Harv's Corner

Regard​ing Immigration;
While standard reasons for being denied entry or detained still apply (such as criminal records, past immigration violations like overstaying, misrepresentation, or lack of sufficient funds), the recent reports focus on detentions perceived as arising from heightened scrutiny, policy changes, or unclear causes, contributing significantly to Canadian traveler apprehension

Canadians booking far fewer U.S. visits
Trump’s bluster, border arrests have taken a toll.
By ROB GILLIES and JIM MORRIS The Associated Press​

VANCOUVER - Diana and Rick Bellamy initially planned to take a Caribbean cruise out of Houston before heading to Laurel, Miss., to visit the home of one of their favorite HGTV shows, "Home Town."

The Calgary, Alberta, couple scrapped those plans and vacationed last month along Mexico's Pacific coast instead, put off by U.S. President Donald Trump's trade war with Canada, the insults he's hurled at their homeland, and stories about American border agents searching people's phones and detaining foreigners for minor reasons.
​
Diane Bellamy found it ironic that she felt more comfortable traveling to Mexico than the U.S.

"I never thought I would hear myself say that," she said.

Trump's attacks on Canada's economy and threats to make it the 51st state have infuriated Canadians, who are canceling trips to the U.S. in large numbers.

They also seem to have also flipped the narrative heading into Canada's parliamentary elections on Monday, with Prime Minister Mark Carney's Liberal Party surging after trailing far behind in the polls just a few months ago.

The U.S. gets more visitors from Canada each year than from any other country, according to the U.S. Travel Association, an industry trade group, which said the 20.4 million visits from Canada last year generated $20.5 billion in spending.

But there has been a big drop in foreigners traveling to the U.S. since Trump took office, and Canadians are no exception.

There were more than 910,000 fewer land border crossings from Canada into the U.S. last month than in March 2024 — more than a 22% drop — according to U.S. Customs and Border Protection data. An Air Canada spokesman, meanwhile, said Canada-U.S. flight bookings for April through September are down about 10%.

Since Trump started his second term, there have been well-publicized reports of tourists being stopped at U.S. border crossings and held for weeks at immigration detention facilities before being allowed to fly home at their own expense.

On March 3, Canadian Jasmine Mooney, an actor and entrepreneur on a U.S. work visa, was detained by U.S. border agents in San Diego. She was released after 12 days detention.

The Canadian Association of University Teachers, which represents university faculty and staff, warned its members against nonessential U.S. travel.

McKenzie McMillan, a consultant with a Vancouver travel agency The Travel Group, said its bookings to the U.S. have dried up. "We have seen a neartotal collapse of U.S. business," he said. "Probably about a 90% drop since February."

Lesley Keyter, the CEO and founder of the Travel Lady agency in Calgary, said she's seen people actually forfeit money to cancel their U.S. trips.

"Even if they're going on a Caribbean cruise, they don't want to go down to Fort Lauderdale to get on the cruise ship," she said.

Harv's Corner

We in Minnesota have this problem - what's going on in your state?

Minnesota's hospital network is financially fragile post-pandemic, with nearly a quarter (31 of 127) considered distressed after 2023 due to operational losses. Key challenges include severe staffing shortages driving up costs (especially for contract labor) and increased reliance on ERs. There's significant concern that potential federal cuts to programs like Medicaid could worsen the situation, potentially leading to further service reductions or even hospital closures, particularly impacting rural and independent facilities and threatening the state's healthcare safety net. While some hospitals remain profitable and others are exploring collaborations and innovative solutions, a widening financial gap exists between struggling and stable hospitals.

Staffing costs push some Minn. hospitals to the financial brink
When permanent staff can’t be hired, hospitals must spend more on temps.
By JEREMY OLSON The Minnesota Star Tribune

Minnesota has emerged from the COVID-19 pandemic with a fragile network of hospitals at risk of closure and vulnerable to cuts in government aid.

