How Medicare payment cuts are hurting health care

Summary

Marketplace Podcast Episode Summary Title: How Medicare Payment Cuts Are Hurting Health Care
Host/Author: Marketplace
Release Date: November 26, 2024

Every weekday, Marketplace, hosted by Kai Ryssdal, demystifies complex economic and business news, making it accessible to all. In the November 26, 2024 episode, titled "How Medicare Payment Cuts Are Hurting Health Care," the program delves into several pressing topics, ranging from financial markets and climate negotiations to significant shifts in the healthcare sector.

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1. Bond Market Dynamics and Scott Besant's Appointment

Timestamp: 00:01 – 03:09

The episode opens with a discussion on the $28 trillion Treasury bond market, a critical indicator of global economic health and investor sentiment. The bond yields had been climbing due to robust economic data and concerns over inflation following President-elect Donald Trump's election. However, the appointment of hedge fund billionaire Scott Besant as the Treasury Secretary has introduced a sense of optimism.

Key Points:

• Market Reaction to Scott Besant: Investors view Besant as a stabilizing influence, expecting him to moderate tax cuts and tariff implementations that could exacerbate inflation and deficit concerns.
• Economic Policy Balance: Besant is anticipated to advocate for a balance between Trump's expansionary economic policies and fiscal responsibility.

Notable Quotes:

• Thomas Urano, SAGE Advisory: "[Besant] is viewed more as a moderating force on some of the tax, tariffs and deficit concerns." [01:05]
• Jennifer Lee, BMO Capital Markets: "He said his first priority is delivering on all the tax cuts the president-elect has promised instead of tariffs." [02:07]

Analysis: Experts believe Besant's Wall Street experience is crucial, especially given the rising federal deficit. However, there's caution that this rally may be temporary, as upcoming inflation data could sway Treasury yields once again.

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2. COP 29 Climate Summit Outcomes

Timestamp: 03:09 – 06:33

The episode transitions to the COP 29 UN climate summit held in Baku, Azerbaijan. Despite low expectations due to the absence of major greenhouse gas emitters like the U.S., China, and France, some progress was made.

Key Points:

• Financial Commitments: Developed nations pledged $300 billion annually to aid poorer countries in adapting to climate change, tripling previous contributions.
• Criticism of Commitments: Experts argue that this amount falls significantly short of the $1.3 trillion per year advocated by developing nations and their allies.

Notable Quotes:

• Dana Fisher, American University Environment Professor: "This year's conference is a carbon-infused nothing burger." [04:19]
• Daniel Brissette, Environmental and Energy Study Institute: "Anybody who expected this 29th round of climate negotiations in a petro state theoretically to stop the climate crisis was fooling themselves." [04:32]
• Kava Gillanpour, Climate and Energy Solutions: "There's nothing legally binding about the $300 billion deal." [05:34]

Analysis: While the financial commitment marks progress, the lack of enforceable measures and the shortfall in funding targets underscore ongoing challenges in global climate negotiations. Subnational actors like state governments and the private sector in the U.S. remain engaged despite federal withdrawal.

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3. Impact of Medicare Payment Cuts on Healthcare

Timestamp: 06:24 – 11:15

A significant portion of the episode focuses on impending Medicare payment cuts and their ramifications for healthcare providers.

Key Points:

• Payment Reduction: Starting next year, doctors will face approximately a 3% pay cut for caring for Medicare patients unless Congress intervenes, despite care costs rising by 3.5% annually.
• Physician Fee Schedule: Adjustments to this schedule determine doctor reimbursements, which are currently trending downward.
• Consequences for Doctors:
  • Financial Strain: Increased operational costs combined with reduced Medicare payments make it challenging for private practices to sustain.
  • Patient Access: Some physicians may limit the number of Medicare patients, stop accepting new Medicare patients, or even close their practices.

