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Friday, September 5, 2025

CVS sued after PBM favors Wegovy over Zepbound

 Two New York residents have filed a lawsuit against CVS after the company’s pharmacy benefit manager, Caremark, denied coverage for Zepbound in favor of Wegovy. 

The plaintiffs — Dennis Larkin of Mahopac, N.Y., and Danielle Gosline of Auburn, N.Y. — said the coverage denials were “arbitrary and capricious” and that Zepbound was medically necessary,” according to the lawsuit filed Sept. 3. The lawsuit alleges CVS Caremark violated ERISA, the Employee Retirement Income Security Act. 

In July, CVS Caremark chose Wegovy as the preferred GLP-1 medication for its largest commercial template formularies after the PBM secured a lower net price for the Novo Nordisk drug compared to Zepbound. 

Mr. Larkin was prescribed Zepbound for weight management and severe obstructive sleep apnea, and Ms. Gosline was prescribed Zepbound for weight management, according to the lawsuit. 

Eli Lilly’s Zepbound is a GIP/GLP-1 drug approved for chronic weight management and obstructive sleep apnea, while Novo Nordisk’s Wegovy is a GLP-1 for chronic weight management, cardiovascular disease and liver disease. 

The lawsuit seeks to be classified as a class action, declare Zepbound as medically necessary for weight management and obstructive sleep apnea, and order CVS to cover Zepbound. 

CVS told Becker’s the lawsuit lacks merit and the company intends to “defend ourselves vigorously against those claims.”

“Wegovy and Zepbound are two clinically similar products, and by forcing the drug manufacturers to compete with one another on price, CVS Caremark has unlocked significant cost savings for the employers and unions who hire us to manage their pharmacy benefits,” CVS said in a statement. “In addition to increasing affordability and access to this therapy class immediately, we anticipate that our formulary decision will encourage both Eli Lilly and Novo Nordisk to more aggressively compete with one another in the future and lower the U.S. prices for their products.”

https://www.beckershospitalreview.com/pharmacy/cvs-sued-after-pbm-favors-wegovy-over-zepbound/

Medicaid + health system liquidity: 10 notes

 Health systems gauge financial strength on a variety of metrics, with one of the key indicators being days cash on hand.

While the average days cash on hand has improved in the last year, according to Strata’s “Performance Trends Report: Market Insights from Q2 2025,” eminent changes to the Medicaid program could derail this progress.

Ten things to know:

1. Medicaid is typically the lowest reimbursing payer for healthcare organizations and systems serving a larger Medicaid population often have below average days cash on hand.

2. Days cash on hand has fluctuated over the last year; health systems nationally reported 112 days in June 2024 and at times dipped to 110 days before ending June 2025 at 128 days, a 12-month high.

3. Health systems reported on average, Medicaid accounts for 12% of overall revenue.

4. The One Big Beautiful Bill Act signed July 4 tightened eligibility for Medicaid, introduced work requirements and accelerated the redetermination cycle over the next two years. The Congressional Budget Office estimated 11.8 million people will lose Medicaid coverage as changes are rolled out, and increase the number of uninsured people in the U.S.

5. The lack of insurance could lead to more patients delaying care until they need the ER, an expensive site of care. “If fewer people qualify for Medicaid benefits due to policy changes, a troubling shift in patient behavior is likely to put additional strain on hospital finances,” according to the report.

6. For health systems with greater than 10% of Medicaid patient days, the days cash on hand improved from 79 days in June 2024 to 123 days a year later. Hospitals with the greater percentage of Medicaid patients closed the gap with hospitals nationally and actually had higher days cash on hand in February and March.

    “Despite this recovery, these health systems remain more vulnerable to policy and reimbursement changes, and the anticipated Medicaid reductions could quickly erode these gains,” the report states.

    7. When Medicaid eligibility tightens, hospitals are likely to see a surge in self-pay patients for emergency visits. In 2023 after the federal government lifted “continuous enrollment” in Medicaid, hospitals reported self-pay ER visits increased for all, with a 60% increase among pediatric patients.

    8. Hospitals take a greater hit on self-pay cases by service line than specialty care. Strata found outpatient orthopedic Medicaid median cost margins were -$247 per case while self-pay medians were -$430 per case. In general medicine, outpatient Medicaid cost margins were -$95 on average, compared with -$486 for self-pay patients.

