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

The New Pharmacy Price Transparency Rule Put Forth by President Trump

The New Hospital Price Disclosure Rule Is Important, But Only A First Step,” Health Affairs, James C. Capretta, August 26, 2019

The new proposed regulation on hospital price transparency is an important step toward consumer-friendly price information. The regulation introduces into federal price transparency, requirements such as the concepts: of service standardization, consumer-friendly organization and terminology, and bundling of which all of are crucial for a marketplace to become price competitive.

As the administration acknowledges, this regulation by itself will not fully address the opacity of today’s market. Additional disruptive changes will be necessary to give consumers usable pricing information. Among which, meaningful transparency requires stricter standardization of the services being priced and “all in” pricing matching how consumers think about the services they need.

Additionally, the reform of the nation’s insurance payment system must be integrated into the price transparency effort to ensure consumers are price sensitive across a wider range of services. Suppliers of services will only compete on price when significant numbers of consumers have strong incentives to seek out low-cost alternatives.

Me: To which I would add there is a big difference between price and cost and it is not being acknowledged.

The Trump administration on Friday put forth two long-anticipated rules that increase price transparency for both hospitals and insurers.

The CMS’ hospital price transparency requirements finalize changes that require health systems to make their standard fees available on-demand and online. The “transparency in coverage” proposed rule would require health plans, including employer-based plans, and group and individual plans, to inform participants, beneficiaries and enrollees about price and cost-sharing information ahead of time.

The agency hopes increased price transparency will boost competition among hospitals and insurers to drive down healthcare spending.

Under the new price transparency rule, hospitals must publish their standard charges online in a machine-readable format. They will need to create at least 300 “shoppable” services, including 70 selected by the CMS.

Under the rule, hospitals would have to disclose the rates they negotiate with third-party payers, which some experts say could be illegal.

Hospitals get ready to fight CMS in Court over Transparency,” FierceHealthcare, Robert King, November 15, 2019

More after the leap!

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Good Morning

I hope everyone had a good Thanksgiving with family, friends, or strangers.

My young and pretty 20 – something year-old wife and I were traveling years ago. We were standing in a long line into the only restaurant at O’hare airport. It was a couple of days before a holiday and the airport was packed.

If you frequent O’Hare today, you must be thinking; “What is he thinking? O’Hare has many assorted places to dine.” Like I said this was years ago. O’Hare was not as big then as it is today.

The line was moving slow and we finally arrived at the front. There were two men dressed in suits behind us, a rarity today, unless you are traveling for business and doing a meeting that same day . . . which I have done at times. The restaurant greeter came to get us.

I asked my wife if she minded if others sat with us as we were going to have a table for 4. She did not mind which I already knew and even so, thought I had better ask first. I asked the greeter if it was ok and of course she did not care as it was two more people out of her way. I turned to the two men.

“We have a table for four and wondered if you might want to join us as the restaurant is terribly crowded.” Of course they did not mind. The one had limited time in which to eat. We were thanked for our courtesy and kindness to include them, strangers, at our table. I do not remember their names. It did not really matter to me. That we could help someone else was more important.

My daughter who looks like a young version of her mom returned from Guatemala a few days ago. Each year, she travels there. No, it was not a vacation. She is a registered nurse (ER) and travels there with a team of nurses, techs, doctors, and surgeons to render aid in this part of North America to those in need. This time they performed 400 hundred surgeries during the 8 days they were there. She sends us pictures of the area and what facilities she visits. Each volunteer pays for their own transportation to there.

My youngest son has taken on similar acts of kindness and assistance to people in need as well as my oldest son. I am sitting here in the quiet of my oldest son’s family room. Everyone is still asleep after having a nice Thanksgiving meal yesterday with my daughter-in-law’s family.

We are doing well in life. I point to two examples of showing a degree of kindness and empathy for others regardless of who they are or from where they emanated. An action of kindness can be whatever you wish it to be towards others and it does not have to be of great magnitude. What matters is whether you will extend yourself to a stranger in need.

