TREASURY NOTES: Panic Attack Mode?

By Staff Reporters

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Treasury notes are typically considered one of the world’s safest safe-haven assets—the US has always repaid bondholders on their investment, plus yield (interest). That’s why you can usually count on the bond market to rally when the stock market craters. And, vice-versa. But not this time:

  • The benchmark 10-year bond yield, which moves inversely to bond prices, had its steepest spike this week since the 2008 financial crisis. The 10-year yield is more closely watched than the 30-year yield (which also spiked) in part because it influences home and auto loan rates.
  • A Treasury auction of 3-year bonds on Tuesday was met with the softest demand since December 2023. That helped drive the bond sell-off on fears of a pullback among international investors, who hold $8.5 trillion in US Treasuries (Japan and China lead the pack).

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REPUTATIONAL BANKRUPTCY: Of the American Dollar

By Vitaliy Katsenelson CFA

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The Reputational Bankruptcy of the American Dollar
I am in an unenviable position. The policy coming out of the White House has a significant impact on economics, more than ever before in my career. If I say anything positive about that policy, I’ll be put in the MAGA camp. If I criticize it, I’ll be accused of suffering from Trump derangement syndrome. I am hired by you to make the best investment decisions possible. Rather than see me as engaged in political commentary, I’d ask that you view my remarks as purely analytical.

Let me give you this analogy. I live in Denver. Let’s imagine I am a huge Broncos fan, and the Broncos are playing the Chicago Bears. If I am betting a significant amount of money on this game, I should put my affinity for the Broncos and hatred of the Chicago Bears aside and analyze data and facts. The Broncos are either going to win or lose; my wanting them to win has zero impact on the outcome. The same applies to my analysis here. My motto in life is Seneca’s saying, “Time discovers truth.” I just try to discover it before time does.

When it comes to politics, I also have a significant advantage. I was not born in this country. From a young age, I was brainwashed about communism, not about team Republican versus team Democrat. The failure of the Soviet Union de-brainwashed me fast concerning the virtues of communism and converted me into a believer in free markets.

As a result, I never bought into either party’s ideology, and thus in the last four presidential elections I voted for a Republican, an independent, a Democrat, and wrote in my youngest daughter, Mia Sarah (not in that order). In my articles I have criticized the policies of both Biden (student loan forgiveness, unions) and Trump (Bitcoin reserve).

I remind myself that in times like these you have to be a nuanced thinker. Some of Trump’s policies are terrific, others … not so much (I am being diplomatic here).

Scott Fitzgerald once said “The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time, and still retain the ability to function.” In 2025 we are taking this “first-rate intelligence” test daily.

What will happen to the US dollar? The US dollar will likely continue to get weaker, which is inflationary for the US. Let me start with some easily identifiable reasons:

We have too much debt. We ran 6-7% budget deficits while our economy was growing and unemployment was at record lows. Now we have $36 trillion in debt. Our interest expenses exceed our defense spending, and these costs will continue to climb. If/when we go into recession, we may see something we have not seen in a long time – higher interest rates. Our budget deficits will balloon to between 9–12%, and the debt market, realizing that inflation (i.e., money printing) is inevitable, will say, “Pay up!”

New competition from Bitcoin. President Trump’s approval of Bitcoin as a potential reserve currency is one of the most self-serving and anti-American things I’ve seen any president do. The US dollar is the world’s reserve currency. We still have little competition for that title. China could be a contender, but it is not a democracy and has capital controls. This policy has no upside for America, only downside.

A stronger Europe. Ironically, we may inadvertently create a stronger Europe by threatening to abandon NATO. I don’t want to insult European clients (or my European friends), but the following analogy describes the US-Europe relationship on some level: Europe gradually evolved into a trust fund kid (when it came to security) and the US turned into its sugar daddy. The trust fund kid was incredibly dependent on the sugar daddy. It criticized its parent for being a barbarian and money-driven, but it relied heavily on that parent to protect it from bullies.

President Trump cut off Europe’s allowance by threatening that the US might not protect Europe from Russia. This has forced Europe to spend more money on defense. Outside of Germany (which has little debt), few European economies can afford that. This may force Europe (or at least some European countries) to become more pragmatic – to cut social programs and bureaucracy. If this leads to a stronger Europe both economically and militarily, the euro will be competing with the US dollar. This is a big if.

Our new foreign policy.

When people describe President Trump’s foreign policy as “transactional,” they’re highlighting a fundamental shift in how America engages with the world – one with profound implications for our global standing, national interests, and the US dollar. The shift affects both types of capital – financial and reputational.

Reputational capital isn’t at risk in ‘one-shot’ transactions like house selling. Imagine you’re selling your primary residence and moving elsewhere. Do you disclose every flaw, or let the buyer figure things out? Your incentive is to maximize short-term profits. You’ll likely never meet this buyer again, and therefore there are incentives not to care what they’ll think of you afterward. You’ll be transactional, seeking the highest price possible for your biggest asset. This exemplifies a ‘one-shot’ system where future interactions aren’t expected.

Contrast this with a relationship- and trust-based system. Now imagine you are a homebuilder in a small town. Your suppliers only extend credit if you have a reputation for paying on time. Your employees do quality work only if you treat them fairly. Your buyers tell friends about their experience with you. The incentives naturally create a relational approach. In this trust-based system, incentives skew toward maximizing long-term profits, where reputational capital becomes the glue creating continuity.

Reputational capital radiates predictability – you know how someone will behave based on their history – but operating with low or negative reputational capital is difficult and expensive. People won’t enter long-term contracts with you or will demand external guarantees. Many potential partners will simply refuse to deal with you.

Building reputational capital works like adding pennies to a jar – each good deed incrementally adds to your standing. Yet reputational capital can collapse instantly by removing the jar’s bottom. A single breach of trust doesn’t just remove one penny; it can wipe out your entire balance and plunge you into reputational bankruptcy. The math is brutally asymmetric: good deeds might add a point or two, while bad deeds subtract by factors of 50 or 100.

This doesn’t mean transactions shouldn’t be profitable. If you’re accumulating reputational capital while consistently losing money, you’re probably in the wrong business. Each deal should be evaluated considering both long-term financial and reputational capital.

Individual transactions can sacrifice some profit but cannot afford to lose reputational capital. A “one-shot” transactional approach used in a trust-system environment may provide greater short-term profitability, but if this success comes at the expense of reputational capital, the long-term consequences for America’s global position could be devastating.

This brings us to our current foreign policy.

Relationships between nations are a trust-based system. I’d argue it’s a super-relational system because it’s multigenerational, lasting beyond the life of any one human. Reputational capital is paramount here.

Part of the US’s strength has been the soft power – the reputational capital – it exerted. We had a lot of friends, which helped us to be more effective in dealing with our foes. We keep telling ourselves that America is an “exceptional” nation. This exceptionalism didn’t just come from our financial and military might – it accumulated based on our reputational capital.

Though we don’t always succeed, we are a people who try to do the right thing. Our exceptionalism has been earned through our actions. We are the country that helped rebuild Europe and gave it six decades to repay lend-lease. We toppled communism.

I don’t know the nuances of the Ukraine mineral deal, but initially it had the optics of extortion. Though I think the renegotiated and signed version appears to be fair to both sides, forcing repayment while Ukraine is dodging Russian missiles made the US look transactional.

Actions by President Trump over the last month have undermined our reputation. We are quickly becoming a “one-shot” transactional player in a trust-based environment. Imposing tariffs on Canada on a whim to try to get it to become the 51st state erodes American reputational capital. So does not ruling out America invading Greenland. This puts us on the same moral plane as Russia invading Ukraine.

The conversation about tariffs has many nuances. For instance, I don’t know anyone who opposes reciprocal tariffs – they seem fair and don’t consume any reputational capital. But tariffs that are used as weapons in a trade war in order to annex another country erode reputational capital. Threatening to leave NATO and not protect countries that don’t spend enough on their defense diminishes reputational capital. Maybe the only way to get European countries to spend on defense was to threaten not to defend them – you can agree or disagree with the rationale behind each of Trump’s decisions, but what can’t be argued is that they undermined our reputational capital.

As we lose soft power, our influence will diminish, and thus so will perceptions of our power. The world will start looking at us not from the perspective of the continuity of generations but of presidential cycles. The word of the American president will have an expiration date of the next presidential or mid-term election.

There are two negotiation styles – Warren Buffett’s and Donald Trump’s. Both have their advantages and disadvantages. Buffett will give you one offer and one offer only. Once the deal is agreed to, even just verbally, that is the deal. Critics would say that there is downside to that predictability, as foes know how you are going to respond. Donald Trump’s style is to be unpredictable, which has its own advantages when you deal with foes – it keeps opponents guessing. But it destroys trust with your allies.

In a world of fiat currencies, all currency is a financial and reputational promise. President Trump, with the help of DOGE (and maybe even tariffs) may increase our financial strength. I hope he does, but it will likely come at a very high cost to our reputational capital, and therefore US global influence and the US dollar will continue its decline.

How are we positioned for this?

About half of our portfolio is foreign companies whose sales are not in dollars. They will benefit from a weaker dollar. We also have exposure to oil, which is priced in the US dollar and usually appreciates when the dollar weakens.

A weaker dollar means our imports will become more expensive, which is inflationary. We own many companies with pricing power and also companies that have claims on someone else’s revenues. Take Uber for example: they get about 20% of each ride. If the cost of the ride goes up, so does their dollar take.

Why does President Trump keep pushing crypto?

In July 2019, Trump said the following: “I am not a fan of Bitcoin and other cryptocurrencies, which are not money, and whose value is highly volatile and based on thin air.” Five years later he promised to establish the US Crypto Reserve, and in 2025 he did.

What changed? There is no logical reason for an American president to endorse crypto. None. Here is the honest answer: Crypto bros made mega-contributions to his campaign.

To top it off, three days before he took office he issued $TRUMP – a shitcoin. Believe it or not, “shitcoin” is a technical term in the crypto community (any coin other than Bitcoin is called a shitcoin by Bitcoin “maximalists”, folks who believe Bitcoin is the one and only digital currency). The future sitting president literally issued – I don’t want to call it a currency, so I guess shitcoin is the right name – that will at some point decline to zero in value. In other words, he’ll fleece his loyal followers who purchase $TRUMP of billions of dollars.

I previously referenced both reputational capital and soft power. These types of acts by a sitting president subtract from both.

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IPOs: Delayed

By Staff Reporters

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Initial Public Offering Defined

IPO stands for initial public offering. It is when a company takes a portion of their shares and makes them available for the general public to buy on the open market. It is a way for the company to raise money by selling those shares to the general public. You can usually access shares from an IPO by working directly with an investment bank.

Paused IPOs

Private companies StubHub and Klarna each paused their imminent plans to go public.

Klarna, which was set to IPO on this Monday, was expected to jump-start the frozen IPO market this year with an expected ~$15 billion valuation.

StubHub, meanwhile, reportedly wants to wait for the market to calm down before resuming its plans to go public.

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Registered Investment Advisor VERSUS Hedge Fund Manager

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters

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A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

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The Hedge Fund manager I am considering is a Registered Investment Adviser [RIA]

QUESTION: What is a Registered Investment Advisor?

