5% rate per year, over ten years elapsed before the original capital was restored.

Finally, with a 10.0% withdrawal rate, it took between 13-15 years to restore the capital.  While the 1973-74 bear market was severe, it is not the worst bear market that can be used to illustrate the risk of significant withdrawals taken when the portfolio’s market value is depressed.

The clear conclusion is that withdrawals of greater than 5.0% are a potential impediment to pursuing long-term capital growth, given the long periods required to restore capital for the various growth-oriented asset mixes offered in this analysis.

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When Was Original (12/72) Capital Restored?
  1. 0% W/D
 

  1. 5% W/D
 

  1. 0% W/D
 100% Stock  9/80(7.75 years) 6/83(10.5 years) 6/86(14.5 years)
80% Stock/ 20% Bond  9/80(7.75 years) 3/83(10.25 years) 6/86(14.5 years)
50% Stock/ 50% Bond  12/76(4.0 years) 3/83(10.25 years) 3/87(15.25 years)

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Another key issue to remember is that the withdrawal rates above are a percentage of current market value, so the dollar value of the cash withdrawn from the account is assumed to decline in a bear market.  However, most of us think of our withdrawal needs in terms of dollars instead of percentages (e.g., $50,000 from a $1,000,000 account, which translates to 5%).

If we attempt to maintain the dollar value of withdrawals in bear market periods, the percentage of current market value being withdrawn actually increases, and the impact on the portfolio far exceeds the example provided above.

SAMPLE:

To demonstrate, consider maintaining withdrawals of $50,000, $75,000 and $100,000 on an account with a $1,000,000 market value as of 12/72 (see table below).

In the case of a $50,000 annual withdrawal, approximately 8-10 years elapse before the original $1,000,000 market value is restored.  If the withdrawals are $75,000 per year, 13 years elapse for the 50/50 asset mix and almost 19 years pass for the 80/20 asset mix before the $1,000,000 is restored.  For the 100% stock portfolio, nearly 25 years elapse before the original $1,000,000 is restored.

Finally, for $100,000 withdrawals off of a $1,000,000 market value in 1972, all capital in the account is depleted within 10-15 years given these withdrawals.  Thus, the risk of significant cash withdrawals having a detrimental impact on the ability to preserve and grow capital is much more pronounced when withdrawals remain high in dollar terms.

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When Was Original Capital ($1,000,000 in 12/72) Restored?
$50,000 W/D  $75,000 W/D  $100,000 W/D
 100% Stock  3/83(10.25 years) 9/97(24.75 years) Capital Depleted9/83
80% Stock/ 20% Bond  12/80(8.0 years) 9/91(18.75 years) Capital Depleted3/85
50% Stock/ 50% Bond  9/80(7.75 years) 3/86(13.25 years) Capital Depleted9/87

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So far, the major point we have established is that a withdrawal rate of 2.5%-3.5% may be achievable without hampering the pursuit of long-term capital growth, but withdrawals of 5% or greater may have a significant impact on the ability to manage for growth.  Therefore, accounts expected to experience withdrawals of 4%-5% (or greater) should be managed with a goal of satisfying these withdrawal needs on a regular basis first, with the pursuit of capital growth taking secondary importance.

However, the analysis provided above also implies that there is a rate of withdrawals that forces us to focus on capital preservation, because depletion of capital is a likely outcome.  For withdrawals in the range of 10.0%, the example above shows that the risk of depletion of capital is significant at these high annual levels, especially if the withdrawals are on a dollar basis and not adjusted by the decline of current market value in a bear market.

In fact, with long-term U.S. government bond yields at approximately 5.0%-6.0%, annual withdrawals greater than 7.5% are likely to be too high to allow a manager to effectively pursue long-term capital growth without a high degree of risk to the capital of the account.  That is, since attempts to provide returns above the current Treasury yields imply risk of volatility, and volatility can lead to the examples provided above, withdrawals at 7.5% or more and maintained on a dollar basis imply a high likelihood that original capital will be depleted over a 15-20 year period.

In general, the current level of yields in the market imply that management of a portfolio requiring over 7.5% per year in withdrawals faces a strong possibility of depleting capital under any scenario, and so portfolio management should focus on dampening market volatility so as to extend the life of the capital for as long as possible as it is drawn down.

Final Questions

The final question[s] (i.e., the appropriate level of withdrawals) is driven by both the client’s need for the assets and the parameters outlined above:

  1. Withdrawals less than 3.5% of current market value should not inhibit the pursuit of long-term capital growth as a primary objective.
  2. Withdrawal rates between 3.6% and 7.4% require a primary focus on satisfying withdrawal needs over the market cycle, possibly with a secondary goal of long-term capital growth to protect future withdrawal needs.
  3. Withdrawal rates greater than 7.5% are likely to result in a depletion of capital, so the goal should be to manage the drawdown of capital by dampening year-to-year volatility of the portfolio.

While we all would like to achieve capital growth, the ability to pursue growth-oriented strategies depends on the flexibility to moderate withdrawals, if required by market conditions, and on the overall reliance on these assets.

As another example, an endowment can control its withdrawals to some extent, but there is a level beyond which the belt cannot be tightened without harming the services being funded.

Yet another example comes from a physician-executive or someone living primarily on an IRA account, especially after becoming accustomed to the high (and falling) interest rate/high asset return environment of the last fifteen years.  Aggressively pursuing capital growth in the face of large withdrawals may result in exposure to significant risk of depletion of the IRA assets when other sources of income are unavailable.

If, on the other hand, the IRA was a small part of the wealth available in retirement, then there is some flexibility to work towards long-term capital growth.

Financial Planning MDs 2015

Implications for defined benefit retirement plans

A defined benefit retirement plan may have an outside source of funding to help restore capital (i.e., contributions from the employer), but defined contribution and Taft-Hartley plans have much less of a safety net.  As a result, the risk taken to pursue growth in the face of significant withdrawals must take into account the nature of the assets and the problems associated with a deterioration of capital in the account.

