Do you have knee pain?
Welcome to the club. You’re among the millions of us.
While knee pain can have several different causes, one common cause is arthritis, which I experienced.
Today, I’m 89 years old. About 10 years ago, the pain in my knees what getting bad enough to interfere with my tennis. So I did the usual.
First, I started applying topical painkillers like menthol. Then menthol plus cannabis. They worked for about an hour, maybe less.
Then came Tylenol which did absolutely nothing, followed by ibuprofen, which actually did work when I took 600mg. right before playing tennis — at least for the first set. After a few weeks, ibuprofen stopped working. Heavier doses might have worked, but would have torn up my stomach.
So I began with elastic bands. Some included copper threads which supposedly have some magical properties. The bands sort of, kind of, almost worked a bit for a short time, probably the placebo effect.
Then I moved on to injections. First the steroids. They worked for about three days. Then came the hyaluronic acid (gel) injections, which supposedly act as a lubricant. (This is the same stuff people smear on their faces to reduce wrinkles.)
They lasted about a day.
Does all of the above sound familiar? It’s the path many knee pain sufferers follow.
While I was going through all of the above failed strategies I spoke with a friend about his knees. He weighed more than 400 lbs., and could hardly walk from the knee pain. So he had knee replacements, and now, a month later, was on the tennis courts, bouncing around like a kid.
What? A 400lb. man cured in a month? Whoever his doctor was, that’s the doctor I wanted.
I asked myself one simple question: “Do I really want to spend the rest of my life in pain, or should I just bite the bullet and have the surgery?
I belatedly chose what I should have chosen years earlier: Surgery. I could have saved myself a lot of pain and a lot of bad tennis, too.
You should know that “knee replacement” does not usually involve replacing the knee.Most replacements involve merely inserting pads called “prothesis” in three places: On each bone and behind the knee cap, as shown above.
I asked my friend to tell me his doctor’s name, and I scheduled a visit. Here is how to choose a doctor for your knee replacement:
1. Talk to people who have had the procedure.
2. Choose a doctor who has done thousands of knees.
Don’t pick the one who does knees, elbows, wrists, ankles, shoulders, and or fingers. Pick the one who does KNEES only, and I mean thousands of knees.
My doctor did 60-70 knees a month. I felt confident that when he opened me up, he wouldn’t say, “Oh, my gosh, I’ve never seen that before.”
Instead, he might say, “Well, only one in a thousand patients has that rare condition, but I’ve already done a couple hundred of those, so no big deal.”
After consulting with, and choosing, the doctor, schedule two things:
1. The operation(s).
2. The rehab.
I advise going to a rehab place, where you can live for two weeks rather than home rehab. The rehab is very important for your recovery, and you want it to take place under the best care where you will not be left to your own lazy devices.
Many rehab places are quite busy, so early scheduling is advisable.
The operation itself is quick — about a half hour per knee. I advise doing both knees (if you have pain in both knees) at the same time. There is no benefit to doing one at a time.You’re able to walk, immediately. And why stretch out the recovery period?
When I woke from the surgery a nurse was standing at my bedside. She said, “Now, let’s walk.” And though I still was a bit groggy, walk we did.
Slow, faster, then even up and down stairs — an 80+ year old man walking stairs ten minutes after surgery! Surprising, but not unusual, I was told.
The good news is that the pain killer still was in my blood stream, so I felt no pain at all. The next day I would start to feel pain.
Here is where you can find some good advice for your recovery period. Read it.
Everyone is different. I had pain the first week, but they gave me all the pain killer I wanted. I even had a pain pump at my bedside, and when I felt pain, I pressed a button for more. Total control.
Don’t worry, you won’t become addicted because you won’t be on it that long if you’re just taking if for pain. Anyway, you won’t like how icky you feel with those drugs in your body, so you’ll tend to use only what you need.
Most insurance requires you to be in the hospital for three days, after which you’ll be able to transition to a rehab facility or home. Again, I recommend the rehab facility for a better recovery.
After a week or so, my pain eased considerably, but the rehab hurt. They push you to straighten your leg all the way, and then bend it so your heel touches your butt. Even when you think you can’t do it, they do it for you.
Lots of pain for a couple days. I did a lot of groaning.
