DAILY UPDATE: Pharmacy Schools and PBMs as Stocks Recover

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One year after forming an alliance with pharmacy schools, Walgreens says it has taken steps to get more people interested in the profession and improve working conditions at the chain.

Walgreens announced the Deans Advisory Council last February, framing it as a collaboration with pharmacy schools to boost the number of students enrolling and address some of the broader issues in the industry, like burnout and declining reimbursements from pharmacy benefit managers.

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US stocks recovered from losses on Wednesday to close higher on the day. Earnings from Alphabet (GOOG, GOOGL) and AMD (AMD) fell short, but Big Tech got a boost from a jump in Nvidia (NVDA) shares.

The tech-heavy NASDAQ Composite (^IXIC) rose 0.2%, while the benchmark S&P 500 (^GSPC) added 0.4%. The Dow Jones Industrial Average (^DJI) led the gains, rising 0.7%, or more than 300 points.

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ND: Naturopathic Doctor [Degree]

DEFINITION

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Naturopathic Doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent, and treat acute and chronic illness to restore and establish optimal health by supporting the person’s inherent self-healing process.

Rather than just suppressing symptoms, naturopathic doctors work to  identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.

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DAILY UPDATE: Bill Gates on Crypto as Stock Markets Rise

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‘There are people with high I.Q.s who have fooled themselves on that one,’ Bill Gates the billionaire Microsoft co-founder told The New York Times. Gates’ comments come as Bitcoin has hit record highs in recent weeks, and the cryptocurrency industry as a whole has hailed the arrival of Donald Trump in the White House as a positive moment. 

The President has said he will introduce policies supportive of digital currencies, and both him and his wife Melania launched their own meme coins last month. Cryptocurrency prices took a hit on Monday from the prospect of a trade war between the US and its trading partners, with some well-known digital assets seeing values fall more than 10 percent, AP News reported. However the notoriously volatile investment recovered later on Monday, with Bitcoin rebounding back above $100,000. Gates, who has a net worth of around $165 billion, has previously shared his skepticism around Bitcoin, and its volatility in particular. 

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US stocks closed higher on Tuesday, led by Big Tech, as investors assessed China’s instant retaliation to US President Donald Trump’s additional tariffs and the potential risks of a trade war.

Traders also took in fresh jobs data, with job openings declining more than expected in December. Investors are continuing to watch any signs of cooling in the labor market as the Federal Reserve debates future interest rate cuts in the face of sticky inflation.

The Dow Jones Industrial Average (^DJI) gained around 0.3%, while the benchmark S&P 500 (^GSPC) rose roughly 0.7%. The tech-heavy NASDAQ Composite (^IXIC) jumped nearly 1.4% to recoup some of Monday’s losses.

Beijing reacted swiftly on Tuesday to Trump’s additional 10% levies on Chinese imports going into effect at midnight. China slapped tariffs of 15% on US coal and liquified natural gas, starting Feb. 10, alongside 10% duties on imports of crude oil, farm equipment, and some autos.

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FLEXNER REPORT: Medical Education

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According to Wikipedia, the Flexner Report was a book-length landmark report of medical education in the United States and Canada, written by Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Flexner not only described the state of medical education in North America, but he also gave detailed descriptions of the medical schools that were operating at the time. He provided both criticisms and recommendations for improvements of medical education in the United States.

Many aspects of the present-day American medical profession stem from the Flexner Report and its aftermath. While it had many positive impacts on American medical education, the Flexner report has been criticized for introducing policies that encouraged systemic racism and sexism.

The Report, also called Carnegie Foundation Bulletin Number Four, called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science principles in their teaching and research. The report talked about the need for revamping and centralizing medical institutions. Many American medical schools fell short of the standard advocated in the Flexner Report and, subsequent to its publication, nearly half of such schools merged or were closed outright.

Colleges for the education of the various forms of alternative medicine, such as electro-therapy were closed. Homeopathy, traditional osteopathy, eclectic medicine, and physiomedicalism (botanical therapies that had not been tested scientifically) were derided.

The Report also concluded that there were too many medical schools in the United States, and that too many doctors were being trained. A repercussion of the Flexner Report, resulting from the closure or consolidation of university training, was the closure of all but two black medical schools and the reversion of American universities to male-only admittance programs to accommodate a smaller admission pool.

In Chapter 11, Flexner stressed that the success of medical education reform and the professionalization of medicine relied heavily on the effective legal and ethical functioning of state medical boards. However, he noted that these boards were failing in their mission, stalling progress and allowing substandard medical practices to continue, thereby jeopardizing public health. This problem persists as a significant issue in the current practice of medicine in the United States.

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DAILY UPDATE: CFPB and Healthcare M&As as Stock Markets Fall Hard but Regain Somewhat

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Just moments after he was appointed by President Donald Trump to be the new acting director of the Consumer Financial Protections Bureau, Treasury Secretary Scott Bessent moved to halt the agency’s work investigating financial abuses and regulating deceptive banking practices impacting American consumers, according to a memo sent to employees and obtained by Scripps News.

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This year is expected to be busy with healthcare mergers and acquisitions (M&A). Consulting company PwC reported that annual healthcare deals shot up 70% through November 15th compared to pre-Covid trends, and projected the trend will continue into 2025.

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US stocks fell on Monday in reaction to the Trump administration’s scheduled tariff rollout against Canada and China, though the major averages pared heavier losses after President Donald Trump said the US would delay duties on Mexican imports by a month.

