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Understanding Hobson’s Choice in Healthcare

Posted on September 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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Hobson’s Choice in Medicine

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Hobson’s choice is a free choice in which only one thing is actually offered. The term is often used to describe an illusion that choices are available. The best known example is “I’ll give you a choice: Take it or leave it”, wherein “leaving it” is strongly undesirable.

The phrase is said to have originated with Thomas Hobson (1544–1631), a livery stable owner in Cambridge, England, who offered customers the choice of either taking the horse in the stall nearest to the door or taking none at all.

A CASE MODEL

Half of Physicians Plan to Change Career Paths

The Physicians Foundation recently conducted a survey on physician practice patterns and perspectives. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not a good Hobson’s Choice in Medicine.

Cite: The Physicians Foundation, September 2018

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V.I.P. PATIENT PARADOX: A Joe Biden Medical Scenario?

Posted on August 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Dr. David Edward Marcinko with non-VIP patients

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The House Committee on Oversight and Government Reform expanded its investigation of the cover-up of former President Joe Biden’s health, prostate cancer, and mental decline.

On June 4th, Chairman James Comer subpoenaed five former senior White House aides to appear for transcribed interviews in addition to Biden’s physician, Kevin O’Connor, M.D. In May, Biden revealed he was diagnosed with advanced prostate cancer. The announcement left the public dumbfounded.

At 82, having spent more than five decades as a president, vice president and senator, Biden had access to world-class medical care. Donald Trump Jr. was one of many political observers who speculated the diagnosis might have been covered up to win the 2020 election. And, Biden’s doctors may have followed standard medical guidelines, and the recommendations about screenings for people of different ages can be controversial, writes health care economist Devon Herrick at the Goodman Institute Health Care Blog.

“Experts often say that men are more apt to die with prostate cancer than from prostate cancer,” wrote Herrick. “There is even some disagreement about whether doctors should treat most occurrences of prostate cancer in older men. That partly explains why Biden had not been screened in a decade.”

Screenings can be costly, time-consuming and uncomfortable, and false positive results can lead to invasive procedures that do not markedly extend life or health. Biden made his first public remarks about his cancer after a Memorial Day event. Biden said he was “feeling good” and expected to “be able to beat this.”

QUESTION: So, was this a case of VIP Patient Paradox?

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DEFINITION: “VIP medical patient paradox syndrome” is a term coined in 1964 by the psychiatrist Walter Weintraub to describe an intriguing paradox: Throughout history, the rich and famous, with all their resources and fancy doctors, have often received worse medical treatment, and suffered from worse health outcomes, than the average person.

VIP DEFINED: https://mdwhistleblower.blogspot.com/2024/08/the-vip-syndrome-threatens-doctors.html

Example: When physicians afford “special privileges” to their powerful patients, from “Mad King” George III to Michael Jackson, they seem to get sicker and even die.

While Weintraub, a psychoanalyst, attributed the problem in part to doctors unconsciously resenting their influential patients, it seems doctors simply get starstruck around famous people and high-ranking figures. Despite their medical expertise, these physicians find themselves opting out of basic tests for “privacy” or prescribing dangerous medications for “comfort.”

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LIFE INSURANCE: Split Dollar Plans

Posted on March 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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

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

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

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DAILY UPDATE: State Farm Insurance VP Fired as US Markets Tank, Again!

Posted on March 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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An executive for insurance giant State Farm was fired this week after he was recorded on an undercover video making comments about the insurer’s premium increases in response to Southern California wildfires. Haden Kirkpatrick, who worked as State Farm’s vice president for innovation and venture capital, was surreptitiously recorded on a video published by O’Keefe Media Group. The Los Angeles Times reported that he claims he was fired over the recording.

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US stocks fell on Thursday, with the S&P 500 (^GSPC) officially entering into correction territory, as economic concerns grew and investors digested the latest inflation data, President Trump’s trade offensive, and a looming US government shutdown.

The S&P 500 (^GSPC) dropped 1.4% to officially enter a correction, as it is now more than 10% off its February record high. The tech-heavy NASDAQ Composite (^IXIC), which itself entered into a correction last week, shed nearly 2% on the heels of a rebound for both gauges. The Dow Jones Industrial Average (^DJI) slid 1.3%, or nearly 550 points.

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

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DAILY UPDATE: Endometriosis Awareness Week as Stock Markets Soar!