Assessment

And so, withdrawals can have a significant impact on the ability of a manager to preserve capital and pursue long-term capital growth.  However, while lessening the level of withdrawals will help provide flexibility for the manager to pursue these goals, the need for the assets may require that withdrawals are maintained at a certain level.  Once withdrawals are minimized, the manager should focus on investment goals that correspond with this minimum level.

If withdrawals are below 3% of current market value, pursuit of long-term capital growth can be a primary objective.  Withdrawals between 4% and 7.5% of market value on an annual basis require a focus on working towards satisfying these annual needs.  Long-term capital growth, in this case, should be a secondary goal.

Finally, if withdrawals are above a 7.5% annual rate, then the investment management approach should focus on preserving capital and dampening market volatility so as to work towards allowing the assets to last as long as possible as they are drawn down.

NOTE: The 10-year Treasury rate’s just fell below 3.91% after Fed, ECB nominees; today.

Conclusion

This historical review paper provides a retrospective review of IRs and implications for modernity.

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

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DAILY UPDATE: Walgreens’s Dividend Dives as Stocks Post Down Week

By Staff Reporters

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DEFINITION: A stock dividend is a payment to shareholders that consists of additional shares rather than cash. The distributions are paid in fractions per existing share. For example, if a company issues a stock dividend of 5%, it will pay 0.05 shares for every share owned by a shareholder. The owner of 100 shares would get five additional shares.

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Stat: 3.9%. That’s Walgreens’s new dividend yield after the pharmacy chain cut its quarterly dividend of 7.0%. The company said that it was using the money to “strengthen [its] long-term balance sheet and cash position.” Walgreens stock fell 11% the day after the announcement. (CNBC)

Here is where the major benchmarks ended:

  • The S&P 500 index was up 8.56 points (0.2%) at 4,697.24, down 1.6% for the week; the Dow Jones Industrial Average® (DJI) was up 25.77 points (0.1%) at 37,466.11, down 0.6% for the week; the NASDAQ Composite® (COMP) was up 13.77 points (0.1%) at 14,524.07, down 3.2% for the week.
  • The 10-year Treasury note yield (TNX) was up about 6 basis points at 4.051%.
  • The CBOE® Volatility Index (VIX) was down 0.77 at 13.36.

Consumer staples and real estate ranked among the market’s weakest performers Friday, and technology shares remained under pressure with tech bellwether Apple (AAPL) extending this week’s nearly-6% slide and ending near a two-month low. Financial shares were one of the stronger sectors with the Philadelphia KBW Bank Index (BKX) rising 1.6% to a 10-month high. Small-cap stocks remained in the red with the Russell 2000® Index (RUT) ending the week down 3.7%. 

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DAILY UPDATE: Second Apple Downgrade with Mixed Markets as Investors Await Payroll Data and Lilly Sells Medications Directly to Patients

By Staff Reporters

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was down 16.13 points (0.3%) at 4,688.68; the Dow Jones Industrial Average® (DJI) was up 10.15 points at 37,440.34; the NASDAQ Composite was down 81.91 points (0.6%) at 14,510.30.
  • The 10-year Treasury note yield (TNX) was up about 9 basis points at 3.997%.
  • The CBOE® Volatility Index (VIX) was up 0.08 at 14.12.

Oilfield services and consumer discretionary shares were also among the market’s weakest performers Thursday. Banking and health care were among the strongest sectors, illustrating renewed investor interest in stocks that lagged the broader market last year.

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And, Eli Lilly is poised to sell medicine directly to consumers — with an emphasis on newly popular weight-loss drugs — in a move toward cutting out the controversial middle players in drug distribution.

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DAILY UPDATE: Technology Stocks Tank on Perihelion Day

By Staff Reporters

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Today the Earth is the closest it can get to the sun, a point in orbit known as perihelion, which happens every year two weeks after the December solstice.

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SPONSOR: http://www.MarcinkoAssociates.com

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was down 38.02 points (0.8%) at 4,704.81; the Dow Jones Industrial Average® (DJI) was down 284.85 points (0.8%) at 37,430.19; the NASDAQ Composite was down 173.73 points (1.2%) at 14,592.21.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 3.91%.
  • The CBOE® Volatility Index (VIX) was up 0.84 at 14.04.

In addition to tech shares, retailers and banks were also among the market’s weakest performers Wednesday. Small-cap stocks were also under pressure with the Russell 2000® Index (RUT) down about 2.7% to a three-week low. Energy shares strengthened behind a jump of nearly 4% in crude oil futures.

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PODCAST: Hospital Cost to Charge Ratios Explained

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/082610254

Medical Cost Accounting: https://medicalexecutivepost.com/2022/08/30/understanding-medical-cost-accounting/

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DAILY UPDATE: Apple and the “Magnificent 7” Stocks Drop with the Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Driving much of the tech slump was a 4% drop by Apple’s stock, a dive precipitated by an analyst downgrade questioning why the $2.9 trillion (market capitalization) company is trading at such an expensive valuation considering its negative earnings and profit growth.

Other members of the “magnificent seven” tech stocks, which gained a collective $5.1 trillion in market cap last year, also flailed Tuesday. Alphabet, Amazon, Meta, Microsoft, Nvidia and Meta each fell 1.6% or more, while Tesla was the sole magnificent seven member in the green, as its shares slipped less than 1% after reporting more fourth-quarter electric vehicle deliveries than fore-casted.

Here is where the major benchmarks ended:

  • The S&P 500 index was down 27.00 points (0.6%) at 4,742.83; the Dow Jones Industrial Average® (DJI) was up 25.50 points (0.1%) at 37,715.04; the NASDAQ Composite was down 245.41 points (1.6%) at 14,765.94.
  • The 10-year Treasury note yield (TNX) was up about 7 basis points at 3.931%.
  • The CBOE® Volatility Index (VIX) was up 0.73 at 13.18.