The tech-heavy NASDAQ Composite (^IXIC) closed down 1.2%, recouping a chunk of its earlier losses. Meanwhile, the S&P 500 (^GSPC) fell roughly 0.7%, and the Dow Jones Industrial Average (^DJI) fell 0.3%.

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INVITE: Dr. David Marcinko to Your Seminar or Speaking Engagements

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Book Dr. David E. Marcinko MBA MEd CMP for your Next Medical, Pharma or Financial Services Seminar or Personal and Corporate Coaching Sessions 

Dr. Marcinko enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. These have included lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.

His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.

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DAILY UPDATE: UnitedHealthcare Settlement, CFPB and Pharmaceutical Company Checks

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UnitedHealthcare has agreed to a $2.5 million settlement in response to a class action lawsuit accusing the company of making unauthorized telemarketing calls. More than 12,000 individuals may be entitled to compensation, with payouts ranging from $350 to $1,000 per person, depending on how many claims are filed.

The lawsuit, filed under the Telephone Consumer Protection Act (TCPA), alleges that UnitedHealthcare placed calls to individuals without their consent between January 9, 2015, and January 9th, 2019. If you received these calls, you could be eligible for a cash settlement—but you must act before April 15th, 2025.

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PALM BEACH, Fla. (AP) — President Donald Trump has fired the director of the Consumer Financial Protection Bureau, Rohit Chopra, in the latest purge of a Biden administration holdover. Chopra was one of the more important regulators from the previous Democratic administration who was still on the job since Trump took office on Jan. 20th.

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A 2020 STAT analysis found more than two-thirds of Congress receiving a check from pharmaceutical companies that year. More recent data from Open Secrets likewise confirms that a large majority of leaders serving in the U.S. Congress and Senate receive significant contributions from pharmaceutical or health products companies, averaging $45,000 and $47,000 for Republicans and Democrats in the House of Representatives, respectively — and $50,000 and $69,000 for Republicans and Democrats in the Senate.

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DAILY UPDATE: Healthcare Bankruptcies as Stock Markets Slide

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Stat: 57. That’s how many healthcare bankruptcies there were in 2024, down from 79 in 2023. (Healthcare Dive)

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US stocks lost ground on Friday after the White House said tariffs against Mexico, Canada, and China will take effect on Saturday, reigniting fears of a coming trade war with the nation’s closest trading partners. White House Press Secretary Karoline Leavitt said the president would impose 25% tariffs on goods from Mexico and Canada, as well as a 10% tariff on goods from China.

All three major gauges fell into the red Friday. The S&P 500 (^GSPC) lost 0.5% at the closing bell, while the Dow Jones Industrial Average (^DJI) shed 0.8%. The tech-heavy NASDAQ Composite (^IXIC) gave up 0.3%, reversing earlier gains.

The dramatic tariff news pushed aside more optimistic updates from earlier in the day, which had buoyed stocks. Solid earnings from Apple (AAPL) and an inflation reading that matched expectations lifted market sentiment for much of the day.

Finally, the S&P and the Nasdaq posted losses for the week of 1% and 1.6%, respectively. The Dow, meanwhile, recorded a weekly gain of 0.3%.

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DAILY UPDATE: Stocks Regain Steam

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US stocks gained steam on Thursday afternoon as investors digested megacap tech earnings and waited for Apple (AAPL) results for more clues on prospects for Big Tech. The S&P 500 (^GSPC) gained 0.5%, while the Dow Jones Industrial Average (^DJI) rose nearly 0.4%. The tech-heavy NASDAQ Composite (^IXIC) was up nearly 0.3%.

And, after the Federal Reserve stood pat on interest rates as expected, investors have turned to parsing earnings reports — and in particular, the first wave of results from the “Magnificent Seven” companies that have driven broader stock market gains.

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Right ahead of the closing bell, President Donald Trump once again teased looming 25% tariffs on Mexico and Canada. The US dollar (DX=F) index spiked on the news, reversing earlier losses to close near flat.

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DAILY UPDATE: Healthcare Cyber Attacks as the FOMC Pauses Rates and Stock Markets Retreat

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HAPPY LUNAR NEW YEAR

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Over half the US population was affected by the Change Healthcare cyberattack last February, according to a statement from its parent company UnitedHealth Group. While United had told the federal government in October that 100 million people were hit by the attacks, an updated estimate on Monday put that number at 190 million.

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Tech stocks led markets lower on Wednesday as the broader mood stayed muted after the Federal Reserve’s latest interest rate decision saw the central bank keep rates unchanged in a range of 4.25%-4.5%.

The tech-heavy NASDAQ Composite (^IXIC) was down about 0.5%, retracing some of a bounce-back rally on Tuesday. The S&P 500 (^GSPC) was also down nearly 0.5%, while the Dow Jones Industrial Average (^DJI) lost 0.3%. In its statement on Wednesday, the Federal Reserve notably removed language from its December statement indicating that it was making progress towards its goal of 2% inflation, stating simply: “Inflation remains somewhat elevated.” Fed Chair Jerome Powell pushed back on that notion, referring to the change as “language cleanup” rather than intending to send a signal. Markets bounced off their lows of the day on Powell’s comments.

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DAILY UPDATE: Stocks Rebound from Sell-Off

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Stocks closed in the green on Tuesday as the NASDAQ and S&P 500 rebounded from their Monday’s steep sell-off, spurred by Chinese startup DeepSeek and its potentially cheaper AI model.

Bellwether Nvidia (NVDA) finished the day up nearly 9% after it shaved off a record $589 billion from its market cap on Monday.

