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The Retire Advocate < Back to Table of Contents November 2025 Stunning New Report From PNHP No Real Choices: How Medicare Advantage Fails Seniors of Color In a stunning new report, PNHP (Physicians for a National Health Program) reveals that Medicare Advantage (MA) plans fail to deliver on their promises of equity for seniors of color. According to the report, seniors of color continue to face all the disparities in health care that characterize the US health care system. the disparities MA plans still impose on seniors of color. The Medicare Advantage ('MA') program, through which health insurance corporations contract with the federal government to deliver Medicare benefits, offers enrollees few upfront costs, an out-of-pocket maximum, extra benefits, and a simple enrollment process. However, these advertised benefits show themselves to be hollow when carefully studied, revealing a program that compromises access, equity, and quality of care. Evidence from an exhaustive literature review and new research reveals that MA enrollees often encounter steep barriers to the physicians and hospitals people with complex conditions need for medically necessary care. Contrary to claims from the insurance industry that MA is a solution to inequity, racial and ethnic minorities enrolled in MA continue to face many of the longstanding disparities that are common in American healthcare. The financial model of MA does little to mitigate existing inequities – and often exacerbates them by disproportionately offering communities of color inferior insurance products. At the same time, MA places a heavier burden on federal spending than Traditional Medicare (TM), which raises doubts about whether the program truly provides worthwhile returns for the people it is meant to serve. Summary of PNHP Report How Medicare Advantage Fails Seniors of Color < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2026 Inside CMS’s Troubling WISeR Vendor List and the Power It Hands to Private Contractors CMS’s chosen WISeR vendors include firms tied to insurer-backed venture funds, former Big Insurance executives and private equity. By Seth Glickman, MD, and Rachel Madley, PhD (Reprinted from HEALTH CARE un-covered) Earlier this year, the Center for Medicare and Medicaid Innovation (CMMI) announced plans to begin the Wasteful and Inappropriate Service Reduction (WISeR) Model in 2026. The model will retain private companies currently using AI to process prior authorizations in the private Medicare Advantage (MA) program to use those processes in the traditional Medicare (TM) program on services that will newly require prior authorization or pre-payment review. As we previously published in HEALTH CARE un-covered , the WISeR model is more than just some small administrative update. The new model dramatically shifts how traditional Medicare patients will access care. Under this demonstration program, the Centers for Medicare and Medicaid Services (CMS) will let private, for-profit contractors and their AI tools decide whether seniors get treatments their doctors recommend – and those contractors will be paid based on how much care they deny. After months of speculation and anticipation, CMS this week announced the private companies selected to participate in the model beginning January 1, 2026. The six companies selected are Cohere Health, Inc., Genzeon Corporation, Humata Health, Inc., Innovaccer Inc., Virtix Health LLC, and Zyter Inc.. Those six companies now have the ability to decide if seniors or people with disabilities in traditional Medicare get the care recommended by their doctors for 17 medical procedures that previously did not require prior authorization. This is a lot of trust to put in private companies, so we dug more into the ones chosen by CMMI to participate in the model. We previously described how insurers and affiliated venture capital firms use their influence and leverage to “self- deal," in effect creating opportunities to boost their profits. The WISeR program and the participants selected appear to follow the same playbook. Most of the companies CMS selected are backed by insurer-linked venture funds or staffed by former insurance industry executives, including from Elevance, Optum, Kaiser, Highmark, and HCSC. For example, Humata Health lists four venture capital firms backed by insurance companies as key investors: Blue Venture Fund (backed by Blue Cross Blue Shield), Optum Ventures (backed by UnitedHealth Group), LRV Health (backed by over 30 health systems and insurers), and Highmark Ventures (backed by Blue Cross Blue Shield insurer Highmark Health). These concerning ties are replicated in other model participants including Cohere Health, which is funded through venture capital and contract ties to Humana, and Innovaccer, which is funded by Kaiser Permanente and Banner. Several already operate in Medicare Advantage, in which private insurers routinely use prior authorization to delay or deny coverage for needed care. Between the lines: WISeR effectively imports the same harmful machinery into traditional Medicare for the first time in the program’s history. Amplifying this concern is that several are pure technology companies without any medical oversight or leadership. This raises serious questions about how they will comply with state and federal regulations requiring licensed clinical personnel to