And then the pain eases and eases and after two weeks it’s just about gone. In a month I was back to tennis, and have had no pain since.
I can run as well as ever in my life, and looking back I regret not having the surgery sooner.
I think the average replacement lasts 10 – 20 years. I’m on my 10th and 11th years with my right and left knees (which, as I said, I should have done simultaneously) and so far, so good. Being 89, there is a good chance my knees will outlive me.
Good luck.
Rodger Malcolm Mitchell
Monetary SovereigntyTwitter: @rodgermitchellSearch #monetarysovereigntyFacebook: Rodger Malcolm Mitchell
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The Sole Purpose of Government Is to Improve and Protect the Lives of the People.
What is a conspiracy theory?
A conspiracy theory is an explanation for an event or situation that asserts the existence of a conspiracy by powerful and sinister groups, often political in motivation when other explanations are more probable.
America’s Rabbit Hole MazeData suggests crimes motivated by conspiracy theories are escalating. Lahaina, Hawaii, is devastated days after Maui’s August wildfires. Conspiracy theorists claim that the fires were set using “energy weapons” developed by the U.S. military. Rick Bowmer/AP
By David Klepper Associated Press
WASHINGTON — Days after Maui’s wildfires killed scores of people and destroyed thousands of homes last August, a shocking claim spread with alarming speed on YouTube and TikTok: The blaze on the Hawaiian island was set deliberately, using futuristic energy weapons developed by the U.S. military.
Claims of “evidence” emerged: video footage on TikTok showing a beam of white light, too straight to be lightning, zapping a residential neighborhood and sending flames into the sky.
The video was shared many millions of times, amplified by neo-Nazis, anti-government radicals, and supporters of the QAnon conspiracy theory, and presented as proof that America’s leaders had turned on the country’s citizens.
“What if Maui was just a practice run?” one woman asked on TikTok. “So that the government can use a direct energy weapon on us?”
The TikTok clip had nothing to do with the Maui fires. It was a video of an electrical transformer explosion in Chile earlier in the year.
But that didn’t stop a TikTok user with a habit of posting conspiracy videos from using the clip to sow more fear and doubt. It was just one of several similar videos and images doctored and passed off as proof that the wildfires were no accident.
Who supports neo-Nazis? Who supports QAnon?
Neo-Nazis: This past summer, hundreds of white supremacists and neo-Nazis mobilized in Charlottesville, Virginia to prove a point — that they were always here and were here to stay.
With anti-Semites, fascists, and racists gathering at the “Unite the Right” rally on the University of Virginia’s campus and racial tensions flaring between white supremacists and counter-protesters, many reactions to the racist violence at Charlottesville were of disgust and sadness.
Even in the wake of contentious partisan politics, both Republicans and Democrats condemned the actions of white supremacists and even called for President Donald Trump to take a stand against their egregious behavior.
Two days later, Trump begrudgingly gave his take on Charlottesville. His position would not only be a lack of condemnation of white supremacy, but he “blamed both sides” for the violence, stating, “You had a group on one side that was bad. You had a group on the other side that was also very violent.
“Nobody wants to say that. I’ll say it right now.” Trump also added: “Not all of those people were neo-Nazis, believe me. Not all of those people were white supremacists by any stretch.”
Trump’s lukewarm response to the events at Charlottesville and, subsequently, his defense of white supremacy was so shocking to many that journalist Jonathan Cait in New York Magazine wrote, “What is new and even shocking is the intermingling of Republican politics with open white supremacy.”
Increasingly a new constituency for the GOP — one that’s fired up like the rest of the MAGA movement, warring with tech giants and ready to battle through Election Day on behalf of a struggling President Trump.
It no longer is a question of whois the primary support for conspiracy theories but why — why has the Republican party turned so sharply to conspiracy theories as its method of communication? Tucker Carlson, QAnon, Marjorie Taylor Greene, Alex Jones, FOX News. All make their living peddling nuttiness.
While politicians of all parties have been infamous for lying, two changes have taken place in the Republican party:
The lies are more extreme, bordering on insane.
When facts emerge, the conspiracy theorists double down, aren’t embarrassed, and continue to promulgate the same lies even after losing lawsuits.
Meta, the owner of Instagram and Facebook, says it tries to remove extremist content. Platforms such as X, formerly Twitter, Telegram, and far-right sites like Gab allow it to flourish.
