By Alan Behr, Tribune News Service

The sun drifted teasingly toward the Norwegian Sea, an amber ball suspended as if from a string. It touched down gently on a low peninsula as the Richard With turned to starboard. The finger of land threatened to obstruct the view from those of us standing on a high deck astern, but we checked by our watches: For the second time on our cruise north along Norway’s western coast, we had viewed the sun at midnight. Nods and words of agreement rose in Norwegian, English and other languages.

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Best sailing destinations in the US

Here was another bonus for having taken this trip not long after the summer solstice. My primary purpose was to sail the fjords — the long, glacier-formed inlets that jut into Norway’s expansive western coastline. Along the route north, the fjords shelter harbor towns over which verdant mountains rise like castle walls. In front of many, a modest lighthouse stands sentry.

You can tour the fjords by road, but for me, that would be like visiting Paris by helicopter; the point of Paris is to walk it and to feel it, and the point of the fjord communities is to steam into them and to come to know them by sea and by land.

I had boarded my ship, the MS Richard With of the Hurtigruten line, in Bergen, an old trading city with a famous harbor-front row of historic, wood-framed merchant houses. I had wisely allowed myself an overnight at a new and luxurious hotel, the Skostredet, to better manage jet lag and also to treat myself to a funicular ride up the nearby Mount Floyen for dinner at the gourmet Floirestauranten. There, I had checked my backpack for my essentials: a 1961 Leica 280mm telephoto lens retrofitted to a contemporary Leica M11 digital camera; binoculars from the same German source; and a very particular flag, carefully unwrapped around its pole.

The MS Richard With steaming through the fjords of Norway. (Alan Behr/TNS/TNS)

By dinnertime the next day, I was aboard my ship and was underway.

Two years earlier, in Oslo, I had struggled to find things that were uniquely Norwegian, so cosmopolitan and diverse had the nation’s capital become. Hurtigruten’s six-night Northern Express would now give me the chance to see Norway among Norwegians. That is in good part because, like others in the line’s fleet, the Richard With is a cruise ship with all the amenities and comforts that the idea of cruising implies, but it is also a ferry, taking locals to ports of call up and down the coastline. At mealtimes, and on shore excursions, I had the chance to get to meet couples and families who were just passing through, to and from homes nearby. All the while, however, I kept secret my purpose for having chosen this northbound route and why the flag furled inside my backpack was part of my visit.

Excursions by bus helped me understand the experience of living and working by the sea, and it was good to walk into towns and along the countryside through which the fjords pushed seawater so imposingly inland. But the biggest thrill came when a group of us donned protective suits in the port of Bode and boarded a flotilla of rigid inflatable boats. Our captain and guide was a solid, agreeable young woman who looked to have lived and worked before the mast since childhood. She steered us up the Salstraumen, a small strait that quickly led us into one of the world’s strongest tidal currents.

Our boat pitched and rocked, our motor seeming at times to wrestle with the strait for control of our destiny as we poured in at high speed under a gray dome of unmoving cloud. We slowed to a swimmer’s pace, and around us seagulls climbed and then dove onto broad whirlpools — the maelstroms — famous vortices of such mythical strength that writers from Edgar Allen Poe to Jules Verne promised that to sail as close to any as we did was to risk being sucked into the depths. Our faces and goggles were now sprayed with water; it was a rugged, yet somehow ethereal thrill — rather as if consciousness had intruded itself upon a darkening dream just enough to offer peace.

Not long after, aboard the Richard With, we celebrated our crossing of the Arctic Circle. When my father had crossed the equator in service with the United States Army in World War II, he had been subjected to an elaborate (and rather rude) initiation ceremony — and got a certificate that I still have. Here was I, decades later, welcomed into my own geographic rite of passage by our ship’s captain, who poured ladles of ice down my back to the cheers of fellow passengers. And I got a certificate. That evening, we welcomed the midnight sun.

71°10’21”N: Our largest excursion group of the trip arrived at the North Cape, the northernmost point on the European continental landmass. A pedestal-mounted skeletal globe marks the spot. I took turns with a father-son team from Poland, snapping each other’s pictures beside the landmark.