Thirty-one of 127 Minnesota hospitals were financially distressed after 2023, meaning they had lost money on operations in four of the prior eight years.

Another eight hospitals were one bad year away from being distressed, while others, such as Riverwood Healthcare Center in Aitkin, Minn., remained stable but lost money on operations for the first time in decades.

"We're trying to uncover every stone we can" to cut spending without cutting medical services, said Ken Westman, chief executive of Riverwood, which lost money on hospital operations in 2022 but recovered in 2023.

The Minnesota Star Tribune analyzed new state data to see whether more hospitals had fallen into financial distress since the end of the pandemic and before the start of any cuts that the Trump administration proposed to federal health care spending.
Import tariffs could also raise the cost of essential drugs and equipment hospitals can't acquire domestically, but state leaders are particularly worried about cuts to Medicaid.

The state-federal program provides health benefits to 20% of Minnesotans, up from 15% a decade ago.

U.S. Sen. Tina Smith, D-Minn., visited Riverwood last month and Hendricks Community Hospital in western Minnesota on Wednesday to highlight the vulnerability of rural hospitals.

They're especially at risk if Congress advances a budget that cuts an estimated $1.5 billion per year from Minnesota's Medicaid program.
U.S. Rep. Kelly Morrison held a forum Tuesday in Bloomington with Gov. Tim Walz and predicted dire consequences if federal losses force Minnesota to cut people off Medicaid or pay hospitals less for their care.

"Entire hospitals may shut down," she said.
The news isn't all bad: Operating margins exceeded 10% for 32 hospitals in 2023, the most recent year for which comparable state data is available.

And some money-losing hospitals in 2023 showed stronger results in 2024, based on their own financial reports. But the state data reveals a widening gap in financial performance that could poke holes in
Minnesota's hospital safety net, which keeps most people within 30 miles of an emergency room and 60 miles of a major trauma center.
"There is a clearer distinction between the haves and the have-nots, meaning hospitals who are constantly struggling," said Stefan Gildemeister, state health economist.
Staffing struggles

Twelve hospitals posted operating losses of 10% or more in 2023, the highest total in at least a decade. Kittson Memorial Healthcare Center in Hallock, Minn., stayed financially healthy for years, even as the population in northwest Minnesota declined. But its operating loss ballooned to 23% in 2023.

Andrea Swenson has dedicated her career to the hospital in Hallock, starting in high school when she worked as a dietary aide before returning after college as a registered nurse. She then earned her master's degree and eventually became Kittson's administrator.

At one time, the hospital could rely on a local pipeline for workers, but interest in health care careers evaporated after the pandemic. Kittson had no choice but to hire outside contract nurses and health care providers at double or triple the cost, Swenson said.

"We don't have eight people who do one job. We have one person who does eight jobs," she said. "In our hospital, we staff with two nurses. That's all we have. We can't have any less than that. We can't cut any more than that."

Hospital fortunes rise and fall from year to year, especially when older buildings need one-time repairs or technology upgrades. So the Minnesota Department of Health takes a longer view of financial performance through eight years before labeling hospitals as distressed.

The Star Tribune based its analysis on operating revenue for hospital operations only.

In some cases, hospitals had other businesses — such as home health care services or pharmacies — that improved their bottom lines or deepened their losses.

Hospital leaders said their staffing problems peaked in 2023, when burned-out doctors and nurses retired early or found jobs elsewhere. Appleton Area Health's losses on hospital operations went from 7% in 2022 to 16% in 2023, and Chief Executive Greg Miner said it was largely because the hospital spared no expense to fill open shifts.
"Temporary staffing is what really kills this hospital," he said.
Repair needs accentuated the losses in 2023, but Miner said the hospital is poised for a comeback. He said he is creating a family culture at the hospital to recruit doctors. Appleton is also opening a clinic in nearby Hancock and debuted an InstaCare online urgent care for anyone in Minnesota.