Posted on March 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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Endometriosis Awareness Week, which brings attention to the chronic disease that affects about 10% of reproductive-age patients with uteruses worldwide. There’s still no known cure, due in part to research being underfunded—in 2022, the NIH allocated just $16 million, or $2 per patient, to endometriosis research, according to a 2024 study.

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US stocks rallied on Wednesday as President Trump provided a one-month auto tariff exemption on Mexico and Canada.

After sliding earlier in the session, the tech-heavy NASDAQ Composite (^IXIC) led the gains, rising more than 1.4%. Meanwhile, the Dow Jones Industrial Average (^DJI) and the S&P 500 (^GSPC) rose roughly 1.1%.

Stocks lifted higher after the White House delayed by one month auto tariffs that could significantly impact US automakers Ford (F), GM (GM), and Stellantis (STLA). Shares of all three automakers were at least 5% higher.

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

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DAILY UPDATE: TeleHealth Coverage Act as Stock Markets Plummet

Posted on February 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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A new bill could change Medicare coverage requirements for Americans across the country. With Medicare was set to run out of funding for telehealth coverage by the end of March, Democratic Representative Ro Khanna of California has introduced the Telehealth Coverage Act to continue the services.

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Stocks plummeted on Thursday as tech sold off following Nvidia’s (NVDA) latest earnings report while investors took stock of the economy amid President Trump’s latest tariff pledges.

The S&P 500 (^GSPC) fell more than 1.6%, while the tech-heavy NASDAQ Composite (^IXIC) dropped 2.8%. The Dow Jones Industrial Average (^DJI) dropped 0.4%.

Investors dug into Nvidia’s quarterly earnings beat, which signaled plenty of scope for growth as it eased worries about DeepSeek and faltering AI demand. The results initially met a muted response as its profit outlook raised doubts on Wall Street. Nvidia’s stock erased early morning gains to dropped more than 8%.

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

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FEBRUARY: National Children’s Dental Health Month

Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

AMERICAN DENTAL ASSOCIATION

By ADA and Staff Reporters

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Every day should be about children’s dental health

This is the message behind the ADA’s National Children’s Dental Health Month resources for 2025. Observed nationally each February, the recognition brings together thousands of dedicated professionals, health care providers and educators to promote the benefits of good oral health to children, their caregivers, teachers and many others.

The ADA is offering new materials to celebrate and promote the importance of children’s dental health, not only during the month of February, but all year.

Posters and flyers emphasizing the importance of brushing are available for free download in two kid-friendly, topical designs and two sizes, 8.5″x11″ and 11″x17″. Matching coloring sheets are offered in 8.5″x11″. All materials have instructions for proper brushing and are available in English and Spanish from ADA.org/NCDHM.

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In addition, the ADA’s 2025 Brushing Calendar is available for free download. This 12-month calendar is valuable year-round for promoting healthy behaviors like brushing twice a day with a fluoride toothpaste to help prevent dental disease. Kids can track their daily brushing and flossing routines and exercise their creativity by coloring the calendar image for each month.

Another tool, the NCDHM Program Planning Guide, provides resources for program coordinators, dental societies, teachers and parents to promote the benefits of good oral health to children. The guide includes easy-to-do activities, program planning tips, a sample NCDHM proclamation and more.

“The sooner children understand the value of good oral health habits, the more likely they are to continue these habits well into adulthood,” said ADA President Brett Kessler, D.D.S. “The ADA is proud that NCDHM will once again equip some of the most influential figures in kids’ lives — like parents, educators and health care providers — to help set our nation’s kids on the path to a lifetime of healthy smiles and healthier lives.”

National Children’s Dental Health Month observances began with a one-day event in Cleveland and a one-week celebration in Akron, Ohio, in February 1941. Since then, the concept has evolved into a nationwide program.

The ADA held the first national observance of Children’s Dental Health Day on February 8th, 1949. The one-day event became a week long event in 1955, and in 1981 the program was extended to a month long celebration known today as National Children’s Dental Health Month.

For questions about NCDHM resources, please email ncdhm@ada.org. For oral health resources, visit MouthHealthy.org.

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DAILY UPDATE: Health Care is Wealth Care as Stock Markets Close Mixed

Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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In great news for investors, a new study found that major healthcare companies have paid out $2.6 trillion to shareholders over the past 20 years in the form of dividends and share buybacks, and those payments are increasing. Bad news for patients: Some of that money could’ve been spent on, well, healthcare. The study, published Februrary 10th in JAMA, found that publicly traded S&P 500 healthcare companies paid shareholders a total of $170.2 billion in 2022, up 315% from payouts of just $54 billion in 2001.

