Relevant and even prescient commentary on news, politics and the economy.

Healthcare Utilization, Costs, and Pricing Drivers – 2017 and 2021

Health Care Cost and Utilization Report,, April 2023 Year-over-year and 5-year cumulative trends in health care spending for individuals with employer-sponsored insurance. A detailed report by the Health Care Cost Institute covering the period 2017 – 2021 which includes the Covid pandemic. Decreases i total costs were seen during the pandemic. Still in the […]


To be clear, our national debt problem is due to revenues insufficient to cover expenditures. More than anything else, for the past 40 plus years, this accumulated deficit is due to Republican opposition to tax increases coupled with their eagerness to cut taxes on the wealthy given the opportunity to do so. Most, if indeed […]

Little Good can Come from Private Equity in the Healthcare Industry

Little Good can Come from Private Equity in the Healthcare Industry, Angry Bear Two Years ago As if we did not have enough issues with the commercial healthcare insurance industry attempting to supplant single payer Medicare (minus setting hospital budgets, doctor fees, and pharmaceutical costs to the consumer) and the VA with commercial healthcare insurance […]

What Happens When a Safety Net Hospital Closes?

Much of this article I rewrote to make it clearer for the reader. It is written by upper management. I do disagree with the conclusions. Throwing more money at healthcare is not going to solve the issues he discusses. The article praises Commercial Healthcare Insurance who pay more for patient care and whose costs are […]

Expanding Medicaid to people in prison

XCons have a tough enough time adjusting to the outside without being denied access to healthcare. It is an adjustment period, they have little power, and they are taken advantage of once released from prison. Denial of healthcare is just another issue on top of all the other issues they face when getting back into […]

FTC and Congress Put PBMs on Notice

FTC and Congress Put PBMs on Notice – AAF ( The conclusion of the Congressional Plan Much of this post in a copy and past. However, the conclusion is mostly mine. I am starting out with the conclusions and actions of Congress to which the author claims could result in fewer PBMs and increasing prices. […]

Testimony of Kip Sullivan, on behalf of Health Care for All Minnesota

I used to think Minnesota was a pretty cool state. Spent some time in the boundary waters between Minnesota and Canada. Great experience for a 15 year old. After reading this, I find Minnesota to be just as backwards as Wisconsin is outside of Madison and Milwaukee. Great place to roam and bad politics. I […]


Back before, municipal and state governments, pension funds, etc. mostly invested in financials of the manufacturing sort. Then, America was in the manufacturing business. An issuing manufacturer was contractually bound to hand over the return owed. The investors were entitled. If they didn’t get their entitle, it was, ‘”see you in court.” In 2023, in […]

April 14, 2023, Letters from an American . . . the Fentanyl Epidemic

The last few days, I have been pointing to the Opioid epidemic which did not just start with Fentanyl. It has been ongoing before the introduction of Qxycontin by the Sadler’s Purdue Pharmaceuticals. In 1996. It was advertised by Purdue as a nonaddictive drug by misquoting Doctors Jane Porter and Herschel Jick’s letter to NEJM […]