EARNINGS SEASON: Consumer Spending

By Staff Reporters

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  • Markets: Stocks notched their fourth winning day in a row yesterday as investors digested the news that the Fed was split about future rate hikes at its last meeting while waiting for this morning’s report on how much consumer prices rose last month.
  • Ozempic continues eating into investors’ appetites for other industries. Its maker, Novo Nordisk, rose on the news that the diabetes drug may help treat kidney failure, but dialysis providers DaVita and Fresenius Medical Care plunged.

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Earnings season is back: PepsiCo, Delta, Dominos, and big banks headline the start of earnings season, one that will have investors looking at how slowing inflation has affected the ability of companies to pad their profit margins. Pepsi’s report will be closely watched as its snack division, Frito-Lay, could be tested by the increasing popularity of weight-loss drugs like Wegovy. Major banks like JPMorgan are expected to post strong results.

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

US consumer spending: Has remained surprisingly strong despite rising interest rates, and a senior spending spree could explain it. According to the Department of Labor, Americans aged 65 and older accounted for 22% of consumer spending last year, the highest percentage since records began in 1972. It also helps that 17.7% of the US population is 65 and older, the highest on record dating to 1920. Better health, longer lifespans, and changes in attitude toward saving for a rainy day after the pandemic have boomers feeling OK about their finances.

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PRIVATE COMPANIES: Raising Capital is Hard ~ No Very Tough!

By Staff Reporters

SPONSOR: http://www.MARCINKOAssociates.com

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The markets are down again and stocks continued their September slump with tech companies getting hit especially hard as investors fretted about another possible Fed rate hike because of data showing prices for manufacturing and services trending upward. It was a mixed bag for the meme stock faithful, with AMC hitting an all-time low after releasing a plan to sell new shares and GameStop rising after-hours thanks to better-than-expected sales last quarter.

MEME: https://medicalexecutivepost.com/2021/10/23/what-are-meme-stocks/

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This all may demonstrate that private companies looking to fund growth in this high-interest rate environment are facing a tough time raising capital amidst falling valuations, according to a new Deloitte survey.

The problem is particularly acute for smaller companies. Many of the companies challenged by capital raising saw themselves putting out the “For Sale” sign within the next six months, which could lead to an M&A boom later this year.

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

“The No. 1 largest factor that people saw as a challenge or a barrier was a decrease in valuations of their business,” Wolfe Tone, vice chair and US and Global Deloitte Private leader, told CFO Brew. “Clearly, increasing interest rates and pricing was closely behind that. Liquidity challenges not far behind that.”

Private companies have been looking to raise capital to fund a range of growth initiatives; meeting talent needs and expanding tech capabilities are at the top of the list, Tone said. Not far behind was “increasing productivity and improving cost structures.”

VC FUNDING: https://marcinkoassociates.com/fmv-appraisals/

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Citigroup, Moderna and A.I. Referee

By Staff Reporters

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Citigroup announced a major reorganization aimed at eliminating unnecessary management layers. It will involve layoffs, but the bank didn’t say how many.

Bank Types: https://marcinkoassociates.com/bank-types/

One day after the CDC recommended that everyone above six months old get the new Covid booster, Moderna stock shot up. But it was mostly because the company showed it’s got a future beyond the virus with encouraging flu-shot trial results.

Elon Musk called for a regulator to ensure that AI development proceeds safely following a closed-door meeting with US lawmakers that also included Alphabet CEO Sundar Pichai and Meta’s Mark Zuckerberg—which was probably an awkward run-in for Musk.

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NYSE: Game-On for IPOs

By Staff Reporters

SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

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DEFINITION: An initial public offering (IPO) or stock launch is a public offering in which shares of a company are sold to institutional investors and usually also to retail (individual) investors An IPO is typically underwritten by one or more investment banks who also arrange for the shares to be listed on one or more stock exchanges. Through this process, colloquially known as floating, or going public, a privately held company is transformed into a public company. Initial public offerings can be used to raise new equity capital for companies, to monetize the investments of private shareholders such as company founders or private equity investors, and to enable easy trading of existing holdings or future capital raising by becoming publicly traded.

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

After the IPO, shares are traded freely in the open market at what is known as the free float. Stock exchanges stipulate a minimum free float both in absolute terms (the total value as determined by the share price multiplied by the number of shares sold to the public) and as a proportion of the total share capital (i.e., the number of shares sold to the public divided by the total shares outstanding). Although IPO offers many benefits, there are also significant costs involved, chiefly those associated with the process such as banking and legal fees, and the ongoing requirement to disclose important and sometimes sensitive information.

Cite: Wikipedia

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Now, the NYSE is the world’s largest stock exchange, and for good reason. From thrilling new entries into the public market to a relentless commitment to transformative tech, the NYSE is constantly upping their game.

Related: https://medicalexecutivepost.com/2023/09/19/ipos-more-caution-ahead/

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SEC: New Cyber-Security Regulations

By Staff Reporters

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The SEC’s new cybersecurity regulations went into effect last week. Most companies are “largely ready” to comply, Matt Gorham, senior managing director and leader of PwC’s Cyber & Privacy Innovation Institute, told CFO Brew, “but that doesn’t mean there isn’t work to do.”