I hope you had a good Thanksgiving Day wherever you were yesterday whether it be with family, friends, or strangers. It is a day meant to be with others no matter where you were.

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Putin Beating Up People At Russia’s Top University

Putin Beating Up People At Russia’s Top University

That would be Moscow State University, the “Harvard” of Russia.

Not in the MSM at all, but I have my sources. Apparently sometime last week, the FSB and the successor to the domestic  arm of the old  KGB, raided Moscow State (whose main building is one of those “Stalin Gothic” skyscrapers) to capture a student who had been posting leaflets on walls protesting recent government actions.  He was reportedly taken into the library and severely beaten to the point of torture.

Oh yes, VV Putin is such a lover of knowledge and science, just like his flunky, Donald J. Trump.

Happy Thanksgiving, you all.

Barkley Rosser

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Plastic: Part of the Problem . . . Part of the Solution – Part 4: Efficient Use of Recyclates

The problem of plastic waste seems insurmountable. The good news is plastic recycling is on the rise and that is good for the circular economy. In parts 1, 2 and 3, we delved into the role of the waste management and recycling industry and how material sorting technologies can help. Part 4 is all about the increased use of recyclates as an essential part of properly closing the plastic cycle.

The plastics industry is facing a great many challenges. Harvesting recyclates from waste is only worthwhile if the plastic has been properly sorted and does not contain any metal, and if the products made from the secondary raw material are similar in quality to those made from new plastic.

Manufacturing recyclates from plastic waste is the first step. But in order to fully close the plastic cycle, more recyclates need to be used in the manufacturing of new products. This is a lucrative business for plastics processors, as recyclates are cheaper than new materials.

With material costs in the plastics industry accounting for 40% to 80% of total expense, depending on the segment, using recycled materials can significantly increase profitability. In addition, the secondary raw material in its ultra-pure state has practically the same characteristics as new plastic.

Yet there are still a number reservations in the industry when it comes to recyclates. The quality of the input material is particularly important in this regard. Recyclates must be free from any contamination to protect processes and machines from damage and ensure that the final products meet high standards of quality.

Survey on the Use of Recyclates by Processers on the Leap

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Plastic: Part of the Problem . . . Part of the Solution – Part 3: Sorting Technology

As I mentioned, this 4 part presentation is being done by Sesotec GmbH, a company which manufactures recycling equipment. Even so the information given by Sesotec is to the point on the topic of pollution by man made packaging and products which can be sued again and again and in some cases up to 8 times. Fair warning as the pitch comes with regards to Sesotec’s abilities.

Around 70 years after the first plastic product hit the market, a world without plastic waste now seems like a distant vision. It’s time for a new perspective on this supposed waste. In the third instalment of our series, we focus on how we must all manage how we deal with plastics in future, and the role materials sorting technologies and contaminant detection systems play in recycling.

Each year, Europeans generate 25 million tonnes of plastic waste. At a global level, 78 million tonnes of plastic waste is created annually. The world has to respond to this global problem together, as recycling rates everywhere have been at a low level so far: 30% in Europe, 25% in China, and just 9% in the USA (Plastikmüll-Statistik 2017). A large portion of the supposed waste is still incinerated, or ends up in landfills and the environment, which harbors risks for our water, air, and food chain.

To achieve a Circular Economy, it’s important that all players contribute to this task: from product design and manufacture on the part of the plastics industry, along with conscious use and avoidance of plastics as well as waste separation on the part of consumers, followed by proper recycling and sorting by the waste and recycling sector, all the way up to conversion into high-quality secondary raw materials and their use in the manufacture of new products.

Past the leap, how a Circular Economy will work.

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Plastic: Part of the Problem . . . Part of the Solution – Part 2: the European Union’s Solution

As you can read for yourself, this is the second part  of the series. This part will introduce the EU’s proposed solution to plastic waste material of which Sesotec is to be a part of the solution. Since I am using Sesotec’s information, I will be stating their name as owner’s of this information from time to time.