    9. Behavioral health had a particularly steep gulf between Medicaid and self-pay margins. Outpatient Medicaid behavioral health cost margins were -$69, compared with -$564 per case for self-pay patients.

    10. Emergency self-pay cases reported -$616 median per case margins, compared with -$128 for Medicaid patients.

      “When care moves from outpatient to emergency settings, hospitals take a double hit: higher care costs combined with lower likelihood of payment,” the report notes. “If care shifts occur in the wake of Medicaid reductions, hospitals could see a widening gap between cost and reimbursement, particularly in high-volume service lines.”

      https://www.beckershospitalreview.com/finance/medicaid-health-system-liquidity-10-notes/

      Do Doctors Make Money Off Vaccines? A Look At Incentives And Bonus Structures

       by Zachary Stieber via The Epoch Times,

      “Doctors are being paid to vaccinate, not to evaluate,” Health Secretary Robert F. Kennedy Jr. said in a recent video.

      “They’re pressured to follow the money, not the science.”

      Doctors administer dozens of vaccines to many children in the United States. Adults are also advised to receive multiple shots.

      Here’s what to know about vaccines and payments.

      What Does the Literature Say?

      A review of studies confirms that some doctors profit from vaccinating.

      In a 2020 paper, researchers found when analyzing three years’ worth of vaccination claims for five Colorado clinics that reimbursements averaged 125 percent of costs, making administering vaccines “financially favorable across the practices.”

      Another study found that various providers in North Carolina, when receiving the maximum payment for reimbursement from insurers or the government, profited from vaccinating patients. Even if they received the minimum payment, pediatric and family medicine practices still reported positive income, according to the 2019 study.

      On the other hand, other doctors say the costs of administering certain vaccines to certain people exceed the vaccine payments.

      In a survey of 34 pediatricians, for instance, more than half said they do not profit from vaccinating, according to a 2009 paper.

      A number of practitioners have also said they face escalating costs associated with vaccination, such as staffing, leading them to stop or consider stopping providing vaccines to patients with private insurance.

      Reimbursement for vaccinating patients varies depending on whether patients have private or public insurance. Under a program called Vaccines for Children, the government also provides vaccines to doctors for free. It does not pay for related costs, but doctors can charge an administration fee that the Centers for Disease Control and Prevention says “helps providers offset their costs of doing business,” with the maximum varying by state.

      What About Those Bonuses?

      Doctors can make extra money for vaccinating under incentive programs from insurers, as highlighted by Brian Hooker, a senior scientist with Children’s Health Defense—a group Kennedy chaired through 2023—and other witnesses during a hearing in July on vaccines held by Sen. Ron Johnson (R-Wis.).

      “Some pediatricians can make upwards to a million or more a year just in those incentives,” Hooker said.

      Asked for citations, Hooker pointed The Epoch Times to documents he collected from insurance companies that list available bonuses.

      Links to those and other documents that outline incentives and are available online are provided below:

      • Blue Cross Blue Shield Blue Care Network of Michigan: $400 per child who receives a set of 24 or 25 vaccine doses on or before their second birthday.

      • Aetna Better Health of Louisiana: $10–$25 per member, depending on level of COVID-19 vaccination coverage practice-wide.

      • Molina Healthcare of Ohio: $100 incentive for COVID-19 vaccination.

      • Anthem Blue Cross and Blue Shield Medicaid: $50 per individual aged 6 months and older who received a COVID-19 vaccine by Dec. 31, 2022.

      • United Healthcare Community Plan of Michigan: Incentives for patients who receive the meningococcal, Tdap (tetanus, diphtheria, and pertussis), and HPV vaccines by their 13th birthday.

      • Meridian: Up to $120 per child who receives the 24 or 25 doses by their second birthday, or adolescents who received three certain doses by their 13th birthday, capped at $9,600 for each category.

      • BlueCross BlueShield of Illinois: $149 for each child, if 63 percent or more meet criteria, who received the 24 or 25 vaccine doses by the time they turn 2.

      • Central California Alliance for Health: Bonuses for children who receive at least 24 doses by the time they turn 2 and the three certain doses before they turn 13.

      The sets of vaccines for which providers receive bonuses are recommended by the Centers for Disease Control and Prevention.

