Category: Government

Feds Waste at Least $4.3 Billion in Duplicate Payments to States Where Medicaid Recipients No Longer Reside

Do taxpayers know how much government fraud and inefficiency they are paying for? Hopefully DOGE can clean up these duplicate (and sometimes triplicate and more) payments. If the Wall Street Journal is capable of finding multiple payments, then surely the government itself can find and stop them.

(p. A1) Health insurers got double-paid by the Medicaid system for the coverage of hundreds of thousands of patients across the country, costing taxpayers billions of dollars in extra payments.

The insurers, which are paid by state and federal governments to cover low-income Medicaid recipients, collected at least $4.3 billion over three years for patients who were enrolled—and paid for—in other states, a Wall Street Journal analysis of Medicaid data found.

The patients were signed up for Medicaid in two states at once, in many cases following a move from one to the other. Most were getting all their healthcare services through one insurer in one state, even though Medicaid was paying insurers in both states to cover them.

Private insurers oversee Medicaid benefits for more than 70% of the about 72 million low-income and disabled people in the program. The companies get paid each month for each person they cover. They aren’t supposed to get paid if a patient leaves for another state.

. . .

(p. A9) The Journal’s analysis turned up some cases in which individuals were signed up in five or more states.

. . .

The Journal’s analysis used detailed Medicaid data, obtained under a research agreement with the federal government, to identify duplicate payments to managed-care companies. The analysis examined where double-enrollees got their medical care each month, using that as an indication of their state of residence.

. . .

“There is very little incentive for the managed-care organization to check eligibility,” said industry consultant Kevin Bagley, the former director of Nebraska’s Medicaid program. Bagley and other Medicaid experts said it is difficult for states to claw back payments from managed-care companies for covering relocated enrollees, largely because it can be unclear exactly when they left.

Sometimes a single insurance company covered the same person in more than one state. During the period covered by the Journal’s analysis, Centene insured about 25,000 people a year, on average, in two different states at the same time. For those people, the company was paid at least $151 million extra. Elevance received $48 million extra for covering the same person twice, and UnitedHealth got $53 million.

One Centene supervisor urged some of the company’s case managers in February to keep Medicaid recipients enrolled after they moved. “Please DO NOT close cases when you learn a member has moved out of state,” the supervisor said in a Microsoft Teams message. “If the member shows eligible and are out of state, they can still can [sic] utilize some of the benefits.”

Centene’s spokesman said the company is required to maintain coverage for members until the state decides whether to disenroll a beneficiary.

The inspector general for the federal Department of Health and Human Services examined the issue of double payments several years ago in a study looking only at people enrolled in multiple state-paid managed care plans in August in 2019 and 2020.

The results led the team of investigators to conclude that taxpayers were wasting about $1 billion a year, said John Hagg, assistant inspector general for audit services at the oversight agency.

“It should be low hanging fruit,” said Hagg. “The data is there showing it is a problem. This is ripe for correction.”

For the full story see:

Christopher Weaver, Anna Wilde Mathews, and Tom McGinty. “Medicaid Spent Billions Covering Same Patients Twice.” The Wall Street Journal (Fri., March 28, 2025): A1 & A9.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the WSJ article has the date March 26, 2025, and has the title “Taxpayers Spent Billions Covering the Same Medicaid Patients Twice.” The passages quoted above omit the subheadings that appear in the print, but not the online, version of the article.)

Rampant Fraud in ‘Skin’ Bandages Paid by Medicare

A “quirk” in the Medicare law allows ‘skin’ bandage firms to charge, and have Medicare pay them, exorbitant prices. Are such quirks accidents or intentional? Medicare rules are so voluminous and obscure that few have an incentive to look carefully at the details. But the firms selling ‘skin’ bandages had an incentive. Entrepreneurs within these firms saw an opportunity and seized it. But they are what William Baumol called “destructive entrepreneurs.” Their energy and talent works against the general good.