Notable Quotes:

• Bruce Scott, AMA President: "Adjusted for inflation, Medicare now pays doctors almost 30% less than it did in the early 2000s." [08:01]
• Jennifer Lee, BMO Capital Markets: "We see a lot of people having a hard time finding a physician who is accepting new Medicare patients." [08:35]
• Michael Chernu, Harvard Medical School: "Our practice had to take out a loan to be able to pay our staff and pay our rent and all of our bills." [10:59]

Case Studies:

• Dr. Bruce Scott, Louisville, KY: Highlights the financial difficulties faced by small practices, exacerbated by external factors like cyberattacks which further strain revenues.
• Mary Clark, Stillwater, OK: Experiences firsthand the challenges patients and doctors face due to reduced Medicare reimbursements.

Analysis: The reduction in Medicare payments not only threatens the financial viability of small and independent practices but also poses risks to patient access, especially in rural areas. While larger hospital systems may navigate these cuts with greater ease, the ripple effects could destabilize the broader healthcare ecosystem.

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4. Migration Trends to the Midwest

Timestamp: 14:08 – 16:33

Shifting focus, the episode explores the increasing popularity of the Midwest as a relocation destination, contrary to the widely recognized Sun Belt migration.

Key Points:

• Urban Development: Cities like Kansas City and Columbus are attracting new residents due to significant development projects, including Intel's new semiconductor plant in Columbus.
• Affordability: Affordable housing remains a primary driver, with median home prices in cities like Cleveland and Indianapolis remaining accessible.
• Return Migration: A notable number of individuals are moving back to the Midwest, often to be closer to family and friends.

Notable Quotes:

• Jonathan Rappa, MMGREA: "People moving to the Midwest are coming to cities like Kansas City and Columbus, where there's been lots of development." [14:08]
• Sean Simpson, Real Estate Agent: "We're seeing a lot of people come in from those California, DC, the New York... looking for a little bit more opportunity with a little bit more affordability." [14:38]
• Ralph McLaughlin, Economist: Discusses the sustained affordability of Midwest markets due to less restrictive zoning laws.

Analysis: The Midwest's appeal is multifaceted, combining economic opportunities with a lower cost of living. This trend is likely to continue as more individuals seek balanced lifestyles away from traditionally high-cost urban centers.

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5. Revival of Print Magazines

Timestamp: 16:33 – 21:32

In a surprising turn against the digital trend, several major magazines are resurrecting their print editions.

Key Points:

• Print Resurgence: Publications like The Atlantic, Saveur, Sports Illustrated, and Vice are restarting physical editions, believing in the enduring value of print media.
• Economic Viability: The main challenge has been the economics of print publishing, but publishers are re-evaluating the benefits, including advertiser preference for print.
• Advertiser Appeal: Print ads offer a controlled, aesthetically pleasing medium free from the intrusiveness and unpredictability of online ads.

Notable Quotes:

• Daniel Brissette: "Publishers may have moved a little too swiftly to kill off this entire arm of their business... advertisers really like print magazines as well." [18:55]
• Daniel Brissette: "There's a lot more upside... more control over how your ad appears, over how obtrusive it is to people." [19:03]
• Daniel Brissette: "A really beautifully designed magazine... is particularly marketable toward a higher-end subscriber." [20:26]

Analysis: The revival of print magazines aligns with niche marketing strategies targeting affluent, educated readers who value high-quality, tangible media. This move also caters to advertisers seeking premium placements away from the cluttered online advertising space.

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6. 'My Economy' Segment: The Art of Mural Painting

Timestamp: 22:01 – 25:03

The episode features Cindy Fletcher Holden, a muralist in Annapolis, Maryland, highlighting the intersection of art and local economies.

Key Points:

• Artistic Heritage: Cindy discovered her passion for mural painting was influenced by her family's history in sign painting and truck lettering.
• Challenges and Rewards: Each mural presents unique challenges, whether dealing with different surfaces or environmental conditions, but the satisfaction of completing a project remains a strong motivator.
• Economic Impact: Murals contribute to the aesthetic and cultural value of communities, potentially enhancing local economies through increased engagement and tourism.

Notable Quotes:

• Cindy Fletcher Holden: "Each job requires a whole different attitude. Some are hot, cold, high up in the air." [22:22]
• Cindy Fletcher Holden: "It's physically fun. It's great to see it finished and have people tell me that they like it." [24:10]

Analysis: Artistic endeavors like mural painting play a significant role in community development and economic vitality. By beautifying spaces and fostering local identity, artists contribute to creating more livable and attractive environments.