Aided by Nvidia’s gains, the tech-heavy NASDAQ Composite (^IXIC) surged over 2%, coming off a closing loss of more than 3%. The S&P 500 (^GSPC) rose around 0.9%, while the Dow Jones Industrial Average (^DJI) gained roughly 0.3%.

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ROBERT LUCAS PARADOX: Law of Diminishing Returns

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Capital is not flowing from developed countries to developing countries despite the fact that developing countries have lower levels of capital per worker, and therefore higher returns to capital.

Classical economic theory predicts that capital should flow from rich countries to poor countries, due to the effect of diminishing returns of capital. Poor countries have lower levels of capital per worker – which explains, in part, why they are poor. In poor countries, the scarcity of capital relative to labor should mean that the returns related to the infusion of capital are higher than in developed countries.

In response, savers in rich countries should look at poor countries as profitable places in which to invest. In reality, things do not seem to work that way. Surprisingly little capital flows from rich countries to poor countries.

This puzzle, famously discussed in a paper by Robert Lucas in 1990, is often referred to as the “Lucas Paradox”.

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DAILY UPDATE: Federal Health Agencies and PBMs as Technology Stock Plunge!

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Federal health agencies are canceled—well, their meetings are at least. In the days following his inauguration, President Donald Trump’s administration asked officials within the Department of Health and Human Services (HHS)—which has a $1.7 trillion budget and includes the FDA, the CDC, and the National Institutes of Health (NIH)—to stop all external communication, according to an internal memo. This means no new health advisories, social media posts, or website posts.

“As the new administration considers its plan for managing the federal policy and public communications processes, it is important that the president’s appointees and designees have the opportunity to review and approve any regulations, guidance documents, and other public documents and communications (including social media),” the memo read. The pause began on Jan. 21st, and according to the memo, will remain in effect until Feb. 1st

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The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

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The NASDAQ tanked on Monday as a Chinese startup rattled faith in US leadership and profitability in AI, taking a hammer to Nvidia (NVDA), wiping out a record $589 billion in market value. The NASDAQ Composite (^IXIC) sank more than 3%, while the S&P 500 (^GSPC) dropped nearly 1.5%. The blue-chip Dow Jones Industrial Average (^DJI), which is less dependent tech stocks gained more than 0.6% as investors flocked to defensive sectors. Shares of Apple (AAPL) and software giant Salesforce (CRM) also bucked the tech rout.

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RN versus LPN Licenses

DEFINITIONS

By Staff Reporters

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Registered Nurse [RN]

RNs must complete an accredited Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program (or, in rare cases, diploma programs). After that, they become eligible to sit the NCLEX-RN exam and apply for registered nurse licensure in their state.

As a registered nurse, duties include basic patient care but expand to more technical responsibilities like medication administration, performing diagnostic tests, and operating medical equipment. Depending on the role, one may also supervise other healthcare workers like LPNs, certified nursing assistants (CNAs), or even other RNs.

Licensed Practical Nurses [LPN]

LPNs may also be called licensed vocational nurses (LVNs), and like registered nurses, LPNs must also complete an education program before becoming eligible for licensure. LPN programs typically take around one year, and you can find them at community colleges or vocational schools. 

Prospective LPNs must then take and pass the NCLEX-PN exam to become licensed. As an LPN, focus is on patient care tasks like monitoring vitals and changing bandages as part of a care team supervised by a physician or RN.

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DAILY UPDATE: Medicare and PBMs as Markets Slither

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The S&P 500 (^GSPC) just capped its best first four trading days under a new president since Ronald Reagan’s first week in 1985. And, the week ahead will bring investors a deluge of news that will put that rally to the test.

Earnings from more than 100 members of the S&P 500 — highlighted by results from tech heavyweights Meta (META), Microsoft (MSFT), Apple (AAPL), and Tesla (TSLA) — are set for release, with Wednesday serving as the week’s busiest. Starbucks (SBUX), Exxon (XOM), and Chevron (CVX) are also set to report.

On this coming ednesday afternoon, the Federal Reserve will also announce its latest monetary policy decision, with the central bank expected to keep interest rates unchanged and investors focused on what Fed Chairman Jay Powell has to say about the balance of 2025.

Last week, the S&P 500, NASDAQ Composite (^IXIC), and Dow Jones Industrial Average (^DJI) each rallied during a holiday-shortened four day trading week. Over the last five days, the S&P 500 and Dow have gained more than 2.8%; the tech index is leading gains over that period, rising more than 3.1%.

Markets welcomed Trump’s initial days in office as limited news on tariffs steadied investors and a massive AI investment announcement helped boost tech stocks.

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

The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

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

Medicare and the Trump 2.0 Administration

People have been concerned about the future of Medicare for years. Now that Donald Trump has begun his second term in office, the question becomes: What will happen next?

According to the JAMA Network and ABC News, here are some predictions for what may come:

  • There will be greater price transparency: During his first term, Trump worked to make prices more transparent to both individuals and health care organizations. This may very well continue.
  • More emphasis on Medicare Advantage plans: Under Project 2025, it’s possible that Medicare Advantage plans will become the “default option for Medicare coverage.” This could lead to a privatization of the program.

Medicare’s future remains to be seen. For now, the best thing current and future retirees can do is keep an eye on their coverage options and costs.

CITE: https://tinyurl.com/tj8smmes

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

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EGO: Protection & Defense

By Staff Reporters

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Ego-Protection refers to psychological strategies individuals use to defend their self-esteem and sense of self-worth against threats or failures. This can include attributing failures to external factors, minimizing the importance of negative feedback, or comparing oneself to others in ways that maintain a positive self-image.

