Since the beginning of January, the site has had a countdown clock on its homepage indicating that it could start functioning as normal on February 1, meaning the site beat its self-imposed timeline by one day.
Less than a week ago we warned, “today Athens, tomorrow Madrid,” and sure enough, emboldened by the success of Syriza in Greece, the people of Spain have turned out in their tens of thousands in Madrid at a demonstration called by the insurgent Spanish leftist party Podemos. As The Independent reports, Podemos, which means “we can”, has surged into first place in opinion polls in the few months since it was set up in the summer of 2014. It is now ahead of the centre-right Popular Party and centre-left Spanish Socialist Workers’ Party in many opinion polls. Podemos’s policies include a universal basic income, increased democracy, crackdowns on tax avoidance, and increased public control over the economy. Most worrying for the status-quo huggers in Brussels, Podemos has also wants to reform the European Union, describing the current euro arrangement as a “trap.”
As we noted earlier this week, while Alexis Tsipras name (and face) are now well known, we suspect few are yet fully aware of Pablo Iglesias, general secretary of Spain’s left-wing Podemos party…
“Winds of democratic change are blowing in Europe.
The change in Greece is called Syriza, in Spain it’s called Podemos.
The Hope is coming.
Hasta La Victoria. SYRIZA – PODEMOS … Venceremos! ” (Until victory – We will win!“
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And sure enough, here are the winds of social change…
One marcher, Jose Maria Jacobo, told the Reuters news agency that Podemos supporters wanted to fight back against the country’s political class.
“It is the only way to kick out all of those politicians who are taking everything from us. They even try to take our dignity away from us. But that they won’t take that from us.”
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Pablo Iglesias, the leader of Spanish anti-austerity party Podemos, pledged to restructure the nation’s debt if he can convert his opinion-poll lead into election victory, following the example of his ally, Greek Prime Minister Alexis Tsipras. “It has to be a rigorous restructuring,” Iglesias, 36, told thousands of supporters at a rally in Madrid on Saturday. The deal “should be appropriate for the fourth-largest euro economy,” he added.
The party has also pledged to take on Spain’s highly entrenched establishment, dubbed “la casta”, which has dominated politics in the country since the fall of fascism there.
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If you want to build a successful, sustainable business, don’t ask yourself what could change in the next ten years that could affect your company.
Instead, ask yourself what won’t change, and then put all your energy and effort into those things.
That’s the advice of Amazon CEO Jeff Bezos, highlighted in an interesting post about Uber’s big ambitions by venture capitalist Bill Gurley.
Bezos suggests that you should build a business strategy around the things you know are stable in time — like that customers will always prefer lower prices — and then invest heavily in ensuring you are providing those things and improving your delivery of them all the time.
“When you have something that you know is true, even over the long term, you can afford to put a lot of energy into it,” Bezos says.
To help it achieve lower prices, Uber has poured time and money into the back-end routing algorithms of its app and an intelligence system for demand prediction, congestion prediction, supply matching, supply positioning, smart dispatch, and dynamic pricing, Gurley points out. It has launched UberPool — a ride-sharing option that Gurley argues has become one of the company’s defining initiatives.
As Uber hustles away on making UberPool a success, it is perfectly achieving Bezos’ strategy. It is making a big investment in something that will never change (people wanting to pay less for transportation).
The things Bezos predicted would always be true for Amazon customers is that they’d always want lower prices and speedy shipping. So, the company has spent the last 11 years investing in those things— often forgoing profits to do so.
To work towards those things, Amazon has spent billions on building fulfillment and sortation centers all over the US and the world, a topic which came up on its fourth quarter earnings call on Thursday.
“What’s happened over the course of last several years, with all the fulfillment centers that we have added, is we have actually gotten selection closer to customers,” CFO Tom Szkutak said. “And so that’s helped us from a delivery speed standpoint. And it’s helped us from a cost standpoint too —in terms of transportation cost — because of being closer to our customers.”
It’s been a long, un-ending effort, but worth-it, since customers will always value Amazon’s fast delivery options.
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Jimmy Lafont, whose towboat operation is among the service companies feeling the pinch on Louisiana’s oil fields. Credit William Widmer for The New York Times
CUT OFF, La. â€” â€œThe first thing you hear is, â€˜Can you cut 10 percent?â€™Â â€ explained Jimmy Lafont, whose towboat operation is one of the countless oil-field service companies spread across south Louisiana. â€œCajuns normally have a habit of cutting the price quick like.â€
As oil prices drop, the squeeze has begun in south Louisiana. It starts with ugly state budget projections, layoff announcements and freezes on new construction projects. Cutbacks at the drilling companies lead to cutbacks at the service companies, and before long the grocery stores and car dealerships start feeling it.
â€œThe price of oil,â€ Mr. Lafont said over biscuits and coffee in a back room of his office just off the bayou, â€œcontrols everything in south Louisiana.â€
But every downturn is a little bit different, and every downturn falls unevenly â€” even within the oil industry, as Louisianaâ€™s complicated place in the current price collapse shows.