oversee utilization decisions (for good reason). Precious little is known about other participants. The website of one of the participants, Virtix Health, doesn’t disclose any executives or board members. It doesn’t even list a physical address or phone number, and the last time the company uploaded a news story was in 2021. These are hardly things that inspire the public’s confidence about its legitimacy, let alone entrusting it to oversee the care of Medicare beneficiaries. What is known about Virtix Health is that it offers risk adjustment coding services, such as chart reviews, to MA plans. These chart reviews are used by MA insurers to add medical codes to an enrollee’s chart, making them appear sicker than they are in order to receive a higher payment from the government. Overpayments, driven largely by coding intensity, means MA plans will be paid $84 billion more than traditional Medicare in 2025; cumulative overpayments between 2025-2034 could reach $1.2 trillion. CMS Administrator Mehmet Oz pledged in his confirmation hearing to go after excessive coding by insurers, which is at odds with his agency giving a contract for the WISeR model to a company that enables this practice as its main line of business. All this begs the question: How were these companies chosen? It’s an important one, especially given the strong ties between current and past leadership at CMMI and the health insurance and venture capital industries that will profit from this program. We have previously called for the disclosure of financial conflicts of interest in the selection of vendors by health insurers (and in this case CMS, which controls billions of our tax dollars), including any underlying financial relationships with the vendor and/or related investors. CMMI has not disclosed whether or how they managed these potential conflicts of interest in the selection process. The American public deserves to know. A coalition of lawmakers have introduced the Seniors Deserve SMARTER Care Act to stop WISeR before it launches. The lawmakers warn that the model “creates a dangerous incentive to put profits ahead of patients’ health” — and they’re right. At the same time, public confidence in insurers’ use of AI has cratered amid lawsuits and reports of algorithms overriding physicians’ judgment. Even President Trump has blasted insurers as “BIG,”“BAD,” and “money-sucking.” Yet WISeR hands many of these same corporate players a new federal revenue stream — and unprecedented authority over seniors’ care in traditional Medicare, which has historically been a safe haven from Big Insurance meddling in coverage. But now, with CMS barreling toward a January 2026 launch, we know, for the first time, exactly which companies will have that power. Editor's Note: Virtix Health is the company selected by CMS to determine prior authorization In Washington State. Rachel Madley, PhD, is Director of Policy and Advocacy at the Center for Health & Democracy. She previously worked for Congresswoman Pramila Jayapal. She received her PhD from Columbia University and has written for publications including The New York Times. Seth Glickman, MD, is a former insurance and health system senior executive. He now is a researcher and advocate for reform in the health care finance space. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents March 2025 I Vaahnt to…Organize Your Workers! Mike Andrew You may remember Bela Lugosi in his iconic title role in Dracula. Or you may remember him as the evil Russian commissar inNinotchka. Or in his roles as the villain in a series of B grade hor- ror films. If you’re a Tim Burton fan, you may think of him as theloopy character played by Martin Landau in Ed Wood. The real-life Bela Lugosi was born Béla Ferenc Dezső Blaskó in Lugos, Kingdom of Hungary, on October 20, 1882. As an actor, hetook the stage name “Lugosi” in honor of his birth- place. As part of the Austro-Hungarian Empire, Hungary entered World War I in 1914, and Lugosi, like other young men, volunteered forthe Hungarian army. Like other young men, he experienced the horror of war – at one point being an article praising the Soviet Union to the socialist magazine New Masses. Before long, Lugosi’s political activities caught the attention of J. Edgar Hoover. The FBI and CIA both opened files on theactor. The House Un-Amer- ican Activities Committee (HUAC) appointed the so-called “Dracula council” to keep tabs on Lugosi.INS even looked into deporting him, despite the fact that he had held American citizenship since 1931. Lugosi was not the only horror star to be targeted for their political activism. Fellow Hungarian refugee Peter Lorre, star of M, andVincent Price, who had appeared in the Invisible Man Returns, received scrutiny for participating in the anti-HUAC radiobroadcast “Hollywood Strikes Back.” The two spoke buried alive under the corpses of his fellow soldiers. And, like many other young men, he came out of the war as a firm supporter of socialism. The war led to the collapse of most` of the old European empires. The Bol- sheviks established the world’s first socialist state onthe ruins of the Russian Empire. The Kaiser fled Germany, and the new German government, with the help of right-wing militias,barely put down a communist-led insurrection. The Austro-Hungarian Empire broke up into its constituent parts. In Hungary, local communists attempted to replicate theRussian revolution, setting up the