According to colleague Dan Ariely PhD, ego-protective mechanisms help people cope with setbacks and maintain mental well-being, although they can sometimes prevent individuals from learning from mistakes or accepting constructive criticism.

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PERSONAL PHYSICIAN COACHING: Thrive Again!

By Ann Miller RN MHA CMP

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http://www.DAVIDEDWARDMARCINKO.com

Dr. David Edward Marcinko works with doctors, nurses, technicians and healthcare professionals who struggle with professional disillusionment, burnout, financial distress and an unbalanced life–all of which can happen at any stage of a medical career. Through our coaching sessions, medical and healthcare professionals can achieve a more meaningful, purposeful, and flourishing life.

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CONTACT: Ann Miller RN MHA CMP

MarcinkoAdvisors@outlook.com

MORE: https://medicalexecutivepost.com/coach/

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Investment Advisor [IA] VERSUS Financial Advisor [FA]

DEFINITIONS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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While IAs and FAs may seem the same, they are not the same. The Financial Industry Regulatory Authority (FINRA) and the Securities Exchange Commission (SEC) have clearly defined investment advisors as distinct from financial advisors.

The term financial advisor is a generic one that can encompass many different financial professionals, although it most commonly refers to stock brokers (individuals or companies that buy and sell securities).

Investment advisor, on the other hand, is a legal term and thus has a more clear-cut definition – or at least as clear as legalese is apt to be.

KEY DIFFERENCES:

  • Financial advisors help with all aspects of your finances, including saving, budgeting, insurance, retirement planning, and taxes.
  • Investment advisors focus specifically on choosing and managing investment portfolios.
  • Financial advisors offer broader financial guidance, while investment advisors concentrate solely on investments.
  • Investment advisors are held to the fiduciary standard, while financial advisors who work as brokers may operate under different rules.

MORE: https://www.financestrategists.com/financial-advisor/advisor-types/investment-advisor/

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PRE-PROCUREMENT: Pre-Purchase Ownership

By Staff Reporters

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According to colleague Dan Ariely PhD, Pre-Procurement Ownership is when you start to feel ownership over something before you actually have it. It’s like mentally moving into a house or car before you’ve signed the papers and moved in or driven away

This psychological quirk makes us more likely to commit to purchases because we’ve already imagined them as ours. Marketers exploit this by encouraging us to “try before you buy.

So, next time you’re trying on a new men’s suit or woman’s skirt, be aware: your brain might already be claiming ownership.

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MLK Jr. & INAUGURATION DAY: Markets Closed Monday

By Staff Reporters

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U.S. Markets will be closed for Martin Luther King Jr. Day this Monday

The U.S. Markets will be closed on Monday, January 20th, 2025. Please be aware that, when making transactions after 4 p.m. EST on Friday, January 17th, 2025, you will receive the closing price as of Tuesday, January 21st 2025.

Martin Luther King Jr. Day is observed in the United States on the third Monday of January. This year coincides with the inauguration of President-elect Donald Trump.

Banks and government offices

Martin Luther King Jr. Day is a federal holiday, which means banks will be closed and government services as well, such as city offices, animal services, administrative offices of the police department, and administrative offices of fire department.

The U.S. Postal Service will not operate on Monday, along with other shipping services.

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BLACKED OUT: Tik-Tok Down

BREAKING NEWS!

By Staff Reporters

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Sorry, TikTok isn’t available right now

A law banning TikTok has been enacted in the U.S. Unfortunately, that means you can’t use TikTok for now.

We are fortunate that President Trump has indicated that he will work with us on a solution to reinstate TikTok once he takes office. Please stay tuned!

In the meantime, you can still log in to download your data.

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DAILY UPDATE: TikToc, Walgreens & Hindenburg Research All Down as Markets Blast Off

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WASHINGTON — The US Supreme Court on Friday delivered a blow to TikTok by upholding a law that could potentially lead to the video-sharing social media platform being banned in the United States. The justices in an unsigned opinion with no dissents rejected a free speech challenge filed by the company, meaning the law is set to go into effect on Sunday as planned. The bipartisan law requires China-based TikTok owner ByteDance to divest itself of the company by Sunday, the day before President-elect Donald Trump is to take office. If no sale takes place, the platform used by millions of Americans will in theory be banned.

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

Legendary short seller Nate Anderson announced this week that he is shutting down his firm, Hindenburg Research, due to extreme job stress. With only 11 employees, Anderson took gargantuan swings at companies—and their billionaire leaders. Hindenburg published deeply researched reports about companies it believed were overvalued and rife with corruption. It got its big break when it shorted electric truck-maker Nikola in 2020, calling the company an “intricate fraud.” Regulators took note, and it led to three fraud convictions for Nikola founder Trevor Milton.

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

US stocks jumped on Friday amid a tech stock revival as investors assessed a week of key data and earnings reports alongside potential policy shifts under a Trump administration.

The Dow Jones Industrial Average (^DJI) gained 0.8% while the S&P 500 (^GSPC) rose 1%, coming off a losing day for the major gauges. The tech-heavy NASDAQ Composite (^IXIC) put on 1.5% as Nvidia (NVDA) and Tesla (TSLA) shares nudged back into the green.

CITE: https://tinyurl.com/tj8smmes

The US Department of Justice (DOJ) filed a lawsuit against Walgreens (WBA), one of the nation’s largest pharmacy chains, alleging widespread prescription drug practice violations. According to the DOJ, Walgreens improperly dispensed millions of prescriptions from August 2012 to the present day that either lacked “legitimate medical purpose” or were otherwise invalid.