If the fund manager is an entity, then any individual you deal with will be a registered investment adviser representative. If the fund manager is an individual, then that individual is a registered investment adviser. In either case, the designation implies several steps have been taken.

In order to become a registered investment adviser, an individual must register for and pass the Series 65 Uniform Investment Adviser Law Exam, a three-hour, 130-question computer-based exam administered by the North American Securities Administrators Association. Topics covered include economics and analysis, investment vehicles, investment recommendations and strategies, and ethics and legal guidelines. A passing score is 70 percent or higher.

Once an individual has passed the Series 65, he or she must then apply via Form ADV to become a registered investment adviser. This application is made to either a state authority or to the SEC, depending on the adviser’s assets under management. If assets under management exceed $30 million, then the adviser must register with the SEC.

Form ADV consists of two parts. Part I provides general information to the regulatory authority. Part II is designed to be distributed to potential clients, and includes disclosure of a decent amount of information about the adviser. If the manager is a registered investment adviser, then you should expect to receive as part of the offering documentation either a current copy of Part II of the adviser’s Form ADV or a brochure that contains all the current information in Part II of Form ADV.

In addition to filing Form ADV and paying a small fee, the registered investment adviser becomes subject to extra administrative/regulatory burden as well as capital adequacy requirements that state the Adviser must maintain certain net worth levels.

By and large, because of the extra administrative burden as well as restrictions on certain activities, hedge fund managers attempt to avoid registering as investment advisers. Whether such managers can or cannot avoid such registration is largely dependent upon the state in which the manager operates. In California, for instance, hedge fund managers must register as investment advisers. In New York, such registration is not necessary. Not surprisingly, hedge fund managers located in California are rare, while they are quite plentiful in New York. 

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MEDICAL DEVICES: Special Considerations

By Staff Reporters

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INFORMATION TECHNOLOGY CONSIDERATIONS FOR MEDICAL DEVICES

In 2013, the Food and Drug Administration (FDA) issued its first cybersecurity safety communication, followed in 2014 by final guidance. It struck a reasonable balance between new regulations (almost none) and guidance (in the form of non-binding recommendations).

In 2015, the Federal Trade Commission (FTC) released a staff report entitled Internet of Things: Privacy & Security in a Connected World, in which it recommend that Internet of Things (IoT) style devices, which of course include medical and clinical devices, need to maintain a good security posture. It’s worth noting that the FDA, FTC, and other government regulators are centering on a few key guidelines. The following recommendations come directly from the FTC report.

Companies should build security into their devices at the outset, rather than as an afterthought. As part of the security by design process, companies should consider:

  • Conducting a privacy or security risk assessment
  • Minimizing the data they collect and retain
  • Testing their security measures before launching their products
  • Companies should train all employees about good security, and ensure that security issues are addressed at the appropriate level of responsibility within the organization
  • Companies should retain service providers that are capable of maintaining reasonable security and provide reasonable oversight for these service providers.
  • When companies identify significant risks within their systems, they should implement a defense-in-depth approach, in which they consider implementing security measures at several levels.
  • Companies should consider implementing reasonable access control measures to limit the ability of an unauthorized person to access a consumer’s device, data, or even the consumer’s network.
  • Companies should continue to monitor products throughout the life cycle and, to the extent feasible, patch known vulnerabilities

According to colleague Shahid N. Shah MS, the FTC report and FDA guidelines are remarkably consistent. When thinking of cybersecurity and data privacy, engineers tend to think about authentication, authorization, and encryption. Those are the relatively easy topics. For safety-critical devices, however, things are much more difficult and need to encompass a larger surface of questions, including but not limited to:

  • Asset Inventory: Is the device discoverable, and can it associate itself with standard IT inventory systems so that revision management, software updates, and monitoring can be automated?
  • Cyber Insurance: Does the device have enough security documentation to allow it to be insured by standard cyber insurance riders?
  • Patching: How is the firmware, operating system (OS), or application going to be patched by IT staff within hospitals (or the home for remote devices)?
  • Internal Threats: Has the device been designed to circumvent insider (hospital staff, network participants, etc.) threats?
  • External Threats: Has the device been designed to lock down the device from external threats?
  • Embedded OS Security: Is the device sufficiently hardened at the operating system level, such that no extraneous software components, which increase the attack surface, are present?
  • Firmware and Hardware Security: Are the firmware and hardware components sourced from reputable suppliers and free of state-sponsored spying?
  • Application Security: Is the Microsoft Security Development Lifecycle (SDL) or similar software security assurance process integrated into the engineering process?
  • Network Security: Have all network protocols not in use by the device been turned off so that they are not broadcasting?
  • Data Privacy: What data segmentation, logging, and auditing is being done to ensure appropriate data privacy?
  • HIPAA Compliance: Have proper steps been followed to ensure Health Insurance Portability and Accountability Act (HIPAA) compliance?
  • FISMA Compliance: If you’re selling to the federal government, have proper steps, such as use of Federal Information Processing Standard (FIPS) certified encryption, been followed to ensure Federal Information Security Management Act (FISMA) compliance?
  • Data Loss Prevention (DLP): Is there monitoring in place to ensure data leakage outside of the device doesn’t occur?
  • Vulnerabilities: Have common vulnerabilities such as the Open Web Application Security Project (OWASP) Top 10 been reviewed?
  • Data Sharing: Are proper data sharing agreements in place to allow sharing of data across devices and networks?
  • Password Management: Are passwords hardcoded into the device or made configurable?
  • Configuration Protection: Are configuration files properly check-summed and protected against malicious changes?

ASSESSMENT

It is vital to perform a security assessment on a healthcare practice to understand the environment, identify risks and perform risk mitigation. A one-time security assessment with risk mitigation is not sufficient in 2025. This is a continuous process that needs to be performed religiously to maintain a secure and compliant practice.

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EMOTIONAL INTELLIGENCE: How EQ Can Make You a Better Investor

By Vitaliy Katsenelson CFA

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How Emotional Intelligence Can Make You a Better Investor. You can also listen to a professional narration of this article on iTunes & online.
Your knee hurts, so you pay a visit to your favorite orthopedist. He smiles, maybe even gives you a hug, and then tells you: “I feel your pain. Really, I do. But I don’t treat left knees, only right ones. I find I am so much better with the right ones. Last time I worked on a left knee, I didn’t do so well.”

Though many professionals — doctors as well as lawyers, architects and engineers — get to choose their specializations, they rarely get to choose the problems they solve. Problems choose them. Investors enjoy the unique luxury of choosing problems that let them maximize the use of not just their IQ but also their EQ — emotional intelligence.

Let’s start with IQ. Our intellectual capacity to analyze problems will vary with the problem in front of us. Just as we breezed through some subjects in college and struggled with others, our ability to understand the current and future dynamics of various companies and industries will fluctuate as well. This is why we buy stocks that fall within our sphere of competence. We tend to stick with ones where our IQ is the highest.

Though we usually think about our capacity to analyze problems as being dependable and stable over time, it isn’t. It might be if we were characters from Star Trek, with complete control over our emotions, like Mr. Spock, or who lacked emotions, like Lieutenant Commander Data. This is where our EQ comes in.

I am not a licensed psychologist, but I have huge experience treating a very difficult patient: me. And what I have found is that emotions have two troublesome effects on me. First, they distort probabilities; so even if my intellectual capacity to analyze a problem is not impacted, my brain may be solving a distorted problem. Second, my IQ is not constant, and my ability to process information effectively declines under stress. I either lose the big picture or overlook important details. This dilemma is not unique to me; I’m sure it affects all of us to various degrees.

The higher my EQ with regard to a particular company, the more likely that my IQ will not degrade when things go wrong (or even when they go right). There is a good reason why doctors don’t treat their own children: Their ability to be rational (properly weighing probabilities) may be severely compromised by their emotions.

A friend of mine who is a terrific investor, and who will remain nameless though his name is George, once told me that he never invests in grocery store stocks because he can’t be rational when he holds them. If we spent some Freudian time with him, we’d probably discover that he had a traumatic childhood event at the grocery store (he may have been caught shoplifting a candy bar when he was eight), or he may have had a bad experience with a grocery stock early in his career. The reason for his problem is irrelevant; what is important is that he has realized that his high IQ will be impaired by his low EQ if he owns grocery stocks.

There is no cure for emotions, but we can dramatically minimize the impact they have on us as investors by adjusting our investment process. First and foremost, investors have the incredible advantage of picking domains where they can remain rational.

To be a successful investor, you don’t need Albert Einstein’s IQ (though sometimes I wish I had Spock’s EQ). Warren Buffett undoubtedly has a very high IQ, but even the Oracle of Omaha chooses carefully his battles; for instance, he doesn’t invest in technology stocks.

Investors have the luxury of investing only in stocks for which both their IQ and EQ are maximized, because there are tens of thousands of stocks out there to choose from, and they need just a few dozen.

Meanwhile, I hope when I go see the doctor, he will tell me, “I don’t do left knees,” because the best result will come from a doctor who while treating me will utilize both IQ and EQ.

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HEDGE FUND: Wrap Fees?

Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

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My stock broker is telling me about a “wrap-fee” program involving a hedge fund manager.

QUESTION: What is a Wrap Fee?

A wrap fee program is a service that provides investment advice and portfolio management to clients for one all-inclusive fee. The fee pays for the services provided to the client, including but not limited to securities transactions, portfolio management, research, brokerage, and administrative services. Wrap fee programs also provide an understanding of a client’s financial goals and objectives; research and selection of assets; implementation of investment decisions; account statements, and access to real-time financial data.

The Investment Advisers Act of 1940 regulates investment advisors when they offer these wrap fee programs and requires them to provide comprehensive disclosure documents before investing. This act helps ensure clients have access to all important information that affects their investment decisions.

QUESTION: Why do I need my stock broker? Can I just go directly to the hedge fund manager?

Yes, you can, but you may find a different fee arrangement when you reach the hedge fund manager, and you may be participating in an unethical transaction. When hedge fund managers set up separate accounts for wrap-fee clients, they agree to take a set fee in exchange for managing this money. They also enter into agreements with one or more brokers to help market this aspect of their money management business. A portion of the wrap fee you pay goes to the broker, and a portion goes to the manager. Incentive compensation is not generally used.

When approached directly, hedge fund managers will typically offer only the hedge fund, complete with incentive compensation and pooled investment features. However, if the hedge fund manager is willing to set up a separate account, it is possible that the investor will find the set fee much less than what he or she would have paid in a wrap fee account through a broker.

Finally, the very large caveat to all this is that the ethics of a hedge fund manager who steals clients from brokers with whom he has a marketing relationship ought to be called into question. And when it comes to hedge funds, the ethics of the manager are of paramount importance.