Some 70 years after the first plastic products hit the market, a world without plastic waste still appears far off. We need a different approach to dealing with what many consider to be rubbish – and we need it fast. In this multi-part series, we will take a look at the role that the waste management and recycling industry can play in the process. Part I took us to China. Now it is time to take a look at Europe.

China is no longer taking on the world’s plastic waste, and our oceans could soon be home to more pieces of plastic than fish. The time to act is now.

There are many ways to reduce plastic waste. Banning their use is one of them. A great deal of plastic packaging is, in fact, unnecessary. Yet it also offers benefits in certain areas, such a hygiene and shelf life, making a complete ban rather unrealistic.

Another approach is to avoid plastic in many situations and to practise “plastic fasting”. Still, even that will not work everywhere, especially in the industrial sector. It is therefore essential to find an alternative solution – one that is also reflected in the EU’s plastics strategy: a circular economy.

The European Union presented its plastics strategy on 16 January 2018. Under the strategy, all plastic packaging must be either reusable or recyclable at low cost by 2030. One of the EU’s goals in its plastics strategy is to stop marine litter. The long-term goal must be to avoid marine plastic waste entirely. However, creating a circular economy and recognising the value of a material that is widely considered to be refuse will be essential to achieving this aim.

The overall EU strategy is based specifically on four basic tenets:

  • manufacturing recyclable products
  • optimising the separation and collection of plastic waste
  • increasing recycling capacities
  • reusing recyclates in production

Past the leap, the EU’s Commitment

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SECURE Act Up for Consideration in the Senate – A Rehash

I covered the House SECURE Act and the Senate RESA version last July. The House RESA Act is up for consideration in the Senate now. It does not look like it is going to make it due to the impeachment process going on and a potential trial in the Senate. There is also a small matter of a budget needing to be passed. It was to be considered under an unanimous consent vote; however, three Republican Senators (Mike Lee of Utah [unidentified reason], Ted Cruz of Texas (529 Accounts), and Pat Toomey of Pennsylvania [Gold Star tax exemption]) put holds on the bill (reasons in parenthesis). Then there is McConnell, who will not bring it to the floor for a vote.

Congress has been working on a much-needed improvement for “Middle Class” savings and growth over the span of employment in order  to boost retirement resource for citizens who can afford to save. Both the Senate and the House versions have been sitting since July. Whata surprise, heh?

Dueling bills to restructure IRAs and 401ks appear to be redundant; but, there are differences.  Better known as the “Setting Every Community Up for Retirement Act” (SECURE Act) H.R.1994 and the Senate has the “Retirement Enhancements and Savings Act” S.792 (RESA) version. Both bills were passed with bipartisan support. Both bills for the Middle Class had pluses and rather big negatives also. It appears the House RESA Act is going forward for a vote.

The RESA Act is mostly for the masses who may be able to save some money for retirement in spite of stagnant wages. No worries for the for the rich in income (unless something has changed since I last looked at this).  A major outcome of the Trump tax bill were tax breaks for the wealthy and corporations. Besides much of the resulting income increases going to 1% of the household taxpayers, the same 1% were given the ability to shelter large amounts of income in gifts to their heirs. It is a great time to be rich in income and have the ability to shelter it by making gifts of it to your heirs’ tax free! Keep in mind, seven or so years out and those income tax cuts will disappear for the middle income brackets. Somebody has to pay for the overall breaks otherwise their tax relief will sunset as they were passed under reconciliation in the Senate.

A little history (past the leap) on why Congress did something which will help those who can afford to save presently, penalize those bequeathed whatever is left over after death, and pay for the IRA and 401k break.

