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New Social Security requirements would be nearly impossible to meet without help in rural communities that lack internet, transportation

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Veronica Taylor doesn’t know how to turn on a computer, let alone use the internet.

The 73-year-old can’t drive and is mostly housebound in her mountainous and remote West Virginia community, where a simple trip to the grocery store can take an hour by car.

New requirements that Social Security recipients access key benefits online or in person at a field office, rather than on the phone, would be nearly impossible to meet without help.

“If that’s the only way I had to do it, how would I do it?” Taylor said, talking about the changes while eating a plate of green beans, mac and cheese and fried fish with a group of retirees at the McDowell County Senior Center. “I would never get nothing done.”

The requirements, set to go into effect March 31, are intended to streamline processes and combat widespread fraud within the system, according to President Donald Trump and officials in his administration.

They say that’s why it’s vital for people to verify their identity online or in person when signing up for benefits, or making a change like where the money is deposited.

But advocates say the changes will disproportionately impact the most vulnerable Americans. It will be harder to visit field offices in rural areas with high poverty rates. Often these are the same areas that lack widespread internet service.

Many Social Security field offices are also being shut down, part of the federal government’s cost-cutting efforts. That could mean seniors have to travel even farther to visit, including in parts of rural West Virginia.

Donald Reed, who runs a local nonprofit that operates two senior centers, said he has serious concerns about the policy change, and how it’ll affect the people his group serves.

“I’m not anti-Trump — let me say that,” he said. “I think the general public greatly supports looking for waste in government. I do not think the general public understands the consequences of the current actions of the government.”

Poor, rural areas could be hardest hit

One in three people live in poverty in McDowell County, once one of the nation’s largest coal producers. Around 30% of the population receives Social Security benefits and 20% lack broadband access. People already face huge challenges in accessing basic needs like food and clothing.

Non-profit groups like The Commission on Aging receive money from the federal government to provide rides to the grocery store, medical appointments and free lunch at the county senior center, and could in theory add a stop to the local Social Security office said Reed, who is the group’s director.

But the transportation grant money is already not enough to meet the need. Last year, Reed ran out of money during the last three months of the fiscal year and had to dip into the Commission’s savings. This year, he said he won’t be able to do so.

Then, last Friday, he found out the Commission had lost an almost $1 million grant he expected, again because of the federal government’s cost cutting.

He had planned to use the money to rebuild one of the two county senior centers, an aging 1980s-era doublewide trailer with limited seating.

“Once the money’s gone, you know, the money’s gone,” he said.

A flurry of new rules, hard for seniors to follow

Seniors at the center gather each weekday for lunch. Usually, they might play bingo or cards. On this day, because of the presence of a reporter from The Associated Press, the conversation turned to politics.

Many are Trump supporters. Every county in West Virginia supported Trump in three presidential elections.

Yet all agreed that the recent flurry of executive orders had been difficult to follow, especially since the county’s last local newspaper shuttered, and they weren’t sure what effect they’d have on their lives.

“I don’t understand a lot of the stuff that’s going on right now, and I just can’t pinpoint things together, you know,” said Brenda Hughes, 72, who said she usually goes to the Social Security office in person anyway because she said she’s found it difficult to get a hold of the call center. “But maybe it’s meant to be like that.”

Mary Weaver, 72, said she doesn’t approve of Trump giving Elon Musk so much leeway to cut and change services, and she doesn’t see those measures helping McDowell County.

“He gone run for president, and he’s going to get the presidency, but he’s going to let someone else tell him how to run the country?” she asked, criticizing Trump’s relationship with Musk.

Other residents aren’t concerned. Barbara Lester, 64, said she wishes she could sit down with Trump and Musk and tell them they’re doing a fantastic job.

“And with all the money they’re saving from the fraud, they could afford to give their senior citizens an increase,” said Lester, who is retired from construction work.

But for Taylor, who depends on rides from the aging commission for most of her outings, the changes to Social Security may be just one more thing that will be difficult.

There are already many places she wants to go and can’t get to. None of her grandkids live nearby, her daughter lives in Roanoke, Virginia, and her 39-year-old son, who used to live in the Welch area near her, died. The walk from her house to the Social Security office is six miles.

