Archive for October 28th, 2009

What ever happened to "I love New York" ?

October 28, 2009

TakeAway: A new study says high taxes are driving people away from NY … especially NYC.

* * * * *

Excerpted from WSJ: Escape from New York, Oct. 28, 2009

An old saying goes that the time to live in New York is when you’re young and poor, or old and rich—otherwise, you’re better off somewhere else. .

Between 2000 and 2008, the Empire State had a net domestic outflow of more than 1.5 million, the biggest exodus of any state, with most hailing from New York City.

The departures have perilous budget consequences, since they tend to include residents who are better off than those arriving. Statewide, departing families have income levels 13% higher than those moving in, while in New York County (home of Manhattan) the differential was 28% .

In 2006 alone, that swap meant the state lost $4.3 billion in taxpayer income. Add that up from 2001 through 2008, and it translates into annual net income losses somewhere near $30 billion.

According to the Tax Foundation, between 1977 and 2008, New York has ranked first or second in the country for its state-local tax burden compared to the U.S. average.

That pattern is consistent with the annual migration patterns, showing that highly taxed and economically lackluster states were most likely to end up in residents’ rear view mirrors. According to the annual study by United Van Lines, states like New York, New Jersey, Michigan and Illinois have been big losers in recent years.

Greener pastures that drew New Yorkers included states like Florida, North Carolina and Pennsylvania.

Liberals continue to insist that they can raise taxes ever higher without any effect on behavior, but the New York study is one more piece of evidence that this is a destructive illusion.

Full article:
http://online.wsj.com/article/SB10001424052748703574604574499772371161800.html?mod=djemEditorialPage

Posted in Taxes | 1 Comment »

Medicare’s cost advantage … real or illusory … and, so what ?

October 28, 2009

Ken’s Take: I would like to see more real economics in the public option debate.   A fundamental question: though counter-intuitive, does the gov’t run more efficient healthcare insurance programs than private industry?

Here are some facts … more “takes” follow.

Private insurers’ profits (included in administrative costs) explain some of Medicare’s cost advantage.

But profits represent only 3% of the insurance industry’s revenues.

* * * * *

By some estimates, Medicare’s administrative costs are only 3% of spending compared with 13% or more for private insurers. So, a government run healthcare plan is widely presumed to enjoy an advantage in overhead.

As for administrative expenses, any advantage for the public plan is exaggerated, say critics. Part of the gap between private insurers and Medicare is statistical illusion: Because Medicare recipients have higher average health expenses ($10,003 in 2007) than the under-65 population ($3,946), its administrative costs are a smaller share of total spending. A public plan, with younger members, wouldn’t enjoy this advantage.

* * * * *

The main advantage of a public plan would be the congressionally mandated requirement that hospitals and doctors be reimbursed at Medicare’s rates — as much as 30% lower than rates paid by private insurers.

With such savings, the public plan could charge much lower premiums and attract lots of customers.

Excerpted from IBD: Promise Of The Public Plan Is A Mirage,  10/23/2009
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=510101

Ken’s Take:

(1) I’ve argued before that the private health insurers don’t really make that much money.  The industry ranks #35 among major industry groupings, and the 3% rate is far downscale.  Since private insurers handle about 1/2 of all healthcare spending — using the above 3% number — if you eliminate all private healthcare profits, the “savings” would be about $30 billion annually. That’s statistically significant but — in my opinion — not compelling.

(2) At first blush — again, using the above numbers — the gov’t admin advantage (3% to 13%) is significant.  First, assuming that the number of transactions handled is proportional to the dollars of healthcare expenses  — then the 3% to 13% advantage carries thru ona transaction basis. Even when you “normalize” the data per patient Medicare seems to have an advantage — Medicare administers a subscriber for $300 per year ($10,000 times 3%) versus $500 per year for private insurers ($4,000 times 13%).  That’s significant.

What’s going on?  My bet: scale economies.  While some private healthcare insurers seem big, their size pales in comparison to the government programs.  Why? Because of the limits on selling insurance across state lines.  There are something like 1,500 private insurance programs.  All have admin staffs, computer systems, etc. 

My conclusion: there are way too many private insurers, not too few.  Consolidate that industry down to a handful of companies, and Medicare’s admin cost advantage would disappear — practically overnite.