Since patients are not paying, they have little incentive to reveal the fraud. So the taxpayers are robbed. In a system where the patients are the payers they would have an incentive to reveal fraud, and to seek alternatives to over-priced medical therapies.

But what of the poor, you ask? Susan Feigenbaum proposed an insurance system where patients would receive lump sum payments for different ailments. Then poor patients could be payers, and have the incentives of payer.

(p. 1) Seniors across the country are wearing very expensive bandages.

Made of dried bits of placenta, the paper-thin patches cover stubborn wounds and can cost thousands of dollars per square inch.

Some research has found that such “skin substitutes” help certain wounds heal. But in the past few years, dozens of unstudied and costly products have flooded the market.

Bandage companies set ever-rising prices for new brands of the products, taking advantage of a loophole in Medicare rules, The New York Times found. Some doctors then buy the coverings at large discounts but charge Medicare the full sticker price, pocketing the difference.

Partly because of these financial incentives, many patients receive the bandages who do not need them. The result, experts said, is one of the largest examples of Medicare waste in history.

Private insurers rarely pay for skin substitutes, arguing that they are unproven and unnecessary. But Medicare, the government insurance program for seniors, routinely covers them. Spending on skin substitutes exceeded $10 billion in 2024, more than double the figure in 2023, according to an analysis of Medicare data done for The Times by Early Read, a firm that evaluates costs for large health companies.

Medicare now spends more on the bandages than on ambulance rides, anesthesia or CT scans, the analysis found.

. . .

(p. 19) . . . experts in health care costs said the spike had been driven . . . by sellers and doctors taking advantage of Medicare’s pricing rules. The government will reimburse any price that a company sets for brand-new skin substitutes, even if it is far above the market average. The higher the price, the larger the doctors’ cut.

And the bigger the bandage, the more they can charge. For one patient in Nevada, Medicare spent $14 million on skin substitutes over the course of a year, according to billing records reviewed by The Times. The wound of a patient in Washington State persisted after Medicare paid $6 million for the coverings. A man in Texas got $1.3 million of bandages despite having no wound at all. Health executives trying to ferret out suspicious spending identified these patients and shared their stories with The Times.

As the Trump administration — and particularly the new Department of Government Efficiency run by Elon Musk — aims to shrink the federal purse, profligate Medicare spending is a ripe target, experts said.

Companies have billed Medicare for hundreds of thousands of urinary catheters that doctors never ordered. Other schemes have peddled urine tests and knee braces. In 2023, a federal watchdog agency flagged skin substitute spending as wasteful for both taxpayers and Medicare enrollees, who ultimately pay the costs with higher premiums.

“It’s the patients, it’s the taxpayers — unfortunately everyone is footing a part of the bill for this outsized spend,” said Dana Rye, an executive with Duly Health and Care, a Chicago-based medical group where payments for skin substitutes have risen 1,400 percent since 2022.

. . .

Five years ago, the most expensive skin substitute cost $1,042 per square inch, while some were as cheap as $45. Today, the three most expensive products on the market each cost more than $21,000. (Samaritan Biologics, a company in Memphis that sells the three products, did not answer questions about why they cost so much.)

Companies can set such high prices because of a quirk in Medicare pricing rules, industry experts said. For the first six months of a new bandage product’s life, Medicare will set the reimbursement rate at whatever price a company chooses. After that, the agency adjusts the reimbursement to reflect the actual price paid by doctors after any discounts.

To circumvent the reimbursement drop, some companies simply roll out new products.

In April 2023, Medicare began reimbursing $6,497 for every square inch of a bandage called Zenith, sold by Legacy Medical Consultants, a company in Fort Worth, Texas. Six months later, Zenith’s reimbursement fell to $2,746.

That month, October 2023, Medicare began reimbursing $6,490 for a new Legacy product, a “dual layer” bandage called Impax.

Marketing materials for the two products use identical photographs and similar language. The company describes both products as providing “optimal wound covering and protection during the treatment of wounds.”