Federal election officials and some lawmakers have suggested regulations governing AI, including rules requiring political campaigns to label AI-generated images used in their ads.
But those proposals wouldn’t affect the ability of extremist groups or foreign governments to use AI to mislead Americans.
Meanwhile, U.S.-based tech platforms have rolled back their efforts to root out misinformation and hate speech, following the lead of Elon Musk, who fired most of the content moderators when he purchased X.
“There’s been a big step backward,” said Evan Hansen, the former editor of Wired.com who was Twitter’s director of curation before leaving when Musk bought the platform.
“It’s gotten to be a very difficult job for the casual observer to figure out: What do I believe here?”
The disinformation spread by extremist groups and even politicians, such as former President Donald Trump, can create the conditions for violence by demonizing the other side, targeting democratic institutions, and convincing their supporters that they’re in an existential struggle against those who don’t share their beliefs.
Trump has spread lies about elections, voting, and his opponents for years. Building on his specious claims of a deep state that controls the federal government, he has echoed QAnon and other conspiracy theories and encouraged his followers to see their government as an enemy.
He even suggested that now-retired Army Gen. Mark Milley, whom Trump nominated to be the top U.S. military officer during his administration, was a traitor and deserved execution.
Milley said he has had to take security precautions to protect his family.
Groups, where any conspiracy theory emanating from such as Trump, FOX, Carlson, et al. is accepted without question, are called “cults.” MAGA is such a cult where the belief comes not from reality but from the personality of the theory’s issuer.
The list of incidents blamed on extremists motivated by conspiracy theories is growing.
The Jan. 6, 2021, riot at the U.S. Capitol, attacks on vaccine clinics, anti-immigrant fervor in Spain, and anti-Muslim hate in India:
All were carried out by people who believed conspiracy theories about their opponents and decided violence was an appropriate response.
To believers, the facts don’t matter.
“You can create the universe you want,” said Danielle Citron, a professor at the University of Virginia School of Law who studies online harassment and extremism.
“If the truth doesn’t matter, and there is no accountability for these false beliefs, then people will start to act on them.”
(“Bothsidesism”) claims that U.S. elected leaders and media cannot be trusted feature heavily in many conspiracy theories with ties to extremism.
In 2018, a conspiracy theorist from Florida mailed pipe bombs to CNN, former Secretary of State Hillary Clinton, and other top Democrats; the man’s social media feed was littered with posts about child sacrifice and chemtrails — the debunked claim that airplane vapor clouds contain chemicals or biological agents being used to control the population.
In another act of violence tied to QAnon, a California man was charged with using a spear gun to kill his two children in 2021.
He told an FBI agent that he had been enlightened by QAnon conspiracy theories and had become convinced that his wife “possessed serpent DNA and had passed it on to his children.”
With its attendant social isolation, the pandemic created ideal conditions for new conspiracy theories as the virus spread fear around the globe.
Vaccine clinics were attacked, and doctors and nurses were threatened. 5G communication towers were burned as a theory spread, claiming they were used to activate microchips hidden in the vaccine.
Fears about vaccines led one Wisconsin pharmacist to destroy a batch of the highly sought-after immunizations, while bogus claims about supposed COVID-19 treatments and cures led to hospitalizations and death.
Trump claimed hydroxychloroquine and bleach as cures for COVID.
He rejected vaccines while boasting that he had helped develop the COVID vaccines and even has been vaccinated. Despite the contradiction, his cult followers continue to believe.
Few recent events, however, display the power of conspiracy theories like the Jan. 6, 2021, insurrection, when thousands of Trump supporters stormed the Capitol, vandalized the offices of Congress, and fought with police in an attempt to disrupt the certification of the 2020 election.
More than 900 have pleaded guilty or been convicted after trials, according to data compiled by The Associated Press.
Many of those charged said they had bought into Trump’s conspiracy theories about a stolen election.
“We, meaning Trump supporters, were lied to,” Jan. 6 defendant Robert Palmer wrote in a letter to a judge, who later sentenced him to more than five years for attacking police.
“They kept spitting out the false narrative about a stolen election and how it was ‘our duty’ to stand up to tyranny.”