The frontline casualties of the current price collapse have been in the shale-drilling boom towns of Texas and North Dakota. These shale plays, where hydraulic fracturing tapped massive oil reserves, rocketed into prominence and have come hard back down to earth.
A crane boat at Port Fourchon, where the longer-term prospects for deepwater drilling have kept an expansion going strong. Credit William Widmer for The New York Times
There has been little of that activity in Louisiana. The large swath of oil-rich shale that spans the center of the state is so geologically complicated that it has mostly been unexplored. And while some small well operators throughout Louisiana will be badly hurt, oil exploration within the state has generally been on the decline for years.
The main oil exploration these days takes place out in the federal waters of the Gulf of Mexico. Many of these are multimillion-dollar, 10-year operations, so involved that they are relatively shielded from market slumps â€” as long as the slumps do not last too long.
â€œI donâ€™t think we will feel it as badly here in Louisiana as other parts of the country may feel it,â€ Don Briggs, the president of the Louisiana Oil and Gas Association, said Monday at an industry luncheon in New Orleans.
That is not to say Louisiana will be spared the pain, only that it may be more of a slow strangle than a sudden jolt.
The most apparent early impact is on the state budget. While it will not be like the catastrophic oil price collapse in the early 1980s, when oil and gas brought in more than 40 percent of the stateâ€™s general fund revenues, it will hurt nonetheless. (Recently, around 14 percent of such revenues have come from oil and gas.)
Shortly after Mr. Briggs made his luncheon speech, the state revenue estimating committee announced that there would be a $104 million shortfall this year because of the price slump, leading to more cuts to already well-hacked state services.
The committee also found that the $1.4 billion hole expected in next yearâ€™s budget would be $204 million deeper.
But the ripples of the big slowdown in shale-drilling country are being absorbed by the private sector here, too. With its deep reserves of oil-field expertise, Louisiana provides much of the labor and tools in boom towns elsewhere, meaning that standstills in North Dakota are felt acutely in the oil city of Lafayette.
Storage tanks at Port Fourchon. Credit William Widmer for The New York Times
â€œThere are a lot of service companies working for firms all over the country,â€ said David E. Dismukes, the executive director at the Center for Energy Studies at Louisiana State University. â€œThose kinds of service sector jobs are probably going to be impacted pretty quickly by this.â€
Among the first to feel a slump are the landmen, who negotiate leases and land rights for oil exploration. Several hundred people working for land companies in Lafayette were laid off in late December.
The service firms, tool fabricators and truckers that make up the bulk of the work force are renegotiating their contracts with the oil companies, in some cases agreeing to steeply lower rates on the notion that poorly compensated work is better than no work at all.
â€œAt this time in 1985, the motto was â€˜Survive in â€™85,â€™Â â€ said Joseph Orgeron, the chief technology officer for Montco Offshore, which caters to offshore rigs. â€œItâ€™s a good time for companies to tighten the belt.â€
With the price of crude oil plummeting, why some countries are faring much better than others.
Video by Quynhanh Do on Publish Date January 27, 2015. Photo by Carlos Garcia Rawlins/Reuters.
But many smaller companies, particularly those that have taken on too much debt, cannot do that for long. Larger firms are already looking forward to a season of acquisitions, furthering a long-term trend of consolidation and leading to fewer, larger companies along the bayou. Mr. Lafont said he saw a new, less frugal generation learning what many learned the hard way in the 1980s.
â€œLast four or five years, some people thought this was never going to stop,â€ he said.
In recent years, Louisianans could be forgiven somewhat for thinking that way, with the juicy promise of a largely untapped shale formation, an eagerly awaited building boom in petrochemical facilities and an ever-growing frenzy in deepwater drilling. Many of those prospects remain, for now, though the fervor is cooling.
On Wednesday, one of the most hotly anticipated petrochemical developments in south Louisiana â€” a $14 billion gas-to-liquids plant â€” was put on indefinite hold. Similar announcements could follow.
Large crane boats, used in oil exploration in the Gulf of Mexico, docked at Port Fourchon. Credit William Widmer for The New York Times
Louisianaâ€™s pain of lowered expectations may differ from the nasty hangovers in Texas and North Dakota, said Stephen R. Barnes, an economics professor at Louisiana State.
â€œYou donâ€™t see the pain when itâ€™s missed opportunity as much as you do when youâ€™re coming down off of a high,â€ he said.
But faith in a boom endures, even in the midst of a bust.
Looking around at service companies the size of his, Chuckie Cheramie, who runs a towboat business that caters to the small oil and gas operations in south Louisiana, sees plenty of misery.
â€œAt this price, itâ€™s really hurting us,â€ he said, adding that his company has had to release more than half its 22 employees. â€œLetâ€™s put it this way: Guys that I used to call for work are now calling me for work. I had a captain working for me at 10 percent of his pay just to keep his job.â€
Mr. Cheramie, however, also sits on the Greater Lafourche Port Commission. Port Fourchon, which he helps oversee, is still undergoing a massive expansion to take part in the deepwater drilling frenzy, driven by giants like Chevron, Exxon, BP and Shell.