      Dr. Paul Thomas, who ran a pediatric practice in Oregon, estimated in a 2021 study that he was losing more than $1 million a year by offering parents what he called informed consent, or detailed discussions about the benefits and risks of the recommended vaccines.

      Thomas—who surrendered his license in 2022 after the Oregon Medical Board determined that his alternative vaccination schedule posed a danger to the public—told The Epoch Times in an email that he was forced to work harder, freeze salaries, and impose an administration fee on every patient to cover income he did not receive due to administering fewer vaccines than many practices. Thomas has said he was unfairly targeted, in litigation denied by courts that found the board is protected by “absolute immunity.”

      People attend an American Academy of Pediatrics (AAP) conference in Anaheim, Calif., on Oct. 8, 2022. AAP, as well as some other groups and doctors, have said physicians are not motivated by money when vaccinating patients. John Fredricks/The Epoch Times

      “It would be near impossible for current pediatric practices to survive if not clearly impossible if they were to suddenly lose half or all their vaccine income, not to mention the catastrophic nature of loss of ‘quality’ bonuses,” Thomas said.

      Dr. Renata Moon, who sits on the board of directors for the American College of Pediatricians, said that her former employer in 2020 started tracking the vaccination rate for patients. She was unable to determine why and said she would not be surprised if they were receiving compensation.

      “It is unethical for physicians to receive bonuses or monetary compensation for pushing the products of pharmaceutical companies. It’s a massive conflict of interest!” Moon told The Epoch Times via email. “Do they have the patient’s best interest at heart or are they focused on their bank accounts?”

      What Do Other Doctors Say?

      The American Academy of Pediatrics (AAP), as well as some other groups and doctors, have said physicians are not motivated by money when vaccinating patients.

      “Pediatricians do not profit off vaccines,” the AAP said in a July 16 post on X.

      The organization declined to make one of its experts available for an interview on the topic. When a spokeswoman was sent studies, including multiple published by the AAP’s journal Pediatrics, that show some pediatricians have made money from vaccinating, she pointed to an AAP webpage that states “pediatricians recommend childhood vaccines because they are one of our most effective tools to help keep children healthy and prevent diseases from spreading in communities.”

      It also states, “pediatricians often take on significant costs to provide the vaccinations their patients need, and the minimal payments they receive do not always cover these costs.”

      Among the costs, the group said: purchasing vaccines and storing them.

      Dr. Todd Porter, a pediatrician employed in Illinois for a multi-specialty physician-led organization, said that he has not paid attention to whether he makes money from vaccinating children.

      “I have to surprisingly side with the AAP on this one even though I no longer support the AAP on just about everything else,” Porter told The Epoch Times in an email. “As a pediatrician, my recommendation of routine childhood vaccines has nothing to do any reimbursement my office may receive and again I can honestly say I have no working knowledge of what that reimbursement would be.”

      Porter says he has been motivated for the more than 20 years he has worked as a doctor to provide vaccines to minimize vaccine-preventable disease. He has never recommended the COVID-19 vaccines and believes the CDC and AAP did not provide adequate details around the risks and benefits of the shots.

      “I have become a bit uncertain about the risk/benefit of each of the vaccines. I still would recommend these historical routine childhood vaccines, but with the growing vaccine hesitancy amongst parents I do not push them,” he wrote. “I also have stopped generally recommending the influenza vaccine until I see more rigorous data to show that it really works.”

      Vaccination rates among kindergartners have declined in recent years, and a third of parents in a recent survey said they would be refusing some or all vaccines for their children.

      Kennedy’s Statements

      Kennedy has spoken several times recently about the payments for vaccinations. During an interview released in June with political commentator Tucker Carlson, he mentioned an article stating half of the revenue for most pediatricians comes from vaccines.

      The Department of Health and Human Services did not respond to a request for that alleged article.

      “And then there’s a whole structure where Blue Cross and the other insurance companies pay bonuses to the pediatrician ... and that’s why your pediatrician, if you say, ‘I want to go slow on the vaccines,’ or, ‘I want to have a little different schedule,’ your pediatrician will throw you out of his practice because you’re now jeopardizing that bonus structure,” Kennedy said. “And these are all perverse incentives that stop doctors from actually practicing medicine and caring for the client because they’re looking at the bottom line.”

