“Learn the rules like a pro, so you can break them like an artist.”
Pablo Picasso

A few bits of news this week which I anticipate effecting my future years. Time to start planning.

The local hospital system has been proactive for years on optimizing dollars fed into its system. It systematically bought all the community hospitals, now using them as a feeder system to the main hospital. The hospital system is the only choice without traveling over a 100 miles.

Local quirk or beginning of a national trend - time will tell.

‘26,000 may be affected’: St. Charles’ possible Medicare Advantage withdrawal prompts questions, concerns KTVZ News Aug 18,2023

BEND, Ore. (KTVZ) -- Citing concerns related to patient care, access and affordability, St. Charles Health System says it may withdraw its participation in all Medicare Advantage plans, including those from Humana, PacificSource, HealthNet and WellCare, and urged participants to consider shifting to traditional Medicare. That has prompted concerns by patients and others, including Summit Health Oregon.

St. Charles said in Monday's announcement that if it makes that move, it will continue to accept original (or traditional) Medicare, which is funded and operated by the federal government. Medicare Advantage plans are funded by the government but run by private insurance companies.
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Chief Financial Officer Matt Swafford said, "Often what happens is that the Medicare Advantage plan gets in the way of the patient and the provider and makes choices that either delay a discharge or prevent access or change the financial situation retroactively, after the care has already been provided."

St. Charles also cited the burden of paperwork, staffing shortages and delays in transferring patients as more reasons to potentially drop Medicare Advantage coverage.

Dr. Mark Hallett, the system's chief clinical officer, explained more scenarios where the Medicare Advantage insurance plans don't cover what people think they do.
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St. Charles is not alone in expressing concerns about Medicare Advantage plans. According to the American Hospital Association, the AHA “is increasingly concerned about certain (Medicare Advantage) plan policies that restrict or delay patient access to care, which also add cost and burden to the health care system.” Additionally, Medicare Advantage plans are under investigation for fraud and delays and denials in coverage.

“We are seeing different outcomes for patients based on the type of insurance they have; with those on Medicare Advantage experiencing higher rates of denials and longer hospital stays, meanwhile our providers must jump through hoops in order to get the care their patients need approved,” said Matt Swafford, chief financial officer for St. Charles.

“We recognize changing insurance options may create a temporary burden for Central Oregonians who are currently on a Medicare Advantage plan, but we ultimately believe it is the right move for patients and for our health system to be sustainable into the future to encourage patients to move away from Medicare Advantage plans as they currently exist. We want to share this notification with seniors in Central Oregon so they have enough time during open enrollment this fall to sign up for traditional Medicare.”

International Relations Theater

BRICS just changed the dynamics world relationships.

'Welcome to the BRICS 11' The Cradle by Pepe Escobar Aug 25, 2023
(alternative link if The Cradle is non-responsive. I have had trouble with the site today)

In the end, History was made. Surpassing even the greatest of expectations, the BRICS nations performed a giant step for multipolarity by expanding the group to BRICS 11.

Starting on January 1, 2024, the five original BRICS members will be joined by Argentina, Egypt, Ethiopia, Iran, Saudi Arabia and the United Arab Emirates (UAE).
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Here is the Johannesburg II Declaration of the 15th BRICS summit. BRICS 11 is just the start. There’s a long line eager to join; without referring to the dozens of nations (and counting) that have already “expressed their interest”, according to the South Africans, the official list, so far, includes Algeria, Bangladesh, Bahrain, Belarus, Bolivia, Venezuela, Vietnam, Guinea, Greece, Honduras, Indonesia, Cuba, Kuwait, Morocco, Mexico, Nigeria, Tajikistan, Thailand, Tunisia, Turkiye and Syria.

By next year, most of them will either become BRICS 11 partners or part of the second and third wave of fully-fledged members. The South Africans have stressed that BRICS “will not be limited to just one expansion phase.”
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Pay attention. That’s Russia-China in synch on connectivity corridors, and they are preparing to further link their continental transportation projects.

On the financial front, the Central Banks of the current BRICS have been instructed to seriously investigate and increase trading in local currencies.

Putin made a point of being very realistic on de-dollarization: “The issue of the single settlement currency is a complex issue, but we will move toward solving these problems one way or another.” That complemented Brazilian President Luiz Inacio Lula Da Silva’s remarks on how the BRICS has started a working group to study the viability of a reference currency.