â€œWeâ€™re not slowing down in Fourchon, I can tell you that right now,â€ Mr. Cheramie said, as excited as he was morose in his other comments.
â€œPrice goes down, everybody panics,â€ he said. â€œBut in a year, the price comes back up. And itâ€™s higher.â€
Funding Markets just called The FOMC’s bluff.
Janet Yellen and her colleagues would like to welcome you, not unlike Tim Geithner’s 2010 expedition in this area, to the recovery. They have removed pretty much all language that would make you think there was anything like lingering destructiveness or erosion. In doing so, they make it very plain that they want you to believe that they will be ending ZIRP, just as they have done to QE.
There is the “solid pace” of economic expansion which has meant “strong job gains”, though, curiously, there won’t be any of the mainstream “inflation” that usually accompanies this outlook. The world may be concerned about oil and all that, but the FOMC wants you to know that you should focus on them instead of such distractions.
Yet for all the supposed expertise and the “best and brightest” that sit upon the monetary throne in the US, funding markets just rejected everything the FOMC proclaimed. Knee-jerks are usually conforming, at least in some manner, but the eurodollar market, in particular, traded in the “opposite” direction of what you might expect had the FOMC left any impression.
The eurodollar curve has been more than suspicious about the Fed’s preferred narrative for some time, going back to June, but you would at least think that this latest statement might carry enough weight as to cause the “right” direction if only in short-term trading. These markets are conditioned toward policy proclamations almost at face value (again, in the short run).
The path of “projected” rate changes has noticeably declined, which amounts to either a lower probability of actually getting to policy rate increases or a much diminished period of receiving them (the Fed does raise rates, but the economy isn’t what they say and the asset bubbles cannot withstand the paradigm shift so that it all ends very badly once more). The inward, flattening of the eurodollar curve, which is supposed to be the closest “market” to funding rates, is a direct contradiction to the “booming” economy as spun by the economists and their models.
I have rescaled the curve to zoom closer to the action so you can plainly see the intraday eurodollar curve moving in the opposite direction of any intended rate increases. And the majority of those movements are right in that central area of focus, the policy window from 2015-17.
These may not seem like large moves, but given the volume of contracts and the amount of “money” in the notional values there is a bit of exaggeration here. A 10 bps swing in a matter of a couple hours is significant, but very much so given that the “money section” of the funding curve not only dismisses the monetary policy statement in full, but actively trades against it. Eurodollars are essentially calling the FOMC’s bluff.
I have said this pretty much since the beginning of the taper drama, that policymakers are acting out rational expectations theory or at least how they see it. In other words, their job is not to analyze actual economic conditions, but to condition economic thought toward the end goal. If they convince you that they believe the economy is on track they further believe you will act accordingly (“you” being both investor and economic agent). The more the economy diverges from the “preferred” projection, the more emphatic the cries of “recovery” become. At some point, desperation becomes palpable.
There are other factors to consider here, of course, but it is at least interesting as that seems to be theme guiding funding market trading here. The more the FOMC says the economy is great, the less credit markets seem to believe it – desperation rather than reality, now even to the shortest of timescale.
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NOTE: Things got even worse on Friday as the market really accelerated its bluff calling for The Fed…
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01/30/2015 – 20:25
The Tulip Lunacy in the Bond market is just off the charts stupidity at its finest! The U.S. 2-Year Bond is currently pricing in no rate hike, and in fact, a negative rate of inflation over the…
Greek Prime Minister Alexis Tsipras waits for European Parliament President Martin Schulz outside the Greek Premier’s office in Athens January 29, 2015.
Credit: Reuters/Marko Djurica
Between Throwback Thursday and apps like Timehop, nostalgia definitely factors into how we use technology today. Product Hunt, a discovery website that shows you the newest startups and products, has collected a bunch of websites and apps that wi…
The Market, a food complex underneath Twitter’s San Francisco headquarters, just opened last week. It has virtually anything you could want: a sushi/oyster bar, a taco bar, a pizzeria, and more, all surrounding an organic grocery store. This is amazin…
A month ago, when we first observed the biggest monthly gold repatriation from the NY Fed since 2001, when 47 tons of foreign-owned gold were withdrawn from the vault below 33 Liberty street which lowered the gold inside to just 6,029 tons, and which brought the 2014 YTD total withdrawal to 166.5 tons, we noted a math anomaly when accounting for the previously reported 122 tons of gold withdrawn by the Netherlands:
net of the Netherlands withdrawals, there is some 44 tons of extra gold that has been also quietly redeemed (by another entity). The question is who: is it now the turn of Austria to reveal in a few weeks that it too, secretly, withdrew some 40+ tons of gold from “safe keeping” in the US? Or was it Belgium? Or did the Dutch simply decide to haul back some more. Or did Germany finally get over its “logistical complications” which prevented it from transporting more than just a laughable 5 tons in 2013? And most importantly, did Germany finally grow a pair and decide not to let “diplomatic difficulties” stand between it and its gold?
