Fraud: More Than We Can Imagine?

 by John Hinderaker

The U.S. government spends more than $900 billion annually on Medicaid. How much of that money is stolen by criminals? HHS Secretary Robert Kennedy Jr. pegs the theft total at $100 billion. I am going to embed the entire quote in the tweet below: 

RFK JR: “We shut down 800 hospices. You know what a hospice is? Where you’re going to die. Typically, if you go to a hospice, you leave within 18 days because your dying is terminal.”

“We started looking at these hospices in Los Angeles, and the people never died. Two or three years later they were there, and we’re paying $6,000 a month.”

“We found a hotel room with 29 hospices in it. I mean a hotel, every room was a hospice, and none of them had any patients. They were just addresses.”

“The guys who own them, they were Estonians and Armenians and people from Eastern Europe who were getting the patient numbers. They were stealing them from doctors’ offices.”

“They were also going into poor neighborhoods in Los Angeles and they’d say to the people, ‘We’ll give you this $375 flat-screen TV. You give us your patient number and we’re going to enroll you in this hospice. You don’t ever have to go. We’re just going to enroll you,’ and then we’ll charge Medicaid $6,000 a month forever. And the guy never dies, of course, because he was never sick.” 

“We didn’t get a single call from a congressman or from a business owner saying, ‘Oh, you shut down my hospice and all these patients are on the street.’ None of them, because they were all crooked and they knew they were crooked.”

 https://www.powerlineblog.com/archives/2026/07/fraud-more-than-we-can-imagine.php

California is aging fast — and socialism won’t make it younger

 California, long associated with youth, is getting old — and twice as quickly as the national average. The walker seems likely to replace the surfboard as the state’s defining feature.

California’s over-65 population, the Stanford Center on Longevity notes, will double in 20 years, while  the nationwide population this will take 30 years to double.

By 2060, the state’s median age is projected to be over 45. In 1970, it was nearly 28.

The aging of California is made more difficult by the steady loss of working-age people, particularly in middle-aged families. Since 2000, more than 4 million net domestic migrants have moved to other parts of the nation from California, a pace that has accelerated in recent years.

From 1980–2020, the share of 25-to-35-year-olds in California who owned their homes declined to just 15.5%.Dragana Gordic – stock.adobe.com

Even immigrants seem to have stopped coming, and not only because of President Donald Trump’s policies.

LA’s foreign-born population actually declined in the 2010s, as immigrants looked elsewhere for work. In the deindustrializing economy that is California outside of the high-tech sector, immigrants are propelling a poverty rate that is the highest of any state. 

California has stopped building schools and factories. Instead, we build hospitals to accommodate the old.

Rapid aging is also a natural byproduct of extremely high house prices. These lead young people, particularly those with children, to leave the state.

The gap between California homeownership rates and those in the nation at large is now at a record high, notes Berkeley’s Terner Center. Between 1980 and 2020, the share of 25-to-35-year-olds in California who owned their homes declined from 39.4% to just 15.5%.

So it is no surprise that people in their 30s and early 40s, according to IRS numbers, are precisely the group deserting the state most rapidly, including in Silicon Valley. 

Perhaps most revealing, California now ranks last in per capita terms of attracting new residents, a stunning reversal from its traditional role as a beacon to the rest of the country and the world.

We could also encourage the building of senior housing, as was recently proposed by LA Mayor Karen Bass.David Buchan for CA Post

The precipitous decline in state’s total fertility rate is therefore no surprise. Long above the national average, California’s fertility rate is now the nation’s 10th lowest, far below that in key competitor states like Texas. 

In LA County and Orange County, birth rates have plunged over 15% in the past decade. In LA County, the nation’s most populous, the under-25 population shrank by nearly three-quarters of a million. That’s three-quarters of a million people who would have joined the prime-age workforce over the next 25 years.

In contrast, Texas, Utah, Idaho and Arizona have enjoyed double digit growth in this same cohort over  the past two decades. 

Given this worrisome trend we might consider some serious policy changes. Regulations make it  extraordinarily difficult to build the single-family homes preferred by the vast majority of Californians. Dense, expensive urban areas are not ideal places to raise a family, except for the very affluent. 