Hungarian Soviet Republic in 1919. Lugosi, by then already an activist in the Hungarian actor’sunion, supported the revolution. The Hungarian Soviet was short- lived. Britain and France encouraged Romania to invade Hungary and occupy a large part ofits territory. Admiral Miklós Horthy, a leftover from the old Austro-Hungarian Empire, set up a military dictatorship in the remainder of Hungary. Lugosi fled the country. He ended up in New York where he acted in Hungarian stage plays before being cast in the English language play The Red Poppy. In 1927, he was cast in the role that made him famous: Count Dracula. Lugosi’s charismatic stage performance and his persistent lobbying of Universal Studios got him the role in the 1931 film version. After his star-making film role in Dracula, Lugosi became a founding member of the Screen Actors Guild (SAG). Another founding member was Frankenstein star and frequent Lugosi costar Boris Karloff. The two actors worked to sign up the casts of their films, The Bride of Frankenstein, The Raven, and The Invisible Ray. Theirefforts paid off when SAG signed its first contract with the Hollywood studios in 1937. Lugosi’s solidarity extended beyond his fellow actors. During World War II, Bela Lugosi headed the Hungarian American Council for Democracy, an anti-fascist organization. In 1945 he signed a petition protesting the deportation proceedings against ILWU leader Harry Bridges. Lugosi also contributed out alongside Lauren Bacall, Humphrey Bogart, Judy Garland, Frank Sinatra, and other stars. Lorre was also investigated because of his long-standing friendship with Marxist playwright Bertolt Brecht. Price was unable to find work for a year due to his outspokenness, and under pressure from the FBI had to sign a secret oath that he was not a communist. Socialist Themes in Lugosi’s Horror Films No one would say Lugosi made great films, but many of his movies contain memorable political and social themes. The 1932 film White Zombie, in which Lugosi played voodoo master Murder Legendre, dramatizes the exploitation of Black Haitians. Legendre uses his zombie slaves to work his sugar mill and increase his wealth. He offers his zombie workers to a plantation owner saying “They are not worried about long hours.” When one of the zombies falls into the mill and is crushed, work continues as usual. Nothing is allowed to delay the productionof profits. This scene is in- tended as a critique of the forced labor system that was actually introduced in Haiti during what was then a US military occupation. Another 1932 horror film, Island of the Lost Souls, an adaptation of the Island of Doctor Moreau, contains similar anti-colonial themes. Lugosi has the small, but important role of the Sayer of the Law, the mouthpiece of Dr. Moreau’slaws for the Beast Men. At the climax of the film, the Beast Men attack Moreau, after the Doctor has ordered one ofthem to commit murder. The purpose of the oppressor’s laws are revealed to be total control over the masses, and he is free to break his own laws whenconvenient. Moreau defends him- self with a whip, the tool of the slaver. This climax was so shocking that the film was banned in many countries. Tellingly, in Australia it was forbidden from being shown to Aboriginal audiences, lest they get any ideas of how to deal withtheir colonial overlords. The 1934 film The Black Cat was a highpoint in Lugosi’s filmography. The film was the first to team him with Boris Karloff and both actors give stunning performances. The plot follows Werdegast (Lugosi) and Poelzig (Karloff), both veterans of the Eastern front during World War I. Poelzig betrayed Werdegast and the other soldiers to the enemy and left them for dead. Lugosi as Werdegast gives a powerful anti-war monologue saying, “Did we not both die here in Marmorus 15 years ago? Are we any the less victims of the war than those whose bodies were torn asunder? Are we not both the living dead?” Many of Lugosi's films are available on popular streaming services. They're worth a look. Mike Andrew is the Executive Director of PSARA and Editor of the Advocate < Back to Table of Contents

The Retire Advocate < Back to Table of Contents March 2025 Photo Spread < Back to Table of Contents

The Retire Advocate < Back to Table of Contents February 2025 PSARA 2025 Legislative Agenda PSARA Board PSARA is a multi-generational grass roots organization advocating for all people, and seniors in particular, to be able to live their lives with economic security, dignity, and respect. Health Care PSARA believes that comprehensive, affordable, accessible, and culturally appropriate health care is a fundamental human right. Promote Leveling the Playing Field in Medicare SJM 8002 Protect against healthcare program cuts and advance immigrant health equity Support efforts to advance universal healthcare SJM 8004 Ensure quality affordable health care for nursing home workers (WA Essential Worker Healthcare Program) Strengthen and protect WA Cares Housing and Homelessness PSARA supports keeping people housed, building more low-income housing, and preventing homelessness in the first place. Ensure reasonable and more predictable rent increases by passing rent stabilization Invest $500 million in the Housing Trust Fund RA supports legislation that promotes healthy families and workplaces. Extend job protection in the Family & Medical Leave Program to ensure low wage earners can return