As their companies’ finance leaders, CFOs are instrumental in determining whether a cybersecurity incident is material, but they have other roles to play as well. Gorham shared his advice for how CFOs can help their organizations comply with the new regs. Now, aAs a reminder, the regulations consist of what Gorham refers to as three “buckets.” Companies that file with the SEC are required to:

  • Declare any material cybersecurity incidents to the SEC on Item 1.05 of Form 8-K within four business days of determining materiality
  • Disclose information about their cyber risk management and strategy on a new section of the 10-K called Item 1C
  • Disclose information about their boards’ and management’s role in overseeing cybersecurity risk

The first two “buckets,” Gorham said, will likely require the most work to comply with.

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Physician Assets, Liabilities and Personal Net Worth

How are Assets and Liabilities Related to Doctor Net Worth?

cropped-dem

Dr. David E. Marcinko MBA  

Before the relationship among financial assets, liabilities and net worth can be examined, some based definitions must be understood. 

LINK: http://www.CertifiedMedicalPlanner.org

[A] Short-Term Assets

Short-term goals (less than 12 months) require liquidity or short-term assets. These assets include cash, checking and saving accounts, certificates of deposit, and money market accounts. These accounts have two things in common. The principal is guaranteed from risk of loss, and pay a very low interest rate.  As an investment, they are considered substandard and one would only keep what is actually needed for liquidity purposes in these accounts.           

[B] Long-Term Assets

Longer-term assets (more than 12 months) include real estate, mutual funds, retirement plans, stocks, and life insurance cash value policies. Bonds may also be an appropriate long-term investment asset for a number of reasons, for example, if you are seeking a regular and reliable stream of income or if you have no immediate need for the amount of the principal invested. Bonds also can be used to diversify your portfolio and reducing the overall risk that is inherent in stock investments. 

[C] Short-Term Liabilities

Short-term liabilities (less than 12 months) include credit card debt, utility bills, and auto loans or leasing. When a young doctor leaves residency and starts practice, the foremost concern is student debt. This is an unsecured debt that is not backed by any collateral, except a promise to pay. There are recourses that an unsecured creditor can take to recoup the bad debt. Usually, if the unsecured creditor is successful obtaining a judgment, it can force wages to be garnished, and the Department of Education can withhold up to ten percent of a wages without first initiating a lawsuit, if in default.  It is also probable that young medical professionals have been holding at least one credit card since their sophomore year in college.  Credit card companies consider college student the most lucrative target market and medical students hold their first card for an average of fifteen years. There are several other types of other unsecured debt, including department store cards, professional fees, medical and dental bills, alimony, child support, rent; utility bills, personal loans from relatives, and health club dues, to name a few.  

[D] Long-Term Liabilities

A secured debt, on the other hand, is debt that is pledged by a specific property. This is a collateralized loan. Generally, the purchased item is pledged with the proceeds of the loan. This would include long-term liabilities (more than 12 months) such as a mortgage, home equity loan, or a car loan. Although the creditor has the ability to take possession of your property in order to recover a bad debt, it is done very rarely. A creditor is more interested in recovering money. Sometimes, when borrowing money, there may be a requirement to pledge assets that are owned prior to the loan.  

For example, a personal loan from a finance company requires that you pledge all personal property such as your car, furniture, and equipment.  The same property may become subject to a judicial lien if you are sued and a judgment is made against you. In this case, you would not be able to sell or pledge these assets until the judgment is satisfied.

A common example of a lien would be from unpaid federal, state or local taxes. Doctors can be found personally liable for unpaid payroll taxes of employees in their professional corporations.  Be aware that some assets and liabilities defy short or long-term definition. When this happens, simply be consistent in your comparison of financial statements, over time. 

[E] Personal Physician Net Worth

Once the value of all personal assets and liabilities is known, net worth can be determined with the following formula: Net worth = assets minus liabilities. Obviously, higher is better.  In The Millionaire Next Door, Thomas H. Stanley, PhD, and William H. Danko give the following benchmark for net worth accumulation. Although conservative for physicians of a past generation, it may be more applicable in the future because of current managed care environment.

Here is the guide: Multiple your age by your annual pre-tax income from all sources – except inheritances – and divide by ten. 

Real-Life Medical Example: As an HMO pediatrician, Dr. Curtis earned $ 60,000 last year. So, if she is 35, her net worth should be at least $ 210,000.

How do you get to that point? In a word, consume less, save more and watch the student loans. Stanley and Danko found that the typical millionaire set aside 15 percent of earned income annually and has enough invested to survive 10 years, at current income levels if he stopped working.  Now, if Dr. Curtis lost her job tomorrow, how long could she pay herself the same salary? 

[F] Common Liability Management Mistakes

 A common liability management mistake is not recognizing when you are heading for trouble. If doctors are paying only the minimum payments on credit card debt, while continuing to charge purchases at a rate faster than the pay-down, trouble is brewing. If you don’t categorize your debt, you could find yourself paying down non-priority debt while ignoring priority debt.

A priority debt is one that is essential or subject to serious consequences, if not paid. Examples include rent, mortgage payments, utility bills, child support, car payments, unpaid taxes, and other secured debt. If in one month, a doctor had to choose between paying his accounting bill or his rent, it would be essential to pay the rent. 

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

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)Invite Dr. Marcinko

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RITE AID: Gets it Financially Wrong?

By Staff Reporters

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Last quarter, interest expense grew to $65 million from $48 million last year, contributing to Rite Aid reporting a net loss of $306.7 million despite sales of $5.6 billion. Management forecasts a net loss of between $650 million and $680 million for the full fiscal year 2024. Rite Aid’s losses leave it with little financial wiggle room to navigate two significant headwinds: a looming lawsuit and increasing losses from theft.

RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

In March, for example, the Department of Justice filed a civil suit against Rite Aid, claiming pharmacists “repeatedly filled prescriptions for controlled substances with obvious red flags” and alleging it “intentionally deleted internal notes about suspicious prescribers.”

The lawsuit continues a string of high-profile cases brought against companies contributing to the spread of the opioid epidemic. Opioid drugmakers Purdue Pharma, Endo Pharmaceuticals, and Mallinckrodt have already declared bankruptcy because of lawsuits. Walgreens and CVS Health have inked opioid settlements valued at $5.7 billion and $4.9 billion over the past year.

How much Rite Aid would need to pay to settle its suit remains to be seen, but a billion-dollar price tag isn’t unfathomable, given Walgreens and CVS’ outcomes. 

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

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IPOs: More Caution Ahead

By Staff Reporters

http://www.MARCINKOASSOCIATES.com

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From 2020 to 2021, when VC money was cheap and tech IPOs were hot, the tech companies that went public via IPO were mostly growth-focused unicorns that had yet to see any profits. But Instacart, which has turned a profit for the last five quarters, is something different.

Chip design company Arm, which debuted last week in the year’s biggest IPO, was the first venture-capital-backed startup to go public in the US since December 2021. It may have broken the ice, but Instacart is the next big test.

However, being profitable and being valuable aren’t the same thing. In 2020, investors valued Instacart at $39 billion, its highest valuation and roughly $29 billion more than what it’s expected to be worth to investors today.

  • Late-stage investors in Instacart, such as Fidelity and T. Rowe Price, stand to lose 40% or more.
  • Sequoia Capital—Instacart’s largest external shareholder—was also one of its earliest. Its initial $8 million investment in 2013 is worth $1 billion today, but its later investment of $50 million in 2021 has shrunk to $12 million.

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FTC & DOJ Announce Revised Merger Guideline

By Health Capital Consultants, LLC

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FTC & DOJ Announce Revised Merger Guidelines

On July 19, 2023, the Federal Trade Commission (FTC) and the Department of Justice (DOJ) released a draft update of its Merger Guidelines, which guides the regulatory agencies in their review of both mergers and acquisitions in evaluating compliance with federal antitrust laws.

The new Guidelines replace, amend, and consolidate the Vertical Merger Guidelines and Horizontal Merger Guidelines, which were published in 2020 and 2010, respectively.

This Health Capital Topics article will discuss the new Guidelines and the proposed changes to antitrust laws that may affect the future of healthcare. (Read more…) 

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Pricing Increases at Independent Hospitals Post-Acquisition

By Health Capital Consultants, LLC

Pricing Increases at Independent Hospitals Post-Acquisition

Over the past decade, hospital acquisitions have changed the healthcare market, with transactions leading to hospital consolidation and resulting in larger health systems and fewer hospitals.

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

An August 2023 study conducted by the Public Policy Institute of health insurer Elevance Health (formerly known as Anthem) found that when independent hospitals are acquired by health systems, employers, payors, and consumers are exposed to higher pricing without a similar increase in hospital care access or quality of care. This Health Capital Topics article will review the Elevance study and the impact of acquisitions on independent hospital pricing. (Read more…)

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Arm IPO: NASDAQ Success over NYSE

By Staff Reporters

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Stocks shot up yesterday on the strength of Arm’s IPO. Investors were pleased with the British chip-maker’s debut: Shares surged 25%, leading to the best day for the Dow since early August.

Arm’s debut was also a big win for NASDAQ, which hopes to parlay the successful IPO into grabbing more listings over rival NYSE.

IPOs: https://medicalexecutivepost.com/2023/05/01/initial-public-offerings/

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DAILY UPDATE: Social Security COLA, Illegal Drugs and the Markets

By Staff Reporters

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The forecast for next year’s Social Security increase rose to 3.2% from 3% on Wednesday after the government said inflation ticked up in August. Annual inflation in August rose to 3.7%, from 3.2% in July but off a 40-year high of 9.1% in June 2022. Without the volatile food and energy sectors, the so-called “core” inflation rate was 4.3%, down from July’s 4.7%. 

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Illegal drugs are expected to be one of the biggest threats to national security in 2024 as overdose deaths topped 100,000 in the last year, according to the Department of Homeland Security’s annual threat study. In its report released Thursday, DHS said it expects illegal drugs produced in Mexico and sold in the United States will continue to kill more Americans than any other threat.

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U.S. stocks ended sharply higher and the greenback jumped on Thursday as robust economic data failed to budge expectations that the Federal Reserve will leave its key interest rate unchanged next week. The rally boosted a broad array of assets. All three major stock indexes ended higher, as did all 11 major sectors of the S&P 500. The dollar jumped to a six-month high, 10-year Treasury yields rose, and crude oil futures hit their highest this year, helping energy stocks outperform the broader market.

A spate of economic data released before the opening bell showed energy prices, specifically gasoline, were largely responsible for a hotter-than-expected producer prices print and a consensus-beating retail sales reading.

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Here is where the major benchmarks ended:

  • The S&P 500 Index was up 37.66 points (0.8%) at 4,505.10; the Dow Jones Industrial Average was up 331.58 points (1.0%) at 34,907.11; the NASDAQ Composite (COMP) was up 112.47 points (0.8%) at 13,926.05.The 10-year Treasury note yield (TNX) was up about 4 basis points at 4.286%. CBOE’s Volatility Index (VIX) was down 0.69 at 12.79.