Since 2022, spending on Zenith and Impax has exceeded $2.6 billion, according to Early Read’s analysis.

. . .

A cottage industry of doctors and nurses make house calls to treat wounds. Some skin substitute companies pitch themselves to wound care doctors by offering a cut of the rising bandage prices.

Dr. Caroline Fife, a wound care doctor from Texas who often writes about industry excesses, shared on her blog last year an email she received from an undisclosed skin substitute company. The company boasted that other doctors had developed “a healthy revenue stream” from its bandages and that a patch smaller than a credit card “would generate a little over $20,000 for your practice.”

Some companies offer doctors a “bulk discount” of up to 45 percent, according to doctor interviews and contracts reviewed by The Times. But doctors then collect a Medicare reimbursement for the full price of the product.

For the full story, see:

Sarah Kliff and Katie Thomas. “‘Skin’ Bandages Cost Medicare, And Doctors Get a Cut of Billions.” The New York Times, First Section. (Sun., April 13, 2025): 1 & 19.

(Note: ellipses added.)

(Note: the online version was updated April 14, 2025, and has the title “Medicare Bleeds Billions on Pricey Bandages, and Doctors Get a Cut.”)

The article by William Baumol praised in my initial comments is:

Baumol, William J. “Entrepreneurship: Productive, Unproductive, and Destructive.” The Journal of Political Economy 98, no. 5, Part 1 (Oct. 1990): 893-921.

The article by Susan Feigenbaum praised in my initial comments is:

Feigenbaum, Susan. “Body Shop’ Economics: What’s Good for Our Cars May Be Good for Our Health.” Regulation 15, no. 4 (Fall 1992): 25-31.

Croatian Government Does Not Learn from Distant Past (or Recent Past) That Price Controls Do Not Work

In Croatia, as in the United States, inflation resulted when each government “flooded the country with cash” to buy votes during the Covid pandemic.

(p. 4) In 301 A.D., the Emperor Diocletian made a bold but ultimately unsuccessful bid to address the inflation that was rampaging across the eastern half of the divided Roman Empire.

Prices of everything from purple thread and feathers to slaves and cattle were dictated by his Edict on Maximum Prices. Violators faced the death penalty. Diocletian gave up power about four years after issuing his edict, watching his measure fail from his sprawling retirement palace in the heart of what became the city of Split in Croatia.

Now Croatia’s government is trying a similar tactic to rein in prices that have soared in recent years and sparked protests and retail boycotts by the country’s beleaguered consumers.

. . .

The rules that came into effect this month are the Croatian government’s third attempt at controlling prices by fiat since September 2022. The first two efforts were largely ineffective, with retailers simply refusing to stock most price-controlled goods.

. . .

Economists blame the increases on a three-headed hydra of pandemic-era economic rescue packages that flooded the country with cash, increases in public sector wages and retailers rounding up prices after Croatia adopted the euro in 2023.

. . .

John H. Cochrane, an economist and fellow at the Hoover Institution, a research center, pointed to the role Diocletian’s edict played in causing shortages and fueling a black market.

“It’s like trying to stem the symptoms rather than treating the underlying disease,” Mr. Cochrane said of price controls. “It offers people the appearance of help for a while, and then it takes a few weeks or, a month or two, for all the problems to break out.”

For the full story, see:

Joe Orovic. “A Croatian Plan to Rein In Prices Echoes the Tack of an Emperor.” The New York Times, First Section. (Sun., March 9, 2025): 4.

(Note: ellipses added.)

(Note: the online version was updated March 10, 2025, and has the title “Echoing a Roman Emperor, Croatia Tries to Cap Soaring Prices.” Where there is a slight difference in wording, the passages quoted above follow the online version.)