We returned to the Richard With and steamed eastward through the Barents Sea. Nearly 1,000 feet below us lay the mangled wreck of the German battle cruiser Scharnhorst — sunk by the Royal Navy on Boxing Day (Dec. 26), 1943. Our final meal aboard ship was dinner, served to me quietly by my waiter as I enjoyed my final view of the sea from my table just below prow-facing picture windows.

We disembarking passengers left early the next morning, along with our luggage, for Kirkenes, population 3,400. The town, which lies on Norway’s short eastern border with Russia, is supported by two notable sources of trade: tourism and espionage. It enjoys an international reputation as a quiet and inviting den of spies, with Russian agents trying to keep an eye on NATO, and with the West appropriately returning the favor.

During the Second World War, when Norway was occupied by the Germans, the Soviet Union bombed the town often; appropriately, the first stop on our tour was the large, dark and cold bunker that could house a good portion of the population during raids.

Then we came at last to the border crossing with Russia. The fjords had topped my European bucket list for years along with one other destination: St. Petersburg.

Scruples now prevent me from visiting what had been Leningrad and that, for all I know, will soon be called Putingrad, so this could well be as close as I will ever get. To remind myself and anyone else who cared to notice why I would not cross the border, from my backpack I withdrew and gently unfurled the flag I had so carefully packed: the blue and yellow national banner of Ukraine. I gave it a good wave in case any Russian border guard was looking and then, with the help of another passenger, planted it in the ground just below the last meters of Norwegian territory.

I spent the night in the Snowhotel, an ice hotel of the kind where you literally can sleep in a large igloo. And, I chose a conventional, comfortable cabin instead, heated to room temperature. After helping to feed the hotel’s resident reindeer, I then flew back to Oslo.

Snowhotel Kirkenes, guest room for igloo-style accommodations. (Alan Behr/TNS/TNS)

There, I returned to the Munch Museum, where the works of Norway’s famously gloomy (and brilliant) artist Edvard Munch, are on permanent display. On this occasion, however, there was a large temporary exhibition on the themes of illness, injury and death — which is about as an appropriate Munch experience as a curator can offer.

It all seemed to fit, oddly enough. From the fjords, with their majesty, maelstroms, reindeer and tales (and numerous statues) of trolls, to the modern interruption of good daily life brought on by Russia’s merciless war, to the brooding, humanizing power of great Nordic art. I had finally done what I had set out to do two years before: I had seen and at last got an authentic understanding of this austere and yet graceful nation

If you go

At sea: Hurtigruten. The line operates the MS Richard With and similar ships, all to a fine standard. +1-888-969-8297; www.hurtigruten.com/en-us/; reservations@hurtigruten.com. Tip: Book as many shore excursions as you have time to enjoy.

In Bergen: Skostredet Hotel.  Domkirkegaten 6, 5017 Bergen, Norway; +47-55-30-40-50; booking@skostredethotel.no.

In Kirkenes: Snowhotel Kirkenes. Sandnesdalen 14, 9910 Bjørnevatn Tromsog Finnmark, Norway; +47-78-97-05-40; info@snowhotelkirkenes.com

Caution: Beware that third-party reservation services have tarted themselves up to look like they offer the official sites of these and other Norwegian hotels; they are not, and they may charge excessive additional fees.

©2025 Tribune Content Agency, LLC.

By Julie Appleby, KFF Health News

Medicare enrollees who buy the optional Part D drug benefit may see substantial premium price hikes — potentially up to $50 a month — when they shop for next year’s coverage.

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Such drug plans are used by millions of people who enroll in what is called original Medicare, the classic federal government program that began in 1965 and added a drug benefit only in 2006. The drug plans are offered through private insurers, and enrollees must pay monthly premiums.

It’s not known whether insurers will pursue the maximum increase allowed, as premium prices for next year won’t be revealed until closer to open enrollment, which starts Oct. 15.

Increases are expected to mainly affect stand-alone Part D plans, not the drug coverage offered as part of Medicare Advantage, the private sector alternative to original Medicare. More on that later.

Policy experts say premiums are likely to go up for several reasons, including increased use of some higher-cost prescription drugs; a law that capped out-of-pocket spending for enrollees; and changes in a program aimed at stabilizing price increases that the Trump administration has continued but made less generous.