Retailers were among the market’s strongest sectors Thursday in the wake of stronger-than-expected August retail sales reported by the Commerce Department. Energy companies also climbed as crude oil futures extended a rally and topped $90 a barrel for the first time since mid-November. Small-cap stocks joined the upswing, with the Russell 2000 Index (RUT) rising nearly 1.5% and ended at a one-week high. Volatility based on the VIX fell under 13.00 and near pre-pandemic levels of early 2020.

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DAILY UPDATE: Rothification and the Markets

By Staff Reporters

REMINDER

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Starting in 2026, high-income earners over the age of 50 who make more than $145,000 can no longer make catch-up contributions to regular 401(k)s. Instead, those catch-ups will head to Roth accounts. That carries significant tax implications.

MORE: https://taxfoundation.org/blog/what-rothification-means-for-tax-reform/

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

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Here is where the major benchmarks ended yesterday:

  • The S&P 500® Index (SPX) was down 25.56 points (0.6%) at 4,461.90; the Dow Jones Industrial Average (DJIA) was down 17.73 points at 34,645.99; the NASDAQ Composite was down 144.28 points (1.0%) at 13,773.61.
  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.272%.
  • CBOE’s Volatility Index (VIX) was up 0.42 at 14.22.

While tech was the weakest performing sector Tuesday, consumer discretionary and communication services shares were also lower. Energy shares led sector gainers Tuesday as oil prices continued to rise.

The Philadelphia Oil Service Index (OSX) gained more than 2% and ended at its highest level since April 2019. WTI crude futures, the U.S. benchmark, extended gains to near $90 a barrel after OPEC, in a report, slightly increased its forecasts for global consumption in 2023 and 2024.

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NURSING HOMES: Federal Minimum Staffing Levels

A JOE BIDEN PROPOSAL

By Staff Reporters

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WASHINGTON (Reuters) – President Joe Biden’s administration just proposed setting federal minimum staffing levels for nursing homes, a move aimed at addressing longtime complaints about abuse and neglect in the industry that were highlighted during the COVID-19 pandemic.

MORE: https://medicalexecutivepost.com/2019/02/18/government-report-finds-92-percent-of-nursing-homes-employ-convicts/

Biden pledged last year to protect American seniors’ lives and life savings by cracking down on nursing homes that commit fraud or endanger patients’ safety and address the chronic under staffing at long-term care facilities that was exposed during the pandemic.

PODCAST: https://medicalexecutivepost.com/2021/07/24/podcast-nursing-home-care/

USBLS: https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm

The nursing home industry takes in nearly $100 billion a year from U.S. taxpayers, yet many under staff their facilities, the White House said. The new rule proposes that facilities have a registered nurse (RN) on site around the clock. It says each resident should receive 2.45 hours (two hours and 27 minutes) of care from a nurse aide every day, plus at least 33 minutes of care from an registered nurse every day.

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

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DAILY UPDATE: C-Suite and the Markets

By Staff Reporters

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Most CFOs think we’ll avoid a recession this year—and that confidence is shared by other members of the C-suite. That’s according to PwC’s August Pulse Survey, which found that only 8% of CFOs predict a recession within the next six months. The survey polled more than 600 C-suite executives from a variety of public and private companies.Among all respondents just 17% strongly agreed there’d be a recession in the next 6 months—a sharp decline from October 2022, when 35% did.Economists, policymakers, and executives “see…the possibility of a soft landing,” Wes Bricker, PwC US vice chair and trust co-leader, said during a media call. “It’s encouraging to see optimism from so many business leaders who participated in our survey.”

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Here is where the major benchmarks ended:

  • The S&P 500® Index (SPX) was up 27.60 points (0.6%) at 4,433.31; the Dow Jones Industrial Average (DJIA) was up 213.08 points (0.6%) at 34,559.98; the NASDAQ Composite was up 114.48 points (0.8%) at 13,705.13.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 4.21%.
  • CBOE’s Volatility Index (VIX) was down 0.60 at 15.08.

Energy shares were among Monday’s strongest sectors, as crude oil futures rose for a third-straight session and closed at the highest level in over a week. Regional banks and retailers were also higher.

The U.S. dollar index (DXY) eased slightly but remained near a three-month high, reflecting expectations interest rates will stay elevated.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Health Care Entity: Venture Capital Funding

http://www.MARCINKOASSOCIATES.com

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Venture capital funding in the digital health space cooled a bit in 2022 following a red-hot 2021. Overall, digital health companies raised $15.3 billion last year, down from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to Rock Health a seed fund that supports digital health startups.

MORE: https://marcinkoassociates.com/fmv-appraisals/

Nevertheless, analysts predict VC investors and bankers will still put a good amount of money into digital health in 2024 and 2025, especially in alternative care, drug development, health information technology technology, EMRs and software that reduces physician workload.

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

Of course. an essential first part of attracting VC interest and money is the crafting and presentation of your formal business plan [“elevator pitch”]; as well as the needed technical and managerial experience. This is crucial for success and exactly where we can assist.

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READ MORE: https://marcinkoassociates.com/welcome-medical-colleagues/

CONTACT: MarcinkoAdvisors@msn.com

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DAILY UPDATE: Mortgages Rates and the Markets are Up!

By Staff Reporters

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Home Mortgage rates just hit their highest mark since 2002, making home ownership even less attainable to potential buyers. Stagnation in the housing market could also put a squeeze on consumer spending, slowing broader economic growth. The average 30-year fixed-rate mortgage, a popular home loan, hit 7.09% last Thursday, up from 6.96% the week before, according to mortgage behemoth the Federal Home Loan Mortgage Corporation (Freddie Mac).