“If I ask people more than two times to take me somewhere, it’s like begging. And I don’t beg nobody to do nothing for me,” she said. “I’m independent like that. I don’t beg nobody for nothing.”

This story was originally featured on Fortune.com



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Ozempic and Wegovy are trimming waistlines—and showing how quickly U.S. health care can turn into a gold rush

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Is there anything GLP-1s can’t do? Diabetes and obesity are increasingly looking like the tip of the semaglutide iceberg. The Food and Drug Administration (FDA) has approved Wegovy for cardiovascular disease, and researchers are now exploring the potential of GLP-1s for a host of conditions, including asthma, arthritis and psoriasis, certain liver diseases, depression, eye disorders, Alzheimer’s, and substance use disorders. A recent study even found GLP-1s may reduce the risk of 10 different cancers.

The growing list of potential GLP-1 indications suggests the drugs may target the root cause (inflammation, probably) of the most prevalent and costly conditions in the U.S. If even a fraction of the trials now underway pan out, GLP-1s have the potential to reshape health care as we know it.

But they can’t solve everything. In fact, the GLP-1 phenomenon is making the fragmentation and dysfunction of our health care system even more apparent. Just as GLP-1s may help us discover the common denominator in seemingly disparate diseases, they are shining a bright light on the root causes of the health care system’s ills.

Drugs are too expensive

The price tag of GLP-1s in the U.S.—up to $15,000 per year, far higher than in other affluent countries—has become one of the single biggest drivers of rising health care costs. Private employers, already facing an unsustainable cost trend, are feeling the pressure from their workforce to cover the drugs, yet they quite literally may not be able to afford it. Some studies suggest widespread GLP-1 adoption, absent cost controls, could bankrupt Medicare and the health care system as a whole.

GLP-1s are also shining a harsh light on the inefficiency and inequity in health care. Those who can afford to pay out of pocket are gobbling up the supply of GLP-1s (in some cases for vanity use), while access remains limited for people on Medicare or Medicaid who are disproportionately burdened by obesity and diabetes. For example, Eli Lilly’s recent move to slash the price of Zepbound only applies to patients paying out of pocket; and at several hundred dollars per month, even the markdown price is out of reach for many.

GLP-1s shows how quickly health care can turn into a gold rush

Pharmaceutical companies, telehealth providers, and even supplement sellers are marketing GLP-1s directly to consumers to meet the runaway demand. Exploiting a loophole resulting from the GLP-1 shortage, some providers are prescribing compounded generic versions of the drugs that the FDA has warned may be unsafe.

This is a prime example of the limitations of the transactional Telehealth 1.0 model and the dangers of consumerism running amok. Patients can easily get compounded GLP-1s, even when lifestyle changes or other approaches are more clinically appropriate. But who is looking after their health once the transaction is complete? Who is helping them manage side effects, as well as their overall physical and mental health?

If patients get sick from compounded GLP-1s, they could end up in the ER—and their employer and insurer foot the bill. In this scenario, no one wins.

Fragmented care delivery

The type of clinicians prescribing GLP-1s has expanded rapidly. In their first act as a diabetes drug, GLP-1s were prescribed almost exclusively by endocrinologists. Now cardiologists, orthopedists, internal medicine physicians, and even psychiatrists are prescribing them—presumably with a different lens than an endocrinologist would, and sometimes without full visibility into the patient’s overall health. Different specialties are starting to establish their own clinical guidelines for GLP-1s.

Given how siloed specialty care is, it’s increasingly likely that a primary care physician (PCP) might prescribe GLP-1s for weight management without the patient’s cardiologist knowing about it—and vice versa. Who’s looking out for the whole person? Who’s looking at clinical outcomes and costs in a holistic way—for that patient, and for the system as a whole?

The prescription we really need

I’m rooting for GLP-1s to be a miracle drug. But the jury is still out, and in the meantime, the GLP-1 frenzy is exposing healthcare stakeholders across the system—patients, employers, insurers, providers—to unsustainable clinical and financial risks.