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FINANCIAL RATIOS: Profitability for Doctors

By CFI Team and Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Profitability Ratios

Profitability ratios measure a company’s ability to generate income relative to revenue, balance sheet assets, operating costs, and equity. Common profitability financial ratios include the following:

The gross margin ratio compares the gross profit of a company to its net sales to show how much profit a company makes after paying its cost of goods sold:

Gross margin ratio = Gross profit / Net sales

The operating margin ratio, sometimes known as the return on sales ratio, compares the operating income of a company to its net sales to determine operating efficiency:

Operating margin ratio = Operating income / Net sales

The return on assets ratio measures how efficiently a company is using its assets to generate profit:

Return on assets ratio = Net income / Total assets

The return on equity ratio measures how efficiently a company is using its equity to generate profit:

Return on equity ratio = Net income / Shareholder’s equity

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STOCK MARKETS PLUNGE: A Friday Redeux

BREAKING US STOCK MARKET NEWS

By ME-P Staff Reporters

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Stocks in the U.S. opened sharply lower on Friday, extending a slide from the previous trading session triggered by President Trump’s announcement of sweeping new tariffs on U.S. imports earlier this week. 

The S&P 500 fell 144 points, or 2.5%, to 5,252 as of 9:34 a.m. EST. The Dow Jones Industrial Average tumbled 1,006 points, or 2.5%, and the NASDAQ Composite slid 3.1%.

The indexes’ free-fall Thursday was their biggest one-day drop since 2020, with more than $2 trillion in investor wealth erased from the S&P 500. The S&P 500 and Dow each sank more than 4% yesterday, while the tech-heavy NASDAQ plunged nearly 6%. 

NOTE: Drops of this magnitude aren’t unheard of on Wall Street, but they’re rare. Over the last 25 years, the S&P 500 has fallen 4% in a single day 38 times, according to Adam Turnquist, chief technical strategist for brokerage firm LPL Financial.

UPDATE: [1:06pm EST]

DJIA 38,962.49 -1,583.44 (-3.91%)

NASDAQ 15,779.20 -771.41 (-4.66%)

S&P 500 5,148.70 -247.82 (-4.59%)

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TRADITIONAL INVESTMENT PORTFOLIO DIVERSIFICATION MODEL: Routed by Larry Fink CEO of BlackRock?

BREAKING NEWS – MARKET VOLATILITY

By Staff Reporters

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US stocks nosedived on Thursday, with the Dow tumbling more than 1,200 points as President Trump’s surprisingly steep “Liberation Day” tariffs sent shock waves through markets worldwide. The tech-heavy NASDAQ Composite (IXIC) led the sell-off, plummeting over 4%. The S&P 500 (GSPC) dove 3.7%, while the Dow Jones Industrial Average (^DJI) tumbled roughly 3%. [ongoing story].

So, does the traditional 60 stock / 40 bond strategy still work or do we need another portfolio model?

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The 60/40 strategy evolved out of American economist Harry Markowitz’s groundbreaking 1950s work on modern portfolio theory, which holds that investors should diversify their holdings with a mix of high-risk, high-return assets and low-risk, low-return assets based on their individual circumstances.

While a portfolio with a mix of 40% bonds and 60% equities may bring lower returns than all-stock holdings, the diversification generally brings lower variance in the returns—meaning more reliability—as long as there isn’t a strong correlation between stock and bond returns (ideally the correlation is negative, with bond returns rising while stock returns fall).

CORRELATION: https://medicalexecutivepost.com/2024/10/27/correlation-diversification-in-finance-and-investments/

For 60/40 to work, bonds must be less volatile than stocks and economic growth and inflation have to move up and down in tandem. Typically, the same economic growth that powers rallies in equities also pushes up inflation—and bond returns down. Conversely, in a recession stocks drop and inflation is low, pushing up bond prices.

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  • But, the traditional 60/40 portfolio may “no longer fully represent true diversification,” BlackRock CEO Larry Fink writes in a new letter to investors.
  • Instead, the “future standard portfolio” may move toward 50/30/20 with stocks, bonds and private assets like real estate, infrastructure and private credit, Fink writes.
  • Here’s what experts say individual investors may want to consider before dabbling in private investments.

It may be time to rethink the traditional 60/40 investment portfolio, according to BlackRock CEO Larry Fink. In a new letter to investors, Fink writes the traditional allocation comprised of 60% stocks and 40% bonds that dates back to the 1950s “may no longer fully represent true diversification.

DI-WORSIFICATION: https://medicalexecutivepost.com/2024/04/09/what-is-financial-portfolio-di-worsification-2/

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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PHYSICIAN PAYMENT INCREASE: Excluded by Continuing Resolution

By Health Capital Consultants, LLC

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Continuing Resolution Excludes Physician Payment Increase Again

On March 15th, 2025, President Donald Trump signed a continuing resolution (CR) that avoided a government shutdown and funds the federal government for the rest of the fiscal year, i.e., through September 30th, 2025.

Perhaps more notable than what was included in the spending bill was what was once again excluded. While the COVID-era tele-health waivers were temporarily extended, Medicare physician payment rates were not addressed, meaning physicians will continue experiencing a 2.93% pay cut for 2025.

This Health Capital Topics article discusses the healthcare provisions included in and excluded from the CR, and the impacts on healthcare providers. (Read more…)

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HEDGE FUNDS: In Individual Retirement Accounts?

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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QUESTION: What is a Hedge Fund?

A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

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QUESTION: Can I invest my Individual Retirement Account [IRA] in a Hedge Fund?

This is up to the manager, but there is no legal restriction on a hedge fund accepting individual retirement account (IRA) assets. IRA accounts are not well suited for funds that make extensive use of leverage, however. In such cases, the fund is likely to generate significant amounts of unrelated business taxable income (UBTI) – profits of the fund attributable to the use of leverage. The holder of an IRA account must pay taxes on UBTI, even if the UBTI was generated in an IRA account.

But, today’s hedge funds may or may not use leverage. Many hedge funds are not hedged at all, but rather are just specialized versions of regular long stock portfolios. If such funds do not use much leverage, IRA investors will not encounter much difficulty with UBTI and should not hesitate in considering these funds.

In considering whether to accept IRA money, hedge fund managers must consider several factors. If the only type of retirement money accepted by the hedge funds is IRA money, then the manager has no limit on how much retirement money the fund can accept. If, however, there are other types of retirement money invested in the fund, such as pension funds, IRA money will be counted towards a total of 25 percent of fund assets that can be invested in retirement accounts before the fund becomes subject to the Employment Retirement Income Security Act of 1974 (ERISA). Funds subject to ERISA regulations face a heavy administrative burden and more restrictions than most fund managers like.

Finally, IRA distributions from a hedge fund are subject to the standard 20 percent withholding unless the funds are directly rolled over to other qualified plans.

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ACCOUNTABLE CARE ORGANIZATION: A Financially Toxic Contract Example for Physicians

SPONSOR: http://www.MarcinkoAssociates.com

By. Dr. David Edward Marcinko; MBA MEd CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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WARNING – DISASTROUS ACO EXAMPLE – WARNING

GIVEN CASH FLOW MODEL

Suppose that in a new Accountable Care Organization [ACO] contract, a certain medical practice was awarded a new global payment or capitation styled contract that increased revenues by $100,000 for the next fiscal year. The practice had a gross margin of 35% that was not expected to change because of the new business. However, $10,000 was added to medical overhead expenses for another assistant and all Account’s Receivable (AR) are paid at the end of the year, upon completion of the contract.

Cost of Medical Services Provided (COMSP):

The Costs of Medical Services Provided (COMSP) for the ACO business contract represents the amount of money needed to service the patients provided by the contract.  Since gross margin is 35% of revenues, the COMSP is 65% or $65,000.  Adding the extra overhead results in $75,000 of new spending money (cash flow) needed to treat the patients. Therefore, divide the $75,000 total by the number of days the contract extends (one year) and realize the new contract requires about $ 205.50 per day of free cash flows.

Assumptions

Financial cash flow forecasting from operating activities allows a reasonable projection of future cash needs and enables the doctor to err on the side of fiscal prudence. It is an inexact science, by definition, and entails the following assumptions:

  • All income tax, salaries and Accounts Payable (AP) are paid at once.
  • Durable medical equipment inventory and pre-paid advertising remain constant.
  • Gains/losses on sale of equipment and depreciation expenses remain stable.
  • Gross margins remain constant.
  • The office is efficient so major new marginal costs will not be incurred.

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Physician Reactions:

Since many physicians are still not entirely comfortable with global reimbursement, fixed payments, capitation or ACO reimbursement contracts; practices may be loath to turn away short-term business in the ACA era.  Physician-executives must then determine other methods to generate the additional cash, which include the following general suggestions:

1. Extend Account’s Payable

Discuss your cash flow difficulties with vendors and emphasize their short-term nature. A doctor and her practice still has considerable cache’ value, especially in local communities, and many vendors are willing to work them to retain their business

2. Reduce Accounts Receivable

According to most cost surveys, about 30% of multi-specialty group’s accounts receivable (ARs) are unpaid at 120 days. In addition, multi-specialty groups are able to collect on only about 69% of charges. The rest was written off as bad debt expenses or as a result of discounted payments from Medicare and other managed care companies. In a study by Wisconsin based Zimmerman and Associates, the percentages of ARs unpaid at more than 90 days is now at an all time high of more than 40%. Therefore, multi-specialty groups should aim to keep the percentage of ARs unpaid for more than 120 days, down to less than 20% of the total practice. The safest place to be for a single specialty physician is probably in the 30-35% range as anything over that is just not affordable.

The slowest paid specialties (ARs greater than 120 days) are: multi-specialty group practices; family practices; cardiology groups; anesthesiology groups; and gastroenterologists, respectively. So work hard to get your money, faster. Factoring, or selling the ARs to a third party for an immediate discounted amount is not usually recommended.

3. Borrow with Short-Term Bridge Loans

Obtain a line of credit from your local bank, credit union or other private sources, if possible in an economically constrained environment. Beware the time value of money, personal loan guarantees, and onerous usury rates. Also, beware that lenders can reduce or eliminate credit lines to a medical practice, often at the most inopportune time.

4. Cut Expenses

While this is often possible, it has to be done without demoralizing the practice’s staff.

5.  Reduce Supply Inventories

If prudently possible; remember things like minimal shipping fees, loss of revenue if you run short, etc.

6. Taxes

Do not stop paying withholding taxes in favor of cash flow because it is illegal.

Hyper-Growth Model:

Now, let us again suppose that the practice has attracted nine more similar medical contracts. If we multiple the above example tenfold, the serious nature of potential cash flow problem becomes apparent. In other words, the practice has increased revenues to one million dollars, with the same 35% margin, 65% COMSP and $100,000 increase in operating overhead expenses. 

Using identical mathematical calculations, we determine that $750,000 / 365days equals $2,055.00 per day of needed new free cash flows!  Hence, indiscriminate growth without careful contract evaluation and cash flow analysis is a prescription for potential financial disaster.

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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MEDICARE: Four Payment Models Ended Early

By Health Capital Consultants, LLC

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Four Medicare Payment Models Ended Early

In the latest iteration of Trump Administration healthcare cuts, the Centers for Medicare & Medicaid Services (CMS) announced on March 12th, 2025 that four Center for Medicare and Medicaid Innovation (CMMI) payment models would be sunset at the end of 2025, earlier than originally scheduled.

Cutting these models, which decision was based on “a comprehensive and data-driven review of [CMS’s] model portfolio,” are anticipated to save nearly $750 million (although the source of these savings was not detailed).