In a statement tied to the release, Freddie Mac noted that the rise of the 10-year Treasury yield and the strength of the economy both contributed to the high rate.

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Here is where the major benchmarks ended:

  • The S&P 500® Index rose 49 points (1.1%) to 4,436.02; the Dow Jones Industrial Average (DJIA) rose 184 points (0.54%) to 34,472.98; the NASDAQ Composite (COMP) rose 215 points (1.59%) to 13,721.03.
  • The 10-year Treasury note yield (TNX) fell 15 basis points to 4.180%.
  • CBOE’s Volatility Index (VIX) fell roughly 1 point to 16.03.

Communication services—which is home to tech-adjacent companies such as Google parent Alphabet (GOOG), Facebook parent Meta (META), and Netflix (NFLX)—and technology were the top-performing sectors Wednesday.

Energy was the laggard, as crude oil futures slipped more than 1% to below $79.

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The Next-Generation of “Anti-Millionaire” Doctors

“$1 Million Mistake: Becoming a Doctor”

See the source image

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

CBS Moneywatch published an article entitled “$1 Million Mistake: Becoming a Doctor” Aside from the possibility that devoting one’s life to helping others might be considered a mistake, medical student Dan Coleman was struck by the “$1 million” figure.

Before medical school, he worked in the pharmaceutical industry and even turned down a hefty promotion to his education as soon as possible, rather than defer for a year or two. But, his financial calculations made it fairly obvious that, including benefits, bonuses, and potential promotions, his medical decision was not a $1 million mistake, but was more like a $1.3 million dollar disaster. Still; he opined:

Yet, even today, as we stare down the barrel of the Affordable Care Act, being a doctor is a very desirable job. We may not be famous, but we will be well-respected. We may not be rich, but we will certainly live comfortably. We may work a lot, but we will never be out of work. To future doctors, the young and impecunious, the anti-millionaires, tuition is a mere afterthought. All that matters is the MD.

Source: http://in-training.org/medical-students-the-anti-millionaires-4361

Millionaire Interview 81 - ESI Money

OVER HEARD IN THE MEDICAL STUDENT’S LOUNGE

“We are medical students.
We are young, proud, and righteous.
We have made the hard choice (medicine), but we have cleared the high hurdle (getting into school).


We know healthcare is a difficult, imperfect art, but we are devoted.
We arm ourselves with the weapons of knowledge and compassion, prepared to defend against the onslaught of trauma, disease, and time.
We are here to the bitter end, for our patients and ourselves.
And above all, we know the cost of our choice.

And if we’re lucky, it will stay under 6% interest through graduation”.

Daniel Coleman

[Georgetown University School of Medicine]

First-year Student

Your thoughts are appreciated,

THANK YOU

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

ODER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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HEALTH CARE ENTITY: Venture Capital Funding

http://www.MARCINKOASSOCIATES.com

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Venture capital funding in the digital health space cooled a bit in 2022 following a red-hot 2021. Overall, digital health companies raised $15.3 billion last year, down from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to Rock Health a seed fund that supports digital health startups.

Nevertheless, analysts predict VC investors and bankers will still put a good amount of money into digital health in 2024 and 2025, especially in alternative care, drug development, health information technology technology, EMRs and software that reduces physician workload.

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

Of course. an essential first part of attracting VC interest and money is the crafting and presentation of your formal business plan [“elevator pitch”]; as well as the needed technical and managerial experience. This is crucial for success and exactly where we can assist.

***

READ MORE: https://marcinkoassociates.com/welcome-medical-colleagues/

CONTACT: MarcinkoAdvisors@msn.com

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RETAIL: Sales

By Staff Reporters

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Stat: 0.7%. That’s how much retail sales grew last month, a sign that inflation isn’t dampening consumer spending or demand. (CNBC)

Quote: “This is pure market economics. We do not magically have thousands of additional AI developers, product managers, and everything else.”Paul J. Groce, partner and head of the Americas at recruitment firm Leathwaite, on how a talent shortage is driving up wages for AI positions. (the Wall Street Journal)

Read: The teetering company threatening China’s economy. (the New York Times)

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FINANCIAL RESOLUTIONS: For Mid-Yeat 2023

A MID-YEAR UPDATE

By Staff Reporters

Are you the kind of ME-P reader who makes resolutions on New Year’s Day? If so, here are five steps we encourage all investors to consider taking to boost your financial fitness at any time of the year; according to Charles Schwab & Company. So, why not resolve to take them right now? 

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

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Resolution 1: Create a budget

Committing to a saving and investing program during your working years is generally the best way to boost your net worth and achieve many of life’s most important goals. Of course, first you’ll need to know how much money you’ve got to work with. That’s where a budget and net worth statement can help. Here’s how to think about them.