      Twenty-one percent of pediatricians told surveyors that they dismissed families who declined one or more vaccines, Dr. Sean O'Leary, the current chair of the AAP Committee on Infectious Diseases, reported in a 2015 study. A 2020 review co-authored by O'Leary found evidence that dismissing families “appears to be increasing as a strategy for dealing with vaccine refusal.”

      A form dismissal letter offered to doctors by the AAP states, “It has become clear that our philosophies regarding medical care differ greatly.” The letter directs parents to arrange for medical care for their children elsewhere.

      O'Leary and other AAP officials said in a 2024 report that there are ethical issues about dismissing families, including whether doctors have a responsibility to care for all patients who come to them, Dismissal, they wrote, “can be an acceptable option ... after repeated attempts to help understand and address parental values and vaccine concerns, engender trust, and strengthen the therapeutic alliance.”

      Kennedy added in the X video on Aug. 8 that “we’re scanning every corner of the health care system for hidden incentives that corrupt medical judgment” and that officials had found “doctors are being paid to vaccinate, not to evaluate.”

      He said that officials discovered that more than 36,000 doctors had reimbursements from Medicare altered based on the vaccination rates of children in their practices.

      The video was released as Kennedy announced officials were repealing a previous policy that favored hospitals that reported the vaccination rates of staff members.

      “Doctors should be guided by medical judgment and their Hippocratic Oath, not by financial incentives or government mandates,” Kennedy said. “That’s what this policy change is about, and it’s just the beginning.”

      https://www.zerohedge.com/medical/do-doctors-make-money-vaccines-look-incentives-and-bonus-structures

      Democrat Extremism Underwrites Trump

        by J.T. Young via RealClearPolitics,

      Democrats’ extremism continues to underwrite Donald Trump’s agenda. Since 2021, this has been the case, and it shows no sign of stopping. Rather than bolstering them as an alternative, Democrats are giving Trump the leverage to pursue his aggressive agenda.

      President Trump remains divisive. While his job approval and favorability ratings are higher than they were eight years ago, they remain low. According to Real Clear Politics’ August 28 average of national polling, Trump’s approval rating is 45.3%-51.5% for -6.2% net; on August 28, 2017, Trump sat at -16.9%. According to RCP’s polling average of Trump’s favorability, he is 44.3%-52.1%, for -7.8%; on August 28, 2017, Trump was -17.9%.

      Trump’s 2024 victory was a landslide in swing states and states between the coasts. However, Trump’s win in the popular (below 50%) and in the electoral votes (312-226) was hardly historic. Nor did he bring home large congressional majorities: Republican control of the Senate (by six votes, 53-47) and House (by five votes, 220-215) do not approach past presidents’ majorities. 

      Yet Trump took office governing like FDR in his first 100 days. Now into his third “hundred days,” Trump is still doing so. And this is a president who was twice impeached and once defeated: No impeached president has ever been reelected (let alone a twice-impeached one), and the last time a defeated president was reelected occurred over 130 years ago. 

      How is this continued momentum possible? Democrats’ extremism is making them even less popular. 

      According to a recent WSJ poll, Democrats’ popularity is at a 35-year low. This is no outlier: Other polls show similar results. Between 2020 and 2024, Republicans gained up to 4.5 million registered voters versus Democrats, who saw net losses in all 30 states reviewed by the NYT. And Trump’s 2024 victory was attributable to an overwhelming win in “fly-over” country: The 46 states outside California, New York, Massachusetts, and Washington contain 80.5% of America’s electoral votes; Trump won 72% of them in 2024. 

      The issues that the Biden-Harris ticket lost on last November are the same issues that Democrats are insistent about fighting Trump on now. 

      On illegal immigration, RCP’s average of national polling showed Biden’s last job approval rating was just 33.5%. Yet Democrats continue to challenge Trump at every juncture: They have tried to make Kilmar Abrego Garcia into a martyr; they have stormed ICE detention facilities; they have tried to jeopardize ICE agents’ safety by pushing to bar them from wearing masks.   

      On crime, RCP’s average of national polling showed Biden’s last job approval rating was just 38%. Yet Democrats continue to challenge Trump on his push against crime: They have objected to him deploying the National Guard in Washington, D.C., despite D.C. Mayor Muriel Bowser saying it has reduced the city’s crime; and they have threatened to take him to court if he tries to deploy the National Guard in crime-ridden Chicago.

