It is reasonable to reduce equity risk in light of high valuation and many uncertainties. Bonds got complicated with stronger employment number than expected. Is it a one off or not?
Now that the generous 5% yield in Monet market, CD, and T bills have disappeared since the FED cut rate in September. So either the investors accept lower yields or take a bit more risk to invest in short term bonds. @catch's bond data reported above point to where one can invest in.

@bee I'm not sure I like the wording, "government transfers." I take it as a gift from the gov., which most of it isn't. VA Benny's all earned as is my SS monthly check.

It's a very interesting topic and can appear convoluted. Couldn't an argument be made that we (the public) transfer more of our money to the government than we did years ago?
Take the lottery for example. I see this as both public/government transfer. Wish I was on the winning end of the these transfers.
Taxes are public transfers to the government that hopefully become government transfers to build bridges and roads, fund public safety and education, arm the military. Let's not forget the government transfers that pay for a growing number of government salaries.
Others:
SS= runs partially on (earned income) public transfer - it needs to balance out with future public transfers = or > government transfer to SS recipients.
Medicare = Pooled Public transfers "in" by way of premium payments...shared payment out by way of government payments and public co-payments for medical services.
Medicaid = Appears a one way Government Transfer out, but there must be a public funding source for medicaid, right?

How does Medicaid financing work?
Medicaid financing is shared by states and the federal government with a guarantee to states for federal matching payments with no pre-set limit. The percentage of costs paid by the federal government varies for specific services and types of enrollees and depending on whether the costs are for medical care or program administration.
The federal share of spending for services used by people eligible through traditional Medicaid, which includes individuals who are eligible as children, low-income parents, because of disability, or because of age (65+), is determined by a formula set in statute. The formula is designed so that the federal government pays a larger share of program costs in states with lower average per capita income. The resulting “federal medical assistance percentage” or “FMAP” varies by state and ranged from 50 percent to 78 percent for FFY 2023 (Figure 5).
States can use provider taxes and IGTs (intergovernmental transfers) to help finance the state share of Medicaid. States have some flexibility to use funding from local governments or revenue collected from provider taxes and fees to help finance the state share of Medicaid within certain limits and rules. Provider taxes are an integral source of Medicaid financing, comprising approximately 17% of the nonfederal share of total Medicaid payments in SFY 2018 according to the Government Accountability Office (GAO). All states (except Alaska) have at least one provider tax in place and many states have more than three (Figure 8). The most common provider taxes are on nursing facilities (46 states) and hospitals (44 states). As of July 1, 2022, 32 states including DC also reported at least one provider tax that is above 5.5% of net patient revenues, which is close to the maximum federal safe harbor or allowable threshold of 6%. Federal action to lower that threshold or eliminate provider taxes, as has been proposed in the past, would therefore have financial implications for many states.
The most common Medicaid provider taxes in place in FY 2022 were taxes on nursing facilities (46 states), followed by taxes on hospitals (44 states), intermediate care facilities for individuals with intellectual disabilities (33 states), and MCOs7 (18 states).
https://kff.org/report-section/medicaid-budget-survey-for-state-fiscal-years-2022-and-2023-provider-rates-and-taxes/

Bottom line, we pay more today in public transfers to local, county, state, and federal governments so they can orchestrate these transfers out.
I might imagine that years ago a larger proportion of these transfers and services happened between the public and private organizations - churches, non-profits and philanthropy.
IMHO we have grown governments along with the growth of these government transfers.
Maybe its time to review the role of government regarding both sides of these transfers.