Rather than urban “infill” housing, we need more lower-density developments. Less-dense regions also tend to produce more children than larger, dense areas. 

The impact on California schools is obvious. California’s schools have seen enrollment declines higher than in the rest of nation. Enrollment fell by 325,000 students (5%)  between 2019 and 2023. By 2031, this loss could widen to one million. In LAUSD, the state’s largest district, total enrollment has decreased by 27% over the last decade, and 44% over 20 years.

Reforms in housing policy are necessary to remain competitive with the rest of the country. But those reforms would require changes in California’s land use patterns, energy policy, taxes, and regulations .  

Reform of tax policies, for example, could allow seniors to sell their houses without crushing capital gains liabilities, something now being proposed in Washington. We could also encourage the building of senior housing, as was recently proposed by LA Mayor Karen Bass, which could open opportunities for young people to buy the houses they leave.

Restoring hope to the younger generation should be an imperative, even for the Boomers. If not, young people will find their desperate offspring roused to generational war against what The Atlantic describes as  a corrupt  gerontocracy that has  “amassed disproportionate wealth and power.”    

We have already seen this script play out in  New York, where underpaid and often overeducated  young people opt for radical leftism, embracing redistribution of wealth. In reality, that means taking money not just from billionaires but from any Boomer with a decent income and some property. This will supposedly pay for free buses and daycare; rent control; and government-owned groceries. The primary victims? People like small landlords — largely first and second-generation immigrants — and bodega owners, the vast majority Latino. 

Socialism is not the answer to the aging crisis in California. But if we fail to address the housing crisis, and start creating better jobs, we may experience the dystopian future staring at us.

Joel Kotkin is the presidential fellow in urban futures at Chapman University and senior research fellow at the Civitas Institute of the University of Texas at Austin.

https://nypost.com/2026/07/19/opinion/california-is-aging-fast-and-socialism-wont-help/

China cracks down on chatbot romances as birthrate crisis worsens

 China is reportedly tightening restrictions on AI companion chatbots as the country grapples with a shrinking population and record-low birthrate.

New rules that went into effect Wednesday prohibit chatbots from encouraging emotional dependence or forming virtual romantic or familial relationships with minors. Companies must also contact a guardian or emergency contact if a user faces a life-threatening crisis, according to the Cyberspace Administration of China.

The regulations have already prompted Alibaba and TikTok parent ByteDance to disable certain chatbot features, The Wall Street Journal reported.

Beijing is reportedly concerned that AI companions could discourage people from pursuing real-world relationships.

"They don’t like the idea of a large portion of their population being in deep emotional relationships with chatbots that could take them out of the marriage market," Matt Sheehan, a senior fellow at the Carnegie Endowment for International Peace, told The Wall Street Journal.

Officials also fear addiction, dependency and other social problems, according to Sheehan.

"They want to encourage people to be in actual, real-world relationships," Sheehan added. "Could we imagine a future where, three or four years from now, 15 million Chinese women say that their partner is a chatbot, and therefore they’re not having kids?"

The new rules require AI companion chatbots to pass a government review before being released to the public. The government will also have more authority to shut down services they consider unsafe, the outlet reported.

China’s restrictions go further than similar laws in California and New York.

Those two states require chatbots to remind users that they are not human and direct people that are experiencing a crisis to support services.

The crackdown comes as China faces a worsening demographic crisis. The country’s population declined in 2025 for the fourth consecutive year, while its birthrate fell to a record low, according to The Wall Street Journal.

At the same time, Beijing is also seeking to expand its influence over the future of artificial intelligence worldwide.

At a major technology conference in Shanghai on Friday, Chinese President Xi Jinping promoted open-source AI and pledged to help developing countries build their capabilities. Xi also warned that unequal access to AI could create "new historical injustices," according to Reuters.

https://www.foxbusiness.com/technology/china-cracks-down-chatbot-romances-birthrate-crisis-worsens-report

Pledging to 'rewire Britain', 'King of the North' Burnham becomes PM

 Andy Burnham, dubbed the 'King of the North', becomes Britain's seventh prime minister in a decade on Monday, promising to "rewire" the nation to better focus on issues people care about, such as a cost-of-living crisis and poorly performing services.