"Imagine yourself being at a lake in Minnesota, and your kid has a sore throat. Well, you can dial up and take a look through a telehealth [visit]," Miner said.

"And we will see you Monday through Friday, 8 to 5. You would be surprised how that is starting to catch on."

More is at stake than medical access. The hospital became Appleton's largest employer after a prison closed in 2010, and its middle- and upperincome jobs are irreplaceable to the largely agricultural local economy.

Being small isn't necessarily the problem. Hospitals with 25 or fewer beds qualify for federal critical-access designations and payments from the Medicare program for senior citizens.

Those help them come closer to covering their costs.
Sanford Health's 14-bed hospital in Jackson, Minn., routinely posts operating gains of 20% or higher. It has the critical-access designation and doesn't have to subsidize money-losing operations such as nursing homes tethered to other hospitals, said Eric Hilmoe, chief operating officer for Sanford's southwest Minnesota region. Just to the west, though, Sanford's 48-bed hospital in Worthington is distressed while maintaining a full range of hospital services for a wide geographic area without critical-access support.

'The bare minimum'
Federal cuts threaten even metro hospitals, especially the trauma centers at North Memorial in Robbinsdale and Hennepin Healthcare in Minneapolis, Morrison said during Tuesday's forum. Hennepin is already financially distressed.

Fifteen of the 20 hospitals that posted the largest operating losses in Minnesota in 2023 were independent. Gildemeister said hospitals affiliated with larger systems benefit from efficiencies, such as cheaper electronic record keeping and bulk pharmacy orders.

But even affiliated hospitals are vulnerable: Mayo Clinic Springfield closed in 2020 under financial pressure.

No Minnesota hospitals have closed since 2020, but nine held public hearings last year, which state law requires when closing units. Three stopped scheduling baby deliveries while two closed inpatient mental health units.

Minnesota's smallest hospitals saw a 15% decline in inpatient admissions from 2019 to 2023 and a 6% decline in childbirths.
But they encountered a 12% increase in ER visits, partly because patients with reduced health care access have nowhere else to go, said Dr. David Taylor, Riverwood's chief medical officer.

Taylor recently tended to a patient in the ER who couldn't schedule an appointment to address an irregular heartbeat.
"I sat down with him and answered questions that nobody had answered with him because he couldn't get in to see his cardiologist," Taylor said.

"I mean, that's not [supposed to be] my role. That's not my expertise. ... He just got a really expensive counseling visit."
If more people lose Medicaid, they will resort to ER visits, he said. The hospital, in turn, will lose more money because federal law requires treating those patients, regardless of whether they have insurance.
Riverwood's survival strategy is partnerships. The independent hospital shares surgeons with Cuyuna Regional Medical Center, 20 miles to the west in Crosby, Minn., that neither could support individually.

Riverwood also helped form the Headwaters Network, a collaboration of 17 hospitals that are standardizing medical practices and pooling results to earn payfor-performance rewards from insurers.
Community Memorial Hospital in Cloquet, Minn., also shares its childbirth simulation mannequin, allowing Riverwood's obstetric workers to keep their skills sharp, even in years when they deliver relatively few babies.

The Cloquet hospital is financially distressed, having routinely posted gains until 2019, when it started losing money every year on operations. Blue Cross and Blue Shield of Minnesota funded the simulator in 2022 in Cloquet, which is one of the smallest hospitals in the state that still schedules childbirths.