The source link for these rough calculations is below. If anyone has another method of calculation; please let us know. The calculator uses a standard CPI government number. Whether you agree or not; this is the method used for various COLA's to the best of my knowledge. Having a COLA for a pension or SS is valuable. For those fortunate enough to have a pension, let alone a COLA; you should be 'happy'.
I'll use 10 years looking back, to present, as a sample; with $1,000 as a base number.
YES, there numerous types of CPI; including formulas that do not use government methods.
IF one had SS or a pension paying $1,000/month in 2014, then the following numbers seem to apply:
--- Pension, no COLA: One still has a $1,000 monthly payment, but the 'purchasing power is NOW $670 from 10 years ago .
--- Pension w/COLA: One's monthly payment may now be in the range of $1,332.
*** A very large gap in those two numbers in 2024, eh?
Annual in 2024:
Pension w/o COLA = $8,040
Pension w/COLA = $15,984
Compounding operates in two directions !!!
HEY, I/we need to know if there is a large mistake with this math.
Calculator source

@msf Appreciate the detailed explanation. All of the gory details and granular ins-and-outs and contingencies and add-ons and options, etc. only show what a broken non-system we have. Thanks for the corrections, too. Yes, Single-Payer, gummint-operated stuff will be, no doubt, a cluster-flop, too. ... Dental is not included, though. And I still do better getting some of my 'scripts via Canada.

I am so confused to read complaints like this from someone in Massachusetts and others about costs and screwups. Depending on Mass. county, Tufts and BCBS alike (nonprofits, or so they say) offer MA policies that are zero-premium, include (at least Tufts) serious, meaning $1500, dental prepaid card, modest eyeglasses and less-modest ($240) OTC benefits, and on and on. No referrals, huge network (or so it seems for our many docs).
My wife and I switched to Tufts Access PPO a year ago and have never given any care a second thought, even after I was hit by a car and needed all sorts of expensive care. BCBS has something similar and competitive.
Zero or low costs for all our meds too (Optum, Costco, CVS).
I am studying 2025 details to see what is going to get worse. But anyone in Mass. who has not delved at least Tufts Access PPO may be missing out bigtime.

I saw an S&P target of 8,000 by the end of the decade from a perma bull. While that number looks big, it is only about 33% over the next six years. That comes to about 5% per year or 6% inclusive of dividends and an equity risk premium of only 2% at the current 10 yr yield of 4.10%. I am tempted to reduce equity exposure in favor of high yield corporate bond fund(s) yielding at 6+%.

At this point, I have chosen peace of mind with no medical bills over lowest cost.
As I said, as I get older, one thing less to worry about in my life might be worth the extra $372 a year.

Same here. That amounts to the current combined amount I collect monthly from my bond funds. And we live beneath our means already, so... It's not missed.

@msf
My wife and I have been with Traditional Medicare and a medicare supplemental plan over 7 years and have never had to communicate an appeal, request authorization, denied coverage, or received a bill during that time. I can see any doctor who accepts Medicare anywhere in the country.
I choose the peace of mind that I’ve experienced with Traditional Medicare and Supplemental plan even though it costs me more in the short term; and even though the supplemental plan increases each year, I know there will be no surprises with accessing the health care, I or my wife needs.

Well said, exactly the same reasons why I chose to stay in Original Medicare Plan F.
May I also add that I just spoke to a friend of mine who is a retired NYC schoolteacher. He told me that when the City first rolled out its Medicare Advantage Plan, the retirees were assured that any doctor who accepts Original Medicare would also accept the City's new Advantage Plan. However, all of my friend's doctors told him that they do not accept any Advantage Plan, period. They most frequently mentioned the onerous procedure they would have to follow of obtaining access to critical medical care for their patients through pre-authorizations.

@Level5
Thanks for the well stated post. I agree that much of this comes down to trust, which is a variant of what @fred495 originally expressed as peace of mind.
Your supplemental plan, whether it is NYC's Senior Care or a standard Medigap plan (A-N), is provided by the same "dishonest" insurance companies that provide MA plans. So some trust in these companies is still needed. Though perhaps because less can go wrong with supplemental plans they are easier to trust. Or perhaps seven years of good experience has made your provider more trustworthy.
Not all MA providers are out for profit. Some, like HealthFirst, like the "Blues" that haven't yet gone over to the dark side (switching from not-for-profit to for-profit), aren't driven by making money. Maybe that makes a difference. I don't know. Though I agree that there is something off putting about profiting from, effectively, someone's misery.
For me, I've had more hassles with insurers because of incompetence than because of what motivates them.
Quick example: my SO and I had the same policy, went to the same PCP on the same day, had the same blood test. One of us was charged a $20 copay, the other was charged $0. I recognized this as a coding problem. One had been coded as a lab procedure ($0 copay), the other as a diagnostic test ($20 copay).
The insurer refused to acknowledge that this inconsistency proved that something was wrong. I had to go to the state attorney general's office (they have a special department to handle this stuff) to get the insurer to fix things. On principle.
I did mention last court decision, but dismissed it as nothing substantial: "Nothing new aside from the injunction being sustained on appeal."
With any luck, Adams won't be the one pressing on much longer. Can I say that, or is it too political? :-)

