It’s the time of year for leaves, baseball, and 30-page open enrollment guides*. If you’re a prospective employee, “we offer benefits” doesn’t have the precision on the scale of value as does a first class flights to Europe. “We offer a free first class direct flight to London. Travel dates and times are flexible. Towels…
Category: High Deductible Health Plans
Could Healthcare Be Like Lasik?
Lasik is odd in at least two ways. It’s in a rare deflationary healthcare category. It’s also awkwardly priced at an average of $2,000 per eye. “Shoes for sale, $50 per shoe.” That aside, could healthcare be more like Lasik, shoppable and/or deflationary? There are key differences. There are more options in your city for…
January’s Healthcare Index
Inspired by the monthly Harper’s Index, this is 2019’s first index on healthcare and finance. The average ratio of Medicaid-to-Medicare payments spending across the US across all services: .72; In CA: .52. The factor by which commercial insurance payments exceed the reimbursements from Medicare: 1.88x The net assets of HCA, the largest publicly-traded hospital in the…
Stats on High Deductibles
November has past and healthcare open enrollment is behind us. It’s the time when spreadsheets are pulled together, employees and spouses (even actuaries) run front and back of the envelope calculations to decide where to enroll. Stock photos of happy couples in the 30-page guides beckon workers toward a tortuous process. It’s usually a choice…
Costco: Lessons from Member Obsession.
Some call them clients, others guests or customers. Costco (Ticker: COST, revenue $141B) calls them members, a term that makes you feel like you’re part of a special club. It’s a club that will not sell you junk*. They do not exaggerate. Theirs is not fake-Enron-style-ethics-bragging, and they actually list shareholders’ interests last. Focus on the…
Cadillac Consequences
Mothers and psychologists remind us that we have a built-in bias to do what’s easiest or to follow the path of least resistance. Water and electricity are like this. We are naturally lazy so to stick to an exercise plan, it should be something we like, with shoes left by the bed, perhaps done with…
Passive vs. Active in Investing and in Health
It has taken over 40 years for index investing to reach 20% market share. That’s longer and less heft than most people would guess. But it’s also a reminder of how a good idea can take generations of incremental awareness and results to move beyond shallow roots. Index investing is a form of passive investing,…
The All-You-Can-Eat-Healthcare-Buffet
A couple of weeks ago I was with my family in Guanajuato, a beautiful and historic colonial city in central Mexico. Imagine a hillside version of Venice with winding alleys and colorful buildings. We arrived and settled in the rented apartment. We met Don Chava, owner of the corner store, and then ventured out to…
The Cost of Being Over-Insured
$45,000. That’s a conservative estimate of the 30 year opportunity cost of having family PPO coverage instead of a high deductible health plan (HDHP). Allow me to explain. According to Kaiser Family Foundation (“Kaiser”), the average annual family premium for a HDHP is $1,900 cheaper than a preferred provider plan (and has averaged $2,000 over…
A Transparency Lesson from Harvard
There’s an employee benefit that ranks higher than flexible work hours, more vacation time, student loan assistance, triple-strained yogurt, organic tofu, or German ping pong tables. It’s outlined in a 20-40 page document, relates to your health and finances, can be useful in pay negotiations, and is the most valued benefit by job seekers. It’s a…