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PREMATURE CLOSURE: Cognitive Bias

By Staff Reporters

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Premature Closure is the tendency to make quick, decisive judgments without considering all the evidence. It’s like jumping to conclusions on a trampoline – fast and often wrong. Our brains crave certainty and dislike ambiguity, leading us to close the case prematurely. This can save time but often results in mistakes and oversights. To avoid premature closure, take a step back, gather more information, and keep an open mind about this cognitive bias.

And so, colleague Dan Ariely PhD suggests that we remember: haste makes waste, especially in decision-making.

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DAILY UPDATE: PBM Mark-Ups as Stocks Waiver

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The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

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

The S&P 500 fell 0.2%. The NASDAQ 100 lost 0.7%. The Dow Jones Industrial Average slid 0.2%. A gauge of the “Magnificent Seven” megacaps slipped 1.9%. The Russell 2000 added 0.2%. The KBW Bank Index declined 0.2%.

The yield on 10-year Treasuries declined four basis points to 4.61%. The Bloomberg Dollar Spot Index rose 0.1%.

CITE: https://tinyurl.com/tj8smmes

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

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COGNITIVE Dissonance

By Staff Reporters

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Cognitive Dissonance is the discomfort experienced when holding conflicting cognitions, like believing in healthy eating while munching on a donut. It’s a mental tug-of-war that makes us squirm.

To reduce this discomfort, we often change our beliefs or behaviors to align them. This is why smokers might downplay the health risks of smoking. Understanding cognitive dissonance helps us recognize these mental gymnastics and strive for consistency in our beliefs and actions.

So, according to colleague Dan Ariely PhD, the next time you feel that mental itch, it’s cognitive dissonance asking for some resolution.

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DAILY UPDATE: Capital One, CPI and Medicare as Wall Street Blasts Off

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The U.S. Department of Labor reported a 0.4% increase in the monthly CPI after seasonal adjustment, overshooting the forecast of 0.3% and the previous value of 0.3%. On an annual basis, inflation climbed to 2.9%, up from 2.7% in November, the highest rate since July 2024.

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

US stocks ripped higher on Wednesday as high hopes for bank earnings paid off and a crucial consumer inflation update showed key prices increased less than expected in December.

The benchmark S&P 500 (^GSPC) popped more than 1.8%, while the Dow Jones Industrial Average (^DJI) rose more than 1.6%, or over 700 points. Meanwhile, the tech-heavy NASDAQ Composite (^IXIC) soared 2.5%.

Stocks took a leg higher after the Consumer Price Index (CPI) showed progress toward the Fed’s 2% inflation target in December. Prices climbed 0.2% month-on-month on a “core” basis, which strips out the more volatile costs of food and gas, an easing from November’s 0.3% gain. Over last year, core CPI rose 3.2%.

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

Capital One is being sued by the US government’s consumer watchdog agency for “cheating millions of consumers” and not paying more than $2 billion in interest to holders of its high-interest savings accounts.

CITE: https://tinyurl.com/tj8smmes

As of January 1st 2025, beneficiaries enrolled in Part D prescription drug plans will have their out-of-pocket spending capped at $2,000 for the year. This new policy was part of President Joe Biden’s 2022 Inflation Reduction Act (IRA), which included other drug pricing measures such as capping the cost of insulin at $35 per month for seniors.

But only a small share of Medicare enrollees will benefit from the cap, according to an analysis from nonprofit organization AARP’s Public Policy Institute, as most don’t spend more than $2,000 annually on their medications after hitting their deductible (which is up to $590 for standard plans in 2025). Beneficiaries spent an average of $400 to $500 per year as of 2022, the Hill reported, citing data from the US Department of Health and Human Services (HHS).

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MUTISM Selective

By Staff Reporters

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Selective Mutism: Some people experience selective mutism, a condition where intense trauma or anxiety leaves them temporarily unable to speak. It’s a defense mechanism that shields them from emotional overwhelm. It is characterized by:

  • A person’s inability to speak in certain social settings, even though they are otherwise capable of speech.
  • Triggers for selective mutism can include specific situations, places, or people.
  • People with SM can speak comfortably and communicate well in other settings, such as at home with family.

For many, according to colleague Dan Ariely PhD, this silence is involuntary, reflecting how deeply emotions affect speech.

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BIAS: In-Group Favoritism

By Staff Reporters

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In-group bias refers to the unfair favoring of someone from one’s own group. You might think that you’re unbiased, impartial, and fair, but we all succumb to this bias, having evolved to be this way.

That is, according to colleague Dan Ariely PhD, from an evolutionary perspective, this bias can be considered an advantage—favoring and protecting those similar to you, particularly with respect to kinship and the promotion of one’s own line.

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HOSPITAL Revenue Metrics Review

By Staff Reporters

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The emphasis on hospital revenue metrics at hospitals may be a sign of misplaced prioritization away from patients and their well-being. For example:

  • Orthopedic Surgeons Generated the $2.75 Million in Hospital Revenue Per Orthopedist Per Year.
  • Interventional Cardiologists Generated $2.45 Million in Hospital Revenue Per Cardiologist Per Year.
  • General Surgeons Generated $2.17 Million in Hospital Revenue Per Surgeon Per Year.
  • Family Practice Doctors Generated $1.5 Million in Hospital Revenue Per Doctor Per Year.

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SUPERSTITIONS: In Medicine?