Semiconductor companies led the way lower Tuesday after Bloomberg reported Netherlands-based ASML Holding NV (ASML) canceled shipments of some of its machines to China at the request of U.S. President Biden’s administration weeks before export bans on the high-end chipmaking equipment came into effect. The Philadelphia Semiconductor Index (SOX) tumbled 3.7%. Health care and energy sectors were among the few areas of strength, the latter gaining despite a 1.6% drop in crude oil futures.

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PODCAST: Why Hospitals Cry “Poor”

By Eric Bricker MD

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DAILY UPDATE: ChristianaCare Settles FCA Lawsuit as Stock Markets Celebrate 2023 but Start Off Rocky in 2024

By Staff Reporters

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ChristianaCare agreed to pay $47.1 million to resolve illegal kickback allegations flagged by its former chief compliance officer.

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Markets: The stock market was closed yesterday to give investors time to celebrate New Year’s Day 2024. As the just passed old year, 2023, provided plenty of reasons to pop bottles and celebrate:

For example, global stock markets had their best year since 2019, and all three major US indexes finished the year higher than they started it, with tech company gains pushing the NASDAQ up the most. Even among tech giants, Nvidia was a standout, boosted by A.I. suddenly being everywhere.

But, all major markets are down as of this posting time, today.

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HELPING DOCTORS ACHIEVE: New Year Resolutions

COACHING AND MENTORING

Physician Goal Setting [Business V. Personal Approach] in 2024

By Marcinko Associates, Inc.

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CORPORATE APPROACH

The year-end physician, nurse and/or medical employee reviews in general aren’t very effective at motivating employees in ACOs, and VBC organizations, etc.

And, according to a Gallup [non-medical worker] poll, only 14% of employees “strongly agreed” that a performance review inspired them to improve. But in recent years, some workplaces have changed how they conduct performance reviews—or abandoned them altogether especially in technology.

  • A decade ago, Microsoft disbanded its version of stack ranking, the practice pioneered by General Electric CEO Jack Welch in the 1980s in which the company would rank every employee. Experts say it hurts morale and can create a toxic work culture.
  • Netflix has around 10,000 employees but has eschewed the year-end review for informal conversations during the year.
  • Google revamped its system last May by reducing performance reviews from twice to once a year.
  • Apple dropped performance reviews completely.

Healthcare business and corporate employees want feedback, even physicians, but it has to be useful.

PERSONAL APPROACH

Now that you’ve set your personal goals on your landmark date (New Year 2024), how you pursue it will go a long way toward whether you achieve it. There are generally two ways to tackle the goals you’ve set for yourself—and one yields more success than the other.

  • Avoidance goals: While this works well when it comes to your ex-medical partner or spouse, it’s not how you want to attack resolutions. Avoidance goals include “stop eating sweets” or “watch less TV.”
  • Approach goals: Instead of avoiding a behavior, you create a new one. Your goals would be “eating more vegetables” or “reading more books” to replace the habits you want to shake.

And, a recent study found that approach goals are more likely to be accomplished (59%) than avoidance goals (47%) across a wide range of potential resolutions. Good luck with that!

WE CAN HELP.

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HAPPY NEW YEAR: From All of Us at the ME-P

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EDUCATION: https://marcinkoassociates.com/textbooks-academic-catalog/

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 From us all to you and yours.
Here’s to making a difference and paying it forward today, in 2024, and beyond. 

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DAILY UPDATE: S&P 500 is High as McKinsey Settles Opioid Claims

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The S&P 500 has climbed about 24% in 2023, hovering right around its all-time high. And, the NASDAQ Composite is up 44%, although the tech-heavy index still has some ground to cover before it starts carving out new all-time highs of its own.

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By Staff Reporters

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Consulting firm McKinsey and Co. has agreed to pay $78 million to settle claims from insurers and health care funds that its work with drug companies helped fuel an opioid addiction crisis. The agreement was revealed late Friday in documents filed in federal court in San Francisco. The settlement must still be approved by a judge.

Under the agreement, McKinsey would establish a fund to reimburse insurers, private benefit plans and others for some or all of their prescription opioid costs. The insurers argued that McKinsey worked with Purdue Pharma – the maker of OxyContin – to create and employ aggressive marketing and sales tactics to overcome doctors’ reservations about the highly addictive drugs. Insurers said that forced them to pay for prescription opioids rather than safer, non-addictive and lower-cost drugs, including over-the-counter pain medication. They also had to pay for the opioid addiction treatment that followed.

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DAILY UPDATE: Stocks Fall on Last Day of a Strong 2023 Year

By Staff Reporters

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 13.52 points (0.28%) to 4,769.83; the Dow Jones Industrial Average® was down 20.56 points (0.05%) at 37,689.54; the NASDAQ Composite® (COMP) was down 83.78 points (-0.56%) at 15,011.35.
  • The 10-year Treasury note yield (TNX) rose nearly 2 basis points to 3.86%. 
  • The CBOE® Volatility Index (VIX) finished nearly unchanged at 12.51, still near recent four-year lows.

The S&P 500 and Dow Jones Industrial Average posted their ninth consecutive weekly advances, but the NASDAQ Composite finished slightly lower for the week, hurt in part by a soft performance from Apple (AAPL). The Russell 2000® Index (RUT) fell 1.18% on Friday but climbed 15% for the year.

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DAILY UPDATE: Another Health System Data Breach as the “Magnificent Seven” Stocks End Mixed

By Staff Reporters

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A health system in Michigan has experienced its second cybersecurity breach this year, affecting more than 1 million patients, according to state officials. Michigan Attorney General Dana Nessel announced Tuesday there was a breach at HealthEC, a vendor that provides services to Corewell Health’s southeast Michigan properties. The breach exposed patients’ personal and medical information.

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With Nvidia and Tesla on the rise, acronyms like FAANG and MAMAA no longer cut it: The top tech giants (Amazon, Alphabet, Apple, Meta, Google, plus Nvidia and Tesla) have now been dubbed the “Magnificent Seven.” Buoyed by the generative AI gold rush, they were responsible for 29% of the S&P 500’s total value.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 1.77 points at 4,783.35; the Dow Jones Industrial Average was up 53.58 points (0.1%) at 37,710.10; the NASDAQ Composite® (COMP) was down 4.04 points at 15,095.14.
  • The 10-year Treasury note yield (TNX) was up nearly 6 basis points at 3.844%.
  • The CBOE® Volatility Index (VIX) was up 0.03 at 12.46.

