It’s a stutter.

I had a bad stutter for years,

From mid-seventh grade up thru high school I struggled mightily to get the words out, to avoid humiliation, laughter, scorn and – worst of all – pity.

As a formerly eloquent speaker and school play actor I had no idea what happened, why, how to fix it, and whether I’d ever be able to stand up in front of people and just…say   my   name.

It came and went for years after high school…I have a very painful recollection of  stuttering badly while giving a talk about exercise physiology during graduate school, watching the group suffer along with me.

Over the years I forced myself into situations again and again as I tried to overcome stuttering…for reasons unknown my stutter eventually faded into a distant if very painful memory.

I relate this because I am appalled by the media’s laziness, stupidity, crassness, and total lack of empathy all on full display when discussing President Biden’s occasional word stumbles. He’s not going thru dementia, nor does he have Alzheimer’s, and he’s not suffering the after-effects of a stroke.

Nope, he’s got a stutter.

Unlike me, the President has not fully conquered his stutter, yet he puts himself out there every day, knowing all too well he’s going to be laughed at, mocked, and demeaned because he stutters.

The meme-makers, mockers and insulters are pathetic indeed, seeking to drag down a person because of a sometimes-disabling condition, to use Biden’s condition to make them feel better about themselves, to get a cheap laugh from equally-pathetic barroom morons.

As for the media, I am furious with TV anchors, pundits, reporters, and editors for failing to address this consistently, fairly and completely. No, these superficial “personalities” would much rather parrot the “he’s old, see he can’t finish a sentence, mixes up his words, mumbles at times, and veers off track…” idiocy.

Well, you idiots masquerading as media those are ALL STRATEGIES STUTTERERS USE TO TRY TO GET THE WORDS OUT.

Mumbling hides stutters.

Mixing up words happens when you are desperately trying to find a word to use instead of the word that’s stuck in your throat.

Not finishing a sentence is because you can’t get the last words out without stuttering.

Going off track – same..

What does this mean for you?

How would you feel if you stuttered? Couldn’t communicate verbally? Got laughed at for something you can’t control?

I thought so.    So don’t be a jerk.



Good news Friday – Crime is down!

If it bleeds…it leads.

That’s the mantra driving local news reporting, one that really distorts what’s ACTUALLY happening – which is in most cities crime has dropped – a lot. That includes violent crime.

According to the highly-regarded Council on Criminal Justice,

  • The number of homicides in the 30 study cities was 9% lower in the first half of 2023 than in the first half of 2022.
  • Robberies, burglaries and larcenies all decreased in the first half of 2023 compared to the first half of 2022.
  • Levels of nearly all offenses are lower, or barely changed in the first half of 2023 compared with the same period in 2022.

Notably, murder rates peaked 3+ years ago, under the previous administration and have dropped by half since then.

The one area where volumes have increased is in car theft…mostly due to big problems with Kias and Hyundai thefts which are up 1,000% since 2020. …it has gotten so bad police departments in multiple cities are giving away steering wheel locks to Kia and Hyundai owners…

In Milwaukee more than half of car thefts were Kias or Hyundais.

What does this mean for you?

Tell the fear mongers to stuff it.

And put a steering wheel lock on your Kia/Hyundai.



Since the Supreme Court overturned the right to abortion, almost 60,000 women had rape-caused pregnancies – and live in states where they cannot get an abortion.

From the American Medical Association’s research:

In the 14 states that implemented total abortion bans following the Dobbs decision, we estimated that 519 981 completed rapes were associated with 64 565 pregnancies during the 4 to 18 months that bans were in effect (Table 2). Of these, an estimated 5586 rape-related pregnancies (9%) occurred in states with rape exceptions, and 58 979 (91%) in states with no exception, with 26 313 (45%) in Texas.

Notably, even in states that allegedly allow exceptions for rape or incest – e.g. Idaho – the AMA found NO abortions have occurred.


60,000 girls, teens, and women who were raped will have live or dead babies.

The psychological damage will be devastating for them, their loved ones, and their babies.

Make no mistake, the burden will fall on the least fortunate of us...almost everyone subscribed to MCM has healthcare; you and your daughters/wives can travel to states that allow abortion.

The vast majority of victims live in states that have crappy Medicaid coverage, so many/most won’t have coverage for/access to pre-natal care, ob/gyn services, labor and delivery, and infant/pediatric health.

Not to mention mental health.

The shameless hypocrisy of the “protect life” crowd in these states is overwhelming... forcing rape victims to have babies and not providing the women or the babies with healthcare is just…unthinkable.