@msf
First, let me say that I enjoy your investment contributions on this site. You take a focused and analytical approach to data, which is well thought-out and clearly outlined. I appreciate it. You have carried that forward in your response to me about MA plans and what they are *required* and *should* provide. For me, there is a trust issue at stake, especially as my wife and I age, requiring more anxiety provoking health services.
My wife and I have been with Traditional Medicare and a medicare supplemental plan over 7 years and have never had to communicate an appeal, request authorization, denied coverage, or received a bill during that time. I can see any doctor who accepts Medicare anywhere in the country. All of these items are advertised as policy for MA Plan.
But what I keep in mind is that all MA Plans are private companies whose overarching principle is to generate profits. That in itself is not a bad thing. I invest my money with companies to generate an income. But I think health care is a different entity completely, and I do not trust that drive for profit in this case.
So I do not dispute what you’ve posted (with one exception - the last court decision was 5/2024; Adams continues to press on). I choose the peace of mind that I’ve experienced with Traditional Medicare and Supplemental plan even though it costs me more in the short term; and even though the supplemental plan increases each year, I know there will be no surprises with accessing the health care, I or my wife needs.
Simply put, it comes down to - “who do you trust?”

For a review of the history of our struggle to maintain our choice of health services you can visit one of the union sites here: https://psc-cuny.org/whats-happening-retiree-healthcare/
This is old news because basically nothing has changed since August 2023, when the injunction barring NYC from implementing its retiree health plan switch was made permanent. Nothing new aside from the injunction being sustained on appeal.
Since you brought up PSC CUNY, it is worth mentioning that its retirees have their own drug plan which they would not lose in a move to Aetna.
Looking at the appellate ruling, it is predicated on "Many City retirees [having] stated that their chosen providers and hospitals, like many healthcare providers, do not accept the MAPs [Medicare Advantage Plans]."
However, when using a PPO, it doesn't really matter whether a chosen provider accepts the PPO. If you go to an out-of-network provider who accepts Original Medicare, you're covered.
There are three possibilities:
1. The provider, though out-of-network, bills the PPO. I have an out-of-network provider that does this. The amount of the bill is set by law (see below) so long as it is a Medicare provider and you are enrolled in Medicare (any form, original or MA).
Your PPO pays the provider (even though out of network), less your cost-sharing portion. The provider may not take Aetna, but it will not turn down a check from Aetna. The provider then bills you the remaining balance, i.e. your cost-sharing amount.
2. You are presented a bill that you can pass along to your PPO. From there, things proceed as above.
3. The provider insists on immediate payment. I have another out-of-network provider that does this. You pay the bill and then send it along with a receipt to the PPO for reimbursement. You get reimbursed for all but your cost-sharing amount.
No matter what the procedure, at the end of the day you wind up paying just the cost-sharing amount stated in the Evidence of Coverage for the out-of-network service.
The three possibilities above are just expositions of Aetna's Evidence of Coverage:

It is best to ask an out‑of‑network provider to bill the plan first. But, if you have already paid for the covered services, we will reimburse you for our share of the cost for covered services. Or if an out‑of‑network provider sends you a bill that you think we should pay, you can send it to us for payment.

