Before 1976, portfolios were constructed by stock picking only, assuming good stock selection counts for all the returns. Academic research from 1950- 1960s showed a systemic way to construct a portfolio to balance risk and return (many Nobel prizes were awarded to the economists who published such theories / models). The arrival of computer allowed a practical way of such portfolio construction and thus the 1976 launch of Vanguard index mutual fund. The rest they say is history with the popularity of passive index investing putting many active stock pickers out of job. But history is not done. Later research found many market factors that could explain over 95% of portfolio returns. Momentum investing is based on factor-based investing. Instead of investing the whole market without regards why the market fluctuates, factor-based investing posits that some factors are better than others in each different market environment. Now the public can choose passive index, or active management, or factor-based investing. Briefly, 5 factors that drive a portfolio return are: market beta, size,
value, momentum, profitability & quality. Invesco SPMO ETF tracks momentum factor only for its highest risk adjusted return of all the factors. There is no "free lunch" because when the market reverses, momentum investing becomes "free fall". In April 2025, SPMO declined 12% from peak to trough, while Vanguard S&P500 ETF VOO declined about 9%. Do 5-factor portfolios perform better than market-weighted index portfolio? It depends on market cycles and implementation techniques. Many fund advisors seem to concur that factor-based investing is too sophisticated for individuals while delivering only a marginal risk-adjusted advantage over the market weight index portfolio.
I followed the recommendations from Morningstar and TIPS Watch: go for individual TIP bonds to keep up with expected future inflation and still earn a respected 2% on top of inflation (buying from the secondary market). You can buy the TIP bond based on maturity date to match personal need or expectation, avoid TIP funds which are affected by interest rate changes hence volatile.
Fen-Phen and Vioxx fiascos made Congress cautious about lifting the payment prohibition before long term studies are done, and of course politics. GLP-1 drugs are known to cause thyroid tumors in animals; hence they are prohibited by FDA for a group of susceptible patients. This class of drugs could be the new miracle drugs for many people, although they cost about $10 to $16 K a year for life. Medicare has been paying for gastric bypass surgery since 2006 (about $30 K one-time payment), after the procedure was proved to be effective since 1970s (yes, it took over 30 years of data).
One note of caution: CoPilot AI copied the headline and body of the OP to reply to my query as facts when I last checked. Nothing personal but then AI is not a person, and it needs to be taught for the benefit of the humans.
A handful of genes influence appetite, satiety, metabolism, fat storage, and energy expenditure. Population-based studies show that heritable traits vary by age, diet, exercise, environment, and population (from 25% to 80%). Medicare covers gastric bypass surgery as durable effective weight loss and health benefits for people with BMI over 35.
Some background information for the curious HD forum readers: 1) Arthroscopy for osteoarthritis is NOT recommended by the American Academy of Orthopaedics Surgeons, British Medical Journal after multiple decade studies showing ineffectiveness. CMS still pays, prior authorization is not required (but optional under selected regions) under traditional Medicare. 2) Nerve stimulation devices do not address underlying causes of pain, are ineffective in low back pain, and other chronic pain conditions. CMS still pays without prior authorization. 3) Congress created Medicare Part D covering drug prescriptions in 2003, but specifically prohibited weight loss drugs after the 1990's sensational weight loss drug combo Fen-Phen was later found to cause heart valve damage and pulmonary hypertension (right side heart failure). Multiple attempts since then to lift this prohibition failed. 4) Another sensational drug was Vioxx (1999), marketed as pain medicine without stomach side effects. Traditional Medicare did not pay, so people signed up with Medicare Advantage to get it. Kaiser Medicare Advantage refused to cover it and petitioned the FDA to withdraw the drug due to increased stroke and heart attack. Merck withdrew Vioxx in 2004 after a long term study confirmed the increased risks and an estimate of 60,000 deaths.
"A major Medicare benefit just vanished" Really? But I looked and could not find any! The CMS Factsheet on Wasteful and Inappropriate Services Reduction Model (WISer) confirms that this is a 6-year pilot program in selected regions (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington) with no change in coverage, payment or coding procedure for any of the 17 services. Participation in this pilot program is voluntary - any provider is free to ignore this program, although CMS routinely conducted medical reviews, and this time this review will be done by WISeR contractors' AI program and licensed clinicians (called participants).Anyone can say that prior authorization is synonymous with benefit denial, but it might be semantics with regards to Medicare programs whether denial is done early before services via preauthorization or done after services via CMS medical documentation review. The public has been shielded from the CMS preauthorization game: the rules are hidden; the players are rotating teams of coders from CMS government positions to private coding companies. Usually, CMS lost most games no matter what new rules or models are rolled out - most recent were CMS's coordinated care and disease management demonstration project, Medicare Part D premium stabilization demonstration program.