Ironically, less than three weeks later, our bolded speculation above was proven to be absolutely correct when Germany confirmed that not only had it resumed repatriating its gold from the NY Fed as originally announced two years ago, after the mere 5 tons of gold transported to Frankfurt in all of 2013, but had substantially picked up the pace, when on January 19 the Bundesbank reported that it had indeed “grown a pair” and repatriated 35 tonnes of gold from Paris and, more importantly, 85 tonnes of gold from the NY Fed in all of 2014.
This is what Buba said:
The Bundesbank successfully continued and further stepped up its transfers of gold last year. In 2014, 120 tonnes of gold were transferred to Frankfurt am Main from storage locations abroad: 35 tonnes from Paris and 85 tonnes from New York. “Implementation of our new gold storage plan is proceeding smoothly. Operations are running very much according to schedule,” said Carl-Ludwig Thiele, Member of the Executive Board of the Deutsche Bundesbank.
The Bundesbank took advantage of the transfer from New York to have roughly 50 tonnes of gold melted down and recast according to the London Good Delivery standard, today’s internationally recognised standard. “We also called on the expertise of the Bank for International Settlements for the spot checks that had to be carried out. As expected, there were no irregularities,” said Mr Thiele.
According to its new gold storage plan, unveiled in January 2013, the Bundesbank will be storing half of Germany’s gold reserves in its own vaults from 2020 onwards. This necessitates a phased transfer to Frankfurt am Main of 300 tonnes of gold from New York and all 374 tonnes of gold from Paris.
Since the transfers began in 2013, the Bank has relocated a total of 157 tonnes of gold to Frankfurt am Main – 67 tonnes from Paris and 90 tonnes from New York. This is equivalent to roughly 23% of the total quantity to be transferred. The following table gives an overview of the gold that has been transferred to date.
As at 31 December 2014, the Bundesbank’s gold reserves were stored at the following locations.
The Bundesbank assures the identity and authenticity of German gold reserves throughout the transfer process – from when they are removed from warehouses abroad until they are stored in Frankfurt am Main. As soon as the gold was removed from the warehouse locations abroad, Bundesbank employees cross-checked the lists of bars belonging to the Bundesbank against the information on the bars removed. Finally, once they arrived in Frankfurt am Main, all the transferred gold bars were thoroughly and exhaustively inspected and verified by the Bundesbank. When all the inspections had been concluded, no irregularities came to light with regard to the authenticity, fineness and weight of the bars.
At the time we commented that there was “a curious amount of precautions and safeguards when transporting the “safe” and “untainted” gold held at the NY Fed to Frankfurt. Almost as if the Bundesbank, gasp, did not trust the quality and content of the NY Fed-held gold, nor its well-meaning intentions.”
Judging by the latest disclosure by the NY Fed, Buba may have had good reason to be “concerned” about its gold at the Fed, because according to the Fed’s latest update of “earmarked gold” for December there was yet another math anomaly.
Whereas in November, the cumulative total correctly hinted that there was more withdrawals than had been disclosed, the December 2014 total suggests that either the Fed just made an egregious error when keeping track of its entrusted physical gold, or someone is lying.
As a reminder, based on purely public information, between just the Netherlands’ 122 tons of repatriated gold and the Bundesbank’s 85 tons, at least 207 tons of gold were quietly withdrawn from the NY Fed in all of 2014. This is what the NY Fed should have reported in its December earmarked gold update delivered yesterday. It also means that the NY Fed should have reported some 40.5 tons of gold withdrawn in December, after reporting 166.5 tons of withdrawals for 2014 through November, for the math to make sense. Instead, according to Federal Reserve data, only $14 billion in earmarked gold was withdrawn in December, bringing the total down to $8,170 billion, or 6,019 tons.
Translated into actual metal, this means that the Fed reported only 10.3 tons of gold withdrawals in the last month of the year, suggesting that there is a quite substantial hole of 30 tons in publicly withdrawn gold that, at least for the time being, is unaccounted for by the Fed.
So what happened: did an intern input the Fed’s gold redemptions figures for December, supposedly a different intern than the one who works at the IMF and who caused a stir earlier this week when the IMF, allegedly erroneously, reported that the Dutch – after secretly repatriating 122 tons of gold – had also bought 10 tons of gold in the open market for the first time in nearly a decade.
Or perhaps some “other” bank, central or commercial, decided to offset the redemptions by the Netherlands and Germany, and inexplicably added 30 tons of gold in December? The question then becomes: “who” deposited said gold, especially when one considers that even the adjoining JPM vault which is allegedly connected to the NY Fed by a tunnel, only contains some 740K ounces of gold, or about 23 tonnes.
Or is it simply that when it comes to accurately reporting the flows of physical gold, classical math is incapable of keeping track of the New Normal gold moves, and the Fed has decided that even when dealing with physical gold there is a “settlement” period?
We will find out the answer for sure next month, when unless the Fed revises its 2014 numbers, or plugs the outstanding repatriation “hole” with a late January withdrawal, then a key question will emerge, namely: how can central banks report 2014 inflows of 207 tons from the NY Fed, while said NY Fed only reports 177 tons of outflows.
And no, the GAAP vs non-GAAP excuse won’t work this time.