https://www.nyc.gov/assets/olr/downloads/pdf/rfp/ma-hearing/cony-ma-eoc-soc-02102023.pdf
------------------
There is a federal law, §1852(k)(1) of the Social Security Act, that says that a Medicare provider cannot charge anyone enrolled in Medicare Advantage (originally called Medicare+Choice) more than it would charge a person enrolled in Original Medicare.
https://www-origin.ssa.gov/OP_Home/ssact/title18/1852.htm
This is what makes Medicare PPOs work. If you're covered by a PPO other than Medicare Advantage (e.g. an employer plan), then a provider can charge whatever. The PPO insurer will pay only a UCR (usual, customary and reasonable) amount that it itself determines. This nearly always leaves you owing more than the policy cost sharing amount.
For example, suppose a doctor bills $100 and your stated copay is $10. If the insurer decides that the doctor should get only $50, then it will pay the doctor $40 ($50 minus your $10 copay). You'll get stuck paying the $60 difference. That shouldn't happen under Medicare since a billed amount is not subject to a provider's whim.

Just speaking for my own state, the counties shown has collecting the most in government transfers are also the ones with the most ardent 45 supporters despite facts and data suggesting that they will be the same ones hurt most by his intended policy's and intentions. I suspect that's true across the nation.

NOTE:

My intention, at this time; is to present the data for the selected bond sectors, as listed; through the end of the year (2024). This 'end date' will take us through the U.S. elections period, pending actions/legislation dependent upon the election results, pending Federal Reserve actions and market movers trying to 'guess' future directions of the U.S. economy. As important during this period, are any number of global circumstances that may take a path that is not expected; and/or 'new' circumstances. In the 'cooking pot' we currently have the big ingredients of the middle east and also, how much damage Ukraine may inflict upon Russia and the response.

NOTE TWO: I MAY NOT have a report next week, as the Shop Vac comes out on Friday to remove my gall bladder. I don't know what condition, my condition will be in..... :)
FIRST: The NEWS is very full of elections info and the terrible hurricane(s) reports and the resulting suffering. Ukraine and Russia are still busy with war. And is Lebanon entering a period of becoming a GAZA-fication relative to infrastructure and death? Song lyrics arise: "No where to run to, no where to hide."
W/E October 11 , 2024..... Make your best guess week for bond NAV's
--- I was away from market news for the week, so I only have bits and pieces of the weekly picture based on the NAV's. This week found the w/e NAV price results for many of the bond sectors to have followed the overall trend for the majority of the week; down, down, down. The weekly broad bonds sectors found the long duration to be out of favor, some of the short duration had modest gains and shorter duration TIPS were more happy. The MINT etf, to the best of my recall, has maintained a positive price for the year, each and every week; and these remains for this week.
A few numbers for your viewing pleasure.
NEXT:
*** UST yields chart, 6 month - 30 year. This chart is active and will display a 6 month time frame going forward to a future date. Place/hover the mouse pointer anywhere on a line to display the date and yield for that date. The percent to the right side is the percentage change in the yield from the chart beginning date for a particular item. You may also 'right click' on the 126 days at the chart bottom to change a 'time frame' from a drop down menu. Hopefully, the line graph also lets you view the 'yield curve' in a different fashion, for the longer duration issues, at this time. Save the page to your own device for future reference. NOTE: take a peek at the right side of this graph to find the yield swings of the past week, and for the current yields for the last business day.
For the WEEK/YTD, NAV price changes, October 7 - October11, 2024
***** This week (Friday), FZDXX, MM yield continues to move with Fed funds/repo/SOFR rates; and ended the week at 4.67% yield (no change). Fidelity's MM's continue to maintain decent yields, as is presumed with other vendors similar MM's. Theoretically, a new yield bottom is in place, until the next FED action. SO, one is still obtaining a decent MM yield. MOST MM's found a few hundreds basis drop in yield for the week.
--- AGG = -.46% / +3.03% (I-Shares Core bond), a benchmark, (AAA-BBB holdings)
--- MINT = +.14% / +4.75% (PIMCO Enhanced short maturity, AAA-BBB rated)
--- SHY = +.02% / +3.57% (UST 1-3 yr bills)
--- IEI = -.23% / +2.98% (UST 3-7 yr notes/bonds)
--- IEF = -.63% / +2.06% (UST 7-10 yr bonds)
--- TIP = +.08% / +4.02% (UST Tips, 3-10 yrs duration, some 20+ yr duration)
--- VTIP = +.23% / +4.78% (Vanguard Short-Term Infl-Prot Secs ETF)
--- STPZ = +.30% / +4.72% (UST, short duration TIPs bonds, PIMCO)
--- LTPZ = -.76% / +2.11 % (UST, long duration TIPs bonds, PIMCO)
--- TLT = -1.94% / -2.41% (I Shares 20+ Yr UST Bond
--- EDV = -2.82% / -5.42% (UST Vanguard extended duration bonds)
--- ZROZ = -3.19% / -7.78% (UST., AAA, long duration zero coupon bonds, PIMCO
--- TBT = +4.09% / 11.98% (ProShares UltraShort 20+ Year Treasury (about 23 holdings)
--- TMF = -5.85% / -20.09% (Direxion Daily 20+ Yr Trsy Bull 3X ETF (about a 2x version of EDV etf)
*** Additional important bond sectors, for reference:
--- BAGIX = -.40% / +3.45% Baird Aggregate Bond Fund (active managed, plain vanilla, high quality bond fund)
--- LQD = -.64% / +3.50% (I Shares IG, corp. bonds)
--- BKLN = +.33% / +6.39% (Invesco Senior Loan, Corp. rated BB & lower)
--- HYG = -.04% / +7.63% (High Yield bonds, proxy ETF)
--- HYD = -.23%/+5.36% (VanEck HY Muni)
--- MUB = -.21% /+1.67% (I Shares, National Muni Bond)
--- EMB = -.49%/+7.33% (I Shares, USD, Emerging Markets Bond)
--- CWB = +1.03% / +8.71% (SPDR Bloomberg Convertible Securities)
--- PFF = +.24% / +11.65% (I Shares, Preferred & Income Securities)
--- FZDXX = 4.67% yield (7 day), Fidelity Premium MM fund
*** FZDXX yield was .11%, April,2022. (For reference to current date)
Comments and corrections, please.
Remain curious,
Catch

