Marco's Evening Report

Monday, September 21, 2026
Tonight: ON · night 1 of 7

Night one, Marco. Seven nights, Plant City, off the morning of the 28th — this was the sleep-shift day, so I hope the nap happened. Nothing on your calendar conflicts with the 6 PM start tonight. The one thing that won't wait past tomorrow: your fantasy waiver bids have to be in Tuesday evening before you leave, because claims clear at 3 AM Wednesday while you're on the floor, and you still have no backup quarterback. And one for the admit list — dengue is circulating in Hillsborough County, 134 local cases and a death, and it's a story my last two runs missed.

1 · Tonight & Tomorrow

Tonight — Monday, September 21 · ON

Tomorrow — Tuesday, September 22

Next 7 days

Tue 9/22 — Shift 6p, night 2 · fantasy waiver bids in before you leave
Wed 9/23 — Woodshop: Jointer, Planer and Bandsaw 12–2 PM, Nassau St · Shift 6p, night 3 · waivers clear 3 AM
Thu 9/24 — Shift 6p, night 4
Fri 9/25 — Shift 6p, night 5
Sat 9/26 — The heavy one: off shift 6a → Machine Shop Safety 9–11:30a (orange door) → Let's Learn to Turn Pens 1–4p → back on shift 6p, night 6. AEW All Out 8 PM (you'll be at work).
Sun 9/27 — Shift 6p, night 7 — last one. Start planning the flip back to days for Monday morning.
Mon 9/28 — Off the block at 6 AM. Nothing scheduled — protect it.

Looking one day past the block: Tuesday 9/29 is double-booked across the state. EPIC training for the NCH hospitalist onboarding runs 8:30 AM–1:30 PM in Naples (NCH Business Center, 1100 Immokalee Rd — report to the security desk), and Turn a Christmas Ornament is 6:30–8:30 PM in Tampa. That's roughly two and a half hours of driving between them with no slack if the training runs long. Worth deciding now which one moves.

Next class · Wed, 2 days Next first-night · Mon 10/5, 14 days Next wrestling · 5 days Machine Shop Safety · 5 days RV due · log still empty

2 · Hackerspace

Slack checked on the garage Mac. Nothing is waiting on a reply from you — the Activity feed hasn't moved since Paula Sandusky's 3D-printing slide deck last Friday, and there are no new mentions or DMs.

Your classes

Worth a look

Shop floor

Welding, standing answer: still nothing on the board beyond the MIG class you're already registered for. That gap is several weeks old now, and there's still nothing on aluminum. Registration is always at member.tampahackerspace.com — a Slack post is not a seat.

3 · Ring Report

SAT26SEP
AEW · Pay-per-view
All Out: Chicago
8:00 PM ET · NOW Arena, Hoffman Estates, IL
HBO Max · Prime Video · PPV.com
card & details
5days

Main event: Will Ospreay (AEW World Champion) vs Jon Moxley, 60-minute time limit, with the rest of the Death Riders allowed at ringside. Tag titles: Cope & Christian Cage (c) vs FTR vs The Young Bucks, three-way ladder match. Okada defends the International title against Tommaso Ciampa. Mercedes Moné isn't medically cleared, so Thekla vs Willow Nightingale is for a WrestleDream shot in October instead. Women's tag titles are a Chicago street fight.

You're on shift that night — night 6 of 7 — and it's also your two-class Saturday. Replay on HBO Max.

Nothing else inside 14 days. Next after All Out: WWE Money in the Bank, Sat 10/10, Smoothie King Center, New Orleans — card TBA.

4 · RV

The maintenance log is still blank — no odometer, no generator hours, no "last done" dates — so there is nothing for me to compute against, and this section can't tell you anything real until it's filled in. Fifteen minutes with the file would switch it on permanently. Header first: odometer and generator hours with today's date. Every interval in the table starts tracking itself after that.

Still open: the generator work planned for Tue 9/8 — carburetor, fuel injector, oil and filter — sits under "Planned" with no log entry. If it got done, that's your first line in the log and it resets the generator-oil clock.

Storm prep: nothing required. Nothing is flagged in the Gulf or the eastern Caribbean (Section 9).

5 · Training

No training on the calendar this week.

6 · Fantasy Football

LordHaveMRSA · Daily Report

Week 2 vs Team chaseelson30: 49.32 – 102.28, behind. Sleeper has you at 6%. You have two starters left — Kyren Williams and Cam Skattebo, both in tonight's 8:15 Rams–Giants game — and he has none. You'd need roughly 53 from two backs. It's gone.

Lineup: clean and nothing to do. Every slot you could still change is already locked; Nacua (questionable, projected 20.45) is on your bench and there's no open WR or FLEX spot to move him into.

