Providing alternative facts to the Brazos Valley since 2012
Standing Clear of New Stand Alone ERs
Rapid growth in our community has been (mostly) a blessing. New businesses are providing goods, services and cuisine to fill needs we didn't even know we had. Then there's the stand alone, no wait emergency rooms which have spread here from the Dallas and Houston areas, adding nothing to our health care system but more costs.
True, there's nothing new about large bills from hospital emergency rooms, where high intensity medical cases are seen and a high volume of uninsured charity care is provided. But ERs have never marketed their services so aggressively for anything "from a hang nail, to a heart attack"--for which you would need to be transferred to an actual hospital, by the way.
Full disclosure: The Beagle is employed by an organization that owns hospitals and works shifts in a hospital emergency room when they are short handed. Which has no bearing on my opinion that these are mercenary businesses designed to serve the interests of their owners and meet no previously unmet need in our community.
Texas leads the nation in such businesses, which typically locate in the most medically insured neighborhoods and depend on unsophisticated health care consumers. So, no surprise that the latest additions are perched right off the A&M campus, where they will see much the same patient population that would otherwise be seen at a clinic or urgent care facility. But patients can end up being billed 5 to 10 times more for the same complaint due to higher billing rates and more aggressive diagnostics and treatment of what are generally non-emergency presentations.
Previously, insurance companies cracked down on such abuses--but then the state government showed up to "help". By creating a regulatory framework, they also provided a blueprint for such enterprises to market and bill for their services with virtual impunity. They do have to use the word "Emergency" somewhere in their name, but they otherwise do their best to impersonate a neighborhood medical clinic, with friendly concierge service. But the service isn't always completely honest as related to The Beagle by a former employee at one such facility, "I didn't mind that everyone had cars more expensive than my house, but when they told me I couldn't even give patients information that would help them decide where best to receive care, that was too much. Even if a patient would call us accidentally thinking we were St Joseph's ER, I wasn't allowed to tell them that we weren't. My job was to get them in the door however I could or I got in trouble."
But aren't they just being good old fashioned entrepreneurs in a free market? Absolutely not. Because their customers are mostly spending other people's money, and that's not how free markets work. The spread of these stand alone emergency rooms is hardly all that's wrong with our health care system, but it's the most egregious example of waste, abuse and crony capitalism that I've encountered.
My medical advice is to use common sense. Go to the hospital emergency room if you think you may need to be in a hospital. Otherwise, see your doctor, or go to one of the many acute care or urgent care facilities already here. These other guys can go back where they came from, because they're taking up valuable space that could be put to better use as another gourmet taco restaurant.
Dow 20,000--Now What?
A year ago, with the stock market well into correction territory, the Dow under 16,000 and market experts warning of a new bear market, The Beagle advised you not to panic and even to "use such opportunities to add to your positions or re-balance into stocks from bonds or cash" and to make sure you were well diversified including exposure to "the scary emerging markets" which have rallied even more strongly. Hope that at least covered the cost of your subscription.
It is just a number and not even one that professional money managers follow closely. But it does give us an opportunity to re-evaluate our investing strategy. And I think we should. Because investment returns are likely to be much lower for the next eight years than they were for the last eight. Valuations of large and small companies in the US are high, which predicts lower returns going forward. Alternative assets like commodities are up sharply from one year ago and don't represent much of a value at this point.
Think the economy will strengthen and that we will avoid a dangerous trade war? So does the market. Which means that this optimism is already priced in. And if we get unexpected bad news, the market will be hit that much harder. Sorry, that's how it works.
Still, stocks remain the best LONG TERM investment and you should stick with them. . .but with sober expectations. The good news is that interest rates are up a bit and yields on longer term bonds should at least keep you ahead of inflation now.
Also in our favor is the strong dollar. Which means we should look at purchasing overseas stocks which have lagged badly since the market low nearly eight years ago. How much of your stock investment to allocate overseas is a subject of much debate. Keep in mind that most of the world's economy and roughly half the world's investable markets are overseas. But a 50% international allocation subjects you to too much currency volatility. Also, large US companies derive nearly half their earnings internationally, so you already have a lot of exposure to those economies indirectly. The Beagle's prediction? Eight years from now, you'll be glad that you allocated 20 to 40% of your stock investments internationally in a broad, low cost index such as Vanguard FTSE All- World ex-US Index (ETF symbol VEU).
Hateful Trump Bans Muslims!
A case of mass hysteria seems to have gripped the nation. Haven't we been lectured for decades for our failure to expedite the immigration of Jews from Europe in the 1930's? But now we are somehow violating our "American values" by giving preference to the immigration of Christians from some countries in the Middle East? Didn't we learn our lesson about blaming racist America even before the embers have cooled on a suspicious fire? http://www.nationalreview.com/article/420572/church-burnings-falsified-history-repeats-itself-michelle-malkin
Looking for hysteria free information on the recent changes to America's immigration policies?
Super Bowl Trophy to Go to Team With Most Points!
Usually the winning team in football will have more total yards than the loser. But there are often exceptions, which tells you that the opponents were more evenly matched than the final score might indicate. Still, you don't get to claim that the winner is illegitimate. Because if it had been decided ahead of time to award the game to the team with the most yards, the winning team would have played the game very differently and the losing team may very well have still lost.
It also doesn't matter that the home team brought more fans to the game than the visitors or that they all wore the same funny hats. Speaking of which, would anyone expect the Packers to bring more fans to a road game in D.C. than the hometown Redskins? Yet the Packers enjoy as much or more support in the rest of the country.
The 6 million strong Washington D.C. metropolis should have been expected to turn out heavier for both Obama inaugurations (not just the first) in the overwhelmingly pro-Government and heavily Democrat region. Television ratings were comparable but neither Trump nor Obama topped Ronald Reagan's first inaugural (Do you recall any media reports that "Obama has a nice little crowd today, but this is nothing like Reagan's!") but Republicans did pretty well as the road team. . . especially on a work day.
Sadly, the largest turnout was for the . . .well, whatever that was when the feminists marched together wearing whatever that was on their heads. And what rights exactly were last week's protesters seeking that has been denied them? I can think of no rights that men have in America that are not also possessed by women. The major difference being that men do not have the right to kill their own offspring.
The losers this Sunday can also march in protest, appeal to the commissioner, claim that the pre-game reporting wasn't fair or that foreign governments determined the outcome, but it won't change the final score. And they still don't get a trophy.
Holocaust Survivor Wows Aggie Crowd
Given the recent campus political climate, I attended last week's talk by holocaust survivor Thomas Gabor '61 sponsored by A&M Hillel with some trepidation. But I couldn't have been more impressed with the speaker or the Aggies in attendance. He was a beautiful person who kept the audience in rapt attention as he related his childhood memories of Hungarian ghettos and concentration camps, teenage years under communism and young adult years in Aggieland, all in his thick Eastern European accent.
The subsequent audience questions were poignant, but an audible groan spread through the packed Rudder theater crowd when the final question invited his commentary on America's current political climate, relative one supposes, to Nazism. No doubt, the questioner expected this man, who survived not only Hitler but the subsequent communist dictators of Romania, to melt down over the election of Donald Trump, or lecture us on our racism, nationalism or xenophobia.
Despite being hard of hearing, he understood the question clearly--but would have none of it. His response, as not reported by The Eagle, was met with thunderous applause, "You have to understand, after what I've been through, I am an optimist. I don't understand what so many Americans are upset about today. I think we live in a great country!"