One thing is surer than ever, say many policy experts: Beneficiaries should not simply roll over their existing stand-alone Medicare drug plans.

“Everyone should shop plans in open enrollment,” said Stacie Dusetzina, a professor of health policy at Vanderbilt University Medical Center.

Here are three reasons prices would rise.

1. It’s the Spending!

Every year, insurers keep an eye on what they’re spending on drugs so they can build that into their premium estimates. Spending covers both the prices charged by drugmakers and volume, meaning how many people take the medications and how often.

And it’s up. Spending by insurers and government programs for prescription drugs in 2024 across the market grew more than 10%, which is slightly greater than in recent years, according to a research report published in last month’s issue of the American Journal of Health-System Pharmacy. Estimates are not yet available for this year’s trends.

Still, in 2024, researchers found that drug prices overall decreased slightly. Spending rose because of drugs coming on the market and increased utilization, especially for pricey weight loss drugs and another category of medications that treat various autoimmune conditions, such as rheumatoid arthritis.

Such increased use is evident in Medicare. Many beneficiaries, for example, are treated for autoimmune conditions. And even though Medicare doesn’t cover treatment for weight loss, many members have diabetes or other conditions that a new type of weight loss drugs can treat.

The Trump administration, according to The Washington Post, is considering a five-year pilot program in which Medicare Part D plans could voluntarily expand access to the drugs, which can cost more than $1,000 a month without insurance. Details have not yet been provided, but the pilot program would not begin in Medicare until 2027.

Another wild card for insurers is the Trump administration’s tariffs on businesses that purchase products made overseas, which could boost drug prices because the U.S. imports a lot of its pharmaceuticals. Much, however, remains unknown about whether drugmakers will pass along any additional tariff costs to consumers.

So, while rising spending is one factor, it isn’t the only reason next year’s premium prices are expected to go up.

2. New Out-of-Pocket Caps for Consumers

Changes made to Medicare aimed at helping people with high out-of-pocket costs for expensive medications may be a bigger factor.

Here’s why: Starting this year, Medicare enrollees have a limit on how much they must pay out-of-pocket for prescription drugs. It’s capped at $2,000, a threshold that will rise each year to cover inflation.

Lawmakers in Congress set those changes in the Inflation Reduction Act under President Joe Biden. The law also shifted a larger share of the cost of drugs used by Medicare beneficiaries from the federal program to insurers.

That $2,000 cap is a big change from previous years, when people taking expensive drugs had a higher threshold to meet annually and were on the hook to pay 5% of the drug’s cost even after meeting that amount. Those additional 5% payments ended last year under the provisions of the IRA.

Before that law passed, “people would spend $10,000 or $15,000 out-of-pocket each year just for a single drug,” Dusetzina said. “The Inflation Reduction Act was necessary to make Part D proper health insurance, but there’s a cost to do so.”

While the cap is a big help for affected consumers, the reduced amounts paid by some beneficiaries — coupled with the cost shift to insurers — could lead plans to spread their increased expenses across all policyholders through higher premiums. A growing number of health plans have also begun to require enrollees to pay a percentage of a drug’s cost, rather than a flat-dollar copay, which can lead to larger-than-expected costs at the pharmacy counter, Dusetzina said.

While consumers not currently taking high-cost specialty drugs may not see a benefit in the $2,000 cap initially, they might one day, say policy experts, who note that drugmaker prices continue to rise and that enrollees could fall ill with a condition like cancer or multiple sclerosis for which they need a very high-priced drug.

“It’s important to think not just in context of those groups who hit the cap every year, but also people are paying more in premiums to protect their future selves as well,” said Casey Schwarz, the senior counsel for education and federal policy at the Medicare Rights Center, an advocacy group.

The new prescription drug cap and other changes apply to both the stand-alone Part D drug plans and Medicare Advantage plans. But those Medicare Advantage plans are not expected to increase the drug portion of their premiums, partly because the private sector plans are paid more per member than what it costs taxpayers for the traditional program.