This Health Capital Topics article discusses the models being ended and the impact on healthcare stakeholders. (Read more…)

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MERGER ARBITRAGE: Risk Arbitrage Defined

By Dr. David Edward Marcinko; MBA MEd CMP

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Sponsor: http://www.CertifiedMedicalPlanner.org

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Merger Arbitrage (a.k.a. Risk Arbitrage)

Merger risk arbitrage, while a subset of a larger strategy called event-driven arbitrage, represents a sufficient portion of the market-neutral universe to warrant separate discussion.

Merger arbitrage earned a bad reputation in the 1980s when Ivan Boesky and others like him came to regard insider trading as a valid investment strategy. That notwithstanding, merger arbitrage is a respected strategy and when executed properly, can be highly profitable. It bets on the outcomes of mergers, takeovers and other corporate events involving two stocks which may become one.

Example:

A classic example is acquisition of SDL Inc. (SDLI) by JDS Uniphase Corp (JDSU). On July 10, 2010 JDSU announced its intent to acquire SDLI by offering to exchange 3.8 shares of its own shares for one share of SDLI. At that time, the JDSU shares traded at $101 and SDLI at $320.5. It was apparent that there was almost 20 percent profit to be realized if the deal went through (3.8 JDSU shares at $101 are worth $383 while SDLI was worth just $320.5).

This apparent mispricing reflected the market’s expectation about the deal’s outcome. Since the deal was subject to the approval of the U.S. Justice Department and shareholders, there was some doubt about its successful completion.

Risk arbitrageurs who did their homework and properly estimated the probability of success bought shares of SDLI and simultaneously sold short shares of JDSU on a 3.8 to 1 ratio, thus locking in the future profit. Convergence took place about eight months later, in February 2011, when the deal was finally approved and the two stocks began trading at exact parity, eliminating the mis-pricing and allowing arbitrageurs to realize a profit.

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Hedge Fund Research defines the strategy as follows:

Merger Arbitrage,also known as risk arbitrage, involves investing in securities of companies that are the subject of some form of extraordinary corporate transaction, including acquisition or merger proposals, exchange offers, cash tender offers and leveraged buy-outs. These transactions will generally involve the exchange of securities for cash, other securities or a combination of cash and other securities. Typically, a manager purchases the stock of a company being acquired or merging with another company, and sells short the stock of the acquiring company. A manager engaged in merger arbitrage transactions will derive profit (or loss) by realizing the price differential between the price of the securities purchased and the value ultimately realized when the deal is consummated. The success of this strategy usually is dependent upon the proposed merger, tender offer or exchange offer being consummated.

When a tender or exchange offer or a proposal for a merger is publicly announced, the offer price or the value of the securities of the acquiring company to be received is typically greater than the current market price of the securities of the target company. Normally, the stock of an acquisition target appreciates while the acquiring company’s stock decreases in value. If a manager determines that it is probable that the transaction will be consummated, it may purchase shares of the target company and in most instances, sell short the stock of the acquiring company. Managers may employ the use of equity options as a low-risk alternative to the outright purchase or sale of common stock. Many managers will hedge against market risk by purchasing S&P put options or put option spreads.

Cite: https://www.hfr.com See § 23.03[E].



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Providing Physician Centric [Not Advisor Centric] Holistic Financial Planning Advice

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP

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SPONSOR: http://www.MarcinkoAssociates.com

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Selecting a Healthcare Focused Financial Advisory Team

Most retail financial services products are designed to enhance the well-being of the Financial Advisor and vendor at the expense of clients.

The clients get only the leftovers.

Of course, no one tells them that secret.

They have to figure it out for themselves.

As the old line goes, “Where are the customers’ boats?”

Rowland, M: Planning Periscope [Where Advisors are the Clients]. Financial Advisors Magazine; page 36, April 2014.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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LEGAL: Expert Witness Defined

By Staff Reporters

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What exactly is an Expert Witness?

At D.E. Marcinko & Associates an “expert witness” possesses specialized knowledge in a particular field and is qualified to provide deposition or testimony in court and under oath. This testimony can be based on their personal experience, education, training and/or research. The role of an expert witness is to provide objective and unbiased opinions, analysis, and insights to help a lawyer, judge and/or jury understand technical or complex issues related to the case.

EDUCATION: Books

An expert witness can be called by either the prosecution or the defense in a legal case. The expert witness may be required to provide a written report or affidavit detailing their opinions, analyses and conclusions, and they may be asked to testify in court to provide oral testimony and answer questions from the judge and lawyers.

MORE: https://marcinkoassociates.com/expert-witness/

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HOSPITAL: Finances Hold Steady in 2025

By Health Capital Consultants, LLC

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Hospital Finances Held Steady in First Month of 2025

In the first month of 2025, hospital revenue and expenses both increased, balancing each other out and resulting in continued steady financial performance for hospitals, according to Kaufman Hall’s January 2025 National Hospital Flash Report.

Revenues grew more quickly in the inpatient setting, as more patients were treated in the hospital and emergency department than in outpatient settings. While expense increases were largely driven by drug costs, the rate of that growth has significantly slowed.

This Health Capital Topics article reviews the report and the current state of hospital operations. (Read more…) 

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DAILY UPDATE: NIH, FDA, CMS and HHS Nominees as Stock Markets Collapse

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

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Dr. Jay Bhattacharya is officially the new NIH director. The Senate voted to confirm the Stanford University professor’s appointment on March 26 in a 53–47 vote. Marty Makary MD was also confirmed as FDA commissioner in the same hearing in a 56–44 vote. The appointments come as additional “healthcare disruptors,” alongside Robert F. Kennedy Jr.’s confirmation as HHS secretary and Mehmet Oz’s nomination as head of the Centers for Medicare and Medicaid Services. The nominees have faced backlash from the medical community following their controversial stances on topics like vaccinations and alternative medical practices.

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US stocks tanked on Friday as Wall Street grappled with President Trump’s escalating trade war and weighed signs of reinvigorated inflation pressures as consumer sentiment plummets.

The Dow Jones Industrial Average (^DJI) dropped more than 700 points or nearly 1.7%, while the benchmark S&P 500 (^GSPC) fell almost 2%. The NASDAQ Composite (^IXIC) dropped 2.7% as tech stocks led the declines.

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As noted above, the major averages fell on Friday after the release of a hotter-than-expected Personal Consumption Expenditures index reading, which includes the Federal Reserve’s preferred inflation gauge of “core” PCE. The reading showed prices increased more than expected last month, rising 0.4% month over month and 2.8% year over year, continuing a stubborn plateau on the path to the Fed’s 2% target.

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

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PHYSICIAN NET WORTH: Versus Average Family

By Dr. David Edward Marcinko MBA MEd CMP®

SPONSOR: http://www.MarcinkoAssociates.com

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Average Net Worth of an American Family

Both median and average family net worth surged between 2019 and 2022, according to the U.S. Federal Reserve. Average net worth increased by 23% to $1,063,700, the Fed reported in October 2023, the most recent year it published the data. Median net worth, on the other hand, rose 37% over that same period to $192,900.

You might wonder why the average and median net worth figures are so different. That’s because when you take the average of something, you add together every value in a data set and then divide that figure by the number of individual values.

When calculating a median, you simply look at the middle figure within a data set. That said, an average figure can be significantly higher or lower than a median figure if there are extreme outliers – meaning a group of people with significantly more net worth than the rest of the group can bring the average higher.

Average Net Worth by Age

The average net worth of someone younger than 35 years old is $183,500, as of 2022. From there, average net worth steadily rises within each age bracket. Between 35 to 44, the average net worth is $549,600, while between 45 and 54, that number increases to $975,800. Average net worth surges above the $1 million mark between 55 to 64, reaching $1,566,900.

Average net worth again rises for those ages 65 to 74, to $1,794,600, before falling to $1,624,100 for the 75 and older group. The median net worth within every single age bracket, however, is much lower than the average net worth.

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Physicians [MD/DO] Net Worth by Specialty

A 2023 Medscape report shows the top 10 specialties with the most survey respondents saying they are worth more than $5 million.

  1. Plastic Surgery (31% of all survey respondents)
  2. Orthopedics (28%)
  3. Gastroenterology (25%)
  4. Urology (23%)
  5. Cardiology (22%)
  6. Ophthalmology (18%)
  7. Radiology (17%)
  8. Oncology (17%)
  9. Pathology (14%)
  10. Ob/Gyn (14%)

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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CURRENT RATE OF RETURN: Defined

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Current Rate of Return

An important concept for all medical professionals to understand is the current rate of return (CCR).

According to this principle, the current rate of a taxable return must be evaluated in reference to a similar non-taxable rate of return. This allows you to focus on your portfolio’s real (after-tax return), rather than its’ nominal, or stated return.

Now, since most medical professionals own a combination of both vehicles, it is important to calculate the average rate of return (ARR), as demonstrated in the following matrix. Usually, this will result in the assumption of more risk, for the possibility of great return.

To compare after tax yields, with taxable yields, use the following formulas:

Tax equivalent yield = yield / (1 – MTB), while taxable yield X (1-tax rate) = tax exempt yield.

Example: if the yield on a tax exempt municipal bond was 6%, and you are in a 28% tax bracket; the equivalent taxable yield (ETY), is 8.3%, calculated in the following manner: 06 / 1.00 – .28 =.083, or, 8.3% ETY. This means that you would need a taxable instrument paying almost 9 % to equal the 6 percent tax exempt bond.       

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INTEL: Board Members Step Down!

BREAKING NEWS

By Staff Reporters

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Intel (NASDAQ: INTC) just said today, that three members of its board of directors would be stepping down as the embattled chip maker reshapes itself under new Chief Executive Lip Bu-Tan.

Omar Ishrak, the former CEO of medical device maker Medtronic (MDT), University of California, Berkeley Dean Tsu-Jae King Liu and University of Pennsylvania professor Risa Lavizzo-Mourey are leaving Intel’s board, the company said in a filing.

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READERS NOTE: Ever hear of Andy Grove? https://en.wikipedia.org/wiki/Andrew_Grove

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CRYPTOCURRENCY: Real Money-or Not?

By Rick Kahler CFP®

http://www.KahlerFinancial.com

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Is cryptocurrency really money?

For years, I thought of cryptocurrency as a digital replacement for traditional money. After all, Bitcoin has “coin” right in the name. But let’s be honest: if Bitcoin is a currency, then my mother’s old Beanie Baby collection is a retirement fund.

A real currency needs to be stable. It should allow you to buy a coffee today without wondering whether, by tomorrow, that same amount could buy a car—or be worth nothing at all. Bitcoin and its kin like Ethereum and Dogecoin fail this test spectacularly.

Recently I have realized that cryptocurrency might be something even bigger and stranger than currency. It is not just digital money; it’s a bet on the huge global demand for financial autonomy.

In an age where every dollar is tracked, crypto offers an escape from traditional financial oversight. That makes it attractive not just to cybercriminals and tax evaders, but also to privacy advocates, speculators, and people living under restrictive financial policies. It doesn’t replace traditional money, it sidesteps it. It allows people to move, store, create, and destroy wealth outside of conventional banking systems. Some use it for transactions. Others see it as a hedge against inflation or a bet on the future of decentralized finance. Governments and banks don’t quite know what to do with it.