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7. Additional Segments and Closing Remarks

Timestamp: 25:03 – 26:33

The episode concludes with brief updates on the stock market, Macy's accounting issues, and the resurgence of interest in Broadway adaptations like "Wicked." Listener testimonials underscore Marketplace's role in providing comprehensive and relatable economic insights.

Notable Segments:

• Market Updates: Dow Jones, NASDAQ, and S&P 500 performances.
• Macy's Accounting Scandal: Discovery of unreported expenses due to intentional bogus entries.
• Entertainment News: Success of "Wicked" as a Broadway adaptation boasting record-breaking box office numbers.

Closing Remarks: The host emphasizes the importance of informed listening and invites audience engagement through donations and participation in ongoing series like "My Economy."

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Conclusion

The November 26 episode of Marketplace effectively intertwines various facets of the current economic landscape, from financial markets and climate policy to healthcare challenges and cultural shifts. Through expert interviews, real-world case studies, and insightful analysis, the podcast provides listeners with a nuanced understanding of how interconnected systems influence everyday life and broader societal trends.

Transcript

[Amy Scott]

On the show today, we've got three M's, not the company markets, magazines and murals from American Public Media. This is Marketplace in Baltimore. I'm Amy Scott in for Kai rysdal. It's Monday, November 25th. Good to have you with us. We talk about the bond market a lot on this show because the $28 trillion treasury market tells us a lot about the global economy and where investors think it's headed. And that's where we're going to start. As the market reacts to President elect Donald Trump's choice for treasury secretary, hedge fund billionaire Scott Besant. Bond yields had been rising steadily since September as strong economic data and then Trump's reelection had investors worrying about inflation. But but as Marketplace's Mitchell Hartman reports, yields have been coming down more recently.

[Mitchell Hartman]

Up until the announcement of hedge fund manager Scott Besant as Trump's treasury pick, investors were focused intensely on inflation and whether it might soon surge higher again, in part because of what the incoming Trump administration is expected to do, says Thomas Urano at SAGE Advisory. Tax cuts, tariffs, immigration the market generally preceding the Trump administration to embark on policy that might add to inflationary pressures, add to growth, but also add to the deficit brings into question whether the Fed is going to continue cutting rates. There's a bit less worry now that investors expect Scott Besant to hold the most important economic position in the new administration, says Urano. It's just a little bit of a relief rally. He's viewed more as a moderating force on some of the tax, tariffs and deficit concerns. In particular, Bessen is seen as ready to advocate for a balance between Trump's stimulatory wish list and fiscal reality, says Jennifer Lee at BMO Capital Markets.

[Jennifer Lee]

He said his first priority is delivering on all the tax cuts the president elect has promised instead of tariffs. The fact that he also wants to cut spending is also encouraging, as opposed to spending, you know, like there's no tomorrow.

[Mitchell Hartman]

Besant is on the record favoring gradual implementation of tariffs, which could reassure companies and consumers worried about higher interest import prices hitting right away. Some of the relief in markets comes simply from the fact that Besant is a seasoned Wall street hand at a time when the federal deficit is high and likely going higher, says Quincy Crosby at LPL Financial.

[Jennifer Lee]

The need to raise money to pay for that deficit via auctions, for example. You need to have someone highly experienced. I mean, that's something that the market was in essence, demanding.

[Mitchell Hartman]

But the Besant rally may not last, says Crosby. We get more inflation data later this week, and if the news isn't good. Treasury yields could shoot up again. I'm Mitchell Hartman for Marketplace on Wall Street.

[Amy Scott]

You know what people say about Mondays. Yeah, not today. We'll have the details when we do. The COP 29, the annual UN climate summit, came to a close over the weekend in Baku, Azerbaijan. Expectations were low given the absence of top world leaders from some of the largest greenhouse gas emitters, including the United States, China and France, and the fact that for the third year in a row, a petro state hosted the meeting after Egypt and the uae. In the end, there was some progress. Developed countries agreed to commit $300 billion a year to help poorer countries adapt to climate change by a decade from now. That's three times what wealthy countries had been contributing. But as Marketplace's Kaylee Wells reports, it's far less than experts say is needed.