The S&P 500, Dow Jones Industrial Average, and NASDAQ Composite are all on track for a ninth consecutive weekly advance. Other parts of the market Thursday turned in mixed performances. The Russell 2000® Index (RUT) fell 0.4% but is still on track for a seventh consecutive weekly gain and has climbed 17% for the year.

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DEFLATION: Another Holiday Surprise?

By Staff Reporters

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Deflation could be arriving this holiday season. Walmart CEO Doug McMillon recently said deflation may be on the horizon, citing a decline in the prices of grocery items such as chicken and eggs. McMillion said that although some items like beef remain expensive, he expects prices on other staples to come down in the coming months.

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It’s the latest welcome news for everyone feeling the squeeze from inflation and rising interest rates.

  • Target Chief Growth Officer Christina Hennington said earlier this week that the average price of basics fell three percentage points between Q2 and Q3.
  • JCPenney announced last month that it planned to keep prices for Black Friday the same or lower than last year.

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DAILY UPDATE: 2023 Business Start-Up Failure Review with Stock Market Gains

By Staff Reporters

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3,200 business startups failed in 2023, according to PitchBook data. Those startups raised more than $27 billion combined, or roughly the 2022 GDP of Cambodia. (Business Insider).

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Here’s where the major benchmarks ended:

  • The S&P 500 index was up 6.83 points (0.1%) at 4,781.58; the Dow Jones Industrial Average was up 111.19 points (0.3%) at 37,656.52; the NASDAQ Composite® (COMP) was up 24.60 points (0.2%) at 15,099.18.
  • The 10-year Treasury note yield was down over 9 basis points at 3.791%.
  • The CBOE® Volatility Index (VIX) was down 0.49 at 12.50.

Small-cap stocks continued a strong finish to the year as the Russell 2000® Index (RUT) gained 0.3% to settle at its highest level since April 2022. Retailer shares were among the market’s strongest performers amid reports of strong holiday sales. The S&P Retail Select Industry Index (SPSIRE) rose 0.6% and ended near an 11-month high.

In other markets, the U.S. dollar traded around $1.11 versus the euro (EUR/USD), its weakest level since late July and a reflection of expectations that lower rates in the United States will prompt investors to seek higher returns elsewhere.

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IRS: A Late PayPal Gift for 2023 Tax Returns

GOODBYE FORM 1099-Ks

By Staff Reporters

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The IRS just said it is again delaying the implementation of a 2021 law that requires payment platforms such as Venmo, Paypal or Cash App to send tax forms called 1099-Ks to anyone who received more than $600 in the current tax year. 

It’s the second consecutive year the IRS has delayed enacting the new regulation, after the tax agency last year pushed off the new law until 2023. On Tuesday, the IRS said it will push the regulation back another year “to reduce taxpayer confusion” after hearing from taxpayers, tax professionals and payment processors.

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DAILY UPDATE: Holiday Spending Solid as Stock Market Rally Continues

By Staff Reporters

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Consumer spending grew solidly this holiday season, rebuking concerns of a slowdown and reinforcing positive signals about the U.S. economy as it approaches the end of a tumultuous year.

Buying among shoppers rose 3.1% over the holidays compared to the same period last year, according to data released on Tuesday by Mastercard SpendingPulse, which measures in-store and online purchases from November 1st to December 24th across all forms of payment. The data is not adjusted for inflation.

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Here’s where the major benchmarks ended: 

  • The S&P 500 index was up 20.12 points to 4,774.75 up 0.42%; the Dow Jones Industrial Average was up 159.36 points at 37,54533, up 0.2% ; the NASDAQ Composite® (COMP) was up 81.6 points to 15,074.57 up 0.54% to start the week.  
  • The 10-year Treasury note yield (TNX) was down 1 basis point to 3.895%.
  • The CBOE® Volatility Index (VIX) was down 0.38% to 12.98.

Small-cap stocks continued to outpace their larger cousins, a common theme lately. The Russell 2000® Index rose Tuesday following six weeks of gains. Financials and real estate sectors were among strongest S&P 500 performers during the session, and the Russell 2000 has a heavy exposure to financials. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and now trades at five-month lows, reflecting ideas that potentially lower interest rates may prompt investors to seek higher returns elsewhere.

With just three trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. With Tuesday’s gains factored in, the SPX is closing in on its all-time high close just below 4,800 posted in early 2022. Through Tuesday, the S&P 500 was up more than 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 44%, respectively, after losing 8.8% and 33% in 2022.

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PODCAST: State Health Insurance Commissioners

By Eric Bricker MD

MORE ON OUT-OF-NETWORK SURPRISE MEDICAL BILLS

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HEALTHCARE: Spending Grew in 2022

By Health Capital Consultants, LLC

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On December 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released its annual report on healthcare spending in the U.S., highlighting the growth in private insurance and Medicaid spending in 2022, which was offset by the declines in supplemental federal funding as a result of the COVID-19 pandemic.

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This Health Capital Topics article reviews the notable healthcare spending findings in CMS’s report. (Read more…) 

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HOLIDAY BONUS: Wall Street is Down

By Staff Reporters

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For the second straight year, Wall Street bankers should prepare for smaller bonuses this holiday season, according to a report from consulting firm Johnson Associates. Cash bonuses for investment bankers in particular could shrivel up to 25% compared to 2022. Now, bonuses often account for a huge share of bankers’ total compensation. In some cases, they can be double their salary. That adds up to tens of billions of dollars in Wall Street’s bonus pot, which hit an all-time high in 2021.

But two years later, the economy looks a lot different.

For example, IPOs have slowed, interest rates are up, and we’re down a few banks. Investment bankers aren’t the only ones feeling the effects:

  • Regional bankers are likely to see bonuses fall 10%–20%.
  • Workers in asset management and sales could get 5%–10% less this year.
  • The only groups expected to receive bonus bumps this year are wealth managers and retail or commercial bankers at major global banks. Goldman Sachs is also reportedly considering bigger (but still unspecified) bonuses to keep top traders.

