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What is Medical Price Transparency Worth?

Shopping for medical care, like reducing food waste, or the adage that half of advertising is wastedeven more than 50% is probably wasted due to high abandonment rates and manipulation. See Facebook example of not counting ad views of under 3 seconds., is an exercise that first starts with disbelief and ends with reality. Simple observations are cheap. 99th percentiles masquerade as the norm. Some key findings and structural limits can guide us through why price transparency has its limits. In ...

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On Case Studies

I have a case study of a perfect stock trade where I made 3x my money in three years. It had it all: Mr. Market offered a discount relative to growth and earnings power. I had an analytical edge, plus the temperament of a monk. It was also a micro-cap company where the markets are (probably) less efficient. The market for this company (ticker: PETS) was growing and is large. American's spend over $70B a year on pets. The company was in my circle of competence, and it's business had a moat. In t ...

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Average vs. Median

There is an oft-cited study from Fidelity on healthcare savings needed in retirement for the average couple: $275,000 in today's dollars. This assumes the actuarial tables grant you both around 20 years of runway, you have original Medicare, and you retiree at 65. That comes to $1,100 per month per couple (here I assume the $275,000 you have squirreled away is invested at the same rate of long-term healthcare trend; of course costs are lumpy with much of it perhaps coming in the last 5 years, an ...

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Health Savings Accounts And Promotion

What companies say and don't say says a lot about what they do. What do vendors say about Health Savings Accounts (the triple-tax savings accounts, or the 401k+ of healthcare) and how they're promoted by the brokers and consultants? These often decide which vendor is chosen amidst the fragmented market for the 20M+ Americans who have these accounts. Optum (UHC): We're No. 1. UMB Financial: “Healthcare solutions that make you look good.” HealthEquity: “Offer your clients a comprehensive, conv ...

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Of Synergies and Spreadsheets

When buying anything, whether it's a company choosing a vendor, a suburban soccer mom considering solar panels on a home, investing in stocks, or as a CEO considering an acquisition, the big and easy decisions are what you should focus on, not the slick presentations or the fancy math (or total lack of numbers). Is there a quick back-of-the-envelope ROI? What are the explicit and implicit costs? Since ~90% of health happens outside of intervention settings, you should focus on net value, or what ...