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Lean Hog Futures— Lean hog futures in the June contract rallied 50 points this Friday afternoon in Chicago settling at 84.10 after settling last Friday at 80.20 rallying up almost 400 points as I’ve been recommending a short position for several months as originally we were in the February contract which hit another contract low this week, however blamed on spreading the June contract rallied while the February contract sold off and if you are in the June contract at the current time place your stop above the 10 day high which currently stands at 86.75 risking about 365 points or $1,500 per contract plus slippage and commission.
Lean hog prices have come from 100 in late November all the way down to around the 80 level last week as I think this rally in the June contract was based on oversold conditions, so I continue to remain bearish as expansion in the hog market will continue to pressure prices over the next several months as the commodity markets in general look very bearish as the U.S dollar is at an 11 year high.
The chart structure in hogs is poor at the current time as volatility is extremely high in cattle and hogs so make sure you place the proper amount of contracts risking 2% of your account balance as I remain bearish as prices are still trading below their 20 and 100 day moving average telling you that the trend is to the downside as I do think prices will break the 80 level here in the next several weeks. TREND: LOWER –CHART STRUCTURE: POOR
If you are looking to contact Michael Seery (CTA—COMMODITY TRADING ADVISOR) at 1-312-224-8140 he will be more than happy to help you with your trading or visit www.seeryfutures.com
Skype Address: mike.seery3
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There is a substantial risk of loss in futures and futures options. Furthermore, Seery Futures is not responsible for the accuracy of the information contained on linked sites. Trading futures and options is Not appropriate for every investor.
Michael is the sole owner of SEERYFUTURES.COM which is a commodity futures and options consulting, advisory, and educational firm.
Michael frequently appears on multiple business networks including Bloomberg News, Fox Business, CNBC Worldwide, CNN Business, and Bloomberg TV. He also writes market commentary for several commodity websites and is interviewed for commodity comments by the Wall Street Journal. He is also a guest on First Business, which is a national and internationally syndicated business show.
Michael started his career in 1990 at the Chicago Board of Trade as a runner. He soon worked his way up to becoming a Series 3 broker. He works with seasoned traders as well as novice beginners educating them on trading the futures markets as well as using simple and complex option strategies. Michael covers all markets including grains, metals, energies, and all other futures markets that are traded.
To Michael the biggest lesson any trader needs to learn is risk management. Michael believes this is the most important factor in trading. He also works with traders to help them determine the proper risk for their trading style. Michael has spent a lot of time educating his clients to help them understand trading strategies and trading techniques while enjoying spending quality time with customers going over the markets or just talking general trading philosophies.
The key report this week is the January employment report on Friday.Other key reports include the January ISM manufacturing index on Monday, January vehicle sales on Tuesday, the ISM non-manufacturing index on Wednesday, and the December Trad…
Tim Bucher, founder and CEO of a photo storage and sharing startup called Lyve, has had a long career in Silicon Valley, working directly with some of the brightest minds in tech, including Steve Jobs, Bill Gates, and Michael Dell.
Bucher founded or co-founded two tech startups before Lyve. Mirra, a consumer hard drive company he flipped to Seagate for as much as $30 million, and a mobile entertainment company called ZING, bought by Dell in 2007.
Any time in his life that Bucher has needed to make an important decision, or when he wanted to come up with his next big idea, he always does the same thing: head to his vineyard.
“All of my Silicon Valley ideas come to me on my tractor,” he told Business Insider. “Period.”
At 16, Bucher pooled together $100,000 with his nine siblings to buy a 2-acre grape vineyard. Today, he owns three ranches in Sonoma Valley.
“It clears my mind, he says. “I just sit there and I chew and I chew and I chew. You’re paying attention to what you’re doing, but it also releases this other side of your brain that goes nuts. In a ten hour day in the vineyard, I can basically process what I would in months in an office. That’s where I come up with new ideas.”
Bucher says that he sees heard about the same experience from other entrepreneurs, many of whom take to extreme sports to clear their minds.
“I think in general when you’re an entrepreneur you take it to the edge — my edge is just a little bit different,” he says. “Every company I’ve started, I can remember exactly where it happened — which block in the vineyard.”
Besides Mirra and Zing, Bucher founded TastingRoom.com, Trattore Wines, and Dry Creek Olive Company.
Now, he works mainly on Lyve, which he founded to help people manage their unruly photo collections. The company’s free app collects and sorts an unlimited number of your stored photos, so they’re accessible from any device, and it also sells a physical storage device, the 2-terabyte, $299 Lyve Home.
California’s ambitious effort to save billions of dollars by changing how the state’s costliest patients get treated is on the ropes.
California’s ambitious effort to save billions of dollars by changing how the state’s costliest patients get treated is on the ropes.
According to the American Academy of Family Physicians, around 10 percent of family doctors already offer shared medical appointments, sessions that bring together a dozen or more patients with similar medical conditions to meet with a doctor for 90 minutes. With pressure from the government and insurers to bring down the cost of care while treating the increasing number of people with health insurance, patients can expect group visits to become more common. “It’s efficient. It’s economical.“
– From the Bloomberg article: Your Next Doctor’s Visit Could Get Crowded
Get ready, this is coming. While this trend was already happening before the passage of Obamacare, it’s not hard to imagine that private medical consultations could soon be a thing of the past for your average American serf.