to their jobs after leave to care for themselves or family members Extend unemployment benefits to striking workers and undocumented workers Build economic security for low-income families by creating the Washington Future Fund Program (Baby bonds) Climate and Environmental Justice PSARA supports the right of all people to live and work in a clean and healthy environment. Divest Washington State Investment Board (WSIB) funds from fossil fuels (No Coal Act) Add a Green Amendment to the Washington State Constitution Improve solid waste management outcomes by reducing use of plastic wrap and containers Fiscal Reform and Revenue PSARA supports a state budget that is transparent, pays a living wage to state workers, and provides services that help our people, economy, and environment thrive. Prevent devastating budget cuts by providing new progressive revenues such as a wealth tax that taxes extraordinary financial assets < Back to Table of Contents

The Retire Advocate < Back to Table of Contents July 2025 4,000 Attend No Kings Event at People’s Park, Tacoma! John Alessio Our Vote, Our Choice, Our Power, Our Voice!” “Power to the People, We Insist-Billionaires Should Not Exist!” “Say it Once,Say it Twice, We Will Not Put Up With ICE!” These are just a few of the chants heard at People’s Park Saturday, June 14th. PSARA joined Indivisible Tacoma and many other organizations to create an informative, riveting, and festive event on “No Kings Day”. Other participating groups were: 350 Tacoma; AF- SCME Council 28; Evergreen Resistance Tacoma; Black Panther Party, The TSM Shop; Jewish Voice for Peace Tacoma; La Resistencia; Rainbow Center; The Tacoma Urban League; LD27, LD28, and LD29 Democrats; Oscar’s Enemies; Pierce County Central Labor Council, AFL-CIO; Pierce County Immigration Alliance; Tacoma Democratic Socialists of America; Tacoma Fellowship of Reconciliation; Tacoma for All; Tacoma Veterans for Peace; The Conversation 253; Washington Wildlife First; and United Food & Commercial Workers Local 367. Careful planning included meetings and continuous communication between the leaders of many of these organizations to assure a safe and meaningful protest of the Trump administration’s immoral and unconstitutional activities. Preparation included de-escalation training sessions that resulted in a roaming Safety Team during the event. A First Aid Sation was created, with drinking water, snacks, and other relevant supplies. Various groups had their own information booths, plus a booth for sign-making, and even a face painting booth. People’s Park was humming with excitement and enthusiasm. Four thousand people, peacefully demonstrating, were completely rapt for two and a half hours listening to inspiring speeches about what is being done, and what still needs to be done, to stop Trump and his minions from destroying our democracy and inflicting more grievous harm on large segments of our population. The event started and ended with lively protest music, and there were clever chants interspersed throughout. The importance of local elections was emphasized, and people were encouraged to get involved by door-knocking, providing support to progressive candidates, and especially voting in the upcoming 2025 Primary on August 5 and again in the General on November 4th! Action events were announced, such as a June 18th “Door-Knocking for Introverts” to help people become effective doorknockers. On July 9th Indivisible Tacoma endorsed candidates will participate in a Candidate Forum at 6:30PM at Tahoma Unitarian Universalist Church, 1115 So. 56th, Tacoma. La Resistencia and others will continue to strategize and call for united actions against the activities of ICE and the Northwest Detention Center - a critical court hearing is set for September. Some people may want to attend the “Breakfast With the Sheriff” meetings to remind Pierce county Sheriff Keith Swank that Washington state laws protect people from unconstitutional harassment and arrest. The next scheduled breakfast is 7-9AM Saturday, June 21st. We know he would love to see us. A Facebook message to a friend read: “I was at People’s Park with my brother who is blind and paralyzed on his left side. We had the best day. He felt part of society.” That statement captures the mood and inclusive spirit of the Tacoma “No Kings Day”. Let’s keep it going! John Alessio is a member of PSARA and Indivisible Tacoma. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents October 2025 Trump Tariffs and Stagflation: Why TACO is the Least Bad Option Robert Pollin (reprinted from Left Hook Economics) The first obvious step right now for fighting stagflation is for Trump to dump his tariff policies. Is stagflation—the toxic blend of high unemployment and high inflation—taking hold now in the U.S. economy? The most recent evidence mostly signals “yes.” If stagflation is on the way, we can mainly thank President Donald Trump’s imposition of unprecedented tariffs—that is, taxes on the products we import from more than 90 countries. The latest data from the Bureau of Labor Statistics (BLS) reported that only 106,000 jobs had been added to the U.S. labor market between May and July. This represents a nearly 80% drop in job growth relative to the 474,000 jobs created over the same three-month period last year. Meanwhile, wholesale prices spiked by 0.9% in July, the largest monthly wholesale inflation increase since May 2022. It was