Similar story in CT.
We continue to have a "choice" (Medicare Supplemental vs Medicare Advantage) but the premium difference between the two attracted a lot of retirees to sign up for our MA option.
Both are offered by United Healthcare.
Curiously, that premium difference was a factor of 10X for 2024, with UHMA being 10X cheaper. Now that a large number of retirees have this UHMA plan, UHMA tripled their premium for 2025. The United Healthcare Medicare Supplemental plan premium actually decreased about 3% for 2025.
Seems like a pure bait and switch with the UHMA choice.

@msf @fred495 I am one of those NYC retirees, of which there are over 250,000 of us, represented by multiple unions (firefighters, EMT, teachers, etc). Prior to the MA proposals we had a choice of multiple plans. However, both the first proposal between two private health insurance companies, and the second cobbled together by Aetna, if approved, would have removed any choice, and forced us into the MA plan.
The political and legal shenanigans which took place by the current city administration over the past 2+ years have been repelled in court in multiple cases. This is not “old news.” The Adams administration has continued to appeal the court decisions.
The majority of NYC retirees do not want to lose our choice of health care plans which were part of the hiring package and promise to us, and that access to traditional medicare would always be available to us.
For a review of the history of our struggle to maintain our choice of health services you can visit one of the union sites here: https://psc-cuny.org/whats-happening-retiree-healthcare/
My apologies for going off topic, but the tangential topic of the NYC retirees, issue with health care, required some background info. The reasons for our push-back are already embedded in earlier posts.