Somehow I doubt members of Congress will be having group visits any time soon…
In a typical doctor’s visit, you wait around for a while, get your vitals checked, and spend a few minutes alone in a room with a physician. It’s private and short. Some doctors, frustrated by a relentless schedule of 15-minute, one-on-one visits, are experimenting with appointments that are neither.
According to the American Academy of Family Physicians, around 10 percent of family doctors already offer shared medical appointments, sessions that bring together a dozen or more patients with similar medical conditions to meet with a doctor for 90 minutes. With pressure from the government and insurers to bring down the cost of care while treating the increasing number of people with health insurance, patients can expect group visits to become more common. “It’s efficient. It’s economical. It’s high-quality care when it’s done right,” says Edward Noffsinger, a California psychologist who created the model in the 1990s at Kaiser Permanente, the state’s largest health maintenance organization (HMO).
In a group visit, exams and tests are still conducted privately, but patients discuss their ailments in front of the group. The theory is that each patient can learn from the others’ experience, and doctors get to have a longer, more relaxed discussion instead of hopscotching to three or four exam rooms in an hour. “You have one appointment with 10 observers,” says Marianne Sumego, an internist at the Cleveland Clinic. “Patients are really getting the equivalent of 10 visits.”
They’ve already started with the hedonics. Incredible.
Here’s what is clear: Seeing several patients at once can be good for harried doctors’ finances. In 90 minutes, a physician might be able to complete five or six one-on-one visits. A group visit could allow doctors to see double that number or more in the same time, and medical assistants or nurses can take care routine aspects of care—checking patients in, taking vital signs, writing refills of medication.
Finally, the real reason for groups visits is revealed.
Often it takes a fair amount of promotion by doctors to get patients interested in exploring group appointments, which require them to sign privacy agreements. “Patients have a lifetime of expecting a one-on-one visit,” says Noffsinger. “We’re asking them to do something entirely different.”
Yeah they’re “asking” you now, but I suspect they’ll be “telling” you faster than you can say free healthcare.
Never forget, group doctors visits are what happens to a society with an increased standard of living. Keep telling yourself that.
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For other healthcare related articles, see:
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A customer holds balloons outside a McDonald’s restaurant on the day of its reopening in central Moscow November 19, 2014.
Credit: Reuters/Sergei Karpukhin
Credit Allison Boesch
I always cringe a little when I hear people say that affirmative action doesnâ€™t work or isnâ€™t fair. Thatâ€™s because I know I wouldnâ€™t be where I am today without it. I also know that very few people see the issue from the same perspective that I do.
As a young black male from Brownsville in Brooklyn, I was extremely athletic. I played baseball, touch football and basketball. I even took ballet classes with the Eliot Feld ballet school in a special program for disadvantaged city youth. I dreamed of being Gregory Hines.
Growing up in the 1970s, I also had an addiction â€” video games and pinball â€” and I desperately craved quarters. I never knew my father, and my mother was often on welfare or working an exhausting temporary job. Feeding my addiction was on me.
I got my first paying gig at the age of 10, bagging groceries at a Key Food on Avenue B and Sixth Street in Manhattan through the father of a schoolmate who managed the store. (We had moved to the Lower East Side after a fire forced us out of our apartment in Brooklyn.) That summer I worked daily shifts, roughly four hours each, for tips. On a good day I brought home $3. On a great day, $5. I was supposed to share a percentage with my mother, but I often shortchanged her.
It became a major source of pride for me, this â€œpay for laborâ€ thing, and it instilled a work ethic I would never lose. Not even after I was shot in the back while walking home one night. The police never did find my shooter, and the bullet, still lodged near my spine today, paralyzed me for life from the waist down at the age of 13. I spent six months in the hospital trying to recover. My arms were so weak I could barely lift them over my head. I had to learn to do everything all over again.
In high school, I watched as many of my able-bodied friends juggled school and part-time jobs. By this time I had gained considerable upper-body strength. However, as someone who was paralyzed, I never imagined that any employers in their right minds would hire me.
I was fiercely independent and darted around the city in my wheelchair with no assistance, but who would hire a cripple when you could have a â€œregularâ€ kid? I wasnâ€™t going to deliver pizzas or wash cars or stand behind a counter and ring people up on a cash register. I assumed I would just collect a disability check well into my adulthood. Maybe if I got lucky I would score a computer job down the line.
In the spring of my junior year in high school, a guidance counselor told me about a government-sponsored program that placed high school students with disabilities in work positions for the summer. She encouraged me to apply. I would make minimum wage, of course, but it promised to be more worthwhile than hanging out watching TV, so I signed up.
That June I nervously started my first placement, at a dermatology office at Bellevue Hospital, a bus ride from where my family now lived in Chelsea. Monday through Friday, 9 to 5, I sorted dermatology slides, answered phones and ran materials to and from Bellevue and the neighboring N.Y.U. medical center. I loved it. Someone depended on me to show up. I never took a sick day that summer.