On the plus side, these mounting risks—and the unprecedented attention from consumers and the industry alike—may finally be what it takes to fix broken health care models. And the solutions to the problems surrounding GLP-1s are the same ones we’ve needed all along:

  • Prevention. The U.S. invests far less in preventive and primary care than other affluent nations. Increasing access to primary care and mental health services—including through virtual care—is essential to sustainably address the upstream causes of the conditions we’re now treating with GLP-1s.
  • Integrated care. This includes longitudinal care coordination between PCPs and specialists, as well as navigators and patient advocates. The wrap-around financial and administrative support these care team members provide is especially important given the high cost of the drugs and the challenges of managing chronic conditions like diabetes.
  • Outcomes-based payment. The recent push to include GLP-1s in Medicare negotiations is a good start, but it’s not a silver bullet for the healthcare cost trend. Despite the consumer demand for GLP-1s, studies have shown that as many as two-thirds of patients don’t stick with the drugs long enough to achieve or sustain the clinical benefits, which means substantial upfront costs with little to no payoff for patients and healthcare purchasers. Business and payment models tied to clinical and financial outcomes that matter—and that incentivize judicious prescribing and the integrated care needed to boost adherence and long-term results—are a critical step toward minimizing waste and realizing the full value of GLP-1s.

GLP-1s have the potential to transform medicine. But if we continue shoehorning them into our siloed and fragmented health care system, their potential will be stunted. It’s yet another indication that we need to reimagine the health care system from the ground up.

Read more:

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

This story was originally featured on Fortune.com



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The housing market’s spring selling season has arrived. Here’s the best time to list your home

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  • As the housing market reaches its traditional selling season, the best time to list can depend on location. While house-hunting activity surges around Memorial Day, the highest premium can be had in March, June, or even November in some cities.

While spring is typically the season when prospective buyers go house hunting, the time a seller lists a home could pose a significant financial advantage on returns, according to reports. 

Sellers can generally expect better gains when they list between March 15 and July 31, according to Zillow. But in particular, Memorial Day is marked as the season’s peak as buyers look to settle into their homes before summer kicks into full gear. 

As a result, that time of the year provides the highest premium for sellers. Last year, homes listed in the last two weeks of May had a 1.6% premium on average nationwide, representing a $5,600 increase over a typical U.S. home listed in other times of the year. 

The highest premium can vary regionally. For example, in the second half of March, home prices in San Diego, Calif., and Austin, Texas, increased by 2% and 2.3%, respectively, yielding an additional $20,100 and $10,400. In late November, the premium in Phoenix, Ariz., reached 1.4%, translating to $6,400 above average closing price.

In San Jose, Calif., listing a home in the second half of March yielded a $93,200 price increase and a 3.9% premium. And hitting the market in Atlanta, Georgia, in early June saw prices jump 1.2%, a $4,700 bump. 

Meanwhile, separate data from Realtor.com notes the best listing time across the nation this year is between April 13 and 19.

Historically, home prices during this week are 1.1% higher than during an average week throughout the year and 6.7% more than in January. During this time period, homes sell 17% faster than normal, and there are 13.2% fewer sellers on the market.

But the best time of the year to sell is also subject to change, and dependent on overall housing market conditions. For instance, stubbornly high mortgage rates and home prices have restricted buyer activity in recent years.

In March 2022, the Fed began increasing its rates, and in turn mortgages soared. At its peak, rates for 30-year fixed-rate mortgages skyrocketed above 7% in August 2023 and hovered near that level during 2024. Due to these high rates, homeowners have felt locked in by their mortgages, contributing to a stagnant housing market. Meanwhile, median home sales prices reached a record high of $426,900 in June 2024.

“In the past few years, mortgage rate fluctuations upended the traditional spring home shopping season,” Orphe Divounguy, a Zillow senior economist, said in a report. “Buyers who are on the edge of qualifying for a loan jump in and out of the market depending on what’s happening with rates.”

Mortgage rates are poised to drop if inflation continues to cool, according to Realtor.com. It eased from 3% in January to 2.8% in February, and the 30-year fixed mortgage sits around 6.67%, according to Freddie Mac.

“When rates fall, more buyers rush in, putting upward pressure on prices, which could happen at any time of year,” Divounguy said.

This story was originally featured on Fortune.com



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