Rice Prices Soar as Japan Government Pays Rice Farmers to NOT Grow Rice

The long-standing policy of Japan’s government is to pay rice famers to grow less rice in order to raise the price of rice, so that rice farmers will earn more. In February 2025 the price of rice in Japan rose by 81 percent and supermarkets limited how much rice consumers could purchase. The average earnings of rice farmers in 2022 was about $23,000 and was not high enough to stop the exodus of rice farmers from farming.

Maybe Japan does not have a comparative advantage in growing rice, possibly due to high land prices and worker wages. Maybe in a totally free world market, Japan would not and should not grow much rice, buying it instead from places where land and wages are cheaper. The Japanese government, and the rest of us too, should embrace laissez-faire.

Source of the Japan rice story is:

River Akira Davis and Hisako Ueno. “Japanese Rice Farmers Blame Shortages on ‘Misguided’ Government Rules.” The New York Times (Mon., March 31, 2025): B4.

(Note: the online version of the NYT article has the date March 30, 2025, and has the title “In Tokyo, Rice Farmers Protest ‘Misguided’ Rules Fueling Shortages.”)

“Republicans in Congress Have Embarked on a Spree of Deregulation”

If Trump achieves a new Golden Age it will be through his “spree of deregulation” (as the NYT labels it), not through his tariffs.

(p. 24) As President Trump moves unilaterally to slash the federal bureaucracy and upend longstanding policies, Republicans in Congress have embarked on a spree of deregulation, using an obscure law to quietly but steadily chip away at Biden-era rules they say are hurting businesses and consumers.

In recent weeks, the G.O.P. has pushed through a flurry of legislation to cancel regulations on matters large and small, from oversight of firms that emit toxic pollutants to energy efficiency requirements for walk-in freezers and water heaters.

To do so, they are employing a little-known 1996 law, the Congressional Review Act, that allows lawmakers to reverse recently adopted federal regulations with a simple majority vote in both chambers. It is a strategy they used in 2017 during Mr. Trump’s first term and are leaning on again . . .

. . .

Because resolutions of disapproval under the Congressional Review Act need only a majority vote, they are some of the only legislation that can avoid a filibuster in the Senate. This allows them to circumvent the partisan gridlock that stands in the way of most significant bills.

So far this year, Mr. Trump has signed three such measures: one overturning Biden-era regulations on cryptocurrency brokers, another canceling fees on methane emissions and a third doing away with additional environmental assessments for prospective offshore oil and gas developers. Another five, including one that eliminates a $5 cap on bank overdraft fees, have cleared Congress and await Mr. Trump’s signature.

That is a much slower pace than eight years ago, when Republicans erased 13 Obama administration rules within Mr. Trump’s first 100 days in office. Before then, the law had been successfully used only once, when President George W. Bush reversed a Clinton-era ergonomics rule.

Now Republicans are trying to go much further with the law, including using it to effectively attack state regulations blessed by the federal government. The House this week passed three disapproval resolutions that would eliminate California’s strict air pollution standards for trucks and cars by rejecting waivers from the Environmental Protection Agency that allowed them to take effect.

. . .

Republicans, . . ., argue that the scope of their review prerogatives should not be determined by unelected bureaucrats.

“It’s members of Congress — not the G.A.O., not the parliamentarian — who decides how we proceed under the C.R.A.,” Representative Chip Roy, Republican of Texas, said in a speech on the House floor.

For the full story, see:

Maya C. Miller. “Republicans Use an Obscure Statute to Roll Back Biden-Era Regulations.” The New York Times, First Section. (Sun., May 4, 2025): 24.

(Note: ellipses added.)

(Note: the online version has the date May 3, 2025, and has the title “Republicans in Congress Use Obscure Law to Roll Back Biden-Era Regulations.” The online version says that the print version of the article in the New York edition was on p. 20 of the First Section. But in my National edition of the print version the article was on p. 24 of the First Section.)

Ramaswamy “Mapped Out” Plan to “Dismantle Much of the Federal Government”

If you choose to submit a suggestion to the deregulatory “suggestion box,” you need to do so by May 12, 2025 for the suggestion to be considered. I apologize for not getting this information out earlier–I only read yesterday the article quoted below.