That job gave me a powerful sense of purpose and belonging. I became friendly with many of the staff members there, like nurses, doctors and lab technicians.
Another high school student, a Puerto Rican girl from Harlem who worked in outpatient check-in, became a dear friend. On breaks we would visit one anotherâ€™s departments and flirt. Every payday Friday, she and I would go out to lunch at our favorite pizza place on Second Avenue.
I fell in love with her. But thatâ€™s a whole other story. The point is that Working â€” with a capital W â€” filled me with such confidence and increased my self-esteem in such immeasurable ways that I could feel comfortable falling for a beautiful able-bodied girl.
My boss at Bellevue was Rachel, a middle-aged doctor, who talked to me as if I were an adult. She set the bar impossibly high for all of my future bosses. She was humorous and laid-back, but was also conscientious and well respected by her peers. I remember thinking that if I ever got to be someoneâ€™s boss, Iâ€™d strive to be like her.
On my last day there before having to return to school for my senior year, Rachel took me out to lunch at a popular Indian restaurant. She told me she often took new interns there. I felt special, important, appreciated. She said she would miss me and that if I wanted to return, there would be a job there for me next summer. I nodded, thinking that was exactly what I wanted. But that next summer the program gave me a different placement at the Bobst Library at N.Y.U. in the heart of Greenwich Village, placing bar codes in books.
Though the mood and responsibilities were different, the pride and sense of self-worth were the same. It gave me great satisfaction to get out of the house by 8 every morning knowing I wouldnâ€™t be back until nightfall because I had a job. I had to be someplace where my knowledge and expertise were needed.
Even the drug dealers in my neighborhood respected me. I knew this because my building had three steps to the entrance, and every morning and night one of those dealers helped me up or down the steps. The one I was closest to would see me in the morning and say: â€œGotta get Jerry to the office.â€
It has been nearly 30 years since I rolled into that Bellevue lobby, a skinny kid with a Richard Pryor Afro in a clunky wheelchair. With the exception of a few tiny breaks, I havenâ€™t stopped working since. Iâ€™ve been a customer service representative, a case manager for homeless youth, an actor in commercials and films and a production manager and writer for a theater company, among other things. Once I even dressed up as a cow and passed out fliers in Times Square to promote a new Ben & Jerryâ€™s. And I always have that pride â€” that feeling that Iâ€™m a contributing member of society. I matter.
My belief is that the people who are against affirmative action must lack an empathy gene. Oh, if they could only roll a mile in my wheelchair. The unemployment rates for people with disabilities worldwide are mind-numbingly high. I know because Iâ€™ve traveled to over two dozen countries and met these people, as a tour guide leader for those with disabilities. The main reason the jobless rate is so high for people with disabilities is that they are not given an equal chance in the mainstream work world.
Employers bring their own baggage and ill-conceived preconceptions about my tribe. The Americans With Disabilities Act and similar laws notwithstanding, some employers are unwilling to make certain changes to an office space that would make a workerâ€™s life more comfortable and productive. I had several jobs where the floor on the building I worked in didnâ€™t have a wheelchair-accessible bathroom; at one job I even had to go across the street to a different office building to use a bathroom that didnâ€™t belong to my company. This little trip was a bonus in the summer, but was dreadful in the winter.
The sad truth is that sometimes employers need a forceful nudge to make them do the right thing. Thatâ€™s just the harsh reality. I got really lucky. But luck should not have to be a part of the equation.
JERRY McGILL is the author of “Dear Marcus: A Letter To The Man Who Shot Me” (Spiegel & Grau) and the recently self-published thriller “Othello’s Brother.” He lives in Portland, Ore.
A version of this article appears in print on February 1, 2015, on page BU8 of the New York edition with the headline: Losing Mobility and Gaining a Work Life.
Paulette Sheffield, left, of the Leadership Council for Health Communities in Washington, helping a client find insurance. Credit Jonathan Ernst/Reuters
WASHINGTON â€” Obama administration officials and other supporters of the Affordable Care Act say they worry that the tax-filing season will generate new anger as uninsured consumers learn that they must pay tax penalties and as many people struggle with complex forms needed to justify tax credits they received in 2014 to pay for health insurance.
The White House has already granted some exemptions and is considering more to avoid a political firestorm.
Mark J. Mazur, the assistant Treasury secretary for tax policy, said up to six million taxpayers would have to â€œpay a fee this year because they made a choice not to obtain health care coverage that they could have afforded.â€
But Christine Speidel, a tax lawyer at Vermont Legal Aid, said: â€œA lot of people do not feel that health insurance plans in the marketplace were affordable to them, even with subsidies. Some went without coverage and will therefore be subject to penalties.â€
The penalties, approaching 1 percent of income for some households, are supposed to be paid with income taxes due April 15. In addition, officials said, many people with subsidized coverage purchased through the new public insurance exchanges will need to repay some of the subsidies because they received more than they were entitled to.