That narrative continues among Trump’s MAGA followers despite 60+ losing lawsuits and other investigations proving otherwise. As with virtually all cults, counter-facts only harden the belief in the conspiracy theory.
“Who was the bigger spreader of COVID misinformation: some guy with four followers on Twitter or the president of the United States? The problem is our politicians,” Uscinski said.
“January 6 happened, and people said: ‘Oh, this is Facebook’s fault.’
No, the president of the United States told his followers to be at this place, at this time, and to fight like hell.”
Tom Fishman, CEO of the nonprofit Starts With Us, said, “We can look at the window and see a foreshadowing of what could happen if we don’t (defeat conspiracy theories): threats to a functioning democracy, threats of violence against elected leaders.”
Conspiracy theories have always been with us. But why are they so prevalent now, and more so with the Republican Party? The reason: Donald Trump, like most cult leaders, is a proven psychopath, but being President of the United States, he has a louder microphone than any cult leader in history.
Trump meets all twenty criteria for psychopathy (See “The Hare Psychopathy Checklist”), and his mental condition allows him to lie — and even be caught lying — without a pang of conscience.
He is focused on what is best for him and seemingly oblivious to the consequences to anyone else. He is the perfect conspiracy theory machine.
As a psychopath, Trump attracts fearful people, those who feel threatened by the dangerous world they live in. Trump repeats their fears of non-whites, foreigners, non-Christians, gays, the poor, criminals, and women, then tells then only he can protect them.
They so desperately want to believe, they ignore the incongruity and cruelty of his claims and solutions. He becomes the drug they cannot survive without. He defends every lie, never admits being wrong, and attacks those who tell the truth by claiming his misdeed actually is theirs.
If he tells them something as absurd as “a famous politician is kidnapping children, torturing them, raping them, storing them in the basement of a fast-food restaurant, then selling them,” the frightened followers will believe.
Cults are mental drugs. They are addictive. Even when members know the preaching isn’t true, their emotions tell them to believe. You cannot convince an addict or a cult member. There is no outside cure for an addict or cult member,
They can be cured only if they want to be.
Trump was right when he said he could shoot someone on 5th Avenue and not lose any followers. They are hooked.
Rodger Malcolm Mitchell
Monetary SovereigntyTwitter: @rodgermitchellSearch #monetarysovereigntyFacebook: Rodger Malcolm Mitchell
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The Sole Purpose of Government Is to Improve and Protect the Lives of the People.
Donald Trump’s accomplishments in office pale compared to Biden’s three years. Despite fighting Republicans, who have been devoted to stopping anything the Democrats propose, Biden has had a remarkably good term.
SIGNIFICANT BILLS BIDEN HAS PASSED IN 3+ YEARS
1. American Rescue Plan Act: A $1.9 trillion stimulus package aimed at addressing the economic impact of the COVID-19 pandemic. It includes provisions for direct payments, unemployment benefits, child tax credits, and funding for vaccine distribution.
2. Infrastructure Investment and Jobs Act: A $1.2 trillion bipartisan infrastructure bill that focuses on improving physical infrastructure, including roads, bridges, broadband, and public transit.
3. For the People Act of 2021: This bill aims to expand Americans’ access to the ballot box, reduce the influence of big money in politics, and strengthen ethics rules for public servants.
4. COVID-19 Hate Crimes Act: This bipartisan legislation addresses the rise in hate crimes against Asian Americans during the pandemic. It aims to improve reporting and response mechanisms.
5. Juneteenth National Independence Day Act: Designated June 19th as a federal holiday to commemorate the end of slavery in the United States.
6. Emergency Temporary Standard for COVID-19 Workplace Safety: Issued by OSHA to protect workers from COVID-19 exposure in certain industries.
7. Climate Executive Orders: President Biden signed several executive orders addressing climate change, rejoining the Paris Agreement, and promoting clean energy initiatives.
8. High-Tech Funding and NATO Expansion Bills: President Biden signed two bipartisan bills into law. One bill provides funding for high-tech initiatives, and the other adds Sweden and Finland to NATO.
9. Medicare Drug Price Negotiation: For the first time, Medicare can negotiate the price of certain high-cost drugs. Additionally, a month’s supply of insulin for seniors is capped at $35, and seniors’ out-of-pocket expenses at the pharmacy are capped at $2,000 a year.