(p. A1) . . . at the Federal Communications Commission, which regulates radio and television broadcasting and satellite communications, President Trump’s appointees published a seemingly exuberant notice asking for suggestions on which rules to get rid of, titled “DELETE, DELETE, DELETE.”

Across the more than 400 federal agencies that regulate almost every aspect of American life, from flying in airplanes to processing poultry, Mr. Trump’s appointees are working with the Department of Government Efficiency, the cost-cutting initiative headed by Elon Musk and also called DOGE, to launch a sweeping new phase in their quest to dismantle much of the federal government: deregulation on a mass scale.

Usually, the legal process of repealing federal regulations takes years — and rules erased by one administration can be restored by another. But after chafing at that system during his first term and watching President Joseph R. Biden Jr. enact scores of new rules pushed by the left, Mr. Trump has (p. A17) marshaled a strategy for a dramatic do-over designed to kill regulations swiftly and permanently.

At Mr. Trump’s direction, agency officials are compiling the regulations they have tagged for the ash heap, racing to meet a deadline next week after which the White House will build its master list to guide what the president called the “deconstruction of the overbearing and burdensome administrative state.”

The approach, overseen by Russell T. Vought, the director of the White House Office of Management and Budget, rests on a set of novel legal strategies in which the administration intends to simply repeal or just stop enforcing regulations that have historically taken years to undo, according to people familiar with the plans. The White House theory relies on Supreme Court decisions — some recent and at least one from the 1980s — that they believe give them the basis for sweeping change.

. . .

The specifics of the new approach coalesced in the days after the election, when Mr. Musk teamed with Vivek Ramaswamy, the Trump ally who co-founded the Department of Government Efficiency. As Mr. Musk pushed the DOGE team to quickly fire workers and eliminate government offices, Mr. Ramaswamy mapped out a more detailed plan to use a pair of recent Supreme Court rulings to seek out old regulations that, under the new decisions, could now be legally vulnerable.

One of those rulings, in 2022, limited the Environmental Protection Agency’s ability to regulate carbon emissions from power plants. The other, in 2024, ended a precedent known as Chevron deference in which federal agencies were given wide legal latitude to interpret laws.

Together, the Supreme Court’s actions served to limit the broad regulatory authority of federal agencies, and Mr. Ramaswamy asserted that they could justify permanently erasing many rules that had been adopted before those precedents.

The mission has gained steam since the inauguration under the direction of Mr. Vought, who took over the planning after Mr. Ramaswamy left the Department of Government Efficiency to run for Ohio governor.

Mr. Trump ordered agency heads in February to work with DOGE teams to identify rules that impede technological innovation, energy production, and private enterprise and entrepreneurship, among other issues, giving them a 60-day window to prepare their target lists.

Mr. Musk, meanwhile, developed an artificial intelligence tool intended to comb through the 100,000-plus pages of the Code of Federal Regulations and identify rules that are outdated or legally vulnerable in the wake of the two Supreme Court decisions, according to two people familiar with the matter. It is not yet clear whether the tool has succeeded in its assignment, one of the people said.

. . .

Mr. Vought is seeking public input. He posted a call for ideas on the Federal Register, the government portal where the public can comment on proposed regulatory changes, adding a deregulatory “suggestion box.”

For the full story, see:

Coral Davenport. “Behind The Rush To Discard Rules And Reshape Life.” The New York Times. (Thurs., April 17, 2025): A1 & A17.

(Note: ellipses added.)

(Note: the online version was updated April 16, 2025 and has the title “Inside Trump’s Plan to Halt Hundreds of Regulations.”)

“Deregulation on a Mass Scale”

The NYT article that I refer to in my Facebook post above is:

Coral Davenport. “Behind The Rush To Discard Rules And Reshape Life.” The New York Times. (Thurs., April 17, 2025): A1 & A17.