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MERRY CHRISTMAS

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EDITOR’S CORNER: Fierce Health-Care’s 10 Most-Read Stories of 2023

By Heather Landi

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READ HERE: http://tinyurl.com/484773vm

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What is the SANTA CLAUS Stock Market Rally?

LATE DECEMBER – EARLY JANUARY RISE

By Staff Reporters

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RALLY: A rally is a period of sustained increases in the prices of stocks, bonds or indices … An increase in prices during a primary trend bear market is called a bear market rally. A bear market rally is sometimes defined as an increase of 10% to 20%.

Now, a Santa Claus Rally describes a sustained increase in the stock market that occurs in the last week of December through the first two trading days in January. There are numerous explanations for the causes of a Santa Claus rally including tax considerations, a general feeling of optimism and happiness on Wall Street, and the investing of holiday bonuses.

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Another theory is that some very large institutional investors, a number of which are more sophisticated and pessimistic, tend to go on vacation at this time, leaving the market to retail investors, who tend to be more bullish.

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A Financial Early “Christmas Eve Carol” [Parts 1 and 2]

By Rick Kahler MS CFP®

http://www.KahlerFinancial.com

Rick Kahler MS CFPFor me, the Christmas season doesn’t seem complete without Charles Dickens’s A Christmas Carol. I’ve long been captivated by the transformation of the cold-hearted and calculating Mr. Scrooge, the seemingly inherent goodness of Bob Cratchit, and the haunting visits of the Ghosts of Christmas.

As a student of Dickens’s fable, I’ve been amazed at the wisdom and universal truths contained in that seemingly simple story. I have discovered that Mr. Scrooge isn’t merely the villain he’s often made out to be, nor is Cratchit the straightforward hero.

It’s not uncommon for the average American to have a stressful, even adversarial relationship with money, especially since half of Americans have no savings or investments and live month to month. Stress over money is especially exacerbated during the Christmas season each year. Many Americans borrow heavily on credit cards for gifts and end up stressing for months afterward trying to pay the bill.

Financial Transformations

How ironic that what Dickens unveils in the short A Christmas Carol is a powerful process for financial transformation (or any desired transformation). Dickens gives us a four-step process that anyone can employ to change destructive financial behaviors.

A few years ago I co-authored a book, The Financial Wisdom of Ebenezer Scrooge that highlights the subtle wisdom of Dickens’s story as it pertains to transforming one’s behavior around finances. The story became the heart of a successful model employed by financial planners and therapists to help transform a person’s relationship with money.

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The Story

The first big event in the story is the visit to Scrooge by the ghost of his old business partner, Jacob Marley. Scrooge takes to heart Marley’s warning to change his ways, thereby becoming willing to consider changing. Psychologists would call this an intervention.

The first and most important step toward transformation needs to be a personal realization that something is amiss with your behavior and it’s you who wants to contemplate changing, as opposed to someone else insisting you ought to or should change. Meaningful and sustainable change comes only from within, not without. Blaming personal financial problems on family, employers, the wealthy, or the government just keeps a person stuck in delusion.

What is the key to developing an internal desire to change? Addiction recovery programs call this “hitting bottom.” I describe it as reaching a state of openness to accept the facts and circumstances as they are, not as you wish they were. It is becoming convinced that change is crucial and that you are passionately ready to take action to change.

On that Christmas Eve, inexplicably, Scrooge was finally ready consider the message his old friend Marley had tried to deliver to him on many Christmas Eves previously.

In the book Changing for Good, psychologist James O. Prochaska and his co-authors describe this as moving from the stage of pre-contemplation to contemplation. Scrooge was willing to consider that his firmly entrenched world view might be skewed and to consider seeing the facts for what they were, not as he assumed they were.

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bear

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We may not be misers like Scrooge, but when it comes to our beliefs around money, we have as many delusions as he did. A few of the more popular of these beliefs, or money scripts, are: “More money is the answer,” “The stock market is a gamble,” “I work hard so I deserve to spend money,” and, “If I work hard I will make money.”

Assessment

Becoming willing to consider change is half the battle to free ourselves from destructive financial behavior based on these delusions. But it is only half. Next time we will look at three additional steps to transformation.

Part 2: A Financial “Christmas Carol” [Part 2]

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IRS: Gift and Estate Tax Exempt Limits Increased

By Staff Reporters

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Annual Gift Tax Exclusion Increased

Currently, you can give any number of people up to $17,000 each in a single year without taxation. For 2024, this will be increased to $18,000. For married couples, $36,000 will be available to be given to beneficiaries, tax-free, beginning next year.

Lifetime Gift Tax Exemption

Additionally, the IRS has announced that the lifetime estate and gift tax exemption will increase to $13.61 million in 2024. If a gift exceeds the annual limit ($17,000 this year, $18,000 in 2024), that does not automatically prompt a gift tax. The difference is simply taken from the person’s lifetime exemption limit and no taxes are owed.

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DAILY UPDATE: Happy “Festivus” with Drug Delays as the Stock Market Win Streak Continues

By Staff Reporters

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Festivus is a secular holiday on December 23rd as an alternative to the pressures and commercialism of the Christmas Season. Originally created by author Daniel O’Keefe, Festivus entered popular culture after it was made the focus of the 1997 Seinfeld episode which O’Keefe’s son, Dan,co-wrote.

The non-commercial holiday’s celebration includes a Festivus dinner, an unadorned aluminum Festivus pole, practices such as the “airing of grievances” and “feats of strength”, and the labeling of easily explainable events as “Festivus miracles”. The TV episode refers to it as “a Festivus for the rest of us”.

It has been described both as a parody holiday festival and as a form of playful consumer resistance. Journalist Allen Salkin describes it as “the perfect secular theme for an all-inclusive December gathering”.