That means Advantage plans have far more money to add benefits, such as vision and dental coverage, which traditional Medicare does not include, or to use them to cushion the impact of rising spending on drug costs, thus limiting premium increases.

Those additional benefits are advertised to attract customers to Medicare Advantage, which also sometimes offers plans with minimal or no monthly premium costs. There are other differences between traditional Medicare and private sector plans. For example, Advantage members must stick to doctors and hospitals in the plan’s networks, and they may face more prior authorization or other hurdles than in the traditional program.

The growing difference between premiums — fueled by the extra rebates flowing to the private sector plans — “is increasingly tilting coverage toward Medicare Advantage and making traditional Medicare plus a stand-alone PDP [prescription drug plan] unaffordable for many enrollees,” said Juliette Cubanski, deputy director of the program on Medicare policy at KFF, a health information nonprofit that includes KFF Health News.

3. Trump Administration Reduced Funding Meant To Slow Premium Growth

The final factor in the premium increase equation is a program set up to slow the rise of premiums in stand-alone Part D plans.

It began under the Biden administration to offset premium increases tied to changes in the Inflation Reduction Act by temporarily injecting additional federal dollars to help insurers adjust to the new rules.

That plan sent just over $6 billion this year to Part D insurers.

And it had an effect.

The average monthly premium for a stand-alone Part D drug plan dropped 9%, from $43 last year to $39 this year, according to KFF, even when factoring in that some plans raised prices by up to $35 a month, the maximum increase allowed under the stabilization plan for this year.

In a memo released in late July, the Trump administration said it would continue the program for next year, while shaving about 40% of the funding. A government official told The Wall Street Journal that the administration felt that keeping the full funding would have mainly benefited the insurers and cost taxpayers an “enormous, excess amount.”

The stabilization effort next year will send $10 a month per enrollee to Part D insurers to help keep premiums in check, down from $15 this year. Among other changes, it allows insurers to raise premiums by as much as $50 a month, up from the $35 allowed this year.

That would be a substantial increase, Cubanski noted, although it is not clear just how many insurers would pursue the full amount.

“We did see some plans this year were taking premium increases of that $35 amount in 2025, and I fully expect we will see some plans with increases up to $50 a month” next year, she said.

Another reason to take a close look at all the options once open enrollment begins.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

JACKSON HOLE, Wyo. — Federal Reserve Chair Jerome Powell on Friday opened the door ever so slightly to lowering a key interest rate in the coming months but gave no hint on the timing of a move and suggested the central bank will proceed cautiously as it continues to evaluate the impact of tariffs and other policies on the economy.

In a high-profile speech that will be closely watched at the White House and on Wall Street, Powell said that there are risks of both rising unemployment and stubbornly higher inflation. That puts the Fed in a tough spot, because it would typically cut its short-term rate to boost hiring, while keeping it high — or raising it — to fight inflation.

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“The stability of the unemployment rate and other labor market measures allows us to proceed carefully as we consider changes to our policy stance,” Powell said in prepared remarks. That suggests the Fed will continue to evaluate jobs and inflation data as it decides whether to cut rates, including at its next meeting Sept. 16-17.

“Nonetheless, with policy in restrictive territory, the baseline outlook and the shifting balance of risks may warrant adjusting our policy stance,” he added, a more direct sign that Powell is considering a rate cut than he has made in previous comments.

Still, Powell’s remarks suggest the Fed will still proceed carefully in the coming months and will make its rate decisions based on how inflation and unemployment evolve in the coming months. That may frustrate financial markets, which have hoped for clearer signals of the Fed’s next moves, and President Donald Trump, who has castigated Powell for not lowering rates sooner.

Powell spoke at the Fed’s annual economic symposium in Jackson Hole, Wyoming, a conference with about 100 academics, economists, and central bank officials from around the world.

Powell spoke as markets largely expect a rate cut in September, according to futures pricing, though those odds have slipped this week. Trump has repeatedly called for rate cuts, arguing there is “no inflation” and saying that a cut would lower the government’s interest payments on its $37 trillion in debt.

Trump and his allies have ramped up attacks on the Fed, including this week by calling on a Fed governor, Lisa Cook, to resign, after a Trump official alleged she may have committed mortgage fraud.