After Keir Starmer makes his farewell speech outside his Number 10 Downing Street office and tenders his resignation formally to King Charles, Burnham, a former mayor of Greater Manchester, will also meet the monarch to become prime minister.

Then the hard work begins.

Burnham, 56, faces a long list of problems, from Britain's underperforming utilities to anaemic economic growth, and must first unveil his top team of ministers - already the subject of much debate in the governing Labour Party.

BURNHAM TO LAY OUT NEW GOVERNMENT PATH

Describing his election to become Labour leader as "the most significant change moment in our politics for 40 years", Burnham has promised to radically change Britain's political system to quickly raise living standards.

"The government I lead will confidently lay that path out starting next week," he said on Friday when he promised to offer Britain the hope and change the country "was crying out for".

"It will take us to a country where life is more affordable and all people and places are lifted from where they are now."

That message was made directly to Labour lawmakers, who, after he returned to parliament last month, see him as one of the few politicians who can reduce the threat from veteran Brexit campaigner Nigel Farage's populist Reform UK party - something they doubted the unpopular Starmer could do.

Burnham's first hurdle will be the appointment of his cabinet team, particularly his choice of finance minister. Friction in this crucial partnership at the heart of government has led to the downfall of previous administrations.

An early frontrunner for the position, energy security and net zero minister Ed Miliband, has been on the receiving end of some hostile briefing and interior minister Shabana Mahmood now appears to be favourite for the job.

Burnham called on his party to ignore "speculation" on Friday and said he had not yet decided on his team.

His early policy decisions will also face scrutiny, with his team keen to move on with his agenda quickly.

On Sunday, one early move was to scrap plans for all employees to hold a digital identity document, a scheme designed to tackle illegal migration but deemed to be a "fiasco" by a cross-party committee of lawmakers.

More attention will be paid to Burnham's subsequent decisions, particularly on taxation and spending, oil and gas, and underperforming utilities companies, which he wants to see under stronger public control.

On Sunday, his ally, deputy Labour leader Lucy Powell suggested Thames Water, a debt-stricken utility, could be brought under "special measures", meaning it would operate under government control.

"He wants to refocus and reprioritise the government's resources, the government's attention onto his priorities of tackling the cost of living, really rewiring the way the country, the economy works," she told Sky News.

https://www.aol.com/articles/pledging-rewire-britain-king-north-230421000.html

‘It’s treatable’: MUSC specialist on cyclosporiasis, cause of ‘blow-out diarrhea

 “It’s treatable. It’s a spectrum. For bad, symptomatic cases, we prescribe a sulfa drug. It’s the treatment of choice for cyclosporiasis.” That drug, trimethoprim-sulfamethoxazole, is sold under the brand names Bactrim, Septra and Cotrim. “It will kill the pathogen and make you better, quicker,” Scott Curry MD, Medical University of South Carolina Health infectious diseases specialist, said.

https://www.musc.edu/content-hub/News/2026/07/17/its-treatable-musc-expert-on-cyclosporiasis-cause-of-blow-out-diarrhea

UK Biobank Study: Brain Aging Advances More Quickly for People With Metabolic Syndrome

 Middle-aged and older adults with metabolic syndrome had older-appearing brains, a large imaging study from the U.K. Biobank cohort suggested.

Participants with metabolic syndrome had a significantly higher brain age gap than those without metabolic syndrome (β=1.13), reported Abigail Dove, PhD, of the Karolinska Institute in Stockholm, at the Alzheimer's Association International Conference.

Brain age gap is the difference between a person's estimated brain age based on MRI and their chronological age. A positive brain age gap can be a predictive biomarker for cognitive decline.

The study findings, published in Alzheimer's & Dementia, suggest that metabolic syndrome -- a cluster of five risk factors for diabetes and cardiovascular disease including hyperglycemia, hypertension, central adiposity, low HDL cholesterol, and high triglycerides -- may represent a modifiable target to slow brain aging, Dove suggested.