All options are on the table when it comes to the survival of Kittson, which treats Hallockarea residents who otherwise would have to drive 50 to 70 miles for hospital care. Swenson said she has considered following the lead last year of Mahnomen Health, which took advantage of a new federal program and became the Midwest's first rural emergency-only hospital with no inpatient services.
Kittson shelved the idea, for now, based on feedback from residents. The hospital already shut down its operating room and halted eye procedures after it lost an ophthalmologist.
"They value everything we offer because we already do the bare minimum," she said.
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"Nobody wants to see any of these things go."
[email protected]

Harv's Corner

Social Security's move to tighten online account security, while necessary to combat fraud, creates a significant challenge when combined with reduced staffing at field offices. Beneficiaries unable to navigate the new technical requirements may be forced to seek in-person assistance, precisely when office capacity is shrinking. This convergence is projected to cause much longer wait times and delays at SSA offices, making it considerably harder for individuals to access services, manage their benefits, report essential changes, or resolve problems efficiently. The result is likely to be increased frustration and stress for those attempting to interact with the agency.

​These difficulties will disproportionately affect vulnerable populations, including older adults, people with disabilities, rural residents, and those with limited digital literacy or resources, who may struggle with both the online security protocols and the burdens of accessing understaffed offices. This mismatch between the increased need for accessible support (driven partly by the security changes) and reduced agency resources risks creating significant barriers. Ultimately, it could impede timely access to benefits and essential assistance for the very individuals Social Security aims to serve, particularly those most reliant on direct, in-person support.

Social Security website keeps crashing as IT staff cuts loom
DOGE wants to slash the technology division that runs the portal by 50%.
By LISA REIN, HANNAH NATANSON and ELIZABETH DWOSKIN • The Washington Post

​Retirees and disabled people are facing chronic website outages and other access problems as they attempt to log in to their online Social Security accounts, even as they are being directed to do more of their business with the agency online.

The website has crashed repeatedly in recent weeks, with outages lasting anywhere from 20 minutes to almost a day, according to six current and former officials with knowledge of the issues. Even when the site is back online, many customers have not been able to sign in to their accounts — or have logged in only to find information missing.

For others, access to the system has been slow, requiring repeated tries to get in.

The problems come as the Trump administration's cost-cutting team, led by Elon Musk, has imposed a downsizing that's led to 7,000 job cuts and is preparing to push out thousands more employees at an agency that serves 73 million Americans. The new demands from Musk's U.S. DOGE Service include a 50% cut to the technology division responsible for the website and other electronic access.

Many of the network outages appear to be caused by an expanded fraud check system imposed by the DOGE team, current and former officials said. The technology staff did not test the new software against a high volume of users to see if the servers could handle the rush, these officials said.

The technology issues have been particularly alarming for some of the most vulnerable Social Security customers. For almost two days last week, for example,many of the 7.4 million adults and children receiving monthly benefits under the anti-poverty program known as Supplemental Security Income, or SSI, confronted a jarring message that claimed they were "currently not receiving payments," agency officials acknowledged in an internal email to staff.

The error messages set off widespread panic until recipients discovered that their monthly checks had still been deposited in their bank accounts. Another breakdown disabled the SSI system for much of the day on Friday, prompting claims staff to cancel appointments because they could not enter new disability claims in the system and blocking some already receiving benefits from gaining access to their accounts.

"Social Security's response has been, 'Oops,' " said Darcy Milburn, director of Social Security and health care policy at the Arc, a national nonprofit that advocates for people with disabilities.

The group fielded dozens of calls last week from nervous clients who saw the inaccurate message and assumed their monthly check, usually paid on the first of the month, would not arrive.

"It's woefully insufficient when we're talking about a government agency that's holding someone's lifeline in their hands," Milburn said.

The disruptions are occurring as acting commissioner Leland Dudek and the DOGE team move to lay off large swaths of the workforce in a new phase of downsizing. Thousands already have been pushed out — many in customer-facing roles, others with expertise in the agency's cumbersome technology systems. At least 800 of the 3,000 employees left in the division that manages all of the Social Security databases face layoffs, a senior official said on Friday. The newly named chief information officer, Scott Coulter, a Musk-aligned private equity analyst, has demanded a cut of 50%, the official said.

The network outages are one in a cascade of blows to customer service that also have hobbled phone systems and field office operations as the workforce shrinks.