The cost – in terms of destroyed lives and unfunded/uncovered healthcare expenses – is immeasurable.

What does this mean for you?






Dumbest law of the month…#2

Okay, this isn’t a law, rather a school board ruling.

But it is so amazingly, blindingly, completely stupid that it beggars belief.

Last June the duly-elected Escambia County School Board  banned 8 dictionaries and encyclopedias because they…wait for it…contain depictions or descriptions of sexual conduct.

Who knows if these vile, disgusting, immoral books contained anything problematic…but under Florida’s “Don’t Say Gay” law, one parent – yup, just one – can force a school to pull a book from its shelves and conduct a lengthy review to ascertain if it is – according to some made-up criteria – inappropriate for that school.

So, let’s see…what could qualify?

  • A parent kissing their spouse?
  • Reproduction by an earthworm?
  • A trout laying eggs?
  • A medical textbook describing intercourse?

Those are all “sexual conduct…

That’s not the worst of it. Under Florida’s law, ANY parent could force a school too pull ANY book – which could include…the Biblewhich does reference various activities that could be construed as “sexual conduct”.

What does this mean for you?

Don’t let your kids go to Escambia County schools.




What should happen in workers’ comp – but probably won’t

I’ve finally figured out that what I think should happen often doesn’t.

So, here’s my take on the 5 things that SHOULD happen in worker’s comp this year but likely won’t.

  1. We won’t hear more caterwauling about “rising medical costs”.
    Ha. The latest NCCI research indicates execs still don’t understand what’s really happening with medical costs – despite NCCI’s diligent efforts to educate same.
  2. Work comp execs will embrace innovation.
    I wrote about this three years ago here. Basically,

    1. execs got to be execs by avoiding anything remotely risky.
    2. The industry is making billions in profits so why try anything new.
    3. Frequency and premium rates are declining, so why try something for a declining business?
    4. And worker’s comp is mandatory in 48 states, so they’ll have to buy it from someone.
  3. Buyers will stop asking about/measuring/caring about medical “savings”.
    I’ve written about this a gazillion times…here’s one example. The net – it’s really easy to show a reduction below list price – we Americans have been trained to do just that.
    Even when it makes zero sense…follow the link to get why there’s a horrendously ugly sport jacket here…

    Oh, And, this industry is pretty lazy.
  4. The industry will wake up to human-caused global warming. 
    Ha. Nice to see that some pundits have finally raised this as an issue – but jeez people it’s 2024, and we’ve KNOWN we are boiling the planet for decades. Nope, there will be minor moves, with little public discussion among or by work comp execs.
    Great question.
  5. The industry will seriously embrace behavioral health, take major steps to understand this as a disability driver, and seek out meaningful solutions.
    Sure, some have – and kudos to them for doing so – And kudos to good friend, colleague, and mentor Bill Zachry, David Vittoria of Carisk, Dr Les Kertay, and others who have been leading the charge.
    But let’s get real folks…disability is as much- if not more – mental/emotional/
    psychological as physical, yet far too many payers don’t want to accept that blindingly obvious truth, scared of “owning the psych”.”
    You already own it.

    (Carisk is an HSA client)



Good news Friday…

The best possible news hit the wires yesterday – there won’t be a government shutdown next week.

The House – in a bipartisan vote – passed a continuing resolution (aka CR) to keep current funding levels in place till early March, giving the House and Senate time to negotiate on 12 individual spending bills.

The really good news is this passage:

  • was bipartisan, with 207 Democrats and 107 Republicans joining together to pass the CR
  • did not result in a move to oust current House Speaker Mike Johnson (R LA) (a similar bill cost then-speaker Kevin McCarthy R CA the Speakership)

While it is way too early to celebrate a new era of bipartisanship and congratulate the radicals on both ends of the spectrum for their maturity, and

…it is mind-blowing that we now celebrate a near-government shutdown as “good” news, 

Given recent history this does count as good news.

What does this mean for you?

That said, we cannot continue governing like this.  Thoughtful, principled compromise must return to Washington.


Good news Friday!!

With all the craziness in the world, its easy to miss some of the good things that are happening…stuff that makes life just a little better.

The gubmint is actually making progress…on those incredibly annoying junk fees.

Overdraft and other banking fees

The Consumer Financial Protection Bureau is finalizing regs that will protect us from bank overcharge fees.  In 2022 banks took $7.7 billion from customers.

A big percentage of those hit with overdraft fees are poorer folks – the ones who get hit with a $35 charge for buying a few groceries. The new regs will really help  those folks.