  • Budget and save. At a minimum, be sure to have a high-level budget with three things: how much you’re taking in after taxes, how much you’re spending, and how much you’re saving. If you’re not sure where your money is going, track your spending using a spreadsheet or an online budgeting tool for 30 days. Determine how much money you need to cover your fixed monthly expenses, such as your rent or mortgage and other living expenses, and how much you’d like to put away for other goals. For retirement, our rule of thumb is to save 10%–15% of pre-tax income, including any match from an employer, starting in your 20s. If you delay, the amount you may need to save goes up. Add 10% for every decade you delay saving for retirement. Once you commit to an amount, consider ways you can save automatically, such as through monthly direct deposits. 
  • Calculate your personal net worth annually. It doesn’t have to be complicated. Make a list of your assets (what you own) and subtract your liabilities (what you owe). Subtract the liabilities from the assets to determine your net worth. Don’t panic if your net worth declines when the market is struggling. What’s important is to see a general upward trend over your earning years. If you’re retired, you’ll want to plan an income and distribution strategy to help make your savings last as long as necessary and support other objectives.
  • Project the cost of essential big-ticket items. If you have a big expense in the near term, like college tuition or roof repair, put the money aside or increase your savings and treat that money as spent. If you know that you’ll need the money within a few years, keep it in relatively liquid, safe investments like short-term certificates of deposit (CDs), a savings account, or money market funds purchased within a brokerage account. If you choose to invest in a CD, make sure the term ends by the time you need the cash. If you have more than a few years, invest wisely, based on your time horizon.
  • Prepare for emergencies. If you aren’t retired, we suggest creating an emergency fund with three to six months’ worth of essential living expenses, set aside in a savings account. The emergency fund can help you cover unexpected but necessary expenses without having to sell more volatile investments.
  • Retired? Invest your living-expense money conservatively. Consider keeping 12 months of living expenses—after accounting for non-portfolio income sources like Social Security or a pension—in short-term CDs, an interest-bearing savings account, or a money market fund. Then consider keeping another two to four years’ worth of spending laddered in short-term bonds or invested in short-term bond funds as part of your portfolio’s fixed income allocation. You can use this money to cover expenses in the near term. Having a chunk of savings invested conservatively should allow you to invest a portion of your remaining savings for growth, at a level of risk appropriate for you, while reducing the chances you’ll be forced to sell more volatile investments (like stocks) in a down market.

Resolution 2: Manage your debt

Debt is neither inherently good nor bad—it’s simply a tool. It all depends on how you use it. For most people, some level of debt is a practical necessity, especially to purchase an expensive long-term asset to pay back over time, such as a home. However, problems arise when debt becomes more of a burden than a tool. Here’s how to stay in control.

  • Keep your total debt load manageable. Don’t confuse what you can borrow with what you should borrow. Keep the monthly costs of owning a home (principal, interest, taxes, and insurance) below 28% of your pre-tax income, and your total monthly debt payments (including credit cards, auto loans, and mortgage payments) below 36% of your pre-tax income.
  • Eliminate high-cost, non-deductible consumer debt. Try to pay off credit-card debt and avoid borrowing to buy depreciating assets, such as cars. The cost of consumer debt adds up quickly if you carry a balance. Consider consolidating your debt in a low-rate home equity loan or line of credit (HELOC), set a realistic budget, and implement a schedule to pay it back.
  • Match repayment terms to your time horizons. If you’re likely to move within five to seven years, you could consider a shorter-maturity loan or an adjustable-rate mortgage (ARM), depending on current mortgage rates and options. Don’t consider this if you think you may live in your home for longer or struggle to manage mortgage payment resets if interest rates or your plans change. We also don’t suggest that you borrow money under the assumption that your home will automatically increase in value. Historically, long-term home appreciation has significantly lagged the total return of a diversified stock portfolio. And, for any type of debt, have a disciplined payback schedule. Create a plan to pay off the mortgage on your primary home before you plan to retire.

Resolution 3: Optimize your portfolio

We all share the goal of getting better investment results. But research shows that it’s extremely difficult to always invest at the “perfect” time. So, create a plan that will help you stay disciplined in all kinds of markets. Follow your plan and adjust it as needed. Here are ideas to help you stay focused on your goals.

  • Focus on your overall investment mix. After committing to a savings plan, how you invest is your next most important decision. Have a targeted asset allocation—that is, strategically proportioned mix of stocks, bonds, and cash in your portfolio—that you’re comfortable with, even in a down market. Make sure it fits your long-term goals, risk tolerance, and time frame. The longer your time horizon, the more time you’ll have to potentially benefit from up or down markets.
  • Diversify across and within asset classes. Diversification can help reduce risk and can be a critical factor in helping you reach your goals. Mutual funds and exchange-traded funds (ETFs) are great ways to own a diversified basket of securities in just about any asset class.
  • Consider taxes.Place relatively tax-efficient investments, like ETFs and municipal bonds, in taxable accounts, and relatively tax-inefficient investments, like mutual funds and real estate investment trusts (REITs), in tax-advantaged accounts. Tax-advantaged accounts include retirement accounts, such as a traditional or Roth individual retirement account (IRA). If you trade frequently, do so in tax-advantaged accounts to help reduce your tax bill.
  • Monitor and rebalance your portfolio as needed. Evaluate your portfolio’s performance at least twice a year using a benchmark that makes sense for you. Remember, the long-term progress that you make toward your goals is more important than short-term portfolio performance. As you approach a savings goal, such as the beginning of a child’s education or retirement, begin to reduce investment risk, if appropriate, so you don’t have to sell more volatile investments, such as stocks, when you need them. 
  • Choose appropriate benchmarks. Lastly, your benchmark to measure investment performance should match your portfolio and your goals. Don’t be tempted to compare your portfolio to what performed best in the market last year or even a portfolio invested 100% in stocks. You should have a portfolio selected to best meet your goals, with an appropriate balance of potential return and risk as well. Progress toward your goals is more important than picking the top-performing stocks each year—which, for any investor, isn’t possible to predict.