A surge in visitors to the website is overwhelming the computer system as customers — nervous that the rapid changes at the agency will compromise their benefits — download their benefit and earnings statements and attempt to file claims. President Donald Trump has said that his administration will not reduce Social Security benefits.
The chaos could accelerate starting April 14, when new identification measures are set to take effect that will require millions of customers applying for benefits to authenticate their identity online, part of the administration's campaign to root out allegedly fraudulent claims.
"We're just spiking like crazy," said one senior official, who, like others in this article, spoke on the condition of anonymity because they were not authorized to speak publicly about agency operations. "It's people who are terrified that DOGE is messing with our systems.

It's the sheer massive volume of freaked-out people."
The Social Security press office said in a statement that officials are "actively investigating the root cause" of the incidents, which they called "brief disruptions" averaging about 20 minutes each with the exception of the SSI error message.

But on several occasions, including during an outage last Monday, customers were shut out of the website for hours.

The system was back online last Monday after two hours, but lingering issues lasted through the afternoon while all backlogged queries were processed, current and former officials said.

And a system upgrade on a Saturday in late March took several hours longer than anticipated and knocked out the network.

Three times in a recent 10-day stretch, the online systems the field office staff rely on to serve the public have crashed, said one employee in an Indiana office.

The downed programs included tools employees use to schedule visits, to see who has booked an appointment and to check who has arrived, the employee said. It is unheard-of for the system to fail this often, and each outage has led to chaos, they said.

T he network crashes appear to be caused by an expansion initiated by the Trump team of an existing contract with a credit-reporting agency that tracks names, addresses and other personal information to verify customers' identities.

The enhanced fraud checks are now done earlier in the claims process and have resulted in a boost to the volume of customers who must pass the checks.

But the technology staff did not test the software against a high volume of users to see if the servers could handle the rush, current and former officials said. Connectivity issues and bugs with the expanded system have caused the portal that manages log-ins and authentication for many Social Security applications to go down, officials said.
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At a weekly operations meeting on March 28 that was made public last week, Wayne Lemon, deputy chief information officer for infrastructure and IT operations, acknowledged the network crashes and said, "While they've been brief, we prefer no outages." He said the outages were under investigation and may involve "challenges we've experienced with a number of partners." Part of the problem may be that the outages have occurred during "high volume use of the network."

Harv's Corner

Tariffs are generally considered detrimental to an economy because they act as taxes on imported goods, raising prices for consumers and businesses. This reduces purchasing power and can increase production costs for domestic industries reliant on imports. Furthermore, tariffs often invite retaliatory tariffs from other nations, harming export industries and potentially leading to trade disputes, ultimately reducing competition and overall economic efficiency.
​

​Anxious consumers brace for tariffs
Worried about inflation, Americans are reluctant to spend on nonessential items.
By ABHA BHATTARAI The Washington Post
​
Americans are tapping the brakes on spending — pulling back on dining out, hotel stays and other expenses, as they boost their savings ahead of new tariffs and continued economic uncertainty.

Consumers are increasingly anxious about the economy, and they're curbing spending habits accordingly, data released Friday shows.

Consumer spending inched up by 0.1% in February, after adjusting for inflation, following a 0.6% drop the month before, according to government figures. Meanwhile, the personal savings rate — or how much of their incomes people set aside — rose to 4.6%.

A separate survey released by the University of Michigan, meanwhile, showed that Americans' views on the economy fell for a third straight month, to the lowest level since 2022, as households and businesses prepare for a wave of higher prices once new tariffs go into effect this week.

"Consumers are increasingly apprehensive about spending," said Lydia Boussour, a senior economist at EY-Parthenon. "We are seeing clear signs that people are being more careful — they're reluctant to spend on nonessential expenses. They're worried about inflation and have preemptive anxiety around tariffs."

Strikingly, economists say Americans of all income levels, including the wealthiest, are rethinking their spending — in what could be a pivotal warning. The drop-off in consumer spending is expected to drag down economic growth in the first three months of the year, with many economists now forecasting a contraction after years of consistent growth.