Retirement junk fees

There are potential conflicts of interest for retirement plan advisers, conflicts that might encourage advisers to recommend an investment that isn’t in your best interest.

From USNews…

the Administration is pushing changes in “three specific areas to lower fees for Americans preparing for retirement. These are related to closing loopholes in the purchase of any investment product, advice given about IRA rollovers and recommendations for 401(k)s and other company-sponsored plans.” [emphasis added]

Colleges and junk fees..

Colleges and universities have gotten pretty darn good at sucking money out of students’ accounts with some pretty outrageous stunts.

From USNews:

Student flex fees are a target..some colleges are keeping left over funds after graduated.


Congress may actually get something done...I know, who woulda believed it. A bi-partisan effort to address stupid- and unconscionably high insulin costs, appears to be gathering steam.

From WaPo:

their bill would extend Medicare’s $35-per-month cap on insulin prices to individuals with private insurance, rein in the business practices of prescription drug middlemen and make it easier for new generic and biosimilar drugs to enter the market. [emphasis added]

What does this mean for you?

Government gets stuff done…


Predictions for 2023…how’d I do?


A year has passed (good riddance!), and it’s time to own up to how I did on my annual predictions for workers’ comp – and stuff that will drive WC.

A view inside HSA’s intergalactic headquarters’ predictive analytics department…

Here we go…predictions and results thereof:

  1.  The soft market continues…
    And it won’t harden in 2023. Medical costs remain very much under control (with an exception), rates continue to drop, employment remains very strong (essential for return-to-work) and there’s lots of payers fighting for market share.

    . The fine folks in Oregon’s helpful analysis of state work comp rates…indicate once again rates were down. For years work comp rates have been artificially high; that continued in 2023 driven in large part by the opioid hangover.
  2. Medical spend is NOT a problem – and will NOT be in 2023.
    With a couple notable exceptions – to be covered in a future post – medical inflation will remain under control. In part this is driven by much lower drug spend and more specifically the continued decline in opioid spend. The latter has a big impact on claim closure and total medical spend.

    Client data and early indicators point to relatively modest increases – if any – in medical spend. Facility costs are the exception, but a shift in location of service has – for now – moderated the impact.
  3. Behavioral health and its various iterations will gain a lot of traction.
    More State Funds, carriers and TPAs will adopt BH programs, more patients will benefit, and more dollars will be spent. There’s a growing recognition that medical issues aren’t hindering “recovery” near as much as psycho-social ones. This is great/wonderful/long-needed and will really benefit patients and payers alike. Kudos to early adopters, and LETS GO to you laggards!

    True – although there is not enough infrastructure to support BH. Sure there are companies that have BH-specific experience and expertise; Carisk among the leaders, AppliedVR is the only FDA-authorized virtual reality chronic pain solution and is gaining significant traction…unfortunately there are no national or even regional provider networks providing full BH services.This is in large part because payers want discounts (do NOT get me started on the stupidity of this) coupled with a national shortage of providers. (Carisk and AppliedVR are both HSA consulting clients)

  4. One Call will be sold. 
    I keep forecasting this…and one day I’ll be right.  It has to be this year. CEO Jay Krueger and colleagues have OCCM on a better track, but structural problems (i.e. declining claim volume) and internalization of One Call-type services by Sedgwick and others make the future…less than promising. Couple that with recent ratings actions by Moody’s and S&P and it’s time to do the deal.

    Wrong – Again.
    Well, can’t seem to win this one.  Any interested parties have run away –
    because OCCM’s current owners are suing each other. Gotta feel for Jay Krueger and colleagues…I’m quite sure if the circular firing squad hadn’t pulled out their guns OCCM’s staff, clients, and customers – and the investors as well – would be in a much better place.

  5. New technology will make its impact felt.
    Wearables, chatbots (I HATE THEM), and Virtual Reality-driven care are three ways tech platforms/systems/things will significantly ramp up in ’23. Expect several large/mid-tier payers to adopt new tech in a major way – aka not just a small pilot.
    Structural issues with health care (try to find a LCSW or Psych-trained counselor), lack of trained adjusters, and frustration with rising rehab expenses are all contributors.

    True – AppliedVR is working with several workers’ comp payers today – as well as the VA; Plethythe recovery support company – is rapidly expanding its client base, and many payers are trying other tech – with quite mixed results.
    Plethy’s data indicates consistently high patient adherence to home exercise and remarkable outcomes. Other wearable tech that requires provider
    training, uses vision technology to monitor movement and the like are struggling with low adoption and adherence. (Plethy is an HSA consulting client)

Tomorrow  – the other five predictions.