Ah yes, to paraphrase a classic line from Mary Poppins, a spoonful of "inflation" helps the medicine go down, in a most delightful way! Even AI confirms it: there is broad consensus that inflation around 2% or lower is best to balance consumer needs, worker's employment stability and population's future expectation. Every worker wants a stable job with annual pay raise, but no one wants to pay more for the chocolate, petrol / gasoline. More than 2% will cause economic disturbance. People are happy when their houses worth more, even if they could not afford the higher HELOC interest rates for home equity access. Inflation is also an easier medicine to take than deflation. We could live with no pay raise, but we would be angry with a pay cut, despite the increasing worth of the pound / dollar to buy the same bar of chocolate or a gallon of gasoline. People are depressed when their houses worth less, even if their shelters have not changed physically.
Congratulations on your new freedom. From personal experience, our mental habit would not change easily unless we deliberately subject ourselves to new demands or routines for a while. After 2 decades of hospital on-call duties, and despite 4 years into retirement, I still have not escaped the startled / surprised / anxious feeling when I got unexpected night call or text. Just be amused how work life conditioned us. Now that work is no longer a part of our life, we are free to unlearn and recondition ourselves to new happiness. Goodbye the old golden cage, and good ridden.
I use bond ladder in my taxable account. Pros: predictable return via yield to maturity, ultra safe and free of state / local tax from Treasuries, no transaction cost with Treasuries. Cons: illiquid if held to maturity, interest rate risk / loss if sold early, no diversification unless very large capital spreading over many dozen bonds, limited upside, and larger downside when inflation is expected - i.e. real yield (nominal yield - inflation rate) may be small or negative. The longer the bond duration, the higher the price volatility, i.e. NFL or no free lunch. Last year, I got 5% total return - 3% inflation = 2% real yield. S&P500 index total return for 2024 was 25%.
Comments
Before 1976, portfolios were constructed by stock picking only, assuming good stock selection counts for all the returns. Academic research from 1950- 1960s showed a systemic way to construct a portfolio to balance risk and return (many Nobel prizes were awarded to the economists who published such theories / models). The arrival of computer allowed a practical way of such portfolio construction and thus the 1976 launch of Vanguard index mutual fund. The rest they say is history with the popularity of passive index investing putting many active stock pickers out of job. But history is not done. Later research found many market factors that could explain over 95% of portfolio returns. Momentum investing is based on factor-based investing. Instead of investing the whole market without regards why the market fluctuates, factor-based investing posits that some factors are better than others in each different market environment. Now the public can choose passive index, or active management, or factor-based investing. Briefly, 5 factors that drive a portfolio return are: market beta, size, value, momentum, profitability & quality. Invesco SPMO ETF tracks momentum factor only for its highest risk adjusted return of all the factors. There is no "free lunch" because when the market reverses, momentum investing becomes "free fall". In April 2025, SPMO declined 12% from peak to trough, while Vanguard S&P500 ETF VOO declined about 9%. Do 5-factor portfolios perform better than market-weighted index portfolio? It depends on market cycles and implementation techniques. Many fund advisors seem to concur that factor-based investing is too sophisticated for individuals while delivering only a marginal risk-adjusted advantage over the market weight index portfolio.
Post: Got Momentum?
Link to comment from July 7, 2025
I followed the recommendations from Morningstar and TIPS Watch: go for individual TIP bonds to keep up with expected future inflation and still earn a respected 2% on top of inflation (buying from the secondary market). You can buy the TIP bond based on maturity date to match personal need or expectation, avoid TIP funds which are affected by interest rate changes hence volatile.
Post: Bond Conundrum
Link to comment from July 7, 2025
Fen-Phen and Vioxx fiascos made Congress cautious about lifting the payment prohibition before long term studies are done, and of course politics. GLP-1 drugs are known to cause thyroid tumors in animals; hence they are prohibited by FDA for a group of susceptible patients. This class of drugs could be the new miracle drugs for many people, although they cost about $10 to $16 K a year for life. Medicare has been paying for gastric bypass surgery since 2006 (about $30 K one-time payment), after the procedure was proved to be effective since 1970s (yes, it took over 30 years of data).
Post: A major Medicare benefit just vanished
Link to comment from July 7, 2025
One note of caution: CoPilot AI copied the headline and body of the OP to reply to my query as facts when I last checked. Nothing personal but then AI is not a person, and it needs to be taught for the benefit of the humans.