This is not an exhaustive list but highlights some significant legislative actions the Biden Administration took.
While Trump passed many bills, most were narrowly focused and of minimal significance to America. Most of Trump’s bills aimed to undo bills signed by Obama, a Trump fixation that continues.
SIGNIFICANT BILLS TRUMP PASSED IN 4 YEARS
1. The CARES Act was a stimulus package passed by Congress in response to the COVID-19 pandemic. It helped provide direct cash payments and tax rebates to households, especially those with low income and children, support small businesses and workers through forgivable loans and increased unemployment benefits.
2. The Tax Cuts and Jobs Act Aimed to simplify the tax code, reduce tax rates for wealthy individuals and corporations, and stimulate economic growth.
3. First Step Act: President Trump signed a bipartisan criminal justice reform bill, the First Step Act, into law in 2018. It aimed to reduce recidivism, improve prison conditions, and provide opportunities for rehabilitation and reentry for incarcerated individuals.
TRUMP: “It’s an urgent problem, but don’t deal with it. I want to complain about it before the election.”
WHAT “ACCOMPLISHMENTS” TRUMP WON’T BRAG ABOUT
1. The economy lost 2.9 million jobs. (Under Biden, the economy added more than 14 million jobs.). The unemployment rate increased by 1.6 percentage points to 6.3%.
2. The S&P 500 index rose 67.8%. (Under Biden, the S&P 500 has increased 28.2% above Trump’s level.)
3. The number of people lacking health insurance rose by 3 million. (Under Biden, people without health insurance decreased by 0.7 percentage points or 2.4 million people.)
4. Handgun production rose 12.5% last year compared with 2016, setting a new record. (Under Biden, for three straight years, gun purchases declined.)
5. Under Trump, the murder rate in 2019 rose to the highest level since 1997. (In 2020, nine out of ten states with the highest per capita violent crime rates leaned Republican, while eight out of ten states with the lowest rates leaned Democrat. As to the murder rate specifically, states that voted for Donald Trump consistently exceeded states that voted for Joe Biden every year since 2000.)
In sum, the economy, employment, and crime improved under Biden compared to Trump. This left Trump to focus on immigration.
Trump claims that immigrants bring crime and drugs into America. However, research indicates that undocumented immigrants commit far fewer crimes compared to U.S. citizens. U.S.-born citizens are over twice as likely to be arrested for violent crimes and 2.5 times more likely to be arrested for drug crimes.
Although illegal immigrants actually are a net positive for the American economy — they consume, pay taxes, and work at low-pay, unpleasant jobs most citizens won’t accept — most Americans want to reduce the number of illegals entering America. Trump has based his presidency run on that topic.
And now, he has destroyed his own best talking point:
“Donald Trump doesn’t care if your family’s safety or the lives of law enforcement officers are in the balance,” a voiceover said in the ad. “He’s on the side of the cartels, coyotes, and child traffickers.”
The ad highlighted Trump’s role in killing Biden’s border deal, which was negotiated with several key Republicans and included significant concessions to conservative demands on immigration. Trump repeatedly urged Republicans to vote against the agreement, which they eventually did.
“Joe Biden is ready to protect America’s southern border,” the ad continued. “There’s only one problem” — at this point, the ad cuts to a clip of Biden, who finishes the sentence by saying, “Donald Trump.”
Trump took to social media to vent about the ad, writing a long, rambling post on Truth Social after midnight on the East Coast. He lashed out at what he called the “Failed Lincoln Project.”
“The perverts at the Failed Lincoln Project, who I was told were left-leaning RINOS that had lost their way and almost all of their financial support, just did an ad showing a grassy, calm, and peaceful Southern Border, not an Illegal Migrant in sight, explaining what a great job Crooked Joe Biden did in dealing with what has become just one of many Biden inspired, Country threatening, problems facing the United States today,” Trump wrote.
There is a certain irony in a man who has just been fined millions of dollars for attacking one woman and who has boasted about grabbing women’s genitalia, now calling members of the Lincoln Project “perverts.”