Each individual component of metabolic syndrome was associated with older brain age. "The relationship between metabolic syndrome and older brain age was dose-dependent," she observed.

"People with three metabolic syndrome components had brains that appeared about 1 year older than expected based on their chronological age," Dove told MedPage Today. "This rose to 1.7 years with four components and 2.3 years with all five."

The risk factors encompassed in metabolic syndrome are highly modifiable through lifestyle changes, she emphasized. "Our findings have an empowering message that the more of these that can be brought under control, the better for brain health," Dove said.

More than one in three Americans has metabolic syndrome. It is associated with dementia and other neurologic disorders, though how it affects the brain is unclear.

Dove and colleagues studied 27,375 U.K. Biobank participants ages 40 to 70, classifying those with at least three of the five constituent components as having metabolic syndrome. On average, participants were age 54.9 at baseline and had brain MRI 9 years later. About half (46.4%) were college educated and most (93%) were white.

At baseline, 28.5% of participants met criteria for metabolic syndrome. The most prevalent component was hypertension (66.8%), followed by low HDL cholesterol (36.5%), elevated triglycerides (35.9%), central adiposity (24.7%), and hyperglycemia (14.0%).

Brain age was estimated with a machine learning model based on 1,079 phenotypes from MRI data that assessed regional brain volumes, white matter hyperintensities, microbleeds, white matter microstructural integrity, and functional connectivity during rest and during active engagement.

Baseline blood samples were used to assess levels of 33 plasma metabolites. Eight metabolites significantly mediated the association between metabolic syndrome and brain age gap, accounting for between 2.6% and 16.5% of the association.

"This might give us some hints at the pathway linking metabolic syndrome to brain aging," Dove noted.

The largest proportions of the association were mediated by fatty acids, including omega-6 and other polyunsaturated fats; glycated acetyls that indicated systemic inflammation; and apolipoproteins ApoB and ApoA1, markers of atherosclerosis.

People in the U.K. Biobank were substantially healthier, more socioeconomically advantaged, and less diverse than the general British population, the researchers acknowledged. Participants with neuroimaging and metabolite biomarker data were younger, more highly educated, and metabolically healthier than the overall U.K. Biobank sample.

Brain MRI data were available at one time point, limiting the ability to characterize longitudinal relationships between metabolic syndrome and brain aging.

Disclosures

Dove disclosed funding from Svenska Sällskapet för Medicinsk Forskning, Alzheimerfonden, the David and Astrid Hagelén Foundation, Demensfonden, the Loo and Hans Osterman Foundation for Medical Research, the Foundation for Geriatric Diseases at Karolinska Institutet, Stiftelsen för Gamla Tjänarinnor, and the Sigurd and Elsa Goljes Memorial Foundation.

Primary Source

Alzheimer's & Dementia

Source Reference: Dove A, et al "Metabolic syndrome is associated with accelerated brain aging" Alzheimer's Dement 2026; DOI: 10.1002/alz.71563.

https://www.medpagetoday.com/meetingcoverage/aaic/122257

KFF: A Sales Tax on Doctor Visits and Medicine? In Missouri, Some Worry

 Missouri healthcare advocate Leslie Ortbals and her husband want to start a family, but she worries they can't afford it. The 27-year-old said she takes 10 medications daily to manage multiple chronic illnesses.

Now she worries the cost of those drugs could rise -- not because of price increases, but because of a tax system revamp put on the ballot by the state's Republican-dominated legislature and backed by the Republican governor.

Prescription drugs and doctor visits are currently exempt from taxes in the state. But in August, Missouri voters will weigh in on a proposed constitutional amendment to give the legislature the power to replace the state's income tax with expanded sales taxes, including on goods and services currently exempt.

"Politicians want Missourians to trust them when they say not to worry about our medications and healthcare being up for grabs," Ortbals said at a June press event organized by Progress MO, a progressive advocacy group.

"I have spent enough time in Jefferson City to know better," said Ortbals, who works for a Democratic state legislator but was speaking in her personal capacity. "I have watched them speak about protecting life while making lifesaving healthcare less accessible."

