Such wisdom, Jonathan, and so contrary to what is being pushed out by many other financial and “ life” counselors. The email after yours was from John Mauldin who is pushing a “life transforming “ newsletter( for $1400) that promises health and “wellness” therapies that will allow the lucky subscribers to live for 150 or 200 years and identify companies that will make it happen. These companies are on the “verge” of massive breakthroughs. Of course, they are held back by a criminally incompetent FDA that “should be abolished”. Snake oil salesman. How do people believe this junk?
While I have all our account clustered in Quicken, I always doubt their ROI calculations. It is impossible to tell if they use the true beginning and ending values on multiple account or the whole. If anyone else has solved this please let me know. I also do not know the methodology at Schwab and Fido, so don’t know if they accurately track withdrawals and additions. You would think it would be straight forward, but not. All I know is we have more money now than we did 10 years ago, despite college expenses and buying a new house!
I use face id on apple devices as I figure it is at least as secure as a password. I use 1password for non financial sites. Lastpass got hacked so I switched I am very worried about. security on financial sites, and I suspect we will not hear if Schwab or Fido gets hacked. Isn’t it interesting that Schwab seems to have dropped voice ID? maybe too easy for AI to crack?
I am glad that you managed to find new goals in retirement. Was your goal in life previously really to make money? This seems very superficial; surely you took pride in doing a job well, even if it was personal investing. The people I have known who really only focused on making money seem shallow and can never admit they have reached their goals. How much is enough? The people I have known who were the happiest were people who had jobs they loved so much they would do them for free, like Buffett. I remember waiting for my medical school admittance interview with several other candidates. One announced loudly that he thought becoming a doctor was stupid ( I guess his parents had forced him) because he could make more money by taking the tuition money and investing it. I doubt he was ever very happy in anything he did.
As a retired Primary care doc ( now on straight MC) I can offer the following thoughts based on years of being on the other end, caring for patients on Medicare Advantage. In a nutshell MA plans are a disaster for MDs and patients. As noted the plans are paid more for more “complex” patients( doctors usually aren’t ) but CMS did a poor job defining complex; it basically relates to the total number of coded diagnoses. That is the reason for the house visits from a MA nurse, to find any possible diagnosis and add many codes to otherwise simple things. low thyroid becomes an autoimmune disease, hypertension morphs into kidney and heart disease, etc. $$$ up go the payments the Feds are forced to pay to the plan, every year. This money has nothing to do with the care someone receives, it is gaming the system. Some MA in places with great stable hospital system ( usually at least a duopoly) are OK as they have not choice to use the big University hospital for complex specialties. But it may not be the one you want. Even in CT my MA patients were frequently told they could not go to Yale for heart surgery but had to go to a community hospital with a marginal record. MA plans place a huge burden on MDs and staff who have to jump through hoops to get care plans approved, and many times they are denied without reason, by a clerk. Unless you cannot possible afford traditional MC, stay away from MA. Once you sign up with a MA traditional Medicare will take you back during open enrollment, but the insurance companies running the supplement (paying for 20%) do not have to take you on or can charge you much higher premiums.
Musk and Zuckerberg political activities are a pretty effective counter to your entire argument. I think social media’s control over civic discourse has changed the entire argument. When people amass these huge fortunes and then spend them controlling our government, the consequences are dire and disastrous and will get worse. It started with the Kochs, and “Project 2025” will destroy America, all funded by right wing billionaires. The US defense relies heavily on Starlink and NASA on SpaceX. Remember when Musk cut Ukraine off of Starlink? Do we really want our national security dependent on Elon? Look at Zuckerberg’s recent transformation. He believes in “companies not countries”. He also says “Meta” has no responsibility for stopping falsehoods about vaccinations, election deniers, etc and is sorry he apologized to parents whose kids killed themselves because of Facebook pressure. With his money he apparently can do anything he wants. https://www.theguardian.com/commentisfree/2024/sep/27/mark-zuckerberg-metaverse-ai-elections-mental-health?CMP=Share_iOSApp_Other Billionaires are the problem. None of them got there by being nice or supporting the common good. Bill Gates was cited by the NLRB for employment violations when Microsoft had fewer than 50 employees. The example of the Whaltons giving money for art museums ignores the fact that Walmart destroyed previously vibrant small town businesses.