in response to the dismal May-July job report that Trump fired BLS Commissioner Erika McEntarfer, after claiming, without evidence, that she had “rigged” the numbers to make him look bad. How could Trump’s tariff polices produce stagflation? According to the Yale Budget Lab, as of July 30, U.S. consumers are facing an average import tax/tariff rate of 17.5%, the highest since 1934. At the same time, imports account for 14% of overall purchases in the U.S. economy. Therefore, if the average 17.5% tariff rate were simply passed on, dollar for dollar, to U.S. consumers, this alone would raise average prices in the United States by 2.5% (that’s 17.5% x 0.14 = 2.5%). But price increases resulting from the tariffs don’t need to be confined to imported products only. This is because higher prices for imports create cover for businesses to raise prices on domestically produced goods and services as well, enabling them to boost their profit margins. Of course, nobody forces businesses that sell imported products to raise their prices. The alternative is for them to pay the tariffs to the U.S. Treasury and then just eat their average 17.5% cost increases by cutting their profits. Obviously, businesses would much rather raise prices before letting their profit margins shrivel. Why should employment conditions also get worse in this situation? This is because businesses worry that the tariffs will cut into their profits. They therefore hold off on plans to expand their operations and hire new people. To date, the Trump program to combat stagflation has two prongs. First, cook the government data to make reality disappear. Second, lambaste Jerome Powell, the chair of the Federal Reserve (which is the US central bank, and commonly referred to as “the Fed”), into cutting interest rates. Trump regularly ridicules Powell as a “stiff,”“numbskull,” or “moron” for not having cut interest rates so far. Most recently, Trump also began attacking and demanding the resignation of Lisa Cook, the first Black woman to serve as a member of the Fed Board of Governors and a Biden appointee. Trump and company claim that Cook committed mortgage fraud in 2021, before she joined the Fed. Cook vehemently denies the charges and insists that she will not resign. Trump’s real purpose here is to replace independent voices at the Fed with loyalists who will toe his policy line, whatever that line happens to be. In fact, by maintaining relatively high interest rates to fight inflation, Powell, Cook, and the other Fed policymakers are only following the standard Fed playbook. The aim with high interest rates is to slow the economy and increase unemployment. The higher unemployment rate then weakens workers’ bargaining power, which lowers labor costs for businesses, enabling businesses to maintain their profit margins without raising prices. Thus, it is baked into the standard Fed inflation control program that working people are the designated sacrificial lambs, even if their wage increases have not caused the inflation in the first place. Trump’s tantrums aside, there are indeed major problems with this standard Fed approach. To begin with, workers gaining excessive bargaining power has never been the driver of stagflation in the United States. In the 1970s and early 1980s, stagflation resulted because global crude oil prices rose roughly tenfold between 1973 and 1980, from $3.56 to $39.50 a barrel. The only other bout of stagflation was after the COVID lockdown was lifted. In this case, stagflation resulted because the production of major items, like new cars, had been cut during the lockdown conditions. Demand for cars then returned quickly when lockdown conditions lifted, but with new cars in short supply, used car prices rose by 40%. From a longer-term perspective, we also have to remember how the U.S. working class has fared, on average, under the 50 years of neoliberalism that preceded Trump. The most central facts are that average wages for nonsupervisory workers are basically where they were 50 years ago, at roughly $50,000 per year (in 2024 dollars), even while average worker productivity has increased by 150%. Meanwhile, over this same 50-year period, average CEO compensation has risen nearly tenfold, from $1.5 million to almost $15 million. In fact, in a major August 22 speech, Powell signaled that, at its next official meeting in September, the Fed is likely to modestly reduce the main interest rate that it controls (the federal funds rate), due to mounting evidence of worsening employment conditions. As Powell knows well, this will accomplish nothing to reduce the inflationary pressures created by Trump’s tariffs. In other words, through deploying the Fed’s main policy tool of manipulating interest rates, you can either reduce inflation through raising unemployment or reduce unemployment at the cost of higher inflation. What you can’t do is combat both sides of stagflation—inflation and unemployment—at the same time. The first obvious step right now for fighting stagflation is for Trump to dump his tariff policies. We shouldn’t rule that option out. Trump didn’t earn the nickname TACO—“Trump Always Chickens Out”—for nothing. But even if Trump does chicken out on the tariffs, we will still be stuck at square one in terms of advancing inflation control policies that also enable U.S. workers to get the long-overdue raises they deserve. Robert Pollin is Distinguished University Professor of Economics and Co-Director of the Political Economy Research Institute (PERI) at the University of Massachusetts-Amherst. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents October 2025 A Fake Drug War Against Venezuela Cindy Domingo In less than a month, three boats off the coast of Venezuela have purportedly been bombed by US naval forces now stationed off the coast of Venezuela. The first boat sank on September 2, allegedly carried eleven people, and it was unclear whether any survived. Reports in the media suggested that the bombing may have been an artificial intelligence film as well as questions whether the boat may not have been a drug smuggling operation since high speed drug boats carry few passengers in order to carry more drugs. The story quickly left the media pages until the latest boat sinkings in mid-September. These boat bombings have followed a heightened build-up towards war against Venezuela since August of this year. On August 7, the bounty for the arrest of Venezuelan President Nicolas Maduro increased from $25 million to $50 million, with US Attorney General Pam Bondi accusing Maduro of collaborating with foreign terrorist organizations to smuggle drugs into the US. It was during the first Trump administration in 2020 that a bounty was placed on Maduro for $15 million and then in January 2025 it was raised to $25 million. On August 8, the US military deployed eight warships, 1,200 missiles, 10 F-35 fighter jets, a nuclear submarine off the coast of Venezuela and some 4,500 military personnel including 2,200 Marines and amphibious assault crews. These moves were followed by the bombings of the small boats. In addition to Maduro’s bounty, increased financial sanctions, lesser bounty rewards and travel visa restrictions have been levied against others in Maduro’s administration and Venezuelan state oil and transportation officials. These provocations under the guise of a drug war come even as there is little evidence that Venezuela and President Nicolas Maduro are involved in any drug smuggling. Juan Gonzalez, former senior director for the Western Hemisphere at the US National Security Council, has stated clearly that there is no credible evidence that Maduro directs any narco-gangs. Furthermore, the United Nations Office on Drugs and Crime 2025 report notes that only 5% of drugs going to the US pass through Venezuela; that in fact the country has consolidated its status as a territory free from coca leaf cultivation or drug production, as well as free from international criminal cartels. Yet Trump continues to push the narrative that Maduro is the head of a cartel called “Cartel of the Suns” and the attack on Venezuela is part of his War on Drugs. Trump’s real purpose is “regime change” in Venezuela, a strategy that was implemented in 2019 when Trump and other countries proclaimed Juan Guido as President of Venezuela even though not one person in Venezuela voted him into office and Maduro had won in the national presidential elections. And the real reason for regime change is the US wants control of Venezuela’s oil resources, the largest deposit of oil in one country in the world. Venezuela’s oil resources have been a lifeline to Cuba and lays the basis for important trade with China and Russia. The US war against Venezuela has been met with resistance in and outside Venezuela. In response to the warships, Maduro mobilized Venezuela’s popular militia that reportedly counts for 4.5 million members with its purpose to defend the country’s sovereignty. On September 1, Maduro was quoted by Al Jazeera that the US is “seeking a regime change through military threat…Venezuela is confronting the biggest threat that has been seen on our continent in the last 100 years…If Venezuela is attacked, we would immediately move to armed struggle in defense of our territory.” Maduro continued to state that he would declare Venezuela “a Republic in arms.” The September 1 issue of Venezuelan newspaper Ultimas Noticias reports that governments of 80 nations have repudiated the presence of US warships in the Caribbean and the Community of Latin American and Caribbean States (CELAC), an alliance of 33 countries, convened an emergency session to address the crisis. The 10 countries of the Bolivarian Alliance for the Peoples of Our Americas (ALBA-TCP) have unanimously condemned the US deployments. The Presidents of Mexico, Columbia and Brazil have been outspoken about the US military aggression as well as they know they are also targets of Trump’s manufactured War on Drugs and plans for regime change. Cindy Domingo is PSARA's Co-VP of Outreach and a veteran activist with LELO (Legacy of Equality, Leadreship, organizing), APALA (Asian Pacific Ameri- can Labor Alliance), and Standing for Democracy. < Back to Table of Contents

I Can't Look Backward, I Can't Look Forward, Part 3 Dina Burstein and Mohamed Ibrahim discuss his immigrant experience. Read