On Feb 4, videos went viral on X showing participants in the “Take Back Our Border” convoy expressing confusion at the distinct lack of chaos at the border. “They expected to see lines of immigrants lined up wanting entry and many trying to cross over outside the normal ports of entry,” Ford News wrote on X. “They say this isn’t happening at all.”
“In fact,” Ford News continued, “they aren’t seeing lines at all, no one crossing the border.… Some aren’t even sure now why they are there.”
The Lincoln Project also “didn’t happen to mention anything about the 18,000,000 Illegal Aliens that will have invaded our Country, many from prisons and mental institutions, by the end of the failed Biden Administration,” Trump wrote in his Truth Social rant.
In fact, as of 2021, there are about 10.5 million undocumented immigrants in the US in total. Between 2007 and 2021, the number of unauthorized immigrants in the country decreased by 1.75 million, according to the Pew Research Center.
As always, Trump inflates facts as he sees fit, hoping no one will notice. He was just fined $380 million for inflating the value of his real estate.
According to the Cato Institute, a conservative think tank, Biden’s Department of Homeland Security removed “a higher percentage of arrested border crossers in its first two years than the Trump DHS did over its last two years.
Moreover, migrants were more likely to be released after a border arrest under President Trump than under President Biden.”
“Nor did [the Lincoln Project] talk about the drugs pouring into the USA in amounts so large that no one, just three years ago, would have thought it possible,” Trump continued.
According to the National Immigration Forum, in 2022, 88% of fentanyl trafficking offenders were US citizens.
In an April 2023 report, Third Way revealed that “just 0.02% of people arrested by Border Patrol for illegally crossing possessed fentanyl.”
That’s only two out of every ten thousand.
IN SUMMARY
Despite Trump’s false and ironic claim that Biden is incompetent, Biden’s records on the economy, healthcare, crime, employment, infrastructure, the environment, global warming, unemployment, and even immigration all are better than Trump’s.
This has reduced Trump to making provably fake complaints about illegal immigrants bringing in drugs and crime.
And now, even those complaints are gone at Trump’s own hands. He instructed his GOP toadies not to vote for an immigration control package that was created by Republicans together with Democrats because he cynically wanted to preserve it as a talking point before the election.
It’s as though he were telling his followers, “It’s a serious problem that hurts America daily. But don’t cure it. I want it to worsen before the election so I can whine about it. Also, I don’t want Republicans to work with Democrats. I prefer the chaos and stagnation of my presidency.”
So, as his next outrageous act, the worst pervert in U.S. presidential history is now left to claiming that those who criticize him are perverts.
You might wonder why MAGAs don’t open their eyes and see Trump for the lying, con artist, traitor, and psychopath he really is. But that would be missing the point.
MAGAs don’t care about facts. They use fact only as a rationalization for their feelings. They are afraid and believe Trump will protect them.
They are afraid of “them.” Nonwhite, the poor, gays, women, Muslims, Jews, immigrants, foreigners (except Putin) — these comprise “them.”
MAGAs, being afraid of “them,” hate “them,” because fear and hate are two sides of the same coin. You can’t hate someone unless, deep inside, you also fear them.
That is why Trump can “shoot someone on 5th Ave. and not lose followers,” as he famously claimed.
And that is why he can get away with claiming, against all evidence, that undocumented immigrants bring crime, drugs, and unemployment to America, poison our blood, do not pay taxes, and take without contributing. At the same time, Trump rejects Biden’s efforts to reduce undocumented immigration.
It makes no logical sense, but there is no logic. There are no facts. There is only fear and hatred stirred up by Trump, Fox News, Breitbart, and other immoral opportunists.
The MAGAs love to wave American flags to prove their patriotism. But, like members of every cult, their allegiance is not to America but only to the cult leader, who promises to protect his followers while fleecing them of everything they have.
Want further evidence? See the comment section of this post.
Hospitals are deploying their political power to protect their bottom lines in the battle to control healthcare costs.
The point of contention: For decades, Medicare has paid hospitals — including hospital-owned physician practices that may not be physically located in a hospital building — about double the rates it pays other doctors and facilities for the same services, such as mammograms, colonoscopies, and blood tests.
The rationale has been that hospitals have higher fixed costs, such as 24/7 emergency rooms and uncompensated care for uninsured people.
I can understand why federally funded Medicare would pay moreto organizations with higher fixed costs, but why would they pay lessto organizations with lower fixed costs?