In parallel, the BRICS’ New Development Bank (NDB) has welcomed three new members: Bangladesh, Egypt, and UAE. Yet their road to prominence from now will be even steeper.

Pepe Escobar: BRICS 11 - Strategic Tour de Force Sputnik News Aug 26, 2023

It will take time for the Global South, or Global Majority, or “Global Globe” (copyright President Lukashenko), not to mention the stunned collective West, to fully grasp the enormity of the new strategic stakes.
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India wanted 3 new members. China wanted as many as 10. A compromise was finally reached, with 6 members: Egypt, Iran, Saudi Arabia, United Arab Emirates (UAE), Argentina and Ethiopia.
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Now let’s get into the strategic stakes. For all practical purposes, in Eurasian terms, BRICS 11 is now on the way to lord over the Arctic Sea Route; the International North South Transportation Corridor (INSTC); BRI’s East West Corridors; the Persian Gulf; the Red Sea; and the Suez Canal.

That blends several overland corridors with several nodes of the Maritime Silk Roads. Nearly total integration in the Heartland and the Rimland. All with just a single strategic move in the geopolitical/geoeconomic chessboard.
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By incorporating Iran, Saudi Arabia and the UAE, BRICS 11 instantly shines on as an oil and gas powerhouse. BRICS 11 now controls 39% of global oil exports; 45.9% of proven reserves; and at least 47.6% of all oil produced globally, according to InfoTEK.

With BRICS 11 possibly including Venezuela, Algeria and Kazakhstan as new members as early as in 2024, it may control as much as 90% of all oil and gas traded globally.
Inevitable corollary: operations settled in local currencies bypassing the US dollar. And inevitable conclusion: petrodollar in a coma. The Empire of Chaos and Plunder will lose its free lunch menu: control of global oil prices and means to enforce “diplomacy” via a tsunami of unilateral sanctions.
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In the G20 last year, China was the first nation to lobby for the inclusion of the 55-member African Union (AU). That may happen at the G20 summit next month in New Delhi; in that case, Global South representation will be close to parity with the Global North.
Claims that Beijing was organizing a malign conspiracy to turn BRICS into a weapon against the G7 are infantile. Realpolitik – and geoeconomic indicators – are dictating the terms, configuring the Shock of the New: the G7’s irreversible irrelevance with the rise of BRICS 11.

Can BRICS Dethrone US Empire? (56:45) Aug 22, 2023 (pre-BRICS summit)

Vladimir Soloviev speaks excellent English (no need for the translator), lived several years in Arkansas, expresses strong opinions and is well versed in Russian and American cultures. He has met Putin multiple times and has interviewed him twice.

Discussion on Putin.
(4.22 min)

Full interview.
Scott Ritter Show Ep. 42 with Vladimir Soloviev (52:34)

Economic Theater

US extends China chip curb waiver for allies’ fabs Asia Times Aug 26, 2023

The United States government has decided to extend a waiver to allow mainland China-based Taiwanese and South Korean firms to import chip-making equipment for another year from October.
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This move, together with the US Commerce Department’s recent decision to remove 27 Chinese firms from its unverified list, is welcomed by Beijing.

In early July, Chinese officials held deep talks with US Treasury Secretary Janet Yellen in Beijing and persuaded the Biden administration to reduce to the scope of its investment curbs against China’s high technology sectors.
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On August 17, the US Commerce Department said it will set preliminary anti-dumping duties of 122.5% on tin mill steel imported from China, 7.02% on imports from Germany and 5.29% on imports from Canada to protect domestic steelmakers. No duties will be imposed on the steel products imported from Britain, the Netherlands, South Korea, Taiwan and Turkey.

China’s duties were higher as a major producer refused to cooperate in the investigation while other respondents could not prove that they were independent of the Chinese government, according to a Commerce Department official.

Ukrainian Theater

A plane fell from the sky this week killing all on board. The story has disrupted reporting on Ukrainian lives lost and thwarted attacks on Russia.

The narrative from earlier in the week in various media sources has changed from "Putin did it" to "Who did it?"

Who Killed Prigozhin? POWER PANEL: w/Ritter, Johnson, McGovern Intel Roundtable (29:17 min)

The livestream videos this week by Judge Napolitano channel ongoing discussions regarding current Ukraine/Russia conflict. The interviews are generally posted on Monday through Thursday if would like to view them in a more timely manner. The link opens in the LIVE column, occasionally an interview only appears in VIDEOS section.

What is on your mind today?