(Note: the online version was updated April 16, 2025 and has the title “Inside Trump’s Plan to Halt Hundreds of Regulations.”)

(Note: the title of this entry is a quote from p. A1 of the article.)

If you choose to submit a suggestion to the deregulatory “suggestion box,” you need to do so by May 12, 2025 for the suggestion to be considered. I apologize for not getting this information out earlier–I only read yesterday the article quoted above.

Tim Friede’s “Daredevilry” in Taking 650 Venom Injections and 200 Poisonous Snake Bites to Help Create a Universal Antivenom “for Humanity”

Back during Covid, over 38,000 adults volunteered to participate in a “challenge” clinical trial of the new vaccines, but such trials were not allowed. In a challenge trial each participant receives the vaccine and then is exposed to the disease. Phase 3 trials for efficacy can be completed much more quickly, with many fewer participants, and at much lower costs, if the trials are “challenge” trials.

We allow people the freedom to dangerous actions for fun or excitement, or to help humanity, like Tim Friede (below) injecting snake venom and letting snakes bite him. Why then did we not allow challenge trials with the Covid vaccine?

Note on another issue, that the researchers are planning in their next step to test their antivenom on dogs who are bitten by snakes. This is a good example of my ideal use of dogs in medical research–where the trial aims at benefits for both the humans AND the dogs.

(p. A1) Over nearly 18 years, the man, Tim Friede, 57, injected himself with more than 650 carefully calibrated, escalating doses of venom to build his immunity to 16 deadly snake species. He also allowed the snakes — mostly one at a time, but sometimes two, . . . — to sink their sharp fangs into him about 200 times.

This bit of daredevilry (one name for it) may now help to solve a dire global health problem. More than 600 species of venomous snakes roam the earth, biting as many as 2.7 million people, killing about 120,000 people and maiming 400,000 others — numbers thought to be vast underestimates.

In Mr. Friede’s blood, scientists say they have identified antibodies that are capable of neutralizing the venom of multiple snake (p. A19) species, a step toward creating a universal antivenom, they reported on Friday [May 2, 2025] in the journal Cell.

“I’m really proud that I can do something in life for humanity, to make a difference for people that are 8,000 miles away, that I’m never going to meet, never going to talk to, never going to see, probably,” said Mr. Friede, who lives in Two Rivers, Wis., where venomous snakes are not much of a threat.

. . .

“This is a bigger problem than the first world realizes,” said Jacob Glanville, founder and chief executive of Centivax, a company that aims to produce broad-spectrum vaccines, and lead author on the study.

Dr. Glanville and his colleagues found that two powerful antibodies from Mr. Freide’s blood, when combined with a drug that blocks neurotoxins, protected mice from the venom of 19 deadly snake species of a large family found in different geographical regions.

This is an extraordinary feat, according to experts not involved in the work. Most antivenoms can counter the venom from just one or a few related snake species from one region.

The study suggests that cocktails of antitoxins may successfully prevent deaths and injuries from all snake families, said Nicholas Casewell, a researcher at the Liverpool School of Tropical Medicine in England.

. . .

There were other mishaps — accidental bites, anaphylactic shocks, hives, blackouts. Mr. Friede describes himself as a nondegree scientist, but “there’s no college in the world that can teach you how to do it,” he said. “I was doing it on my own as best I could.”

Two teams of scientists sampled Mr. Friede’s blood over the years, but neither project led anywhere. By the time he met Dr. Glanville, in 2017, he was nearly ready to give up.

Dr. Glanville had been pursuing what scientists call broadly acting antibodies as the basis for universal vaccines against viruses. He grew up in a Maya village in the Guatemala highlands, and became intrigued by the possibility of using the same approach for universal antivenom.

. . .

The researchers next plan to test the treatment in Australia in any dogs that are brought into veterinary clinics for snakebites. They are also hoping to identify another component, perhaps also from Mr. Friede’s blood, that would extend full protection to all 19 snake species that were subjects of the research.