[Dana Fisher]

Developing countries and their advocates wanted to see a $1.3 trillion per year commitment. American University environment professor Dana Fisher calls this year's conference a carbon infused nothing burger.

[Daniel Brissette]

Anybody who expected this 29th round of climate negotiations in a petro state theoretically to stop the climate crisis was fooling themselves.

[Dana Fisher]

And Fisher says it's not like there's an agreed upon punishment if countries don't fork over their share of that money.

[Daniel Brissette]

It's green smoke and mirrors. I mean, it's just performative climate action at this point.

[Dana Fisher]

President Elect Trump pulled the US out of the Paris climate agreement during his first administration, and he has promised to reverse President Biden's decision to recommit to the treaty. Daniel Brissette, president of the climate nonprofit Environmental and Energy Study Institute, went to the conference and didn't come away too worried.

[Daniel Brissette]

The rest of the world has kind of been to this rodeo before and has found ways to cope.

[Dana Fisher]

Plus, just because the federal government pulls out doesn't mean the whole country has to.

[Daniel Brissette]

One thing that was hard to miss was the sort of the state and local government. The US Sub national message was we're still in.

[Dana Fisher]

Ann Brissette says much of the corporate and private sector is still in, too. There's nothing legally binding about the $300 billion deal, says Kava Gillanpour of the think tank's center for Climate and Energy Solutions.

[Mitchell Hartman]

But there are political and moral repercussions, and I'm pretty confident that they will deliver against that.

[Dana Fisher]

Gillen Poor was also at the conference where he says COP leaders produced a blueprint for their next meeting, which is.

[Mitchell Hartman]

Essentially tasked with Getting the Incoming Cop 30 Presidency of Brazil to think about how you do move from these billions.

[Dana Fisher]

To the wider trillions, meaning that $1.3 trillion per year target is still on the table for next year's conference in Bel, Brazil. I'm Kaylee Wells for Marketplace.

[Amy Scott]

As you may have heard, we have a Marketplace podcast focused on climate change policy solutions and your questions. You can find how we survive wherever you listen to podcasts. Starting next year, doctors will earn about 3% less money caring for older patients with Medicare unless Congress intervenes before January. And that's even though the cost of providing care is projected to rise by about three and a half percent every year by law. The Centers for Medicare and Medicaid Services makes adjustments to what's called the physician fee schedule, which determines how much doctors get paid for different services. The American Medical association and other groups representing doctors are pushing back against the cuts and say they're making the math of being in private practice increasingly difficult. Marketplace's Samantha Fields has more Everything about.

[Bruce Scott]

Running a medical practice has been getting more expensive, especially in the last few years.

[Michael Chernu]

Staff salaries have gone up. Our rent has gone up. All of our equipment.

[Bruce Scott]

Bruce Scott is an ear, nose and throat doctor in Louisville, Kentucky, and current president of the American Medical Association.

[Michael Chernu]

At the same time, what Medicare has paid us has gone down.

[Bruce Scott]

Adjusted for inflation, Medicare now pays doctors almost 30% less than it did in the early 2000s, according to the AMA, and Scott says that ripples through the entire health care system. Private insurance tends to pay significantly more than Medicare, but when Medicare rates go down, private insurance rates often do, too.

[Michael Chernu]

As a result, physicians have made difficult choices. In some cases, it's to limit the number of Medicare patients that they're willing to see, to stop accepting new Medicare patients or close their practice completely.

[Bruce Scott]

That's an issue in Stillwater, Oklahoma, where Mary Clark works as a family doctor.

[Jennifer Lee]

We see a lot of people having.

[Amy Scott]

A hard time finding a physician who is accepting new Medicare patients, and I hear that from my staff on a weekly basis.

[Bruce Scott]

She also hears it from colleagues in other rural areas. If you're a small, independent practice, you need at least some patients with private insurance to make the math work.

[Amy Scott]

You can't see every Medicare patient. It's not financially possible.