Resolution 4: Prepare for the unexpected

Risk is a part of life, particularly in investments and finance. Your financial life can be upended by all kinds of surprises—an illness, job loss, disability, death, natural disasters, or lawsuits. If you don’t have enough assets to self-insure against major risks, make a resolution to get your insurance needs covered. Insurance helps protect against unforeseen events that don’t happen often but are expensive to manage yourself when they do. The following guidelines can help you prepare for life’s unexpected moments.

  • Protect against large medical expenses with health insurance. Select a health insurance policy that matches your needs in areas such as coverage, deductibles, co-payments, and choice of medical providers. If you’re in good health and don’t visit the doctor often, consider a high-deductible policy to insure against the possibility of a serious illness or unexpected health-care event.
  • Purchase life insurance if you have dependents or other obligations. First, take advantage of a group term insurance policy, if offered by your employer. Such programs don’t generally require a medical check and can be a cost-effective way to provide income replacement for dependents. If you have minor children or large liabilities that will continue after your death for which you can’t self-insure, you may need additional life insurance. Unless you have a permanent life insurance need or special circumstances, consider starting with a low-cost term life policy before a whole life policy.
  • Protect your earning power with long-term disability insurance. The odds of becoming disabled are greater than the odds of dying young. According to the Social Security Administration, a 20-year-old American has a 25% chance of becoming disabled before normal retirement age and a 13% chance of dying before retirement age.1 If you can’t get adequate short- and long-term coverage through work, consider an individual policy.
  • Protect your physical assets with property-casualty insurance. Check your homeowner’s or renter’s and auto insurance policies to make sure your coverage and deductibles are still right for you.
  • Obtain additional liability coverage, if needed. A personal liability “umbrella” policy is a cost-effective way to increase your liability coverage by $1 million or more, in case you’re at fault in an accident or someone is injured on your property. Umbrella policies don’t cover business-related liabilities, so make sure your business is also properly insured, especially if you’re in a profession with unique risks and aren’t covered by an employer.
  • Consider the pros and cons of long-term-care insurance. If you consider a long-term-care policy, look for a policy that provides the right type of care and is guaranteed renewable with locked-in premium rates. Long-term care typically is most cost-effective starting at about age 50 and generally becomes more expensive or difficult to find after age 70. You can get independent sources of information from your state insurance commissioner. A sound retirement savings strategy is another way to plan for long-term-care costs.
  • Create a disaster plan for your safety and peace of mind. Review your homeowner’s or renter’s policy to see what’s covered and what’s not. Talk to your agent about flood or earthquake insurance if either is a concern for your area. Generally, neither is included in most homeowner’s policies. Keep an updated video inventory of valuable household items and possessions along with any professional appraisals and estimates of replacement values in a safe place away from your home.

Consider storing inventories and important documents on a portable hard drive. It’s also a good idea to have copies of birth certificates, passports, wills, trust documents, records of home improvements, and insurance policies in a small, secure evacuation box (the fireproof, waterproof kind you can lock is best) that you can grab in a hurry in case you have to evacuate immediately. Make sure your trusted loved ones know about this file as well, in case they need it.

Resolution 5: Protect your estate

An estate plan may seem like something only for the wealthy. But there are simple steps everyone should take. Without proper beneficiary designations, a will, and other basic steps, the fate of your assets or minor children may be decided by attorneys and tax agencies. Taxes and attorneys’ fees can eat away at these assets and delay the distribution of assets just when your heirs need them most. Here’s how to protect your estate—and your loved ones.

  • Review your beneficiaries, especially for retirement accounts, annuities, and life insurance.The beneficiary designation is your first line of defense, to make your wishes for assets known, and ensure that they transfer to who you want quickly. Keep information on beneficiaries up-to-date to ensure the proceeds of life insurance policies and retirement accounts are consistent with your wishes, your will, and other documents.
  • Update or prepare your will. A will isn’t just about transferring assets. It can provide for your dependents’ support and care and help you avoid the costs and delays associated with dying without one. It can also spell out plans to repay debts, such as a credit card or mortgage. Keep in mind that a beneficiary designation or asset titling trumps what’s written in a will, so make sure all documents are consistent and reflect your desires. When writing a will, we recommend working with an experienced lawyer or estate planning attorney.
  • Coordinate asset titling with the rest of your estate plan. The titling of your property and non-retirement accounts can affect the ultimate disposition and taxation of your assets. Talk with an estate attorney or lawyer about debts and the titling of assets, such as a home, that don’t have a beneficiary designation, to make sure they reflect your wishes and are consistent with titling laws that can vary by state.
  • Have in place durable powers of attorney for health care. In these documents, appoint trusted and competent confidants to make decisions on your behalf if you become incapacitated.
  • Consider a revocable living trust. This is especially important if your estate is large and complex, and you want to spell out how your assets should be used in detail, or if you have dependent children and want to spell in detail how assets should be managed to support them, who will manage the assets, and other issues. A living trust may not be needed for smaller estates where beneficiaries, titling, and a will can be sufficient, but talk with a qualified financial planner or attorney to be sure.
  • Take care of important estate documents. Make sure a trusted and competent family member or close friend knows the location of your important estate documents.

Finally, remember you don’t have to do everything at once. There’s a lot you can do to improve your financial health by taking one step at a time and think of these resolutions as a checklist. This ME-P and our books and posts can help. Make some real progress on your journey this year. 