By Dr. David Edward Marcinko MBA MEd

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  • Saying a patient’s name in the emergency room will almost ensure that person comes in that day.
  • A code cart next to an unstable patient is said to ward off evil spirits.
  • Traditional healers usually use superstition in their practices to manage human health problems and diseases.
  • Such practices create a conflict with the medical profession and its evidence-based practices.

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So, what exactly is a Superstition? Does superstition change a measurable patient outcome, such as decreased anastomotic leak rate, surgical site infection, or mortality? Hard to say. But does it improve the surgeon’s confidence, thereby improving their performance? Likely so.

Science is not the opposite of superstition; it is the result of superstition, the result of humans trying to make sense of the world and prove each other wrong. We keep doing the things we do to maintain some semblance of control. In further defense of superstition, ritualistic behaviors ensure that the necessary boxes are checked and that we pay attention to the details. In surgery, details matter.

“Superstition is the irrational belief that an object or behavior has the power to influence an outcome, when there’s no logical connection between them. Most of us aren’t superstitious – but most of us are a ‘littlestitious.’”
– Gretchen Rubin

So, until there is evidence to the contrary, I will keep tearing off the little patient labels and keeping their names with me in hopes that they do well after surgery.

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ADAPTATION Release

By Staff Reporters

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Activation due to release from adaptation = Extra activation caused by stimulus change = (Response to the two different stimuli paired together) – (Response to same stimuli presented without the change) E.g. (1/4 + 4/1) – (1/1 + 4/4) To look for adaptation paralleling same/diff perception. Make a contrast weighting each adaptation release value by the subject’s behavioural responses on that part of the same/different curve. Rajeev Raizada – UW MRI talk, Oct

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Release from Adaptation is the joy you feel when something changes after becoming accustomed to it. It’s like the relief of a cool breeze after a hot day. Our brains get used to stimuli, making them less noticeable over time. When there’s a change, it’s like hitting the refresh button on our senses.

This is why, according to colleague Dan Ariely PhD, novelty feels so exciting and routine can become dull. So, inject some variety into your life to keep things fresh and enjoy the small releases from adaptation.

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CREDIT: Much About Agreements!

By Staff Reporters

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Credit report with score on a desk

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Credit analysis is a form of financial analysis used primarily to determine the financial strength of the issuer of a security, and the ability of that issuer to provide timely payment of interest and principal to investors in the issuer’s debt securities. Credit analysis is typically an important component of security analysis and selection in credit-sensitive bond sectors such as the corporate bond market and the municipal bond market.

Credit default swap index (CDX) is a credit derivative, based on a basket of CDS, which can be used to hedge credit risk or speculate on changes in credit quality.

Credit default swaps (CDS) are credit derivative contracts between two counterparties that can be used to hedge credit risk or speculate on changes in the credit quality of a corporation or government entity.

Credit quality reflects the financial strength of the issuer of a security, and the ability of that issuer to provide timely payment of interest and principal to investors in the issuer’s securities. Common measurements of credit quality include the credit ratings provided by credit rating agencies such as Standard & Poor’s and Moody’s. Credit quality and credit quality perceptions are a key component of the daily market pricing of fixed-income securities, along with maturity, inflation expectations and interest rate levels.

Credit Rating Agency (CRA) is a company that assigns credit ratings for issuers of certain types of debt obligations as well as the debt instruments themselves. In the United States, the Securities and Exchange Commission (SEC) permits investment banks and broker-dealers to use credit ratings from “Nationally Recognized Statistical Rating Organizations” (NRSRO) for similar purposes. As of January 2012, nine organizations were designated as NRSROs, including the “Big Three” which are Standard and Poor’s, Moody’s Investor Services and Fitch Ratings.

Credit rating downgrade, by a credit rating agency (Standard & Poor’s, Moody’s or Fitch) means reducing its credit rating for a debt issuer and/or security. This is based on the agency’s evaluation, indicating, to the agency, a decline in the issuer’s financial stability, increasing the possibility of default. A downgrade should not to be confused with a default; a debt security can be downgraded without defaulting. And, conversely, a debt issuer can suddenly default without being downgraded first–credit ratings and credit rating agencies are not infallible.

Credit ratings are measurements of credit quality provided by credit rating agencies. Those provided by Standard & Poor’s typically are the most widely quoted and distributed, and range from AAA (highest quality; perceived as least likely to default) down to D (in default). Securities and issuers rated AAA to BBB are considered/perceived to be “investment-grade”; those below BBB are considered/perceived to be non-investment-grade or more speculative.

Credit risk is the inability or perceived inability of the issuers of debt securities to make interest and principal payments will cause the value of those securities to decrease. Changes in the credit ratings of debt securities could have a similar effect.

Credit Risk Transfer Securities (CRTS) are unsecured obligations of the GSEs (Government Sponsored Enterprises). Although cash flows are linked to prepays and defaults of the reference mortgage loans, the securities are unsecured loans, backed by general credit rather than by specified assets.

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COMPETITION Paradox

By Staff Reporters

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Definition of the Paradox of Competition

The Paradox of Competition refers to the complex and often counterintuitive effects competitive behaviors can have within markets and industries. Generally, competition is seen as a positive force that drives innovation, lowers prices, and improves quality and choice for consumers. However, the paradox lies in the fact that intense competition can sometimes lead to negative outcomes, such as diminished profitability for companies, reduced incentives to innovate, and the potential for a race to the bottom in terms of quality and sustainability.

According to colleague Dan Ariely PhD, understanding the nuances of the Paradox of Competition reveals the complexity of market dynamics and the importance of strategic, informed approaches to competition, both from businesses and regulators.