I share many of these experiences. As a young doctor, I was convinced I could have a great career in academic medicine research and publishing. I took a job at a top flight medical school that required me to work at the VA hospital. Jonathan the VA makes Citi look like the most efficient organization in history. To succeed in academics I had to not focus on patient care, which reinforced my understanding that what I really loved about medicine was taking care of patients, the more complicated the better. As the VA was impossible for efficient patient care, I knew I had to leave and eventually joined a private practice where I stayed 30 years, and loved every minute. I realized I had found my ideal job, and was very appreciated by my patients, many of who still keep in touch.
Corporations have proven to be horribly irresponsible in the use of their excessive cash, with absolutely no regard cor their “owners” their shareholders. Huge CEO salaries ( thousands of times their average worker) with no concern for preformance, excessive fringes, multiple corporate jets, lush meeting locales, and massive stock buybacks ( the latter accounted for 50% of the market’s gains ). Dividends do not eliminate these abuses, but the are at least a bit of a brake, and at
in the case of most of the “Aristocrats” are part of the “corporation culture” and while not guaranteed, are pretty safe. Mr Grossman should use a few more examples, other than P and G.
In my 40 years of medical practice, I always found optimism was a powerful drug! I had many patients with horrible prognoses do very well, an unexpected outcome if you just looked at “medians”. No one knows what the future holds for any of us. I have had friends drop dead. One day at a time, stay close to family and friends, enjoy Paris and we will keep praying for you and your loved ones.
A quick search of Exon 20 therapy shows a good review
as of March 2024 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11010879/ including the Papillon trial, recently completed and published. You dont need to go to the Mayo clinic for state of the art treatments! https://www.nejm.org/doi/suppl/10.1056/NEJMoa2306441/suppl_file/nejmoa2306441_research-summary.pdf
Comments:
Such wisdom, Jonathan, and so contrary to what is being pushed out by many other financial and “ life” counselors. The email after yours was from John Mauldin who is pushing a “life transforming “ newsletter( for $1400) that promises health and “wellness” therapies that will allow the lucky subscribers to live for 150 or 200 years and identify companies that will make it happen. These companies are on the “verge” of massive breakthroughs. Of course, they are held back by a criminally incompetent FDA that “should be abolished”. Snake oil salesman. How do people believe this junk?
Post: Four Questions
Link to comment from December 28, 2024
While I have all our account clustered in Quicken, I always doubt their ROI calculations. It is impossible to tell if they use the true beginning and ending values on multiple account or the whole. If anyone else has solved this please let me know. I also do not know the methodology at Schwab and Fido, so don’t know if they accurately track withdrawals and additions. You would think it would be straight forward, but not. All I know is we have more money now than we did 10 years ago, despite college expenses and buying a new house!
Post: What is The 10 Year Return on Your Portfolio?
Link to comment from December 1, 2024
I use face id on apple devices as I figure it is at least as secure as a password. I use 1password for non financial sites. Lastpass got hacked so I switched I am very worried about. security on financial sites, and I suspect we will not hear if Schwab or Fido gets hacked. Isn’t it interesting that Schwab seems to have dropped voice ID? maybe too easy for AI to crack?
Post: Passkeys, anyone? by 1PF
Link to comment from December 1, 2024
I am glad that you managed to find new goals in retirement. Was your goal in life previously really to make money? This seems very superficial; surely you took pride in doing a job well, even if it was personal investing. The people I have known who really only focused on making money seem shallow and can never admit they have reached their goals. How much is enough? The people I have known who were the happiest were people who had jobs they loved so much they would do them for free, like Buffett. I remember waiting for my medical school admittance interview with several other candidates. One announced loudly that he thought becoming a doctor was stupid ( I guess his parents had forced him) because he could make more money by taking the tuition money and investing it. I doubt he was ever very happy in anything he did.