[Bruce Scott]

Michael Chernu, a professor of health policy at Harvard Medical School, says nationally, people with Medicare report they have as good, if not better, access to doctors than people with commercial insurance. That's according to a recent survey from MedPAC, the Medicare payment Advisory Commission, which he chairs.

[Jennifer Lee]

It can be hard to find doctors to take Medicare. It can also be hard to find doctors to take Commercial insurance.

[Bruce Scott]

There are huge variations in how all of this is playing out around the country and for big hospital systems versus private practices. And Robert Berenson at the Urban Institute says not all specialties are paid the same.

[Mitchell Hartman]

There's doctors who interpret images. There's doctors who do surgery. There's doctors who spend time in office visits.

[Bruce Scott]

And some of those services are paid more highly than others.

[Mitchell Hartman]

Have you ever had liquid nitrogen applied to a wart? It takes about a minute, and Medicare.

[Bruce Scott]

Pays dermatologists roughly $165 to do it.

[Mitchell Hartman]

Meanwhile, a payment for 40 minutes with a very complex patient who probably has one or more chronic conditions is about the same $177.

[Bruce Scott]

Berenson says the whole process is broken.

[Mitchell Hartman]

It results in overpayment for procedures and imaging and tests and underpayment for time spent with patients.

[Bruce Scott]

Even with the overall decline in rates, he says plenty of doctors are doing just fine. And big hospitals have leverage to negotiate higher rates with insurance companies. But small practices like Dr. Bruce Scott's do not. In Louisville, he says, one insurance company covers about 60% of patients with commercial plants.

[Jennifer Lee]

And that company has actually offered us.

[Michael Chernu]

Rates less than Medicare now. And we can't even bring them to the table to talk because they know that we can't really say no.

[Bruce Scott]

Earlier this year, Scott says a major cyber attack on the payment processing company Change Healthcare meant his practice didn't have any revenue coming in for about six weeks.

[Michael Chernu]

Our practice had to take out a loan to be able to pay our staff and pay our rent and all of our bills. And the physicians stop taking paychecks for several pay periods. That's how close to the edge we are.

[Bruce Scott]

Which is why, he says, every reduction in reimbursement rates matters. I'm Samantha Fields for Marketplace.

[Amy Scott]

Coming up.

[Cindy Fletcher Holden]

Over time, the hanging upside down became my trademark.

[Amy Scott]

Everyone has their thing. But first, let's do the numbers. The Dow Jones Industrial Average rose 440 points 1% to finish at 444,736. The NASDAQ added 51 points a quarter percent to close at 19,054. And the S&P 500 gained 18 points 3. 10% to end at 59.87. At least $132 million worth of small package delivery expenses never made it onto the books at Macy's. The retailer reported today that a lone employee intentionally made bogus accounting entries worth at least that much between the second half of 2021 and this month. It also reported that while sales are looking pretty good in the current quarter, they weren't great. During the third quarter, shares gave up 2.2%, per Mitchell Hartman's story. Bond prices rose. The yield on the 10 year T note fell to 4.27%. You're listening to Marketplace. Hi, this is Nicole from Camphill, Pennsylvania. I'm always surprised how much content Marketplace can pack into 30 minutes. Listening is part of my daily routine. I love the way they make the content digestible and relatable. For us folks who don't have a strong background in economics or business, join me by making a gift to Marketplace [e-mail] donate this is Marketplace. I'm Amy Scott. If you were to move maybe to another part of town, maybe another region in the United States, where would you go? The Sun Belt gets a lot of attention for the large numbers of people relocating and buying homes in states like Arizona, Texas and Florida. But a new survey from the national association of Realtors shows another part of the country is getting a lot of love, too. The Midwest, Marketplace's Elizabeth Troval explains.

[Jonathan Rappa]

People moving to the Midwest are coming to cities like Kansas City and Columbus, where there's been lots of development, says Jonathan Rappa with brokerage advisory service mmgrea.

[Jennifer Lee]

The confluence of factors that has really kind of seen development tick up in the Midwest.

[Jonathan Rappa]

Take Columbus, Ohio, where Intel is opening up a new semiconductor plant nearby, and home sales have been strong. Sean Simpson is a real estate agent there.