Out of curiosity, I checked my local area in IL. It shows 94 plans in my local area.
50 MAPD & MA plans from Aetna, BCBS, Cigna, Humana, United Healthcare, Wellcare
29 Medigap plans from BCBS, Cigna, Humana, Mutual of Omaha
15 Part D plans from Aetna, BCBS, Cigna, Wellcare, United Healthcare
Fido About Us indicates some selectivity is involved. It shows pictures of 3 licensed agents.
https://medicare.fidelity.com/about-us/
"Insurers we work with
We offer many high-quality plan options from trusted, vetted insurance companies. We choose insurance companies based on their:
Range of plan options, including additional benefits and discounts.
Commitment to high-quality customer service.
Ability to effectively serve customers in your area."
It seems that access to the database is open and by Zip Codes - no login required. An interesting resource to start with. Apparently, this phone service is complimentary. Fido probably gets some referral bonus or fees to put plans on this platform.

You're talking about old news here. I'll have to dredge up old links from when this was new news and I was talking about it with some NYC retirees. As I recall, neither side was being especially honest. And there was an earlier proposal for coverage provided by a joint operating agreement (or some such entity) created by two different insurers.
Most of your post (2+ of 3 paragraphs) talks about how unethical, money hungry the health care insurers are. No argument there. If your position is one of principle, how does that comport with buying Supplemental Medicare insurance from one of these private insurers?
"four of the five largest players – UnitedHealth, Humana, Elevance [formerly Anthem] and Kaiser – have faced federal lawsuits". Can we infer that the fifth in that group of largest players has not faced federal lawsuits? That would be CVS (Aetna), the insurer that NYC planned to use.
https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2024-enrollment-update-and-key-trends
"NYC retirees age 65+ and their eligible dependents have ... choices in how they receive their retiree health insurance benefits, with the vast majority of retirees in either HIP VIP HMO, or GHI Senior Care."
https://bplc.cssny.org/blog/nyc-retiree-health-benefits-update
HIP and GHI are insurance brands of EmblemHealth, a large regional health insurance provider. Senior Care is a "supplemental coverage plan that works with Original Medicare. HIP VIP HMO is exactly what it sounds like - an HMO. Since it is an Emblem plan, it is regional and retirees must be living in the NYC area to use it. Retirees (especially ones out of town) can also choose among other HMOs and PPOs.
https://www.nyc.gov/site/olr/health/retiree/health-retiree-choosing-a-health-plan.page
This chart (link below) compares the existing (VIP HMO and Senior Care) plans with the proposed Aetna plan. On features and value, Aetna comes out even or slightly ahead.
https://www.nyc.gov/assets/olr/downloads/pdf/health/aetna-ma-docs/plan-comparison-chart-seniorcare-hip-aetna.pdf
The union members raised many objections, such as: "concerns that retirees will be stuck with a smaller network of providers and larger out-of-pocket costs." The above cited chart says otherwise.
OTOH, the added preauthorization requirement for some procedures would be a real, change, and the only substantial objection that I found credible. The KFF study reports that over 90% of preauthorization requests are granted in full for MA insurers generally.
In court, Aetna submitted figures for its own plans. "According to Aetna, out of more than 82 million claims under its Medicare Advantage plans last year, only 3.4% were subject to prior approval, and 0.49% were denied."
https://gothamist.com/news/aetna-reveals-health-care-denial-rates-in-medicare-advantage-court-case-for-nyc-retirees
That 0.49% may not give you peace of mind, but then again, Original Medicare also denies some procedures.
P.S. When people quote from articles (or even paraphrase) it would be nice if they would cite the articles. The NYTimes article is here:
https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html
Regarding Aetna, it says: "The fifth company, CVS Health, which owns Aetna, told investors its practices were being investigated by the Department of Justice." That was two years ago. Any updates?