Crypto exists in a financial gray zone. It’s not widely accepted for everyday purchases, yet it can hold immense value. Unlike cash, which is limited by geography, or gold, which requires secure storage, crypto can be transferred globally in seconds. That’s part of its appeal, especially in countries with strict capital controls or volatile economies.

At the heart of cryptocurrency’s identity is the way it is produced. Crypto isn’t just a speculative asset—it’s an industrialized wealth-creation system. Imagine a massive warehouse filled with powerful computers “manufacturing” cryptocurrency. These mining operations exist solely to create new “coins” and process transactions, consuming enormous amounts of electricity in the process. The larger the operation, the more crypto it produces.

This is not how traditional currencies work. Fiat currencies are managed by central banks aiming for economic stability. Crypto, by contrast, is controlled by a decentralized network of miners and participants [block-chain]. Its supply is fixed, immune to government intervention. Some see this as a weakness. Others argue it is crypto’s greatest strength.

As Bitcoin and other major cryptocurrencies become more integrated into mainstream finance, the risks evolve. Even as regulators warn about crypto’s role in illicit activity, major corporations and investment firms are offering crypto-backed products. Some politicians, including President Trump, are discussing national Bitcoin reserves. This growing legitimacy makes crypto harder to ignore. But if crypto-backed funds become widespread, a crash could ripple far beyond crypto traders. That said, crypto remains a small fraction of global finance. Unless institutional adoption grows significantly, even a major downturn likely wouldn’t trigger systemic collapse.

Crypto’s increasing presence in finance does not make it a sound retirement investment. It is still a speculation. And speculations—whether in Bitcoin, meme stocks, or dot-com startups—are high-risk and not suitable for long-term financial security. Retirement portfolios should be built on diversification, stability, and predictable returns. Crypto offers none of these.

For years, I saw crypto as a failed currency. What I now think it to be is a decentralized speculative asset, driven by a growing demand to bypass traditional financial systems. Its future remains uncertain. As regulation increases and mainstream adoption expands, its role will continue to shift. But crypto is no longer just a niche experiment. It has become a financial force that governments, institutions, and individuals must reckon with—whether they embrace it or try to control it.

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DAILY UPDATE: Stablecoin [USD1] as US Stock Markets Gain Again

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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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Donald Trump has officially dropped a stablecoin. It’s called USD1, and it’s pegged 1:1 with the US dollar, according to a statement from his family company World Liberty Financial Inc, (WLFI) today. The company says the token is fully backed by short-term US government treasuries, USD deposits, and other cash equivalents. Every token equals one dollar, no exceptions. WLFI says it built the whole thing to give people a stablecoin they don’t have to second guess.

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US stocks rose for a third day in a row despite souring consumer confidence — and as investors weighed whether President Trump would temper his plans for upcoming tariffs.

The benchmark S&P 500 (^GSPC) rose more than 0.1%, while the Dow Jones Industrial Average (^DJI) ticked just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) rose nearly 0.5%, bolstered by a more than 3% jump from Tesla (TSLA).

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

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HEALTH POLICY EDITION: Fast and Furious Pace

By Health Capital Consultants, LLC

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Fast & Furious: Healthcare Policy Edition

During his first month in office, President Donald Trump’s administration has rolled out edicts calling for significant changes at a fast and furious pace, with a number of healthcare agencies and programs across the U.S. Department of Health & Human Services (HHS) targeted.

In an attempt to keep up with the latest actions of the legislative and executive branches of the federal government, this Health Capital Topics article summarizes recent events in Washington and the impact of these changes (both imminent and impending) on providers and patients. (Read more…)

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ECONOMIC THEORY: Congestion Pricing and Charges

By Wikipedia and Staff Reporters

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Congestion pricing or congestion charges is a system of surcharging users of public goods that are subject to congestion through excess demand, such as through higher peak charges for use of bus services, electricity, railways, telephones, and road pricing to reduce traffic congestion; airlines and shipping companies may be charged higher fees for slots at airports and through canals at busy times. This pricing strategy regulates demand, making it possible to manage congestion without increasing supply.

According to the economic theory behind congestion pricing, the objective of this policy is to use the price mechanism to cover the social cost of an activity where users otherwise do not pay for the negative externalities they create (such as driving in a congested area during peak demand).

By setting a price on an over-consumed product, congestion pricing encourages the redistribution of the demand in space or in time, leading to more efficient outcomes.

EDUCATION: Books

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23andMe Files for Bankruptcy

By Staff Reporters

BREAKING NEWS

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Deoxyribonucleic acid or DNA is a polymer composed of two polynucleotide chains that coil around each other to form a double helix. The polymer carries genetic instructions for the development, functioning, growth and reproduction of all known organisms and many viruses.

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The 23andMe Public Company

The genetic testing company 23andMe went from biotech superstar to the brink of collapse. And, its most valuable asset might be its controversial customer DNA data trove.

More: http://www.23andme.com

Now, 23andMe filed for bankruptcy late Sunday night and announced the resignation of its chief executive officer Anne Wojcicki who is stepping down from her position but remains on the board of directors.

Wojcicki has so far tried unsuccessfully to rescue the business by buying it back and capping a precipitous fall for the DNA-testing company.

MORE: https://tinyurl.com/38rtfjck

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DAILY UPDATE: DJIA, S&P 500 & NASDAQ Futures Rise in Search of Bounce-Back Week

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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.

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US stock futures rose yesterday Sunday, as the major indexes looked for another week of gains toward the end of a rough month and quarter.

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Futures attached to the benchmark S&P 500 (ES=F) rose 0.6%, with NASDAQ 100 (NQ=F) futures up 0.7%. Futures tied to the Dow Jones Industrial Average (YM=F) advanced around 0.4%.

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

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ESTATE PLANS: When Physicians Should Review

By J. Chris Miller JD

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Your personal and financial life is constantly changing.  Significant changes always necessitate the need to review your life.  However, a few key events trigger the need to review your estate plan.  If any of the events below have occurred since you reviewed your estate plan, see a competent adviser to help you achieve your goals.

  1. Birth of a child or grandchild. 
  2. Death of a spouse, beneficiary, guardian, trustee or personal representative. 
  3. Marriage of you or your children.
  4. Divorce.  (Review beneficiary designations and asset titling)
  5. Move out of state.  An estate is settled under the laws of the state in which the decedent resided.  Certain provisions of a will that are valid in one state may not be in another.
  6. Change in estate value.  A large increase or decrease in the size of an estate may greatly affect some of the strategies that were implemented.
  7. Changes in business.  Starting, buying or selling a medical practice or other business has an impact on your estate. The addition or death of a business owner will cause a review.
  8. Tax law changes.  EGTRRA has dramatically changed the way we plan for estate taxes.  It is important to note that only planning for estate taxes has been effected.  Estate planning involves much more than just the motivation to reduce or eliminate taxes.  Assuring that your family is financially taken care of, that children have the opportunity to go to college, that your debts are paid, that charitable desires are achieved, provisions for a needy child, proper selection of a guardian, the list goes on.  Please do not use the new law as an excuse to not plan your estate.

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OVERHEARD IN THE FINANCIAL ADVISOR’S LOUNGE

From my perspective, estate planning is a team sport, and lawyers rely on financial advisers all the time to spot issues for clients. We do not share the opinion that non-lawyers are incapable of giving good advice. 

-J. Chris Miller JD

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The Missing Piece in America’s Health Care Debate

By Rick Kahler CFP™

http://www.KahlerFinancial.com

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The recent horrifying murder of UnitedHealthcare Group CEO Brian Thompson has called attention to the anger many Americans feel about our health care system. This tragedy has thrust the very real issue of health care costs back into the headlines.

One article on the topic, from Ken Alltucker for USA Today, offered seven reasons why Americans pay so much for health care with such poor results. When I saw the headline, I thought, “Finally, someone’s going to bring up the elephant in the room: taxes.”

The seven reasons included bloated administrative costs, lack of price transparency, overpaid specialists, higher prescription drug prices, and more. But I didn’t see a word about how, compared to other developed nations with “cheaper” health care, Americans pay far lower taxes. That omission feels like leaving a critical piece of the puzzle off the table.

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In reality, countries with universal health care are not pulling off some magic trick of efficiency. They are simply collecting the money differently—through significantly higher taxes. Americans, on the other hand, pay for health care more directly, through out-of-pocket costs and insurance premiums.

In a column last year, I did the math. Americans spend about 17.8% of GDP on health care, plus 27.7% of GDP in taxes. That’s a total of 45.5%. Now compare that to twelve European countries with universal health care. They spend a median of 11.5% of GDP on health care and collect 41.9% of GDP in taxes. Total? 53.4%. In other words, Americans are spending 7.9% less overall on healthcare and taxes combined.

The saving isn’t what it appears, though. A fair comparison of healthcare costs and taxes needs to account for the fact that universal healthcare systems cover 100% of their populations, while the U.S. system currently leaves about 8% uninsured. If you factor in the cost of covering our uninsured residents, the U.S. likely spends a comparable percentage of income on healthcare as European countries with universal systems.

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Our system is far from perfect. As the USA Today article points out, administrative costs are bloated. Harvard’s David Cutler estimates up to 25% of our health spending goes toward paperwork, phone calls, and processing. Price transparency is practically nonexistent. The cost of a diagnostic test might vary from $300 to $3,000 depending on where you go. We pay much more for prescription drugs and many procedures than those same treatments cost in other developed nations. Another issue is the fee-for-service model that rewards doctors for ordering more tests and procedures, whether or not patients get better.

We can do better. Innovations like value-based care, where providers are paid for outcomes rather than procedures, could help shift the system toward real results. Greater price transparency would empower patients to make informed choices and force providers to compete. And addressing administrative inefficiencies could save billions.

Yet fixing the system requires being honest about trade-offs. If we want universal health care at European price rates, we need to accept European tax rates. That’s the part of the conversation that often gets left out. It’s easy to be angry at hospitals, insurance companies, and drug manufacturers—and yes, they all have plenty to answer for. But we also need to face the reality that we’ve chosen a system that prioritizes lower taxes over centralized health care.

Anger may have put the flaws in our health care system in the spotlight. Finding genuine solutions will require moving beyond expressions of anger and frustration. It will demand thoughtful discussions about what kind of health care system, as individuals and as a nation, that we want and how we are willing to fund it.

EDUCATION: Books

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WORKER’S COMPENSATION: Physician Insurance

By Staff Reporters

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While some medical practitioners and facilities can operate without Professional Liability Insurance coverage, one business related insurance that cannot / should not be avoided is Worker’s Compensation.  Employers in all but seven states – so-called “monopolistic” states because they have their own state funds, are under statutory obligation to provide coverage for their employees.  Historically, Worker’s Compensation pre-dates Social Security entitlements and well before the emergence of employer sponsored group benefits.

The coverage under worker’s compensation provides for lost income due to on-the-job accidents or work-related disability or death and the amount of benefits vary by state.  In some instances, the coverage will reimburse the employee for medical expenses incurred with the accident. 

The four general benefits covered under Worker’s Compensation are:

Medical Care – for expenses incurred usually without limitations on amount or period of care.