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Plastic: Part of the Problem . . . Part of the Solution – Part 1 (of 4): A Global Problem

Introduction: I am still on the mailing lists of quite a few resin and plastics companies. This particular presentation is from Sesotec GmbH (“company with limited liability”). Sesotec was an exhibitor at the K trade fair in Düsseldorf and now is reflecting on an exciting and positive trade fair appearance (for them) with its topic of a “Circular Plastics Economy.” This is part 1 of a 4 part presentation which I believe to be done in an exemplary manner and worthy of repeating.  Having cost modeled plastic parts at SY and Yazaki NA and purchased resins for Marquardt, Flex, and Stoneridge, I enjoyed the presentation.

This is why I thought this was worthy of presentation  at Angry Bear: “The K trade fair is held every three years and is an optimal opportunity to learn about current topics in the industry and to exchange information about these topics.

Marc Setzen, CEO of Sesotec GmbH: ‘We are more than satisfied with the results of the trade fair. With concern to the focal topic of the K trade fair, the Circular Economy not only is a technical challenge but also requires a change of the way people think. The attitude of plastics being throwaway products must be abandoned and people must become aware of the fact plastics being valuable reusable materials. Our machines and systems only are one component in the material cycle; but nevertheless, they make an essential contribution because they ensure the high quality of secondary raw materials made from recyclate and guarantee that the cycle really works.'”

This fits with what we must change to and be doing today.

Some 70 years after the first plastic products hit the market, the vision of a world without plastic waste still appears far off. Yet this substance – a plague once it becomes waste – is an extremely attractive material. What we need is a different approach to dealing with plastic waste. In this multi-part series, we will take a look at the role that the waste management and recycling industry can play in the process. Part 1 takes us to a variety of destinations, including China.

The production of plastic has increased dramatically around the world in recent decades and currently stands at 200 times the amount manufactured by factories back in 1950. Europe is responsible for one-quarter of the world’s plastic consumption, mainly due to packaging that lands in the rubbish bin after being used for only a short time. Plastic is also used in construction (20%), vehicles (8.6%) and electronics (5.7%).

After the leap, how China and the EU are increasing the pressure . . .

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Mankiw’s Ideal Democrat (Bloomberg Alert)

Mankiw’s Ideal Democrat (Bloomberg Alert)

Greg Mankiw has always been a Never Trumper:

I just came back from city hall, where I switched my voter registration from Republican to unenrolled (aka independent). Two reasons: First, the Republican Party has largely become the Party of Trump. Too many Republicans in Congress are willing, in the interest of protecting their jobs, to overlook Trump’s misdeeds (just as too many Democrats were for Clinton during his impeachment). I have no interest in associating myself with that behavior. Maybe someday, the party will return to having honorable leaders like Bush, McCain, and Romney. Until then, count me out. Second, in Massachusetts, unenrolled voters can vote in either primary. The Democratic Party is at a crossroads, where it has to choose either a center-left candidate (Biden, Buttigieg, Klobuchar, Yang) or a far-left populist (Warren, Sanders) as their nominee for president. I intend to help them choose the former. The latter propose to move the country too far in the direction of heavy-handed state control. And in doing so, they tempt those in the center and center-right to hold their noses and vote for Trump’s reelection.

In a way I get this and a lot of other centrist Republicans are saying similar things. Enter Michael Bloomberg:

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S&P 500 BY PRESIDENTIAL TERMS

With the presidential election still a year away, Wall Street is starting its normal analysis that if a democrat is elected it will cause a devastating stock market crash.  One would think that after all these years of such claims being proven dead wrong that the street would finally give up on it. In the post WWII era from Truman to Obama it is 70 years and each party has had bad candidates in office for half that time.  Truman was only President for seven years and five months so the Democrats only had 35.4 years in office while the Republicans had 36 years in office.  Over these years the average annual S&P 500 gains was 15.9% for Democrats and 6.6% for Republicans. If you look at the actual returns, you would think if anything; Wall Street analyst would be warning about the dangers of a Republican President for the stock market.

Because the chart is already so cluttered I left Truman and Ike off.  But it seem so obvious that the record shows that it is Republican Presidents that investors should fear.  Just to clearly show that stock market gains have been more that double under Democrats versus Republicans I’ve also presented the data in a table.

 

 

 

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