Mr. Friede himself is done now, however. His last bite was in November 2018, from a water cobra. He was divorced — his wife and children had moved out. “Well, that’s it, enough is enough,” he recalled thinking.

He misses the snakes, he said, but not the painful bites. “I’ll probably get back into it in the future,” he said. “But for right now, I’m happy where things are at.”

For the full story see:

Apoorva Mandavilli. “Man of 200 Snake Bites May Be the Antivenom.” The New York Times (Saturday, May 3, 2025): A1 & A19.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 2, 2025, and has the title “Universal Antivenom May Grow Out of Man Who Let Snakes Bite Him 200 Times.”)

The academic article in the journal Cell mentioned above is:

Glanville, Jacob, Mark Bellin, Sergei Pletnev, Baoshan Zhang, Joel Christian Andrade, Sangil Kim, David Tsao, Raffaello Verardi, Rishi Bedi, Sindy Liao, Raymond Newland, Nicholas L. Bayless, Sawsan Youssef, Ena S. Tully, Tatsiana Bylund, Sujeong Kim, Hannah Hirou, Tracy Liu, and Peter D. Kwong. “Snake Venom Protection by a Cocktail of Varespladib and Broadly Neutralizing Human Antibodies.” Cell 188 (2025): 1-18.

Democratic Donor Warren Buffett Praises DOGE

(p. A1) . . . at the end of Saturday’s Berkshire Hathaway annual meeting, the Oracle of Omaha dropped a bonbshell before a gathering of some 17,000 shareholders: that he’s set to step aside as Berkshire CEO, with vice chairman Abel taking his place.

. . .

(p. A4) It was little surprise that the very first question from moderator Becky Quick of CNBC in the Saturday [May 3, 2025] Q&A had to do with tariffs.

. . .

While critical of Trump’s tariffs, Buffett had little bad to say about Trump’s budget and program-slashing Department of Government Efficiency.

He called the current 7% gap between the federal government’s revenues and expenditures unsustainable. Whether that’s two or 20 years “it’s something that cannot go on forever,” he said. And if it isn’t brought under control, he said, it risks rampant inflation.

“I think it’s a job I don’t want, but it’s a job I think should be done, and Congress doesn’t seem to be doing it,” Buffett said.

For the full story, see:

Cordes, Henry J. “Buffett to Step Down as CEO of Berkshire.” Omaha World-Herald (Sunday, May 4, 2025): A1 & A4.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the article has the title “Warren Buffett stepping down as Berkshire Hathaway CEO at end of year; shareholders react.”)

A Rare Antibody in James Harrison’s Blood Protected the Lives of 2.4 Million Australian Babies

I recently purchased from Amazon, but have not read, Good Blood, which describes the discovery of a cure, and the struggle for acceptance of the cure, for the RH disease sketched in the passages quoted below. The disease affected my family, but I am not sure I remember exactly how. I am Rh positive and I think my mother was Rh negative. I think with each child after me, there was increasing risk and worry of possible bad health effects.

According to the Amazon summary for Good Blood, the book also describes the devotion of master blood donor James Harrison, whose recent obituary is quoted below.

Starting at least in the 1960s medical experts were often optimistic that future medical advances would come from designer chemicals enabled by scientific advances in our knowledge of chemistry and biological processes. Taxpayer funding was devoted to that approach in Nixon’s War on Cancer. But fewer medical advances have come from that approach than hoped, and more advances than expected have continued to come from the evolved usable chemicals (sometimes poisons, sometimes antibodies) of plants, animals, and exceptional human beings like Mr. Harrison.

Mao is often misquoted as saying ‘Let a thousand flowers bloom,’ but someone should say it (at least if the cost of planting the flowers is not too high).

(p. A25) James Harrison did not much care for needles. Whenever he donated plasma, he would look away as the tip went into his arm.