(3) I’ve also pointed out the vicious cycle that’ll occur if doctors are squeezed with reimbursement rates far below “market prices” and sometimes below cost.  Eventually, the private plans get snuffed, and more important, the base of healthcare suppliers — docs and hospitals will shrink.  That means rationing.

* * * **

Posted in Health Care / Medical Insurance | Leave a Comment »

Like advertising, half of all healthcare spending is wasted. Yeah, but …

October 28, 2009

Ken’s Take: Keep in mind that (1) medical tort reform isn’t even on the negotiating table, (2) much of the “billing & administration” is feeding the Medicare / Medicaid systems, and (3) they’ve been chasing the same fraud dollars for decades.

* * * * *

Excerpted from Reuters: US Health Care Wastes Up to $800 Billion a Year, Oct 26,2009

The U.S. healthcare system wastes between $505 billion and $850 billion every year, according to a report from Thomson Reuters – Healthcare Analytics.

One example — a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.

“It is waste when caregivers duplicate tests because results recorded in a patient’s record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed,” the report reads.

Some other findings in the report from Thomson Reuters:

  • Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 a year.
  • Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.
  • Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.
  • Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.
  • Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.
  • Wasteful use of emergency rooms due to a lack of primary care doctors.

“The average U.S. hospital spends one-quarter of its budget on billing and administration, nearly twice the average in Canada.”

“American physicians spend nearly eight hours per week on paperwork and employ 1.66 clerical workers per doctor, far more than in Canada.”

Source article:
http://www.cnbc.com/id/33477157#

Posted in Health Care / Medical Insurance | 1 Comment »

Falcon wasn’t inside that Colorado balloon, but there was a valuable cargo … here’s proof.

October 28, 2009

How could all of the mainstream media outlets miss this one ?

* * * * *

In the air …

image001

On the ground …

image002

Pop !

image003

Posted in Laughs | Leave a Comment »

Ring, ring, ring … want a couple of bucks off?

October 28, 2009

TakeAway:  Mobile coupons delivered directly  to  smartphones are catching on, spurring impulse purchases. 

* * * * *

Excerpted from CNBC, “Coupons Via Cellphone: Whipping Up the Impulse Buy,” By Christina Cheddar Bank, October 15, 2009

To date, the concept of receiving coupons on your cell phone has been more theory than practice. This is despite a resurgence in coupon use and an increasing dependence on cell phones.

But with the focus on mobile coupons as a marketing tool on the rise, is the industry heading to an inflection point? A new Harris interactive survey … of more than 2,000 adults … found that 42 percent of those who were between 18 and 34 years old, and 33 percent of those 35 to 44 years old are at least somewhat interested in receiving opt-in alerts on their cell phones for specials at their favorite establishments …

This type of technology is even more impressive when one considers how many purchases consumers make on the fly … 9-in-10 Americans have made an impulse purchase when they were out shopping in a store based on a sale or a special that was going on around where they were … Among adults who own a cell phone, nearly a quarter — some 22 percent — make this type of purchase at least once per week or more often …

1020 Placecast  has designed a system to use digital marketing and mobile devices in an attempt to drive consumers to specific locations.  Using their systems, a restaurant or retailer can send an alert to a customer’s phone whenever the person is nearing its location …

Coupons.com … developed applications for the Apple’s iPhone and other devices to help consumers sort through coupons and pair them with their grocery lists … also trying out a system that allows shoppers to browse through coupon offerings on its Web site, then load the offers on to a key tag. Once at the store, shoppers can wave their key tags over the scanner during checkout in order to get the credit.

Both companies caution this is still early days for these technologies.

However, with the number of smartphone users on the rise … penetration is about 15 percent in the U.S. today (about 40 million phones) … most forecasts call for that number to at least double by the end of 2011 … coupled with the yet untapped interest, there may be significant opportunities for a technology that is simple enough for consumers to understand and appreciate …

Still, at this time, the reality is there is still more buzz about mobile coupons than people actually using these offers. But as retailers look to hone in on how they can improve relationships with their customers it seems the demand for this type of service is there.

Edit by TJS

* * * * *

Full Article
http://www.cnbc.com/id/33244923

* * * * *

Posted in Mktg - Promotion, Mobile Marketing, Uncategorized | Leave a Comment »