The Week in Charts (10/11/24)
The most important charts and themes in markets and investing, including:
00:00 Intro
00:16 Free Wealth Path Analysis
00:54 Topics
01:41 Rising Prices at a Slower Pace
06:05 Market Expectations = Fed Expectations
13:24 The Rate Cut Tradeoff
16:39 Why Mortgage Rates Rose After the Fed Cut
21:50 What Are They Trying to Hide?
24:55 The Goldilocks Moment
29:56 Rising Real Wages
Video
Blog - 10/11 blog not currently available

I'm not going to try to dissuade you from staying with Plan F. Peace of mind has a certain intangible value that for you exceeds $372.
Regarding absence of bills with Plan F, that's the theory. And at worst, you may get a couple of bills that you're not responsible for paying. But you still have to deal with them. Crash gave an example. The result of our crazy quilt insurance system. [...]
"require prior authorization ... probably the reason why most good doctors shy away from Advantage plans". We can test that theory. Do most good doctors shy away from all commercial insurance - employer sponsored, ACA, etc.? The vast majority of these policies also require prior authorizations. [...]

Well, despite Crash's example, all I can say is that I have been on Plan F for over a decade and have never received a medical bill in my mailbox.
Regarding prior authorization, I recently came across an article in a local paper (City&State) regarding the so far unsuccessful efforts by the City of NY to force its retired employees from Original Medicare into an Aetna Medicare Advantage Plan. Here is an excerpt: "Opponents of Medicare Advantage say that the privately-managed plan will make it more difficult for retirees to receive care, citing investigative reports in The New York Times and Kaiser Health News that documented how private plans were ripping off the federal government while restricting retirees’ access to critical medical care through pre-authorizations.
The Times investigation, published in October, ran under the headline: “‘The Cash Monster Was Insatiable’: How Health Insurers Exploited Medicare for Billions – By next year half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers have been accused in court of fraud.”
According to the Times, “eight of the 10 biggest Medicare Advantage insurers – representing more than two-thirds of the market – have submitted inflated bills, according to the federal audits. And four of the five largest players – UnitedHealth, Humana, Elevance and Kaiser – have faced federal lawsuits alleging that efforts to over diagnose their customers crossed the line into fraud. … The additional diagnoses led to $12 billion in overpayments in 2020, according to an estimate from the group that advises Medicare on payment policies – enough to cover hearing and vision care for every American over 65.”

@BB
I have to admit that I am puzzled by your disappointment at this fund on the basis of a single data point -- 6 month returns.
Here are the metrics I see(per PV) and why I continue to hold. The 25% cash position does not bother me and I'm comfortable with managers being contrarian, not following the herd and willing to sacrifice short term returns in the interest of the long term.
From 1/1/21 to 9/30/24 as compared to VWELX
- CAGR 15.24% v 7.83%
- MaxDD -10.16% v -20.22%
- Sortino 1.78 v 0.68
- 3 month return 5.13% v 5.17%
- YTD return: 16.86% v 13.82%

Fidelity has gotten into the Medicare brokerage business. I just sent them a note because, as I conclude in the note, it doesn't yet seem ready for prime time.
My note to Fidelity:
I ran across this service at:
https://medicare.fidelity.com/home/
I don't need help but wanted to give you some feedback. First, it isn't clear to me what the value-add above Medicare.gov is, unless one speaks to a Fidelity agent.
More importantly it omits several providers, notably HealthFirst in NYC. According to its website, HealthFirst has more Medicare Advantage customers in the NY metropolitan area than any other insurer. FWIW, it's a good insurer - I used one of its ACA plans.
It looks like the only companies that Fidelity is listing are national (as opposed to regional) insurers: United Healthcare, Aetna, Cigna, Wellcare (Centene), Anthem. That may make sense from Fidelity's perspective, but it can steer people away from other plans that might suit them better.
A note advising that this is not a complete list of available plans might help.
In New York, Fidelity only shows two companies for Medigap plans, Humana and Mutual of Omaha. It omits even some national carriers like United Healthcare and Globe
Also problematic is omission of information. For example, Cigna True Choice Medicare PPO (Plan H7849-082-000) has a $25 copay for PCP out of network. Fidelity doesn't show this. Likewise, there is a $60 copay for specialists out of network that Fidelity doesn't show. And so on.
I like Fidelity for one stop shopping (e.g. HSAs). But this particular service does not yet seem ready for prime time.