[Jennifer Lee]

We're seeing a lot of people come in from those California, you know, the dc, the New York, or looking for a little bit more of an opportunity with a little bit more of an.

[Jonathan Rappa]

Affordable housing aspect, he says. These newcomers are also willing to move further from urban centers in exchange for.

[Jennifer Lee]

Other perks to get the schools they want, the parks they want, the amenities they want, and also a lot of them are bringing cash.

[Jonathan Rappa]

Some people are also moving back to the Midwest after moving away, says Matt Kristofferson with the national association of Realtors.

[Daniel Brissette]

It was about a quarter of movers.

[Jonathan Rappa]

To the Midwest moved back to the.

[Daniel Brissette]

Somewhere where they previously lived. So combining that with the point that they're really driven by being close to family and friends, they're most likely moving back to their home, maybe hometown, or at least where their family lives.

[Jonathan Rappa]

People have also moved away from the Midwest, but states like Ohio and Indiana have been seeing net migration gains with affordability playing a role, says economist Ralph.

[Jennifer Lee]

[e-mail] places like Akron and St. Louis.

[Mitchell Hartman]

And Cleveland and Indianapolis, those are the places where you only need to make 50 to $70,000 to buy the median priced home.

[Jonathan Rappa]

Andy says those markets are likely to stay affordable since they're less constricted by geography and zoning laws that limit new construction. I'm Elizabeth Trovall for.

[Amy Scott]

Earlier this fall, the Atlantic, the American magazine publisher, did something surprising. It announced plans to increase the number of print editions it puts out each year. That's right, increase from 10 magazines to 12. The Atlantic isn't the only magazine investing in print these days this year, Saveur, if I'm saying that right, Sports Illustrated and Vice have all committed to restarting their physical editions. Amanda Mull wrote about it in Bloomberg Businessweek the other day. Amanda, good to have you back.

[Daniel Brissette]

Thanks for having me.

[Amy Scott]

All right, so several magazines have actually restarted their print publications and there are some newcomers. What is going on?

[Daniel Brissette]

Right. So we're probably all pretty familiar with like the decline of print over the past 10, 15, 20 years. Over that period of time, a lot of long standing publications that had started as print magazines, you know, decades or even a century, PR had phased out their print editions and tried to funnel everybody online. In the past couple of years, some of those publications have started to think twice about that decision. Just in, you know, recently Field and Stream, Nylon, Saveur, Sports Illustrated, Vice, all of these companies are like, hold on a second, why don't we bring back a little bit of print magazine and see how it goes?

[Amy Scott]

And why do you think that is? Were readers clamoring for a print copy to hold in their hands again?

[Daniel Brissette]

Well, I think that fundamentally the issue is that people didn't stop buying print magazines and companies didn't stop printing print magazines because consumers hated them. They stopped printing them because the economics of printing physical editions of a magazine became sort of untenable. And I think that what we're seeing is the realization among publishers of periodicals that they may have moved a little too swiftly to kill off this entire arm of their business. And it turns out that advertisers really like print magazines as well. So you might not be able to print a weekly magazine anymore. And some of these companies probably can't print a monthly magazine anymore. But maybe like a quarterly magazine, there's demand for it among readers, there's demand among advertisers. So like, why not give it a try and see if it works?

[Amy Scott]

You mentioned that advertisers like appearing in magazines. What how are these ads different than what they might pay for online?

[Daniel Brissette]

Well, I remember when I was a kid reading magazines, there were lots of advertisements, especially in the sort of fashion realm, but also in consumer Technology in beauty and lots of different industries that were like downright artistic that people would tear out of magazines and put on their walls. These were advertisements for products, but people didn't encounter them as an inconvenience or as something that was trying to get in their way. So that is still the case. In fact, it might be even more so the case. You know, the bad online advertising or bad technology in implementing online advertising can make people think worse of your publication or of your product if you're the advertiser. And you really don't get that same capacity for blowback in a print publication because it is just a lot more standardized, it's a different user experience and you have, there's a lot more upside. So especially for high end brands and advertisers, going that direction gives you as an advertiser a lot more control over how your ad appears, over how obtrusive it is to people, and ultimately more control over what they might think of you as a result. So there's a lot of upside for advertisers.