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(Bloomberg) — Drug-makers are slow-walking products to market to get around President Joe Biden’s plan to lower medication prices.

Companies from Roche Holding AG to biotech Alnylam Pharmaceuticals Inc. are among those delaying or evaluating therapies in light of the government’s new ability to negotiate for lower prices. Firms that normally try to sell drugs as soon as possible are suspending clinical trials and shifting timelines, while patient groups are demanding change. 

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 7.88 points (0.2%) at 4,754.63, up 0.8% for the week; the Dow Jones Industrial Average was down 18.38 points at 37,385.97, up 0.2% for the week; the NASDAQ Composite® (COMP) was up 29.11 points (0.2%) at 14,992.97, up 1.2% for the week.
  • The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.901%.
  • The CBOEe® Volatility Index (VIX) was down 0.62 at 13.03.

Small-cap stocks continued a strong finish to the year. The Russell 2000® Index (RUT) rose 0.8% Friday to end at its highest level since April 2022 and rose 2.5% for the week, the small-cap benchmark’s sixth consecutive weekly gain. Regional banks and utilities were also among the strongest performers. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and dropped to its weakest level since late July, reflecting ideas an outlook for lower interest rates may prompt investors to seek higher returns elsewhere.

Finally, with just four trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. Through Friday, the S&P 500 was up nearly 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 43%, respectively, after losing 8.8% and 33% in 2022.

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Tips to Cruise Safely into the Holidays & New Year 2024

Follow these 5 Tips to be sure you cruise safely into the new year!

By Dr. David Edward Marcinko MBA

I am not an auto mechanic but I did cover the local hospital ER for more than a decade.

So, here are some holiday driving tips and pearls for Christmas, Holiday motoring safety and the New Year 2024.

1. Get a Pre-holiday Vehicle Check-up

A general pre-holiday vehicle check-up at your dealership can reduce your risk of having problems on the road. You’ll want to pay close attention to your vehicle’s tire pressure. Temperature fluctuations can affect pressure and a little destabilization can create unsafe driving conditions. Be sure to check yours and when you need to add air to those tires.

2. Raise ‘Em High – to Not Drinking and Driving

Sounds obvious but it bears repeating. Whether it’s at the company Christmas party, New Year’s Eve or just catching up with friends for a festive drink, drinking and driving is just not worth it. Designate a driver or enjoy a mock-tail instead.

3. Slow the Rein-Deer Down and Pay Attention

Not only are drivers distracted today by all their electronic devices, pedestrians are too. Be aware and pay attention to everyone. Speed is another one of the leading causes of car accidents (plus sudden acceleration is a major gas guzzler). Yes, rushing around can make you feel like you can make up some time on the road. But we promise you that your friends and family would rather have you arrive safely even if you are 10 minutes late.

4. Buckle Up

Another pretty obvious tip…but, you don’t want to wrinkle your new party dress! That dress is not going to impress the Emergency Room Doctor! According to the National Highway Traffic Safety Administration, in 2015, seat belts saved an estimated 13,941 lives among passenger vehicle occupants age 5 and older. An estimated 266 lives of children under age 5 were saved by their use of restraints and an estimated 2,573 lives were saved by frontal air bags. You definitely want to be part of that statistic in the event of an accident.

5. Rest Up Before Your Trip

Be sure to stay alert and be well rested before heading out. Late night holiday gatherings or long trips to visit family can lead to drowsiness. Sharing the driving responsibilities can help. You can stretch and walk around to help wake your body up. Be sure to take additional breaks as needed. If you are feeling tired and fatigued, pull over to get coffee, water and a snack.

Assessment

Remember GOMER = Get Out of My Emergency Room

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EMPLOYEE LAYOFFS: A Different Type of Holiday “Window Dressing”

END-OF-YEAR FINANCE

By Staff Reporters

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We’ve discussed end of year mutual fund “window-dressing” before on this ME-P. Essentially, with mutual funds, window dressing refers to the superficial changes a fund might make to its portfolio of holdings to appear more attractive to current and prospective investors. At a glance, a potential investor might be drawn in with what appears to be good performance. 

For example, a mutual fund management team might choose to sell losing stocks and buy winning ones at or around the end of a quarter. This strategy hides weak performance and gives investors a perception of impressive returns. 

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Window dressing in stocks is an example from another part of the world of finance, as public companies sometimes use window dressing when reporting earnings. Depending on the specifics, this practice can range from “creative accounting” to something bordering on or actually qualifying as fraud.

For example, some economics researchers cite rounding as a manipulative form of window dressing. A firm might round $5.99 million in quarterly earnings up to $6 million because the round number can be more psychologically attractive.

MORE: https://medicalexecutivepost.com/2023/12/02/what-is-mutual-fund-window-dressing/

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The GM-owned self-driving car company Cruise will lay off 24% of its staff (~900 employees) as well as nine executives following a serious autonomous taxi crash in San Francisco in October 2023 and the vehicles’ subsequent banning in the state of California.

Cruise’s staff reduction appears mostly due to the safety concerns around the company’s robo-taxis, but it comes after a deluge of other high-profile companies made major cuts just before the holidays:

  • Etsy. The online marketplace said it was laying off 11% of its staff. CEO Josh Silverman blamed the macroeconomic environment and previous over-hiring despite gross merchandise sales remaining flat since 2021.
  • Hasbro. The toymaker laid off 1,100 workers (roughly 20% of its staff) after a period of less-than-stellar toy sales following a pandemic surge. This most recent layoff is in addition to the 800 jobs it cut earlier this year.
  • Spotify. The streaming giant announced its third round of 2023 layoffs earlier this month. The company cut 1,500 jobs, which equates to about 17% of staff.
  • Why do companies do this?

Pre-holiday layoffs might seem especially cruel, but sadly, they aren’t uncommon. December job cuts are the quickest way for companies to pad the balance sheet and EOY reports before they show them to shareholders. Plus, it means they’ll have to give out fewer end-of-year bonuses.