More than 6.5 million people had insurance through the exchanges at some point last year, and 85 percent of them qualified for financial assistance, in the form of tax credits, to lower their premiums. Most people chose to have the subsidies paid in advance, based on their projected income for 2014. If their actual income was higher â€” because they received a raise or found a new job â€” they will be entitled to a smaller subsidy and must repay the difference, subject to certain limits.
â€œIf the advanced premium tax credit amount is too high, the taxpayer could have an unwelcome surprise and owe money,â€ said Nina E. Olson, the national taxpayer advocate at the Internal Revenue Service.
Many people awarded insurance subsidies for 2014 did not realize that the amount would be reviewed and recalculated at tax time in 2015.
Consumers are sure to have questions, but cannot expect much help from the tax agency, where officials said customer service had been curtailed because of budget cuts.
The 2015 filing season could be the most difficult in decades, officials said. Ms. Olson said new paperwork resulting from the Affordable Care Act would probably exacerbate problems with customer service, which â€œhas reached unacceptably low levels and is getting worse.â€
â€œThe I.R.S. is unlikely to answer even half the telephone calls it receives,â€ she added. â€œTaxpayers who manage to get through are expected to wait on hold for 30 minutes on average and considerably longer at peak times.â€
Timothy S. Jost, an expert on health law at the Washington and Lee University School of Law who supports the Affordable Care Act, said: â€œIt will be very easy to find people who are unhappy with the new tax obligations â€” people who have to pay a penalty, who have to wait forever to get through to somebody at the I.R.S. or have to pay back a lot of money because of overpayments of premium tax credits.â€
Taxpayers normally report income and compute taxes annually. But the health care law is different. Consumers may be subject to tax penalties for any month in which they had neither insurance coverage nor an exemption.
The calculations will be relatively simple if all members of a household had coverage for every month of 2014. They can simply check a box on their tax return. But lower-income people often have changes in employment, income and insurance. If any members of a household were uninsured in 2014, they must fill out a work sheet showing coverage month by month, and they may owe penalties.
To claim tax credits, consumers need to fill out I.R.S. Form 8962, which includes a matrix with 12 rows and six columns â€” a total of 72 boxes, to compute subsidies for each month of the year.
Federal officials have authorized more than 30 types of exemptions from the penalty for not having insurance. One is available to low-income people who live in states that did not expand Medicaid. Another is available to people who would have to pay premiums amounting to more than 8 percent of their household income. The government will also allow a variety of hardship exemptions and in most cases will require taxpayers to send in documents as evidence of hardship.
The open enrollment period, during which people can sign up for health insurance, ends on Feb. 15. But many people will not realize that they must have coverage or pay a penalty until they file their tax returns in April.
Obama administration officials said they were considering a â€œspecial enrollment periodâ€ that would give some people extra time to obtain insurance. But they said consumers could not count on an extension of the Feb. 15 deadline and should not delay signing up.
Health plans are classified in five categories, such as gold, silver and bronze, based on how comprehensive the coverage is. To calculate their tax credits, consumers need to know the cost of their own health insurance policies, but must also know the cost of a benchmark plan, the second-lowest-cost silver plan. To claim an exemption if the available coverage was unaffordable, they also need to know the premium for the lowest-cost bronze plan in the area in 2014.
Sylvia Mathews Burwell, the Department of Health and Human Services secretary, said the administration was working with nonprofit groups like AARP and tax preparation companies like H & R Block, Jackson Hewitt and Intuit, the maker of TurboTax software, to help people meet their tax obligations under the health care law.
Federal regulators have persuaded Toyota, Chrysler and Honda to recall about 2.1 million vehicles because the airbags might deploy even when the vehicle is not in a crash, the National Highway Traffic Safety Administration announced on Saturday.
The vehicles were previously recalled for the problem in 2013 and 2014, but the fix did not work, Mark Rosekind, the N.H.T.S.A. administrator, said at a news conference in Washington.
Mr. Rosekind said the safety agency received about 40 reports that the remedy did not work, prompting it to investigate. Mr. Rosekind said the agency was aware of three injuries but no deaths from inadvertent airbag deployments. The models covered were produced in the early 2000s and are the Acura MDX, Dodge Viper, Jeep Grand Cherokee, Honda Odyssey, Pontiac Vibe, Toyota Corolla, Toyota Matrix and Toyota Avalon.
Mr. Rosekind said a full remedy for the vehicles may not be immediately available and that repairs could take until the end of 2015.
â€œWe want these companies to get it right,â€ Mr. Rosekind said.
The problem is an electronic component in the airbags made by the American supplier TRW Automotive. The previous fix involved installing an electronic filter to try to protect the faulty component. Mr. Rosekind said the automakers will now replace the component.
About one million of the Honda and Toyota models are also covered by recalls for defective airbags made by the company Takata that can deploy with too much force. When that happens, a metal component can rupture and send shards of metal into the passenger compartment.
The Takata airbag flaw has forced Honda and nine other manufacturers to recall more than 18 million vehicles in the United States, not including the recall announced on Saturday. At least five deaths have been linked to the airbag flaw.
Owners will be notified by the automakers if their vehicles are covered by the recall.