[Amy Scott]

Well, and it's not just the advertisers who are high end. Right. You mentioned that a lot of the readers are going to be higher income, more educated. It's become kind of a luxury Good.

[Daniel Brissette]

Yes, I think that a really beautifully designed magazine full of like, interesting freshly reported stories is something that is that a lot of these publications look at as particularly marketable toward a higher end subscriber, somebody who might pay $100 or $120 for an annual subscription. And then when you, when you make a sort of like sophisticated, high minded product that you can better sell to this like cohort of the population, you then make a publication that can make a really great pitch toward advertisers who are looking for people with disposable income who are looking for, you know, that same cohort of the population essentially.

[Amy Scott]

Are you subscribing to anything in print that you might have read online previously?

[Daniel Brissette]

Oh, I subscribe to tons of things. My mailman is extremely busy.

[Amy Scott]

All right, well, Amanda Mull, it's always good to talk to you. She writes at Bloomberg Business Week, which has a print edition.

[Daniel Brissette]

We do. It's beautiful.

[Amy Scott]

Amanda, thanks so much.

[Daniel Brissette]

Thank.

[Amy Scott]

Speaking of art, when was the last time you saw a good mural? I'm lucky to live in a city full of them, giving life to an otherwise dull concrete wall or office space, telling a story, making you think. For this next installment of our series, My Economy, we hear from someone who creates these works of art for A living.

[Cindy Fletcher Holden]

My name is Cindy Fletcher Holden. I am a muralist, an artist and a sign painter and I live in Annapolis, Maryland. I graduated with a degree in painting. Not quite sure what I was going to do with that, but so I got a job in the sign shop and I learned the trade of hand painted lettering and got involved right away into the full career of painting names on boats. The interesting thing then was to learn the trade of sign lettering. My employer would cut out a stencil and I would literally go and hang upside down off the back of the boat and use the brush to form the letters. And over time, the hanging upside down became my trademark. My aunt asked me if I wanted some of my grandfather's art supplies. So when I went to go get them, I was shocked to see that we had all the same supplies that I had. He had lettering brushes, he had gold leaf supplies, he even had the same one shot sign paint. And as I went through his art supplies, I realized that we did the same thing. He did truck lettering, signs and murals. And I did not know this until at that point, it made me realize that this whole lettering mural painting is in my DNA. I do murals in businesses, in private homes, in private schools, in public schools. I've done a couple of public murals as a result of a contest. They're all a challenge. Each one is different. Even some of the ones that I've done that are the same logo, they might be on a different surface, some are outside. So each job requires a whole different attitude. Some are hot, cold, high up in the air. I have to learn how to drive all kinds of lifts and climb scaffolding. So I love the challenge. I'd like to keep on going for as long as I can. It's physically fun. It's great to see it finished and have people tell me that they like it, of course. So I'm very lucky. I have not had a slow down for a couple years at all. So I hope it keeps going.

[Amy Scott]

Cindy Fletcher Holden, Muralist in Annapolis, Maryland. You know we can't do this series without you. Tell us what's happening in your [e-mail] myeconomy this final note on the way out today. Did you catch Glickid over the weekend? Yeah, it's no Barbenheimer, But Wicked and Gladiator 2 each did a pretty respectable business at the box office over the weekend. Wicked was by far the bigger attraction, bringing in $114 million. The biggest opening ever for a Broadway adaptation. The Gladiator sequel brought in 55 and a half million. That's a lot of popcorn. Our daily production team includes Andy Corbin, Nicholas Guillaume, Elise Jose Hassan, Maria Hollenhorst, Sarah Leeson, Shawn McHenry, and Sophia Terenzio. I'm Amy Scott. Hope to see you back here tomorrow. This is apm.

[Mitchell Hartman]

Hey, it's Kai. My minivan. And I, as I've said on the radio, have logged a lot of miles with Marketplace. Luckily, it's still running, you know, pretty well. But if your car doesn't drive as well as it used to, listen up. It can still help drive Marketplace. When you donate your old car or truck, we'll use the proceeds to support the great programs you hear every day. Start your vehicle [e-mail] vehicle.