Waivers — Tuesday evening. FAAB claims clear Wed 9/23, 3:00 AM ET, mid-shift on night 3. Bids must be in before you leave tomorrow. About $94 left, priority 9. The hole is still QB2 behind Maye (bye week 11). On waivers now, with byes that don't collide: Geno Smith (NYJ, bye 13), Daniel Jones (IND, bye 13), Aaron Rodgers (PIT, bye 9).

Trading note: chaseelson30 put both Bo Nix and Matthew Stafford on the block this afternoon. Same hole you have — but this league vetoed a two-for-nothing swap over the weekend, so a waiver bid is the surer route.

7 · Medicine Desk

Dengue is in your county, and one patient has died of it

What happened. The Florida health department confirmed that an 80-year-old Tampa woman who died at Tampa General on September 4 died of dengue — her death certificate lists dengue infection, septic shock and multi-organ failure — and Hillsborough County now has 134 locally acquired cases, about nine in ten of every local case in the state.

Why it matters to you. Plant City is Hillsborough County; these are your admits, and this one was an otherwise healthy older adult who went from a mosquito bite near her house to septic shock.

Do this. On a febrile older adult with headache, body aches, a falling platelet count or a rash and no obvious source, order dengue testing alongside the usual sepsis workup, and ask about mosquito exposure at home rather than only about travel — these are locally acquired.

Caught late: this ran September 18–19 and my last two reports missed it. Mosquito testing has come back negative recently and officials think the outbreak may be waning, but the cases already admitted are still yours. WUSF / Health News Florida · Bay News 9

Measles is landing on adults this year, not just kids

What happened. Adults are now over half of this year's measles hospitalizations in the US — 156 of 301 — even though they're under four in ten of the cases, and in Pennsylvania, the worst-hit state, roughly seven in ten cases are in people 18 and older.

Why it matters to you. The picture everyone carries of measles is a child, so a 45-year-old with fever and a rash gets worked up for everything else first and sits in a shared space while it happens.

Do this. Put measles on the list for any adult with fever and a rash, and mask and isolate them at the door rather than after the rash is described — the exposure happens in the waiting area, not in the room.

Published today. CIDRAP op-ed, Jess Steier DrPH, Sept 21

Medicare is proposing to cut what it pays for lab tests

What happened. CMS announced today that it wants to bring Medicare's lab payment rates in line with what private insurers pay starting January 1, 2027, phased in at no more than 15% per year through 2029 — about $1 billion a year out of Medicare lab spending. Comments are open for 30 days; final rates land in November.

Why it matters to you. Hospital labs run on those rates, and squeezed lab budgets usually show up on the floor as pressure on send-outs, repeat panels and daily draws rather than as a memo.

Announced Sept 21, 2026. CMS — Clinical Laboratory Fee Schedule

8 · The Debate

Should Medicaid peg US drug prices to what other rich countries pay?

Why it's live: on September 18 the White House announced that all 50 states, DC and Puerto Rico have signed on to "most-favored-nation" pricing for Medicaid through the CMS Innovation Center's GENEROUS model, under which manufacturers pay states supplemental rebates to bring Medicaid drug prices down toward the lowest price paid in other developed countries. The Council of Economic Advisers puts the savings at $64.3 billion over ten years — $36.6 billion federal, $27.6 billion state. Every state signing on in one week turned an argument about the idea into an argument about the design.

The case for

Americans fund the world's drug development twice — once through prices and once through research — and no amount of rebate arithmetic has closed the gap. Tying Medicaid to an external benchmark does what negotiation hasn't: it imports a price the manufacturer has already agreed to accept somewhere else, so the company can't claim it is below cost. The administration has signed agreements with 26 manufacturers covering close to 90% of branded products, and states get the savings without new legislation.

Rep. Dan Meuser, commending the extension of most-favored-nation pricing to all state Medicaid programs, Sept 18.
The case against

Foreign prices are set by governments that accept slower access and narrower formularies in exchange — importing the price without the tradeoff imports the tradeoff eventually. Medicaid is also the wrong place to look for savings, because statutory rebates already make it the cheapest payer in the system, so a supplemental rebate on top may deliver much less than the headline. And because the underlying deals are confidential, nobody outside can check the arithmetic.

Steve Ubl of PhRMA calls it "importing foreign prices from socialist countries," and warns it will cost treatments and investment.

Where it lands. The sharpest criticism isn't from industry — it's from analysts who want the policy to work. Rachel Sachs and colleagues, writing in the New England Journal of Medicine, call the GENEROUS model's promise real but its limitations structural, and KFF's read is that existing Medicaid rebates already cut drug spending so far that the new supplemental rebate has limited room to move. The honest state of play: nobody outside the confidential agreements can yet say whether the most-favored-nation price is actually below what states pay today. The savings estimate and the skepticism rest on the same unpublished numbers.

Sources: White House fact sheet, Sept 18 · Reuters via US News · NEJM — Sachs et al., "Medicaid's GENEROUS Most-Favored-Nation Pricing Model" · KFF analysis

9 · World & Screens

Background / already covered