This paradox challenges the conventional wisdom that competition is universally beneficial, highlighting the need for a more nuanced view of how competitive forces shape markets and societies.

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SMISHING: Beware Scams!

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Smishing is a form of phishing that uses Short Message Service (SMS), commonly known as text messages, instead of email. Typically, the scammer poses as a legitimate institution, such as a bank, a service provider or a reputed company. The text message they send creates a sense of urgency or threatens consequences if the victim doesn’t respond immediately. It downloads malware on the phone or includes a link to a fraudulent website designed to look like the legitimate organization’s site. When victims reach that site they are tricked into entering their personal information.

Seven Types of Smishing Scams

1. Impersonation Scams: The attacker pretends to be a known organization or individual. The attack could be via a message pretending to be from a bank, government agency or a reputable company.
2. Tech Support Scams: Attackers pose as representatives from tech companies, claiming that the victim’s device or account has been compromised and that they need sensitive data to fix the problem.
3. Account Suspension Scams: These messages claim that an account (bank account, social media or any other service) has been suspended and prompt the victim to verify their identity by providing sensitive information.
4. Missed Delivery Scams: Attackers send messages claiming that the victim has missed a package delivery, and they need to provide personal details or a fee to reschedule the delivery.
5. Prize or Lottery Scams: Messages claiming that the victim has won a prize or a lottery, and they need to provide personal details or make a payment to claim the winnings.
6. Charity Scams: In these attacks, scammers impersonate a charitable organization, asking for donations, usually following a large-scale disaster or during holiday seasons.
7. Malware Link Scams: Messages containing a link, which when clicked, installs malware on the victim’s device, allowing the attacker to steal information or gain control over the device.

Attackers are constantly innovating and finding new ways to exploit human trust, so it’s crucial to be skeptical of any unsolicited or unexpected message that asks for sensitive information or prompts to click a link.

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WILLIAM JEVONS Efficiency Paradox

By Staff Reporters

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William S. Jevons Paradox suggests that increases in efficiency lead to even larger increases in demand; according to colleague Dan Ariely PhD.

The Jevons Paradox is when making something work better actually leads to using more of it, not less.

Imagine you have a really fast bike that makes you use less energy to speed up. Because it’s so good, you want to bike everywhere, even more than before. Now, even though your bike is better at saving energy, you end up using it so much that you may use even more energy overall

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DAILY UPDATE: Medicare Advantage Bonus Payments as Stocks Rise and Technology Pops

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Health plans made billions in Medicare Advantage bonus payments. A yearlong investigation reveals how. (the Wall Street Journal)

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The 10-year Treasury note yield ($TNX) is higher by ~3 basis points to 4.63%.

The U.S. Dollar Index ($DXY) is lower by 0.69 to 108.26.

WTI Crude Oil (/CL) is trading higher by 0.68% to $74.46 per barrel.

Gold prices have traded in a range of $2,624.60 to $2,663.80 and were last seen trading lower by 0.39% to $2,644.40/oz.

Natural Gas prices have traded in a range of $3.502-3.726 and were last seen trading higher by 7.30% to $3.599/MMBtu.

Bitcoin (/BTC) is trading higher by 3.83% to $102,114.50 today.

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US stocks largely rose on Monday as chip names popped and investors awaited the release of key monthly jobs data later this week.

The S&P 500 (^GSPC) was up about 0.5%, while the Dow Jones Industrial Average (^DJI) fell about 0.1% after being higher for most of the session. The tech-heavy NASDAQ Composite (^IXIC) led the gains, adding about 1.2%, after a tech-led rally on Friday.

Chip stocks rallied after a record revenue and a strong sales forecast from Nvidia (NVDA) server partner Foxconn (2317.TW, HNHPF), which boosted optimism for AI-fueled growth. Shares of Nvidia climbed more than 3%, as the stock closed at a record high. Meanwhile peer Micron Technology (MU) rose over 10%.

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CONFABULATION Bias

By Staff Reporters

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Confabulation Bias is the creation of false memories without the intent to deceive. Our brain fills in gaps, sometimes creating memories that feel real but are entirely fabricated.

According to colleague Dan Ariely PhD, this can happen especially when memory gaps are subconsciously filled to maintain coherence.

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CANADA: Prime Minister Justin Trudeau Resigns

BREAKING NEWS!

By Staff Reporters

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TORONTO—Canadian Prime Minister Justin Trudeau just announced that he will resign after almost a decade in power, bowing to members of his party who have been calling on him to step aside ahead of an election later this year.

“It has become clear to me that if I’m having to fight internal battles, I cannot be the best option in that election,” said Trudeau in an announcement from the country’s capital, Ottawa.

Cite: 45 minutes ago

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MORALITY Priming

By Staff Reporters

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Morality Priming refers to subtle reminders of ethical principles that can make us behave more responsibly. It’s like an internal nudge that brings our conscience to the surface.

And, according to colleague Dan Ariely PhD, by focusing on moral standards, people are often encouraged to act more honestly, even in small, everyday decisions.

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MAURICE ALLAIS: Behavioral Finance Paradox

By Reporters

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For Question 1, people preferred Prospect A to prospect A , which means: (0.11) u( 1,000,000) > (0.10) u( 5,000,000) For Question 2, people preferred Prospect B to prospect B, which means: (0.10) u( 5,000,000) > (0.11) u( 1,000,000) Allais Paradox. shows that, individuals’ decisions can be inconsistent with Expected Utility Theory.

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Allais Paradox is a change in a possible outcome that is shared by different alternatives affects people’s choices among those alternatives, in contradiction with expected utility theory.