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DAILY UPDATE: Three Arrows Capital is Down as Stock Markets Rebound

By Staff Reporters

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Almost $1 billion in assets belonging to the founders of cryptocurrency hedge fund Three Arrows Capital have been frozen by a British Virgin Islands court, according to the firm’s liquidator. The court issued an order preventing co-founders Su Zhu and Kyle Davies, as well as Davies’ wife Kelly Chen, from transferring or selling assets worth up to $1.14 billion, the liquidator Teneo said in an emailed statement, adding that it estimates creditors are owed roughly $3.3 billion. 

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Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was up 48.40 points (1.0%) at 4,746.75; the Dow Jones Industrial Average was up 322.35 points (0.9%) at 37,404.35; the NASDAQ Composite®(COMP) was up 185.92 points (1.3%) at 14,963.87.
  • The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.89%.
  • The CBOE® Volatility Index (VIX) was down 0.02 at 13.65, after earlier rising to 14.49.

Among market sectors, Micron Technology’s gain helped send the Philadelphia Semiconductor Index (SOX) up 2.8%. Retail and transportation shares were also among the strongest performers.

The Russell 2000® Index (RUT), which is largely small cap focused, rose 1.7% and is on track for a sixth consecutive weekly gain.

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Of Gray Rhinos & Other Financial Threats!

Rick Kahler MS CFP

By Rick Kahler MS CFP®

“There he is,” our South African guide whispered excitedly. About 200 feet away stood a black rhino, the rarest and most aggressive of the rhinos. The rhino focused his full attention on us as he repeatedly took a few steps and stopped. After several minutes, he moved so a bush blocked our view of him. “Ok, he is using the bush as a cover and is probably going to charge. We need to leave. Start walking backward and keep your eyes in the direction where you saw the rhino.”

As I started backing up as fast as I could, the guide barked in his loudest whisper, “Don’t run! If he charges drop to the ground; he won’t trample you.” I can’t say I was comforted by this bit of information.

This experience taught me a rhino on the horizon represents a real and present danger.

Ignoring it can result in paying a heavy price

At this year’s FPA Retreat, one of the speakers was Michele Wucker, author of The Gray Rhino: How to Recognize and Respond to the Obvious Dangers We Ignore. She said that when it comes to financial planning and investments, rhinos loom everywhere. Wucker described these dangers as different from elephants and black swans.

The elephant in the room is something we see but no one is going to do anything about. It’s not going anywhere, and we will construct our life to accommodate it. Common financial elephants that I see are adult children financially dependent upon enabling parents, a financially controlling spouse with a history of poor financial decisions, or a family member addicted to spending,

A black swan is unpredictable, something we don’t even see. It can be the loss of a job, the sudden death of a breadwinner, or the collapse of a highly rated financial institution.

The grey rhino is something you know is stalking you. You know it is coming, but you don’t know when. The trick to avoiding a rhino is recognizing and acting on the obvious dangers we ignore.

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Ex-Cathedra black swan

[Black Swan]

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There are a lot of grey rhinos in the financial world

Here are a few common ones:

1. The next stock market crash. I guarantee you the stock market will crash at some time in the future. The best plan I know is to prepare yourself to do nothing, so you don’t panic and sell.
2. Death. It is certainly inevitable, yet the majority of Americans don’t have a will.
3. Health costs. At some point in your life you will need health care, and good health care is, and will always be, expensive.
4. House and vehicle repairs. Normal wear and tear should come as no surprise.

Yet another critter lurks around the financial landscape: the bat. Where I live, bats show up every evening at dusk, without fail. Financial bats are equally predictable.

These are future events or expenses that we know are coming, such as:

1. College. Subtract each minor child’s age from 18. That’s the number of years you have to save to fund their college education.
2. Retirement. Subtract your age from the age at which you want to quit working. This is how many years you have to accumulate enough wealth to replace your salary.
3. Taxes. We even know the day and the hour on this one.
4. Birthday and Christmas gifts. These come every year, just as reliably as the bats.

Assessment

What’s the best way to cope with this financial zoo? I suggest emulating another animal—the lowly ant from Aesop’s fable. Unlike the happy-go-lucky grasshopper, the ant put away resources so it was prepared for future hardships.

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:

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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HAPPY HOLIDAYS: A New Covid Virus Variant!

By Staff Reporters

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READ HERE: N.1 is the Covid variant that’s spiking just in time to disrupt the holidays.

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HOLIDAY: Tip Etiquette 2023?

GRATUITIES

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DAILY UPDATE: First Day of Winter as FedEx and the Stock Markets Crash!

HAPPY WINTER SOLSTICE

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Astronomical winter begins at the winter solstice, which is the shortest day of the year. This means days get longer during winter—very slowly at first, but at ever-larger daily intervals as the March Equinox approaches, heralding the start of spring.

Locations closer to the poles experience larger differences in day length throughout the year, so winter days are shorter there. In Toronto, the shortest day is just under 8 hours and 56 minutes long; in Miami, roughly 2000 kilometers or 1200 miles farther south, it lasts about 10 hours and 32 minutes.

Places within the polar circles experience polar night during all or part of the winter season when the Sun does not rise at all.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index (SPX) was down 70.02 points (1.5%) at 4,698.35; the Dow Jones Industrial Average (DJI) was down 475.92 points (1.3%) at 37,082.00; the NASDAQ Composite® (COMP) was down 225.28 points (1.5%) at 14,777.94.
  • The 10-year Treasury note yield (TNX) was down about 6 basis points at 3.858%.
  • The CBOE® Volatility Index (VIX) was up 1.14 at 13.67.

Shares of semiconductors and banks were among the weakest performers Wednesday, giving back some recent gains after ranking among upside leaders during the recent rally.

Transportation shares also slumped behind weakness in FedEx. The Dow Jones Transportation Index (DJT) fell 1.5% and ended at its lowest level in a week. 

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EtG – The Rosie Ruiz of Bent Science and Bad Medicine

BAD Medicine … and that is NOT “Good”

Langan MD[By Michael Lawrence Langan MD]

The original pitch to the medical boards for Etg  was done by ex-felon Greg Skipper who is one of the Federation of State Physician Health Program (FSPHP) “impaired physician” architect…

EtG: https://www.verywellmind.com/widely-used-etg-test-for-alcohol-unreliable-80212

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:

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

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PODCAST: FFS MedicalPayment As a Public Health Threat?

