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.
Jeff Bezos of Amazon is famous for being customer-centric, so much so that Amazon's annual letters proudly say, "We seek to be Earth’s most customer-centric company." Shipping, easy returns, streaming, and Kindle are proof. "Free" 2-day shipping for Prime membership is a big part for me. So far this year I've ordered 54 packages, or … Continue reading In Praise of the Six Page Narrative
If you rent a car, have cable or internet, or health insurance, your experiences are likely to be less stellar than if you use Netflix or shop at Nordstrom. TV providers show up late for your scheduled appointment, and, since they feel for you, they raise your bill after six months. Conversely, Netflix charges $10.99/month … Continue reading Does The Net Promoter Score Matter in Healthcare?
No economist, junior high student, employee, or small business owner* in the United States thinks healthcare should be tied to employment. Ask around. It's equally unpopular across the political spectrum. But we have it, and it's not by accident, but rather an unintended consequence of the 1942 Stabilization Act. The WW2 era Act led to … Continue reading Why Employer-Provided Healthcare is Here to Stay
12% and 33%. According to a 2015 study in the Journal of the American Medical Association, only 12% of adults have a proficient state of healthcare literacy. That's why goals to eliminate waste in the US healthcare system, help people to be better consumers, and shop for care, need to start with the front door, … Continue reading The Case For Healthcare and Financial Literacy
$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 … Continue reading The Cost of Being Over-Insured
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
I used to wonder why airlines seats were so uncomfortable(1). Then I started to understand metrics like revenue per seat, that seats were a commodity, that industry consolidation had taken its toll on differentiation, and how cramped legs were used to push the well-heeled into first class. This increases cash flow and share prices. Until … Continue reading Intentional Discomfort
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?
Charlie Munger reminds us that inversion helps us to solve problems we may not be able to solve in other ways. As an example, he says if you want to help India it's helpful to first ask "what's doing the worst damage in India....and how do I avoid it?" Said in a personal way: What … Continue reading The Power of Inversion, or What to Avoid.