      The same anti-Trump intransigence has led Democrats to take similarly extremist positions on allowing biological males to compete against biological females (something Americans overwhelmingly oppose), to lock arms against Trump’s push to keep tax rates from rising to pre-2017 levels (every Democrat in the House and Senate voted against it), and for many, to object to his strike against terrorist-backing Iran’s nuclear facilities. 

      Americans oppose allowing biological males to compete against girls and women. RCP’s average of national polling showed Biden’s last job approval rating on the economy – which would have been devastated by the tax hike that would have occurred if Democrats had blocked keeping 2017 tax rates in place – was just 38.8%. The RCP average showed Biden’s last job approval rating on foreign policy – to which America’s support for Israel has been foundational for decades – was a mere 35.6%. 

      Time and time again, Democrats are choosing the wrong side of lopsided issues. In doing so, they are maintaining the margin between themselves and Trump, and they are not giving Americans a plausible alternative to Trump. No alternative means giving Trump all the leverage.

      There is an old joke about two men encountering a lion. Terrified, the first man whispers to the other man, “What are you going to do?” “Run,” the other man whispers back. The first man responds, “Are you crazy, you can’t outrun a lion!”  “I don’t have to outrun the lion,” says the second, “I just have to outrun you.”

      Right now, Trump is outrunning the Democrats, and the Democrats aren’t even making it a race.

      J.T. Young is the author of the recent book, Unprecedented Assault: How Big Government Unleashed America’s Socialist Left from RealClear Publishing and has over three decades’ experience working in Congress, the Department of Treasury, the Office of Management, and Budget, and representing a Fortune 20 company.

      https://www.zerohedge.com/political/democrat-extremism-underwrites-trump

      Vietnam Replacing China As Key Link In Global Supply Chains

       Vietnam is turning into a production powerhouse for the world as a result of the U.S. trade war, , according to Caixin.

      For example, once a farming region, Bac Ninh has become northern Vietnam’s industrial hub, driven by Chinese manufacturers relocating operations south to avoid U.S. tariffs and diversify supply chains.

      The shift began with the U.S.-China trade war and has accelerated as clients pressure suppliers to set up in Vietnam. “When the trade tensions began in 2018, one client suggested we look into Vietnam,” said Li Fangting of Mingjie, a Dongguan-based plastics maker. “After the pandemic, those suggestions turned into demands. Some clients said we wouldn't be considered for new orders unless we had a presence in Vietnam.” Mingjie now produces in Bac Ninh for U.S. and European markets.

      But costs are rising. Industrial land in Bac Ninh is pricier than in many Chinese regions, and wages are catching up. Some firms now produce goods costlier than their Chinese equivalents, relying on tariff gaps that could vanish overnight. In April, the U.S. slapped a 46% tariff on Vietnamese exports, later trimmed to 20%.

      Despite these pressures, northern Vietnam is emerging as a “world assembler.” Samsung, which has invested over $23 billion since 2008, anchors a cluster of electronics producers, joined by Apple suppliers like Foxconn, Goertek, and Luxshare. “Over the past few years, we’ve seen a surge in supply chain companies, logistics providers, and packaging firms entering Vietnam, following in the footsteps of their major clients,” said Anchalee Prasertchand of Thailand’s WHA Group.

      Caixin writes that supply chains remain incomplete, forcing many manufacturers to import components from China. In textiles, 80% of yarn still comes from China, said Tian of Hechang Threads Dyeing. Furniture is more self-sufficient, with 90% of inputs sourced locally, though steel and panels remain scarce. As one factory owner put it: “In fact, the global center of furniture production shifted from Dongguan to Binh Duong by 2018. This industry won’t be going back to China.”

      Even with higher costs, Vietnam’s tariff advantage sustains momentum. Executives estimate Vietnamese goods are 15% more expensive than Chinese ones, but with U.S. tariffs averaging 57.6% on Chinese products versus 20% on Vietnamese, the gap is decisive.