Post: Time’s A-Wasting
Link to comment from November 23, 2024
As a retired Primary care doc ( now on straight MC) I can offer the following thoughts based on years of being on the other end, caring for patients on Medicare Advantage. In a nutshell MA plans are a disaster for MDs and patients. As noted the plans are paid more for more “complex” patients( doctors usually aren’t ) but CMS did a poor job defining complex; it basically relates to the total number of coded diagnoses. That is the reason for the house visits from a MA nurse, to find any possible diagnosis and add many codes to otherwise simple things. low thyroid becomes an autoimmune disease, hypertension morphs into kidney and heart disease, etc. $$$ up go the payments the Feds are forced to pay to the plan, every year. This money has nothing to do with the care someone receives, it is gaming the system. Some MA in places with great stable hospital system ( usually at least a duopoly) are OK as they have not choice to use the big University hospital for complex specialties. But it may not be the one you want. Even in CT my MA patients were frequently told they could not go to Yale for heart surgery but had to go to a community hospital with a marginal record. MA plans place a huge burden on MDs and staff who have to jump through hoops to get care plans approved, and many times they are denied without reason, by a clerk. Unless you cannot possible afford traditional MC, stay away from MA. Once you sign up with a MA traditional Medicare will take you back during open enrollment, but the insurance companies running the supplement (paying for 20%) do not have to take you on or can charge you much higher premiums.
Post: Prefer the Original
Link to comment from October 26, 2024
Musk and Zuckerberg political activities are a pretty effective counter to your entire argument. I think social media’s control over civic discourse has changed the entire argument. When people amass these huge fortunes and then spend them controlling our government, the consequences are dire and disastrous and will get worse. It started with the Kochs, and “Project 2025” will destroy America, all funded by right wing billionaires. The US defense relies heavily on Starlink and NASA on SpaceX. Remember when Musk cut Ukraine off of Starlink? Do we really want our national security dependent on Elon? Look at Zuckerberg’s recent transformation. He believes in “companies not countries”. He also says “Meta” has no responsibility for stopping falsehoods about vaccinations, election deniers, etc and is sorry he apologized to parents whose kids killed themselves because of Facebook pressure. With his money he apparently can do anything he wants. https://www.theguardian.com/commentisfree/2024/sep/27/mark-zuckerberg-metaverse-ai-elections-mental-health?CMP=Share_iOSApp_Other Billionaires are the problem. None of them got there by being nice or supporting the common good. Bill Gates was cited by the NLRB for employment violations when Microsoft had fewer than 50 employees. The example of the Whaltons giving money for art museums ignores the fact that Walmart destroyed previously vibrant small town businesses.
Post: In defense of billionaires
Link to comment from September 28, 2024
I share many of these experiences. As a young doctor, I was convinced I could have a great career in academic medicine research and publishing. I took a job at a top flight medical school that required me to work at the VA hospital. Jonathan the VA makes Citi look like the most efficient organization in history. To succeed in academics I had to not focus on patient care, which reinforced my understanding that what I really loved about medicine was taking care of patients, the more complicated the better. As the VA was impossible for efficient patient care, I knew I had to leave and eventually joined a private practice where I stayed 30 years, and loved every minute. I realized I had found my ideal job, and was very appreciated by my patients, many of who still keep in touch.
Post: Never Quite Enough
Link to comment from September 21, 2024
Corporations have proven to be horribly irresponsible in the use of their excessive cash, with absolutely no regard cor their “owners” their shareholders. Huge CEO salaries ( thousands of times their average worker) with no concern for preformance, excessive fringes, multiple corporate jets, lush meeting locales, and massive stock buybacks ( the latter accounted for 50% of the market’s gains ). Dividends do not eliminate these abuses, but the are at least a bit of a brake, and at in the case of most of the “Aristocrats” are part of the “corporation culture” and while not guaranteed, are pretty safe. Mr Grossman should use a few more examples, other than P and G.
Post: Yielding No Advantage
Link to comment from August 31, 2024
In my 40 years of medical practice, I always found optimism was a powerful drug! I had many patients with horrible prognoses do very well, an unexpected outcome if you just looked at “medians”. No one knows what the future holds for any of us. I have had friends drop dead. One day at a time, stay close to family and friends, enjoy Paris and we will keep praying for you and your loved ones.
Post: Looking Different
Link to comment from July 6, 2024
A quick search of Exon 20 therapy shows a good review as of March 2024 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11010879/ including the Papillon trial, recently completed and published. You dont need to go to the Mayo clinic for state of the art treatments! https://www.nejm.org/doi/suppl/10.1056/NEJMoa2306441/suppl_file/nejmoa2306441_research-summary.pdf
Post: Looking Different
Link to comment from July 6, 2024