FEE FOR SERVICE

By Eric Bricker MD

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DOL: Proposes “Best Interest” Retirement Investment Advice

SPONSOR: http://www.MARCINKOASSOCIATES.com

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The Department of Labor’s proposal aims to close governance loopholes and require financial advisers to give retirement advice in the best interests of savers rather than chase the highest payday.

“Bad financial advice by unscrupulous financial advisers driven by their own self-interest can cost a retiree up to 1.2% per year in lost investment,” President Biden said. “That doesn’t sound like much but if you’re living long, it’s a lot of money.

MORE: https://medicalexecutivepost.com/2023/03/11/recast-an-interview-with-fiduciary-bennett-aikin-aif-2/

“Over a lifetime, it can add up to 20% less money when they retire. For a middle-class household, that can amount to tens of thousands of dollars over time.”

MORE: https://marcinkoassociates.com/financial-planning/

FIDUCIARY OATH: https://medicalexecutivepost.com/2023/02/19/the-fiduciary-oath/

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DAILY UPDATE: IRS Zaps Debt as Stock Markets Ascend!

By Staff Reporters

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Americans who owe back taxes will be given an incentive to pay up after the Internal Revenue Service it would waive nearly $1 billion in late-payment penalties. Roughly 4.6 million individual taxpayers who owe for tax years 2020 and 2021 will be eligible for the penalty relief. The IRS is extending the olive branch because it stopped sending out many collection letters during the pandemic. It hoped the letter halt would help struggling taxpayers and reduce its backlog. The long absence of these computer-generated letters had big consequences for taxpayers. Americans’ debt on unpaid back taxes had been growing with interest and penalties, and many were likely in the dark about just how much they owed.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 27.81 points (0.6%) at 4,768.37; the Dow Jones Industrial Average was up 251.90 points (0.7%) at 37,557.92; the NASDAQ Composite® (COMP) was up 98.03 points (0.7%) at 15,003.22.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 3.924%.
  • The CBOE® Volatility Index (VIX) was down 0.03 at 12.53.

Energy shares extended an early week rally behind a continued rebound in WTI Crude Oil futures (/CL), which rose for a fifth straight day and ended near a three-week high above $74 per barrel.

Banks and retailers were also particularly firm. The S&P 500 Retail Select Industry Index (SPSIRE) surged over 2% and ended at its highest level in over 10 months.

And, Tuesday’s big winner was Affirm, whose shares skyrocketed 15% after the buy now, pay later company announced it’s expanding its Walmart partnership to include the retailer’s self-checkout kiosks.

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DAILY UPDATE: Goldman Sachs Speaks as the Stock Markets Rise

By Staff Reporters

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The Federal Reserve’s pivot last week to an easier monetary policy made many investors more bullish toward stocks. You can count Goldman Sachs among them. It has raised its year-end 2024 target for the S&P to 5,100 from 4,700. The new forecast represents an 8% increase from 4,740 on Dec. 18. Goldman has a three-month target of 4,800 and a six-month target of 4,900.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 21.37 points (0.5%) at 4,740.56; the Dow Jones Industrial Average was up 0.86 points at 37,306.02; the NASDAQ Composite was up 90.89 points (0.6%) at 14,904.81.
  • The 10-year Treasury note yield (TNX) was up about 2 basis points at 3.946%.
  • The CBOE® Volatility Index (VIX) was up 0.25 at 12.53.

Energy shares were among Monday’s strongest performers behind a rally in WTI Crude Oil futures (/CL), which jumped 1.7% to end at a two-week high amid concern over supply disruptions following attacks on ships in the Red Sea.

Communication services and consumer staples were also firm. Financials gave back some of last week’s sharp gains, with the KBW Bank Index (BKX) down nearly 1%.

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IRS Inheritance Rule Change and the “Delta Dental” Data Breach

By Staff Reporters

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The IRS is demanding billions from small business who took this credit ...

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The IRS Quietly Changed the Rules on Children’s Inheritance

The IRS just issued Revenue Ruling 2023-2, which had a substantial impact on estate planning, particularly where an irrevocable trust is involved.

In the last decade or so, more families have begun utilizing irrevocable trusts to protect their assets from spend-down in order to qualify for government benefits, such as Medicaid and VA Aid and Attendance. Prior to the issuance of this ruling, it was unclear whether assets passing to beneficiaries through an irrevocable trust would receive a step-up in basis, thereby eliminating any capital gains taxes that would otherwise be owed.

Historically, assets that are disposed of during an individual’s lifetime are subject to capital gains taxes on the increase in value of that asset over time. The amount of capital gains owed is determined largely by the difference between the value at the time of purchase and the value at the time of transfer.

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Delta Dental of California data breach exposed info of 7 million people

“Delta Dental of California and its affiliates are warning almost seven million patients that they suffered a data breach after personal data was exposed in a MOVEit Transfer software breach.Delta Dental of California provides 24 months of free credit monitoring and identity theft protection services to impacted patients to mitigate the risk of their exposed data.”

LINK: https://tinyurl.com/bp4u2chv

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DAILY UPDATE: The “Magnificent Seven” Technology Stocks PLUS Uber

By Staff Reporters

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  • Markets: The Magnificent Seven technology mega-cap stocks—Microsoft, Apple, Alphabet, Nvidia, Tesla, Meta, and Amazon—have surged 75% this year, while the other 493 companies in the S&P 500 have gained 12%. The Magnificent Seven now account for nearly 30% of the entire index’s value, per the WSJ.
  • Stock spotlight: Speaking of the S&P 500, it’s getting a prominent new member—Uber will join the index today. With a market cap of $127 billion, Uber is the most valuable company that hadn’t yet been included in the S&P 500, and it celebrated by notching a 52-week high last week.
  • CITE: https://www.r2library.com/Resource

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