Taxes on healthcare are unusual in the United States but not unprecedented. Most states already tax over-the-counter drugs. Illinois, Missouri's neighbor, is the only state to also tax prescription drugs. Delaware, Hawai'i, New Mexico, and Washington all have taxes on services by physicians, dentists, out-of-hospital nursing providers, and medical laboratories.

Critics of the amendment to eliminate income tax in Missouri say it'd be difficult to make up the lost revenue without also imposing taxes on healthcare. Nearly two-thirds of the state's general revenue budget comes from income taxes, about $8.7 billion in 2026. Failing to make up that revenue could lead to steep cuts in state services.

The proposed tax cut comes at an already precarious time for the state budget. Missouri Gov. Mike Kehoe (R) restricted about $440 million in spending in this year's budget over concerns of lagging revenues. The state legislature has passed a series of tax cuts since 2022, including repealing capital gains taxes. Federal COVID aid has propped up the budget in recent years, but the state's auditor recently warned that the surplus is dwindling. And the state is projected to lose about $14 billion in federal Medicaid funding over 10 years due to cuts from President Donald Trump's signature One Big Beautiful Bill Act.

Proponents of the Missouri income tax proposal, such as Elias Tsapelas of the Show-Me Institute, a conservative think tank, say the cut would spur economic and population growth in the state, both of which have been flat in recent years. He doubts healthcare would be among the things subject to sales tax. But even if it were, he said, it could be done in ways that wouldn't target lower-income residents. New Jersey, for example, taxes cosmetic procedures (excluding reconstructive surgeries), which tend to be performed on wealthier people.

In a statement to KFF Health News, Kehoe spokesperson Gabby Picard said the governor "will never support extending sales taxes on agriculture, healthcare, or real estate," noting that the legislature would have to decide what to exempt if the ballot measure passes.

Federal law already prohibits states from imposing taxes on many healthcare services covered by government programs such as Medicare, the federal health insurance program for seniors, and Medicaid, the joint state-federal health insurance program for people with low incomes or disabilities, Picard wrote. More than a third of Americans were insured through those two programs in 2024.

But Jay Hardenbrook, advocacy director for AARP Missouri, argued that raising taxes on healthcare, real estate, and agriculture is the real reason for the amendment, considering the legislature doesn't need special permission to cut income taxes. He cautioned that because the amendment opens the door to new taxes on anything, it could unleash a "weird feeding frenzy" with special-interest groups lobbying for exemptions.

"Let's say we do protect prescription drugs from a tax increase; does that mean that the cost of food goes up?" Hardenbrook said.

And if the Missouri measure passes and the legislature exempts healthcare and real estate from new taxes, Hardenbrook worries about cuts to state-funded services like home- and community-based care.

"When I talk about taxes going up, and the price of every good and services going up, that's the best-case scenario," Hardenbrook said. "The worst-case scenario is that the income tax just goes away, and we just don't have the money to do the things that we need to do."

Eight states have no income tax, and Washington taxes only capital gains, but Carl Davis of the Institute on Taxation and Economic Policy, a progressive think tank, said the way Missouri is going about its elimination is nearly unprecedented. Only Alaska has repealed a broad-based personal income tax that had previously accounted for a significant portion of the state budget, Davis said.

"The situation in Alaska was they struck oil, and they had this gusher of economic activity and tax revenue that resulted from that," Davis said. "Missouri has not struck oil."

A 2012 tax cut in Kansas that reduced income taxes for individuals and eliminated them for some types of businesses created a large budget hole, prompting lawmakers there to largely repeal the cuts 5 years later.

Tsapelas of the Show-Me Institute said Missouri's income tax elimination wouldn't happen overnight but would instead be more akin to recent income tax reductions in the state: phased in and tied to revenue targets that would shield the state from massive budget gaps.

"It's not as doom and gloom as some people are worried about," Tsapelas said.

But Ortbals, the healthcare advocate, said too many Missourians are already delaying medical care because of costs.

"I want a Missouri where young people can afford to stay, where families can afford to grow, where chronic illness does not become financial ruin," Ortbals said.

https://www.medpagetoday.com/publichealthpolicy/publichealth/122231