The Allais paradox is a choice problem designed by Maurice Allais 1953 to show an inconsistency of actual observed choices with the predictions of expected utility theory theory.

According to colleague Dan Ariely PhD, the Allais paradox demonstrates that individuals rarely make rational decisions consistently when required to do so immediately. The independence axiom of expected utility theory, which requires that the preferences of an individual should not change when altering two lotteries by equal proportions, was proven to be violated by the paradox.

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OUTCOME: Bias

By Staff Reporters

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Outcome bias is judging a decision based on its result rather than the quality of the decision at the time it was made.

It’s like saying a bad poker play was smart because you won the hand. Or, a bad stock picker or financial advisor was good because the price went up!

According to psychologist and colleague Dan Ariely PhD, this bias ignores the process and focuses solely on the outcome. It’s why we celebrate lucky breaks and criticize thoughtful risks that didn’t pan out.

So, the next time you’re evaluating a decision, focus on the reasoning behind it, not just the end result.

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CULTURE: Donation Dependency

By Anonymous

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When you keep donating without thinking it through, people can start relying on those donations more than building their own sustainable solutions. It can feel nice to help, but constant aid might discourage local initiatives. You want people to grow and thrive on their own, not just depend on outside help.

This is known as donation dependency.

Sometimes, consistent aid can become a crutch instead of a stepping stone. Communities may stop exploring ways to solve their own problems if help is always coming in from elsewhere. Encouraging self-reliance is crucial in ensuring your help leads to long-term benefits.

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TRUMP INTERNATIONAL HOTEL: Vehicle Catches Fire and Explodes Outside Las Vegas Lobby

BREAKING NEWS

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LAS VEGAS (AP) — A vehicle caught fire and exploded Wednesday outside the lobby of President-elect Donald Trump’s hotel in Las Vegas, authorities said.

Las Vegas police said they are investigating the fire and explosion, but neither they nor the Clark County Fire Department immediately provided more details. A county spokeswoman said in a statement that the fire was in the hotel’s valet area and was reported at 8:40 a.m.

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NEW ORLEANS: 10 Dead with 35 Injured in Truck Incident – Suspect Dead [Motivation Unknown]

BREAKING NEWS WITH SPECIAL REPORT [3:15 a.m. EST]

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At least 10 people are dead and 35 injured after a man drove a pickup truck into a large crowd on New Orleans’ Bourbon and Canal streets early New Year’s Day, officials said. The suspect is dead. President Biden has been notified.

In an early Wednesday press conference, New Orleans Police Department (NOPD) chief Anne Kirkpatrick said a man drove a pickup truck down Bourbon Street with “clear intent.”

  • “He was hell bent on creating the carnage and the damage he did,” Kirkpatrick said, adding that two NOPD officers are among those injured.

The man drove down Bourbon Street “at a very fast pace,” indicating “very intentional behavior [and] trying to run over as many people as he possibly could,” Kirkpatrick said.

  • At least one improvised explosive device was found on the scene, said FBI New Orleans special agent-in-charge Alethea Duncan, and officials are “working on confirming if this was a viable device or not.”
  • The FBI is taking over the investigation, officials said.
  • More updates are expected from NOPD headquarters at 11 a.m. and 3 p.m. local time.

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DAILY UPDATE: Covid-19 Update as Stock Markets Fall Again and US Treasury Hacked

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

Stat: 4 in 10. That’s about how many US nursing home residents got an updated Covid-19 vaccine in the winter of 2023–24, according to the CDC, despite the recommendation that adults 65 and older get the new shot. (KFF)

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

Stocks fell on Monday, with the woes of the three major indexes continuing in the final week of the year as an otherwise strong 2024 comes to a close.

The benchmark S&P 500 (^GSPC) slipped more than 1% while the tech-heavy NASDAQ Composite (^IXIC) fell roughly 1.2%. The Dow Jones Industrial Average (^DJI) fell about 0.8%.

Stocks moved lower as the 10-year Treasury yield (^TNX) retreated from a seven-month high to hover near 4.55%. Stocks closed out last week with a Friday slide from Big Tech names like Tesla (TSLA) and Nvidia (NVDA), with the NASDAQ Composite falling 1.5% and the S&P 500 down over 1%.

The highly anticipated “Santa Claus” rally, which is statistically one of the most consistent seven-day positive stretches of the year for the S&P 500, has flopped thus far. Since 1950, the S&P 500 has risen 1.3% during the seven trading days beginning December 24th, well above the typical seven-day average of 0.3%, according to LPL Financial chief technical strategist Adam Turnquist. In the current period, the S&P 500 is down nearly 1%.

CITE: https://tinyurl.com/tj8smmes

Chinese state-sponsored hackers breached the U.S. Treasury Department’s computer security guardrails this month and stole documents in what Treasury called a “major incident,” according to a letter to lawmakers that was provided to Reuters on Monday.

The hackers compromised third-party cybersecurity service provider BeyondTrust and were able to access unclassified documents, the letter said.

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PARADOXICAL: Persuasion

By Staff Reporters

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QUESTION: Ever tried convincing someone by arguing against your own point?

If so, that’s paradoxical persuasion. It’s like reverse psychology’s sophisticated cousin. By presenting the opposite argument, you make people defend your original point. It’s a mental judo move, using their own momentum against them. Next time you want someone to agree with you, try saying, “You’re right, maybe we shouldn’t get pizza.”

So, according to Dan Ariely PhD, watch as they passionately argue why pizza is, in fact, the best choice for dinner.

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