Disability Income – payable for both total and partial disability and is usually based on 66 2/3 percent of their wage base.

Death Benefits – generally fall into two categories; one a flat amount for “burial” insurance; and two, survivor benefits.  Though varying by state, these benefits are similar to the disability payment (a percentage of weekly base wages) but may be capped as to total benefit, such as $50,000 or a period, such as 10 years

Rehabilitation Benefits – includes not only medical rehabilitation, but vocational rehabilitation, vocational counseling, retraining or educational benefits, and job placement

Traditionally, the secondary purpose of Worker’s Compensation was to reduce potential litigation because employees accepting the benefits from a Worker’s Compensation claim generally waived their right to sue their employer. 

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However, in our litigious society, this “protective shelter” has been severely tested and is crumbling.

Employers may provide their Worker’s Compensation three ways:

  • Private commercial insurance
  • State government funds
  • Self-insurance

Very few factors drive the premium structure – the occupation of the workers is the single most important determinant of premiums.  An office worker may have premiums as low as $.10 per hundred of wages and a coal miner may exceed $50.00 per hundred of wages.  Generally speaking, however, Worker’s Compensation premiums for the medical profession or healthcare worker are among the lowest available.

Therefore, for the medical practice, some physicians may consider self-insurance because the weekly benefits are typically below $500, thus making this decision attractive. 

Alternatively, because officers and owners can elect not to be covered by Worker’s Compensation, the decision to purchase coverage from a private insurance company may afford inexpensive assurance that the benefits will be conveniently provided, and administered, by a private insurance company for their employees.

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HEDGE FUND: Terms and Definitions

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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  • Absolute Return – the goal is to have a positive return, regardless of market direction.  An absolute return strategy is not managed relative to a market index.
  • Accredited Investor – wealthy individual or well-capitalized institutions covered under Regulation D of the Securities Act of 1933.
  • Alpha – the return to a portfolio over and above that of an appropriate benchmark portfolio (the manager’s “value added”).
  • Arbitrage – any strategy that invests long in an asset, and short in a related asset, hoping the prices  will converge.
  • Attribution – the process of “attributing” returns to their sources.  For example, did the returns to a portfolio (over and above some benchmark) come from stock selection, industry/sector over- or under-weighting or factor weighting.  Software programs are helpful in reporting an attribution.
  • Beta – a measure of systematic (i.e., non-diversifiable) risk.  The goal is to quantify how much systematic risk is being taken by the fund manager vis-à-vis different risk factors, so that one can estimate the alpha or value-added on a risk-adjusted basis.
  • Correlation – a measure of how strategy  returns  move with one another, in a range of –1 to +1.  A correlation of –1 implies that the strategies move in opposite directions.  In constructing a portfolio of hedge funds, one usually wants to combine a number of non-correlated strategies (with decent expected returns) to be well diversified.
  • Drawdown – the percentage loss from a fund’s highest value to its lowest, over a particular time frame.  A fund’s “maximum drawdown” is often looked at as a measure of potential risk.
  • Hurdle Rate – the return where the manager begins to earn incentive fees.  If the hurdle rate is 5% and the fund earns 15% for the year, then incentive fees are applied to the 10% difference.
  • Leverage – one uses leverage if he borrows money to increase his position in a security.  If one uses leverage and makes good investment decisions, leverage can magnify the gain.  However, it can also magnify a loss.
  • Opportunistic – a general term that describes an aggressive strategy with a goal of making money (as opposed to holding on to the money one already has).

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  • Pairs Trading – usually refers to a long/short strategy where one stock is bought long, and a similar stock is sold short, often within the same industry.  Buying the stock of Home Depot and shorting Lowe’s in an equal amount would be an example.
  • Portfolio Simulation – involves testing an investment strategy by “simulating” it with a database and analytic software.  Often referred to as “backtesting” a strategy.  The simulated returns of the strategy are compared to those of a benchmark over a specific time frame to see if it can beat that benchmark.
  • Sharpe Ratio – a measure of risk-adjusted return, computed by dividing a fund’s return over the risk-free rate by the standard deviation of returns.  The idea is to understand how much risk was undertaken to generate the alpha.
  • Short Rebate – if you borrow stock and then sell it short, you have cash in your account.  The short rebate is the interest earned on that cash.
  • R-Squared – a measure of how closely a portfolio’s performance varies with the performance of a benchmark, and thus a measure of what portion of its performance can be explained by the performance of the overall market or index.  Hedge fund investors want to know how much performance can be explained by market exposure versus manager skill.
  • Transportable Alpha – the alpha of one active strategy can be combined with another asset class.  For example, an equity market-neutral strategy’s value-added can be “transported” to a fixed income asset class by simply buying a fixed income futures contract.  The total return comes from both sources.
  • Value at Risk – a technique which uses the statistical analysis of historical market trends and volatilities to estimate the likelihood that a specific portfolio’s losses will exceed a certain amount.

Cite: https://www.hedgefundmarketing.org/

EDUCATION: Books

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DAILY UPDATE: Medicare TeleHealth Coverage as Wall Street Stock Markets Rise

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

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Stocks on Wall Street shook off a weak start and closed slightly higher Friday, snapping a four-week losing streak.

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The S&P 500 edged up 0.1%. The index finished with a 0.5% gain for the week. It’s still down 4.8% so far this month. The Dow Jones Industrial Average eked out a 0.1% gain, while the NASDAQ composite rose 0.5%.

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It appears Medicare coverage for tele-health is here to stay—at least for the next six months. When the House of Representatives and Senate passed a budget on March 11t and 14th, respectively, they not only avoided a government shutdown, but also extended a resolution for Medicare to cover non-behavioral health tele-health appointments until September 30th.

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

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PIFs & PIDs: Definitions with Video

Beware – Public Improvement Fees

Beware – Public Improvement Districts

By Staff Reporters

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A Public Improvement Fee (PIF) is a fee that developers may require their tenants to collect on sales transactions to pay for on-site improvements. The PIF is a fee and NOT a tax; therefore, it becomes a part of the overall cost of the sale/service and is subject to sales tax

Examples of these improvements include curbs and sidewalks, parking facilities, storm management system, sanitary sewer systems, road development (within the site) and outdoor public plazas. 

Video: https://www.tiktok.com/@hollyintheclouds/video/7206365328966700334

Public Improvement Districts (PIDs) are a financing mechanism used to fund new developments and infrastructure improvements. PIDs are relatively easy to create and can be done by the local municipality. A majority of property owners within the district may petition a local government to create the district. Bonds can then be issued to fund a development or infrastructure improvements. Through an industry analysis and view of the current political environment, PIDs are certainly a beneficial mechanism to fund projects otherwise not feasible due to constraints on city budgets. Local elected officials will want PIDs monitored and only used in proper circumstances.

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DAILY UPDATE: US Stock Markets Retreat

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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.

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U.S. stock indexes edged lower Thursday following another reminder that big, unsettling policy changes are underway because of President Donald Trump, along with more signals suggesting the U.S. economy remains solid for now.

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The S&P 500 slipped 0.2% after flipping between modest gains and losses through the day. The Dow Jones Industrial Average dipped by 11 points, or less than 0.1 %, and the NASDAQ composite fell 0.3%.

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

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TAXATION: Avoidance V. Evasion V. Voluntary Compliance

DEFINITION

SPONSOR: http://www.MarcinkoAssociates.com

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Tax avoidance—An action taken to lessen tax liability and maximize after-tax income.

Tax evasion—The failure to pay or a deliberate underpayment of taxes.

Underground economy—Money-making activities that people don’t report to the government, including both illegal and legal activities.

Voluntary compliance—A system of compliance that relies on individual citizens to report their income freely and voluntarily, calculate their tax liability correctly, and file a tax return on time.

MORE: https://apps.irs.gov/app/understandingTaxes/whys/thm01/les03/media/ws_ans_thm01_les03.pdf

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DAILY UPDATE: Scripps Health & WHO as US Stock Markets Rise

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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

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FIRST DAY OF SPRING

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Stat: $1.2 billion. That’s how much San Diego-based Scripps Health plans to spend building a new hospital in San Marcos, California. (Becker’s Hospital Review)

Read: What WHO Director-General Tedros Adhanom Ghebreyesus said about USAID cuts. (Stat)

Pharm fresh: Check out in-depth strategies designed to help increase engagement between pharma reps and primary care clinicians. It’s all right here in Pri-Med’s research. Read the report.

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Shares of Charles Schwab Corp. SCHW+1.51% rallied 1.51% to $78.73 Wednesday, on what proved to be an all-around favorable trading session for the stock market, with the S&P 500 Index SPX+1.08% rising 1.08% to 5,675.29 and the Dow Jones Industrial Average DJIA+0.92% rising 0.92% to 41,964.63.

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

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FOMC: Interest Rates Remain Steady

BREAKING NEWS!

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The Federal Reserve just opted to hold interest rates steady as officials reckon with fearful markets and concerns of an economic slowdown sparked by the trade wars launched by President Donald Trump and his efforts to overhaul and dismantle government agencies.

After a two-day meeting of its monetary policy committee in Washington, D.C., the Fed announced it would hold its rate target at a range of 4.25% to 4.50%. Investors anticipated the move. The Fed’s target rate remains a full percentage point lower than it was when the Fed pivoted to cutting rates last September.

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LIFE INSURANCE: Split Dollar Plans

By Staff Reporters

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Split-Dollar Life Insurance: An arrangement under which a life insurance policy’s premium, cash values, and death benefit are split between two parties—usually a corporation and a key employee or executive. Under such an arrangement an employer may own the policy and pay the premiums and give a key employee or executive the right to name the recipient of the death benefit.

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Several factors will affect the cost and availability of life insurance, including age, health, and the type and amount of insurance purchased. Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policy holder also may pay surrender charges and have income tax implications. You should consider determining whether you are insurable before implementing a strategy involving life insurance.

Any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.

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DAILY UPDATE: US Stock Markets Routed

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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.

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US stocks pulled back on Tuesday, led by a nearly 2% decline in the NASDAQ, following two days of gains as investors concerned about an economic slowdown looked to the Federal Reserve’s policy meeting for insights.

The tech-heavy NASDAQ Composite (^IXIC) plummeted about 1.7% as Nvidia (NVDA) shares fell roughly 3% as its annual GTC event failed to impress investors. Other “Magnificent Seven” names also dragged down the tech-heavy index. Notably, those stocks are having their worst quarter in more than two years.

The Dow Jones Industrial Average (^DJI) and S&P 500 (^GSPC) also moved to the downside on Tuesday, dropping about 0.6% and 1.1%, respectively.

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Uncertainty still dogs markets as investors debate whether the sell-off that pushed the S&P 500 into correction territory is over. Traders now turn their attention to the Fed’s two-day policy meeting, which kicked off on Tuesday, for clues on the health of the economy and potential tariff risks.

Policymakers are largely expected to hold rates steady in their decision on Wednesday.

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MALTA: A Hedge Fund Haven?

By Dr. David E. Marcinko MEd MBA CMP

SPONSOR: http://www.MarcinkoAssociates.com

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OVER HEARD IN THE DOCTOR’S LOUNGE

“Malta has quietly leveraged the rising tide of the financial transparency imperative to attract hedge funds.