I know. That sounds like double talk. If you pay more to one group, you pay less to another. But there is a point to be made.
Colleen DeGuzman
Medicare is an agency of the Monetarily Sovereign federal government. Contrary to popular wisdom, Medicare is not funded by FICA taxes.
All federal tax dollars, including FICA, are destroyed upon receiptby the U.S. Treasury.
The dollars begin in the M2 money supply measure, but when they reach the Treasury, they cease to be part of any money supply measure.
Effectively, they are destroyed. There cannot be a money supply measure for an entity with the limitless ability to create dollars by clicking computer keys.
Alan Greenspan: “A government cannot become insolvent with respect to obligations in its own currency. There is nothing to prevent the federal government from creating as much money as it wants and paying it to somebody. The United States can pay any debt it has because we can always print the money to do that.”
All federal agencies — Congress, the White House, SCOTUS, the military, etc. are funded the same way: By federal new money creation. That includes Medicare and Social Security.
Since the federal government can create dollars, why should it try to save dollars? It shouldn’t.
When there is a question about how much the federal government should pay for anything, the wise course is to err on the side of paying more. That would add growth dollars to the economy at no cost to anyone.
Suppose the goal is to pay hospitals the same rate as other doctors and facilities for the same services. In that case, the federal government shouldn’t cut hospital pay but rather increase the pay to other doctors and facilities.
Insurers, doctors, and consumer advocates have long complained it’s an unequal and unfair arrangement that results in higher costs for patients and taxpayers.
It may or may not be “unfair,” but why would hospital pay be considered too high? No one has demonstrated that hospitals should receive less money. So why is reducing hospital pay the cure for “unfairness”?
It’s also a profit incentive for hospitals to buy up physician practices, which health economists say can lead to hospital consolidation and higher prices.
It would seem that the real profit incentive is not with the hospitals to buy physician practices. Instead, there would be an incentive for doctors to sell their practices, depending on how Medicare dollars are split between doctors and hospitals.
In December, the House passed a bill that included a provision requiring Medicare to pay the same rates for medical infusions, like chemotherapy and many treatments for autoimmune conditions, regardless of whether they’re done in a doctor’s office or clinic owned by a hospital or by a different entity.
The policy, known as site-neutral payment, has sparked a ferocious lobbying battle in the Senate, not the first of its kind, with hospitals determined to kill such legislation.
There would be no need for “ferocious lobbying” if doctors’ pay were increased rather than hospitals’ pay decreased.
According to the Congressional Budget Office, the House legislation would save Medicare an estimated $3.7 billion over a decade.
To put this in perspective, the program is projected to pay hospitals upward of $2 trillion during that same period. But hospitals have long argued that adopting site-neutral payments would force them to cut jobs or services or close facilities altogether — particularly in rural areas. And senators are listening.
“Saving Medicare $3.7 billion is identical to saying, “cost the economy 3.7 billion it otherwise would have received.”
“The Senate is very much attuned to rural concerns,” Sen. Ron Wyden (D-Ore.), who chairs the Finance Committee, told KFF Health News. His panel has jurisdiction over Medicare, the health program for seniors and people with disabilities.
“I have heard many questions about how these proposals would affect rural communities and rural facilities,” he said. “So we’re taking a look at it.”
Outpatient departments at rural hospitals can have outsize importance to their communities. Taking any funding away from stand-alone rural hospitals is seen as risky. Scores have closed in the past decade due to financial problems.
With fewer patients, rural hospitals often struggle to attract doctors and update technology amid rising costs.
Taking money from rural hospitals impoverishes them while doing nothing for doctors or for the federal government, which has infinite money. This is how economics ignorance hurts everyone.
Sen. Bill Cassidy, R-La., a physician serving on the Finance Committee, indicated he was apprehensive about the legislation.
“In some cases,” he said, higher Medicare hospital payments are “justified.”
“In some cases, it doesn’t seem to be,” he said. He told KFF Health News he was planning to introduce legislation on the issue but didn’t provide details, and his office didn’t respond to inquiries.
As the two senators show, the issue doesn’t break cleanly along partisan lines. In December, the House quickly passed the Lower Costs, More Transparency Act, the broader bill that included this Medicare payment change, with 166 Republicans and 154 Democrats voting.