Post: A major Medicare benefit just vanished
Link to comment from July 7, 2025
A handful of genes influence appetite, satiety, metabolism, fat storage, and energy expenditure. Population-based studies show that heritable traits vary by age, diet, exercise, environment, and population (from 25% to 80%). Medicare covers gastric bypass surgery as durable effective weight loss and health benefits for people with BMI over 35.
Post: A major Medicare benefit just vanished
Link to comment from July 7, 2025
Some background information for the curious HD forum readers: 1) Arthroscopy for osteoarthritis is NOT recommended by the American Academy of Orthopaedics Surgeons, British Medical Journal after multiple decade studies showing ineffectiveness. CMS still pays, prior authorization is not required (but optional under selected regions) under traditional Medicare. 2) Nerve stimulation devices do not address underlying causes of pain, are ineffective in low back pain, and other chronic pain conditions. CMS still pays without prior authorization. 3) Congress created Medicare Part D covering drug prescriptions in 2003, but specifically prohibited weight loss drugs after the 1990's sensational weight loss drug combo Fen-Phen was later found to cause heart valve damage and pulmonary hypertension (right side heart failure). Multiple attempts since then to lift this prohibition failed. 4) Another sensational drug was Vioxx (1999), marketed as pain medicine without stomach side effects. Traditional Medicare did not pay, so people signed up with Medicare Advantage to get it. Kaiser Medicare Advantage refused to cover it and petitioned the FDA to withdraw the drug due to increased stroke and heart attack. Merck withdrew Vioxx in 2004 after a long term study confirmed the increased risks and an estimate of 60,000 deaths.
Post: A major Medicare benefit just vanished
Link to comment from July 7, 2025
"A major Medicare benefit just vanished" Really? But I looked and could not find any! The CMS Factsheet on Wasteful and Inappropriate Services Reduction Model (WISer) confirms that this is a 6-year pilot program in selected regions (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington) with no change in coverage, payment or coding procedure for any of the 17 services. Participation in this pilot program is voluntary - any provider is free to ignore this program, although CMS routinely conducted medical reviews, and this time this review will be done by WISeR contractors' AI program and licensed clinicians (called participants). Anyone can say that prior authorization is synonymous with benefit denial, but it might be semantics with regards to Medicare programs whether denial is done early before services via preauthorization or done after services via CMS medical documentation review. The public has been shielded from the CMS preauthorization game: the rules are hidden; the players are rotating teams of coders from CMS government positions to private coding companies. Usually, CMS lost most games no matter what new rules or models are rolled out - most recent were CMS's coordinated care and disease management demonstration project, Medicare Part D premium stabilization demonstration program.
Post: A major Medicare benefit just vanished
Link to comment from July 6, 2025
Ah yes, to paraphrase a classic line from Mary Poppins, a spoonful of "inflation" helps the medicine go down, in a most delightful way! Even AI confirms it: there is broad consensus that inflation around 2% or lower is best to balance consumer needs, worker's employment stability and population's future expectation. Every worker wants a stable job with annual pay raise, but no one wants to pay more for the chocolate, petrol / gasoline. More than 2% will cause economic disturbance. People are happy when their houses worth more, even if they could not afford the higher HELOC interest rates for home equity access. Inflation is also an easier medicine to take than deflation. We could live with no pay raise, but we would be angry with a pay cut, despite the increasing worth of the pound / dollar to buy the same bar of chocolate or a gallon of gasoline. People are depressed when their houses worth less, even if their shelters have not changed physically.
Post: Inflation, Through a Glass Half Full.
Link to comment from July 4, 2025
Congratulations on your new freedom. From personal experience, our mental habit would not change easily unless we deliberately subject ourselves to new demands or routines for a while. After 2 decades of hospital on-call duties, and despite 4 years into retirement, I still have not escaped the startled / surprised / anxious feeling when I got unexpected night call or text. Just be amused how work life conditioned us. Now that work is no longer a part of our life, we are free to unlearn and recondition ourselves to new happiness. Goodbye the old golden cage, and good ridden.
Post: Today’s the Day!
Link to comment from July 3, 2025
I use bond ladder in my taxable account. Pros: predictable return via yield to maturity, ultra safe and free of state / local tax from Treasuries, no transaction cost with Treasuries. Cons: illiquid if held to maturity, interest rate risk / loss if sold early, no diversification unless very large capital spreading over many dozen bonds, limited upside, and larger downside when inflation is expected - i.e. real yield (nominal yield - inflation rate) may be small or negative. The longer the bond duration, the higher the price volatility, i.e. NFL or no free lunch. Last year, I got 5% total return - 3% inflation = 2% real yield. S&P500 index total return for 2024 was 25%.
Post: Is now the time to go long in bonds?
Link to comment from July 3, 2025