Good news…Monday. Rising wages + Lower inflation = Higher portfolios

About to head home after two weeks in Southeast Asia…off the grid for much of it.

Here’s the good stuff that happened whilst I was floating down the Mekong River.

Wages are up…

and have been rising steadily for the last 3 years…outpacing inflation.

And will keep going up…

From The Economist – “A blue-collar bonanza is under way…three forces that shape labour markets—demand, demography and digitisation—have each shifted in ways that benefit workers.”

If you’ve had to hire a plumber, carpenter, or electrician recently, you know what they’re talking about.

Implication – higher wages = higher premiums.

While inflation continues to drop…

One economist got this right, while many just endlessly caterwauled about the imminent rise in unemployment and drop in wages necessary to tame inflation.

Gotta love economists…or not.

Fuel prices continue to drop…leaving more dollars in our pockets

All this good economic news – consumers have more money to spend, employment remains very strong, and prices are moderating means there will be…

More dollars in your investment portfolio

You’ll likely see your investment portfolio rise in value…BofA, RBC, and Deutsche Bank are among the firms predicting record returns in 2024.

What does this mean for you?

As you start your week, don’t buy into the “economy is awful” nonsense. 

Finally – -one of the keenest observers of trends in business and the body politic is Scott Galloway of NYU. I highly recommend his weekly newsletter.


Customer service, bean counters, and Too Big to Care

During another holiday week a few years back I penned a terrific post on customer service. If I do say so myself, and I do.

Customer service comes to mind as I sit on a transcontinental flight from NYC to Singapore to attend our son’s wedding.

For once I did the smart thing…my lovely bride and I are on Singapore Air, consistently the top-rated airline for customer service. Oh my what a difference between this airline and any other I’ve flown in the past several decades. And I’ve flown a LOT.

Singapore Airlines is…fabulously wonderfully totally about its customers.

One incredibly tiny example…I got up to use the restroom, and an impeccably polite steward very diplomatically noted that cabin service had been halted due to turbulence and perhaps I should stay in my seat unless my sojourn was of utmost importance. I aborted the trip and returned to my seat.

Five minutes later anther flight attendant came by to inform me that things were back to normal and I could safely walk about the cabin. A tiny thing, totally insignificant and yet a blindingly clear demonstration of how serious these people take customer service.

Management clearly gets it. And I will fly Singapore whenever I possibly can. Because any time a flight attendant is that focused on customer service, it is because the entire enterprise is – most importantly top management.

Allow me to reprise the post from 2018, as it is even more topical today.

To that point, here’s an example of a huge business that completely misses the point.

This summer (back in 2018) American Airlines allowed flight attendants to give little things to passengers upset about delays or other problems. Frequent flyer miles, drink coupons, seat upgrades, stuff that didn’t cost AA anything but made angry passengers feel that AA cared about the problems the airline caused.

Then, some genius at HQ decided this was a bad idea.

This from Forbes:

Every time some bright young marketing executive tried to make American (or some other airline) more responsive, and more quickly responsive to passengers’ dissatisfaction by empowering front-line workers to offer some form of compensation, the bean counters back at headquarters quickly noticed that the cost of such empowerment escalated rapidly. The result, alas, always has been the dramatic reduction or elimination of front-line workers’ authority to solve customer service issues at the point of contact.

Instead of fixing the problem, the corporate knuckleheads tried to deal with the fallout – but stopped when it cost too much. 

update – American is currently rated #82 out of the world’s best airlines. Well behind RyanAir (!!!), Air Mauritius and Azerbaijan Airlines, This isn’t due to American’s front line workers, rather management decided service is about #82 on their list of important things.

This is exactly what killed US manufacturing, autos, and many other businesses. At the end of their assembly lines, GM, Ford, and Chrysler diverted many just-built cars with manufacturing defects to another mini-factory.

Auto worker using hammers to straighten a hood on a just-built car…

There, very skilled and very expensive workers diagnosed and fixed cars that had just been built. These guys are yesterday’s American Airlines flight attendants, tasked with fixing problems caused by management.

Clearly senior management didn’t understand that if they spent the time and energy and dollars to do it right the first time, they wouldn’t have to a) fix problems with cars they just built, and b) deal with pissed-off customers.

Yes, it takes that time and energy and dollars. But the results are measured in customers kept, service problems eliminated, and extra costs avoided.

Or, you can just wait for your businesses’ version of Honda to come in and eat your lunch.

What does this mean for you?

Find out what your customers want, and do it right the first time. They will love you and reward you for it.