      Chinese firms are also eyeing Vietnam’s domestic market of 100 million people. “Trade wars may be the spark, but going overseas is really about tapping global markets — not just the U.S., but also Europe and Southeast Asia,” said Niu Qiang of KCN Investment Consulting. “For Chinese companies, this is the true start of globalization.”

      Automakers highlight the shift. Shineray Motors, which entered in 2018, adapted trucks for local roads and weather. Its mini-commercial vehicles now hold 30% of Vietnam’s market. “Now is a good time to lay the groundwork for the passenger car and new energy vehicle market,” said general manager Wang Lu. Giants like Geely and Great Wall are also investing, cementing Vietnam’s role as both a manufacturing hub and consumer battleground.

      https://www.zerohedge.com/markets/vietnam-replacing-china-key-link-global-supply-chains

      Top Indian Refiner Snubs US Oil In Latest Tender

       By Tsvetana Paraskova of OilPrice.com

      India’s top refiner, Indian Oil Corporation Ltd (IndianOil), has forgone buying U.S. crude at this week’s tender, instead opting for Middle Eastern and West African crude, sources in the oil trade industry told Reuters on Friday.

      At the previous tender last week, IOC bought as many as 5 million barrels of U.S. West Texas Intermediate crude.  

      But this week, the biggest refiner in the world’s third-largest crude importer bought 2 million barrels of West African crude, another one million barrel of Nigeria’s Agbami and Usan crudes, and two million barrels of Middle East crude, including one million barrels of Abu Dhabi’s Das from Shell, according to Reuters’ sources. 

      Competitive prices for U.S. crude in an open arbitrage window to Asia have prompted Indian state and private refiners to accelerate buying of American oil in recent weeks.

      A few weeks ago, rising prices of Middle Eastern grades opened the arbitrage window for West Texas Intermediate (WTI) to flow to Asia.

      Key grades from the Middle East, such as Dubai and Murban, have seen their prices rise in recent weeks on the back of strong demand for high-sulfur crude in Asia and reduced shipments of Murban.

      As India’s purchases are driven by economics above all else, both state and private refiners bought more U.S. crude in August to take advantage of the lower freight costs and the open arbitrage window. 

      The higher purchases of U.S. crude could help reduce the huge trade deficit that the United States runs with India.

      With difficult U.S.-India trade talks, the Trump Administration has singled out India to punish as a buyer of Russian crude.

      Indian refiners, however, are not giving up on Russian crude—they continue to seek bargain prices and are expected to import more Russian oil in September compared to August levels as discounts are deepening amid Russia’s constrained refining capacity due to Ukrainian drone strikes.  

      https://www.zerohedge.com/energy/top-indian-refiner-snubs-us-oil-latest-tender

      AI Can Replace Nonessential Government Personnel

       


      America’s national debt is a much bigger ticking time bomb than it was ten or twenty years ago. If the debt was a Hiroshima-sized device in 2005, it now has the hydrogen payload of the Soviets’ Tsar Bomba nation-destroyer, making the debt a national security threat as America teeters on the brink of fiscal insolvency.

      If voter entitlements (Social Security, Medicare, Medicaid) are truly the untouchable third rail of American politics, then workplace attrition and culling entitlements for lower hanging fruit like millions of past, present, and future government employees becomes even more of an existential necessity.

      Steve Bannon famously referred to this aspirational undertaking as the deconstruction of the (permanent) deep state. President Trump’s executive order (EO 14171) reinstating Schedule F (making some career federal employees subject to dismissal) remains in legal limbo amid furious pushback from government unions, the woke judiciary, and media.

      Contrary to what the public is told, millions of federal employees didn’t enter into government work out of the goodness of their hearts, or a desire to solve problems or “give back” to their communities. They’re in it for the easy money, the no-work Club Fed lifestyle, and the many, many bennies.

      Millions of employees throughout the federal government’s cabinets, departments, agencies, and sub-agencies (numbering in the many hundreds, nobody knows exactly how many)) contribute virtually nothing to the economy in terms of goods and services.

      The roads and dams and electrical grids are already built, and still they can’t fill that pothole or that dry reservoir or break ground on that high-speed rail project that has already cost taxpayers billions of dollars.

      Speaking of high-speed rail to nowhere, why are working class conservative taxpayers in Oklahoma and Kentucky on the hook for California’s or New York’s cost overruns, poor decisions, fiscal mismanagement, graft, and blue social experimentations gone awry?