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The S&P 500 fell 0.5%. The NASDAQ 100 slid 1.2%. A gauge of the “Magnificent Seven” mega-caps sank 2.2%. Nvidia Corp.’s shares slid 2.8% on the eve of the company’s results, while Tesla slumped 8.4% to fall below $1 trillion in market value. The DJIA was up.

The yield on 10-year Treasuries sank 11 basis points, while its Australian counterpart fell four points in early trading on Wednesday.

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DAILY UPDATE: Synapse Fin-Tech and UnitedHealthcare Part C as Stock Markets Slide

Posted on February 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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A grand jury is investigating criminal misconduct at a Silicon Valley fintech firm where customer funds went missing, and has questioned an executive who raised alarms before the company collapsed, people familiar with the matter said. Synapse connected financial technology firms with banks, helping startups that marketed flashy savings apps find a place to park their digital customers’ funds. The middleman managed billions of dollars at its peak, before its sudden collapse in April left thousands of people unable to access their money.

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The US Department of Justice is reportedly investigating the insurance giant UnitedHealthcare for its Medicare billing practices. The federal government is examining whether UnitedHealthcare is using patient diagnoses to illegally increase the lump sum monthly payments received through the Medicare Advantage program, according to a report in the Wall Street Journal.

US stocks sold off into the close on Monday as investors weighed the prospects of President Donald Trump’s tariff policies and also shifted focus to this week’s Nvidia (NVDA) earnings.

The Dow Jones Industrial Average (^DJI) was little changed on the heels of its worst week since October. The S&P 500 (^GSPC) fell 0.5%, while the tech-heavy NASDAQ Composite (^IXIC) fell 1.2%.

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Filed under: Drugs and Pharma, Ethics, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: Apple, bank, california, DJIA, DOW, fin-tech, FTC, Marcinko, Medicare Advantage, Medicare Part C, NASA, NASDAQ, Nvidia, Part C, PBMs, S&P 500, silicon valley, synapse, textbooks, TNX, travel, United Health, UnitedHealthcare, VIX, WSJ | Leave a comment »

DAILY UPDATE: S&P 500 Notches Record Market Close

Posted on February 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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US stocks were mixed on Tuesday to begin a holiday-shortened week of trading, with potential policy moves by the Federal Reserve and President Donald Trump in focus.

The benchmark S&P 500 (^GSPC) rose nearly 0.2%, with most of the games coming in the final 10 minutes of trading, to hit a fresh record close of 6,129.58. Meanwhile, the Dow Jones Industrial Average (^DJI) and NASDAQ Composite (^IXIC) finished barely in the green.

Stocks on Wall Street were largely cautious after Monday’s closure for Presidents Day as investors debate the future path of interest rates. Fed officials over the long weekend signaled a firm belief that rates should stay at current levels to combat rising inflation.

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

Treasury yields stepped higher as investors sought more clues to the chances of rate cuts this year, given recent data failed to give a clear steer. The benchmark 10-year yield (^TNX) rose to trade around 4.54%.

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

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

Posted on January 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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: Ascension Healthcare Cyber Crime Attack as Stock Market “Christmas Rallies” On!

Posted on December 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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MERRY CHRISTMAS and HAPPY HANUKKAH

The financial markets will close early on Tuesday, December 24th, for Christmas Eve and will be closed on Wednesday, December 25th, for Christmas Day. Brokerage firms will process transaction requests received after 1 p.m., Eastern time, on Tuesday, December 24th, as if received on Thursday, December 26th, before 4 p.m., Eastern Standard time

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Healthcare provider Ascension has revealed the sensitive data of 5.6 million patients was compromised in a massive cyberattack earlier this year. The ransomware attack occurred in May and threw the company into turmoil, with patient portals and files inaccessible, elective services postponed, and some ambulances diverted, according to a filing with the Maine Attorney General that was reported by TechRadar. Ascension did not name the hackers, but CNN reporting indicated it stemmed from a Russian-speaking cybercrime affiliate known as Black Basta. It’s not clear if Ascension paid a ransom to get their systems back online.

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

US stocks rallied in the final, shortened trading session before the Christmas holiday. The benchmark S&P 500 (^GSPC) finished the session up over 1.1%, while the tech-heavy NASDAQ Composite (^IXIC) rose roughly 1.4%. The Dow Jones Industrial Average (^DJI) climbed around 0.9%.