The Retire Advocate < Back to Table of Contents February 2025 Medicare Advantage Gaming the System Diane Archer UnitedHealth now employs or contracts with about 10 percent of the physicians in the US. It’s one way UnitedHealth maximizes Medicare Advantage profits, report Anna Wilde Mathews, Christopher Weaver, and Tom McGinty for the Wall Street Journal. UnitedHealth incentivizes its physicians to include additional diagnoses codes on Medicare Advantage patient records, which enables UnitedHealth to receive higher Medicare payments. UnitedHealth advises its physicians to check their Medicare Advantage patients for certain diagnoses. So, in Eu- gene, Oregon, one physician explained that before he could move from one patient to another, he must enter into a software system whether his patient had any of a list of diagnoses. In many cases, the diagnoses had nothing to do with the patient, such as hyperaldosteronism, which is a hormone condition related to high blood pressure. Rather than ensuring their doctors focus on treating Medicare Advantage patients for the conditions these patients are reporting, UnitedHealth is focused on having its doctors document as many conditions as possible that will increase the company’s Medicare payments. UnitedHealth does nothing to ensure its doctors document additional conditions for their patients in traditional Medicare. That’s not surprising. Because of the way Medicare pays insurers in Medicare Advantage, adding diagnoses codes to traditional Medicare patient records would hurt UnitedHealth financially. The Wall Street Journal found that patients leaving traditional Medicare for Medicare Advantage in the three years ending 2022 had many more diagnoses in their medical records once they were in Medicare Advantage. Their “sickness scores” typically increased 55 percent. To put it succinctly, once in Medicare Advantage, from a sickness perspective, patients effectively had HIV and breast cancer. While UnitedHealth does more than other insurers to raise sickness scores for its Medicare Advantage patients, other insurers raised scores by 30 percent for new patients in Medicare Advantage. There is no evidence what- soever that entering more diagnoses into Medicare Advantage enrollees’ medical records benefits patients in any way. In fact, UnitedHealth doctors do not use the company’s diagnoses software for patients outside of Medicare Advantage. By the Wall Street Journal’s calculations, United’s Medicare Advantage enrollees who saw UnitedHealth physicians had such high sickness scores that UnitedHealth benefited financially to the tune of $4.6 billion over three years. This insurer gaming of the Medicare payment system must end. Among other things, it is gouging taxpayers, depleting the Medicare Trust Fund, and driving up Medicare Part B premiums. This article summarizes an investigative piece first published in the Wall Street Journal. This article appeared in Diane Archer’s January 11 Just Care weekly newsletter. Diane Archer is the founder and President of Just Care USA, and a senior advisor to Social Security Works for Medicare policy. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2025 We Remember Norma Kelsey Contributions from Maureen Bo, Cindy Schu, Nancy Greenup, and David Kelsey The Puget Sound area labor and social justice movements lost a fierce activist with the passing of Norma Kelsey on September 21, 2024, at age 89. Norma was a leader of the Office and Professional Employees Union Local 8 (Secretary-Treasurer 1985-1989, President 1989-2001) and worked for Plumbers Local 32 and Laborers Local 440 for many years. Norma also held various leadership positions with El Centro de la Raza, Mothers for Police Accountability, Coalition of Labor Union Women, and the Martin Luther King County Labor Council. Norma served on a citizens’ panel of the Seattle City Council’s World Trade Organization Accountability Review Committee and was a member of Puget Sound Alliance for Retired Americans (now PSARA). Norma was a true trade unionist and believed in the movement with her heart and soul. Norma was born September 19, 1935, in Independence, Kansas. Her grandparents settled there years before, having arrived in a covered wagon. In her youth she was a member of the Salvation Army Church where she was taught that her role in life should be to help others. Later, when she began to work for unions, she recognized a familiar belief system of helping and giving to others. She brought those values full strength to her work for unions and the community. Norma was married at age 16, but this brutal first marriage ended in divorce. She later married Bob Kelsey and moved to California and eventually to Washington, where they raised four children and several adopted and foster children. Norma and Bob, usually with their son Jack, traveled extensively to Nicaragua, Venezuela, the Philippines, Haiti, and throughout Europe and Central America. The travel often involved reconnecting with former refugees who had fled violence in their home countries and who had been aided by Bob and Norma when seeking housing and assistance in the United States. Norma provided a key leadership role in the mid-1980’s, when a group of women, led by former Local 8 Board Member Maureen Bo (who after the revolution was elected Business Manager), decided their union was headed in the wrong direction. Norma’s kindness, vision, and belief in social justice and creating a humane community helped to provide a focus for their shared work. Maureen, Norma, Nancy Greenup, and Janet Graham, along with others, ousted Local 8’s leadership at the time. They fought off a hard push for an ill-advised merger with another union, which would have stripped Local 8 of its own direction. Instead, they reshaped their local into the vibrant, progressive labor union it is today. These founding mothers focused on building a transparent, fiscally responsible, and democratically run local with organizing made a top priority. Norma’s labor friends remember her passion and kindness, which will live on in so many of the hearts she touched. Her determination was unmatched. And she never lost sight of the important goals she had for a more just world. Norma taught us endless lessons in perseverance with dignity. She was truly one of a kind. The world is a better place because of her. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents February 2025 Make Crypto Great Again Michael Righi Who bought the 2024 election? We all know about Elon Musk. But there was another huge source of election cash – cryptocurrency (it’s not really currency) firms and their wealthy owners. Crypto Political Action Committees (PACs) spent $265 million on the elec- tion, the most of any “industry.” What did they get for their money? FairShake, a crypto PAC, helped defeat critic Katie Porter in the California Democratic primary. FairShake, along with AIPAC, helped defeat progressives Cori Bush and Jamaal Bowman in their primaries. Crypto money’s biggest win was taking down Ohio’s Sherrod Brown, the Democratic leader on the Senate Banking Committee. They also helped Trump, who, back in the day, derided crypto as “thin air,” But recognizing a good scam, Trump and family are now all in. Besides Musk, Trump is surrounding himself with crypto parasites, from J.D. Vance to Paul Atkins (SEC appointee) and Howard Lutnick (Commerce). And who knew we needed an AI and Crypto Czar (David Sacks)? Rug Pulls and Wash Trading If it’s not currency, what is it? Currency, or money, is a social construct we have developed to buy and sell things and services. This may sound weird, but money is based on trust – trust that the bank where you deposited your pay will make payments when you write a check (old school) or use a card or a digital payment system. Or trust that the government will accept payment in the currency it prints and make depositors whole if a bank goes belly-up. In addition, the central bank will rescue the financial system as a whole if private banks or finance institutions threaten a collapse or depression. That’s what happened in 2008. Neo- liberal deregulation allowed bankers to create and speculate (“innovate,” they call it) on a whole slew of risky financial derivatives. These crashed in value, and the private banks were bailed out by central banks buying their bad assets. Financial fraud was revealed, but no one went to jail. Banks and bankers were bailed out, and homeowners were not. So in 2008, a private group created Bitcoin, a digital currency that was supposed to bypass the corrupt top-down financial institutions and allow users to make payments directly to each other. Did that work? Well, not really. Extremely complicated computer verification of transactions makes it impossible to use crypto to buy a cup of coffee or your groceries. It is not money. But hundreds and thousands of companies now issue cryptocurrency and crypto tokens. So what are they? They are “investments” of a very peculiar kind. They are not shares of stock in a company that produces or owns some thing. They are just pieces of digital code that are being traded back and forth in what is a gambling economy. Crypto shills said it would go up in value forever. Influencers pushed it. This became a perfect opportunity for fraudsters to create a token, get inter- net posters to push it, then pull the rug out by selling at the top, leaving small investors to take the loss. Or buy and sell tokens back and forth from one account to another, driving up values, then getting out. Casino Capitalism Covid meant too many folks were isolated in front of their computer screens, trying to make the big score. This culminated in the Super Bowl ads of 2022, with Matt Damon and Kim Kardashian helping to push crypto to $3 trillion. Then, the inevitable crash came in May of that year and wiped out $2 trillion of that value. Of course, the “whales” were not wiped out; smaller investors were. From 2015 to 2022, 75 percent of crypto investors lost money. Speculative investments enrich only the already wealthy. We do have to recognize what crypto actually is good for. Because crypto holdings are pseudo-anonymous, trans- actions are hidden. So it is useful to opioid traffickers, tax avoiders, money launderers, ransomware hackers, gun runners, and anyone trying to avoid international sanctions. We have plenty of reasons to want to limit crypto and its scammers and criminals. But crypto businesses want more, and the incoming administration is poised to give it to them. They want “light-touch” regulation that would mainstream them. They do not want to be prosecuted for fraud, as many of them should be. They want crypto to be designated as a special asset, not a security with all the investor protections that implies. With very light legitimizing regulation, they could draw in millions from our pension funds and other traditional investment funds. That would mean their booms and crashes and fraud would have a more significant impact on the traditional financial system, the one we use. Yes, we need to reform that system with stricter regulation and new initiatives like postal accounts and public banks. But we also have to protect it from fraudsters and casino capitalists. Michael Righi is a retired economics professor and a member of the Retiree Advocate Editorial Board. < Back to Table of Contents