But Mr. Harrison was one of the most prolific donors in history, extending his arm 1,173 times. He may have also been one of the most important: Scientists used a rare antibody in his plasma to make a medication that helped protect an estimated 2.4 million babies in Australia from possible disease or death, medical experts say.

“He just kept going and going and going,” his grandson Jarrod Mellowship said in an interview on Monday [March 3, 2025]. “He didn’t feel like he had to do it. He just wanted to do it.”

. . .

Mr. Harrison’s plasma contained the rare antibody anti-D. Scientists used it to make a medication for pregnant mothers whose immune systems could attack their fetuses’ red blood cells, according to Australian Red Cross Lifeblood.

Anti-D helps protect against problems that can occur when babies and mothers have different blood types, most often if the fetus is “positive” and the mother is “negative,” according to the Cleveland Clinic. (The positive and negative signs are called the Rhesus factor, or Rh factor.)

In such cases, a mother’s immune system might react to the fetus as if it were a foreign threat. That can lead babies to develop a dangerous and potentially fatal condition, hemolytic disease of the fetus and newborn, which can cause anemia and jaundice.

. . .

In Australia, scientists from the Walter and Eliza Hall Institute of Medical Research in Melbourne are working to create a synthetic version of the drug using what some have called “James in a Jar,” an antibody that can be made in a lab.

But for now, human donors are essential: The anti-D shots are made with donated plasma, and Mr. Harrison was one of about 200 donors among the 27 million people in Australia, Lifeblood said.

. . .

Mr. Harrison knew the importance of his work firsthand. At 14, he needed a lot of blood transfusions during a major lung surgery. The experience inspired him to donate and encourage others to donate, too.

For the full obituary, see:

Amelia Nierenberg. “James Harrison, Whose Rare Antibodies Helped Millions, Is Dead at 88.” The New York Times (Saturday, March 8, 2025): A25.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the obituary was updated March 7, 2025, and has the title “James Harrison, Whose Antibodies Helped Millions, Dies at 88.”)

The Good Blood book, mentioned above, is:

Guthrie, Julian. Good Blood: A Doctor, a Donor, and the Incredible Breakthrough That Saved Millions of Babies. New York: Harry N. Abrams Press, 2020.

Trump Proposes to “Chop Domestic Spending to Its Lowest Level in the Modern Era”

Source of graph: NYT article cited below.

My entry today is part of a continuing effort to document Trump administrations actions to deregulate and downsize in the hope that the good from deregulation and government downsizing will dominate the bad potentially done by tariffs.

(p. A1) President Trump on Friday [May 2, 2025] proposed slashing $163 billion in federal spending next fiscal year, a drastic retrenchment in the role and reach of government that, if enacted, would eliminate a vast set of climate, education, health and housing programs, including some that benefit the poor.

Issuing his first budget proposal since returning to office, Mr. Trump sketched out a dim view of Washington. His blueprint depicted many core government functions as woke, weaponized, wasteful or radical, as the president looked to justify his request that Congress chop domestic spending to its lowest level in the modern era.

. . .

(p. A17) For Mr. Trump, the budget served to formalize his conservative vision and his disruptive reorganization of the government, a campaign that has already shuttered entire agencies and dismissed thousands of federal workers without the explicit approval of Congress.

. . .

. . ., many Republicans have echoed Mr. Trump’s desire to slash federal spending, though warring G.O.P. factions have disagreed at times over the exact scope.

Party lawmakers have also raced to identify potentially trillions of dollars in cuts that they can include to finance a related package that would expand a set of expiring tax cuts for families and businesses, one of the president’s signature — and costliest — economic policy priorities.

For the full story see:

Tony Romm. “Trump Seeks Drastic Cuts To Core of U.S. Spending.” The New York Times (Saturday, May 3, 2025): A1 & A17.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date May 2, 2025, and has the title “Trump Proposes $163 Billion in Cuts Across Government in New Budget.”)