      Bureaucratic mediocrities used to be benignly referred to as pencil or paper pushing dorks but today’s Poindexters don’t even do that. Once they have attained civil service protections, federal government employees have an inside joke about going ROAD (Retired On Active Duty).

      What does ROAD look like, in practice? It means sitting at home or in the office with the laptop on, pretending to be working while shopping or looking at porn online. Maybe working out at the gym or hitting the beach or planning that next paid vacation (airfare and other travel expenses often taxpayer subsidized as well), or simply taking care of personal chores.

      Even in the lowly quasi-governmental U.S. Postal Service (USPS), it means endless paid “sick” days, thousands of hours of paid vacation, ample opportunity for criminal mischief, supervisors making six figures while doing virtually nothing other than showing up when they please to spend the day checking their social media or tending to their personal affairs.

      Private companies like FedEx and United Parcel Service (UPS) turn profits without injections of taxpayer money, but USPS squanders billions each fiscal quarter because the employee entitlements have run completely amok.

      Oh, and when you retire as a federal employee (age 50 in many cases, even younger), it gets even better.

      How about retiring young and receiving most of your final highest salary annually for the rest of your natural life? Or how about double dipping (dual compensation waivers, in government-speak) after retirement by getting rehired for another highly compensated and coveted federal job while still receiving all your retirement pay from the first federal job you “retired” from?

      Throw in platinum health care for the federal welfare queen for life. And all the free time of a fifth grader on the first day of a long summer vacation.

      It has been forecast that the rise of Artificial Intelligence (AI) mostly threatens jobs in the white collar or information economy. Absent robotics, blue collar vocations in the physical, productive, goods and services economy (welding, transportation, carpentry, manufacturing, hospitality, et al.) are mostly safe.

      Properly programmed, AI can serve a noble purpose by cheaply replacing redundant employees throughout virtually all government agencies. America’s so-called Tax Freedom Day, typically designated for mid-to-late April, could be moved back by months as taxpayers retain far more of their income for themselves.

      Even the Internal Revenue Service could be administered far more efficiently and fairly, without the nonstop political targeting conservatives are all too familiar with.

      If new regulations need to be written or enacted, (or, preferably, subtracted), AI can achieve far better results than any human. And while large-scale AI data centers would require lots of electrical energy, the energy could be obtained from abundant fossil fuels, nuclear energy, and even renewables.

      And AI wouldn’t waste or steal taxpayers’ money with self-dealingfraud, or loud demands for higher salaries and more benefits from despised citizens (snarky pejoratives like “cash cattle” and the portmanteau MAGAts are commonly voiced by federal employees when they ridicule private sector taxpayers).

      DOGE was on its way to making significant federal cost-savings inroads before being derailed by progressive judges issuing judicial fiats well beyond their jurisdictions in tandem with hysterical, hair-on-fire bureaucratic and media resistance.

      We all recall the sob stories, whining, and pity parties when a handful of federal employees were cashiered or otherwise dismissed, as if nobody in the private sector had ever faced termination or job uncertainty before.

      Provided its algorithmic engrams don’t reflect those of progressive programmers, AI itself can easily compose a workable roadmap to eliminating the vast majority of federal jobs, most of which are charitably described as superfluous to begin with. On your smartphone or computer, simply ask Grok or ChatGPT for guidance and you will find no shortage of excellent ideas and insights.

      The biggest downside to laying off a million or more federal employees is the possibility for mischief and payback for the loss of their sinecures.

      CIA and FBI personnel who faced possible layoffs earlier this year openly threatened they would share sensitive intelligence with rogue foreign states, the American news media, and other bad actors. Which proves that even if you take the progressive out of the government, you can’t take the pouting, entitled ingrate out of the progressive.

      Much of the existing flea-bitten federal bureaucracy is already united on a resist and sabotage agenda, slow-walking or refusing to implement MAGA reforms, lawful directives, or action items that offend progressive sensibilities.

      Nevertheless, the national debt and unfunded entitlements given to nonperforming federal drones demands a reckoning. Any midterm examination or stress test of the Trump administration needs to address whether and how much deadwood and dry rot has been removed from government.

      https://www.americanthinker.com/articles/2025/09/ai_can_replace_nonessential_government_personnel.html