Wall Street successfully entered its Christmas break rejuvenated, after tech stocks including AI chip giant Nvidia (NVDA) led the march higher. Markets closed at 1 p.m. ET and are off tomorrow for Christmas Day.

Sizable gains in the past three trading sessions have put the indexes back on the path toward their record highs, from which they took a Fed-fueled nosedive last week.

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

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TRAVEL: Deals on Tuesday

Posted on December 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINED

By Staff Reporters

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Travel Tuesday, also known as Travel Deal Tuesday, is a marketing term for e-commerce transactions occurring on the Tuesday after Thanksgiving in the UJSA. It originated in 2017, when Hooper, an online flight marketplace, realized that the Tuesday after Thanksgiving was profitable for consumers to book flights. It is mainly a United States-based phenomenon. However, some overseas companies do recognize the holiday.

History

In 2017, Hopper, an online flight marketplace, created Travel Tuesday after realizing that in the post-Thanksgiving shopping period, the Tuesday after Thanksgiving was the most profitable time for consumers to book flights. Since then, major airline providers such as Orbitz, Travelocity and and Cheap Tickets have recognized the holiday. However, outside the United States, the holiday is rarely celebrated.

Impact

In 2018, Hopper stated that for them, the day offered the highest airfare sales in 2017, also noting that compared to Cyber Monday and Black Friday, fares were somewhat cheaper. In 2022, flight sales because of Travel Tuesday were thrice as much compared to the sales in the rest of the post-Thanksgiving period.

Note: From Wikipedia, the free encyclopedia

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PARADOX: Generosity V. Miserliness

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

By Staff Reporters

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

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

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

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

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GIBSON’S PARADOX: Inaccurate Economic Observations

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

Why were interest rates and prices correlated?

By Staff Reporters

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

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

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

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

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MEMORY: Fallibility

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

By Staff Reporters

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

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

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

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ARTIFICIAL INTELLIGENCE: Big Technology Stocks

Posted on November 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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After its AI-related earnings disappointed Wall Street last quarter, Big Tech doubled down in the latest period:

Amazon spent $22.6 billion on property and equipment like data centers and chips. That’s an 81% spike from the same time last year.
Meta raised its low-end guidance for capex (capital expenditures), which could reach $40 billion by the end of the year. It beat earnings estimates, even with AR glasses subsidiary Reality Labs costing $4.4 billion in operating losses.
Apple is still betting on Apple Intelligence to boost sales. Most revenue came from the new iPhone 16, Apple Watch, and AirPods, but Apple services like TV+ and iCloud also grew massively to account for a quarter of the business.
Google crushed earnings estimates and revealed that more than 25% of all new code it writes is generated by AI (and reviewed by engineers).

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

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ANCHORING: Initial Mental Brain Trickery

Posted on October 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

COGNITIVE BIASES

By Staff Reporters

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According to colleague Dan Ariely PhD, anchoring is the mental trick your brain plays when it latches onto the first piece of information it gets, no matter how irrelevant. You might know this as ‘ first impressions ’ – when someone relies on their own first idea of a person or situation.

Imagine you’re buying a car, and the salesperson starts with a high price. That number sticks in your mind and influences all your subsequent negotiations. Anchoring can skew our decisions and perceptions, making us think the first offer is more important than it is. Or, subsequent offers lower than they really are.

So, the next time you’re haggling or making a big decision, be aware of that initial anchor dragging you down.

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Stocks, Oil, Gold and Bitcoin

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

By Staff Reporters

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October continues to be a tough month for stocks, with all three major indexes spending yesterday afternoon in the red. The Dow in particular had a horrible day and dropped over 500 points, while major tech stocks were pushed lower by a series of analyst downgrades.
Oil continued its hot streak yesterday, rising above $77 on the back of geopolitical conflict in the Middle East. That helped ensure that, while everything else fell, energy was the only positive sector in the S&P 500.
Gold has often found itself rising in tandem with crude, though it broke that habit, with the shiny safe haven dropping a hair as investors digest the idea that the Fed’s next interest rate cut may be smaller than they thought.
Bitcoin broke above $64,000 for a moment yesterday only to be yanked back down, as crypto traders ride out the recent volatility.

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DAILY UPDATE: FluMist, Neural Data and the Jobs Report

Posted on October 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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

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

SPONSORED BY: Marcinko & Associates, Inc.

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