The highest-earning 10% of Americans, with annual household incomes of $250,000 or more, have been driving much of the economy's postpandemic boom, accounting for 49.7% of all U.S. spending, according to calculations by Moody's Analytics for the Wall Street Journal.

But a recent slide in stock prices, combined with a burgeoning trade war, is causing even those well-heeled shoppers to think twice before booking vacations and snapping up designer watches. The forces driving Americans' recent wealth gains "are under considerable risk of slowing or reversing," Mark Zandi, chief economist at Moody's Analytics, wrote in a February report.

Johnny Franco, a plastic surgeon in Austin, said clients are increasingly opting for simpler procedures and local anesthesia, which can be thousands of dollars cheaper than going under during surgery.

"There's only so much money to go around for our patients," he said.

It's important to note, economists say, that consumers haven't stopped spending altogether. Americans who want jobs largely have them, and they're getting wage increases. But years of inflation, combined with a slowing labor market and new tariffs, have many anxious about what's ahead. Two-thirds of consumers now expect the unemployment rate — currently 4.1 percent — to rise in the coming year, the highest reading since 2009, according to the Michigan survey.
Federal job cuts

At Well-Paid Maids, a cleaning company with branches in Washington, D.C., New York and Chicago, sales have slowed considerably this year. The drop has been most pronounced in the Washington area, where federal job cuts and funding freezes have left many government workers or contractors, and those around them, concerned about their finances.

More than 10 percent of recurring customers in the D.C. area have canceled altogether in the past two months, they've lost their jobs or are worried they soon might.

'We only buy things on sale'
"The real challenge is the vibes," founder Aaron Seyedian said. "People really do buy and spend based on economic vibe, and right now, there's just an amalgam of red arrows trending downward in peoples' minds. And that really don't make them want to reach for their wallets."

Americans spent less on a range of items in February compared with January, including cars, electronics, sporting goods and dining out, census data shows. Many of those items could soon become even more expensive, as the Trump administration places sweeping tariffs on vehicles and other imported goods.

In Indianapolis, Erika Ocampo and her partner have shelved plans to buy a second car. With higher grocery and housing costs, their budget is already stretched thin. Since January, they've spent $6,000 on vet bills for a dog with cancer and several hundred more on diapers, clothing and food for their 2-year-old daughter.

"Things used to be so cheap here in Indianapolis," said Ocampo, 32, a technical recruiter. "But now we're thinking hard about every cost. We only buy things on sale and it's like, 'Do we really need Amazon Prime? What else can we cancel?'" (Amazon founder Jeff Bezos owns the Washington Post.)

Major retailers, including Target, Foot Locker and Macy's, have all recently noted signs of shopper hesitation. And U.S. airlines this month warned that demand is slowing, with Delta Air Lines, Southwest Airlines and American Airlines all revising down their forecasts for the first three months of the year.

'Waiting to see'
"People are cautious, and they're pulling back a little bit on travel," Delta CEO Edward Herman Bastian said in a presentation. Travelers, he said, are "kind of waiting to see what's going to transpire, whether it's trade and tariff challenges or macroeconomic policy changes."
Adinah Greene, who lives in Sonoma County, California, lost her job working on employee benefits at the end of January. Since then, she's sent out hundreds of applications and secured a few interviews, but says she's still being prudent about spending. Big-ticket purchases are on hold, and she is limiting takeout to one $30 order a week.
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Early in the pandemic, Greene had bought a series of vacation packages, prepaying for accommodations in destinations like Puerto Rico and the Dominican Republic. But even the thought of scheduling one of those trips now — and paying for airfare — feels ludicrous.
"I keep getting calls about my next booking and it's just, like, 'Dude, I can't go on a vacation anytime soon,'" said Greene, who's 45. "I haven't dialed back my spending completely, but I'm definitely being more careful."