Whenever Congress votes for “lower costs for the federal government,” it means “Fewer growth dollars for the economy, i.e., the private sector.” Lower costs for the federal government means taking money from you.
In short, you pay for all federal savings.
“It’s more about how close different members are to the hospital industry,” said Matthew Fiedler, a former White House health economist under President Obama and now a senior fellow at the Brookings Institution.
Barack Obama was notoriously ignorant about federal finances. He famously claimed the federal government had to “live within its means.”
The federal government always lives with its means because its “means” are infinite. It never can run short of dollars.
Obama also signed the Budget Control Act to cut annual government spending by about $1 trillion over the next 10 years. Additionally, the act charged the Joint Select Committee on Deficit Reduction with finding an additional $1.5 trillion in savings.
Translation: The Budget Control Act aimed to reduce the economy’s supply of growth dollars by $1 trillion and charged the Joint Select Committee on Economic Growth Reduction with taking another $1.5 trillion from the American people.
The American Hospital Association described the site-neutral policy as a “cut” to hospital Medicare payments.
It said in a statement to a House subcommittee that it “disregards important differences in patient safety and quality standards required in these facilities.”
Rather than cutting payments to hospitals, Medicare could accomplish equality by increasing payments to healthcare suppliers, not in hospitals. This would satisfy rural hospitals, grow the economy, and improve the nation’s healthcare.
Chip Kahn, president and CEO of the Federation of American Hospitals, representing for-profit hospitals, offered a similar characterization of the House-passed legislation.
“This is no time for so-called ‘site-neutral’ Medicare cuts that could harm beneficiaries,” he said in a statement.
Right. There has never been a time to make cuts to save the federal government money.
“This is not a hospital cut. It is rolling back an unethical price increase,” said Mark Miller, a former MedPAC executive director now an executive vice president at Arnold Ventures, a philanthropy founded by John and Laura Arnold.
No, it’s a hospital cut. All the mealy-mouth rationalizations don’t change that fact. It is an unnecessary cut with zero benefit to America and much pain to the economy and our hospitals.
Large hospital systems with the money to buy physician practices, Miller said, have exploited the disparity between Medicare payments to physician offices and hospitals to increase their revenue and consolidate.
Miller said he’s hopeful the site-neutral provision of the House bill will be part of a larger government spending bill that must be passed next month to keep the government open.
If lawmakers need to offset the bill’s costs, “then it is more likely to get in the funding package,” he said.
But, lawmakers do not need to offset the bill’s costs. The reluctance to spend and keep the government open is total bullshit. Yes, there is no better way to state it: Total bullshit that has been fed to the American public.
The purpose of the bullshit is simple: To make the middle- and lower-income groups stop asking for federal benefits. When the people are told (falsely) that Medicare and Social Security “can’t afford” more benefits or even existing benefits, they meekly accept their impoverishment.
And that makes the rich, who run America, richer.
Sorry, folks, but your representatives are cheating you by keeping you ignorant of federal finances. Ignorance is costly.
The House-passed legislation is viewed as an “incremental” change, said Fiedler, but it faces a rough path forward.
Evening out Medicare payment for physician-administered drugs, hospitals fear, could lead to similar moves for other outpatient services.
“Hospitals have a lot of money at stake and will fight this hard,” he said. “Hospitals feel if they lose here, there will be more substantial steps down the road.”
Yes, the rich will fight like hell to widenthe Gap between the rich and the rest — if we let them get away with the Big Lie — the bullshit that the federal government can run short of dollars.
President Kennedy was wrong when he said, “My fellow Americans: ask not what your country can do for you — ask what you can do for your country.”
He should have said, “Ask not how much you can pay your federal government — ask how much your federal government will pay you.”
I could have saved myself a lot of pain and a lot of bad tennis, too.
You should know that “knee replacement” does not usually involve replacing the knee. Most replacements involve merely inserting pads called “prothesis” in three places: On each bone and behind the knee cap, as shown above.
I asked my friend to tell me his doctor’s name, and I scheduled a visit. Here is how to choose a doctor for your knee replacement:
While politicians of all parties have been infamous for lying, two changes have taken place in the Republican party:
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#Monetary Sovereignty - Mitchell 