$4,537 can buy a lot of Skittles*. Or it can buy you the average single deductible for an unsubsidized enrollee with healthcare coverage on the Affordable Care Act (ACA) exchanges. At 3.4x less, the $1,350 average deductible for the 152 million who get their insurance through an employer looks benevolent. In spite of having the word "affordable" … Continue reading The $4,500 Deductible
Today the cost of healthcare landed on the front page of The Wall Street Journal, just below a story on bond yields, and next to the dancing UK Prime Minister, Teresa May. The angle of the story is how the cost of family healthcare premiums in the United States now approaches $20,000. The genesis of … Continue reading The $20,000 Price Tag: Insights into the 2018 Kaiser Family Foundation Employer Survey.
Price opacity is one of the grievances people have with healthcare in the US. Hip replacement price variation is an oft-cited procedure, yet another example where hoarding information and obfuscation is the norm. In one city, prices can vary by a factor of 3x or more. Price transparency is a laudable goal and progress is … Continue reading How Outlier Stories Stain Healthcare
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 … Continue reading The All-You-Can-Eat-Healthcare-Buffet
The Holy Grail scene in Indiana Jones and the Last Crusade shows the closing piece of the riddle to find the cup of Christ. Walter, businessman-turned-scoundrel, outsourced his decision on which cup to choose to Elsa, the archeologist. Caught by his lust for power, he drinks from a beautiful golden cup. “He chose poorly,” and … Continue reading Business, Statistics, and the Carpenter’s Cup
People who work on the business side of healthcare often wish that companies would think about healthcare more often, or even concede that they are in "the healthcare business." I suppose part of this is the law of the instrument, which even if not said by Mark Twain, sounds like Mark Twain: "To a man … Continue reading Is The Cheesecake Factory in the Healthcare Business?
Shopping for medical care, like reducing food waste, or understanding the adage that half of advertising is wasted*, is an exercise that first starts with disbelief (and even outrage), but a closer look keeps you grounded in reality. Simple observations are cheap. Some key findings and structural limits can guide us through why price transparency … Continue reading What is Medical Price Transparency Worth?
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 … Continue reading On Case Studies
To understand healthcare, pay attention to the stock market and companies earnings filings. This way you can capture a glimpse of how companies make money, how much they pay to acquire, how their incentives are aligned, how healthcare exchanges work and what value they deliver, how interest rates may affect their revenue (see HSAs), what … Continue reading 5.5%
This is the excerpt for your very first post.