There was a time when the quaint island sought to play on the traditional terrain, offering anonymity and a “laissez-faire regulatory regime,” not to mention very low taxes, as in no capital gains taxes and no taxes on dividends; all while English speaking and USD currency denominated.

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While many leading domiciles for offshore hedge funds remain in the Caribbean – notably the Cayman Islands, the British Virgin Islands, Bermuda, and the Bahamas – the island of Malta is drawing attention, especially from European funds.

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FINANCIAL ADVISORS: Real Monetary Worth?

BY DR. DAVID EDWARD MARCINKO; MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

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SO – HOW MUCH IS A “FINANCIAL ADVISOR” REALLY WORTH?

This blog holds a rather uncomplimentary opinion of financial advisors, and the financial services and brokerage industry as a whole; deserved, or not? The entire site hints at this attitude as well, in favor of a going it alone or ME, Inc investing when possible. Nevertheless, it is reasonable to wonder how much boost in net-returns might an educated and informed, fee transparent and honest, fiduciary focused “financial advisor” add to a clients’ investment portfolio; all things being equal [ceteris paribus].

And, can it be quantified?

Well, according to Vanguard Brokerage Services®, perhaps as much as 3%? In a decade long paper from the Valley Forge, PA based mutual fund and ETF giant, Vanguard said financial advisors can generate returns through a framework focused on five wealth management principles:

Being an effective behavioral coach: Helping clients maintain a long-term perspective and a disciplined approach is arguably one of the most important elements of financial advice. (Potential value added: up to 1.50%).

Applying an asset location strategy: The allocation of assets between taxable and tax-advantaged accounts is one tool an advisor can employ that can add value each year. (Potential value added: from 0% to 0.75%).

Employing cost-effective investments: This component of every advisor’s tool kit is based on simple math: Gross return less costs equals net return. (Potential value added: up to 0.45%).

Maintaining the proper allocation through rebalancing: Over time, as investments produce various returns, a portfolio will likely drift from its target allocation. An advisor can add value by ensuring the portfolio’s risk/return characteristics stay consistent with a client’s preferences. (Potential value added: up to 0.35%).

Implementing a spending strategy: As the retiree population grows, an advisor can help clients make important decisions about how to spend from their portfolios. (Potential value added: up to 0.70%).

Source: Financial Advisor Magazine, page 20, April 2014.

Assessment

However, Vanguard notes that while it’s possible all of these principles could add up to 3% in net returns for clients, it’s more likely to be an intermittent number than an annual one because some of the best opportunities to add value happen during extreme market lows and highs when angst or giddiness [fear and greed] can cause investors to bail on their well-thought-out investment plans.

And, is the study applicable to doctors and allied healthcare providers? Doe Vanguard have a vested interest in the topic. What about fee based versus fee-only financial advice?

Conclusion

Finally, recognize the plethora of other financial planning life-cycle topics addressed in this ME-P were not included in the Vanguard investment portfolio-only study a decade ago. 

And what about today with contemporaneous internet advising, chat-rooms, linkedin, robo-advisors, reddit and the like?

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BIN Credit Card Attack?

BANK IDENTIFICATION NUMBER – DEFINED

By Staff Reporters

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What Is a BIN Attack?

The BIN, or the Bank Identification Number, is the first six digits on a credit card. These are always tied to its issuing institution – usually a bank. In a BIN attack, fraudsters use these six numbers to algorithmically try to generate all the other legitimate numbers, in the hopes of generating a usable card number.  

How Does a BIN Attack Work?

Fraudsters conduct BIN attacks by generating hundreds of thousands of possible credit card numbers and testing them out.

  1. A fraudster looks up the BIN of the bank they will target. Ranging from four to six digits, this information is in the public domain and is thus easy to source.
  2. Using dedicated software such as an auto-dialer, they generate thousands, often tens of thousands, combinations of possible existing card numbers by this issuer.
  3. At this point, these credentials need to be tested. The fraudster identifies a suitable online shop or donation page.
  4. They start card testing by attempting a small payment with each generated card number.
  5. They keep track of the small percentage of card details that worked, which they are ready to use in earnest for their fraudulent pursuits. 

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Remember that the fraudster will start off with only six digits, yet there are many more card details required for a successful transaction. If those are entered erroneously, the transaction will decline. This includes the CVV number, the expiration date, as well as likely address verification service (AVS) failures. Card testing transactions are executed remotely in a fast fashion, so distance checks should also be a hint as well as velocity alerts. 

Fraudsters may use bad merchant accounts directly for this purpose, or more frequently involve multiple online stores and services during a BIN attack, as their attempts keep getting blocked at most outlets.

MORE: https://seon.io/resources/dictionary/bin-attack/

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MEDICAL PRACTICE: Valuation Adjustments

NET INCOME STATEMENT AND BALANCE SHEET ADJUSTMENTS

By Dr. David Edward Marcinko; MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

Net Income Statement Adjustments

When analyzing a set of financial statements to determine practice value, adjustments (normalizations) generally are needed to produce a clearer picture of likely future income and distributable cash flow. It also allows more of an “apples to apples” line item comparison. This normalization process usually consists of making three main adjustments to a medical practice’s net income (profit and loss) statement.

1. Non-Recurring Items: Estimates of future distributable cash flow should exclude non-recurring items. Proceeds from the settlement of litigation, one-time gains/losses from the selling of assets or equipment, and large write-offs that are not expected to reoccur, each represent potential nonrecurring items. The impact of nonrecurring events should be removed from the practice’s financial statements to produce a clearer picture of likely future income and cash flow.

2. Perquisites: The buyer of a medical practice may plan to spend more or less than the current doctor-owner for physician executive compensation, travel and entertainment expenses, and other perquisites of current management. When determining future distributable cash flow, income adjustments to the current level of expenditures should be made for these items.

3. Non-cash Expenses: Depreciation expense, amortization expense, and bad debt expense are all non-cash items which impact reported profitability. When determining distributable cash flow, you must analyze the link between non-cash expenses and expected cash expenditures.

The annual depreciation expense is a proxy for likely capital expenditures over time. When capital expenditures and depreciation are not similar over time, an adjustment to expected cash flow is necessary. Some practices reduce income through the use of bad debt expense rather than direct write-offs. Bad debt expense is a non-cash expense that represents an estimate of the dollar volume of write-offs that are likely to occur during a year. If bad debt expense is understated, practice profitability will be overstated.

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Balance Sheet Adjustments

Adjustments also can be made to a practice’s balance sheet to remove non-operating assets and liabilities, and to restate asset and liability value at market rates (rather than cost rates). Assets and liabilities that are unrelated to the core practice being valued should be added to or subtracted from the value, depending on whether they are acquired by the buyer.

Examples include the asset value less outstanding debt of a vacant parcel of land, and marketable securities that are not needed to operate the practice. Other non-operating assets, such as the cash surrender value of officer life insurance, generally are liquidated by the seller and are not part of the business transaction.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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POA: Power of Attorney Mistakes

The Power of Attorney Mistake That Could Cost You Everything

By Rick Kahler CFP®

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Recently, reading a training manual on elder abuse, I was reminded of a financial risk that is often overlooked. One of the fastest and easiest ways to unravel your financial security is to have the wrong person gain control of your money.

The example in the manual mirrored a heartbreaking situation I once experienced with a long-term client. As her mental and physical health declined, this single woman moved into assisted living. Her newly designated power of attorney, a relative from out of town, took control of her financial affairs.

Almost immediately, without consulting us, the relative began making large withdrawals, closed her accounts, and transferred funds elsewhere. They challenged the financial plan, investments, and strategies we had established to safeguard the client’s financial security and provide for her long-term care. Even though their actions threatened the client’s wellbeing, we were powerless to stop them. Our only recourse was to report the behavior to the authorities.

This heartbreaking and frustrating experience underscored just how critical it is to be mindful when executing a Power of Attorney. Besides designating someone you trust, it is wise to build in safeguards to prevent even a well-meaning relative from inadvertently derailing a carefully constructed financial plan.

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One such safeguard is to include a financial advisor in your POA—as long as that person is a fee-only, fiduciary advisor with an obligation to act in your best interests. In many cases, advisors are hesitant to suggest this option because they are sensitive to the potential conflict of interest and do not want to appear self-serving. An unfortunate reality is that you should be cautious if an advisor, particularly one who sells products on commission, seems eager to be added to your POA.

Including your financial advisor in your POA does not mean you designate them as your agent to manage your affairs. Instead, you include a clause naming them as the professional of record you want your designated agent to continue working with. This creates continuity and accountability. It prevents your agent from replacing your advisor with someone who may be unfamiliar with your needs and goals, unqualified, or untrustworthy.

Your advisor might also recommend adding a secondary safeguard, such as naming an attorney or accountant to oversee the selection of a successor advisor in case your current advisor is unable to continue. This additional layer of protection ensures that the financial professionals guiding your portfolio remain aligned with your best interests. Taking these extra steps can save you—and your loved ones—from significant financial stress down the road.

Including safeguards in your POA is not about mistrusting your loved ones, but about equipping them with the right resources and support to act in your best interest. Financial management is complex, and it requires expertise that most people, even those with the best intentions, may not possess.

One of the hardest parts about planning for diminished financial capacity is the emotional aspect. No one likes to imagine a time when they might not be able to manage their own money. But in reality, taking steps now to protect your financial future is the ultimate act of control. It can help ensure that your wishes are respected and the financial foundation you’ve worked so hard to build remains intact.

Remember, too, that avoiding conversations often increases financial vulnerability. If you don’t have a POA or aren’t comfortable with what you do have, now is the time to bring it up with your advisor, attorney, or a trusted family member. These safeguards are about protecting yourself. They also support those you will rely on to care for you and your financial legacy,

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HEALTH ACTUARY: Medical Professions

By Dr. David Edward Marcinko MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

THE MEDICAL AND HEALTHCARE ACTUARY

Health actuaries analyze potential risks, profits and trends that will affect their employers, which are often in the health insurance, government health services and medical provider industries. They advise companies on issuing policies to consumers based on risks, calculated premiums and upcoming changes in health-care costs.

It’s common for an actuary to have a bachelor’s degree or higher in actuary studies, mathematics or statistics. Coursework on medical terminology and hierarchy of the medical field is also beneficial. In addition to academic education, certification is also necessary to reach “professional status,” which is required by most employers.

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The professional organization, Society of Actuaries, certifies actuaries in the health and medical field. Their statistical work is commonly done with predictive tables, probability tables and life tables that are created on customized statistical analysis software such as Stata or XLSTAT.

The actuary field as a whole is growing faster than other fields, according to the Bureau of Labor Statistics [BLS]. In 2020, it expanded by 27 percent. The average annual salary for an actuary in 2010 was $87,650. More specifically, in the health insurance field, the salary was slightly higher at $91,000.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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TONTINE Funds

By Staff Reporters

DEFINITION

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According to Wikipedia, a tontine (/ˈtɒntaɪn, -iːn, ˌtɒnˈtiːn/) is an investment linked to a living person which provides an income for as long as that person is alive. Such schemes originated as plans for governments to raise capital in the 17th century and became relatively widespread in the 18th and 19th centuries.