1Johanna Maleh and Tiffany Bosley. “Disability and Death Probability Tables for Insured Workers Who Attain Age 20 in 2022.” Social Security Administration, December 2022.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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SIX TYPES: OF Financial Professionals

By Aleksandar Stojanović, MSc

Here’s a brief insight before the explanations:

  • 𝗖𝗙𝗢𝘀 are heavily invested in strategic planning, leadership, and risk management, often overlooking the entire financial spectrum.
  • 𝗖𝗼𝗻𝘁𝗿𝗼𝗹𝗹𝗲𝗿𝘀 play a key role in accounting, financial reporting, and regulatory compliance, ensuring financial integrity.
  • 𝗙𝗣&𝗔 𝗠𝗮𝗻𝗮𝗴𝗲𝗿𝘀 focus on financial modeling, analytical skills, and business acumen to drive business growth.
  • 𝗜𝗻𝘁𝗲𝗿𝗻𝗮𝗹 𝗔𝘂𝗱𝗶𝘁𝗼𝗿𝘀 specialize in risk management, regulatory compliance, and analytical tasks to ensure internal control.
  • 𝗙𝗶𝗻𝗮𝗻𝗰𝗲 𝗔𝗻𝗮𝗹𝘆𝘀𝘁𝘀 are adept at financial modeling, analytics, and reporting to support data-driven decisions.
  • 𝗔𝗰𝗰𝗼𝘂𝗻𝘁𝗮𝗻𝘁𝘀 emphasize accounting skills, financial reporting, and regulatory compliance for precise record-keeping.

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Now, generally, CFOs and FP&A Managers might spend more time connecting to business stakeholders for strategic decisions, while Controllers and Internal Auditors focus more on regulatory and compliance tasks.

Finance Analysts and Accountants are more involved in financial modeling and reporting.

These titles and responsibilities can be interchanged in some job descriptions, and the weight of these skills also depends on the industry and project.

But this breakdown is still quite helpful when planning career paths or understanding the roles within a finance department.

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

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High-Earning Americans to Lose 401(k) Tax Deduction in 2023

By Staff Reporters

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Changes to a popular 401(K) tax deduction are set to hit millions of high-earning Americans from next year. Workers over the aged of 50 are entitled to make catch-up contributions to their 401(K)s worth up to $7,500 this year. The annual cap on all contributions is $30,000. 

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

But from 2024, those earning over $145,000 will no longer be able to put these catch-up payments into a traditional 401(K).  Instead, the money will be only funneled into a Roth IRA account, according to new rules passed through Congress in December. 

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DAILY UPDATE: The Markets, Retail Earnings and US Steel

By Staff Reporters

.Markets: The market’s rally during the first half of the year has fizzled out this summer despite a greater share of companies beating earnings projections than usual, the WSJ reports. For example, UPS, Apple, and PayPal all topped Wall Street expectations…only to watch shares fall after their reports. Investors suggest it’s a “snap back to reality” moment after market euphoria in H1.

  • Retailers take the earnings stage. Walmart, Home Depot, and Target will give us a peek into consumer spending, which drives two-thirds of the US economy. Americans filling up their shopping carts (despite interest rates rising to a 22-year high) is one of the main reasons those recession predictions haven’t materialized yet.
  • US Steel, a symbol of American industrial might in the early 20th century, is considering selling itself.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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SEC: Money Market Fund Reforms

RICHARD CAYNE

By Staff Reporters

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  • SEC money market fund reforms: On July 12, 2023 the SEC released new rules intended to decrease the risk of runs on money market funds (MMFs). MMFs must charge liquidity fees if their daily net redemptions exceed 5% of their net assets, or if their boards deem it necessary, and must maintain a liquidity buffer of at least 25% of their total daily assets and at least 50% of their weekly assets. MMFs are also no longer allowed to use “gates” to temporarily suspend redemption!
  • CITE: https://www.r2library.com/Resource

    Goes into effect:
    60 days after the rule is published in the Federal Register.

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PODCAST: The FOUR PERCENT Spending Rule with Challenge?

Still Valid or Not?

PLUS the “RULES of 72, 78 and 115″ Explained”

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

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What Is The 4% Rule? How Much Money Do I Need To Retire? - YouTube

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The 4% Rule is a practical rule of thumb that may be used by retirees to decide how much they should withdraw from their retirement funds each year; according to Investopedia.

READ: https://www.investopedia.com/terms/f/four-percent-rule.asp#:~:text=The%20Four%20Percent%20Rule%20is%20a%20rule%20of,account%20balance%20that%20keeps%20income%20flowing%20through%20retirement.

The purpose of adopting the rule is to keep a steady income stream while maintaining an adequate overall account balance for future years. The withdrawals will consist primarily of interest and dividends on savings.

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

READ: https://www.financial-planning.com/news/kitces-smart-fix-for-the-4-rule#:~:text=The%20purpose%20of%20the%204%25%20rule%20is%20to,when%20it%20provides%20superior%20outcomes%20in%20all%20situations.

CHALLENGE: But, experts like Mike Kitces are divided on whether the 4% withdrawal rate is the best option. Many, including the creator of the rule, say that 5% is a better rule for all but the worst-case scenario.

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RULES of 72, 78 and 115: https://medicalexecutivepost.com/2020/11/22/the-rules-of-72-78-and-115/

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PODCAST: https://www.bing.com/videos/search?q=4+percent+rule&&view=detail&mid=5B0C2D1CABA12C7CF6075B0C2D1CABA12C7CF607&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3D4%2Bpercent%2Brule%26FORM%3DHDRSC3

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