Tontines enable subscribers to share the risk of living a long life by combining features of a group annuity with a kind of mortality lottery. Each subscriber pays a sum into a trust and thereafter receives a periodical payout. As members die, their payout entitlements devolve to the other participants, and so the value of each continuing payout increases. On the death of the final member, the trust scheme is usually wound up.

Tontines are still common in France. They can be issued by European insurers under the Directive 2002/83/EC of the European Parliament. The Pan-European Pension Regulation passed by the European Commission in 2019 also contains provisions that specifically permit next-generation pension products that abide by the “tontine principle” to be offered in the 27 EU member states.

Questionable practices by U.S. life insurers in 1906 led to the Armstrong Investigation in the United States restricting some forms of tontines. Nevertheless, in March 2017, The New York Times reported that tontines were getting fresh consideration as a way for people to get steady retirement income.

MORE: http://www.tontine.com

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The Best and Worst Investment Decisions I’ve Made

By Vitaliy Katsenelson CFA

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Today, I’m going to share stories about my best and worst investment decisions. But don’t worry, this isn’t just a brag-and-cringe session about making or losing money. These stories are about the valuable lessons learned, and how these adventures in investing helped shape my current approach. 

The Best Investment Decision

In investing, you don’t get extra points for creativity or difficulty. A million dollars earned while you are smiling buys as many potatoes as a million dollars that cost you your marriage and hair.

However, from a personal, creative satisfaction perspective, our investment in Uber was one of our best. That’s not to say that it has been the most successful decision from a financial perspective, at least not yet.

Uber doesn’t fit into the traditional value stock category. Until 2023, the third year of our ownership, it never made money. It was a stock everyone hated. After we bought it, I had clients reach out to me asking if I had been kidnapped and someone else was making these purchases of Uber.

We bought more shares very opportunistically during and after the pandemic. I wrote a long research report on it, which you can read here.

On one hand, Uber’s switchboard is a digital business, but the company also has a physical presence in thousands of cities, which incurs costs (the analog side of the business). Additionally, the availability of cheap money caused the ride-share market to go crazy and act rationally irrational, as competitors jostled in a land grab.

My thesis consisted of several insights:

  1. Unlike traditional-tech, digital-only companies, Uber is a hybrid, both digital and analog. Thus, its cost structure is much higher than that of other companies. This, in part, explains the higher losses.
  2. It has a strong brand; its name has become a verb.
  3. The rideshare market is inevitable and will only continue to grow. Uber is not just in competition with taxis, second cars, or seldomly used cars; it is also in competition with the favors we ask of friends and relatives, such as dropping us off at the mechanic or picking us up from the doctor’s office.
  4. Uber has global scale, which its competitors lack, allowing it to spread R&D across more markets.
  5. As its revenue grows, each incremental dollar comes with a very high margin, which directly drops to the bottom line. Therefore, at some point, its earnings will explode to the upside as fixed costs stop growing, allowing it to scale.

The Uber story is not over; we still own the stock. I don’t want to do a celebratory dance. But this idea came with a lot of creative satisfaction. There is another point of pride here. Despite our very tumultuous ownership of this stock, we remained rational (I have written about that here). We bought more when it became extremely undervalued, and I would be lying if I said that was psychologically easy – it was not, but we followed our research and process.

The Worst Investment Decision

My worst investments that resulted in losses had several things in common: They were low-quality companies; their financials were complex and not transparent (for instance, one-time items were labeled as “one-time” every quarter); and they had questionable management. 

However, they were all considered “cheap”… until they were not. Now, I hope you see why I am dogmatic about quality. 

However.

When you are wrong on an investment and you lose money, the most you can lose is 100%. I have learned a lot from those. But they were not my worst investments. Those were the ones where I left 300–400% on the table when I sold too soon. Let me detail two examples.

EA – Electronic Arts

We bought EA in the early 2010s. I wrote about it – you can read my investment case for it here. To sum up, games were moving from being sold in stores to being digital downloads, which would lead to higher margins (don’t have to pay for packaging and Best Buy to sell them). The market for games was exploding, as every adult and teenager had a gaming device in their hands – a smartphone. The market for video games was going to be much larger. EA was the largest player in that space, with great franchises.

The following two years of ownership were very painful. EA had a few big game flops, and the market did not care about improving fundamentals. The stock kept declining. We continued to buy more. Every time we bought more shares, the stock fell further. Fast-forward a year or two. The stock doubled from our original purchase, but I was mentally exhausted. I did a celebratory dance and sold the stock. The stock then went up another 4x within a few years after we sold it. It went up for the right reasons – its earnings exploded to the upside, in line with my original thesis.

The sale was a mistake, not because the price went up but because I let frustration over the stock-price decline (volatility) get to me. Investing is a mental game. I learned from this adventure that it is important to zoom out and not obsess over individual stocks in the portfolio. This is why we have a portfolio. It was a very costly but educational mistake. Our ownership of Uber was not a walk in the park, either – just look at the stock price over the last few years. But I had learned my lesson from EA and was able to do the analysis, update our model, and zoom out.

In investing, there is a big difference between intellectual and tactile knowledge. I am going to go PG-13 on you for a second and quote the irascible Charlie Munger: “Learning about investing through a model portfolio is like learning about sex through romantic novels.” A big part of investing is observing yourself as an investor – your thoughts and emotions as you ride the actual rollercoaster of owning a stock.

I also made an important modification to our process.

We always value every company in the portfolio on earnings (free cash flows) at least four years out. Why four years? Three seems too short. There is no magic in this number, other than it being longer than most analyst estimates. We do this for all stocks in the portfolio, and then the total return for each is calculated and annualized. If a company has strong growth potential, it may appear to be expensive based on current earnings; but in reality, it may actually be cheap based on earnings projected four years from now.

On the other side of the spectrum, a company that has no growth or dividends may seem “cheap” based on its current earnings multiple, but this cheapness may quickly dissipate once a total return is calculated using future earnings. Time is on the side of growing businesses and the enemy of the ones that stand still. Therefore, a non-growing or slow-growing business needs a much greater discount (margin of safety) to secure a spot in our portfolio.

I want to stress another point. We sometimes sell a stock and then it goes higher. If we sold it for the right fundamental reasons, this doesn’t bother me. There is very little to learn.

Twilio

I’ll give you another crazy example. We bought Twilio at $25 in 2017 or so. Our thesis was that they had built the largest digital telecommunications network, which gave them a brief competitive advantage. They were also spending 5x more on R&D than competitors to build applications around this network, which would give them long-term advantages.

The stock price went up to $60 in a few months without anything significantly changing, so we sold a third of our position. Then it went up to $90, and we sold some more. To our disbelief, we sold the rest at around $120, a bit before the pandemic.

During the pandemic, Twilio’s price hit $400. I had zero regret about not holding on to the shares. Absolutely none. Twilio’s profitability did not match the stock market’s opinion of its price. Twilio’s stock price was as crazy to me at $250 as it was at $300 or $400. After reviewing our models, we concluded that even $120 was at the extreme end of our optimistic assumptions. Fast-forward to today, where the stock is at $60 or so. We are currently sharpening our pencils, but we have not bought the stock – yet.

Selling EA was a mistake; selling Twilio was not.

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Key takeaways

  • My “best investment decision” with Uber wasn’t just about financial gains, but the creative satisfaction it brought. It taught me the value of sticking to our research and process, even when it’s psychologically challenging.
  • The worst investments often share common traits: low-quality companies, complex financials, questionable management, and the illusion of being “cheap.” This reinforces my dogmatic stance on prioritizing quality.
  • Sometimes, the costliest mistakes aren’t the ones where you lose money, but those where you leave significant gains on the table by selling too soon. My experience with EA taught me this lesson the hard way.
  • There’s a crucial difference between intellectual and tactile knowledge in investing. Actually owning stocks and experiencing the emotional roller coaster is invaluable for developing as an investor.
  • Selling a stock that later increases in value isn’t always a mistake if the decision was based on sound fundamental reasons. My experience with Twilio illustrates this point – sometimes it’s right to sell even if the price continues to climb.

NOTE: Please read the following important disclosure here.

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SURVEILLANCE: Pricing and Gouging

DEFINITION

By Staff Reporters and FTC

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Surveillance pricing is a broad term to describe the practice of linking pricing to individualized consumer data.

Companies employing it might use algorithms, personal information, and AI to set a price for their goods based on everything from where you live to your age to your browsing or credit history. The practice, sometimes called dynamic pricing or personalized pricing, is growing increasingly common, but isn’t completely new.

In 2012, the travel website Orbitz began directing people on Macs to higher hotels after realizing they often had more purchasing power. It stopped the practice after the Wall Street Journal reported on it.

Is surveillance pricing the same thing as surge pricing? Yes and no.

You might know about surge pricing from the last time you tried to call an Uber during a rainstorm. As demand skyrockets for a ride share, so does the price. This is one kind of surveillance pricing, but what the FTC is targeting appears more specific. The FTC said its probe concerns “when the pricing is based on surveillance of an individual’s personal characteristics and behavior.”

Is surveillance pricing bad?

The FTC opened its probe into companies using surveillance pricing because it’s worried about the risks it might pose to consumers

“Firms that harvest Americans’ personal data can put people’s privacy at risk. Now firms could be exploiting this vast trove of personal information to charge people higher prices,” FTC Chair Lina M. Khan said in a statement. “Americans deserve to know whether businesses are using detailed consumer data to deploy surveillance pricing, and the FTC’s inquiry will shed light on this shadowy ecosystem of pricing middlemen.”

The FTC is looking into four major areas of the practice: types of products being offered, data collection, customer and sales information, and impacts on consumers and prices.

Many Americans, it fears, don’t know when their data is being harvested and how it is affecting what they pay. “Consumers may now be subjected to surveillance pricing when they shop for anything, big or small, online or in person: a house, a car, even their weekly groceries,” the FTC said.

The FTC sent the orders for more information to Accenture, Bloomreach, Chase, Mastercard, McKinsey & Co., Pros, Revionics, and Task.

“Advancements in machine learning make it cheaper for these systems to collect and process large volumes of personal data, which can open the door for price changes based on information like your precise location, your shopping habits, or your web browsing history,” the FTC wrote.

FTC: https://www.ftc.gov/news-events/features/surveillance-pricing

EDUCATION: Books

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CPI: February 2025

BREAKING NEWS

By Staff Reporters

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The Consumer Price Index (CPI) for February found that the cost of goods and services rose 0.2% on the month. The annual rate of inflation was also up 2.8% — slightly less than expected.

Here’s a breakdown of several price changes for February:

  • Food: increase 0.2%
  • Energy: increase 0.2%
  • Electricity: increase 1.0%
  • New vehicles: decrease 0.1%
  • Used vehicles: increase 0.9%
  • Apparel: increase 0.6%
  • Shelter: increase 0.3%
  • Transportation: decrease 0.8%
  • Medical care services: increase 0.3%

The Bureau of Labor Statistics reported that according to its indexes, over the month the cost of medical care rose 0.3%, physicians’ services were 0.4% higher, hospital services added 0.1%, and prescription-drug costs were unchanged. 

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